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Results for “Nasal Surgical Procedures”

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PubMed1954

Classification of adenotonsillectomy as minor surgery.

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Adenoidectomy↗

PubMed1995

Do ventilated packs reduce post-operative eustachian tube dysfunction?

Nasal packing is associated with post-operative Eustachian tube dysfunction in patients undergoing nasal surgical procedures. The effect of cannulated nasal packs which may improve nasopharyngeal ventilation was investigated in a prospective randomized controlled trial. Adult elective patients without tympanometric evidence of pre-operative Eustachian tube dysfunction were recruited. All subjects underwent single or combined intranasal surgical procedures and were randomized to receive either bilateral cannulated or non-cannulated Merocel nasal packs. Middle ear pressures (MEP) were recorded pre-operatively and post-operatively before nasal pack removal. Left and right ear results were amalgamated for analysis and 40 adults, 20 in each group were analysed. There was no difference in pre-operative MEP, -15 dPa (median value) in both groups. Post-operatively the MEP changed in both groups P < 0.0001. There was no significant inter group difference in the post-operative median MEP, -85 dPa in the cannulated and -70 dPa in the control groups, (95% c.i. for the difference in the medians -25-55 dPa). Nasal surgery with post-operative packing leads to an objective reduction in MEP which is not altered by venting the packs.

Acoustic Impedance Tests↗

PubMed1956

Correction of collapsed nasal alae; a simple surgical procedure.

Collapse of the nasal alae against the septum brings about a serious obstruction to the airway. Collapse may be overlooked on routine examination because the speculum may prevent it. In most cases alar collapse can be corrected by a simple surgical procedure, herein described, which can be readily done at the same time as operation on the caudal portion of the septum.

Cartilage↗

PubMedDate not supplied

[Carbon dioxide laser uvulopalatopharyngoplasty (UPPP). Part I. Surgical technique].

Snoring should not be regarded merely as a socially disruptive nuisance, but also as a potential risk factor of increased morbidity and mortality. Since numerous therapeutic approaches have been developed to treat snoring, the physician is faced with the dilemma of deciding which of the many possible treatments is the best for each snorer. Snoring is a sign of partial occlusion at the oropharyngeal level. Increased nasal airway resistance (NAR) may induce pharyngeal inspiratory collapse. Surgical treatment should be directed towards hindering pharyngeal collapse by surgical resection of redundant oropharyngeal tissue and/or surgical normalization of nasal resistance. Eighty-three consecutive patients suffering from snoring as major complaint together with nasal stuffiness were included in the study. Patients with OSA were excluded from the study. Increased nasal airway resistance (NAR) was a common finding in our population. Nasal surgery, involving both the external pyramid and nasal cavity, aimed at normalizing NAR was performed in 63 patients. In 15 cases, UPPP was performed contemporaneously or as a second surgical step. In 5 patients with no nasal abnormalities, pharyngeal surgery was the only surgical procedure. Personal variation of the classic UPPP is illustrated step by step in Part I. The procedure is carried out using the carbon dioxide laser, which offers several advantages both to surgeon and patient. The modified technique, which is associated with minimal morbidity, appears easy to standardize and successful in treating snoring. Results of the surgical procedures (nasal surgery and/or carbon dioxide laser UPPP) performed to treat snoring are reported in Part II.

Adolescent↗

PubMed2004

Nasal ciliary beat after insertion of septo-valvular splints.

