Lateral Nasal Wall Research Articles

Effect of Lateral Crural Procedures on Nasal Wall Stability and Tip Aesthetics in Rhinoplasty.

To evaluate the lateral nasal wall stability, nasal function, and cosmesis when creating an aesthetically pleasing nasal tip subunit utilizing lateral crus (LC) altering procedures. Retrospective cohort. In this retrospective cohort study, cosmetic rhinoplasty patients undergoing LC procedures with available lateral wall insufficiency (LWI) scores were included. An LWI grading system was used to evaluate internal (zone 1) and external (zone 2) nasal valves objectively. Secondarily, Nasal Obstruction Symptom Evaluation (NOSE) Score, Visual Analog Scale (VAS) and Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) results were evaluated. Based on the LC intervention, the cohort was divided into six groups: lateral cural strut graft (LCSG), mini-LCSG, lateral crural overlay (LCO) with and without additional support, cephalic trimming, and cephalic turn-in flaps. Subjects undergoing LCO with and without support, LCSG, and mini-LCSG showed significant improvement in zone 1 LWI (P = .042, P = .041, P < .001, and P < .001, respectively), while cephalic trimming and turn-in/hinged flaps had no effect. Subjects undergoing LCO with support and LCSG showed significant improvement in zone 2 LWI (P = .022, P = .004), while LCO without support, mini-LCSG, cephalic trimming, and turn-in flaps showed no effect on LWI. The SCHNOS-C and VAS-C showed significant improvement in all subgroups (P < .05) when comparing pre- to postoperative values. Alar-spanning sutures did not significantly change zone 1 scores but did conceal zone 2 improvements in LCSG and LCO with support groups. Selected LC procedures are robust techniques for improving tip cosmesis independently without compromising nasal lateral wall stability. Some LC procedures can improve nasal valves patency in tip surgery. Laryngoscope, 131:E1830-E1837, 2021.

Impact of middle turbinate conchoplasty in management of rhinogenic contact headache

Background Rhinogenic contact point headache (RCPH) is intermittent pain localized in the periorbital and temporozygomatic or medial canthal regions. RCPH occurs owing to the presence of anatomical variations between adjacent mucosal surfaces in the nasal cavity. Concha bullosa (CB) is pneumatization of the middle turbinate, which is a common anatomic variation of lateral nasal wall. CB may increase in such a way that it fills the space between septum and lateral nasal walls, which creates areas of mucosal contact, predisposing to rhinogenic headache. Aim To evaluate the efficacy and outcomes of endoscopic turbinoplasty technique for CB ‘conchoplasty’ compared with lateral partial turbinectomy (LPT), in patients with RCPHs not responding to medical treatment. Patients and methods A prospective study was conducted that included 30 patients with RCPH and significant CB. The patients were randomly divided into two groups: group A included 15 patients who underwent LPT and group B included 15 patients who underwent conchoplasty. Results Complete cure or significant reduction in the severity of complaints reported in 13 patients who underwent LPT. In the conchoplasty group, 14 patients were completely cured at the end of the follow-up period. In the LPT group, a complication noted was synechiae formation in two cases. Conclusion Compared with LPT, conchoplasty is an equally effective surgical treatment of significant CB with lesser incidence of complication.

