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Ashour MM, Abdelaziz TT, Mahmoud MS, Askoura A, Abuelela SA, Saleh MI, Ashour DM. Nasal Septum Deviation in Patients with Acute Invasive Fungal Rhinosinusitis in a Tertiary Care Hospital: A Cross-Sectional Study. Indian J Otolaryngol Head Neck Surg 2024; 76:2987-2994. [PMID: 39130263 PMCID: PMC11306849 DOI: 10.1007/s12070-023-04438-1] [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: 11/07/2023] [Accepted: 12/04/2023] [Indexed: 08/13/2024] Open
Abstract
This is a retrospective study exploring the demographics and the role of nasal septum deviation in acute invasive fungal rhinosinusitis (AIFS); and if this deviation contributes to the laterality predilection of this opportunistic infection. Fifty-six craniofacial CT scans were evaluated by two radiologists blinded to the clinical data and outcome for laterality of the disease; and nasal septal deviation (NSD). NSD was graded based on the measured septal angle of deviation into mild, moderate, and severe and furtherly classified into one of seven types based on Mladina's classification. High prevalence of remarkable nasal septum deviation existed in our population with AIFS, with type 7 Mldina NSD represented the most prevalent in this population. We found no significant statistical relation between the side of deviation and the initial side of the fungal disease. We recommend screening for early manifestations of AIFS in similar debilitated patients; with high degrees of nasal septum deviation for considering it as an anatomical risk factor.
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Affiliation(s)
- Manar M. Ashour
- Department of Diagnostic Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Tougan T. Abdelaziz
- Department of Diagnostic Radiology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohammad S. Mahmoud
- Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Anas Askoura
- Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Soha A. Abuelela
- Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed I. Saleh
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Doaa M. Ashour
- Department of Ophthalmology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Kapıcı OB, Abuş S, Ayhan S, Koparal M, Kaya H. Comparison of frontal QRS-T angle of patients with nasal septal deviation with healthy controls. BMC Cardiovasc Disord 2023; 23:415. [PMID: 37612611 PMCID: PMC10464060 DOI: 10.1186/s12872-023-03421-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/30/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND This study compares frontal QRS-T angle (fQRS-T) in electrocardiogram (ECG) examinations of people with nasal septal deviation (NSD) with healthy controls (HC). METHODS Eighty-two patients whom a radiologist with paranasal computed tomography definitively diagnosed with NSD were included in the study. 101 individuals without NSD were selected as HC. RESULTS Compared to the HC group, the fQRS-T in was considerably wider in patients with NSD (p < .001). According to Spearman correlation analysis, fQRS-T and NSD angle, and platelet lymphocyte ratio (PLR) were significantly correlated (p = .021, p < .001, and p = .003, respectively). In linear regression analysis where the fQRS-T was taken as a dependent variable, NSD angle and PLR predicted the fQRS-T significantly and positively (F(5.76) = 8.451, R2 = 0.357, Adjusted R2 = 0.315 and p < .001). CONCLUSION In this study, fQRS-T was significantly higher in patients with NSD. In future studies, fQRS-T can be compared before and after septoplasty in NSD patients.
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Affiliation(s)
- Olga Bayar Kapıcı
- Department of Radiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey.
| | - Sabri Abuş
- Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Selçuk Ayhan
- Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Mehtap Koparal
- Department of Otorhinolaryngology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
| | - Hakan Kaya
- Department of Cardiology, Adiyaman University Education and Research Hospital, Adiyaman, Turkey
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Susaman N, Çetiner H. Is septoplasty required whenever anterior septal deviation is present? J Laryngol Otol 2023; 137:404-407. [PMID: 35730214 DOI: 10.1017/s0022215122001505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Post-operative success and patient satisfaction were assessed following septoplasty for mild to severe anterior septal deviation. METHODS The study included patients with an anterior nasal septal deviation in the form of a 'C' shape and close to the nasal valve in the anterior septal area. Deviation severity was classified as severe (group 1), moderate (group 2) or mild (group 3). Open or closed septoplasty procedures were performed. All patients were surveyed twice using the Nasal Obstruction Symptom Evaluation scale and the 36-Item Short Form Health Survey. RESULTS The mean Nasal Obstruction Symptom Evaluation score for group 1 was 15.58 ± 2.34 prior to surgery and 6.61 ± 3.29 following surgery. The corresponding pre- and post-surgery scores in group 2 were 11.9 ± 2.82 and 6.3 ± 3.03, respectively. In group 3, these values were 8.28 ± 2.63 and 7.12 ± 3.18, respectively. The mean 36-Item Short Form Health Survey physical function value for groups 1 and 2 increased after surgery; in group 3, this value decreased after surgery, but the result was not statistically significant. CONCLUSION Septoplasty is very successful for treating moderate or advanced deviations, but great care should be taken when employing septoplasty for mild deviations.
