RESUMEN
This article presents the case of a 33-year-old woman who consulted the authors' ENT clinic in the 39th week of pregnancy with recurrent epistaxis. A livid endonasal mass was found on the left side, subtotally displacing the nose and leading to deformation of the external nose. External biopsy provided no indications of malignancy. Postpartum CT of the paranasal sinuses revealed a mass destroying the cartilaginous nasal septum. Endoscopic resection of the finding was performed with preservation of the clinically sound nasal septal cartilage. Histopathological examination revealed a capillary hemangioma, which was classified as granuloma gravidarum due to its occurrence during pregnancy.
Asunto(s)
Epistaxis , Hemangioma Capilar , Cartílagos Nasales , Deformidades Adquiridas Nasales , Complicaciones Hematológicas del Embarazo , Complicaciones Neoplásicas del Embarazo , Humanos , Femenino , Embarazo , Adulto , Epistaxis/diagnóstico por imagen , Epistaxis/patología , Recurrencia , Complicaciones Hematológicas del Embarazo/diagnóstico por imagen , Complicaciones Hematológicas del Embarazo/patología , Biopsia , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/patología , Cartílagos Nasales/diagnóstico por imagen , Cartílagos Nasales/patología , Hemangioma Capilar/diagnóstico por imagen , Hemangioma Capilar/patología , Complicaciones Neoplásicas del Embarazo/diagnóstico por imagen , Complicaciones Neoplásicas del Embarazo/patologíaRESUMEN
The location of nasal septal deviation (NSD) directly impacts nasal physiology. The objective is to examine, using computational fluid dynamics (CFD), the difference in the airflow and air conditioning characteristics according to the location of NSD. Twenty patients with septal deviation were divided into two: 10 caudal septal deviation (CSD) and 10 posterior septal deviation (PSD). Physiological variables were compared and numerical models for nasal cavity were created with CT scans. Cases with CSD had distinctive features including restricted airflow partition, larger nasal resistance, and decreased surface heat flux in the more obstructed side (MOS), and lower humidity and air temperature in the lesser obstructed side (LOS). Physiological differences were observed according to the location of septal deviation, CSD cases exhibit significantly more asymmetric airflow characteristics and air conditioning capacity between LOS and MOS.
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Obstrucción Nasal , Deformidades Adquiridas Nasales , Humanos , Aire Acondicionado , Tabique Nasal/diagnóstico por imagen , Cavidad Nasal/fisiología , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/etiología , Hidrodinámica , Simulación por Computador , Obstrucción Nasal/diagnóstico por imagen , Obstrucción Nasal/etiologíaRESUMEN
BACKGROUND: Anatomical deformities can greatly alter nasal function, which can be largely corrected during septoplasty and septorhinoplasty operations. In this study, we aimed to objectively measure the results of septoplasty surgeries of deviated noses with radiological analysis and compare the results with clinical evaluations. PATIENTS AND METHODS: Forty patients who were undergoing septorhinoplasty were included in the study. Patients were evaluated with preoperative and postoperative paranasal computed tomography scan measurements and satisfaction surveys. RESULTS: Preoperative and postoperative mean ± SD septal deviation angle measurements were 11.9 ± 5.3 degrees and 6.5 ± 3.1 degrees, respectively. Preoperative and postoperative mean ± SD septal deviation distance measurements were 7.3 ± 4 and 3 ± 1.3 mm, respectively. Preoperative and postoperative mean ± SD oblique conchal measurement on the deviated side was 17.3 ± 3.2 and 13.4 ± 2.8, respectively. Preoperative and postoperative mean ± SD patient satisfaction survey scores were 17 ± 1.9 and 4.5 ± 1.9 points, respectively. DISCUSSION: To obtain a nose with a greatly improved functional gains, especially in heavy deviated noses, is an important goal in septorhinoplasty surgery. It is essential to apply the technique that will benefit the patient. The most important success criterion seems to be the regression of the clinical complaints of the patients, which can be proven objectively with computed tomography scan measurements.