Влияние формы средней носовой раковины на развитие рецидивирующего риносинусита

In the presence of a paradoxically curved middle nasal turbinate, treatment tactics may be different. To achieve the best effect in the treatment of chronic rhinosinusitis, in some cases, a complete resection of the middle nasal turbinate is performed. However, in this group of patients in the postoperative period, complaints may appear from the quality of nasal breathing, which is associated with the development of paradoxically difficult breathing, when with sufficient passage of the air jet, the patient complains of difficulty in nasal breathing. Also, these patients are characterized by a decrease in the sense of smell. It is important that the absence of the middle nasal turbinate during repeated surgical interventions deprives the surgeon of an important anatomical landmark. We want to share a clinical example in which we received a positive outcome of surgical treatment in a patient with chronic left-sided rhinosinusitis in the presence of a paradoxically curved middle nasal turbinate and a slightly deviated nasal septum. In order to restore ventilation of the anterior group of the paranasal sinuses, the lateral part of the paradoxically curved middle nasal turbinate was removed with its preservation and expansion of the natural anastomosis of the maxillary sinus. In the postoperative period, the patient noted a significant improvement in her condition and did not make any previous complaints. This clinical case demonstrates that the middle nasal turbinate plays an important role in the functioning of the nasal cavity, in particular the osteomeatal complex, and in various anatomical variants can disrupt its work, both in combination with other structural features of the lateral nasal wall, and in isolation. In this connection, during the surgical treatment, a sparing, organ-preserving technique was chosen in order to preserve the functions of the middle turbinate, which in the postoperative period led to the achievement of a stable positive result.

Endoscopic Sphenopalatine Artery Ligation in Posterior Epistaxis

Introduction: Posterior epistaxis brings us with a more challenging condition that can even threaten the life of a patient. Approaching the posterior nasal cavity is not an easy task because of its anatomical complexity and impending vision by turbinate. Increase endoscopic anatomic details of lateral nasal wall and endoscopic expertise with high definition camera leads to a higher success rate of endoscopic sphenopalatine artery ligation.Methods: This prospective study was conducted in patients with refractory posterior epistaxis between January 2017 to December 2019. All patient who had undergone Endoscopic Sphenopalatine artery ligation were included in this study. The site of bleeding was confirmed with the help of a rigid endoscope. Bipolar cauterization or clipping was performed to stop bleeding. Data analysis was done by using SPSS 26.0 version.Results: Twenty nine patients who had undergone Endoscopic sphenopalatine artery for posterior epistaxis were included during this study period. The mean age of the patient was 53.31 ± 18.65years. The site of bleeding was mostly from the left in 20 (75.9%) cases and 10 (34.4%) cases had severe bleeding that needed a blood transfusion. No recurrence of bleeding was found during follow up period. The severity of bleeding was significantly correlated with the age of patients (p&lt;0.003). Out of 29 patient, 27 patients had undergone bipolar diathermy and 2 patients clipping was done.Conclusion: Sphenopalatine artery ligation is an effective management strategy for surgical control of refractory epistaxis. The early timing of sphenopalatine artery ligation may lead to reductions in length of stay.

Sinonasal alterations in computed tomography scans in adult cystic fibrosis patients

Adult CF patients often have upper airway involvement, and many develop chronic rhinosinusitis (CRS). There is a disagreement on which paranasal sinus CT features of CRS in CF patients should be considered essential. It is important to define the main criteria for evaluation of the paranasal sinus CT scans and signs of CRS associated with CF to improve CRS diagnosis in CF patients. The aim of the study was to assess the main of paranasal sinus disorders in adult CF patients and increase the effectiveness of CRS diagnosis by CT. Methods. CT features of CRS were assessed in 97 adult CF patients (range: 18 - 44 years, median: 25.8 ± 5.4) with no history of surgical treatment of CRS from different regions of the Russian Federation. The paranasal sinus CT scans performed in 2015 - 2019 were evaluated. Specific features of the paranasal sinus and middle nasal meatus structure and bony variants were found, and the prevalence of sinusitis with different paranasal sinus involvement was assessed. Results. The analysis of CT scans of 97 adult CF patients showed that the main CT features of CRS are maxillary sinus hypoplasia, opacified maxillary and sphenoid sinuses, as well as the ostiomeatal complex changes: enlargement of ethmoid infundibulum, polypous hypertrophy of uncinate process, and medial bulging of the lateral nasal wall. Conclusion. The characteristic CT features of paranasal sinuses in adult CF patients include agenesis of the frontal, maxillary, and sphenoid sinuses, opacification of the maxillary and ethmoid sinuses, and changes in the middle nasal meatus structures. Correct assessment of the listed paranasal sinus CT features will help to diagnose CRS and CF in adult patients.

