1,721,082 research outputs found
Gli innesti di cartilagine auricolare nella ricostruzione nasale primaria
No full textLa ricostruzione nasale primaria dopo un trauma del volto è spesso una problematica di difficile approccio. Infatti il naso per la sua prominenza e per la posizione centrale è spesso esposto a traumatismi di vario tipo e qualunque alterazione nel suo aspetto esteriore ha significativi effetti sullo stato psico-sociale del paziente.
Nelle forme traumatiche, la ricostruzione nasale è importante non solo per migliorare l’estetica ma anche per evitare alterazioni della respirazione nasale.
In questo articolo, riportiamo un caso inusuale di amputazione parziale del naso occorso a seguito di un incidente stradale con i dettagli di ricostruzione della struttura nasale.
E’ stata utilizzata la cartilagine auricolare per preparare vari innesti che hanno consentito di ricostruire un supporto per la piramide nasale, evitando deformità a sella e alterazioni della valvola nasale. Il risultato della ricostruzione sulla piramide nasale è stato soddisfacente dal punto di vista estetico e funzionale
Endoscopic coblator-assisted epiglottoplasty in 'obstructive sleep apnoea syndrome' patients
No full textThe Obstructive sleep apnea syndrome is a complex nosological entity characterized by an obstruction at various levels of the upper airways during sleep. The gold standard treatment is represented by ventilation therapy with c-PAP, which, despite being safe and effective, is sometimes poorly tolerated by patients. In this case the surgical therapy might be a good option but its efficacy depends on the ability to locate and solve the different obstructive sites. This article is protected by copyright. All rights reserved
Endoscopic Repair of Nasal Septal Perforation with "Slide and Patch" Technique.
No full textOBJECTIVE:The aim of this study is to report our new endoscopic technique for the repair of nasal septal perforations, called the "slide and patch" technique because it combines a mucoperiosteal free graft of the inferior turbinate with a mucosal rotational or advancement flap from the nasal septum.
METHODS:Twenty-two patients with symptomatic septal nasal perforation of various sizes underwent our method of repair.
RESULTS:At the last follow-up, 21 (95.4%) perforations were closed. There was a partial closure in only 1 patient with a large perforation (3.5 cm in diameter). After surgery, 19 (86.3%) patients were asymptomatic, 2 (9%) showed persistence of crusting, and 1 (4.5%) showed the appearance of nasal obstruction 1 month postoperatively.
CONCLUSION:The method described herein has shown to be effective in nasal septal perforation repair and in nasal symptoms relief with the advantage of not requiring grafts from outside the nose
Retraction pockets of pars tensa in pediatric patients: clinical evolution and treatment
No full textObjective: To assess outcome in pediatric patients after treatment for retraction pockets of pars tensa in relation to retraction grade, site, occurrence of complications, and patient age.
Methods: Outcomes in 45 ears of 37 children medically or surgically treated for retraction pockets were compared to a control group of 40 untreated children over a follow-up period of at least 24 months.
Grade I and II retractions were treated with medical therapy or ventilation tube insertion; in III or IV grade retractions, excision and tympanic reinforcement with cartilage grafting and in some cases
ossiculoplasty were performed.
Results: Medical treatment or ventilation tube insertion resolved grade I and II retractions in 94% of cases. In grade III or IV retractions the anatomic success rate was 75.8%. Normal hearing (air–bone gap <10 dB) was restored in 31 (68.8%) cases. Surgical failures and complications (recurrence, tympanic membrane perforation, progression to cholesteatoma) were higher in posterior retractions. In the control group, only 35% of retractions healed spontaneously; in the remaining cases the condition
progressed to more serious retractions or complications.
Conclusion: A wait and see approach or conservative therapy is indicated only in mild-to-moderate retraction pockets owing to their benign prognosis. Pocket excision and tympanic reinforcement are
absolutely indicated in advanced retractions with complications and/or bilateral conductive hearing loss to avert progression to more serious pathologies
Endoscopic treatment of cerebrospinal fluid leaks with the use of lower turbinate grafts: a retrospective review of 125 cases
No full textBackground: Endoscopic transnasal approaches to the skull base have revolutionized the treatment of cerebrospinal fluid (CSF) fistulae, making repair less invasive and more effective compared with craniotomy or extracranial techniques.
Aim: This study evaluated, retrospectively, the results of endoscopic repair of dural defects with the use of mucoperiostal grafts taken from the lower turbinate.
