鼻中膈彎曲術無效？合併治鼻過敏才正確

一名年約四十歲的婦女，由於鼻中膈嚴重彎曲，造成鼻腔內氣流不順暢，長期下來出現併發症，被鼻竇炎及慢性下鼻甲肥大症所擾，鼻塞鼻炎流鼻血、鼻涕倒流、記憶力不集中等症狀愈來愈嚴重。患者曾在半年前接受鼻中膈手術治療，可惜術後病情未見改善，經耳鼻喉科醫師診斷發現，雖已矯正鼻中膈彎曲並痊癒，但病人仍有嚴重的過敏性鼻炎及鼻竇炎，導致各項鼻病症狀依舊存在。

基本上，絕大部份的人都有鼻中膈彎曲的現象，只是彎曲角度多寡的問題，如果鼻中膈微微彎曲但無症狀者，其實不需要開刀治療。唯有當鼻中膈彎曲很嚴重，並且造成併發症，例如鼻瘜肉、鼻竇炎、鼻過敏或下鼻甲肥大，出現鼻腔腫脹、嚴重鼻塞、呼吸困難不順、頭脹頭疼等現象，就必需選擇藥物或手術來治療。台北市中山醫院耳鼻喉科主任醫師暨宏仁診所院長李宏信表示，多數病患同時也罹患了鼻過敏，若不治療過敏現象，只是矯正鼻中膈，鼻病的根源問題未解決，病症當然會再出現。

至於某些病人是因為外傷撞擊而導致鼻中膈彎曲，是否需要接受手術矯正呢？李宏信說明，要不要開刀，應該取決於鼻中膈彎曲的嚴重程度。假使鼻中膈彎曲所突起的部位，經常會造成鼻黏膜組織隆起發炎，甚至猛流鼻血，需要採行手術切除鼻中膈彎曲的軟骨及骨骼。如果鼻中膈彎曲不嚴重，病人只是在感冒才會引起鼻塞鼻炎的話，選擇服用抗組織胺藥物、類固醇鼻噴劑、去充血消腫劑等，就能改善發病時的症狀。不過針對鼻黏膜嚴重肥大及鼻過敏患者而言，藥物治療的效果有限。

根據臨床經驗，鼻中膈彎曲病情嚴重的患者，經常也伴隨著鼻過敏，由於鼻過敏不易診治，經常久治不癒，不斷刺激鼻腔內的微血管擴張，久而久之讓症狀更加惡化。鼻過敏是相當難纏的病症，如果長期服藥或使用鼻噴劑無效者，建議接受手術治療，目前有冷凍療法、電刀熱灼術、雷射、紅外線及微創手術等方式，其中鼻過敏神經截除術，是以電波射頻低溫熱透的方法來處理，特製的雷管探頭由鼻孔進入鼻腔最後端的翼管口，此項治療不是開刀，而是以射頻電波深部熱灼的方式來截除神經，在門診就可進行，約十分鐘，傷口小，不必開刀也免住院。

罹患鼻中膈彎曲的病人，若有鼻子不舒服的感覺，或出現鼻塞、鼻涕倒流等症狀，應該盡速找鼻科醫師診斷，家醫科李政道醫師提醒，許多人誤以為鼻中膈彎曲就必需要開刀治療，由於害怕開刀而延誤了治療的黃金期，引起更嚴重的鼻子併發症。事實上，治療鼻中膈彎曲，並非每位病人都需要開刀，若病人同時罹患其他鼻病，唯有對症下藥才能改善病症。【

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