鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正治疗外伤性歪鼻畸形的临床分析

目的对鼻内镜下自体软骨（鼻中隔软骨、耳软骨和肋软骨）鼻整形同期行鼻中隔偏曲矫正治疗外伤性歪鼻畸形的临床分析。方法收集2017~2018年20 例陈旧外伤性歪鼻畸形患者的临床资料,所有患者均行全麻下鼻小柱倒“V”型切口暴露松解并切除偏曲的鼻中隔软骨及骨质,针对不同患者设计使用不同软骨（鼻中隔软骨、耳软骨和肋软骨）矫正鼻中隔骨性或软骨性支架,对鼻尖、鼻背及外鼻重新塑形。结果随访3~12个月,行鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正术的患者鼻外形及通气均有明显改善,手术效果更好,无鼻腔粘连、鼻中隔血肿及穿孔。结论鼻内镜下自体软骨鼻整形同期鼻中隔偏曲矫正治疗外伤性歪鼻畸形同期解决了鼻部畸形和鼻通气功能,实现了美容和功能的统一,同时减少了手术治疗的次数和费用,可行性高。     

鼻中隔偏曲软骨塑形在同期歪鼻整形术中的应用

目的:探讨利用自体鼻中隔偏曲软骨塑形后同期进行外伤性歪鼻矫形手术的临床应用价值.方法:选取12例临床确诊住院手术的陈旧外伤性歪鼻伴鼻中隔偏曲患者为研究对象,在内镜辅助下做鼻中隔鼻阈倒L切口,沿切口向上潜行分离建立鼻背畸形移植填充区;之后利用切取的鼻中隔软骨塑形后植入到偏曲凹陷的鼻背区加以歪鼻矫形,满意后行鼻外固定.结果...     

鼻整形术:歪鼻整形

歪鼻整形的内容涵盖了鼻的美学及功能。鼻上1/3偏曲的矫正多使用截骨术,鼻中间1/3偏曲通常使用鼻中隔矫正术修复。刻痕、切除、撑开移植物、自体组织撑开瓣等方法被用于矫正鼻背。鼻中隔尾侧偏曲通过刻痕、切除和在鼻前棘上重置鼻中隔来治疗。不同的截骨术用于不同类型的歪鼻畸形。治疗下鼻甲肥大和内鼻阈塌陷是纠正歪鼻气道功能受损的关键。鼻小柱支撑移植物、鼻尖缝合技术和鼻翼基底切除术用于修饰鼻尖和鼻翼。     

内镜辅助下功能性鼻整形术治疗歪鼻合并鼻中隔偏曲226例临床分析北大核心CSCD

Objective To explore the method and effect of endoscopic assisted functional rhinoplasty for patients with deviated nose and deviated nasal septum, which achieve correction of nasal morphology and ventilation dysfunction. Methods The clinical data of 226 patients with deviated nose and deviated nasal septum from June 2009 to February 2022 who were treated by endoscopic assisted functional rhinoplasty in the Affiliated Hospital of Qingdao University were analyzed retrospectively. There were 174 males and 52 females, with the age ranging from 7 to 67 years old. The effect was evaluated by subjective and objective evaluation methods. SPSS 27.0 software was used for statistical analysis. Results All patients were followed up for 6 to 24 months, 174 cases were cured (174/226, 76.99%), 52 cases were effective (52/226, 23.01%), and the total effective rate was 100% (226/226). The difference between preoperative and postoperative facial appearance deviation was statistically significant ((6.84±2.25)mm vs (1.82± 1.05)mm, t=38.94, P<0.001), and the nasal ventilation function of all patients was improved. Conclusions Endoscopic assisted functional rhinoplasty for the patients with deviated nose combined with deviated nasal septum has the advantages of clear surgical field, fewer complications, and good result. It can achieve the purpose of simultaneous correction of nasal and ventilation dysfunction, which is recommended for popularizing in clinical application. © 2023 The Author(s).     

