No abstract available.
Nasal Surgical Procedures*

As the imaging techniques and the endoscopic procedures have improved, reports about structural variations of the nasal cavity have increased. The bifid inferior turbinate is an extremely rare variation of the nasal cavity and only four cases have been reported to this date. All cases with a bifid inferior turbinate had absence of the uncinate process. Therefore, these findings were interpreted as the bifid inferior turbinates originating from the uncinate process. Here we report a case of bifid inferior turbinate without any combined variation including missing uncinate process. The patient had no history of trauma or nasal surgery. We present this case as the first report of a "true" bifid inferior turbinate with a review of the relevant literature.
Humans ; Nasal Cavity ; Nasal Surgical Procedures ; Turbinates

BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced for various purposes including hemostasis, stabilization of nasal structure, and synechia prevention. However, the use of nasal packing has led to the development of uncomfortable symptoms such as nasal obstruction. In this study, therefore, we have devised a new method of nasal packing involving the use of an airway tube for reducing nasal obstruction and discomforts in association with post-surgical nasal obstruction. Materials and METHODS: An airway tube was made by cutting the distal end of a 1cc syringe. It was inserted between the nasal septum and the packing material. Nasal cavities of 20 patients (Group 1) who underwent nasal surgery were packed using packing materials and the devised airway tubes following nasal surgery. We evaluated the symptoms of nasal obstruction after the postoperative nasal packing in this study group and compared them with those of the 20 patients (Group 2) who received packing with existing merocel nasal stents and 20 patients (Group 3) who were given packing with only merocel without airway tubes after nasal surgery. RESULT: In this study, nasal obstruction and discomforts in association with post-surgical nasal obstruction were significantly improved among patients given packing material and devised airway tubes (Group 1) comparative to other patient groups. CONCLUSION: Devised airway tube is useful in minimizing the symptoms of nasal obstruction and discomforts as well as in reducing surgical expense.
Formaldehyde ; Hemostasis ; Humans ; Nasal Cavity ; Nasal Obstruction ; Nasal Septum ; Nasal Surgical Procedures ; Polyvinyl Alcohol ; Stents ; Syringes

PURPOSE: The majority of nasal bone fractures have been managed by routine procedure of closed reduction and intranasal packing. However, nasal packing can cause nasal injury, hypoxia and patients' discomfort. And, synechiae formation frequently occurs after the nasal surgery. Various methods are used to reduce the incidence of synechiae formation. The purpose of this study is to compare routine procedure and nasal packing with reverse "U" shaped silicone sheet with respect to postoperative nasal synechiae formation and final outcome. METHODS: We analyzed the medical records of 100 patients with nasal bone fracture who were operated by closed reduction in the last one year. The silicone sheet was designed in reverse "U" fan-shape and inserted between the middle turbinate and the septal wall. Nasal packing was removed at two days after the operation, and silicone sheet was removed on 10 to 14 days. RESULTS: Synechiae in the middle meatus developed in 2 of 75 patients. Although synechiae between the middle meatus and nasal septum occurred in patients, the patients did not complaint of any olfactory disturbance or nasal obstruction. CONCLUSION: The reverse "U" fan-shape silicone sheet caused less pain for patients and no significant differences in outcome were found. The results of this study suggest that insertion of silicone sheet between the middle meatus and septum can be a useful method in the prevention of intranasal synechiae formation. The reverse "U" silicone sheet is a good alternative for routine packing methods.
Anoxia ; Humans ; Incidence ; Medical Records ; Nasal Bone ; Nasal Septum ; Nasal Surgical Procedures ; Silicones ; Turbinates

OBJECTIVE: This study was performed to evaluate the frequency of nasal septal perforation at the suture fixation site of a silastic sheet inserted during nasal surgery. METHODS: Seven hundred and twenty-one patients with silastic sheet insertion during common nasal surgeries were examined. The frequency of perforations and subjective symptoms of the patients were evaluated. RESULTS: Nasal septal perforation at the suture fixation site occurred in seven patients (0.97%). In three patients, perforations occurred immediately after removal of the sheet, while four patients developed perforations 2 to 4 weeks later. In most cases, perforations were small and did not exceed 2 to 3 mm in diameter. No patient complained of nasal symptoms related to the septal perforation postoperatively. CONCLUSION: The frequency of the septal perforation at the suture fixation site of a silastic sheet was very low and subjective symptoms were absent.
Dimethylpolysiloxanes ; Humans ; Nasal Septal Perforation ; Nasal Septum ; Nasal Surgical Procedures ; Sutures

