内镜辅助鼻内进路治疗外伤性骨性鼻锥畸形的临床疗效研究

The clinical effect of endoscope-assisted intranasal approach in the treatment of traumatic bone nose cone deformity

目的 探索内镜辅助鼻内进路治疗外伤性骨性鼻锥畸形的临床疗效研究。方法 回顾分析2016~2019年中山大学孙逸仙纪念医院耳鼻咽喉头颈外科收治的外伤性骨性鼻锥畸形患者23例,其中初期7例,骨痂期9例,塑形期7例。经内镜辅助下鼻内进路手术矫正治疗,术后随访3个月。计算术后满意度,对于合并鼻腔通气障碍的患者,采用t检验统计VAS评分。结果 本组23例中,行鼻内镜下鼻内进路骨性鼻锥闭合复位术6例,切开复位术13例,截骨复位术4例。术后22例外形满意(满意度95.6%),10例通气障碍患者,术后VAS评分有明显改善(P<0.05)。结论 内镜辅助鼻内进路骨性鼻锥畸形矫正术临床效果满意,可成为有效治疗手段。

OBJECTIVE To explore the accurate correction method of traumatic bone nose cone deformity,and apply endoscope-assisted intranasal approach nose bone surgery to treat traumatic bone nose cone deformity.METHODS A retrospective analysis of 23 patients with traumatic nasal cone deformity admitted to the Department of Otolaryngology Head and Neck Surgery,Sun Yat-sen Memorial Hospital,Sun Yat-sen University from 2016 to 2019.Seven cases were in the initial stage;9 were in the callus stage;7 cases of shaping period.All patients were treated by endoscope-assisted rhinoplasty.Deviated parameters were measured before and after operation.All patients were followed up after 3 months.The satisfaction rate was calculated.For patients with nasal ventilation dysfunction,the t-test was used to calculate the VAS scores before and after the operation.RESULTS Endoscope assisted closed reduction method was performed in 6 cases.Endoscope assisted open reduction method was performed in 13 cases.Endoscope assisted nasal osteotomy was performed in 4 cases.23 cases were followed up after 3 months.The satisfactory repair outcomes were achieved in 22 cases,satisfaction rate was 95.6%.Among them,10 patients with preoperative ventilation dysfunction had obvious postoperative ventilation function(VAS score) improvement(P<0.05).CONCLUSION Endoscope-assisted intranasal approach for individualized nasal cone deformity correction surgery has a satisfactory clinical effect,and it can be widely used in clinical treatment of nasal cone deformity.