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3.
Medicine (Baltimore) ; 101(35): e30300, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107523

RESUMO

INTRODUCTION: Saddle nose deformities are typically reconstructed with cartilage grafts; however, conchal cartilage grafts are and associated with a risk of damage to the posterior auricular ligament and insufficient amounts, and costal cartilage grafts require invasive surgery under general anesthesia. We proposed a double-layer dermofat graft as an alternative to these methods. PATIENT CONCERNS: Two patients with type IV saddle nose deformity underwent reconstruction with nasal augmentation with a double-layer dermofat graft harvested from the gluteal sulcus. DIAGNOSIS: After operation, photogrammetric analysis demonstrated an improvement in the dorsal depression area, which corresponded to the angle between the sellion, most depressed point, and pronasale. Rhinoplasty Outcome Evaluation questionnaire was assessed. INTERVENTIONS: The graft was divided into 2 sections; the first section was implanted transversely into the depressed nasal framework, and the second section was inserted vertically from the nasion to the supratip break for augmentation. OUTCOMES: Both patients reported high satisfaction with the Rhinoplasty Outcome Evaluation questionnaire. The mean preoperative angle between the sellion, most depressed point, and pronasale was 157.8°, and the mean postoperative angle at 6 months was 176.9°. CONCLUSION: The simple method double-layer dermofat graft technique demonstrated excellent outcomes in saddle nose deformity correction, did not require cartilage, and was easily performed under local anesthesia.


Assuntos
Cartilagem Costal , Deformidades Adquiridas Nasais , Rinoplastia , Cartilagem/transplante , Cartilagem Costal/transplante , Humanos , Nariz/cirurgia , Deformidades Adquiridas Nasais/etiologia , Deformidades Adquiridas Nasais/cirurgia , Rinoplastia/métodos
4.
BMJ Case Rep ; 15(9)2022 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104034

RESUMO

Slingshots or hand catapults, historically used as a military or hunting weapon, are common toys among children and young teenagers. Their use can be dangerous as a strike to the eye or orbit can result in significant injuries including blindness. We describe a rare case of a sino-orbital foreign body caused by a slingshot injury in a young boy. The case was managed by a multidisciplinary team involving ear, nose and throat, ophthalmology and paediatrics, and the foreign body of a metal ball bearing was removed using an endoscopic transnasal approach. Although the patient made a good recovery, the case highlights the danger of slingshot devices misused by children.


Assuntos
Corpos Estranhos , Adolescente , Criança , Endoscopia/efeitos adversos , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Cabeça , Humanos , Masculino , Nariz , Faringe
5.
Contrast Media Mol Imaging ; 2022: 8603625, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36101798

RESUMO

This study aimed to investigate the safety, tolerance, and comfort of the subjects in gastroscopy by observing and comparing the effect of gastroscopy under two different breathing modes: nasal breathing and nasal inspiration and oral expiration. A total of 60 subjects who underwent routine gastroscopy in the hospital from January 2021 to June 2021 were selected as the research subjects. According to the willingness of the subjects, they were divided into a nasal breathing group and a nasal inspiration and oral expiration group. The differences in vital signs, adverse reactions, and visual analog scale (VAS) scores were compared between the two groups. There were no significant differences in mean arterial pressure, heart rate, and blood oxygen saturation between the two groups before, during, and after the examination (P > 0.05). The nasal breathing group had fewer adverse reactions such as nausea, cough, belching, and restlessness than the nasal inspiration and oral expiration group, and the difference was statistically significant (P < 0.01). VAS score of the nasal breathing group was lower than that of the nasal inspiration and oral expiration group, and the difference was statistically significant (P < 0.01). Subjects are more tolerant to nasal breathing mode, which causes fewer adverse reactions, less pain, and more comfort and is more worthy to be popularized in primary hospitals.


