RESUMO
A man in his 60s presented with diminution of vision of the left eye with nasal bleeding after accidental fall. On examination his left upper eyelid was lacerated and left temporal sclera was punctured which was repaired under local anaesthesia after which he was discharged by ophthalmologists but continued to complain of pain and left nasal obstruction. A non-contrast CT of paranasal sinuses revealed fracture of medial wall of left orbit, left ethmoid haemosinus and a metallic foreign body (FB) in the septum and anterior face of sphenoid. Diagnostic nasal endoscopy performed to remove the metallic FB showed plastic splinters embedded in the mucosa of nasal cavity which was unexpected. Hence, the FB was removed in two sittings because of diagnostic dilemma.
Assuntos
Corpos Estranhos , Humanos , Masculino , Pessoa de Meia-Idade , Corpos Estranhos/cirurgia , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/complicações , Tomografia Computadorizada por Raios X , Nariz/lesões , Acidentes por Quedas , Fraturas Orbitárias/cirurgia , Traumatismos Oculares/complicações , Traumatismos Oculares/cirurgia , Traumatismos Oculares/etiologia , Endoscopia/métodos , Obstrução Nasal/etiologia , Obstrução Nasal/cirurgia , Órbita/lesões , Órbita/diagnóstico por imagem , Ferimentos Oculares Penetrantes/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Ferimentos Oculares Penetrantes/complicaçõesRESUMO
BACKGROUND: Correction of asymmetry and irregularity deformities with autologous grafts, without osteotomies, offers advantages to both plastic surgeons and patients with severe deviation. Various autologous tissues such as fat, bone, and cartilage grafts are viable options for this purpose. OBJECTIVES: This study aimed to compare the efficacy of 3 autologous filling materials in patients with bone asymmetry. METHODS: A retrospective evaluation was conducted on 297 patients seeking aesthetic nose surgery between 2015 and 2022. Only primary patients without prior surgery and those with bone asymmetry from trauma, with dorsum protrusion <3 mm, and without osteotomy were included. Patients were divided into fat, cartilage, and bone groups. Grafts were applied to the concave side during closed rhinoplasty, and evaluations were done 12 months after surgery by blinded plastic surgeons and patients using established assessment tools. RESULTS: Fat, cartilage, and bone grafts were utilized in 74, 127, and 96 patients, respectively, with a mean follow-up of 19 months. The mean graft volumes were 1.0 cc (bone), 1.3 cc (cartilage), and 1.6 cc (fat). The patient self-assessment scores were 75%, 84.9%, and 86.6%, respectively. The Asher-McDade averages were 77.2%, 86.7%, and 88.4%, respectively. Cartilage and bone graft results were statistically similar in patients' self-evaluation and significantly higher than those of fat grafts. Blinded assessments showed no significant difference between the cartilage and bone groups. CONCLUSION: Placing autologous grafts on the concave side for patients with minimal nasal bone protrusion (<3 mm) yields successful results. Cartilage grafts offer advantages in volume, result estimation, and preparation time, making them suitable for larger patient cohorts.
Assuntos
Tecido Adiposo , Transplante Ósseo , Cartilagem , Rinoplastia , Humanos , Masculino , Feminino , Rinoplastia/métodos , Estudos Retrospectivos , Adulto , Tecido Adiposo/transplante , Transplante Ósseo/métodos , Cartilagem/transplante , Deformidades Adquiridas Nasais/cirurgia , Transplante Autólogo , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Adolescente , Nariz/cirurgia , Nariz/lesõesRESUMO
Soft tissue injuries to the midface (and nose) are common causes for seeking trauma care. As trauma patients, observing advanced trauma life support protocols is warranted given the risk of concomitant injuries. Here, options for optimizing tissue preservation, microvascular replantation, non-microvascular tissue replacement, and wound stabilization are discussed. Included in this discussion are data-driven predictors for successful replantation as well as technique descriptions with anatomic references to guide surgeons in choosing optimal donor vessels. In both partial and complete avulsion injuries, venous congestion is common. Several postoperative wound care protocols to maximize tissue perfusion and long-term viability are discussed.
