鼻中隔成形術對鼻阻力變化的影響

Nasal Resistance Before and After Septoplasty

賴穎臻(Ying-Chen Lai) ； 徐欣健(Hsin-Chien Hsu) ； 黃弘孟(Hung-Meng Huang)

《台灣耳鼻喉頭頸外科雜誌》 49卷3期 (2014/09) Pp. 139-145

https://doi.org/10.6286/2014.49.3.139

摘要

背景：運用主動式前端鼻阻力儀，可客觀測量呼吸時鼻腔的壓力（pressure）與氣體流量（flow），對鼻腔的通暢性進行分析；並可分析手術前後鼻腔寬側與窄側的氣流量與壓力變化。方法；共有47名患者（男性24名，女性23名）納入本研究，年齡分佈由17歲至69歲，平均年齡34.4歲。有長期性鼻塞症狀，但未有重大系統性疾病及鼻腔內相關腫瘤及鼻竇息肉。分別於鼻中隔成形手術前、術後3個月及12個月接受主動式前端鼻阻力儀檢查，測量鼻腔壓力與氣流量，收集檢查結果後統計分析手術前後之鼻阻力變化。結果：鼻腔阻力與流量數值左右側分開測量，將手術前因鼻中隔彎曲造成鼻腔截面積較小、氣流量較小、阻力較大的一側作為窄側（narrow side），另一側作為寬側（wide side）。鼻腔窄側在術後3個月與12個月與術前相比有氣流量增加（兩者皆p ＜ 0.00 1）、阻力降低的明顯差異（p = 0.001及p＜ 0.001）。鼻腔寬側在術後有氣流量下降及鼻阻力上升，但統計學上無明顯差異。術後3個月與12個月比較則無明顯鼻阻力與氣流量之差異。結論：鼻阻力檢查可做為一客觀且有效的手術前評估及術後追蹤工具。鼻中隔矯正手術可明顯改善原先因鼻中隔彎曲造成的鼻腔縮窄，同時改善鼻阻力與氣流量。會些微影響鼻中隔彎曲封側的氣流量與阻力但不顯著（p = 0.139及p = 0.685），並且手術的效果可以持續12個月以上。

關鍵字

鼻中隔彎曲 ； 鼻中隔成形術 ； 主動式鼻阻力測量儀 ； 鼻阻塞 ； 鼻腔氣流

並列摘要

Background: Rhinomanometry allows objective assessment of nasal airflow and resistance. Rhinomanometry is an effective evaluation measure for nasal patency before and after septoplasty. Methods: Forty-seven patients (24 male and 23 female) were enrolled in the study. Their ages ranged from 17 to 69 years old (mean, 34.4 yrs). All patients have nasal obstruction symptoms for long time. Patients with major systemic disease, nasal tumor, or nasal polyp were excluded. Rhinomanometry were performed preoperatively and 3 months, one year subsequent to septoplasty. Results: The nasal airflow of the narrower side of nose increased 3 months and 1 year after septoplasty (p ＜ 0.001, both). The resistance for narrower side of nose decreased 3 months and 1 year after septoplasty (p ≤ 0.001, both). No significant difference was noted among the airflow and resistance of the wider side of nose before and after septoplasty. Conclusions: Rhinomanometry can be used for objective evaluation prior to septoplasty. It can also use as a tool for postoperative follow-up. In our study, airflow and nasal pressure consistently improved at the narrower side of nose one year after septoplasty. Although the airflow of the wider side of nose decreased, the difference was not statistically significant.

並列關鍵字

septal deviation ； septoplasty ； rhinomanometry ； nasal obstruction ； nasal airflow