摘要
目的 分析个性化设计3D打印鼻前庭器支撑扩张与常规支撑扩张对鼻前庭区狭窄治疗后鼻腔通气功能和前鼻孔形态上恢复疗效的评价。方法 73例单侧外伤性鼻前庭区狭窄的患者,随机分为两组,35例对照组采用常规支撑扩张,38例试验组采用3D打印鼻前庭器支撑扩张,分别从主观评价指标、客观的局部形态结构参数和数值模拟鼻腔气流动力学参数等方面来评价两组患者术前和支撑扩张治疗后鼻腔局部形态和功能恢复情况。结果 两组患者支撑治疗后鼻塞主观感觉和鼻孔对称性满意度视觉模拟评分(VAS)均较术前有明显改善(P<0.05),在鼻孔对称性满意度方面试验组评分高于对照组(P<0.05);支撑扩张治疗后两组的鼻瓣区截面积[对照组(0.86±0.29)cm2和试验组(0.71±0.26)cm2]均较手术前明显增加(P<0.05),其中对照组鼻瓣区截面积均值大于试验组(P<0.05),但鼻孔形态学参数显示支撑扩张治疗后试验组Δ长轴比值和Δ短轴比值的值均小于对照组(P<0.05),在恢复鼻孔形态上个性化设计3D打印的鼻前庭支撑器支撑扩张治疗更优;支撑扩张治疗后两组的狭窄侧鼻腔阻力均分别低于术前(P<0.05),并且试验组[(0.022±0.008)Pa.s.mL-1]比对照组[(0.028±0.012)Pa.s.mL-1]有更小的狭窄侧鼻腔阻力值(P<0.05),但两组的总鼻腔阻力值差别不明显(P=0.64);鼻腔气流温度与湿度调节功能参数结果显示,支撑扩张治疗后对照组(94.55±2.54)%和试验组(95.26±3.21)%患者的鼻腔气流的加温效率较手术前[对照组(95.45±2.93)%和试验组(96.14±2.63)%]均有明显减小(P<0.05),但两组之间患者总鼻腔加温效率和加湿效率无明显差异(P均>0.05)。结论 个性化设计3D打印鼻前庭支撑器用于前鼻孔狭窄患者的术后支撑扩张治疗使前鼻孔外形、鼻腔正常的通气功能和鼻腔气流的温湿度调节作用均有较好的恢复,能够体现个性化治疗的优势并让患者获得更为满意
Objective To evaluate the efficacies of individually designed three-dimensional(3D)printed nasal vestibular support expansion and conventional support expansion on the recoveries of nasal ventilation function and anterior nostril morphology in nasal vestibular stenosis.Methods Seventy-three patients with traumatic unilateral nasal vestibular stenosis were randomly divided into control group of 35 cases(by conventional support expansion)and experimental group of 38 cases(by 3D printed nasal vestibular support expansion).Subjective evaluation indexes,morphological parameters and nasal airflow numerical simulation parameters were used to evaluate the local morphological and functional recoveries of the nasal cavity.Results The visual analogue scale(VAS)scores of subjective nasal patency and nostril symmetry satisfaction in the control group and the experimental group were both significantly improved after support expansion treatment compared with those before operation(P<0.05),while the VAS score of nostril symmetry satisfaction in the experimental group was higher than that in the control group(P<0.05).The cross-sectional areas of nasal valve in both groups after support expansion treatment[(0.86±0.29)cm 2 in the control group and(0.71±0.26)cm 2 in the experimental group]were significantly increased compared with those before operation(P<0.05),and the mean cross-sectional area of nasal valve in the control group was larger than that in the experimental group(P<0.05).However,theΔlong-axis ratio andΔshort-axis ratio of the experimental group were both lower than those of the control group after the support expansion treatment(P<0.05),which indicated that 3D-printed nasal vestibular support was better than conventional nasal vestibular support in restoring the nostril shape.The stenotic side nasal resistances in both groups after support expansion treatment were lower than those before operation(P<0.05).The stenotic side nasal resistance after support expansion in the experimental group[(0.022±0.008)Pa.s.mL-1]was
作者
汪涛
陈东
徐洲
王钟颖
王珮华
于洋
WANG Tao;CHEN Dong;XU Zhou;WANG Zhongyin;WANG Peihua;YU Yang(Department of Otolaryngology Head and Neck Surgery,Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China;Department of 3D Printing Center,Shanghai Ninth People’s Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200011,China)
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
CSCD
2023年第3期69-76,共8页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
上海交通大学医学院附属第九人民医院临床研究助推计划(临+计划,JYLJ202009)。
关键词
3D打印鼻前庭支撑器
鼻前庭狭窄
数值模拟
视觉模拟评分
Three-dimensional printed nasal vestibular support
Nasal vestibular stenosis
Numerical simulation
Visual analogue scale
