phenylephrine-hydrochloride and Edema

Nasal surgeries (such as Functional Endoscopic Sinus Surgery, Rhinoplasty, and Septorhinoplasty) are popular procedures. But perioperative bleeding, eyelid edema, and periorbital ecchymosis remain problems. Tranexamic acid (TXA) is an antifibrinolytic, and it was used to reduce the perioperative bleeding. However, there is no enough evidence judging its safety and efficiency. Therefore, a meta-analysis is conducted by us to evaluate the role of TXA in patients undergoing nasal surgeries.. A search of the literature was performed until June 2018; the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar databases were searched for related articles using search strategy. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed. Only randomized controlled trial (RCT) articles were included, and subgroup analysis was established to deal with heterogeneity. RevMan 5.3 software was selected to conduct the meta-analysis.. Eleven RCTs were included in our meta-analysis. There were significant differences in blood loss (P < .001), surgical field quality (P < .001), edema rating of upper (P < .001) and lower (P < .001) eyelid, ecchymosis rating of upper (P < .001) and lower eyelid (P < .001) when comparing the TXA group to the placebo group. However, the difference in operation time (P = .57) was not significant between the two groups.. Perioperative TXA could reduce the blood loss and improve the quality of surgery field during nasal surgery, and it was helpful for reducing the edema and ecchymosis after nasal surgeries, but it has little influence in reducing the operation time.

Topics: Antifibrinolytic Agents; Blood Loss, Surgical; Ecchymosis; Edema; Eyelid Diseases; Humans; Nasal Surgical Procedures; Nose; Operative Time; Randomized Controlled Trials as Topic; Tranexamic Acid

The therapeutical results such as recoveries or substantial improvements obtained by neurovascular decompressive functional morpho-corrective rhino-skull base surgery on 2124 cases of primary headaches (migraine with aura, migraine without aura, cluster headache, chronic paroxysmal hemicrania, tension-type headache) obliges a thorough review of the classical chapter on "rhinogenous headaches" (Bonaccorsi, Novak, Blondiau, Bisschop, Hoover, Clerico). In fact all those headaches seemingly "primary", but having a "central-peripheral" etiopathogenesis proved by a well documented (CT) volumetric reduction of "ethmoidosphenoidal subcribriform chamber" according to hemoangiokinetics purposes of endo-exocranial anastomotic circulation of this area, should be included in the chapter of "rhinogenous headaches". This endo-exocranial anastomotic circulation is considered a "functional unit" owing to the continuity of rhino-ophthalmic-encephalic trigeminal-vegetative and vascular circuits (Hannerz, Hardebo, Moskowitz). These morphological abnormalities of the rhino-skull base osteo-vascular-mucous structures acquire physio-pathological significance only in patients with "low pain threshold and elevated central integrative capability", modulated and timed by the neurogenic biorhythms. It is described the surgery of rhino-skull base by "neurovascular decompressive septo-ethmoidosphenoidectomy" procedure, either conservative or radical till the III grade monolateral with trigeminal and vegetative selective neurotomy that permits to save olfaction and to remove even the controlateral pain decompressing the circulation and eliminating stasis even on the opposite side. Further, it is emphasized that the neurological deficit or central irritative symptomatology (visual aura, sensory-motor paresis, epilepsy) disappears after surgical removal of the "peripheral rhinogenous trigger". It demonstrates a cause and effect relationship that is the central peripheral functional interdependence, even if it's included in the neuro-transmissive, biochemical, neuro-endocrine, constitutional background which is controlled by the psychical, vegetative and dysnociceptive biorhythms.

Topics: Edema; Ethmoid Bone; Humans; Ischemia; Nasal Cavity; Nasal Septum; Nerve Compression Syndromes; Nose; Radiography; Sphenoid Bone; Treatment Outcome; Trigeminal Nerve; Vascular Headaches

Both for the nose and the lower airways there is an extensive subepithelial capillary network. That for the nose is fenestrated, and this is true for the tracheobronchial tree of rats, guinea pigs, and hamsters, and for that of human asthmatics. However, healthy humans, dogs, and sheep have capillaries without fenestrations except for those close to neuroepithelial bodies and submucosal glands. Deeper in the mucosa there is a capacitance system of vessels, conspicuous in the nose but present also in the lower airways of rabbits and sheep and, to a lesser extent, in those of dogs and humans. Both for the nose and the lower airways, parasympathetic nerves are vasodilator, sympathetic nerves are vasoconstrictor, and sensory nerves are able to release dilator neuropeptides. Most inflammatory and immunologic mediators are vasodilator. A conspicuous difference between the nasal and lower airway vasculatures is the presence of arteriovenous anastomoses only in the former. Countercurrent mechanisms also exist in the nose to increase its efficiency in air conditioning, but they have not been established for the trachea. The pulmonary vasculature could be part of such a system for the bronchi. Distension of the airway vasculature thickens the mucosa, probably both by vascular distension and by edema formation. The latter can lead to exudation into the airway lumen. These processes have not been well quantitated, and the balance sheet of capillary and capacitance vessel volumes, interstitial liquid volume, and exudate volume needs to be worked out in physiologic and pathologic conditions.