鼻内镜辅助下鼻小柱入路同期鼻中隔偏曲及歪鼻畸形矫正手术的临床效果分析

目的:分析鼻内镜辅助下鼻小柱入路同期鼻中隔偏曲及歪鼻畸形矫正手术的临床效果.方法:收集2016年1月-2019年6月在空军军医大学第一附属医院耳鼻咽喉头颈外科手术的33例鼻中隔偏曲伴歪鼻畸形患者的临床资料.所有患者均在全身麻醉下手术,采用鼻小柱倒"V"型切口暴露松解,并在鼻内镜辅助下切除偏曲的鼻中隔软骨及骨质,12例(...     

鼻内镜辅助下改良鼻骨骨折复位治疗外伤性歪鼻合并鼻中隔偏曲

目的 探讨鼻内镜辅助下改良鼻骨骨折复位治疗外伤性歪鼻合并鼻中隔偏曲。方法 选取2018年1月～2021年6月收治于无锡市第二人民医院的100例外伤性歪鼻合并鼻中隔偏曲患者,随机分为2组,各50例,观察组行鼻内镜下全麻复位治疗联合鼻中隔成形术治疗,对照组行局部麻醉下传统鼻骨复位手术治疗。比较两组手术治疗效果、手术前后鼻腔客观指标、外鼻测量值和术后并发症。结果 观察组患者治疗总有效率（92.00%）明显高于对照组（76.00%）且术后并发症发生率（8.00%）明显低于对照组（24.00%）(P<0.05);观察组患者术后鼻腔客观指标和外鼻测量值改善情况明显优于对照组（P<0.05）。结论 鼻内镜辅助下改良鼻骨骨折复位治疗外伤性歪鼻合并鼻中隔偏曲有良好的治疗效果。     

鼻内进路歪鼻-鼻中隔矫正术

目的探讨歪鼻-鼻中隔矫正的手术治疗效果。方法60例病人中22例行鼻中隔矫正术；14例行骨部歪鼻矫正术：24例行骨部、软骨部歪鼻矫正术(其中歪鼻合并鞍鼻矫正术8例，合并驼峰鼻矫正术3例)。结果经随访6～24个月，60例病人中，歪鼻矫正良好54例(满意率90．0％)。结论鼻内进路歪鼻-鼻中隔矫正术，适应症广泛、操作方便、效果满意、并发症少。术中矫正鼻中隔、彻底松解畸形部位的组织及矫正后的内外固定是保证手术成功的关键。     

鼻中隔偏曲矫正200例

鼻中隔偏曲是耳鼻咽喉科的一种常见病，治疗方法为手术矫正。我科近1年来收治鼻中隔偏曲患者200例，现就术中及术后遇到的一些问题总结如下，以供参考。     

鼻中隔-鼻整形术矫正严重外伤性鼻畸形伴鼻中隔偏曲一例

正歪鼻畸形分为先天性和后天性~([1]),可严重影响患者外观及心理。大多数歪鼻还伴有鼻中隔偏曲症状,如鼻阻塞、头痛等。外伤性歪鼻则更为复杂,可能同时存在鞍鼻、驼峰鼻、歪鼻及鼻中隔偏曲等多种鼻内鼻外畸形。此类患者因日常生活倍受困扰,就诊时对改善鼻外形和鼻腔功能均有较高期望值。对于严重外伤性歪鼻合并鼻中隔偏曲的患者,需要在矫正鼻中隔偏曲的同时矫正歪鼻畸形,使患者同时     

