摘要
目的:探讨婴幼儿先天性鼻后孔闭锁鼻内镜下扩张成形的手术技巧及随访疗效。方法:回顾性分析2016-09-2018-01期间手术治疗的7例先天性鼻后孔闭锁患儿的临床资料,术后阶段性密切随访,分析术后疗效。结果:7例患儿均在行电子鼻咽喉镜检查后明确鼻后孔闭锁诊断,鼻部CT检查明确闭锁板性质,均顺利完成手术,随访8～23个月,术后鼻腔通气良好。1例双侧鼻后孔闭锁术后3个月拔除鼻腔支撑管,1个月后出现双侧鼻后孔狭窄,再次鼻后孔扩张成形手术,术后留置鼻腔支撑管6个月,随访15个月无再次狭窄或闭锁。1例因自身原因放弃进一步治疗失访,其余5例患儿术后均无明显缩窄,通气良好,均无手术并发症发生。结论:电子鼻咽喉镜诊断鼻后孔闭锁无创、便捷、准确,鼻部CT检查可明确闭锁板性质,鼻内镜下鼻后孔扩张成形术留置鼻腔支撑管时间宜在6个月以上,可避免再次狭窄。
Objective: To discuss the operative technique and follow-up effect of endoscopic dilatation and plasty for congenital choanal atresia in infants. Method: Clinical data of 7 children with congenital choanal atresia operative treatmented during September 2016 to January 2018 were analyzed retrospectively. the follow-up were followed closely and analyz the operative effect. Result: Seven cases were diagnosed by electronic nasopharyngoscope, nasal CT confirm the nature of atresia plate, and all 7 case successfully complete the operation. Follow-up survey ranged from 8 months to 23 months, postoperative nasal ventilation is good. The first case of bilateral choanal atresia was removed the nasal stenting after operative 3 months, and founded stenosis 1 month later. Reoperation to enlarge the choanal and retained the nasal stenting for 6 months, no restenosis or atresia after 15 months of follow-up. One patient gave up further treatment because of his own reasons and was lost to follow-up. The other 5 cases had no obvious constriction, good ventilation and no operative complications. Conclusion: Electronic nasopharyngoscope is noninvasive, convenient and accurate in the diagnosis of choanal atresia. Nasal CT confirm the nature of the atresia plate. Endoscopic dilatation and plasty of choanal atresia should be retained the nasal stenting for more than 6 months, avoid re-constriction.
作者
邓海燕
高兴强
郭宇峰
DENG Haiyan;GAO Xingqiang;GUO Yufeng(Department of Otolaryngology Head and Neck Surgery,Children's Hospital of Fudan Univercity Xiamen Branch,Xiamen Children's Hospital,Xiamen,361000,China)
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2019年第4期367-370,共4页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
