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Airway Surgery
Published in T.M. Craft, P.M. Upton, Key Topics In Anaesthesia, 2021
Nasal surgery. Vasoconstriction of the nasal mucosae will reduce intraoperative bleeding. This may be achieved by regional or topical techniques. A regional block to the sphenopalatine ganglion will include the vasodilator fibres of the nasal blood vessels. Topical vasoconstrictors include 25% cocaine paste or 10% cocaine with an equal volume of 1:1000 epinephrine (adrenaline).
Nasal foreign bodies and rhinoliths
Published in S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague, ENT Head & Neck Emergencies, 2018
Catriona M Douglas, Brian Bingham
The problem of retained surgical foreign bodies after surgery is a problem for the whole surgical team involved in the operation. The retention of a surgical object left in the nasal cavity has both potential medical and legal consequences; it is imperative, therefore, that systems are in place to ensure this risk is reduced. In nasal surgery, potential objects that could be retained after surgery include neurosurgical patties, sutures, internal nasal splints and nasal packing.
Adult Anaesthesia
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Daphne A. Varveris, Neil G. Smart
Nasal surgery is performed for cosmetic or functional restoration of the nasal airway, and includes operations such as septoplasty (operation to the nasal septum), rhinoplasty (operation to move the nasal contour), turbinectomy or these combined. Sinus surgery is performed to eliminate infection, polyps or neoplastic conditions of the sinuses, and the goal is to provide aeration of the sinuses so that secretions can drain adequately into the nasopharynx.
Prognostic factors for post-operative outcomes in chronic rhinosinusitis with nasal polyps: a systematic review
Published in Expert Review of Clinical Immunology, 2023
Shiru Cai, Hongfei Lou, Luo Zhang
Previous nasal surgery is broadly accepted as a prognostic factor for poorer surgical outcomes, as confirmed in our systematic review. Research on E/M ratio is not limited to the Chinese population. However, the results are not consistent between Asian and North American population [72,73]. Whether the conflicting results are attributable to the different study designs between these studies or different endotypes between Asian and Western patients requires further investigation. Surgical strategy, post-operative medical regimen, and adherence to that regimen are important to improve the treatment outcomes of CRSwNP. However, these factors are heterogeneous among studies and are influenced by surgeons’ individual selections and the willingness of patients. Thus, any interventions at baseline and after surgery should be described as clearly as other patient characteristics and adjusted for in future studies [74].
Classification of facial phenotypes in Asian patients with obstructive sleep apnea
Published in Acta Oto-Laryngologica, 2022
Zishanbai Zhang, Huijun Wang, Dance Sun, Nanxi Fei, Yanru Li, Demin Han
Patients with this cluster type had the narrowest Upper and Lower Nasal Widths; therefore, they may experience nasal airway obstruction. In the face, this manifests as narrowing of the Nasal Base Width and Nasal Width. Earlier studies have shown that nasal obstruction-related nasal resistance contributes to OSA either directly or by exacerbating negative pressure in the palatopharyngeal cavity [13]. Nasal reflex and nasal resistance detection can be performed using nasal endoscopy to assess nasal obstruction and guide treatment selection. Patients with nasal obstruction may be treated with pharmacotherapy first, and if that is not effective or well tolerated, nasal surgery may be performed. Nasal surgery includes septoplasty, turbinate surgery, and functional endoscopic sinus surgery (FESS), etc [14]. Several studies have shown a significant reduction in total nasal airflow resistance after nasal surgery in patients with OSA, thereby alleviating OSA objective indicators and subjective symptoms [15]. In addition, nasal obstruction therapy may enhance CPAP tolerance and improve oral appliance management in OSA [15].
Treatment of posttraumatic olfactory dysfunction with corticosteroids and olfactory training
Published in Acta Oto-Laryngologica, 2020
Mette Bratt, Kent G. Moen, Ståle Nordgård, Anne-S. Helvik, Toril Skandsen
Of the 23 patients with posttraumatic OD, 74% was men (Table 1). The mean age of all patients at the time of trauma was 45 years, and 44% had severe TBI. The time from trauma to inclusion in the study was mean 62 (SD 25) months. The proportion of patients with anosmia at baseline was 65%. The majority was scanned with MRI (20/23) in addition to CT (23/23), and orbitofrontal lesions were depicted in 90% of the cases where MRI had been performed. The findings in patients with endoscopy ‘not normal’ were mucosal oedema alone (n = 3), mucosal oedema and septal deviation (n = 2), septal deviation alone (n = 3) and mucosal synechia after primary trauma and repositioning (n = 1). Out of the five participants with mucosal oedema, two tested allergy positive and one reported known asthma. Three participants reported previous nasal surgery, two primary repositioning after trauma and one unknown. Four other participants had contraindications or objections to corticosteroids, and oral corticosteroids were omitted, but they participated in the OT.