Can the Sino‐nasal Outcome Test (SNOT‐22) be used as a reliable outcome measure for successful septal surgery?

Can the Sino‐nasal Outcome Test (SNOT‐22) be used as a reliable outcome measure for successful septal surgery? Septoplasty and submucous resection are common procedures in the UK. This study looks prospectively at 40 patients undergoing surgery at two hospitals. A pre‐ and postoperative assessment (3 months) was made using the Sino‐nasal Outcome Test. This test was originally designed for rhinosinusitis but our study suggests that it is a useful tool in nasal septal surgery, in that it combines both nasal specific and general health questions, which can be analysed individually or together. Improvements in nasal obstruction (75%), facial pain (33%) and catarrh (10%) were noted.     

Intranasal temperature and humidity profile in patients with nasal septal perforation before and after surgical closure

Common complaints of patients with a nasal septal perforation are crusting, dryness and bleeding. As shown previously, intranasal humidity values are significantly lower in patients with a septal perforation compared with healthy volunteers. The aim of this study was to determine the influence of surgical closure of septal perforations on intranasal temperature and humidity, and to evaluate changes in clinical symptoms after surgery. Ten patients with septal perforations were included in the study. Intranasal temperature and humidity were measured at the nasal valve and anterior turbinate areas before and after surgical closure. Clinical symptoms were assessed using a nasal symptom score. The end‐inspiratory humidity values were significantly (P ≤ 0.05) higher postoperatively than preoperatively. The increase in temperature at the anterior turbinate area was significantly higher postoperatively. The temperature values at the nasal valve area were not significantly different. Recurrent epistaxis and nasal dryness were reduced after surgery. Nasal septal perforations disturb the intranasal temperature and humidity profile. After surgical closure, heating and humidification is improved. This may be responsible for the reduction of frequent complaints such as bleeding and dryness.     

鼻内镜下黏膜瓣修补鼻中隔穿孔的方法学进展

鼻内镜下利用带蒂黏膜瓣修补鼻中隔穿孔的成功率较高,已经成为治疗鼻中隔穿孔的主要手段.目前报道的黏膜瓣类型繁多,依据黏膜瓣是否带有血管蒂,可将其归为无血管蒂、部分保留血管蒂及带血管蒂黏膜瓣3个主要类型.同时又依据黏膜瓣转移到穿孔区的方式,可分为推进、旋转和翻转3种方式.此外,黏膜瓣因取材位置的不同也存在诸多变化.本文主要...     

A new method of nasal dermoplasty (MW grafting method) in patients with large septal perforation

Nasal dermoplasty is effective in controlling epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). Skin graft take failure occurs mostly in cases of large septal perforation. The MW method was developed as a modification of nasal dermoplasty designed for patients with HHT having a large septal perforation. It seems to be a safe and effective approach and should be tried for recurrent bleeders with septal perforation.     

鼻中隔穿孔患者手术前后鼻腔通气功能的变化

目的探讨鼻中隔穿孔患者手术前后鼻腔主客观通气功能的变化。方法对1 8例鼻中隔穿孔患者术前、术后分别行鼻阻力测量（Rhinomanometry,RM）、鼻呼吸量测量（Nasalspirometry,NS）,并同时利用视觉评分系统（visual analogue scale,VAS）对患者的鼻塞症状进行评分。采用SPSS 16.0统计软件,对手术前后的数据进行配对t检验,并对VAS评分和RM、鼻呼吸量比率（nasal partitioning of airflow ratio,NPR）进行相关性分析。结果术前RM、NPR和VAS评分分别为（0.365±0.124）kPa.s/L、0.28±0.14、3.46±1.02,术后分别为（0.32±0.112）kPa.s/L、0.18±0.1 2、1.7 4±0.64;手术前后的VAS评分差异有统计学意义（P〈0.01）,RM、NPR无统计学意义（P〉0.0 5）。手术前后VAS评分和RM、NPR相关系数分别为0.638、0.687,但无统计学意义上的相关性;手术前后RM、NPR之间差异有统计学意义（P〈0.01）,其相关系数为0.864。结论鼻中隔穿孔患者鼻阻力、鼻呼吸量客观通气功能和主观通气功能VAS评分具有一定的相关性,对选择手术侧别和制定手术方案具有一定的指导意义。     

Nasal septal perforation in a patient with subclinical celiac disease: a possible new association

A female patient presented with nasal septal perforation that did not respond to conventional therapeutic management. Later, because of a malabsorption problem in one of her children, she underwent analytic tests and distal duodenal biopsy, which revealed that she was suffering from subclinical/silent celiac disease. The treatment, a gluten-free diet, unexpectedly resulted in the cessation of the destructive nasal process. Four years later, the patient remains asymptomatic. Nasal septal perforation might constitute a new entity associated with celiac disease hitherto not described in the literature.     

Quality‐of‐life changes following three‐dimensional printing of prosthesis for large nasal septal perforations—Our experience of 13 patients

Nasal septal perforations can be caused by a number of aetiology including intra‐nasal drug abuse, trauma and iatrogenic causes.     

Endoscopy‐Negative,Computed Tomography‐Negative Facial Pain in a Nasal Clinic

Objectives To establish the etiology of facial pain in individuals attending the nasal clinic of the Department of Otorhinolaryngology, University Hospital, Nottingham, U.K., with normal nasal endoscopy and computed tomography of the paranasal sinuses. Study Design A retrospective analysis of a cohort of 973 patients consecutively presenting to the nasal clinic with symptoms of rhinosinusitis and/or facial pain. Methods We reviewed the case notes of 973 consecutive patients who presented to the nasal clinic with either symptoms of rhinosinusitis or facial pain, and in particular 101 who had facial pain without any objective evidence of nasal disease as detected by nasal endoscopy or computed tomography. The diagnosis was based on the outcome and response to treatment after a mean of 2 years 2 months. Results One hundred one patients had pain as a predominant symptom with normal nasal endoscopy and computed tomography of the paranasal sinuses. None of these patients responded to either medical or surgical treatment for what some workers have hypothesized could be “occult” sinonasal disease. A neurological diagnosis was made in 99 patients. Eighty patients received successful medical treatment for “neurological” diagnoses, 8 patients experienced spontaneous resolution of their symptoms, 7 failed to respond to any treatment modality, 2 were lost to follow‐up, and 2 refused any treatment. Conclusion The majority of patients presenting to a rhinologic clinic with facial pain and no objective evidence of sinus disease, as detected by endoscopy and computed tomography, responded well to neurological treatment and surgical intervention was unnecessary. These patients should receive a trial of medical therapy, such as low‐dose amitriptyline for 6 weeks in the first instance, before any surgical intervention is considered.