Correlation Analysis of the Pneumatization of the Supraorbital Ethmoid Cell and the Position of the Anterior Ethmoidal Artery.

OBJECTIVES: This study aimed to measure the supraorbital ethmoid cell (SOEC) and characterize the relationship between the degree of SOEC pneumatization and the position of the anterior ethmoidal artery (AEA) in relation to the skull base. METHODS: Computed tomography (CT) scans of 100 patients were analyzed. The correlation between the pneumatization of SOEC and the distance of the AEA from the skull base was explored by Spearman's correlation rho efficient test. RESULTS: The distance of the AEA from skull base was 3.10 (2.60,3.60) mm in patients with SOEC compared with 0.6(0.40,2.10)mm in those without(P < .001). In 50.5% of the patients, the AEA was located below the skull base; the incidence of this localization was significantly higher in those with SOEC than in those without (78.79%vs22.77%, P < .001). Compared to female patients, male patients owned greater SOEC height (9.65vs8.20mm, P = .007). The SOECs volume (r = 0.45, P < .001), height (r = .30, P = .003), and transverse diameter (r = 0.28, P = .005) were all significantly correlated with the distance of the AEA from the skull base. CONCLUSIONS: The pneumatization of SOEC critically impact the distance between the AEA and skull base. The higher the degree of pneumatization, the farther from the skull base the AEA will be, increasing the risk of complications during nasal endoscopic surgery. These results provide an important reference for protecting the AEA during nasal endoscopic surgery.

Clinical application of collagen membrane with umbilical cord-derived mesenchymal stem cells to repair nasal septal perforation.

Objective. We aimed to investigate the clinical efficacy of collagen membrane with umbilical cord-derived mesenchymal stem cells in the endoscopic repair of nasal septal perforation.Methods.We performed a prospective clinical trial between March 2017 and October 2019. Nasal septal perforations were repaired by the endoscopic sandwich technique with the collagen membrane and umbilical cord-derived mesenchymal stem cells. These patients were followed up postoperatively. Their outcomes were comprehensively evaluated by assessing the healing process of the perforations, the visual analog scale (VAS) for nasal discomfort, and the nasal mucociliary transit time (MTT) for the regenerated nasal mucosa.Results. Our study included a total of eight patients with nasal septal perforation (six males and two females, age 36.6 ± 12.8 years, diameter of perforation 1.0 ± 0.2 cm). Seven patients successfully underwent surgical repair. These patients had significantly improved VAS scores 1 month after the operations (1.1 ± 0.4) compared with the preoperative period (5.9 ± 0.7) (P< 0.05). Although the nasal MTT in the nasal septum and the inferior turbinate surface were within the normal limits before the operation and at 1 month after the operation, the postoperative transit time (11.1 ± 2.0 m) was significantly shorter than the preoperative transit time (12.1 ± 2.4 m) (P< 0.05). There were no recurrences of perforation, scab formations, or epistaxis after the operation.Conclusions. The application of the collagen membrane with umbilical cord-derived mesenchymal stem cells is a simple and feasible endoscopic procedure to repair perforated nasal septa and restore satisfactory functional mucosa.

Application of continuous suture of inferior turbinate in surgery for chronic hypertrophic rhinitis with or without nasal septum deviation.

PURPOSE: To explore the application value of continuous suture of the inferior turbinate in inferior turbinate submucosal bone resection. METHODS: Twenty patients with chronic hypertrophic rhinitis with or without nasal septum deviation underwent inferior turbinate submucosal bone resection with or without septoplasty. The inferior turbinate was continuously sutured with or without nasal septum suture after surgery. The nasal cavity was not packed. The postoperative clinical outcome was evaluated using visual analog scales (VASs), saccharin test, nasal endoscopy, and nasal resistance test. Postoperative complications were recorded. RESULTS: All 20 endoscopic surgeries were successfully performed. One day after surgery, the VAS scores of nasal pain (1.3 ± 0.5), headache (0.8 ± 0.4), tearing (0.3 ± 0.3), and bleeding (0.3 ± 0.3) in patients were low; 1 week after surgery, the nasal mucociliary transport time was not significantly prolonged compared to that before surgery (P > 0.05); 1 month after surgery, the symptoms of nasal congestion had improved significantly, as the VAS score for nasal congestion was lower than that before surgery (P < 0.05); the volume of the hypertrophied inferior turbinate of all patients was reduced, the mucous membrane was smooth and rosy, the nasal septum was centrally located, and the total nasal resistance values at 150 Pa pressure had returned to the normal reference range (0.282 ± 0.103 Pa/cm3/s); no complications such as bleeding, nasal infection, nasal dryness, and olfactory disorders occurred. CONCLUSION: After inferior turbinate submucosal bone resection with or without septoplasty, inferior turbinate continuous suture with or without nasal septum suture instead of nasal packing can significantly improve postoperative discomfort, improve nasal ventilation, protect nasal function, and accelerate postoperative recovery.