Epistaxis is a common otorhinolaryngological emergency with complex etiological factors and varied clinical manifestations. The key to epistaxis treatment is accurate diagnosis and adequate hemostasis. Electrocoagulation is a reliable, safe and effective treatment for epistaxis. However, there are still several deficiencies in application of the commonly used electrocoagulation surgical products. This paper introduces a new type of radiofrequency head incorporating the dynamic circulatory functions of drip, irrigation, hemostasis and aspiration. We aim to achieve noninvasive, effective and accurate hemostasis in the treatment of epistaxis or nasal sinus surgery.
Humans ; Epistaxis/surgery* ; Electrocoagulation ; Treatment Outcome ; Paranasal Sinuses

A Le Fort I osteotomy is a common procedure for correcting dental and facial deformities in orthognathic surgery. In rare cases, a delayed hemorrhage can occur as early as several hours or up to 12 weeks, postoperatively. The most frequently involved blood vessels in a delayed hemorrhage are the descending palatine artery, the internal maxillary artery, and the pterygoid venous plexus of veins. Intraoral bleeding accompanied by severe epistaxis in these cases makes it difficult to locate the precise bleeding focus. Eventual uncontrolled bleeding would require Merocel packing or surgical intervention. In general, a severe late postoperative hemorrhage is most effectively managed by angiography and embolization. Herein we describe a delayed hemorrhage case in which the cause was not evident on angiography. We were able to detect the bleeding point through an endoscopic nasal approach and treat it using direct cauterization.
Aneurysm, False ; Angiography ; Arteries ; Blood Vessels ; Cautery ; Congenital Abnormalities ; Epistaxis ; Hemorrhage ; Maxillary Artery ; Orthognathic Surgery ; Osteotomy ; Postoperative Complications ; Postoperative Hemorrhage ; Veins

The purpose of this study was to report and discuss the diagnosis and treatment of obstructive atelectasis secondary to pus obstruction in a patient who had developed a maxillofacial abscess, and to review the literature on similar cases. Persistently discharging pus within the oral cavity can act as an aspirate, and may lead to obstructive atelectasis. Additionally, maxillofacial surgery patients should be carefully assessed for the presence of risk factors of obstructive atelectasis, such as, epistaxis after nasotracheal intubation, oral bleeding, and mucus secretion. Furthermore, patients with these risk factors should be continuously followed up by monitoring SPO₂, breath sounds, and chest x-ray.
Abscess ; Anesthesia, General ; Diagnosis ; Epistaxis ; Hemorrhage ; Humans ; Intubation ; Mouth ; Mucus ; Pulmonary Atelectasis ; Risk Factors ; Suppuration ; Surgery, Oral ; Thorax

BACKGROUND: Nasal fracture and orbital blowout fracture often occur concurrently in cases of midface blunt trauma. Generally, these multiple fractures treatment is surgery, and typically, the nasal bone and orbit are operated on separately. However, we have found that utilizing a transconjunctival approach in patients with concurrent nasal bone fracture and orbital blowout fracture is a useful method. METHODS: The participants in the present study included 33 patients who visited the Plastic Surgery outpatient department between March 2014 and March 2017 and underwent surgery for nasal fracture and orbital blowout fracture. We assessed patients’ and doctors’ satisfaction with surgical outcomes after indirect open reduction via a transconjunctival approach for the treatment of nasal bone fracture with associated orbital blowout fracture. RESULTS: According to the satisfaction scores, both patients and doctors were satisfied with transconjunctival approach. CONCLUSION: We presented here that our method enables simultaneous operation of nasal fracture accompanied by orbital blowout fracture, rather than treating the two fractures separately, and it allows precise reduction of the nasal fracture by direct visualization of the fracture site without any additional incisions or difficult surgical techniques. Also, by preventing the use of excessive force during reduction, this method can minimize damage to the nasal mucosa, thereby reducing the incidence of nasal bleeding.
Epistaxis ; Facial Bones ; Fractures, Multiple ; Humans ; Incidence ; Methods ; Nasal Bone* ; Nasal Mucosa ; Orbit* ; Orbital Fractures ; Outpatients ; Surgery, Plastic

Nasotracheal intubation is an anesthetic technique widely used for maxillofacial surgery. It has the advantage of easier access to the surgical site to surgeon. However, when the nasothracheal intubation is performed a few complications may occur, such as nasal mucosa damage, epistaxis, sinusitis by sinus drainage occlusion and transient bacteremia. In addition, concha bullosa is a common anatomic variant of the middle turbinate, which is pneumatized, and very susceptible to trauma. We report a case of accidental middle turbinectomy by nasotracheal intubation, in the patient who had bilateral concha bullosa.
Bacteremia ; Drainage ; Epistaxis ; Humans ; Intubation* ; Nasal Mucosa ; Sinusitis ; Surgery, Oral ; Turbinates

