Nose Obstruction Research Articles

Surgical Approach to Nasal Valves and the Midvault in Patients with a Crooked Nose

Management of the crooked nose and valve obstruction is a challenge for even the most experienced rhinoplasty surgeon. Optimal treatment to restore a functional airway and improve cosmesis requires addressing the nasal valves. Several different techniques are available to guide the rhinoplasty surgeon to achieve the best outcome.

The efficiency of Nose Obstruction Symptom Evaluation (NOSE) scale on patients with nasal septal deviation

The aim in this study was to evaluate the efficiency of Nasal Obstruction Symptom Evaluation (NOSE) scale for septoplasty (without turbinate reduction) in comparison with other examination methods. Prospective observational study was undertaken in otolaryngology department of university hospital. NOSE scale for quality of life assessment, visual analog scale for examination findings, acoustic rhinometry and coronal computed tomography were performed before and after septoplasty. The efficiency of NOSE scale to assess for septoplasty results and the correlation between NOSE scores and other techniques was analyzed. Twenty-seven patients underwent septoplasty; there was a very significant improvement in mean NOSE scores of patients (60.2 versus 11.28, p<0.01). There was no correlation between NOSE scores and acoustic rhinometry. Correlation was found between NOSE scores and examination and computed tomography findings (p<0.05). NOSE scale that is well correlated with examination findings and computed tomography, is very useful tool to evaluate the effectiveness of pure septoplasty.

Śluzowiaki zatok przynosowych

Paranasal sinus mucocoele is a benign pseudocystic lesion, which may originate from any sinus cavities when their natural ostia are blocked. Raising mucocoele in frontal, ethmoid or sphenoid sinus causes headache, disorders of eye mobility and deformities of forehead or orbit. was clinical analysis of treatment results taking into consideration the method of surgical treatment. Presented material consists of 42 patients (39 adults and 3 children), 22 females and 20 males, in the age from 8 to 76 treated at Department of Otolaryngology of Medical University of Gdansk in the years from 1995 to 2005 for paranasal sinuses mucocoele. Fronto-ethomidal mucocoele was found in 22 (52.4%) patients, ethmoidal--in 10 (23.8%), frontal--in 4 (9.5%), spheno-ethmoidal--in 4 (9.5%) and maxillar in 2 (4.8%) patients. 14 (33.3%) cases were primary and 28 (66.7%) secondary of mucocoeles. The most frequent symptoms of frontal or ethmoidal mucocoele were: headache, lacrimation, deformity of orbit, blepharoedema, and diplopia. Sphenoethmoidal and maxillar mucocoele caused mostly nose obstruction and severe headache. Destruction of sinuses and orbital bony wall was found in 16 patients (38.1%), and in 9 of them (21.4%) there were in medial wall of orbit, in 3 (7.1%)--in inferior wall of frontal sinus, in 3 (7.1%)--in anterior wall of frontal sinus, and in 1 (2.3%) in anterior wall of maxillary sinus. In 3 patients (97.1%) with fronto-ethmoidal mucocoele as the consequence of disease the development of empyema was observed. Endoscopic intranasal treatment was applied in 9 patients (21.4%) with fronto-ethmoidal, spheno-ethmoidal and maxillar mucocoele. Complete recovery was observed in 30 (71.4%) patients, recurrence was noted in 12 (28.6%) and these patients were operated from extranasal approach. Paranasal sinuses mucocoele is found when natural ostia of sinuses are blocked after prior operation. They cause destruction of bony walls of sinuses. Extranasal approach is an optimal method of treatment in extended mucocoele and their complications.

Solitary fibrous tumor of the nasal cavity and paranasal sinuses

The solitary fibrous tumor (SFT), also known as benign fibrous mesothelioma or submesothelial fibroma is one of the different types of existing mesothelial tumors. It was originally described in the pleura by Klemper and Rabin in 1931 1 an dwa slate rreferre dt oa sa SF To fth epleur aand peritoneum with no actual mesothelial differentiation. Although the majority of these tumors are originated in the pleura, a number of extrapleural sites with no relationship to mucosal surfaces have been reported; these include the liver, parapharyngeal space, sublingual gland, tongue, vulva ,paroti dgland ,thyroid ,an dlarynx. 2 Th eSF To fthe nasal cavity and paranasal sinuses is extremely rare, with only 22 cases reported in the world literature so far. A 32-year-old man, originally from Mexico City with a family history of type 2 diabetes mellitus and hypertension presented to us with a 2-month history of bilateral nose obstruction, predominantly on the right side, greenish rhinorrhea, general malaise, and fever, all of which partially resolved after numerous medications previously given to him. Physical examination and endoscopy revealed a smooth-textured, grayish mass that completely obstructed the right nasal cavity and pushed the nasal septum toward the left side. Computed tomography showed a large mass that occupyied the entire right nasal cavity and part of the left cavity with remodeling and erosion of the nasal septum and right lateral nasal wall. The mass completely occupied the right ethmoidal sinus and part of the right sphenoidal an dmaxillar ysinuse s(Fi g1) .Administratio no fintravenous contrast revealed heterogeneous hyperdensity of the lesion. Examination of a biopsy specimen reported a benign tumor compatible with Schwannoma and functional endoscopic sinus surgery was performed. During surgery, the nasal mass was found to be originating from the right lateral nasal wall, with great vascularity and intense bleeding when manipulated with microdebrider. Approximately 60% of the mass was resected and was later sent for histopathologic analysis. A benign tumor was observed microscopically, with the presence of spindle-shaped cells with long nuclei and a moderate amount of eosinofilic cytoplasm; some areas showed interstitial dense collagen deposits while some other sabundan thyalinizatio n(Fig s2 an d3) .Fe wscattered dilated blood vessels and horseshoe-shaped vessels were seen, but there was no evidence of atypical cellularity, necrosis, hemorrhage, or an increase in the number of mitosis. Immunohistochemical staining was positive for vimentin ,CD3 4(Fi g4) ,an dCD9 9an dnegativ efo rS-10 0protein, actin and desmin, thus helping us establish a diagnosis for SFT.

A rare cause of rhinolithiasis: Ectopic tooth

Summary Rhinolith describes the pathology which is formed by means of deposition of salts on an organic or inorganic nidus in the nose. A nidus may be endogenous or exogenous. A rinolith may develop on an endogenous nidus such as dried blood clots, desquamated epithelium, dried purulent material, bone fragments and rarely ectopic tooth. A 23-year-old male patient presented to our clinic with one-sided nasal obstruction, nasal discharge and deformity of nose. Anterior rhinoscopy, nasal endoscopy and computed tomography (CT) scan revealed a rinolith in the right nasal cavity. In this case, preoperative CT scan and postoperative histological examination revealed that the nidus of the rhinolith was an intranasal ectopic tooth. We herein discuss ectopic tooth as a rare cause of rhinolithiasis.

Endoscopic potassium-titanyl-phosphate laser treatment for the reduction of hypertrophic inferior nasal turbinate.

This study investigated the efficacy of using the KTP/532 laser in endoscopic inferior turbinate reduction surgery. Potasium-titanyl-phosphate (KTP/532) laser is a useful tool in endoscopic intranasal operations, due to its outstanding capabilities in hemostasis, tissue penetration, and the maneuverability of its flexible transmission optic fiber. A total of 124 patients (male/female 73:51, mean age 38.7 +/- 12.3 years) with chronic hypertrophic rhinitis who received endoscopic KTP/532 laser inferior turbinate reduction surgery (7 Watts, continuous mode, 0.6-1-mm spots) were available for follow-up (mean follow-up period, 25.1 +/- 7.3 months). Medical records were retrospectively reviewed, and patients were interviewed with a questionnaire. The KTP/532 laser was excellent in relieving nose obstruction caused by inferior turbinate hypertrophy; 87% of patients reported improvement. The outcomes were less promising in reducing post-nasal drip; 12.9% reported only some improvement. Under intranasal endoscopy, the risk of postoperative bleeding and complication was low. The findings proved that, with the use of an endoscope, the KTP/532 laser appears to be an excellent alternative for treating hypertrophic inferior turbinate.

Nasale Cpap Bij Slaapgebonden Ademhalingsstoornissen: Patientenprofiel, Therapietrouw En Invloed Op De Gasuitwisseling En Het Longfunctiepatroon.

SummaryA survey performed in 100 CPAP users indicated that irritation of the face, a painful nose and nasal obstruction were among the most frequently mentionned complaints in chronic CPAP users. In 132 normocapnic SAS patients a significant improvement of PaO2 was shown, with a decrease of the alveolo-arterial oxygen difference. This improved gas exchange was parallelled by a significant increase in the FRC and TLC. Maybe a modulation in force of the respiratory muscles may be involved. These data were more pronounced in obstructive sleep apnea than in central sleep apnea. In 50 chronic CPAP users we could show a lower AHI immediately after CPAP withdrawal after a previous prolonged treatment. These findings may support the insufflation theory as a mechanism of action of CPAP. Traditionnally, mechanical splinting of the upper airway has been considered as the dominant mechanism of action. Other mechanisms like changes in regulation of breathing and decrease of the pharyngeal edema may be involved as well.

Cul-de-sac hypernasality test with pattern recognition of LPC indices.

Acoustic differences between samples of [i], [u], and [a] uttered in nose-open and nose-obstructed condition were studied in 6 women with isolated cleft palate and pathological nasalance scores and 9 healthy women with normal nasalance scores. The speech samples were depicted by 14-component vocal tract area feature vectors obtained by linear prediction and the differences between the samples were studied with a self-organized feature map. Each location on the map corresponds to a certain signal pattern, neighboring locations to similar patterns. The group of healthy subjects differed from the patients for vowels [i] and [u] but not for [a]. In the patients the nose obstruction induced a significant change in the location of these vowel samples on the map. In healthy subjects no such changes were detected. The results agreed with perceived differences between the subjects.

Nasal obstruction as a cause of reduced PCO2 and disordered breathing during sleep

Nasal obstruction is a cause of disordered breathing during sleep. Our previous study demonstrated diminished end-tidal PCO2 with nose obstruction while subjects were awake. If this is also the cause during sleep, decreased CO2 stimulus may easily induce apnea, hypopnea, and disordered breathing. To test this hypothesis, six male volunteers were examined to compare sleep disorders during both nose-open and nose-obstructed conditions. End-tidal PCO2 during nose-obstructed sleep was lower than that during nose-open sleep in all of the subjects. Furthermore apnea during nasal obstruction occurred most frequently shortly after transition to a deeper sleep stage. These results suggest that diminished PCO2 stimulus combined with depressed behavioral activity play an important role for disordered breathing in nose-obstructed sleep.

Anterior Trimming vs Outer Displacement of Inferior Turbinate: A Comparative Study at a Tertiary Care Hospital

Background: Obstruction of nose due to enlargement of inferior turbinate is a very common problem faced by ENT surgeon.In thisstudy a usefultechnique for treatment of inferior turbinate hypertrophy is described.Objective:To determine the surgical outcome and complications ofthe two surgicalprocedures.Material and Methods: This non-randomized comparative study was performed in the Department of ENT, HNS, MTI/LRH,Peshawar, Pakistan, from June 01, 2017 to May 31, 2018. After ethical approval, sample size of 112 was calculated and patientsincluded of both genders fulfilling inclusion criteria. After taking consent patients were equally divided into two groups with nonrandom number table method. Both subjective and objective assessment was carried out and observations were recorded on apredesignedproforma.Data were analyzed using SPSS 20.Results: Total patients were 112,in age range from 16 to 50 years. There were 56(50%) patients in each group.Maleswere 71 andfemale 41withmale to female ratio of 1.7:1 and mean age was 32.92+S.D 10.29 years.Relief from nasal obstruction obtained was94.64% and 92.86% in Group A and B respectively. Headachewas relived 83.34 % and 88.38% in Group A and B respectively. Thecomplications experienced were post operative bleeding, adhesion formation and crusting 2.6%, 3.5% and 1.78% respectively.Statistics showed no significant difference between the two operations (p &gt;0.05).Conclusion: Both trimming and outer displacement of hypertrophied inferior turbinate are effective procedures for relief of nasalobstruction but there was no significant difference betweenthe two techniques interm of outcome and complications.Keywords:Inferiorturbinate, Hypertrophy, Trimming, Outer displacement. Nasal obstruction

WINTER COUGH AND NOSE OBSTRUCTION.

WINTER COUGH AND NOSE OBSTRUCTION.