2-mm V-shaped osteotomes reduce postoperative edema and ecchymosis and can be maneuvered cephalically to the medial oblique osteotomy with the best cosmetic results.
Aneurysmal bone cyst (ABC) is an uncommon benign lesion that rarely presents in the craniofacial region. Aneurysmal bone cysts represent nearly 1.4% of all bone tumors, and among those, only 3% are located in the cranium. In this study, we report on an ABC located in the sphenoid bone with superior nasal cavity and ethmoid extension. The presenting symptom of our patient was headache, followed by diplopia, loss of visual accuracy, and abduction restriction. We successfully resected the lesion by a combined subcranial-midfacial degloving approach without any complications or recurrence.
Septorhinoplasty aims to improve not only the esthetic appearance but also breathing function of the nose. Although the esthetic improvement can be judged by the patient and the surgeon easily, evaluation of nasal breathing is more complicated. Besides the subjective symptom scores given by the patient, some objective methods have been developed. One of the most widely used of these objective methods is acoustic rhinometry, which gives valuable information about the cross-sectional areas and volumes of the nasal airway as a function of distance from the nostril. Since the introduction of acoustic rhinometry, many papers were reported regarding its efficiency with some conflicting conclusions. Septorhinoplasty has the potential to narrow the nasal airway, especially if it includes lateral osteotomies and hump reduction. We aimed to evaluate the role of rhinoplasty on nasal obstruction with the help of subjective symptom scores and acoustic rhinometry. The study consisted of 26 patients who underwent septorhinoplasty. Before and after surgery, the symptom scores and findings of acoustic rhinometry were collected both before and after decongestion of the nasal mucosa. Symptom scores decreased on both sides, which were statistically significant (p< 0.05), however, the changes in cross-sectional areas of the nasal airway were not statistically significant (p > 0.05). The correlation between the symptom scores and acoustic rhinometry findings was not significant for all levels. The effect of septorhinoplasty on nasal airway and some important maneuvers to protect against nasal obstruction are discussed.
Rhinophyma is a disease that can badly deform the nose and can be treated by radiofrequency. We described radiofrequency treatment of large rhinophymas with good aesthetic outcomes.
Epidermoid cysts are benign lesions, which are usually detected on the floor of the mouth in the head and neck region. They can develop from abnormal epithelial components of an ectoderm tissue during the embryological life or alternatively they can arise from the implanted epithelium after trauma or surgery. The diagnosis of an epidermoid cyst in the maxillary sinus can be challenging and it could be easily mistaken for any benign or malign lesion of the nasal cavity and paranasal sinuses. In this case, we present a 44-year-old man with a giant epidermoid cyst in the right maxillary sinus with a previous history of paranasal sinus surgery. We present a very rare case of epidermoid cyst and also discuss the importance of radiological imaging modalities in differential diagnosis of a unilateral expansile mass in the maxillary sinus.
Warping is the most important problem of costal cartilage grafts used in secondary rhinoplasties. The aim of this study is to show that costal cartilage grafts prepared with oblique sliced method (OSM), can solve the warping problem and provides successful results in both functional and aesthetic appearance. There are 42 patients who had previous nose surgery and dissatisfied with their facial appearance included in the study to perform secondary rhinoplasty with costal cartilage graft OSM technique. The outcomes of the operations were performed objectively using facial measurements and subjectively using rhinoplasty outcomes evaluation (ROE) scale, before and 12 months after the operation. The mean of total ROE score was 8.171 ± 3.285 on the pre-operative period and it was increased to 19.11 ± 3.652 where the P value was found to be <0.0001. And the post-operative 12th month period all values of nasal dorsal angulation was lower then 1° and the mean of angulation degrees was 0.224° with the minimum value 0.000° and maximum value 0.801°. The study revealed the outcome of rhinoplasty which done by OSM was statically significant both subjective patient's satisfaction and objective facial measurements. The authors suggest using of OSM in secondary rhinoplasties because the graft can be easily prepared with the desired thickness and carved into different shape without risk of warping.
A 32-year-old woman was referred to our ENT clinics for the evaluation of multiple symmetrical swellings in her neck. In the patient's family history, there was cross-cousin marriage between her grandparents. The patient and her sister had severe hearing loss and type 1 diabetes mellitus since their childhood. The patient also had symmetric hyperpigmented and erythema nodosum-like lesions on the anterior surface of the lower extremities which would suggest that she has an immune system disorder (Figure 1a). The head and neck examination revealed bilateral symmetrical firm, painless, and fairly mobile periparotid and submandibulary masses (Figure 1b). Magnetic resonance imaging (MRI) scans on the neck revealed conglomerated lymph nodes of a size 45x27 mm on the right parotid region and 37x22 mm on the left and also a solid lymph node of a size 26x18 mm on the right submandibular region and 21x18 on the left. According to the patient's blood sample tests, C-reactive protein and rythrocyte sedimentation rate were high, while capillary protein electrophoresis showed polyclonal hypergammaglobulinemia. Antithyroglobulin, anti-thyroid peroxidase, and anti-nuclear antigen were also positive. The patient's cardiac MRI showed that there was a uniform contoured mass lesion which is adherent to the
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