MyMedR

Evaluation of nasal cavity by acoustic rhinometry in Chinese, Malay and Indian ethnic groups

Huang ZL, Wang DY, Zhang PC, Dong F, Yeoh KH

Acta Otolaryngol, 2001 Oct;121(7):844-8.

Acoustic rhinometry (AR) evaluates the geometry of the nasal cavity by measuring the minimum cross-sectional area (MCA) and nasal volume (V) by means of acoustic reflection. Understanding the normal and pathologic conditions of the internal nasal cavity using AR is important in the diagnosis of structural abnormalities in patients. The aim of this study was to investigate the normal range of AR parameters in healthy volunteers from three ethnic groups in Singapore: Chinese, Malay and Indian. We also attempted to evaluate the role of these measurements in the documentation of structural abnormalities in the nose. A total of 189 Singaporeans, aged > or = 18 years, were recruited from a nationwide survey study. They comprised 83 Chinese, 35 Malays and 71 Indians. Eighty-nine subjects had a rhinoscopically normal nose (Group 1), 77 had significant septal deviation (Group 2) and 23 had inferior turbinate hypertrophy (Group 3). AR was performed to measure the MCA at the anterior 1-5 cm from the nostril and the volume (V) between points at the nostril and 5 cm into the nose. A mean MCA (mMCA; equal to (L + R)/2) and a total volume (Vt; equal to L + R) were then calculated for each subject, where L and R refer to the measurements made for the left and right nostrils, respectively. The results showed that there was no statistically significant difference in mMCA (p = 0.80) and Vt (p = 0.60) among the three ethnic subgroups of Group 1. Statistically significant differences were found only between Groups 1 and 3 (p < 0.001 for both mMCA and Vt) and between Groups 2 and 3 (p = 0.001 for mMCA and p = 0.013 for Vt). Although there was no significant difference between Groups 1 and 2, significant differences in MCA (p = 0.001) and V (p = 0.040) were found between the narrower sides (smaller volume) and the wider sides in Group 2, indicating volume compensation between the nasal cavities. In conclusion, our study demonstrates that there is no significant difference in the normal range of AR measurements among Chinese, Malay and Indian ethnic groups. AR is able to determine the structural abnormality of the internal nasal cavity caused by septal deviation and inferior turbinate hypertrophy.

Matched MeSH terms: Nasal Septum/abnormalities*; Nasal Septum/physiology*

Fulltext Mucoepidermoid carcinoma of the nasal septum (case report)

Alazzawi S, Sivalingam S, Raman R, Mun KS

Ann Saudi Med, 2015 10 29;35(5):400-2.

PMID: 26506975 DOI: 10.5144/0256-4947.2015.400

We report an extremely rare case of mucoepidermoid carcinoma of the nasal septum. A patient with a history of right-sided nasal obstruction presented to our clinic. Clinical examination revealed a mass in the right nasal cavity originating from the nasal septum. Biopsy revealed a high-grade mucoepidermoid carcinoma. The patient was treated with surgical resection only. Surgery alone might be suitable for small tumors when direct inspection of the surgical site is feasible to detect early recurrence.

Matched MeSH terms: Nasal Septum/surgery*

Fulltext Traumatic transnasal penetrating injury with cerebral spinal fluid leak

Teng TS, Ishak NL, Subha ST, Bakar SA

EXCLI J, 2019;18:223-228.

PMID: 31217785 DOI: 10.17179/excli2018-1971

CSF leak in penetrating skull base injury is relatively rare compared to close head injury involving skull base fracture. We report a 5-year-old boy presented with epistaxis and impacted pencil into the left nostril. The child was hemodynamically stable without any neurological deficit. Intraoperatively, there was a nasal septal defect posteriorly with anterior skull base fracture associated with CSF leak. The pencil was removed from the left nostril and the CSF leak was repaired using harvested abdominal fat under the same setting. Computed Tomography (CT) of the brain showed right cribriform plate fracture with small pneumocranium. Postoperatively, a prophylactic antibiotic was given for seven days and he was discharged well. Subsequent clinic visits up to one-year postoperative period showed no recurrence of the CSF leak. History taking, physical examination and CT imaging give valuable diagnostic values in managing the penetrating skull base injury. Early intervention for removal of the foreign body and repair of the CSF leak is advocated to prevent catastrophic complication.

