Dissertations / Theses: 'Nasal Septum'

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Носова, Я. В., and М. Ю. Тимкович. "Determination of nasal resistance according to CT data." Thesis, ХНМУ, 2020. http://openarchive.nure.ua/handle/document/13512.

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The principal nasal airflow regime is turbulent, in which the logarithmic velocity profile at typical flow rates is set at about half the length of the nasal cavity. The analysis of the configuration of the nasal cavity showed that the most common local disturbance of the airflow in the nasal passages is the resistance of the "latch" and "turn of the flow" type, caused, as a rule, by the presence of local curvature of the nasal septum.

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Monredon, Olivier de. "Obstruction nasale morphologique : identification et rôle du septum, application au traitement chirurgical de l'obstruction nasale." Bordeaux 2, 1996. http://www.theses.fr/1996BOR23018.

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Truilhé, Yves. "Rhinométrie acoustique et confort nasal : étude prospective sur 102 cas." Bordeaux 2, 1999. http://www.theses.fr/1999BOR23001.

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Zanda, Marcelo Junior. "Avaliação de desvio do septo nasal em imagens panorâmicas e tomográficas volumétricas." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/25/25132/tde-22102009-113125/.

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Neste estudo avaliou-se a eficácia da radiografia panorâmica na detecção de desvio do septo nasal. Para tanto, utilizou-se como padrão ouro o exame clínico e imagens tomográficas da face. A amostra foi composta por imagens radiográficas panorâmicas e por imagens de tomografia computadorizada da face de 70 indivíduos. Dentre os indivíduos que compuseram o estudo, 30 eram pacientes que seriam submetidos a tratamento odontológico e possuíam radiografias panorâmicas nas quais foram observadas imagens compatíveis com desvio do septo nasal. Estes pacientes foram avaliados por um otorrinolaringologista e submetidos, segundo o critério da justificação, ao exame de tomografia computadorizada da face. Os outros 40 indivíduos foram selecionados a partir de imagens panorâmicas dos prontuários de pacientes disponíveis no arquivo da Clínica de Estomatologia da FOB-USP e que também haviam realizado tomografia computadorizada da face para elaboração de diagnóstico e plano de tratamento odontológico. Os resultados mostraram que a radiografia panorâmica, segundo a metodologia adotada, foi eficaz na detecção do desvio do septo nasal, com 100% de Especificidade. Além disso, este exame permite a confirmação da ausência deste desvio na maioria dos casos, com 86% de Sensibilidade.
OBJECTIVE: Discern the efficacy of panoramic radiography on nasal septum deviation. Gold standard computerized tomography along with clinical examination was used for comparison. MATERIAL AND METHODS: Sample was composed of 70 subjects from Stomatology files of FOB-USP. Nasal septum deviation was assessed using the panoramic radiographies. Then, computerized tomography was analyzed and the results confronted. RESULTS: Images of nasal septum deviation were observed and confirmed in both exams on 100% of the subjects. However, in those cases with no deviation observed with the panoramic radiographies, its presence was confirmed in 86% after computerized tomography. CONCLUSION: Panoramic radiography was trustable for confirmation of nasal septum presence, with 100% of Specificity. Further, this exam allows the confirmation of the absence of this deviation in the majority of cases, with 86% of Sensibility.

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Prado, Priscila Capelato. "Dimensões internas nasais de adultos com obstrução nasal avaliadas por rinometria acústica." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/61/61132/tde-27042009-160711/.

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Objetivo: Caracterizar a geometria nasal de adultos com obstrução nasal (ON) decorrente de desvio septal (DS) e/ou hipertrofia de conchas (HC) pela análise de áreas seccionais e volumes de segmentos específicos da cavidade nasal por rinometria acústica. Modelo: Estudo prospectivo. Local de Execução: Laboratório de Fisiologia, HRAC-USP e Ambulatório de Otorrinolaringologia, Hospital Estadual Bauru. Participantes: Trinta pacientes com queixa de ON, de ambos os sexos, idade entre 18-40 anos, apresentando DS+HC (n=24), DS (n=5) ou HC (n=1) ao exame clínico. Variáveis: Foram avaliadas as áreas seccionais correspondentes às três primeiras deflexões do rinograma (AST1, AST2, AST3), suas respectivas distâncias em relação às narinas (dAST1, dAST2, dAST3) e os volumes nos segmentos correspondentes a 1,0-3,2cm (V1), 3,3-6,4cm (V2) e 7,0-12,0cm (V3), antes e após a descongestão nasal (DN), utilizando um Rinômetro Acústico Eccovision. Para fins de análise, calculou-se a soma dos valores das cavidades direita e esquerda. Resultados: Antes da DN, os valores médios (±DP) corresponderam a 0,83±0,23cm2(AST1), 1,66±0,52cm2(AST2), 2,36±0,77cm2(AST3), 2,19±0,20cm(dAST1), 4,01±0,33cm(dAST2), 5,85±0,37cm(dAST3), 2,77±0,51cm3(V1), 6,52±1,99cm3(V2), 26,00±9,62cm3(V3). Esses valores foram significantemente menores (p<0,05) que os definidos para adultos sem ON no mesmo laboratório. A DN causou aumentos proporcionalmente maiores de AST e V no grupo com ON, sugerindo a participação de componente funcional. Foram observados 12 casos com resultados normais, apesar da presença de DS e/ou HC. Conclusão: Os resultados obtidos demonstraram, na maioria dos pacientes analisados, significativo comprometimento da patência nasal associado à ON decorrente de alterações estruturais.
Objective: To characterize the nasal geometry of adults with nasal obstruction due to septal deviation and/or turbinate hypertrophy by analyzing sectional areas and volumes of specific segments of the nasal cavity by means of acoustic rhinometry. Design: Prospective study. Setting: Laboratory of Physiology, HRAC-USP and Otorhinolaryngology Clinics, Hospital Estadual Bauru. Participants: Thirty patients with nasal obstruction complaints, of both sexes, aged 18 to 40 years, presenting septal deviation+turbinate hypertrophy (n=24), septal deviation only (n=5) or turbinate hypertrophy only (n=1) on clinical examination. Main Outcome Measures: Sectional areas measured at the three main deflections of the rhinogram (CSA1, CSA2, CSA3), their respective distances from the nostrils (dCSA1, dCSA2, dCSA3) and volumes at the 1.0-3.2cm (V1), 3.3-6.4cm (V2) and 7.0-12.0cm (V3) segments were evaluated, before and after nasal decongestion, by means of an Eccovision Acoustic Rhinometer. For analysis, the values from the right and left cavities were added. Results: Before nasal decongestion, mean values (±SD) obtained corresponded to 0.83±0.23cm2(CSA1), 1.66±0.52cm2(CSA2), 2.36±0.77cm2(CSA3), 2.19±0.20cm(dCSA1), 4.01±0.33cm(dCSA2), 5.85±0.37cm(dCSA3), 2.77±0.51cm3(V1), 6.52±1.99cm3(V2), 26.00±9.62cm3(V3). These values were significantly lower (p<0.05) than those set for adults without obstruction at the same laboratory. Decongestion caused CSA and V increases proportionally higher in the group with nasal obstruction, suggesting the involvement of a functional component. Twelve cases presented normal results, despite the presence of septal deviation and/or turbinate hypertrophy. Conclusion: The results showed, in most patients analyzed, significant impairment of nasal patency associated with nasal obstruction due to structural defects.

