鼻内镜下功能性鼻整形术

Functional rhinoplasty under nasal endoscope

目的:就鼻内镜下同期进行外鼻整形(鼻背及鼻外侧壁的整复)加鼻功能手术(鼻中隔矫正加下鼻甲、中鼻甲手术,甚至扩展至鼻腔扩容术、鼻窦炎手术等)的手术方法进行探讨。方法:选取2010-2015年在同仁医院同期进行鼻内镜下功能性鼻整形术的20例患者为研究对象。其中17例行鼻内镜下鼻中隔矫正术加歪鼻畸形矫正术(1例同期行腺样体等离子切除术,7例行下鼻甲或中鼻甲手术);1例行鼻内镜下泪囊鼻腔吻合术加鼻中隔矫正术加歪鼻畸形矫正术;2例行鼻内镜下鼻窦开放术加鼻中隔矫正术加歪鼻矫正术。20例行鼻内镜下外鼻整形术中只有5例使用硅胶假体,其余15例均使用自体软骨。结果:20例手术患者,与单独行鼻整形、鼻内镜下鼻中隔矫正加下鼻甲、中鼻甲手术,甚至扩展至鼻腔扩容术、鼻窦炎手术的患者相比,手术效果更好,无其他并发症发生,反而减少了手术治疗的次数及住院费用。结论:鼻内镜下功能性鼻整形术(联合鼻内镜下鼻功能手术加外鼻整形术)不仅同期解决了鼻部形态和鼻部的通气功能,避免了鼻整形过程中对通气功能的影响,实现了美容和功能的统一,同时减少了手术治疗的次数和费用,和常规手术相比无其他并发症发生,可行性高。

Objective：At different times and cultural background,people have different definition of beauty.With the improvement of economic level and culture quality,people are becoming more and more recognition of nasal appearance and function are equally important.Even the importance of the function of the nasal is higher than the importance of shape of the nose.Concurrent rhinoplasty（nasal dorsum and lateral nasal wall reduction）and functional sinus surgery（nasal septum reconstructory,middle turbinate,inferior turbinate surgery even extended to the nasal cavity expansion tecunhnique,sinusitis surgery）with endoscopic surgical surgical methods were discussed.Method：The study included 20 patients with deformed functional endoscopic rhinoplasty,2010-2015 in Beijing Tongren Hospital,of ages 16-53,male 14 cases,female 6 cases,11 cases had history of trauma,all of 20 patients have unilateral nasal plugging.Operating methods,17 patients were performed nasal endoscopic septoplasty and rhinoplasty at the same time.One case cocurrent endoscopic rhinodacryocystostomy.Two cases were performed Nasal endoscopic sinus operation.Only 5 cases use silica gel prosthesis,1 5 cases use autologous cartilage in functional rhinoplasty.Result：Twenty patients compared with performed rhinoplasty,nasal septum reconstructory,middle turbinate,inferior turbinate surgery,nasal cavity expansion,sinusitis surgery separately,surgery is better,no other complicationgs occurred.Actually decredsed the number of surgical treatment and hospitalization expenses.Conclusion：Functional endoscopic rhinoplasty,over the same period it solved the nasal shape and nasal ventilation function.To avoid impact on ventilation function in the process of the rhinoplasty.Implements the unification of beauty and function.Reduce the surgical treatment of times and cost.No other complication compared to convertional surgery,high feasibility.