Nasal surgery

Last updated
Nasal Surgery
Pronunciationˈnā-zəl ˈsərj-rē
MeSH D059747

Nasal surgery is a medical procedure designed to treat various conditions that cause nasal blockages in the upper respiratory tract, for example nasal polyps, inferior turbinate hypertrophy, and chronic rhinosinusitis. [1] It encompasses several types of techniques, including rhinoplasty, septoplasty, sinus surgery, and turbinoplasty, each with its respective postoperative treatments. [2] Furthermore, nasal surgery is also conducted for cosmetic purposes. [3] While there are potential risks and complications associated, the advancement of medical instruments and enhanced surgical skills have helped mitigate them.

Contents

History

The history of nasal surgery can be separated into three periods. The first was when nasal operations only consisted of the repair of minimal external nose injuries. The second period was characterised by the need for restoring amputated noses in several countries. The third period marks the current era of nasal surgery development. [4]

The first period of nasal surgery was dated back to 1500 B.C. There were no attempts to treat nasal damage, leading to complete loss of the nose. Nose amputation served as penalisation for war criminals and women deemed indecent, resulting in the demand for nasal reconstruction. [5]

In view of the situation, Sushruta, regarded as the "Father of Plastic Surgery'', initiated the second period of nasal surgery. Under the ideologies of Ayurveda in 600 B.C., he used leaves as a template for the damaged nose, together with a cheek skin flap to reconstruct wounded noses. This laid a solid foundation for the evolution of nasal surgery. The emerging idea of nasal surgery has then spread to the Roman Empire and other parts of the world. [5]

The third period of nasal surgery continues to this day with the subcategories of rhinoplasty, septoplasty, sinus surgery, and turbinoplasty coupled with the culmination of advanced plastic technology and the ongoing surgical development. [2]

Types of nasal surgery

Nasal surgery is a specialty including the removal of nasal obstruction that cannot be achieved by medication and nasal reconstruction. Currently, it comprises four approaches, namely rhinoplasty, septoplasty, sinus surgery, and turbinoplasty, targeted at different sections of the nasal cavity in the order of their external to internal positions. [2]

Rhinoplasty

Rhinoplasty is one of the most common cosmetic approaches despite its intricacy. [3] Rhinoplasty can be categorised into surgical rhinoplasty and non-surgical rhinoplasty. Surgical rhinoplasty emphasises the application of grafting techniques while non-surgical rhinoplasty provides non-invasive options. [6]

The modification of the lower nasal cartilage of the left nostril during a surgical rhinoplasty procedure. Exposing lower lateral cartilage during rhinoplasty.jpg
The modification of the lower nasal cartilage of the left nostril during a surgical rhinoplasty procedure.

Surgical rhinoplasty

Surgical rhinoplasty is an intervention aimed at modifying the nasal appearance in patients. This procedure targets the upper nasal bone and the lower cartilage. First, an incision is carried out at the nasal floor under local or general anaesthesia. During the process, the nasal bones and cartilage are carefully readjusted, with the duration depending on the amount of bone and cartilage that needs to be removed or added with flaps or tissue grafts. Surgeons can retrieve smaller tissue grafts from the interior of the nose, while larger ones may be taken from ribs, implants, or other long bones of the patient. [7] Additionally, another factor under consideration is the patient’s ethnicity. [8]

There are two main strategies involved for surgical rhinoplasty – open rhinoplasty and closed rhinoplasty. Open rhinoplasty offers a more accessible passage for the surgeon to incise the outer nasal skin, but it may introduce external scarring on the nose. Contrarily, closed rhinoplasty utilises the endoscopic approach through the nostril and does not require an incision observable to the eye. The decision between the two depends on the extent of growth abnormalities and the patient's preference. [9]

Non-surgical rhinoplasty

Non-surgical rhinoplasty (liquid rhinoplasty) is a method that incorporates hyaluronic acid dermal fillers and other non-surgical devices, which act as alternatives for minor nasal reconstructions. [10] They are proven to treat minor external nasal injuries more cost-effectively in comparison to surgical rhinoplasty. [11] With respect to the reduced intraoperative loss of tissue and blood, non-surgical rhinoplasty is capable of preventing the occurrence of ischemia or even sepsis. [12]

A congenitally deviated nasal septum shown on Magnetic Resonance Imaging (MRI), which can be corrected by septoplasty. Deviated nasal septum MRI.jpg
A congenitally deviated nasal septum shown on Magnetic Resonance Imaging (MRI), which can be corrected by septoplasty.

