Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.041
Filtrar
1.
Laryngoscope ; 132(3): 509-517, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-34125439

RESUMO

OBJECTIVES/HYPOTHESIS: About 260,000 septoplasties are performed annually in the US to address nasal septal deviation (NSD). Yet, we do not consistently understand what aspects of NSD result in symptoms. STUDY DESIGN: Blinded cohort study. METHODS: Two fellowship-trained surgeons blindly reviewed computerized tomography (CTs) of 10 confirmed NSD patients mixed with 36 healthy controls. All patients were correctly identified, however, 24/36 controls were falsely identified by both surgeons as patients (33.3% specificity), which were grouped as asymptomatic NSD (aNSD), while the remaining controls as non-NSD (healthy). Acoustic rhinometry, rhinomanometry, individual CT-based computational fluid dynamics and nasal sensory testing were applied to address the puzzling questions of why these aNSD had no symptoms and, more fundamentally, what caused symptoms in sNSD patients. RESULTS: aNSD reported no nasal symptoms - Nasal Obstruction Symptom Evaluation score (sNSD: 60.50 ± 13.00; aNSD: 5.20 ± 5.41; non-NSD: 6.66 ± 7.17, P < .05); 22-item Sino-Nasal Outcome Test score (sNSD: 32.60 ± 14.13; aNSD: 10.04 ± 10.10; non-NSD: 9.08 ± 12.42, P < .001). No significant differences in measured nasal resistance, minimum cross-sectional area (MCA), degree of septal deviation, and nasal airflow distributions were found between sNSD and aNSD groups. Only three variables differentiate sNSD versus aNSD: anterior averaged heat flux on deviated side, inferior turbinate peak heat flux on non-deviated side, and nasal cool sensitivity measured by menthol lateralization threshold, with no significant differences among these variables found between the two healthy groups (aNSD vs. non-NSD). These variables by themselves or combined can differentiate sNSD from controls with higher specificity than the physicians (ROC area under the curve = 0.84 with 70% sensitivity and 91.6% specificity). CONCLUSIONS: This study sheds light on the potential mechanisms of NSD symptomatology: distorted nasal cooling due to NSD exacerbated by poorer nasal mucosal sensitivity. It further supports our previous hypothesis that nasal obstruction complaints do not result directly from obstruction, rather from the capacity of our nose to subjectively sense airflow cooling. LEVEL OF EVIDENCE: 3 Laryngoscope, 132:509-517, 2022.


Assuntos
Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/complicações , Estudos de Casos e Controles , Humanos , Septo Nasal/diagnóstico por imagem , Septo Nasal/fisiopatologia , Deformidades Adquiridas Nasais/patologia , Deformidades Adquiridas Nasais/fisiopatologia , Transtornos do Olfato/etiologia , Rinomanometria , Rinometria Acústica , Tomografia Computadorizada por Raios X
2.
Eur Arch Otorhinolaryngol ; 279(4): 1943-1950, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34291346

RESUMO

PURPOSE: To investigate the long-term safety and efficacy of a 3D-printed bioresorbable polycaprolactone (PCL) nasal implant for nasal septal deformity reconstruction. METHODS: Fourteen patients who had undergone nasal septum reconstruction surgery using 3D-printed PCL nasal septal implants were enrolled. The primary outcome was the change in total Nasal Obstruction Symptom Evaluation (NOSE) scale scores between postoperative 3 months and current status (3.59 ± 0.51 years). The secondary outcomes were changes in the minimum cross-sectional area (MCA) and volume of both nasal cavities based on acoustic rhinometry, the cross-sectional area of the ostiomeatal unit, and the nasal septum angle of the paranasal sinus (PNS) in computed tomography (CT) images, and a visual analog scale (VAS) of the patients' subjective satisfaction. RESULTS: The results showed no significant changes in the MCAs (Cohen's d:0.09; p = 0.711) or nasal volume (Cohen's d:0.26; p = 0.356), the area of the ostiomeatal unit (Cohen's d:0.49; p = 0.064), septum angles (Cohen's d:0.18; p = 0.831), the NOSE scale (Cohen's d:0.14; p = 0.621), or patients' subjective satisfaction (Cohen's d:0.52; p = 0.076) during the follow-up period. CONCLUSIONS: This homogeneous composite microporous PCL nasal septal implant demonstrated long-term clinical efficacy and safety in human tissues that required maintenance of mechanical strength. Therefore, the indications for this implant could extend to various other craniofacial reconstructions in the future.


