加速康复外科在鼻中隔偏曲矫正术围手术期的应用效果

目的 探讨在鼻内镜下鼻中隔偏曲矫正术围手术期实施加速康复外科(ERAS)理念的效果.方法 前瞻性选取中山市人民医院行鼻内镜下鼻中隔偏曲矫正术的40例患者纳入研究.随机分为常规组和ERAS组,每组20例.常规组给予常规围手术期处理措施,ERAS组给予ERAS方案.比较两组术后鼻部疼痛视觉模拟评分(VAS)、术后住院时间、...     

胶片在鼻中隔偏曲矫正术中的应用

鼻中隔偏曲矫正术后常规应用凡士林纱条填塞,患者常感疼痛难忍,且必须经口呼吸,痛苦大.2006年1月～2007年4月我们对我科收治的18例鼻中隔偏曲矫正术患者运用胶片固定技术,疗效满意,现报告如下.     

鼻内镜下鼻中隔偏曲矫正术

目的 探讨应用鼻内镜实施鼻中隔手术的治疗效果。方法 在0°和30°鼻内镜引导下实施鼻中隔偏曲矫正术,术中应用经18号麻醉穿刺针改制的吸引器头边吸引分泌物边剥离黏骨膜。结果 62例病人鼻中隔偏曲全部得到矫正,效果良好,无一例鼻中隔穿孔。结论 应用鼻内镜实施鼻中隔偏曲矫正术,并且用麻醉穿刺针改制的吸引器具有吸引及剥离的双重作用,简便、安全、疗效肯定。     

鼻瓣区的鼻中隔偏曲矫正术

2003-2010年我们对单纯鼻瓣区的鼻中隔偏曲及鼻腔并鼻瓣区鼻中隔偏曲患者进行了鼻瓣区鼻中隔偏曲矫正术,效果良好,报告如下。     

硅胶片在鼻中隔偏曲矫正术中的应用

目的 研究硅胶片在鼻中隔偏曲矫正术中的应用。方法 30例患者行鼻中隔矫正术,15例术后将硅胶片剪成上窄下宽近似梯形状,将其卷成圆筒状,从总鼻道放入,然后将其展开贴敷于鼻中隔黏膜面,用膨胀海绵填塞。结果 15例采用硅胶片贴敷的鼻中隔黏膜光滑平直,平均愈合时间4.1d。术后无并发症发生。未采用硅胶片贴敷的黏膜出现溃疡或糜烂、结痂,平均愈合时间15.4d。随访5个月～1年均未见穿孔。结论 硅胶片具有保湿作用,有利于黏膜生长,对鼻中隔黏膜还具有支撑、塑形作用。此外,硅胶片柔软,对鼻腔刺激小,患者痛苦小,具有很好的推广应用价值。     

内镜下鼻中隔偏曲伴鼻窦炎围手术期的护理

目的 围术期护理应用于内镜下的鼻中隔偏曲合并鼻窦炎患者的效果研究.方法 选择2017年1月到2018年12月我院收治的鼻中隔偏曲伴鼻窦炎患者78例,将其随机分成研究组(n=39)与对照组(n=39),对其采取不同护理措施对比,对照组患者按照常规模式护理,观察组患者则予以围术期护理.比较这两组患者经过不同护理模式后的治疗...     

鼻内镜下复杂鼻中隔偏曲矫正术52例报告

目的:探讨鼻内镜下复杂鼻中隔偏曲矫正术的疗效及手术体会。方法:对52例高位后段、巨大嵴突和棘突、多种弯曲形态并存、鼻中隔骨折脱位及需二次矫正偏曲,经鼻内镜检查及鼻窦CT扫描(冠状位)确诊的患者采用经鼻内镜下偏曲矫正术,随访6个月以上。结果:52例患者鼻中隔矫正效果满意,鼻腔通气良好,无鼻中隔穿孔、鼻腔粘连及鼻梁塌陷等症状。结论:在鼻内镜下行复杂鼻中隔偏曲矫正术,照明度好,视野清晰宽广,精细准确,保持了鼻中隔稳定性,安全、微创,符合鼻生理功能的需要及微创手术的要求。     

鼻内镜下鼻中隔偏曲矫正术

鼻中隔偏曲是耳鼻咽喉头颈外科常见疾患,有关手术治疗的文献最早由Cottle^[1]报道,1978年由武汉医学院主编的“耳鼻咽喉科学”将手术治疗该病的方法命名为“鼻中隔黏膜下矫正术”^[2]。自20世纪90年代初期鼻内镜技术在国内逐渐开展并迅速普及后,由于内镜技术的诸多优势,     

应用半导体激光行鼻中隔矫正术

激光在耳鼻咽喉科的应用日渐广泛。近年来 ,国内外有报道用ＣＯ2 及Ｎｄ :ＹＡＧ激光行鼻中隔矫正术 ,效果令人满意。 2 0 0 0年 4月～ 2 0 0 1年 11月 ,作者用半导体激光行鼻中隔矫正术治疗鼻中隔偏曲 15例 ,效果甚佳 ,现报告如下。1　临床资料鼻中隔偏曲 15例 ,男性 9例 ,女性 6例。年龄 12～ 70岁 ,平均 32岁。临床表现 :鼻塞 15例次 ,头痛 8例次 ,打喷嚏、流清涕 4例次 ,鼻出血 3例次。检查 :10例为棘突 ,5例为嵴突。其中 9例合并下鼻甲肥大 ,5例合并鼻窦炎及鼻息肉 ,4例合并过敏性鼻炎 ,1例合并霉菌性鼻窦炎 ,1例合并鼻腔粘连 ,1例有鼻…     

