RESUMO
The anatomical variations of the maxillary septum and the septal bullae can generate challenges during the interpretation of radiographs of the horses' heads and make it difficult to accurately identify the sites affected in sinus disorders. The description of the radiographic appearance of these structures is currently scarce in the scientific literature. This work aims to describe the anatomical and radiographic characteristics of the maxillary septum and maxillary septal bullae in horses. Six chemically preserved equine cadaver heads were used which, after being submitted to the maxillary osseous flap, the maxillary septum and its respective bullae were identified. Radiographic examinations before and after contrast impregnation on these structures were performed. The positioning of the maxillary septum varied between the anatomical specimens and between the sides of the same specimen. The 30° oblique dorsoventral lateral and lateral projections allowed the identification of the maxillary septum and septal bullae. However, the bullae remained superimposed on the dental arches in the dorsoventral projections with the mandible in a neutral position or with the mandible displaced. The oblique offset radiographic positioning was suggested and proved effective for the examination of the maxillary septal bullae, where the mandible was displaced to the side of the bullae to be examined, and the radiographic beam inclined in the same direction. The maxillary septum and its bullae could be properly identified in a macroscopic way after the osseous flap and the contrasted radiographic examination allowed its adequate interpretation. Variations in size and position are considered normal for the equine species.
Assuntos
Cadáver , Cavalos/anatomia & histologia , Animais , Septo Nasal/diagnóstico por imagem , Maxila/diagnóstico por imagem , Radiografia/veterinária , Masculino , Doenças dos Cavalos/diagnóstico por imagemRESUMO
OBJECTIVE: To perform the translation, cultural adaptation, and validation of the NOSE-Perf Scale to Brazilian Portuguese. METHODS: This study was divided into two stages. In the first stage, the questionnaire was submitted for translation and cultural adaptation, following the guidelines recommended by the ISPOR Task Force (International Society for Pharmacoeconomics and Outcomes Research). Then, the Brazilian Portuguese version of the NOSE-Perf scale was applied to a group with septal perforation and a control group. The group with perforation answered the questionnaire again after one month. Internal consistency, test-retest reliability, and discriminant validity were assessed. RESULTS: The Brazilian Portuguese version of the NOSE-Perf scale was applied to 32 participants, 16 from the group with septal perforations and 16 controls. The instrument obtained high internal consistency, with Cronbach's alpha scores of 0.986. High reliability was also obtained, with Spearman's correlation coefficient of 0.996 (pâ¯<â¯0.001) and the intraclass correlation coefficient of 0.965 with a 95% Confidence Interval (95% CI) of 0.886â0.988. The NSP group obtained a mean total score of 13.8⯱â¯12.6 and the control group a score of 2.3⯱â¯1.8, with a statistical difference between the groups (pâ¯<â¯0.001), demonstrating good discriminant validity. CONCLUSION: The Brazilian Portuguese version of the NOSE-Perf scale is a reliable and valid instrument for measuring symptoms in patients with nasal septum perforations. LEVEL OF EVIDENCE: Level 2-Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence.
Assuntos
Traduções , Humanos , Brasil , Reprodutibilidade dos Testes , Masculino , Feminino , Inquéritos e Questionários/normas , Adulto , Pessoa de Meia-Idade , Estudos de Casos e Controles , Comparação Transcultural , Adulto Jovem , Características Culturais , Septo NasalRESUMO
Condylar resorption is an aggressive and disability form of temporomandibular joint (TMJ) degenerative disease, usually non-respondent to conservative or minimally invasive therapies and often leading to surgical intervention and prostheses implantation. This condition is also one of the most dreaded postoperative complications of orthognathic surgery, with severe cartilage erosion and loss of subchondral bone volume and mineral density, associated with a painful or not inflammatory processes. Because regenerative medicine has emerged as an alternative for orthopedic cases with advanced degenerative joint disease, we conducted a phase I/IIa clinical trial (U1111-1194-6997) to evaluate the safety and efficacy of autologous nasal septal chondroprogenitor cells. Ten participants underwent biopsy of the nasal septum cartilage during their orthognathic surgery. The harvested cells were cultured in vitro and analyzed for viability, presence of phenotype markers for mesenchymal stem and/or chondroprogenitor cells, and the potential to differentiate into chondrocytes, adipocytes, and osteoblasts. After the intra-articular injection of the cell therapy, clinical follow-up was performed using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) and computed tomography (CT) images. No serious adverse events related to the cell therapy injection were observed during the 12-month follow-up period. It was found that autologous chondroprogenitors reduced arthralgia, promoted stabilization of mandibular function and condylar volume, and regeneration of condylar tissues. This study demonstrates that chondroprogenitor cells from the nasal septum may be a promise strategy for the treatment of temporomandibular degenerative joint disease that do not respond to other conservative therapies.