Assuntos
Gastroscopia , Hipnóticos e Sedativos , Humanos , Hipnóticos e Sedativos/efeitos adversos , Nariz/fisiologia , Respiração
6.
J Healthc Eng ; 2022: 8706978, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36046012

RESUMO

This study was to investigate the airflow characteristics in nasal cavity under different conditions and analyze the effects of different respiratory intensity, particle diameter, and particle density on the deposition of particles carried by airflow in the nasal cavity, respectively. The three-dimensional geometric model of the nasal cavity was established based on typical medical images. The SST k-ω turbulence model in the computational fluid dynamics (CFD) was used to simulate the airflow in the nasal cavity, and the deposition of particles in the airflow was analyzed with the Lagrange discrete phase model. The results showed that the air in the nasal cavity flows in the left and right nasal passages through the perforation in front of the nasal septum and forms a vortex structure at the perforation site, and the particle deposition efficiencies (DE) under perforation nasal cavity are higher than that under normal nasal cavity. Different parameters had different effects on the particle DE. The results showed that the DE of particles with smaller size (≤2.5 µm) is lower; the higher the respiration intensity, the greater the influence on the DE of the larger particle size; and the larger particle density (>1550 kg·m-3) has little effect on the DE of larger particle size (DP = 10 µm). The results agree well with the corresponding research data.


Assuntos
Hidrodinâmica , Cavidade Nasal , Simulação por Computador , Humanos , Nariz , Tamanho da Partícula
7.
Sultan Qaboos Univ Med J ; 22(3): 387-392, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36072078

RESUMO

Objectives: This study aimed to report the authors' experience with the anatomical subunit technique for unilateral cleft lip repair, which has gained popularity worldwide. Methods: From July 2015 to April 2020, 114 consecutive cases of cleft lip underwent primary cleft lip repair with closed rhinoplasty by a single surgeon. The demographic data, severity and type of the cleft lip, surgical outcomes, including vermillion notching, were assessed by an independent senior surgeon. The rate of revision surgery was collected from the Al-Shifa® - 3Plus healthcare information system (Ministry of Health, Oman). Parents' satisfaction regarding scar quality and lip and nose appearance was collected and all data were statistically analysed. Results: A total of 82 cases satisfied the inclusion criteria. The mean age at surgery for cleft lip was 32 weeks. Among these, 35 cases (43%) were complete cleft lips and 47 cases (57%) were incomplete. Additionally, 43 children (52%) were born of consanguineous marriage. Six patients (7%) needed revision surgery. The digital survey was completed by 40 subjects (response rate: 48.8%) which showed 85% satisfaction rate with the postoperative scar and 77.5% satisfaction with the aesthetic appearance of the nose. Conclusion: The anatomical subunit technique resulted in a predictable outcome indicating a high rate of patient satisfaction with scar quality and nasal and lip symmetry in children with varying severity of cleft lip. The high percentage of consanguinity (52%) in this study highlights the need for more targeted national campaigns involving premarital counselling in the Omani population.


Assuntos
Fenda Labial , Procedimentos Cirúrgicos Reconstrutivos , Criança , Cicatriz/cirurgia , Fenda Labial/cirurgia , Humanos , Nariz/cirurgia , Satisfação do Paciente
8.
Neurocirugia (Astur : Engl Ed) ; 33(5): 219-226, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36084958

RESUMO

BACKGROUND: The purpose of the study was to create computer-aided design models of the sphenoid sinus with a free-source software in order to perform a preoperative planning during trans-sphenoidal endoscopic surgery (TES) and clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures. METHODS: For each patient a 3D volume rendering of the sphenoid sinus was obtained from a thin slice head and maxilla-facial CT scan using a free-source DICOM viewer. The 3D models obtained preoperatively were examined preoperatively by six neurosurgeons in order to identify the boundaries of the sella. RESULTS: For the main anatomical landmark, all of the observers were able to recognize the anatomical structure at a rate ranging from 80 to 98%, 28 to 60% and 25 to 58% for expert (n=3), inexpert (n=3) and the entire group of observers (n=6), respectively. The analysis of the data shows that both observation groups presented a lower recognition rate of the following parameters: right and left medial and lateral optocarotid recesses and tumor prominence, however, the sellar prominence, clival recess, planum sphenoidalis, right and left ICA prominence, right and left optic prominences represent the main anatomical landmarks to be recognized during TES immediately before the opening of the sellar floor. CONCLUSIONS: The use of a preoperative 3D imaging is not in itself a novelty in the literature, however the fact that a simple tool obtained with a free-source software like Horos can represent a considerable help in surgical practice without resorting to the use of more complex software and expensive represents the real utility of this work.


