- Complications in septoplasty based on a large group of 5639 patients. [Journal Article]
- EAEur Arch Otorhinolaryngol 2018 May 16
- CONCLUSIONS: Meticulous attention to detail in identifying the appropriate anatomy and maintaining good visualization is the key to a safe and effective septoplasty, enabling for very low complication rate.
- Nasal Septal Perforation in Propylthiouracil-Induced Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis. [Journal Article]
- CRCase Rep Rheumatol 2018; 2018:8192021
- Here, we present the case of a 29-year-old woman with nasal septal perforation and positive myeloperoxidase- (MPO-) anti-neutrophil cytoplasmic antibody (ANCA). She had been diagnosed with Graves' di...
Here, we present the case of a 29-year-old woman with nasal septal perforation and positive myeloperoxidase- (MPO-) anti-neutrophil cytoplasmic antibody (ANCA). She had been diagnosed with Graves' disease and had been treated with propylthiouracil (PTU) for 14 months. A biopsy of the nasal septum revealed an infiltration of inflammatory cells, with no evidence of malignancy or granulomatous change. Because of the use of PTU, destructive nasal lesion, and positive MPO-ANCA, she was diagnosed with drug-induced ANCA-associated vasculitis (AAV) and was treated with prednisolone and methotrexate after the cessation of PTU. Although PTU is known to be the medicine that induces drug-induced AAV, the manifestation of nasal septal perforation in drug-induced AAV is poorly identified. This is the rare case of drug-induced AAV which manifested only nasal septal perforation.
- Simultaneous Septal Perforation Repair with Septorhinoplasty: A 31-Year Experience. [Journal Article]
- FPFacial Plast Surg 2018 May 15
- Septal perforation repair and septorhinoplasty (SRP) each present unique surgical challenges. However, in many instances, these procedures may be performed together successfully. In this study, the a...
Septal perforation repair and septorhinoplasty (SRP) each present unique surgical challenges. However, in many instances, these procedures may be performed together successfully. In this study, the authors aim to determine the safety and effectiveness of combining primary or revision SRP and septal perforation repair via an open approach. A retrospective review was carried out of all consecutive patients who had SRP and septal perforation repair via an open approach between 1986 and 2017 in the senior author's practice. Perforation closure in surgery and at the patient's last follow-up, resolution of presenting symptoms, cosmetic results, and complications were analyzed. Records for 141 patients who had simultaneous septal perforation repair and SRP via an open approach, with a mean follow-up of 3.24 years, were reviewed. The mean anterior-posterior perforation dimension was 1.41 ± 0.89 cm, and the mean vertical perforation dimension was 1.16 ± 0.59 cm. The most common etiologies for septal perforation were previous SRP (35.4%) and septoplasty (24.1%). An overall 93.6%, perforation closure, 91.1% symptom relief, and 91.2% patient satisfaction with cosmetic results were achieved. Septal perforations under 1.5 cm in height were closed in 96.7% of patients as opposed to 71.4% of patients with perforations 1.5 cm or taller. Minor revision rhinoplasties were performed in 7.0% of patients. Postoperative infections were rare and noted in only two (1.4%) patients. In the largest study of its kind to date, the authors have shown that in experienced hands septal perforation repair may be performed simultaneously with primary or revision SRP via an open approach without compromising the perforation repair outcome. The vertical dimension of a septal perforation and presence of mucosa above and below a perforation are important considerations for the difficulty of a perforation closure, as septal mucosa is recruited from these locations in our technique of four-quadrant intranasal bipedicled mucosal advancement flap closure.
- Pyoderma gangrenosum on the nose. [Journal Article]
- ANAuris Nasus Larynx 2018 May 09
- Pyoderma gangrenosum is a rare ulcerative condition associated with various systemic diseases. Lesions on the lower extremities and the trunk are common, but lesions on the nose are rare. Here we rep...