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Obstrucción Nasal , Deformidades Adquiridas Nasales , Rinoplastia , Humanos , Satisfacción del Paciente , Resultado del Tratamiento , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/cirugía , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/cirugía , Tabique Nasal/anomalías , Rinoplastia/métodos , Obstrucción Nasal/cirugíaRESUMEN
Background: Despite successful septoplasty surgery, some patients still complain of nasal obstruction (NO). Aim: Our aim in the present study is to determine whether preoperative computed tomographic (CT) parameters have prognostic significance for the success of septoplasty. Material and Methods: Retrospective data from 61 patients in a secondary care hospital who had undergone septoplasty met the inclusion and exclusion criteria. The effects of demographic and preoperative CT parameters (internal nasal valve [INV], external nasal valve area, angle of septal deviation, choana area, aperture pyriformis area, high septal deviation [HSD], transverse diameter of midnose, anterior/posterior deviation, concha and meatus diameter [superior, middle, inferior]) were studied in relation to the change in NOSE scores and the success of surgery. Results: Of the 61 patients studied, 31 were male (51%) aged 18-55 years with a mean age ± SD (26.59 ± 9.41). It was found that the changes in NOSE scores were significantly different from each other (P < 0.01). Male gender, trauma history, moderate septal deviation, HSD, mucosal pathology, posterior deviation, bullous turbinate (right and left middle, right superior), and in the absence of allergy, paradoxical turbinate (right and left middle and superior), S-shaped deviation were found to have a significant correlation in the change of NOSE scores (P < 0.05). Age and internal valve differed with respect to outcome (P < 0.05). Variables in multiple linear regresion models of all parameters were found to be insignificant (P < 0.05). Conclusion: Preoperative CT parameters are informative, but do not predict the postoperative success of septoplasty.
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Deformidades Adquiridas Nasales , Rinoplastia , Femenino , Humanos , Masculino , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/cirugía , Estudios Retrospectivos , Rinoplastia/métodos , Tomografía Computarizada por Rayos X/métodos , Resultado del TratamientoRESUMEN
INTRODUCTION: The impact of the nasal septum morphology on the severity of obstruction symptoms has not been fully explored. OBJECTIVE: This study aimed to investigate whether the morphology of the deviated nasal septum assessed by computed tomography may explain nasal obstruction severity. METHODS: The study included 386 patients who were referred to the computed tomography examination of the paranasal sinuses. Patient selection criteria were the absence of facial anomalies, facial trauma, nasal surgery, and sinonasal tumors. Computed tomography images were used to estimate deviated nasal septum prevalence, the prevalence of Mladina's seven types of deviated nasal septum, and to measure the deviated nasal septum angle. Nasal obstruction severity was assessed by the nasal obstruction symptom evaluation, NOSE scale. The relationship between NOSE score, deviated nasal septum morphology, and deviated nasal septum angle was performed by a statistical regression model on the reduced sample of 225 patients. RESULTS: The prevalence of deviated nasal septum was 92.7%. Type 7 deviated nasal septum was the most frequent (34.2%) followed by type 5 (26.2%) and type 3 (23.6%). The worst NOSE scores were recorded in the type 2 deviated nasal septum (45.00⯱â¯28.28). The mean deviated nasal septum angle in patients with nasal obstruction was 8.5°â¯±â¯3.24. NOSE scores were not significantly associated with deviated nasal septum types and angles. CONCLUSION: Patients with different types of deviated nasal septum have different NOSE scores. Computed tomography morphology of the deviated nasal septum could not fully explain the severity of nasal obstruction.
