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Storck K, Eufinger J, Kotz S, Classen C, Ritschl LM. Measurement of Nasal Contour Landmarks in Septorhinoplasties with Special Regard to the Course of Postoperative Swelling Using a Three-Dimensional Camera. Life (Basel) 2024; 14:813. [PMID: 39063568 PMCID: PMC11278402 DOI: 10.3390/life14070813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/29/2024] [Accepted: 06/20/2024] [Indexed: 07/28/2024] Open
Abstract
The integration of three-dimensional (3D) cameras into clinical practice for pre-operative planning and post-operative monitoring of rhinoplasties remains controversial. However, this technology offers the advantage of capturing the 3D surface without exposing patients to potentially harmful radiation. Continuous assessment allows the follow-up of swelling patterns, cartilage alignment, and bone remodeling. The primary objective of our study was to quantify changes in nasal structure before and after rhinoplasty by using 3D photography. Our study cohort consisted of 29 patients who underwent open structural rhinoplasty. We used the Artec Space Spider camera to acquire a total of 103 3D images. We collected pre-operative and at least two or three post-operative follow-up scans, which were taken one, three, and six months after surgery. We evaluated paired scans that included various time intervals to improve our understanding of swelling behavior and to ensure an objective analysis of changes. Eleven specific anatomical landmarks were identified for measurement. Two independent raters determined the distances between these landmarks over time. The calculation of intraclass correlation coefficients showed low inter-rater variability. Statistically significant changes over time (p < 0.05) were observed for various anatomical landmarks, including soft tissue nasion, soft tissue orbitale right, soft tissue maxillofrontale left, soft tissue maxillofrontale right, nasal bridge, and nasal break point. Conversely, no significant changes (p > 0.05) were observed in the measurements of soft tissue orbitale left, pronasale, subnasale, alare right, or alare left. A visual assessment was conducted using surface distance maps. The results indicate that the complete decrease in swelling takes at least 6 months or even longer. Additionally, 3D photography can provide an objectively comparable analysis of the face and external contours. Furthermore, it allows for a comparison of external contours and therefore pre- and post-operative differences.
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Affiliation(s)
- Katharina Storck
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University Munich, 81675 Munich, Germany; (K.S.); (S.K.)
| | - Julia Eufinger
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University Munich, 81675 Munich, Germany; (K.S.); (S.K.)
| | - Sebastian Kotz
- Department of Otolaryngology, Head and Neck Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University Munich, 81675 Munich, Germany; (K.S.); (S.K.)
| | - Carolina Classen
- Department of Oral and Maxillofacial Surgery, School of Medicine, University of Saarland, Homburg/Saar, 66421 Homburg, Germany;
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University Munich, 80333 Munich, Germany;
| | - Lucas M. Ritschl
- Department of Oral and Maxillofacial Surgery, Klinikum Rechts der Isar, School of Medicine and Health, Technical University Munich, 80333 Munich, Germany;
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Agarwal SS, Datana S, Sahoo NK, Bhandari SK. Correlating Nasal Patency with Obstructive Sleep Apnea in Obese Versus Non-Obese Patients: An Acoustic Rhinometry Study. Indian J Otolaryngol Head Neck Surg 2022; 74:1483-1491. [PMID: 36452587 PMCID: PMC9701976 DOI: 10.1007/s12070-021-02623-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/10/2021] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to correlate nasal patency with Obstructive Sleep Apnea (OSA) in obese versus non-obese patients using Acoustic Rhinometry (AR). Eccovision® Acoustic Rhinometer equipment was used to compare nasal cross-sectional areas (CSA1,2 & 3 corresponding to nasal valve region, anterior portion of middle & inferior turbinate and posterior portion of middle & inferior turbinate respectively) and volume in age and gender matched sample divided into three groups: Group 1: Non-obese patients without OSA (25 patients, 13 males and 12 females); Group 2: Non-obese patients with OSA (25 patients, 14 males and 11 females); Group 3: Obese patients with OSA (25 patients, 13 males and 12 females). The mean nasal cross-sectional areas and volume were lower in Group 2 compared to Group 1 but statistically non-significant (P value > 0.05 for all). The mean nasal cross-sectional areas and volume were significantly lower in Group 3 as compared to Groups 1 and 2 (P value < 0.05 for all). BMI showed a statistically significant positive (direct) correlation with AHI in Groups 2 and 3 (P value < 0.05 for both). The nasal cross-sectional areas and volume showed a statistically significant negative (inverse) correlation with AHI in Groups 2 and 3 (P value < 0.05 for both). OSA diagnosed cases with high BMI may not present with an obvious nasal obstruction; the nasal patency may still be compromised due to reduced nasal lumen secondary to obesity. AR, being cost-effective and non-invasive modality; is advocated to evaluate pre-treatment nasal patency, as well as follow up evaluation to ascertain improvement after the intervention.