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Welk, Thomas Paul. "A candidate gene approach to assessing phenotype/genotype associations in the nasal complex." Thesis, University of Iowa, 2019. https://ir.uiowa.edu/etd/6878.

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Introduction: The nasal septum, a component of the chondrocranium, acts as a growth center that may have a morphogenetic influence on adjacent intramembranous-derived structures of the nasofacial complex. Recent evidence has demonstrated that morphological variation in the nasofacial complex is potentially due to early developmental variation in chondrocranial-derived nasal structures. There are likely both local and systemic factors that affect inter-population nasal variation. If the morphology of the nasal complex is driven, at least in part, by the morphogenetic effects of cartilage during ontogeny, then selection for altered nasal morphology under different climatic conditions is potentially achieved via developmental changes in chondrocranial-derived structures. This suggests that genes influencing the development of cartilage-derived structures may be the targets of climate-mediated selection. The purpose of this study is to further examine the potential influence of variation in chondrocranial-derived structures on gross nasal morphology by utilizing a candidate gene approach to assess phenotype/genotype associations in the nasal complex. Materials and methods: Using cone beam computed tomography scans (CBCT), we collected a series of k=44 landmarks representing different cartilaginous and osseous nasal components from an adult sample (n = 120). A group of 69 loci from 22 genes were selected that have been previously found to have an association to cartilage development or variation in the nasal complex in humans and animal models. Centroid size of coordinate landmark configurations were used to quantify nasal complex size. A principle components analysis was used to quantify nasal complex shape. Phenotypes were characterized using the symmetric component of variation. Subjects were categorized by genotype for each SNP (i.e., AA, AB, BB) analyzed, and significant differences in PC scores were tested using ANOVA. Results: There were no significant associations between nasal complex size and genotype for any of the SNPs analyzed. Phenotype/genotype relationships were assessed for the first four PCs, which accounted for 47.89% of the total variation in the sample. Significant associations between individual PC scores and genotypes were found. Conclusion: Our results indicate that nasal complex variation is associated with a number of genes that have been previously linked to skeletal tissue development and facial morphogenesis.

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Rambo, Lindsay Ellen. "TEMPOROMANDIBULAR JOINT DISORDERS AND NASAL SEPTUM DEVIATION IN DENTOFACIAL DEFORMITY PATIENTS." Master's thesis, Temple University Libraries, 2015. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/343993.