Septoplasty

Septoplasty is a surgical procedure involving the correction of the nasal septum, which refers to the bone and cartilage dividing the space between the nostrils. When a nasal septum is bent or crooked, it indicates the narrowing or blockage of the airway, leading to breathing difficulties and worsened sinus infections due to poor drainage. [13]

During septoplasty, the surgeon first lifts the mucous membrane enclosing the septum to visualise and assess the cartilage and bone. The surgeon then trims, reshapes or even replaces deviated parts to straighten the nasal septum. [14] A septoplasty typically takes one to three hours and is coupled with other nasal surgeries to ameliorate the defect. [15] The nasal septum is hence repositioned along the midline of one’s nose.

Most septoplasties are typically done with a closed procedure that utilises a thin, flexible endoscope with a tiny camera and a light. [16] In certain cases, septorhinoplasty, which is the combination of rhinoplasty and septoplasty, requires an open procedure with a headlight and nasal speculum to fix the nasal septum. [15]

Sinus surgery

The techniques of sinus surgery vary from ethmoidectomy to balloon sinuplasty. They treat chronic sinusitis and nasal polyps by reopening the sinus passageways. [17]

Ethmoidectomy

The coronal section of nasal cavities showing the ethmoid sinus, which is a hollow space near the nose and the eyes that allows drainage of other sinuses. Gray859.png
The coronal section of nasal cavities showing the ethmoid sinus, which is a hollow space near the nose and the eyes that allows drainage of other sinuses.

Ethmoidectomy treats ethmoid sinusitis through removing the inflamed mucosal lining on the ethmoid sinus. The method of conducting ethmoidectomy is classified based on the location of the incision, namely external, intranasal, and transantral approaches. [18]

External ethmoidectomy

The surgeon carries out an incision on the skin between the medial canthus and the medial palpebral ligament, in which the ligament may be repositioned afterwards. The surgeon then dissects the periosteum and a portion of the anterior ethmoid. By perforating the lamina papycracea, the floor of the ethmoidal bulla can be subsequently resected. With the opening of the posterior ethmoid, the surgeon proceeds with the elimination of the inflamed mucus. [18] [19]

Intranasal ethmoidectomy

Intranasal ethmoidectomy (Functional Endoscopic Sinus Surgery) is the most predominant type of ethmoidectomy with a success rate of 79%. [18] [20] First, the patient is injected with local anaesthetic and adrenaline to decongest the nasal cavity. Next, the middle turbinate is cautiously medialised to render the cribriform plate intact. The dissection of the infundibulum allows the removal of the uncinate process. With a more accessible view of the ethmoid bulla, the remaining fragments are eliminated along the lamina papyrcea. The use of an endoscope facilitates the dissection from the anterior to posterior ethmoid. [18] [21]

Transantral ethmoidectomy (Caldwell-Luc approach)

Transantral ethmoidectomy is a surgical treatment for recurrent chronic rhinosinusitis and malignant tumours of the maxillary sinus. [22] The operation begins with a puncture through the canine fossa, allowing the surgeon to view the bulging of the ethmoid bulla in the maxillary sinus. Then, an aperture on the inferior nasal meatus is created for intranasal counter drainage. The surgeon eventually dissects the inflamed anterior and posterior ethmoid cells. [18] [23]

The working principle of balloon sinuplasty. A balloon catheter is inserted into the swelling sinus and inflated, which enables reopening of the sinus passage. Balloon sinuplasty 3.png
The working principle of balloon sinuplasty. A balloon catheter is inserted into the swelling sinus and inflated, which enables reopening of the sinus passage.

Balloon sinuplasty

Balloon sinuplasty is an optimal treatment for chronic rhinosinusitis. [ citation needed ] A flexible balloon catheter is initially inserted into the inflamed sinus. Next, the inflation of the balloon widens the sinus while preserving the lining. Consequently, the expanded opening aids mucosal drainage. After the removal of the balloon, the irrigation catheter sprays saline on the inflamed sinus to expel the pus. [24] Given the simplicity of the process, around 87% of balloon sinuplasty was conducted as an outpatient procedure, with a duration of approximately thirty minutes and a recovery of one to two days. [25]

Turbinoplasty

The lateral section of the nasal cavity showing the superior, middle, and inferior nasal conchae (turbinates). Gray153.png
The lateral section of the nasal cavity showing the superior, middle, and inferior nasal conchae (turbinates).