Matched MeSH terms: Nasal Septum

Fulltext Pleomorphic adenoma of the frontal sinus masquerading as a mucocele

Chew YK, Brito-Mutunayagam S, Chong AW, Prepageran N, Chandran PA, Khairuzzana B, et al.

Ear Nose Throat J, 2015 Dec;94(12):E4-6.

PMID: 26670764 DOI: 10.1177/014556131509401202

Pleomorphic adenoma is the most common type of benign salivary gland tumor. It can also be found in the larynx, ear, neck, and nasal septum. It is rarely found in the maxillary sinus, and it has never been reported in the frontal sinus. We report a case of pleomorphic adenoma of the frontal sinus that masqueraded as a mucocele. We discuss the clinical presentation, diagnosis, and treatment of this patient, and we review the literature.

Matched MeSH terms: Nasal Septum

Insulin-transferrin-selenium prevent human chondrocyte dedifferentiation and promote the formation of high quality tissue engineered human hyaline cartilage

Chua KH, Aminuddin BS, Fuzina NH, Ruszymah BH

Eur Cell Mater, 2005 Jun 17;9:58-67; discussion 67.

PMID: 15962238

This study was to investigate the effects of insulin-transferrin-selenium (ITS) on the proliferation and quantitative gene expression of adult human nasal septum chondrocytes in monolayer culture expansion and the formation of tissue engineered hyaline cartilage. Effects of ITS on human nasal septum chondrocytes monolayer culture expansion and gene expression were evaluated in various culture media either added with 2% fetal bovine serum (FBS) or 1 ng/mL basic fibroblast growth factor plus 1 ng/mL transforming growth factor or both serum and growth factors supplementation in comparison with medium added with 10%FBS. Chondrocytes cultured in medium added with 2% fetal bovine serum and growth factors either supplemented with or without ITS were then mixed with pluronic F-127 hydrogel for in vivo tissue engineered cartilage formation in nude mice model. Engineered tissues were removed after 8 weeks of implantation and evaluated with histological staining, immunohistochemistry, transmission electron microscopy and quantitative gene expression analysis. ITS promoted human chondrocytes proliferation and reduced chondrocytes dedifferentiation in media supplemented with serum and growth factors. ITS with 2% FBS and growth factors provided 15-fold increased in chondrocytes number by the end of the culture period compared to the standard culture medium used in chondrocytes culture (medium added with 10% FBS). Engineered tissue resulted from ITS supplementation demonstrated higher quality of cartilage formation. In conclusion, our study has demonstrated the benefits of ITS supplementation in human chondrocytes monolayer culture and tissue engineering cartilage formation.

Matched MeSH terms: Nasal Septum

Myomodulation Using Botulinum Toxin in Septorhinoplasty for Crooked Noses: Introducing the Concept and Application of Nasal Muscle Imbalance Theory

Wong EHC, D'Souza A

Facial Plast Surg, 2024 Feb;40(1):52-60.