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Oral Biology
M.S.
Introduction: The purpose of this study was to subclassify the types of facial asymmetries present in a pre-surgical dentofacial deformity patient population to determine the prevalence of each subcategory. Associations between the craniofacial characteristics of each asymmetry and pre-surgical Jaw Pain and Function Questionnaire (JPFQ) scores, diagnosis of temporomandibular disorders (TMD), and posterior facial asymmetry (PFA) as determined by nasal septum deviation were analyzed. In addition, the data will aid in the development of a phenomics database to allow for subsequent genotyping and gene expression evaluation from patient saliva and masseter muscle samples that were obtained at the time of corrective orthognathic surgery. Methods: Pre-surgical posterio-anterior (PA) cephalograms, submentovertex (SMV) and panoramic (PAN) radiographs from 92 pre-surgical dentofacial deformity patients at the Department of Oral and Maxillofacial Surgery, University of Lille, France were collected to evaluate facial asymmetry. PAs were traced and analyzed according to the Grummons Simplified Frontal analysis and Ramal Height analysis (Dolphin Imaging). SMVs were analyzed by the refined clinical system of the Ritucci and Burstone analysis proposed by Arnold et al along with original angular measurements for maxillary, mandibular, and nasal septum deviations (ImageJ). PFA was determined by a nasal septum deviation greater than 15 degrees. Lastly, PANs were evaluated visually for condylar pathologies. A comprehensive diagnostic decision tree for facial asymmetry was formulated based upon the current literature for normal variation of landmarks and the study design. Patient diagnosis via the decision tree was compared to visual examination of the appropriate x-rays to verify accuracy. Using this decision tree, patients were classified into subtypes and prevalence of each was calculated to form a phenomics database for future research on genotyping and gene expression. Associations between the subclassifications, mean pre-surgical JPFQ scores, temporomandibular joint (TMJ) clinical examination results (TMD+ or TMD-), and the diagnosis of posterior facial asymmetry (PFA+ or PFA-) were completed. Results: Sixty-two patients were able to fulfill all radiographic requirements to arrive at a diagnosis. Eighteen patients demonstrated facial asymmetry that fell within normal biological variation while the other 44 were diagnosed as having a form of facial asymmetry – Cranial Base Asymmetry: 11 female, 6 male; Non-Condylar Mandibular Asymmetry: 5 female, 3 male; Hemimandibular Elongation: 2 female, 3 male; Maxillary Asymmetry: 3 female, 1 male; Idiopathic Condylar Resorption: 3 female, 1 male; Atypical Asymmetry: 3 female, 1 male; Hemimandibular Hyperplasia: 1 female, 0 male; and Maxillary Base & Mandibular Body Asymmetry: 0 female, 1 male. JPFQ scores for symmetric patients ((x ) ̅= 5.33) and asymmetric patients (x ̅= 4.57) were non-significant overall, however, differences between gender were noted (female symmetric (x ) ̅= 6.13, male symmetric (x ) ̅= 1.33, female asymmetric (x ) ̅= 5.36, male asymmetric (x ) ̅= 3.19). TMD was diagnosed by pre-surgical TMJ examinations and MRIs. Four symmetric patients (3 female, 1 male) were positively diagnosed with TMD while 14 asymmetric patients (11 female, 1 male) also were diagnosed. PFA was diagnosed when nasal septum deviation was greater than 15 degrees – 25⁰ to ≤35⁰: 9 patients; >35⁰ to ≤45⁰: 3 patients; >45⁰: 1 patient. Twenty patients with a positive PFA were asymmetric while the other 8 symmetric. Twenty-one patients with PFA were female while the other 7 were male. Conclusion: A comprehensive diagnostic decision tree for facial asymmetry classification was formulated and validated. With it, it was found that: Females have increased JPFQ scores and clinical diagnosis of TMD versus males. Asymmetric females have decreased JPFQ scores, but increased prevalence of TMD. Presence of PFA does not appear to be a strong influence on development of facial asymmetry but is significantly linked to the presence of TMD. PFA is present in nearly half of all dentofacial deformity subjects. Mandibular asymmetry is most commonly associated with increased JPFQ scores and presence of TMD. However, Hemimandibular Hyperplasia, a particular and less common form of mandibular asymmetry, never associated with TMD. One form of mandibular and mid-facial asymmetry, Atypical Asymmetry, had a relatively high prevalence of TMD. Future directions for this research include continuation of genotypic description of IGF1 and Nodal biologic pathways to determine how gene expression levels in masseter muscle and patient genotypes differ in the eight subclassifications of craniofacial asymmetry compared to the symmetric population.
Temple University--Theses

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Wulkan, Marcelo. "Estudo comparativo em cadáveres do uso de enxertos cartilaginosos septais e costais para aumento da área seccional externa narinária." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5132/tde-27022013-144721/.

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INTRODUÇÃO: A área da seccção externa da narina é a parte inferior da válvula nasal externa que é o primeiro obstáculo ao fluxo de ar. Existem dúvidas e controvérsias em relação a eficácia de tratamentos cirúrgicos nessa região do nariz durante a rinoplastia. Neste estudo, compararam-se em cadáveres o uso do enxerto de reforço alar modificado de cartilagem septal e costal para analisar o aumento da área seccional externa narinária. MÉTODOS: Trinta narinas de cadáveres foram dissecados no Serviço de Verificação de Óbito da Capital- Universidade de São Paulo. A escolha dos cadáveres foi aleatória (9 mulheres e 6 homens) excluíndo-se os casos com lesão deformante nasal ou doença intra-nasal. Todos os enxertos septais e costais apresentavam as mesmas dimensões (30 x 5 x 1 mm) e foram inseridos acima do ramo lateral das cartilagens alares de maneira aleatória. A seguir, realizaram-se fotos padronizadas e mensurações das 90 áreas seccionais externas de narina com o programa Autocad®; 30 antes de qualquer procedimento; 60 após a inclusão de enxertos (30 usando cartilagem costal e 30 usando cartilagem septal). A análise estatística foi feita com um modelo de medidas repetidas e ANOVA (análise de variância) para a variável área. A comparação das médias foi feita pelo método de Tukey, sendo o coeficiente de confiança global de 95%. RESULTADOS: A área seccional externa da narina sem tratamento, com inclusão de enxerto de reforço alar modificado septal e costal é, respectivamente, 0,76 cm2, 0,85 cm2 (aumento de 11,8%) e 0,91 cm2 (aumento de 19,7%). CONCLUSÃO: O enxerto de reforço alar modificado de costela é estatisticamente mais efetivo que o enxerto de reforço alar modificado de septo para aumentar a área de secção externa da narina
INTRODUCTION: The nostril cross-sectional area (bottom of the external nasal valve) presents the first obstacle to airflow. There are doubts and controversies regarding the effectiveness of surgical treatments in this region of the nose during a rhinoplasty. In this study, we have tested two modified strategies for alar reinforcement, one using a cartilage graft from the nasal septum and the other using rib cartilage, to analyze and compare their effectiveness in augmenting nostril cross-sectional area. METHODS: Thirty corpses nostrils were dissected in the Division of Postmortem Inspection at the University of São Paulo. Corpses were chosen at random (9 women and 6 men) excluding those with deforming nasal injury or intra-nasal disease. All nasal septum and rib grafts had the same dimensions (30 x 5 x 1 mm) and were inserted randomly above the lateral crura of the alar cartilages. Then, a total of 90 standardized photographs were taken to measure nostril cross-sectional area using the Autocad® program; one per nostril on all 15 cadavers, at three separate intervals. Thirty photos were taken prior to any procedure being performed, and 60 after the insertion in each nostril, of the two different types of cartilage grafts. After one graft was tested, it was removed and replaced with the other type. The order of the procedures was randomized. Statistical analyses were conducted using a model for repeated measures and ANOVA for the variable area. The comparison of means was done with Tukeys method and a 95% confidence coefficient. RESULTS: The nostril cross-sectional area before treatment, after modified alar reinforcement using septum cartilage graft, and after modified alar reinforcement using rib graft were 0,76 cm2, 0,85 cm2 (increase of 11,8%) and 0,91 cm2 (increase 19.7%), respectively. CONCLUSION: The modified alar reinforcement using grafts of rib cartilage is statistically more effective than the modified alar reinforcement using grafts of nasal septum in increasing the nostril cross-sectional area