Turbinoplasty is an intervention aiming to treat turbinate hypertrophy by reducing turbinate volume. Turbinate hypertrophy is commonly characterised by enlarged nasal turbinates arising from allergic rhinitis. [26] This procedure has a success rate of 82% and can be carried out in a clinic as a same-day procedure. [27]

Turbinoplasty is classified as intraturbinoplasty and extraturbinoplasty. Intraturbinoplasty only involves the resection of soft tissue, while extraturbinoplasty also removes a portion of the inferior turbinate bone. [26] Intraturbinoplasty can be conducted through an improved mucosal-sparing approach with microdebrider or radiofrequency, thus alleviating postoperative complications. [26] [28]

Turbinoplasty is performed with different equipment shown as follows:

Coblation turbinoplasty

Coblation turbinoplasty incorporates radiofrequency to vapourise and disintegrate the soft erectile tissue of the turbinate, lowering the turbinate size and causing tissue fibrosis. The reduction in turbinate volume alleviates the conditions of inferior turbinate hypertrophy. Since fibrosis stiffens the attachment of the mucosa to the periosteum, it remedies the shortcomings of possible sequela. According to the review, this technique outcompetes its conventional counterpart in terms of safety and effectiveness. [26]

Radiofrequency turbinoplasty

First, an incision is carried out on the inferior turbinate bone to allow the insertion of the Piezo. Using an electric current, the Piezo reduces the turbinate volume and prevents direct damage. It is followed by lateralisation of the turbinate by the Mayo scissors. To ameliorate intraoperative bleeding, bipolar cautery is used along with the insertion of a Merocell sponge between the turbinate and nasal septum. [29] [30] It is notably distinctive from coblation turbinoplasty in the absence of saline. [26]

Microdebrider turbinoplasty

The use of the microdebrider maintains continuous blood drainage, creating a more precise visual field. It also facilitates the specific elimination of the submucosal tissue without damaging the turbinate bone. Besides preserving the mucosa, shorter operative time, lower blood loss, and improved accuracy are significant advancements brought by microdebrider. [26] Also, research found that it is more effective at mitigating nasal blockade than radiofrequency turbinoplasty. [29]

Ultrasound turbinoplasty

Emerging as a novel technique in sinus surgery, the principle of ultrasound turbinoplasty is highly similar to that of coblation and radiofrequency turbinoplasty. First, an ultrasonic nasal probe is placed along the submucosal lining of the inferior turbinate, and is then moved forward and backward repeatedly. Compared to radiofrequency turbinoplasty, the destruction of swelling tissues by ultrasound exhibits increased nasal flow and minimal postoperative complications. [26] [31]

Post-operative treatment

Patients who have undergone rhinoplasty and septoplasty are placed on bed rest with the head raised. To lower mucus build-up, physicians may prescribe appropriate dosage of corticosteroids at regular intervals for several days. [32] This can therefore reduce the likelihood of postoperative ecchymosis. After the surgery, internal bandages, nasal packs, and silicone splints may be applied to the wound for a week to support the skin grafts and the realigned nasal septum. Doctors can also use a small piece of gauze (drip pad) to absorb any possible drainage on top of the aforementioned. [33]

Ethmoidectomy and turbinoplasty patients are prescribed nasal saline spray. It is applied four to five times daily to remove blood clots and moisturise the nasal cavity. Depending on the patient's conditions, doctors may administer medication ranging from nasal steroids that can alleviate mucosal inflammation to antibiotics that can negate the risk of recurrence. [34] [35]

After three to five days of ethmoidectomy, the physician will eliminate the middle meatus packing and debride the dried blood clots during a follow-up visit. [18] The patient recovers from ethmoidectomy after a month, while the recovery from turbinoplasty takes six weeks. [27] [36]

Risk and complications

Rhinoplasty and septoplasty may precipitate certain issues such as the collapse and perforation of the nasal septal cartilage. The tip projection of nasal alar cartilages may also deviate without adequate support depending on the individual’s nasal structure. This will lead to asymmetry and concavity of the nasal sidewall. [37]

Common complications of sinus surgery and turbinoplasty include haemorrhage. [26] Additionally, sinus surgery may potentially result in visual impairment and the leakage of cerebrospinal fluid (CSF). [18] The loss of vision and haemorrhage can be caused by unintentional injuries of the optic nerve and the internal carotid artery in the ethmoid sinus respectively. [38] CSF leakage may lead to meningitis, which is resulted from the fracture of the cribriform plate. [18]

Current development

The Rhinoplasty Outcome Evaluation (ROE) questionnaire is distributed among rhinoplasty patients to examine the results collected. [39] ROE also encourages the application of more innovative techniques, for instance the incorporation of Piezoelectric equipment. [40]

Septoplasty is still considered to be a relatively risky procedure with a high incidence of postoperative complications compared to other types of nasal surgeries. In response to this, specialists in nasal surgery are working to establish a peer-reviewed classification database that can define each type of anomaly involved. [41]

See also

Related Research Articles

<span class="mw-page-title-main">Otorhinolaryngology</span> Medical specialty

Otorhinolaryngology is a surgical subspeciality within medicine that deals with the surgical and medical management of conditions of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, head, and neck. These commonly include functional diseases that affect the senses and activities of eating, drinking, speaking, breathing, swallowing, and hearing. In addition, ENT surgery encompasses the surgical management of cancers and benign tumors and reconstruction of the head and neck as well as plastic surgery of the face, scalp, and neck.