PMID: 36878680 DOI: 10.1055/a-2047-7179

The role of septorhinoplasty for adequate correction of deviated nose is well documented, but the rationales and patterns for recurrences after proper rhinoplasty remain unclear. There has also been little attention given to the influence of nasal musculatures on the stability of nasal structures after septorhinoplasty. The aim of this article is to propose our nasal muscle imbalance theory, which may explain the potential reason for redeviation of the noses in the initial period after septorhinoplasty. We postulate that in a chronically deviated nose, the nasal muscles on the convex side will be stretched and develop hypertrophy after prolonged period of increased contractile activity. On the contrary, the nasal muscles on the concave side will undergo atrophy due to reduced load requirement. In the initial period of recovery after a septorhinoplasty to bring the nose back to midline, this muscle imbalance is still uncorrected with unequal pulling forces on the nasal structure because the stronger nasal muscles on the previously convex side is still hypertrophied and exert stronger forces compared with the previously concave side, therefore increasing the risk of redeviation of the nose back to the preoperative side until muscle atrophy occurs in the convex side and a balanced nasal muscle pull is achieved. We believe that postseptorhinoplasty botulinum toxin injections can be used as an adjunct in rhinoplasty surgery to effectively block the pulling actions of the stronger or overacting nasal muscles by speeding up the atrophy process while allowing patient's nose to heal and stabilize in the desired position. However, further studies to objectively confirm this hypothesis is required, which include comparing topographic measurements, imaging and electromyography signals before and after injections in postseptorhinoplasty patients. The authors have already planned a multicenter study to further evaluate this theory.

Matched MeSH terms: Nasal Septum/surgery

Fulltext Endoscopic septoplasty: The open book method

Prepageran N, Lingham OR

Indian J Otolaryngol Head Neck Surg, 2010 Sep;62(3):310-2.

PMID: 23120731 DOI: 10.1007/s12070-010-0090-9

The advent of endoscopes has revolutionized rhinology and the traditional headlight based surgeries have largely been replaced by endoscopes. Septoplasty for deviated nasal septum or Sluder's neuralgia have been conventionally performed with the aid of headlight. This can be technically challenging as visualization of the nasal cavity, particularly the posterior portion is rather limited as the procedure is performed via the nostrils. In addition, with headlights for illumination, teaching this procedure can be difficult as only the surgeon who is wearing the headlights has direct vision of the surgical field.Endoscopic septoplasty is an accepted alternative to traditional headlight approach to septoplasty. This approach provides a direct-targeted route to the anatomic deformity, improved visualization, and magnification of the surgical field. Our experience in endoscopic septoplasty is highlighted in this paper, excluding septoplasties performed as part of exposure to the sinuses. We use the open book method that to best of our knowledge has not been described in literature before.

Matched MeSH terms: Nasal Septum

The efficacy of silastic sheet nasal splints in endoscopic nasal septal repair surgery: a prospective, randomized, single-blinded controlled trial

Alasousi F, Fan J, Pascual A, Hernaiz-Leonardo JC, Javer AR

Int Forum Allergy Rhinol, 2021 09;11(9):1381-1383.

PMID: 33742768 DOI: 10.1002/alr.22791

Matched MeSH terms: Nasal Septum/surgery

Formation of in vivo tissue engineered human hyaline cartilage in the shape of a trachea with internal support

Ruszymah BH, Chua K, Latif MA, Hussein FN, Saim AB

Int J Pediatr Otorhinolaryngol, 2005 Nov;69(11):1489-95.

PMID: 15941595

Treatment and management of congenital as well as post-traumatic trachea stenosis remains a challenge in pediatric surgery. The aim of this study was to reconstruct a trachea with human nasal septum chondrocytes by using the combination of biodegradable hydrogel and non-biodegradable high-density polyethylene (HDP) as the internal predetermined shape scaffold.

Matched MeSH terms: Nasal Septum/cytology

Fulltext Nasal Septal Angiofibroma in a Post-Menopausal Woman: A Rare Entity

Ewe S, Dayana F, Fadzilah FM, Gendeh BS

J Clin Diagn Res, 2015 Dec;9(12):MD03-5.

PMID: 26816925 DOI: 10.7860/JCDR/2015/14921.6947

Juvenile angiofibromas (JAs) are well-characterised in literature, arising typically in the posterolateral wall of the nasal cavity of young males. Numerous theories have been proposed to explain the occurrence of this unique and rare tumour. Angiofibromas originating in other sites within the head and neck have been described but this is exceedingly rare, constituting less than 2% of all diagnosed cases. Extranasopharyngeal angiofibroma is a rare lesion, and more importantly, controversial. It is not known whether it is actually a relative of the well-known JA that is seen exclusively in adolescent males. We present the case of a post-menopausal woman with unilateral nasal obstruction who was unexpectedly diagnosed as nasal septal angiofibroma.

