鼻内镜下保留鼻中隔粘膜瓣的鼻中隔结节切除

目的探讨保留鼻中隔粘膜瓣切除鼻中隔粘膜结节微创手术的优点。方法通过对31例鼻中隔偏曲同时合并鼻中隔粘膜结节,其中11例伴有前组鼻窦炎的患者,在行鼻中隔成形术、鼻窦开放术的同时行鼻中隔结节粘膜下剥离,美敦力动力系统吸切粘膜下组织,保护粘膜结节表面的正常粘膜,保证中隔粘膜的完整性,避免中隔粘膜表面创面出现。结果 31例患者术后7d中隔粘膜面见手术切痕,粘膜结节消失,中隔粘膜表面平整,中鼻甲、中鼻道暴露。随访6~12个月鼻中隔与中甲及鼻腔外侧壁无粘连,鼻中隔粘膜结节无复发。结论鼻内镜下保留鼻中隔粘膜瓣的微创手术治疗鼻中隔粘膜结节的方法,能有效防止鼻腔术后粘连,促进鼻窦术后的引流与恢复。

Endoscopic node resection on nasal septum with reserved mucosal flap of the nasal septum

Objective To probe the advantage of minimal invasive surgery in nasal septal mucosal nodules patients who received nodules section with preservation of nasal septal mucosal flap.Methods 31 cases with nasal septal deviation and mucosal nodules,among which 11 cases with the former group sinusitis,had septoplasty and sinus surgery,also received nodules section with preservation of nasal septal mucosal flap at the same time.Medtronic power system was used to protect the normal mucosal surface of nodules,ensure the integrity in the septal mucosa,and avoid the wound on septal mucosal surface.Results 7 days after surgery in 31 patients met the septal mucosa surgical scars,mucosal nodules disappeared,septal mucosal surface smooth,middle turbinate,middle meatus exposure..With 6～12 months follow-up,there is no adhesion in nasal septum and lateral wall and no recurrence of mucosal nodules.Conclusion Minimal invasive surgery in nasal septal mucosal nodules patients who received nodules section with preservation of nasal septal mucosal flap is a effective way to prevent postoperative adhesion of nasal cavity and promote sinus drainage and postoperative recovery.