鼻中隔缝合在鼻中隔矫正术后的临床应用

目的评价鼻中隔缝合在鼻中隔矫正术后应用的临床疗效。方法选取40例鼻中隔偏曲患者,随机分成2组。缝合组：术后5-0薇乔线贯穿连续缝合鼻中隔黏膜;填塞组：术后以高膨胀海绵填塞鼻腔。分别于术后第1天、第2天对患者主观不适感以视觉模拟评分法（visual analogue scale,VAS）进行评分,并观察术后鼻中隔血肿、鼻腔粘连等临床指标。结果术后第1天、第2天两组患者在鼻塞、头痛、口干、睡眠困难、吞咽困难5个方面的VAS评分均值比较,差异均有统计学意义（P均<0.05）。两组患者在术后3个月内鼻中隔血肿、鼻腔粘连、感染等方面的发生率比较,差异无统计学意义（P均>0.05）。结论鼻中隔偏曲矫正术后,与鼻腔填塞相比,鼻中隔缝合在降低患者痛苦、提高术后舒适度方面具有明显的优势。     

Nasal air conditioning in patients before and after septoplasty with bilateral turbinoplasty

OBJECTIVE: Septoplasty is one of the most frequently performed surgical procedures by ear, nose, and throat surgeons. Yet the objective control of success concerning septal surgery still is very difficult and causes controversy. Data concerning one of the main functions of the nose, namely the heating and humidification of inspired air, before and after nasal surgery, are still missing. Therefore, the aim of this study was to compare intranasal air temperature and humidity values before and after septoplasty with bilateral turbinoplasty. METHODS: Sixteen patients were included in this prospective study. Intranasal temperature and humidity were measured in the anterior turbinate area close to the head of the middle turbinate. A miniaturized thermocouple and a humidity sensor were applied for continuous intranasal detection. RESULTS: Significant differences between temperature and humidity values before and after septoplasty could be observed, including absolute temperature, increase in temperature, absolute humidity, and increase in humidity. The postoperative values were significantly higher than the preoperative ones (P < .05). CONCLUSIONS: According to the results of our study, patients seem to profit from septoplasty as heating and humidification as one of the most important nasal functions are restored and even improved after surgery. We therefore conclude that properly performed septoplasty is able to main its importance within the variety of nasal surgical procedures ensuring improved nasal function as well as patient contentment.     

Comparison of visual analogue scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) score in evaluation of post septoplasty patients

ObjectiveTo compare and correlate the efficacy of the NOSE score & the VAS score in determining the symptomatic benefit in patients undergoing septoplasty.Materials and methodsEighty patients with deviated nasal septum undergoing septoplasty were included in the study. NOSE score & VAS score (out of 100) was documented before and after surgery. Results were correlated and compared statistically.ResultsIn the NOSE score, the most bothersome symptom was trouble breathing through the nose (85.83); followed by Nasal obstruction or blockage (82.50). Wilcoxon test showed significant improvement with NOSE score and VAS score in all patients at 1 month and 3 months. Spearman's coefficient showed a positive correlation between the two, though the score improvement and patient satisfaction rate was significantly high with NOSE score.ConclusionsNOSE score and the VAS score both provide effective framework for evaluating treatment responses after septoplasty. However, the NOSE score showed higher improvement and better patient satisfaction rate when used to measure of nasal obstruction as compared to the VAS score.     

A novel surgical technique: Crushed septal cartilage graft application in endonasal septoplasty

Objective

Nowadays, different septoplasty procedures are applied for therapy of nasal septum deviation. However, various complications of the septoplasty procedures have been described. Several techniques have been developed to decrease the incidence of these complications by surgeons. We aimed to present the effectiveness of the crushed septal cartilage graft, which is a novel septoplasty technique.

鼻中隔成形术中鼻中隔缝合法与鼻腔填塞法的效果比较

目的 探讨鼻中隔成形术中鼻中隔缝合法与鼻腔填塞法的效果比较。 方法 2014年9月至2015年8月延边大学附属医院耳鼻咽喉科收治鼻中隔偏曲患者95例,均行鼻中隔成形术,将患者随机分为鼻腔填塞组及鼻中隔缝合组,比较两组患者术后头痛、鼻部胀痛、流泪及鼻塞症状的VAS评分,以及手术费用及术后并发症的发生情况。 结果 在术后头痛、鼻部胀痛、流泪及鼻塞等方面,填塞组的VAS评分明显高于缝合组,差异具有统计学意义(P<0.05),鼻腔填塞组手术相关费用较鼻中隔缝合组高。 结论 鼻中隔缝合法在鼻中隔偏曲成形术中的应用可以减轻患者的术后痛苦,费用相对低廉,值得推广。     