Management of coexistent sinonasal pathology in patients undergoing endoscopic cerebrospinal fluid rhinorrhea repair

IntroductionPatients who undergo endoscopic cerebrospinal fluid rhinorrhea repair may occasionally present with coexistent sinonasal pathology which may or may not need to be addressed prior to surgical repair. Some patients may develop new onset nasal morbidity related to endoscopic repair. ObjectiveTo study the prevalence and management of additional sinonasal pathology in patients who undergo endoscopic repair of cerebrospinal fluid rhinorrhea MethodsA retrospective review of patients who underwent endoscopic cerebrospinal fluid leak repair was conducted to note the presence of coexistent sinonasal morbidity preoperatively and in the followup period. ResultsOf a total of 153 patients who underwent endoscopic closure of cerebrospinal fluid leak, 97 (63.4%) were female and 56 (36.6%) males. Most patients (90.2%) were aged between 21 and 60 years, with a mean of 40.8 years. Sixty-four patients (41.8%) were found to have coexistent sinonasal morbidity preoperatively, the commonest being symptomatic deviated nasal septum (17.6%), chronic rhinosinusitis without polyps (11.1%) and chronic rhinosinusitis with polyps (3.3%). Rare instances of septal hemangioma (0.7%) and inverting papilloma (0.7%) were also seen. Postoperatively, there was cessation of cerebrospinal fluid rhinorrhea in 96.7% which rose to 100% after revision surgery in those with recurrence. Resolution of coexistent sinonasal pathology occurred in all patients with followup ranging from 10 to 192 months. New onset sinonasal morbidity which developed postoperatively included synechiae between middle turbinate and lateral nasal wall (5.9%) and sinonasal polyposis (1.3%). ConclusionPatients who undergo endoscopic cerebrospinal fluid leak repair may have coexistent sinonasal pathology which needs to be addressed prior to or along with repair of the dural defect. New onset sinonasal morbidity, which may arise in a few patients postoperatively, may require additional treatment. A protocol for the management of coexistent sinonasal conditions ensures a successful outcome.

The Frequency of Intranasal Synechiae Formation between Nasal Septum and Lateral Nasal Wall after Endoscopic Sinus Surgery Among Patients with Sinonasal Polyposis

Objectives: To determine the frequency of intranasal synechiae formation between lateral nasal wall and nasal septum after (ESS) Endoscopic Sinus Surgery among patients with Sino nasal Polyposis Methods: After obtaining approval from the ethical committee of our Hospital, a total number of 150 subjects fulfilling the study criteria were recruited in the research which was conducted in the department of Otorhinolaryngology, Services Hospital, Lahore. Demographic information (name, age, gender, contact details) was also obtained were included in this study. All the patients underwent ESS and were followed up post operatively at the end of 1st, 2nd, 3rd and 4th weeks respectively, to observe the formation of synechiae. Results: Age range in this study was between 21-40 years out of which a small number of patients were &lt; 20 years old. Mean age of the patients was 35.30±10.54 years. Male patients were 80 (53.3%) while female patients were 70 (46.7%). Intranasal Synechiae formation was observed in 28 patients (18.7%). Conclusion: Intranasal Synechiae formation between lateral nasal wall and nasal septum was found in 18.4% of the patients after endoscopic sinus surgery. Keywords: Sino nasal polyposis, ESS, Intranasal Synechiae Formation

Anterior Pedicled Lateral Nasal Wall Flap for Endonasal Lining: A Radiologic and Anatomical Study.