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Affiliation(s)
- N Susaman
- Department of Otolaryngology, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
| | - H Çetiner
- Department of Otolaryngology, Elazığ Fethi Sekin City Hospital, Elazığ, Turkey
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Sunnychan S, Deshmukh P. Association Between Anterior Rhinoscopic/Endoscopic Assessment of Internal Nasal Valve and Various Nasal Deformities in the Rural Population of Vidarbha Region of India: A Cross-Sectional Study. Cureus 2023; 15:e35682. [PMID: 37012943 PMCID: PMC10066658 DOI: 10.7759/cureus.35682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
Background The nasal valves constitute the majority of the nasal cavity's resistance. Any reduction in this already narrow area can cause a significant reduction in the nasal airflow. In this present study, the aim was to do an endoscopic assessment of the internal nasal valve (INV) in patients with various nasal septal deviations, with or without external nasal deformity. We measured endoscopically the INV in various nasal deformities and derived its association with the INV on anterior rhinoscopy and endoscopic assessment. Method We included 75 patients in the study who were analyzed for angle and grade of the INV by anterior rhinoscopic examination and Hopkins rod zero-degree nasal endoscope (Karl Storz SE & Co., Tuttlingen, Germany). Nasal septal deviations were also studied with respect to the Mladina classification. Correlation between various nasal septal deviations with the INV was done. Since studies addressing the classification of INV are not available in the literature, for the purpose of simplification of observation of INV angle, (normal range 9-15 degrees), subjective stratification was made in the study, i.e. below 9, 9-15, and more than 15 degrees for the sake of knowing the underlying cause and its relationship. Result An anterior rhinoscopic examination was performed on 75 patients. INV Grade 1 was the most common, with 18 patients of (69.2%), 15 patients of DNS with caudal dislocation (55.6%), five patients of DNS with spur (38.5%), and four patients of DNS with external nasal deformity (50%). The next frequently observed Grade of INV on anterior rhinoscopy examination was Grade 2, in 11 patients of DNS with caudal dislocation (40.7%), four patients of DNS with spur (30.8%), and three patients of DNS with external deformity (37.5%), which was statistically significant in our study. In the majority of patients with all types of nasal septal deviations with or without external nasal deformity, INV (angle) of less than 9 degrees was noted, which was statistically significant. A linear relationship, ie., Grade 0 INV in Type I, Grade 1 INV in types II, III, IV, and V, and Grade 2 in Type VII was observed. Our study is on par with the literature questioning the dogma of the normal angle of INV being 9-15 degrees. Conclusion We were able to establish a positive and complimentary role of anterior rhinoscopic and endoscopic assessment of INV. The proposed novel classification of the angle of INV by endoscopic assessment gives a better insight into the association of INV with various nasal septal deformities with or without external nasal septal deviation.