Assuntos
Obstrução Nasal , Rinoplastia , Humanos , Obstrução Nasal/cirurgia , Septo Nasal/anormalidades , Septo Nasal/diagnóstico por imagem , Septo Nasal/cirurgia , Impressão Tridimensional , Rinometria Acústica , Rinoplastia/métodos , Resultado do Tratamento
3.
Auris Nasus Larynx ; 49(1): 67-76, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33966932

RESUMO

OBJECTIVE: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. METHODS: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. RESULTS: The AP was significantly correlated with the VAS score (r=-0.58, p=0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14±0.06 to 0.03±0.03, p=0.004), but not by KI (0.09±0.08 to 0.04±0.03, p=0.25). OSR also improved nasal airway resistance (1.10±0.44 to 0.42±0.15, p=0.02), and the VAS score (79.11±14.74 to 5.78±7.89, p=0.004). CONCLUSION: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique.


Assuntos
Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Septo Nasal/anormalidades , Septo Nasal/patologia , Deformidades Adquiridas Nasais/complicações , Estudos Retrospectivos , Rinoplastia/métodos
4.
Plast Reconstr Surg ; 148(6): 983e-991e, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847124

RESUMO

BACKGROUND: Late correction of cleft lip nose deformity continues to be a challenge because of the weakness of cartilages and the collapsing forces of tight contracted soft tissues. The authors describe the new technique of costal cartilage spring graft for columella and lower lateral cartilage as a block to achieve symmetric, aesthetically more durable, and acceptable results for the late correction of cleft lip nose deformity. METHODS: Late cleft lip nose repair with simultaneous rhinoplasty was performed in 92 patients with unilateral cleft lip nose deformity. For correction of cleft lip nose deformity, a strut graft 2 to 3 mm in width, 0.5 to 1 mm in thickness, and 5 to 7 cm in length was prepared from costal cartilage (autograft or allograft). The strut graft was curved and bowed with fingers to simulate the medial and lateral crura of the alar cartilage. A crescent-shaped skin excision from the alar rim and a vertical incision in the columella were made. The intercrural and alar areas were dissected to create sufficient space for the insertion of a bow-shaped spring cartilage graft. After insertion of the cartilage graft, the alar rim was closed with continuous 6-0 Monocryl and the columella was closed with 5-0 Vicryl. RESULTS: Correction of depressed alar cartilage and webbing, lengthening the columella using spring costal cartilage, and symmetric nostrils were achieved in all cases. The mean follow-up period was 5 years (range, 2 to 15 years). CONCLUSION: These procedures, septoplasty, and simultaneous rhinoplasty provided long-term satisfactory results in the late correction of cleft lip nose deformity. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Fenda Labial/complicações , Cartilagem Costal/transplante , Septo Nasal/anormalidades , Rinoplastia/métodos , Adolescente , Adulto , Estética , Feminino , Seguimentos , Humanos , Masculino , Septo Nasal/cirurgia , Fatores de Tempo , Tempo para o Tratamento , Transplante Autólogo/métodos , Transplante Homólogo/métodos , Resultado do Tratamento , Adulto Jovem
5.
PLoS One ; 16(11): e0259468, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34735521

RESUMO

BACKGROUND & AIMS: Nasal obstruction caused by nasal septal deviation is very bothersome and, therefore, can affect the patient's emotional state. However, little is known about the effect of nasal septal deviation (NSD) on the neuropsychiatric aspects of patients. Therefore, this study aims to verify the higher incidence of anxiety, depression, and migraine in patients diagnosed with NSD compared to general populations using big data. METHODS: This retrospective cohort study collected subjects from the Korean National Health Insurance Service (NHIS) database. Adjustments were made to minimize the confounding of variables for age, sex, residence type, income levels, hypertension, diabetes, dyslipidemia, rhinitis, and chronic rhinosinusitis between the two groups. The primary endpoint of this study was newly diagnosed anxiety, depression, and migraine between January 2009 and December 2018. Kaplan-Meier survival curves, logarithmic rank test, and Cox proportional regression test were used for statistical analysis. RESULTS: Among a total of 135,769 subjects in the NHIS database, 48,495 patients with NSD (NSD group) and 54,475 control subjects (control group) were selected. Patients with NSD had an increased risk of anxiety, depression, and migraine compared to the control group. In the NSD group, the adjusted hazard ratios (HR) were 1.236 (95% CI, 1.198-1.276) for anxiety, 1.289 (95% CI, 1.238-1.343) for depression, and 1.251 (95% CI, 1.214-1.290) for migraine. CONCLUSION: NSD is associated with a higher incidence of anxiety, depression, and migraine. Therefore, it is suggested that physicians carefully consider psychoneurological distress and employ therapeutic strategies to minimize these conditions.