The objective of this radiological/anatomical study was to evaluate the feasibility of a new endoscopic technique that uses the anterior pedicled lateral nasal flap (APLNW) for the endonasal lining in complex nasal reconstructions. An anatomical study was performed on 20 nasal fossae of cadaverous specimens to measure the area and lengths of the anterior pedicled nasal lateral wall flap. In addition, a radiological analysis with computed tomography was performed in 150 nostrils to determine the potential donor of the simple and extended flap in the nasal fossa floor. Complex nasal reconstruction with nasofrontal flap and internal lining using the lateral wall pedicled flap was performed in 3 patients. Complete reconstruction for the inner lining of the nasal tip and lateral nasal wall was achieved in the cadaveric study (10 specimens). The surface areas of the simple and extended APLNW flaps were 7.53 (standard deviation [SD] 1.25) cm2 and 24.6 (SD 3.14) cm2 , respectively. Using computed tomography scans, we determined that to reconstruct defects secondary to full-thickness nasal defects, the APLNW flap surface for the simple and extended versions was 7.90 (SD 1.68) cm2 and 23.64 (SD 4.7) cm2 . We present one case were the APLNW flap was used. The simple or expanded APLNW flap represents a feasible option to reconstruct the internal lining in complex nasal reconstruction. NA Laryngoscope, 131:E1462-E1467, 2021.

Lateral nasal wall haemangioma in a young female: a rare case

&lt;p class="abstract"&gt;Hemangiomas are benign tumours originating from vascular structures in the body. Histologically they are divided into capillary, cavernous and mixed types. Although it is very commonly seen in head and neck region, it is very rarely seen in the nasal cavity, nasopharynx and paranasal sinuses and it accounts for only 10% of all head and neck haemangiomas. In this patient the haemangioma was seen arising from the lateral nasal wall, of the right nasal cavity. So far in the literature very few such cases have been reported till date. &lt;/p&gt;

Endoscopic Endonasal Dacryocystorhiniostomy (EEDCR) (Libyan Experience)

Endoscopic endonasal dacryocystorhiniostomy (EEDCR) is a valid alternative to external procedures in the management of nasolacrimal duct obstruction with success rate ranging from 82% to 95% . It is a less invasive procedure, can be done both under general and local anesthesia Patients and methods: In the present study twenty patients (18 Females and 2 males), aged 17 to 65 years were studied in the period between May 2009 to March 2010 to determine the success rate of such operations. All cases were operated under general anesthesia with the help of zero endoscope and drill of lacrymal bone. Results: Stents were applied in 5 recurrent cases after failed external approach, unresolved acute dacryocystites with abscess formation, and dacryocystocele. Few complications were encountered (such as granulation tissue at operative site in 4 cases, recurrence of symptoms due to incomplete removal of mucosal flap, and synechia between lateral nasal wall and middle turbinate). Conclusion: After a follow up of 6 months the success rate in this series was 95%. Thus it is suggested that stent application should not be carried out routinely in every case, while close and regular follow up helps early identification of complications, early intervention and hence it decreases the recurrence and revision surgery.

In Vivo Morphology of Nasolacrimal Duct Opening into the Inferior Meatus.

To study the in vivo morphology of nasolacrimal duct (NLD) openings into the inferior meatus. Patients undergoing endoscopic dacryocystorhinostomy and lacrimal intubation had endoscopic real-time examination of the NLD opening. Morphology of NLD openings (size, shape, mucosal folds), and their location from the axilla of the inferior turbinate were assessed. Forty-three lacrimal systems of 39 adult patients (11 males, 28 females) with a mean age of 61 years were studied. Thirty-five patients had unilateral involvement, and 74% had anatomical NLD obstruction. Of 43 lacrimal systems, 41 had a visible NLD opening. The majority was sulci shaped (63%, 26/41) followed by fissure type (34%), and 2% had wide-open round morphology. The majority of the openings (93%) were oriented vertically, and 67% (14/21) of the sulci shaped openings continued into gutter like channels along the lateral nasal wall. Mucosal folds were present in 7% (3/41) of the openings along the edges. The mean distance between the opening and the axilla of the inferior turbinate was 3.7± 2.1 mm (median, 3.6; range, 0-7.2). Sulci shaped NLD openings were the most common morphology, and mucosal folds were less commonly observed compared with cadaveric studies.

