Most Common Functional Nose Problems

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Most Common Functional Nose Problems

The nose is responsible for conducting air to the lungs. First, inside the nose, it is heated, moistened, and filtered, preventing the passage of dust and germs. It is the main airway of the respiratory system, the outer and upper part of which is bony and the lower outer part cartilaginous. In addition to being the organ of smell, it is a potentiator of the sense of taste.

Most Common Problems

  • Nasal obstruction
  • Deformation of the nose
  • Nasal septum perforations
  • Rhinosinusitis
  • Rhinitis
  • Hypertrophied nasal turbinates
  • Turbinate inflammation
  • Septum fracture
  • Nasal polyps
  • Deviations of the septum or nasal septum
  • Benign and malignant tumors
  • Adenoid hypertrophy (vegetations)
  • Anatomic alterations of the turbinates
  • Accumulation of blood or pus in the nasal septum.

Functional Nose Surgery

What is sought is to amend functional and structural disturbances of the nose, such as smell, respiratory, or voice modulation difficulties, through a surgical procedure. First, a diagnosis is made to determine the problem of each patient, and the doctor suggests different alternatives to solve it.

  • Nasal valve surgery
  • Turbinates surgery
  • Endoscopy surgery
  • Nostril and sinus surgery
  • Septoplasty
  • Rhinoseptoplasty: Includes aesthetic and functional
  • Adenoidectomy
  • Improves respiratory function.
  • Corrects congenital or acquired deformities.
  • It composes nasal lesions or tumors.
  • Improve heart rate
  • Improves the quantity and quality of sleep.
  • Improves sports, work, and intellectual performance.
  • It improves mental concentration.

Functional and aesthetic rhinoplasty, from my point of view, are two sides of the same coin; this because when making a change in the aesthetic part, changes will occur in the functional part; the nose must be seen as a whole both internally and externally. 

Everything You Need To Know About Nasal Obstruction

One of the most frequent consultations in my ENT practice is for nasal obstruction. The nose has no other means of expressing an illness than by obstruction, runny nose (mucus discharge), sneezing, itching, and pain.

The two most frequent diseases in the nose are rhinitis due to structural problems in the nostrils and allergy, followed by infectious rhinitis and vasomotor rhinitis (exaggeration of normal responses).

In people under twelve years of age, the most common disease is an allergy; in older adults, there are anatomical or structural problems. Although the allergy is basically medical treatment, its exact diagnosis is not easy; in general, it can be associated with structural disorders; in these cases, the anatomical problem can be corrected, and then the remaining allergy can be treated.

Classification Of Nasal Obstruction

Intermittent or sporadic and continuous or permanent, the first being more frequent. In the case of anatomical problems, these can be asymptomatic (their manifestations are not perceived), especially because they do not have the vasomotor component (dilation of the corneas with obstruction) and in this case, there is no awareness of the disease, since the. When occasional problems begin, they usually get worse until they become permanent (symptomatic).

It’s Important To Consider

80% of people looking for nasal aesthetics have structural nasal obstruction problems, if it is not corrected at the time of the aesthetic, the problems will persist and are very likely to appear shortly after surgery.

Effects Of Nasal Obstruction

  • Decreased peripheral blood oxygen pressure
  • Frontal, hemifacial, or intercalary headaches (between the eyebrows)
  • Impaired facial growth (asymmetries, third middle atrophy, elongated face)
  • Alterations in nasal growth (large, deviant, deformed)
  • Dental disorders (bad occlusion, palate with a high arch, and narrow)
  • Pulmonary atrophy of the narrow side
  • Lung disease predisposition
  • Thoracic asymmetry (scoliosis)
  • Predisposition to chronic bronchitis and emphysema (long-term)
  • Decreased sports performance
  • Snoring
  • Sleep apnea, sleep disorders
  • Daytime sleepiness
  • Predisposition to epistasis (nosebleed)
  • Predisposition to sinusitis
  • Rhinorrhea (mucus discharge)
  • Reaction to changes in climate, temperature, humidity
  • Oral breathing
  • Frequent rhinitis
  • Sneezing
  • Smell alterations
  • Gingivitis (oral hygiene problems, periodontal disease)
  • Dorsal spine pain
  • Premature aging of the skin

