• Title/Summary/Keyword: nasal obstruction

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Closed Reduction of Nasal Bone Fracture Under the Mask Ventilation Anesthesia Using Oral Airway (기도유지기 마스크 환기마취를 이용한 비관혈적 비골골절 정복술)

  • Park, Byung-Chan;Nam, Hyun-Jae;Lee, Jun-Ho;Kim, Yong-Ha;Heo, Min-Jung;Seo, Il-Sook
    • Archives of Craniofacial Surgery
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    • v.9 no.2
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    • pp.77-80
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    • 2008
  • Purpose: The majority of nasal fractures have been treated by closed reduction. And they were manipulated under local anesthesia or general anesthesia. Under the local anesthesia, patients can feel the pain and fear, so general anesthesia through the endotracheal intubation became popularized recently to treat the nasal fracture. But it has still the drawbacks of postanesthetic complication. Therefore, under the mask ventilation anesthesia using oral airway, we tried to manipulate the nasal fracture. Methods: From July 2007 to November 2007, we worked with fifty patients that were manipulated the nasal fracture. Fifty patients were divided into two groups, general anesthesia with the endotracheal intubation group(n=25) and the mask ventilation using oral airway group(n=25). We checked up the anesthesia time, postanesthetic complication, postoperative aesthetic & functional problem of nose in two groups. Results: In total operation time and sore throat frequency among the postoperative anesthetic complications, there was statistically significant difference between the mask ventilation group and the endotracheal intubation group(p<0.05). But there was no difference statistically in nausea frequency(p>0.05). And no patients complained of postoperative nasal complication such as septal deviation, septal perforation, nasal obstruction and hump nose in two groups. Conclusion: Through the mask ventilation using oral airway, we could reach satisfactory results in the anesthetic time and postanesthetic complication.

Correlation between nasal mucosal thickness around the lacrimal sac fossa and surgical outcomes in endonasal dacryocystorhinostomy

  • Yoo, Jae Ho;Kim, Chang Zoo;Nam, Ki Yup;Lee, Seung Uk;Lee, Jae Ho;Lee, Sang Joon
    • Kosin Medical Journal
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    • v.33 no.3
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    • pp.358-368
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    • 2018
  • Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

Esthesioneuroblastoma in a boy with 47, XYY karyotype

  • Jo, Hee Cheol;Lee, Seong Wook;Jung, Hyun Joo;Park, Jun Eun
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.92-95
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    • 2016
  • Neuroblastomas are sometimes associated with abnormal constitutional karyotypes, but the XYY karyotype has been rarely described in neuroblastomas. Here, we report a case of an esthesioneuroblastoma in a boy with a 47, XYY karyotype. A 6-year-old boy was admitted to our hospital because of nasal obstruction and palpable cervical lymph node, which he first noticed several days previously. A polypoid mass in the right nasal cavity was detected through sinuscopy. Biopsy of the right nasal polyp was performed. Based on the result, the patient was diagnosed with a high-grade esthesioneuroblastoma. Nuclear imaging revealed increased uptake in both the right posterior nasal cavity and the right cervical IB-II space, suggesting metastatic lymph nodes. Cytogenetic analysis revealed a 47, XYY karyotype. Twelve courses of concurrent chemotherapy were administered. Three years after the completion of chemotherapy, the patient had had no disease recurrence. He manifested behavioral violence and temper tantrums, so we started methylphenidate for correction of the behavior.

A Case of the Angiofibroma of the Nasal Septum (비중격에 발생한 혈관섬유종 1례)

  • 권혁진;박호선
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.17.5-18
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    • 1983
  • Angiofibroma in otorhinolaryngologic field is rare, highly vascular and non-metastatizing benign tumor. It was noted as histologically benign but clinically malignant tumor because of the anatomical site, severe bleeding in surgery and recurrence in incomplete removal. It occurs almostly in nasopharynx of adolescent males. Recently, the authors have experienced a very rare case of angiofibroma which occupied the nasal septum in a 37-years-old-male with complaints of nasal obstruction and frequent nasal bleeding. The tumor mass was removed surgically through intranasal approach under local anesthesia. We report our case with review of current literatures.

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The Clinical Study on Childhood Common Cold in Four Seasons (계절별(季節別) 증상(症狀)을 중심으로 한 소아감모(小兒感冒)의 임상적 고찰)