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Affiliation(s)
- Shiv Shankar Agarwal
- Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India
| | - Sanjeev Datana
- Department of Orthodontics and Dentofacial Orthopedics, Armed Forces Medical College, Pune, India
| | - N. K. Sahoo
- Department of Oral and Maxillofcial Surgery, Armed Forces Medical College, Pune, India
| | - S. K. Bhandari
- Department of Oral and Maxillofcial Surgery, Armed Forces Medical College, Pune, India
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Bogdan MS, Slavic DO, Babovic SS, Zvezdin BS, Kolarov VP, Kljajic VL. Olfactory Perception and Different Decongestive Response of the Nasal Mucosa During Menstrual Cycle. Am J Rhinol Allergy 2021; 35:693-699. [PMID: 33496600 DOI: 10.1177/1945892421990308] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Sex hormones are known to have some influence on nasal functions, but their effect on the decongestive response of the nasal mucosa during menstrual cycle is still undetermined. OBJECTIVES The aim of this study was to examine the nasal physiology, the interconnectedness of olfactory and respiratory nasal function and the decongestive response of the nasal mucosa during menstrual cycle. METHODS This study included 101 healthy women aged 23.26 ± 4.81 years with a regular menstrual cycle. The nasal respiratory function and the decongestive response of the nasal mucosa were examined by rhinomanometry. Subjective sense of nasal obstruction and the subjective odor intensity were assessed by standardized questionnaires. The odor identification ability was assessed by Sniffin' Sticks test. RESULTS Statistically significant higher values of nasal resistance (0.311 ± 0.107 Pa/cm3/s) and NOSE score (11.893 ± 13.83) were observed in the ovulatory phase compared to the luteal (0.281 ± 0.084 Pa/cm3/s and 9.029 ± 11.12). An odor identification test score was significantly higher in luteal phase (12.476 ± 1.48) compared to the ovulatory phase (11.971 ± 1.51), opposite of odor intensity. The difference of nasal resistance before and after decongestion was significantly higher in ovulatory phase (0.105 ± 0.097 Pa/cm3/s) compared to the luteal (0.084 ± 0.079 Pa/cm3/s). Correlation between subjective and objective parameters of the examinated nasal functions was not statistically significant in any menstrual phase. CONCLUSION In the population of women studied, total nasal resistance and NOSE score were significantly lower in the luteal phase of the menstrual cycle. Odor identification was significantly higher in the luteal phase but odor intensity significantly higher in the ovulatory phase. The decongestive response of nasal mucosa was better in the ovulatory phase of the menstrual cycle.
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Affiliation(s)
- Maja S Bogdan
- The Clinic for Obstructive Pulmonary Diseases and Acute Pneumopathies, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
| | | | | | - Biljana S Zvezdin
- The Clinic for Obstructive Pulmonary Diseases and Acute Pneumopathies, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia.,Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Violeta P Kolarov
- The Clinic for Obstructive Pulmonary Diseases and Acute Pneumopathies, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia.,Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
| | - Vladimir L Kljajic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.,Clinical Centre of Vojvodina, Clinic for Otorhinolaryngology and Head and Neck Surgery, Novi Sad, Serbia
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Rodrigues MM, Carvalho PHDA, Gabrielli MFR, Lopes RN, Garcia Junior OA, Pereira Filho VA, Passeri LA. How obesity affects nasal function in obstructive sleep apnea: anatomic and volumetric parameters. Braz J Otorhinolaryngol 2020; 88:296-302. [PMID: 32782124 PMCID: PMC9422712 DOI: 10.1016/j.bjorl.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/29/2020] [Accepted: 06/07/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction Obstructive sleep apnea is a consequence of upper airway collapse. Any obstructive sector in the upper airway can contribute to pharyngeal collapse. Obesity and obesity-related disorders play an important role in obstructive sleep apnea and its relationship with increased upper airway resistance. Objective This study was designed to evaluate the relationship between obesity and properties of the nasal cavity in patients with obstructive sleep apnea. Methods The study was conducted retrospectively by review of medical records of adult patients. The nasal obstruction symptom evaluation, NOSE instrument, was used to measure nasal obstruction. Sleep breathing disorders were evaluated by polysomnography exams. Nasal volume was obtained by computed tomography scans and volumetric reconstruction of nasal airway. Nasal anatomic alterations were assessed by nasal endoscopy. Results Analysis of 83 patient records, among whom 54 were male and 29 females, found the mean body mass index of 28.69 kg/m2. Obese and non-obese groups were determined by using cut-off 30 kg/m2. In the comparison between groups, the obese group had a positive and significant correlation with apnea/hypopnea index (p = 0.02), NOSE instrument (p = 0.033) and inferior turbinate hypertrophy (p = 0.036), with odds ratio 1.983 (95% IC 1.048 − 3.753). nasal septum deviation (p = 0.126) and nasal airway volume evaluation (p = 0.177) showed no significant results. Conclusion Obesity was significantly correlated with subjective nasal obstruction, NOSE scale, and inferior turbinate hypertrophy in patients with obstructive sleep apnea. There was no correlation with the nasal volume evaluation. Level of Evidence 3b - Individual case-control study.
