It is commonly assumed that nasorespiratory function can exert a dramatic effect upon the development of the dentofacial complex. Specially, it has been stated that chronic nasal obstruction leads to mouth breathing, which causes altered tongue and mandibular positions. If this occurs during a period of active growth, the outcome is development of the "adenoid facies". Such patients characteristically manifest a vertically long lower third facial height, narrow alar bases, lip incompetence, a long and narrow maxillary arch and a greater than normal mandibular plane angle. But several authors have reported that so-called adenoid facies is not always associated with adenoids and mouth breathing, and that a particular type of dentition is not always found in mouth breathers with or without adenoids. Some authors have believed adenoids lead to mouth breathing in cases with particular facial characteristics and types of dentition. We assumed that the ability to adapt to individual's neuromuscular complex is various. So, we compared the difference of influence of mouth breathing between childrens who have different facial types. This study included 60 patients and they were divided into three groups by Rickett's facial type. Their dentition and tongue position were compared. The results are as follows. 1. There is a significant difference in arch width of upper molars between different facial types. Especially dolichofacial type patients have narrowest arch width. 2. There is a significant difference in tongue position between different facial types. Especially dolichofacial type patients have lowest positioned tongue.
Background: Primary rhinoplasty outcomes may not meet individual expectations. Consequently, reoperation may be advocated to improve results. This study examines the prevalence of individuals considering revision rhinoplasty, while identifying the main cosmetic and functional complaints and factors associated. Methodology: This is a cross-sectional study conducted in Saudi Arabia using a self-reported online questionnaire distributed through social media channels. The sample included 1370 participants who were all Saudi nationals over the age of 16 who had undergone primary rhinoplasty at least 1 year prior. Results: The prevalence of individuals considering revision rhinoplasty was 44.7%. The primary reason for considering it was the desire for further esthetic improvement in an already acceptable result (50.16%). The most common cosmetic complaints subjectively reported were poorly defined nasal tip (32.35%). The most prevalent nasal function symptom was nasal obstruction (56.9%). Significant factors associated with considering revision rhinoplasty included the physician not understanding the patient's complaints, short consultation time, low monthly income, inadequate information about the expected results, not using computer imaging to predict outcomes, lack of rapport with the surgeon, and inadequate information about the risks and complications. Conclusions: A thorough understanding of patient concerns and expectations, as well as thoughtful consideration of risk factors, may help surgeons achieve more successful outcomes and potentially reduce the incidence of revision rhinoplasties. Level of evidence: III.
Objective: The purpose of this clinical observation was to estimate the efficacy of Quetong & Voice on the abatement of subjective symptoms related nose & pharynx. Methods: We observed 46 patients who visited Kang-Nam oriental hospital with subjective symptoms related nose & pharynx that were prescribed Quetong or Voice. We made an inquiry into the inconvenience, side effect, abatement of subjective symptoms, etc. We used the Wilcoxon signed rank test. Results and Conclusions: 1. The distribution of age & sex was as fallows: 21-30 years(34.8%) were the most, 31-40 years(26.1 %) were the second, 1-10 years(24.0%) were the third. Total patient numbers for men and women were 15 men(32.6%), 31 women(67.4%). 2. The distribution of prescribed aerosols for 46 patients: 5 cases(10.9%) prescribed Quetong, 22 cases(47.9%) prescribed Voice, and 19 cases(41.3%) prescribed Quetong & Voice. 3. The duration of use: 12 cases(26.1 %) used 1 week, 19 cases(41.3%) used 1-2 weeks, 9 cases(19.6%) used 2-4 weeks, 4 cases(8.7%) used 4-8 weeks, and 2 cases(4.3%) used above 8 weeks. 4. The frequency of use: The most patients used 1-5 times(69.6%) or 5-10 times(21.7%) for a day. 5. Quetong & Voice were effective on abatement of subjective symptoms(rhinorrhea, nasal obstruction, pharyngalgia, sneeze or cough, post nasal drip, pharyngeal pruritus, pharyngeal dryness, nasal dryness, and globus hystericus). 6. We must prescribe Quetong to the child or the sensitive patients with discretion becouse of the sting. 7. The side effect was not occurred in all of 46 patients.
