Surgical correction of posttraumatic nasal deformities in adolescent athletes

Nasal breathing is of great importance for professional athletes because of the peculiarities of carbon dioxide metabolism in the body. Problems with nasal breathing caused by post-traumatic deformities of the nose can be successfully corrected with the help of rhinoseptoplasty, but the possibility of performing this surgery on patients under 18 years of age is a discussed matter. This study aimed to analyze the results of the effect functional rhinoseptoplasty has on nasal breathing, consider rhinoseptoplasty as the preferred method of treatment for adolescents with post-traumatic deformities of the structures of the nose. The study involved 15 professional athletes aged 15–18 years with post-traumatic deformities of the external nose and troubled nasal breathing. Five of them (33.3%) were female, 10 (66.7%) were male; all underwent open rhinoseptoplasty. The NOSE and SCHNOS questionnaires were used to assess the symptoms of nasal obstruction before and after surgery. Post-surgery, all patients subjectively noted that their nasal breathing improved, which was confirmed by the filled questionnaires. There were no significant complications registered during the follow-up period. Functional rhinoseptoplasty is a viable surgical option for adolescents under 18 years of age.

Arhinia and Bilateral Anophthalmia: Report of a Rare Case and Review of Literature

Arhinia is an extremely rare condition reported in less than 100 cases so far. We report a case of arhinia with bilateral anophthalmia. In physical examination, only alar portions of the nose were partially formed. No septal, lower, upper lateral cartilages or nasal bones were detectable. Both nostrils were atretic. The orbital area was covered with skin, and eyebrows were partially formed. Bilateral complete cleft lip and palate were evident. Surgical interventions should be considered not only for reconstruction of the external nose but for timely creation of a lacrimal passage and repair of the accompanying cleft lip and palate.

The nose and paranasal sinuses

The external nose is pyramidal and consists of a bony cartilaginous framework. The root/radix is continuous with the forehead an inferiorly terminates at the nasal tip. The dorsum of the nose is formed by two lateral surfaces that converge in the midline. The cartilaginous structure of the nose is formed by paired upper (lateral) cartilages that contribute to the internal nasal valve with the nasal bones, and lower lateral cartilages, combined with additional minor nasal cartilages that surround the ala. The nasal septum relies upon anastomoses from five vessels: two from the ophthalmic, two from the maxillary and one from the facial. Collectively, they form Kieselbach’s plexus. The paranasal sinuses are the frontal, sphenoidal, ethmoidal and maxillary – located within the bones of the same name. They are paired structures lined with mucosa that is continuous with the lateral nasal side wall into which they drain, facilitating clearance of mucus by way of the mucociliary escalator.

Reconstruction of Congenital Arhinia With Stereolithographic Modeling: Case Correlate and Literature Review

Complete congenital arhinia is a rare defect of embryogenesis leading to the absence of the external nose and airway. We report our novel multistaged reconstructive approach and literature review. Nasal methyl methacrylate prosthesis was created from a stereolithographic model for use as a temporary prosthesis and tissue expander. Lefort 1 with cannulization was utilized for midface advancement and airway formation. External framework was reconstructed with bilateral conchal bowl cartilage and rib osteocartilagenous grafts. Patient was pleased with the aesthetics and had safe decannulation with the ability to breathe through the nose and airway.

Comparing Reliability Between 3D Imaging And 2D Photography For External Nasal Anthropometry

Background: This study investigates and compare the reliability and reproducibility of two facial anthropometric methods about external nasal angles, 3D imaging and conventional 2D photography. Methods: 2D photograph images and 3D images about external nose of 30 volunteers were taken using digital camera and Morpheus 3D scanner. To evaluate intra-rater reliability, each images were taken over two different days for each subject by the same researcher. To evaluate inter-rater reliability, another researcher took each images for each subject on the first day. The reliability of each method for measuring 4 external nasal angle is obtained using intraclass correlation coefficient (ICC) and compared.Results: Inter-rater and intra-rater reliability of both 3D imaging and 2D photography had excellent agreement in all 4 nasal angles. In the nasofacial angular parameter, Inter-rater ICC, 2D photography was significantly higher than 3D imaging. Result of intra-rater ICC also showed both 3D imaging and 2D photography had good reliability in all 4 nasal angles. Similar to those of inter-rater ICC, nasofacial angular parameter showed statistically significant differences between 3D imaging and 2D photography.Conclusion: In terms of reliability, both 2D and 3D showed appropriate anthropometric results and considering its own advantage, each methods can be used complementarily.

Excellency of Converse Scalping Forehead Flap for Reconstruction of External Nasal Soft-Tissue Defects

Introduction Reconstruction of external nasal defects poses a challenge for the plastic surgeons. The scalping forehead flap, first described by Converse in 1942 is a versatile technique for subtotal and total external nasal reconstruction. The flap is extremely reliable with robust vascularity and provides excellent colour and texture match for the external nose with minimal donor-site morbidity. Materials and Methods In this series, eleven patients with external nasal soft-tissue defects (post traumatic and post excisional) were reconstructed with scalping forehead flap; among them four presented with congenital naevus, three with post-traumatic external nasal defect, two presented with basal cell carcinoma, and two with arterio-venous malformation. The age of the patients ranged between 24 and 67 years; eight male and three female patients were included in this study. Among them three had comorbidities like diabetes mellitus and/ hypertension. Results All the flaps survived nicely. I didn’t face any complication in any of my patients. The external nasal defects were reconstructed with scalping forehead flap in two stages with an interval of three weeks in between. Conclusion The Converse scalping forehead flap is an excellent option in the armamentarium of plastic surgeons for subtotal and total nasal reconstruction because of its reliability, vascularity, and simplicity even in the era of microvascular free tissue transfer.

RHINOPLASTY OF POSTTRAUMATIC NOSE INJURIES

The aesthetic and functional significance of the external nose gives particular relevance to the treatment of its injuries. The social importance of the problem is caused by the widespread prevalence of nasoseptal injuries, the frequency of development ofserious post-traumatic disorders of the appearance and normal physiology of patients, and unsatisfactory results of treatment of this pathology. The pyramid of the nose is the most vulnerable and fragile part of the facial skull, therefore, fractures of the nasal bones constitute a significant proportion of all injuries of the musculoskeletal system and occupy the third place among the total number of fractures of the human skeleton, are the most common among emergency conditions of ENT organs. In the general population, patients with this pathology account for up to 0.021%.

Respiratory adaptation to climate in modern humans and Upper Palaeolithic individuals from Sungir and Mladeč

As our human ancestors migrated into Eurasia, they faced a considerably harsher climate, but the extent to which human cranial morphology has adapted to this climate is still debated. In particular, it remains unclear when such facial adaptations arose in human populations. Here, we explore climate-associated features of face shape in a worldwide modern human sample using 3D geometric morphometrics and a novel application of reduced rank regression. Based on these data, we assess climate adaptations in two crucial Upper Palaeolithic human fossils, Sungir and Mladeč, associated with a boreal-to-temperate climate. We found several aspects of facial shape, especially the relative dimensions of the external nose, internal nose and maxillary sinuses, that are strongly associated with temperature and humidity, even after accounting for autocorrelation due to geographical proximity of populations. For these features, both fossils revealed adaptations to a dry environment, with Sungir being strongly associated with cold temperatures and Mladeč with warm-to-hot temperatures. These results suggest relatively quick adaptative rates of facial morphology in Upper Palaeolithic Europe.