ABSTRACT
Patients with deformed external noses and deviated nasal septum also have lateral wall deformities compromising the osteomeatal complex leading on to sinusitis. These patients will need septorhinoplasty along with functional endoscopic sinus surgery (FESS) to facilitate proper drainage of sinuses. The two main risks of combined procedure are firstly the risk of infection if done in infected sinusitis and secondly, the fear of collapse of nasal bone and the frontal process of the maxilla if medial and lateral osteotomies are done after extensive ethmoidectomy for extensive sinus disease. Our objective was to study the outcomes of combined septorhinoplasty with functional endoscopic sinus surgery in patients having sinusitis along with nasal deformity. In this retrospective study we describe the outcomes of patients who have undergone combined FESS + Rhinoplasty. We controlled the sinus infection and avoided extensive polyposis for combined procedure. We found that nasal block, facial pain, anosmia, rhinorrhea improved in all the patients There was a complete resolution of symptoms in the group. Thus, in combined surgery, we could simultaneously get a good functional airway, solve the sinus complaints and improve the nasal aesthetics satisfactorily. The patients were subjected to SNOT scale in 2023 and average score of SNOT score was found as 11 at an average postop followup period of 14 Years post op. We found that combined Rhinoplasty and Functional Endoscopic Sinus Surgery for patients having nasal deformity with chronic Rhinosinusitis can be performed safely and effectively. Simultaneously harvested septal cartilage could be used judiciously for meticulous reconstruction. It, avoided the extra cost and patient's time of two staged partial surgery.
ABSTRACT
In this article, we describe a chronic case of rhinofacial mucormycosis caused by Mucor irregularis, formerly known as Rhizomucor variabilis var. variabilis, a rare mycotic agent in humans. The infection caused progressive destruction of the nasal septum and soft and hard palate, leading to collapse of the nose bridge and an ulcerative gaping hole. The mucoralean mold cultured from a nasal biopsy specimen was determined by multilocus DNA sequence data to be conspecific with M. irregularis.
Subject(s)
Mucormycosis/diagnosis , Rhizomucor/isolation & purification , Adolescent , Biopsy , Cluster Analysis , DNA, Fungal/chemistry , DNA, Fungal/genetics , DNA, Ribosomal/chemistry , DNA, Ribosomal/genetics , Fungal Proteins/genetics , Genes, rRNA , Humans , India , Male , Molecular Sequence Data , Mucormycosis/microbiology , Mucormycosis/pathology , Multilocus Sequence Typing , Mycological Typing Techniques , Nasal Septum/pathology , Palate/pathology , Peptide Elongation Factor 1/genetics , Phylogeny , RNA, Fungal/genetics , RNA, Ribosomal/genetics , RNA, Ribosomal, 18S/genetics , Rhizomucor/classification , Rhizomucor/genetics , Sequence Analysis, DNA , Skin Ulcer/pathologyABSTRACT
Four cases of NPA with extra-nasopharyngeal extensions have been presented, two of which had an intracranial extension. On of the cases with intracranial extension underwent a transtemporal craniotomy removal and four temporal fossa. The other three cases were managed by the sublabial and transantral routes. Methods of pre-operative diagnosis of such extensions have been discussed and the importance of pre-operative recognition of extension in every NPA has been emphasized. Various approaches to the lateral and intracranial extensions have been reviewed. We feel that, for lateral extensions, sublabial and/or transantral or transzygomatic approaches are adequate, while the radical approach of Karnik is to be preferred only in large lateral extensions and in cases of intracranial extensions without symptoms of a space-occupying intracranial lesion. However, for patients with intracranial symptoms, a staged procedure is indicated and is safe for the patient.
