Submucosal Correction of Nasal Septum

Nasal bleeding is one of the common emergency cases in otolaryngology, and nasal bleeding caused by nasal septum deviation has a considerable proportion in clinical practice. Submucosal medial correction can correct such conditions. Treatment of diseases: nasal septum deviation traumatic epistaxis Indication Nasal septum submucosal correction for the treatment of epistaxis is not only suitable for young and middle-aged people, but also safe and effective for the elderly. Preoperative preparation After admission, the bleeding was immediately filled with nasal cavity or the stuffing was refilled, and all were filled with skill. If it is a spinous process, it should be filled from the top and bottom and curved in the arc to fill the Vaseline oil gauze. The spine is used to press the hemorrhage up and down. If it is , it can be changed from top to , from Double-layer stuffing from bottom to bottom. If the anterior nostril filling effect is not good, the nostril can be replaced after the diversion. Those who have been nasally occluded, take Vaseline gauze for 48-72 hours, routinely apply antibiotics and hemostatic agents. Severe anemia patients receive blood transfusions. For those with hypertension and diabetes, the corresponding medical treatment is given. Nasal septum correction was performed after the patient's condition was stable and the Vaseline oil gauze was withdrawn. Surgical procedure Surgery was performed under local anesthesia or intensive local anesthesia. ECG monitoring is routinely performed in elderly patients and patients with hypertension and/or heart disease. The patient took a semi-recumbent position, routine disinfection, toe cap, and drape. Mucosal surface anesthesia was performed on a bilateral nasal cavity with a cotton pad containing 1% caffeine and 1% ephedrine. Local anesthesia was performed under the septal mucosa with 1% lidocaine containing 1 adrenaline. An "L"-shaped incision is made about 0.5cm behind the left anterior skin and mucosal junction of the nasal septum, from the top of the nasal cavity to the bottom of the nasal cavity, and the left mucosa and cartilage are cut through the septum to the contralateral mucosa Next, the bilateral mucosa and mucosa are separated, and the range is slightly more than the deviation of the epiphysis (or spine). The degenerated cartilage is removed and the callus (or spine) is removed. After hemostasis, the bilateral medial septum was placed in the median position, the mucosal incision was sutured, and the bilateral nasal cavity was filled with Vaseline oil gauze. Postoperative administration of antibiotics and hemostatic agents was performed. Nasal tamponade was removed 48 to 72 hours after surgery, and the line was removed 5 to 7 days later. The septum on the convex side of the septum (spine) is thin and even smashed, and it is easy to break when separated. Therefore, it is better to separate the concave side first and keep the integrity of the side mucosa as much as possible to prevent the penetration and cause the perforation of the septum. For patients with high degree of deviation or greater osteophyte, it is advisable to break the fracture after the one side of the mucosa is completely separated, reduce the tension and then separate it, which can reduce the chance of mucosal damage. The main reason is that the posterior segmental deviation of the septum can be corrected under nasal endoscopy. The mucosa is cut only in the vicinity of the sacral spine, and the osteophytes (or spines) are removed after separation. The resected tissue is small, the damage is small, and the recovery is small. Fast, the incidence of septal perforation is low. Combined with inferior turbinate hypertrophy and nasal polyps, partial inferior turbinate resection and/or nasal polypectomy were performed at the same time to facilitate tamponade.