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Le, Taillandier de Gabory Ludovic. "Etude du comportement d'un implant BCP pour la réparation du septum nasal." Thesis, Bordeaux 2, 2010. http://www.theses.fr/2010BOR21705/document.

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Le septum nasal joue un rôle prépondérant dans la croissance de l’étage moyen de la face et la physiologie ventilatoire. Sa solidité, sa rectitude et sa position sagittale sont déterminantes pour percevoir un confort respiratoire diurne et nocturne. Vulnérable aux traumatismes de part sa projection antérieure, la destruction ou l’inefficience de son squelette entraîne une demande de réparation fonctionnelle et esthétique. Dans les cas les plus sévères, le remplacement tissulaire fait appel à des volumineux greffons autologues pour lesquels la morbidité du site donneur et leurs imperfections propres restent un écueil. Pour les remplacer, certains biomatériaux ont été essayés de manière empirique sans donner de résultats fiables. Le premier objectif de notre travail été d’évaluer le comportement d’un implant phosphocalcique biphasique pour la reconstruction du septum nasal afin d’éviter ces greffons tout en répondant aux objectifs biofonctionnels locaux, au contact d’un milieu septique et susceptible d’être exposé aux particules aéroportées de l’environnement. Le deuxième objectif était d’évaluer la cytotoxicité des nanotubes de carbone à double paroi sur des cellules de l’arbre respiratoire, premier organe concerné par une exposition potentielle lors de leur fabrication. Par la suite, les résultats de ces deux sujets différents ont été utilisés de manière synergique pour répondre au troisième objectif qui était, d’évaluer l’influence des nanotubes de carbone sur la cicatrisation du septum nasal en présence ou non de l’implant phosphocalcique
The nasal septum plays a paramount role in the growth of the face and respiratory physiology. Its solidity, its straightness and its sagittal position are determining to perceive a diurnal and night respiratory comfort. Vulnerable to the traumas, the destruction or the inefficiency of its skeleton involves request for a functional and aesthetic repair. In severe cases, the tissue replacement requires large autologous grafts for which the morbidity of the donor site and their own imperfections remain a problem. To replace them, certain biomaterials were tested in an empirical way without giving reliable results. The primary goal of our work was to evaluate the behaviour of a biphasic phosphocalcic implant to repair nasal septum in order to avoid these grafts with an adapted biofunctional implant, exposed to the septic nasal content and the airborne particles of the environment. The second objective was to evaluate the cytotoxicity of the double wall carbon nanotubes on epithelial respiratory cells, first organ concerned by a potential exposure during their manufacture. Thereafter, the results of these two different subjects were used in a synergistic way to answer the third objective which was, to evaluate the influence of the carbon nanotubes on the cicatrization of the nasal septum in presence or not of the phosphocalcic implant

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Carlos, Ana Catarina Sousa da Silva. "Prevalência de turbinados aberrantes e desvio do septo nasal em Bouledogues Franceses." Master's thesis, Universidade de Évora, 2021. http://hdl.handle.net/10174/29184.

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A crescente popularidade das raças braquicéfalas tornou a Síndrome Braquicefálica uma afeção frequente em clínica de animais de companhia. Esta caracteriza-se por alterações anatómicas que provocam a obstrução das vias aéreas superiores. O presente estudo retrospetivo avaliou a prevalência de turbinados aberrantes e de desvio do septo nasal em 45 Bouledogues Franceses, sem sinais clínicos compatíveis com Síndrome Braquicefálica, submetidos a exame de tomografia computorizada craniano. Os resultados mostraram que 68,9% da população de Bouledogues Franceses apresenta desvio do septo nasal, com maior probabilidade de ocorrência naqueles que pesam entre 11-14 kg, seguidos dos com 8-11 kg. É também expectável que 64,4% dos Bouledogues Franceses apresentem turbinados aberrantes caudais. Em Bouledogues Franceses, estas anomalias intranasais podem não estar a contribuir para o aparecimento desta síndrome pois a sua prevalência é elevada em animais sem esta afeção; Prevalence of aberrant turbinates and nasal septum deviation in French Bulldogs ABSTRACT: The increasing popularity of brachycephalic breeds has made Brachycephalic Syndrome a common disease in small animal clinics. This syndrome is characterized by anatomical changes that cause upper airways obstruction. The present retrospective study evaluated the prevalence of aberrant turbinates and nasal septum deviation in 45 French Bulldogs without clinical signs compatible with Brachycephalic Syndrome, subjected to head’s computed tomography exam. The results showed that 68,9% of the French Bulldog population had nasal septum deviation, with a higher probability of occurrence in those with weight between 11-14 kg, followed by those with 8-11 kg. It is expected that 64,4% of French Bulldogs will have caudal aberrant turbinates. In French Bulldogs these intranasal abnormalities may not be contributing to the appearance of the Brachycephalic Syndrome because their prevalence is high in animals without this condition.

