控制性降压在鼻内窥镜手术中的应用

目的 :观察控制性降压在鼻内窥镜手术中应用的意义。方法 :80例双侧鼻息肉、鼻窦炎患者 ,局麻、鼻内窥镜下行双侧鼻息肉摘除、全筛切除及开放上颌窦自然开口。其中 38例术中控制性降压 (降压组 ) ,另 42例作为对照。结果 :降压组术中出血 (6 1 39± 38 5 2 )ml,对照组出血 (140 12± 81 82 )ml,差异有显著性意义 (P <0 0 1) ;手术时间分别为 (4 9 2 5± 7 0 6 )min和(6 2 4 0± 9 90 )min ,差异有显著性意义 (P <0 0 1)。结论 :控制性降压可明显减少术中出血 ,缩短手术时间。     

Extracorporeal Septoplasty Combined with Open Rhinoplasty

Extracorporeal septoplasty is a radical solution for the severely deviated nose. The major problems associated with this procedure are fixation of the septal cartilage graft and dorsal irregularities. Extracorporeal septoplasty was performed in combination with open rhinoplasty in 17 patients with severe nasal deformities. In this technique septum was totally removed through the columellar incision of open rhinoplasty, corrected outside, and replaced as a free ``L' shaped cartilage graft. The cartilage graft was fixated to the upper lateral cartilages to restore the natural relations of the anatomical structures. Additional rhinoplastic manipulations were also performed. The follow-up period was up to 18 months. The overall result was successful in all patients. Nasal deviation did not recur and secondary revisions were not needed for any patient during follow-up.     

Nasal nicotine spray: a rapid nicotine delivery system

Plasma nicotine concentrations following administration by two types of nasal nicotine spray were compared in ten subjects. Absorption was particularly rapid during the first 2.5 min, the average rise in blood nicotine concentrations during this time being 8.6 ng/ml for the two products, followed by a small further rise to an average peak increase of 10.5 ng/ml 5 min after the dose of 2 mg nicotine base (mean 27.8 micrograms/kg). Despite a four-fold Cmax variation between subjects, the levels of individual subjects were fairly consistent across the two products. There were no significant differences between the two products in blood nicotine concentrations or cardiovascular responses, and the correlation between the AUCs from the two products was 0.68 (P = 0.01). Eight subjects reported subjective feelings of light-headedness or slight dizziness, which are not typical after slower absorption from nicotine gum or skin patches. Blood nicotine levels within the smoking range were soon built up with repeated doses, even in the subject with the least efficient nasal absorption. In a second study of ad libitum use under clinical conditions both products appeared sufficiently acceptable for therapeutic use as an aid to smoking cessation. There was no tendency to escalate to excessive use over 4 weeks, and blood nicotine concentrations in nine subjects averaged only 44% of their prior smoking levels. Only one subject had levels equivalent to prior smoking and possible reasons why this was not more common are discussed.     

施地瑞玛生理性海水鼻腔喷雾器治疗小儿干燥性鼻炎的临床观察

目的:探讨施地瑞玛生理性海水鼻腔喷雾器治疗小儿干燥性鼻炎的疗效。方法:将58例患儿随机分成2组,2组均不使用其他药物。治疗组给予施地瑞玛生理性海水鼻腔喷雾器喷鼻;对照组给予生理性盐水滴鼻液滴鼻,观察2组治疗前后症状、体征及有效率。结果:根据2组的主要症状、体征及疗效,治疗组优于对照组(P<0.05)。结论:生理性海水鼻腔喷雾器治疗小儿干燥性鼻炎,可以缩短病程,改善鼻腔功能,疗效确切,且使用安全、舒适、方便,可以作为治疗小儿干燥性鼻炎的理想药物。     

弱激光血疗法的发展及展望

本文主要介绍了弱激光血疗的机制及其在我国的发展过程.弱激光血疗法起源于前苏联的紫外光量子疗法,传入我国后经历了静脉内照射疗法,离体血液激光照射回输疗法,口咽部照射伴吸氧疗法,鼻腔内照射疗法等.本文对各种疗法的特点及临床应用进行了详细叙述.有些学者认为,中医的观点也能揭示激光血疗的机制.从中医辨证的角度,人的体质分为虚证和实证.结合中医针灸的虚则补之,实则泻之的原理,根据患者的虚实状况,采用含有中医补泻信息的调制激光照射血液,同时加照相关敏感穴位,促进疗效,以体现中医的辨证施治的原则可取得更好的疗效.     

自体髂软骨及松质骨移植在牙槽突裂同期行鼻畸形整复术中的应用

目的　探索牙槽突裂与鼻畸形同期整复的新方法。方法　对 4 2例牙槽突裂患者采用自体髂骨及松质骨充填牙槽裂隙 ,髂嵴软骨片覆盖并充垫塌陷的梨状孔外缘及鼻侧区 ,同时利用鼻前庭黏膜软骨复合组织瓣V Y推进法整复鼻畸形。结果　 9～ 11岁患者牙槽突高度恢复平均为86 7% ,厚度恢复平均为 89 6 % ,牙槽突外形和功能为Ⅰ、Ⅱ级 ,尖牙在骨移植区萌出 ,梨状孔外缘鼻侧区低陷处高度恢复 ,鼻翼塌陷畸形恢复 ,鼻孔形态对称 ;12岁以上患者牙槽突高度恢复平均为70 1% ,厚度恢复平均为 71 7% ,牙槽突外形和功能为Ⅱ级、Ⅲ级 ;2例 18岁患者鼻背长轴、鼻端偏斜未能改善。结论　利用自体松质骨和软骨来修复牙槽突裂并同时进行鼻畸形整复 ,既能保证牙槽突高度、牙弓连续性的恢复 ,鼻畸形的改善 ,又能防止鼻背、鼻端长期畸形发展而造成难以矫正的偏斜 ,同时也能尽早消除因畸形给患者带来的心理障碍 ,是一种比较理想的整复方法     

Nasal glioma- a diagnostic challenge

Summary  In this unusual case there was a difficulty in diagnosis on the basis of histopathological reporting. On the grounds of clinical suspiscion one has to try to find out the proper diagnosis by advanced diagnostic methods like immunohistochemistry.     

Pleomorphic adenoma of the nasal septum

Despite the common occurrence of pleomorphic adenoma of major salivary glands, intranasal pleomorphic adenoma are rare. We present a ease of pleomorphic adenoma of the nasal septum along with a brief review of literature. The histological nature of this lesion in comparison to other salivary gland tumours and the importance of an accurate diagnosis has been stressed.     

双侧唇裂继发鼻畸形的矫正

目的通过对双侧唇裂继发鼻畸形进行细致的病理解剖学分析，制定出具体的治疗目标，探讨矫正的有效手术方法。方法以双侧唇裂继发鼻畸形的病理解剖学为基础，将手术程序分为鼻小柱及鼻尖整形、鼻翼软骨的整形、鼻底的整形3个连续的步骤。结果自2000年以来应用上述方法手术矫正36例，其中畸形严重的双侧完全性唇裂术后患者22例，占61．6％。所有病例术后伤口均Ⅰ期愈合，鼻外形明显改善，无感染及皮瓣坏死等并发症发生。术后随访10～24个月，平均17个月，满意率高达100％。结论双侧唇裂继发鼻畸形具有其特有的病理解剖学特征，以解剖学特征基础制定具体手术方案，确保了最终疗效的满意率。