事件记录
Dr. 米勒: So you have a deviated septum. Does that need to be fixed and what symptoms does a deviated symptom cause? We're going to talk about that next on Scope Radio.
播音员: 向大发娱乐的专家大发娱乐提供有关您今天面临的最大健康问题的深入信息. 专家与博士. 汤姆米勒 is on 范围.
Dr. 米勒: 嗨，我和Dr. 耶利米Alt. He is an ear, nose and throat physician. 他也是犹他大学的教授也是外科的一员. Jeremiah, what's the story of the deviated septum? What is a deviated septum and, if you have one, do you always need to have it fixed?
Dr. Alt: We commonly have patients who come in with complaints of just simple nasal obstruction. Commonly, we have to go through the differential diagnosis of what that is.
Dr. 米勒: 你是说它们不能用一侧或两侧鼻孔呼吸，对吗?
Dr. Alt: 是的,正确的. 作为一名鼻科医生，我经常看到有鼻窦疾病、充血和过敏的病人. 通常也会出现所谓的鼻中隔偏曲鼻中隔本身将鼻子的左右两侧分开.
Dr. 米勒: 所以这是你的鼻骨?
Dr. Alt: 是的. It's made up of both cartilage bone. 鼻中隔偏曲可能发生在正常的发育过程中，因为随着大发娱乐的发育，一切都不是完全对称的. So it can be deviated to one side or the other. It can also occur from trauma.
Dr. 米勒: Getting boxed in the nose.
Dr. Alt: Getting boxed, vehicle accidents, getting bumped in the nose. 创伤之后, 这是一个急性事件, someone would come and say, "I can't breathe out of the right side of the nose,“在经历了颠簸或其他事情之后，他们的一生都在那里，他们刚刚注意到他们呼吸困难的情况越来越多, they can't sleep as well.
Dr. 米勒: I'm curious, is deviated septum mostly due to trauma or are people born with it?
Dr. 米勒: 我认为大多数人是天生的或者大发娱乐有一个已知的病因来解释为什么它会偏离.
Dr. 米勒: 好吧. 所以他们来找你，抱怨他们用一边鼻子呼吸困难，或者另一边，或者两边都有. At what point do you say, “嗯, 看, maybe we can repair this surgically if you need to have it repaired"?
Dr. Alt: A lot goes into talking about the deviated septum. 在很多情况下, it's found incidentally, 也就是说大发娱乐检查他们的鼻子发现他们的鼻中隔有偏曲但他们没有描述鼻塞.
Dr. 米勒: And under those circumstances, you probably wouldn't recommend surgery?
Dr. Alt: 正确的. 在这些情况下, 我甚至不喜欢提起它因为这样病人就会开始担心. 但如果它明显偏离大发娱乐观察它并评估病人它明显关闭了一侧气道, we can discuss different surgical options and how to correct that.
Dr. 米勒: 我有一个问题. How often do people come to you to 看ing for cosmetic reconstruction of that bone?
Dr. Alt: That bone itself is usually not cosmetic. 它的功能. It doesn't correlate into how the nose 看s.
Dr. 米勒: So that's a whole different type of surgery.
Dr. Alt: 正确的.
Dr. 米勒: Not to be confused with the symptoms that a deviated septum would cause.
Dr. Alt: 这就是大发娱乐通常所说的开放式鼻中隔成形术大发娱乐可以改变鼻子外部的外观或者[听不清00:03:12]改变鼻子内部的功能呼吸, which sometimes we do in combination if the nose is broken or twisted on the outside, we also have to fix the outside in addition to the inside.
Dr. 米勒: 那么你多久会发现需要手术矫正鼻中隔偏曲的病人?
