ABSTRACT
BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced for various purposes including hemostasis, stabilization of nasal structure, and synechia prevention. However, the use of nasal packing has led to the development of uncomfortable symptoms such as nasal obstruction. In this study, therefore, we have devised a new method of nasal packing involving the use of an airway tube for reducing nasal obstruction and discomforts in association with post-surgical nasal obstruction. Materials and METHODS: An airway tube was made by cutting the distal end of a 1cc syringe. It was inserted between the nasal septum and the packing material. Nasal cavities of 20 patients (Group 1) who underwent nasal surgery were packed using packing materials and the devised airway tubes following nasal surgery. We evaluated the symptoms of nasal obstruction after the postoperative nasal packing in this study group and compared them with those of the 20 patients (Group 2) who received packing with existing merocel nasal stents and 20 patients (Group 3) who were given packing with only merocel without airway tubes after nasal surgery. RESULT: In this study, nasal obstruction and discomforts in association with post-surgical nasal obstruction were significantly improved among patients given packing material and devised airway tubes (Group 1) comparative to other patient groups. CONCLUSION: Devised airway tube is useful in minimizing the symptoms of nasal obstruction and discomforts as well as in reducing surgical expense.
Subject(s)
Humans , Formaldehyde , Hemostasis , Nasal Cavity , Nasal Obstruction , Nasal Septum , Nasal Surgical Procedures , Polyvinyl Alcohol , Stents , SyringesABSTRACT
BACKGROUND AND OBJECTIVES: There are several methods of sinus irrigation, they also have several problems such as, local pain and damage to the orbit or the tooth, bleeding, soft tissue swelling of the cheek, prolonged procedure time and so on. Now, a new instrument for sinus irrigation, self-supportable sinus irrigator, has been devised for easy, feasible, and efficacious sinus irrigation. MATERIALS AND METHODS: Self-supportable sinus irrigator has two component parts. One is an irrigator part and the other is a self-supportable part. After the irrigator tip is introduced into the middle meatus beyond the uncinate process or into the maxillary sinus via the natural ostium, the irrigator part is supported by the self-supportable part. The sinuses are irrigated using normal saline. RESULTS: Two models have been devised. Type 1 irrigator was used for irrigation of the ethmoid sinus and the frontal sinus and type 2 for the maxillary sinus. Sinuses could be irrigated with minimal complications with less time-consuming efforts. Fluid collection in the maxillary sinus could be identified on Waters' view in both models. CONCLUSION: The irrigator is useful for sinus irrigation and can be practically used by outpatients.
Subject(s)
Humans , Cheek , Ethmoid Sinus , Frontal Sinus , Hemorrhage , Maxillary Sinus , Orbit , Outpatients , Paranasal Sinuses , ToothABSTRACT
BACKGROUND AND OBJECTIVES: This study was done to evaluate the safety of Gore-Tex as a nasal implant. Materials and METHOD: A retrospective multicenter study was carried out on 15 surgeons from 11 general hospitals and 4 private practice clinics regarding the safety of the Gore-Tex as a nasal implant. The study involved 853 patients, of whom 656 received primary surgery and 197 revision surgery. Gore-Tex was mainly used as a dorsal implant in a form of sheet or as a reinforced nasal implant. RESULTS: The overall complication rate associated with Gore-Tex was 2.5% (21 cases). Infection was the most common complication (18 cases ; 2.1%) followed by 2 cases of seroma and 1 case of persistent nasal swelling. In 19 out of 21 complication cases, the graft needed removal to control the infection or seroma (91% removal rate). Nine cases of infection developed in both primary cases (1.37%) and in revision cases (4.57%), which suggests a higher association rate between infection and revision cases (p=0.0062). Infection developed within 1 month in 5 cases while 9 cases developed infection after 6 months of operation. Other complications such as aesthetic problems (malpositioning of the implant or dorsal irregularities) were found in 15 cases (1.8%) and hematoma in 1 case. CONCLUSION: The infection rate of Gore-Tex used in rhinoplasty was about 2% and it rose significantly in the revision cases. If infected, almost all of the implanted Gore-Tex needs removal; therefore, we suggest judicious use of Gore-Tex in rhinoplasty.