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Outcome of Continuous Positive Airway Pressure Adherence Based on Nasal Endoscopy and the Measurement of Nasal Patency-A Prospective Study. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010219. [PMID: 36676168 PMCID: PMC9867109 DOI: 10.3390/life13010219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/15/2023]
Abstract
The gold standard for treating obstructive sleep apnea in adults is continuous positive airway pressure (CPAP). However, it can be difficult to convince patients to adhere to this therapy. The aim of this study was to determine the relationship between nasal endoscopy findings/nose patency and CPAP adherence. Material and methods: A cohort of 450 consecutive patients suspected of having OSA were prospectively enrolled. For further analyses, 47 OSA patients undergoing CPAP treatment were selected (13 females and 34 males, average age, 65.3 years, BMI 34.1, apnea-hypopnea index. AHI 51.0). The patients were divided into two groups: patients with good CPAP adherence (n = 35) and patients who did not adhere to CPAP therapy (n = 12). The influence of nasal endoscopy and flow measurement on CPAP adherence was explored. Results: We found a statistical independence between adherence to CPAP and AHI (p = 0.124), T90 (p = 0.502), endoscopic findings (p = 0.588) and nasal patency measured by a flowmeter (p = 0.498). Conclusions: In our studied sample, endoscopic findings and nasal patency measured by a flowmeter were not predictors of CPAP non-adherence in the first year of the treatment. Our data show that while an endoscopic finding in the nasal cavity could indicate that a patient has a severe obstruction, compliance with CPAP therapy is not reduced in these patients and neither is it reduced with a decrease in nasal flow, according to our observation.
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An Evaluation of Health-Related Quality of Life in Children with Nasal Septum Deviation. CHILDREN 2022; 9:children9111714. [DOI: 10.3390/children9111714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/05/2022] [Accepted: 11/08/2022] [Indexed: 11/10/2022]
Abstract
Background: From the 1950s, the quality of life criterion came to be studied in earnest, originally forming a part of measurement of human development in Western Europe and the USA. The present study aims to compare the health-related quality of life (HRQL) between children with nasal septum deviation and healthy children controls. Materials and Methods: Subjects were children suffering from nasal septum deviation, one of the commonest chronic diseases of the upper respiratory tract. Controls were randomly recruited from kindergarten, primary and secondary schools (junior high school & high school). All schools and subjects were randomly selected. The CHQ-PF50 questionnaire was used and outcome scores were calculated by an algorithm for the 13 tested HRQL variables. Results: Means for all outcome scores in the test subjects (i.e., children with deviated nasal septums) varied between 3.65–89.27 with a standard deviation between 0.83–25.66 and a median between 3.4–100 (n = 101). Those for the controls (n = 102) were 3.78–97.11, 0.86–14.21 and 4.40–100, respectively. Test subjects showed significant scoring declines in Physical Fitness, Role/Social–Emotional/Behavioral, Role/Social–Physical, Mental Health, Self-esteem, General Health Perceptions, Parental Impact Emotional and Time and Family Limitations in Activities. Conclusions: 1. The well-being of children with nasal septum deviation was found to be chiefly limited by their physical fitness, effects of physical condition on social behavior/interaction and how health is perceived. 2. Parents considered their children’s health to be paramount, as demonstrated by assessing the HRQL.
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Singh A, Garg LN, Singh G, Singh A, Puri A. To Assess the Effect of Septoplasty on Pulmonary Function Tests: A Prospective Study. Indian J Otolaryngol Head Neck Surg 2022; 74:967-971. [PMID: 36452585 PMCID: PMC9702185 DOI: 10.1007/s12070-020-02041-2] [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: 06/15/2020] [Accepted: 08/08/2020] [Indexed: 11/30/2022] Open
Abstract
To assess the effect of septoplasty on pulmonary function test (PFT). 50 cases were chosen between the age group 18-50. All cases had nasal obstruction due to nasal septum deviation. Demographic data, detailed clinical examination including anterior and posterior rhinoscopy was performed. PFT values (fvc, fev1, fev1/fvc, fef25%, fef50%, fef75%, fif25%, fif50%, fif75%) were taken pre operatively and 1 month after the surgery by using Helios 401 spirometer. All the data were recorded and spss version 20.0 was used to analyse the data. Among 50 patient, most of the patients were males 78% (n = 39) and the rest were females (n = 11) 22%. The patient were in between 18 and 50 age group. The maximum patient belonged to age group 18-27 years (n = 25) 50% of the total patients. 38% (n = 19) were in the age group of 27-37 years. 12% (n = 6) of the patients were in age group of 37-50. Nasal obstruction was present in all patients (n = 50) followed by sneezing (56%), nasal discharge (42%), and headache (26%). Maximum number of patient had deviation of septum to the left (n = 28) 56% and the rest had to the right (n = 22) 44%. After the surgery there was improvement in PFT values in all types of patient with DNS, but statistical significance was seen in type II in fef25% and fif75% values (p < 0.05). In rest of the patients there was no statistical significant improvement seen. A favorable outcome was seen in PFT values after Septoplasty, thus signifying the effect of deviated nasal septum on lower airway.
