Revision of submucous resection of nasal septum / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the clinical significance and surgical technique for revisionary submucous resection of nasal septum.</p><p><b>METHODS</b>Thirty-two patients who had undergone nasal septal resection were evaluated rhinologically and the causes of unsuccessful septoplasty were analysed . Based on the location and extent of deviation, the status of residual cartilage and bone, and the age of the patients, one of three incisions was chosen during septal surgeries: (1) For 5 cases with anterior, 1 with inferior and 14 with superior deviation, a "U" shaped incision at the left side of anterior edge of septum cartilage was used. (2) For 8 cases with posterior and 2 with superior deviation, the site of the incision was located just anterior to the deviation, with the aid of endoscope. (3) For 2 cases with anteroinferior deviation, because of their young age, a sublabial incision was made to surge the mucosa of the septum and base of nasal cavity, the otological electronic drill was then used.</p><p><b>RESULTS</b>Revision nasal septoplasty was successful in all cases. The symptoms resulting from septal deviation disappeared or significantly relieved. Following successful revision surgery, the treatment outcomes of concomitant nasal and/or sinusal diseases also significantly improved.</p><p><b>CONCLUSION</b>Revision nasal septoplasty requires different approaches depending on different clinical characteristics. A successful correction of septal deviation can not only relieve the symptoms derived from deviation, but also be of significance for the treatment of concomitant nasal and/or sinusal diseases.</p>

Twenty four cases of cholesterol granuloma of the paranasal sinuses / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the etiology and pathogenesis of cholesterol granuloma of the paranasal sinuses and the treatment for the disease.</p><p><b>METHODS</b>Twenty four cases of cholesterol granuloma of the paranasal sinuses treated in our hospital during the period from March 1996 to March 2003 were retrospectively analysed. All cases were verified by surgery and pathology.</p><p><b>RESULTS</b>Of all cases, 10 cases were diagnosed as chronic sinusitis, 8 cases as nasal sinus cyst, and 5 cases as nasal polyp before operation, only 1 case was considered as cholesterol granuloma. The main symptoms were nasal obstruction (20/24), rhinorrhea (18/24), dysosmia (10/24), headache (7/24), pain around the eye (5/24), double vision (2/24), et al. Different surgical approaches were selected depending upon different pathological changes. Good results were obtained in 23 cases and postoperative follow-up for at least one year showed no recurrence. Only one case received revision nasal endoscopic surgery two years after Caldwell-Luc operation because of recurrence, and remained symptom-free for three years.</p><p><b>CONCLUSIONS</b>The pathogenesis of cholesterol granuloma includes obstruction of ventilation and drainage and brooding in sinuses. Cholesterol granuloma of the paranasal sinuses seems to have a close relation with chronic sinusitis, especially sinus mucocele. The surgical approach depends upon the location, extension, and severity of the lesion. The principle of surgery is to eliminate the pathological focus and create an adequate drainage.</p>

Correction of posttraumatic deviated nose in 136 cases / 中华创伤杂志

Objective To explore a good of treating posttraumatic deviated nose. Methods Clinical data of 136 patients with posttraumatic deviated nose were analyzed.Closed nasal bone replacement was employed in 34 patients with the disease history of 20-30 days,while open rhino- plasty approach was employed in 102 patients with the disease history over 6 months to correct their postt- raumatic deviated nose,and straightening the septum and ectomizing the inferior turbinate were done if necessary.Results The follow-up was over one year.In the 34 patients with the disease history of 20- 30 days,the outcome was excellent in 28 cases and good in 6.In the 102 patients with the disease history over 6 months,the outcome was excellent in 81 cases and good in 21.The deformity of nose was corrected satisfactorily.Normal nasal shape and good ventilation were obtained.Conclusion Posttraumatic devi- ated nose deformities are often caused by delayed and inaccurate treatment.Closed nasal bone replace- ment can be employed for the patients with trauma history less than one month,and open rhinoplasty ap- proach and straightening the septum and restoration of the nasal shape are employed for other patients.In this way good results can be obtained.