nasal obstruction surgery

鼻塞手术
  • 文章类型: Case Reports
    作者报告了一例涉及中鼻甲的单骨纤维结构异常。以前,全球仅有4例涉及中鼻甲的纤维发育不良(FD)病例。所有这些都需要严重的表现和手术治疗。我们报告了中东首例无症状的中鼻甲单骨FD,历时10年。纤维骨损伤很少见,鼻窦和眼眶区良性肿瘤。颅面FD最常影响上颌骨和下颌骨,紧随其后的是额叶,顶叶,和枕骨.大多数患有单骨性颅面FD的患者的患病率在10%至29%之间。它通常是偶然发现的,最有可能是无症状的。在这种情况下,由于中鼻甲的参与以及FD扩展到外侧薄片和筛板中,颅底损伤和脑脊液渗漏的风险增加。尽管疾病程度不同,但由于临床症状较小,我们的患者得到了保守的定期随访。我们的目标是阐明与中鼻甲相关的具体挑战,并有助于在这一领域不断增长的知识体系,最终改善受这种情况影响的个人的护理和生活质量。
    The authors report an unusual case of monostotic fibrous dysplasia involving the middle turbinate. Only four cases of fibrous dysplasia (FD) involving the middle turbinate had previously been documented globally, all of which entailed severe presentation and were treated surgically. We report the first case of asymptomatic monostotic FD of the middle turbinate in the Middle East, followed over a span of 10 years.  Fibro-osseous lesions are rare, benign tumors of the sinonasal and orbital regions. Craniofacial FD most commonly affects the maxilla and mandible, followed by the frontal, parietal, and occipital bones. The prevalence of most patients presenting with monostotic craniofacial FD is between 10% and 29%. It is typically found incidentally, and is most likely to be asymptomatic. The risk of skull base damage and cerebrospinal fluid leaks is increased in this case due to the involvement of the middle turbinate and the expansion of FD into the lateral lamella and the cribriform plate.  Our patient was managed conservatively with regular follow-up due to the minor clinical symptoms despite the extent of the disease. We aim to elucidate the specific challenges associated with middle turbinate involvement and contribute to the growing body of knowledge in this field, ultimately improving the care and quality of life for individuals affected by this condition.
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  • 文章类型: Journal Article
    引言鼻塞是临床实践中最常见的症状之一。鼻塞的第二大常见原因是下鼻甲肥大,通常需要手术治疗的鼻病理学。本研究旨在确定下鼻甲肥大(ITH)患者最有效的手术方法。材料与方法本研究于2018年9月至2019年10月在雅典Evangelismos医院耳鼻咽喉头颈外科进行。研究人群包括205名接受手术并在医院接受监测的患者。射频消融(RFA)是73例患者的治疗方法,68例患者接受了微清创器辅助鼻甲成形术(MAT)治疗,其余64例患者使用电灼术(EC)进行手术。手术后,对术后并发症进行评估和量化.总体结果,205例患者接受手术治疗。第一组(n=73)使用射频消融进行手术,并发症发生率为30.1%。在73名患者中,51恢复无并发症。其余22人出现并发症,由16例出血患者和6例鼻后滴漏患者组成。第二组(n=68)使用微清创方法进行处理。并发症发生率为26.5%,其中50例患者术后未出现任何症状,18例出现症状。具体来说,这种方法鼻后滴注更为普遍,因为所有18例患者的并发症均为鼻后滴注。第三组(n=64)采用电灼术治疗。本组患者并发症最多(n=24),16例归因于鼻后滴漏,8例归因于感染,及时口服抗生素治疗。使用该方法的并发症发生率为37.5%。结论在我们的研究中,微清创器辅助鼻甲成形术的并发症发生率最低,其次是射频消融和电灼。然而,所有这三种方法都可以减轻鼻塞并治疗下鼻甲肥大。由于缺乏关于下鼻甲肥大的最佳手术技术的共识,因此需要更多的研究。
    Introduction Nasal obstruction is one of the most frequently reported symptoms in clinical practice. The second most common cause of nasal obstruction is inferior turbinate hypertrophy, a nasal pathology for which surgical treatment is often required. This study aims to determine the most effective surgical method in patients with inferior turbinate hypertrophy (ITH). Materials and methods The study was performed from September 2018 to October 2019 in the Otolaryngology-Head and Neck Surgery Department of the Evangelismos Hospital of Athens. The study population comprised 205 patients that underwent surgery and were monitored in the hospital. Radiofrequency ablation (RFA) was the method used in 73 patients, 68 patients were treated with the microdebrider-assisted turbinoplasty (MAT), and the remaining 64 patients were operated on using electrocautery (EC). Following surgery, postoperative complications were assessed and quantified. Results Overall, 205 patients underwent surgery. The first group (n=73) was operated on using radiofrequency ablation and had a complication rate of 30.1%. Out of 73 patients, 51 recovered without complications. The remaining 22 had complications, consisting of 16 patients with bleeding and six with postnasal drip. The second group (n=68) was treated using the microdebrider method. The complication rate was 26.5%, where 50 patients did not present with any symptoms post-operatively and 18 exhibited symptoms. Specifically, postnasal drip was more prevalent with this method as all 18 patients showed postnasal drip as their complication. The third group (n=64) was treated with electrocautery. Patients in this group had the most complications (n=24), 16 were attributed to postnasal drip and eight to infections, treated promptly with oral antibiotics. The complication rate using this method was 37.5%. Conclusion In our study, the microdebrider-assisted turbinoplasty offered the lowest complication rate, followed by radiofrequency ablation and electrocautery. However, all three methods managed to alleviate the nasal obstruction and treat inferior turbinate hypertrophy. More research is needed as a lack of consensus remains regarding the optimal surgical technique for lower turbinate hypertrophy.
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  • 文章类型: Case Reports
    鼻中隔软骨肉瘤是一种罕见的恶性肿瘤。由于其非特异性鼻窦主诉,其早期诊断很困难。我们报告了一例72岁的女性,该女性表现为进行性鼻塞和嗅觉缺失。鼻内窥镜检查显示鼻腔肿块阻塞两个鼻腔,与鼻中隔无法分离。内镜活检证实软骨肉瘤。通过内窥镜方法对肿瘤进行完整的边缘手术。这种疾病的临床表现,这种情况的诊断和治疗,并对文献进行了综述。
    Chondrosarcoma of the nasal septum is a rare malignancy. Its early diagnosis is difficult because of its non-specific sinonasal complaints. We report a case report of a 72-year-old woman who presented with progressive nasal obstruction and anosmia. Nasal endoscopy showed a nasal mass obstructing both nasal cavities, which was not separable from the nasal septum. Endoscopic biopsy confirmed chondrosarcoma. The tumour was operated on with complete margins by an endoscopic approach. The clinical presentation of the disease, diagnosis and treatment of this case, and a review of the literature are discussed.
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