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Affiliation(s)
- Anshul Singh
- Department of E.N.T, Maharishi Markandeshwar (Deemed to be) University, Mullana, India
| | - Lakshmi Narayan Garg
- Department of E.N.T, Maharishi Markandeshwar (Deemed to be) University, Mullana, India
| | - Gurchand Singh
- Department of E.N.T, Maharishi Markandeshwar (Deemed to be) University, Mullana, India
| | - Anukrati Singh
- Department of Obstetrics and Gynaecology, Teerthanker Mahaveer University, Moradabad, India
| | - Anisha Puri
- Department of Anaesthesia, Maharishi Markandeshwar (Deemed to be) University, Mullana, India
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Sabry O, Dewidar H, Aziz MA, Elemam A, Nassar A. Efficiency of modified Goldman’s technique in open pediatric septoplasty. THE EGYPTIAN JOURNAL OF OTOLARYNGOLOGY 2021. [DOI: https://doi.org/10.1186/s43163-021-00074-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background
Performing nasal surgery on children has been the subject of controversy among surgeons. Specifically, the indications for and timing of septoplasty in children have been debated for the last several decades.
In this study, we access the efficacy of the modified Goldman’s technique in dealing with caudal septal deviation in pediatric population suffering from severe nasal obstruction and its effect on nasal functions postoperatively.
In this study, 30 pediatric patients suffering from deviated nasal septum who are candidate for septoplasty were included and underwent open septoplasty using modified Goldman’s technique.
They were subjected to detailed assessment protocol preoperatively including NOSE scale, anterior rhinomanometry, and CT scans. Follow-up assessment was done at second week postoperative including anterior rhinoscopy and nasal endoscopy and 3 months postoperative including NOSE scale and anterior rhinomanometry.
Results
There was a statistically significant decrease of the NOSE scale severity to none in 90% of cases. Three months postoperative, all of the patients performed postoperative anterior active rhinomanometry with statistically significant decrease in the postoperative total nasal resistance values with inspiratory values ranging from 0.1 to 0.5 Pa/cm3/s with mean of 0.26 Pa/cm3/s and expiratory nasal resistance values ranging from 0.1 to 0.6 Pa/cm3/s with mean of 0.31 Pa/cm3/s.
Conclusions
Open septoplasty in children using the modified Goldman’s technique has enabled accurate and conservative approach for correction of nasal septal deviation especially those located in the caudal septal region. The technique also offers a significant reduction of the nasal symptoms postoperatively with marked improvement of the nasal resistance and quality of life in severe cases of deviated nasal septum.
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Zheng HD, Mecham JC, Abdel-Aty Y, Lal D, Marino MJ. Microbiology, Histopathology, and Radiographic Findings in Silent Sinus Syndrome. Am J Rhinol Allergy 2021; 35:685-692. [PMID: 33463370 DOI: 10.1177/1945892421989161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The histopathology and microbiology associated with silent sinus syndrome (SSS) have not been well described. OBJECTIVE This study details the histopathological and microbiological characteristics in addition to radiographic findings of SSS in comparison to those of chronic maxillary sinusitis (CRS). METHODS 42 patients diagnosed with SSS at Mayo Clinic Hospital in Arizona were identified. Paranasal computed tomography scans of the 42 SSS patients as well as 42 matched CRS patients were analyzed in order to assess differences in the prevalence of septal spurs/deviation. 20 of the SSS patients and 19 of the matched CRS patients also had histopathology and microbiology reports, which were compiled and summarized. Additionally, 19 SSS and 19 matched CRS patients were contacted via phone survey for a more complete patient history regarding maxillary dental disease/surgery. RESULTS SSS patients have a significantly higher prevalence of septal spurs/deviation than CRS patients. The microbiomes of SSS patients more closely resemble those of healthy controls than those of CRS patients. Analysis of the histopathology of SSS reveals chronic, non-specific inflammation similar to that seen in non-eosinophilic CRS without polyps. SSS patients were significantly more likely to have a history of maxillary dental disease requiring surgery. CONCLUSION These data support the hypothesis that the pathogenesis of SSS is more likely due to anatomical/mechanical factors than inflammatory/microbiological factors.