Endoscopic Modified Danker's Approach for Management of Sinonasal Inverted Papilloma: Our Experience.

Sinonasal inverted papilloma (SNIP), Inverting papilloma, Schneiderian papilloma etc. It is a benign tumor with incidence nearly 70% of all sinonasal papilloma and 0.5-4.0% of all sinonasal neoplasms. The most common site of origin is lateral nasal wall and common presenting symptom is nasal obstruction followed by epistaxis. On histopathology examination, it is characterized by invagination of neoplastic epithelium into underlying stroma. With the advent of technology, the endoscopic modified dankers approach became the surgical approach of choice. The present study was undertaken to study its role in management of SNIP with reference to rate of recurrence and malignancy. An observational study was conducted in a tertiary health center in which 40 biopsy proven cases of SNIP, operated by endoscopic assisted modified Danker's approach between September 2008 and January 2019 with minimum follow-up period of 6months were analyzed. Male:Female ratio was 2.33:1. The most common symptom was nasal obstruction (97.5%) followed by rhinorrhoea (87.5%). Using various imaging and diagnostic measures, lateral nasal wall was found to be the most common site of origin. Out of total 40 cases, 9 (27.5%) patients had recurrence, of these, 6 were benign and remaining 3 had malignancy as confirmed by biopsy. Most of the cases of SNIP can be managed endoscopically, although extensive lesions or the lesions with malignant transformation, external approach may be needed so expertise in both endoscopic and conventional techniques is needed. Although most of the recurrences occurred in first 2years, but life time follow-up is advisable.

Management of External Nasal Valve Collapse: Literature Review

Rhinoplasty is one of the most frequent cosmetic surgeries in the world and among the most common complications is valve collapse due to excessive resection of the alar cartilage. Facial paralysis, as well as aging, can collapse the lateral wall in inspiration due to dysfunction of the nasal muscle, causing weakening of the fibroalveolar tissue of the nasal lateral wall, and there are also genetic causes that produce valve collapse. Currently, various techniques are practiced to improve valve collapse and none are one hundred percent effective, most of them focus on correcting the nasal valve itself or the triangular cartilage, which indicates that they are fixed on a single factor and not on multifactorial etiology that produces it. This study reviews the clinical evidence that guides a correct diagnosis and effective management of external nasal valve dysfunction, using various techniques that are currently used to improve nasal valve collapse.

A Descriptive Study of Anatomical Variations of Uncinate Process on Sinonasal Computed Tomography

Aim: The purpose of our study was to assess various anatomical variations of the uncinate process of the lateral nasal wall and to study the clinical association of its anatomical variations on computed tomography. Methods: A descriptive study of anatomical variations of the uncinate process with clinical association was undertaken in the Department of Ear, Nose &amp; Throat of a Medical College and Tertiary Health care centre. The study was of 2 years duration and included 50 patients from August 2014-2016 and included 50 patients. Patients were selected according to a specified criteria and sinonasal computed tomography scans were undertaken with the help of Somatom Emotion 6 CT machine. Data was organised charted and analysed using statistical software SPSS 16. Results: The key findings in our study were that six types of anatomical variations of uncinate process and there frequency distribution was identified according to Landstiener and Friedman classification. Uncinate process types according to age and gender were charted and tests of association were applied. Conclusion: After statistical analysis we found no association between type of uncinate process and sinonasal symptoms. No association was seen between age and gender and variations of uncinate process. In our study, variation of superior attachment of uncinate process were found in 100% cases.