Assuntos
Ansiedade/epidemiologia , Depressão/epidemiologia , Transtornos de Enxaqueca/epidemiologia , Obstrução Nasal/psicologia , Septo Nasal/anormalidades , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/genética , República da Coreia/epidemiologia , Estudos Retrospectivos
6.
J Plast Reconstr Aesthet Surg ; 74(10): 2744-2750, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34266802

RESUMO

BACKGROUND: Even a small amount of bleeding during nose surgery can impair the surgeon's vision, prolong the duration of operation, and affect surgery quality; therefore, various techniques have been proposed to control the bleeding. The aim of this study was to compare the efficacy of the local use of tranexamic acid (TXA) in the dry field of surgery. METHOD: This randomized, double-blinded, controlled trial was conducted in the operation room of Imam Reza Hospital, Tehran, Iran, from January 10, 2016 to February 8, 2017. Sixty patients with age range from 20 to 60 years and the American Society of Anesthesiologists physical status classes I candidates who require septoplasty enrolled. Patients were randomized through white and black cards to receive either syringes. Thirty patients in the intervention group received lidocaine + adrenaline + TXA and 30 patients in the control group received lidocaine + adrenaline. Bleeding volume accumulated in the suction chamber, the nasopharyngeal pack, and hemodynamic variations were measured. Surgeon's satisfaction scores and suitability of operation field were obtained from the surgeon by using the Likert scale and Boezaart grading scale, respectively. RESULTS: The intervention group had a higher score of surgeon satisfaction [4.1 vs 3.16 in the control group (P = 0.001)] and fewer hemodynamic variations. The mean bleeding volume in the intervention was 187.23 ± 54.61 mL and in the control group was 341.22 ± 49.17 mL (P = 0.001). The mean Boezaart score (suitability of operation field) in the intervention group was 1.8 (score range: 1-3) and in the control group was 2.53 (score range: 2-4) and it was statistically significant (P = 0.001). CONCLUSION: The local use of TXA + lidocaine + adrenaline is associated with reduced bleeding, greater surgeon satisfaction, reduced need for Karpol injection, and better hemodynamic stability.


Assuntos
Antifibrinolíticos/administração & dosagem , Septo Nasal/cirurgia , Qualidade da Assistência à Saúde , Rinoplastia/normas , Ácido Tranexâmico/administração & dosagem , Administração Tópica , Pressão Arterial/efeitos dos fármacos , Atitude do Pessoal de Saúde , Perda Sanguínea Cirúrgica/prevenção & controle , Volume Sanguíneo , Método Duplo-Cego , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/cirurgia , Duração da Cirurgia
7.
Plast Reconstr Surg ; 148(1): 133-143, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34076624

RESUMO

BACKGROUND: Secondary cleft rhinoplasty presents some of the most challenging cases of both cosmetic and functional nasal deformities. Understanding the anatomy and growth abnormality seen with the cleft nasal deformity helps to tailor surgical management. This article seeks to expand on the application of current concepts in secondary rhinoplasty for unilateral cleft lip nasal deformity. METHODS: The authors review nasal analysis in the cleft rhinoplasty patient and provide the surgical management for each aspect in the secondary cleft rhinoplasty. RESULTS: The secondary rhinoplasty was divided into seven areas: piriform hypoplasia, septal reconstruction, dorsal reshaping, tip reshaping, tip projection, alar reshaping, and alar repositioning. Surgical management for each is provided. CONCLUSION: Secondary cleft rhinoplasty requires an understanding of the structural dysmorphology, and the use of cosmetic, functional, and secondary rhinoplasty techniques for its successful management.


Assuntos
Fenda Labial/cirurgia , Cartilagens Nasais/anormalidades , Septo Nasal/anormalidades , Reoperação/métodos , Rinoplastia/métodos , Fenda Labial/complicações , Estética , Humanos , Cartilagens Nasais/crescimento & desenvolvimento , Cartilagens Nasais/cirurgia , Septo Nasal/crescimento & desenvolvimento , Septo Nasal/cirurgia , Resultado do Tratamento
8.
Plast Reconstr Surg ; 148(1): 66-70, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34181604

