Objective:To assess the efficacy of "three-step" strategy for preparing autologous pedicled nasal mucosal flaps in repairing cerebrospinal fluid（CSF） leaks following transsphenoidal pituitary adenoma surgery. Methods:A retrospective study was conducted on the clinical data of 25 patients who developed CSF leaks after transsphenoidal pituitary adenoma surgery at the First Affiliated Hospital of Kunming Medical University between July 2012 and June 2022. Surgical repair was selected step by step using nasal septal mucosal flap with either the posterior septal artery or septal branch of the sphenopalatine artery as the pedicle, or a pedicled middle turbinate mucosal flap. All patients underwent ≥2-year endoscopic follow-up to assess flap viability and CSF leak recurrence. Results:The median postoperative hospital stay was 4 days. Five patients developed intracranial infections postoperatively. The follow-up period ranged from 2 to 12 years. Nasal endoscopic examinations showed good mucosal flap growth, with no recurrence of CSF leakage in any of the patients. Conclusion:High-flow cerebrospinal fluid（CSF） leaks following pituitary tumor surgery pose significant challenges for clinical repair. Based on intraoperative nasal septal mucosal preservation and the condition of sellar base CSF leakage, the "three-step" strategy for preparing autologous pedicled nasal mucosal flaps-utilizing posterior septal artery, ethmoidal artery-based, or pedicled middle turbinate mucosal flaps sequentially-is a safe and effective repair method.
Humans ; Retrospective Studies ; Pituitary Neoplasms/surgery* ; Surgical Flaps ; Nasal Mucosa/surgery* ; Cerebrospinal Fluid Leak/surgery* ; Adenoma/surgery* ; Postoperative Complications/surgery* ; Male ; Female ; Middle Aged ; Adult ; Aged

Objective:To investigate the clinical effect of free anterolateral thigh myocutaneous flap combined with oral repair membrane in the reconstruction of nasal mucosa defect after maxillary malignant tumor surgery. Methods:A total of 12 patients with maxillary gingival squamous cell carcinoma and maxillary sinus cancer who had been treated in Department of Oral and Maxillofacial Surgery, Beijing Anzhen Nanchong Hospital, Capital Medical University & Nanchong Central Hospital, were selected from November 2020 to November 2023. Free anterolateral thigh musculocutaneous flap transplantation combined with oral repair membrane were used in all patients. Meanwhile, maxillary soft and hard tissue defects and nasal mucosa defects left after tumor operation were repaired and reconstructed. The clinical effect was evaluated after 6-12 months follow-up. Results:Subtotal maxillary resection was performed in 1 case, total maxillary resection in 9 cases and extended maxillary resection in 2 cases. The musculocutaneous flaps of all patients survived, the facial appearance was basically symmetrical, no obvious depression deformity, the swallowing and speech function recovered well, the mouth and nasal cavity were closed completely, the food could be eaten through the mouth, and the lower nasal passage was not blocked. Conclusion:The free anterolateral thigh musculoflap combined with oral repair membrane can be used to repair and reconstruct maxillary malignant tumor complicated with extensive maxillary tissue and nasal mucosa defect after operation, and the appearance and function can be recovered well after operation, which is a choice for maxillary malignant tumor complicated with nasal mucosa defect.
Humans ; Myocutaneous Flap ; Plastic Surgery Procedures/methods* ; Maxillary Neoplasms/surgery* ; Carcinoma, Squamous Cell/surgery* ; Male ; Middle Aged ; Female ; Nasal Mucosa/surgery* ; Maxilla/surgery* ; Thigh/surgery* ; Maxillary Sinus Neoplasms/surgery*

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

OBJECTIVE: To investigate the efficacy outcomes of laser assisted outpatient septal spur surgery for contact point pain in a carefully selected group of patients. METHOD: This investigation included 32 patients who were selected for laser-assisted septal spur surgery in an outpatient surgical suite. All had endoscopically visible spur contact as well as nansal CT scans. Patients of sinusitis were excluded. The area of the contact point was treated with decongestant and lidocaine. If the headache completely disappeared or diminished by more than 50% in intensity, subjects were considered candidates for surgery. Headache characteristics were assessed preoperatively and at follow-up (30 months after surgery) using a standardized questionare. RESULT: Nine cases (28.1%) were free from pain at the last follow-up; 19 cases (59.4%) had their headache scores improved after surgery; four cases (12.5%) had a less than 25% reduction in their headache score. No septal perforation, hematoma, was reported. CONCLUSION For selected patients with contact point headaches, septoplasty may be useful. The positive dicaine test may indicate better effect of operation. Laser-assisted outpatient septal spur surgery for contact point pain shows good results in short-term effect, and has less complications, but long-term follow-up is required to assess its real effect.
Adult ; Anesthesia, Local ; Female ; Headache ; etiology ; surgery ; Humans ; Laser Therapy ; Male ; Middle Aged ; Nasal Cavity ; Nasal Mucosa ; surgery ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVE: To explore the blood supply of the pedicle nasal septum mucosa flap of rabbit, in order to supply the theory and experiment basis for making the pedicle nasal septum mucosa flap to repair nasal cavity and skull base defect. METHOD: Twenty rabbits corpses were induced into the experimental subject, and inject 5 ml blue ink into the external carotid artery, then longitudinal cut apart the middle head of rabbit, finally observe the blood supply of the pedicle nasal septum mucosa flap. RESULT: The blood supply of the pedicle nasal septum mucosa flap mostly come from the vessels of extremitas anterior part of nasal septum. CONCLUSION Keep the he vessels of extremitas anterior part of nasal septum can guarantee the blood supply of mucous membrane, enhance the survival rate of nasal septum mucous membrane.
Animals ; Graft Survival ; Male ; Nasal Cavity ; surgery ; Nasal Mucosa ; blood supply ; Nasal Septum ; Rabbits ; Skull Base ; surgery ; Surgical Flaps ; blood supply ; Wound Healing

