| Objective:Nasal obstruction is seriously affect the patient nasal function and quality of life of the common problems,inferior turbinate shift nasal broaden the operation,to widen the area of intact nasal mucosa and turbinate structure on the basis of the nasal passage retention.In clinical practice that is a date effect better surgical approach.Under this background,this study of inferior turbinate hypertrophy,nasal congestion,nasal stenosis patients complained of inferior turbinate outfracture nasal surgery and widening,in the preoperative and postoperative awake multislice spiral CT(multisice computed tomography state,MSCT)measurements,both from the nasal cavity and nasal objective function and other aspects of comparison and the combination of preoperative and postoperative nasal inspiratory effective resistance(inspiratory effective resistance,IER)and nasal expiratory effective resistance(expiratory effective resistance,EER)changes of inferior turbinate outfracture nasal cavity and evaluate the superiority of widening the feasibility of operation,so as to provide a more comprehensive and detailed clinical improvement of surgical treatment and follow-up on the basis of,play a good role in guiding.Method:In October 2011 to July 2012 in Nanjing Tongren Hospital inpatient treatment of 50 cases of nasal obstruction in complaints of the inferior turbinate hypertrophy patients as the research object,are required for inferior turbinate shift in the nasal cavity to broaden operation,after operation within 30 days of all patients with periodic review of endoscopic,1 week/times.The observation was focused on the patient is the emergence of a nasal cavity adhesion,complication and nursing staff to the timely liquidation of patients with nasal secretions change regularly,as appropriate,to reduce congestion of the nose drops.After 4 weeks,1 times every 2 weeks,3 months after the use of MSCT and nasal resistance instrument for positioning the nasal cavity,specifically speaking:1.coronal between the medial margin of turbinate soft tissue sieve funnel center under the level of bilateral distance between the(minimum distance minimal inferior turbinate soft tissue,MDTT);between the 2 and the coronal infundibulum center level bilateral inferior turbinate(minimal distance betweem the the minimum distance of inferior turbinate bone,MDTB);3,axial nasal inferior turbinate at the minimum distance threshold(nasal limen minimal distance betweem the inferior turbinate,NLDT);4,coronal sieve the center level of inferior turbinate(inferior turbinate thickness,thickness ITT),to compare the change of nasal structure before and after surgery.Nasal resistance meter(rhinomanometry,RM)measurement:1,nasal inspiratory phase effective resistance(effective resistance inspiratory,IER);2,nasal expiratory phase effective resistance(effective resistance expiratory,EER).Measurement data were paired t test,Spearman rank correlation was used to evaluate the patients before and after surgery,to investigate the correlation between the total resistance of the nasal inspiratory phase and the nasal expiratory phase and MDTT,MDTB.Result:Compared with before surgery,IER,EER,MDTB,MDTT,NLDT,right ITT,left ITT were significantly different(t=-17.831,-22.982,-8.321,8.703,6.710,12.126,14.492,P<0.05).The total resistance and MDTT,MDTB were negatively correlated(-0.570-0.551,P<0.05).The total resistance and MDTT,MDTB were negatively correlated(R values were-0.570,P,'-0.551<0.05).Before surgery,the VAS score of 50 patients with nasal obstruction was significantly lower than the preoperative score,and the effective rate was 84%.Compared with before surgery,all patients after operation corresponding to the inferior turbinate nasal meatus compared with the preoperative significantly wider,narrow nasal cavity is greatly improved,the cross-sectional area of the nasal cavity,effective volume of gas increased significantly.Conclusion:1.Inferior turbinate moved to broaden the operation of nasal obstruction in complained of inferior turbinate hypertrophy in patients with therapeutic effect is good,worthy of clinical application.2.Multi slice spiral CT measurement can reflect more comprehensive,multi-faceted examination and inferior turbinate and nasal cavity structure display,with inferior turbinate moving outside nasal cavity widening before and after surgery,is objective proof of the nasal cavity to broaden the surgery after change of nasal structure method,measurement of nasal resistance is reliable evaluation objective method of nasal ventilation,can improve to evaluate the effect of operation and nasal ventilation function as effective basis,for the improvement of the clinical surgery and subsequent treatment to provide more comprehensive and detailed basis,can play a good role in guiding.3.Nasal inspiratory resistance and sieve funnel center level of bilateral nasal soft tissue between the medial margin of the minimum distance,bilateral inferior turbinate between minimum distance showed negative correlation(r=-0.570,-0.551,P<0.05);and the total resistance of the nasal expiratory phase and sieve funnel center level of bilateral nasal soft tissue between the medial margin of the minimum distance,bilateral inferior turbinate between minimum distance showed negative correlation(r=-0.570,-0.551,P<0.05). |
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