The nose and nasopharynx
Rogan J Corbridge in Essential ENT, 2011
This is a cosmetic operation that aims to improve the aesthetic appearance of the nose. Septorhinoplasty will also attempt to improve the nasal airway by repositioning a deviated septum. Both the patient and the surgeon must be aware of the surgical priority: airway or appearance. Details of rhinoplasty are beyond the scope of this book, but we shall outline the most common negative features of the nose that rhinoplasty can improve: An overly large nose can be made smaller with a reduction rhinoplasty.Deviation of the nasal bones and/or deviation of the cartilaginous septum may be straightened with a septorhinoplasty.A broad nasal bridge may be narrowed.Nasal hump is a common feature after a nasal injury and may be removed.Dorsal saddling results from inadequate support for the dorsum of the nose, usually as a result of destruction of the dorsal cartilaginous septum. This may be augmented using cartilage, bone or a silastic prosthesis.Over- or under-rotation of the nasal tip can be corrected.
Hunter disease/mucopolysaccharidosis type II/iduronate sulfatase deficiency
William L. Nyhan, Georg F. Hoffmann, Aida I. Al-Aqeel, Bruce A. Barshop in Atlas of Inherited Metabolic Diseases, 2020
Patients with the severe form of Hunter disease have the characteristic coarse features of mucopolysaccharidosis (Figures 78.2, 78.3, 78.6, and 78.7) [18]. The nose is flat, the nasal bridge depressed. The lips are thickened, the gums hypertrophic, and the tongue is large. Patients are generally hirsute and have low hairlines (see Figures 78.2 and 78.3). The superciliary ridges become very prominent. The head may appear disproportionately large. Stature is short, but this may not be as pronounced as in Hurler disease. Joints are stiff and mobility may become limited, or there may be contractures. Hearing loss is common; it may not be severe [19], but it tends to be progressive. The hands are broad and the fingers stubby. The claw-hand appearance (Figures 78.6 and 78.7) may be indistinguishable from that of Hurler patients. Patients tend to develop high coloration. The liver and spleen are large and hard.
Individual conditions grouped according to the international nosology and classification of genetic skeletal disorders*
Christine M Hall, Amaka C Offiah, Francesca Forzano, Mario Lituania, Michelle Fink, Deborah Krakow in Fetal and Perinatal Skeletal Dysplasias, 2012
Other disorders with limb reduction defects: Roberts syndrome (p. 467); Fryns syndrome and tetrasomy 12p (Pallister-Killian syndrome) should be considered. These patients have coarse features, with a broad forehead, normal OFC, apparent hypertelorism, sagging cheeks and a droopy mouth. Hair seems sparse especially over the temporal areas. Birth weight is often normal. Hypopigmented macules; hyperpigmentation, similar to incontinentia pigmenti may occasionally be present. Other conditions include TAR syndrome; radial aplasia, with preservation of the thumbs, is combined with thrombocytopenia of early onset. Megakaryocytes are reduced and anaemia and eosinophilia may be seen. The haematological features become less severe. There are also lower limb malformations, congenital heart defects, and abnormalities of the ribs and cervical spine. Holt-Oram syndrome (p. 464), Fanconi anaemia (p. 460) and Baller-Gerold syndrome: coronal or multiple suture synostosis, radial aplasia, absent thumb, short and bowed ulna, absent carpal and metacarpal bones. Occasionally hypertelorism, epicanthic folds, prominent nasal bridge, midline capillary haemangiomas, genitourinary malformations, mental retardation. Caused by mutations of the gene RECQL4.
Skin problems related to personal protective equipment among healthcare workers during the COVID-19 pandemic (online research)
Published in Cutaneous and Ocular Toxicology, 2021
Fatma Etgu, Sevda Onder
In this current study, 70.8% of the participants reported that they had more than two body areas adversely affected by PPE in this current study. In a previous study, the authors found 27.4% of the respondents reported two or more injuries and 76.8% had multiple body part involvement15. In our study, the most commonly affected areas were the hands and followed by the bridge of the nose, cheeks, ears, forehead, and wrists, respectively. Pei et al. reported that the face was the most commonly affected site, followed by hands, limbs, truncus, and the whole body in their study19. In another study, hands, cheeks, and nasal bridges were stated to be the most commonly affected body parts17. Lan et al. reported the nasal bridge was the most commonly affected area followed by hands, cheeks, and forehead22. Similar to our results, Kiely et al. found that the hands were the most commonly affected area followed by the nose, cheeks, and forehead21.
Spotlight on corneal neurotization
Published in Expert Review of Ophthalmology, 2021
Giuseppe Giannaccare, Marco Pellegrini, Federico Bolognesi, Paolo Fogagnolo, Enrico Lupardi, Fabiana Allevi, Federico Bernabei, Alessandro Lozza, Christian Plazza, Claudio Marchetti, Vincenzo Scorcia, Federico Biglioli
This technique was firstly described by Terzis and collaborators in 2009 in a series of 6 patients with different stages of facial palsy and anesthetic corneas due to intracranial diseases [15]. The contralateral supraorbital and supratrochlear nerves were coapted to the corneal perilimbal area. Initially, these nerves were identified through a coronal incision and carefully dissected under high magnification, proximal to the supraorbital margin. In order to transfer the nerve branches to the contralateral side, they were tunneled over the nasal bridge emerging from a small incision along the lid crease of the upper lid of the affected eye. Then, an incision was created over the superior conjunctiva behind the supero-nasal position of the corneal limbus. A blunt dissection was performed to create a conjunctival tunnel reaching the perilimbal area around the temporal, nasal and superior side. Each distal nerve termination was finally sutured to the sclera close to the limbus with 10–0 monofilament nylon sutures and the conjunctiva was then repaired. Subsequently, other authors, including our group, proposed a sutureless approach for positioning transferred nerves thanks to the use of fibrin glue as well as the creation of a 1.0-mm scleral-corneal tunnel for each fascicle into the anterior corneal stroma to help nerve growth toward the center of the cornea [16].
Exposure of Contralateral Eyes to Laser Radiation during Retinal Photocoagulation
Published in Current Eye Research, 2021
Donald Gauldin, Kinza T Ahmad, Scott Ferguson, Sami H Uwaydat
We hypothesized that the bridge of the nose may have served as a protective barrier for the untreated eye. We further hypothesized that the nasal bridge protection might be lost in eyes with significant proptosis, where the globe extended past the nasal bridge. We repeated the experiments as above, this time directing the laser near the “untreated” sensor (Figure 1a,b). This would effectively eliminate any possibility of anatomic protection by the nasal bridge. Nonetheless, using the aforementioned standard settings, no laser exposure was detected in the untreated eye. With higher settings (700 mW), an exposure of 0.003315 ± 0.002176 µJ (range 0.001–0.00737 µJ, SD 95% CI 0.001513 to 0.004016 µJ) was measured and at the highest power (1000 mW), a mean exposure of 0.005254 ± 0.001324 µJ (range 0.00409–0.07 µJ, SD 95% CI 0.000910 to 0.00241 µJ) was detected. Based on our results, the nasal bridge only provides a minimal added barrier to laser exposure. It is likely that the untreated eye is protected simply by virtue of the absence of direct laser exposure, irrespective of the nose bridge.
Related Knowledge Centers
- Canthus
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- Nose
- Epicanthic Fold
- Genetic Disorder
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