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作者在分析成年人的鼻部畸形时,涉及儿童期的外伤因素,特对儿童外伤性鼻畸形的手术提出一些问题。首先是外伤史,Gray(1983)曾随访过出生时经过检查的5～7岁儿童,出生时即有鼻中隔偏曲而未经治疗的,仍然保持原状,或随鼻的发育而加重。手术的成年人中,有鼻及中隔部外伤史者,其发生时间可追溯至儿童期。再与20例无变态反应或先天性畸形者同时分析,可得出结论:在面中部受伤后数月内,鼻部变化不明显,变化迅速且明显时期是在青春发育旺盛期。所以,在青春期结束之前,对儿童期鼻外伤的预后是无法估计的。通过头颅侧位片的测量发现:上颌向下及向前的发育均差,且面部中及下三分之一的某些平面的角度有改变。这些变化是否为长期用口呼吸或外伤的影响,或二者共同的作用不能肯定。
When analyzing adult nasal deformities, the author is involved in childhood traumatic factors and raised some special questions about the surgery of traumatic nasal deformities in children. The first is the history of trauma. Gray (1983) has followed over 5 years old children at birth who have been examined at birth and have nasal septum deviation at birth without any treatment. They remain intact or develop as their nose grows. Among adults who have surgery, those with a history of nasal and septal trauma may have their origins dating back to childhood. And then with 20 cases of non-allergic or congenital malformations were analyzed at the same time, we can draw the conclusion: within a few months after injury in the midface, the nasal changes were not obvious, rapidly changing and obviously during the vigorous growth period. Therefore, the prognosis of childhood nasal trauma until the end of adolescence can not be estimated. The measurement of the lateral cephalograms revealed that the maxilla developed poorly both downward and forward, and the angles of some planes in the middle and lower third of the face changed. Whether these changes are long-term effects of mouth breathing or trauma, or both, is not certain.