<span class="mw-page-title-main">Sinusitis</span> Inflammation of the mucous membrane that lines the sinuses resulting in symptoms

Sinusitis, also known as rhinosinusitis, is inflammation of the mucous membranes that line the sinuses resulting in symptoms that may include thick nasal mucus, a plugged nose, and facial pain. Other signs and symptoms may include fever, headaches, a poor sense of smell, sore throat, a feeling that phlegm is oozing out from the back of the nose to the throat along with a necessity to clear the throat frequently and frequent attacks of cough.

<span class="mw-page-title-main">Rhinoplasty</span> Surgical procedure to enhance or reconstruct a human nose

Rhinoplasty, commonly called nose job, medically called nasal reconstruction is a plastic surgery procedure for altering and reconstructing the nose. There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt, and penetrating trauma and trauma caused by blast injury. Reconstructive surgery can also treat birth defects, breathing problems, and failed primary rhinoplasties. Rhinoplasty may remove a bump, narrow nostril width, change the angle between the nose and the mouth, or address injuries, birth defects, or other problems that affect breathing, such as a deviated nasal septum or a sinus condition. Surgery only on the septum is called a septoplasty.

<span class="mw-page-title-main">Nasal cavity</span> Large, air-filled space above and behind the nose in the middle of the face

The nasal cavity is a large, air-filled space above and behind the nose in the middle of the face. The nasal septum divides the cavity into two cavities, also known as fossae. Each cavity is the continuation of one of the two nostrils. The nasal cavity is the uppermost part of the respiratory system and provides the nasal passage for inhaled air from the nostrils to the nasopharynx and rest of the respiratory tract.

<span class="mw-page-title-main">Nasal concha</span> Piece of bone in the breathing passage of humans and other animals

In anatomy, a nasal concha, also called a nasal turbinate or turbinal, is a long, narrow, curled shelf of bone that protrudes into the breathing passage of the nose in humans and various animals. The conchae are shaped like an elongated seashell, which gave them their name. A concha is any of the scrolled spongy bones of the nasal passages in vertebrates.

<span class="mw-page-title-main">Septoplasty</span> Corrective surgical procedure

Septoplasty [ˈsɛp.toˌplæ.sti] (Etymology: L, saeptum, septum; Gk, πλάσσειν plassein – to shape), or alternatively submucous septal resection and septal reconstruction, is a corrective surgical procedure done to straighten a deviated nasal septum – the nasal septum being the partition between the two nasal cavities. Ideally, the septum should run down the center of the nose. When it deviates into one of the cavities, it narrows that cavity and impedes airflow. Deviated nasal septum or “crooked” internal nose can occur at childbirth or as the result of an injury or other trauma. If the wall that functions as a separator of both sides of the nose is tilted towards one side at a degree greater than 50%, it might cause difficulty breathing. Often the inferior turbinate on the opposite side enlarges, which is termed compensatory hypertrophy. Deviations of the septum can lead to nasal obstruction. Most surgeries are completed in 60 minutes or less, while the recovery time could be up to several weeks. Put simply, septoplasty is a surgery that helps repair the passageways in the nose making it easier to breathe. This surgery is usually performed on patients with a deviated septum, recurrent rhinitis, or sinus issues.

<span class="mw-page-title-main">Nasal septum deviation</span> Disorder of the nose

Nasal septum deviation is a physical disorder of the nose, involving a displacement of the nasal septum. Some displacement is common, affecting 80% of people, mostly without their knowledge.

<span class="mw-page-title-main">Nasal septum perforation</span> Medical condition

A nasal septum perforation is a medical condition in which the nasal septum, the bony/cartilaginous wall dividing the nasal cavities, develops a hole or fissure.

<span class="mw-page-title-main">Ethmoid sinus</span> Air-filled space near the nasal cavity

The ethmoid sinuses or ethmoid air cells of the ethmoid bone are one of the four paired paranasal sinuses. Unlike the other three pairs of paranasal sinuses which consist of one or two large cavities, the ethmoidal sinuses entail a number of small air-filled cavities. The cells are located within the lateral mass (labyrinth) of each ethmoid bone and are variable in both size and number. The cells are grouped into anterior, middle, and posterior groups; the groups differ in their drainage modalities, though all ultimately drain into either the superior or the middle nasal meatus of the lateral wall of the nasal cavity.

