• Archives of Plastic Surgery
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• 제32권1호
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• pp.49-54
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• 2005

Evaluations and treatments of nasal bone fracture have been mainly focused on aesthetic aspect, but nose has an important role as an airway. The purpose of this study was evaluation of nasal bone fractures in the view of nasal obstruction and its improvement after reduction. Acoustic rhinometry was applied to the 77 nasal bone fractured patients who received closed reduction from August 2002 to July 2003 and received closed reduction. This was tested twice, before and 6 days after reduction, for all 77 patients and additional acoustic rhinometry was also possible in 26 patients after 6 months. The analysis of acoustic rhinometry were based on data of minimal cross-sectional area(MCA) according to fracture sites(one side, both side and tip) and septal displacement. Mean MCA for all cases before reduction was $0.43{\pm}0.21cm^2$, which was 19% decrease compared to normal adult data($0.53{\pm}0.12cm^2$). Depending on fracture sites the MCA were $0.45{\pm}0.16cm^2$ for one side fracture, $0.35{\pm}0.18cm^2$ for both side fracture, and $0.42{\pm}0.25cm^2$ for tip fracture. The patients with septal displacement showed more severe obstruction than ones without septal displacement, $0.26{\pm}0.26cm^2$ and $0.46{\pm}0.10cm^2$, respectively. The MCA was improved up to $0.50{\pm}0.22cm^2$ after reduction and showed slight decrease after 6 month($0.48{\pm}0.23cm^2$). Based on the results of this study, nasal bone fracture really caused airway obstruction(19% decrease). Both side fracture showed more profound decrease than one side fracture and septal displacement was an important parameter which causes nasal obstruction. Closed reduction improved MCA by 14% right after reduction, and 11% after 6 month follow up.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.433-442
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• 2010

Purpose: Many authors reported about the posttraumatic 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.

• 대한한방소아과학회지
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• 제18권1호
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• pp.153-163
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• 2004

Objective: For last 20 years our living environment has been changed rapidly. Accordingly. there have been many changes in prevalence of diseases; In nasal disease of the pediatrics, the number of children suffering from chronic rhinorrhea and nasal obstruction has been increased. And respiratory symptoms suggesting rhinitis and sinusitis also were increased. Allergic disease is considered as an important cause of this phenomenon while importance of infection as pathogen is fading today. The aim of this study is to investigate the effect of TonggyutangGarnibang on the nasal disease of children. Methods: Children with nasal disease answer the questionnaires on their chief complaints and medical past history on their first visit to our clinic. They were treated 'With TonggyutangGarnibang for 4weeks. After treatment they answered the questionnaire on improvement of their symptoms. Results: Among treated patients, 70 were male(69%) and 32 were female(31%); sex ratio was 2.2.3:l(male:female). And children from 3-8 years old took majority of patients(64%). Major symptoms of children with nasal disease were as follows; nasal obstruction 9lchildren(62%), rhinorrhea 86children(84%), sneezing 63children(62%), cough 63children(62%), snoring 48children (47%), poor appetite 44children(43%), itching 39children(38%), headache 32children(31%), stomache 25children(25%), epistaxis 23children(23%), constipation 17children(17%), diarrhea 12children(12%). Past history and impression of the disease of the patients were as follows; allergic rhinitis(66%), atopic dermatitis(42%), sinusitis(40%), asthma(25%), urticaria(12%). Severity of symptom improved after TonggyutangGamibang treatment, it showed high treatment efficacy as follows; sneezing 70%, cough 70%, rhinorrhea 63%, nasal obstruction 59% Conclusion: This study shows TonggyutangGamibang has distinctive treatment effect on children with nasal disease.

• Archives of Plastic Surgery
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• 제36권2호
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• pp.188-193
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• 2009

Purpose: Several authors reported about the post - traumatic nasal aesthetic complications. However, the study for functional or intra - nasal complications has been reported not enough. 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 undergone 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. Additionally, the incidence of subjective nasal obstruction and olfactory dysfunction is 18%(n = 72) and 13%(n = 51). But 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.

• Journal of Korean Biological Nursing Science
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• 제15권4호
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• pp.264-271
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• 2013

Purpose: The purpose of this study was to analyze the symptoms of allergic rhinitis among university students and assess their quality of life (QOL) in order to establish an effective program for university students with allergic rhinitis. Methods: The data were collected in May, 2012 in a university school health center. The collected data were analyzed in terms of frequency, percentage and mean for the symptom types and QOL among 131 university students with allergic rhinitis. An independent t-test was conducted to determine differences in QOL according to general and disease related characteristics. Results: Symptoms were reported in the following order: nasal obstruction, rhinorrhea, sneezing, and nasal itching respectively. The mean score of QOL of the participants was 2.24 (5 point). Nasal symptoms such as rhinorrhea (M=3.16) and nasal obstruction (M=3.12) had the highest score and affected QOL badly in the item analysis. QOL differed according to the diagnosis of allergic rhinitis history, skin test reaction, some symptoms and allergens. Conclusion: To establish an effective management program for increasing QOL among university students with allergic rhinitis, symptom management methods for nasal obstruction and rhinorrhea should be included in the program.