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Obstrucción Nasal , Procedimientos Quírurgicos Nasales , Deformidades Adquiridas Nasales , Humanos , Obstrucción Nasal/complicaciones , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/complicaciones , Deformidades Adquiridas Nasales/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
Third-party payers request objective confirmation of the nasal septum deviation (NSD) severity by computed tomography (CT) before authorizing financial support for septoplasty. Previous studies have provided contradictory results related to the link between obstruction severity and CT-measured angle of the NSD. The aim of this study was to investigate whether the diverse CT morphology of NSDs (including previously neglected types and shapes) could predict obstruction severity. The study included 225 patients with NSD. The CT morphology of the septum was analyzed using 5 different classifications of NSD that are commonly used in the clinical practice and research. The angle of NSD was also measured. Nasal obstruction was assessed by the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. A relationship between CT morphology and the angle of the NSD and NOSE scores was analyzed using appropriate regression models. Patients with NSDs located in the anterior part of the septum always have some degree of nasal obstruction, while those with posterior NSDs did not necessarily report obstruction symptoms no matter how complicated NSD they have. Regression analysis did not reveal any causal relationship between NOSE scores and CT morphology and the angle of NSD. The presence of spurs and whether they divide nasal passages have no statistically significant predictive effect on the obstruction severity. The CT morphology and the angle of the NSD could not predict severity of the nasal obstruction. Requesting CT examination just to objectively confirm nasal obstruction is not justified.
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Obstrucción Nasal/diagnóstico por imagen , Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Evaluación de Síntomas/clasificación , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Adulto , Femenino , Humanos , Modelos Lineales , Masculino , Cavidad Nasal/diagnóstico por imagen , Obstrucción Nasal/clasificación , Obstrucción Nasal/etiología , Deformidades Adquiridas Nasales/clasificación , Deformidades Adquiridas Nasales/complicaciones , Valor Predictivo de las Pruebas , Rinoplastia , Índice de Severidad de la Enfermedad , Encuestas y Cuestionarios , Evaluación de Síntomas/métodosRESUMEN
BACKGROUND: Olfactory neuroblastoma (ONB) is a sinonasal malignancy seldom seen in clinical practice. It is also known by various other names like esthesioneuroblastoma, esthesioneuroepithelioma, esthesioneurocytoma, and esthesioneuroma. Surgery and radiation therapy are considered as standard treatment modalities for ONB; however, the role of chemotherapy is not well established. AIMS: We aim to define the role of chemotherapy in the neoadjuvant setting in a case of ONB. METHODS AND RESULTS: We report a young female patient presenting with a naso-facial swelling causing facial disfigurement, proptosis, decreased visual acuity, and poor performance status. She was diagnosed with advanced-stage ONB. Prompt administration of chemotherapy led to the improvement in the symptoms and rapid regression of the tumor mass. Later on, the tumor mass was excised completely without any neurological deficit. CONCLUSION: This report justifies the role of neoadjuvant chemotherapy in the management of ONB.
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Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Depresión/terapia , Estesioneuroblastoma Olfatorio/terapia , Deformidades Adquiridas Nasales/terapia , Neoplasias Nasales/terapia , Adulto , Belleza , Cisplatino/administración & dosificación , Depresión/etiología , Depresión/psicología , Diagnóstico Diferencial , Estesioneuroblastoma Olfatorio/complicaciones , Estesioneuroblastoma Olfatorio/diagnóstico , Etopósido/administración & dosificación , Cara , Femenino , Humanos , Imagen por Resonancia Magnética , Cavidad Nasal/patología , Cavidad Nasal/cirugía , Procedimientos Quírurgicos Nasales , Terapia Neoadyuvante/métodos , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/psicología , Neoplasias Nasales/complicaciones , Neoplasias Nasales/diagnóstico , Resultado del TratamientoRESUMEN
BACKGROUND: The esthetic characteristics of face and nose are commonly evaluated before rhinoplasty using a completely subjective method, due to the lack of validated and reliable methods for quantifying facial esthetics and for accurate nose treatment planning. The aim of the study was to review the literature to determine and evaluate the points, distances, and angles commonly used in the treatment planning for rhinoplasty. METHODS: Research based on anthropometric studies of the face and nose, published from 1987 to 2018 was included. Finally, 138 papers were selected after a statistical analysis through a simple random and non-random sample selection, and all papers were evaluated in their entirety. RESULTS: According to the frequency of citation, 198 points, 336 distances, and 199 angles were listed. The first quartile of each distribution was eliminated, and frequency of more than 25% was selected. A group of 49 points, 77 distances, and 11 angles, were classified according to their anatomical region, that is, bone and soft tissues, was obtained. CONCLUSIONS: An enormous inhomogeneity and lack of standardized anthropometric measurement system, specifically of the nose, was evident, as the studies were conducted by authors of different origins. According to universally accepted parameters, the importance of a reliable method for nose surgery planning is highlighted.