  • Koo, Jin-Suk;Baek, Jung-Han;Seo, Jung-Min
    • The Journal of Pediatrics of Korean Medicine
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    • v.19 no.2
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    • pp.31-40
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    • 2005
  • Objectives: This study was performed to investigate the character of childhood common cold according to four seasons. Methods: We made an investigation into medical record of 432 children under fifteen years of age who visited pediatrics or emergency room suffering from common cold. We analyzed the principal and secondary symptoms of the children classifying four seasons by $SPSS^{\circledR}$ 12.0 for windows. Results: Male to female ratio were 1.42:1, the average of age was 3.86 years old. Distribution of principal symptoms was that nasal discharge was 231(56.1%), cough was 233(54.1%), nasal obstruction was 162(39.3%), secretion and sputum were 126(30.6%), fever was 121(29.4%), and headache was 13(3.2%). Out of these fever occurred in high frequency during spring and summer, nasal obstruction occurred in high frequency during spring and autumn. Distribution of secondary symptoms was that throat pain was 93(22.6%), otalgia was 39(9.5%), vomiting was 35(8.5%), abdominal pain was 30(7.3%), anorexia was 23(5.6%), sweating was 21(5.1%), diarrhea was 19(4.6%), and startle was 11(2.7%). Out of these otalgia occurred in high frequency during spring and summer, diarrhea occurred in high frequency during autumn and winter. Conclusions: A few symptoms can be the character according to four seasons.

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The efficacy of mobile application use on recall of surgical risks in nasal bone fracture reduction surgery

  • Kim, Choong Hyeon;Cheon, Ji Seon;Choi, Woo Young;Son, Kyung Min
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.41-47
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    • 2018
  • Background: The number of surgical risks recalled by a patient after surgery can be used as a parameter for assessing how well the patient has understood the informed consent process. No study has investigated the usefulness of a self-developed mobile application in the traditional informed consent process in patients with a nasal bone fracture. This study aimed to investigate whether delivery of information, such as surgical risks, through a mobile application is more effective than delivery of information through only verbal means and a paper. Methods: This prospective, randomized study included 60 patients with a nasal bone fracture. The experimental group (n=30) received preoperative explanation with the traditional informed consent process in addition to a mobile application, while the control group (n=30) received preoperative explanation with only the traditional informed consent process. Four weeks after surgery, the number of recalled surgical risks was compared for analysis. The following six surgical risks were explained: pain, bleeding, nasal deformity, numbness, nasal obstruction, and nasal cartilage necrosis. Results: The mean number of recalled surgical risks among all patients was $1.58{\pm}0.56$. The most frequently recalled surgical risk was nasal deformity in both groups. The mean number of recalled surgical risks was $1.72{\pm}0.52$ in the experimental group and $1.49{\pm}0.57$ in the control group. There was a significant association between mobile application use and the mean number of recalled surgical risks (p=0.047). Age, sex, and the level of education were not significantly associated with the mean number of recalled surgical risks. Conclusion: This study found that a mobile application could contribute to the efficient delivery of information during the informed consent process. With further improvement, it could be used in other plastic surgeries and other surgeries, and such an application can potentially be used for explaining risks as well as delivering other types of information.

Effect and Prognosis of Combined Essential Oil Inhalation and He-Ne Laser Treatment of Nasal Diseases (비강질환에 대한 향기흡입과 He-Ne 레이저 병행 치료의 효과 및 예후)

  • Jeong, Sun-Hee;Lee, Seung-Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.2
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    • pp.149-160
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    • 2003
  • Objective : Essential oil inhalation and He-Ne laser treatment has become increasingly available in children with nasal diseases. But the reports on the effect and prognosis have been poor. In this study, we analyzed the treatment effect, recurrence rate and the degree of recurrent symptoms. Materials/Methods: 23 children(2-10 year-old) with nasal diseases, who received essential oil inhalation with He-Ne laser treatment at least 10 times in our hospital from January 1st 2001 to December 31th 2002 were studied. Result : Ten cases are male & thirteen cases are female. The average of age was 4.91 year-old. The most frequency symptoms are nasal discharge (82.6%), nasal obstruction (78.3%), cough (47.8%), secretion sound (39.1%), sneezing (17.4%). Average numbers of treatment period, interval and treatment times are 71.79 days, 4.06 days, 18.13 times respectively. Of the 23 children, 14 children were in 'all symptom improved' at the remedial ends, and 22 children relapsed. In the degree of recurrent symptoms, 15 children were in 'more improved then before-treatment and not equal to directly remedial ends'. No case was in 'worse than before-treatment'. The final result of treatment, 6 children keep the degree of remedial ends, on the other hand 17 children are not. Conclusions : Even though, the recurrence rate was high, this combined treatment improve nasal symptoms. The final assessment is good, when the treatment-result is good, when the treatment interval is regular and when parent's are cooperative. If the symptoms continue a whole year, the result is not so good.

