scholarly journals Correction of bony deviation in rhinoplasty

2020 ◽  
Vol 47 (6) ◽  
pp. 516-521
Author(s):  
Kook Hyun Kim
Keyword(s):  
Side Effects ◽  
Nasal Bone ◽  
Functional Results ◽  
Review Article ◽  
Anatomical Structures ◽  
Patients Satisfaction ◽  
Deviated Nose ◽  
Nasal Bones ◽  
Precise Understanding ◽  
And Cartilage

In rhinoplasty, osteotomy is becoming more and more frequent as a way to achieve aesthetically pleasing and functional results, as well as patient satisfaction. In procedures to correct a deviated nose, osteotomy to correct the bone plays an essential role in addition to correction of the septum and cartilage, and osteotomy can reduce the wide nose bridge and give a slightly higher appearance in Asian rhinoplasty. However, osteotomy is relatively invasive, and the nasal bones of Asians are often low and thick, so bleeding or swelling during surgery can be somewhat more severe, and a stuffy nose can occur after surgery if osteotomy is performed incorrectly. Since side effects are possible, it is necessary to have a precise understanding of the relevant anatomy and technique. Several articles have described nasal bone osteotomy in rhinoplasty, and this review article introduces the methods presented in various articles, describes indications and limitations, and reviews the relevant anatomical structures and techniques in an accurate manner. We introduce a method that can increase patients’ satisfaction and the completeness of surgery through accurate osteotomy, as well as reducing the risk of side effects.

Treatment of the Middle Third and Septal Deformity: A Trizonal Approach

2021 ◽  
Author(s):  
William Lawson ◽  
Eliezer C. Kinberg
Keyword(s):  
Clinical Assessment ◽  
Functional Results ◽  
Endonasal Approach ◽  
Deviated Nose ◽  
Nasal Bones ◽  
Rosetta Stone ◽  
Cartilage Biomechanics

AbstractGenetic, developmental, traumatic factors can produce a wide variety of nasal septal deformities in caudal–cephalic/dorsal–maxillary planes alone or in combination. These can be corrected by an endonasal approach through a transfixion incision by resecting, transposing, or utilizing principles of cartilage biomechanics. The authors are proposing a “Rosetta Stone” based on a trizonal analysis of the deviated nose that considers the contribution of each region to the deformity. Clinical assessment of the deviated nose should be segmental as well as global. Surgical correlation of the nasal bones, perpendicular, and quadrilateral plates, lateral cartilages, and turbinates may be necessary to achieve a satisfactory cosmetic and functional results.

Ultrasound screening and catamnesis of euploid fetuses with nasal bones aplasia/hypoplasia

2017 ◽  
Author(s):  
N.P. Veropotvelyan, A.A. Bondarenko
Keyword(s):  
Chromosomal Abnormalities ◽  
Nasal Bone ◽  
Normal Karyotype ◽  
Psychomotor Development ◽  
Ultrasound Screening ◽  
Normal Height ◽  
Term Infants ◽  
Nasal Bones ◽  
Postnatal Outcome ◽  
Selection Of

Objective. To evaluate the pre- and postnatal outcomes of euploid fetuses with aplasia/hypoplasia of the nasal bones (NB). Methods. We have made the catamnestic monitoring of children with a normal karyotype, who had been prenatally detected NB aplasia or hypoplasia (less than 5 perentile) at 11–24 weeks of gestation at ultrasound screening in the period between 2006–2015 years. Our study included a selection of 242 fetuses with NB aplasia or hypoplasia, in 128 (52.8 %) of them the NB was not visualized or appeared as an echogenic dot only. Results. Among all 63 fetuses with NB aplasia (absence or looks as an echogenic dot) in the 1st trimester in 24 (38 %) cases chromosomal abnormalities (CA) were found (including T21 — 15 (62.5 %) cases). Other 39 (61.9 %) fetuses had a normal karyotype. Among 65 fetuses with NB aplasia, examined in the 2nd trimester of gestation 12 (18.4 %) cases of CA were detected (one fetus with T21 had the only one ultrasound marker – isolated NB aplasia), 53 (81.5 %) fetuses had a normal karyotype. 62 mothers of the euploid fetuses with NB aplasia had been surveyed. We have received and analyzed 31 (50 %) responses. In 16 cases of euploid fetuses with NB, aplasia pregnancy outcome was adverse or relatively unfavorable, only 5 (31.2 %) fetuses of them had isolated NB aplasia. In other cases healthy full-term infants were born, who showed normal height and weight indexes, physical and psychomotor development observed in age from 0 to 10. Conclusion. In 51.6 % fetuses and children prenatally had aplasia of the nasal bone was marked by unfavorable pre- or postnatal outcome, according to the survey of their mothers.