Assuntos
Amputação Traumática , Lesões dos Tecidos Moles , Humanos , Amputação Traumática/cirurgia , Microcirurgia/métodos , Reimplante/métodos , Lesões dos Tecidos Moles/cirurgia , Nariz/cirurgia , Nariz/lesõesRESUMO
PURPOSE: Injuries of the nasal vestibular skin caused by the rotating burr shafts can represent a tedious complication following endonasal drilling and is experienced sooner or later by every rhino-surgeon. MATERIAL AND METHODS: To protect the nasal entrance from laceration by the free rotating drill shaft we position an otology speculum in the nasal entrance. The speculum is held in place by the scrub nurse during the critical phase of bone drilling. RESULTS: Following the introduction of the ear speculum protection, we successfully treated our dacryocystostamia procedures (n = 27) and median maxillectomia procedures (n = 6) without any further soft tissue erosions. DISCUSSION: Preventive measures for injuries by endonasal drilling procedures are not reported extensively in literature. This stands in contrast to the fact that these injuries are prone to cause significant suffering as amply described in the case of nostril laceration due to nasogastric intubation or nasogastric feeding tubes. CONCLUSION: The use of a readily available, reusable ear speculum in endonasal drill application eliminated the complication of nasal entrance lacerations throughout our institution, hitherto.
Assuntos
Lacerações , Humanos , Lacerações/prevenção & controle , Lacerações/etiologia , Instrumentos Cirúrgicos , Nariz/lesões , Nariz/cirurgia , Desenho de Equipamento , Masculino , FemininoRESUMO
Emergency situations involving the ears, nose, and throat (ENT) area can pose considerable challenges for clinicians and often require an interdisciplinary approach due to the involvement of different organ systems. To avoid damage to highly relevant sensory and perception organs and life-threatening bleeding or respiratory complications, strategies that are as quick and targeted as possible are necessary. This article aims to provide an overview of ENT emergency management strategies. The entire spectrum from simple conservative to highly complex surgical measures plays a role here, both diagnostically and therapeutically. Aspects such as bleeding, respiratory problems, inflammation, hearing disorders, vertigo, facial palsy and injuries to the head and neck area are discussed. In addition, important topics such as preventive measures and possible complications are also addressed to ensure optimal patient care.
Assuntos
Emergências , Nariz , Humanos , Inflamação , Nariz/lesõesRESUMO
As lesões na face decorrentes de mordedura humana estão entre os tipos de trauma causados por violência interpessoal. Injúrias causadas nesta região podem gerar uma série de morbidades como perdas teciduais importantes, infecções, além de cicatrizes irreversíveis quando a ferida é passível de reparo, portanto, os cuidados pós-trauma devem visar à minimização de cura, além da funcionalidade, buscando o máximo de estética possível. Este trabalho tem como objetivo relatar um caso clínico de mordida humana em região de dorso nasal, com avulsão da ponta nasal, atendida no Hospital da Restauração Governador Paulo Guerra, Recife-PE, pelo serviço de Cirurgia Buco-Maxilo-Facial. Procedeu-se com reparo primário e antibioticoterapia profilática, no qual o resultado do tratamento foi considerado satisfatório, boa cicatrização tecidual e sem queixas funcionais e estéticas... (AU)
Injuries to the face resulting from human bite are among the types of trauma caused by interpersonal violence. The injuries caused in this region, can generate a series of morbidities such as major tissue loss, infection, and irreversible scarring when the wound is repairable, therefore, posttrauma care should aim to minimize healing, in addition to functionality, seeking maximum aesthetics as possible. This paper aims to report a clinical case of human bite in the nasal dorsum region, with avulsion of the nasal tip, attended at the Hospital da Restauração Governador Paulo Guerra, Recife-PE, by the service of Oral and Maxillofacial Surgery. It was proceeded with primary repair and prophylactic antibiotic therapy, in which the result of the treatment was considered satisfactory, good tissue healing and without functional and aesthetic complaints... (AU)
Las lesiones faciales producidas por mordeduras humanas se encuentran entre los tipos de traumatismos causados por la violencia interpersonal. Las lesiones causadas en esta región pueden generar una serie de morbilidades como la pérdida de tejidos importantes, la infección y la cicatrización irreversible cuando la herida es reparable, por lo tanto, los cuidados posttrauma deben tener como objetivo minimizar la cicatrización, además de la funcionalidad, buscando la máxima estética posible. Este trabajo tiene como objetivo reportar un caso clínico de mordedura humana en la región del dorso nasal, con avulsión de la punta nasal, atendido en el Hospital da Restauração Governador Paulo Guerra, Recife-PE, por el servicio de Cirugía Oral y Maxilofacial. Se procedió a la reparación primaria y a la terapia antibiótica profiláctica, en la que el resultado del tratamiento se consideró satisfactorio, con buena cicatrización de los tejidos y sin quejas funcionales y estéticas... (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Violência , Cicatrização , Nariz/lesões , Antibioticoprofilaxia , Traumatismos FaciaisRESUMO
The timing and method of reconstruction of an amputated nose due to a dog bite are still controversial. Here, we describe a delayed reconstruction using the paramedian forehead flap with a simultaneous cartilage graft to address a contracted nose from a dog bite. A healthy, 52-year-old patient was attacked by his acquaintance's dog, resulting nasal tip amputation that included cartilage. The composite graft was performed, and secondary healing resulted in a short nose deformity. Five months after the injury, a conchal cartilage graft and paramedian forehead flap were performed simultaneously to correct the shape of the deformity. At 1 year postoperatively, the flap survived without complications, and the short nose deformity was successfully corrected. In summary, immediate composite graft after a dog bite could result in a contracted nose, but the deformity can be corrected by a simultaneous paramedian forehead flap and cartilage graft.
