对侧辅助切口结合岛状软骨瓣的改良鼻中隔成形术

目的：探讨内镜下采用对侧辅助切口结合岛状鼻中隔软骨瓣矫正复杂性鼻中隔偏曲的手术方法和临床效果。方法：21例复杂性鼻中隔偏曲患者,均采用左侧皮肤黏膜交界处纵切口,同时右侧鼻底行小横切口,首先剥离双侧鼻底部黏膜,而后剥离鼻中隔黏膜,使二者在棘突尖端＂会师＂,彻底松解双侧黏膜后矫正骨性偏曲。软骨四周进行减张制作岛状鼻中隔软骨瓣矫正软骨部偏曲。结果：21例患者术后鼻中隔外观居中,通气良好,无1例发生鼻中隔穿孔、塌鼻等并发症。结论：采用对侧辅助切口、进行上下＂会师＂剥离、制作岛状鼻中隔软骨瓣能够使鼻中隔矫正手术更加安全和有效,适用于复杂鼻中隔偏曲患者。

Modified Septoplasy with the Lateral Auxiliary Incision and Island Cartilage Flap

Objective： To explore the surgicalmethods and the clinical effects of the complicated deviation of nasal septum with the lateral auxiliary incision and island cartilage flap.Method： 21 cases of complicated deviation of nasal septum were treated with endoscopic surgery. The first incision were made at the front end of left septal wall. The second incision were made at the front end of the right nasal bottom. The mucoperichondrim of nasal bottom and septum was diverged respectively and converged at the processus spinosus. The osteal deviation were dislodged. The island cartilage flap formed by the edge of cartilage were relaxed and the cartilagineus deviation were corrected.Result： All cases had satisfacotory surgical result. All had an unobstructed nasal cavity and no complications such as perforation of nasal septum and bridge of nose collapsed.Conslusion： The lateral auxiliary incision, bidirectional debonding and island cartilage flap make the endoscopic surgery for the complicated ceviation of nasal septum more safely and effectively.