The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
/
v.16
no.3
/
pp.185-199
/
2003
Objectives : The purpose of this clinical report was to estimate the efficacy of Lizhongtang plus Baidusan(理中湯合敗毒散) on allergic rhinitis. Methods : We prescribed Lizhongtang plus Baidusan(理中湯合敗毒散) for 15 patients who visited Kabsan oriental clinic with allergic rhinitis. We inquired into distribution of age, case history period, improvement of symptoms, etc. We used the statistical methods of student t-test in order to analysis of the different of symptom before and after treatment(p 〈0.05). Results : 1. The distribution of sex & age was as follows; Total patient were women. 10-19 years 2 cases, , 30-39 years 5 cases, 40-49 years 6 cases and 50-59 years 2 cases. 2. The case of history period was as follows; under a year 1 case, 1-3 years 3 cases, 3-5 years 2 cases, 5-10 years 4 cases and over 10 years 5 cases. 3. The amount of herbal medicine they took as follows: 1 je(劑) 1 case, 2 je(劑) 7 cases, 3 je(劑) 5 cases and 4 je(劑) 2 cases. 4. The frequency of acupuncture and moxibustion was as follows; under 5 times 1 case, 6-10 times 10 cases, 11-15 times 3 cases, over 16 times 1 case. 5. The nasal symptoms except the nasal mucosa color(pale) were improved significantly after treatment(p 〈0.05). 6 The general symptoms except menstruation pain were improved significantly after treatment(p 〈0.05). 7. The curative influence of rhinitis by Lizhongtang plus Baidusan(理中湯合敗毒散) was as follows excellent 2 cases. good 11 cases, ineffectiveness 2 cases. Conclusion: If we administer Lizhongtang plus Baidusan(理中湯合敗毒散) to allergic rhinitis patients with cold in the Zhong Jiao of deficiency type (中焦虛寒), it improves not only allergic symptoms such as the watery rhinorrhea, turbinate swelling, sneeze, nasal obstruction, etc but also coldness of the limbs(手足冷症), dyspepsia, dysmenorrhea, etc. Therefore, we consider that administration of Lizhongtang plus Baidusan(理中湯合敗毒散) to allergic rhinitis patients with cold in the Zhong Jiao of deficiency type (中焦虛寒) improves in quality of life, as removes inconvenience of life and stress.
Purpose: The diagnosis of chronic rhinosinusitis requires a comprehensive knowledge of the signs and symptoms of the disease and an accurate radiographic assessment. Computed tomography (CT) is the superior imaging modality for diagnosis of chronic rhinosinusitis. However, considering the lower dose and higher resolution of cone-beam computed tomography (CBCT) compared to CT, this study aimed to assess the agreement between the findings of CBCT and functional endoscopic sinus surgery (FESS). Materials and Methods: This descriptive prospective study evaluated 49 patients with treatment-resistant chronic rhinosinusitis who were candidates for FESS. Preoperative CBCT scans were obtained before patients underwent FESS. The agreement between the CBCT findings and those of FESS was determined using the kappa correlation coefficient. The frequency of anatomical variations of the paranasal sinuses was also evaluated on CBCT scans. Results: Significant agreement existed between pathological findings on CBCT scans and those of FESS, such that the kappa correlation coefficient was 1 for mucosal thickening, 0.644 for nasal deviation, 0.750 for concha bullosa, 0.918 for nasal polyp, 0.935 for ostiomeatal complex (OMC) obstruction, and 0.552 for infundibulum thickening. Furthermore, 95.9% of patients had 1 or more and 79.6% had 2 or more anatomical variations, of which nasal deviation was the most common (67.3%). Conclusion: Considering the significant agreement between the findings of CBCT and FESS for the detection of pathological changes in the paranasal sinuses, CBCT can be used prior to FESS to detect chronic rhinosinusitis and to assess anatomical variations of the OMC.
Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.
Objective: To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing. Methods: Objective measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). Results: Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. Conclusions: Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.
Albino, Frank P.;Wood, Benjamin C.;Han, Kevin D.;Yi, Sojung;Seruya, Mitchel;Rogers, Gary F.;Oh, Albert K.
