论文部分内容阅读
目的:探讨鼻中隔双向黏骨膜瓣治疗成人难治性后鼻孔闭锁的效果。方法:9例后鼻孔闭锁患者,其中先天性闭锁2例,鼻咽癌放疗后闭锁7例。所有患者均接受了鼻内镜下后鼻孔成形术,术中使用鼻中隔双向黏骨膜瓣,术后未放置硅胶扩张管。观察患者术后的症状改善程度及是否发生后鼻孔再狭窄或闭锁。结果:9例患者术后鼻塞、张口呼吸等症状明显改善。在平均19.3个月的随访时间内,新成形后鼻孔通畅,黏膜瓣无移位及坏死,亦无后鼻孔再狭窄或闭锁发生。其中2例患者出现鼻腔粘连,1例出现后鼻孔边缘肉芽组织增生,经鼻内镜处理后无复发。结论:鼻内镜下后鼻孔成形术中,鼻中隔双向黏骨膜瓣的应用可降低再狭窄或闭锁的发生率,术后可不用放置硅胶扩张管。
Objective: To investigate the effect of nasal septum bi-directional mucoperiosteal flap in the treatment of nostril atresia in adults. Methods: Nine patients with posterior nostrilial atresia, including congenital atresia in 2 cases, nasopharyngeal carcinoma after radiotherapy and atresia in 7 cases. All patients underwent endoscopic rhinoplasty with nasal septum bi-directional mucoperiosteal flap without silicone expansion tube. Observe the patient’s postoperative symptoms and whether the occurrence of post-nostril restenosis or atresia. Results: Nine cases of postoperative nasal obstruction, mouth breathing and other symptoms improved significantly. During an average follow-up of 19.3 months, the newly formed nostrils were unobstructed and no mucosal flap displacement or necrosis was found. No post-nostril restenosis or atresia occurred. Two of the patients had nasal adhesions, one of them had proliferated granulation tissue around the nostril and no recurrence after endoscopic treatment. CONCLUSIONS: Nasal endoscopic rhinoplasty with nasal septum bi-directional mucoperiosteal flap reduces the incidence of restenosis or atresia, and does not require the placement of a silicone dilator postoperatively.