RESUMO

BACKGROUND: The primary element of a crooked nose is a midline deviation of the nasal pyramid. To date, no surgical strategies have been described as compatible with the philosophy of dorsal preservation. The dorsal preservation technique differs from the Joseph structured rhinoplasty because it preserves both the keystone area and the continuity of the cartilaginous vault. The authors focused on the versatility of the dorsal preservation technique even for the deviated nose, introducing the "Pisa Tower concept." METHODS: From January of 2015 to June of 2019, 280 patients diagnosed as having a crooked nose underwent primary septorhinoplasty with dorsal preservation through an asymmetric bony wedge resection and lowering of the bony pyramid onto the frontal process of the maxilla (the let-down osteotomy), in accordance with the Pisa Tower concept. Inclusion criteria were a preoperative computed tomography examination, nasal axis deviation, a complete photographic examination preoperatively, and at least a 1-year follow-up. RESULTS: The mean nasal axis deviation was 7.62 degrees preoperatively and 1.15 degrees postoperatively (p < 0.05). Of the 84 patients, 47 (55.95 percent) were very satisfied, 33 (39.28 percent) were satisfied, and four (4.76 percent) were unsatisfied with surgical results and required revision surgery. CONCLUSIONS: The authors' opinion is that the association of "swinging door" septoplasty with the Pisa Tower concept can be a valid alterative to other techniques when working with the structured rhinoplasty philosophy in patients with a crooked nose. Although this is only a preliminary study, the decreased use of spreaders graft and less aggressive reconstructive methods look very promising. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.


Assuntos
Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/cirurgia , Satisfação do Paciente , Rinoplastia/métodos , Adolescente , Adulto , Estética , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/lesões , Septo Nasal/cirurgia , Reoperação/estatística & dados numéricos , Estudos Retrospectivos , Rinoplastia/estatística & dados numéricos , Resultado do Tratamento , Adulto Jovem
9.
Auris Nasus Larynx ; 48(5): 914-921, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33685756

RESUMO

OBJECTIVE: Many authors have investigated the most appropriate surgical approach to the deviated septum in childhood, considering the obligate mouth-breathing habit a possible cause of malocclusion and disharmonious development of the facial skeleton in growing kids. Nevertheless, controversies still remain about the long-term functional/esthetic results of such procedures, mainly due to the duration of the follow-up and possible confounding factors. METHODS: 111 Caucasian children (age range: 6-13 years) were submitted to a personal "Quick" septoplasty surgical technique between 2005 and 2010. Preoperative otorhinolaryngological examination using flexible nasal endoscopy, anterior active rhinomanometry (AAR), Nasal Obstruction Septoplasty Effectiveness (NOSE) questionnaire, and dentofacial evaluation (including cephalometry) were performed. Postoperative AAR, NOSE questionnaire and cephalometric assessment were carried out in all patients at the age of 18 years. Informed consent was obtained from children's parents as appropriate. RESULTS: No surgical complication was recorded. Among our patients, a significant (p <0.001) improvement of nasal breathing resistances at AAR and NOSE questionnaire scores was found after surgery. A significant improvement in cephalometric/dental parameters (gonial angle values, anterior facial height, prevalence of class I occlusion, maxillary intermolar width, and cross-bite frequency) was noticed after the follow-up with respect to preoperative conditions. CONCLUSION: The "Quick" septoplasty technique described is a practical and conservative procedure with a low complication rate that offers long-term favourable results for the correction of nasal septum deviations in children. Nasal-breathing restoration may favor a physiological and harmonious development of craniofacial and dental structures in offspring.


Assuntos
Ossos Faciais/crescimento & desenvolvimento , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Rinoplastia/métodos , Adolescente , Cefalometria , Criança , Feminino , Humanos , Masculino , Má Oclusão/epidemiologia , Respiração Bucal/fisiopatologia , Obstrução Nasal/fisiopatologia , Septo Nasal/anormalidades , Estudos Prospectivos , Mecânica Respiratória/fisiologia , Rinomanometria
10.
Nutrients ; 13(1)2021 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-33467180

RESUMO

Craniofacial development requires extremely fine-tuned developmental coordination of multiple specialized tissues. It has been evidenced that a folate deficiency (vitamin B9), or its synthetic form, folic acid (FA), in maternal diet could trigger multiple craniofacial malformations as oral clefts, tongue, or mandible abnormalities. In this study, a folic acid-deficient (FAD) diet was administered to eight-week-old C57/BL/6J female mouse for 2-16 weeks. The head symmetry, palate and nasal region were studied in 24 control and 260 experimental fetuses. Our results showed a significant reduction in the mean number of fetuses per litter according to maternal weeks on FAD diet (p < 0.01). Fetuses were affected by cleft palate (3.8%) as well as other severe congenital abnormalities, for the first time related to maternal FAD diet, as head asymmetries (4.6%), high arched palate (3.5%), nasal septum malformed (7.3%), nasopharynx duct shape (15%), and cilia and epithelium abnormalities (11.2% and 5.8%). Dysmorphologies of the nasal region were the most frequent, appearing at just four weeks following a maternal FAD diet. This is the first time that nasal region development is experimentally related to this vitamin deficiency. In conclusion, our report offers novel discoveries about the importance of maternal folate intake on midface craniofacial development of the embryos. Moreover, the longer the deficit lasts, the more serious the consequent effects appear to be.