Topics: Air; Animals; Blood Flow Velocity; Bronchi; Cold Temperature; Dogs; Edema; Humans; Humidity; Inflammation; Microcirculation; Mucous Membrane; Nose; Pharmacokinetics; Sheep; Trachea; Vasoconstriction; Vasodilation

Post-operative periorbital ecchymosis and edema following rhinoplasty is a well-known sequela of surgery. Unfortunately, this can be a source of distress for patients, resulting in a longer post-operative recovery time and a delayed return to work. Trauma caused by lateral osteotomies is likely the most significant cause of periorbital edema and ecchymosis in rhinoplasty. There have been various strategies proposed to minimize swelling and ecchymosis with varying success rates and accompanied risks. Intraoperative nasal compression is one potential strategy that may reduce post-operative edema and ecchymosis with minimal risk.. To determine whether applying direct lateral nasal pressure intraoperatively immediately after performing lateral osteotomies reduces visible post-operative edema and ecchymosis.. A prospective, randomized blinded study on consecutive patients undergoing rhinoplasty with lateral osteotomies was conducted in a single academic tertiary care medical center. Each of the participants were randomized into direct pressure application post-lateral osteotomies on the right or the left hand side. Intra-operatively, direct lateral nasal pressure was performed on the pre-determined side for 5 min timed by stopwatch after osteotomy. Post-operatively, standard photographs were taken of the patient on post-operative days 1, 3, and 7. These photographs were then shown to 20 blinded-physicians and the degree of ecchymosis and edema was graded using a previously published scale.. A total of 16 patients were included in this study. Based on our blinded-grading, 11 of the 16 patients had a clear global improvement in the degree of peri-orbital post-operative edema and ecchymosis with compression post lateral osteotomies. Based on the 3 blinded expert reviewers, Periorbital ecchymosis was significantly decreased on the ipsilateral side of pressure application in 10 of the 16 patients, and periorbital edema was significantly decreased in 13 of the 16 patients. The differential degree in periorbital ecchymosis was most pronounced on post-operative day 7. Patient factors such as gender, age, skin color, history of nasal trauma, side of pre-operative nasal deviation, and smoking status did not have a significant influence on the effect of pressure application post lateral osteotomies.. Application of direct continual lateral nasal pressure intraoperatively after performing lateral osteotomies can help reduce post-operative edema and ecchymosis up to post-operative day 7. This may lead to an overall improved appearance and subsequently an improved post-operative experience for the patient. Although the effect may be variable to some degree, this is an intervention with no additional risks involved and thus can be used in a safe manner.

Topics: Adult; Compression Bandages; Ecchymosis; Edema; Female; Humans; Intraoperative Care; Male; Middle Aged; Nose; Postoperative Complications; Pressure; Prospective Studies; Rhinoplasty; Young Adult

Background/aim: Periorbital edema and ecchymosis may develop following rhinoplasty. The aim of this study was to assess the efficacy of adhesive strip application on the upper and lower eyelids to reduce postoperative edema and ecchymosis following rhinoplasty. Materials and methods: The eyelids of one side were randomly selected, and an adhesive strip of standard size and number was applied at the end of the operation. The strips were removed at postoperative day 3; photos of the eyes were taken at days 3 and 7. Edema and ecchymosis were graded on a scale from 1 to 4. The ecchymosis areas on the lower and upper eyelids were measured and compared in square centimeters. Results: The mean ecchymosis area of the lower eyelid on the side of the adhesive strip and on the side without the strip was 1.63 cm2 and 3.32 cm2 in the early period, respectively. It was 1.15 cm2 on the upper eyelid on the side of the adhesive strip, and 1.87 cm2 on the side without the strip. It was 0.224 cm2 on the side of the adhesive strip, and 0.498 cm2 on the side without the adhesive strip in the late period. Conclusion: Applying adhesive strips reduces periorbital edema and ecchymosis.

Topics: Adhesives; Adolescent; Adult; Ecchymosis; Edema; Eyelids; Female; Humans; Male; Nose; Postoperative Complications; Rhinoplasty; Young Adult

Edema persists for months after rhinoplasty. Numerous modalities have been described to counteract postoperative edema.. To evaluate the effect of postrhinoplasty taping (PRT) on nasal edema and nasal draping.. In this randomized clinical trial, 57 patients undergoing rhinoplasty at a tertiary reference center from August 1, 2014, to January 31, 2015, were assigned to a control group or to 2- or 4-week PRT groups. Baseline nasal thickness was measured with ultrasonography at the nasion, rhinion, supratip, and tip, and mean nasal skin thickness (MNST) was calculated. Participants in each group were categorized by the baseline MNST measurement from the lowest to greatest MNST; those in the upper half were categorized as having thick skin; those in the lower half, thin skin. The control group underwent no PRT after the removal of external packing. Patients in the 2- and 4-week PRT groups received additional taping during the allocated time. Data were collected from August 1, 2014, to June 31, 2015. Follow-up was completed on June 31, 2015, and data were analyzed from July 1 to August 1, 2015.. Postoperative measurements of MNST were performed at the end of weeks 1, 3, and 5 and month 6.. Of the 57 total patients (33 male and 24 female patients; mean [SD] age, 30.0 [11.7] years), 17 were in the 2-week PRT group; 20, the 4-week PRT group; and 20, the control group. Compared with the control group, 4-week PRT had a significant effect on the supratip (P = .001). Comparisons of MNST with the control group revealed significant effects of 2-week (P = .02) and 4-week (P = .007) PRT. The effect on the tip was not significant (P = .052). Postrhinoplasty taping had no effect in thin-skinned patients. Comparison among thick-skinned patients revealed a significant effect on the MNST (P = .01) and the rhinion (P = .02) but not the tip (P = .06) and supratip (P = .07).. Postrhinoplasty taping helps the skin envelope to compress to the underlying framework and decrease postoperative edema. The procedure can be used particularly in thick-skinned patients, in whom skin draping and nasal refinement is crucial to the surgical outcome.. 1.. clinicaltrials.gov Identifier: NCT02626585.

