目的 探讨驼峰鼻合并歪鼻畸形患者的综合治疗方案和手术效果评价方法。方法 通过多平面鼻部截骨复位,以及鼻中隔软骨的移植,重建驼峰鼻合并歪鼻患者的鼻部外形轮廓,同时改善鼻腔通气功能。手术前后分别运用鼻阻力测定(RM)和鼻声反射测量法(AR)检测鼻腔通气效果的变化。结果 术后随访4~8个月,16例驼峰鼻伴歪鼻畸形患者均对术后外观效果表示满意;除1例自觉通气状况无明显改变外,其余患者均自觉通气功能改善。本组无复发和并发症患者。根据RM和AR检测结果,患侧鼻腔最小横截面积(MCA)、鼻腔容积(NV)、鼻阻力(NR)手术前后有显著差异(P<0.01)。结论 驼峰鼻合并歪鼻畸形患者的治疗包含鼻部外形轮廓的修复和鼻腔通气功能的重建。鼻阻力测定和鼻声反射测量法的检测可以客观评价鼻腔通气功能的改变。

Objective To explore the comprehensive surgical technique for hump nose combined with nasal deviation deformity, and the objective evaluation method of operative effect. Methods The nasal contour was reconstructed and the nasal ventilation function was improved through the multi plane nasal osteotomy and the transplantation of the nasal septal cartilage. The changes of nasal ventilation were measured by nasal resistance measurement (RM) and nasal acoustic reflex (AR) before and after operation. Results Followed up for 4-8 months after operation, 16 cases were all satisfied with the nasal appearance. Only 1 case felt no obvious change of nasal ventilation function, the rest of the patients felt obvious change, comparing with preoperative nasal ventilation consciousness. No recurrence and complications were observed. According to the results of RM and AR, the nasal minimal cross-sectional area , the nasal volume and nasal resistance all had significant improvement postoperatively (P<0.01). Conclusion The treatment of hump nose associated with deviated nose includes the repair of nasal contour and the reconstruction of nasal ventilation function. The measurement of nasal resistance (RM) and nasal acoustic reflex (AR) can objectively evaluate the changes of nasal ventilation function.