Assuntos
Endoscopia , Seio Esfenoidal , Endoscopia/métodos , Humanos , Nariz , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/patologia , Seio Esfenoidal/cirurgia , Tomografia Computadorizada por Raios X
9.
J Craniofac Surg ; 33(6): 1684-1689, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36054885

RESUMO

ABSTRACT: Maxillary skeletal expansion (MSE) provides a new nonsurgical method for the treatment of patients with insufficient maxillary arch expansion width. In this study the aerodynamic changes of the upper airway after MSE in adult patients were explored based on three-dimensional reconstruction technology of cone-beam computed tomographic data and the numerical simulation technology of computational fluid dynamics. An upper airway experimental model was then created based on three-dimensional printing technology and tested in vitro to verify the reliability of the numerical simulation method. The comparison between numerical simulation and experimental results shows that the 2 results are in good agreement. The results of numerical simulation showed that the cross-sectional area of the upper airway was increased after MSE, the pressure and velocity of the upper airway were reduced, and airway resistance was also reduced during exhalation and inhalation. This study shows that MSE can effectively improve the airway dynamics of patients.


Assuntos
Técnica de Expansão Palatina , Faringe , Adulto , Tomografia Computadorizada de Feixe Cônico/métodos , Humanos , Maxila/diagnóstico por imagem , Nariz , Faringe/diagnóstico por imagem , Reprodutibilidade dos Testes
10.
J Craniofac Surg ; 33(6): 1762-1768, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36054889

RESUMO

BACKGROUND: The purpose of this study was to evaluate the epidemiology and perioperative complications of different reconstructive strategies to correct cleft nasal deformity, with particular attention paid to type and timing of cartilage grafting. METHODS: Retrospective cohort study was conducted of cleft rhinoplasty performed between 2012 and 2017 in North America utilizing the American College of Surgeons National Surgical Quality Improvement Program- Pediatric hospital network. Medical/surgical complications, reoperations, and readmissions within 30 days postoperatively were analyzed with appropriate statistics. RESULTS: During the study interval, 3317 pediatric patients underwent cleft rhinoplasty, with 8.0% involving the use of cartilage grafts. Ear cartilage was significantly more commonly used for intermediate repair, whereas rib cartilage was more commonly used for late repair (P=0.006). Overall, rhinoplasties with ear cartilage grafts had shorter procedure durations than those without cartilage grafts (P=0.005), whereas those with rib cartilage grafts had increased procedure duration (P<0.001). The use of cartilage grafts was not associated with increased complications in either intermediate or late cleft rhinoplasty. Patients with bilateral clefts were more likely to undergo rhinoplasty with cartilage grafts overall (P=0.047) and with cartilage grafts for late reconstruction (P=0.039). CONCLUSIONS: Ear cartilage is most frequently utilized for intermediate repair, whereas rib cartilage is most frequently utilized for late repair during cleft rhinoplasty. Ear cartilage grafts are associated with significantly decreased procedure duration, whereas rib cartilage grafts are associated with significantly increased procedure duration. Not surprisingly, cleft rhinoplasty is relatively safe, with a 2% overall short-term complication rate.


Assuntos
Fenda Labial , Cartilagem Costal , Rinoplastia , Criança , Fenda Labial/cirurgia , Cartilagem Costal/transplante , Cartilagem da Orelha/cirurgia , Humanos , Nariz/cirurgia , Estudos Retrospectivos , Rinoplastia/métodos
11.
J Craniofac Surg ; 33(6): 1869-1874, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36054892

