코안 점막유착의 치료

Surgical Treatment for Intranasal Synechiae

  • 최요안 (순천향대학교 의과대학 성형외과학교실) ;
  • 최환준 (순천향대학교 의과대학 성형외과학교실) ;
  • 탁민성 (순천향대학교 의과대학 성형외과학교실)
  • Choi, Yo-Ahn (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Choi, Hwan-Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University) ;
  • Tark, Min-Seong (Department of Plastic and Reconstructive Surgery, College of Medicine, Soonchunhyang University)
  • 투고 : 2009.12.29
  • 심사 : 2010.03.23
  • 발행 : 2010.07.10

초록

Purpose: Many authors reported about the posttraumatic nasal aesthetic complications. However, the studies for functional or intranasal complications are not enough yet. We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae, and the synechiae formation was a frequently occurred after the nasal bone reduction. And then, the aim of this study is to identify the usefulness of the treatment of intranasal synechiae. Methods: We reviewed the data from 10 patients with symptomatic intranasal synechiae from June 2007 to June 2009. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We studied 10 patients with intranasal synechiae who had persistence postoperative symptoms. We studied the patients who were operated by removal of synechiae and ancillary surgical treatments in the last two years. Results: In the previous report, the incidence of intranasal synechiae was 15% (n=62) and symptomatic synechiae was 16% (10/62). We classified the nasal bone fracture according to Stranc classification. In this paper, the incidence of treated intranasal synechiae was 13% (2/15) in Frontal Impact (FI) Type I, 11% (2/18) in FI Type II, 100% (2/2) in FI Type III, 0% (0/2) in Lateral Impact (LI) Type I, 25% (3/12) in LI Type II, and 33% (1/3) in LI Type III, respectively. After removal of synechiae, all patients improved nasal obstruction and little improved olfactory disturbance. Conclusion: Simple removal of synechiae by scissors improved postoperative symptoms and complications such as nasal obstruction and olfactory dysfunction. After removal of synechiae, all patients improved nasal obstruction, however, little improved anosmia. So, we thought that olfactory dysfunction may result in many intranasal factors. First of all, education of delicate procedure regarding this subject should be empathized accordingly.

키워드

참고문헌

  1. Choi HJ, Lee YS, Choi CY, Tark MS: A clinical study of nasal synechiae causing by closed reduction for nasal bone fractures. J Korean Soc Plast Reconstr Surg 36: 188, 2009
  2. Choi HJ, Wee SY, Choi CY: Treatment of nasal bone fracture with reverse U-shaped silicone sheet. J Korean Soc Plast Reconstr Surg 36: 242, 2009
  3. Lee JY, Kim SW, Jang YD, Chun SS, Cho SH, Kang EG: Prevention of lateral synechia formation with silastic sheet in the endoscopic sinus surgery. Korean J Otolaryngol-Head Neck Surg 50: 48, 2007
  4. Shin SH, Sohn JH, Park JY: Clinical value of olfactory function test following functional endoscopic sinus surgery. Korean J Otolaryngol-Head Neck Surg 40: 568, 1997
  5. Kim JH, Kim KS, Yoon HC, Lee JH, Yoon JH, Song KJ, Park TJ: Anti-adhesive effect of GUARDIX-SLⓇ after endoscopic sinus surgery. Korean J Otolaryngol-Head Neck Surg 48: 1478, 2005
  6. Park WY, Kim YH: A clinical study of the nasal bone fracture according to Stranc classification. J Korean Soc Plast Reconstr Surg 35: 289, 2008
  7. Kim SB, Han SK, Kim WK: Airway improvement after reduction of nasal bone fracture. J Korean Soc Plast Reconstr Surg 32: 49, 2005
  8. Lee TH, Kim BY, Kim DY: Effectiveness of the turbonoplasty in the patient with deviated septum of nose. Korean J Otolaryngol 48: 326, 2005
  9. Kim SW, Nam IC, Kim BG, Kang MG, Lee DM, Cho JH, Yoon HR: The evaluation of olfactory function in patients with septal and turbinate surgery. Korean J Otolaryngol-Head Neck Surg 47: 1107, 2004
  10. Ahn BH, Lee SY, Sohn SG, Shin HC, Kim ED, Nam SI: The relationship between nasal septal deviation and inferior turbinate hypertrophy. Korean J Otolaryngol-Head Neck Surg 46: 950, 2003
  11. Leopold DA: The relationship between nasal anatomy and human olfaction. Laryngoscope 98: 1232, 1988
  12. Doty RL, Mishra A: Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis. Laryngoscope 111: 409, 2001 https://doi.org/10.1097/00005537-200103000-00008