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.
Epistaxis
S. Musheer Hussain, Paul White, Kim W Ah-See, Patrick Spielmann, Mary-Louise Montague in ENT Head & Neck Emergencies, 2018
If the methods previously described fail to control the bleeding, then there are several options available, including surgical intervention and embolisation. A general anaesthetic may allow adequate nasal packing (anterior or posterior) in an uncooperative patient. This may also allow endoscopic examination and effective cauterisation. Correction of a deviated septum is also possible under general anaesthesia, allowing access to the bleeding site and permitting cautery. The option of surgical arterial ligation, including sphenopalatine artery and anterior ethmoid artery ligation, should be considered. Arterial ligation should be performed at the most distal (nasal) point, with a progression to more proximal ligation if the initial procedure is unsuccessful.
Neurology: cranial nerves
Shahed Yousaf in Medical Examination Made Memorable (MEMM), 2018
Inspect nasal passages with a torch for obstructions, deviated septum. Occlude one nostril with your finger and check the other one with essence bottles of scent such as coffee, ask them to identify it with their eyes closed. Usually not tested.
Identification of bleeding sites and microwave thermal ablation of posterior epistaxis
Published in Acta Oto-Laryngologica, 2019
Zhengcai Lou, Hong Wei, Zihan Lou
Blood in the nasal cavity was removed by suction under general anesthesia. A 0° rigid endoscope was used to determine whether the bleeding point was in Kiesselbach’s area. Then the patients were examined for the presence or absence of a deviated nasal septum, and to determine whether the bleeding originated from the convex or concave side of the deviated septum or from septal spurs. The presence of intranasal tumors or polyps was also investigated. If the bleeding site could not be identified, a more detailed examination was performed using using different diameter and angle endoscope, to include the anterior nasal septum, olfactory cleft, middle meatus, middle nasal septum, inferior meatus, the lateral wall of inferior nasal concha, PNA septum, Woodruff’s plexus, and the floor of the nasal cavity, in that order. The bleeding point was determined after the identification of the bleeding site. Retained blood was removed and the bleeding point was sought following a preliminary estimation of the bleeding site, using a small-diameter suction tip. Pulsating or jet-like bleeding was observed in the bleeding site if the mucosa was scraped using a suction tip, the bleeding point should be confirmed based on the miliary or punctate bulge or papillary hyperplasia in the nasal mucosa.
The effect of nasal septum deviation on voice aging
Published in Logopedics Phoniatrics Vocology, 2022
Ceren Ersoz Unlu, Ozlem Akkoca
Nasal septum deviation (NSD) is a nasal deformity that is typically present since the early years of life; unless it is surgically corrected, patients will suffer from nasal obstruction for the rest of their lives. Some reports have highlighted the relationship between NSD and systemic diseases. Nasal obstruction has been shown to be related with sleep apnea, and even in the absence of snoring and sleep apnea, it may cause excessive daytime sleepiness and impaired quality of life scores related to sleep disorders [7]. Septoplasty has been shown to improve pulmonary function and exercise capacity [8,9]. It has also beneficial effect on blood pressure in young hypertensive patients [10], and it can therefore be assumed that NSD has a role in hypertension etiology. The association of NSD with pulmonary arterial pressure has also been reported [9,11].
Disease-related expenditures and revision rates in chronic rhinosinusitis patients after endoscopic sinus surgery
Published in Journal of Medical Economics, 2018
Tina D. Hunter, Adam S. DeConde, R. Peter Manes
In addition to the impact of NP on revision rates, other factors were found to be influential. While we observed lower revision rates for patients with a diagnosis of deviated septum, Rudmik et al.16 reported a similar result based on concurrent septoplasty, which was highly correlated with the diagnosis in our population. Another study reported a similar correlation between the presence of septal deviation accompanied by septoplasty and improvement in patient reported outcomes after ESS (p = .004)21. We also found that females had an increased likelihood (p < .0001, HR = 1.2) of revision, which is consistent with the results of a logistic regression model (OR =1.20, p < .001) reported by Stein et al.13. Finally, several studies have reported significant differences in revision rates based on geography, with higher differences seen between individual US states and between regions within Alberta, Canada than we saw in this study, based on the larger and more diverse US Census Regions22,23.
Related Knowledge Centers
- Cartilage
- Paranasal Sinuses
- Sleep Apnea
- Vomer
- Nasal Cavity
- Nasal Septum
- Nostril
- Septal Nasal Cartilage
- Perpendicular Plate of Ethmoid Bone
- Snoring