数字化技术联合内窥镜矫正歪鼻的效果

Morphological and functional evaluation of digital technology combined with endoscope-assisted surgery of crooked nose

目的探讨数字化技术联合内窥镜矫正歪鼻-鼻中隔偏曲一期手术的效果。方法2015年1月至2020年1月,北京大学第三医院成形外科和耳鼻喉科完成32例(男21例,女11例;年龄18~45岁,平均27.34岁)骨性歪鼻伴鼻中隔偏曲患者一期矫正手术。术前后通过3D数字化成像技术、CT扫描等测量,用视觉模拟量表(VAS)、鼻整形效果评估(ROE)量表、鼻塞症状评估量表(NOSE)、功能性鼻整形术后调查(FROI-17)等量表,对手术外形修复和功能改善效果进行评估。结果与术前比较,术后3D成像测量显示歪鼻的偏曲距离、偏曲角度有明显改善(t=8.191、7.760;均P<0.05),长期手术稳定性较好。患者外形VAS评分和ROE评分较术前显著升高,NOSE评分和FROI-17评分评估鼻塞症状较术前好转。结论该方法修复歪鼻伴鼻中隔偏曲能达到同期修复鼻外形和改善鼻功能目的,手术微创、效果稳定,具有较好的临床效果和患者满意度。

Objective To explore the clinical effect of digital endoscopic-assisted one-stage rhinoplasty and septoplasty by using subjective and objective methods.Methods Thirty-two patients with skeletal crooked nose and nasal septum deviated who underwent endoscopic-assisted rhinoplasty and septoplasty were included in this study from January 2015 to January 2020.This study used objective measurements such as 3D digital imaging technology and CT scans,as well as subjective measurements such as Visual Analogue Scale(VAS),Rhinoplasty Outcomes Evaluation(ROE)scale,Nasal Obstruction Symptom Evaluation(NOSE)and Functional Rhinoplasty Outcome Inventory(FROI-17)to evaluate the crooked nose morphology and nasal respiratory function before and after surgery.Results Compared with preoperatively,postoperative 3D facial imaging results showed that the deviation distance and deviation angle of the crooked nose were significantly improved(both P<0.05),and the long-term effect of the operation was stable.Subjectively,the patient's appearance VAS score and ROE score were significantly higher than those before surgery,while the NOSE score and FROI-17 score of nasal congestion symptoms were lower than those before surgery.Conclusions Endoscope-assisted one-stage rhinoplasty and septoplasty can achieve the purpose of repairing the nose appearance and improving the nasal respiratory function at the same time.Through a combination of subjective and objective evaluations,our study found that this procedure had the advantages of minimally invasive,stable effect and shorter recover time;meanwhile,this procedure has high patients'satisfaction and is worthy of clinical promotion.