Assuntos
Côndilo Mandibular , Septo Nasal , Humanos , Septo Nasal/cirurgia , Feminino , Masculino , Adulto , Côndilo Mandibular/patologia , Transtornos da Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/terapia , Cirurgia Ortognática/métodos , Condrócitos/metabolismo , Diferenciação Celular , Reabsorção Óssea , Células-Tronco Mesenquimais/metabolismoRESUMO
OBJECTIVES: This study aimed to evaluate quality-of-life and satisfaction outcomes in patients undergoing the MES using the Portuguese version of the Nasal Obstruction Symptom Evaluation (NOSE-p) and Rhinoplasty Outcome Evaluation (ROE), and also to evaluate the frequency of possible complications of this technique. METHODS: We conducted a single-center prospective study with patients who had the indication for MES, from May 2016 to September 2020 at the Facial Plastic Surgery Clinic of Otolaryngology Department of the Hospital de Clinicas de Porto Alegre. The primary outcome was the relative postoperative change in NOSE-p. Secondary outcome was the variation in ROE, a validated quality-of-life questionnaire for rhinoplasty patients. RESULTS: Of the 31 patients submitted to extracorporeal septorhinoplasty who were evaluated, twenty-seven patients were included. Preoperative and postoperative NOSE-p scale scores were 65.2⯱â¯29.9 and 23.5⯱â¯26.7, respectively (mean differences of 42.04; [95% CI 27.35-56.73]; pâ¯<⯠0.0001). Pre and postoperative ROE scores were 38.3 ± 24.3 vs. 67.29 ± 29.7, respectively (mean differences of -29.02; [95% CI -40.5 to -17.5]; pâ¯=⯠0.0001). Residual septal deviation was verified in 2 patients (7.4%). CONCLUSION: Most of the patients submitted to modified extracorporeal septoplasty had a significant improvement in quality of life scores of nasal obstruction, with good aesthetical outcomes and low indices of postoperative complications. LEVEL OF EVIDENCE: Level 3.
Assuntos
Obstrução Nasal , Septo Nasal , Satisfação do Paciente , Qualidade de Vida , Rinoplastia , Humanos , Estudos Prospectivos , Rinoplastia/métodos , Feminino , Masculino , Adulto , Septo Nasal/cirurgia , Septo Nasal/anormalidades , Obstrução Nasal/cirurgia , Resultado do Tratamento , Adulto Jovem , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
BACKGROUND: This study introduces and assesses the outcomes of a novel rhinoplasty technique, TRICK-TIP (Transcolumellar and Inter Cartilaginous Keystoning with Tip preservation), employing a combined open and closed approach with tip anatomy conservation and structured tip support. METHODS: The procedure involves a low stairstep columellar sectioning, followed by transmembranous and intercartilaginous incisions without skin dissection in the columella or tip. Elevating the entire mobile nose as a three-layered flap provides extensive access to the entire nasal pyramid and septum. Tip modifications, including retrograde cephalic cartilage resection and supratip skin thinning, are performed based on individual cases. A key columellar strut is frequently used, initially sutured in the interdomal space and then turned down for height adjustment and final fixation. Interdomal sutures, supratip sutures, and alar resection are implemented as needed. RESULTS: One hundred twenty patients participated, with high satisfaction and a low frequency of adverse effects reported using four FACE-Q™ questionnaires. One hundred and two independent raters evaluated pre and postoperative photographs, scoring "overall nose result" as 3.6 out of 5, with minimal or absent nostril deformities (1.84), soft triangle deformities (1.73), and columellar external scar deformity/visibility (1.35) where 1 is the absence of the deformity and 5 is disfigurement. Complications were absent, and revisions were infrequent. CONCLUSIONS: The combined benefits of the wide-open approach, shortened surgery duration, and nasal tip preservation contribute to outcome optimization. TRICK-TIP rhinoplasty is characterized by simplicity, enabling targeted modifications, preventing soft triangle and rim complications, and facilitating essential tip support while maintaining favorable results. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Assuntos