Materials and methods: Between January 1997 and January 2007, 125 cases of anterior skull base CSF fistulae were treated endoscopically at the Instituto Felippu de Otorrinolaringologia, Sao Paolo, Brazil, and at the Department of Otolaryngology of the University Hospital “Ospedali Riuniti”, Foggia, Italy. Fistula closure was achieved by overlay apposition of a lower turbinate mucoperiostal graft fixated with fibrin glue and Surgicell.
Results: The etiology of the fistula was accidental trauma in 41 cases, iatrogenic trauma in 29, skull base tumour in 12, and spontaneous in 43. The site of the defect was the sphenoid sinus in 43 patients, the cribriform plate in 42, the anterior ethmoid roof in 21, the posterior ethmoid roof in 17, and the posterior wall of the frontal sinus in 2. The success rate at first attempt was 94.4%; the 7 cases of postoperative recurrent CSF leakage involved patients presenting with
spontaneous fistula and elevated intracranial pressure; 5 of these had a body-mass index > 30 and 3 suffered from diabetes mellitus.
Discussion and conclusion: In our hands, the success rate of endoscopic fistula repair was high, even in defects larger than 2 cm. Success rates may be further improved with accurate
diagnosis of elevated intracranial pressure, a contributing factor to failure of spontaneous fistula repair
Clinical picture of rhinusinusitis and management of out-patients [Inquadramento clinico della rinosinusite e gestione del paziente in ambulatorio]
No full textRhinosinusitis is generally due to the propagation of a nasal inflammation and may involve one or more paranasal sinuses. Depending on how long the disturbance lasts, it is classified as acute, acute recurrent and chronic. The acute and acute recurrent forms are resolved with appropriate medical therapy and there is no permanent damage to the mucosa, unlike the chronic form the pharmacological therapy of which does not determine complete anatomical pathological cure and for which the sole treatment is surgical. The incidence of this pathology lies in a range of between 0.5% and 10% depending on which author is reporting. Usually secondary to a viral infection (Rhinovirus, parainfluenzal virus 1, 2, 3, syncytial respiratory virus, adenovirus, enterovirus) it complicates following bacterial attack (S. pneumoniae, H. influenzae, M. Catarrhalis, anaerobic Streptococchi and Bacteroides). Runny nose, cephalea, slight persistent fever, cough, halitosis are the symptoms that characterise nasosinus phlogistic pathology although they are not exclusive to these conditions and can occur in other infectious situations (mucopurulent rhinitis, rhinoadenoiditis). Standard X-ray pictures do not provide constantly reliable diagnostic elements; by contrast, computed tomography (CT), magnetic resonance (MR) and optical fibre nasal endoscopy can provide precise information in view, for example, of a surgical programme. Antibiotic therapy is the cornerstone of the medical treatment of nasosinus infectious pathology. Among the antibiotics of choice we find amoxicillin clavulanate, the 2nd or 3rd generation oral cephalosporins, the ketolides and the quinolones. Other important therapeutic aids are those aimed at facilitating the reduction of the mucous oedema of the osteo-meatal complexes and drainage of secretions from the paranasal cavities and use of nasal washing with physiological solution, decongestion agents, mucolytics and possibly antihistaminics (allergic patients). Topical corticosteroids as shown by recent clinical studies most certainly represent a useful class of drugs for the management of rhinosinusitis. Surgical therapy is used on chronic and acutely complicated forms
May nasal hyperreactivity be a sequela of recurrent common cold?
No full textRespiratory viral infections may worsen bronchial hyperreactivity. However, there is no data on the possible role of recurrent infectious rhinitis in nose hyperreactivity. This study was therefore designed to investigate whether subjects suffering from recurrent common cold have nasal hyperreactivity, assessed by histamine nasal challenge. This study included a group of 40 patients (19 males, mean age 34.1 years) with history of at least five episodes of common cold in the previous year, but without documented allergy, and twenty healthy subjects (8 males, mean age 32.3 years) were enrolled as control group, all of whom were non-allergic. Nasal provocation test with histamine was performed in all subjects. Nasal provocation test with histamine induced a 200% increase in nasal resistance after provocation in 24 (60%) patients suffering from recurrent viral rhinitis. No normal subject had an increase >180% in nasal resistance. There was a significant difference between the patient group and the control group (p<0.05). In conclusion, this study shows that nasal hyperreactivity might be a sequela of recurrent common cold. Further studies should be conducted to confirm this preliminary finding
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