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Nariz/diagnóstico por imagen , Antropometría , Humanos , Nariz/cirugía , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/cirugía , RinoplastiaRESUMEN
OBJECTIVES: To demonstrate the correction of overhanging alar with the vestibular triangular excision technique using preoperative and postoperative photographs. Methods: This descriptive retrospective study was conducted at King Abdulaziz University Hospital, Riyadh, Saudi Arabia. Fifty patients who underwent open rhinoplasty with the vestibular triangular excision technique were retrospectively assessed. Preoperative and postoperative photographs were examined to evaluate the alar-columellar relationship. Patients included had undergone either primary or revision rhinoplasties between January 2013 and March 2018 and had a thick hanging alar with a grade IV Gunter's rating for alar-columellar discrepancies. Patient outcomes and satisfaction were subjectively assessed using the rhinoplasty outcome evaluation (ROE) scale and visual analog scale (VAS) by independent analysis of the right lateral, left lateral, and frontal view photographs by 2 rhinoplasty surgeons, both preoperatively and 1-year postoperatively. Statistical significance was calculated by Wilcoxon signed-rank tests. Results: Patients' ages ranged from 18 to 37 years (mean, 26.34). The study included 22 men (44%) and 28 women (56%). Mean preoperative and postoperative ROE scores were 10.12 and 19.3 and VAS scores 5.14 and 7.94. P-values for preoperative and postoperative comparison of both ROE and VAS were statistically significant (p=0.001). Conclusion: Caring of alar soft tissue during rhinoplasty is important to correct overhanging alar to improve nasal appearance and patient satisfaction. The sail excision technique is reliable and simple and provides good patient satisfaction.
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Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Satisfacción del Paciente , Rinoplastia/métodos , Adolescente , Adulto , Estética , Femenino , Humanos , Masculino , Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Evaluación del Resultado de la Atención al Paciente , Fotograbar , Estudios Retrospectivos , Arabia Saudita , Escala Visual Analógica , Adulto JovenRESUMEN
BACKGROUND: Despite extensive literature on the classification and management of nasal septal deviation (NSD) for preoperative planning, standardized objective measures to evaluate the NSD severity remains challenging. In this study, we quantitatively analyzed NSD to determine the most predictive two-dimensional (2D) computed tomography (CT)-landmark for overall three-dimensional (3D) septal morphology derived from nasal airway segmentation. METHODS: A retrospective study was conducted at a large academic center. One hundred four patients who underwent CT scans of the face were selected from a computer imaging database. Demographic variables were screened to ensure an equal number of men and women in different age groups. Digital Imaging and Communications in Medicine files were imported for 3D nasal cavity segmentation using 3D Slicer software. A volumetric analysis was performed to determine 3D NSD ratios. These values were compared to previously reported methods of obtaining objective 2D NSD measures using OsiriX and MATLAB software. Maximum deviation values were calculated using OsiriX, while the root mean square values were retrieved using MATLAB. Deviation area and curve to line ratios were both quantified using OsiriX and MATLAB. RESULTS: The data set consisted of 52 men and 52 women patients aged 20 to 100 years (mean = 58 years, standard deviation = 23 years). There was a strong correlation between 3D NSD ratio and maximum deviation (r = 0.789, Pâ<â0.001) and deviation area (r = 0.775, Pâ<â0.001). Deviation area (r = 0.563, Pâ<â0.001), root mean square (r = 0.594, Pâ<â0.001), and curve to line ratio (r = 0.470, Pâ<â0.001) had a positive correlation of moderate strength. The curve to line ratio was not significant (r = 0.019, P = 0.85). CONCLUSIONS: The 2D CT-based NSD landmarks maximum deviation and deviation area were the most predictive of the severity of NSD from 3D nasal cavity segmentation. We present a robust open-source method that may be useful in predicting the severity of NSD in CT images.