Subject(s)
Humans , Hematoma , Hospitals, General , Polytetrafluoroethylene , Private Practice , Retrospective Studies , Rhinoplasty , Seroma , TransplantsABSTRACT
Leiomyoma may occur wherever smooth muscle is present. The most common locations are the uterus, alimentary tract, skin and subcutaneous tissue. Leiomyoma of the nasal cavity and paranasal sinus is rare because of the paucity of smooth muscle in the nose. It may have originated from the smooth muscular tissue existing in the middle layer of the blood vessles supplying sinus. We experienced 2 cases of leiomyomas excised by endoscopic removal and external approach, respectively.
Subject(s)
Leiomyoma , Muscle, Smooth , Nasal Cavity , Nose , Skin , Subcutaneous Tissue , UterusABSTRACT
BACKGROUND AND OBJECTIVES: Traditional open rhinoplasty produces a scar on the columella. In previous survey using questi-onnaires, 77 percent of subjects refused to accept a small scar in the columella region, even when they were told that the scar would disappear in time. To avoid such a scar, rhinoplasty was performed without transcolumellar incision. MATERIALS AND METHODS: Skin incision was extended from a traditional marginal incision to the footplate of the medial crus. Rhinoplasty was done in 99 patients. RESULTS: The columella artery was not damaged. Necrosis, notching, and scar did not occur on the columella. Because the skin continuity was preserved, it was easier to watch and correct any or all abnormalities of the external nasal contour during operation than traditional open rhinoplasty. It was possible to accurately operate both the tip and the dorsum under direct vision like traditional open rhinoplasty. CONCLUSION: Approach via extended marginal incision is a very useful method in operating both the nasal tip and the nasal dorsum.
Subject(s)
Humans , Arteries , Cicatrix , Necrosis , Rhinoplasty , SkinABSTRACT
BACKGROUND AND OBJECTIVES: A successful reduction rhinoplasty would require more than a hump removal, since most of the patients show drooped nasal tips with an acute naso-frontal angle. For better results, therefore, the patients also need to receive a stronger cephalic rotation of the nasal tip as well as augmentation of the nasion. In order to perform such combined procedures, the external rhinoplasty approach is considered to be suitable for correcting hump noses since this approach provides a better visual field. This report analyses reduction rhinoplasty using augmentation of nasal tip and nasion. MATERIALS AND METHODS: A retrospective study was performed on 46 patients who underwent reduction rhinoplasty from Jan 1994 through May 1997. Almost all of the cases were performed by using the external approach. RESULTS: Reduction rhinoplasty using the external approach of tip projection and augmentation of the nasion following the hump removal gave satisfactory results. CONCLUSION: We conclude that the external approach of augmentation of the nasal tip and the nasion offers satisfactory outcome in reduction rhinoplasty.
Subject(s)
Humans , Nose , Retrospective Studies , Rhinoplasty , Visual FieldsABSTRACT
The nose is located centrally in the face and occupy an important place in the harmonic architecture of the face. Also, it plays important functions such as respiraton, olfaction and phonation. Therefore, reconstructive rhinoplasty is dealt with both cosmetic and functional aspect in mind. We have recently experienced three cases of reconstructive rhinoplasty for seborrheic keratosis of the nose, traumatic nasal defect, and basal cell carcinoma of the nose. Local flap and split calvarial bone graft were used for the reconstruction of the nose.
