Commentary on: Comparison of Changes in Nasal Skin Sensation After Primary and Revision Rhinoplasty Procedures Using Semmes-Weinstein Monofilament Testing

Abstract Background Numbness of the nasal skin is one of the most common complications following rhinoplasty. Objectives The present study investigated postoperative changes in nasal skin sensation among primary and revision rhinoplasty patients and evaluated the recovery outcomes for both groups. Methods A prospective, randomized blinded study was undertaken involving 100 primary and 34 revision open rhinoplasty patients and 50 volunteers as control group. Semmes-Weinstein monofilament testing was performed on 7 designated nasal points preoperatively and at postoperative months 1, 3, 6, and 12, and the results were evaluated. Results Among the primary rhinoplasty patients, the change in reduced sensation on pressure to the tip and infratip over time was significant (P < 0.001), whereas there was no statistically significant difference for the other points. Among the revision rhinoplasty patients, the change in reduced sensation on pressure to the tip, infratip, and base of columella over time was significant (P < 0.001), whereas there was no statistically significant difference at the other points. In a comparison of the revision and primary rhinoplasty patients at all timepoints, a statistically significant reduction in sensation was noted on the application of pressure to all points in the revision patient group (P < 0.001). Conclusions This study found that the sense of touch on pressure returned to normal, aside from at the tip and infratip, by the end of month 12 in primary rhinoplasty patients. The revision rhinoplasty patients, in turn, were observed to have reduced sensation on pressure by the end of month 12, with the greatest reduction at the tip, infratip, and columellar base. Level of Evidence: 3

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Costal Cartilage Lateral Crural Strut Graft for Correction of External Nasal Valve Dysfunction in Primary and Revision Rhinoplasty

Ear Nose & Throat Journal ◽

10.1177/0145561320983940 ◽

2021 ◽

pp. 014556132098394

Author(s):

Mohamed A. Taha ◽

Christian A. Hall ◽

Harry E. Zylicz ◽

William T. Barham ◽

Margaret B. Westbrook ◽

...

Keyword(s):

Costal Cartilage ◽

Primary Group ◽

Nasal Valve ◽

Lateral Crus ◽

Valve Dysfunction ◽

Score Improvement ◽

Revision Rhinoplasty ◽

Final Score ◽

Sinonasal Outcome Test ◽

External Nasal Valve

Objective: To evaluate and compare the costal cartilage lateral crural strut graft’s (LCSG) ability to support a weak lateral crus in patients with external nasal valve dysfunction (EVD) undergoing primary versus revision functional rhinoplasty. Methods: This is a prospective cohort study of 26 patients (mean [SD]: 40.23 [6.75] years of age; 10 [38%] females) with clinically diagnosed EVD, who underwent primary versus revision functional rhinoplasty with the use of a costal cartilage LCSG (10 [38%] primary functional rhinoplasty patients and the 16 [62%] revision patients). Preoperative and 12-month postoperative subjective and objective functional measurements along with statistical analysis were performed. Results: While all baseline demographic and preoperative functional measurement scores were similar between the 2 groups, the primary cohort’s preoperative scores were higher overall. Follow-up was a mean of 14.58 months. The primary group demonstrated a greater difference in score improvement postoperatively in all categories. All patients had significantly improved visual analog scale (VAS), Nasal Obstruction Symptom Evaluation Scale, 22-Item Sinonasal Outcome Test, and nasal peak inspiratory flow (NPIF) scores. When comparing the overall score outcome and surgical efficacy of the LCSG, both groups had near equal final score outcomes with the exception of VASL and NPIF. Conclusion: The LCSG is a viable and versatile option in the management of EVD for both primary and revision rhinoplasty patients.

