Search Results (98)

Background/Objectives: This retrospective study aimed to evaluate the association between decayed, missing, and filled teeth (DMFT) scores and sinonasal anatomical variations, including Haller cells, concha bullosa, and the direction and severity of nasal septal deviation in children. Methods: Cone-beam computed tomography (CBCT) images of 167 patients aged 6–17 years were retrospectively analyzed. The direction and severity of nasal septal deviation, presence of Haller cells, presence and subtypes of concha bullosa, and DMFT index were evaluated. Nasal septal deviation was categorized as mild (<9°), moderate (9–15°), or severe (≥15°). Concha bullosa was classified as lamellar, bulbous, or extensive. DMFT scores were assessed radiologically using reconstructed panoramic images, without intraoral clinical examination data. The DMFT index was calculated only for permanent teeth. Results: Among the 167 patients, 87 were male and 80 were female. Mild nasal septal deviation was the most common type, observed in 63.5% of cases. Lamellar concha bullosa was the most frequently detected subtype on both sides. No statistically significant association was found between concha bullosa or Haller cells and DMFT scores (p > 0.05). However, a significant positive ordered trend was observed between increasing nasal septal deviation severity and DMFT scores (p = 0.004). Conclusions: Increased nasal septal deviation severity was associated with higher DMFT scores in children. However, because of the retrospective design and radiological assessment of DMFT, this association should be interpreted as a potential relationship rather than a causal effect. Full article

The nasofrontal region of mammals is generally characterized by direct contact between the paired nasal bones and the frontal bone. However, detailed spatial relationships among the frontal bone, nasal bones, and osseous nasal septum remain insufficiently documented in bats. This study investigated the three-dimensional organization of the nasofrontal complex in the brown long-eared bat (Plecotus auritus) using high-resolution micro-computed tomography. Ten adult skulls were analyzed using three-dimensional reconstructions and multiplanar image analysis. A consistent and previously undescribed organizational pattern was identified in all specimens. Its principal feature was a median rostral extension of the frontal bone, designated processus internasalis ossis frontalis (nova structura), which projected between and separated the caudal portions of the paired nasal bones. This structure was consistently associated with ala ossis nasalis (nova structura), facies parasagittalis ossis nasalis (nova structura), a pronounced internasal sagittal impression, and a close topographical relationship with the osseous nasal septum. Together, these features constitute an integrated morphological complex rather than isolated anatomical modifications. The observed arrangement differs from the generalized mammalian condition, in which the paired nasal bones maintain direct median contact at the nasofrontal boundary. These findings reveal a distinct pattern of nasofrontal organization in P. auritus and demonstrate the value of high-resolution micro-computed tomography for identifying previously unrecognized aspects of mammalian cranial anatomy. Full article

Introduction: We investigated the effect of transverse maxillary constriction on nasal septal deviation (NSD) and nasal floor slanting. Methods: 60 growing Wistar rats (21 days old) were divided into four groups: (1) Experimental Group 1 received active constriction force (100cN), (2) Experimental Group 2 received active expansion force (100cN), (3) Sham received the same spring as Experimental Groups without receiving any active force, and (4) Control group did not receive any appliance. Samples were collected after 28 days for microcomputed tomography (μCT) analysis. Results: Experimental Group 1 demonstrated maxillary constriction (both skeletal and dental), accompanied by mandibular shift on closure, clockwise mandibular rotation, and increased mandibular plane angle and facial height. Constriction was also associated with severe nasal floor slanting in the molar area that extended posteriorly. Nasal floor canting was accompanied by a slanted vomer and a C-shaped NSD. The direction of nasal floor canting and mandibular shift was always similar. Experimental Group 2, on the other hand, was not associated with nasal deviation, and a slight slanting of the nasal floor was observed only when there was a mandibular shift. Conclusions: Our study suggests that the constricting transverse forces applied to the maxilla can be associated with nasal septal deviation. One possible mechanism by which constriction contributes to nasal septal deviation is by promoting mandibular shift. Mandibular shift, in turn, dictates the direction of slanting of the nasal floor and, consequently, the vomer, which may, in turn, lead to nasal septal deviation. Full article