<span class="mw-page-title-main">Empty nose syndrome</span> Medical condition

Empty nose syndrome (ENS) is a clinical syndrome, the hallmark symptom of which is a sensation of suffocation despite a clear airway. This syndrome is often referred to as a form of secondary atrophic rhinitis. ENS is a potential complication of nasal turbinate surgery or injury. Patients have usually undergone a turbinectomy or other surgical procedures that injure the nasal turbinates.

Balloon sinuplasty is a procedure that ear, nose and throat surgeons may use for the treatment of blocked sinuses. Patients diagnosed with sinusitis but not responding to medications may be candidates for sinus surgery. Balloon technology was initially cleared by the U.S. Food and Drug Administration in 2005 and is an endoscopic, catheter-based system for chronic sinusitis. It uses a balloon over a wire catheter to dilate sinus passageways. The balloon is inflated with the goal of dilating the sinus openings, widening the walls of the sinus passageway and restoring normal drainage.

Silent sinus syndrome is a spontaneous, asymptomatic collapse of an air sinus associated with negative sinus pressures. It can cause painless facial asymmetry, diplopia and enophthalmos. Diagnosis is suspected based on symptoms, and can be confirmed using a CT scan. Treatment is surgical involving making an outlet for mucous drainage from the obstructed sinus, and, in some cases, paired with reconstruction of the orbital floor. It is slightly more common in middle age.

<span class="mw-page-title-main">Nasal cartilages</span> Supportive structures in the nose

The nasal cartilages are structures within the nose that provide form and support to the nasal cavity. The nasal cartilages are made up of a flexible material called hyaline cartilage in the distal portion of the nose. There are five individual cartilages that make up the nasal cavity: septal nasal cartilage, lateral nasal cartilage, major alar cartilage, minor alar cartilage, and vomeronasal cartilage.

<span class="mw-page-title-main">Functional endoscopic sinus surgery</span> Surgery to enlarge the paranasal sinus drainage pathways

Functional endoscopic sinus surgery (FESS) is a procedure that is used to treat sinusitis and other conditions that affect the sinuses. Sinusitis is an inflammation of the sinuses that can cause symptoms such as congestion, headaches, and difficulty breathing through the nose.

<span class="mw-page-title-main">Orbital blowout fracture</span> Medical condition

An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall that typically results from the impact of a blunt object larger than the orbital aperture, or eye socket. Most commonly this results in a herniation of orbital contents through the orbital fractures. The proximity of maxillary and ethmoidal sinus increases the susceptibility of the floor and medial wall for the orbital blowout fracture in these anatomical sites. Most commonly, the inferior orbital wall, or the floor, is likely to collapse, because the bones of the roof and lateral walls are robust. Although the bone forming the medial wall is the thinnest, it is buttressed by the bone separating the ethmoidal air cells. The comparatively thin bone of the floor of the orbit and roof of the maxillary sinus has no support and so the inferior wall collapses mostly. Therefore, medial wall blowout fractures are the second-most common, and superior wall, or roof and lateral wall, blowout fractures are uncommon and rare, respectively. They are characterized by double vision, sunken ocular globes, and loss of sensation of the cheek and upper gums from infraorbital nerve injury.

<span class="mw-page-title-main">Human nose</span> Feature of the human face

The human nose is the first organ of the respiratory system. It is also the principal organ in the olfactory system. The shape of the nose is determined by the nasal bones and the nasal cartilages, including the nasal septum which separates the nostrils and divides the nasal cavity into two.

<span class="mw-page-title-main">Turbinectomy</span> Surgical removal of the turbinate bones in the nasal passage

A turbinectomy or turbinoplasty is a surgical procedure, that removes tissue, and sometimes bone, of the turbinates in the nasal passage, particularly the inferior nasal concha. The procedure is usually performed to relieve nasal obstructions. In most cases, turbinate hypertrophy is accompanied by some septum deviation, so the surgery is done along with septoplasty.

Endoscopic endonasal surgery is a minimally invasive technique used mainly in neurosurgery and otolaryngology. A neurosurgeon or an otolaryngologist, using an endoscope that is entered through the nose, fixes or removes brain defects or tumors in the anterior skull base. Normally an otolaryngologist performs the initial stage of surgery through the nasal cavity and sphenoid bone; a neurosurgeon performs the rest of the surgery involving drilling into any cavities containing a neural organ such as the pituitary gland. The use of endoscope was first introduced in Transsphenoidal Pituitary Surgery by R Jankowsky, J Auque, C Simon et al. in 1992 G.

<span class="mw-page-title-main">Sinus implant</span> Medical implant

A Sinus implant is a medical device that is inserted into the sinus cavity. Implants can be in conjunction with sinus surgery to treat chronic sinusitis and also in sinus augmentation to increase bone structure for placement of dental implants.

