http://www.rhinoplastyinseattle.com Seattle Facial Plastic Surgeon, Dr. Thomas Lamperti, uses advanced HD fiberoptic technology to show what a deviated nasal septum and enlarged inferior turbinates look like. He points out basic anatomic landmarks such as the septum, inferior turbinates and nasopharynx. Dr. Lamperti is certified by both the American Board of Facial Plastic and Reconstructive Surgery and the American Board of Otolaryngology-Head & Neck surgery. He has devoted his career to treatments of the head, face and neck. He feels that by focusing his plastic surgery endeavors solely to the face he is best able to provide the excellent results his patients desire. He is an active member of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS.org) and the Washington Society of Facial Plastic Surgeons. For more information about Lamperti Facial Plastic Surgery or to schedule a consultation please visit http://www.drlamperti.com or call (206) 505-1234.
Nose: - Inspect the nose: it should be midline and in proportion to other facial features. - Patency: push nostril shut and ask patient to sniff. Absence of sniff indicates obstruction. - When using the otoscope, gently lift up the tip of the nose with your finger before inserting. - Inspect the nasal mucosa. It should be red, smooth, and moist. Note any swelling, discharge, bleeding, or foreign bodies. - Observe the nasal septum for deviation. - Inspect the middle and inferior turbinates, note any swelling.
Wondering what it's like to get a septoplasty? Here's my 24-hour assessment on the procedure and my take on what to expect. I ended up having this procedure as a result of having a severely deviated septum that was causing frequent sinus infections. Not only was it causing infections, but also caused mouth breathing at night and only being able to breath through one nostril. ACK!. I'll continue to update these videos until i'm 100% Please leave a comment, ask a question or share some advice.
ENT/ Otorhinolaryngology Clinical Physical Examination Part (3) Examination of Nose [part i] Anterior Rhinoscopy Demonstration by Dr. Awais Samee ENT Dept Mayo Hospital, King Edward Medical University Lahore, Pakistan. Video Credits: Haania Khan, Taha Masood Project Supervisor: Laiba Khalid Subscribe for more medical education videos ! Website: http://www.kemunited.com/ Follow us on Facebook: https://www.facebook.com/kemunited Follow us on Pinterest: https://www.pinterest.com/kemunited Follow us on Twitter: https://twitter.com/kemunited Follow us on Instagram: https://instagram.com/kemunited
Wondering what it's like to get a Septoplasty? Here's my 72-hour assessment on the procedure and my take on what to expect. I ended up having this procedure as a result of having a severely deviated septum that was causing frequent sinus infections. Not only was it causing infections, but also caused mouth breathing at night and only being able to breath through one nostril. ACK!. I'll continue to update these videos until i'm 100% Please leave a comment, ask a question or share some advice. Some things I learned after 72-hours: Showering helps Use a humidifier at night Don't chase pain - take your pain killers on time Probiotics are your friend Don't forget to eat
What is NASAL SEPTUM PERFORATION? What does NASAL SEPTUM PERFORATION mean? NASAL SEPTUM PERFORATION - NASAL SEPTUM PERFORATION definition - NASAL SEPTUM PERFORATION explanation. Source: Wikipedia.org article, adapted under https://creativecommons.org/licenses/by-sa/3.0/ license. A nasal septum perforation is a medical condition in which the nasal septum, the cartilaginous membrane dividing the nostrils, develops a hole or fissure. This may be brought on directly, as in the case of nasal piercings, or indirectly, as by long-term topical drug application, including intranasal ethylphenidate, methamphetamine, cocaine, crushed prescription pills, or decongestant nasal sprays, chronic epistaxis and as a complication of nasal surgery like septoplasty or rhinoplasty. Much less common causes for perforated nasal septums include rare granulomatous inflammatory conditions like granulomatosis with polyangiitis. It has been reported as a side effect of anti-angiogenesis drugs like bevacizumab. A perforated septum can vary in size and location, and is usually found deep inside the nose. It may be asymptomatic, or cause a variety of signs and symptoms. Small perforations can cause a whistling noise when breathing. Larger perforations usually have more severe symptoms. These can be a combination of crusting, blood discharge, difficulty breathing, nasal pressure and discomfort. The closer the perforation is to the nostrils, the more likely it is to cause symptoms. Septal perforations are managed with a multitude of options. The treatment often depends on the severity of symptoms and the size of the perforations. Generally