Background and Objectives: The combination of endoscopic dacryocystorhinostomy (En-DCR) and septoplasty enhances the surgical field, facilitating more effective treatment within the nasal cavity. This study compares the outcomes of revision En-DCR performed with or without concomitant septoplasty in patients with recurrent symptoms after primary En-DCR. Materials and Methods: A retrospective analysis was conducted on patients who underwent revision En-DCR after failure of primary En-DCR at our institution between March 2013 and June 2023. Patients were categorized into two groups: the revision En-DCR + septoplasty group and the revision En-DCR only group. Demographic information, intraoperative findings, and postoperative outcomes were thoroughly examined. Results: A total of 489 primary En-DCRs were performed on 381 patients, of whom 70.2% were female, with a mean age of 60.18 ± 14.38 years. Thirty-six patients (42 eyes, 8.6%) underwent revision En-DCR due to failed initial procedures, involving 30 unilateral and 6 bilateral cases. A total of 15 cases (35.7%) underwent combined endoscopic surgery with septoplasty, while 27 cases (64.3%) underwent revision En-DCR alone. Anatomical obstruction recurrences were observed in 1 case (6.7%) in the En-DCR + septoplasty group, whereas 6 cases (22.2%) experienced recurrence in the En-DCR-only group. The surgical success was numerically higher in the En-DCR + septoplasty group than in the En-DCR-only group (93.3% vs. 77.8%, p = 0.390). Conclusions: In this retrospective series, the combination of revision En-DCR with concomitant septoplasty yielded acceptable surgical outcomes despite more unfavorable nasal anatomy. This suggests that concomitant septoplasty can play a supportive role in revision cases by improving intranasal anatomy for anatomically challenging cases. However, because septoplasty was preferentially performed and the sample size was small, this study does not establish the independent benefit of septoplasty in revision En-DCR. Full article

Background: Costal cartilage is the preferred structural material for augmentation rhinoplasty when robust and durable tip support is required. However, conventional full-thickness harvest is associated with significant donor-site morbidity, and commonly employed rigid fixation strategies—such as the septal extension graft—substantially restrict postoperative nasal tip compliance. The present study introduces a novel two-component technique combining a half-harvest costal cartilage procurement method with a pyramidal-shaped columellar strut graft anchored on the floating-tip principle, with the objective of maintaining postoperative nasal tip flexibility while providing structural support following augmentation rhinoplasty. Methods: A retrospective review was performed of consecutive patients who underwent primary or revision augmentation rhinoplasty using the pyramidal costal cartilage columellar strut graft technique by a single surgeon between June 2018 and February 2026. The medial half of the conjoined costal cartilage at the seventh, eighth, or ninth rib was procured via a half-harvest approach, preserving the lateral cortex and perichondrium to minimize donor-site morbidity and potential cartilage regeneration was considered a theoretical benefit. The harvested cartilage was carved into a pyramidal columellar strut and secured to the anterior nasal spine using a floating fixation construct; the inferior base of the strut was rigidly fixed to the nasal septum and anterior nasal spine with a minimum of three PDS 5-0 sutures, while the superior portion remained free to preserve physiologic nasal tip mobility. Adjunctive cap and shield grafts, perichondrial wrapping, and dermal fat grafts were employed as indicated. Primary outcomes included nasal tip projection, postoperative tip mobility, donor-site morbidity, and surgical complication rates. Results: Favorable clinical observations of maintained tip projection were noted throughout follow-up. Manual postoperative examination suggested preservation of tip flexibility in most patients; however, no validated objective mobility assessment tool was available. The revision rate for clinically significant tip deviation was low. No major donor-site adverse events—including pneumothorax or rib fracture—were encountered. Postoperative chest wall pain was minimal and transient, with most patients resuming daily activities within one week of surgery. Conclusions: The pyramidal-shaped costal cartilage columellar strut graft with half-harvest technique is a novel, biomechanically informed, and technically reproducible approach to augmentation rhinoplasty that was developed to address donor-site morbidity and postoperative tip rigidity, two commonly recognized limitations of conventional costal cartilage rhinoplasty: donor-site morbidity and postoperative nasal tip rigidity. Preservation of the lateral cortex and perichondrium during procurement may contribute to reduced postoperative donor-site discomfort, accelerates functional recovery, and may promote endogenous cartilage regeneration over time. The anatomically derived pyramidal strut geometry, combined with floating fixation to the anterior nasal spine, was designed to approximate the native columellar architecture, enabling consistent preservation of physiologic nasal tip mobility. The present series demonstrated a favorable safety profile with a low overall complication rate and an absence of major donor-site adverse events. Prospective studies with validated objective outcome measures are required to confirm these findings, to delineate the optimal patient selection criteria, and to establish evidence-based long-term outcome benchmarks for this technique. Full article

