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Rhinoplasty Following Nasal Trauma
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Forty percent of facial fractures affect the nasal bones, and many of these involve damage to the nasal septum. External forces that are sufficient to cause a bony or cartilaginous deformity can also damage the overlying skin and soft-tissue envelope, commonly leading to a scar or contour abnormality.
Facial anatomy
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
The nasal bones are paired bones which form the bony portion of the nasal bridge (Figure 3.5), found in the midline in the upper part of the face. The superior portion of the nasal bone is covered by the procerus and nasalis muscles. The nasal bones articulate with the frontal bone superiorly, the maxillae laterally and the ethmoid bones posteriorly. They are punctured at multiple sites by tiny foramina which allow for veins to exit the skull. Great care must therefore be taken when administering filler for non-surgical rhinoplasty due to the significant risk of venous ischaemia at this point.
Data and Picture Interpretation Stations Cases 1–42
Published in Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox, ENT OSCEs: A Guide to Passing the DO-HNS and MRCS (ENT) OSCE, 2019
Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox
What the obvious pathology? Fractured nasal bones
Correction of severe medial ectropion using a novel osseous fixation technique
Published in Orbit, 2023
Ivan Vrcek, David Seamont, Ashtyn Zapletal, Marie Somogyi, Alison Huggins Watson, Tanuj Nakra
When a medial spindle procedure is not sufficient, such as in cases of severe cicatricial and paralytic ectropion, a medial canthoplasty can be performed by adding a posterior vector to the medial lower eyelid. Trans-nasal wiring involves tendon fixation traditionally requiring dissection of the contralateral normal side, although modifications utilize ipsilateral wiring techniques.7,14 This procedure requires extensive dissection and can be complicated by nasal hemorrhage and damage to the normal contralateral side.14,15 Further, achieving posterior vector can be technically difficult due to wire positioning.14 Multiple unilateral techniques requiring less dissection have been described using screws, anchoring systems, microplates, or orbicularis flaps.8,14,16,17 Similar to trans-nasal wiring, the use of screws or pitons has been criticized for technical difficulty in posterior positioning.14 The Mitek Anchor allows for more precise positioning along the posterior lacrimal crest in the anchoring of soft tissue to bone.8,18 Microplates combine this precise positioning with increased bone stabilization in the cases of trauma or nasal bone instability.8,14 An orbicularis flap canthoplasty with orbicularisorrhaphy is another viable option for severe medial ectropion repair, but involves manipulation of the upper lid as well and does not provide osseous support.17
High-resolution computed tomography assessment of bony nasolacrimal parameters: variations due to age, sex, and facial features
Published in Orbit, 2021
Zhiheng Lin, Namita Kamath, Adeela Malik
For measurements of the face, standardisation was achieved by aligning the axial plane with the superior surface of the hard palate (Figure 4) as a landmark to account for variable flexion of the neck. We also aligned the sagittal plane to a midsagittal line running between the crista galli and the protuberantia internus occipitalis (Figure 5) to account for a face turn. Reconstructed images were then used. For nasal height and width, the most inferior axial image where the tip of the nasal bone (rhinion) was visible was used, measuring width from between the nasolacrimal grooves (Figure 6). For upper facial width, the most anterior coronal image displaying the zygomatico-frontal sutures was analysed, measuring from the outer aspects (Figure 7).
Effect of fentanyl nasal packing treatment on patients with acute postoperative pain after closed reduction of nasal bone fracture: a randomized double-blind controlled trial
Published in Journal of Plastic Surgery and Hand Surgery, 2019
Kwan-Sub Kim, Sung Chul Yu, Jung-Woo Han, Sung-Min Shim, Soohyun Kwak, Yong-Min Kim, Seong-Su Kim
Recent work by Apuhan T et al. has demonstrated that Merocel packing rehydration with levobupivacaine or prilocane solution is an easy, inexpensive, safe and effective analgesic method to the patients undergoing nasal surgery [17]. Nasal packing rehydration can provide effective analgesia during packing removal, which has been reported to cause significant discomfort [18]. While use of levobupivacaine and prilocaine resulted in statistically significant differences in visual analog score (VAS) and Ramsay sedation scores, fentanyl is a short-acting synthetic opioid with a pharmacokinetic profile better suited for fast relief of brief episodic pain, is longer-acting, and is more cost-efficient than lidocaine [8]. Therefore, we performed a prospective, randomized, double-blind controlled trial to evaluate the effectiveness of fentanyl-soaked nasal packing in alleviating postoperative pain following closed nasal bone fracture reduction.