【摘要】 目的观察鼻内镜下"挖隧道"法治疗复杂性鼻中隔偏曲的临床疗效及安全性。方法对术前经鼻窦CT和鼻内镜检查确认为复杂性鼻中隔偏曲的48例患者,采取全麻鼻内镜黏-软骨膜下隧道技术行鼻中隔偏曲矫正术,术后双侧鼻腔均使用高吸水性膨胀海绵填塞,观察术后患者的手术并发症及不良反应发生情况。结果术后鼻内镜检查鼻中隔偏曲骨性组织均得到矫正,症状明显改善。所有患者均未发生鼻中隔血肿及外鼻塌陷,平均住院时间约10.5 d,其中5例患者术后有鼻中隔黏膜纵向撕裂伤,长度均小于1.0 cm,发生率为10.41%,随访观察1个月,未见鼻中隔穿孔、鼻腔粘连、鼻梁塌陷发生。结论黏-软骨膜下隧道解剖技术符合鼻中隔偏曲产生的生物力学特点,对于减少复杂性鼻中隔偏曲手术并发症具有一定优势,值得临床推广应用。更多还原

【Abstract】 Objective To investigate the effect of "tunneling " method on treatment of complicated septum deviation under nasal endoscope. Methods 48 patients diagnosed as complicated septum deviation with sinus computed tomography scan and nasal endoscopy received endoscopic septoplasty with tunneling technology. Surgical effect and safety of this technology were evaluated. Results In all the 48 patients,postoperative endoscopic examination showed correction of bony deviation with obvious symptom improvement. All the patients got discharged from hospital without septal hematoma or external nasal collapse. Follow-up of one month after treatment showed no serious complications such as septal perforation,adhesion of nasal cavity structures,or nasal bridge collapse were encountered in all patients including 5 cases with intraoperative mucosal laceration. Conclusions The tunnel dissection technique is accordant with biomechanics of deviated septum. With advantages of good clinical effect and reducing surgical complications,this technique is worthy of clinical promotion.更多还原