RESUMO
@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> Crooked nose deformity is a commonly seen reason for septorhinoplasty in the otolaryngology clinic. The purpose of this study is to initially determine the different etiologies of patients with crooked nose deformities who underwent septorhinoplasty, and to describe the different types of crooked nose by their level of deviation and surgical management in our institution.<br /><strong>METHODS:</strong><br /> <strong> Design:</strong> Case Series<br /> <strong> Setting:</strong> Tertiary Public University Hospital<br /> <strong> Participants:</strong> A chart review of all patients with a crooked nose deformity who were admitted at the otorhinolaryngology ward of the National University Hospital and underwent septorhinoplasty from January 2012 to January 2015 was conducted, and data consisting of age, sex, etiology of crooked nose deformity, level of deviation, cartilage source, and surgical intervention were obtained and analyzed.<br /><strong>RESULTS:</strong> A total of 21 patients underwent septorhinoplasty for crooked nose deformity in the study period. The most common etiology for crooked nose was physical violence (13/21 or 62%), followed by sports injury (4/21 or 19%), vehicular accidents (2/21 or 9%), and accidental fall (1/21 or 5%). There were more upper and middle third deviations than lower third deviations. Sixteen out of 21patients (76%) underwent open rhinoplasty, while the rest underwent an endonasal approach. Twelve (57%) underwent intervention on the nasal fracture after at least a year (old or neglected fracture) as compared to the 9 (43%) who had immediate intervention after less than two weeks. Thirteen used septal cartilage, while 4 used conchal cartilage, and 1 used tragal cartilage. The most common grafts used were spreader and camouflage, followed closely by dorsal onlay, and columellar strut grafts.<br /><strong>CONCLUSION:</strong> The majority of crooked nose deformities that were subjected to septorhinoplasty in our department were secondary to old nasal bone fractures caused by physical violence. Upper and middle third level deviations were more common, and most underwent open rhinoplasty with autologous cartilage grafts. Future studies may increase our understanding of, and improve our techniques in septorhinoplasty for crooked nose deformities in Filipino noses in particular, and Asian noses in general. </p>
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Adulto Jovem , Rinoplastia , Nariz , Ferimentos e LesõesRESUMO
@#<p style="text-align: justify;"><strong>OBJECTIVES:</strong> Axial flap surgery is associated with numerous complications. The purpose of this study is to determine the frequency of these complications, and identify possible factors contributory to their occurrence.<br /><br /><strong>METHODS:</strong><br /><strong>Design: </strong>Cross-Sectional Study<br /><br /><strong>Setting: </strong>Tertiary Public University Hospital<br /><br /><strong>Subjects: </strong>Records of all patients who underwent axial pedicled flap reconstruction at the otorhinolaryngology ward of our tertiary public university hospital from January 2013 to July 2015 were retrospectively reviewed, and data consisting of age, sex, diagnosis, disease stage, smoking history, alcohol intake, co-morbidities, past operations, pre-operative hemoglobin and albumin, total operative time, total blood loss, location and total area of the surgical defect and length of hospitalization were tabulated. All complications were listed. Data were analyzed for any potential trends.<br /><br /><strong>RESULTS:</strong> A total of 38 patients underwent axial pedicled flap reconstruction in the study period. Nineteen out of 38 (50%) cases involved complications. The most common complication was infection. Most of the complications occurred in males with history of alcohol intake, advanced cancer stage, significant blood loss, recurrent tumors, low pre-operative hemoglobin and albumin levels, and a large area of surgical defect.<br /><br /><strong>CONCLUSIONS:</strong> The complication rate for axial flap surgery in our series was significant at 50%. Potential risk factors identified were male gender, advanced cancer stage, tumor recurrence, alcohol intake, low pre-operative hemoglobin and albumin levels, significant blood loss, longer operative time, and a larger surgical defect.</p>