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The Neuroradiology Journal Aug 2020The nasal cavities are complex anatomical structures with high inter-individual variability that relates to different functions. Different anatomic variants may manifest...
The nasal cavities are complex anatomical structures with high inter-individual variability that relates to different functions. Different anatomic variants may manifest at this site, mainly belonging to the nasal septum and turbinates. Precise knowledge of the anatomy and variants is fundamental for both radiologists and ENT surgeons. This article provides an overview of the main anatomic variants and their frequency, according to the existing literature, as well as ongoing research on nasal cavity segmentation in order to obtain personal 3D models and to predict post-surgical results.
Topics: Anatomic Variation; Female; Humans; Male; Nasal Cavity; Nasal Septum; Tomography, X-Ray Computed; Turbinates
PubMed: 32193968
DOI: 10.1177/1971400920913763 -
International Journal of Oral Science Jul 2020Surgeons need to understand the effects of the nasal cartilage on facial morphology, the function of both soft tissues and hard tissues and nasal function when... (Review)
Review
Surgeons need to understand the effects of the nasal cartilage on facial morphology, the function of both soft tissues and hard tissues and nasal function when performing nasal surgery. In nasal cartilage-related surgery, the main goals for clinical research should include clarification of surgical goals, rationalization of surgical methods, precision and personalization of surgical design and preparation and improved convenience of doctor-patient communication. Computational technology has become an effective way to achieve these goals. Advances in three-dimensional (3D) imaging technology will promote nasal cartilage-related applications, including research on computational modelling technology, computational simulation technology, virtual surgery planning and 3D printing technology. These technologies are destined to revolutionize nasal surgery further. In this review, we summarize the advantages, latest findings and application progress of various computational technologies used in clinical nasal cartilage-related work and research. The application prospects of each technique are also discussed.
Topics: Computer Simulation; Face; Humans; Models, Anatomic; Nasal Cartilages; Nasal Septum; Nose; Printing, Three-Dimensional; Rhinoplasty
PubMed: 32719336
DOI: 10.1038/s41368-020-00089-y -
Ear, Nose, & Throat Journal Oct 2023Juvenile nasopharyngeal angiofibroma is a benign vascular tumor seen predominantly in adolescent males in the second decade of life. Extranasopharyngeal angiofibroma...
Juvenile nasopharyngeal angiofibroma is a benign vascular tumor seen predominantly in adolescent males in the second decade of life. Extranasopharyngeal angiofibroma includes vascular fibrous masses that occur outside the nasopharynx. The diagnosis of an angiofibroma is based on the clinical presentation and imaging, with biopsies being avoided to avoid excessive bleeding. Computed tomography scan is considered sufficient for the diagnosis of extranasopharyngeal angiofibroma as it clearly delineates and identifies the tumor.
Topics: Male; Adolescent; Humans; Nose Neoplasms; Angiofibroma; Nasopharyngeal Neoplasms; Nasal Septum; Nasopharynx; Respiratory Tract Neoplasms
PubMed: 34134540
DOI: 10.1177/01455613211026517 -
Acta Bio-medica : Atenei Parmensis Jan 2019The nasal valve deserves relevant in patients presenting with nasal obstruction. In particular, the nasal valve plays an important role in nasal airflow control, it is... (Comparative Study)
Comparative Study Review
The nasal valve deserves relevant in patients presenting with nasal obstruction. In particular, the nasal valve plays an important role in nasal airflow control, it is relevant for the otolaryngologist to not only consider but also fully evaluate the nasal valve when seeing a patient with nasal obstruction. These data reported in this Supplement confirms the clinical relevance of the nasal valve in different groups of patients and normal subjects. In fact, an integrity of nasal valve is fundamental to ensure a physiological nasal breathing that in turn guarantees a correct pulmonary function. The possibility to use the non-surgical and well-accepted option constituted by the nasal internal dilator represent an interesting opportunity for both the physician and the patient.