Estética , Satisfação do Paciente , Rinoplastia , Humanos , Rinoplastia/métodos , Feminino , Adulto , Masculino , Adulto Jovem , Pessoa de Meia-Idade , Resultado do Tratamento , Técnicas de Sutura , Cartilagens Nasais/cirurgia , Septo Nasal/cirurgia , Estudos de Coortes , Nariz/cirurgia , Retalhos Cirúrgicos/transplante , Adolescente , Estudos RetrospectivosRESUMO
OBJECTIVE: Many studies have been published about the vascular anatomy of the nose and its utility for nasal reconstruction. Anatomic variations of the main arteries and their perforators are well described in the literature. A nasal tip perforator, not well described in the published studies, is analyzed in the present study and its utility for columellar reconstruction. This paper presents an anatomic study of the nasal tip artery and its clinical applications for columellar repair. METHODS: This study investigated the nasal tip perforator artery during nasal tip flap surgery for columellar repair in patients with sequels after nasal continuous positive airway pressure use. A descriptive anatomic study was conducted using intraoperative vascular dissection of patients operated on for nasal columellar defects by the author between 2013 and 2018. An observational study of a group of patients operated on for columellar repair using the axial nasal tip flap is presented here. RESULTS: The nasal tip artery was found in all the intraoperative dissections. Location and trajectory are described. Observed columellar length and width in operated patients have been nonstatistical and significantly different than controls in this study. CONCLUSIONS: The presence and trajectory of the nasal tip artery have been consistent in all the studied cases. The nasal tip flap based on this perforator has been a useful method for columellar repair in the studied group of patients. The presence of this vessel may augment blood supply to the nasal tip skin. By confirming the preservation of this artery, the surgeon may elevate the nasal tip flap safely.
Assuntos
Nariz , Rinoplastia , Humanos , Rinoplastia/métodos , Masculino , Feminino , Nariz/cirurgia , Nariz/irrigação sanguínea , Adulto , Pessoa de Meia-Idade , Septo Nasal/cirurgia , Retalhos Cirúrgicos/irrigação sanguínea , Retalho Perfurante/irrigação sanguínea , Artérias/cirurgiaRESUMO
BACKGROUND: Achieving an aesthetically pleasant tip rotation is paramount in rhinoplasty, and these results should be long-lasting. However, even powerful structural techniques such as septal extension grafts can lose rotation over time, as most support depends on the attachment of the graft to the septal cartilage. METHODS: We describe a simple suture technique to strengthen tip support in rhinoplasty, by suspending it to the cartilaginous dorsum, providing additional support to the tip against forces, such as gravity, scar contraction and muscle tension. CONCLUSIONS: Combining traditional techniques with suspension sutures can improve intraoperative results and could enhance long-term tip stability.
Assuntos
Rinoplastia , Humanos , Rinoplastia/métodos , Técnicas de Sutura , Cartilagem/transplante , Suturas , Rotação , Septo Nasal/cirurgia , Nariz/cirurgiaRESUMO
The dynamic retrograde intercrural columellar strut graft placement is a novel technique for a columellar strut insertion via a hemi-transfixion incision in patients undergoing endonasal functional or cosmetic surgery. It has a maximally concealed incision and does not disrupt major or minor tip support mechanisms. In our article, we give a detailed description of this unique surgical technique. Laryngoscope, 134:1246-1248, 2024.