One-week intubation in external dacryocystorhinostomy– a report on long-term outcome

ABSTRACT Purpose The role of silicone stent intubation in dacryocystorhinostomy (DCR) is not clear, and conclusions presented in the literature are contradictory both regarding if intubation should be recommended and if so, the appropriate duration of intubation. This paper reports on the long-term outcome of a comparatively short duration of silicone stent intubation, one week, and discusses the possibility of an optimal duration of intubation where the benefit of the silicone stent is utilized but with minimal risk of complications. Methods A total of 70 cases of DCR were followed in 67 patients for four years in a descriptive case series of uncomplicated external DCR with one-week silicone stent intubation. Pre- and perioperative findings, complications, and the need for additional surgery were recorded. At end of follow-up, a questionnaire was sent to the patients asking them to grade the frequency of epiphoric problems. If graded often/constant, a follow-up visit was offered. Results One patient received additional surgery during follow-up due to persistent epiphora caused by synechiae between the middle turbinate and lateral nasal wall. The response rate to the questionnaire was 88%, with 93% of the respondents reporting epiphora never/seldom. Four patients reported persistent problems: one declined further examination, the tear duct was anatomically patent in two, and one was referred to the ENT department due to inflamed nasal mucosa and extensive adhesions. The long-term functional or anatomical success rate was 97%. Conclusions This study shows that a high long-term success rate for uncomplicated DCR is possible with only one-week silicone stent intubation.

The blood supply of the inferior nasal concha (turbinate): a cadaveric anatomical study.

The blood supply of the lateral nasal wall acquires a great deal of interest for many reasons especially for the treatment of clinical conditions such as epistaxis that sometimes needs surgical interventions and endoscopic sinus and skull base surgeries that requires a good choice of endonasal flaps including inferior nasal concha (commonly named as inferior turbinate by clinicians) flap to close the dural defects. Successful treatment of epistaxis and closure of such defects depends on detailed anatomical knowledge of lateral nasal wall vasculature and a vital flap with good blood supply, respectively. Because of these we aimed to study the blood supply of inferior turbinate, regarding the sources and courses of the blood vessels. Forty formalin-fixed hemisected cadaveric heads were used at Hacettepe University Anatomy Dissection Laboratory. Anatomical dissection of the inferior nasal concha and the lateral nasal wall was done by dissecting microscope. Coloring dye injection to the arteries was performed. After a detailed examination of the lateral nasal wall; the position of the sphenopalatine foramen (SPF) and the sphenopalatine artery (SPA) were identified. The posterior lateral nasal artery (PLNA) found to give middle and inferior conchal (turbinate) arteries. The average length of the inferior turbinate artery (ITA) was 9.057 ± 1.674mm, the diameter was 1.452 ± 0.172mm, the distance from posterior end of inferior turbinate was 7.879 ± 1.52mm. Anastomosis in the lateral nasal wall between the ITA and the anterior ethmoidal and the lateral nasal (branch of the facial artery) arteries were established. The blood supply of inferior nasal concha is mainly provided by ITA and its anastomotic contributors. Detailed knowledge related to it, before surgical interventions, may reduce intraoperative bleeding and increase endoscopic exposure.

How I do it: Surgical management of maxillary sinus hemangiomas via prelacrimal approach.

Hemangiomas are tumours originating from the vascular endothelium and can be found throughout the body. These are relatively common in the head and neck regions but very rarely seen in sinonasal region. In the nose and sinuses tumours typically are seen on the septum or lateral nasal wall (1-4). These tumours can be quite vascular and bleed during attempted resection. Incomplete resection does result in residual disease or recurrence so the best approach to achieve complete resection is important.

Treating Symptomatic Midvault Soft Tissue Collapse in Revision Rhinoplasty with a Nasal Wall Implant.