Background/Objectives: Nasal septal deviation (NSD) is a common anatomical condition that may influence nasal airflow and has been proposed as a potential factor associated with craniofacial growth and morphology. However, available studies use heterogeneous classifications and measurement methods, including the Mladina classification, angular parameters, volumetric assessment, CT, CBCT, and cephalometric analyses. This scoping review aimed to map and synthesize the available evidence on the relationship between NSD classifications, including the Mladina system, and craniofacial morphological correlates. Methods: This scoping review was conducted according to Joanna Briggs Institute methodology for scoping reviews and reported in accordance with the PRISMA-ScR checklist. The protocol was prospectively registered in the Open Science Framework. A broad literature search was performed in PubMed, Embase, Cochrane Library, BASE, and Google Scholar, without restrictions on publication date or language. Eligible studies included clinical or academic investigations assessing NSD using a defined classification or quantitative parameters and relating it to craniofacial, maxillary, mandibular, dentofacial, or asymmetry-related outcomes. Results: From 715 identified records, 387 remained after deduplication, and 6 studies met the inclusion criteria. The included studies varied substantially in sample size, imaging modality, NSD assessment method, and outcome domains. The most consistent findings suggested associations between NSD and localized or transverse nasomaxillary changes, particularly involving the palate, maxilla, nasal floor, and dentoalveolar region. Evidence regarding global facial asymmetry, basic maxillomandibular dimensions, and malocclusion was limited and inconsistent. Studies using the Mladina classification did not provide uniform conclusions across outcome domains. Conclusions: Current evidence does not support NSD as a uniform marker of global craniofacial morphology abnormalities. NSD appears more plausibly associated with selected local and transverse nasomaxillary features than with overall facial asymmetry. Future studies should combine standardized NSD classifications, especially the Mladina system, with precise three-dimensional craniofacial assessment in homogeneous populations. Full article

Background/Objectives: Septal deviation is a common cause of nasal obstruction, and achieving long-lasting septal straightening while preserving cartilage remains a surgical challenge. In this study, we describe and evaluate a simple suture technique designed to effectively straighten the nasal septum in both experimental and clinical settings. Methods: The technique combines cartilage scoring with the placement of a mattress suture to correct septal deformities. It was first tested in vitro using fifteen rabbit ear cartilage specimens and subsequently applied in vivo in a clinical series of forty-five patients presenting with septal deviation. The approach was assessed for ease of application, suitability in difficult anatomical regions (including severe caudal or dorsal deviations), cartilage preservation, and durability of correction. Clinical outcomes were followed for up to twelve months. Results: The combined scoring and mattress suture technique successfully straightened cartilage in both experimental and clinical applications. The method proved technically straightforward and applicable even in challenging septal areas. It allowed for conservative management with increased cartilage preservation. In the patient cohort, initial favorable outcomes were maintained throughout follow-up period. Conclusions: This simple suture technique represents an effective and conservative method for septal straightening. It is easy to perform, preserves cartilage, and seems to provide stable short- to mid-term results. The method may be particularly useful in cases of severe caudal or dorsal septal deviation. Full article

A deviated nasal septum (DNS) is a frequently observed anatomical abnormality that can lead to nasal airflow obstruction and reduced quality of life. Although septoplasty is widely regarded as the standard surgical approach for symptomatic cases, its effectiveness compared with conservative, nonsurgical treatments remains a subject of ongoing debate. Methods: We performed a systematic literature review up to 26 December 2025, using databases including PubMed, EMBASE, CENTRAL, and Web of Science. The review included only randomized controlled trials (RCTs) involving adult patients with DNS that compared septoplasty to non-surgical treatment strategies. Results: A total of three studies were included in the final analysis. Septoplasty significantly improved NOSE scores at 3 months (MD −12.58, 95% CI −19.10 to −6.06), 6 months (MD −28.73, 95% CI −33.44 to −24.03), and 12 months (MD −17.27, 95% CI −22.85 to −11.69) compared to non-surgical management. Similarly, SNOT-22 scores favored septoplasty at all time points, with the largest benefit observed at 6 months (MD −9.64, 95% CI −12.66 to −6.62). PNIF scores showed improvement in the septoplasty group at 6 months (MD 15.26, 95% CI 4.20 to 26.31), though significance varied over time. Conclusions: In adults with deviated nasal septum, the currently available randomized evidence suggests that septoplasty may provide greater improvement in symptoms and quality of life compared with non-surgical approaches. However, these findings should be interpreted cautiously due to the limited number of included studies and the low-to-moderate certainty of evidence. Full article

