Zusammenfassung
Im folgenden Referat wird die Nasenseptum- und Nasenmuschelchirurgie dargestellt. Nach einem Überblick über die anatomischen und physiologischen Grundlagen werden Indikationen zur Septumplastik herausgestellt, sowie das heutige operative Standardverfahren nach Cottle mit seinen Variationen skizziert. Im weiteren Verlauf wird auf spezielle Operationstechniken eingegangen, mit denen besondere Probleme im Bereich der Septumchirurgie gelöst oder erwünschte Effekte an der äußeren Nase erzielt werden können. Eine Darstellung der möglichen Komplikationen sowie die Langzeitergebnisse folgen. Hier sei aber darauf hingewiesen, dass die derzeitige Studienlage von rhinochirurgischen Eingriffen gerade im Hinblick auf höhere Evidenz-Level noch immer recht unbefriedigend ist. In einem weiteren Kapitel werden Techniken zum Septumperforationsverschluss vorgestellt und ihre Indikation im Vergleich zu der mittlerweile als Standardverfahren geltenden Brückenlappentechnik diskutiert. Der zweite Teil widmet sich der Nasenmuschelchirurgie. Nach einer erneuten Darstellung der anatomischen und physiologischen Grundlagen werden Indikationen zur Nasenmuschelchirurgie insbesondere vor dem Hintergrund verschiedener Operationstechniken diskutiert. Es folgt die Beschreibung der einzelnen Techniken sowie deren Nachsorge, Komplikationen und Langzeitergebnisse.
Schlüsselwörter
Nasenatmungsbehinderung - Septumchirurgie - Septumperforationsverschluss - Nasenmuschelchirurgie
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Prof. Dr. med. Christoph Matthias
Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde Klinikum Großhadern
Marchioninistraße 15 81377 München
Email: Christoph.Matthias@med.uni-muenchen.de