Assuntos
Rinoplastia , Humanos , Rinoplastia/métodos , Nariz/cirurgia , Septo Nasal/cirurgia , Próteses e Implantes , Estética , Técnicas de Sutura , Resultado do TratamentoAssuntos
Humanos , Masculino , Feminino , Adulto , Insuficiência Respiratória/terapia , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Qualidade de Vida , Esteroides , Obstrução Nasal/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto , Resultado do TratamentoRESUMO
SUMMARY: The purpose of this study was to inform the anatomical types of the nasal septum of which including variations by dissection and to provide guidelines for clinical adaptation. For this purpose dissections were performed on 70 nasal septums of formalin fixed Korean adult cadavers (20 males, 11 females, and 39 of unknown sex) with an age at death of 13-105 years. The septal deviation was checked before midsagittal section the nasal cavity with the aid of a laryngoscope. The mucosa on the nasal septum was then removed to observe the morphology of the nasal septum. The shape of each component of the nasal septum was identified, and photographs were taken from a midsagittal plane. This study has discovered various anatomical types of the nasal septum and its variations. The correlations between septal types according to their proportions were also analyzed. The results reported herein provide detailed anatomical knowledge that can be used as a valuable reference for rhinoplasty procedures.
El propósito de este estudio fue informar los tipos anatómicos del tabique nasal incluyendo las variaciones por disección y brindar pautas para la adaptación clínica. Para este propósito, se realizaron disecciones en 70 tabiques nasales de cadáveres adultos coreanos fijados con formalina (20 hombres, 11 mujeres y 39 de sexo desconocido) con una edad de muerte de 13 a 105 años. La desviación septal se comprobó antes de la sección medio sagital de la cavidad nasal con la ayuda de un laringoscopio. A continuación, se retiró la mucosa del tabique nasal para observar la morfología del tabique nasal. Se identificó la forma de cada componente del tabique nasal y se tomaron fotografías desde un plano mediano sagital. En el estudio se descubrieron varios tipos anatómicos del tabique nasal y sus variaciones. También se analizaron las correlaciones entre los tipos septales según sus proporciones. Los resultados informados en este documento proporcionan un conocimiento anatómico detallado que se puede utilizar como una referencia valiosa para los procedimientos de rinoplastía.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Septo Nasal/anatomia & histologia , Cadáver , República da Coreia , Variação AnatômicaRESUMO
Presentamos el caso clínico de una mujer de 58 años que consulta por episodios de epis-taxis autolimitadas por fosa nasal derecha asociados a hipersensibilidad al manipular dicha fosa nasal. A la exploración se evidenció en el septum nasal una lesión mucosa nodular, de consistencia dura y aspecto violáceo. Se llevó a cabo exéresis de la misma por vía endonasal, con resultado histopatológico de tumor glómico (TG) del septum nasal. El TG es una neoplasia benigna perivascular, derivada de las células musculares lisas presentes en el cuerpo glómico; estructura con función termorreguladora, formada por un shunt entre arteriolas y vénulas, sin presencia de red capilar. Los cuerpos glómicos están presentes, mayoritariamente, en extremidades (lecho ungueal). Los tumores glómicos son, verdaderamente, excepcionales en el área ORL, existiendo sólo una treintena de casos publicados hasta la fecha a nivel nasosinusal. La mayoría de casos se presentan entre la 5ᵃ y 6ᵃ década de la vida y más, frecuentemente, en mujeres. Plantea diagnóstico diferencial, fundamentalmente, con dos entidades: el paraganglioma (con el que no debe ser confundido desde el punto de vista terminológico ni histológico), y con el tumor fibroso solitario (antiguo hemangiopericitoma). El comportamiento es benigno y el tratamiento es la cirugía
