鼻腔粘连合并鼻中隔偏曲的手术治疗

目的 探索鼻腔粘连合并鼻中隔偏曲的手术治疗方案.方法 鼻腔粘连合并鼻中隔偏曲患者13例.其中11例在施行粘连分解术的同时行鼻中隔偏曲矫正术和Merocel膨胀海绵持续性填塞鼻腔,1例施行单纯粘连分解术,1例联合施行粘连分解和鼻中隔偏曲黏膜下切除术.术后观察比较鼻腔创伤愈合情况及其功能改善效果.结果 第1组病例均获得痊愈;行单纯粘连分解术的1例症状无改善,改用第1组所用治疗方法后获得成功;第3种术式治疗的病例虽然粘连成功分解,但发生了鼻中隔穿孔.结论 对鼻腔粘连合并鼻中隔偏曲的患者,需在分解粘连的同时施行鼻中隔偏曲矫正术,重建鼻中隔,并行Merocel膨胀海绵持续性鼻腔填塞,有利于创伤愈合.

Surgical therapy for synechia nasal with deflection of nasal septum

Objective To explore the optimal surgical procedures for the treatment of synechia nasal with deflection of nasal septum based on a clinical study carried out in a group of such cases. Methods This study included 13 cases of synechia nasal with deflection of nasal septum. Among them, 11 were treated by the combined procedures of synechia nasal separating procedures combined with septal reconstruction and continuous Meroeel stuffing packing, one case treated by simple synechia nasal separating surgery and the other case treated by synechia nasal separating surgery plus submucous resection of nasal septum. Then, observed among these cases were the healing course of operative area and improving degrees of nasal function following the surgery. Results All the 11 cases were cured following the combined surgical procedures, while the case received the simple synechia nasal separating surgery showed no improvement in the clinical symptoms and was operated on again with the combined surgical procedures, with a good outcome following the second stage of surgery. However, septal perforation was resulted in the other case following synechia nasal separating surgery plus submueous resection of nasal septum, even if with the synechia nasal separated successfully. Conclusions For the treatment of synechia nasal with deflection of nasal septum, it should be more practicable to separate the synechia nasal combined septoplasty by cartilage implanting and continuous nasal packing by Merocel stuffing. Then, the recovery will be much better in the healing course of operative trauma in nasal cavity, with the complication of septum perforation rarely occurring following the operation.