武汉市2020年应用基础前沿项目（2020020601012310) ; 武汉市卫健委2019年科研项目面上项目（WX19C07）
First hospital of Wuhan
目的 探讨鼻中隔偏曲合并外鼻畸形的解剖学形成特点,总结分析同期行鼻中隔偏曲矫正和手术同期外鼻畸形整复手术方法。方法 回顾性分析2016年3月至2019年3月我科18例鼻中隔偏曲矫正同期外鼻畸形整复患者的临床资料,包括术前和术后1年的鼻内镜和鼻腔鼻窦CT影像资料、外鼻形态拍照照片、鼻腔通气功能和外鼻形态的VAS评分表及鼻阻力测定值。对外鼻畸形的结构特征进行解剖学分类,对外鼻畸形整复的常用手术方法进行归纳总结。结果 18例鼻中隔偏曲合并的外鼻畸形主要表现形成原因为大翼软骨发育异常、鼻中隔软骨尾侧端畸形及上颌骨骨性畸形,外鼻畸形整复采用了缝合矫形、切除矫形、和支撑矫形等手术方法。18例患者鼻内镜检查、鼻腔鼻窦CT显示术后鼻中隔偏曲与外鼻畸形形态改善明显。术后1年鼻腔通气功能和外鼻形态VAS评分明显低于术前,术后1年双侧鼻腔总阻力明显低于术前,差异均有统计学意义(P<0.05)。结论 本研究初步总结了鼻中隔偏曲并外鼻畸形的解剖学构成分类和常用手术方法体会,为临床上工作中兼顾鼻腔功能与美学的治疗策略提供参考。
Objective To investigate the anatomic characteristics of nasal septum deviation combined with external nasal deformity, and to summarize and analyze the surgical methods of nasal septum deviation combined with external nasal deformity. Methods From March 2016 to March 2019, the clinical data of 18 patients with nasal septum deviation were retrospectively analyzed, such as preoperative and postoperative 1-year nasal endoscopy and CT examination report of nasal cavity and paranasal sinuses, external nasal morphology photos, nasal ventilation function and external nasal morphology VAS score table and nasal resistance measurement value. Anatomic classification of the structural characteristics of the external nose deformity, common surgical methods of external nose deformity reduction are summarized. Results 18 cases of nasal septum deviation combined with external nasal deformity were mainly manifested as alar cartilage dysplasia, caudal end of nasal septum cartilage deformity and bone deformity. Suture, resection and support surgical methods were used to repair the external nasal deformity. Nasal endoscopy and CT of nasal cavity and paranasal sinuses showed that the deviation of nasal septum and the shape of external nose improved significantly in 18 patients. The VAS score of nasal ventilation function and external nasal morphology at 1 year after operation was significantly lower than that before operation, and the total resistance of bilateral nasal cavity at 1 year after operation was significantly lower than that before operation (P < 0.05). Conclusion This study summarizes the anatomical classification and common surgical methods of nasal septum deviation and external nasal deformity, which can provide reference for clinical treatment strategy of nasal function and aesthetics.