We present the clinical case of a 58-year-old woman who consulted for episodes of self-limited epistaxis in the right nostril associated with hypersensitivity to manipulation of this nostril. Examination revealed a nodular mucosal lesion in the nasal septum, with a hard consistency and purplish appearance. The lesion was excised endonasally, with histopatho-logical result of a glomus tumor (GT) of the nasal septum. The GT is a benign perivascular neoplasm, derived from smooth muscle cells present in the glomus body; structure with thermoregulatory function, formed by a shunt between arterioles and venules, without the presence of capillary network. Glomus bodies are mostly present in the extremities (nail bed). Glomus tumors are truly exceptional in the ENT area, with only about thirty cases published to date at the nasosinusal level. Most cases occur between the 5th and 6th decade of life and more frequently in women. It raises differential diagnosis fundamentally with two entities: paraganglioma (with which it should not be confused from the terminological or histological point of view) and with solitary fibrous tumor (former hemangiopericytoma). The behavior is benign and the treatment is surgery.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Neoplasias Nasais/diagnóstico , Tumor Glômico/diagnóstico , Septo Nasal/patologia , Neoplasias Nasais/patologia , Tumor Glômico/patologiaRESUMO
OBJETIVO: Identificar e descrever o perfil de recém-nascidos que apresentaram lesão de septo nasal em uso de Ventilação Não Invasiva e o tratamento utilizado. MÉTODO: Pesquisa descritiva, exploratória, com coleta retrospectiva de dados em prontuários de recém-nascidos hospitalizados entre janeiro/2020 a dezembro/2021, por meio de um instrumento estruturado, com análise de frequência descritiva simples. RESULTADOS: A lesão de septo nasal foi identificada em 19,0% dos recém-nascidos, com idade gestacional entre 30-35 semanas e peso ao nascer <1.500 gramas. O Estágio da lesão mais frequente foi I, tratado com Askina spray + rodízio de prongas, seguida de Hidrocoloide + Dersani Hidrogel, entre 1-7 dias (36,4%). CONCLUSÃO: A equipe de enfermagem depara-se com dificuldades na abordagem ao recém-nascido submetido a ventilação não invasiva com pronga, tornando-se relevante investir em sua qualificação e em protocolos assistenciais de cuidados com a pele para o desempenho de uma assistência segura e humanizada.
OBJECTIVE: To identify and describe the profile of newborns who presented nasal septal injury using Noninvasive Ventilation and the treatment used. METHOD: Descriptive, exploratory research, with retrospective data collection in medical records of newborns hospitalized between January/2020 and December/2021, through a structured instrument, with simple descriptive frequency analysis. RESULTS: Nasal septal injury was identified in 19.0% of newborns, with gestational age between 30-35 weeks and birth weight <1,500 grams. The most frequent stage of injury was I, treated with Askina spray + prong rotation, followed by Hydrocolloid + Dersani Hydrogel, between 1-7 days (36.4%). CONCLUSION: The nursing team encounters difficulties in the approach to newborns submitted to noninvasive ventilation with prong, making it relevant to invest in their qualification and in care protocols for skin care and for the performance of safe and humanized care.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Ventilação não Invasiva , Hospitalização , Septo Nasal/lesões , Estudos RetrospectivosRESUMO
Pólipo coanal es el término utilizado para una masa de tejido blando, solitaria y benigna que se extiende hacia la unión de la cavidad nasal y la nasofaringe; es decir, la coana. Los pólipos coanales nasales se presentan típicamente en tres formas diferentes: pólipos antrocoanales, esfenocoanales y etmoidocoanales. Sitios atípicos de origen han sido reportados en la literatura; por ejemplo, el tabique nasal y el cornete inferior. El conocimiento de los médicos sobre la existencia de pólipos coanales de sitios inusuales puede ayudar en el diagnóstico de los mismos, considerando crucial descartar previamente otros potenciales diagnósticos para estos casos de presentación atípica. A continuación reportamos el caso de un pólipo inflamatorio de inserción en techo de fosa nasal en un paciente de 65 años diagnosticado y tratado en nuestro servicio, cuyo caso es el primero reportado en la literatura.
Coanal polyp is the term used for a solitary, benign soft tissue mass extending into the junction of the nasal cavity and nasopharynx, i.e., the choana. Nasal coanal polyps typically present in three different forms: antrochoanal, sphenocoanal, and ethmoidocoanal polyps. Atypical sites of origin have been reported in the literature; these include the nasal septum and inferior turbinate. Physicians' awareness of the existence of coanal polyps from unusual sites may help in the diagnosis of coanal polyps considering it crucial to previously rule out other potential diagnoses for these cases of atypical presentation. Here we report the case of an inflammatory polyp of insertion in the roof of the nostril in a 65-year-old patient diagnosed and treated in our department, which is the first case reported in the literature.