Topics: Cross-Sectional Studies; Dilatation; Female; Humans; Male; Nasal Cavity; Nasal Obstruction; Nasal Septum; Quality of Life; Reference Values; Respiration
PubMed: 30715036
DOI: 10.23750/abm.v90i2-S.8105 -
JAMA Facial Plastic Surgery Sep 2017The rabbit is the primary animal model used to investigate aspects of nasal surgery. Although several studies have used this model, none has provided a comprehensive...
IMPORTANCE
The rabbit is the primary animal model used to investigate aspects of nasal surgery. Although several studies have used this model, none has provided a comprehensive analysis of the surgical anatomy and techniques used to gain access to the rabbit nasal fossae and septum.
OBJECTIVE
To describe and optimize the surgical anatomy and approach to the rabbit nasal vault and septal cartilage.
DESIGN, SETTING, AND PARTICIPANTS
In an ex vivo animal study conducted at an academic medical center, preliminary cadaveric dissections were performed on rabbit head specimens to establish familiarity with relevant anatomy and rehearse various approaches. Live Pasteurella-free New Zealand white rabbits (3.5-4.0 kg) were used to further develop this surgical technique developed here. Access of the nasal vault was gained through a midline nasal dorsum incision and creation of an osteoplastic flap with a drill. Submucosal resection was performed with preservation of the mucoperichondrium. All rabbits were monitored daily for 4 weeks in the postoperative period for signs of infection, pain, and complications. The study was conducted from June 1, 2014, to December 1, 2014.
MAIN OUTCOMES AND MEASURES
Surgical anatomy and techniques used to gain access to the rabbit nasal vault and harvest septal cartilage.
RESULTS
Four Pasteurella-free New Zealand white rabbits (Western Organ Rabbit Co), ranging in age from 9 to 12 months and weighing between 3.5 and 4.0 kg, were used in this study. Initial dissections demonstrated the feasibility of harvesting septal cartilage while preserving the mucoperichondrial envelope. Access to the nasal vault through this 3-osteotomy approach allowed for maximal exposure to the nasal cavity bilaterally while maintaining the integrity of the mucoperichondrium following septal cartilage harvest. The maximum amount of bulk, en bloc, cartilage harvested was 1.0 × 2.5 cm. Following surgical dissection, all animals maintained adequate airway patency and support to midface structures. Furthermore, all specimens preserved the integrity of the mucoperichondrium, septum, vascular anatomy, and airway dynamics. No operative complications, postoperative airway compromise, or infections were observed.
CONCLUSIONS AND RELEVANCE
Access to the rabbit nasal vault and septal cartilage is feasible through a variety of surgical approaches and techniques. To date, this is the first study to meticulously document and review the surgical approaches to the rabbit nasal cavity. This approach describes a novel, 3-osteotomy method of accessing the nasal cavity bilaterally and successfully harvesting rabbit septal cartilage in a submucoperichondrial plane. The ability to preserve native anatomy and function allows for improved outcomes in translational and animal guided clinical research.
LEVEL OF EVIDENCE
NA.
Topics: Animals; Models, Animal; Nasal Cartilages; Nasal Septum; Rabbits; Rhinoplasty
PubMed: 28472203
DOI: 10.1001/jamafacial.2017.0116 -
Brazilian Journal of Otorhinolaryngology 2022Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used. (Review)
Review
INTRODUCTION
Surgical treatment of medium and large sized nasal septal perforation is challenging. Techniques with and without interposition grafts are used.
OBJECTIVE
The aim of this study is to explain how we apply the sandwich graft technique that we use in medium and large nasal septal perforations as well as to present the results.
METHODS
We retrospectively reviewed the patients who were operated with the sandwich graft technique between January 2014 to December 2018 and followed up for at least 6 months. The demographic data, symptom scores, examination, and surgical findings of the patients were taken from the hospital records. Surgical outcomes were presented according to both perforation etiologies (idiopathic or iatrogenic) and sizes (Group A: < 2 cm, Group B: ≥ 2 cm).
