MyMedR

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

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

Fulltext Nasal airflow of patient with septal deviation and allergy rhinitis

Lim ZF, Rajendran P, Musa MY, Lee CF

Vis Comput Ind Biomed Art, 2021 May 20;4(1):14.

PMID: 34014417 DOI: 10.1186/s42492-021-00080-2

A numerical simulation of a patient's nasal airflow was developed via computational fluid dynamics. Accordingly, computerized tomography scans of a patient with septal deviation and allergic rhinitis were obtained. The three-dimensional (3D) nasal model was designed using InVesalius 3.0, which was then imported to (computer aided 3D interactive application) CATIA V5 for modification, and finally to analysis system (ANSYS) flow oriented logistics upgrade for enterprise networks (FLUENT) to obtain the numerical solution. The velocity contours of the cross-sectional area were analyzed on four main surfaces: the vestibule, nasal valve, middle turbinate, and nasopharynx. The pressure and velocity characteristics were assessed at both laminar and turbulent mass flow rates for both the standardized and the patient's model nasal cavity. The developed model of the patient is approximately half the size of the standardized model; hence, its velocity was approximately two times more than that of the standardized model.

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 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

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

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 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

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 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

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*

Fulltext The prevalence of anatomical variations in osteomeatal unit in patients with chronic rhinosinusitis

Azila A, Irfan M, Rohaizan Y, Shamim AK

Med J Malaysia, 2011 Aug;66(3):191-4.

PMID: 22111438 MyJurnal

The complexities of the anatomy of the nose and paranasal sinuses, as well as its variations may create technical difficulties during surgery. The significance of these anatomical variations in pathogenesis of rhinosinusitis, which is the commonest disease in the region, is still unclear.

Matched MeSH terms: Nasal Septum/pathology*

Fulltext Nasal septal abscess with uncontrolled diabetes mellitus: case reports

Dinesh R, Avatar S, Haron A, Suhana, Azwarizan

Med J Malaysia, 2011 Aug;66(3):253-4.

PMID: 22111451

Nasal septum abscesses caused by uncontrolled diabetes mellitus are rare. We report 3 cases. Very few cases have been published concerning non-traumatic nasal septum abscesses. The development of the condition, possible complications, and treatment are discussed.

Matched MeSH terms: Nasal Septum*

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

Fulltext The association of concha bullosa and deviated nasal septum with chronic rhinosinusitis in functional endoscopic sinus surgery patients

Vincent TE, Gendeh BS

Med J Malaysia, 2010 Jun;65(2):108-11.

PMID: 23756792 MyJurnal

Chronic rhinosinusitis (CRS) remains a prevalent disease and a major cause of morbidity for many patients and functional endoscopic sinus surgery (FESS) is the gold standard for the treatment of CRS. Many factors contribute to the development of CRS, among others nasal anatomic variation. The authors aim to study the association of concha bullosa and deviated nasal septum with CRS patients requiring FESS amongst the diversified multiethnic Malaysian race. The records of 137 patients with CRS who had undergone FESS between March 2002 and October 2006 at the Department of Otorhinolaryngology, Head and Neck Surgery of the Hospital Universiti Kebangsaan Malaysia (HUKM), Kuala Lumpur were retrospectively reviewed. The data revealed that deviated nasal septum (DNS) and concha bullosa (CB) were the two commonest anatomical variations in the nasal cavity. In this study, CB was statistically significant amongst the females and in the Chinese and Indian ethnic groups. DNS is also prevalent but has no significant statistical relationship with sex, age, ethnic group in the local context. CB and DNS are coincidental variations and this study disprove that DNS is associated with CB in its development and pathogenesis of CRS. The mere presence of both these conditions also does not predispose the patients to CRS in the adjacent paranasal sinuses.

Matched MeSH terms: Nasal Septum

Fulltext Nasal septal haemangioma in pregnancy

Noorizan Y, Salina H

Med J Malaysia, 2010 Mar;65(1):70-1.

PMID: 21265255 MyJurnal

A pregnant lady in her third trimester presented with a rapidly growing right-sided nasal mass associated with epistaxis and nasal obstruction for two months. Examination showed a non tender, protruding mass completely occluding her right nostril. Wide surgical excision was done under local anaesthesia. Histopathology revealed capillary haemangioma. In a gravid patient with a rapidly growing intranasal lesion, capillary haemangioma should be considered as a differential diagnosis. Due to the rapidity of growth, presentation with epistaxis and its macroscopic appearance which often mimics malignancy; histologic confirmation is crucial.

Matched MeSH terms: Nasal Septum*

Fulltext Endoscopic resection of primary nasoseptal chondrosarcoma

Jenny L, Harvinder S, Gurdeep S

Med J Malaysia, 2008 Oct;63(4):335-6.

PMID: 19385498 MyJurnal

Chondrosarcoma of the nasal septum is an extremely rare malignant tumor. It accounts for only 10% to 20% of primary bone tumors, with approximately 10% found in the head and neck. A case is presented here to illustrate its presentation, evaluation and surgical treatment.

Matched MeSH terms: Nasal Septum*

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 Open septorhinoplasty: operative technique and grafts

Gendeh BS, Tan VE

Med J Malaysia, 2007 Mar;62(1):13-8.

PMID: 17682563 MyJurnal

In this case series, the senior author details his series of patients who had undergone open septorhinoplasty for functional and/or aesthetic purposes in the Otorhinolaryngology Department at the Hospital Universiti Kebangsaan Malaysia (HUKM), Kuala Lumpur between January 2003 and September 2005. There were 23 patients, consisting of 15 men and 8 women from different Malaysian ethnic groups. Discussion on open septorhinoplasty with regards to operative technique, grafts and implants is presented from an otorhinolaryngologist's point of view.

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

Displaying publications 1 - 20 of 32 in total