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Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cavidad Nasal/diagnóstico por imagen , Cavidad Nasal/cirugía , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Estudios Retrospectivos , Programas Informáticos , Tomografía Computarizada por Rayos X/métodos , Adulto JovenRESUMEN
The purposes of this study were to compare the postoperative changes in nasal septal (NS) deviation between total impaction (TI) and anterior elongation (AE) of the maxilla after Le Fort I osteotomy (LF-IO) and to investigate the correlation between the change in NS deviation and the amount of surgical maxillary movement. Twenty-eight patients, who underwent LF-IO and sagittal split osteotomy by a single surgeon, were divided into TI group (Nâ=â13; meanâ=â1.5âmm) and AE group (Nâ=â15; mean = 1.6âmm). NS deviation was measured using computed tomography and deviation indices before and after surgery at 3 coronal measurement planes (CMP) passing through the nasion, crista galli, and the most anterior point of the sphenoid sinus (MAPS). Then, statistical analysis was performed. The AE group did not have significant changes in any deviation indices after surgery. The TI group; however, exhibited significant increases in the MAPS-CMP and total deviation indices (0.67-1.16âmm, Pâ<â0.01; 5.45-6.43âmm, Pâ<â0.05). The TI group also exhibited a greater increase in the ΔMAPS-CMP deviation index than the AE group (0.49âmm versus 0.06âmm, Pâ<â0.05). The amount of forward movement of the maxilla was positively correlated with the nasion-CMP and total deviation indices (râ=â0.422, Pâ<â0.05; râ=â0.398, Pâ<â0.05). LF-IO for TI and forward movement can worsen NS deviation posteriorly and anteriorly, respectively. It is necessary to manage the nasal septum and the nasal crest of the maxilla meticulously during LF-IO procedure.
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Maxilar/cirugía , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/diagnóstico por imagen , Osteotomía Le Fort/efectos adversos , Craneotomía , Humanos , Deformidades Adquiridas Nasales/etiología , Periodo Posoperatorio , Tomografía Computarizada por Rayos X , Adulto JovenAsunto(s)
Granulomatosis con Poliangitis/complicaciones , Deformidades Adquiridas Nasales/etiología , Adulto , Anticuerpos Anticitoplasma de Neutrófilos/análisis , Granulomatosis con Poliangitis/diagnóstico , Granulomatosis con Poliangitis/diagnóstico por imagen , Humanos , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Nódulos Pulmonares Múltiples/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Tomografía Computarizada por Rayos XRESUMEN
PURPOSE: This study sought to determine the effectiveness of subspinal Le Fort I osteotomy (SLFIO) in preventing nasal deformation, by analyzing changes in the nasal profile on three-dimensional computed tomography (3D-CT) images. PATIENTS AND METHODS: The participants were 39 Japanese patients with mandibular prognathism (6 men and 33 women) who underwent bilateral sagittal split ramus osteotomy and Le Fort I osteotomy with maxillary advancement: SLFIO was performed in 20 patients and conventional Le Fort I osteotomy (CLFIO) in 19 patients. All patients underwent modified alar base cinch suture, V-Y closure, and reduction of the piriform aperture. CT data acquired before and 1 year after the surgery were evaluated three-dimensionally with software to determine changes in the nasal profile. RESULTS: Changes in alar width, alar base width, nasal length, and nasofrontal angle were significantly smaller following SLFIO than following CLFIO, although there were no significant differences in nasal projection, nasal tip angle, or nasolabial angle between two procedures. CONCLUSION: SLFIO for anterior repositioning of the maxilla can prevent undesirable transverse soft tissue changes of the nose.