Advantages Of Breathing Through The Nose

  • Improves the quantity and quality of sleep
  • Improves sports performance
  • Improve heart rate
  • Improves the perception of odors
  • Brings favorable personality changes
  • Tones the abdominal muscles
  • Decreases asthma and respiratory diseases
  • Increases blood oxygenation

The rhinoplasty functional and aesthetic, in my view, are two sides of the same coin; this because when making a change in the aesthetic part, changes will occur in the functional part; the nose must be seen as a whole both internally and externally.…

Post-Operative Care In Nose Surgery

Post-operative care is based on patient comfort, reduction of runny nose and edema, patency of the nasal airway, and stabilization of the nose. Upon leaving the institution, all intranasal dressings are removed, the patient or his or her companions are given a detailed list of instructions with the surgeon in charge.

Regular checks are essential to detect situations that can be corrected with additional early procedures.

General measures such as the position of the patient, semi-sitting, after surgery, and the placement of local ice for two or three days in the immediate post-operative period decrease the number of components attracted by surgical trauma to the operated tissues.

The placement of local heat on the third day, causing vessel dilation, allows the vasculature to remove the remains of bruises and waste products from the healing.

Obviously, the most important consideration is the prevention of nasal trauma, nasal decongestant therapy is useful in conjunction with analgesic medication that could include pharmacological preparations of acetaminophen with codeine.

The value of corticosteroids in conventional rhinoplasty is a point of controversy.

The use of first-generation prophylactic cephalosporin antibiotics is ideal for covering skin germs and intranasal mucosa and should be continued for at least five days.

In complex secondary cases, particularly if atrial cartilage has been taken, a quinolone type ciprofloxacin is used to add a pseudomonal coating without forgetting the irrigations with saline solution in the frequency and quantity desired by the patient.

The sun, ultraviolet rays can cause inflammation and spots on the skin, so you should limit your exposure for at least two months after surgery, the pressure from the glasses on the nasal dorsum allowed only after six weeks, the exercise should be limited for at least two weeks after surgery and intense exercise after six weeks.

The external splint is removed five to seven days after surgery; Careful removal of the bandage by separating it from the skin with a blunt instrument is important. Failure to comply with this recommendation may disrupt the newly formed subcutaneous fibroelastic layer leading to additional scarring or abrupt hematoma. The photographic documentation in each consultation helps us to feed ourselves and determine which of the procedures we carry out in the intraoperative led us to achieve the appropriate result and which one we must perfect because the result was not the most appropriate. If on the first trip through the forest you make the map, measure times and distances, record trails and accidents and on each of the following trips correct them, on the tenth trip you would walk faster,

After Surgery:

  • After surgery for a period of 8 days, you will remain with a nasal immobilization that you must take maximum care of, do not wet, and do not remove. You should not bathe in very hot water, as steam can detach the bandage. In case it takes off, you should go to the office to reinforce it. When removing it, a lighter bandage will be left for an approximate time of 8 to 15 more days.
  • Any reddish discoloration of the whites of the eyes or eyelids is just the normal process of inflammation and will improve during the recovery period. Sometimes there can be inflammation and bruising around the eyes that will disappear within 15 days. It is recommended to put on a surgical glove with ice wrapped in a towel over the eyes and cheeks permanently for the first 48 hours.
  • In general terms, you can return to your activity in a period of 5 to 8 days if you will not be exposed to drastic changes in temperature, physical effort, or risk of blows to the face.
  • The final appearance of your nose will only be established at the end of 6 months after the procedure. Nasal cosmetic surgery is a highly specialized and very demanding procedure, and therefore, no procedure, however small it may seem, is easy. It may require some other surgical procedure to achieve a result very close to that desired before surgery. This can only be done after six months of the first procedure.

The above are general indications, do not hesitate to call us if you need any clarification. Remember that the success of the surgery depends largely on the post-operative care.