结构性鼻塞的病因学及机制研究进展

Advances in etiology and mechanism of structural nasal obstruction

鼻塞(nasal obstruction)是耳鼻喉科的常见主诉,是多数鼻科疾病的共有症状,可严重影响患者的睡眠及生活质量[1]。鼻塞可以由炎症(过敏性及感染性)、占位病变、鼻气道结构异常、药物性、生理性、感觉神经性及心理性等因素引起[2-3]。其中黏膜炎症引起的鼻塞多数持续时间不会太长,为急性或亚急性,药物治疗可有效缓解[4]。但对于鼻塞持续时间超过半年以上的慢性鼻塞患者,其病因更为复杂且顽固。

Structural nasal obstruction(SNO)is a series of diseases caused by congenital or acquired structural anatomical abnormalities of nasal airway and its surrounding tissues,which leads to increased nasal ventilation resistance.The effect of medication drugs for SNO is poor and surgical intervention is often needed.However,the abnormal structure of nasal airway is very complex,including the periphery of nasal airway,internal nasal airway,the front and rear of nasal airway and complex factors.These abnormal structures may interfere with the nasal airflow mechanics by changing the nasal ventilation volume and disrupting the symmetry of the bilateral nasal cavity,and finally lead to subjective feeling of nasal obstruction.In addition,the structure of nasal airway has plasticity.After the abnormal structure appears,the corresponding compensation of nasal airway can occur to ensure normal nasal ventilation and bilateral nasal cavity symmetry.Therefore,the SNO is the result of the failure of nasal airway remodeling after the appearance of abnormal structures.The etiology of SNO is complex,involving original structural abnormalities,nasal symmetry changing and nasal airway structure remodeling.Therefore,accurate identification of the main factors leading to SNO is the vitalpremise of making personalized nasal ventilation surgery.