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Gomes, Erika Ferreira. "Relevância das variações anatômicas das cavidades nasais no acesso transesfenoidal endoscópico." Universidade de São Paulo, 2012. http://www.teses.usp.br/teses/disponiveis/5/5143/tde-07122012-162943/.

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Introdução: As cavidades nasais constituem a via de acesso à hipófise na cirurgia transesfenoidal endoscópica. Deste modo, alterações naturais ou adquiridas da anatomia nasal podem prejudicar a cirurgia. Objetivos: Estudar as variações anatômicas das cavidades nasais, principalmente desvio do septo, correlacionando-as com a visibilidade no acesso transesfenoidal endoscópico, para subsidiar a decisão do tipo de acesso ou necessidade de correção do desvio. Material e Método: Estudo seccional em 38 pacientes submetidos ao acesso transesfenoidal endoscópico entre fevereiro de 2009 e janeiro de 2011 em centro de referência. No intraoperatório foram registradas as variações anatômicas, localização do desvio de septo no plano axial e coronal, largura do corredor cirúrgico, profundidade do acesso até o esfenoide e a sela, exposição do esfenoide e da sela após abertura dos mesmos. A dificuldade de visibilidade do acesso foi avaliada por escala ordinal: 0- sem dificuldade, 1- dificuldade leve a moderada, 2- dificuldade acentuada. Os testes empregados para correlação entre as variáveis foram qui-quadrado e razão de verossimilhança. A comparação entre duas médias foi pelo teste t de Student e três ou mais médias pela análise de variância (ANOVA), com teste complementar de Turkey. Resultados: Foram estudadas 76 cavidades nasais e foram observados 50 desvios septais (66%). A largura do corredor cirúrgico no local do desvio menor ou igual a 9 mm associou-se em 72% à dificuldade acentuada (p<0,001). Desvios de septo no andar médio (p=0,005) ou terço posterior (p<0,001) associaram-se à dificuldade acentuada. A largura da cavidade na região do desvio também foi menor no desvio do andar médio (8,41 mm, p=0,012) ou no desvio do terço posterior (6,9 mm, p<0,0001). No corredor cirúrgico, apenas a largura do meato médio se associou à dificuldade (5-13 mm, 73% dificuldade acentuada, p=0,001). Variações anatômicas das conchas foram observadas em 17%, sem impacto na visibilidade. O comprimento médio do septo nasal foi 64 mm (IC95%: 61,8-66,8 mm), a profundidade até o rostro do esfenoide 69 mm (IC95%: 67-71 mm) e até a sela 82 mm (IC 95%: 80,2- 83,8 mm). A exposição média do esfenoide foi de 20 mm (laterolateral) e 20,8mm (anteroposterior), enquanto da sela foi de 12,8 mm e 11,7 mm respectivamente. Conclusões: A largura da cavidade nasal na região do desvio e a presença de desvio de septo localizado em terço posterior ou no andar médio da cavidade nasal associaram-se à maior dificuldade na visibilidade do acesso transesfenoidal
Background: Nasal anatomical variations can impair the visibility on endoscopic transsphenoidal approach for pituitary tumors. Objective: To evaluate anatomical variations, mainly nasal septum deviation, and their impact on the visibility of transsphenoidal endoscopic approach. To support the decision of access type or need to correct the deviated septum. Methods: Cross-sectional study with 38 patients who underwent transsphenoidal endoscopic surgery using the two nostrils - four hands between February 2009 and January 2011 in a referral center. They were submitted to the intraoperative register of anatomical variations, septal deviations, surgical corridor width and location of the deviated septum (height and depth), depth of the access to sphenoid and sella, exposure of sphenoid and sella after opening. Visibility was assessed using an ordinal scale: 0- no difficulty, 1- low to moderate difficulty, 2- severe difficulty. Comparisons of two means were performed using Students t test, and three or more means using analysis of variance (ANOVA) with Turkeys complementary test. Correlations between scores were analyzed using the non-parametric chi-square test and the likelihood ratio. Results: Seventy-six nasal cavities were studied, and 50 septal deviations were found (66%). Among the patients with severe difficulty, 73% had a surgical corridor width in the location of the deviated septum of up to 9 mm (p < 0.001). Septal deviations in the middle level (p = 0.005) or posterior third (p < 0.001) were associated with severe difficulty. The width of the nasal cavity at the deviation was also smaller in the middle level (8.41 mm, p = 0,012) or posterior third (6.9 mm, p<0.001). In the surgical corridor, only the middle meatus was associated with difficulty (5 to 13 mm, 73% severe difficulty, p = 0.001). Anatomical variations of the nasal conchae were observed in 17% of cases with no impact on visibility. The average length of the nasal septum was 64 mm (95% CI 61.8 -66.8 mm); the mean depth to the sphenoid was 69 mm (95% CI 67-71 mm) and to the sella 82 mm (95% CI 80.2 - 83.8 mm). The average lateral exposure of the sphenoid was 20 mm and anteroposterior 20.8 mm and to the sella 12.8 mm and 11.7 mm respectively. Conclusions: The width of nasal cavity at deviation and site of septal deviation were associated with difficulty in visibility of the access. Septal deviations located at posterior third and at middle level in nasal cavities were strongly associated with difficulty

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Cherobin, Giancarlo Bonotto. "Rinomanometria realizada por meio da fluidodinâmica computacional." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5143/tde-30012018-091608/.