Matched MeSH terms: Nasal Septum

Fulltext The hazards of impacted alkaline battery in the nose

Ramasamy V, Nadarajah S

J Family Med Prim Care, 2019 1 2;7(5):1083-1085.

PMID: 30598962 DOI: 10.4103/jfmpc.jfmpc_47_18

A foreign body in the nose is a common referral dealt by the otolaryngologist on daily basis. Here we report a case of a 5-year-old girl who was referred from a primary care center with complaints of left nasal blockage and epistaxis along with foul smelling brownish discharge for 1-day duration. Nasal endoscopic examination of the left side of the nose revealed an impacted button battery at the cartilaginous portion of the nasal septum.

Matched MeSH terms: Nasal Septum

Fulltext Montelukast sodium-induced hypomania

Zainal, N.Z., Tan, T.Y

Malaysian Journal of Psychiatry, 2015;24(1):96-98.

MyJurnal

Objective: A rare case of induced hypomania was reported. Method: Patient was a 78-year-old Indian female with squamous cell carcinoma of the nasal septum, childhood bronchial asthma and underlying bipolar disorder. Her bipolar disorder is currently in remission. She developed hypomanic symptoms after one week of initiation of montelukast sodium for treatment of acute exacerbation of bronchial asthma. Result: Her hypomanic symptoms improved after stopping usage of montelukast sodium. Conclusion: Montelukast sodium likely had induced hypomania in this patient.

Matched MeSH terms: Nasal Septum

Significance of Nasal Septum Angulation and Its Association with Rhinosinusitis Symptom Scores

Lazim NM, Abdullah AM, Abdullah B, Ismail ZIM

Medeni Med J, 2019;34(4):333-339.

PMID: 32821458 DOI: 10.5222/MMJ.2019.25986

Objective: The aim of the study was to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptom score and Visual Analog Score (VAS).

Method: The study was performed as a cross sectional study conducted at two different centres in Malaysia. Ninety-eight patients who were diagnosed with rhinosinusitis and fulfilled the selection criteria were assessed as for the symptom score and VAS and the measurement of angulation of nasal septum was performed through a coronal view of CT paranasal sinuses in bone window setting at osteomeatal complex level.

Results: The result obtained from one-way ANOVA test revealed a significant association between category of severity of septal angulation and the symptom score of rhinosinusitis (p=0.025). In addition, the result obtained from one-way ANOVA test also revealed a significant association between category of severity of septal angulation and the VAS of rhinosinusitis (p<0.05).

Conclusion: Severity of nasal septum angulation may be significantly associated with severity of rhinosinusitis based on symptom score and VAS. These findings could be used in tailored management of patient with rhinosinusitis especially during functional endoscopic sinus surgery.

Matched MeSH terms: Nasal Septum

Nasal septal clamp

Raman R, Dahalil MB

Otolaryngol Head Neck Surg, 2000 Dec;123(6):750.

PMID: 11112973

Matched MeSH terms: Nasal Septum/surgery*

Fulltext Chondrosarcoma of the nasal septum

Indudharan R, Das PK, Azman AA, Suhaiza S

Singapore Med J, 1998 Aug;39(8):376-9.

PMID: 9844502

A case of chondrosarcoma of the nasal septum is presented with the result of treatment. The patient was admitted for a growth in the nose of four years' duration. Fine needle aspiration for cytological examination was suggestive of squamous cell carcinoma. She was treated with lateral rhinotomy and wide excision followed by septorhinoplasty. Histological examination showed that the lesion was chondrosarcoma. The patient remained free of disease 26 months after surgery.

Matched MeSH terms: Nasal Septum/pathology*; Nasal Septum/surgery

Fulltext Basic fibroblast growth factor with human serum supplementation: enhancement of human chondrocyte proliferation and promotion of cartilage regeneration

Chua KH, Aminuddin BS, Fuzina NH, Ruszymah BH

Singapore Med J, 2007 Apr;48(4):324-32.