Assuntos
Humanos , Masculino , Idoso , Pólipos Nasais/cirurgia , Pólipos Nasais/diagnóstico , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Pólipos Nasais/diagnóstico por imagem , Endoscopia , Inflamação , Septo NasalRESUMO
Introducción: La desviación de la punta nasal suele producir alteración estética y funcional nasal. Generalmente, asocia alteraciones morfológicas de los cartílagos alares, además de dismorfia del cartílago septal. Objetivo: Presentar una técnica quirúrgica alternativa para el tratamiento de la laterorrinia en tercio inferior nasal y sus resultados. Material y Método: Se trataron 27 pacientes con una laterorrinia en punta nasal con la técnica del septum bisagra, incluyendo la colocación de uno o dos injertos de expansión. Describimos el protocolo de anamnesis y exploración que seguimos en estos pacientes y la descripción detallada de la técnica quirúrgica. Resultados: En 19 pacientes se utilizó un injerto de expansión unilateral para completar la técnica y en ocho de forma bilateral. Se obtuvo una puntuación media en la escala visual analógica (EVA) de ventilación de 8,3, con una mejoría de seis puntos, y en la EVA de aspecto estético de 8,1, mejorando en 4,6 puntos. Conclusión: la utilización de la técnica del septum bisagra es beneficiosa para el tratamiento de la desviación de la punta nasal, tanto a nivel funcional como estético. Presenta ciertas diferencias frente a otras técnicas descritas. La indicación se debe adecuar a cada paciente de manera individualizada.
Introduction: Deviation of nasal tip usually produces aesthetic disturbance and nasal ventilation decrease. It is usually associated with alar cartilages morphologic disturbances and dysmorphia of the septal cartilage. Aim: To present an alternative surgical technique for treating laterorrhinia in the nasal inferior third and its outcomes. Material and Method: 27 patients with nasal tip laterorrhinia were treated with the hinge septum technique, including the placement of one or two spreader grafts. We describe the anamnesis and exploration protocol that we carried out in these patients and a detailed description of the surgical procedure. Results: Unilateral spreader graft was used in 19 patients to complete the technique, and bilateral spreader graft was used in eight. The average score in visual analogue scale (VAS) related to nasal flow was 8.3, which means an improvement of six points, and in VAS related to aesthetic appearance the score was 8.1, improving 4.6 points. Conclusion: The use of the hinge septum technique is useful to treat the deviation of the nasal tip in a functional and aesthetic way. There are several differences compared to other described techniques. The indication has to be suitable for each patient individually.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Adulto Jovem , Rinoplastia/métodos , Nariz/cirurgia , Septo Nasal/cirurgia , Obstrução Nasal , Nariz/anormalidades , Estudos Retrospectivos , Septo Nasal/anormalidadesRESUMO
An important parameter in diagnostic analysis and treatment planning of different biological areas is facial symmetry, and several etiological factors have been attributed to skeletal facial asymmetry. Although causality cannot be determined, previous studies have reported a relationship between the anatomical deviation of the nasal septum and facial development. Diagnosis is critical for patients in growth stages due to the association between nasal septum deviation (NSD) and abnormal growth of the nasomaxillary complex. To understand this relationship, this study aimed to investigate the influence of nasal septum deviation on fluctuating asymmetries (FA) of the nasomaxillary complex at different stages of skeletal maturation. Another goal was to determine whether an association exists between the degrees of septal deviation severity and asymmetry of the nasomaxillary complex. This was a retrospective, cross-sectional observational study comprising 60 selected cone-beam computed tomography (CBCT) scans that were divided into four groups (n = 15) according to the degree of septal deviation and skeletal maturation: mild deviation (MD; <10°), moderate to severe deviation (MSD; ≥10°), early group (EG), and late group (LG). The angle and area of deviation were measured for the greatest NSD, and a geometric morphometric approach was used to evaluate the nasal septum (NS) shape. The morphology of the nasomaxillary complex and the presence of fluctuating asymmetries were evaluated using 23 two-dimensional landmarks on the nasomaxillary complex (nasal, lateral, and palatal regions) with Procrustes ANOVA and Mann-Whitney test. Additionally, Spearman's correlation and multivariate regression were used to correlate the NSD with asymmetries in these regions. No significant differences were observed in the Procrustes FA scores of the nasomaxillary complex between the MD-EG × MSD-EG and MD-LG × MSD-LG (p > 0.05). However, the results of the multivariate regression revealed more specific aspects of asymmetry (asymmetry component), there was a positive correlation between the NSD angle and the palatal regions (p = 0.035 and p = 0.047, middle and posterior, respectively), and the nasal septum shape and anterior palatal regions (p = 0.039). The nasal and lateral regions did not correlate with the NSD angle in the multivariate regression analysis (p > 0.05). The results of this study indicate that there were no significant differences in the fluctuating asymmetry of the nasomaxillary complex between the mild and moderate to severe nasal septum deviation groups, in both early and late skeletal maturation stages. However, a positive correlation was observed in the degree of nasal septum deviation angle and asymmetry components of the middle and posterior palatal regions, likewise between the nasal septum shape and asymmetry components of the anterior palatal region. The diagnosis of nasal septum deviation by both physicians and dentists is important, as a relationship was observed with fluctuating asymmetry component of the palatal region. This information can guide the decision of the treatment planning for these individuals, and should be considered, especially in cases of severe septum deviation, due to the great anatomical proximity of these structures.
