Քթի միջնապատի ուղղումը մանկական տարիքում

Abstract

Pediatric septoplasty has been one of the most controversial topics discussed among ENT and plastic surgeons. The aim of the study is to evaluate the outcome of septoplasty several years after performing it during the pediatric age, and if it contributes subsequently to the recurrent deformation of the nasal septum or the external nasal structure. The study also touches on the notion of whether adenoidectomy and/or inferior turbinate reduction without correcting the deviated nasal septum are enough to restore nasal breathing. The study included 56 children aged 5-15 years. 33 were male and 23 were female. All the participating patients were diagnosed with deviated nasal septum, but were divided into 2 groups according to the surgical techniques performed. The first group included 24 patients and their difficult nasal breathing was conditioned by deviated nasal septum, adenoid tissue hypertrophy with 5 of the children also having inferior turbinate hypertrophy. However, they all underwent adenoidectomy and inferior turbinate radiofrequency reduction only. The second group included 32 patients with difficult nasal breathing caused by deviated nasal septum, adenoid tissue hypertrophy with 11 children also having inferior turbinate hypertrophy. All the patients in this group underwent septoplasty, adenoidectomy and where indicated, inferior turbinate radiofrequency reduction. All the 24 patients included in the first group exhibited improvement in nasal breathing index from 231,6 ± 9,26 cm3 up to 427,0±5,6 cm3 (P<0,05). As for the snoring loudness scale, there was improvement from 2,6±0,1 to 1,3±0,1 (P<0,05), but without complete disappearance. Patients included in the second group which totalled 32 in number saw improvement in nasal breathing index from 228,5±7,29 cm3 to 592,9±5,29 cm3 P<0,05) while snoring loudness scale improved from 2,47±0,09 to 0,09±0,05 (P<0,05). Our study results have shown us that for pediatric patients diagnosed with deviated nasal septum, it is advisable to perform septoplasty while preserving the corresponding anatomical growth zones, as it provides the patient adequate nasal breathing and prevents potential deformation of facial bone structure in the future.Thus, we can conclude that any cause of difficult nasal breathing in the pediatric age must be alleviated, be it conservatively or surgically, to avoid future complications.