Objectives: To investigate the possible association between nasal obstruction and maxillary constriction using postero-anterior (PA) cephalograms in nontreated adolescents. Materials and Methods: This retrospective observational study was performed by analyzing the initial PA of 92 subjects in permanent dentition (forty-nine males and forty-three females) who presented without maxillary constriction (control group) and with maxillary transverse deficiency (experimental sample), ages between 12 and 17 years. Patients with any previous orthodontic or surgical treatment of the craniofacial complex were excluded from the study. Linear and angular measurements were taken on PA cephalograms to assess nasal obstruction caused by turbinate hypertrophy and/or the nasal septal deviation. Interval estimation of the prevalence of different variables within gender groups was calculated using the Clopper–Pearson method with a 95% confidence level. The possible associations between maxillary constriction and the presence of nasal anatomical findings were assessed using odds ratios with corresponding 95% confidence intervals. Results: More females than males showed maxillary constriction, but the difference was not significant. Neither the association between maxillary constriction and turbinate hypertrophy nor that with nasal septal deviation reached statistical significance. Conclusions: The hypothesis was rejected. A deviated nasal septum could be slightly associated with a maxillary constriction. However, these results should be taken with caution due to the bi-dimensionality of the measurements on PA. In contrast, three-dimensional evaluations in a wider sample could provide further outcomes to be discussed. Full article

Objectives: To evaluate the relationship between anterior maxillary sinus wall position and nasal bone asymmetry, and to assess their association with patient-reported aesthetic and functional outcomes following septorhinoplasty. Methods: Preoperative and postoperative evaluations were performed using the Rhinoplasty Outcome Evaluation (ROE) and Nasal Obstruction Symptom Evaluation (NOSE) questionnaires. Nasal bone dimensions were measured preoperatively using computed tomography (CT) scans. Results: A positive correlation was observed between anterior maxillary sinus wall position and nasal bone asymmetry, with significant nasal bone discrepancies contributing to nasal deviation. Conclusions: Anterior maxillary sinus wall position and nasal bone asymmetry are significantly associated with patient-reported outcomes following septorhinoplasty. Consideration of these anatomical parameters during surgical planning may improve aesthetic and functional results. Full article

Background: Eyelid reconstruction is particularly challenging because of the delicate anatomy and its critical functional and aesthetic roles. Although various methods have been described for anterior and posterior lamellar repairs, no standardized approach has been established. We developed a single-stage technique integrating reconstruction of both lamellae. Methods: This retrospective case series included seven consecutive patients who underwent full-thickness eyelid reconstruction between 2012 and 2024. Patients were included if they had full-thickness defects requiring reconstruction of both lamellae, underwent reconstruction using a nasal septal chondromucosal graft combined with a large local flap, and had at least 12 months of follow-up. The posterior lamella was reconstructed using nasal septal chondromucosal grafts, and the anterior lamella using large local flaps. Donor sites were managed using various methods. Results: All patients (7/7) achieved complete graft survival without partial or total graft loss. All patients achieved complete eyelid closure without lagophthalmos, and no cases of ectropion, corneal complications, or graft failure were observed. Buccal mucosal grafting demonstrated the most favorable donor-site outcomes, with uneventful healing and no septal perforation or airway-related complications. Conclusions: This single-stage approach combining chondromucosal grafts and local flaps is a feasible and reproducible option for selected patients, providing reliable structural support and satisfactory functional outcomes. Full article

Chondrosarcoma of the maxillofacial skeleton is a rare malignant tumor characterized by cartilaginous differentiation and locally invasive growth. Diagnosis is particularly challenging in low-grade tumors because histological features often overlap with those of benign chondroma. We describe a 62-year-old woman with a recurrent cartilaginous tumor of the hard palate. After previous resections in 2013 and 2022, a third recurrence was detected. MRI showed a lobulated lesion at the anterior hard palate contiguous with the nasal septum. A two-staged treatment was performed, starting with a minimal invasive access Brown class 2a maxillectomy guided by a patient-specific cutting guide. Pending histological confirmation, an obturator prosthesis was placed to seal the oroantral communication. Histopathology confirmed a low-grade chondrosarcoma with clear margins of at least 5 mm. A second-stage reconstruction was performed a year later using a posterior pedicle lateral nasal wall flap (inferior turbinate flap) and palatal rotation flap restored nasal lining and oral mucosa. This approach achieved oncologic clearance with excellent functional outcomes. The case highlights the value of image-guided maxillectomy and staged regional flap reconstruction. Full article

