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Virginia F, Giuseppe F, Carlotta L, Andrea C, Daniele M, Silvia P. Is Ehlers-Danlos Syndrome a Neglected Cause of Nosebleeds? Ear Nose Throat J 2024:1455613241246832. [PMID: 38590201 DOI: 10.1177/01455613241246832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Affiliation(s)
- Fancello Virginia
- ENT and Audiology Clinic, Department of Neurosciences and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Fancello Giuseppe
- Department of Otology and Skull Base Surgery, Gruppo Otologico, Piacenza, Italy
| | - Liberale Carlotta
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Ciorba Andrea
- ENT and Audiology Clinic, Department of Neurosciences and Rehabilitation, University Hospital of Ferrara, Ferrara, Italy
| | - Monzani Daniele
- Unit of Otorhinolaryngology, Head and Neck Department, University of Verona, Verona, Italy
| | - Palma Silvia
- Otolaryngology and Audiology Unit, University of Modena and Reggio Emilia, Modena, Italy
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Madi M, Alsaad SS, AlAssiry N, Attia D, AlAssiry M, Zakaria O. Multilevel Modeling Analysis of Odontogenic Risk Factors and Nasal Septum Deviation Associated with Maxillary Sinus Mucosal Thickening: A Cone-Beam Computed Tomography Study. Dent J (Basel) 2024; 12:74. [PMID: 38534298 DOI: 10.3390/dj12030074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/29/2024] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
(1) Background: In this study, the impact of odontogenic risk factors with nasal septum deviation on maxillary sinus mucosal thickening was assessed using Cone-beam computed tomography CBCT. (2) Methods: A total of 328 maxillary sinus regions from 164 patients (85 males and 79 females) were examined. Images were interpreted by dental specialists and Otolaryngologists. Coronal and sagittal sections were examined to assess the proximity of the root tips of posterior maxillary teeth (RPMT) to the maxillary sinus. The periodontal bone loss for all maxillary posterior teeth was also assessed. Consequently, maxillary sinus mucosal thickening (MT) was further classified into three gradings. Multilevel modeling regression analysis was used due to the hierarchical structuring of the data. Four models were developed, a null model with no factors, a model with tooth-level factors (RPMT, PBL, tooth condition, and root length), a model with patient-level factors (gender and nasal septum deviation), and a model with combined patient- and tooth-level factors. Regression estimates (AOR) and 95% confidence intervals (CIs) of individual and tooth factors were calculated. (3) Results: Multilevel regression analysis showed that RPMT was significantly associated with MT of maxillary sinus (p < 0.001), where patients who had RPMT > 0 had higher odds of MT of maxillary sinus. Tooth condition was also found to be significantly associated with MT of maxillary sinus, where teeth with failed RCT (p < 0.001) and teeth with restorations (p < 0.008) had higher odds of MT of maxillary sinus (AOR = 2.87, 95%CI 1.65, 4.42, AOR = 1.64, 95%CI 1.14, 2.36, respectively). (4) Conclusions: In order to plan preoperative treatment for maxillary posterior teeth, it is important to assess the anatomical relationship between the sinus floor and the root tips of the maxillary posterior teeth. Additionally, we establish a better understanding of the clinician before surgical intervention is conducted.
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Affiliation(s)
- Marwa Madi
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Sara S Alsaad
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Nada AlAssiry
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
| | - Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
| | - Mansour AlAssiry
- Department of Otolaryngology, King Fahad Specialist Hospital, Dammam 32253, Saudi Arabia
| | - Osama Zakaria
- Department of Biomedical Dental Science, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia
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Varghese L, Mohan A. Stamm's S Point-An Often-Missed Site in Recurrent Epistaxis. Otolaryngol Head Neck Surg 2024; 170:996-997. [PMID: 37811671 DOI: 10.1002/ohn.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 08/20/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Lalee Varghese
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
| | - Anuja Mohan
- Department of Otorhinolaryngology, Christian Medical College, Vellore, India
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Jing J, Li L, Wu Y, Zheng L, Zhang L, Li H, Wang H. Application of Biologic Graft in Nasal Septal Perforation Repair. Ear Nose Throat J 2024:1455613241233748. [PMID: 38404028 DOI: 10.1177/01455613241233748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Abstract
Objective: To explore the clinical outcome when biomaterials are used to repair nasal septal perforations. Methods: A total of 12 patients were treated. The nasal septum was dissected via endoscopic approach. A 4 cm × 7 cm biologic graft (Biodesign® Tissue Graft) was folded to form a double layer, was placed over the perforation, and was affixed into place using suture. Results: Follow-up ranged from 2 to 8 months after the operation. One patient was not completely healed and presented with a remaining defect of about 2 mm × 8 mm in the upper part of the nasal septum. The remaining 11 patients healed completely. Conclusion: Using a biologic graft to repair nasal septal perforations is an easy operation as it prevents the need to take autologous tissue from the patient, allows for a repair to be performed without creating septal flaps, and has good histocompatibility. It is a safe and effective method that can be used clinically.
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Affiliation(s)
- Jianjun Jing
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
| | - Liang Li
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
| | - Yongxiang Wu
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
| | - Liang Zheng
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
| | - Longfang Zhang
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
| | - Haihong Li
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
| | - Hui Wang
- Department of Otorhinolaryngology-Head and Neck Surgery, General Hospital of Xinjiang Military Region of the Chinese People's Liberation Army, Urumqi, China
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Drake I, Wilkinson S, Kubba H. Spontaneous abscess of the nasal septum in children: a 10-year series. J Laryngol Otol 2024:1-3. [PMID: 38311333 DOI: 10.1017/s0022215124000276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND This paper reports a 10-year series of spontaneous nasal septal abscesses in immune-competent children, with suggestions for optimal management. METHODS A retrospective case note review was conducted of children undergoing an operation for incision and drainage of nasal septal abscesses between 2013 and 2023. RESULTS Six children were identified via electronic hospital records during the 10-year review period, five with a spontaneous abscess. The children were aged 10-14 years. All were immunocompetent and none had active sinus infection. The most common presenting features were nasal swelling, facial swelling, headache, nasal congestion and fever. The most common bacterial isolate was Staphylococcus aureus. All children received prompt surgical drainage and intravenous antibiotic therapy. Complications were seen in three children, with one child developing significant intracranial complications. CONCLUSION To our knowledge, this is the first series of spontaneous nasal septal abscesses in immunocompetent children. The high prevalence of Staphylococcus aureus suggests spread from the nasal mucosa or vestibule. Early recognition, computed tomography scanning, surgical drainage and antibiotic therapy are the mainstays of treatment, to prevent potentially life-threatening complications.
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Affiliation(s)
- Ivy Drake
- Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
| | - Sophie Wilkinson
- Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
| | - Haytham Kubba
- Department of Paediatric Otolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
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Joo HA, Jang YJ. Factors Affecting the Surgical Outcome in Nasal Septal Perforation Repair. Ann Otol Rhinol Laryngol 2024; 133:14-21. [PMID: 37357889 DOI: 10.1177/00034894231178964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
OBJECTIVE Nasal septal perforation (NSP) repair is challenging surgery considered in patients with symptomatic NSP intractable to conservative treatments. This study aimed to assess the success rate and identify factors affecting the surgical outcome of NSP by analyzing consecutive series of NSP repairs by a single surgeon. METHODS We enrolled 84 patients diagnosed with NSP and who underwent surgical repair of NSP by a single surgeon (Y.J.J.) between November 2007 and July 2022. Medical records were retrospectively reviewed regarding variables involving preoperative symptoms, rhinologic history, etiology, surgical techniques, and the outcome of surgery. In addition, features of NSP were objectively evaluated using computed tomography scans. RESULTS The overall success rate of NSP repair was 64.3% (54 of 84). Nasal obstruction (79.8%), crusting (34.5%), and epistaxis (27.4%) were frequent preoperative symptoms. Iatrogenic injury from previous nasal surgery (70.2%) was the most common cause. The average size of NSP on preoperative CT was 9.53 ± 6.68 mm. Patients with incomplete NSP closure had significantly larger perforations (12.21 ± 7.92 mm) than those with successful closure (8.04 ± 5.41 mm) preoperatively (P = .005). Patients with smoking history (OR = 2.971, 95% CI 1.170-7.548, P = .020) and NSP repair with combined rhinoplasty (OR = 3.811, 95% CI 1.401-10.370, P = .007) were more likely to experience incomplete closure. Patients whose perforations were reinforced with interposition graft were more likely to result in successful repair (OR = 6.752, 95% CI 2.496-18.262, P < .001). The bilaterality of mucosal flap coverage, surgical approach, types of mucosal flap and interposition graft, perforation shape, mucosal thickness around perforation, and distance from the nasal floor were not significantly related to the surgical outcome. CONCLUSIONS Significant factors affecting the outcome of NSP repair were patient's smoking status, combined rhinoplasty, application of interposition graft, and perforation size.
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Affiliation(s)
- Hye Ah Joo
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yong Ju Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Lee YW, Ko Y, Kim JO, Chung J. Actinomycosis Confined to the Nasal Septum. Ear Nose Throat J 2023:1455613231211308. [PMID: 38044535 DOI: 10.1177/01455613231211308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Actinomycosis is common in the head and neck region but rarely occurs in the nasal septum. A 75-year-old male patient with an edentulous maxilla, hypertension, and diabetes developed actinomycosis confined to the nasal septum and showed mucosal necrosis and septal bony sequestration. The patient underwent surgery and medication therapy; this case was reported using endoscopic photographs and radiographs and a literature review was conducted to provide further context and understanding of the condition of the patient.
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Affiliation(s)
- Yong Won Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Veterans Health Service Daejeon Hospital, Daejeon, Republic of Korea
| | - Yeona Ko
- Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Daejeon, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jong Ok Kim
- Department of Pathology, Daejeon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Daejeon, Republic of Korea
| | - Jihyun Chung
- Department of Anesthesiology and Pain Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Daejeon, Republic of Korea
- Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Tumlin P, Assi S, Armeni M, Ramadan HH, Reyes C, Makary CA. Outcome of Endoscopic Repair of Nasal Septal Perforation. Ann Otol Rhinol Laryngol 2023; 132:1617-1620. [PMID: 37246364 DOI: 10.1177/00034894231176610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION The anterior ethmoidal artery (AEA) flap has been demonstrated to be a reliable option for endoscopic repair of symptomatic nasal septal perforations. The purpose of this study is to study the outcome of this technique. METHODS A retrospective case series of all consecutive patients who underwent repair of nasal septal perforation utilizing the AEA flap among 2 institutions from August 2020 to July of 2022 was conducted. Demographics and comorbidities were collected preoperatively and postoperatively. The main outcome of this study was to identify the risk factors for surgical failure. RESULTS Forty-one patients were included. Mean perforation size was 2.2 cm (range 0.5-4.5 cm). Mean age was 42.5 years (range 14-65 years), 53.6% were female, 39% were active smokers, mean body-mass-index (BMI) was 31.9 (range 19.1-45.5), 20% with history of CRS and 31.7% had diabetes mellitus (DM). Etiologies of the perforation included idiopathic (n = 12), iatrogenic (n = 13), intranasal drug use (n = 7), trauma (n = 6), and secondary to tumor resection (n = 3). Overall success rate for complete closure was 73.2%. Active smoking, history of intranasal drug use, and DM were significantly associated with surgical failure (72.7%vs 26.7%, P = .007; 36.4%vs 10%, P = .047; and 63.6%vs 20%, P = .008 respectively). CONCLUSION The endoscopic AEA flap is a reliable technique for closure of nasal septal perforation. It may not work when the etiology is intranasal drug use. Close attention to diabetes and smoking status is also needed.