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The Emotional Sources of "Chills" Induced by Music

Music Perception An Interdisciplinary Journal ◽

10.2307/40285693 ◽

1995 ◽

Vol 13 (2) ◽

pp. 171-207 ◽

Cited By ~ 252

Author(s):

Jaak Panksepp

Keyword(s):

Human Brain ◽

Subjective Experience ◽

Social Bonds ◽

Social Loss ◽

College Age ◽

Emotional Process ◽

Emotional Meaning ◽

Skin Sensation ◽

Normal Human ◽

Large Survey

Music modifies moods and emotions by interacting with brain mechanisms that remain to be identified. One powerful emotional effect induced by music is a shivery, gooseflesh type of skin sensation (commonly called "chills" or "thrills"), which may reflect the brain's ability to extract specific kinds of emotional meaning from music. A large survey indicated that college-age students typically prefer to label this phenomenon as "chills" rather than "thrills," but many mistakenly believe that happiness in music is more influential in evoking the response than sadness. A series of correlational studies analyzing the subjective experience of chills in groups of students listening to a variety of musical pieces indicated that chills are related to the perceived emotional content of various selections, with much stronger relations to perceived sadness than happiness. As a group, females report feeling more chills than males do. Because feelings of sadness typically arise from the severance of established social bonds, there may exist basic neurochemical similarities between the chilling emotions evoked by music and those engendered by social loss. Further study of the "chill" response should help clarify how music interacts with a specific emotional process of the normal human brain.

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Retroactive Enhancement of a Skin Sensation by a Delayed Cortical Stimulus in Man: Evidence for Delay of a Conscious Sensory Experience

Neurophysiology of Consciousness ◽

10.1007/978-1-4612-0355-1_10 ◽

1993 ◽

pp. 196-204

Author(s):

B. Libet ◽

E. W. Wright ◽

B. Feinstein ◽

D. K. Pearl

Keyword(s):

Sensory Experience ◽

Skin Sensation

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Revision rhinoplasty

Scott-Brown's Otorhinolaryngology: Head and Neck Surgery 7Ed ◽

10.1201/b15118-236 ◽

2008 ◽

pp. 2979-2986

Author(s):

Gerhard Rettinger ◽

Claudia Rudack

Keyword(s):

Revision Rhinoplasty

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6 Repair of Nasal Airway Obstruction in Revision Rhinoplasty

Revision Rhinoplasty ◽

10.1055/b-0034-71400 ◽

2008 ◽

Keyword(s):

Airway Obstruction ◽

Nasal Airway ◽

Revision Rhinoplasty

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Endoscopic-assisted rib cartilage harvesting for revision rhinoplasty

Plastic and Aesthetic Research ◽

10.20517/2347-9264.2019.12 ◽

2019 ◽

Vol 2019 ◽

Author(s):

Abdulkadir Goksel ◽

Emre Ilhan

Keyword(s):

Rib Cartilage ◽

Revision Rhinoplasty

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Successful Management of Rhabdomyolysis with Acute Infection Resulting from Chronic Sacrococcygeal Pressure Ulcers in a Paraplegic Patient: A Case Report

10.21203/rs.3.rs-89467/v1 ◽

2020 ◽

Author(s):

Kai Huang ◽

Yansheng Zhu

Keyword(s):

Physical Examination ◽

Laboratory Tests ◽

Pressure Ulcers ◽

Acute Infection ◽

Case Presentation ◽

The Past ◽

Sacrococcygeal Region ◽

Skin Sensation ◽

Life Threatening ◽

Paraplegic Patient

Abstract Background: Rhabdomyolysis, a potentially life-threatening syndrome, is caused by the breakdown of skeletal muscle cells and leakage of intramyocellular contents into the bloodstream. The treatment of cases with rhabdomyolysis resulting from chronic sacrococcygeal pressure ulcers have been rarely reported.Case presentation: A 62-year-old man suffered from high fever and dark-colored urine. For the past 30 years, the patient has lived with paraplegia, which led to his immobility. According to his physical examination, the wound on his sacrococcygeal region was dehisced and exuded repeatedly with loss of skin sensation. Upon corroboration of a physical examination and laboratory tests, the patient was diagnosed with rhabdomyolysis with an acute infection resulting from sacrococcygeal pressure ulcers. We first debrided the necrotic tissue, and then the chronic ulcer was repaired. The wound dressing was changed frequently, and antimicrobial therapy and nutritional support were included in the treatment. The fever and dark-colored urine were gradually relieved post-operatively. Renal function was also improved according to the typical indicators in laboratory tests. Additionally, the size of the pressure ulcers was reduced, to some extent. The patient was discharged after one month of hospitalization.Conclusions: Accurate diagnosis is critical for clinicians to administer precise treatment to paraplegic patients with progressive rhabdomyolysis.

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