Assuntos
Mordeduras e Picadas , Neoplasias Nasais , Rinoplastia , Animais , Cães , Testa/cirurgia , Testa/lesões , Neoplasias Nasais/cirurgia , Nariz/cirurgia , Nariz/lesões , Mordeduras e Picadas/cirurgia , Cartilagem/transplante , Amputação Cirúrgica , Rinoplastia/métodosRESUMO
Background: Endoscopic endonasal surgery (EES) requires wide sinonasal dissection to achieve adequate visualisation of anatomical landmarks. This can also result in nasal sequelae like crusting, nasal discharge, and anosmia. Aim: To use the sinonasal outcome test (SNOT) 22 questionnaire to study the postoperative sinonasal morbidity and its recovery in patients who have undergone EES. Materials and Method: Prospective study conducted from November 2017 to May 2018. SNOT-22 questionnaire was administered on patients operated between before EES and then re-administered during outpatient visits at 1 month, 3 months, and 6-12 months following surgery. Results: Results of 46 patients were analyzed. The mean duration of follow-up was 11.8 months. The mean preoperative SNOT-22 score was 2.69 ± 4.95. SNOT-22 score at 1 month was 5.52 ± 6.77, at 3 months follow-up was 0.39 ± 1.02, and after 6 months was 0.30 ± 1.00. In 32 patients with a nasoseptal flap, mean preoperative score was 3.34 ± 5.68 (P = 0.18), one month following surgery it was 6.68 ± 6.88 and at 3 and 6 months following surgery it was 0.56 ± 1.19 and 0.38 ± 1.15. The mean preoperative nasal domain score was 1.022 (±2.13), the postoperative 1 month score was 2.3 ± 3.7, at 3 months following surgery was 0.22 ± 0.82 and after 6 months of surgery was 0.28 ± 0.96. Conclusion: Patients undergoing EES experienced transient worsening of SNOT 22 scores in the first month following surgery and recovered within 3 months of surgery. The improvement was sustained in follow-up visits beyond 6 months of surgery.
Assuntos
Endoscopia , Doenças Nasais , Nariz , Base do Crânio , Endoscopia/efeitos adversos , Endoscopia/métodos , Seguimentos , Humanos , Nariz/lesões , Doenças Nasais/etiologia , Doenças dos Seios Paranasais/etiologia , Seios Paranasais/lesões , Neoplasias Hipofisárias/cirurgia , Estudos Prospectivos , Qualidade de Vida , Recuperação de Função Fisiológica , Base do Crânio/cirurgia , Resultado do TratamentoRESUMO
Emergencies in ear, nose and throat medicine in the preclinical setting are common. Due to the narrow anatomical conditions, relocation or bleeding in this area can quickly lead to an emergency situation. In this article, the most important causes of bleeding, shortness of breath and trauma are to be presented and the corresponding treatment briefly outlined.
