鼻内镜下黏膜瓣修补鼻中隔穿孔的方法学进展

Endoscopic repair of nasal septal perforation using mucosal flap: advances in technique

摘要:

鼻内镜下利用带蒂黏膜瓣修补鼻中隔穿孔的成功率较高，已经成为治疗鼻中隔穿孔的主要手段。目前报道的黏膜瓣类型繁多，依据黏膜瓣是否带有血管蒂，可将其归为无血管蒂、部分保留血管蒂及带血管蒂黏膜瓣3个主要类型。同时又依据黏膜瓣转移到穿孔区的方式，可分为推进、旋转和翻转3种方式。此外，黏膜瓣因取材位置的不同也存在诸多变化。本文主要对上述黏膜瓣修补鼻中隔穿孔的方法进行归纳，重点介绍不同黏膜瓣的取材策略和转移方法，以便于其临床应用。

关键词:鼻中隔穿孔;鼻内镜术;带蒂黏膜瓣;鼻黏膜;鼻中隔穿孔修补术

Abstract:

Endoscopic repair with pedicled mucosal flap has become the main treatment of septal perforation with high success rat. There are many types of mucosal flaps reported. According to whether it has vascular pedicle, the mucosal flap is classified into three main types, i.e. non-vascular, partially preserved vascular and vascular pedicled mucosal flap. At the same time, it can also be divided into advancement, rotation and cross-over mucosal flap based on the way of transfering to the perforation area. In addition, there are many variations in mucosal flap due to different donor location. With special emphases on the strategy of obtaining mucosal flap and the method of transferring mucosal flap, this paper summarizes the above-mentioned repair methods for septal perforation with mucosal flap to promote the clinical application.

Key words:Nasal septal perforation;Endonasal surgery;Pedicled mucosal flap;Nasal mucosa;Repair of perforation of nasal septum