Antral lavage is a largely obsolete surgical procedure in which a cannula is inserted into the maxillary sinus via the inferior meatus to allow irrigation and drainage of the sinus. It is also called proof puncture, as the presence of an infection can be proven during the procedure. Upon presence of infection, it can be considered as therapeutic puncture. Often, multiple repeated lavages are subsequently required to allow for full washout of infection.

References

  1. ↑ Kwah, JH; Peters, AT (2019). "Nasal polyps and rhinosinusitis". Allergy and Asthma Proceedings. 40 (6): 380–384. doi:10.2500/aap.2019.40.4252. ISSN   1539-6304. PMID   31690375. S2CID   207902240 . Retrieved 2023-04-12.
  2. 1 2 3 Kao, R; Rabbani, CC; Ting, JY; Shipchandler, TZ (2019). "In-office functional nasal surgery". Otolaryngologic Clinics of North America. 52 (3): 485–495. doi:10.1016/j.otc.2019.02.010. hdl: 1805/21643 . PMID   30905568. S2CID   85497766 . Retrieved 2023-04-12.
  3. 1 2 Sidle, D; Hicks, K (2018). "Nasal Obstruction Considerations in Cosmetic Rhinoplasty". Otolaryngologic Clinics of North America. 51 (5): 987–1002. doi:10.1016/j.otc.2018.05.011. PMID   30017096. S2CID   51676362 . Retrieved 2023-04-12.
  4. ↑ Morrison, LE (1959). "A history of rhinoplasty". A.M.A. Archives of Otolaryngology. 69 (6): 667–673. doi:10.1001/archotol.1959.00730030681002. PMID   13649029 . Retrieved 2023-03-26.
  5. 1 2 Shaye, DA (2021). "The history of nasal reconstruction". Current Opinion in Otolaryngology & Head and Neck Surgery. 29 (4): 259–264. doi:10.1097/MOO.0000000000000730. PMC   8270507 . PMID   34074876 . Retrieved 2023-03-26.
  6. ↑ Halepas, S; Lee, KC; Castiglione, C; Ferneini, EM (2021). "Grafting in modern rhinoplasty". Oral and Maxillofacial Surgery Clinics of North America. Modern Rhinoplasty and the Management of Its Complications. 33 (1): 61–69. doi:10.1016/j.coms.2020.09.003. PMID   33153889. S2CID   226270982 . Retrieved 2023-03-26.
  7. ↑ Ghosh, A; Friedman, O (2016). "Surgical treatment of nasal obstruction in rhinoplasty". Clinics in Plastic Surgery. 43 (1): 29–40. doi:10.1016/j.cps.2015.09.007. PMID   26616692 . Retrieved 2023-03-26.
  8. ↑ Cobo, R (2022). "Non-Caucasian rhinoplasty". Clinics in Plastic Surgery. 49 (1): 149–160. doi:10.1016/j.cps.2021.07.008. PMID   34782133. S2CID   241052685 . Retrieved 2023-03-26.
  9. ↑ Gupta, R; John, J; Ranganathan, N; Stepanian, R; Gupta, M; Hart, J; Nossoni, F; Shaheen, K; Folbe, A; Chaiyasate, K (2022). "Outcomes of closed versus open rhinoplasty: a systematic review". Archives of Plastic Surgery. 49 (5): 569–579. doi:10.1055/s-0042-1756315. PMC   9507448 . PMID   36159386.
  10. ↑ Kumar, V; Jain, A; Atre, S; Shome, D; Kapoor, R; Doshi, K; Vadera, S (2021). "Non-surgical rhinoplasty using hyaluronic acid dermal fillers: a systematic review". Journal of Cosmetic Dermatology. 20 (8): 2414–2424. doi:10.1111/jocd.14173. PMID   33900020. S2CID   233398537 . Retrieved 2023-03-26.
  11. ↑ Harb, A; Brewster, CT (2020). "The nonsurgical rhinoplasty: a retrospective review of 5000 treatments". Plastic and Reconstructive Surgery. 145 (3): 661–667. doi:10.1097/PRS.0000000000006554. PMID   32097303. S2CID   211523016 . Retrieved 2023-03-26.
  12. ↑ Rohrich, R; Alleyne, B; Novak, M; Bellamy, J; Chamata, E (2022). "Nonsurgical rhinoplasty". Clinics in Plastic Surgery. 49 (1): 191–195. doi:10.1016/j.cps.2021.08.005. PMID   34782136. S2CID   241922118 . Retrieved 2023-03-26.
  13. ↑ Teixeira, J; Certal, V; Chang, ET; Camacho, M (2016). "Nasal septal deviations: a systematic review of classification systems". Plastic Surgery International. 2016: e7089123. doi: 10.1155/2016/7089123 . PMC   4737055 . PMID   26933510.
