外观呈三鼻孔样先天性鼻畸形的诊断与鉴别诊断——文献复习及临床分析

目的：探讨外观呈三鼻孔样先天性鼻畸形的分类与诊断,以期为临床提供较为规范的诊断标准。方法：总结我国自1994年以来公开发表且被“中国期刊全文数据库”收录的有关外观呈三鼻孔样先天性鼻畸形丈献14篇共26例病例,从外科情况、辅助检查、合并畸形等方面进行归纳,分析其相同点及不同点,从胚胎学角度探讨其发生机理。结果：根据异常鼻孔部位不同,分为鼻孔位于鼻尖部和位于鼻翼一侧,并有三个不同的诊断。结论：应根据病例特点及胚胎学发生原理对三鼻孔样畸形诊断。异常鼻孔位于鼻尖者为“额外鼻孔”：异常鼻孔位于鼻翼一侧,与鼻腔相通者为“副鼻”：不与鼻腔相通者为“先天性鼻窦道”。

Diagnosis and differential diagnosis of congenital nasal malformation with triple nostrils appearance (literature review and clinical analysis)

Objective To discuss the classification and diagnosis of congenital nasal malformation with triple nostrils appearance and put forward a diagnostic criterion for the clinical practice.Methods Summarized from fourteen articles about twenty-six cases of congenital nasal malformation with triple nostrils appearance from 1994 to 2006 which were adopted by the CNKI.Concluded from the surgical conditions,accessory examinations and concurrent abnormalities.The homologies and diversities were analyzed.The occurrence mechanisms were discussed in embryology.Results Based on the different positions of the abnormal nostril,which either on the nasal tip or at one side of ala nasi,three different diagnosis were brought forward.Conclusion The triple nostrils malformation should be diagnosed according to the case characteristics and the embryology principles.The abnormal nostril on the nasal tip is called "additional nostril".The abnormal nostril at one side of ala nasi and has the connection with the nasal cavity is called" supernumerary nostril".The abnormal nostril at one side of ala nasi with no connection with the nasal cavity is called "congenital nasal sinus".