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Deformidades Adquiridas Nasales/prevención & control , Osteotomía Le Fort/métodos , Complicaciones Posoperatorias/epidemiología , Adolescente , Adulto , Femenino , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Deformidades Adquiridas Nasales/diagnóstico por imagen , Complicaciones Posoperatorias/diagnóstico por imagen , Estudios Retrospectivos , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Adulto JovenRESUMEN
OBJECTIVE: To investigate the impact of the presence and the severity of the nasal septal deviation (NSD) on the paranasal pneumatization. METHODS: Initially, the deviated and contralateral sides was compared to evaluate the impact of the presence of NSD on pneumatization. Then, NSD classification groups were categorized according to the severity of deviation degree; 1: mild (<9°), 2: moderate (9°-15°), and 3: severe (>15°). Pneumatization of all paranasal sinuses, osteomeatal complex (OMC), frontoethmoid recess (FER) and variant structures were compared according to the NSD classification groups separately both for the deviated and the contralateral sides. RESULTS: Although there was no statistically significant difference in pneumatization of the paranasal sinuses between the deviated and contralateral sides, a significant difference was observed in OMC and FER diameters. In the deviated side, there was statistically significant difference in ethmoid sinus volume, in FER and OMC diameters between NSD classification groups. In the contralateral side, FER and OMC diameters were found to be significantly different between group 1 and group 2 and between group 1 and group 3, respectively (Pâ=â0.04 and 0.06, respectively). Both the presence and severity of the NSD did not statistically significant influence the pneumatization of variant structures, air cells and vital structures. CONCLUSION: The severity of NSD effects the ethmoid sinus volume. The relationship of FER and OMC with NSD is evident, however this may not always be in a proportional pattern. The paranasal pneumatization did not affect Keros type, bone integrity of carotid canal and optic canal.
Asunto(s)
Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Adolescente , Adulto , Senos Etmoidales/diagnóstico por imagen , Senos Etmoidales/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Senos Paranasales/diagnóstico por imagen , Senos Paranasales/cirugía , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
OBJECTIVES: This study aimed to investigate the relationship between nasal septal deviation and paranasal abnormalities in the etiology of primary acquired nasolacrimal duct obstruction (PANDO). METHODS: A total of 37 (8 men, 29 women) patients (48 eyes with PANDO) between the ages 20 and 77 years (mean age, 52.8â±â13.1 years) were included in the study. In the axial sections of paranasal sinus computed tomography, the transverse diameters at the most upper part and the most distal part of the nasolacrimal canal were separately measured. In addition, the relationships between PANDO and nasal septal deviation, inferior turbinate hypertrophy, agger nasi cells, paradoxical middle turbinate, concha bullosa, and the angle between the bony inferior turbinate and medial wall of the maxillary sinus were investigated. RESULTS: A statistically significant relationship was found between PANDO and the axial location of septal deviation classification, axial angle of septal deviation classification, paradoxical middle turbinate, angle between the bony inferior turbinate and medial wall of the maxillary sinus and inferior meatus measure. CONCLUSION: The authors concluded that the location and angle of the nasal septal deviation in the axial plane, width of the angle between the bony inferior turbinate and medial wall of the maxillary sinus, inferior meatus measure, and paradoxical middle turbinate may be effective factors in the etiology of PANDO.
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Obstrucción del Conducto Lagrimal/etiología , Tabique Nasal/diagnóstico por imagen , Conducto Nasolagrimal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Deformidades Adquiridas Nasales/complicaciones , Tomografía Computarizada por Rayos X , Adulto JovenRESUMEN
INTRODUCTION: Endoscopic sinus surgeries (ESS) are frequently used in the treatment of optic nerve decompression, other intracranial lesions and sinonasal pathologies. The olfactory fossa can be localized on different levels in relation to the anterior cranial fossa. The aim of the present study was to evaluate the depth and width of the olfactory fossa (OF) in relation to nasal septum deviation (NSD). METHODS: A total of 225 patient (141 female and 84 male, age range between 15 to 56 years) of cone beam computed tomography (CBCT) data was used in this study. NSD, OF width, OF depth were measured. OF depth which was grouped according to the Keros classification as Type I, II, and III was calculated. All measurements were performed bilaterally except for NSD. RESULTS: In the right and left OF depth were found Keros Type I 32 (14.2%) and 30 (13.3%), Keros Type II 171 (76%) and 167 (74.2%), and Keros Type III 22 (9.8%) and 28 (12.4%) respectively. There was no statistically significant found between OF depth and NSD (Pâ>â0.05). The mean angle of the NSD in men and women were 4.36â±â4.69 in women 4.11â±â4.36, respectively. The mean width of the right OF was 2.50â±â0.64âmm and 2.58â±â0.72âmm for the left side and there was no statistically significant association between OF width - NSD and OF width - OF depth (Pâ>â0.05). CONCLUSION: The anatomy of the OF should be well established before surgical intervention increase of the length of the lateral lamella is also increases the risk of developing complications such as cerebral damage, hemorrhage, and cerebrospinal fluid fistula during endoscopic sinus surgery. Although there is no significant difference between OF measurement and NSD, with three-dimensional imaging detailed research is required before endoscopic sinus surgical operations.