OBJECTIVE: At present, endonasal paraseptal splints are devices frequently employed in rhinosurgery. We evaluated the local tolerance of a newly shaped device, the Guastella/Mantovani splint (G/M-SVS), with respect to the physiological mechanism of mucociliary clearance. STUDY DESIGN AND SETTING: The study involved 20 patients who underwent septoplasty and/or turbinoplasty or other nasal surgical procedures. A sample of ciliated cells was obtained by nasal brushing and was examined ex vivo to determine the ciliary beat frequency (CBF) and morphology, before and 15 days after surgery. RESULTS: Before surgery the mean CBF was 10.87 Hz +/- 0.56 Hz and when splints were removed it was 10.25 Hz +/- 1.9 Hz. Morphological evaluation of the ciliary motion after surgery demonstrated a normal, coordinated beat. CONCLUSIONS: The G/M-SVS does not appear to interfere with the physiological mechanism of mucociliary clearance since CBF remain within a normal range. SIGNIFICANCE: This is the first study that demonstrates an optimal tolerability and safety of the septo-valvular splints on nasal mucosa.

Adult↗

PubMed1984

The effect of Le Fort I maxillary impaction on nasal airway resistance.

To evaluate the effect of maxillary superior movement via Le Fort I osteotomy on nasal airway resistance, eleven Caucasian patients whose surgical orthodontic treatment included Le Fort I impaction (range 2 to 8 mm, mean 5.3 mm) were selected. Nasal airway resistance in these patients was determined a few days before and approximately 8 weeks after the Le Fort I surgical procedure. Nasal airway resistance was determined by means of a uninasal active mask rhinomanometric technique. Contrary to the predicted negative effects of maxillary superior movement on nasal airway function, there was a statistically significant improvement in nasal airway resistance (P less than 0.01) after maxillary superior movement. This rather unexpected finding can be explained by examining the effect of maxillary superior movement on the nasal valve area in the anterior nose. The nasal valve area is a teardrop-shaped area bordered by the nasal septum, the caudal end of the upper lateral nasal cartilage, the floor of the nose, and the soft fibrofatty tissue on the lateral aspect of the nose. The apex of the teardrop-shaped area (the angle between the nasal septum and the upper lateral cartilage) is called the nasal valve. In the Caucasian type of nose, the nasal valve accounts for most of the inspiratory resistance to airflow. Maxillary superior movement increases the alar width. It is proposed that this increase in alar width is transmitted at least partially to the nasal valve angle, causing it to widen slightly, paradoxically reducing nasal airway resistance while reducing skeletal intranasal dimensions.

Adolescent↗

PubMed1989

Alternatives to packing in septorhinoplasty.

Nasal packing is considered routine by most physicians and patients at the completion of nasal and septal surgery. Yet the rationale for this maneuver is not clearly defined by reported investigation or logical analysis. We discuss 75 consecutive nasal surgical procedures completed without packing. There were two postoperative episodes of bleeding, both from pyriform aperture incisions for lateral osteotomy and both managed in the recovery room with an absorbable gelatin sponge. Technical refinements such as scrupulous preoperative history taking, through-and-through suturing of the entire septal flaps, small-caliber osteotomy, meticulous closure of all intranasal incisions, and proper application of a conforming dressing are essential for hemostasis. We offer specific procedural guidance to minimize the risk of postoperative nasal bleeding.

Adolescent↗

PubMed2006

Video-endoscopy and digital image analysis of the nasal valve area.

The aim of this study was to evaluate the benefit of digital image analysis of video-endoscopic images of the valve area to study changes in cross-sections of the nasal valve area before and after nasal surgery. Fifty patients scheduled for septoplasty or septorhinoplasty were included. Successful recordings of the valve area and digitally calculated cross-sections of the nasal valve area served as main outcome measures. First, various endoscopes (rigid 0 degrees - and 25 degrees -endoscopes and fibreoptic 0 degrees -endoscope) were tested and video-endoscopy was standardised in 39 patients. Second, preoperative and postoperative images of the nasal valve area in 11 patients with obstruction of the nasal valve area were digitally analysed and compared. In these patients, a significant widening of the valve area could be shown postoperatively. We conclude that digital image analysis of the nasal valve area can be helpful in the measurement of cross-sections of the nasal valve area before and after nasal surgical procedures in selected patients.

Adult↗

PubMed1955