Topics: Adult; Compression Bandages; Edema; Female; Humans; Male; Nose; Postoperative Period; Rhinoplasty; Skin; Ultrasonography; Young Adult

To characterize the venous, lymphatic, and arterial blood supply of the nose and determine the effect of the external rhinoplasty approach on this vasculature. We hypothesized that dissection in the areolar tissue plane below the musculoaponeurotic layer of the nose will preserve the nasal vasculature and minimize postoperative nasal tip edema.. The study included preoperative and postoperative clinical evaluation, cadaver dissection, and histologic examination. In the clinical section, lymphoscintigraphy was performed before and after rhinoplasty using the endonasal (transnostril) or external (open) approach. Additionally, nasal tip edema was subjectively quantified at specified interval after surgery. In the cadaver dissection section, 15 fresh cadavers were dissected to identify the venous and arterial vasculature. In the histology section, fresh nasal tissue was examined by light microscopy to verify the anatomy of arteries, veins, and lymphatic vessels.. Subjects for the clinical section of the study were volunteers undergoing primary rhinoplasty surgery at the University of Illinois College of Medicine at Chicago.. Lymphoscintigraphy was performed on nine patients who underwent rhinoplasty surgery. Seven of these patients underwent postoperative lymphoscintigraphy.. The rhinoplasty procedures included three different methods of exposure of the nasal structures. Two patients underwent an endonasal (transnostril) nondelivery approach using a transcartilaginous incision. Five patients underwent the external approach with three receiving dissection in the areolar tissue plane below the musculoaponeurotic layer (preserving major nasal vasculature) and two undergoing dissection above the musculoaponeurotic layer (disrupting nasal vasculature).. In the clinical section of the study, the outcome measures were tracer flow as seen on lymphoscintigraphy and tip edema scores subjectively quantitated on a scale from 1 (none) to 4 (maximal).. Clinical Section: Lymphoscintigraphy revealed flow of tracer along the lateral aspect of the nose (cephalic to lateral crura) to the preparotid lymph nodes. Postoperative scans revealed preservation of flow of tracer with the endonasal (transnostril) approach and the external approach with submusculoaponeurotic areolar tissue plane dissection. There was loss of normal flow of tracer with the external approach using dissection that disrupted the musculoaponeurotic layer with supratip debulking. The nasal tip edema scores for the transnostril and external approach using areolar plane dissection were significantly lower than the external approach with disruption of the musculoaponeurotic layer. Cadaver Dissection Section: Other than the lateral nasal veins, the major arteries, veins, and lymphatic vessels ran superficial to the musculoaponeurotic layer of the nose. The lateral and dorsal nasal and the columellar arteries comprise an alar arcade that provides the major blood supply to the flap elevated in the external rhinoplasty approach. Histologic Section: Light microscopy of plastic resin sections verified the lymphoscintigraphic and cadaver dissection findings. The lymphatic vessels were located primarily in the reticular dermis above the muscle layer.. The major arterial, venous, and lymphatic vasculature courses in or above the musculoaponeurotic layer of the nose. In the external rhinoplasty approach, dissection in the areolar tissue plane below the musculoaponeurotic layer will minimize tip edema and protect against skin necrosis by preserving the major vascular supply to the nasal tip.

Topics: Cadaver; Dissection; Edema; Follow-Up Studies; Humans; Lymphoscintigraphy; Nose; Nose Diseases; Rhinoplasty

Topics: Edema; Hematoma; Humans; Nose; Nose Deformities, Acquired; Postoperative Complications; Rhinoplasty; Streptokinase; Wound Healing

Excessive nasal edema is among the complications after rhinoplasty translating into Skin-Soft Tissue Envelope (SSTE) thickening and disruption in the nasal framework's definition. Revision rhinoplasties are suspected of causing even more nasal edema. The objective postoperative SSTE thickness between revisionary and primary rhinoplasties is compared in this study.. A study was conducted over a recorded database of eligible candidates who had attended the senior author's private clinic in a 12-month period and underwent primary and revisionary open-approach rhinoplasties. The SSTE thickness was measured by ultrasonography in each nasion, rhinion, supratip, and tip region at months 1, 3, 6, and 12 after each episode of rhinoplasty. Paired T-test was used for pairwise comparisons of the corresponding region-time thicknesses between primary and revisionary rhinoplasties. Repeated measure ANOVA tests were used to assess mean thickness changes over time after each surgery-P < 0.05 indicated significance.. Of the 36 participants analyzed, the SSTE was significantly thicker after revisionary surgery in all the follow-up sessions and nasal regions, except for the 1-month follow-up in the nasion (p = 0.273) and 12-month follow-up in the rhinion (p = 0.050). Mean nasal SSTE thickness showed decreasing trends in each region after either primary or revisionary surgery, with a lower level of resolution in the nasion region after revision rhinoplasty (p < 0.001).. The nasal SSTE had been significantly thicker in most regions after revisionary procedures than primary ones, and the swelling had subsided slightly slower. Surgeons are recommended to consider revisionary rhinoplasties based on these findings cautiously.. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Topics: Edema; Esthetics; Humans; Nasal Septum; Nose; Retrospective Studies; Rhinoplasty; Skin; Treatment Outcome; Ultrasonography