PMID: 17384880

The objectives of this study were to determine the optimum concentration of basic fibroblast growth factor (bFGF) in foetal bovine serum (FBS) or human serum (HS) supplemented medium for adult human nasal septum chondrocyte culture and to evaluate the potential of cartilage regeneration.

Matched MeSH terms: Nasal Septum/cytology*

Fulltext Nasal septal abscess--retrospective analysis of 14 cases from University Hospital, Kuala Lumpur

Jalaludin MA

Singapore Med J, 1993 Oct;34(5):435-7.

PMID: 8153693

Fourteen patients who presented to the University Hospital of Kuala Lumpur between June 1981 and June 1991 were reviewed retrospectively. Nasal septal abscesses are uncommon and therefore there are limited reports in the medical literature. Early diagnosis and immediate therapy is mandatory to avoid cosmetic nasal deformity or intracranial infection. Two out of the fourteen patients developed saddle nose deformity and septal perforation because of delay in treatment, the cases were misdiagnosed by non-otolaryngologist as turbinates swelling. The leading cause of nasal septal abscess was non-surgical trauma which accounted for about 85.7%. The commonest pathogenic organism isolated from the pus of nasal septal abscess was Staphylococcus aureus.

Matched MeSH terms: Nasal Septum/injuries; Nasal Septum/microbiology*

Objective assessment of nasal resistance in patients with nasal disease

Suzina AH, Hamzah M, Samsudin AR

J Laryngol Otol, 2003 Aug;117(8):609-13.

PMID: 12956914

Nasal obstruction is a subjective complaint in patients with nasal disease. The ability to quantitate the nasal ventilation dysfunction would be useful for making the appropriate choice of nasal disease management. This cross-sectional study comprised of 200 adult subjects. They underwent assessment of relevant symptoms, nasal examination and investigations before undergoing active anterior rhinomanometry (AAR) assessment. A group of 88 normal subjects and 112 patients with nasal disease were included. The mean total nasal air resistance (NAR) was significantly higher in patients with nasal disease (0.33 Pa/cm(3)/s) as compared to normal subjects (0.24 Pa/cm(3)/s). There was no significant difference in total NAR between patients with symptoms of nasal obstruction and those without the symptoms (p = 0.42). It is concluded that AAR is a sensitive but not a specific tool for the detection of abnormalities in NAR and it failed to relate to the symptom of nasal obstruction.

Matched MeSH terms: Nasal Septum/physiopathology

Birth trauma and nasal septal deformity in neonates

Saim L, Said H

J Singapore Paediatr Soc, 1992;34(3-4):199-204.

PMID: 1305661

The prevalence of nasal septal deformity and its relationship with the different types and difficulty of delivery were studied in a randomised group of newborns at the Maternity Hospital Kuala Lumpur between 1st November 1989 to 31st January 1990. Out of a total of 674 noses examined using the otoscope, 147 (21.8%) were found to have nasal septal deformity. There was no significant difference in the prevalence of nasal septal deformity in the different types of delivery. There was also no significant increase in the prevalence of nasal septal deformity with increasing degree of difficulty of the delivery. Therefore, we cannot then attribute parturition pressures or birth trauma as the etiology of these congenital nasal septal deformity. Nevertheless a policy of routine screening in view of early correction is advocated to decrease the morbidity associated with this deformity in newborns and children.

Matched MeSH terms: Nasal Septum/abnormalities*

Fulltext Infrasellar craniopharyngioma of the posterior nasal septum: a rare entity

Chiun KC, Tang IP, Tharumalingam V, Nurshaline Pauline HK

Med J Malaysia, 2012 Feb;67(1):131-2.

PMID: 22582569 MyJurnal

To report an unusual location of infrasellar craniopharyngioma in a peadiatric patient.

Matched MeSH terms: Nasal Septum*

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