Assessment of nasal airflow and pain, safety and cost of an improvised nasal airway (nasogastric) tube after endoscopic sinus surgery

@#Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: Design: Quasi - Experimental Prospective Cohort Study Setting: Tertiary Government Training Hospital Participants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.

Multi-purpose Use of Nasal Stents for Prosthetic Rehabilitation of Facial Defect: A Case Report

@#Basal cell carcinoma is the most common cause of nasal defects. For large lesions with deep tissue extensions a total rhinectomy may be indicated followed by adjunctive therapies, such as radiotherapy or chemotherapy. Subsequent surgical reconstruction of these defects poses a challenge due to the compromised tissue bed and may require rehabilitation with facial prosthesis. In current case report, patient had basal cell carcinoma, which had involved the nasal cartilages, right inferior turbinate, nasolabial fold, upper lip and adjacent vascular and perineural tissues. Basal cell carcinoma was surgically excised, followed by postoperative radiotherapy. The resulted nasal defect was closed by forehead pedicle flap. Nasal stents were inserted postoperatively to prevent stenosis of nostrils. Prosthetic rehabilitation of a complete nasal defect was done by utilising nasal stents to prevent nasal stenosis, improved stability and precision, in placement of prosthesis over flat nasal defect. Skin adhesive was applied on margins to enhance the retention of prosthesis and to blend the margins of prosthesis with adjacent skin.