speaking anterior septal perforations are more bothersome and symptomatic. Posterior septal perforations, which mainly occur iatrogenically, are often managed with simple observation and are at times intended portions of skull base surgery. Septal perforations that are not bothersome can be managed with simple observation. While no septal perforation will spontaneously close, for the majority of septal perforations that are unlikely to get larger observation is an appropriate form of management. For perforations that bleed or are painful, initial management should include humidification and application of salves to the perforation edges to promote healing. Mucosalization of the perforation edges will help prevent pain and recurrent epistaxis and majority of septal perforations can be managed without surgery. For perforations in which anosmia, or the loss of smell, and a persistent whistling are a concern the use of a sillicone septal button is a treatment option. These can be placed while the patient is awake and usually in the clinic setting. While complications of button insertion are minimal, the presence of the button can be bothersome to most patients. For patients who desire definitive close, surgery is the only option. Prior to determining candidacy for surgical closure, the etiology of the perforation must be determined. Often this requires a biopsy of the perforation to rule out autoimmune causes. If a known cause such as cocaine is the offending agent, it must be ensured that the patient is not still using the irritant. For those that are determined to be medically cleared for surgery, the anatomical location and size of the perforation must be determined. This is often done with a combination of a CT scan of the sinuses without contrast and an endoscopic evaluation by an Ear Nose and Throat doctor. Once dimensions are obtained the surgeon will decide if it is possible to close the perforation. Multiple approaches to access the septum have been described in the literature. While sublabial and midfacial degloving approaches have been described, the most popular today is the rhinoplasty approach. This can include both open and closed methods. The open method results in a scar on the columella, however, it allows for more visibility to the surgeon. The closed method utilizes an incision all on the inside of the nose. The concept behind closure includes bringing together the edges of mucosa on each side of the perforation with minimal tension. An interposition graft is also often used. The interposition graft provides extended stability and also structure to the area of the perforation.
Cottle test is done to detect if the obstruction is due to vestibular component of nasal valve.
Now the septum is largely divided into a cartilaginous part, that is the soft part in the front part of the nose and a bony part which is the back part of the nose as well as along the lower floor of the nose. Now deviations which are slightly about say, a centimeter and a half or two behind the tip of the nose can be dealt with by a surgical procedure called as septoplasty. Now in septoplasty ,what we aim to do is to remove the bony support which is there at the lower part of the nasal septum and the back and allow the cartilage to occupy the space which is there by removing the bone, thereby straightening itself. But then, cartilage is a very funny structure. It’s a structure which is very similar to the cartilage in the ear, like this is very elastic, similarly the nose is also very elastic. So thy have a memory. So however we will try to make it straight, if the curvature is quite strong and if there’s been for a long duration or time, it can recur into the same position because of the inherent memory it has got. Now that is something that has to be assessed by the surgeon and if it is to his assessment that such a scenario can occur, this memory can be broken, and restructured using certain techniques which are available for septoplasties so that the septum doesn’t recur and cause symptoms again. Now the other people who require septoplasty as an adjuvant procedure would be somebody who has a very, what we medically call it as crooked nose. You will be seeing people with the nose which is slightly bent towards one side, like a C shape, or an S shape, because generally following injury. In such persons, they will require a combination of procedure, what we call it as septorhinoplasty. Now without addressing the upper part deviation, only addressing the inner part may not give them benefit. So here, septoplasty would be an adjuvant surgery to rhinoplasty and rhinolplasty in this circumstance would not only be a cosmetic procedure, but also a functional procedure. I think these are the technical details which the surgeon needs to take as to who will require a rhinoplasty, who will require septoplasty.