The effects of intraday operation time on pain and anxiety of patients undergoing septoplasty

IntroductionAnxiety and pain levels of septoplasty patients may vary according to intraday operation time.ObjectiveTo investigate the effects of septoplasty operation and intraday operation time on anxiety and postoperative pain.MethodsNinety-eight voluntary patients filled out the hospital anxiety and depression scale to measure the anxiety level three weeks before, one hour before and one week after surgery. Forty-nine patients were operated at 8:00 am (morning group); other 49 were operated at 03:00 pm (afternoon group). We used a visual analogue scale to measure postoperative pain. Preoperative and postoperative scores were compared, as were the scores of the groups.ResultsMedian hospital anxiety and depression scale scores one hour before the operation [6 (2–10)] were significantly higher compared to the median scores three weeks before the operation [3 (1–6)] (p <  0.001), and one week after the operation [2 (1–6)] were significantly lower compared to the median scores three weeks before the operation [3 (1–6)] (p <  0.001). Hospital anxiety and depression scale scores one hour before the operation were significantly greater in the afternoon group [8 (7–10)], compared to the morning group [4 (2–6)] (p <  0.001). Postoperative first, sixth, twelfth and twenty-fourth-hour pain visual analogue scale scores were significantly higher in the afternoon group compared to the morning group (p <  0.001).ConclusionSeptoplasty might have an increasing effect on short-term anxiety and postoperative pain. Performing this operation at a late hour in the day might further increase anxiety and pain. However, the latter has no long-term effect on anxiety.     

Effect of septoplasty on left ventricular myocardial performance in patients with nasal septum deviation

IntroductionNasal septum deviation is the leading cause of upper airway obstruction. Chronic upper airway obstruction may cause myocardial injury due to chronic hypoxia. Effects of septoplasty on left venticular diastolic and sistolic functions are not well known. The myocardial performance index is an easy-to-apply and reliable parameter that reflects systolic and diastolic cardiac functions.ObjectiveThe present study aimed to investigate the effect of nasal septoplasty on the myocardial performance index in patients with nasal septal deviation.MethodsThis prospective study consisted of 50 consecutive patients who underwent septoplasty due to symptomatic prominent C- or S-shaped nasal septal deviation. Transthoracic echocardiogarphy was performed in all patients before and 3 months after septoplasty. Calculated myocardial performance indices were compared.ResultsSignificantly higher left ventricular myocardial performance index (0.52 ± 0.06 vs. 0.41 ± 0.04, p < 0.001), longer isovolumic relaxation time (95.0 ± 12.5 vs. 78.0 ± 8.6 ms, p < 0.001), longer isovolumic contraction time (45.5 ± 7.8 vs. 39.5 ± 8.6 ms, p < 0.001), longer deceleration time (184.3 ± 32.5 vs. 163.6 ± 45.4 ms, p = 0.004), higher ratio of transmitral early to late peak velocities (E/A) (1.42 ± 0.4 vs. 1.16 ± 0.2, p = 0.006) and shorter ejection time (270.1 ± 18.3 vs. 286.5 ± 25.8 ms, p < 0.001) were observed before septoplasty when compared to values obtained 3 months after septoplasty. Left ventricular systolic ejection fraction was similar before and after septoplasty (63.8±2.8% vs. 64.6±3.2%, p = 0.224).ConclusionSeptoplasty surgery not only reduces nasal blockage symptoms in nasal septal deviation patients but also may improve left ventricular performance. Thus, treatment of nasal septal deviation without delay is suggested to prevent possible future cardiovascular events.     

Role of rhinomanometry to assess nasal airflow and resistance in patients undergoing septoplasty

Nasal obstruction is a common symptom. Rhinomanometry is a tool to objectively assess the nasal airway. A prospective study was undertaken to assess the nasal airflow and nasal resistance in 25 patients of deviated nasal septum undergoing septoplasty using rhinomanometry preoperatively and postoperatively. Rhinomanometric improvement in nasal airflow and decreased nasal resistance were found in 88% patients after surgery.     

A prospective study using rhinomanometry and patient clinical satisfaction to determine if objective measurements of nasal airway resistance can improve the quality of septoplasty

In the ENT Department of University Central Hospital, Turku, the waiting list for elective septoplasty grew to 4 to 5 years in the late 1980s. Therefore, a prospective clinical project was initiated during which all patients waiting for septal surgery were re-examined and nasal airway function was measured with rhinomanometry. Patients with high nasal resistance or other specific indications for nasal obstruction were selected for surgery (n = 432). The remaining patients were excluded from surgery and followed up (n = 284). Results showed that if patients were referred for septal surgery without rhinomanometric study, about 10% became symptom-free within 3 to 5 years. Patients operated on after defining a high preoperative intranasal resistance had a higher postoperative satisfaction level (85%) than those operated on with normal nasal resistances but other indications for correcting the nasal septum (69%). After 3 years, the majority of patients not treated surgically were satisfied with their conservative treatments, although certain patients still required some form of nasal surgery to relieve recurring nasal and/or sinus complaints.