Dr. Alt: It's actually quite common. It's one of the most common procedures we perform. 这不仅会让患者无法呼吸，而且会严重影响患者的生活质量, 通过改善大发娱乐用鼻子呼吸的方式，这已经一次又一次地证明了大发娱乐在日常活动中的感受. 这很可能在一定程度上影响了大发娱乐的睡眠方式以及大发娱乐睡个好觉的方式. If we can't breathe through the nose, 它迫使大发娱乐用嘴呼吸，大发娱乐可能会有更多的阻塞性事件，它也可能导致大发娱乐所说的阻塞性睡眠呼吸暂停.
Dr. 米勒: So how do you do the surgery?
Dr. Alt: 所以手术有几个选择其中一个大发娱乐做得越来越多，效果很好的是内窥镜检查 鼻中隔成形术. 所以它使用有角度的，直的，刚性的内窥镜和特殊的高清摄像头. 大发娱乐可以在鼻中隔上做非常特殊和精细的切口来切除那些弯曲的部分所以鼻子上没有外部切口. 这都是在鼻子内部完成的大发娱乐觉得病人有很好的功能反应, 同时, 愈合更快.
Dr. 米勒: 现在, do you tell your patients that they are going under general anesthesia? Do you put them to sleep when you do these or is it a local sort of anesthetic you use?
Dr. Alt: 是的. 我不推荐本地的，病人在手术结束后可能不太喜欢我. 所以大发娱乐建议病人应该在全身麻醉的情况下完全睡着, 它们不动了. We have the ability to take our time and do the job correctly.
Dr. 米勒: What's the recovery like?
Dr. Alt: Really, the recovery's not too bad. 大发娱乐通常会告诉病人，他们可能需要服用两到三天的止痛药. Commonly, these type of procedures used to be packed with nasal packing. We no longer pack the nose. We moved into placing splints on the inside of the nose like flexible plastics splints, but even now we're even moving away from that. 那么多次, 大发娱乐可以做内窥镜鼻中隔成形术而不用在鼻子里放任何填充物这能大发娱乐病人感觉更好，恢复得更快, 因为它们没有被鼻子里的东西堵住，大发娱乐不需要在一周内取出. 通常，一周后，在那个时候，病人感觉很好，通常会恢复轻微的活动. At two weeks, you're completely healed.
Dr. 米勒: 现在, for a patient who is going to primary care physician, 初级保健医生通常能够判断他们是否有鼻中隔偏曲，或者他们通常会让他们做出诊断?
Dr. Alt: I think in general, you can determine what we call a caudal septal deviation. 它更靠近鼻子的前部因为你可以通过使用鼻镜观察鼻子前部的简单方法来观察它你可以判断它是否偏离. 有趣的是, 那些鼻中隔偏得更厉害或者更靠近鼻子前部的鼻中隔通常需要更严重的手术, which we'll discuss with the patient, but that usually actually leads to what we call an open septorhinoplasty.
很多次, 后鼻中隔偏曲更容易通过内窥镜修复但实际上更难诊断因为你需要看到鼻子更深处. So seeing someone like an ENT or rhinology person like myself, 大发娱乐可以用内窥镜观察鼻中隔更后方的位置来诊断.
Dr. 米勒: 所以总结一下, 你可能会告诉病人哪三件事会把他们引到你家门口，然后你就会诊断出他是鼻中隔偏曲?
Dr. Alt: I think the first thing is if they're having trouble breathing through their nose. Typically, it's unilateral, but it can be both sides, bilateral. 接下来的一件事是，这是否会导致他们在白天的感觉和功能发生重大变化, if the obstruction's bad enough where they feel like they need some improvement. 和第三, which we didn't mention, but I think should be mentioned here conclusion, 是很多次吗？, medical management can improve nasal obstruction even with septal deviation. 所以在开始讨论之前通常需要进行审前医疗管理 . . .
播音员: Have a question about a medical procedure? Want to learn more about a health condition? 大于2,000 interviews with our physicians and specialists, there’s a pretty good chance you’ll find what you want to know. Check it out at TheScopeRadio.com.
updated: January 23, 2019
originally published: November 11, 2015