Assuntos
Assimetria Facial , Septo Nasal , Humanos , Estudos Transversais , Estudos Retrospectivos , Septo Nasal/diagnóstico por imagem , Septo Nasal/anatomia & histologia , FaceRESUMO
La granulomatosis con poliangitis (GPA) es una condición clínico-patológica que cursa con inflamación granulomatosa del tracto respiratorio superior e inferior, glomerulonefritis necrotizante focal y vasculitis necrotizante de vasos de pequeño y mediano tamaño (capilares, vénulas, arteriolas y arterias). La afectación de la GPA orbitaria oscila entre el 7 y el 45%. En ocasiones, la glándula lagrimal puede estar afectada de forma aislada y ser la manifestación inicial de la enfermedad. Presentamos el caso de una paciente con GPA y fístula nasolagrimal.
Granulomatosis with polyangiitis (GPA) is a clinical-pathological condition that presents with granulomatous inflammation of the upper and lower respiratory tract, focal necrotizing glomerulonephritis and necrotizing vasculitis of small and medium-sized vessels (capillaries, venules, arterioles and arteries). Orbital GPA involvement ranging from 7-45%. The lacrimal gland can occasionally be affected in isolation and be the initial manifestation of the disease. We present the case of a patient with GPA and nasolacrimal fistula.
Assuntos
Septo NasalRESUMO
Resumen Los schwannomas son neoplasias derivadas de las células de Schwann de la cubierta de los nervios periféricos. Su desarrollo en la región nasosinusal es poco frecuente, especialmente a nivel septal. Su diagnóstico diferencial es variado y debe establecerse con otras causas más habituales de masa nasal unilateral. Su tratamiento es quirúrgico. Describimos el caso de un varón de 47 años con una masa nasal derecha intervenida mediante cirugía endoscópica nasosinusal y con diagnóstico anatomopatológico de schwannoma septal.
