Способ хирургического лечения седловидной деформации спинки носа

Abstract

Saddle deformity of the external nose, which is a consequence of trauma, is usually combined with a nasal septal deviation and is quite widespread in the population. The problem of surgical treatment of this group of patients lies not only in the technical complexity, trauma of the proposed methods but also in the need to carry out significant interventions under general anesthesia, which limits the use of available techniques by a wide number of ENT surgeons, increases the duration of the operation, recovery time and temporary disability of the patient. The invention aims to improve surgical treatment of patients with saddle nasal deformity by providing stable cosmetic and functional results. Materials and methods: The proposed method of surgical treatment of saddle deformity of nasal dorsum includes several stages. Cartilage autograft taken from nasal septum during septoplasty is milled to 0,5–1,0 mm, mixed with 0,5 ml of latex tissue glue (LTG) having hemostatic and antiseptic properties due to aminocaproic acid and dioxidine content, respectively. This mixture is kept for 5 minutes and delivered to the pocket formed under the SMAS (superficial musculoaponeurotic system) layer in the soft tissues of the dorsum of the external nose, after which the final shape of the nose is simulated and fixed with a plaster splint for a week. Results: Based on the department of otolaryngology of Semashko Ryazan Regional Clinical Hospital, for the period from 2012 to 2019, 17 patients were treated with a diagnosis: saddle deformity of the external nose and nasal septum deviation. All patients underwent rhinoseptoplasty under local anesthesia using LTG as described above. No complications were observed in the postoperative period. During follow-up from 7 to 24 months, patients retain constant functional and cosmetic results. Conclusions. This method is a simple, low-traumatic one of surgical treatment of saddle deformity of the nasal dorsum, which allows reducing the operation time, performing it under local anesthesia and obtaining good cosmetic and functional results. The technical simplicity and accessibility of the method make it possible to use it in hospitals engaged in the surgical treatment of nasal diseases.