BACKGROUND AND OBJECTIVES: Various surgical techniques have been tried to relieve nasal obstruction in patients who have hypertrophic inferior turbinate. Recently, coblators and microdebriders are the favored surgical procedure. This study is aimed at evaluating the long term efficacy of posterior resection of inferior turbinate performed on patients for whom the previous inferior turbinate surgery had not relieved the symptoms of nasal obstruction. SUBJECTS AND METHOD: We selected 27 patients who have had previous inferior turbinate surgery, but were not relieved of the symptom for nasal obstruction. Under local or general anesthesia, hypertrophied posterior part of inferior turbinate was removed. The symptom changes of nasal obstruction and patients satisfaction were checked pre and postoperatively at 1, 2, 3, 6, 12 month by Visual Analogue Scale (VAS) score. The minimal cross-sectional area of second notch and volume of nasal cavity were measured at 1, 2, 3, 6, 12 month after operation. RESULTS: There were significant improvement in the VAS score of nasal obstruction and patient satisfaction after the operation. The minimal cross-sectional area of second notch did not change significantly after surgery, but the nasal cavity volume was significantly improved after surgery. CONCLUSION: This study suggests that posterior resection of inferior turbinate is an effective surgical procedure for patients who have hypertrophic inferior turbinate especially on the posterior part.
Anesthesia, General ; Humans ; Nasal Cavity ; Nasal Obstruction* ; Nasal Surgical Procedures ; Patient Satisfaction ; Rhinitis ; Turbinates*

The keystone area of nose is a clinically important structure for maintaining the stability of dorsum of nose. However, anthropometric data for individual structure constituting the keystone area were less studied. Dissections of external nose were performed in 12 cadavers for measuring the length and width of structural components of keystone area. Shape of nasal bones and the overlap area between upper lateral cartilage and nasal bonewere classified. Measurements of the keystone area were also performed in 380 MRI and PACS images. Types of the caudal margin of nasal bone were classified as follows; type A: flat margin, type B: M shape, type C: extended midline, type D: retracted midline. Types of overlapped portion between upper lateral cartilage and nasal bone were categorized as follows; type Ao: flat midline, type Bo: short elongated midline, type Co: long elongated midline. Overlap length of upper lateral cartilage with nasal bone was 4~9 mm (mean 6.5 mm)in the midline, 0~4.5 mm (mean 2.7 mm)in the paramedian area of nasal bone. Overlapped width of upper lateral cartilage with nasal bone was 8~14 mm(mean 9.7 mm). Individual component of the keystone area has various shape and overlapped length. Therefore, cautious preoperative and intraoperative evaluation of each component is necessary for a safe nasal surgery.
Cadaver ; Cartilage ; Nasal Bone ; Nasal Septum ; Nasal Surgical Procedures ; Nose ; Rhinoplasty

Endoscopes ; Humans ; Nasal Cavity ; surgery ; Nasal Septum ; surgery ; Reconstructive Surgical Procedures ; Rhinoplasty ; Surgical Flaps

BACKGROUND AND OBJECTIVES: Nasal packing after nasal surgery is commonly practiced. Merocel(R) is one of the most popular packing material, however it can be associated with significant pain and bleeding on its removal. A prospective study was performed to compare the efficacy and patient tolerance of Merocel(R) and newly designed Latex-covered Merocel(R) (LCM). MATERIALS AND METHOD: Sixty patients underwent septoplasty for septal deviation. Following septoplasty, the patients were randomly allocated into two groups of 30 patients each who underwent insertion of either Merocel(R) or LCM. Patients were asked to record pain levels using a visual analogue scale(VAS) before and after packing removal, and number of analgesic injection were recorded. Resistance and amount of bleeding on packing removal were also recorded. RESULTS: Both nasal packs effectively prevented post-operative bleeding. However the VAS score for nasal pain and numbers of analgesic use before and after packing removal were significantly lower in the LCM group. LCM was removed more smoothly causing significantly less amount of bleeding on removal. CONCLUSION: LCM provides good post-operative hemostasis and its removal is less traumatic and painful for the patients, therefore improving patient's comfort.
Hemorrhage ; Hemostasis ; Humans ; Nasal Surgical Procedures ; Prospective Studies

Recently, with the increasing interests in the endoscopic nasal surgery, it is essential for practitioners to have detailed knowledges of the anatomical structures for the successful surgery. This study was undertaken to provide morphological information of the nasal turbinates as anatomical reference during endoscopic nasal surgery. A total of 43 adult cadaver heads were bisected midsagitally and evaluated morphometrically. The results were as follows: The highest nasal turbinatee were observed in 66.7% of the case. After removal of the mucosa, the distances from the akanthion to the anterior end of superior, middle, inferior nasal turbinate were 46.75 mm, 38.23 mm, 18.51 mm respectively. The distances from the akanthion to the posterior end of superior, middle, inferior nasal turbinate were 55.11 mm, 54.72 mm, 50.26 mm respectively. The lengths of the superior, middle, inferior nasal turbinate were 22.20 mm, 40.14 mm, 40.97 mm respectively. The detailed measurements of the nasal turbinates performed in this study may provide useful anatomical landmarks for the endonasal endoscopic surgery.
Adult ; Cadaver ; Head ; Humans ; Mucous Membrane ; Nasal Surgical Procedures ; Turbinates*