Fibrous dysplasia (FD) is a rare type of fibro-osseous lesion characterized by progressive replacement of normal bone with immature tissue. The involvement of craniofacial bones is reported in 10% of FD cases, while the involvement of sinonasal cavity is extremely rare. We report a unique case of FD in which the primary complaint was nasal obstruction. As FD cases involving the turbinate bones are very rare, we also reviewed all reported cases of FD involving the inferior or middle turbinates. Based on our experience and a review of the relevant literature, we conclude that inferior and/or middle turbinectomy via endoscopic approach and septoplasty can improve nasal symptoms.
Nasal Obstruction* ; Turbinates*

Septochoanal polyp is a rare entity in the nasal septum. This type of polyp can extend into the choana to cause nasal obstruction and snoring, similar to the symptoms of an antrochoanal polyp. Septochoanal polyps may therefore be confused with antrochoanal polyps because of their similar appearances. The authors report a case of a seven-year-old boy who was diagnosed with a septochoanal polyp. The patient was successfully treated via an endoscopic surgical approach.
Humans ; Nasal Obstruction ; Nasal Septum ; Polyps ; Snoring

The term concha bullosa describes aerated turbinate and it is most common on middle turbinate. Symptoms of concha bullosa depends on the amount of pneumatization and location. Concha bullosa without symptoms does not need surgical treatment, however, surgical treatment is indicated when it causes nasal obstruction. There are many reports of concha bullosa because it is a common anatomic variation. Despite many reports of concha bullosa, there is no definite statistics on the size of concha bullosa, and there has been no reports on what its largest size is. This report deals with a giant concha bullosa of middle trubinate of 4.5 cm in length, 2.2 cm in width size causing complete nasal obstruction.
Anatomic Variation ; Nasal Cavity ; Nasal Obstruction ; Turbinates

Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: Design: Quasi - Experimental Prospective Cohort Study Setting: Tertiary Government Training Hospital Participants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.
stents ; nasal obstruction ; nasal polyps ; sinusitis

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

The morbidity rate of cleft palate is relatively high (1/800). There are about 87500 children with disease. The plastic surgery for correction of cleft palate aims to early close the cleft, solve the functions of eating and drinking preventing from the shock and regulate the development of upper maxillary bone. 15 patients with nasal deformity due to the congenital cleft palate during 1996-1998 were received the plastic surgery for correction of nose-petal and nose-head by using transplants from the cartilage of the ear-rim. Results: the transplants from cartilage of the ear-rim are suitable for this operation. The ages of children are about 12-13 and above to assure the relatively complete development of cartilage frame and ear-rim and their size are the same as these in adults
Abnormalities ; Nasal Obstruction ; therapy ; surgery

PURPOSE: Several authors reported about the post- traumatic nasal aesthetic complications. However, the studies for functional or intra-nasal complications have been rarely reported. The aim of this study is to observe the incidence of intranasal synechia. METHODS: We reviewed the data from 401 consecutive patients with nasal bone fracture from september 2006 to December 2007. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We classified the nasal bone fracture according to the anatomy and severity of fracture. Type I is nasal tip fracture(15%, n=59), Type II is simple lateral without septal injury(38%, n=152), Type III is simple lateral with septal injury(23%, n=92), Type IV is closed comminuted(20%, n=82), Type V is open comminuted or complicated(4%, n=16). We studied 98 patients with nasal bone fracture who had postoperative symptoms or underwent postoperative endoscopic evaluation. And then we evaluated the postoperative endoscopic finding and nasal synechal formation after operation. RESULTS: The incidence of intranasal synechiae was 15%(n=62). According to the endoscopic findings, the incidence of intranasal synechiae was 10%(n=6) in Type I, 8%(n=12) in Type II, 16%(n=15) in Type III, 24%(n= 20) in Type IV, and 56%(n=9) in Type V, respectively. Additionally, the incidence of subjective nasal obstruction and olfactory dysfunction is 18%(n=72) and 13%(n= 51), while the incidence of symptomatic synechiae of nasal obstruction and olfactory dysfunction is 92%(57/ 62) and 55%(34/62). CONCLUSION: We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae. Based on the results of this study, intranasal synechiae really caused airway obstruction(92%). Our data showed significant relationship between intranasal synechiae and severity of the fracture, because of increasing mucosal handling and destructive closed reductional procedures. First of all, education of delicate procedure regarding this subject should be empathized accordingly.
Handling (Psychology) ; Humans ; Incidence ; Nasal Bone ; Nasal Obstruction ; Prevalence