• Korean Journal of Acupuncture
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• 제28권3호
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• pp.221-231
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• 2011

Objectives : Kamibojungikgi-tang is one of the most frequently used medical treatment for the allergic rhinitis. The main symptoms of the allergic rhinitis are nasal obstruction, watery rhinorrhea, and sneezing. In this study, we investigated the medical effect of the Kamibojungikgi -tang with intradermal acupuncture treatment on the allergic rhinitis in 10-11 years old children. Methods : For 8 weeks, we administered Kamibojungikgi-tang to 84 patients and treated them with intradermal acupuncture. We checked their serum IgE and examined 10 symptoms of the allergic rhinitis (nasal obstruction, watery rhiorrhea, sneezing, nasal pruritus, hyposmia, quality of life, color of nasal mucosa, edema of nasal mucosa, postnasal drip, and complication). Results : 1. Serum IgE decreased 2.62 point. which showed no significance. 2. Nasal obstruction, watery rhiorrhea, sneezing, nasal pruritus, hyposmia, quality of life, color of nasal mucosa, edema of nasal mucosa, and postnasal drip were improved. (p<0.005) 3. Complication showed no significance. Conclusions : After treatment, we had a lower symptom index scores. Kamibojungikgi-tang with intradermal acupuncture treatment had an effect on the allergic rhinitis.

• 한방안이비인후피부과학회지
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• 제25권3호
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• pp.56-64
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• 2012

Objectives : This study was performed in order to investigate an immediate improvement effect of nasal obstruction after having patient with chronic rhinitis use nasal spray in nasal cavity after distilling Korean medicine, satisfaction for its fragrance and irritation and its effect continuance time. Methods : A questionnaire was performed for an immediate therapeutic effect of nasal spray 1, 2 and 3 weeks later after using spray by targeting 13 patients who used Korean medicine distillate spray for over 3 weeks among the patients who visited Sangji University Korean Medicine Hospital and whose symptoms were determined as chronic rhinitis and for whom Korean medicine distillate spray was prescribed. 3 weeks later after using spray, a questionnaire was performed for fragrance, irritation and continuance effect of Korean medicine. Immediate therapeutic effect being felt right after spraying was also surveyed and symptom scores was expressed from 10 to 0 and on the assumption that nasal obstruction symptom just before spraying was 10 points, symptom score after spraying was surveyed. In case of evaluation of satisfaction, satisfaction for fragrance and irritation of nasal spray was evaluated by scale based on full score of 5 point from 'very satisfied=5', 'satisfied=4', 'average=3', 'unsatisfactory=2' and 'very unsatisfactory=1', respectively. Effect continuance time after spraying was surveyed by dividing it into within 5 minutes, within 5-10 minutes, within 10-30 minutes and over 30 minutes. All the data was statistically analyzed by Friedman Test that is non-parametric test of Paired t-test and descriptive statistics. Results : Total surveyed patients were 13 persons including 6 males and 7 females and total average age was represented to be $27.1{\pm}17.7$ years old. Score of immediate nasal obstruction improvement effect at 1st week was $6.3{\pm}2.4$ points, at 2nd week $5.7{\pm}2.5$ points and at 3rd week $5.5{\pm}2.5$ points and when comparing 1st week, 2nd week and 3rd week statistically, p value was 0.047<0.05 and from this, it could be seen that the longer spray was used, the more was improvement effect represented with slight significance. In case of fragrance and irritation, both of its score was represented to be high as average $4.0{\pm}1.08 $points and average $4.4{\pm}0.8$ points, respectively. Effect continuance time below 10 minutes was represented in 8 persons who accounted for 61.5%. Conclusions: Immediate improvement effect of nasal obstruction being felt by the patients by using Korean medicine nasal spray could be confirmed and by having the patients use such spray for 3 weeks continuously, it could be realized that such effect was sustained and satisfaction for fragrance or irritation of Korean medicine nasal spray was significant. However, rather short sustained time was considered to be unsatisfactory and this shortcomings is required to be improved in the future.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.31-34
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• 2020

Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.

• Archives of Plastic Surgery
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• 제39권6호
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• pp.612-617
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• 2012

Background Packing after closed reduction of a nasal bone fracture causes inconvenient nasal obstruction in patients. We packed the superior meatus with Vaseline gauze to support the nasal bone, and packed the middle nasal meatus with a Doyle Combo Splint consisting of an airway tube, a silastic sheet, and an expandable sponge to reduce the inconvenience. In addition, we aimed to objectively identify whether this method not only enables nasal respiration but also sufficiently supports the reduced nasal bone. Methods Nasal ventilation was measured via spirometry 1 day before surgery and compared to 1 day after surgery. To compare support of the reduced nasal bone by the 2 methods, 2 plastic surgeons assessed the displacementon X-rays taken after the surgery and after removing the packing. The extent of nasal obstruction, dry mouth, sleep disturbance, headache, and swallowing difficulty were compared with visual analog scales (VAS) on a pre-discharge survey. Results In the experimental group, the nasal respiration volume 1 day after surgery remained at $71.3%{\pm}6.84%$ on average compared to 1 day prior to surgery. Support of the reduced bone in the experimental group ($2.80{\pm}0.4$) was not significantly different from the control group ($2.88{\pm}0.33$). The VAS scores for all survey items were lower in the experimental group than in the control group, where a lower score indicated a lower level of inconvenience. Conclusions The nasal cavity packing described here maintained objective measures of nasal respiration and supported the reduced bone similar to conventional methods. Maintaining nasal respiration reduced the inconvenience to patients, which demonstrates that this packing method is useful.

• 임상이비인후과
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• 제29권2호
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• pp.269-275
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• 2018

Nasal valve compromise (NVC) is a distinct cause of symptomatic nasal obstruction, yet there are several ambiguities surrounding the diagnosis and management of this disease. Understanding of nasal valve anatomy with critical assessment of the site of obstruction is essential to effective nasal valve management. Technique selection should be individualized to the type of valve dysfunction. This case report presents a 56 year old man with nasal valve dysfunction due to narrow middle vault, concave lower lateral cartilage and swollen septal body which was diagnosed by various techniques including navigation system and treated by spreader graft, alar batten graft and reduction of septal body.