Cengiz ESER, Eyüphan GENCEL, İbrahim TABAKAN, Erol KESİKTAŞ, Metin YAVUZ

Travmatik Nazal Deformasyonu Olan Olgularda Uygulanan Osteotomili ve Osteotomisiz Açık Septorinoplasti Yöntemlerinin Karşılaştırılması

Amaç: Bu çalışmanın amacı, travmatik nazal deformasyonlu hastalarda, solunum fonksiyonlarını arttırmak ve deformasyonu düzeltmek amaçlı uygulanan osteotomili ve osteotomisiz açık septorinoplasti yöntemlerinin, fonksiyonel sonuçlarının karşılaştırılmasıdır. Materyal ve Metod: Prospektif ve klinik olarak planlanan bu çalışmada, 2007-2009 yılları arasında travmatik nazal deformasyon şikayetiyle başvuran 26 hasta çalışmaya dahil edildi. Hastaların ameliyat öncesi ve sonrası fizik muayeneleri, fotoğraf kayıtları, periorbital ödem ve ekimoz bulguları ve solunum değişimleri kaydedildi. Hastalarda belirgin nazal dorsum düzensizliği, septum deviasyonu ve solunum zorluğu olduğu tespit edildi. 13 hastaya (% 50) osteotomili, 13 hastaya (% 50) osteotomisiz açık septorinoplasti uygulandı. Osteotomi yapma kararı, nazal dorsum genişliğine ve burun uzunluk ölçümlerine göre verildi. Hastalar postoperatif 1, 3, 6 ve 12 aylık dönemlerde sonuçların değerlendirilmesi amacıyla kontrollere alındı. Bulgular: Operasyonlar sonrası tüm hastalarda fonksiyonel olarak iyileşme saptandı.Osteotomisiz grupta osteotomili gruba göre solunum şikayetlerindeki düzelmenin daha fazla olduğu, nazal pasajda daralmanın daha az olduğu, postoperatif dönemde ödem ve ekimozun daha az olduğu görüldü. Sonuç: Açık septorinoplasti operasyonu, klasik olarak osteotomi uygulanarak yapılsa da osteotomi uygulanmadan yapılan operasyonların, nazal pasajda daralmaya neden olmadığı, postoperatif ödem ve ekimozun daha az olduğu görülmüştür. Osteotomisiz rinoplasti, preoperatif dönemde detaylı ön çalışma ile seçilmiş hastalarda yararlı bir prosedür olabilir.

Anahtar Kelimeler:

Osteotomi, açık septorinoplasti, nazal obstrüksiyon

The Comparison of Open Septorhinoplasty Methods with or without Osteotomies Performed in Situations of Traumatic Nasal Deformation

Purpose: The aim in this study is to compare the functional results of open septorhinoplasty with and without osteotomies performed with the aim of increasing respiratory functions and healing the deformations in patients with traumatic nasal deformations. Material and Methods: In this prospective and clinical study, 26 patients with traumatic nasal deformation, who applied between 2007 and 2009 were analyzed. The physical examination, medical photographies, the findings of periorbital edema and ecchymosis and changes in respiratory behaviors before and after the operation were recorded. Evident irregularities of nasal dorsum, septum deviation and respiratory distress were identified in all of the patients. Open septorhinoplasty with osteotomy (13 patients – 50 %) and without osteotomy (13 patients – 50 %) were applied to a total of 26 patients. Osteotomy decision was given according to nasal dorsal width and nasal height. All the patients were controlled in the in the first, third, sixth and twelfth months of the postoperative period to analyze the results. The data gathered through these cases were compared with the literature. Results: Functional improvements were observed after open septorhinoplasty operations in all patients. When the postoperative results of the open septorhinoplasty operations with and without osteotomy are compared, it was observed that among the group of patients on which osteotomies were not practiced respiratory complaints improved better, stricture in the nasal passage was not caused, edema and ecchymosis in the postoperative period was lesser. Conclusion: In this study, the attempt was to prove that although open septorhinoplasty operations are classically performed with osteotomy, the operations without osteotomy has not cause stricture in the nasal passage, it causes less edema and ecchymosis in the postoperative period compared to the group with osteotomy. It is an acceptable procedure for patients chosen in the preoperative period through a detailed preliminary work

Keywords:

Osteotomy, open septorhinoplasty, nasal obstruction,

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