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Affiliation(s)
- Henry D Zheng
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona
| | - Jeffrey C Mecham
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, Arizona
| | - Yassmeen Abdel-Aty
- Department of Otorhinolaryngology/Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona
| | - Devyani Lal
- Department of Otorhinolaryngology/Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona
| | - Michael J Marino
- Department of Otorhinolaryngology/Head and Neck Surgery, Mayo Clinic, Phoenix, Arizona
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Comparison of nasal functional outcomes of let down rhinoplasty and open technical rhinoplasty using spreader graft. Eur Arch Otorhinolaryngol 2020; 278:371-377. [PMID: 32789709 DOI: 10.1007/s00405-020-06270-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/03/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to compare open technique rhinoplasty with spreader graft and Let Down rhinoplasty using Nasal Symptom Obstruction Evaluation (NOSE), Sinonasal Outcome Test-22 (SNOT-22), and Visual Analog Scale (VAS). MATERIALS AND METHODS A total of 50 patients were included in the study. Patients with a hump greater than 4 mm and mild septal deviation participated in the study. The patients were divided into two groups. Group 1 consisted of 26 patients who underwent Let Down rhinoplasty, while Group 2 consisted of 24 patients who underwent open rhinoplasty with spreader graft. NOSE, SNOT-22, and VAS scales were completed by both groups preoperatively and postoperatively. RESULTS There was no significant difference between the groups in terms of age and gender. Postoperative values of scales were significantly lower than preoperative values in Group 1 (p < 0.001). In Group 2, postoperative values were significantly lower than preoperative values (p < 0.001). There was no significant difference between the two groups according to NOSE, SNOT-22 and VAS scores. CONCLUSION According to the comparison of scale scores, both Let Down rhinoplasty and open technique rhinoplasty using spreader graft improved nasal functional results such as nasal obstruction.
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Arsov B, Antunovic R, Kovac Bilic L, Hodzic Redzic S, Bilic M. Morphological, anatomical, radiological and clinical features of Mladina type 6 nasal septum deformations in humans. Eur Arch Otorhinolaryngol 2020; 277:3375-3380. [PMID: 32749605 DOI: 10.1007/s00405-020-06215-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/14/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE The objective of this study was to prove the higher frequency of the type 6 deformations overall compared to the results obtained by conventional diagnostic methods, such as computed tomography images and clinical examination. METHODS The study was performed at the Institute of Anatomy, where a total of 114 randomly selected skulls were examined. The skulls were then scanned in a fixed position using the cone-beam technique (CBCT). The literature epidemiological data of the clinical incidence of type 6 in studies that also used Mladina classification were obtained. RESULTS There was a statistically significant difference (p < 0.0001) in the frequency of type 6 deformation as diagnosed by visual inspection (22.8%) and computed tomography (7.9%). The frequency obtained by CT imaging amounted 7.9% and was almost the same as the results obtained by a clinical examination which varied between 9 and 11%. CONCLUSIONS The frequency of type 6 nasal septal deformation is higher by visual inspection of the skulls than by computed tomography imaging at a level of significance of 0.05. The incidence of type 6 findings on coronal CT images of paranasal sinuses is approximately the same as that found with anterior rhinoscopy. Type 6, visible or concealed; probably have one-fourth to one-fifth people in population, so the number of clinically overlooked and/or unrecognized types 6 is much greater than we thought it to be.
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Affiliation(s)
- Borna Arsov
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Romano Antunovic
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Lana Kovac Bilic
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Selma Hodzic Redzic
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia
| | - Mario Bilic
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Center Zagreb, Kispaticeva 12, 10000, Zagreb, Croatia.