  14. ↑ Most, SP; Rudy, SF (2017). "Septoplasty: basic and advanced techniques". Facial Plastic Surgery Clinics of North America. 25 (2): 161–169. doi:10.1016/j.fsc.2016.12.002. PMID   28340647 . Retrieved 2023-03-26.
  15. 1 2 Liu, JF; Yan, ZF; Zhang, ZJ; Wang, NY (2021). "Septoplasty alone is not suitable for most structural nasal obstructions". World Journal of Otorhinolaryngology - Head and Neck Surgery. 7 (4): 322–327. doi:10.1016/j.wjorl.2020.05.007. PMC   8486691 . PMID   34632347.
  16. ↑ Champagne, C; Ballivet de Régloix, S; Genestier, L; Crambert, A; Maurin, O; Pons, Y (2016). "Endoscopic vs. conventional septoplasty: a review of the literature". European Annals of Otorhinolaryngology, Head and Neck Diseases. 133 (1): 43–46. doi: 10.1016/j.anorl.2015.11.004 . PMID   26679230.
  17. ↑ Fassas, SN; Peterson, AM; Farrokhian, N; Zonner, JG; Cummings, EL; Arambula, Z; Chiu, AG; Goyal Fox, M (2022). "Sinus surgery and balloon sinuplasty: what do patients want to know?". Otolaryngology–Head and Neck Surgery. 167 (4): 777–784. doi:10.1177/01945998221076803. PMID   35133898. S2CID   246677240 . Retrieved 2023-04-12.
  18. 1 2 3 4 5 6 7 8 Goanță, CM; Cîrpaciu, D; Sorică, A; Tușaliu, M; Budu, VA (2017). "Ethmoidectomy - procedures and complications". The Official Journal of the Balkan Medical Union. 52 (3). Retrieved 2023-03-25.
  19. ↑ Fagan, J; Sutherland, N; Holbrook, E (2021). "External ethmoidectomy and frontal sinusotomy/trephine". Open Access Atlas of Otolaryngology, Head and Neck Operative Surgery. Retrieved 2023-03-27.
  20. ↑ Calus, L; Van Bruaene, N; Bosteels, C; Dejonckheere, S; Van Zele, T; Holtappels, G; Bachert, C; Gevaert, P (2019). "Twelve-year follow-up study after endoscopic sinus surgery in patients with chronic rhinosinusitis with nasal polyposis". Clinical and Translational Allergy. 9 (1): 30. doi: 10.1186/s13601-019-0269-4 . PMC   6570859 . PMID   31249662.
  21. ↑ Piemontesi, J; Thamboo, A; Abdalkhani, A (2021). "Endoscopic complete ethmoidectomy: how I do it (with video)". European Annals of Otorhinolaryngology, Head and Neck Diseases. YO-IFOS educational video special issue, part 4: Rhinology and plastics. 138: 109–110. doi: 10.1016/j.anorl.2021.05.018 . PMID   34140267. S2CID   235472611.
  22. ↑ Bajan, A; Sarafoleanu, C; Melinte, VG; Decuseara, R (2020). "Indications of the Caldwell-Luc procedure in the era of endoscopic sinus surgery". Romanian Journal of Rhinology. 10 (39): 78–84. doi: 10.2478/rjr-2020-0017 . S2CID   220772002.
  23. ↑ Şahin, MM; Yılmaz, M; Karamert, R; Cebeci, S; Uzunoğlu, E; Düzlü, M; Ceylan, A (2020). "Evaluation of Caldwell-Luc operation in the endoscopic era: experience from past 7 years". Journal of Oral and Maxillofacial Surgery. 78 (9): 1478–1483. doi:10.1016/j.joms.2020.04.024. PMID   32464104. S2CID   218984076 . Retrieved 2023-04-02.
  24. ↑ Patel, VA; O'Brien, DC; Ramadan, J; Carr, MM (2020). "Balloon catheter dilation in pediatric chronic rhinosinusitis: a meta-analysis". American Journal of Rhinology & Allergy. 34 (5): 694–702. doi:10.1177/1945892420917313. PMID   32264691. S2CID   215407033 . Retrieved 2023-03-26.
  25. ↑ Lofgren, DH; Shermetaro, C (2022), "Balloon Sinuplasty", StatPearls, Treasure Island (FL): StatPearls Publishing, PMID   31536277 , retrieved 2023-04-13
  26. 1 2 3 4 5 6 7 8 Abdullah, B; Singh, S (2021). "Surgical interventions for inferior turbinate hypertrophy: a comprehensive review of current techniques and technologies". International Journal of Environmental Research and Public Health. 18 (7): 3441. doi: 10.3390/ijerph18073441 . PMC   8038107 . PMID   33810309.
  27. 1 2 "Turbinate reduction surgery: what it is, procedure & recovery". Cleveland Clinic. Retrieved 2023-04-12.