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Affiliation(s)
- Parker Tumlin
- Department of Otolaryngology, West Virginia University, Morgantown, WV, USA
| | - Sahar Assi
- American University of Beirut, Beirut, Lebanon
| | - Mark Armeni
- Department of Otolaryngology, West Virginia University, Morgantown, WV, USA
| | - Hassan H Ramadan
- Department of Otolaryngology, West Virginia University, Morgantown, WV, USA
| | - Camilo Reyes
- Department of Otolaryngology, Augusta University, Augusta, GA, USA
| | - Chadi A Makary
- Department of Otolaryngology, West Virginia University, Morgantown, WV, USA
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Han PS, Punjabi N, Goese M, Inman JC. The Creation of an Average 3D Model of the Human Cartilaginous Nasal Septum and Its Biomimetic Applications. Biomimetics (Basel) 2023; 8:530. [PMID: 37999171 PMCID: PMC10669719 DOI: 10.3390/biomimetics8070530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 11/25/2023] Open
Abstract
The cartilaginous nasal septum is integral to the overall structure of the nose. Developing our an-atomic understanding of the septum will improve the planning and techniques of septal surgeries. While the basic dimensions of the septum have previously been described, the average shape in the sagittal plane has yet to be established. Furthermore, determining the average shape allows for the creation of a mean three-dimensional (3D) septum model. To better understand the average septal shape, we dissected septums from 40 fresh human cadavers. Thickness was measured across pre-defined points on each specimen. Image processing in Photoshop was used to superimpose lateral photographs of the septums to determine the average shape. The average shape was then combined with thickness data to develop a 3D model. This model may be utilized in finite elemental analyses, creating theoretical results about septal properties that are more translatable to real-world clinical practice. Our 3D septum also has numerous applications for 3D printing. Realistic models can be created for educational or surgical planning purposes. In the future, our model could also serve as the basis for 3D-printed scaffolds to aid in tissue regeneration to reconstruct septal defects. The model can be viewed at the NIH 3D model repository (3DPX ID: 020598, Title: 3D Nasal Septum).
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Affiliation(s)
- Peter S. Han
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92350, USA
- Department of Head and Neck Surgery, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Nihal Punjabi
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92350, USA
- Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
| | | | - Jared C. Inman
- Department of Otolaryngology–Head and Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA 92350, USA
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Lo WL, Yeh CF. Using Surgicel-wrapped Merocel to reduce pain during the removal of nasal packing. Acta Otolaryngol 2023; 143:984-988. [PMID: 38134221 DOI: 10.1080/00016489.2023.2292754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND Merocel is a commonly used material for nasal packing; nevertheless, the majority of patients experience pain when the nasal packing is removed.Aims/Objectives: This study aims to introduce a novel technique for nasal packing using Surgicel-wrapped Merocel. MATERIAL AND METHODS Patients who underwent septoplasty received either Merocel or Surgicel-wrapped Merocel as nasal packing. Clinical complications related to bleeding and subjective symptoms associated with the packing materials were assessed. RESULTS Between 2018 and 2021, a total of thirty-three patients with a deviated nasal septum underwent septoplasty. Among them, eight patients received Merocel nasal packing, while twenty-five patients were treated with the new nasal packing technique involving Surgicel-wrapped Merocel. We observed a significant reduction in pain during removal in the Surgicel-wrapped Merocel group compared to the Merocel group (p = .008). However, no significant differences were noted in other discomforts related to packing or bleeding after removal between these two groups.Conclusions and Significance:Using Surgicel-wrapped Merocel as nasal packing following septoplasty is an effective method to alleviate pain during removal.
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Affiliation(s)
- Wen-Ling Lo
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chien-Fu Yeh
- Department of Otorhinolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Otorhinolaryngology, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Aghaee F, Moudi E, Vahdani N, Bijani A, Haghanifar S. Evaluation of Anatomical Variations of the Maxillary Sinus in Patients With and Without Mucous Retention Cyst. Ear Nose Throat J 2023:1455613231206284. [PMID: 37843070 DOI: 10.1177/01455613231206284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
Objectives: Mucous retention cyst (MRC) is a benign and self-limited lesion that can be caused by many risk factors, including anatomical variations of the sinonasal region. This study aims to investigate the relationship between anatomical variations and the presence of MRC. Materials and Methods: In total, 2109 sinonasal cone beam computed tomography images were evaluated for the presence of MRC, and the sinonasal anatomical regions such as the osteomeatal complex (OMC), infundibulum length, ostium height, the diameter of the ostium, the presence of accessory ostium, concha bullosa, and mucosal thickening of the maxillary sinuses. Shapiro-Wilk normality test, independent sample t-test, and chi-square test were used for statistical analysis, and P < .05 was considered significant. Results: The prevalence of MRC was 119 (5.6%) cases. The average diameter of the ostium in cases with and without MRC was 0.49 ± 0.41 mm and 0.99 ± 0.76 mm, respectively, which showed a significant inverse relationship(P < .001). A significant relationship was found between the septum deviation, the ostium height, the concha bullosa, and the accessory ostium with the presence of MRC (P < .001). Conclusions: Sinonasal anatomical variations such as ostium diameter, ostium height, septal deviation, the presence of accessory ostium, and concha bullosa can cause MRC development, and considering that surgery may be necessary in some cases; this could be of great importance to clinicians and surgeons for treatment and prevention of development or recurrence of these pseudocysts in patients.
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Affiliation(s)
- Fateme Aghaee
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Ehsan Moudi
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Nazmehr Vahdani
- Dental Materials Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Sina Haghanifar
- Oral Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Bao X, Jin M, Bai Y, Xue H, Zhao Z. The Effect of Trans-Sutural Distraction Osteogenesis on Nasal Bone, Nasal Septum, and Nasal Airway in the Treatment for Midfacial Hypoplasia in Growing Patients. J Craniofac Surg 2023; 34:1971-1977. [PMID: 37322585 PMCID: PMC10521799 DOI: 10.1097/scs.0000000000009487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 05/14/2023] [Indexed: 06/17/2023] Open
Abstract
The purposes of this study were to analyze the effect of trans-sutural distraction osteogenesis (TSDO) on nasal bone, nasal septum, and nasal airway in the treatment of midfacial hypoplasia. A total of 29 growing patients with midfacial hypoplasia who underwent TSDO by a single surgeon were enrolled. The 3-dimensional measurement of nasal bone and nasal septum changes was performed using computed tomography (CT) images obtained preoperatively (T0) and postoperatively (T1). One patient was selected to establish 3-dimensional finite element models to simulate the characteristics of nasal airflow field before and after traction. After traction, the nasal bone moved forward significantly ( P <0.01). The septal deviation angle was lower than that before traction (14.43±4.70 versus 16.86 ±4.59 degrees) ( P <0.01). The length of the anterior and posterior margin of the vomer increased by 21.4% ( P <0.01) and 27.6% ( P <0.01), respectively, after TSDO. The length of the posterior margin of the perpendicular plate of ethmoid increased ( P <0.05). The length of the posterior inferior and the posterior superior margin of the nasal septum cartilage increased ( P <0.01) after traction. The cross-sectional area of nasal airway on the deviated side of nasal septum increased by 23.0% after traction ( P <0.05). The analysis of nasal airflow field showed that the pressure and velocity of nasal airflow and the nasal resistance decreased. In conclusion, TSDO can promote the growth of the midface, especially nasal septum, and increase the nasal space. Furthermore, TSDO is conductive to improve nasal septum deviation and decrease nasal airway resistance.
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Affiliation(s)
- Xueer Bao
- Department of Vascular and Plastic Surgery, Guangdong Provincial People’s Hospital, Guangzhou, Guangdong, China
| | - Mengying Jin
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yanjie Bai
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Hongyu Xue
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Zhenmin Zhao
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
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Altun BD, Dumlu A. Evaluation of maxillary sinus volumes and pathologies in children with and without cleft lip and palate using cone beam computed tomography. Orthod Craniofac Res 2023. [PMID: 37776070 DOI: 10.1111/ocr.12718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 08/10/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVE The aim of this study is to evaluate the maxillary sinus (MS) volume and pathologies, nasal septum (NS) deviation, and MS septa formation in children with and without cleft lip and palate (CLP); also to investigate the possible causes of MS pathologies. MATERIALS AND METHODS Cone Beam Computed Tomography (CBCT) images of 200 (100 CLP, 100 control) children (5-18 years old) were evaluated from the computer database of Marmara University Faculty of Dentistry. Children with a history of maxillofacial trauma, diseases that affect bone metabolism, orthognathic surgery, extrinsic pathologies of the MS, and accompanying syndromes were excluded. NS deviation, MS septa formation, volume, and pathologies evaluated using Mimics® software. In statistical evaluations; Student t test, paired sample t test, Chi-Square test, Fisher's Exact Chi-Square test, Continuity Correction, Chi-square analysis in one-eyed layout, McNemar test, and logistic regression analysis were used. RESULTS Total MS volume was smaller in the CLP group (21 232 mm3 ) than in control children (23 763 mm3 ) (P:0.026). NS deviation and MS pathology were more frequent in the CLP. In logistic regression analysis, there was no significant relation between the presence of NS deviation and pathology in MS. The presence of CLP increased the risk of MS pathology by 2.6 times. CONCLUSION We found that children with CLP have less MS volume and an increased rate of NS deviation and MS pathology compared to the control group. Further radiological and clinical studies are needed to explain the predisposing factors of MS pathology in children with CLP.