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Affiliation(s)
- Marcos Marques Rodrigues
- Universidade de Araraquara (Uniara), Faculdade de Medicina, Divisão de Otorrinolaringologia, Araraquara, SP, Brazil
| | - Pedro Henrique de Azambuja Carvalho
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Araraquara, SP, Brazil.
| | - Mário Francisco Real Gabrielli
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Divisão de Cirurgia Oral e Maxilofacial, Araraquara, SP, Brazil
| | - Ricardo Nasser Lopes
- Universidade de Araraquara (Uniara), Faculdade de Medicina, Divisão de Otorrinolaringologia, Araraquara, SP, Brazil
| | | | - Valfrido Antonio Pereira Filho
- Universidade Estadual de São Paulo (UNESP), Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Divisão de Cirurgia Oral e Maxilofacial, Araraquara, SP, Brazil
| | - Luis Augusto Passeri
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Cirurgia, São Paulo, SP, Brasil
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Rodrigues MM, Gabrielli MFR, Garcia Junior OA, Pereira Filho VA, Passeri LA. Nasal airway evaluation in obstructive sleep apnoea patients: volumetric tomography and endoscopic findings. Int J Oral Maxillofac Surg 2017. [PMID: 28623043 DOI: 10.1016/j.ijom.2017.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Obstructive sleep apnoea (OSA) results from the recurrent collapse of the upper airway during sleep. Nasal abnormalities influence the stability of the pharynx. The aim of this study was to evaluate the volumetric and anatomical changes of the nasal cavity in patients with OSA. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to grade nasal obstruction. Sleep-related breathing disorders were evaluated by polysomnography. The nasal airway volume was obtained from computed tomography scans through volumetric reconstruction of the nasal airway. Alterations to the nasal anatomy were identified by nasal fibre-optic endoscopy. Ninety-four patient charts were analyzed. The final sample comprised 32 patients with severe OSA, 16 with moderate OSA, 23 with mild OSA, and 20 without OSA. Three groups were established based on nasal obstruction and OSA. The groups were compared for nasal airway volume (P=0.464) and body mass index (P=0.001). The presence of nasal septum deviation and inferior turbinate hypertrophy were related to the NOSE score (P=0.05 for both), apnoea-hypopnoea index (P=0.03 and P=0.05, respectively), and nasal airway volume (P=0.71 and P=0.78, respectively). In this nasal airway evaluation of OSA patients, the presence of sites of obstruction was correlated with the severity of OSA; this was not the case for the evaluation of the nasal airway volume dimensions.
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Affiliation(s)
- M M Rodrigues
- Otolaryngology Division, Medical School, University of Araraquara - UNIARA, Araraquara, SP, Brazil
| | - M F R Gabrielli
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dental School at Araraquara - UNESP, Araraquara, SP, Brazil
| | - O A Garcia Junior
- Graduate Programme, Medical School, University of Araraquara - UNIARA, Araraquara, SP, Brazil
| | - V A Pereira Filho
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dental School at Araraquara - UNESP, Araraquara, SP, Brazil
| | - L A Passeri
- Oral and Maxillofacial Surgery, Department of Surgery, School of Medical Sciences - UNICAMP, Campinas, SP, Brazil.
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