变应性鼻炎并鼻中隔偏曲手术159例

1998年12月～2004年12月，我院对159例变应性鼻炎并鼻中隔偏曲患者行鼻中隔矫正术，取得了良好的效果。现报告如下。     

253例原发鼻中隔肿块的临床分析

目的：探讨鼻中隔肿块的临床诊断与治疗。方法：对1983年3月-2007年8月收治的253例原发于鼻中隔的肿块患者的临床资料进行回顾性分析。结果：253例鼻中隔肿块中,良性肿瘤2J9例,恶性肿瘤34例;良性肿瘤采用鼻内／鼻侧径路,随访6个月～12年（平均72个月）,173例无复发和恶性变,12例复发再次手术,9例死于其他疾病,25例失访。恶性肿瘤采用鼻内／鼻侧径路加放／化疗,随访12个月～15年3个月,6例于术后2年～6年7个月因复发或转移而死亡;余28例生存,未见肿瘤复发。结论：对于原发于鼻中隔的良性肿瘤以手术切除为主,关键是一次性彻底切除,而恶性肿瘤应采取综合治疗,术后应进行定期随访。     

Histopathology of the inferior turbinate with compensatory hypertrophy in patients with deviated nasal septum

OBJECTIVE: To measure the dimensions, composition, and possible structural and/or histopathological changes of the compensatory hypertrophic inferior turbinate in patients with deviated nasal septum. STUDY DESIGN: A prospective, nonrandomized, and morphometric study. METHODS: Nineteen patients with deviated nasal septum and compensatory hypertrophy of the inferior turbinate in the contralateral nasal cavity underwent surgery for correction of nasal obstruction. Patients' specimens were compared with those of a control group consisting of 10 inferior turbinates removed at autopsy. Quantitative measurements of the inferior turbinate histological sections were carried out and included the width of the layers and morphometric calculations of the relative proportions of the soft tissue constituents. Also, qualitative study was performed to detect pathological changes. RESULTS: Of all layers, the inferior turbinate bone underwent a twofold increase in thickness and manifested the most significant expansion (P < or =.001), whereas the contribution of the mucosal layers to the inferior turbinate hypertrophy was modest. The morphometric analysis revealed a larger proportion of venous sinusoids in hypertrophic turbinates, but the difference was small and statistically insignificant. Qualitative assessment disclosed normal mucosal architecture in all inferior turbinates with compensatory hypertrophy. Eleven remained intact, while eight disclosed mild to moderate pathological changes. CONCLUSIONS: The data gathered in the present study are of importance to the decision-making process regarding turbinate surgery. The significant bone expansion and the relative minor role played by the mucosal hypertrophy would support the decision to excise the inferior turbinate bone at the time of septoplasty.     

鼻窦鼻中隔联合手术对鼻中隔术后修复的影响

目的:探讨鼻窦鼻中隔联合手术,对鼻中隔手术后修复的影响.方法:65例鼻中隔偏曲并发慢性鼻窦炎的患者,行鼻内镜鼻窦鼻中隔联合手术,观察中隔术后的临床指标,并与单纯鼻中隔手术对照.结果:鼻窦鼻中隔联合手术组的术后早期反应重于单纯鼻中隔手术组,3个月后患者对手术的满意度高于后者,未发生鼻中隔感染等并发症.结论:鼻窦鼻中隔联合手术对鼻中隔手术预后没有产生不良影响,该术式安全,临床疗效可靠.     

鼻内镜辅助下外鼻整形同期鼻中隔偏曲矫正术

目的 总结33例外鼻畸形伴鼻中隔偏曲患者施行内镜辅助下鼻整形术同期鼻中隔偏曲矫正术的临床资料,分析手术方法和术后疗效。 方法 患者均在全麻下经鼻小柱鼻前庭做切口,骨膜下暴露鼻骨及上颌骨额突,在内镜辅助下进行截骨整复并矫正鼻中隔,酌情将取出的自体鼻中隔骨质及软骨条修整后填于塌陷处或支撑鼻小柱、修整鼻尖等。术中可同期行下鼻甲成形术。随访3个月以上。 结果 全部患者术后均取得满意的整形效果,鼻腔通气良好。 结论 鼻内镜辅助下鼻整形术同期行鼻中隔偏曲矫正术效果好,无排异反应,不仅能改善鼻部外观,而且能改善鼻腔通气效果。     