Assuntos
Anormalidades Craniofaciais/etiologia , Doenças Fetais/etiologia , Deficiência de Ácido Fólico/complicações , Fenômenos Fisiológicos da Nutrição Materna/fisiologia , Complicações na Gravidez , Prenhez , Animais , Anormalidades Craniofaciais/embriologia , Feminino , Camundongos Endogâmicos C57BL , Septo Nasal/anormalidades , Septo Nasal/embriologia , Nasofaringe/anormalidades , Nasofaringe/embriologia , Palato/anormalidades , Palato/embriologia , Gravidez
11.
Auris Nasus Larynx ; 48(1): 90-97, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32727704

RESUMO

OBJECTIVES: The aim of this prospective study was to evaluate the effect of modified extracorporeal endonasal septoplasty on nasal tip shape and function in patients with severe caudal septal deviation. METHODS: The study population comprised of 55 patients undergoing modified extracorporeal endonasal septoplasty, which called marionette septoplasty. To analyse the aesthetic objective outcomes, postoperative photographs were measured for projection index (PI), tip projection (TP), nasolabial angle (NLA), tip deviation angle (TDA), nasofrontal angle (NFA), supratip height (STH), columellar height (CH), at three times (2 weeks, 3, and 6 months after surgery) and were compared with preoperative photographs. Functional and aesthetic outcomes were also evaluated using nasal obstruction symptom evaluation (NOSE) scale and standardized cosmesis and health nasal outcomes survey (SCHNOS). RESULTS: Between the pre- and post-operative 6th-month examinations, a significant increase in PI and TP were 7%, and 5% respectively. There was a significant alteration in the NLA and TDA values following the last examination (mean difference ± standard error of mean 9.68 ± 0.9° and 1.5 ± 0.8°, respectively). Moreover, the technique did not make a significant change in the final NFA, STH, and CH, measurements. Following surgery, the NOSE and SCHNOS scores were decreased significantly and the improvement continued over time until the last examination. CONCLUSION: The present study findings suggest that the marionette septoplasty technique is an effective to correct and stabilize severe caudal septal deviations. This technique also can provide tip support and protection with a low incidence of dorsal irregularity.


Assuntos
Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Rinoplastia/métodos , Adolescente , Adulto , Estética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cartilagens Nasais/transplante , Obstrução Nasal/cirurgia , Septo Nasal/anormalidades , Nariz/anatomia & histologia , Estudos Prospectivos , Adulto Jovem
12.
Ear Nose Throat J ; 100(10): 710-712, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32466730

RESUMO

OBJECTIVE: To investigate the association of high septal deviation with the olfactory fossa depth and Gera angle. METHODS: Fifty-four computed tomography scans of patients with high septal deviation were evaluated. The olfactory fossa depth and Gera angle were measured. The values of the deviated and nondeviated sides were compared. RESULTS: No association between high septal deviation and the olfactory fossa depth and Gera angle was found. CONCLUSION: High septal deviation does not affect the olfactory fossa depth and Gera angle. In other words, the olfactory fossa depth and Gera angle have no association with the high septal deviation.


Assuntos
Fossa Craniana Anterior/anormalidades , Septo Nasal/anormalidades , Tomografia Computadorizada de Feixe Cônico , Fossa Craniana Anterior/anatomia & histologia , Fossa Craniana Anterior/diagnóstico por imagem , Osso Etmoide/anatomia & histologia , Osso Etmoide/diagnóstico por imagem , Humanos , Septo Nasal/diagnóstico por imagem , Seios Paranasais/diagnóstico por imagem , Estudos Retrospectivos , Base do Crânio/anatomia & histologia , Base do Crânio/diagnóstico por imagem
13.
Ear Nose Throat J ; 100(5_suppl): 645S-651S, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31996042