Topics: Airway Obstruction; Anesthesiology; Edema; Humans; Laryngeal Edema; Nose; Pharynx

Proper control of postoperative edema in rhinoplasty matters significantly, both regarding patient satisfaction and preventing loss of definition and aesthetic surface contour in the dorsum and tip. The "3 points compartmentalization" technique described in this paper aims to fulfill the above goals by (1) dissection in a subperichondrial-subperiosteal plane and (2) reducing the dead space by three strategically placed key sutures that compartmentalize the nose and redrape the single-plane dissection in an anatomically correct position.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Topics: Edema; Esthetics; Humans; Nasal Septum; Nose; Rhinoplasty; Treatment Outcome

The size, shape, and symmetry of the nose contribute significantly to the facial aesthetic, so it is understandable why rhinoplasty is one of the most popular cosmetic procedures undertaken nowadays. Several factors are associated with the rates of both success and postoperative complications of rhinoplasty.. To determine the relationship between nasal skin thickness and postoperative periorbital ecchymosis and edema among patients who underwent rhinoplasty at King Abdulaziz University Hospital.. A prospective study was conducted among all patients operated on for rhinoplasty at King Abdulaziz University Hospital in the Department of Otolaryngology, Riyadh, Saudi Arabia, between May and December 2018. To determine the relationship between nasal skin thickness and postoperative periorbital edema and ecchymosis, demographic data (gender, age), mean nasal skin thickness, surgical factors (time of surgery, extent of intraoperative bleeding), and scoring for periorbital ecchymosis and edema were obtained. The statistical analysis was done by comparing means and frequency using analysis of variance.. A total of 54 patients participated in this study with ages ranging from 19 to 33 years and a mean age of 24.43. According to this study, postoperative edema presentation on the first, third, and seventh days upon examination was higher among patients with thicker nasal skin (6 mm), and results are statistically significant (. This study concludes that the severity of edema and ecchymosis correlates with nasal skin thickness. The degree of edema and ecchymosis was higher during the initial postoperative examinations, but following that, it was reduced and completely diminished by the 21st day post-surgery.

Topics: Adult; Ecchymosis; Edema; Female; Humans; Male; Nose; Postoperative Complications; Postoperative Period; Predictive Value of Tests; Prognosis; Prospective Studies; Rhinoplasty; Skin; Skinfold Thickness; Treatment Outcome; Young Adult

Posterior nasal nerve (PNN) cryoablation is a novel surgical technique used to address chronic rhinitis. The purpose of this study is to review the medical device reports (MDRs) submitted to the Food and Drug Administration's (FDA) Manufacturer and User Device Facility Experience (MAUDE) database to identify adverse events related to the use of ClariFix, a device designed for office-based cryosurgical ablation of the PNN. A total of 12 adverse events associated with ClariFix from January 2017 to August 2020 were identified and analyzed. The most common adverse events associated with ClariFix PNN cryoablation include epistaxis and nasal swelling. Further studies are needed to clarify whether PNN cryoablation is associated with epistaxis in certain populations.

Topics: Chronic Disease; Cryosurgery; Edema; Epistaxis; Humans; Nose; Rhinitis; United States

Understanding the postoperative dynamics of the nasal soft-tissue envelope (NSTE) is necessary to obtain the desired cosmetic results after rhinoplasty. This study was conducted to determine the changes of NSTE thickness and its effects on periorbital edema and ecchymosis following rhinoplasty.. Thirty-five patients who underwent rhinoplasty were included in the study. Nasal skin and subcutaneous tissue thickness at the tip, supratip, rhinion, and nasion were measured using ultrasonography preoperatively and at the postoperative 3rd and 10th months. Periorbital edema and ecchymosis were evaluated at postoperative days 1, 3, and 7. The patients were categorized as the thick NSTE group (n = 17) and the thin NSTE group (n = 18) according to the preoperative median NSTE thickness.. In the thin NSTE group, supratip skin, subcutaneous tissue, and total NSTE thickness were lowest on the preoperative day but no statistically significant difference was found for the thick NSTE group. In the thin NSTE group, total NSTE thickness of the rhinion was highest at the postoperative 3rd month, but in the thick NSTE group, there was no statistically significant difference between postoperative 3rd and 10th months. In both groups, total NSTE thickness of the nasion was highest at the postoperative 3rd month and lowest at the postoperative 10th month.. Supratip fullness occurs more prominent in patients with thin NSTE. Postoperative edema in the rhinion is greater in patients with thin NSTE for the early postoperative period but it lasts longer in patients with thick NSTE. Soft-tissue envelope atrophy at the nasion occurs in both groups in the late postoperative period. Periorbital edema and ecchymosis severity are not affected by NSTE thickness.

