摘要
鼻炎是一種全球性疾病。根據發病機轉的不同，可分為過敏性和非過敏性鼻炎。台灣鼻炎的盛行率逐年持續上升。鼻炎雖然不會危及生命，但往往會對工作效率、社交活動、睡眠質量和學校學習造成重大影響；這也給社會經濟成本帶來了沉重的負擔。過敏性鼻炎是一個影響全球10%至20%人口的健康問題，主要是因過敏反應產生鼻黏膜發炎，病人常見症狀為打噴嚏、鼻子或眼睛搔癢、流清鼻水、及鼻塞，嚴重者也可出現嗅覺喪失。第一線治療多以藥物為優先選擇，但長時間口服用藥難免會效果欠佳，甚而產生抗藥性。鼻中隔彎曲及下鼻甲肥厚是過敏性鼻炎病人常見的結構問題，易阻塞下鼻道及通氣量，影響鼻纖毛黏液清除率及嗅覺功能，加重病人鼻黏膜腫脹、鼻阻塞感及鼻水堆積。手術主要方式為鼻中隔整形術及下鼻甲減積手術，目的為切除或矯正彎曲鼻中隔，縮小下鼻甲過度肥厚體積，恢復正常下鼻通道，減少病人鼻塞、流鼻水及倒流等問題。另外，針對頑固性過敏性鼻炎，亦有翼管神經或後鼻神經阻斷術，可減輕流鼻水及噴嚏症狀。本文回顧國內外文獻，提供臨床醫師清楚了解手術在治療過敏性鼻炎所扮演的角色。
關鍵字
allergic rhinitis ； inferior turbinoplasty ； non-allergic rhinitis ； rhinitis ； septoplasty ； vidian neurectomy（過敏性鼻炎 ； 下鼻甲手術 ； 非過敏性鼻炎 ； 鼻炎 ； 鼻中隔整形術 ； 翼管神經阻斷術）並列摘要
Rhinitis is a global disease. Based on its different pathogeneses, it is classified as allergic(AR) or non-allergic rhinitis(NAR). The prevalence of rhinitis in Taiwan has continued to increase over the past few decades. Although rhinitis is not lethal, it often significantly influences work efficiency, social activities, sleep quality, and school learning. It also imposes high socioeconomic costs.AR represents a global health problem affecting 10%-20% of the population. It is a chronic immune-mediated inflammatory nasal condition with the hallmark symptoms of sneezing, nasal itching, mucus discharge, and nasal obstruction. Smell loss has been observed in patients with severe allergies. Drugs are the first-line treatment option for rhinitis; however, long-term medication inevitably leads to poor results and even drug resistance. A deviated nasal septum and hypertrophy of the inferior turbinate are common structural problems in patients with rhinitis, which can easily block the inferior meatus passage and ventilation, affect the clearance of mucociliary function, and aggravate swelling of the nasal mucosa. The major surgeries for rhinitis include septoplasty and inferior turbinate reduction. The purpose of surgery is to remove or correct the deviated nasal septum, reduce the excessive hypertrophic volume of the inferior turbinates, and restore normal inferior meatus passage. In addition, for refractory rhinitis, vidian nerve or posterior nasal nerve block surgery can relieve the symptoms of nasal discharge and sneezing. This article reviews the relevant literature to provide clinicians with a clear understanding of the role of surgery in patients with rhinitis.