带蒂骨-骨膜肌瓣转移植入治疗原发性萎缩性鼻炎的临床观察

目的评价上颌窦前外侧壁骨-骨膜肌瓣鼻腔黏骨膜下植入术对中、重度原发性萎缩性鼻炎治疗的疗效。方法对2007年2月～2010年2月收治的40例中、重度原发性萎缩性鼻炎患者行上颌窦前外侧壁骨-骨膜肌瓣鼻腔黏骨膜下植入术,术后随访2～5年,观察患者疗效。结果全部手术成功,手术时间平均为60 min,无严重并发症。所有患者术后随访2年,按萎缩性鼻炎记分及分度标准进行疗效评估,其中中度原发性萎缩性鼻炎术后显效率为95.45%（21/22）,重度原发性萎缩性鼻炎术后显效率为66.67%（12/18）。8例患者术后随访5年以上,总有效率100%（40/40）。结论上颌窦前外侧壁骨-骨膜肌瓣鼻腔黏骨膜下植入术操作简便,对中、重度原发性萎缩性鼻炎疗效显著,值得临床推广使用。

Treatment of primary atrophic rhinitis with transplantation of nasal submucous pedunculated complex tissue flap

Objective To evaluate the clinical application of pedunculated bone-periosteum muscle flap extracted from the anterior and lateral walls of maxillary sinus in the treatment of primary atrophic rhinitis. Methods From Feb 2007 to Feb 2010, 40 patients with moderate to severe primary atrophic rhinitis received transplantation of pedunculated bone-periosteum muscle flap extracted from the anterior and lateral walls of maxillary sinus to narrow the nasal cavity. All the patients were followed up for two to five years postoperatively to observe the surgical effect. Results Successful operation was achieved in all 40 cases with a median operation time of 60 min and without severe surgical complications. All patients were followed postoperatively for 2 years, the obvious effective rate of the moderate group was 95.45% （21/22） , and that of the severe group was 66.67% （12/18）. 8 patients were followed up for more than 5 years, the total efficiency of 100% （40/40）. The difference of obvious effective rate between the moderate and severe groups was significant. Conclusion Transplantation of pedunculated bone-periosteum muscle flap extracted from the anterior and lateral walls of maxillary sinus offers a simple and effective way for the treatment of moderate to severe primary atrophic rhinitis. Operation should be performed before it goes severe.