Indications for Preservation Rhinoplasty: Avoiding Complications

2021 ◽  
Vol 37 (01) ◽  
pp. 045-052
Author(s):  
Mario Bazanelli Junqueira Ferraz ◽  
Guilherme Constante Preis Sella
Keyword(s):  
Nasal Bone ◽  
Nasal Dorsum ◽  
Ideal Candidate ◽  
Deviated Nose ◽  
Lateral Osteotomy ◽  
Upper Lateral Cartilage ◽  
High Radix ◽  
The One ◽  
Different Levels ◽  
The Ideal

AbstractNasal dorsal preservation surgery was described more than 100 years ago, but recently has gained prominence. Our objective is to show the surgical technique, the main indications and counterindications, and the complications. It is a technique that does not cause the detachment of the upper lateral cartilage (ULC) from the nasal septum, and has the main following sequence: preparation of the septum and its resection can be at different levels (high or low, i.e., SPAR [septum pyramidal adjustment and repositioning] A or B); preparation of the pyramid; transversal osteotomy; lateral osteotomy(s); and septopyramidal adjustment. The result is a nose with a lower radix than the original, a deprojection of the nasal dorsum tending to maintain its original shape; an increase in the interalar distance (IAD) and enlargement of the nasal middle ⅓; and loss of projection of the nasal tip and roundness of the nostrils. Thus, the ideal candidate is the one who benefits from such side effects, that is: tension nose, that is, high radix with projected dorsum, projected anterior nasal septal angle (ANSA), narrow middle ⅓, narrow IAD, thin nostrils and straight perpendicular plate of the ethmoid (PPE), and, depending on the characteristics, the deviated nose. The counterindications are low radix, irregularities in the nasal dorsum, ANSA lower than rhinion, and a wide middle ⅓. And the main stigmas are: a nose with a very low radix, middle ⅓ enlarged, residual hump, and saddling of the supratip area. Other issues of this technique are: the shape of the radix; the need or not to remove PPE; wide dorsum; irregular dorsum; ANSA lower than rhinion; weak cartilages; long nasal bone; deviated PPE; and obsessive patient. We conclude that this is a great technique for noses with characteristics suitable to it; care must be taken with the stigmas it can cause.

scholarly journals The Deviated Nose and the Nasal Airway

1979 ◽  
Vol 72 (11) ◽  
pp. 848-851
Author(s):  
A G D Maran
Keyword(s):  
Airway Obstruction ◽  
Experimental Work ◽  
Septal Cartilage ◽  
Nasal Airway ◽  
Deviated Nose ◽  
Bony Segment ◽  
Submucous Resection ◽  
And Cartilage ◽  
Valve Area ◽  
Taking Care

The pathology of the deviated nose is discussed in relation to its bony and cartilaginous components. The importance of the interlocking stresses within the septal cartilage is pointed out especially with respect to continuing deformation after trauma. The methods of rhinometry are analysed and normal airflow through the nose is described. The effects on the nasal airway of a caudal dislocation of the septum, an angulation at the valve area, a high septal deflection and an excessively wide choana are discussed. In the treatment of a deviated bony segment the difficulties of medial and lateral osteotomies are described. The indications for a septoplasty are thought to be a dislocated caudal end, a tip deviation and an external lateral angulation. The submucous resection of the septum should be reserved for resolved haematoma and cartilage absorption. The importance of the patient's priorities in deciding what operation to do are pointed out. Finally the experimental work on the effect of cartilage and mucoperichondrium resection on nasal growth is reviewed. It is suggested that a child with a severe septal deflection and airway obstruction should be offered a septoplasty taking care not to damage the mucoperichondrium.

scholarly journals Treatment satisfaction in 5q-spinal muscular atrophy under nusinersen therapy

2021 ◽  
Vol 14 ◽  
pp. 175628642199890 ◽  
Author(s):  
Alma Osmanovic ◽  
Gresa Ranxha ◽  
Mareike Kumpe ◽  
Claudia D. Wurster ◽  
Benjamin Stolte ◽  
...  
Keyword(s):  
Side Effects ◽  
Spinal Muscular Atrophy ◽  
Outcome Measures ◽  
Treatment Satisfaction ◽  
Treatment Duration ◽  
Treatment Effectiveness ◽  
Muscular Atrophy ◽  
Patients Satisfaction ◽  
Motor Outcome ◽  
Ambulatory Patients