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Staged Bilateral Nasal Alar Reconstruction with Free Vascularized Helical Root Flaps, Case Report (이개기시부 유리피판을 이용한 단계적 양측 콧방울의 재건례)

  • Woo, Kyong Je;Lim, So Young;Pyon, Jai Kyong;Mun, Goo Hyun;Bang, Sa Ik;Oh, Kap Sung
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.788-791
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    • 2009
  • Purpose: Reconstruction of full - thickness defects of the nasal ala has always been a challenge. Local flaps can be used easily, and good result can be achieved when it is indicated. But local flaps often result in facial scars and bulky ala that require secondary revisions. Composite auricular chondrocutaneous graft may matches nasal alae well in terms of contour, color and texture, however, the size of composite graft is limited. We performed free vascularized helical root flaps for reconstruction of nasal ala. Methods: Bilateral ala were excised and the defects were reconstructed with a chondrocutaneous free helical root flap. Each side of ala was reconstructed in 3 months interval. Superficial temporal vessels of vascularized helical root flap were anastomosed to facial vessels. Great saphenous vein was used for interpositional vascular graft. Results: Flaps were survived successfully. The contour, texture and color match were satisfactory. Functional problem of nasal obstruction caused by scar stenosis of nostrils was also resolved. Conclusion: The free vascularized helical root flap is a reliable method in reconstruction of nasal alar defects. The donor deformity was minimal.

Fixation of Nasal Bone Fracture with Carved Merocel® (Carved Merocel®을 이용한 비골골절의 고정)

  • Kong, Jung Sik;Jung, Jae A;Kang, So Ra;Kim, Yang Woo;Jeon, Young Woo
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.93-96
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    • 2011
  • Purpose: In most cases of nasal bone fracture, closed reduction with internal or external splint fixation approach is selected. However, because of indiscriminate insertion of the internal splint without considering of anatomical difference or deformity, insufficient fixation happens frequently that need additional fixation. Therefore, we suggest a new method for providing adequate support in reduced nasal bone by carving $Merocel^{(R)}$ that is fixed for the anatomical structure. Method: Closed reduction and internal fixation with carved $Merocel^{(R)}$ was performed in 15 nasal bone fracture patients from March, 2010 to July, 2010. Each patient was evaluated by physical examination, facial photographic check, simple X-ray, and computerized tomography. On the first day post-operation, location of packing and amount of reduction were checked by follow up X-ray and computerized tomography. In addition, patients' symptoms were evaluated. During the 3-month post-op follow up at out-patient clinic, operator, 2 doctors in training and one assistant performed the objective evaluations by physical examination on nasal dorsal hump, nasal deviation, nasal depression, nasal breath difficulty, and nasal airway obstruction. A survey of subjective patients' satisfaction in 4-stages was also performed. Results: The results of follow-up computerized tomography of the 15 patients revealed that 11 patients had good reduced state. Three patients with combined maxillary frontal process fracture had over reductions. A survey performed on the first day post-operation showed that 14 of 15 patients answered that their current symptoms were more than tolerable. At the 3-month follow-up physical exam, one case had a dorsal hump. However, there were no nasal deviations, nasal depressions, nasal breath difficulties, or nasal airway obstructions. Twelve of the 15 patients answered more than moderate on the 3-month survey. Conclusion: Intranasal packing after carving the $Merocel^{(R)}$ considering anatomical structure is a new effective method to promote proper-reduction, maintain stability, and minimize patients' symptoms by addition of a simple procedure.

Clinical Analysis of the Nasal Bone Fracture (비골골절에 대한 임상적 분석)

  • Lim, Kwang-Ryeol;Kim, Hong-Il;Ahn, Sung-Min;Hwang, So-Min;Jung, Yong-Hui;Song, Jennifer K.
    • Archives of Craniofacial Surgery
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    • v.12 no.2
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    • pp.81-85
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    • 2011
  • Purpose: Nasal bone fracture is the most common facial fracture. Although nasal bone fractures are considered to be minor injuries, the incidence of post-traumatic nasal deformity remains high. This study is designed to support management and patient satisfaction by classifying the simple nasal bone fracture, and survey the care method and result, which is compared with other studies. Methods: From May 2008 to April 2010, 334 patients with simple nasal bone fractures visited our hospital. The incidence, cause, types of nasal bone fracture, treatment, and complications are analyzed according to clinical examination, patient's record and radiographic images. Results: The mean age of patients was 30 years old, with 74% of the patients having been male, and 26% were female. The highest incidence of this fracture was between late teens to late twenties. The causes of nasal bone fracture were the following: having slipped or fallen down (39%), violence (16%), sports accident (14%), traffic accident (11%), industrial accident (6%), and others (16%). Patient's radiographic images were analyzed by Stranc and Robertson classification, frontal impact plane I was 38%, plane II was 16%, plane III was 1%, lateral impact plane I was 21%, plane II was 21%, and plane III was 3%. On average, surgical treatment was performed 7.2 days after trauma under general anesthesia. Closed reduction of nasal bone fracture was performed in 99% of patients. In patients with septal injuries, septal management was performed in 76.7% of cases. Aesthetic surgery was done on same time in 24% of patients. There were some complications, such as residual nasal deformity (7.2%), nasal obstruction (0.9%) and hyposmia (0.3%). Conclusion: According to this study, nasal bone fractures occurred commonly in physically active age groups (age 15~29 years), as a result of having slipped or fallen down, at afternoon and at night time. And it could be treated successfully by closed reduction and septoplasty by 7 days after trauma.