PURPOSE: Many authors reported about the post-traumatic nasal aesthetic complications. However, the studies for functional or intranasal complications are not enough yet. We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae, and the synechiae formation was a frequently occurred after the nasal bone reduction. And then, the aim of this study is to identify the usefulness of the treatment of intranasal synechiae. METHODS: We reviewed the data from 10 patients with symptomatic intranasal synechiae from June 2007 to June 2009. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We studied 10 patients with intranasal synechiae who had persistence postoperative symptoms. We studied the patients who were operated by removal of synechiae and ancillary surgical treatments in the last two years. RESULTS: In the previous report, the incidence of intranasal synechiae was 15%(n=62) and symptomatic synechiae was 16%(10/62). We classified the nasal bone fracture according to Stranc classification. In this paper, the incidence of treated intranasal synechiae was 13%(2/15) in Frontal Impact(FI) Type I, 11%(2/18) in FI Type II, 100%(2/2) in FI Type III, 0%(0/2) in Lateral Impact(LI) Type I, 25%(3/12) in LI Type II, and 33%(1/3) in LI Type III, respectively. After removal of synechiae, all patients improved nasal obstruction and little improved olfactory disturbance. CONCLUSION: Simple removal of synechiae by scissors improved postoperative symptoms and complications such as nasal obstruction and olfactory dysfunction. After removal of synechiae, all patients improved nasal obstruction, however, little improved anosmia. So, we thought that olfactory dysfunction may result in many intranasal factors. First of all, education of delicate procedure regarding this subject should be empathized accordingly.
Humans ; Incidence ; Nasal Bone ; Nasal Obstruction ; Nose ; Olfaction Disorders ; Prevalence

OBJECTIVES: Cross-hatching incisions have been considered mandatory for correcting cartilaginous septal deviation. We evaluated the clinical outcome of septoplasty without cross-hatching incisions to determine the necessity for making septal cartilage incisions. METHODS: The reconstructed septal components during septoplasty were categorized into four anatomical areas: vomer, maxillary crest, perpendicular plate of ethmoid (PPE) and septal cartilage (the area for cross-hatching incisions). During septoplasty, we attempted to complete the surgery only by removing or fracturing the bony part of the septum without cross-hatching incisions on the cartilage. Only in the cases that the deviation was not immediately corrected, the cross-hatching incisions were made onto the cartilage at the end of the procedure. We analyzed the frequency of manipulating the septal components. The changes of symptoms were evaluated using a modified nasal obstruction symptom evaluation (NOSE) scale and a visual analog scale (VAS) preoperatively, 1 and 3 months after the surgery. RESULTS: Seventy five percents of the deviated septums were immediately corrected only by removing or fracturing of the bony septal components. In decreasing order of frequency, the sepal components for correcting septal deviation were the vomer (59%), maxillary crest (49%), septal cartilage (cross-hatching only: 25%) and PPE (15%). The modified NOSE scale and the VAS demonstrated significant improvement of the nasal symptoms postoperatively (P<0.05). CONCLUSION: Most of septal deviations could be corrected by manipulating only the bony septum. The results of this procedure were not different from conventional septoplasty with cross-hatching incisions. Our data suggest cross-hatching incisions during septoplasty might have been overemphasized and that the main cause for cartilaginous deviation may be the extrinsic forces that are generated by the neighboring bony structures.
Cartilage ; Nasal Obstruction ; Nasal Septum ; Nose ; Symptom Assessment ; Vomer