Subject(s)
Carcinoma, Basal Cell , Keratosis, Seborrheic , Nose , Phonation , Rhinoplasty , Smell , TransplantsABSTRACT
A sound understanding of the preferred appearance of the external nose is central to successful rhinoplasty. A survey using photographs was conducted among college students and employees aged 20 to 39 years in Inchon, Korea. Three hundred and twenty-one subjects filled out a questionnaire about their preferences regarding external nasal appearance. The most commonly preferred height of the nasion, measured from the corneal plane, was 6 mm among both sexes, and the most commonly preferred depth of the nasion, measured from the glabella plane, was 3 mm among both sexes. Regarding the nasofrontal angle, men preferred an angle of 135 degrees and women preferred an angle of 140 degrees. Men preferred a nasofacial angle of 33 degrees while women preferred an angle of 30 degrees. A straight nasal dorsum was most commonly preferred among both sexes and the most commonly preferred dorsal width was 13 mm among men and 10 mm among women. The most commonly preferred tip projection was 30 mm among men and 27 mm among women and the preferred tip angle was 105 degrees among both sexes. The angle of the apex in the most commonly preferred nasal base configuration was 85 degrees among men and 70 degrees among women. The angle of the apex in the most commonly preferred lobular configuration was 65 degrees among both sexes. The most commonly preferred ratio between nostril length and the distance from the subnasale to the tip was 45 percent among both sexes. The most commonly preferred angle between both nostril axes was 60 degrees among both sexes. The most commonly preferred nasolabial angle was 90 degrees among men and 95 degrees among women. The main difference in preference between Koreans and Caucasians seemed to center on the radix area rather than the tip. These results can be useful as basic guidelines for rhinoplasty.
Subject(s)
Female , Humans , Male , Korea , Nose , Rhinoplasty , Surveys and QuestionnairesABSTRACT
BACKGROUND: There have been few objective data about the most preferred nasal shape. OBJECTIVES: Understanding the attitude towards rhinoplasty and preference for external nasal appearances is the foundation for successful rhinoplasty. MATERIALS AND METHODS: Five hundred college students and employees filled out a questionnaire on rhinoplqsty. RESULTS: Rhinoplasty had been performed in 1.4% of totql subjects. Furthermore, 5.2% were so displeased with their nasal appearances that they wanted to correct them. More common reasons why they wished to correct their nasal shapes were due to low nasal dorsum and wide alar base. The most preferred nasal appearance includes nasal height as 6mm(72.0% of the total), the straight shape of the dorsum in 63.2%, the 35 degree nasofacial angle in 75.8%, the 105 degree tip angle in 55.4%, the straight axis of the alar in 83.4%, the smooth concave and straight shape of the columella limb in 46.7% and 46.4%, respectively, and the smooth concave shape of the subnasale segment in 80.6%.
Subject(s)
Humans , Axis, Cervical Vertebra , Extremities , Surveys and Questionnaires , RhinoplastyABSTRACT
Transforming growth factor (TGF)-beta1, beta2, and beta3 are multifunctional proteins which play an important role in chronic inflammatory process, angiogenesis, and epithelial differentiation. In nasal polyps and postoperative polypoid mucosa after functional endoscopic sinus surgery (FESS), changes of expression of TGF-beta family were assessed to identify its role in formation of nasal polyps and mucosal healing after FESS. Nasal polyps and polypoid mucosa were obtained during FESS and in outpatient clinic after the surgery, respectively. Immunohistochemical staining was performed. TGF-beta family was highly expressed in the epithelium, subepithelial glands, neutrophils and eosinophils of nasal polyps. On the other hand, expression of TGF-beta family decreased in the epithelium and subepithelial gland of polypoid mucosa according to a postoperative period after FESS. These results suggest that TGF-beta family may play an important role in formation of nasal polyps and it decreases in process of mucosal healing after FESS.
Subject(s)
Humans , Ambulatory Care Facilities , Eosinophils , Epithelium , Hand , Mucous Membrane , Nasal Polyps , Neutrophils , Postoperative Period , Transforming Growth Factor beta , Transforming Growth FactorsABSTRACT
A nasal provocation test is the most reliable diagnostic test to confirm allergen in allergic rhinitis. However, there are neither specific objective methods nor a standardized method and interpretation. In 20 normal subjects and 86 allergic rhinitis patients, we applied acoustic rhinometry as a new objective method to assess changes in nasal patency induced by nasal allergen challenge, a procedure which is used for confirming allergic rhinitis. The result shows that a minimal cross-sectional area (MCA) and volume from the nose tip on back to 7 cm (nasal cavity volume) after allergen challenge were significantly decreased in allergic rhinitis patients in comparison with the control subjects. We conclude that acoustic rhinometry can provide a sensitive index for evaluating the results of a nasal provocation test.