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Affiliation(s)
- Busra Dilara Altun
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Marmara University, Istanbul, Turkey
| | - Asim Dumlu
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Marmara University, Istanbul, Turkey
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Kim DH, Park JB, Kim SW, Stybayeva G, Hwang SH. Effect of Infraorbital and/or Infratrochlear Nerve Blocks on Postoperative Care in Patients with Septorhinoplasty: A Meta-Analysis. Medicina (Kaunas) 2023; 59:1659. [PMID: 37763778 PMCID: PMC10535682 DOI: 10.3390/medicina59091659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Through a comprehensive meta-analysis of the pertinent literature, this study evaluated the utility and efficacy of perioperative infraorbital and/or infratrochlear nerve blocks in reducing postoperative pain and related morbidities in patients undergoing septorhinoplasty. Materials and Methods: We reviewed studies retrieved from the PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to August 2023. The analysis included a selection of seven articles that compared a treatment group receiving perioperative infraorbital and/or infratrochlear nerve blocks with a control group that either received a placebo or no treatment. The evaluated outcomes covered parameters such as postoperative pain, the amount and frequency of analgesic medication administration, the incidence of postoperative nausea and vomiting, as well as the manifestation of emergence agitation. Results: The treatment group displayed a significant reduction in postoperative pain (mean difference = -1.7236 [-2.6825; -0.7646], I2 = 98.8%), as well as a significant decrease in both the amount (standardized mean difference = -2.4629 [-3.8042; -1.1216], I2 = 93.0%) and frequency (odds ratio = 0.3584 [0.1383; 0.9287], I2 = 59.7%) of analgesic medication use compared to the control. The incidence of emergence agitation (odds ratio = 0.2040 [0.0907; 0.4590], I2 = 0.0%) was notably lower in the treatment group. The incidence of postoperative nausea and vomiting (odds ratio = 0.5393 [0.1309; 2.2218], I2 = 60.4%) showed a trend towards reduction, although it was not statistically significant. While no adverse effects reaching statistical significance were reported in the analyzed studies, hematoma (proportional rate = 0.2133 [0.0905; 0.4250], I2 = 76.9%) and edema (proportional rate = 0.1935 [0.1048; 0.3296], I2 = 57.2%) after blocks appeared at rates of approximately 20%. Conclusions: Infraorbital and/or infratrochlear nerve blocks for septorhinoplasty effectively reduce postoperative pain and emergence agitation without notable adverse outcomes.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (D.H.K.); (S.W.K.)
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea;
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; (D.H.K.); (S.W.K.)
| | - Gulnaz Stybayeva
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA;
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
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15
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Kang SS, Kim EJ, Min JY, Kim J, Doo JG. Excessive Postoperative Nasal Bleeding Following Septoplasty Caused by a Branch of the Middle Meningeal Artery. Ear Nose Throat J 2023:1455613231199698. [PMID: 37705379 DOI: 10.1177/01455613231199698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
Septoplasty is a widely performed procedure globally to correct a deviated nasal septum and improve nasal breathing. Life-threatening nasal bleeding as a complication of septoplasty has been reported in a few cases in the literature. In cases of massive postoperative nasal bleeding, transarterial embolization using angiography was performed for the treatment. This article documents 1 case of excessive postoperative nasal bleeding following an uneventful septoplasty, which was successfully treated with embolization of the frontal branch of the middle meningeal artery. This case represents an extremely rare occurrence, and we present it in conjunction with a literature review.
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Affiliation(s)
- Sun Seong Kang
- Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea
| | - Eui-Jong Kim
- Department of Radiology, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Jin-Young Min
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University Hospital, Kyung Hee University School of Medicine, Seoul, South Korea
| | - Jisun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea
| | - Jeon Gang Doo
- Department of Otorhinolaryngology-Head and Neck Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea
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16
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Abstract
Pleomorphic adenoma is a benign tumor that commonly arises from the major salivary glands, such as the parotid and submandibular glands. However, they rarely originate from the nasal cavity. Herein, we describe the case of a 49-year-old woman who presented with nasal obstruction. Preoperative evaluation revealed a giant pleomorphic adenoma attached to the nasal septum. Transnasal endoscopic removal was successfully performed using a specimen retrieval bag. We performed an endoscopic complete en-bloc resection of a large pleomorphic adenoma in the nasal cavity, using a specimen retrieval bag. There were no complications seen, no local recurrences after 2 years of follow-up, and the patient satisfaction was high. We therefore recommend that this technique of using specimen retrieval bags can be favorably utilized for endoscopic removal of large nasal tumors like pleomorphic adenoma.
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Affiliation(s)
- Akinobu Kubota
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
| | - Yuki Komabayashi
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Isamu Kunibe
- Department of Otolaryngology-Head and Neck Surgery, Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | - Yasuaki Harabuchi
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Japan
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17
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Folic MM, Barac AM, Ugrinovic AB, Jotic AD, Trivic AS, Milovanovic JP, Borozan NN, Peric AR, Stevanovic G, Krejovic-Trivic SB, Cvorovic L, Stojkovic GM. Effectiveness of the Treatment of Rhinogenic Headache Caused by Intranasal Contact. Ear Nose Throat J 2023; 102:605-610. [PMID: 34077274 DOI: 10.1177/01455613211019706] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The aim of the study is to evaluate the effectiveness of the surgical and nonsurgical treatment of headache caused by contact points (CPs) between the nasal septum and inferior or middle turbinate. METHODS The research was designed as a prospective clinical case-series study. The patients with CP headaches were offered to choose between 2 treatment options, surgery and medical treatment. Two groups of surgically treated patients (surgery groups 1 and 2, depending on whether there is a contact between nasal septum and inferior turbinate or middle turbinate) were evaluated and compared for headache intensity and frequency. Headache intensity was measured using a visual analog scale value from 0 to 10; the frequency of headache was expressed as the number of days during 1 month with a headache (before surgery, 1 month, and 6 months after surgery). A comparison was also made between surgically and nonsurgically treated patients. RESULTS We found more intensive and frequent headache in patients who had CP between the nasal septum and the middle turbinate (P = .038 and P = .003, respectively). A significant reduction in headache intensity and frequency was found in both groups of surgically treated patients 6 months after surgery; however, this reduction was more significant in patients with mucosal contact between nasal septum and middle turbinate. The nonsurgical treatment made a significant reduction of headache intensity and frequency at 1-month follow-up (P = .012 and P = .031, respectively), but not at 6-month follow-up (P = .114 and P = .088, respectively). CONCLUSION Surgery gave a statistically significant reduction in the intensity and frequency of headache, which was assessed 6 months after surgery. Surgery was found as superior to nonsurgical treatment in the therapy of CP headache.
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Affiliation(s)
- Miljan M Folic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Aleksandra M Barac
- Faculty of Medicine, University of Belgrade, Serbia
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | - Aleksandar B Ugrinovic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
| | - Ana D Jotic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Aleksandar S Trivic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Jovica P Milovanovic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | | | - Aleksandar R Peric
- Department of Otorhinolaryngology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - Goran Stevanovic
- Faculty of Medicine, University of Belgrade, Serbia
- Clinic for Infectious and Tropical Diseases, Clinical Centre of Serbia, Belgrade, Serbia
| | - Sanja B Krejovic-Trivic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Ljiljana Cvorovic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
| | - Goran M Stojkovic
- Clinic for Otorhinolaryngology and Maxillofacial Surgery, Clinical Centre of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Serbia
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Gnatowski P, Gwizdała K, Kurdyn A, Skorek A, Augustin E, Kucińska-Lipka J. Investigation on Filaments for 3D Printing of Nasal Septum Cartilage Implant. Materials (Basel) 2023; 16:ma16093534. [PMID: 37176416 PMCID: PMC10180510 DOI: 10.3390/ma16093534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
Septoplasty is a widely used method in treating deviated septum. Although it is successfully implemented, there are problems with excessive bleeding, septal perforation, or infections. The use of anatomically shaped implants could help overcome these problems. This paper focuses on assessing the possibility of the usage of a nasal septum cartilage implant 3D printed from various market-available filaments. Five different types of laments were used, two of which claim to be suitable for medical use. A combination of modeling, mechanical (bending, compression), structural (FTIR), thermal (DSC, MFR), surface (contact angle), microscopic (optical), degradation (2 M HCl, 5 M NaOH, and 0.01 M PBS), printability, and cell viability (MTT) analyses allowed us to assess the suitability of materials for manufacturing implants. Bioflex had the most applicable properties among the tested materials, but despite the overall good performance, cell viability studies showed toxicity of the material in MTT test. The results of the study show that selected filaments were not suitable for nasal cartilage implants. The poor cell viability of Bioflex could be improved by surface modification. Further research on biocompatible elastic materials for 3D printing is needed either by the synthesis of new materials or by modifying existing ones.
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Affiliation(s)
- Przemysław Gnatowski
- Department of Polymer Technology, Faculty of Chemistry, Gdańsk University of Technology, Gabriela Narutowicza Str. 11/12, 80-233 Gdańsk, Poland
| | - Karolina Gwizdała
- Department of Polymer Technology, Faculty of Chemistry, Gdańsk University of Technology, Gabriela Narutowicza Str. 11/12, 80-233 Gdańsk, Poland
| | - Agnieszka Kurdyn
- Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdańsk University of Technology, Gabriela Narutowicza Str. 11/12, 80-233 Gdańsk, Poland
| | - Andrzej Skorek
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdańsk, Marii Skłodowskiej-Curie Str. 3a, 80-210 Gdańsk, Poland
| | - Ewa Augustin
- Department of Pharmaceutical Technology and Biochemistry, Faculty of Chemistry, Gdańsk University of Technology, Gabriela Narutowicza Str. 11/12, 80-233 Gdańsk, Poland
| | - Justyna Kucińska-Lipka
- Department of Polymer Technology, Faculty of Chemistry, Gdańsk University of Technology, Gabriela Narutowicza Str. 11/12, 80-233 Gdańsk, Poland
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19
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Matsumoto N, Kagoya R, Yasui M, Uozaki H, Ito K. A Case of Fungal Maxillary Sinusitis Extending to the Contralateral Side Through the Nasal Septum. Cureus 2023; 15:e39548. [PMID: 37378191 PMCID: PMC10292175 DOI: 10.7759/cureus.39548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 06/29/2023] Open
Abstract
Fungal rhinosinusitis (FRS) presents as various phenotypes ranging from asymptomatic colonization to life-threatening infections. Here, we report an atypical case of FRS of the left maxillary sinus that extended to the contralateral maxillary sinus through the nasal septum. An 80-year-old woman with a history of osteoporosis was referred to our hospital for further management of headaches and chronic rhinosinusitis. Computed tomography (CT) of the sinus revealed a mass lesion with calcification in the left maxillary sinus, extending to the contralateral maxillary sinus through the nasal septum. T1-weighted and T2-weighted magnetic resonance imaging revealed a mass lesion with low-intensity signals. Endoscopic sinus surgery was performed for the diagnosis and treatment. Histopathological examination revealed fungal elements in the caseous material of the left maxillary sinus. However, no tissue-invasive fungal forms were found. Additionally, eosinophilic mucin was not observed. Based on these findings, the patient was diagnosed with fungus ball (FB). To the best of our knowledge, there are no reports of a FB extending contralaterally through the nasal septum. This report serves as a reminder that FB can extend into contralateral paranasal sinuses through the nasal septum and the possibility that osteoporosis is a cause of extensive bone destruction.