RESUMO

BACKGROUND: Patients with alveolar cleft unrepaired suffer from nasal deformities of different magnitude. Bone and cartilage grafts are harvested through several incisions. In this study, we present a method to simultaneously correct nasal deformities and repair alveolar cleft using grafts from the nasal septum. PATIENTS AND METHODS: All 6 patients with unilateral cleft lip and palate have alveolar cleft unrepaired combined with nasal deformity. Computed tomography scans and 3-dimensional-printed models of vomer and ethmoid bone were used for the purpose of preoperative design and for assessing the magnitude of deformity. Grafts of bone and cartilage from deviated septum were harvested by septoplasty through which dorsum deviation was corrected. Bone grafts from vomer and ethmoid were then fixed to the prepared alveolar cleft to repair the defect and elevate the alar base. Septal cartilage was adjusted into different shapes of grafts and deformities of nasal tip, nostrils, and columella were then corrected by rhinoplasty to restore the symmetry of the nose. RESULTS: Symmetry of nostrils was improved. The height of alar base on the cleft side was elevated to the level close to the noncleft side. Deviation of the septum, nasal dorsum, and columella was corrected. Projection of the nasal tip was adjusted to facial midline. Midface aesthetics was generally improved. CONCLUSION: Application of septal grafts reduce the number of incisions. One-stage repair of alveolar cleft and nasal deformities, with the aid of digital design, improves the postoperative experience and the general outcome of the surgery.


Assuntos
Fenda Labial , Fissura Palatina , Doenças Nasais , Rinoplastia , Cartilagem/transplante , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Estética Dentária , Osso Etmoide/cirurgia , Humanos , Septo Nasal/cirurgia , Septo Nasal/transplante , Nariz/anormalidades , Nariz/cirurgia , Doenças Nasais/cirurgia , Rinoplastia/métodos , Resultado do Tratamento , Vômer/cirurgia
14.
Emerg Infect Dis ; 28(10): 2035-2042, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36084650

RESUMO

Reducing zoonotic influenza A virus (IAV) risk in the United States necessitates mitigation of IAV in exhibition swine. We evaluated the effectiveness of shortening swine exhibitions to <72 hours to reduce IAV risk. We longitudinally sampled every pig daily for the full duration of 16 county fairs during 2014-2015 (39,768 nasal wipes from 6,768 pigs). In addition, we estimated IAV prevalence at 195 fairs during 2018-2019 to test the hypothesis that <72-hour swine exhibitions would have lower IAV prevalence. In both studies, we found that shortening duration drastically reduces IAV prevalence in exhibition swine at county fairs. Reduction of viral load in the barn within a county fair is critical to reduce the risk for interspecies IAV transmission and pandemic potential. Therefore, we encourage fair organizers to shorten swine shows to protect the health of both animals and humans.


Assuntos
Vírus da Influenza A , Influenza Humana , Infecções por Orthomyxoviridae , Doenças dos Suínos , Animais , Humanos , Vírus da Influenza A/genética , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Nariz , Infecções por Orthomyxoviridae/epidemiologia , Infecções por Orthomyxoviridae/prevenção & controle , Infecções por Orthomyxoviridae/veterinária , Prevalência , Suínos , Doenças dos Suínos/epidemiologia , Doenças dos Suínos/prevenção & controle , Estados Unidos
15.
J Drugs Dermatol ; 21(9): 983-988, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36074508

RESUMO

Defects involving the glabella and nasal root require an optimal cosmetic outcome due to its critical position in the mid-face. Glabellar defects often involve multiple cosmetic subunits, hair variations, and various skin thicknesses (forehead superiorly, eyebrows / eyelids laterally, nasal root and dorsum inferiorly), further complicating the reconstruction. The eyebrows and natural concavity of this area must be preserved if possible. Repair options in this location vary by personal preference and experience rather than literature-based outcomes. Key considerations include the location of the defect (glabella vs nasal root +/- brow +/- medial canthus), the position of the defect (midline or off-center) and the texture/thickness of the skin (thick glabellar skin or thin skin of medial canthus). The rich blood supply in this area has made local flaps the preferred option for moderate to large defects. However, two pitfalls for local flaps are pincushioning resulting in a “bull nose” and the possibility of causing synophrys. Often, a combination of flaps, grafts, and/or primary closures are necessary to adequately close large glabellar/nasal root defects. There is a paucity of literature for reconstructive options of the glabella and nasal root, and in the authors’ experience, even experienced surgeons struggle to decide on these. We present a series of reconstructive approaches for the majority of moderate to large cutaneous glabellar and nasal root defects with excellent functional and aesthetic results. J Drugs Dermatol. 2022;21(9):983-988. doi:10.36849/JDD.6132.


