RESUMEN
INTRODUCTION: The appearance of postrhinoplasty mucous cysts is a very rare complication, affecting mostly the nasal dorsum, along with the lines of a nasal osteotomy. There have been also descriptions of other rare locations like the nasal tip, the medial canthus, and the paranasal area. CASE: We present for the first time the appearance of a recurrent mucous cyst in the glabellar area, away from any intervention field during a rhinoplasty. Ectopic free mucosal graft implantation during surgical treatment, herniation of mucosa through intranasal incisions, or improper clearing of mucous epithelial remnants and bony or cartilage parts during the operation are the most accepted theories for the formation of mucous cysts after rhinoplasty. Until now, there have been published 19 cases of postrhinoplasty mucous cysts, with the nasal dorsum being the most affected side. The glabella, as a site away from any line of osteotomy in an usually performed rhinoplasty, has never been before reported as a region of mucous cyst formation. CONCLUSION: The patient is still under periodical control, and 68 months postoperatively, there is no evidence of a recurrence.
Asunto(s)
Frente/patología , Mucocele/etiología , Complicaciones Posoperatorias , Rinoplastia/efectos adversos , Enfermedades de la Piel/etiología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Mucinas , Mucocele/patología , Recurrencia , Mucosa Respiratoria/patología , Enfermedades de la Piel/patologíaRESUMEN
OBJECTIVE: The patient selection for septoplasty usually relies on clinical judgement alone. It is not clear, if surgeons' selection criteria are able to accurately anticipate patients' long term satisfaction as only a few studies exist on the outcome of nasal septal surgery. In this study, we analyze patients' long term satisfaction following septoplasty based on their subjective opinion. MATERIALS AND METHODS: In this prospective study, 67 consecutive patients, who underwent septoplasty during one year in a District General Hospital, were included. We used the fairley nasal symptom questionnaire (FNQ) preoperativeiy and postoperatively and the Glasgow benefit inventory (GBI) postoperatively to assess the outcome. Patients were mailed two questionnaires 2-3 years postoperatively, to evaluate their perception of the procedure's long term results. As a criterion to measure the success of the operation we used the median postoperative FNQ score and patients were divided into two groups, consisting of patients with more and less successful result, respectively. RESULT: Fifty-one patients responded (76%). Analysis of the outcomes revealed significant improvement of total nasal symptom score (FNQ) postoperatively (from mean score 13.25 to 9.09) with significant benefit in the nasal obstruction, sore throat and the sense of smell but not for headaches. Significant improvement in nasal breathing was recorded mainly from patients with anterior septal deviation. Patients in the below criterion group (49%) had a mean GBI total score of 6.3, reporting no satisfaction after surgery, whereas patients in the above criterion group (51%) had a mean of 23.8, which is also not a satisfactory result. Social and physical components of GBI had no difference between groups having considerably low scores. CONCLUSION: The principal benefits of septal surgery are related to improvement in nasal symptoms. In this study GBI results did not reflect a significant change in health status from septoplasty even in the above criterion group. The significant percentage of patients who did not report satisfaction in the long term, questions the objectivity of surgeons' criteria regarding nasal septal surgery. It also indicates that positive evaluation by patients of septal surgery outcome tends to be attenuated with time.
Asunto(s)
Tabique Nasal/cirugía , Satisfacción del Paciente , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Cefalea/diagnóstico , Cefalea/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Obstrucción Nasal/diagnóstico , Obstrucción Nasal/epidemiología , Tabique Nasal/fisiopatología , Trastornos del Olfato/diagnóstico , Trastornos del Olfato/epidemiología , Faringitis/diagnóstico , Faringitis/epidemiología , Estudios Prospectivos , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
OBJECTIVE: To assess the ability to smell and appreciate food in children with adenoid hypertrophy pre and post-adenoidectomy. METHODS: A total of 35 children with adenoid hypertrophy admitted for adenoidectomy (aged 5-9.3 years, mean age 5.9 years) were tested preoperatively. In a follow up appointment 3 months postoperatively, 28 of them returned and were tested again. The control group consisted of 30 healthy children (aged 5-10.2 years, mean age 6.1 years). Orthonasal olfactory function was assessed psychophysically using "Sniffin sticks" 12 item odor identification test. Retronasal olfaction was assessed using a collection of 12 grocery available powders applied to the oral cavity. RESULTS: Both orthonasal and retronasal olfactory function of the study group preoperatively were significantly lower in comparison with the results of the control group (p<0.0001). The difference in retronasal olfaction between groups was significantly higher in comparison with the difference in orthonasal odor identification (p=0.048). There is a strong correlation between adenoid hypertrophy grade and retronasal testing results (t=-5.461, p<0.0001), but not with the orthonasal results (t=-1.677, p=0.9). Significant improvement of orthonasal and retronasal olfaction was observed in the follow-up appointment (p<0.0001). Relative increase postoperatively was higher for the retronasal olfaction compared to orthonasal olfaction (p=0.0029). CONCLUSIONS: Children with adenoid hypertrophy have a reduced ability to smell, with retronasal olfactory function being more affected. Surgery had a greater impact on retronasal olfaction.
Asunto(s)
Adenoidectomía , Tonsila Faríngea/fisiopatología , Enfermedades Linfáticas/fisiopatología , Tonsila Faríngea/patología , Tonsila Faríngea/cirugía , Niño , Preescolar , Técnicas de Diagnóstico del Sistema Respiratorio , Femenino , Humanos , Hipertrofia , Enfermedades Linfáticas/complicaciones , Enfermedades Linfáticas/patología , Enfermedades Linfáticas/cirugía , Masculino , Trastornos del Olfato/etiología , Trastornos del Olfato/cirugía , Recuperación de la Función , Olfato/fisiología , Gusto/fisiología , Trastornos del Gusto/etiología , Trastornos del Gusto/cirugíaRESUMEN
Solitary fibrous tumor (SFT) arises in the pleura and less commonly in extrapleural sites. SFT can be found in various head and neck sites. SFTs of the nasal cavity and paranasal sinuses are extremely rare with only ten previously reported cases in the world literature. This case report presents an additional case of SFT of the nasal cavity underlining the benign pattern and the bleeding tendency of nasal SFT, that surgeons managing these tumors should be aware of. Diagnostic procedure, clinical and histopathological findings as well as immunoreactivity of this tumor are discussed, with a review of the current literature.