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Affiliation(s)
- Naoyuki Matsumoto
- Otolaryngology, Teikyo University, Tokyo, JPN
- Otorhinolaryngology-Head and Neck Surgery, The University of Tokyo, Tokyo, JPN
| | - Ryoji Kagoya
- Otolaryngology, Teikyo University, Tokyo, JPN
- Otorhinolaryngology-Head and Neck Surgery, The University of Tokyo, Tokyo, JPN
| | | | | | - Ken Ito
- Otolaryngology, Teikyo University, Tokyo, JPN
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20
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Yetkin AA, Karataş M. Effect of Nasal Septum Deviation on the Choroidal Thickness. Cureus 2023; 15:e37840. [PMID: 37213969 PMCID: PMC10198657 DOI: 10.7759/cureus.37840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 05/23/2023] Open
Abstract
INTRODUCTION Nasal cavity blood circulation and ocular blood circulation have common pathways for both arterial blood supply and venous drainage. Therefore, nasal pathologies can affect ocular blood circulation. This study aimed to evaluate the relationship between nasal obstruction and choroidal thickness. METHODS A prospective study was planned by forming a group of 144 patients diagnosed with nasal septum deviation at the otorhinolaryngology clinic and 100 healthy voluntary individuals. Of the total, 69 patients with nasal right septum deviation were evaluated as Group 1, 75 patients with nasal left septum deviation as Group 2, and 100 healthy volunteers as the control group. Detailed ophthalmological examinations of all the participants were performed, and choroidal thickness was measured using spectral domain optical coherence tomography. The relationship between choroidal thickness and ocular parameters was evaluated and compared between the patient groups with nasal septum deviation and the control group. RESULTS When the choroidal thickness measurements of the patients in Group 1 were examined, the choroidal thickness increased in all the regions in the eye contralateral to the deviation side (left), and intraocular pressure (IOP) was higher compared to the eye on the deviation side (right) and the control group at a statistically significant level. In Group 2, the choroidal thickness measurements increased in all the regions in the eye contralateral to the deviation side (right), and IOP was higher compared to the deviation side (left) and the control group. CONCLUSIONS We found that the patients with nasal septum deviation had higher choroidal thickness and IOP values in the eye contralateral to deviation.
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Affiliation(s)
- Ali A Yetkin
- Department of Ophthalmology, Adiyaman University Faculty of Medicine, Adiyaman, TUR
| | - Mehmet Karataş
- Department of Otorhinolaryngology, Adiyaman University Faculty of Medicine, Adiyaman, TUR
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21
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Tang G, Du B, Lan Y, Tian L. Pleomorphic Adenoma of Nasal Septum a Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:978-983. [PMID: 37206715 PMCID: PMC10188774 DOI: 10.1007/s12070-023-03530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/23/2023] [Indexed: 02/12/2023] Open
Abstract
Introduction Pleomorphic adenoma is a common benign tumor of large and small salivary glands. It mainly occurs in the parotid gland, followed by the submandibular gland, sublingual gland and small salivary gland in the oral cavity. It is very rare in the nasal septum. Patient Concerns A 27-year-old female patient attended our clinic with Nasal congestion and a diminished sense of smell. Diagnoses Endoscopic examination revealed a mass within the right nasal passage. A pathological biopsy revealed pleomorphic adenoma. Interventions The nasal septum pleomorphic adenoma was resected by endoscopic approach. Outcomes No recurrence was observed for over 41 months of follow-up. Conclusion To prevent recurrence, extensive local resection with clear histological margins and long-term endoscopic follow-up with an endoscope are necessary.
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Affiliation(s)
- Guangjun Tang
- Department of otolaryngology head and neck surgery, People’s Hospital of Anshun City Guizhou Province, No. 140 of Huangguoshu Street, Xixiu District, 561000 Guizhou, Anshun City, Guizhou Province China
| | - Bo Du
- Department of otolaryngology head and neck surgery, People’s Hospital of Anshun City Guizhou Province, No. 140 of Huangguoshu Street, Xixiu District, 561000 Guizhou, Anshun City, Guizhou Province China
| | - Youxing Lan
- Department of otolaryngology head and neck surgery, People’s Hospital of Anshun City Guizhou Province, No. 140 of Huangguoshu Street, Xixiu District, 561000 Guizhou, Anshun City, Guizhou Province China
| | - Li Tian
- Department of Otolaryngology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 of Shi’erqiao Road, Jinniu District, 610075, 610072 Chengdu, Chengdu, China
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22
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Baldwin MC, Zarudnaya D, Liu ZJ, Herring SW. The nasal septum and midfacial growth. Anat Rec (Hoboken) 2023. [PMID: 36965023 DOI: 10.1002/ar.25214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/22/2023] [Accepted: 03/09/2023] [Indexed: 03/27/2023]
Abstract
The nasal septum is the only element of the chondrocranium which never completely ossifies. The persistence of this nonarticular cartilage has given rise to a variety of theories concerning cranial mechanics and growth of the midface. Previously, using pigs, we demonstrated that the septum is not a strut supporting the snout and that septal growth seems capable of stretching the overlying nasofrontal suture, a major contributor to snout elongation. Here we investigate whether abnormalities of the septum are implicated in cases of midfacial hypoplasia, in which growth of the midface is inadequate. Mild midfacial hypoplasia is common in domestic pig breeds and often severe in the Yucatan minipig, a popular laboratory breed. Normal-snouted and midfacial hypoplastic heads of standard (farm mixed breed) and minipigs ranging in age from perinatal to 12 months were dissected, imaged by CT, and/or prepared for histology. Even at birth, Yucatan minipigs with midfacial hypoplasia exhibited greater caudal ossification than normal; the ventral cartilaginous sphenoidal "tail" was diminished or missing. In addition, cells that morphologically appeared to have divided recently were less numerous than in newborn standard pigs. Juvenile Yucatan minipigs lacked caudal cartilaginous growth zones almost completely. In standard newborns, the ventral caudal septum was more replicative than the dorsal, but this trend was not seen in Yucatan newborns. In conclusion, accelerated maturation of the caudal septum was associated with midfacial hypoplasia, a further indication that the septum, particularly its ventral portion, is important for midfacial elongation.
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Affiliation(s)
- Michael C Baldwin
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, Washington, 98195, USA
| | - Diana Zarudnaya
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, Washington, 98195, USA
| | - Zi-Jun Liu
- Department of Orthodontics, University of Washington, Box 357446, Seattle, Washington, 98195, USA
| | - Susan W Herring
- Department of Orthodontics, University of Washington, Box 357446, Seattle, Washington, 98195, USA
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23
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Kim DH, Kim SW, Hwang SH. Efficacy and safety of endoscopic septoplasty for treating nasal septal deviations compared with conventional septoplasty: A systematic review and meta-analysis. Clin Otolaryngol 2023; 48:108-121. [PMID: 36537862 DOI: 10.1111/coa.14021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/04/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES We assessed the effects and safety of endoscopic septoplasty in patients with nasal septal deviations (NSD), compared with those of conventional septoplasty. DESIGN AND SETTING Systematic review and meta-analysis. PARTICIPANTS Patients who have undergone various endoscopic septoplasty procedure, such as hemitransfixion incision, incision at the deviated site and Killian incision, and conventional septoplasty. MAIN OUTCOME MEASURES Six databases were searched up to April 2022. We analysed studies comparing improvements in NSD-related symptoms and post-operative complications between endoscopic septoplasty and control (conventional septoplasty) groups. RESULTS A total of 38 articles with 2733 individuals were included. There were no significant differences in operative time (-0.4354, 95% confidence interval [CI: -1.1670; 0.2962]) or intra-operative bleeding (-1.3011 [-2.8003; 0.1981]) between the two groups. In the endoscopic septoplasty group, the change in nasal obstruction symptom evaluation score (9.5143 [5.4613; 13.5674] was statistically higher and the incidence of mucosal tearing (0.2766 [0.1889; 0.4049]) was lower. The incidences of full relief from symptoms such as headache (2.1996 [1.6896; 2.8634]), hyposmia (4.4468 [2.6806; 7.3767]), nasal obstruction (5.9871 [4.3292; 8.2800]), post-nasal drip (4.7241 [3.4086; 6.5472]) and snoring (2.9980 [1.2622; 7.1211]) were significantly higher in the endoscopic septoplasty group. In terms of post-operative endoscopic findings, epistaxis (0.3043 [0.1969; 0.4703]), hematoma (0.2022 [0.0785; 0.5213]), nasal obstruction 0.3373 [0.1334; 0.8527]), residual posterior septal deviation (0.1562 [0.0921; 0.2650]), septal perforation (0.2286 [0.1069; 0.4889]), residual spur (0.1294 [0.0602; 0.2780]) and synechia (0.2537 [0.1849; 0.3483]) were significantly less common in the endoscopic septoplasty group. CONCLUSION Endoscopic septoplasty better relieved NSD-related symptoms and reduced surgery-related complications compared to conventional septoplasty.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
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Hakami KT, Almalki ZA, Alnemari FS, Alotaibi RM, Bajunaid FR. A Comparison of Symptom Improvement and Outcomes After Septoplasty Alone Versus Septoplasty With Turbinoplasty. Cureus 2023; 15:e36628. [PMID: 37101989 PMCID: PMC10123449 DOI: 10.7759/cureus.36628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2023] [Indexed: 04/28/2023] Open
Abstract
Background Various causes can lead to nasal obstruction, with the most frequent anatomical cause being deviated nasal septum. It seriously affects patients' quality of life. As a result, septoplasty is performed to enhance the nasal airways. This study aimed to compare the improvement of nasal symptoms following septoplasty with or without turbinoplasty and evaluate the surgical outcomes in both different groups. Methodology A retrospective study was conducted at a tertiary hospital among patients who had undergone septoplasty with or without turbinoplasty between 2020 and 2022. Data regarding demographics, clinical features, surgical data, and complications were collected from patient files. The Nasal Obstruction Symptom Evaluation (NOSE) scale score was assessed through structured interviews. Results In our analysis of 209 patients who underwent surgery for deviated nasal septum, septoplasty was done in 110 (52.6%) patients, whereas the remaining 99 (47.4%) underwent septoplasty with turbinoplasty. The mean NOSE score was found to be 32.94 ± 35.67%. Patients who underwent septoplasty alone significantly showed higher mean scores (56.36 ± 34.62%) compared to those who underwent septoplasty with turbinoplasty (11.14 ± 18.93%) (p < 0.001). The long-term complications showed revision surgery was done in 13 patients, which was comparatively more often done in patients who underwent a septoplasty. Other long-term complications were found to be significantly higher in patients who underwent septoplasty (76.9%) compared to those who underwent septoplasty with turbinoplasty (23.1%). Conclusions Patients who underwent additional turbinoplasty experienced an improvement in nasal symptoms than those who underwent septoplasty alone. In addition, more long-term complications were noted in patients who underwent septoplasty alone.
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Affiliation(s)
- Khalid T Hakami
- Department of Otolaryngology, Head and Neck Surgery, Rhinology Unit, Al-Hada Armed Forces Hospital, Taif, SAU
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Noreikaite G, Kim SA, Horcher A. Nasal Septal Angioleiomyoma and Septal Sinus Surgery: A Review of 2 Cases. Ear Nose Throat J 2023; 102:NP72-NP75. [PMID: 33530742 DOI: 10.1177/0145561321991322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Angioleiomyomas are smooth muscle masses originating from blood vessel tunica media. This is a rare tumor, comprising less than 1% of benign sinonasal cavity tumors. Failure to recognize and surgically excise nasal angioleiomyomas can result in lesion recurrence. We present 2 new cases of nasal septum angioleiomyoma at a single institution. Additionally, both cases underwent septal and nasal surgery. Due to the nonspecific clinical and imaging findings, a high index of suspicion is needed to diagnose nasal septum angioleiomyoma, often requiring histopathological verification. Preferred treatment is complete surgical excision. From our experience, concurrent corrective septal and sinus surgery can be completed with tumors less than 1.0 cm in size.