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Introdução: A obstrução nasal é um sintoma presente em várias doenças nasais. Este projeto propõe desenvolver uma metodologia para o cálculo da resistência nasal ao fluxo aerífero por meio de fluidodinâmica computacional e comparar os resultados dessa técnica com os da rinomanometria. Métodos: a resistência nasal ao fluxo aerífero foi medida por rinomanometria, experimentalmente e por fluidodinâmica computacional. A influência da segmentação da tomografia computadorizada nas variáveis de fluidodinâmica computacional foi investigada. O modelo computacional de escoamento laminar foi comparado ao modelo de turbulência k-w padrão. Foram analisadas a acurácia, correlação e concordância entre a resistência nasal calculada por fluidodinâmica computacional com aquela obtida por experimento e rinomanometria. Resultados: A resistência nasal provida por fluidodinâmica computacional pode variar até 50% de acordo com os critérios de segmentação da tomografia computadorizada. O modelo de turbulência k-w padrão apresentou acurácia de 93,1%, demonstrando melhor desempenho que o modelo laminar para prever a resistência da cavidade nasal. A correlação entre a vazão em 75Pa obtida por rinomanometria e fluidodinâmica computacional foi alta para ambas as cavidades, Pearson r = 0,75 p < 0,001. Não houve concordância entre a resistência nasal fornecida pelos dois métodos. A resistência nasal por fluidodinâmica computacional é, em média, 65% da resistência por rinomanometria. Conclusão: os critérios para segmentação da cavidade nasal interferem na resistência calculada por fluidodinâmica computacional. A metodologia de fluidodinâmica computacional para calcular a resistência nasal foi validada experimentalmente. O modelo de escoamento turbulento é melhor que o modelo laminar para calcular a resistência nasal. A resistência nasal calculada por fluidodinâmica computacional apresentou alta correlação com a medida por rinomanometria anterior ativa, mas o nível de concordância entre os métodos não permite comparação direta entre os valores obtidos por cada um
Introduction: Nasal obstruction is a symptom present in various nasal diseases. This project proposes to develop a methodology for the calculation of nasal resistance to airflow through computational fluid dynamics and, to compare the results of this technique with those of rhinomanometry. Methods: nasal airflow resistance was measured by rhinomanometry, experimentally and computational fluid dynamics. We investigated the influence of computed tomography segmentation on the computational fluid dynamics variables. The computational model of laminar flow was compared to the kw turbulence model. The accuracy, correlation and agreement between the nasal resistance calculated by computational fluid dynamics was analyzed comparing it with nasal resistance obtained through experiment and rhinomanometry. Results: The nasal resistance provided by computational fluid dynamics can vary up to 50% according to the computed tomography segmentation criteria. The k-w turbulence model showed accuracy of 93.1%, presenting a better performance than the laminar model to predict nasal cavity resistance. The correlation between the flow in 75Pa obtained by rhinomanometry and computational fluid dynamics was high for both cavities, Pearson r >= 0.75 p < 0.001. There was no agreement between nasal resistance provided by the two methods. Nasal resistance due to computational fluid dynamics is, on average, 65% of rhinomanometric resistance. Conclusion: the criteria used for nasal cavity segmentation interfere with the resistance calculated by computational fluid dynamics. The methodology of computational fluid dynamics to calculate nasal resistance was validated experimentally. The turbulent flow model is better than the laminar model to calculate nasal resistance. The nasal resistance calculated by computational fluid dynamics showed a high correlation with the measurement by active rhinomanometry, but the level of agreement between the methods does not allow a direct comparison between the values obtained by each one

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Chavarria, Mendoza Pedro Antonio. "Desviación del septum nasal y rinitis no alérgica. Hospital Nacional Arzobispo Loayza agosto – octubre 2006." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2007. https://hdl.handle.net/20.500.12672/14558.

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La desviación del septum nasal asociada a rinitis no alérgica ha sido poco estudiada, conociéndose en la actualidad que la mayoría de diagnósticos se refieren a rinitis, considerándola como alérgica, sin tener en cuenta a la rinitis relacionada a cambio estructural septal. Se revisaron 124 pacientes con diagnóstico de desviación del septum nasal en el Servicio de Otorrinolaringología del Hospital Nacional Arzobispo Loayza, en el periodo agosto a octubre 2006. El objetivo del estudio fue determinar la relación entre la desviación septal y la rinitis no alérgica en pacientes de ambos sexos, de 20 a 29 años de edad, que acuden al Servicio de Otorrinolaringología del HNAL. Los resultados muestran que la desviación septal en los pacientes del Servicio de ORL del HNAL se presenta con un grado variable de rinitis no alérgica y se pueden presentar a cualquier edad e indistintamente en varones y mujeres
Trabajo académico

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Ємєльяненко, Н. Р. "Анатомічні особливості носової перегородки в плодовому періоді онтогенеза людини." Thesis, Видавництво СумДУ, 2010. http://essuir.sumdu.edu.ua/handle/123456789/11479.