Assuntos
Emergências , Medicina , Humanos , Pescoço , Nariz/lesões , FaringeRESUMO
OBJECTIVE: To study anterior nasal spine fractures, including the incidence, missed diagnosis rates, and relationship with shapes using computed tomography (CT). METHODS: Two hundred cases of axial CT images performed for maxillofacial trauma were reviewed. The incidence, correct, and missed diagnosis rates of anterior nasal spine fractures were studied. The relationship between the fracture and the shape of the anterior nasal spine was also analyzed. RESULTS: The rate of anterior nasal spine fractures was 22.00% (44 of 200). The diagnostic accuracy was 4.55% (2 of 44) and the missed diagnosis rate was 95.45% (42 of 44). The fracture rates of the double rod, single rod, triangle, and irregular anterior nasal spine were 33.85% (22 of 65), 32.26% (10 of 31), 12.24% (12 of 98), and 0.00% (0 of 6), respectively. The double and single rod types of anterior nasal spine were most likely to be fractured than the type of triangle (χ2 = 11.05, 6.67, P < .0167). No fracture was found in the irregular type of anterior nasal spine. CONCLUSION: Anterior nasal spine fractures are not rare and the high missed diagnostic rate results from unfamiliarity with the structure. Double and single rod types of anterior nasal spines are easy to fracture. Bony reconstruction and thin thickness of CT images are necessary for diagnosis.
Assuntos
Fraturas Maxilares/diagnóstico por imagem , Nariz/diagnóstico por imagem , Nariz/lesões , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Incidência , Masculino , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Fraturas Maxilares/epidemiologia , Fraturas Maxilares/etiologia , Pessoa de Meia-Idade , Diagnóstico Ausente , Nariz/anatomia & histologia , Adulto JovemRESUMO
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Identify common negative outcomes that arise with conventional nasal reconstruction. 2. Understand the technical refinements that help avoid and reduce negative outcomes in nasal reconstruction. 3. Learn about the utility of regional axial island flaps for nasal reconstruction, in particular, the lateral nasal artery flap. SUMMARY: Nasal reconstruction has been a preoccupation of surgeons dating to before 600 bc. The nose is the central focal point of the face and a key identifying facial feature, and surgery to the nose can prove to be challenging to even the most experienced surgeon. The objective of this CME article is to outline the most commonly used surgical options for each nasal aesthetic subunit, and the specific complications observed for each. The best surgical options and technical refinements are highlighted, and principles that may help restore the nose are outlined.
Assuntos
Deformidades Adquiridas Nasais/cirurgia , Neoplasias Nasais/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Rinoplastia/métodos , Estética , Feminino , Humanos , Masculino , Nariz/anatomia & histologia , Nariz/lesões , Nariz/cirurgia , Deformidades Adquiridas Nasais/etiologia , Complicações Pós-Operatórias/etiologia , Rinoplastia/efeitos adversos , Retalhos Cirúrgicos/efeitos adversos , Retalhos Cirúrgicos/transplante , Resultado do TratamentoRESUMO
La foliculitis pseudolinfomatosa, descripta por McNutt en 1986, es una afección de etiología desconocida y poco frecuente, que simula un linfoma cutáneo tanto por su clínica como por su histología. Se presenta como una lesión nodular solitaria, eritematosa, de 0,5 hasta 3cm, de crecimiento rápido, sobre todo en la cara, en personas de 40 a 60 años, con una histopatología caracterizada por un infiltrado linfocitario B yT perifocular, y células dendríticas positivas en la inmunohistoquímica para S100yCD1a. Su curso es benigno, muchas veces autolimitado. Se expone el caso de una paciente con una particular forma clínica de pseudolinforma.
Pseudolymphomatous folliculitis, described by McNutt in 1986, is a non-frequent entity of unknown etiology that simulates a cutaneous lymphoma, both clinically and histologically. It shows as a solitary erythematous nodular lesion of 0.5 to 3 cm, with a rapid growth, mainly on the face, in people aged 40 to 60 years, and histopathology characterized by a perifollicular B and T lymphocytic infiltrate, and positive dendritic cells for immunohistochemistry S100 and CD1a. Its course is benign, often self-limited. The case of a patient with a particular clinical form of pseudolymphoma is presented.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Cutâneas , Pseudolinfoma/diagnóstico , Foliculite/diagnóstico , Triancinolona Acetonida/administração & dosagem , Nariz/lesões , Nariz/patologia , Procedimentos Cirúrgicos NasaisRESUMO
Introducción. Los defectos de cobertura en la región nasal secundarios a resecciones oncológicas deben ser cubiertos con tejido de las mismas características que el resecado, idealmente con tejido vascularizado adyacente. El colgajo bilobulado reúne las condiciones doble transposición, con una estructura y diseño que permite una adecuada distribución de las fuerzas de tensión a lo largo de su eje de rotación, evitando deformidades y excedente cutáneo generados por otros colgajos o cierre primario, respetando las unidades estéticas de la nariz. Método. Se presentan 48 casos clínicos en el periodo abril 2018 - abril 2020 describiendo la técnica de realización del colgajo bilobulado para la reconstrucción de secuelas de resección oncológica nasal por los diferentes tipos de tumores de piel. Para defectos de dorso nasal 26, punta nasal 14 y alares 8 casos. Resultados. La vitalidad de los colgajos fue de un 100%, 6 casos presentaron dehiscencia en extremo distal que requirió revisión. Adecuado resultados estéticos con similitud de textura y color de piel del colgajo. Cicatrices resultantes en área dadora y receptora ocultas en líneas de sombra. Disminución de complicaciones agregando resección triangular adicional. Conclusiones. Los defectos de tegumento en región nasal deben ser cubiertos por tejido vascularizado. Las resecciones de hasta 3 cm de diámetro pueden ser cubiertas con colgajos bilobulados adyacentes. El adecuado planeamiento de las cicatrices tanto en área dadora como receptora permite mejores resultados estéticos. Siempre deben tenerse en cuenta las regiones estéticas para obtener mejores resultados.