Abstract Schwannomas are tumors that proceed from Schwann cells in the cover of peripheral nerves. It is uncommon in the sinonasal area, especially in the nasal septum. The differential diagnosis is extensive and requires contemplating other more frequent causes of unilateral nasal mass. The current treatment of septal schwannoma is surgical. We report a 47-year-old male with a right nasal mass operated by endoscopic sinonasal surgery with an anatomopathological diagnosis of a nasal septal schwannoma.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasais/patologia , Septo Nasal/patologia , Neurilemoma/patologia , Células de Schwann/patologia , Neoplasias Nasais/cirurgia , Neoplasias Nasais/diagnóstico por imagem , Diagnóstico Diferencial , Septo Nasal/cirurgia , Septo Nasal/diagnóstico por imagem , Neurilemoma/cirurgia , Neurilemoma/diagnóstico por imagemRESUMO
Resumen Introducción: La rinoplastia de preservación dorsal es una técnica innovadora en rinoplastias de reducción primaria, logrando una adecuada ventilación nasal y resultados estéticos naturales. Objetivo: Describir los resultados estéticos y funcionales en pacientes sometidos a rinoplastias de preservación dorsal. Material y Método: Se realiza un estudio de intervención no aleatorio "antes-después", donde se evaluaron las variables estética y funcional previo a la cirugía y luego a los seis meses. La variable estética se evaluó mediante el cuestionario de Utrecht (CU), escala visual análoga de apariencia nasal (EVA) y set de fotos clínicas. La variable funcional mediante el cuestionario de NOSE (Nasal Obstruction Symptoms Evaluation). Resultados: Un total de 15 pacientes fueron sometidos a rinoplastia de preservación dorsal. No hubo complicaciones tanto intra como posoperatorias. Ningún paciente intervenido presentó irregularidades dorsales, asimetrías, ni deformidades en "V" invertidas. Se observó una mejoría estadísticamente significativa (p < 0,01) en los resultados del CU, EVA y NOSE. Conclusión: La rinoplastia de preservación dorsal ofrece como resultado una nariz funcional, con líneas dorsales posoperatorias naturales. Esta técnica no presenta estigmas quirúrgicos, por lo que no es necesario la utilización de injertos para reparación del dorso nasal. Es rápida y fácil de realizar por cualquier cirujano especialista en rinoplastias.
Abstract Introduction: Dorsal preservation rhinoplasty is an innovative technique in primary reduction rhinoplasty, achieving adequate nasal ventilation and natural aesthetic results. Aim: To describe the aesthetic and functional results in patients undergoing dorsal preservation rhinoplasties. Material and Method: A non-randomized "before-after" intervention study was carried out, where the aesthetic and functional variables were evaluated before surgery and then at six months. The aesthetic variable was evaluated using the Utrecht questionnaire (CU), the visual analog scale of nasal appearance (VAS), and a set of clinical photos. The functional variable using the Nasal Obstruction Symptoms Evaluation (NOSE) questionnaire. Results: A total of 15 patients underwent dorsal preservation rhinoplasty. There were no intraoperative and postoperative complications. No patient who underwent surgery presented dorsal irregularities, asymmetries, or inverted "V" deformities. A statistically significant improvement (p < 0.01) was observed in the UC, VAS, and NOSE results. Conclusion: Dorsal preservation rhinoplasty results in a functional nose, with natural postoperative dorsal lines. This technique does not present surgical stigmata, so it is not necessary to use grafts to repair the nasal dorsum. It is quick and easy to perform by any rhinoplasty surgeon.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Rinoplastia/métodos , Estética , Septo Nasal/cirurgia , Cuidados Pós-Operatórios , Obstrução Nasal/cirurgia , Inquéritos e Questionários , Procedimentos de Cirurgia PlásticaRESUMO
ABSTRACT BACKGROUND: Allergic rhinitis (AR) is a chronic inflammatory disease that affects almost 30% of the adult population. OBJECTIVE: To describe and compare the evolution of symptoms in patients diagnosed with AR and septal deviation prior to and following septoplasty (STP). DESIGN AND SETTING: Quasi-experimental study developed in A Coruña University Hospital. METHODS: Patients aged 18-65 years who had been diagnosed with AR and septal deviation were recruited. Obstruction airflow was evaluated before and after surgery, by means of anterior rhinomanometry (RNM). Severity symptoms and quality of life were assessed using a visual analogue scale (VAS) and the ESPRINT questionnaire, respectively. RESULTS: A total of 50 subjects underwent STP and 42 were included in this study. Their mean age at the time of surgery was 34.16 ± 9.74 years (range 18-64). Significant reductions in mean VAS and ESPRINT were observed after surgery (P < 0.01). These outcomes were considered to represent an overall improvement in quality of life. The RNM results also improved significantly, from mean values of 478.07 ± 165.4 cm3/s before STP to 826.4 ± 175.5 cm3/s afterwards (P < 0.01). CONCLUSIONS: The negative correlations of VAS and ESPRINT with RNM, from before and to after STP, demonstrate the efficacy of scales and questionnaires as objective methods for determining obstruction in the absence of rhinomanometry. Patients with allergic rhinitis and septal deviation showed improvements in obstruction severity and medication use after STP.