Background: Nusinersen was the first approved disease-modifying therapy for all 5q-spinal muscular atrophy (SMA) patients regardless of age or disease severity. Its efficacy in adults has recently been demonstrated in a large cohort by motor outcome measures, which were only partially suitable to detect changes in very mildly or severely affected patients. Patient-reported outcome measures (PROs) have been suggested as a valuable addition. Here, we aimed to assess treatment satisfaction and investigate whether it may be a useful PRO to monitor SMA patients. Methods: We enrolled 91 mainly adult 5q-SMA patients treated with nusinersen in a national, multicenter, cross-sectional observational study. 21 patients underwent longitudinal follow up. Patients’ satisfaction with treatment in four dimensions (global, effectiveness, convenience, side effects) was assessed by the Treatment Satisfaction Questionnaire for Medication German version 1.4 (TSQM-1.4©) and related to clinical parameters, motor scores, and treatment duration. Results: More than 90% of SMA patients were consistently satisfied over a median treatment duration of 10 months. Highest mean scores were observed in the dimensions ‘side effects,’ ‘global satisfaction,’ and ‘effectiveness’ (93.5 ± 14.8 versus 73.1 ± 21.0 and 64.8 ± 20.6, respectively). Patients’ satisfaction with the convenience of treatment was considerably lower (43.6 ± 20.2). Interestingly, satisfaction with the effectiveness was higher in ambulatory ( p = 0.014) compared with non-ambulatory patients and directly correlated to motor outcome measures. Five non-ambulatory patients withdrew from therapy. All of them presented with a deterioration of motor outcome measures and reported dissatisfaction with treatment effectiveness and convenience. Conclusion: Most patients were satisfied with nusinersen treatment effectiveness. Less severely affected patients indicated higher satisfaction. The TSQM-1.4© helped to identify therapy non-responders, who mainly addressed dissatisfaction with effectiveness and convenience. We suggest introducing the TSQM-1.4© as an additional PRO in SMA into clinical practice.

scholarly journals Update on therapy for superficial mycoses: review article part I

2013 ◽  
Vol 88 (5) ◽  
pp. 764-774 ◽  
Author(s):  
Maria Fernanda Reis Gavazzoni Dias ◽  
Maria Victoria Pinto Quaresma-Santos ◽  
Fred Bernardes-Filho ◽  
Adriana Gutstein da Fonseca Amorim ◽  
Regina Casz Schechtman ◽  
...  
Keyword(s):  
Side Effects ◽  
Drug Interactions ◽  
Fungal Infections ◽  
Review Article ◽  
Practical Approach ◽  
Superficial Mycoses ◽  
World Markets ◽  
The World ◽  
The Right ◽  
Therapeutic Alternatives

Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets.

scholarly journals A NEW METHOD OF EPISTAXIS MANAGEMENT USING NASAL GEL: A SINGLE CENTER, RANDOMIZED CLINICAL TRIAL

2018 ◽  
Vol 11 (3) ◽  
pp. 104 ◽  
Author(s):  
Mehdi Torabi ◽  
Ava Roughani Esfahani ◽  
Shiva Moeinaddini ◽  
Mohammad Reza Baneshi
Keyword(s):  
Clinical Trial ◽  
Side Effects ◽  
Randomized Clinical Trial ◽  
Patients Satisfaction ◽  
Stop Time ◽  
Common Causes ◽  
Procedural Time ◽  
Nasal Bleeding ◽  
The Common ◽  
Discharge Length

 Objective: Epistaxis is one of the common causes of patients’ referral to the emergency departments. In the majority of cases, epistaxis is managed by traditional methods. We investigated the efficacy of nasal gel (NG) in comparison to anterior nasal packing (ANP) to stop mild-to-moderate anterior nasal bleeding.Methods: In this prospective, randomized clinical trial, patients were divided into two groups of ANP (n=60) and NG (n=40). We determined and compared the efficacy of treatment (bleeding stop time and recurrence), patients’ satisfaction at discharge (length of stay in the hospital, pain during the procedure, and procedural time), and safety (less side effects) in both groups.Results: The procedural time ≤2 min was observed in 90% and 58.33 % of NG group and ANP group, respectively (p<0.001). Pain score during procedure ≤4 and patients’ satisfaction ≥7 were, respectively, seen in 87.5% and 65% of NG group, but it was 43.33% and 41.7% in ANP group, respectively (p<0.001, p=0.02). The side effects in ANP group were 35%; however, no side effects were observed in NG group.Conclusion: In the management of mild-to-moderate anterior nasal bleeding although NG efficacy is equivalent to ANP, using NG may be more convenient and satisfactory for patients. In addition, the use of this gel may result in more safety and fewer side effects.

scholarly journals Is Ultrasonography Efficient for the Detection of the Zygomatic Arch, Nasal Bone and Cartilage Fractures?