Pyoderma gangrenosum is a rare ulcerative condition associated with various systemic diseases. Lesions on the lower extremities and the trunk are common, but lesions on the nose are rare. Here we report a case of pyoderma gangrenosum on the nose. A 33-year-old woman presented with fever, nasal obstruction, and painful swelling on the nasal bridge. Physical examination revealed swellings on the nasal septal mucosa bilaterally. Computed tomography showed a septal abscess and a subcutaneous abscess on the nasal bridge. The lesions worsened despite treatment with intravenous antibiotics and abscess drainage. Meanwhile, the patient also complained of bloody stools and was diagnosed with ulcerative colitis. Therefore, pyoderma gangrenosum on the nose was suspected, and was diagnosed by exclusion of other diseases. Treatment with systemic corticosteroids was started and the nasal lesions improved rapidly. However, saddle nose deformity occurred. A review of the literature reveals that pyoderma gangrenosum on the nose can cause ulcerations, septal abscess, and sinusitis. Further, there is a high likelihood of nasal complications, including saddle nose deformity, septal perforation, and skin defects. Pyoderma gangrenosum should be included in the differential diagnosis when nasal ulceration, abscesses, and sinusitis do not improve with antibiotics and drainage.
- Diagnosis and treatment of postoperative intestinal perforation in infants and young children with congenital heart disease: A report of three cases. [Journal Article]
- ETExp Ther Med 2018; 15(5):4498-4502
- The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize expe...
The aim of the present study was to analyze risk factors of intestinal perforation following surgery for the treatment of congenital heart disease in infants and young children, and to summarize experiences of diagnosis and treatment. A total of 3,270 children, who underwent congenital heart disease surgery under extracorporeal circulation from January 2010 to July 2015, were retrospectively analyzed. Among these children, three (0.09%) developed postoperative intestinal perforation. Primary diseases were Tetralogy of Fallot (two cases) and ventricular septal defect combined with atrial septal defect (one case). The age range of the children was 6-11 months and the weight range was 7.3-8.6 kg. Furthermore, these children underwent radical surgery under general anesthesia and extracorporeal circulation in low temperatures. Abdominal symptoms appeared 4-10 days after surgery, and included poor appetite, abdominal distension, intermittent vomiting, high fever, refractory irritability, crying and shortness of breath. One case was confirmed by routine abdominal puncture and the remaining two were confirmed by the detection of free gas under the diaphragm, as revealed by abdominal X-ray. Following the diagnosis of intestinal perforation, emergency intestinal fistula surgery was performed. At 3-5 days post-surgery, the patients underwent treatment by fasting and intravenously administered parenteral nutrition. Diet was increased following recovery of bowel function. All patients recovered following active treatment and 3-4 months following hospital discharge, the fistula was successfully closed. In conclusion, a concerted effort should be made to identify intestinal perforation in infants and young children with postoperative congenital heart disease during emergency surgery. Early diagnosis and treatment may significantly improve prognosis and reduce mortality.
- Surgical perspective of percutaneous device closure of atrial septal defect. [Journal Article]
- ACAsian Cardiovasc Thorac Ann 2018 Jan 01; :218492318776568
- Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal ...
Background Percutaneous device closure of an ostium secundum atrial septal defect is associated with excellent outcomes and cosmetic results but at the cost of occasional serious and sometimes fatal complications as well as lifelong follow-up. Surgical intervention is required in cases of device-related complications, which carries a slightly higher risk compared to primary closure of an atrial septal defect. We present a surgical perspective of device closure of atrial septal defect. Methods Our database was searched over 4 years for complications related to percutaneous device closure of atrial septal defect, which required surgical retrieval of the device and closure of the defect. We identified 14 cases that required surgical intervention. Results The median age of the 14 patients was 18 years (range 4-58 years). The size of the defect ranged from 15 to 40 mm (median 30 mm). Device embolization into any part of the cardiovascular system ( n = 8) was the most common complication, followed by malalignment of the device ( n = 5). One patient had left atrial appendage perforation causing pericardial effusion and cardiac tamponade, and underwent surgical repair. The other 13 patients underwent removal of the device and atrial septal defect closure. One patient developed severe mitral regurgitation requiring mitral valve replacement. There was no mortality. Conclusion Although the incidence of device-related complications may be small, they carry a high risk of death or long-term morbidity, even with a small atrial septal defect, unlike primary surgical closure of isolated atrial septal defect.