Packing the nose after septoplasty is common practice. The use of postoperative packing has been proposed to reduce the dead space between the subperichondrial flaps and minimize postoperative complications such as hemorrhage, septal hematoma, and formation of synechiae. Additionally, postoperative packing is thought to stabilize the remaining cartilaginous septum and minimize persistence or recurrence of septal deviation. Despite these theoretic advantages, evidence to support the use of postoperative packing is lacking. Additionally, nasal packing is not an innocuous procedure. The use of nasal packing actually cause these complications such as postop- erative pain, mucosal injury, bleeding, worsening of breathing due to sleep disorders, and postoperative infections. Routine use of anterior nasal packing after septoplasty should be challenged for not presenting proven benefit. As alternatives to traditional packing, septal suturing, septal stapler and fibrin glue have been used recently. The purpose of this article is to summarize the progress of traditional packing to no packing after septoplasty.
Bandages ; Epistaxis ; Humans ; Nasal Cartilages ; surgery ; Nasal Septum ; abnormalities ; surgery ; Pain, Postoperative ; Postoperative Complications ; Postoperative Period ; Rhinoplasty ; methods ; Surgical Flaps ; Sutures ; Tampons, Surgical ; statistics & numerical data

We report a rare case of pleomorphic adenoma arising from the nasal septum. A 37-year-old woman presented with a 1-year-history of right-sided occasional epistaxis. Computed tomographic scans revealed an oval mass in the right nasal cavity. The tumor was removed endoscopically with endonasal approach. The microscopic finding showed numbers of myoepithelial cells and duct-like structures consisting of loose myxoid stroma. This lesion had histological characteristics of a pleomorphic adenoma, and this was confirmed by immunohistochemical expression of cytokeratin, S-100 protein and SMA. Her post-operative course was uneventful, and she is currently free from the disease 1.5 years after surgery.
Actins ; metabolism ; Adenoma, Pleomorphic ; diagnosis ; surgery ; Adult ; Endoscopy ; Epistaxis ; Epithelial Cells ; Female ; Humans ; Keratins ; metabolism ; Nasal Septum ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; S100 Proteins ; metabolism

Corrective rhinoplasty, a commonly performed plastic surgery, is occasionally followed by numerous risks and complications. In this report, we present, with discussion of the causes and proper management, a case of lagophthalmos that occurred after a rhinoplasty. A 35-year-old female visited our outpatient clinic due to continuous nasal obstruction even after septoplasty. After thorough evaluation, corrective rhinoplasty was performed to release the patient's nasal symptoms and manage the deviated external nose and nasal septum. During the surgery, we encountered excessive nasal bleeding after percutaneous osteotomy. In addition, immediate postoperative findings presented left periorbital edema without limited eye movement or reduced eye vision associated with the paralysis of the eyelid localized to the medial side of the left upper palpebra. Surgeons should be aware of rare but possible complications of corrective rhinoplasty such as lagophthalmos, and a rapid and intensive care is recommended for early management and better prognosis of postoperative complications.
Adult ; Ambulatory Care Facilities ; Ecchymosis ; Edema ; Epistaxis ; Eye Movements ; Eyelids ; Facial Paralysis ; Female ; Humans ; Critical Care ; Nasal Obstruction ; Nasal Septum ; Nose ; Osteotomy ; Paralysis ; Postoperative Complications ; Prognosis ; Rhinoplasty* ; Surgery, Plastic

A case of pyogenic granuloma occurred in inferior turbinate was reported and the literatures were reviewed. A 32 years old male patient with left side progressive stuffy nose and repeated epistaxis. Nasal endoscopic examination showed a dark red neoplasm in left nasal cavity and blocked the anterior naris. Nasal cavity enhanced CT showed the neoplasm located in the front of left nasal cavity with marked enhancement. Bilateral sinuses were normal and there was no significant bone destruction. Nasal endoscopic surgery was performed under local anesthesia. Postoperative pathology report showed pyogenic granuloma (granulation tissue type of angioneoplasm).
Adult ; Endoscopy ; Epistaxis ; Granuloma, Pyogenic ; pathology ; surgery ; Humans ; Male ; Nasal Cavity ; pathology ; surgery ; Postoperative Period ; Turbinates ; pathology ; surgery

The patient was a 42 years old female. And the reason why she was addmited to the hospital was progressive bilateral nasal congestion for one year, and bilateral nasal bleeding for one day. Physical examination showed no surgical contraindication so the patient got the nasal endoscope by plasma radiofrequency ablation surgery with general anesthesia on 3rd Dec. 2013. And the result of potholegical examination was nasopharynx pleomorphic adenoma.
Adenoma, Pleomorphic ; pathology ; surgery ; Adult ; Catheter Ablation ; Endoscopy ; Epistaxis ; Female ; Humans ; Nasal Cavity ; pathology ; Nasopharyngeal Neoplasms ; pathology ; surgery