RESULTS
We reviewed 52 cases and 56 surgeries. The average diameter of the perforations was 19.2 mm. The success rate after initial surgeries was 84.6% (44/52). After 4 revision surgeries, the perforation was closed in 88.5% of the cases (46/52). Success rates for Group A and Group B were 90.0% and 86.4%, respectively (p = 0.689). The success rates in idiopathic and iatrogenic cases were 93.3% and 86.5%, respectively (p = 0.659).
CONCLUSION
This study showed that the success rate of sandwich graft technique was higher in medium-sized perforations than large-sized ones and in idiopathic perforations compared to iatrogenic ones, but the latter rate was not statistically significant. This demonstrated that perforation size was not as important in the sandwich graft technique as in flap techniques.
Topics: Humans; Nasal Septal Perforation; Retrospective Studies; Surgical Flaps; Reoperation; Iatrogenic Disease; Nasal Septum; Treatment Outcome
PubMed: 33642213
DOI: 10.1016/j.bjorl.2020.12.018 -
International Journal of Environmental... Feb 2022Tumours of the nasal septum are a rare and heterogeneous group of lesions in the sinonasal tract. The management of the different lesions of this site is debated. The...
OBJECTIVE
Tumours of the nasal septum are a rare and heterogeneous group of lesions in the sinonasal tract. The management of the different lesions of this site is debated. The aim of this study is to share our experience on a rare clinical condition and stimulate other centres to publish theirs.
METHODS
We retrospectively analysed the databases of sinonasal tumours treated at the Sections of Otolaryngology (ENT) of two University Hospitals (Palermo and Genova) between 2012 and 2020.
RESULTS
From the two databases, a cohort of 32 patients with tumours of nasal septum were selected. All patients underwent an endoscopic examination. Large tumours underwent preoperative computed tomography (CT) scan without contrast medium. In 22 (68.7%) cases, the preoperative radiologic evaluation also included magnetic resonance imaging (MRI) with gadolinium to obtain a better differentiation of the lesions and study the vascular pattern. All the large lesions were biopsied under endoscopic guidance using local anaesthesia; the same approach was used to remove the tumours and their attachment with safe resection margins.
CONCLUSIONS
While malignant lesions require an excision of the mass with resection of all layers of the nasal septum, benign lesions must be typed according to histological considerations in order to plan the most appropriate type of surgical resection.
Topics: Endoscopy; Humans; Magnetic Resonance Imaging; Nasal Septum; Paranasal Sinus Neoplasms; Retrospective Studies
PubMed: 35162736
DOI: 10.3390/ijerph19031713 -
Brazilian Journal of Otorhinolaryngology 2019In rhinoplasty, the nasal dorsum has important relevance regarding the esthetic and functional aspects of the surgery. Its reduction should be performed with maximum...
INTRODUCTION
In rhinoplasty, the nasal dorsum has important relevance regarding the esthetic and functional aspects of the surgery. Its reduction should be performed with maximum accuracy and controlled resection to prevent or minimize potential complications. The septum pyramidal adjustment and repositioning consists of a conservative surgical technique of the nasal dorsum, which does not require the detachment of the upper lateral cartilages of the nasal septum, allowing the remodeling of the nasal dorsum while maintaining esthetic lines and nasal function, potentially reducing frequent complications in more traditional surgeries.
OBJECTIVE
To describe the septum pyramidal adjustment technique in detail, presenting its advantages and disadvantages in relation to the other surgical approaches, as well as to disclose results of this surgical procedure in patients submitted to primary rhinoplasty in a specific hospital.
METHODS
The medical records of all patients submitted to surgery from 2011 to 2015 through this surgical technique were evaluated by the same team. Of these cases, certain variables were analyzed such as gender, age, indication for reoperation and surgical complications.
