China
Africa
Explore chapters and articles related to this topic
Nasal Airway Surgery: Management of Septal Deformities
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
Shahram Anari, Ravinder Singh Natt
Postoperative nasal packing remains a varied practice. Some surgeons use septal splints to prevent adhesions or to provide extra support for the septum. Most surgeons apply an external splint after external (open) septoplasty.
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
If the aforementioned treatment options fail with silver nitrate cautery, then ENT referral is usually advised since they are more experienced in delivering further treatment such as electrocautery. Nasal packing is an important treatment option that is effective in controlling most bleeding instances. New expanding nasal sponges are now available, which are inserted into a patient's nasal passages and – with the injection of normal saline – expanded to control bleeding. In severe uncontrolled bleeding, lidocaine with adrenaline can be injected into the bleeding site – strictly under experienced hands since it can cause catastrophic complications, including blindness. Posterior bleeding that is not controlled may be treated endoscopically. The most severe instances of uncontrolled bleeding may require open surgical ligation.
Paediatric epistaxis
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
For posterior epistaxis, the modern method for nasal packing involves the placement under general anaesthesia of an inflatable tamponading single or double balloon catheter (Figure 27.7). These balloons can be left in situ for up to 48 hours, but antibiotic cover must be provided to reduce the risk of intracranial spread of possible infection. Once the balloon(s) is/are removed, the child should be observed for an appropriate amount of time and discharged accordingly.
Treatment of intractable epistaxis in patients with nasopharyngeal cancer
Published in Annals of Medicine, 2023
Xiaojing Yang, Hanru Ren, Minghua Li, Yueqi Zhu, Weitian Zhang, Jie Fu
After NPC radiotherapy, the bleeding site is often concealed and associated with a wide range of lesions located at the back of the nasal cavity or nasopharynx. Nasal packing is currently the preferred hemostatic method to treat epistaxis [46,47]. This method is effective for patients with a small amount of bleeding, and it involves simple operation without advanced equipment. A suitable and effective packing method can be chosen according to the different bleeding sites of the patient, which significantly improves the hemostatic effects. However, patients with various degrees of restricted mouth opening, nasal adhesions, and increased embrittlement of nasal mucosal blood vessels after radiotherapy often need nasal tamponade, which causes great pain for patients and often induces new bleeding. Furthermore, nasal packing can cause nasal infections, reduce nasopharyngeal tissue oxygen supply, and blood circulation, leading to further necrosis of nasopharyngeal tissue and exacerbating the possibility of nasal bleeding, requiring close observation. The packing period should not exceed 3-4 days.
Depression and female gender associated with higher postoperative pain scores after sinonasal surgery
Published in Acta Oto-Laryngologica, 2022
Katharina Schinz, Lukas Steigerwald, Konstantinos Mantsopoulos, Antoniu-Oreste Gostian, Maximilian Traxdorf, Matti Sievert, Robin Rupp, Heinrich Iro, Sarina Katrin Mueller
This was an IRB-approved, retrospective study of n = 492 patients who underwent functional endoscopic sinus surgery (FESS), septoplasty or a combination of both in the Department of Otolaryngology of a German University between January and December 2018. A medical history, demographic information, procedural data, intra- and postoperative medication, complications and comorbidities were collected from all patients. Depression was counted as such based on the previous diagnosis of a physician. All patients were asked about their postoperative pain using the numeric rating scale (NRS). Postoperative pain was assessed using the NRS 3 times daily for the 4 d the patients stayed in the hospital. The 4-day postoperative inpatient stay is standard in the German Health System. Patients who were undergoing a septorhinoplasty were excluded. The assessment of postoperative pain medication (opioids, non-opioids) was conducted continuously for 4 d during the patients’ stay in hospital. For all patients, nasal packing was removed on the first postoperative day. Splints remained in place for 5–7 d after septoplasty.
Frontal osteoplastic flap without frontal sinus obliteration for orbital roof decompression
Published in Orbit, 2021
Matthew Kim, Marc Otten, Michael Kazim, David A. Gudis
Attention is next turned to the endoscopic endonasal approach. A hemitransfixion incision is made on the left caudal septum, and sharp dissection is carried down to cartilage. A submucous resection of the nasal septum is performed to correct septal deviation as necessary, and a maxillary antrostomy and total sphenoethmoid-ectomy are performed bilaterally to skeletonize the medial orbital wall and skull base. The middle turbinate is resected bilaterally in anticipation of a Draf III frontal sinusotomy and to improve exposure and instrumentation. The frontal recess is identified on the left side and widened anteriorly and medially with clear visualization of the craniotomy and posterior table (Figure 4). A superior septectomy is then performed after which the floor of the frontal sinus is resected across the intersinus septum and along the base of the right frontal sinus. A large common frontal cavity is then fashioned, resecting any residual intersinus septum and floor. Mucosa harvested from the middle turbinates is laid as a graft along the posterior table and bolstered in place with a silastic splint. Absorbable nasal packing is placed in the ethmoid cavity with topical steroid.