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Affiliation(s)
- Gabriele Noreikaite
- Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, IL, USA
| | - Sihun A Kim
- Ear Nose Throat and Sinus Surgery, Northwestern Medicine McHenry Hospital, McHenry, IL, USA
| | - Adelaide Horcher
- Pathology, Northwestern Medicine McHenry Hospital, McHenry, IL, USA
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26
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An Y, Shu F, Xie L, Zhen Y, Li X, Li Y. Use of nasal septal bone to straighten septal L-Strut in correction of east Asian short nose: A retrospective study. J Cosmet Dermatol 2023; 22:1825-1834. [PMID: 36718843 DOI: 10.1111/jocd.15643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/13/2022] [Accepted: 01/08/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND The perpendicular plate of ethmoid (PPE) was used to correct short noses in rhinoplasty in Asians, but the safe harvest of the plate and the assessment of its clinical application has been perplexing to plastic surgeons. AIMS To explore how to safely cut the perpendicular plate of ethmoid bone and evaluate its application effect. PATIENTS/METHODS A finite element model was established to guide the clinical operation. A total of 30 patients with short noses were selected. Among them, 15 patients used autologous septal cartilage to lengthen the nasal tip, and 15 patients used the PPE to strengthen the L-shape nasal septum. The differences in the esthetic parameters of the nose, complications, and patients' satisfaction were compared between the two groups. RESULTS Significant differences were noted in the nasal dorsal length (p = 0.001), Goode's ratio (p = 0.001), and nasofrontal angle (p = 0.003) after rhinoplasty, and no significant differences were noted in any of the esthetic parameters between the two groups. The symptoms of nasal obstruction in the experimental group were significantly lighter than those in the control group (p = 0.04). There was no statistically significant difference in the doctors' assessment of outcomes between the two groups (p = 0.48). CONCLUSION The safest region to harvest the PPE is in the middle and lower third. Rhinoplasty improves the esthetics of the patient's nose. The PPE used to strengthen the L-shape nasal septum structure has a smaller probability of nasal septal deviation with the time in Asian short noses.
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Affiliation(s)
- Yang An
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Fan Shu
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Lifeng Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, China
| | - Yonghuan Zhen
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Xiao Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
| | - Yixin Li
- Department of Plastic Surgery, Peking University Third Hospital, Beijing, China
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Tsarapkin GY, Polyaeva MY, Gorovaya EV, Kishinevskii AE, Shvedov NV, Kurilenkova AG, Kudinova AA. [Assessment of the structural features of the hard palate in endonasal surgery]. Vestn Otorinolaringol 2023; 88:58-62. [PMID: 37970771 DOI: 10.17116/otorino20238805158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
Data on the features of the anatomical structure of the hard palate are little described in the scientific literature, and therefore are not taken into account when planning surgical treatment. One of the intraoperative complications during intervention on the lower part of the nasal septum is perforation of the bottom of the nasal cavity, which can develop during a christotomy. This complication mainly depends on the features of the anatomical structure of the hard palate. OBJECTIVE To study the anatomical structure of the hard palate from the point of view of rhinosurgery, using vector analysis of multispiral computed tomography (MSCT), and to establish anatomical features that should be taken into account when performing surgical interventions on the nasal septum. MATERIAL AND METHODS 107 patients (30 men, 77 women) were examined without congenital cleft palate and surgical interventions on the structures of the nasal cavity and hard palate. All patients underwent MSCT of the nose and paranasal sinuses (PNS) followed by multiplanar image reconstruction. The key point relative to which the measurements were carried out was the posterior wall of the incisor canal from the side of the nasal cavity. The line corresponding to the bottom of the nasal cavity was chosen as the main vector. In the work, measurements of the thickness of the hard palate (THP) at the level of the palatal suture and the width of the palatal suture (WPS) were carried out. RESULTS Statistical analysis of the obtained results showed that the THP is 1.74 mm [min 0.28; max 6.46], the WPS is 0.9 mm [min 0.2; max 2.51] (conditional norm). In 19 patients (17.8%), the THP was 0.82 mm, in 2 patients (1.9%) - 0.2 mm. In 3 patients (2.8%), the WPS was equal to 2.5 mm. CONCLUSION Thus, the data obtained by us indicate that the surgical anatomy of the hard palate is characterized by significant variability, while in some patients the THP can be reduced by 8.8 times, and the WPS increased by 2.7 times compared to normal values. Such anatomical features of the structure of the hard palate should be taken into account when planning septoplasty, since this contingent of patients has an increased risk of developing iatrogenic perforation of the nasal floor during surgical intervention on the lower floor of the nasal septum.
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Affiliation(s)
- G Yu Tsarapkin
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - M Yu Polyaeva
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - E V Gorovaya
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - A E Kishinevskii
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - N V Shvedov
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - A G Kurilenkova
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
| | - A A Kudinova
- Sverzhevsky Research Institute of Clinical Otorhinolaryngology Moscow Department of Healthcare, Moscow, Russia
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Shin GC, Kang JW, Park JH, Lee HC, Kim KS. Changes in Subjective Outcomes during the Early Period after Septoturbinoplasty. Yonsei Med J 2023; 64:42-47. [PMID: 36579378 PMCID: PMC9826964 DOI: 10.3349/ymj.2022.0405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
PURPOSE Septoturbinoplasty is frequently performed to correct nasal obstruction; however, there is still a lack of research on changes in nasal and nose-related symptoms early after septoturbinoplasty. Therefore, we aimed to investigate changes in subjective outcomes within 6 months after septoturbinoplasty. MATERIALS AND METHODS The medical records of patients who underwent septoturbinoplasty at Gangnam Severance Hospital were retrospectively analyzed. Symptom scores were evaluated using the Sino-nasal Outcome Test (SNOT-22) and obstruction scores. The SNOT-22 and obstruction scores were investigated before surgery and at 1, 3, and 6 months after surgery. RESULTS We noted significant decreases in both SNOT-22 and obstruction scores at 1 month after surgery, compared to those before surgery (p<0.001). However, there were no significant changes at 3 and 6 months after surgery, compared to scores at 1 month after surgery. Using multivariate logistic regression analysis, a larger difference between SNOT-22 scores preoperatively and 1 month after surgery was significantly associated with a significant improvement in symptoms at 3 or 6 months after septoturbinoplasty (p=0.029). CONCLUSION These results imply that subjective outcomes and degree of improvement in the first month after septoturbinoplasty can be used as a predictor of the results thereof and for counseling patients about its progress.
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Affiliation(s)
- Geun Cheol Shin
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ju Wan Kang
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ju Ha Park
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Han Cheol Lee
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kyung-Su Kim
- Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
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Perić A, Đurđević BV, Sotirović J, Milojević M, Baletić N. Chondromesenchymal Hamartoma With Nasopharyngeal Involvement: Two Unusual Cases of an Extremely Rare Lesion. Ear Nose Throat J 2023; 102:NP8-NP12. [PMID: 33393813 DOI: 10.1177/0145561320986031] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Chondromesenchymal hamartoma (CMH) is a rare, benign lesion of the nasal cavity, paranasal sinuses, and skull base, composed of islands of hyaline cartilage in a myxoid background. The vast majority of CMH cases are infants and young children. According to the world literature, nasopharyngeal involvement of CMH is extremely rare. In all cases, the lesions were masses protruding from the nasal cavity or paranasal sinuses to the nasopharynx. We hereby report 2 adult male patients with masses completely situated in the nasopharyngeal space. In the first patient, the tumor originated from the posterior edge of the nasal septum and in the second one, from the posterolateral wall of the nasopharynx, adjacent to the pharyngeal orifice of the Eustachian tube. In both patients, the lesion was excised endoscopically, and histopathological analyses were consistent with a diagnosis of CMH. To our knowledge, those are the only cases of CMH completely situated in the nasopharynx.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia
| | | | - Jelena Sotirović
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia
| | - Milanko Milojević
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia
| | - Nenad Baletić
- Department of Otorhinolaryngology, Military Medical Academy Faculty of Medicine, University of Defence, Belgrade, Serbia
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Muacevic A, Adler JR, Almahmoudi A, AlGhamdi D, Alharbi M. Common Causes of Failed Septoplasty: A Systematic Review. Cureus 2022; 14:e33073. [PMID: 36721531 PMCID: PMC9883659 DOI: 10.7759/cureus.33073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/30/2022] Open
Abstract
Failed septal correction is an undesirable outcome of primary septoplasty. In this systematic review, we aimed to assess all current studies concerning septoplasty failure, with a view to identifying its common causes. A systematic literature search was conducted by screening the PubMed, MEDLINE, Embase, and Cochrane Library databases for studies that assessed septoplasty failure and were published between January 2008 and January 2021. Three authors independently extracted information from each study and examined all included articles for bias. Four articles provided pertinent data regarding septoplasty failure. We gathered that missed nasal valve abnormality diagnosis, insufficient separation and resection of the bony-cartilaginous junction, and insufficient correction of caudal septal deviation could cause septoplasty failure. Additionally, iatrogenic problems, nasal asymmetry, and side-wall concavity involving the nasofrontal and columellar labial angles are contributing factors. Determining the cause of nasal blockage is challenging because it is subjective. Based on our findings, we concluded that in all patients with septal deviation, utmost care should be taken to avoid overlooking nasal valve abnormalities and other nasal diseases before conducting septoplasty. Moreover, inadequate correction of caudal septal deviation should be avoided. Furthermore, there is currently no widely accepted classification system for septal abnormalities to measure and describe septal deviation characteristics, making surgical planning and documentation difficult. Hence, further research that would lead to the creation of such a classification system is warranted.
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31
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Falsaperla R, Biondi GM, Motta M, Gallerano P, Tancredi G, Pavone P, Ruggieri M. Impressive Nasal Septum Regeneration after Cord Blood Platelet Gel (CBPG) in Extreme Premature Neonate with Non-Invasive Ventilation: A Case Report. Children (Basel) 2022; 9:1767. [PMID: 36421216 PMCID: PMC9689260 DOI: 10.3390/children9111767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/14/2022] [Accepted: 11/09/2022] [Indexed: 09/15/2023]
Abstract
BACKGROUND We evaluated the efficacy of Cord Blood Platelet Gel (CBPG) in the regenerative reconstruction of the nasal septal tissue of a preterm infant undergoing non-invasive ventilation. METHODS A CBPC treatment was used to enhance the regeneration of the nasal septum of a premature patient in an experimental way, evaluating the efficacy described in the literature (selective bibliographic search in PubMed) of the use of blood products for non-transfusion purposes. RESULTS A partial but satisfactory regeneration of the patient's nasal septum was observed. Using the free NIH Image J online software, we were able to calculate the regenerated surface (about 83% of the destroyed cartilage). CONCLUSIONS The use of platelet gel has been a promising alternative to surgical treatment in patients with severe damage to the nasal septum.