Topics: Ecchymosis; Edema; Humans; Nose; Postoperative Complications; Postoperative Period; Rhinoplasty; Ultrasonography

Nonsurgical rhinoplasty with injectable dermal fillers has become an increasingly popular alternative to surgical procedures, in view of its relative low cost, convenience and rapid recovery, and low risk profile. The safety and efficacy of nonsurgical rhinoplasty remains a relatively contentious and ambiguous matter, given that there are few large-scale series reporting results or complications. This study reports the experience of a single clinician performing nonsurgical rhinoplasty in the largest cohort to date.. Patient demographics, indications, treatment details, and outcomes of patients treated between March of 2016 and January of 2019 were reviewed. The nonsurgical rhinoplasty technique described previously by Harb was used using hyaluronic acid dermal filler.. Nonsurgical rhinoplasty was performed in 5000 patients. The commonest indication was dorsal hump (44 percent). Swelling and erythema were self-limiting side effects encountered in approximately half of patients. Infection was seen in two patients, and localized skin necrosis was observed in three patients.. Nonsurgical rhinoplasty is a safe procedure with positive aesthetic results when performed by an experienced clinician. Knowledge of nasal anatomy, comprehensive training, and use of appropriate materials are key in ensuring safety and results.. Therapeutic, IV.

Topics: Adolescent; Adult; Aged; Cosmetic Techniques; Dermal Fillers; Edema; Erythema; Esthetics; Female; Humans; Hyaluronic Acid; Male; Middle Aged; Necrosis; Nose; Patient Satisfaction; Retrospective Studies; Rhinoplasty; Skin; Treatment Outcome; Young Adult

Rhinoplasty is one of the most commonly performed aesthetic procedures today. Although nasal airway obstruction is frequently treated concomitantly with the aesthetic procedure, chronic sinusitis has typically postponed until full resolution of inflammatory symptoms.. To investigate the feasibility of combining FESS with septorhinoplasty by measuring different outcomes including operative time, blood loss, post-operative edema of the upper and lower eyelids, periorbital ecchymosis, patient discomfort and complication rates.. The study included 20 patients with deformed nose associated with chronic rhinosinusitis (CRS) not responding to medical treatment for at least 3 continuous months, irrespective to sex, of ages 20-60, and without any systemic diseases (study group), and 20 patients with deformed nose without any sinus problems (control group).. There was no significant difference between the two groups in the different measured outcomes (P>0.05) except for the operative time which was significantly less in the control group (P<0.05).. Concurrent rhinoplasty and endoscopic sinus surgery may be performed safely and effectively with minimal risks. Proper patient selection and sound intraoperative judgment can avoid potential complications.

Topics: Adult; Case-Control Studies; Ecchymosis; Edema; Endoscopy; Eyelid Diseases; Feasibility Studies; Female; Follow-Up Studies; Humans; Male; Middle Aged; Nasal Cavity; Nose; Operative Time; Patient Satisfaction; Postoperative Complications; Prospective Studies; Rhinitis; Rhinoplasty; Sinusitis; Young Adult

The purpose of this study was to evaluate the potential irritating effects and the systemic exposure level of an antibacterial ointment containing REP8839 as a single agent or in combination with mupirocin versus Bactroban Nasal in rabbits. Additionally, the reversibility of REP8839 effects during a 14-day recovery period was assessed. Five treatment groups of six male and six female New Zealand White rabbits received dose levels of 1%, 2%, and 4% REP8839, 2% Bactroban Nasal, or 2% REP8839/2% mupirocin combination. One additional group of six animals/sex served as the control and received the vehicle, Petrolatum/Softisan 649. The test article or vehicle was administered to all groups via topical administration to the external nares, twice a day (approx. 8h intervals between the doses) for 21 consecutive days, at a dose volume of 100 microL per nare/dose for a total of 400 microL per day (200 microL per nare). Two animals/sex/group were maintained for a 14-day recovery period. The external nares were reflected back and the mucosal lining was evaluated and scored for erythema and edema within 30-60 min following the first dose each day. Blood samples were collected from all animals at designated time points on Day 21 of the study to assess systemic exposure levels. Cross-sectioning of the nasal tract was conducted in all the groups for microscopic evaluation. Mucosal scoring of the nares did not reveal any edema or erythema in any of the dose groups with the antibacterial alone, with the combination product, or with Bactroban Nasal. Mean body weights and food consumption were not adversely impacted by the test articles. Minimal plasma exposure was observed in the rabbits (<5 ng/mL). The REP8839 groups did appear to have dose-responsive exposure (from below the limit of quantitation to 5 ng/mL with 1%, 2%, and 4% REP8839, respectively). Microscopic changes on the nasal sectioning noted in these animals were infrequent and considered incidental findings unrelated to administration of the test articles. In conclusion doses of up to 4% of REP8839 ointment as a single agent or 2% in the combination product, as well as 2% Bactroban Nasal, were not found to induce mucosal irritation when applied topically to the external nares twice a day for 21 consecutive days. Additionally, no delayed effects were observed in the recovery animals.

