Measurement of deformation rate in nasal septum deviation by three-dimensional computer tomography reconstruction and its application in nasal septoplasty endoscopic surgery

摘要

Nasal septum deviation (NSD) typically occurs following otorhinolaryngologic surgery. However, there is a lack of biomechanical parameters able to accurately evaluate the severity of NSD. The present study aimed to determine whether the deformation rate (DR) is associated with visual analogue scale (VAS) and nasal airway resistance (NAR), and to evaluate the application of DR measurements in nasal septoplasty endoscopic surgery. In the present clinical trial, a total of 30 patients with NSD were enrolled, and DRs were calculated prior to surgery by three dimensional computer tomography (3D-CT) reconstruction techniques combined with mechanical analysis. The distribution of stress lines at the nasal septum deviation site was evaluated prior to operation. Following nasal septoplasty endoscopic surgery, pre and postoperation scores for VAS and NAR were compared. The results demonstrated that DR was significantly correlated with preoperational NAR (r=0.534) and VAS scores (r=0.397). According to preoperative CT measurements of NSD, DR and biomechanical properties, selective excision was performed to remove core areas of stress. It was observed that postoperative DR, NAR and VAS scores were significantly lower (all P<0.01) than those measured preoperation. Furthermore, over a follow-up period of 3 months, 23 cases (73.1%) were cured and 7 cases (23.3%) exhibited improvements. These results indicate that preoperative measurement of septum DR by 3D-CT reconstruction techniques may be important in determining the specific surgical approach of nasal septoplasty required.