- Effect of mometasone furoate nasal spray on the DNA of nasal mucosal cells [Journal Article]
- TJTurk J Med Sci 2018 Apr 30; 48(2):339-345
- Background/aim: Allergic rhinitis (AR) is a respiratory disease caused by inflammation of the nasal mucosa. Intranasal corticosteroids (ICs) are an effective treatment for AR; however, their use has ...
Background/aim: Allergic rhinitis (AR) is a respiratory disease caused by inflammation of the nasal mucosa. Intranasal corticosteroids (ICs) are an effective treatment for AR; however, their use has been associated with atrophy in nasal mucosae. Because DNA damage has been linked to several chronic diseases, we hypothesize that use of ICs could cause DNA damage in nasal mucosa cells, leading to mucosal atrophy and septal perforation. Materials and methods: Sixty patients with moderate or severe AR were divided randomly into two groups. Mometasone furoate (MF) and antihistamine tablets (desloratadine) were given to the study (IC) group. Physiologic saline and desloratadine were given to the control ((serum physiologic (SP)) group. Nasal irrigation fluid was taken from patients before study commencement and after 4 weeks of treatment. The comet assay was applied to detect DNA damage in nasal mucosa cells. Results: Nineteen patients were excluded, leaving a study population of 41 patients (IC group: 17 patients; SP group: 24 patients). Genotoxic damage was evaluated by comet assay. Conclusion: Treatment with MF spray for 4 weeks does not cause DNA breaks within cells in the nasal mucosa. These results could form the basis of clinical trials involving treatment with different ICs over longer treatment periods.
- Right Ventricular Perforation by a Defibrillator Lead Migrating to the Left Breast. [Journal Article]
- HSHeart Surg Forum 2018 03 05; 21(2):E087-E089
- Cardiac perforation after an ICD implantation is a rare complication, with a reported incidence between 0.6-5.2%. Its manifestation might be acute, subacute, or delayed, with an acute perforation occ...
Cardiac perforation after an ICD implantation is a rare complication, with a reported incidence between 0.6-5.2%. Its manifestation might be acute, subacute, or delayed, with an acute perforation occurring within the first 24 hours after implantation, frequently accompanied by severe clinical signs, while subacute and delayed perforations have a more benign progression. Here, we report a case of a 69-year old patient with an acute right ventricular perforation by a defibrillator lead migrating all the way through the pericardium and thoracic wall into the left breast, with an unusually mild and benign clinical course, delaying prompt diagnosis and postponing subsequent surgical treatment. Heart perforation with a defibrillator electrode is a rare but dangerous complication, which may lead to pacing failure, cardiac tamponade, cardiogenic shock, and even death. Even with a benign clinical course, one must think of cardiac wall perforation at any time after device implantation, and a contrast enhanced computer tomography (CTA) must be performed if perforation is suspected. At re-implantation, the lead should be located at a different anatomical position within the RV, preferably at the interventricular septal site, and manipulation of the injury site within the RV avoided.
- Endoscopic Transseptal Approach with Bilateral Nasoseptal Flap in Challenging Skull-Base Tumors. [Journal Article]
- WNWorld Neurosurg 2018 Apr 09
- CONCLUSIONS: The endoscopic transseptal approach, by creation of a bilateral nasoseptal flap using a 2-nostrils/4-hands technique, improves surgical visualization and increases instrument maneuverability. Surgical access to challenging skull-base tumors is therefore afforded. The procedure also reduces nasal morbidity by preserving the lacrimal apparatus and anterior maxilla structures and avoiding septal perforation and traumatic nose traction.
New Search Next
- Acellular Human Dermal Allograft as a Graft for Nasal Septal Perforation Reconstruction. [Journal Article]
- PRPlast Reconstr Surg 2018 Mar 20
- CONCLUSIONS: This is the first study to use objective and subjective measurements to confirm success with acellular dermis allograft as an adjunct for septal perforation repair. Demonstrating a statistically significant reduction in patient nasal symptoms following repair.