10000例鼻功能性精准修复的临床体会
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摘要
目的探讨鼻骨骨折、鼻畸形的治疗技巧及效果。方法回顾性分析2008年1月～2018年7月收治的10 000例鼻骨骨折和鼻畸形患者在超声、鼻内镜引导下行闭合复位术、切开复位术及鼻腔填塞,总结其临床疗效。结果所有患者术后随访3个月以上,术后鼻部凹陷畸形消失,CT检查示骨折复位好,患者对鼻部畸形的纠正效果满意。未见其他严重并发症。结论鼻骨骨折、鼻畸形患者临床治疗应根据畸形部位、移位程度、鼻腔局部情况、全身情况、心理等因素综合考虑决定,才能达到满意的效果。
Objective To study the treatment technique and therapeutic effect of nasal bone fracture and nasal deformity.Methods Clinical data of 10 000 patients suffering from nasal bone fracture and nasal deformity treated endoscopically(including closed reduction, open reduction and nasal packing) with guidance of ultrasound in our department from Jan. 2008 to July 2018 were analyzed retrospectively to summarize the therapeutic effect.Results All patients had been followed up for more than 3 months postoperatively. The follow-up results revealed disappearance of nasal depression deformity with good fracture reduction confirmed by postoperative computerized tomography(CT) and patients' satisfactions with the corrective effect of nasal deformity. No serious complications occurred.Conclusions In the treatment of nasal bone fracture and nasal deformity, the location of deformity, degree of displacement, local nasal conditions, general conditions, psychological factors and so on should be taken into comprehensive consideration. Only in this way can satisfactory effect be achieved.
Objective To study the treatment technique and therapeutic effect of nasal bone fracture and nasal deformity.Methods Clinical data of 10 000 patients suffering from nasal bone fracture and nasal deformity treated endoscopically(including closed reduction, open reduction and nasal packing) with guidance of ultrasound in our department from Jan. 2008 to July 2018 were analyzed retrospectively to summarize the therapeutic effect.Results All patients had been followed up for more than 3 months postoperatively. The follow-up results revealed disappearance of nasal depression deformity with good fracture reduction confirmed by postoperative computerized tomography(CT) and patients' satisfactions with the corrective effect of nasal deformity. No serious complications occurred.Conclusions In the treatment of nasal bone fracture and nasal deformity, the location of deformity, degree of displacement, local nasal conditions, general conditions, psychological factors and so on should be taken into comprehensive consideration. Only in this way can satisfactory effect be achieved.
引文
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[11] 马莉,沈素红,胡沛,等.超声引导下闭合性复位鼻骨骨折38例的疗效观察[J].中华耳鼻咽喉头颈外科杂志,2017,52(12):933-935.Ma L,Shen SH,Hu P,et al.The observation of curative effect on closed reduction of nasal bone fracture under ultrasound guidance:report of 38 cases[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2017,52(12):933-935.
[12] 沈志豪,吴素娟,翟亮,等.鼻内镜下改良鼻骨错位复位法61例疗效观察[J].中国耳鼻咽喉颅底外科杂志,2018,24(2):156-158,162.Shen ZH,Wu SJ,Zhai L,et al.Clinical observation on modified reduction of nasal bone fracture combined with dislocation under nasal endoscope:analysis of 61 cases[J].Chin J Otorhinolaryngol Skull Base Surg,2018,24(2):156-158,162.
[2] Trinidade A,Buchanan MA,Farboud A,et al.Is there a change in the epidemiology of nasal fractures in females in the UK[J].J Laryngol Otol,2013,127(11):1084-1087.
[3] Bai L,Li L,Su K,et al.3D reconstruction images of cone beam computed tomography applied to maxillofacial fractures:A case study and mini review[J].J Xray Sci Technol,2018,26 (1):115-123.
[4] Khwaja S,Pahade AV,Luff D,et al.Nasal fracture reduction:local versus general anaesthesia[J].Rhinology,2007,45 (1):83-88.
[5] 蔡其刚,赵永宏,方慧,等.鼻内镜下鼻骨复位术19例[J].中国内镜杂志,2007,13(10):1113-1114.Cai QG,Zhao YH,Fang H,et al.19 cases of nasal bone reduction under nasal endoscope[J].China Journal of Endoscopy,2007,13(10):1113-1114.
[6] 郑顺昌,侯军才,程琳.鼻骨骨折与鼻中隔偏曲同期手术的可行性及处理技巧[J].中国耳鼻咽喉颅底外科杂志,2016,22(6):502-503.Zheng SC,Hou JC,Cheng L,et al.Feasibility and management skills of simultaneous operation for nasal bone fracture and deviation of nasal septum[J].Chin J Otorhinolaryngol Skull Base Surg,2016,22(6):502-503.
[7] Tian L,You J,Wang H,et al.Comparison of two different grafts in nasal framework reconstruction of Binder Syndrome:cartilage and silicone[J].J Craniofac Surg,2017,28 (6):1413-1417.
[8] Schoinohoriti O,Igoumenakis D,Rallis G.Fractures of the nasal bones:is external splinting really warranted[J].J Craniofac Surg,2017,28(8):e760-e763.
[9] Abu-Samra M,Selmi G,Mansy H,et al.Role of intra-operative ultrasound-guided reduction of nasal bone fracture in patient satisfaction and patient nasal profile (a randomized clinical trial) [J].Eur Arch Otorhinolaryngol,2011,268(4):541-546.
[10] 沈素红,马莉,付卓,等.高频超声诊断鼻骨骨折及引导闭合复位的临床价值[J].中华超声影像学杂志,2018,27(10):914-915.Shen SH,Ma L,Fu Z,et al.Clinical value of high-frequency ultrasound in the diagnosis and closed reduction of nasal bone fracture[J].Chinese Journal of Ultrasonography,2018,27(10):914-915.
[11] 马莉,沈素红,胡沛,等.超声引导下闭合性复位鼻骨骨折38例的疗效观察[J].中华耳鼻咽喉头颈外科杂志,2017,52(12):933-935.Ma L,Shen SH,Hu P,et al.The observation of curative effect on closed reduction of nasal bone fracture under ultrasound guidance:report of 38 cases[J].Chinese Journal of Otorhinolaryngology Head and Neck Surgery,2017,52(12):933-935.
[12] 沈志豪,吴素娟,翟亮,等.鼻内镜下改良鼻骨错位复位法61例疗效观察[J].中国耳鼻咽喉颅底外科杂志,2018,24(2):156-158,162.Shen ZH,Wu SJ,Zhai L,et al.Clinical observation on modified reduction of nasal bone fracture combined with dislocation under nasal endoscope:analysis of 61 cases[J].Chin J Otorhinolaryngol Skull Base Surg,2018,24(2):156-158,162.