ABSTRACT
BACKGROUND: The authors present a retrospective, comparative, and analytical cohort study, that aimed to prove the utility of unilateral or asymmetrical bony wedge resection to straighten the twisted nose as applied in let-down and push-down methods. The study involved objective angle measurements preoperatively and postoperatively on frontal view photographs. METHODS: Preoperative and postoperative angle measurements were made on frontal view photographs of 78 patients with twisted noses classified as type C and type I. Angles of deviation were obtained using Scion Image software, measured in degrees. Statistical analysis was performed using Excel v15.13.3. RESULTS: Forty-two patients had twisted nose type C and 28 patients had twisted nose type I. The mean age was 19 years. There was an 81% improvement ratio for twisted nose type C and 79% for twisted nose type I, and the angle correction for each type of nasal deformity was statistically significant ( P < 0.01). The majority of postoperative results were classified as excellent to good, with the exception of four cases with bad outcomes, including two patients with type C and two with type I deviations. CONCLUSIONS: Unilateral or asymmetrical bony wedge resection is a modification of the let-down rhinoplasty technique. This study demonstrates statistically significant improvements in straightening twisted noses among patients with or without preoperative hump and preserving the nasal dorsum. The authors found this modification better suited for type C deviations. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Subject(s)
Rhinoplasty , Humans , Young Adult , Adult , Rhinoplasty/methods , Cohort Studies , Retrospective Studies , Nasal Septum/surgery , Treatment Outcome , Nose/surgeryABSTRACT
BACKGROUND: Our aim in this study was to determine the angle of the internal nasal valve in Mexican patients with the "mestizo nose" feature and without nasal obstructive symptoms. The work was prospective, comparative, and observational in nature and included patients >14 years of age who were seen in the Otolaryngology Department at the Los Angeles Lomas Hospital between April and May 2016. METHODS: The angle of the internal nasal valve was measured in 30 patients without obstructive symptoms. Endoscopic examination was performed with a 0° endoscope framed with tape at a 13-mm distance from the endoscope's tip, and digital photographs of the internal nasal valve were taken. The measurement of the angle of the internal nasal valve was made in sexagesimal degrees using Golden Ratio v3.1 (2012) software. Statistical analysis was performed using Excel v15.13.3. RESULTS: The angles of the internal nasal valve of the patients were (mean ± standard deviation) 24.07 ± 4.8° for the right nasal cavity and 25.07 ± 5.0° for the left nasal cavity, wider than the angle reported in the normal Caucasian nose established in the literature. CONCLUSIONS: According to our results, the Mexican-Hispanic mestizo nose has a wider angle in the internal nasal valve than that considered normal in the literature (10°-15°). We believe it is necessary to undertake a second study and add an airflow resistance measurement with a rhinomanometry procedure so we can compare the results with those in the Caucasian population.
Subject(s)
Nose/anatomy & histology , Adolescent , Adult , Aged , Cross-Sectional Studies , Endoscopy , Female , Humans , Male , Mexico/ethnology , Middle Aged , Prospective Studies , Young AdultABSTRACT
La epistaxis posterior es una patología que representa una urgencia otorrinolaringológica, para la cual, se han empleado diversos métodos en su manejo, tanto conservadores como invasivos, la gran mayoría con un porcentaje de éxito bajo y bastantes complicaciones. Presentamos la experiencia de nuestro servicio al resolver esta patología por medio de ligadura de la arteria esfeno palatina por vía endoscópica intranasal. Se analizaron 13 casos con un promedio de edad de 61 años, en un estudio prospectivo de Marzo de 1999 a Septiembre del año 2000, describiendo la técnica quirúrgica, los días de estancia intra hospitalaria, los factores coadyuvantes y desencadenantes, así como la morbilidad postoperatoria y el porcentaje de éxito. Los resultados muestran un 100 por ciento de éxito con una morbilidad mínima: cefalea, obstrucción nasal unilateral y un caso con nuevo episodio de epistaxis posterior ipsilateral proveniente de arterias etmoidales debido a revascularización en un paciente con enfermedad pulmonar obstructiva crónica. Con el estudio se concluye que en la actualidad, esta técnica es la de elección para el tratamiento de epistaxis posterior, debido a su baja morbilidad y a su alto porcentaje de éxitos.
