Objectives: To compare the operation time, subjective and objective outcomes of septoplasty with three high-tension line resection and two high-tension line resection.
Methods: A prospective randomized controlled study was conducted to identify patients with septal deviation and symptomatic nasal obstruction. The patients were classified into a three high-tension line resection and senior physician group (Group A), a two high-tension line resection and senior physician group (Group B), a three high-tension line resection and junior physician group (Group C), a two high-tension line resection and junior physician group (Group D). In addition, according to whether there were the anterior deviation, some of patients were also divided into a three high-tension line resection and anterior deviation group (Group E) and a two high-tension line resection and anterior deviation group (Group F). The operation time was recorded. The patients completed the Nasal Obstruction Symptom Evaluation (NOSE) Scale (subjective symptom), nasal endoscopy (bodily sign) and rhinomanometry (objective examination) before and 6 months after septoplasty. The operation time and the efficacy were compared between three high-tension line resection operation and two high-tension line resection operation.
Results: There was no significant difference in the operation time between the Group A and the Group B (t=0.724, P=0.799), but the operation time in the Group D was significant shorter than that in the Group C (t=4.200, P=0.017). There were no significant difference in the NOSE scale between the Group A and the Group B, the Group C and the Group D, the Group E and the Group F (t=0.481, -0.147, 1.369, all P>0.05). There was no significant difference in the nasal endoscopy scale between the Group A and Group B, the Group C and Group D, the Group E and the Group F (t=0.806, -0.111, -0.536, all P>0.05). There was no significant difference in rhinomanometry between the Group A and the Group B, the Group C and the Group D, the Group E and the Group F (t=0.472, 1.180, -0.225, all P>0.05)．.
Conclusions: The effect of septoplasty with two high-tension line resection is as good as septoplasty with three high-tension line resection. The septoplasty with two high-tension line resection is more suitable to junior physician because it is easier and the operation time is shorter.
目的: 从手术时间、主观症状、客观体征及辅助检查4个方面比较二线减张和三线减张鼻中隔矫正术。方法: 采用前瞻性随机双盲对照研究，将以鼻塞为主诉的鼻中隔偏曲患者分为三线减张鼻中隔矫正术高年资医生组(A组)、二线减张鼻中隔矫正术高年资医生组(B组)、三线减张鼻中隔矫正术低年资医生组(C组)、二线减张鼻中隔矫正术低年资医生组(D组)；另外，根据前端是否偏曲又设有三线减张鼻中隔矫正术前端偏曲组(E组)和二线减张鼻中隔矫正术前端偏曲组(F组)。记录手术时间；以鼻阻塞症状评估(Nasal Obstruction Symptom Evaluation，NOSE)量表反映主观症状，以鼻内镜检查所见鼻中隔偏曲程度评分反映体征，以鼻阻力作为客观检查。计算术前及术后6个月NOSE评分、鼻内镜检查所见鼻中隔偏曲程度评分和鼻阻力的差值，比较三线减张鼻中隔矫正术和二线减张鼻中隔矫正术的手术时间和手术效果。结果: 在手术时间上，A组和B组差异无明显统计学意义(t=0.724，P>0.05)，但D组完成手术所需时间较C组明显缩短(t=4.200，P<0.05)。在术前、术后NOSE评分改善方面，A组与B组、C组与D组、E组与F组之间差异无明显统计学意义(t值分别为0.481、-0.147、1.369，均P>0.05)。在体征改善方面，A组与B组、C组与D组、E组与F组之间差异无明显统计学意义(t值分别为0.806、-0.111、-0.536，均P>0.05)。在鼻阻力改善方面，A组与B组、C组与D组、E组与F组之间差异无明显统计学意义(t值分别为0.472、1.180、-0.225，均P>0.05)。结论: 不论医生的年资与鼻中隔偏曲是否位于前端，二线减张鼻中隔矫正术可以达到三线减张鼻中隔矫正术相同的效果。二线减张鼻中隔矫正术更适合于低年资医生，因其更易上手，并能节约手术时间。.
Keywords: nasal septum; septoplasty; three high-tension line resection; two high-tension line resection.