Objective: To analyse the clinical effect of endoscopy-assisted functional rhinoplasty. Methods: Twenty-one patients with congenital or traumatic deviated nose with nasal obstruction admitted to Qilu Hospital (Qingdao) from January 2018 to December 2021, including 8 males and 13 females, aged 22 to 46 years, were retrospectively analysed. Endoscopy-assisted functional rhinoplasty was performed in all patients. Deviated nasal septum was corrected, nasal septum cartilage graft was prepared through open approach assisted by endoscopy, the nasal frame structure was adjusted with the endoscopy-assisted rhinoplasty combined with middle and inferior turbinoplasty, and the patient's nasal ventilation function and external nose cosmetology were restored. Visual Analogue Scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal acoustic reflex and nasal resistance were examined preoperatively and 6 months postoperatively. The minimum cross-sectional area of the first two nasal cavities (MCA) MCA1 and MCA2 and their distance between nostrils to the minimum cross-sectional area (MD) MD1 and MD2 were recorded, and the ratio of both sides (expressed in a/b) was calculated. The nasal volume of 5 cm depth from nostril (NV5) and nasal resistance total (RT) were recorded to evaluate the nasal ventilation function to analyse the clinical effect of functional rhinoplasty assisted by nasal endoscope. SPSS 25.0 software was used for statistical analysis. Results: At 6 months after the operation, for nasal ventilation evaluation, the VAS and NOSE scores of nasal obstruction decreased significantly than those before the operation ((1.81±0.81) points vs (6.71±1.38) points, (4.19±2.06) points vs (12.05±2.67) points, all P<0.05). In the objective indexes, MCA1, MCA2 and NV5 were significantly increased whereas RT, MCA1a/MCA1b, MCA2a/MCA2b, MD1a/MD1b and MD2a/MD2b were significantly decreased compared with those before the operation (all P<0.05). The MD1 and MD2 levels before and after operation had no significant differences (all P>0.05). In the evaluation of external nose morphology, postoperative ROE was significantly increased, and the deviation value of nasal appearance was significantly decreased ((16.19±2.56) points vs (10.24±3.24) points, (1.55±1.16) mm vs (5.63±2.41) mm, all P<0.05). In terms of postoperative patient satisfaction, 19 cases (90.5%) were very satisfied with nasal ventilation function, 2 cases (9.5%) were satisfied with nasal ventilation function; 15 cases (71.4%) were very satisfied with nasal appearance, and 6 cases (28.6%) were satisfied with nasal appearance. Conclusions: Nasal endoscopy-assisted functional rhinoplasty can improve the nasal ventilation function and external nasal morphology at the same time, with good clinical effect and high patient satisfaction.
目的： 分析鼻内镜辅助下功能性鼻整形术的临床疗效。 方法： 回顾性分析2018年1月至2021年12月于山东大学齐鲁医院（青岛）收治的伴有鼻塞的先天性或外伤性歪鼻患者21例，其中男8例，女13例，年龄22~46岁。所有患者均接受鼻内镜辅助下功能性鼻整形术，即开放入路在鼻内镜辅助下矫正偏曲的鼻中隔并制备鼻中隔软骨移植物，在内镜辅助下调整鼻部框架结构并联合行中、下鼻甲手术，同期恢复患者鼻通气功能及外鼻形态。于术前及术后6个月分别行鼻塞视觉模拟量表（VAS）、鼻阻塞症状评估量表（Nasal Obstruction Symptom Evaluation，NOSE）、鼻声反射、鼻阻力检查，记录前两个鼻腔最小横截面积（minimal cross-sectional area of nasal cavity，MCA）MCA1和MCA2及其距离前鼻孔的距离（distance between nostril to minimum cross-sectional area，MD）MD1和MD2，并分别计算两侧的比值（以a/b表示），记录距前鼻孔5 cm的鼻腔容积（nasal volume of 5 cm depth from nostril，NV5）及鼻腔总阻力（nasal resistance total，RT），共同评估鼻通气功能。行鼻整形结局评估量表（Rhinoplasty Outcome Evaluation，ROE）和鼻外观偏离值评估外鼻形态，最后以术后满意度进行整体评估，分析鼻内镜辅助下功能性鼻整形术的临床疗效。使用SPSS 25.0软件进行统计学分析。 结果： 术后6个月复查时，在鼻通气评估方面，主观指标鼻塞VAS评分和NOSE评分较术前明显下降［（1.81±0.81）分比（6.71±1.38）分，（4.19±2.06）分比（12.05±2.67）分，P值均<0.05］；客观指标中MCA1、MCA2和NV5较术前明显增加，RT、MCA1a/MCA1b、MCA2a/MCA2b、MD1a/MD1b、MD2a/MD2b较术前明显减少（P值均<0.05）。术前术后的MD1和MD2无明显差异（P值均>0.05）。在外鼻形态评估方面，术后ROE评分明显增加，鼻外观偏离值明显减少［（16.19±2.56）分比（10.24±3.24）分，（1.55±1.16）mm比（5.63±2.41）mm，P值均<0.05］。术后21例患者满意度评估：对鼻通气功能非常满意19例（90.5%），满意2例（9.5%）；对鼻外形非常满意15例（71.4%），满意6例（28.6%）。 结论： 鼻内镜辅助下功能性鼻整形术可同期改善患者鼻通气功能及外鼻形态，临床疗效较好，患者满意度高。.