Postoperative management of nasal vestibular stenosis: the custom-made vestibular device.
Postoperative management of nasal vestibular stenosis: the custom-made vestibular device.
复制标题
鼻前庭狭窄的术后处理：定制前庭装置。
DOI：
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发表时间：
2005
影响因子：
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通讯作者：
G. N. Nolst Trenité
中科院分区：
文献类型：
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作者：
D. Menger;P. Lohuis;S. Kerssemakers;G. N. Nolst Trenité
目的
评价定制的术后前庭装置对再狭窄发生率和严重程度的影响。
设计
这是一项回顾性研究，在学术医学中心面部整形和重建外科中心耳鼻喉科/头颈外科进行。1994年1月至2000年12月，在该三级护理中心，52例鼻前庭狭窄患者接受了前庭装置术后直接，目的是降低再狭窄的风险。前庭装置由热塑性丙烯酸材料组成，并具有促进呼吸的管腔。该装置的形状在手术后1周内定制，随后由患者佩戴12周（连续6周，仅在夜间佩戴6周）。在此期间后，鼻前庭再狭窄的发生和严重程度进行了评估，并评估了潜在的辅助手术的必要性。
结果
术前，52例患者中，38例（73%）为重度狭窄，13例（25%）为中度狭窄，1例（2%）为轻度狭窄。术后，15例（29%）患者出现轻度再狭窄，1例中度狭窄，1例重度狭窄。只有后一名患者需要进行后续翻修。在51例（98%）患者中观察到功能改善，而49例（94%）患者在初次手术后显示出美学改善。
结论
在手术治疗前庭狭窄的情况下，使用定制的前庭装置可能有助于防止再狭窄。除了功能改善之外，该装置还可以改善美学效果。该器械似乎没有任何不良反应，易于制造，患者佩戴舒适。
OBJECTIVE
To evaluate the effect of a custom-made postoperative vestibular device on the occurrence and severity of restenosis.
DESIGN
This was a retrospective study conducted at the Department of Otorhinolaryngology/Head and Neck Surgery, Center for Facial Plastic and Reconstructive Surgery of the Academic Medical Center. In this tertiary care center between January 1994 and December 2000, 52 patients treated for nasal vestibular stenosis received a vestibular device directly postoperatively, with the intention to decrease the risk of restenosis. The vestibular device was composed of thermoplastic acrylic material and had a lumen to facilitate breathing. The shape of the device was custom-made within 1 week after surgery and was subsequently worn by the patient for 12 weeks (6 weeks continuously and 6 weeks only during the night). After this period, the occurrence and severity of restenosis of the nasal vestibule were evaluated and the necessity for a potential adjuvant operation was assessed.
RESULTS
Preoperatively, of the 52 patients, 38 (73%) had severe stenosis, 13 (25%) had moderate stenosis, and 1 (2%) had mild stenosis. Postoperatively, 15 (29%) of the patients had mild restenosis, 1 had a case of moderate stenosis, and 1 had a case of severe stenosis. Only the latter patient required a subsequent revision. Functional improvement was noticed in 51 (98%) of the patients, whereas 49 (94%) of the patients showed aesthetic improvement after the initial procedure.
CONCLUSIONS
In case of surgical treatment of vestibular stenosis, the use of a custom-made vestibular device may help prevent restenosis. In addition to functional improvement, the device may also improve the aesthetic result. The device does not seem to have any negative adverse effects, was easy to make, and was comfortable for the patient to wear.