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Affiliation(s)
- Raffaele Falsaperla
- Neonatal Intensive Care Unit, AUO Policlinico “Rodolico-San Marco”, University of Catania, 95121 Catania, Italy
| | - Giulia Marialidia Biondi
- Postgraduate Training Program in Pediatrics, Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
| | - Milena Motta
- Neonatal Intensive Care Unit, AUO Policlinico “Rodolico-San Marco”, University of Catania, 95121 Catania, Italy
| | - Pasquale Gallerano
- Transfusional Medicine, Complex Operative Unit, PO “Giovanni Paolo II”, 92019 Sciacca, Italy
| | - Giusi Tancredi
- Transfusional Medicine, Complex Operative Unit, PO “Giovanni Paolo II”, 92019 Sciacca, Italy
| | - Piero Pavone
- Section of Pediatrics and Child Neuropsichiatry, Department of Child and Experimental Medicine, University of Catania, AOU “Policlinico PO” G. Rodolico, 95123 Catania, Italy
| | - Martino Ruggieri
- Unit of Rare Diseases of the Nervous System in Childhood, Department of Clinical and Experimental Medicine, Section of Pediatrics and Child Neuropsichiatry, University of Catania, AOU “Policlinico PO” G. Rodolico, 95123 Catania, Italy
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Muacevic A, Adler JR. Rare Presentation of Bilateral Lobular Capillary Hemangioma of the Nasal Septum: A Case Report. Cureus 2022; 14:e31262. [PMID: 36505174 PMCID: PMC9731727 DOI: 10.7759/cureus.31262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 11/09/2022] Open
Abstract
Lobular capillary hemangioma (LCH) is a benign, rapidly growing lesion affecting the skin and mucous membranes. LCH is common in the oral cavity but is rarely observed in the nasal cavity. The disease etiology is not fully understood; however, trauma and hormonal changes are attributable factors. Patients usually present with nasal obstruction and epistaxis. This study reports the clinical picture, diagnosis, and management of a rare case of bilateral septal nasal LCH.
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Tluczynski K, Breiter R. A compositional analysis of native and decellularized porcine nasal septum cartilage. Xenotransplantation 2022; 29:e12781. [PMID: 36125176 DOI: 10.1111/xen.12781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/27/2022] [Accepted: 09/01/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Decellularization of porcine septum cartilage is necessary for its application as xenogenic replacement material. The aim of this study was to investigate spatial differences of structure and composition in the whole native and decellularized porcine nasal septum. Subsequently, the results shall be compared with studies of human nasal septum. METHODS Ten porcine nasal septa were divided into six regions from caudal to cephalic and four regions from dorsal to ventral to create a grid of 24 approximately equal segments. All segments of five septal cartilages were decellularized separately by a wet chemical multistep procedure. The segments were analyzed to determine quantitative amounts of total collagen, chondrocytes, and sulfated glycosaminoglycans (sGAG). RESULTS The distribution of cell number showed no significant differences between the individual regions. For the distribution of collagen and sGAG, no significant differences could be identified from caudal to cephalic, both in native and decellularized tissue. From dorsal to ventral, native and decellularized nasal septum showed significant differences between individual regions. In native septum, linear regression analysis indicated a decreasing collagen and an increasing sGAG content from dorsal to ventral. After decellularization, an increasing collagen and a decreasing sGAG content was detected. CONCLUSION The results of this study showed slightly but significant differences in the distribution of collagen and sGAG from dorsal to ventral. From caudal to cephalic, no differences could be observed. Compared to human, nasal septum differences in cell, collagen, and sGAG content were detected. Despite this, human and porcine nasal septum showed similar distributions and a consistently inverse linearity of collagen and sGAG content. Nevertheless, the midcaudal and midcephalic regions showed the highest porosity and a high stability and thus offer the best conditions for the revitalization of porcine tissue by human cells.
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Affiliation(s)
- Katharina Tluczynski
- Roman Breiter, Institute of Bioprocess Engineering, University of Erlangen-Nürnberg (FAU), Erlangen-Nürnberg, Germany
| | - Roman Breiter
- Roman Breiter, Institute of Bioprocess Engineering, University of Erlangen-Nürnberg (FAU), Erlangen-Nürnberg, Germany
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Perić A, Đurđević BV, Labus M, Gaćeša D, Barsova GK, Baletić N. Simultaneous Nasal Septal Schneiderian Papilloma and Respiratory Epithelial Adenomatoid Hamartoma. Ear Nose Throat J 2022:1455613221135648. [PMID: 36250396 DOI: 10.1177/01455613221135648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Schneiderian papilloma is typically found on the lateral nasal wall, but, in rare cases, can be located at the mucosa of the nasal septum. Respiratory epithelial adenomatoid hamartoma (REAH) is rare, non-neoplastic lesion characterized by an abnormal proliferation of glandular part of the respiratory nasal mucosa. We present a case of a 42-year-old man with five-year history of bilateral nasal obstruction, rhinorrhea, epistaxis, and hyposmia. On endoscopic examination, we found lobulated, yellowish-pink soft tissue masses on both sides of the nasal septum. The results of histopathological analyses showed the characteristics of Schneiderian papilloma in the lesion excised from the right and REAH in the lesion excised from the left side of the nasal cavity. To our knowledge, cases of simultaneous presentation of Schneiderian papilloma and REAH on opposite sides of the nasal septum have not been published so far. An appropriate cooperation of rhinologist and pathologist allows for a correct diagnosis of these rare and unusual lesions.
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Affiliation(s)
- Aleksandar Perić
- Department of Otorhinolaryngology, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Biserka Vukomanović Đurđević
- Institute for Pathology, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | - Milica Labus
- Department of Otorhinolaryngology, Military Medical Academy, Belgrade, Serbia
| | | | | | - Nenad Baletić
- Department of Otorhinolaryngology, Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
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Lee Y, Wang H, Yeh T, Yang S, Lin C, Huang P, Wang K, Lai D, Tseng H, Lin Y. Improved nasal recovery and intact olfactory function after a transseptal approach for endoscopic endonasal transsphenoidal adenomectomy: A retrospective analysis. Laryngoscope Investig Otolaryngol 2022; 7:1695-1703. [PMID: 36544964 PMCID: PMC9764772 DOI: 10.1002/lio2.931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/03/2022] [Accepted: 09/12/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives Endoscopic endonasal transsphenoidal adenomectomy (TSA) is the most frequently performed skull base surgery, and researchers have recently focused on preserving nasal function. The endoscopic transseptal approach is a promising procedure due to its reduced injury to the nasal mucosa; however, there are no studies comparing rhinological and neurosurgical outcomes concurrently with the standard endoscopic transnasal approach. Therefore, we conducted this study to investigate whether the transseptal approach could reduce nasal morbidities with comparable neurosurgical outcomes. Methods We retrospectively reviewed 25 patients who underwent endoscopic endonasal transseptal TSA for pituitary adenoma without encasement of internal carotid artery from January 2019 to December 2020. Another 25 patients who received transnasal approach from January 2017 to December 2018 were selected as controls. Patients with diseases affecting the nasal cavity/olfaction or usage of a nasoseptal flap were excluded for a better comparison of the two procedures. We collected data from radiological studies, endocrine studies, endoscopic evaluations, 22-item sinonasal outcome tests (SNOT-22) and Top International Biotech Smell Identification Test (TIBSIT) for comparison. Results Lower postoperative SNOT-22 and Lund-Kennedy endoscopic scores were observed in the transseptal group. The effect size of differences were classified as large effect (The absolute value of Cohen's d > 0.8). Nevertheless, the TIBSIT scores were not significantly different. The rates of gross total resection, recovery of hormonal abnormalities, and complications were not significantly different. After controlling possible confounding factors using multivariate analysis, the endoscopic transseptal approach remained an independent factor for lower SNOT-22 scores and Lund-Kennedy endoscopic scores. Conclusions The endoscopic transseptal approach provides improved recovery of nasal mucosa and intact olfaction without compromising neurosurgical outcomes. Level of Evidence 2b.
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Affiliation(s)
- Yen‐Hui Lee
- Department of OtolaryngologyNational Taiwan University HospitalTaipeiTaiwan
| | - Huan‐Chih Wang
- Department of NeurosurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Te‐Huei Yeh
- Department of OtolaryngologyNational Taiwan University HospitalTaipeiTaiwan
| | - Shih‐Hung Yang
- Department of NeurosurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Chih‐Feng Lin
- Department of OtolaryngologyNational Taiwan University HospitalTaipeiTaiwan
| | - Po‐Hao Huang
- Department of NeurosurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Kuo‐Chuan Wang
- Department of NeurosurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Dar‐Ming Lai
- Department of NeurosurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Ham‐Min Tseng
- Department of NeurosurgeryNational Taiwan University HospitalTaipeiTaiwan
| | - Yi‐Tsen Lin
- Department of OtolaryngologyNational Taiwan University HospitalTaipeiTaiwan
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de Paula SBS, Nunes LA, de Oliveira Ruellas AC, de Castro ACR. Influence of nasal septum deviation on fluctuating asymmetries of the nasomaxillary complex: A cross-sectional study. J Anat 2022; 241:1273-1286. [PMID: 36087285 DOI: 10.1111/joa.13762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/26/2022] Open
Abstract
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.
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Affiliation(s)
- Sarah Braga Sayão de Paula
- Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Antônio Carlos de Oliveira Ruellas
- Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Amanda Cunha Regal de Castro
- Departamento de Odontopediatria e Ortodontia, Faculdade de Odontologia, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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谌 祎, 胡 彬, 周 建, 肖 旭, 王 宁. [Ossification of nasal septal polyps: a case report]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:719-720. [PMID: 36036076 PMCID: PMC10127628 DOI: 10.13201/j.issn.2096-7993.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Indexed: 06/15/2023]
Abstract
This paper reported a case of a large septal polyp with central calcification. Nasal endoscopy revealed an irregular lobular mass, yellow and smooth, extending from posterior septum to nasopharynx. CT scan revealed a large nasal and nasopharyngeal mass, closely related to the septum, with ossification in the center. This mass was excised by endoscopic surgery and proved to be typical ossification of nasal polyps.