2020 ◽  
Vol 14 (1) ◽  
pp. 178-183
Author(s):  
Amir Eskandarloo ◽  
Atena karimi ◽  
Abbas Shokri ◽  
Jalal Poorolajal ◽  
Mohammad Hosseinipanah
Keyword(s):  
Bone Fractures ◽  
Imaging Modality ◽  
Nasal Bone ◽  
Kappa Coefficient ◽  
Zygomatic Arch ◽  
Nasal Cartilage ◽  
Specificity And Sensitivity ◽  
Wide Range ◽  
Linear Probe ◽  
And Cartilage

Background: The high incidence of nasal and zygomatic arch fractures highlights the need for an accurate imaging modality for their detection. The superimposition of structures is a major problem in conventional radiography. Ultrasonography is a low-cost imaging modality with a wide range of applications, that does not employ ionizing radiation. This study aimed to assess the efficacy of ultrasonography for the detection of the zygomatic arch and nasal bone fractures. Materials and Methods: This study was conducted on 16 sheep heads. Artificial fractures were created in some parts of the zygomatic arch, dorsum and lateral wall of the nose, and nasal cartilage. All sheep heads underwent Cone-Beam Computed Tomography (CBCT) to ensure the presence of a fracture. Next, the lateral nasal and submentovertex radiographs were obtained, and ultrasonography was performed with a 12-15 MHz linear probe. Ultrasonography and radiography were repeated after 1 week to assess their reproducibility by calculating the kappa coefficient. Data were analyzed using Stata 11 software and Chi-square test. Results: The specificity and sensitivity of ultrasonography ranged from 87% to 100%, and 50% to 75%, respectively. The specificity and sensitivity of radiography ranged from 87% to 100%, and 62% to 87%, respectively. The differences between the two imaging modalities were not statistically significant (p>0.05). The kappa coefficient ranged from 46% to 100% for ultrasonography and 44% to 87% for radiography. Conclusion: Ultrasonography seemed useful for the detection of displaced bone and cartilage fractures. For non-displaced fractures, US is not recommended.

scholarly journals Application of fascia of the temporal muscle and cartilage of the auricular tragus in myringoplasty in children

2012 ◽  
Vol 140 (7-8) ◽  
pp. 408-411 ◽  
Author(s):  
Ivan Baljosevic ◽  
Jovica Milovanovic ◽  
Vladan Subarevic ◽  
Mladen Novkovic ◽  
Katarina Stankovic
Keyword(s):  
Surgical Technique ◽  
Tympanic Membrane ◽  
Statistical Significance ◽  
Functional Results ◽  
Young Age ◽  
Temporal Muscle ◽  
Temporal Fascia ◽  
Middle Ear Infection ◽  
Number Of Patients ◽  
And Cartilage

Introduction. Perforation of the tympanic membrane in children may be the cause of recurrent middle ear infection and loss of hearing. Objective. The aim of this study was to analyze the application of different reconstructive materials in surgical technique myringoplasty. Methods. We performed 88 myringoplasties due to auricular tragus perforation in 76 children (aged 4 to 16 years, mean 11.9 years) from July 2001 to July 2009. Age, gender, size and the site of perforation, status of the contra lateral ear, underlying cause of the perforations, surgical technique, preoperative and postoperative hearing levels and postoperative complications were recorded and analyzed. In performing myringoplasty we used fascia of the temporal muscle and cartilage of the auricular tragus. Results. In 43 (48%) patients we used fascia of the temporal muscle and in 45 (52%) cartilage of the auricular tragus. Graft success was defined as an intact eardrum at 12 months postoperatively and improvement in the perception of air-bone gap of 10 dB, which we recorded in 73 (83%) cases. Re-perforations were recorded in 12 (13%) patients, of whom in 8 (18.6%) cases we used the temporal fascia and in 4 (9.3%) cases a tragal cartilage. Retraction of the tympanic membrane was recorded in 3 (4%) cases with the temporal fascia. Conclusion. Myringoplasty is a reasonably successful method with good functional results in pediatric patients. Risk factors of surgical failure are young age, the size of auricular tragus perforation and pathological conditions of the contra lateral ear. The tragal cartilage gives better results in cases with bilateral perforations because the possibility of retractions and re-perforations is lower. Relatively small number of patients is probably the reason that, except for young age, differences between the two groups did not reach the level of statistical significance.

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