Assuntos
Neoplasias Nasais , Procedimentos Cirúrgicos Reconstrutivos , Rinoplastia , Animais , Bovinos , Estética , Testa , Humanos , Masculino , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Rinoplastia/métodos , Retalhos Cirúrgicos/transplante
16.
Rom J Morphol Embryol ; 63(1): 105-111, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36074673

RESUMO

Juvenile nasopharyngeal angiofibroma (JNA) is a rare benign tumor that affects predominantly males and is known by its highly vascular character. We have performed a 3-year retrospective study of patients with JNA surgically treated within the third ENT Department of Prof. Dr. Dorin Hociota Institute of Phonoaudiology and Functional ENT Surgery, Bucharest, Romania. In all the cases, the patients were investigated both clinically and through medical imaging before surgery and all tumors were embolized. Our study comprised of eight cases, of which seven were solved by endoscopic endonasal approach and one case was treated through a combined endonasal-external approach. JNA should always be managed through a multidisciplinary team (MDT) approach in centers with adequate experience, to gain favorable results.


Assuntos
Angiofibroma , Neoplasias Nasofaríngeas , Angiofibroma/diagnóstico , Angiofibroma/patologia , Angiofibroma/cirurgia , Endoscopia/métodos , Feminino , Humanos , Masculino , Neoplasias Nasofaríngeas/diagnóstico por imagem , Neoplasias Nasofaríngeas/patologia , Nariz/patologia , Estudos Retrospectivos , Romênia
17.
Quintessence Int ; 53(9): 778-780, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-35976750

RESUMO

Two nasal foreign bodies were discovered by a dental practitioner on a routine radiographic examination of a 15-year-old autistic patient. Going over past radiographs, one of the nasal foreign bodies was detected in a radiograph performed 2 years previously. No nasal complaints or other clues to the problem were apparent. The patient was referred to the emergency room, and the foreign bodies were removed by an Ear Nose and Throat specialist, under general anesthesia. This paper reviews the diagnosis and treatment of nasal foreign bodies, and highlights the important role of the dental practitioner in the proper detection and diagnosis, prompt referral for management, and reduction in related complications.


Assuntos
Odontólogos , Corpos Estranhos , Adolescente , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Humanos , Nariz/diagnóstico por imagem , Papel Profissional , Radiografia Dentária
19.
Pediatrics ; 150(3)2022 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-36032018

RESUMO

OBJECTIVES: To describe the epidemiology of battery-related emergency department (ED) visits among children aged <18 years in the United States from 2010 to 2019 and compare with previous study findings. METHODS: Data on ED visits were obtained from the National Electronic Injury Surveillance System. Using narrative descriptions and diagnosis codes, battery-related cases were coded into four exposure routes: (1) ingestion, (2) mouth exposure, (3) ear insertion, and (4) nasal insertion. RESULTS: An estimated 70 322 (95% confidence interval: 51 275-89 369) battery-related ED visits among children aged <18 years occurred during the study period, or 9.5 per 100 000 children annually. Button batteries were implicated in 84.7% of visits where battery type was described. A statistically significant increase in the ED visit rate occurred from 2010 to 2017 (P = .03), followed by a nonstatistically significant decrease from 2017 to 2019. The ED visit rate was highest among children aged ≤5 years compared with those 6 to 17 years (24.5 and 2.2 per 100 000 children, respectively). The mean patient age was 3.2 years (95% confidence interval: 2.9-3.4). Ingestions accounted for 90.0% of ED visits, followed by nasal insertions (5.7%), ear insertions (2.5%), and mouth exposures (1.8%). CONCLUSIONS: Pediatric battery-related ED visit rates continued to significantly increase from 2010 to 2017, with children aged ≤5 years having the highest rates. Prevention efforts have not significantly reduced injury rates; therefore, regulatory efforts are needed. Ultimately, hazard reduction or elimination through safer button battery design is critical and should be adopted by the battery industry.


Assuntos
Eletrônica , Serviço Hospitalar de Emergência , Criança , Humanos , Aplicação da Lei , Nariz , Estados Unidos/epidemiologia
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