Asunto(s)
Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico , Fosa Craneal Anterior/diagnóstico por imagen , Fosa Craneal Anterior/cirugía , Endoscopía , Femenino , Humanos , Imagenología Tridimensional , Masculino , Persona de Mediana Edad , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Adulto JovenRESUMEN
BACKGROUND: Hump resection often requires reorganization of the keystone area. OBJECTIVES: The authors sought to describe the importance of the point where the perpendicular plate of ethmoid joins the septal cartilage (SC) and the nasal bones (NB) (Ethmoidal point [E-point]) for hump resection surgical planning. METHODS: Measurements from mid-sagittal slices in nasal computed tomography scans taken in adult Caucasian patients between January 2015 and December 2018 were compared between patients seeking primary rhinoplasty due to a nasal hump and patients not seeking rhinoplasty (control group). Patients with previous nasal surgery or trauma, genetic or congenital facial disorders, and high septal deviation were excluded. The length of overlap between NB and SC was compared between the 2 groups. The location of the E-point in relation to the beginning of the nasal hump in the cephalocaudal direction was documented in the patients seeking rhinoplasty. RESULTS: The study population included 138 patients, 69 seeking and 69 not seeking rhinoplasty (96 females). The mean age was 32.9 years (range, 18-55 years). The length of overlap between NB and SC was similar between both groups (11.7â ±â 3.3 vs 10.8â ±â 3.3; Pâ =â 0.235). The E-point was located before the beginning of the nasal hump in 97% (67/69) of nasal hump patients, and it could be found a mean distance of 2.3 (±2.3) mm cephalic to the latter. CONCLUSIONS: As a rule, the perpendicular plate of the ethmoid does not contribute to the nasal hump; therefore, only in exceptional cases should this be addressed while performing dorsal reduction.
Asunto(s)
Deformidades Adquiridas Nasales , Rinoplastia , Adolescente , Adulto , Femenino , Humanos , Persona de Mediana Edad , Hueso Nasal/cirugía , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/etiología , Deformidades Adquiridas Nasales/cirugía , Radiografía , Adulto JovenRESUMEN
OBJECTIVE: A nasal septal abscess after placement of a dental implant is seldom seen and is usually caused by an infection around the implant. A septal haematoma following dental implantation leading to septal abscess formation has never been reported. METHODS AND RESULTS: We present a case of a patient who developed a septal abscess after dental implantation without accompanying signs of infection around the implant. On the computed tomography scan we found the implant protruding the nasopalatine duct which led to bilateral septal hemorrhage, resulting in abscess formation. The patient underwent reconstructive nasal septum surgery, using an autologous auricular cartilage graft. This resulted in a good nasal function and cosmetic outcome. CONCLUSIONS: Medical health care professionals should be aware of a septal abscess in case of an acute blocked nose even without prior nasal or facial trauma or nasal surgery. Reconstruction of the septal nasal cartilage using autologous conchal cartilage is a good solution to preserve nasal function as well as tip support.