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Bertier, Carlos Eduardo. "Efeitos da rinosseptoplastia sobre as dimensões internas nasais e ressonância da fala em indivíduos com fissura de lábio e palato unilateral reparada: análise por rinometria acústica e nasometria." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/61/61131/tde-19122006-141826/.

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Objetivo: Analisar os efeitos da rinosseptoplatia sobre as áreas seccionais e volumes nasais e a nasalância da fala de indivíduos com fissura de lábio e palato unilateral reparada, utilizando rinometria acústica e nasometria. Modelo: Análise prospectiva. Local de Execução: Centro Cirúrgico e Laboratório de Fisiologia, HRAC-USP. Participantes: Indivíduos com fissura de lábio e palato unilateral reparada (n=21, idade=15-46 anos) foram avaliados antes da cirurgia (PRE) e 6-9 meses (POS1) e 12-23 meses (POS2) após. Variáveis: Na rinometria acústica foram aferidas as áreas de secção transversa dos segmentos correspondentes à válvula nasal (AST1), porção anterior (AST2) e porção posterior da concha nasal inferior (AST3), e, os volumes da região da válvula (V1) e conchas (V2) nasais, de ambas os lados, antes e após a descongestão nasal com vasoconstrictor tópico. Na nasometria, avaliou-se a nasalância na leitura de um texto contendo predominantemente sons nasais, e, outro, exclusivamente sons orais. Resultados: No lado fissurado, antes da descongestão nasal, observou-se um aumento significante (p<0.05) nos valores médios de AST1 e V1 em POS1 e POS2, relativamente ao PRE. Após a descongestão, observou-se aumento também para AST2 e V2 em POS2. No lado não-fissurado, não foram observadas variações significativas. Os valores médios de nasalância em PRE, POS1 e POS2 não diferiram entre si, nos textos oral e nasal. Conclusão: A medida das áreas seccionais e volumes mostraram que a rinosseptoplastia levou, na maioria dos casos analisados, a um aumento significativo da permeabilidade nasal, sem modificações concomitantes na ressonância da fala, estimada pela medida da nasalância.
Objective: To analyze the effects of rhinoseptoplasty on the nasal cross-sectional areas and volumes, and the speech nasalance of individuals with repaired unilateral cleft lip and palate, assessed by acoustic rhinometry and nasometry. Design: Prospective analysis. Setting: Surgery Service and Laboratory of Physiology at the Hospital for Rehabilitation of Craniofacial Anomalies (HRAC-USP). Participants: Individuals with previously repaired unilateral cleft lip and palate (n=21, age=15-46 years) were evaluated before surgery (PRE) after 6-9 months (POST1) and after 12-18 months (POST2). Variables: Acoustic rhinometry was used to measure the cross-sectional areas of segments corresponding to the nasal valve (CSA1), anterior portion (CSA2) and posterior portion (CSA3) of the lower turbinate, and the nasal volumes at the regions of the nasal valve (V1) and nasal turbinates (V2) at both sides, before and after nasal decongestion with a topical vasoconstrictor. Nasometry was employed to evaluate the speech nasalance during the reading of a text predominantly containing nasal sounds and other containing only oral sounds. Results: At the cleft side, before nasal decongestion, there was a significant increase (p<0.05) in mean CSA1 and CSA2 values at POST1 and POST2 compared to PRE. After decongestion, increased values were also observed for CSA2 and V2 at POST2. No significant changes were observed at the non-cleft side. The mean nasalance values at PRE, POST1 and POST2 were not different from each other in both oral and nasal texts. Conclusion: The measurement of cross-sectional areas and volumes by acoustic rhinometry revealed that rhinoseptoplasty provided, in most cases analyzed, a significant increase in nasal patency, without concomitant changes in speech resonance, as estimated by nasalance assessment.

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Alvarez, Peralta Roger M. "Efectividad de extracción, modelaje y reposición del cartílago cuadrangular en pacientes con desviación de la región anterior del septum nasal." Bachelor's thesis, Universidad Nacional Mayor de San Marcos, 2002. https://hdl.handle.net/20.500.12672/1867.

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Se estudia la efectividad de la extracción, modelaje y reposición del cartílago cuadrangular en pacientes con desviación de la región anterior del septum nasal, para lo cual se analizó los datos obtenidos de las historias clínicas y directamente de los pacientes atendidos en el transcurso de esta investigación. Los casos clínicos corresponden a pacientes diagnosticados y operados desde diciembre del 2001 hasta abril del 2002. El sexo masculino fue discretamente más afectado con una relación de 9 a 8. El 82.3% fueron pacientes entre 15 y 35 años. Todos los pacientes procedían de Lima. La mayor cantidad de pacientes tenían el antecedente de traumatismo nasal (76.5%). De los cuales solo un paciente refirió el antecedente de traumatismo obstétrico(parto instrumentado). La sintomatología más frecuente fue la obstrucción nasal (100%), seguido de dolor faringeo (47.1 %). El grado de obstrucción nasal fue severo en 52.9% de los pacientes, moderada en 41.2% y leve en el 5.9%. Se encontró en el 58.8% de los pacientes que la desviación septal se ubicó a la derecha. El 94.1% de los pacientes refirió una mejoría respiratoria marcada, la cual fue progresiva en el transcurso de los días postoperatorios. Todos los pacientes a quienes se le realizó una rinoplastía conjunta quedaron satisfechos con los resultados estéticos. La conclusión más importante de este trabajo de investigación es que realizando la extracción del cartílago cuadrangular con el posterior modelaje y reposición corrige adecuadamente la alteración funcional y estética en las desviaciones de la región anterior del septum nasal la cual no se corrige adecuadamente con las técnicas clásicas.
Tesis

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Oliveira, Thais Feitosa Leitão de. "Avaliação da influência do septo nasal na expansão de maxila cirurgicamente assistida por meio de tomografia computadorizada de feixe cônico." Universidade de São Paulo, 2014. http://www.teses.usp.br/teses/disponiveis/25/25149/tde-10102014-163019/.