  28. ↑ Komshian, SR; Cohen, MB; Brook, C; Levi, JR (2019). "Inferior turbinate hypertrophy: a review of the evolution of management in children". American Journal of Rhinology & Allergy. 33 (2): 212–219. doi:10.1177/1945892418815351. PMID   30554518. S2CID   58767772 . Retrieved 2023-04-12.
  29. 1 2 Kanesan, N; Norhayati, MN; Hamid, SSA; Abdullah, B (2022). "Microdebrider-assisted inferior turbinoplasty versus other surgical techniques". Acta Otorhinolaryngologica Italica. 42 (5): 415–426. doi:10.14639/0392-100X-N1896. PMC   9793141 . PMID   36541379 . Retrieved 2023-03-26.
  30. ↑ Robotti, E; Khazaal, A; Leone, F (2020). "Piezo-assisted turbinoplasty: a novel rapid and safe technique". Facial Plastic Surgery. 36 (3): 235–241. doi: 10.1055/s-0039-3401803 . PMID   31891960. S2CID   209524489.
  31. ↑ Kim, JK; Cho, SW; Kim, H; Jo, SC; Kim, HG; Won, TB; Kim, JW; Lim, JH; Rhee, CS (2022). "Development of high-intensity focused ultrasound therapy for inferior turbinate hypertrophy". Clinical and Experimental Otorhinolaryngology. 15 (2): 160–167. doi:10.21053/ceo.2020.02383. PMC   9149228 . PMID   33781059.
  32. ↑ Aldhabaan, SA; Hudise, JY; Obeid, AA (2022). "A meta-analysis of pre- and postoperative corticosteroids for reducing the complications following facial reconstructive and aesthetic surgery". Brazilian Journal of Otorhinolaryngology. 88 (1): 63–82. doi:10.1016/j.bjorl.2020.05.015. PMC   9422590 . PMID   32605829.
  33. ↑ Kim, SJ; Chang, DS; Choi, MS; Lee, HY; Pyo, JS (2021). "Efficacy of nasal septal splints for preventing complications after septoplasty: a meta-analysis". American Journal of Otolaryngology. 42 (3): 102389. doi:10.1016/j.amjoto.2020.102389. PMID   33482562. S2CID   214177748 . Retrieved 2023-03-26.
  34. ↑ Rohn, G; Gamble, B; Kubala, M (2019). "Post-operative instructions following turbinate reduction" (PDF). Otolaryngology Specialists of North Texas. Retrieved 2023-03-26.
  35. ↑ Levine, CG; Casiano, RR (2017). "Revision functional endoscopic sinus surgery". Otolaryngologic Clinics of North America. 50 (1): 143–164. doi:10.1016/j.otc.2016.08.012. PMID   27888911 . Retrieved 2023-04-01.
  36. ↑ "Clinical indicators: ethmoidectomy". American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). 2021-04-23. Retrieved 2023-04-12.
  37. ↑ Eytan, DF; Wang, TD (2022). "Complications in rhinoplasty". Clinics in Plastic Surgery. 49 (1): 179–189. doi:10.1016/j.cps.2021.07.009. PMID   34782135. S2CID   239157093 . Retrieved 2023-04-12.
  38. ↑ Chin, OY; Ghosh, R; Fang, CH; Baredes, S; Liu, JK; Eloy, JA (2016). "Internal carotid artery injury in endoscopic endonasal surgery: a systematic review". The Laryngoscope. 126 (3): 582–590. doi:10.1002/lary.25748. PMID   26525334. S2CID   25813325 . Retrieved 2023-03-26.
  39. ↑ Nocini, R; Chirumbolo, S; Pirayesh, A; Rahman, E; Kapoor, KM; Caliskan, G; Bertossi, D (2022). "A systematic review and meta-analysis of rhinoplasty using the rhinoplasty outcome evaluation scale". Annals of Maxillofacial Surgery. 12 (1): 60–68. doi: 10.4103/ams.ams_244_21 . PMC   9527829 . PMID   36199467.
  40. ↑ Keyhan, SO; Poorian, B; Fallahi, HR (2021). "Piezoelectric technology in rhinoplasty". Oral and Maxillofacial Surgery Clinics of North America. 33 (1): 23–30. doi:10.1016/j.coms.2020.09.002. PMID   33153888. S2CID   226269203 . Retrieved 2023-03-26.
  41. ↑ Althobaiti, KH; Fida, AR; Almahmoudi, A; AlGhamdi, D; Alharbi, M (2022). "Common causes of failed septoplasty: a systematic review". Cureus. 14 (12): e33073. doi: 10.7759/cureus.33073 . PMC   9883659 . PMID   36721531.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.