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何 婷, 邓 刚, 黄 喜, 江 远, 师 洪. [The clinic research of septoplasty according to different types of nasal septal deviation]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2020; 34:706-709. [PMID: 32842202 PMCID: PMC10127915 DOI: 10.13201/j.issn.2096-7993.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Indexed: 11/12/2022]
Abstract
Objective:To divide the deviation parts of nasal septal into different deviation units,and then classify them according to the the deviation units through nasal endoscope, and carry out individual septoplasty for the deviation types. Method:One hundred and twenty patients having operation indication with different types of nasal septal deviation according to the standard designed by the researchers were included. All included patients underwent individual septoplasty. Result:All included patients, symptoms of nasal obstruction had different degree of improvements after the individual surgery according to the different types of nasal septal deviation. Conclusion: Using the classification of nasal septal deviation based on the deviation units, physicians can implement individual septoplasty for patients, which has great guidance to clinical practice. The study has got great results in practice, and deserved extending.
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Affiliation(s)
- 婷 何
- 武汉市第一医院耳鼻咽喉科(武汉,430001)Department of Otolaryngology Head and Neck Surgery, First Hospital of Wuhan, Wuhan, 430001, China
| | - 刚 邓
- 武汉市第一医院耳鼻咽喉科(武汉,430001)Department of Otolaryngology Head and Neck Surgery, First Hospital of Wuhan, Wuhan, 430001, China
| | - 喜 黄
- 武汉市第一医院耳鼻咽喉科(武汉,430001)Department of Otolaryngology Head and Neck Surgery, First Hospital of Wuhan, Wuhan, 430001, China
| | - 远明 江
- 武汉市第一医院耳鼻咽喉科(武汉,430001)Department of Otolaryngology Head and Neck Surgery, First Hospital of Wuhan, Wuhan, 430001, China
| | - 洪 师
- 华中科技大学同济医学院附属协和医院耳鼻咽喉头颈外科Department of Otolaryngology Head and Neck Surgery, the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
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Geometric morphometric contribution to septal deviation analysis. Surg Radiol Anat 2019; 41:823-831. [DOI: 10.1007/s00276-019-02235-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/28/2019] [Indexed: 10/27/2022]
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Gu JT, Kaplan S, Greenfield S, Calloway H, Wong BJF. Validation of a septoplasty deformity grading system for the evaluation of nasal obstruction. Laryngoscope 2018; 129:586-593. [PMID: 30467854 DOI: 10.1002/lary.27365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS We developed and validated a septal deformity grading (SDG) system that accounts for anatomic location and grading of deformity severity. STUDY DESIGN Retrospective cohort study. METHODS Subjects were patients with nasal obstruction presenting to University of California, Irvine Medical Center. Subjects were given pre- and postoperative Nasal Obstruction Symptom Evaluation (NOSE) questionnaires and were evaluated by a facial plastic surgeon using our septal deformity grading (SDG) system. Validity and reliability analyses were conducted on the SDG results. Statistical analyses were conducted on SDG and NOSE data to assess and compare instruments, and to validate the SDG instrument using the NOSE instrument. RESULTS One hundred thirty-five patients met inclusion criteria. Cronbach's α was ≥ 0.7 for SDG and pre- and postoperative NOSE scores. There was a significant difference in pre- and postoperative NOSE scores (Z score = -7.21, P < .001). Correlations between postoperative NOSE and SDG scores were significant (P = .014), and convergent construct validity was achieved. There was a significant difference in SDG scores between primary versus revision operations (P < .001), history versus no history of nasal trauma, and nasal/septal surgery (P = .025, P = .003, respectively). The odds of having a revision operation were 2.3 times higher for high SDG scores (P < .001), of having a history of nasal trauma were 1.33 times higher for high SDG scores (P = .014), and of having a history of nasal/septal surgery were 2.9 times higher for low SDG scores. CONCLUSIONS Our SDG system addresses the challenge of providing objective anatomic information on the severity of nasal septal deformities, and may be valuable when used in conjunction with subjective data gathered from the NOSE questionnaire. LEVEL OF EVIDENCE 4 Laryngoscope, 129:586-593, 2019.