RESUMO

OBJECTIVE: The aim of this study was to compare the functional and aesthetic outcomes of endonasal septoplasty (ES) and extracorporeal septal reconstruction (ESR) in anterocaudal septal deviation. METHODS: In this study, patients (n = 46) who underwent nasal septoplasty surgery due to anterocaudal septal deviation during February 2015 to August 2017 were analyzed; 23 patients underwent ES and the others (n = 23) underwent ESR. The decision of whether to use the ES or ESR was randomized by random number table method. Nasal obstruction symptoms evaluation (NOSE) scores, total nasal resistance (TNR), aesthetic visual analog scale (VAS), nasal anatomical angles, and incidence of complications were used to assess the patients in 2 groups. RESULTS: The NOSE scores, TNR, aesthetic VAS, tip deviation angle (TDA), nasolabial angle (NLA), nasofrontal angle (NFA) in the ESR group were significantly improved from preoperative to postoperative 1 year, whereas in the ES group, except aesthetic VAS, NLA, NFA, all other postoperative outcomes were improved from preoperative values. The objective and subjective postoperative results of ESR group were better than the ES group except TDA. The incidence of complications was not significantly different between the 2 groups. CONCLUSION: Our study have compared the nasal functional and aesthetic outcomes of 2 septoplasty techniques in a randomized controlled trial. The ESR technique is more effective than ES technique in correcting functional and aesthetic disorders caused by anterocaudal septal deviation.


Assuntos
Endoscopia , Septo Nasal/cirurgia , Procedimentos Cirúrgicos Nasais/métodos , Adulto , Estética , Feminino , Humanos , Incidência , Masculino , Obstrução Nasal/etiologia , Septo Nasal/anormalidades , Cirurgia Endoscópica por Orifício Natural , Complicações Pós-Operatórias/epidemiologia
14.
Ear Nose Throat J ; 100(6): NP283-NP289, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31569977

RESUMO

Nasal septal deviations (NSD) have been categorized into 7 types. The effect of these different deviations on airflow pattern and warming function has not been fully investigated. The purpose of this study was to utilize a computational fluid dynamics approach to assess the impact of NSD of varying types on nasal airflow and warming function. Patients with each type of NSD were enrolled in the study, and a normal participant as the control. Using a computational fluid dynamics approach, modeling of nasal function was performed. Indices of nasal function including airflow redistribution, total nasal resistance, airflow velocity, and airflow temperature were determined. Among all types of NSD, the maximal velocity and total nasal resistance were markedly higher in type 4 and 7 deviations. The flow partition and velocity distribution were also altered in type 4 and 7 as well as type 2 and 6 deviations. Airflow in all categories of NSD was fully warmed to a similar degree. From a computational aerodynamics perspective, the type of septal deviation may contribute to altered airflow characteristics. However, warming function was similar between septal deviation types. Future studies will help to ascertain the functional importance of septal deviation types and the applicability of these computational studies.


Assuntos
Biologia Computacional/métodos , Hidrodinâmica , Septo Nasal/fisiopatologia , Deformidades Adquiridas Nasais/fisiopatologia , Ventilação Pulmonar , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Obstrução Nasal/etiologia , Obstrução Nasal/fisiopatologia , Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/complicações , Adulto Jovem
15.
Ear Nose Throat J ; 100(5): 375-377, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31578106

RESUMO

OBJECTIVE: The main aim is to discuss the effect of nasal septal deviation on the postoperative hearing results of patients with tympanosclerosis. MATERIAL AND METHODS: We analyzed the hearing results of patients with tympanosclerosis who were operated on in a tertiary center. Pure tone audiometric results were compared according to the existence of nasal septal deviation. RESULTS: This study included 48 patients with unilateral tympanosclerosis disease. Moderate or severe septal deviation had no significant effect on postoperative hearing results. CONCLUSION: The nasal septal deviation as the only pathologic factor in patients with tympanosclerosis did not have a deteriorating effect after surgery.


Assuntos
Audição , Mastoidectomia/efeitos adversos , Miringoesclerose/fisiopatologia , Deformidades Adquiridas Nasais/fisiopatologia , Timpanoplastia/efeitos adversos , Adulto , Audiometria de Tons Puros , Feminino , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Masculino , Miringoesclerose/complicações , Miringoesclerose/cirurgia , Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/complicações , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Período Pós-Operatório , Estudos Retrospectivos
16.
Ear Nose Throat J ; 100(9): 673-678, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32339048

