鼻内镜下后鼻孔重建术治疗46例先天性后鼻孔闭锁患儿的疗效观察

Endoscopic reconstruction of the posterior nares for the treatment of 46 children with congenital posterior atresia

目的:分析后鼻孔闭锁患儿鼻内镜下后鼻孔重建术后的临床资料,探讨新后鼻孔再次闭锁的影响因素。方法:46例因后鼻孔闭锁行鼻内镜下后鼻孔重建术的患儿,按照新后鼻孔是否再次闭锁分为闭锁组19例,未闭锁组27例。对2组临床资料进行比较,探寻影响新后鼻孔再次闭锁的因素。结果:2组的性别、年龄、是否单/双侧闭锁及术后是否放置扩张管均无明显差异,2组术前闭锁的性质及术后肉芽增生情况存在差异。对闭锁性质进一步分析显示术前骨性闭锁患儿再闭锁概率明显高于膜性闭锁患儿。结论:全身麻醉鼻内镜下后鼻孔成形术是先天性后鼻孔闭锁患儿较好的手术方法,但骨性闭锁患儿的新后鼻孔仍然有较高的再闭锁概率。

Objective:The aim of this study is to explore the influencing factors of the posterior nostril re-atresia by analyzing the clinical data of endoscopic posterior nostril reconstruction in the children with posterior nostril atresia.Method:Retrospectively reviewed 46 pediatric patients with congenital choanal atresia who underwent endoscopic posterior nostril reconstruction.Randomly divided the cases into the atresia group(19 cases)and the nonatresia group(27 cases)according to whether the new posterior nostril re-atresia again.Compared the difference of the clinical data between the two groups and observed the influencing factors of the posterior nostril re-atresia.Result:The gender,age,unilateral/bilateral atresia or U-shaped stent had no significant differences between the two groups.However,the nature of the atresia and granulation hyperplasia were significant differences between the two groups.Further analysis of the nature of the atresia revealed osseous atresia had higher rate of re-atresia than membranous atresia.Conclusion:Endoscopic posterior nostril reconstruction was a good method for the treatment of the children with congenital posterior nostril atresia.However,the children with osseous atresia had higher re-atresia rate.