鼻内镜下鼻中隔手术出现穿孔的即时处理与预防

目的探讨鼻内镜下即时修复鼻中隔术中黏骨膜破损的方法及预防措施。方法 2008年-2010年在我院就诊的14例鼻中隔偏曲及部分合并鼻窦炎、鼻息肉的病人,行鼻内镜下鼻中隔矫正术,术中出现鼻中隔黏骨膜对穿性破损,立即采用鼻内镜下鼻中隔破损修补术,术中根据不同情况取自体鼻中隔软骨封闭穿孔,转移黏骨膜瓣或取生物膜补片进行了修复。结果 14例进行及时修复的病人,随访6个月,术后均没有出现鼻中隔穿孔。结论鼻内镜下及时修复鼻中隔手术中出现的对穿性破损,视野清晰,修补可靠;异体脱细胞真皮基质组织补片的使用减少了患者的二次创伤与痛苦,易成活,是很好的修复材料。

Immediate endoscopic repair and prevention for intraoperative nasal septal perforation in nasal septal submucous resection

【Objective】 To study the technique and effect of immediate repair under nasal endoscope in patients with intraoperative nasal septal perforation.【Methods】 14 patients with intraoperative nasal septal perforation from 2008 to 2010 of our hospital were treated immediately under nasal endoscope.The residual osseous septum was adopted to accomplish the closure of perforation.Mucoperiosteum flap and biomembrane were used to repair the perforation according to different conditions.【Results】 The nasal septal perforation of fourteen patients under endoscopic surgery immediately were successfuly repaired and folowing-up for six monthes.【Conclusion】 Intranasal endoscopic immediate repairing of intraoperative nasal septal perforation has a definite effect.Acellular dermal matrix patch is good repair material with no twice trauma and easy to survive.