鼻内镜辅助下减张法功能性鼻整形手术疗效观察

Clinical results of endoscope-assisted tension-relaxing method in rhino-septoplasty

目的"减张法"是保持鼻背软骨-鼻中隔软骨复合体完整性、通过解除张力而使其居中对称的方法。本文研究鼻内镜辅助下减张法功能性鼻整形手术的主观和客观疗效。方法对67例行鼻内镜辅助下减张法功能性鼻整形手术的鼻畸形患者临床资料进行回顾性总结分析。美学效果用电子测量尺测量和患者视觉模拟评分法。鼻阻塞改善程度用鼻阻力计测量和鼻阻塞症状评分法评估。结果 34例I型鼻畸形患者鼻畸形角度电子测量值术后(2.24±1.68)度与术前(11.94±3.17)度比较,差异具有统计学意义(P<0.001)。33例C型鼻畸形患者鼻畸形角度电子测量值术后(177.20±5.80)度与术前(158.34±9.96)度比较,差异具有统计学意义(P<0.001)。患者主观满意度很好53例(79.1%),好13例(19.4%),一般1例(1.5%)。术后鼻阻塞较术前明显改善,差异具有统计学意义(α=0.95,P<0.001)。术后随访期间所有患者未见并发症。结论鼻内镜下减张法功能性鼻整形手术有效、微创,适用于各种鼻畸形的治疗。

Objective To study the long-term subjective and objective results of endoscope-assisted tension-relaxing method in rhino-septoplasty.Methods Clinical data of 67 patients with crooked nose deformities underwent functional rhino-septoplasty with endoscope-assisted tension-relaxing method were analyzed retrospectively. The aesthetic effect was estimated by electronic meter measurements(EMM) and the visual analogue scale(VAS). Nasal obstruction was evaluated by measuring nasal airway resistance with active anterior rhinomanometry and the nasal obstruction symptom evaluation(NOSE) scale.Results The preoperative and postoperative mean EMM values of 34 patients with I-shaped crooked nose deformities were(11.94±3.17)° and(2.24±1.68)° respectively, and the difference was statistically significant(P<0.001). Those of 33 patients with C-shaped deformities were(177.20±5.80)° and(158.34±9.96)°, and the difference was also statistically significant(P<0.001). As for the subjective results, postoperative evaluation by VAS revealed excellent effect in 53 cases, good in 13 and moderate in one. Comparison between preoperative and postoperative NOSE scores showed significant improvement of nasal ventilation(P<0.001,α=0.95). No complications occurred during the follow-up period.Conclusion Endoscope-assisted tension-relaxing rhino-septoplasty is an effective, versatile, minimally invasive technique in rhinoplasty.