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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
The rate of complications varies in different studies and it depends on the operator and whether turbinate surgery is performed at the same time of septoplasty. These complications include the following: Bleeding (5–10%)Infection (2–3%)Septal perforation (1–7%)Adhesion (1–7%)Adverse nasal shape, e.g. saddle deformity, nasal tip depression (4–8%)Septal haematoma and septal abscess (1–2%)Hyposmia (1–2%)Upper middle incisors anaesthesia and discolouration (0.1%)
Clefts and craniofacial
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Residual lip deformity is less common with current management, but a lip revision if needed can be performed at 5–6 years. However, nasal deformity is seen in almost all, and tip revision or simple septal surgery can be performed at 5–6 years; but formal septoplasty or osteotomies should be delayed until the mid to late teens.
Nose
Published in Marie Lyons, Arvind Singh, Your First ENT Job, 2018
This is an operation performed in order to change the external appearance of the nose. It is often combined with a septoplasty. The most important aspect of this operation is pre-operative preparation. The surgeon and the patient should have a full and frank discussion of the perceived problem, the patient’s expectations and what is achievable. If there is any suggestion of psychological overlay, a psychiatric opinion should be sought. The patient must have pre-operative photographs. The operation is performed either internally (via an incision just in front of the nasal cartilage) or externally (via an incision on the columellar skin, but remember to warn about the scar, although it is barely visible once healed). There may also be stab incisions on the lateral part of the nose which are made in order to introduce osteotomes for fracture of the nasal bones if this is necessary.
Is tooth conservation possible in odontogenic sinusitis? Prospective evaluation of affected teeth condition-based protocol
Published in Acta Oto-Laryngologica, 2023
Akiko Ito, Muneo Nakaya, Kazuhiro Tada, Junko Kumada, Wataru Kida, Yasuhiro Inayoshi
ESS was performed under general anesthesia. Uncinectomy, middle meatal antrostomy, anterior and posterior ethmoidectomy, and frontal sinusotomy were performed in all the patients. In some cases, a sphenoidotomy was added depending on the extent of the disease. A septoplasty was performed in patients with septal deviation toward the affected side. Counter opening in the inferior meatus was performed to remove the maxillary sinus mucosa with granulation tissue. At the end of the surgery, the sinus was rinsed with saline. If a periapical abscess or radicular cyst was identified at the bottom of the maxillary sinus using a 70° endoscope, the granulation tissue and cyst were removed to decrease pathogens (Figure 3). All the participants gave their written informed consent for the implementation of the present treatment protocol and of any, required, additional procedures for the treatment of periapical lesions or radicular cysts during ESS. Patients whose intraoperative findings revealed an inverted papilloma or eosinophilic sinusitis were excluded.
Sublabial Approach to Tip Rhinoplasty: A Cadaver Model
Published in Journal of Investigative Surgery, 2022
Jason E. Cohn, Tyler Pion, Sammy Othman, Timothy M. Greco
Septal cartilage was harvested in 80% of dissections. Two cadavers did not have sufficient amount of septal cartilage likely due to previous septoplasty or the effects of embalming. In some cases, septoplasty may serve the added benefit of correcting the external nasal pyramid by providing adequate re-alignment, and can thus be incorporated as a septorhinoplasty. The advantage of septal cartilage is such that its biocomposition resembles native nasal tissue and provides increased ease of access [12]. This affords decreased warping, infection, and edema in comparison to other autologous cartilages [13]. The advantage of the sublabial approach is such that there may be an ease of straight-line access to the septum and columella, with shorter operating times and reduced post-operative edema [4]. Although both open and endonasal approaches are effective, sublabial septal cartilage harvest allows for effective procurement and placement with the advantages of minimizing the scar formation that is typically seen in the open approach, while simultaneously mitigating some of the technical difficulties of the endonasal approach. This was demonstrated by Cohen et al. in their series examining columellar reconstruction via the sublabial approach with primarily septal cartilage reinforcement [4].
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.