Asunto(s)
Absceso/cirugía , Implantación Dental/efectos adversos , Implantes Dentales/efectos adversos , Deformidades Adquiridas Nasales/cirugía , Complicaciones Posoperatorias/cirugía , Rinoplastia/métodos , Traumatismos de los Dientes/cirugía , Absceso/diagnóstico por imagen , Absceso/etiología , Humanos , Masculino , Cartílagos Nasales/cirugía , Obstrucción Nasal/etiología , Tabique Nasal , Deformidades Adquiridas Nasales/diagnóstico por imagen , Deformidades Adquiridas Nasales/etiología , Paladar Duro , Complicaciones Posoperatorias/diagnóstico por imagen , Complicaciones Posoperatorias/etiología , Hemorragia Posoperatoria , Procedimientos de Cirugía Plástica , Tomografía Computarizada por Rayos X , Cornetes Nasales/trasplante , Adulto JovenRESUMEN
The purpose of this study was to investigate the effects of craniofacial structure and nasal septal deviation on frontal sinus morphology 3-dimensionally. This study of anatomy, anthropology, morphology, and radiology included 74 dry skulls as study sample. The craniofacial measurements were made through conventional anthropometric methods by the use of calipers. The nasal septal deviation measurements were done by computerized software on photographs taken from frontal view. Frontal sinus volumes were estimated by the computerized tomography-based volumetry. The relationships between craniofacial structure, nasal septal deviation, and frontal sinus morphology were tested by linear regression and correlation analysis. The analysis of numerical variables and categorical variables within different groups was done by Mann-Whitney U/Kruskal-Wallis, and χ2 tests, respectively. There appeared a positive relationship between the dimensions of the frontal sinuses and the maximal cranial length and the nasal height especially on the left side (P < .05). However, after multivariate linear regression model for both factors was created, solely the nasal height kept being a positive factor for frontal sinus size as an independent variable. No statistical relevance was detected between the presence of metopic suture and frontal sinus morphology. Septal deviation itself affected frontal sinus morphometry, but the morphometry did not differ between the deviation side and the opposite side. In conclusion, the cranial structure does not affect the frontal sinus morphology but nasal structure affects. The true influences, among measured craniofacial elements, in relationship with the pneumatization of frontal sinus are appeared to be the nasal structure related.
Asunto(s)
Antropometría/métodos , Tomografía Computarizada de Haz Cónico/métodos , Seno Frontal/diagnóstico por imagen , Imagenología Tridimensional/métodos , Deformidades Adquiridas Nasales/diagnóstico por imagen , Adulto , Distribución de Chi-Cuadrado , Huesos Faciales/diagnóstico por imagen , Huesos Faciales/patología , Femenino , Seno Frontal/patología , Humanos , Modelos Lineales , Masculino , Tabique Nasal/diagnóstico por imagen , Tabique Nasal/patología , Deformidades Adquiridas Nasales/patología , Fotograbar , Cráneo/diagnóstico por imagen , Cráneo/patología , Estadísticas no ParamétricasRESUMEN
OBJECTIVE: The aim of this study is to assess the microstructural changes to the olfactory bulb (OB) in patients with nasal septum deviation (NSD) using diffusion tensor imaging and to research the association between these changes and the degree of NSD. METHODS: Ninety-six patients with NSD (46 males, 50 females) who received diffusion tensor imaging were assessed by 2 independent readers. The patients were separated into 3 groups according to the NSD angle. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the ipsilateral and contralateral OB were measured in all NSD patients by region of interest. RESULTS: According to deviation side, there was significant difference between the right (R) and left (L) OB FA and ADC values across the 3 groups. In patients with left- and right- sided NSD, FA and ADC values for the left and right OB were significantly different between groups 1 and 3, and groups 2 and 3. There was negative correlation between L-FA (râ=â-0.481, Pâ=â0.001; râ=â-0.496, Pâ=â0.001) and R-FA (râ=â-0.705, Pâ=â0.001; râ=â-0.286, Pâ=â0.02) versus age and deviation angle. However, there was positive correlation between L-ADC versus age and deviation angle (râ=â0.493, Pâ=â0.001; râ=â0.482, Pâ=â0.001), as well as positive correlation between R-ADC versus age (râ=â0.646, Pâ=â0.001). CONCLUSION: This is the first study showing ADC increase and FA decrease associated with axonal damage and microstructural integrity loss based on the side of deviation in NSD patients. It has also shown that this abnormality is directly proportional with NSD degree.