Objective: Endoscopic endonasal transsphenoidal pituitary surgery is a diffuse and well-established surgical technique: over the years, the transseptal approach via a nasal mucosal incision has also gained popularity. Here we describe our preliminary experience with an entirely endoscopic one-nostril transseptal transsphenoidal approach (EONOTTA) for pituitary sellar tumor resection; the surgical corridor runs through the entire length of the nasal septum via an incision in the nasal mucosa. Methods: A total of 40 patients with a midline prevalent pituitary tumor who underwent EONOTTA from January 2022 to June 2023 were retrospectively reviewed for the evaluation of the safety and efficacy of this technique. Results: At 1 year follow-up, all patients had no recurrence, and the degree of tumor resection was comparable to that of the control group undergoing the traditional endoscopic endonasal approach. A low rate of nasal and post-surgical complications occurred; globally, EONOTTA was not time-consuming, and a better functional result was noticed, with a better quality of life for patients. Conclusions: This study confirms, in our preliminary experience, the EONOTTA’s excellent risk–benefit ratio in selected cases; for an experienced multidisciplinary team, it provides a good maneuverability and a functional outcome while preserving the integrity of the nasal mucosa. Full article

Objectives: Nasal obstruction is a common presenting symptom in otolaryngology practice. Frequent etiologies include allergic and non-allergic rhinitis, inferior turbinate hypertrophy (HIT), and nasal septal deviation (DNS). This study aimed to evaluate the relationship between major causes of nasal obstruction and their effect on patient-reported quality of life (QoL). Methods: We conducted a retrospective analysis of patients presenting with nasal obstruction who completed the 22-item Sino-Nasal Outcome Test (SNOT-22), the Nasal Obstruction Symptom Evaluation (NOSE) scale, and a visual analog scale (VAS). Patients were categorized into three groups based on etiology: rhinitis, anatomical obstruction, or combined pathology. Results: The study included 170 patients (62% male), with a mean age of 38.4 years. Mean SNOT-22, NOSE, and VAS scores were 38, 61, and 6.5, respectively, with no statistically significant differences observed among the three etiologic groups. QoL outcomes were also comparable across anatomical subgroups, including isolated DNS, HIT, or combined findings. Among SNOT-22 domains, rhinologic symptoms demonstrated the highest burden. Patients with rhinitis exhibited significantly higher rhinologic and ear/facial symptom scores compared with patients with isolated anatomical obstruction (p = 0.04 and p = 0.005, respectively). Strong correlations were observed between SNOT-22, NOSE, and VAS scores across the entire cohort. Conclusions: Nasal obstruction is associated with substantial impairment in multiple domains of quality of life, independent of the underlying etiology. These findings highlight the broad impact of nasal obstruction on patient well-being. Larger prospective studies are warranted to further assess changes in quality of life following medical and surgical interventions. Full article

Background: Occupational exposure to aerosol particles can pose a substantial health risk. The study aimed to characterise the deposition of occupationally relevant aerosols in a 3D anatomical adult nasal cavity model under steady and unsteady flows. Materials: The deposition of aerosolised wheat flour, pine wood sanding dust, carbon black, and Arizona Test Dust A3 was quantified under steady flows (5, 7.5, and 20 L/min per nostril) and an unsteady breathing pattern generated by the commercial breathing simulator. Image analysis with custom software quantified the area covered by deposited particles. The Downstream Penetration Index (DPI) was determined from the outlet mass. Results: The highest segmental deposition occurred in the anterior segment of the lateral wall (WA) and septum (SA), with moderate values in the middle lateral wall (WM) and the lowest in the posterior lateral wall (WP, nasopharynx) and septum (SP). Arizona Test Dust A3 and carbon black demonstrated higher middle-posterior deposition and DPI, consistent with finer particle size distributions (PSD) and greater sub-10 µm fractions. In contrast, wheat flour and pine wood dust, with larger median particle sizes and lower sub-10 µm fractions, showed stronger anterior filtration and lower DPI. Increased flow enhanced anterior filtration of coarse particles and shifted deposition forward, aligning with increased inertial impaction, but elevated DPI for fine particles. Under unsteady flow, deposition was intermediate between 7.5 and 20 L/min. Conclusions: This study shows that PSD, morphology, and flow conditions influence nasal deposition. Coarse aerosols were filtered in the anterior nose, while fine-rich aerosols showed relatively greater middle-posterior deposition and higher DPI. These findings are essential for assessing occupational exposure and developing interventions and prevention strategies. Full article