Topics: Administration, Intranasal; Animals; Anti-Bacterial Agents; Biological Availability; Diamines; Dose-Response Relationship, Drug; Drug Combinations; Edema; Erythema; Female; Irritants; Male; Mupirocin; Nasal Mucosa; Nose; Ointments; Rabbits; Thiophenes

Topics: Aged; Edema; Female; Humans; Lymphoma, T-Cell; Neoplasm Invasiveness; Nose

Topics: Adult; Biopsy; Diagnosis, Differential; Edema; Humans; Male; Nose; Osteoarthropathy, Primary Hypertrophic

Sublabial approach has been widely used as the standard technique for transsphenoidal pituitary surgery. But it has several possible drawbacks, such as; postoperative flat nose deformity, hypesthesia of upper gum, and feeding difficulty until 2 to 3 weeks after surgery. As an alternative, an endonasal approach was adopted for patients who had large nostrils, such as white or acromegalic patients. In patients with small nostrils, especially oriental people, it requires an additional tension release incision that leaves a definitely visible scar at the base of nose.. We applied the transcolumellar approach, which modified the external rhinoplasty approach on the 136 cases of transsphenoidal pituitary surgery that were performed from 1994 to June 1999.. In all patients, we found we could reach the anterior portion of nasal septum in 7 to 8 mm in depth from the skin surface and eliminate the disadvantages of sublabial and endonasal approach. Also, this method can markedly reduce the surgical dissection time and blood loss.. We concluded that this technique was relatively simple and more than adequate in most transsphenoidal pituitary surgery, even in patients with small nostrils.

Topics: Asian People; Cicatrix; Dissection; Edema; Endoscopy; Follow-Up Studies; Humans; Hypophysectomy; Nose; Pituitary Neoplasms; Rhinoplasty; Surgical Flaps; Suture Techniques; Treatment Outcome

In this article, we describe a new flap for use in lower nasal reconstruction.. This technique consists of a planned heminasal transposition rotation flap, with both laterally based and glabellar components. Esthetically favourable incisions are made to follow at the junction between the esthetic subunits.. Gratifying early results are achievable, resulting in little postoperative edema due to maintenance of laterally based lymphatic and venous outflow. Likewise, pleasing long-term outcomes have been noted in each of the ten patients in whom we have utilized this flap for nasal reconstruction. Complete flap survival has been noted in every patients.. Our experience with the use of this flap technique suggests that it provides consistently rewarding, esthetically pleasing results in patients with cutaneous defects of the lower half of the nose.

Topics: Edema; Esthetics; Graft Survival; Humans; Lymphedema; Nose; Nose Diseases; Postoperative Complications; Regional Blood Flow; Rotation; Skin Transplantation; Surgical Flaps; Treatment Outcome

Topics: Acanthosis Nigricans; Adult; Disease Progression; Edema; Fingers; Foot Deformities, Congenital; Hand Deformities, Congenital; Humans; Keratoderma, Palmoplantar; Keratosis; Lip; Male; Mouth; Mouth Mucosa; Nose; Toes; Tretinoin

Topics: Accidents, Traffic; Alcoholic Intoxication; Anesthesia, Local; Cerebrospinal Fluid Rhinorrhea; Child; Contusions; Ecchymosis; Edema; Epistaxis; Frontal Bone; Hematoma; Humans; Nasal Bone; Nasal Septum; Nose; Orbital Fractures; Skull Fractures; Violence

We report a fetus with hydrops, ectrodactyly, syndactyly, duplication of the great toes and several other features. From a review of the literature we suggest that this constellation of abnormalities has not previously been reported.

Topics: Abnormalities, Multiple; Clubfoot; Ear; Edema; Fetus; Fingers; Humans; Kidney; Male; Mandible; Nose; Syndrome; Toes

A case of rhinofacial zygomycosis with of years duration, caused by Conidiobolus coronatus is described. The patient, a 72-years-old woman, presented with a bilateral distortion of the subcutaneous tissue and disfigurement of the face. Treatment with ketoconazole and potassium iodide did not prevent several relapses. At present she is still under treatment with fluconazole with clinical healing. Histopathological and mycological examination confirmed the dermatological diagnosis. An increasing number of cases of zygomycosis caused by fungi of the order Entomophthorales have also been reported in the Northern and Northeastern States of Brazil.

Topics: Aged; Agricultural Workers' Diseases; Brazil; Edema; Face; Female; Fluconazole; Fungi; Humans; Ketoconazole; Mycoses; Nose; Recurrence

Topics: Adult; Edema; Female; Granuloma; Humans; Male; Middle Aged; Nose; Pain; Prostheses and Implants; Rhinoplasty; Silicone Elastomers

In an animal experiment involving Rhesus monkeys the relationship between the rhinomanometrical findings and the results of Eustachian tube tests was investigated. Nasal challenges were performed with histamine and Substance P in order to create an edema of the nasal mucosa. We studied the nasal resistance and tubal function parameters with the help of computer-assisted techniques of pressure and flow measurement. It was the aim of the study to investigate if an edema of the Eustachian tube, demonstrated by an increase of the nasal resistance, has an influence on the tubal function. It was noted that an increase of the nasal resistance influenced some parameters of Eustachian tube function. Especially the steady state pressure and the closing pressure increased with increasing nasal resistance. These experiments illustrate the correlation between edema of the nasal mucosa and the function of the Eustachian tube.

