Septum

Nasal packing after septoplasty: A randomized comparison of packing versus no packing in 88 patients

October 31, 2008     Mohammad Sohail Awan, FCPS and Moghira Iqbal, MBBS
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Abstract

The once-common practice of packing the nose after septoplasty was based on a desire to prevent postoperative complications such as bleeding, septal hematoma, and adhesion formation. However, it was since found that not only is nasal packing ineffective in this regard, it can actually cause these complications. Although the consensus in the world literature is that packing should be avoided, to the best of our knowledge, no truly randomized study has been undertaken in Southwest Asia upon which to justify this recommendation here. Therefore, we conducted a prospective randomized comparison of the incidence of a variety of postoperative signs and symptoms in 88 patients, 15 years of age and older, who did (n = 44) and did not (n = 44) undergo nasal packing following septoplasty. We found that the patients who underwent packing experienced significantly more postoperative pain, headache, epiphora, dysphagia, and sleep disturbance on the night of surgery. Oral and nasal examinations 7 days postoperatively revealed no significant difference between the two groups in the incidence of bleeding, septal hematoma, adhesion formation, and local infection. Finally, the packing group reported a moderate to high level of pain during removal of the packing. Our findings confirm that nasal packing after septoplasty is not only unnecessary, it is actually a source of patient discomfort and other signs and symptoms.

Rhinolithiasis with a nasal polyp: A case report

March 1, 2008     Ibrahim Ozcan, MD, K. Murat Ozcan, MD, Serdar Ensari, MD, and Huseyin Dere, MD
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Abstract

Rhinoliths are uncommon mineralized masses that form as a result of calcification of an endogenous or exogenous nidus. The most common manifestations of rhinolithiasis are unilateral nasal discharge, nasal obstruction, and facial pain. The diagnosis is made by nasal endoscopy and computed tomography. The differential diagnosis includes chronic inflammation, osteomyelitis, benign tumors (e.g., calcified nasal polyps, ossifying fibromas, osteomas, and chondromas), and malignant tumors (e.g., osteosarcomas, chondrosarcomas, and squamous cell carcinomas). Rhinoliths may cause rhinosinusitis, erosion of the nasal septum and medial wall of the maxillary sinus, and perforations of the palate. To the best of our knowledge, the occurrence of a nasal polyp associated with rhinolithiasis has not been previously reported in the English-language literature. In this article, we describe such a case.

Neurosarcoidosis presenting as complicated sinusitis: A case report and review

February 1, 2008     Lt. Matthew T. Brigger, MD, Maj. Ian K. McLeod, MD, and Cdr. Martin P. Sorensen, MD
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Abstract

Sarcoidosis is a systemic granulomatous disease with widely variable clinical characteristics, including numerous head and neck manifestations. We describe the case of a 49-year-old man who presented to the emergency department with symptoms consistent with complicated sinusitis. He was ultimately found to have an atypical case of neurosarcoidosis. This case illustrates the varied multisystem presentation of sarcoidosis and the diagnostic considerations that are merited.

Pediatric nasal septal perforation secondary to magnet misuse: A case report

October 31, 2007     Carl Shermetaro, DO, FAOCO and Melissa Charnesky, DO
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Abstract

We describe the case of a 7-year-old girl who had placed magnetic earrings bilaterally on her nasal ala. However, the two backing magnets that had been placed inside the nasal cavity became attached to each other rather than to the outer jewelry, compressing the nasal septum. Several weeks later, the septum became perforated. The patient was treated conservatively with mupirocin ointment, oral amoxicillin, and nasal saline. Subsequent examinations revealed no enlargement of the perforation, and the patient was followed conservatively with saline nasal spray.

Correction of caudal deflections of the nasal septum with a modified Goldman septoplasty technique: How we do it

September 30, 2007     William Lawson, MD, DDS; Richard Westreich, MD
article
Abstract

Correcting deviations of the caudal septum can be challenging because of cartilage memory, the need to provide adequate nasal tip and dorsal septal support, and the long-term effects of healing. The authors describe a minimally invasive, endonasal approach to the correction of caudal septal deviations. The procedure involves a hemitransfixion incision, unilateral flap elevation, and cartilage repositioning by limited dissection and excision.

Nasal cavernous hemangioma

May 31, 2007     Enrique Palacios, MD, FACR; Philip J. Daroca Jr., MD
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A new method for closure of small to medium-size nasoseptal perforations

March 31, 2007     Ward S. De Witt, MD, FACS
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Correction of caudal septal deviation: Use of a caudal septal extension graft

March 1, 2007     Annette M. Pham, MD; Travis T. Tollefson, MD, FACS
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Nasal septal perforation secondary to rhinitis medicamentosa

May 31, 2006     Harold F. Keyserling, MD; John D. Grimme, MD; Daniel L.A. Camacho, MD; Mauricio Castillo, MD
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Abstract
Nasal septal perforation is a rarely reported complication of rhinitis medicamentosa. We describe such a complication in a 54-year-old man, and we discuss the clinical, pathologic, and imaging aspects of this case.

Endoscopic view of a nasal septal polyp

April 30, 2006     Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD
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Maxillary sinusitis caused by nasoseptal obstruction

March 1, 2006     Dewey A. Christmas, MD; Joseph P. Mirante, MD; Eiji Yanagisawa, MD
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Extramedullary plasmacytoma arising from the nasal septum

November 1, 2005     Byoung J. Baek, MD; Seong W. Kim, MD; Hoon Park, MD; Jin K. Park, MD; Kyung Y. Han, MD; Cheon H. Oh, MD
article
Abstract
We report a rare case of extramedullary plasmacytoma of the nasal septum in a 65-year-old woman. She presented with a 2-month history of left-sided nasal obstruction and intermittent blood-tinged nasal crusting. Nasal endoscopy revealed that a dark-red mass had arisen from the nasal septum; no evidence of invasion to adjacent tissues was seen. A biopsy specimen was diagnosed as a plasmacytoma (kappa light chain'type). Serum and urine electrophoresis failed to detect any myeloma component or Bence Jones protein. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. The mass was completely removed via an endoscopic approach. No recurrence was noted at the 2-year follow-up.
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