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目的探讨鼻中隔矫正术失败而再次手术的技术方法。方法对1992—2004年鼻中隔矫正术失败的32例患者进行鼻科检查,根据患者鼻中隔偏曲的部位、程度,原有软骨及骨质的残留状况和患者年龄,我们采用3种不同的手术切口(径路)进行矫正:①对5例鼻中隔前端偏曲,1例低位偏曲和14例高位偏曲的患者采用鼻中隔前端“U”形切口;②对8例鼻中隔后端偏曲和2例高位偏曲患者,在偏曲部位的前方作纵向切口,并辅助鼻内镜进行矫正;③对2例鼻中隔前端低位偏曲的青少年患者采用唇龈沟正中横切口,向上揭翻,辅助耳科电钻进行手术。结果32例患者均获满意矫正,鼻中隔偏曲引起的临床症状消失或明显改善。随访6~36个月,无一例出现鼻中隔穿孔、鞍鼻、鼻腔粘连等并发症。结论鼻中隔偏曲再次矫正术需针对不同的临床特点选择正确的手术方法,可获满意效果。
Objective To explore the technical method of nasal septoplasty failure and reoperation. Methods A total of 32 patients with failed nasal septoplasty during 1992-2004 were enrolled in the study. According to the location, extent, and residual cartilage and bone remnant status of the patients with nasal septum, we used 3 different surgical incisions (Path) to correct: ① 5 cases of nasal septum deviation, 1 case of low deviation and 14 cases of high deviation patients with nasal septum front U-shaped incision; ② 8 cases of nasal septum posterior deviation and 2 cases of high Deviated patients in front of the deflection for longitudinal incision and assisted endoscopic correction; ③ 2 cases of adolescent nasal septum deviation of the young patients with a median transverse incision in the sulcus, upward revelation, auxiliary ear drills Surgery. Results All 32 patients were satisfactorily corrected, clinical symptoms caused by deviation of nasal septum disappeared or significantly improved. Follow-up 6 to 36 months, no case of nasal septum perforation, saddle nose, nasal adhesions and other complications. Conclusions Re-correction of nasal septum deviation should be based on different clinical features to choose the correct surgical approach, satisfactory results can be obtained.