Nose Tip Elongation and Elevation: A Novel Filler Injection Technique

Background Filler injection for nose tip improvement remains a difficult subject due to efficacy and safety issues. Objectives To better the techniques and safety for nose tip improvement with a filler. Methods Patients seeking nose tip improvement were recruited regardless of their pre-treatment conditions. A hyaluronic acid filler is injected through the skin behind the nose tip into the potential septal space. To achieve tip elevation, the filler is retro injected from the anterior nasal spine, stopping at the mid-level of medial crura. To elongate the nose, the filler is deposited just in front of the caudal septal cartilage. The tip extends in the sagittal plane, causing the nose tip to move either caudally (tip elongation) or anteriorly (tip elevation), or both, as directed by the surgeon. Results Depending on the patients, the nose could be elongated by 2 to 6mm, and the tip could be elevated by 2 to 8 mm. Additionally, stronger columellar support, finer tip structures, and improved nasolabial angle are observed. Interestingly, the upper lip appears shorter. The nostril shapes and the alar widths are also improved. A total of 1288 cases are reported. Only two patients expressed dissatisfaction. Conclusions This technique is easy and safe to perform and, the results are natural and comparable to those from rhinoplasty surgeries. Further, this report of filler nose lengthening may be the first large series in the world. Finally, this technique works well in all populations.

Nasal Septal Abscess Complicating Acute Sinusitis in an 8-Year-Old Child: A Case Report

Introduction: Nasal septal abscess (NSA) in the pediatric population is an uncommon condition, but it can cause devastating complications (such as potentially life-threatening intracranial infections and cosmetic nasal deformity). The objective of this study is to report a case of an pediatric patient presenting with NSA in association with frontal-ethmoid acute sinusitis and intracranial abscess. Method and Results: In this study, we report a case of an 8-year-old patient who progressed from spontaneous nasal septal abscess to sinusitis (maxillary, frontal and ethmoidal), cosmetic nasal deformity (destruction of septal cartilage) and intracranial complication. The purulent collection necessitated urgent surgical drainage and adequate medical treatment. Conclusion: Nasal septal abscess in children is a rare condition that necessitates early appropriate drainage in order to prevent severe life-threatening complications. Furthermore, in the growing child, in case of total destruction of the cartilaginous septum, immediate reconstruction with autologous cartilage graft is essential for normal development of the nose and maxilla.

Ewing Sarcoma of the Ethmoid Sinus in an Adult

Extraskeletal Ewing sarcoma (EES) is a relatively rare primary tumor of the soft tissues predominantly affecting men in the second and third decades of life. They are a less common form of the cancerous growth known as an Ewing sarcoma, which occurs in bones or soft tissue such as cartilage. Head and neck ESS can require intervention including endoscopic sinus surgery, septoplasty, inferior turbinectomy, and left internal nasal valve repairs with septal cartilage This is a case report on an unusual presentation of ESS in the sinonasal region.

Nasolabial Flap and Simultaneous Cartilage Graft for Nasal Alar Reconstruction- A Case Report

A case of full thickness defect involving left ala of nose reconstructed with nasolabial flap for the coverage of skin and mucosal lining, along with simultaneous insertion of septal cartilage, which completes the reconstruction. Bangladesh J Otorhinolaryngol 2021; 27(2): 184-187

Alar cartilage hematoma of the nose secondary to facial trauma.

<p>A 27 years old male patient victim of road traffic accident presented to emergency department by ambulance team with ankle swelling and decrease range of motion, seen by orthopedic team and admitted as case of right ankle fracture for surgical intervention. Patient then referred to otolaryngology regarding on and off nasal bleeding and right nasal swelling arising from inner surface of right lower lateral cartilage of the nose 6 hour after the facial trauma, we present this case of hematoma of lower lateral cartilage which consider as one of the unique and rare condition following nasal and facial trauma. Early recognition of this condition is important, also differentiation between alar hematoma and septal cartilage hematoma is not easy for non-otolaryngology doctor, so increase awareness of this condition as one of possible sequel of fecal trauma and early referral to otolaryngology services is crucial. We present here a case of right sided alar cartilage hematoma, including the approach, management and follow up of the patient. We recommend early surgical drainage to optimize aesthetic out come after trauma.</p>

Chemical septoplasty using papain enzyme—a feasibility study

Background Though surgery can correct nasal septal defects through a procedure called septoplasty, many people seek non-surgical options. Papain enzyme has been used in the past to lyse intervertebral disc and has shown to have a lytic effect on cartilage. Therefore, in this paper, the feasibility to use papain for septoplasty was studied. First, an in vitro study on chicken cartilage was done. Cartilage pieces were emerged in papain solution (5 mg/ml of papain in normal saline) and plain normal saline solution (as control) for 2 weeks at room and refrigeration temperatures. Then, the papain solution was injected in a formalin-fixed cadaver in the submucosal space around the nasal septal cartilage. The control group was injected with normal saline. Results The treated group showed significant lysis with the disintegration of the cartilage, both in the in vitro and cadaver study. Conclusion This study shows that papain can lyse cartilage. It also shows that submucosal injection of papain around nasal cartilage will lyse the septal cartilage. Based on prior experience with papain for disc herniation and the present study, it is worthwhile to further investigate this procedure using live animals.