Topics: Airway Resistance; Animals; Edema; Eustachian Tube; Histamine; Macaca mulatta; Manometry; Nose; Otitis Media with Effusion; Substance P

This study analyzed the effect of perennial allergic rhinitis on dental and facial skeletal characteristics. Twenty-five allergic children who were apparent mouth breathers, their 25 siblings who did not have the disease and were apparent nose breathers, and 14 nasal breathing control subjects were examined medically, dentally, and cephalometrically. Compared with their siblings, the allergic subjects had more nasal mucosal edema, a higher proportion of eosinophils in their nasal secretions, and greater nasal power. The allergic subjects were characterized by deeper palatal height, retroclined mandibular incisors, increased total anterior facial height and lower facial height, a larger gonial angle, and greater SN, palatal, and occlusal planes to mandibular plane angles. All of these measures except gonial angle were also significantly different between the allergic children and the nonconsanguineous controls. Also, the allergic subjects compared with controls had smaller SNB and SN-pogonion angles and an increased overjet. Both allergic and nonallergic sibling groups showed larger mean adenoid size on radiographs than controls. For most variables the nonallergic siblings fell between the allergic children and the control subjects. Overall, the allergic children had longer, more retrusive faces than controls. This retrusive characteristic was present in nonallergic siblings and cannot be ascribed to the apparent breathing mode at the time of the study. These results confirm earlier reports that allergic rhinitis may be associated with altered facial growth. Controlled longitudinal studies to analyze a possible cause-and-effect relationship and the effects of medical and surgical treatments should be undertaken.

Topics: Adolescent; Airway Resistance; Cephalometry; Child; Child, Preschool; Edema; Facial Bones; Female; Humans; Male; Mouth Breathing; Nasal Mucosa; Nose; Pulmonary Ventilation; Rhinitis, Allergic, Perennial; Tooth

Rhinoplasty was performed in 134 non-Caucasians over a 16-year period. The indications and techniques for operative approaches pertinent to achieving facial balance and symmetry in the non-Caucasian are described. Alar flaring is best addressed with alar base resection. Alar base resection does not significantly narrow alar width. Reduction in interalar distance is best performed with interalar reduction. If alar flare and wide interalar distance coexist, one should always consider a secondary or tertiary procedure. Planning a secondary procedure avoids devitalizing tissues and multiple super-imposed incisions and permits minor revisions. A simplified approach to removal of excessive tip fat is discussed. Methods of addressing complications peculiar to non-Caucasian rhinoplasties are described. In order to avoid racial incongruity, one must incorporate an alar narrowing procedure, i.e., interalar reduction or alar sill advancement. The results of this study reemphasize the importance of analyzing the nose with respect to the rest of the face in order to establish guidelines for these often difficult nasal reconstructions.

Topics: Adult; Asian People; Black People; Edema; Facial Asymmetry; Female; Follow-Up Studies; Hispanic or Latino; Humans; Male; Middle Aged; Nose; Postoperative Complications; Rhinoplasty; White People

Dermis grafts were used by themselves or in conjunction with a more rigid material such as cartilage or bone in a series of 220 patients during a period of 18 years. Of these, 182 patients were seen between 6 months and 2 years after operation. The significant problem during the earlier postoperative period was a transient swelling of the recipient site, which was seen in 150 of the 182 patients (82 percent) and which lasted for up to 6 months. It resolved spontaneously in all cases without active treatment in between 3 and 6 months. In the late postoperative period a significant permanent decrease in graft volume with a return to the previous deformity occurred in 9 of 182 patients (5 percent). This paper illustrates the versatility of dermis grafts in dealing with a variety of iatrogenic and accidental traumatic deformities of the nose.

Topics: Edema; Female; Humans; Infections; Male; Nose; Nose Deformities, Acquired; Postoperative Complications; Reoperation; Rhinoplasty; Skin Transplantation

Nasal obstruction during pregnancy may arise from allergic or endocrine factors and often compounded by abuse of topical nasal vasoconstrictors. Severe nasal symptoms occurred in 32% of pregnant women surveyed. Despite self-medication with nose drops and proprietary remedies, as well as prescriptions of antihistamines and systemic decongestants, some instances of rhinitis of pregnancy remain refractory to treatment. Intranasal injection of corticosteroids affords rapid and lasting relief for these patients. In this series, 21 patients with severe nasal obstruction during pregnancy received 27 intranasal steroid injections. Excellent relief of symptoms was obtained, without untoward effects on the pregnancy.

Topics: Edema; Female; Glucocorticoids; Humans; Injections; Nasal Mucosa; Nose; Pregnancy; Pregnancy Complications; Rhinitis

Rhinomanometry is useful for estimating the reactions of nasal mucosa to saline aerosol inhalations. The resistance of the whole nose provides insufficient evidence. Reactions on one side of the nose clearly show that--it is possible to differentiate qualitatively and quantitatively between the first and the second stage after inhalation. The reaction on one side of the nose may be opposite in character to the other side. The same person may respond in a contrary manner on different days both qualitatively and quantitatively. Patients with rhinitis and allergy react particularly briskly. The problems of nasal dynamics are indicated.