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Affiliation(s)
- 祎玮 谌
- 湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科(长沙,410005)Department of Otorhinolaryngology Head and Neck Surgery, Hunan Province People's Hospital[the First Affiliated Hospital, Hunan Normal University], Changsha, 410005, China
| | - 彬 胡
- 湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科(长沙,410005)Department of Otorhinolaryngology Head and Neck Surgery, Hunan Province People's Hospital[the First Affiliated Hospital, Hunan Normal University], Changsha, 410005, China
| | - 建波 周
- 湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科(长沙,410005)Department of Otorhinolaryngology Head and Neck Surgery, Hunan Province People's Hospital[the First Affiliated Hospital, Hunan Normal University], Changsha, 410005, China
| | - 旭平 肖
- 湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科(长沙,410005)Department of Otorhinolaryngology Head and Neck Surgery, Hunan Province People's Hospital[the First Affiliated Hospital, Hunan Normal University], Changsha, 410005, China
| | - 宁 王
- 湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科(长沙,410005)Department of Otorhinolaryngology Head and Neck Surgery, Hunan Province People's Hospital[the First Affiliated Hospital, Hunan Normal University], Changsha, 410005, China
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Rodriguez CA, Al-Sakkaf AM, Verbauvede M. Rhinoplasty with Recycled Dorsum Preservation: Technique and Outcomes. Arch Plast Surg 2022; 49:563-568. [PMID: 36159370 PMCID: PMC9507450 DOI: 10.1055/s-0042-1756314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 04/18/2022] [Indexed: 10/27/2022] Open
Abstract
Rhinoplasty is one of the first surgical procedures described with evidence in the history of medicine. At first, these were performed for the reconstruction of traumatic defects caused by punishments, sequels of war, and then it had been reused after suffering from diseases such as syphilis. Many techniques have been developed from the need of aesthetics outcomes in this field. The objective of our work is to describe a modified approach of recycled dorsum preservation procedure that we have proposed as a safe and reliable technique. In this work, we have showed that this technique has a marked advantage of preserving the natural tissue with satisfactory postoperative result. We had no functional complications up to date. We recommend that every specialist in the field of rhinoplasty should be able to use it as a reproducible and feasible alternative.
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Affiliation(s)
- Carlos A Rodriguez
- Department of Plastic Surgery, Hospital Universitari Sant Joan de Reus, Tarragona, Spain
| | - Ali M Al-Sakkaf
- Department of Plastic Surgery, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma Barcelona, Barcelona, Spain
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Liu D, An F, Li M, Li L, Gong L, Liu X, Liu F. A case of giant nasal septal angiomyolipoma. Ear Nose Throat J 2022:1455613221107735. [PMID: 35929576 DOI: 10.1177/01455613221107735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
Abstract
Angiomyolipoma is an extremely rare, benign mesenchymal tumor of the nasal cavity, primarily common in the kidney and secondarily common in the liver. According to the author's knowledge, no cases of angiomyolipoma of the nasal septum have been identified to date. We report a case of a patient with a giant angiomyolipoma at the posterior end of the nasal septum who recovered after surgery without any complication.
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Affiliation(s)
- Dong Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Fengxian An
- Department of Pathology, Liaocheng People's Hospital, Liaocheng, China
| | - Maocai Li
- Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Lianqing Li
- Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Lili Gong
- Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng People's Hospital, Liaocheng, China
| | - Xia Liu
- Department of Pathology, Liaocheng People's Hospital, Liaocheng, China
| | - Fuxing Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng People's Hospital, Liaocheng, China
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Numano Y, Nomura K, Watanabe M, Sugawara M, Hemmi T, Suzuki J, Katori Y. Fibroepithelial Polyps Originating from the Posterior Nasal Septum: A Case Report. TOHOKU J EXP MED 2022; 257:333-336. [PMID: 35691915 DOI: 10.1620/tjem.2022.j047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Fibroepithelial polyps are benign tumors of mesodermal origin. They rarely occur in the nasal cavity, with only four such cases reported in the relevant English literature. The location was the inferior turbinate in three cases and anterior nasal septum in one case. The etiology has been suggested in other organs; however, it is entirely unknown in the nasal cavity. Pathological findings play an essential role in the diagnosis of fibroepithelial polyps. We report the case of a 76-year-old woman with fibroepithelial polyps originating from the posterior part of the nasal septum. The fibroepithelial polyps were white-yellow lobular masses that differed from a common inflammatory polyp. We made the diagnosis by excluding the other possible tumors based on a pathological examination. This is the first report about fibroepithelial polyps arising from the posterior nasal septum. She had no potential risk factors that might trigger fibroepithelial polyps in the nasal cavity. This case is a valuable example when considering the potential causes (e.g., female hormones and mechanical pressure) of nasal fibroepithelial polyps.
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Affiliation(s)
- Yuki Numano
- Department of Otolaryngology, Tohoku Kosai Hospital
| | | | | | | | - Tomotaka Hemmi
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital
| | - Jun Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital
| | - Yukio Katori
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Hospital
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Çengel Kurnaz S, Kuruca N, Güvenç D, Kaya MT, Güvenç T. Topical Administration of Carvacrol Improves Healing in Nasal Septal Perforation: An Experimental Animal Study. Am J Rhinol Allergy 2022; 36:503-509. [PMID: 35238647 DOI: 10.1177/19458924221085157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clinicians are exploring alternative treatments for nasal septum perforation since surgical treatment is challenging. OBJECTIVE The effects of topical carvacrol on the healing of nasal septal perforation were investigated in an animal model. METHOD Twenty-one male New Zealand rabbits were randomly divided into three equal groups. A 5-mm circular biopsy punch was used to perforate the nasal septum behind the columella. For 14 days, bilateral gelatin sponges impregnated with carvacrol in olive oil in group 1, and only olive oil in group 2 were placed. Perforation only was performed in the control group. Animals were then sacrificed, and their nasal septums were removed. The closure of the perforation was measured, and samples were examined histopathologically. MMP-9 reactivity was evaluated using the immunoperoxidase technique. Histopathologic parameters were scored as 0 = none, 1 = mild, 2 = moderate, and 3 = strong. RESULTS The septum perforation closure in the carvacrol group was statistically significant compared with the other groups (p < 0.001). Cartilage regeneration, connective tissue density, and MMP-9 immunoreactivity were significantly higher in the carvacrol group (p = 0.020, p = 0.009, and p = 0.008, respectively). CONCLUSION Topically administered carvacrol enhances wound healing in rabbit nasal septum perforation. It accelerated perforation closure by increasing cartilage regeneration, connective tissue, and MMP-9 expression.
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Affiliation(s)
- Senem Çengel Kurnaz
- Department of Otorhinolaryngology and Head & Neck Surgery, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
| | - Nilüfer Kuruca
- Department of Pathology, Ondokuz Mayis University Faculty of Veterinary Medicine, Samsun, Turkey
| | - Dilek Güvenç
- Department of Pharmacology, Ondokuz Mayis University Faculty of Veterinary Medicine, Samsun, Turkey
| | - Muhammed Taha Kaya
- Department of Pathology, Ondokuz Mayis University Faculty of Veterinary Medicine, Samsun, Turkey
| | - Tolga Güvenç
- Department of Pathology, Ondokuz Mayis University Faculty of Veterinary Medicine, Samsun, Turkey
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Sambangi J, Prabhakaran N, Annam CS, Gopinath H, Bakshi SS, Aggarwal N. Nasal septal perforation in advanced lepromatous leprosy: A report of two cases with endoscopic findings . Trop Doct 2022; 52:576-580. [PMID: 35775139 DOI: 10.1177/00494755221111698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jahnavi Sambangi
- Senior resident, Department of Dermatology, 577244All India Institute of Medical Sciences, Mangalagiri, India
| | - Nagendran Prabhakaran
- Assistant Professor, Department of Dermatology, 577244All India Institute of Medical Sciences, Mangalagiri, India
| | - Chandra Shekhar Annam
- Senior resident, Department of ENT, 577244All India Institute of Medical Sciences, Mangalagiri, India
| | - Hima Gopinath
- Associate Professor, Department of Dermatology, All India Institute of Medical Sciences, Mangalagiri, India
| | - Satvinder Singh Bakshi
- Associate Professor, Department of ENT, 577244All India Institute of Medical Sciences, Mangalagiri, India
| | - Nidhima Aggarwal
- Assistant Professor, Department of Clinical Microbiology, 577244All India Institute of Medical Sciences, Mangalagiri, India
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Celik S, Kilic O, Zenginkinet T, Tuysuz O, Kalcioglu MT. The Effect of Platelet-Rich Fibrin and Hyaluronic Acid on Perforation of Nasal Septum. Am J Rhinol Allergy 2022; 36:719-726. [PMID: 35635128 DOI: 10.1177/19458924221104547] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Conservative approaches and surgical methods have been tried for the treatment of nasal septum perforations (NSPs), but a satisfactory method has not yet been determined. OBJECTIVE Our study aimed to investigate the effect of platelet-rich fibrin (PRF) and hyaluronic acid (HA) in repairing NSPs, which were experimentally created in rabbit septum. METHODS A total of 36 white New Zealand rabbits were included in the study. Perforations measuring 0.7 × 0.7 cm were created in their nasal septa. No additional intervention was made to the control group, which was the first group. For the second, third, and fourth groups, respectively, HA, PRF, and HA + PRF were used in the NSP region. Macroscopic and histopathological evaluations were performed after 40 days. RESULTS In the first group, closure was observed in none of the rabbits' NSPs. In the second group, 6 rabbits (66.7%) had full closure in their NSPs. In the third group, the NSP of 6 rabbits (66.7%) was completely closed. In the fourth group, the NSP of 7 rabbits (77.8%) had full closure. CONCLUSION Statistically significant closure was achieved with PRF and/or HA in rabbits in which NSP was established. These materials can be used to increase the likelihood of perforations closing.
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Affiliation(s)
- Serdal Celik
- 485544Istanbul Medeniyet University Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Osman Kilic
- 485544Istanbul Medeniyet University Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
| | - Tulay Zenginkinet
- Istanbul Medeniyet University Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Ozan Tuysuz
- 485544Istanbul Medeniyet University Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
| | - M Tayyar Kalcioglu
- 485544Istanbul Medeniyet University Faculty of Medicine, Department of Otorhinolaryngology, Istanbul, Turkey
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AbdullGaffar B, Hamadi I. Are Focal complex Proliferations in Respiratory Epithelial Adenomatoid/Seromucinous Hamartomas Clues of Precursor Neoplastic Lesions to Sinonasal low-Grade Tubulopapillary Adenocarcinoma? Int J Surg Pathol 2022; 31:343-347. [PMID: 35570620 DOI: 10.1177/10668969221101868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Iyad Hamadi
- ENT unit, 62761Dubai hospital, Dubai, United Arab Emirates
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贾 慧, 孙 楷, 刘 晓, 李 勇, 刘 增, 郭 玉. [Scanning electron microscope of the human nasal septum]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2022; 36:335-342. [PMID: 35483681 PMCID: PMC10128257 DOI: 10.13201/j.issn.2096-7993.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Indexed: 06/14/2023]
Abstract
Objective:Explore the significance of ultrastructural differences in tissue engineering, 3D printing, and rhinoplasty. Methods: 32 specimens (8 vomers, 8 perpendicular plates of ethmoid bone, 8 maxillary nasal crests, and 8 septal cartilage) of the nasal septum from patients with a nasal deviated septum and chronic sinusitis undergoing septoplasty were selected and examined using scanning electron microscopy. Results: The nasal septum of patients of different ages behaves similarly under the scanning electron microscope, and the bones of different parts of the nasal septum have similarities and differences. Conclusion:By observing the scanning electron micrograph of the nasal septum and analyzing the surface ultrastructure, it provides important information for the development of tissue engineering, assists in the refined modeling of 3D printing technology, and provides more ideal restoration materials for clinical operations.
