DYNAMICS OF RECOVERY OF FUNCTIONS OF THE NOSE IN PATIENTS WITH NASAL DEFORMITY COMBINED WITH NASAL CAVITY AND PARANASAL SINUSES DISORDERS IN THE POSTOPERATIVE PERIOD

M. I. Makhmudnazarov
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Abstract

Objective: To study dynamical changes in the functional state of the nose in patients with nasal deformity (ND) in combination with diseases of the nasal cavity (DNC) and paranasal sinuses (PNS) before and after single-step surgical treatment. Methods: The functional state of the nasal cavity was studied in 184 patients with ND in combination with DNC and PS in patients aged 16 to 45 years. The patients were divided into two groups of 92 people each. Group 1 consisted of patients with ND and nasal septum deformity (NSD) combined with DNC, and group 2 consisted of patients with ND and NSD combined with the DNC and PNS. The study included rhinoscopy, PNS CT scan, rhinomanometry, olfactometry, and analysis of the average duration of mucociliary transport (MCT). In addition, 184 septoplasties, 96 ultrasound turbinate reductions, 48 submucosal vasotomies, 17 nasal turbinate resections, 15 polypectomies/ethmoidectomies, 8 maxillotomies, and 184 rhinoplasties were carried out as a single-stage procedure. Results: It was revealed that significant impairment of the nose's respiratory, olfactory, protective, and aesthetic functions occurs with ND combined with DNC and PNS. Six months after single-step surgical interventions, the restoration of nasal breathing was observed in 94.6% and 91.3% of patients in groups 1 and 2, respectively. At the same time, in 96.7% and 92.4% of patients in groups 1 and 2, respectively, the sense of smell returned to normal. In addition, normalisation of MCT duration was noted in 92.4% and 89.1% of patients in groups 1 and 2, respectively. Although there were no statistically significant differences in the parameters between the groups, the changes in all the studied dynamic parameters over the observation period in both groups were statistically significant (p<0.01). Conclusion: The obtained results show the effectiveness of single-stage operations compared to multi-step procedures and the feasibility of their implementation in cases of ND in combination with DNC and PNS. Keywords: Paranasal sinuses, nasal deformity, nasal septum deformity, turbinate hypertrophy, one-stage operations, mucociliary transport.
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鼻畸形合并鼻腔及鼻窦病变患者术后鼻功能恢复动态
目的:探讨鼻畸形(ND)合并鼻腔、鼻窦病变(PNS)患者在单步手术治疗前后鼻部功能状态的动态变化。方法:对184例16 ~ 45岁ND合并DNC和PS患者的鼻腔功能状态进行研究。这些患者被分为两组,每组92人。组1为ND合并鼻中隔畸形(NSD)合并鼻中隔畸形(DNC)患者,组2为ND合并鼻中隔畸形(NSD)合并鼻中隔畸形(DNC)和鼻中隔畸形(PNS)患者。该研究包括鼻镜检查,PNS CT扫描,鼻测压,嗅觉测量,以及粘液纤毛运输(MCT)的平均持续时间分析。此外,184例鼻中隔成形术、96例超声鼻甲复位术、48例粘膜下血管切开术、17例鼻鼻甲切除术、15例息肉切除术/筛窦切除术、8例上颌切除术和184例鼻整形术均为单期手术。结果:ND合并DNC和PNS时,鼻部呼吸、嗅觉、保护和审美功能明显受损。单步手术干预6个月后,第1组和第2组患者鼻呼吸恢复率分别为94.6%和91.3%。同时,第1组96.7%,第2组92.4%的患者嗅觉恢复正常。此外,在第1组和第2组中,分别有92.4%和89.1%的患者的MCT持续时间恢复正常。虽然两组间参数比较差异无统计学意义,但两组观察期内各动态参数变化均有统计学意义(p<0.01)。结论:与多步骤手术相比,单阶段手术的有效性和实施ND联合DNC和PNS的可行性。关键词:鼻窦,鼻畸形,鼻中隔畸形,鼻甲肥大,一期手术,纤毛粘膜运输。
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