RESUMO

IMPORTANCE: This is the first randomized study to compare the quality of life of patients undergoing endoscopic septoplasty compared to traditional trans-nasal trans-speculum (TNTS) septoplasty. OBJECTIVE: To assess the clinical outcomes and quality of life results of endoscopic versus TNTS septoplasty in patients with septal deviation and nasal obstruction. DESIGN: A prospective, randomized controlled trial comparing 2 approaches of septoplasty: endoscopic and TNTS septoplasty performed in a single institution during the years 2016 to2017. The follow-up time was 3 months. SETTING: A single institution study in a tertiary health-care referral center. PARTICIPANTS: Patients who underwent primary surgery for repairing deviated nasal septum due to nasal obstruction, were older than 18 years old, and were eligible for study inclusion. Sixty-five patients were enrolled in this study, 34 in the endoscopic arm and 31 in the TNTS septoplasty arm. The overall follow-up rate was 94% at the first visit (2 weeks) and 92% at the last visit (12 weeks). Thus, the final cohort consisted of 60 patients, 30 in each study arm. The patients ranged in age from 18 to 71 years (mean 27 years) old. MAIN OUTCOMES AND MEASURES: The primary outcome was the Sino-Nasal Outcome Test-22 (SNOT-22) score. Secondary outcomes were the Short Form 36 (SF36) QOL score and complication rates. Both questionnaires were administered at 2 weeks and 3 months following surgery. RESULTS: Sixty patients completed this study, 30 in each study arm. Sino-Nasal Outcome Test-22 scores were improved after 3 months, with no difference between the study arms. There were no cases of septal perforation or profound bleeding requiring repeated surgery. CONCLUSIONS AND RELEVANCE: Endoscopic septoplasty and TNTS show similar results for treatment of nasal septum deviation. Trial Registration: Traditional Septoplasty versus Endoscopic Septoplasty for Treating Deviated Nasal Septum, NCT02653950. https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0005ZOR&selectaction=Edit&uid=U00021YC&ts=2&cx=-2w7hot.


Assuntos
Endoscopia , Septo Nasal/cirurgia , Qualidade de Vida , Rinoplastia/métodos , Adulto , Idoso , Endoscopia/efeitos adversos , Endoscopia/métodos , Humanos , Pessoa de Meia-Idade , Obstrução Nasal/cirurgia , Septo Nasal/anormalidades , Duração da Cirurgia , Complicações Pós-Operatórias , Estudos Prospectivos , Rinoplastia/efeitos adversos , Teste de Desfecho Sinonasal , Adulto Jovem
17.
Facial Plast Surg Clin North Am ; 29(1): 123-130, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33220837

RESUMO

Crooked or deviated noses pose a specific challenge as many of the elements in a deviated nose are not symmetric and therefore not ideal for preservation techniques. Deviated noses are often where a hybridization between preservation and structural rhinoplasty is required. Careful preoperative evaluation of the soft tissue and bony anatomy of the patient is very important and congenital or post-traumatic asymmetry may involve more than the nasal pyramid. Full exposure of the nasal pyramid allows for visualization and appropriate osteotomy or rhinosculpture.


Assuntos
Septo Nasal/anormalidades , Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Rinoplastia/métodos , Humanos , Deformidades Adquiridas Nasais/etiologia , Deformidades Adquiridas Nasais/patologia , Osteotomia/métodos
18.
Int. j. morphol ; 38(6): 1544-1548, Dec. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1134475

RESUMO

SUMMARY: The aim of this research was to analyze the morphology of the nasal septum and inferior nasal concha bone in class III facial deformities prior to orthodontic treatment in orthognathic surgery candidates. 40 subjects were included in this research. The inclusion criteria were an Angle class III, negative overjet and SNA angle less than 80º. Patients with facial asymmetry, facial trauma or who had undergone maxillofacial or ENT procedures were excluded. CBCT images were obtained for all the patients and the nasal septum deviation, morphology of inferior nasal concha bone and ostium of the maxillary sinus were analyzed and related to the complexity of the facial deformity expressed by the ANB angle and dental relations. The measurement was standardized by ICC and the data was analyzed using a chi square test and Spearman's coefficient with a p value < 0.005 for statistical significance. Nasal septal deviation was observed in 77.5 %. The deviation angle was 13.28º (±4.68º) and the distance from the midline to the most deviated septum was 5.56 mm (±1.8 mm) with no statistical relation to the complexity of the facial deformity. The deviated nasal septum showed inferior nasal concha bone hypertrophy on the concave side of the nasal septum deviation (p=0.049). The open or closed condition of the maxillary sinus ostium was not related to any conditions in the septum or complexity of the facial deformity. Inferior nasal concha bone hypertrophy could be related to nasal septal deviation. The nasal condition in a class III facial deformity could not differ from the general population; careful in orthognathic surgery as to be assume in the Le Fort I Osteotomy and nasal approach related to nasal septum deviation and inferior nasal concha bone.


