RESUMO
Nasal obstruction due to a collapsed nasal ala occurred in 2% of our patients with facial paralysis. The denervated dilator nasal muscles allow the ala on the paralyzed side to collapse leading to increased resistance to inspiration. This symptom was further aggravated by preexisting external and nasoseptal obstructing deformities. Nasal obstruction from facial paralysis was corrected with septorhinoplasty techniques in three patients and by lateralization of the ala with a facial sling in another.
Assuntos
Paralisia Facial/complicações , Doenças Nasais/etiologia , Nervo Facial/fisiopatologia , Paralisia Facial/fisiopatologia , Paralisia Facial/cirurgia , Humanos , Nariz/inervação , Doenças Nasais/fisiopatologia , Doenças Nasais/cirurgia , RinoplastiaRESUMO
Nasal problems in children are very common. The factors that affect the embryologic development have been discussed. Injuries that occur in prenatal, natal, and postnatal periods affect normal development. Prompt treatment of minor injuries is necessary to prevent airway problems later. The "wait and see" attitude toward nasal deformity is ill advised. X-ray findings are not conclusive, as the nasal pyramid in a child is largely cartilaginous. Obstructive nasal breathing can result in facial asymmetry, malocclusion, and cardiopulmonary problems. Allergy and sinusitis are frequently causes of obstruction.
Assuntos
Deformidades Adquiridas Nasais/complicações , Nariz/lesões , Doença Aguda , Adolescente , Obstrução das Vias Respiratórias/etiologia , Traumatismos do Nascimento/complicações , Cartilagem/lesões , Criança , Pré-Escolar , Traumatismos Faciais/diagnóstico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Má Oclusão/etiologia , Osso Nasal/lesões , Septo Nasal/lesões , Nariz/crescimento & desenvolvimento , Gravidez , Sinusite/etiologia , Fraturas Cranianas/diagnóstico , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/terapia , Ferimentos Penetrantes/terapiaRESUMO
The direction of air currents through the nose have been studied by many investigators. However, in injury of the nose followed by deformities, a marked change in the nasal configuration occurs. Many patients will present localized areas of crusting and attention is not drawn to this condition until the patient is seen with an epistaxis. In this study, we are interested in the character of the mucosa and their changes as affected by long-term injury from the trauma of the inspiratory and expiratory air currents, which, on sniffling or snorting, may reach hurricane speeds. In the study of the naso-respiratory mucosa from these areas by electron-microspy, it was found metaplastic respiratory epithelium where the cells have undergone mucinous transformation and areas exposed to air jets how metaplastic changes followed by erosion. We wish to thank Nikolajs Cauna, M.D. for his assistance and making available the micrographs used in this paper.