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Affiliation(s)
- 慧 贾
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730000)Department of Otorhinolaryngology Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - 楷 孙
- 兰州大学材料与能源学院School of Materials and Energy, Lanzhou University
| | - 晓雯 刘
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730000)Department of Otorhinolaryngology Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - 勇 李
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730000)Department of Otorhinolaryngology Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - 增平 刘
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730000)Department of Otorhinolaryngology Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, China
| | - 玉芬 郭
- 兰州大学第二医院耳鼻咽喉头颈外科(兰州,730000)Department of Otorhinolaryngology Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, 730000, China
- 甘肃省卫生健康委员会HealthCommission of Gansu Province
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Chang SW, Kim JH. Extranodal nasal-type natural killer/T-cell lymphoma with nasal septal perforation. Ear Nose Throat J 2022:1455613221092206. [PMID: 35392686 DOI: 10.1177/01455613221092206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
There are very few reports of extranodal nasal-type NKTL with septal perforation, as seen in our patient. In addition, extranodal nasal-type NKTL is often diagnosed as chronic inflammation on histopathological examination. Therefore, if nasal septal perforation does not improve with appropriate conservative treatment, clinicians should consider a malignant disease such as extranodal nasal-type NKTL.
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Affiliation(s)
- Suk Won Chang
- Department of Otorhinolaryngology, 91577Jeju National University School of Medicine, Jeju, Korea
| | - Jeong Hong Kim
- Department of Otorhinolaryngology, 91577Jeju National University School of Medicine, Jeju, Korea
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Abstract
INTRODUCTION When cross-sucking persists beyond calf-hood, it represents an important problem in dairy heifers and cows. It can cause teat injuries and severe mastitis and lead to significant economic losses. The «SuckStop Müller,» a novel anti-sucking device, is designed to give the calf a negative feedback when cross-sucking on a conspecific. The aim of this study was to assess whether wearing a SuckStop would result in behavioral changes other than cross-sucking and thus, impair welfare in the short- and longer-term. Sixteen group-housed calves were observed in groups of four on five days, before and after fitting the SuckStop: day -2, day -1, day 0, day 1, and day 9. Maintenance behaviors (e.g., feeding, drinking, lying) were recorded using instantaneous scan sampling. In addition, the frequency of contact behaviors (e.g., exploring the feeding fence, touching own body) was recorded by means of continuous focal animal observations. Contact behaviors were classified as «impaired» or «normal» depending on whether or not the calf flinched in response to the contact. Finally, the number of visits to the milk and concentrate feeders was extracted from the computer-controlled feeding system. Fitting a SuckStop resulted in a higher proportion of observations spent lying and less exploration behavior on day 0 and day 1 than on day -2, day -1, and day 9. On day 0 and day 1, 6,3 % of exploration behaviors were classified as impaired, compared to 0,4 % (day -2, day -1) before and 0,2 % (day 9) after fitting the SuckStop. On day 9, all calves had superficial ulcerations on the nasal septum. In four calves, these ulcerations were moderately severe, whereas all other calves had slight ulcerations. In summary, the calves habituated quickly to this novel anti-sucking device. Follow-up studies are necessary to assess the long-term relevance of tissue alterations in the nasal septum for calf welfare as well as the effect of the SuckStop on cross-sucking behavior.
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Affiliation(s)
- C Bisang
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern
| | - C Rufener
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office (FSVO), Agroscope, Ettenhausen, Switzerland
| | - A Steiner
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern
| | - B Wechsler
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office (FSVO), Agroscope, Ettenhausen, Switzerland
| | - N M Keil
- Centre for Proper Housing of Ruminants and Pigs, Federal Food Safety and Veterinary Office (FSVO), Agroscope, Ettenhausen, Switzerland
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Abstract
OBJECTIVE Nasal septum cartilage is a hyaline cartilage that provides structural support to the nasal cavity and midface. Currently, information on its cellular and mechanical properties is widely dispersed and has often been inferred from studies conducted on other cartilage types such as the knee. A detailed understanding of nasal cartilage properties is important for several biological, clinical, and engineering disciplines. The objectives of this scoping review are to (1) consolidate actual existing knowledge on nasal cartilage properties and (2) identify gaps of knowledge and research questions requiring future investigations. DESIGN This scoping review incorporated articles identified using PROSPERO, Cochrane Library (CDSR and Central), WOS BIOSIS, WOS Core Collection, and ProQuest Dissertations and Theses Global databases. Following the screening process, 86 articles were considered. Articles were categorized into three groups: growth, extracellular matrix, and mechanical properties. RESULTS Most articles investigated growth properties followed by extracellular matrix and mechanical properties. NSC cartilage is not uniform. Nasal cartilage growth varies with age and location. Similarly, extracellular matrix composition and mechanical properties are location-specific within the NSC. Moreover, most articles included in the review investigate these properties in isolation and only very few articles demonstrate the interrelationship between multiple cartilage properties. CONCLUSIONS This scoping review presents a first comprehensive description of research on NSC properties with a focus on NSC growth, extracellular matrix and mechanical properties. It additionally identifies the needs (1) to understand how these various cartilage properties intersect and (2) for more granular, standardized assessment protocols to describe NSC.
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Affiliation(s)
- Pranidhi Baddam
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Sandra M. Campbell
- John W. Scott Health Sciences Library, University of Alberta, Edmonton, AB, Canada
| | - Hamdy El-Hakim
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Daniel Graf
- School of Dentistry, University of Alberta, Edmonton, AB, Canada,Daniel Graf, School of Dentistry, University of Alberta, 7020N Katz Group Centre For Research, 11315 - 87 Ave NW, Edmonton, AB T6G 2H5, Canada.
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Fujimoto M, Mano M, Sasaki A, Hasegawa H, Suzuki M, Nojiri N, Minami Y, Tokioka K, Suda N. Three-dimensional Analysis of Factors Related to the Effective Alveolar Molding in Presurgical Infant Orthopedics: Findings From a Pilot Study. Cleft Palate Craniofac J 2022:10556656221083804. [PMID: 35234083 DOI: 10.1177/10556656221083804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Presurgical infant orthopedics (PIO) reduces the severity of the original cleft and burden on patients and their parents, provides better esthetics and function, and enables surgeons to achieve better surgical repair. To reduce the alveolar cleft width and to predict treatment difficulty using PIO, various measures were examined in pretreatment cast models. DESIGN Retrospective case-control pilot study. PATIENTS The patients were 22 infants with non-syndromic unilateral cleft lip and palate (UCLP), and cast models of these infants were used. METHODS After PIO using passive plates, infants with UCLP were divided into two groups: contact group (12 cases with close proximity of the greater and lesser segments) and non-contact group (10 cases without proximity of segments). The two groups were compared, and variables related to the proximity between alveolar clefts were examined. RESULTS There was no significant difference in age at PIO initiation between the two groups. However, the treatment duration was significantly longer in the non-contact group than in the contact group. Among the 13 variables, the initial lateral deviation of the nasal septum was significantly larger in the contact group than in the non-contact group. A significant positive correlation was observed between the initial lateral deviation of the nasal septum and reduction of the alveolar cleft width by PIO. CONCLUSION Initial lateral deviation of the nasal septum is a predictive factor for the proximity between alveolar segments in infants with UCLP at the PIO.
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Affiliation(s)
- Mai Fujimoto
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Mikiko Mano
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Au Sasaki
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Hiroya Hasegawa
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Masaharu Suzuki
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Naoko Nojiri
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Yuri Minami
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
| | - Kazuyuki Tokioka
- Department of Plastic and Reconstructive Surgery, Saitama Medical University, Japan
| | - Naoto Suda
- Division of Orthodontics, Department of Human Development and Fostering, Meikai University School of Dentistry, Japan
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Shokri A, Ramezani K, Jamalpour MR, Mohammadi C, Vahdatinia F, Irani AD, Sharifi E, Haddadi R, Jamshidi S, Amirabad LM, Tajik S, Yadegari A, Tayebi L. In vivo efficacy of 3D-printed elastin-gelatin-hyaluronic acid scaffolds for regeneration of nasal septal cartilage defects. J Biomed Mater Res B Appl Biomater 2022; 110:614-624. [PMID: 34549884 PMCID: PMC9365017 DOI: 10.1002/jbm.b.34940] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/29/2021] [Accepted: 09/09/2021] [Indexed: 12/17/2022]
Abstract
Nasal septal cartilage perforations occur due to the different pathologies. Limited healing ability of cartilage results in remaining defects and further complications. This study sought to assess the efficacy of elastin-gelatin-hyaluronic acid (EGH) scaffolds for regeneration of nasal septal cartilage defects in rabbits. Defects (4 × 7 mm) were created in the nasal septal cartilage of 24 New Zealand rabbits. They were randomly divided into four groups: Group 1 was the control group with no further intervention, Group 2 received EGH scaffolds implanted in the defects, Group 3 received EGH scaffolds seeded with autologous auricular chondrocytes implanted in the defects, and Group 4 received EGH scaffolds seeded with homologous auricular chondrocytes implanted in the defects. After a 4-month healing period, computed tomography (CT) and magnetic resonance imaging (MRI) scans were obtained from the nasal septal cartilage, followed by histological evaluations of new tissue formation. Maximum regeneration occurred in Group 2, according to CT, and Group 3, according to both T1 and T2 images with 7.68 ± 1.36, 5.44 ± 2.41, and 8.72 ± 3.02 mm2 defect area respectively after healing. The difference in the defect size was statistically significant after healing between the experimental groups. Group 3 showed significantly greater regeneration according to CT scans and T1 and T2 images. The neocartilage formed over the underlying old cartilage with no distinct margin in histological evaluation. The EGH scaffolds have the capability of regeneration of nasal cartilage defects and are able to integrate with the existing cartilage; yet, they present the best results when pre-seeded with autologous chondrocytes.
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Affiliation(s)
- Abbas Shokri
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Kousar Ramezani
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Reza Jamalpour
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Chiman Mohammadi
- Research Center for Molecular Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Farshid Vahdatinia
- Dental Implant Research Center, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amin Doosti Irani
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Esmaeel Sharifi
- Department of Tissue Engineering and Biomaterials, School of Advanced Medical Sciences and Technologies, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rasool Haddadi
- Department of Pharmacology and Toxicology, School of Pharmacy, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shokoofeh Jamshidi
- Dental Research Center, Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Sanaz Tajik
- Marquette University, School of Dentistry, Milwaukee, Wisconsin, USA
| | - Amir Yadegari
- Marquette University, School of Dentistry, Milwaukee, Wisconsin, USA
| | - Lobat Tayebi
- Marquette University, School of Dentistry, Milwaukee, Wisconsin, USA
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