OBJECTIVE: To assess the therapeutic effect and study the role of nasal mucosa epithelization after endoscopic surgery using the plasma radiofrequency ablation at low temperature in patients with nasal inverted papilloma. METHOD: The clinical data of 104 patients with nasal inverted papilloma underwent endoscopic surgery u sing the plasma radiofrequency ablation at low temperature from July, 2008 to July, 2012 were analyzed,and the recovery of mucosa was observed under nasal endoscope. RESULT: The mucosa recovery extent showed a decreasing trend from mucosa pattern degree I to III, where the difference was statistically significant by chi-square test between groups (P < 0.05). The average epithelialization time was 2.7 months. It showed a significantly decreasing trend among average epithelialization time of different degrees of mucosa (P < 0.05). The nasal mucosa of most patients completed epithelialization 2.9 months after surgery. CONCLUSION It is safe and effective to treat nasal inverted papilloma with plasma radiofrequency ablation at low temperature. The patients should be followed up with regular reexamination for at least three months after surgery.
Adult ; Aged ; Aged, 80 and over ; Catheter Ablation ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Nasal Cavity ; Nasal Mucosa ; pathology ; Nose Neoplasms ; surgery ; Papilloma, Inverted ; surgery ; Postoperative Period ; Retrospective Studies

OBJECTIVE: In order to explore the effect of plasma radiofrequency ablation on nasal mucosa provocative tests for allergic rhinitis. METHOD: Eighty patients with allergic rhinitis were enrolled in this study. The nasal mucosa provocative tests and nasal airway resistance and subjective nasal patency feeling were studied before and after plasma radiofrequency ablation treatment. The correlation of subjective and objective nasal patency was evaluated. RESULT: The preoperative nasal mucosa provocative test of all the patients allergic to mites were positive. The nasal mucosa provocative tests were negative within 72 patients, while remained positive in eight patients after 3 months of operation. The nasal airway resistance decreased from (0.772 +/- 0.224) kPa x s/L to (0.221 +/- 0.112) kPa x s/L after surgery (P < 0.01); Visual analog scale decreased from 7.0 +/- 2.0 to 2.5 +/- 1.5 after 3 months of operation (P < 0.01). CONCLUSION Due to its ability to reduce the sensitivity of the nasal mucosa, nasal airway resistance and improve subjective feeling of nasal patency, plasma radiofrequency ablation is effective for the treatment of patients with allergic rhinitis.
Adolescent ; Adult ; Airway Resistance ; Catheter Ablation ; Female ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; Nasal Provocation Tests ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial ; diagnosis ; surgery ; Young Adult

OBJECTIVE: To investigate the efficacy of nasal mucosa contact point headache with the treatment of endoscopic sinus surgery. METHOD: Clinical data of 75 cases with nasal mucosa contact point headache treated in our department from Jan 2008 to Nov 2011 were retrospectively analyzed. These patients were performed with endoscopic sinus surgery. RESULT: All patients were followed up for more than six months. They all achieved significant efficacy and no complications occurred. CONCLUSION Nasal mucosa contact point headache and primary headache had different clinical features and different treatment. Misdiagnosis were easily made if not being carefully analyzed. Three lines tension relaxing septorhinoplasty combined with nasal bone fracture correction can achieve satisfactory curative effect and can effectively prevent the occurrence of complications. Therefore, it is necessary to strengthen the awareness of this disease. Nasal structure abnormality is the main reason of nasal mucosa contact point headache. The implementation of individualized nasal endoscopic sinus surgery can achieve satisfactory curative effect.
Adult ; Endoscopy ; Female ; Headache ; diagnosis ; diagnostic imaging ; etiology ; Humans ; Male ; Middle Aged ; Nasal Mucosa ; Nose Diseases ; complications ; diagnosis ; surgery ; Ultrasonography ; Young Adult

Adult ; Female ; Humans ; Nasal Mucosa ; pathology ; Nose Neoplasms ; diagnosis ; surgery ; Papilloma ; diagnosis ; surgery