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Affiliation(s)
- Jeffrey T Gu
- Department of Otolaryngology-Head and Neck Surgery, Irvine, California, U.S.A.,Beckman Laser Institute, Irvine, California, U.S.A.,School of Medicine
| | - Sherrie Kaplan
- School of Medicine.,Health Policy Research Institute, University of California Irvine, Irvine, California, U.S.A
| | - Sheldon Greenfield
- School of Medicine.,Health Policy Research Institute, University of California Irvine, Irvine, California, U.S.A
| | - Hollin Calloway
- Department of Otolaryngology-Head and Neck Surgery, Irvine, California, U.S.A
| | - Brian J F Wong
- Department of Otolaryngology-Head and Neck Surgery, Irvine, California, U.S.A.,Beckman Laser Institute, Irvine, California, U.S.A.,School of Medicine
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Krasnozhen VN, Shcherbakov DA, Volodeev AV, Musina LA, Garskova YA. [The morphological and clinical aspects of the curvature of the nasal septum]. Vestn Otorinolaringol 2017. [PMID: 28631675 DOI: 10.17116/otorino201782325-27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The curvature of the nasal septum (NS) is one of the most widespread deformations of the facial skeleton. The objective of the present study was to substantiate the principles of and develop the rationale for the surgical correction and conservative treatment of this condition based on the morphological features of various types of deflection of the nasal septum. We have undertaken the morphological analysis of the osseous and cartilaginous structures determining the type and the shape of the curvature of the nasal septum together with the clinical analysis of different morphological variants of the deflection of the nasal septum making use of the R. Mladina classification. Type I-IV vertical deflections are regarded as the acquired deformities whereas type II deviations can just as well be congenital malformations. Types V and VI deflections can be a consequence of the birth injury resulting in the displacement of the nasal structures and leading to the curvature of the nasal septum. The authors describe the defects in the anatomical structures adjoining the nasal cavity associated with various types of the deflection of the nasal septum that the surgeons should take into account when planning and performing septoplasty.
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Affiliation(s)
- V N Krasnozhen
- Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Kazan, Russia, 420012
| | - D A Shcherbakov
- Tyumen State Medical University, Ministry of Health of the Russian Federation, Tyumen, Russia, 625028
| | - A V Volodeev
- 'MSCh Neftyanik' Open Joint-stock Company, Tyumen, Russia, 625000
| | - L A Musina
- Tyumen, Russia, All-Russian Centre of Eye and Plastic Surgery, Ufa, Russia, 450075
| | - Yu A Garskova
- Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russian Federation, Kazan, Russia, 420012
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Nath S, Nath K. Patient’s Perspectives on Endoscopic SMR with Spurectomy and
Post-operative Synechia Formation. JOURNAL OF MEDICAL SCIENCES 2017. [DOI: 10.3923/jms.2017.144.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mariño-Sánchez F, Valls-Mateus M, Cardenas-Escalante P, Haag O, Ruiz-Echevarría K, Jiménez-Feijoo R, Lozano-Blasco J, Giner-Muñoz MT, Plaza-Martin AM, Mullol J. Influence of nasal septum deformity on nasal obstruction, disease severity, and medical treatment response among children and adolescents with persistent allergic rhinitis. Int J Pediatr Otorhinolaryngol 2017; 95:145-154. [PMID: 28576524 DOI: 10.1016/j.ijporl.2017.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 01/24/2017] [Accepted: 02/03/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the impact of different types of nasal septum deformity (NSD) on nasal obstruction, rhinitis severity and response to medical treatment among pediatric persistent allergic rhinitis (PER) patients. METHODS In a prospective, real-life study, 150 children and adolescents (mean age 13 ± 2.8 years, females 32.6%) diagnosed with PER according to ARIA guidelines were assessed by nasal endoscopy for NSD according to Mladina's classification, their response to medical treatment (intranasal steroids and antihistamines or antileucotriens), the presence of comorbidities, rhinitis severity (modified-ARIA criterion) and nasal obstruction visual analog scale score (VAS). RESULTS Most patients (87%) had 1 of the 7 types of septal deformities. There was a high prevalence of bilateral (types 4 and 6; 46%) and anterior unilateral (types 1 and 2; 25%) NSD in patients not responding to medical treatment. Type 4 (OR = 6.4; p = 0.005) or type 6 (OR = 4.4; p = 0.03) NSD increased the risk of lack of improvement with medical treatment. Coexistence of anterior unilateral or bilateral NSD with severe turbinate enlargement increased >20-fold the risk of lack of improvement. Patients with bilateral NSD presented greater rhinitis severity. Non-responder adolescents displayed higher prevalence of bilateral NSD than children (53% vs. 23%; p = 0.02). Nasal obstruction VAS was higher for patients with anterior than posterior NSD, and greater for patients with bilateral NSD than any other type of septal morphology. CONCLUSION Nasal endoscopy shows that bilateral and unilateral anterior nasal septum deformities are strongly associated with a poor response to medical treatment, greater rhinitis severity and higher nasal obstruction VAS. Consequently, nasal endoscopy is necessary in the PER patients to understand the disease severity as well as to plan a specific surgical treatment in order to improve nasal obstruction, disease severity, and patient's quality of life.