Archives of Plastic Surgery
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v.43
no.6
/
pp.506-511
/
2016
Background The indications for surgical airway management in patients with Robin sequence (RS) and severe airway obstruction have not been well defined. While certain patients with RS clearly require surgical airway intervention and other patients just as clearly can be managed with conservative measures alone, a significant proportion of patients with RS present with a more confusing and ambiguous clinical course. The purpose of this study was to describe the clinical features and objective findings of patients with RS whose airways were successfully managed without surgical intervention. Methods The authors retrospectively reviewed the medical charts of infants with RS evaluated for potential surgical airway management between 1994 and 2014. Patients who were successfully managed without surgical intervention were included. Patient demographics, nutritional and respiratory status, laboratory values, and polysomnography (PSG) findings were recorded. Results Thirty-two infants met the inclusion criteria. The average hospital stay was 16.8 days (range, 5-70 days). Oxygen desaturation (<70% by pulse oximetry) occurred in the majority of patients and was managed with temporary oxygen supplementation by nasal cannula (59%) or endotracheal intubation (31%). Seventy-five percent of patients required a temporary nasogastric tube for nutritional support, and a gastrostomy tube placed was placed in 9%. All patients continued to gain weight following the implementation of these conservative measures. PSG data (n=26) demonstrated mild to moderate obstruction, a mean apneahypopnea index (AHI) of $19.2{\pm}5.3events/hour$, and an oxygen saturation level <90% during only 4% of the total sleep time. Conclusions Nonsurgical airway management was successful in patients who demonstrated consistent weight gain and mild to moderate obstruction on PSG, with a mean AHI of <20 events/hour.
Song Gin-Ah;Myung Hoon;Hwang Soon-Jung;Seo Byoung-Moo;Lee Jong-Ho;Choung Pill-Hoon;Kim Myung-Jin;Choi Jin-Young
Korean Journal of Cleft Lip And Palate
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v.6
no.1
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pp.17-25
/
2003
Correction of the cleft-lip nasal deformity is a difficult task that requires clear understanding of the associated complex anatomy and function as well as the operation time, the selection of an operation method, On the expectation that it helps enhance understanding the current trend of cleft-rhinoplasty, authors analyzed secondary rhinoplasty between 1999 and 2002, In both the unilateral and bilateral cleft lip rhinoplasty, we reviewed the timing of repair, site of correction and it's major technique, incision or approach method, autogenous cartilage graft method, All patients with a septal deviation did not have a septal surgery, We were active in alar and nasal tip surgery and passive in septal and dorsal deformity correction, And for children, we used a conservative method but for adults, we used radical approach, Most surgeries are focused on esthetic goal and we thought that objective evaluation for nasal obstruction was needed for bener and predictable outcome.
Objective : in order to be convinced of improvement in quality of life in allergic rhinitis patients, I observed clinically remedical effect of Quingbixiaoyanwan-Derivatives(淸鼻消炎丸) on allergic rhinitis with a questionnaire. Methods : We treated forty five allergic patients at the Nam Chun Oriental Medical Hospital from October, 2001 to January, 2002. They were treated with Quingbixiaoyanwan-Derivatives(淸鼻消炎丸), nasal cleansing solution and dietary treatment, and the health-related quality of life with a questionnaire. Results : 1. The gender proportion was twenty five males(55.6%) and twenty females(44.4%); seven teenagers (15.6%); ten patients in their 20s(22.2%); twenty patients in their 30S(44.4%); six patients in their 40s(13.3%); two patients in over 50s (4.4%) 2. The duration of the disease: 0 case within six months; three cases for six months to one year (6.6%); fourteen cases for one year to five years(31.1%); twenty six cases for over five years(62.2%) 3. Major symptoms; forty three cases for watery rhinorrhea (95.5%); thirty one caess for nasal itching(68.8%); 91.1 cases for sneezing(41.0%);thirty nine cases for nasal obstruction (86.6%); sixteen cases for difficulty in smelling(35.5%);seventeen postnasal drip(37.7%);three bloody rhinorrhea (6.6%);fourteen cases for headaches(31.1%); nine cases for eyelid itching (60.0%). 4. Seasonal Distribution: perennial allergic rhinitis occurred as follows: 55.6% in winter; 13.3% in fall; 11.1 % in spring;2.2% in summer. 5. Other combined allergic symptoms; sixteen cases for allergic conjunctives (37.8%); eight cases for sinus(17.8%);four cases for atopic dermatitis (8.9%); three cases for bronchial asthma(6.7%); sixteen cases for none(35.6%) 6. After a specific prescription of Quingbixiaoyanwan-Derivatives(淸鼻消炎丸), nasal cleansing solution and dietary therapy, the quality of life in allergic rhinitis patients was improved to 20.27%, which was significantly.(P<0.001) 7. The specific treatment did not affect GOT/GPT and BUN/Creatinine. 8. The specific treatment did not influence the level of total IgE serum significantly. Conclusions : Based on the above results, I have concluded that the specific treatment of Quingbixiaoyanwan-Derivatives(淸鼻消炎丸), nasal cleansing solution and dietary therapy can improve the quality of life in allergic rhinitis patients.
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