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Outpatient Assessment
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
Martyn L. Barnes, Paul S. White
Endoscopic evaluation using a three-pass technique (Table 28.2). Narrow diameter (2.5–3.0 mm) angled endoscopes (30–45°) confer greater opportunity to look laterally into each nasal meatus. Examples of the endoscopic anatomy, and common pathologic findings, are provided in Figure 28.2.
Head and Neck
Published in Bobby Krishnachetty, Abdul Syed, Harriet Scott, Applied Anatomy for the FRCA, 2020
Bobby Krishnachetty, Abdul Syed, Harriet Scott
The lateral wall of the nose has three nasal conchae (superior, middle and inferior) forming turbinates (horizontal bones with fibrovascular tissue) and four openings Sphenoethmoid recess – opening for the sphenoidal sinusSuperior nasal meatus – opening for the posterior ethmoidal sinusesMiddle nasal meatus – opening for the frontal sinus, maxillary, middle and anterior ethmoidal sinusesInferior nasal meatus – opening for the naso-lacrimal duct
Ear, Nose, and Paranasal Sinus
Published in Swati Goyal, Neuroradiology, 2020
The paranasal sinuses are air-filled spaces between the bones around the nasal cavity. Draining ostia connect four distinct sinuses with the nasal cavity. The anterior ethmoid cells, the frontal sinus, and maxillary sinus drain into the middle meatus. The posterior ethmoid cells and sphenoid sinus drain into the superior meatus. The nasolacrimal duct drains into the inferior nasal meatus.
Nasal floor augmentation for empty nose syndrome
Published in Acta Oto-Laryngologica Case Reports, 2022
Munetaka Ushio, Junko Ishimaru, Sayaka Omura, Yasushi Ohta, Mitsuya Suzuki
First, nasal floor augmentation involves very easy manipulations. Furthermore, we believe that augmentation for the reduced inferior nasal turbinate is more physiological and ideal for correcting the nasal cavity closer to its normal shape. In ENS, however, the inferior nasal turbinate and, in many cases, the nasal septum have undergone treatment in the previous surgeries. After surgical manipulation, the nasal mucosa becomes hard and difficult to stretch. Moreover, an excessively reduced inferior nasal turbinate contains limited space for augmentation between the nasal mucosa and the bone, and the mucosa of the left and right sides of the corrected nasal septum may be tightly adhered. These postoperative changes complicate implantation of autologous or artificial materials, and the materials could be exposed or evacuated as a result. On the other hand, nasal floor augmentation can be performed in a series of easy steps, i.e. removing some pieces of the auricular cartilage, incising the anterior nasal floor, creating the mucosal flap from the bony nasal floor, stacking the pieces of the cartilage, and suturing the incision. In addition, a previously unoperated nasal floor is relatively flexible and unbreakable and unlikely to expose the implanted cartilage pieces. Furthermore, augmentation of the lateral wall of the inferior nasal meatus may result in nasolacrimal duct obstruction. On the other hand, no such concerns are associated with nasal floor augmentation, unless the floor is stacked with a very large number of cartilage pieces.
Particle and inhalation exposure in human and monkey computational airway models
Published in Inhalation Toxicology, 2018
Nguyen Lu Phuong, Nguyen Dang Khoa, Kiao Inthavong, Kazuhide Ito
Deposition hotspots occurred on the vestibule and central nasal passages of the human nasal cavity due to sudden flow changes in the vestibule and the confined space within the nasal meatus (Figure 4(c) and (d)). Significant hotspots were observed on the dorsal and ventral walls of the human airway’s nasopharynx, larynx and trachea. These discernible differences were caused by the significant differences in nasal cavity anatomies.
Combination of a negative pressure suction device and endoscope can accurately locate the bleeding site of refractory epistaxis
Published in Acta Oto-Laryngologica, 2021
Xinghong Yin, Xinhai Zhang, Bo Wang, Keliang Li, Maoli Duan
Blood pressure, heart rate, electrocardiographic monitoring, and oxygen saturation were monitored in the local anesthesia operating room. With the patient supine, a conventional disinfectant towel was laid, nasal filler was removed, tetracaine and epinephrine cotton were used to anesthetize and contract the nasal cavity, and systemic examinations were performed under nasal endoscopy. The systematic search of the entire nasal cavity to detect bleeding was always performed in the same order: from anterior to posterior and from upper to lower, especially the following sites: junction of the nasal septum and nasal domain; nasal roof to the upper end of the nasal septum in the olfactory fissure area; junction of the middle nasal meatus and methyl plate of the middle turbinate (horizontal part and vertical part); upper margin of the inferior turbinate near the posterior fontanelle of maxillary sinus; front of the inferior meatus; posterior fornix of inferior meatus; and upper margin of the posterior nostril. Possible bleeding points were explored and, if none were found, the patients were randomly assigned to the negative pressure group (NPG) or control group (CG). For the CG, local selective tamponade was performed on suspected bleeding points during intraoperative exploration. In the NPG, the negative pressure device was applied, and negative pressure was adjusted to 40 kPa. The negative pressure football was placed into the anterior nostril of the affected side, and the patient was asked to press the other nasal alar with one hand to block the nasal cavity on the non-affected side and asked to hold their breath. The nasal cavity on the affected side connecting a negative pressure device form a closed space. then opening the negative pressure device, negative pressure in the nasal cavity is formed . Then, the bleeding site of the nasal cavity could be explored again under nasal endoscopy to accurately locate the bleeding site by following the blood flow at the time. Bleeding was stopped by electrocoagulation using an attractive haemostatic electrode, as shown in Figure 1. If nosebleed could not be induced, the patients underwent selective packing. The methodological protocol is illustrated in Figure 2.