The relationship between middle ear pressure and deviated nasal septum

The deviated nasal septum may be associated with middle ear problems, particularly on the side of nasal obstruction. This study aims to find out whether middle ear pressure (MEP) correlates with the degree of nasal obstruction secondary to a deviated nasal septum, and to examine changes in MEP following septal surgery. Patencies of the nasal passages (measured with a peak nasal inspiratory flowmeter) and MEP (measured with tympanometer) of 55 patients were obtained prior to surgery and 7.5 (6–10) months post-operatively [median (range)]. Forty patients completed the study. Results were analysed by linear regression. In the ear on the side of nasal blockage, MEP was -25.7±28.4 mm water pre-operatively, and following surgery increased significantly to -2.9±30.4 mm water (mean±sd ) (P < 0.001). Pre-operatively, it was inversely related to the difference in patencies between the two nasal passages (r = -0.32, P < 0.02). Post-operatively, its improvement correlated with the degree of reduction of asymmetry of airway patency (r = 0.56, P < 0.001).     

鼻内镜下个性化矫正鼻中隔偏曲

鼻中隔偏曲是鼻科的常见病及多发病,如果出现症状,药物治疗多无效,最终需要手术矫正。手术方法诸多,如鼻中隔黏膜下切除术、改良鼻中隔黏膜下切除术、改良鼻中隔成形术及三线减张鼻中隔矫正术等。我科2005—02—2012—02对159例鼻中隔偏曲患者在确定偏曲类型后实施综合各种手术特点制定个性化的鼻内镜下矫正术,取得良好效果,现报告如下。     

18例鼻中隔偏曲伴外鼻畸形临床诊疗体会

目的 探讨鼻中隔偏曲合并外鼻畸形的解剖学形成特点,总结分析同期行鼻中隔偏曲矫正和外鼻畸形整复手术方法。方法 回顾性分析2016年3月—2019年3月收治的18例鼻中隔偏曲矫正同期外鼻畸形整复患者的临床资料,其中大翼软骨发育异常11例,鼻中隔软骨尾侧端畸形5例,上颌骨鼻棘畸形2例,所有患者均先行鼻中隔偏曲矫正术;并针对不同类型的畸形结构特征单独或同时使用了缝合矫形、切除矫形和支撑矫形方法。所有患者术后随访1年以上,比较手术前后患者的鼻腔通气功能和外鼻形态视觉模拟量表(VAS)评分。结果 术后1年鼻腔通气功能和外鼻形态VAS量表评分明显低于术前,术后1年双侧鼻腔总阻力明显低于术前,差异均具有统计学意义(P均<0.05)。18例患者鼻内镜检查、鼻腔鼻窦CT显示术后鼻中隔偏曲与外鼻畸形形态改善明显。结论 总结了鼻中隔偏曲并外鼻畸形的解剖学构成分类和常用手术方法体会,为临床工作中兼顾鼻腔功能与美学的治疗策略提供参考。     

鼻内镜辅助下的鼻中隔-鼻整形术

歪鼻常伴有鼻中隔偏曲,患者除了对外形不满意外,还会有鼻塞等功能障碍症状.这部分患者到鼻科就诊的目的是希望既能矫正歪鼻畸形又改善鼻腔通气功能.近年来,国内耳鼻喉科医生们不断探索鼻中隔一鼻整形的术式,鼻外进路、鼻内进路各有优势[1-2],并引入了鼻内镜技术[3],较之美容整形科的单纯外鼻整形更具有优势.我们在传统鼻中隔鼻成形术基础上,采用鼻内镜辅助的方式,重点在内镜下矫正鼻中隔偏曲并同期行鼻甲成形术,可以重新构建鼻腔结构,较好地改善了鼻腔通气功能,收到了外形与功能双满意的疗效.