RESULTS
153 patients underwent rhinoplasty through septum pyramidal adjustment. Of these, 13 patients experienced an indication for a second surgery and four had some type of postoperative complication.
CONCLUSION
The septum pyramidal adjustment surgical technique is a simple procedure, as it does not require the reconstruction of the nasal dorsum. It has a low number of complications and preserves the anatomical structures.
Topics: Adult; Female; Humans; Male; Medical Illustration; Nasal Cartilages; Nasal Septum; Postoperative Complications; Reproducibility of Results; Rhinoplasty; Treatment Outcome
PubMed: 29398580
DOI: 10.1016/j.bjorl.2017.11.009 -
Facial Plastic Surgery & Aesthetic... 2020Although conventional hump resections are a hallmark of rhinoplasty, there has been a rekindled interest in dorsal preservation (DP) techniques as a means for... (Review)
Review
Although conventional hump resections are a hallmark of rhinoplasty, there has been a rekindled interest in dorsal preservation (DP) techniques as a means for addressing the dorsal hump, with claims of superior functional and aesthetic results. As such, an understanding of DP, including technical considerations and outcomes, is imperative. DP allows for mobilization of the osseocartilaginous nasal vault as a single unit and thereby prevents disruption of the natural keystone area. The osseous nasal vault is managed with a transverse osteotomy and either a bilateral single lateral osteotomy (pushdown procedure) or bilateral bony wedge resections (letdown procedure) to allow for descent of the nasal dorsum. A variety of approaches to the septum exist, each differentiated by the location of cartilage resection: subdorsal, high-septal, midseptal, or inferior septum. These techniques result in pleasing dorsal aesthetic lines but may be limited by a higher rate of dorsal hump recurrence. Patency of the internal nasal valve (INV) is theoretically improved with DP. Robust series with patient-reported outcomes are lacking, although several reports and early experience at our center with a newly described high-septal resection technique do suggest positive functional and cosmetic outcomes with DP. With the recent revitalized interest in DP, an understanding of the potential benefits, techniques, and challenges associated with this surgery is helpful. Maintenance of the dorsum as a single unit has implications for maintaining structural integrity at the nasal keystone, pleasing dorsal aesthetic lines, and the patency of the INV. As surgeons continue to develop and employ these techniques, critical assessment of patient-reported outcomes and objective nasal measurements, with an emphasis on comparison with standard hump takedown techniques, will be valuable.
Topics: Humans; Nasal Cartilages; Nasal Septum; Osteotomy; Patient Reported Outcome Measures; Rhinoplasty
PubMed: 32130066
DOI: 10.1089/fpsam.2020.0017 -
Head and Neck Pathology Dec 2017Nasal obstruction is one of the most common complaint that ENT surgeon faces in his day to day practice. Deviated nasal septum is the most common cause for the nasal...
Nasal obstruction is one of the most common complaint that ENT surgeon faces in his day to day practice. Deviated nasal septum is the most common cause for the nasal obstruction. It causes altered airflow dynamics which leads to various histopathological changes in nasal mucosa.Histopathological changes like lymphocytic infiltration and squamous metaplasia were studied and comparison was done between convex and concave side. A prospective randomized study conducted on 42 patients of deviated nasal septum from January 2015 to December 2015 selected from inpatient department of Otorhinolaryngology, KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belagavi. This study determined significantly higher rate of squamous metaplasia and lymphocytic infiltration in septal mucosa on concave side when compared with convex side. Furthermore, there was increased lymphocytic infiltration and squamous metaplasia in lateral wall mucosa on concave side as compared to convex side but the difference was not statistically different. Deviated nasal septum predisposes the nasal epithelium to chronic inflammation and squamous metaplasia as a result of altered airflow. Due to changes in pathophysiology the patient is more susceptible to chronic rhinitis/rhinosinusitis.
Topics: Humans; Nasal Mucosa; Nasal Septum; Prospective Studies
PubMed: 28474294
DOI: 10.1007/s12105-017-0819-9