鼻中隔穿孔手术修复方法
Approach to Surgical Repair of Nasal Septal Perforation.
文献信息
| PMID | 42801325 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Nicole J Reynoso |
| 作者单位 | Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 鼻科 |
中文摘要
鼻中隔穿孔修复在技术上仍具挑战性，术式选择需依据穿孔大小、位置、病因及患者危险因素。当代证据支持：小穿孔（< 1 cm）采用黏膜推进瓣，中等穿孔（1-2 cm）采用双侧推进联合插入移植或三层颞顶筋膜-聚二氧环己酮构建物，大穿孔（≥ 2 cm）或翻修病例采用带蒂皮瓣，总体闭合率为84%至98%。可改变的危险因素，包括主动吸烟、未控制的糖尿病和持续鼻内药物使用，应在术前优化，因为这些因素与失败率显著增加独立相关。
英文摘要
Nasal septal perforation repair remains technically demanding, with technique selection guided by perforation size, location, etiology, and patient risk factors. Contemporary evidence supports mucosal advancement flaps for small perforations (< 1 cm), bilateral advancement with interposition grafting or trilayer temporoparietal fascia-polydioxanone constructs for medium perforations (1-2 cm), and pedicled flaps for large (≥ 2 cm) or revision cases, with overall closure rates ranging from 84% to 98%. Modifiable risk factors, including active smoking, uncontrolled diabetes, and ongoing intranasal drug use, should be optimized preoperatively, as they are independently associated with significantly increased failure rates.