RESUMEN: El objetivo de esta investigación fue analizar la morfología del septum y la concha nasal inferior en sujetos con deformidad facial clase III previo al tratamiento de ortodoncia preparatorio para cirugía ortognática. Fueron incluidos 40 sujetos en esta investigación. Los criterios de inclusión fueron la de presentar una clase III de Angle, overjet negativo y ángulo SNA menor que 80º. Sujetos con asimetría facial, trauma facial o quienes presentaron algún tipo de procedimiento maxilofacial o de otorrinolaringología fueron excluidos. Tomografía computadorizada cone beam (CBCT) fueron obtenidas para todos los sujetos donde le morfología del septum nasal, morfología de la concha nasal inferior y el ostium del seno maxilar fueron analizados y relacionados con la complejidad de la deformidad facial expresada como ángulo ANB y relaciones dentales. Las medidas fueron estandarizadas por el ICC y los datos fueron analizados utilizando la prueba chi cuadrado y coeficiente de Spearman con un valor de p<0,05 para obtener relaciones significativas. La desviación del septum nasal se observó en el 77,5 %; el ángulo de desvío fue de 13,28º (±4,68º) y la distancia de desvío del septum desde la línea media fue de 5,56 mm (±1,8 mm) sin diferencias estadísticas en relación a la complejidad de la deformidad. El desvío de septum nasal demostró hipertrofia de la concha nsal inferior en el lado cóncavo del septum desviado (p=0,049). La condición de ostium abierto o cerrado no fue relacionado con ninguna condición del septum nasal o complejidad de la deformidad facial. La hipertrofia de la concha nasal inferior se relacionó con el desvío de septum nasal. La condición nasal en deformidad facial de clase III no es diferente de la observada en la población general; cuidados deben ser realizados en cirugía ortognática para el desarrollo de la osteotomía de Le Fort I y aproximación nasal en relación al desvío de septum y probable alteración de la concha nasal inferior.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Má Oclusão Classe III de Angle , Osso Nasal/anormalidades , Septo Nasal/anormalidades , Estudos Transversais , Hipertrofia
19.
Plast Reconstr Surg ; 146(6): 1357-1367, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33234969

RESUMO

BACKGROUND: Even today, severe septal deformities are a challenging problem for any rhinoplasty surgeon. Standard techniques are often not able to achieve satisfactory long-term results regarding function or aesthetic form. In such severe cases, a partial or total extracorporeal septal reconstruction may be used, as these techniques provide reliable and lasting results. METHODS: The aim of this work is to present the authors' experience with the technique of total extracorporeal septal reconstruction and its development to today's standard and to prove its effectiveness in the long-term follow-up. RESULTS: This article presents 40 years of clinical experience in this field and describes the technical changes that have evolved. Low complication rates, safe techniques, and favorable long-term outcomes of the total extracorporeal septal reconstruction show the benefits of this technique. CONCLUSION: The indication for a total extracorporeal septal reconstruction has been limited by the development of less complex surgical procedures, but it still represents the best technique to achieve long-term functional and aesthetic results in patients with very complex septal deformities. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Septo Nasal/anormalidades , Deformidades Adquiridas Nasais/cirurgia , Complicações Pós-Operatórias/epidemiologia , Rinoplastia/métodos , Adulto , Estética , Feminino , Seguimentos , História do Século XX , História do Século XXI , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/cirurgia , Complicações Pós-Operatórias/etiologia , Cuidados Pré-Operatórios/métodos , Rinoplastia/efeitos adversos , Rinoplastia/história , Rinoplastia/tendências , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
20.
BMJ Case Rep ; 13(9)2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32900731

RESUMO

Congenital absence of the nasal septum (hyporhynia) is infrequently reported in the literature. We report a rare case in a newborn with multiple congenital anomalies with the aim to highlight its rarity and compatibility with life in a resource-limited setting. The case notes of the child were summarised and the relevant literature reviewed to give the report a context. A 2-hour-old term baby boy presented with a history of abnormal facie characterised by a single nostril and noisy breathing. On examination, he had stridulous breathing, bilateral proptosis, sloping of the forehead, depressed nasal bridge absent nasal septum, absence of columella and hypoplastic mid-face, among other dysmorphic features. A diagnosis of hyporhynia in a baby with multiple congenital anomalies was made and managed accordingly. The baby was discharged to continue follow-up. Congenital absence of the nasal septum is rare and could present without respiratory distress and may be compatible with life.


Assuntos
Anormalidades Múltiplas , Septo Nasal/anormalidades , Anormalidades Múltiplas/diagnóstico , Humanos , Recém-Nascido , Masculino , Nigéria , Fenótipo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...