Background. Coverage defects in the nasal region secondary to oncological resections should be covered with tissue of the same characteristics as the resected, ideally with adjacent raised vascular tissue. The bilobed flap meets the conditions, is a double transposition flap, with a structure and design that allows an adequate distribution of the tension forces along its axis of rotation, avoiding deformities and excess skin generated by other flaps or primary closure. Respecting the aesthetic units of the nose. Methods. 48 clinical cases are presented in the period April 2010- April 2020 describing the technique of making the bilobed flap for the reconstruction of the sequelae of nasal oncological resection by the different types of skin tumors. For dorsal defects 26, nasal tip 14 and alares 8 cases. Results. The vitality of the flaps was 100%, 6 cases presented dehiscence in the distal end that required revision. Adequate aesthetic results with similarity of texture and skin color of the flap. Resulting scars in donor and recipient area hidden in shadow lines. Decrease complications by adding additional triangular resection. Conclusions. Integument defects in the nasal region should be covered by vascularized tissue. Resections up to 3 cm in diameter can be covered with adjacent bilobed flaps. The adequate planning of the scars in both the donor and recipient areas allows for better aesthetic results. Aesthetic regions should always be taken into account to obtain better results
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Neoplasias Cutâneas/terapia , Retalhos Cirúrgicos/cirurgia , Envelhecimento da Pele/efeitos da radiação , Nariz/lesões , Procedimentos de Cirurgia Plástica/métodosRESUMO
The nose is one of the most common sites of facial injury due to its prominence and anatomical placement. Given its intricate anatomy, function, and high visibility, it also proves to be one of the most complex regions for repair. We provide a review of the management of soft tissue injuries to the nose, including the various reconstructive tools available and adjunctive wound care measures. We also discuss special considerations based on mechanism of injury and treatment of this condition in the pediatric population. The main goals of reconstruction should be to preserve function while achieving optimal cosmetic results in this highly visible region of the face.
Assuntos
Traumatismos Faciais , Procedimentos de Cirurgia Plástica , Lesões dos Tecidos Moles , Criança , Traumatismos Faciais/cirurgia , Humanos , Nariz/lesões , Nariz/cirurgia , Lesões dos Tecidos Moles/cirurgiaRESUMO
Background: Midface reconstruction is challenging because the structures and deformities involved are complicated. In this study, we present a strategy for integrally reconstructing nasal and midface defects, including hair-bearing defects, using extended forehead-expanded flaps. Methods: From 2015 to 2018, a total of 22 patients with midface defects underwent reconstruction with extended forehead-expanded flaps. The far end of the expanded flap, which included scalp hair, was used to cover the upper lip defect (Type 1). In cases with large perioral defects (Type 2), we designed two separate supratrochlear artery flaps, one with a shorter pedicle for nasal reconstruction and the other with a longer pedicle for partial reconstruction. The pedicle of the longer flap was saved for upper lip recovery after pedicle interruption. Results: Among the 22 patients (13 male and 9 female), 17 were caused by burns and 5 by trauma. Nineteen patients had Type 1 defects, and three had Type 2 defects. The average postoperative follow-up was 17.6 ± 4.3 months. Patient satisfaction was excellent in most patients. Conclusions: Our extended forehead flap strategy can achieve aesthetic recovery of nasal and perioral defects with a single expansion treatment. The expanded flap can be flexibly designed to fit diverse midface defects.