Summary:Persistent nasal airway obstruction (NAO) due to midvault soft tissue collapse in patients following rhinoplasty or nasal surgery is a clinical challenge for surgeons. An absorbable lateral nasal wall implant is one option available to help treat midvault soft tissue collapse and to improve NAO symptoms. Previous studies have not investigated its use in complex revision functional rhinoplasty with respect to patient-reported outcomes. Data were collected on all patients with a history of previous nasal procedures who underwent Latera implant placement in conjunction with functional rhinoplasty from January to December 2018. The Nasal Obstructive Symptom Evaluation and Visual Analogue Scale were used to evaluate functional outcomes. Eight implants were placed in 6 revision functional rhinoplasty patients with midvault collapse. All patients responded to the survey. Mean follow-up was 16 ± 4 months. There were no implant-related adverse events. Mean Nasal Obstructive Symptom Evaluation score was 33 ± 33, and mean Visual Analogue Scale score was 20 ± 9. In total, 1 patient reported complete resolution of NAO, whereas 2 patients reported mild, 1 reported moderate, 1 reported severe, and 1 reported extreme symptoms. Four of the 6 patients reported nasal obstruction improvement, with all reporting improvement in midvault soft tissue collapse. Apart from being used in nasal valve collapse treatment, a lateral nasal wall implant is a potentially useful solution that may help surgeons improve patients’ NAO symptoms in complex functional rhinoplasty cases. However, in certain cases, a patient’s nasal obstructive symptoms may continue to be multifactorial.

Imaging of Paranasal Sinus Infections in Children: A Review.

Paranasal sinuses (PNS) infections are common in children. They may cause common and well-known complications, but also, unusual and potentially devastating complications. Diagnosing PNS infections and complications in children requires knowledge of the unique anatomy of the nasal cavity and the PNS. In fetal life, nasal mucosa evaginations into the lateral nasal walls initiate the development of the PNS. The PNS continue to develop after birth and complete their maturation and pneumatization at different ages during childhood which makes the pattern of PNS infections determined by patient age. Complications are caused by direct spread of the infection to the orbit, face, intracranial or osseous structures or hematogenous spread of the infection to the intracranial structures. Emergent imaging studies are often necessary in the evaluation of the complications in pediatric patients when the symptoms persist for 10 days and/or if there is evidence of intracranial or orbital complications. In addition, immunocompromised children are especially vulnerable to developing unusual complications. Computed tomography (CT) is excellent for determining whether there is intraorbital extension of PNS disease. However, when the infection approaches the orbital apex, a magnetic resonance imaging (MRI) study with contrast is necessary to assess spread into the cavernous sinus and the intracranial compartment. The goal of this manuscript is to review and characterize imaging findings of PNS infections using CT and MRI allowing determination of the extent of PNS infections and their common and unusual complications in children. In addition, a summary of the development of the normal PNS is provided.

Therapeutic potential of topical naturopathic remedies in otorhinolaryngology

Introduction. Тhe search for drugs that accelerate the process of resolving post-traumatic reactive changes, which have both sufficient anti-edema and anti-inflammatory effects, and reparative properties, is relevant.Goal of reserch. The purpose of this review is to find a means to speed wound healing after nasal traumas.Materials and methods. The researchers conducted an analysis of scientific research data to evaluate the efficacy of naturopathic mountain arnica-based remedies for the treatment of patients with an external nose trauma accompanied by the formation of edema, hematoma of lateral nasal wall and/or skin abrasions of external nose.Results. This work shows that topical plant remedies based on Аrnicamontana has a pronounced anti-inflammatory and antiedema effect, comparable to the traditionally used for this purpose heparin-containing ointments and gels. However, unlike the latter, products based on Arnica montana have a pronounced wound- healing effect, which allows to significantly reduce the time to resolve traumatic injuries of the skin of the external nose. The analysis of the work also demonstrates the absence of adverse reactions when using this drug.Conclusion. The obtained data allow us to recommend topical naturpathic remedies based on Arnicamontana for use as a firstchoice drug for wound healing after nasal traumas. In addition, the drug is effective in the complex treatment of patients with nasal trauma requiring surgical intervention: at the preoperative stage - to reduce post-traumatic reactions and prepare for surgery, and at the postoperative stage - for the early recovery, reducing edema and inflammation.