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Therapie der Nasenklappenstenose

Treatment of nasal valve stenosis

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Zusammenfassung

Störungen der Nasenklappenfunktion gehören zu den häufigsten Ursachen einer Nasenatmungsbehinderung. Sie sind meist kongenital bedingt, treten nicht selten aber auch iatrogen nach funktionell-ästhetischer Rhinoplastik auf. Ihre Diagnosestellung erfolgt durch gezielte Anamnese, Inspektion, Endoskopie und Palpation. Führen Rhinologika, äußere und innere Stents therapeutisch nicht zum gewünschten Erfolg und kann die Störung lokalisiert werden, besteht die Indikation zur operativen Korrektur. Zu den vielfältigen chirurgischen Optionen zählen Eingriffe am Septum, an der Apertura piriformis, an den Flügel- und Seitenknorpeln sowie Korrekturen des äußeren Nasengerüsts.

Abstract

Nasal valve dysfunction is one of the most common causes of obstructed nasal ventilation. In most cases the cause is congenital, but iatrogenic occurrence after functional-aesthetic rhinoplasty is not infrequent. To diagnose nasal valve dysfunction, a thorough anamnesis, inspection, endoscopy, and palpation is required. If conservative therapy using rhinologic substances, as well as outer and inner stenting do not achieve the desired outcome, and the dysfunctional site can be localized, surgical procedures are indicated to improve nasal valve function. Numerous procedures and techniques are available, amongst which the most important ones shall be elucidated and discussed in the present article. These include septoplasty, septorhinoplasty, and enlargement of pyriform aperture stenosis, as well as corrections of the upper and lower lateral cartilages.

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Danksagung

Die Autoren danken der Fa. Karl Storz GmbH & Co. KG für die Mitarbeit bei der Erstellung der Computerzeichnungen.

Einhaltung ethischer Richtlinien

Interessenkonflikt. H. Heppt, T. Hildebrandt und J. Vent geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Hals-Nasen-Ohrenheilkunde,Kopf- und Halschirurgie, Plastische Gesichtschirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland

    W. Heppt

  2. ORL-Praxis an der Limmatklinik, Zürich, Schweiz

    T. Hildebrandt

  3. Medizinische Fakultät Mannheim, Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Ruprecht-Karls-Universität Heidelberg, Universitätsmedizin Mannheim, Mannheim, Deutschland

    J. Vent

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  1. W. Heppt
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  2. T. Hildebrandt
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Correspondence to W. Heppt.

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Heppt, W., Hildebrandt, T. & Vent, J. Therapie der Nasenklappenstenose. HNO 63, 227–244 (2015). https://doi.org/10.1007/s00106-014-2962-x

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