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Affiliation(s)
- Franklin Mariño-Sánchez
- Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain; Unidad de Rinología, Servicio de Otorrinolaringología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain.
| | - Meritxell Valls-Mateus
- Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain
| | | | - Oliver Haag
- Servicio de Otorrinolaringología, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Karen Ruiz-Echevarría
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Rosa Jiménez-Feijoo
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Jaime Lozano-Blasco
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - María T Giner-Muñoz
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Ana M Plaza-Martin
- Sección de Inmunoalergología, Servicio de Pediatría, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Joaquim Mullol
- Immunoal lèrgia Respiratòria Clínica i Experimental (IRCE), Institut d'Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain; Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia, Spain.
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Bhatia DDS, Palesy T, Ramli R, Barham HP, Christensen JM, Gunaratne DA, Marcells GN, Harvey RJ. Two-dimensional assessment of the nasal valve area cannot predict minimum cross-sectional area or airflow resistance. Am J Rhinol Allergy 2017; 30:190-4. [PMID: 27216349 DOI: 10.2500/ajra.2016.30.4299] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Clinicians who manage nasal obstruction often comment on the shape and size of the nasal valve (NV) area. However, correlation of the symptoms of obstruction, nasal airflow dynamics, and the endoscopic appearance of the anatomic cross-sectional area of the NV is poorly understood. Endoscopic imaging and calculation of the NV area is investigated as a tool for either clinical or research use. OBJECTIVE To describe and evaluate a two-dimensional measurement of the minimum cross-sectional area (MCA) of the NV by using endoscopic imaging. METHODS A cross-sectional study of patients with symptoms of nasal obstruction who were undergoing nasal assessment was performed. The NV was measured with digital imaging taken from the endoscopy. Adobe Photoshop was used to calculate the digital MCA of the NV based on pixel count and a reference marker placed in the image field. Airway parameters were assessed by using a nasal obstruction visual analog scale, nasal airway resistance via rhinomanometry, and acoustic rhinometry derived MCA (acoustic MCA). Correlation of the digital MCA and airway parameters was made and interobserver correlation of the MCA measures was calculated. RESULTS Thirty-three nasal airways were assessed: mean (standard deviation) digital MCA (0.28 ± 0.13 cm(2)) and mean (standard deviation) acoustic MCA (0.51 ± 0.15 cm(2)). Correlation of the digital MCA with visual analog scale was poor (Pearson r = 0.10, p = 0.56). Similar finding between digital and acoustic MCA was poor (Pearson r = 0.50, p = 0.56, respectively) despite a moderately strong interobserver correlation for the digital MCA (Pearson r = 0.79, p < 0.001). CONCLUSION Qualitative endoscopic assessment of the NV may help clinicians predict NV dysfunction but simple two-dimensional measures seemed to be of limited value in accurately assessing the three-dimensional NV quantitatively.
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Affiliation(s)
- Daman D S Bhatia
- Rhinology and Skull Base Research Group, St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, Australia
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Skitarelić N, Mladina R. Do nasal septal deformities have anything to do with chronic rhinosinusitis? Int Forum Allergy Rhinol 2016; 6:1101-1102. [DOI: 10.1002/alr.21822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Neven Skitarelić
- Department of Otolaryngology Head and Neck Surgery; General Hospital Zadar; Zadar Croatia
- Department of Health Studies; University of Zadar; Zadar Croatia
| | - Ranko Mladina
- Regular Member of the Academy of Medical Sciences of Croatia; Zagreb Croatia
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