RESUMO
OBJECTIVE: To assess benefits of surgical intervention at an early age and focus on surgical techniques using exclusively autologous cartilage grafts. METHODS: Five children aged 8-15 years, treated between March 2016 and 2020, underwent augmentation rhinoplasty using autologous cartilage, with post-operative follow up ranging from 1.5 to 2 years. Photographs and Rhinoplasty Outcome Evaluation questionnaire scores were examined. RESULTS: Augmentation was achieved without complications. No restricted skin or mucosal pockets were encountered. Patients showed improved confidence and perspective with regard to self-image, and were less socially self-conscious. There was significant improvement in all Rhinoplasty Outcome Evaluation questionnaire scores. CONCLUSION: Early surgery allows augmentation with easier release of skin and mucosal pockets, and without the tension otherwise encountered if primary augmentation is performed at a later age. It offers a chance to improve confidence and self-perception in a growing child conscious about their appearance, which may make them socially withdrawn. Autologous cartilage gives better results than bone grafts, and is comparable with silicone but without its complications.
Assuntos
Cartilagem/transplante , Anormalidades Maxilofaciais/cirurgia , Rinoplastia/métodos , Adolescente , Criança , Intervenção Médica Precoce , Feminino , Humanos , Masculino , Transplante AutólogoRESUMO
Malignant melanoma is a rare tumor in otorhinolaryngology. In this paper, we have reported the first case of melanoma of nasopharynx which we came across in 20 years of ENT practice. A 55 year old male patient with complaints of swelling of nose and left side of neck, nasal blockage and epistaxis was diagnosed as melanoma of nose with metastasis in the neck based on clinical and radiological examination. The tumour was excised by lateral rhinotomy with supraomohyoid block dissection on the left side. The tumour was found to originate from lateral wall of nasopharynx and middle turbinate. The surgery was followed by radiotherapy. Diagnosis of melanoma was confirmed on histopathology. During 30 months follow-up, no recurrence was noticed.
Assuntos
Neoplasias de Cabeça e Pescoço/secundário , Melanoma/secundário , Neoplasias Nasofaríngeas/patologia , Terapia Combinada , Seguimentos , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Masculino , Melanoma/patologia , Melanoma/terapia , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/terapia , PrognósticoRESUMO
Postoperative facial swelling remains the most common complication of Caldwell-Luc operation. Over a period of 5 years 128 Caldwell-Luc operations were performed on 76 patients. We have been able to reduce the incidence of postoperative facial swelling to only 5% of all cases, by using a wide sublabial incision, gentle tissue retraction, and avoidance of antibiotic soaked pack after completion of surgery. In none of the cases post operative bleeding was severe enough to warrant antral packing. Only one case required packing 6 h after completion of surgery. This method reduces morbidity of the operation significantly, cuts short the hospital stay and hence a much better patient compliance is achieved.
Assuntos
Seio Maxilar/cirurgia , Pólipos Nasais/cirurgia , Complicações Pós-Operatórias/prevenção & controle , Adulto , Feminino , Humanos , Masculino , Métodos , Pessoa de Meia-IdadeRESUMO
The thick oily and pigmented skin present in majority of tropical patients makes rhinoplasty challenging surgery. Rhinoplasty by the external approach though gaining increasing acceptance all over the world is yet to gain popularity in this country. Hypertrophied scars are not uncommon in coloured skin and the reluctance to give an external incision for a cosmetic procedure is natural. We started the external rhinoplasty approach with some reservations, however in a series of over seventy cases, no significant problem has been encountered, with the columellar scar. Accurate approximation of the columellar wound is probably a more important factor in wound healing than the skin colour. Our experience of external rhinoplasty is presented.
Assuntos
Procedimentos Cirúrgicos Dermatológicos , Rinoplastia/métodos , Adulto , Cicatriz/patologia , Feminino , Humanos , Masculino , Pele/patologia , Pigmentação da Pele , Clima TropicalRESUMO
Olfactory neuroblastoma is a rare tumor. The role of CT Scan, morphological details and the electron microscopic findings have been highlighted in the diagnosis of the lesion. The present patient, in which the tumor had recurred following surgical excision, was treated successfully with a combination of radiation, further surgery, and maintenance chemotherapy. We also feel that such a planned multidisciplinary approach is justified as the initial treatment for all advanced lesions in view of high recurrence rates reported following use of radiotherapy or surgery alone.