Assuntos
Traumatismos Faciais/cirurgia , Testa/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos , Adulto , Feminino , Seguimentos , Humanos , Lábio/lesões , Lábio/cirurgia , Masculino , Nariz/lesões , Nariz/cirurgia , Satisfação do Paciente/estatística & dados numéricos , Expansão de Tecido , Resultado do TratamentoRESUMO
ABSTRACT: Nasal foreign bodies in children are common complaints encountered by pediatric otolaryngologists. We investigated clinical features, diagnosis, and treatment of nasal foreign bodies in children in a Chinese metro area.Six hundred sixty eight children with nasal foreign bodies presented to Shenzhen Children's Hospital, diagnosed and treated by the authors were enrolled from January 2016 to October 2019, causes for medical consultation, age, sex, duration, types, locations, removal, and complications were recorded and analyzed.Nasal foreign bodies were common in children between 1 and 5âyears of ages (96.8%). The right nasal cavity (61.4%) was the most common site for foreign body insertion (61.4%). Most of the children (89.4%) presented for a complaint of nasal discomfort or foreign body insertion themselves, or for foreign body impaction discovered by the caregivers. Most of the foreign bodies (85.0%) were discovered within 1âday. The most nasal foreign bodies were the whole toys and toy parts (34.1%). The majority of nasal foreign bodies (99.1%) located in the antero-inferior portion of the nasal cavities and could be removed with simple instruments. The occurrence of complications in nasal foreign bodies (10.2%) was not common.The present study objectively exhibited clinical features, diagnosis, and treatment of nasal foreign bodies in a Chinese metro area.
Assuntos
Corpos Estranhos/cirurgia , Cavidade Nasal/lesões , Nariz/lesões , Otolaringologia/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , China , Feminino , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Lactente , Masculino , Estudos RetrospectivosRESUMO
BACKGROUND: Nasal trauma is the most common facial injury worldwide. Prompt assessment allows for recognition of injuries requiring surgical intervention in the form of nasal bone manipulation. The literature is unclear to what extent patients undergoing conservative management subsequently require surgical intervention. METHODS: A retrospective chart review of all patients presenting with nasal injury between July 2017 and July 2018 who underwent conservative and surgical management was undertaken. Re-referral and subsequent surgical intervention were documented. RESULTS: In a cohort of 390 patients with nasal injury 229 patients underwent conservative management. Average age was 29 years. Males comprised 60% of our conservative cohort and 81% of the manipulated cohort. 8.3% of patients managed conservatively and 12% of those undergoing manipulation were re-referred. CONCLUSION: Nasal trauma assessment is a significant workload for an ENT unit. Conservative management is appropriate following clinical assessment and does not lead to increased intervention compared with those who are surgically manipulated.
Assuntos
Traumatismos Faciais/terapia , Nariz/lesões , Traumatismos Faciais/etiologia , Traumatismos Faciais/cirurgia , Feminino , Humanos , Masculino , Nariz/cirurgia , Estudos Retrospectivos , Fatores Sexuais , Resultado do TratamentoRESUMO
PURPOSE: The purpose of this interprofessional team-driven quality improvement project was to implement a Bubble continuous positive airway pressure (CPAP) Skincare Protocol proactively to prevent potential device-related pressure injuries. PARTICIPANTS AND SETTING: The setting was a level 3, 60-bed single patient room neonatal intensive care unit (NICU) located within a Midwest urban academic medical center with more than 200 healthcare providers. Prior to the beginning of this project, the NICU had been using the CPAP apparatus that had documented 6 nasal pressure injuries over a 6-month period. Because of ease of use, the NICU moved to using Bubble CPAP (BCPAP), which is known to place patients at a higher risk of nasal pressure injuries due to the way the apparatus sits inside the nares. APPROACH: An evidence-based practice model provided the guiding framework for the development of our BCPAP Skincare Protocol. Knowing that the unit had already documented nasal pressure injuries, the interprofessional-devised protocol was developed to decrease the risk of nasal injuries with the use of BCPAP in premature infants. The protocol was disseminated via an all-healthcare provider educational program. OUTCOMES: During the first 3 months postprotocol implementation period, one stage 2 nasal injury was noted and immediately treated and healed without incident. During the next 24-month, postimplementation period, there were zero nasal pressure injuries reported. IMPLICATIONS FOR PRACTICE: The healthcare providers found that using an interprofessional team approach in developing and implementing an evidence-based BCPAP Skincare Protocol reduced the incidence of nasal pressure injuries associated with the use of BCPAP in the NICU.