Topics: Aerosols; Airway Resistance; Cold Temperature; Edema; Hot Temperature; Humans; Individuality; Manometry; Naphazoline; Nasal Mucosa; Nose; Rhinitis; Sodium Chloride

Topics: Airway Obstruction; Cerebrospinal Fluid Rhinorrhea; Edema; Facial Injuries; Fracture Fixation; Fracture Fixation, Internal; Fractures, Bone; Humans; Maxillary Sinus; Methods; Nose; Orbit; Zygomatic Fractures

Topics: Abscess; Anti-Bacterial Agents; Blepharoptosis; Blindness; Cellulitis; Conjunctiva; Cornea; Diagnosis, Differential; Edema; Ethmoid Bone; Eye Diseases; Eyelids; Face; Hypesthesia; Lacrimal Apparatus; Neuralgia; Nose; Ophthalmic Nerve; Ophthalmoplegia; Optic Neuritis; Orbit; Papilledema; Periosteum; Prednisone; Pupil; Sinus Thrombosis, Intracranial; Sinusitis

Topics: Adolescent; Adult; Carcinoma, Squamous Cell; Connective Tissue; Edema; Ethmoid Sinus; Female; Frontal Sinus; Humans; Male; Methods; Middle Aged; Nasal Polyps; Nasal Septum; Nose; Nose Neoplasms; Osteomyelitis; Scalp; Sinusitis; Skull

Topics: Adolescent; Aged; Cerumen; Dental Caries; Ear Canal; Ear Diseases; Edema; Female; Glossopharyngeal Nerve; Humans; Male; Maxillary Sinus; Nasal Mucosa; Nose; Nose Diseases; Pharyngeal Diseases; Radiography; Reflex; Sinusitis; Trigeminal Nerve; Turbinates; Vagus Nerve; Vestibular Nerve

Topics: Child; Child, Preschool; Edema; Epistaxis; Fractures, Cartilage; Hematoma; Humans; Infant; Methods; Nasal Septum; Nose; Physical Examination; Surgical Instruments

Topics: Alkaline Phosphatase; Atrophy; Biopsy; Edema; Histocytochemistry; Humans; Mast Cells; Metaplasia; Mucins; Nasal Mucosa; Nose; Rhinitis, Atrophic

Topics: Cocaine; Edema; Female; Humans; Male; Morphine; Nasal Mucosa; Nose; Odorants; Olfaction Disorders; Olfactory Nerve; Pentobarbital; Postoperative Complications; Preanesthetic Medication; Rhinoplasty; Smell

Topics: Carica; Drug Therapy; Ecchymosis; Edema; Humans; Nose; Papain; Peptide Hydrolases; Postoperative Complications; Rhinoplasty; Surgery, Plastic

Topics: Adrenal Cortex Hormones; Anatomy; Edema; Histamine H1 Antagonists; Nasal Mucosa; Nasal Obstruction; Nose; Nose Deformities, Acquired; Physiology; Rhinitis; Rhinitis, Allergic, Seasonal; Rhinitis, Atrophic; Rhinoplasty

Topics: Burns; Edema; Humans; Inflammation; Neoplasms; Nose; Oxyphenbutazone; Postoperative Complications; Skin Transplantation; Surgery, Plastic; Wounds and Injuries

The author has previously shown the conditioning role of the anaphylactoid reaction in the calcification of the snout and paws of the rat after the injection of certain metallic compounds. The present experiments show that it is the dextrin fraction of these compounds which causes these anaphylactoid phenomena before the calcifying response. This fact deserves special attention since dextrin is frequently used in the preparation of certain drugs.

Topics: Anaphylaxis; Calcification, Physiologic; Calcinosis; Dextrins; Edema; Extremities; Hypersensitivity; Nose; Polysaccharides; Rats; Research; Toxicology

Topics: Asthma; Edema; Eosinophilia; Humans; Hypersensitivity; Nasal Polyps; Nose; Paranasal Sinuses; Rhinitis, Allergic, Seasonal; Sinusitis

Topics: Abscess; Anti-Bacterial Agents; Antibiotics, Antitubercular; Child; Edema; Eyelids; Humans; Nose; Orbit; Sinusitis

Topics: Edema; Edetic Acid; Hemostasis; Humans; Nasal Surgical Procedures; Nose; Postoperative Care; Rhinoplasty

Topics: Body Fluids; Edema; Humans; Nasal Polyps; Nose; Polyps

Topics: Edema; Humans; Nose; Otitis Externa; Otorhinolaryngologic Diseases; Pharynx; Phenylbutazone

Topics: Edema; Humans; Nose; Nose Diseases; Prognosis

Topics: Cortisone; Edema; Humans; Nasal Surgical Procedures; Nose; Rhinoplasty; Skin

The sulfonamides and antibiotics have been of great value in reducing the duration and severity of acute sinusitis in children.Chemotherapy, in the acute case, will probably prevent much chronic sinusitis of the infectious type. The most common variety of chronic sinus disease is due to a primary allergic condition plus secondary infection. It is impossible to treat these cases successfully without treating the allergy as well as the infection. The home use of any nose drop preparation is of very little value in the treatment of chronic sinusitis of any type or localization. The local nasal use of sulfonamides or antibiotics is not based upon rational principles. Their clinical value is negligible. They may, moreover, be decidedly irritating to the nasal mucosa. One should not hesitate to resort to rational surgical procedures to improve nasal ventilation in a child with sinusitis. While the advent of chemotherapeutic, antibiotic and antihistaminic drugs has been of inestimable value in the treatment of chronic sinusitis, we must not neglect to surgically correct anatomical defects and irreversible pathological mucosal changes which interfere with proper nasal physiological processes.

Topics: Anti-Allergic Agents; Anti-Bacterial Agents; Child; Chronic Disease; Disease; Edema; Humans; Hypersensitivity; Mucous Membrane; Nasal Mucosa; Nose; Paranasal Sinus Diseases; Paranasal Sinuses; Respiration; Sinusitis