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A expansão da maxila cirurgicamente assistida (EMCA) é um procedimento cirúrgico indicado para a correção da atresia maxilar em pacientes que já atingiram a maturação óssea. Os efeitos da EMCA são observados não só nos arcos dentários, maxilas e mandíbula, mas também na cavidade nasal, já que o septo nasal encontra-se localizado no centro do assoalho nasal, apoiado sobre a sutura palatina mediana. O objetivo deste estudo foi identificar a posição do septo nasal antes e após a separação cirúrgica das maxilas e avaliar sua influência na movimentação da maxila do lado que foi deslocado. Foram avaliadas 56 tomografias computadorizadas de feixe cônico (TCFC) adquiridas no tomográfo i-CAT Classic®, com voxel de 0,3mm, de 14 indivíduos submetidos à EMCA nos períodos préoperatório e pós-operatório de 15, 60 e 180 dias. Inicialmente, as imagens pósoperatórias foram visualizadas nas reformatações multiplanares, para identificar a qual maxila, direita ou esquerda, o septo nasal permaneceu ligado após a EMCA. Numa segunda etapa, foram realizadas medidas lineares nas imagens correspondentes aos períodos pré e pósoperatórios. Essas medidas foram realizadas na reformatação axial imediatamente acima do aparelho expansor, de forma padronizada para cada paciente, e consistiram da distância entre uma linha de referência central, que passava na espinha nasal anterior e no centro do forame incisivo, dividindo o paciente em lado direito e esquerdo, até os caninos e molares direitos e esquerdos. O índice kappa intraexaminador foi > 0,9. Para comparar as diferenças entre as médias dos dois grupos (lado ligado ao septo nasal e não ligado ao septo nasal) foi utilizado o teste t. Em 78,6% dos pacientes o septo nasal permaneceu ligado à maxila esquerda e em 21,4%, ligado à maxila direita. Em relação às medidas lineares, tanto na região de caninos como na região de molares, observouse que, no período pré-operatório, não havia diferença entre os lados direito e esquerdo. Após a EMCA, houve diferença estatisticamente significante (p<0,05), observando que houve menor movimentação da maxila a qual o septo nasal permaneceu ligado. Portanto, podese concluir que a expansão maxilar ocorre de forma assimétrica, pois a maxila que permanece ligada ao septo nasal, após a EMCA, movimenta-se menos do que a maxila não ligada ao septo nasal.
The Surgically assisted rapid palatal expansion (SARPE) is a surgical procedure indicated for the correction of maxillary constriction in adult patients. The effects of EMCA are observed not only in dental, maxillary, and mandibular arches, but also in the nasal cavity, since the septum is located in the center of the nasal floor and rests on the median palatine suture. The purpose of this study the position of the nasal septum before and after surgical separation of the maxillary, was to identify and evaluate their influence on the movement of the jaw which remained attached. Fifty six cone beam computed tomography (CBCT) scanner acquired i-CAT Classic, with 0.3 mm voxel. Fourteen individuals submitted to SARPE in the preoperative and postoperative periods of 15, 60, and 180 days which were evaluated. Initially, postoperative images were visualized using multiplanar reformatting to identify which jaw, right or left, the nasal septum remained bound after the SARPE. In a second step, linear measurements in the images corresponding to the pre- and postoperative periods were performed. These measurements were performed in the axial immediately above the expander reformatting, standardized form for each patient, and consisted of the distance from a central reference line, passing the anterior nasal spine and the center of the incisive foramen, dividing the patient\'s right side and left to the canines and molars on the right and left. The intraobserver kappa index was > 0.9. To compare the differences between the means of two groups (side connected to the nasal septum and not connected to the nasal septum) a t test was used. In 78.6% of patients, the nasal septum remained attached to the left maxilla and 21.4% on right jaw. Regarding linear measurements, both in the region of canines as in the molar region, it was observed that, in the preoperative period, there was no difference between the right and left sides. After the SARPE, a statistically significant difference (p < 0.05) was observed, noting that there was less movement of the maxilla which the nasal septum remained connected. Therefore, it can be concluded that the expansion jaw is asymmetrical because the jaw remains on the nasal septum after SARPE and moves less than maxilla not connected to the nasal septum.

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Ємєльяненко, Н. Р. "Топографо-анатомічні особливості носової перегородки в юнацькому віці." Thesis, Сумський державний університет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/64334.

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Присередня стінка носової порожнини (носова перегородка) представлена хрящовою та кістковою частинами. Хрящова частина утворена чітко вираженим хрящем носової перегородки, який має форму неправильної чотирикутної пластинки. Передньозадній розмір хряща дорівнює 27,0±1,0 мм, вертикальний - 24,0±0,9 мм, а товщина - 3,0±0,05 мм. Задньонижній його край у вигляді невеликого відростка вклинюється між переднім краєм перпендикулярної пластинки решітчастої кістки та переднім краєм лемеша, Кісткова частина утворена перпендикулярною пластинкою решітчастої кістки. Їїпередньозадній розмір становить 32,0±2,7 мм.

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Ємєльяненко, Н. Р. "Топографо-анатомічні особливості носової перегородки в юнацькому віці." Thesis, