Nasal airway obstruction is one of the most frequent causes of revision rhinoplasty despite the golden rule that nasal function should not be sacrificed because of cosmetic reason. Nasal function is jeopardized due to diverse reasons including inaccurate diagnosis or inadequate surgical technique. Detailed and thorough evaluation of the nose with review of previous operative technique is necessary to find out exact causes of obstruction. Septum, middle vault, tip, nostril, and nasal mucosa are common anatomic areas of obstruction after rhinoplasty. They are often weakened, damaged, or even destroyed losing their original shape, strength, or position. Changes in these anatomic structures are strongly related to static and/or dynamic obstruction. In this article, authors reviewed the common locations, anatomic causes, and treatment strategies of nasal obstruction after rhinoplasty.
Diagnosis ; Nasal Mucosa ; Nasal Obstruction* ; Nose ; Rhinoplasty*

The purpose of this study is to evaluate the use of Acoustic Rhinometry in assessing surgical outcomes in sinonasal surgery. This prospective study was carried out from January till December 2001. A group of 44 patients who presented with nasal obstruction due to various rhinologic abnormality were examined with acoustic rhinometry pre and post-operatively. They were examined with acoustic rhinometry pre and post decongestion with cocaine and adrenaline. A highly significant correlation existed between minimal cross sectional area (MCA) and the subjective feeling of nasal problem, pre and post surgery. Thus MCA is a valuable parameter to express objectively the nasal patency. The mucovascular component of the nasal cavity plays a major role in the nasal patency as determined in the pre and post-decongestion acoustic rhinometry measurement. Acoustic rhinometry is a good tool to evaluate the nasal patency in cases where sinonasal surgery is considered in correcting the abnormality as well as for the post-operative evaluation.
Nasal Obstruction/diagnosis ; Nasal Obstruction/*surgery ; *Rhinometry, Acoustic

Humans ; Nasal Cavity ; pathology ; Nasal Obstruction ; diagnosis ; Nasal Polyps ; diagnosis ; Turbinates

We present a case of huge nasal polyp with metaplastic ossification, which obstructed left nasal cavity and nasopharynx, and provoked both nasal obstruction and sleep apnea. The patient had a history of previous sinus surgery at local hospital 30 years ago. Nasal polyp with metaplstic ossification was removed by endoscopic sinus surgery. This case highlights the importance of including metaplastic ossification of nasal polyp in the differential diagnosis of nasal cavity mass.
Diagnosis, Differential ; Humans ; Metaplasia ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps* ; Nasopharynx* ; Sleep Apnea Syndromes

We present a case of huge nasal polyp with metaplastic ossification, which obstructed left nasal cavity and nasopharynx, and provoked both nasal obstruction and sleep apnea. The patient had a history of previous sinus surgery at local hospital 30 years ago. Nasal polyp with metaplstic ossification was removed by endoscopic sinus surgery. This case highlights the importance of including metaplastic ossification of nasal polyp in the differential diagnosis of nasal cavity mass.
Diagnosis, Differential ; Humans ; Metaplasia ; Nasal Cavity ; Nasal Obstruction ; Nasal Polyps* ; Nasopharynx* ; Sleep Apnea Syndromes

Pleomorphic adenoma in nasal cavity is rare and mainly occurs in the major salivary gland. We have experienced a case of a 25 years old woman complaining recurrent nasal bleeding and nasal obstruction. She showed a tumor in the left nasal cavity. We treated the nasal cavity tumor by endoscopic sinus surgery. The tumor was 4.5X3.0X2.5 cm in size and firm, parenchymatous and pale in contour. The pathologic diagnosis was pleomorphic adenoma. We report in this case of pleomorphic adenoma in the nasal septum.
Adenoma, Pleomorphic* ; Adult ; Diagnosis ; Epistaxis ; Female ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum* ; Salivary Glands

OBJECTIVETo develop the Chinese version of the nasal obstruction symptom evaluation (NOSE) questionnaire.

METHODSAfter introduction, forward and backward translation, synthesis, expert committee review, pretest, adaptation and validation followed the international guidelines, the Chinese version of NOSE scale was tested among 223 nasal septal deviation patients and 80 health volunteers to further assess its psychometric and clinical properties. SPSS 19.0 software was used to analyze the data.

RESULTSThe Chinese version demonstrated satisfactory evaluation results. The acceptance rate of the questionnaire was 97.6% and 94.1% in the patient group and control group respectively, and the completion time was (1.5 ± 0.5)min and (1.0 ± 0.5)min. Internal consistency reliability (Cronbach's α) was calculated to be 0.869. Test-retest reliability coefficient was adequate at rs = 0.996. Content validity was approved by our expert committee. Criteria validity (Spearman correlation coefficient) between NOSE Chinese version and SF-36, as well as VAS was -0.837 and 0.725 separately. Construct validity of Chinese version was similar to that of the original edition. The standardized response mean and the effect size at three months postoperatively was respectively 1.34 and 1.21, indicating high responsiveness. Calculated by Mann-Whitney U test, the instrument showed excellent sensitivity to discriminate the subjects with or without nasal obstruction (P < 0.01). The NOSE scores were also correlated with nasal resistance by rhinomanometry.

CONCLUSIONSThe NOSE Chinese version was successfully cross-cultural adapted and validated. It therefore can be recommended as a robust tool for future measuring subjective severity of nasal obstruction in China.

OBJECTIVE: To report the first case of primary bilateral antro-choanal polyps in the elderly age group.

METHODS:
Design: Case report
Setting: Tertiary Government Hospital
Patient: One
Result: A 60-year-old, non-allergic female with progressive bilateral nasal obstruction was subsequently diagnosed with bilateral antro-choanal polyps. Endoscopic sinus surgery was performed and the patient remained asymptomatic on one year follow-up.

Conclusion: Antro-choanal polyps can occur bilaterally in the elderly age group. To the best of our knowledge, this is the first reported case of primary bilateral antro-choanal polyps in an elderly female.

OBJECTIVE: To investigate the psychological statuses of Chinese adults with moderate-to-severe persistent allergic rhinitis, and evaluate the effects of nasal symptoms on their psychological statuseses. METHOD: The Symptom Checklist-90 (SCL-90) or self-reporting Inventory was employed to analyze the psychological statuses of 539 adults with moderate-to-severe persistent allergic rhinitis. RESULT: The SCL-90 scores of the adults with moderate-to-severe persistent allergic rhinitis were statistically higher than those of non-allergic adults in terms of somatization, depression, anxiety and hostility. No statistical discrepancies existed in gender or age. The course of disease contributed to somatization and compulsion. The effects of nasal symptoms included two aspects: nasal obstruction had a conspicuous impact on somatization, compulsion, interpersonal sensitivity, depression, anxiety and psychosis, while nasal itching contributed to somatization, depression and anxiety. CONCLUSION The psychological statuses of adults with moderate-to-severe persistent allergic rhinitis is evidently worse than that of non-allergic adults. Symptoms such as nasal obstruction and itching had an obvious impact on outpatients' psychological statuses.
Adult ; Humans ; Nasal Obstruction ; Rhinitis, Allergic, Perennial ; diagnosis ; psychology

Sarcoidosis is a chronic granulomatous disease, involving multisystem, confirmed by the presence of non-caseating granulomas. Sinonasal involvement in sarcoidosis is rare and difficult to diagnose since the symptoms of nasal obstruction and rhinitis are nonspecific. The diagnosis of sarcoidosis begins with clinical suspicion, followed by with imaging, and finally confirmed with tissue biopsy. In this study, we report a case of sarcoidosis of the nasal septum, which was early confirmed by a biopsy of the nasal septum and hilar lymph node.
Biopsy ; Diagnosis ; Granuloma ; Granulomatous Disease, Chronic ; Lymph Nodes ; Nasal Obstruction ; Nasal Septum* ; Rhinitis ; Sarcoidosis*