nasal septum rhinoplasty

From the perspective of bone growth and development, the skull is developed earlier, and the development of the nasal septal cartilage is completed later, that is, the nasal septal cartilage is still growing when the frontal bone and the maxilla and tibia are completed. Therefore, the upper and lower nasal septum are fixed, and the upper and lower stress relationship can be formed because it cannot be extended. The main focus is on the connection between the weak nasal septal cartilage and the peripheral bone, which may be the most important factor in the formation of the nasal septum. Nasal paralysis of the nose helps to correct this disease. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: nasal septum deviation Indication 1, the nasal septum is deviated, affecting the nasal breathing. 2, nasal septum deviation caused by reflex headache. 3, nasal septum deviation obstructs sinus drainage. 4, the front of the nasal septum deviation caused by repeated nosebleeds. 5, nasal septum deviation caused by vasomotor rhinitis. Contraindications 1. Acute inflammation of the upper respiratory tract. 2, systemic diseases, such as blood diseases, high blood pressure, heart disease, diabetes and so on. 3, women's menstrual period. Preoperative preparation Regular use of antibiotics to prevent infection. Surgical procedure 1. The patient takes a semi-sitting or supine position, 75% ethanol disinfects the nose and facial skin, and disinfects the towel. 2, incision: generally should be on the left side of the nasal septum, in the forefoot of the nasal septum cartilage through the incision, the upper part of the nasal septum, down to the bottom of the nose. 3. Use the nasal septum stripper to separate the incision side nasal septal perichondrium and periosteum until the vomer. 4, free nasal septal cartilage. Along the posterior superior and posterior margins of the septal cartilage, that is, at the junction with the vertical plate of the ethmoid bone, the cartilage edge is directly separated, so that the septal cartilage is disconnected from the bone, and the joint between the cartilage and the bone can be removed by 2 to 4 mm. Cartilage strips to achieve the purpose of free nasal septal cartilage. Then, the exfoliated body is inserted through the posterior edge of the cartilage, and the mucoperiosteum of the nasal septum of the deformed convex side is separated. 5, the rongeur bite off the deflection of the vertical plate of the ethmoid bone, the vomer, the bone chisel to the maxillary nose. 6. After all the curved bones are removed, check whether the nasal septum is upright, whether there is bleeding point, absorb blood and blood clots, and take out the broken bone pieces. The mucosa of the nasal septum on both sides can be bitten if there is still bending. 7, suture the mucosal incision 1 ~ 2 needles to prevent mucosal retraction, cartilage exposure. 8. Both sides of the nasal cavity are filled with oil gauze or expansion sponge. complication 1, nasal septum hematoma: that is, the nasal septum mucosa sac blood. After the nasal cavity is taken out after the operation, if the nasal septum has a semicircular bulge and a soft foreign body on both sides of the nasal septum, the patient is stuffy. The drop of ephedrine saline can not be improved, and the hemorrhagic fluid can be diagnosed by puncture. Small hematomas can be absorbed by themselves, and large hematomas must be cut and drained. 2, nasal septum abscess: after surgery, due to nasal septum hematoma secondary bacterial infection, must be cut open drainage, anti-infective treatment. 3, nasal septum perforation: because the mucosa is removed, the nasal septum and spine mucosa is too thin, high tension, caused by mucosal rupture. In the presence of nasal inflammation, even a one-sided tear may result in perforation. 4, nose deformation: Because the nasal septum is an important support of the outer nose, when the nasal septum and cartilage are removed or moved, there is a risk of nasal collapse. Nasal septum abscess causes cartilage liquefaction necrosis, and such malformations can also occur. 5, intracranial complications: because the vertical plate of the ethmoid is connected with the brain plate, the elderly and osteoporosis surgery, may occur cerebral rupture, resulting in cerebrospinal fluid leakage. Nasal septum abscess may spread up to the brain, causing intracranial infection.

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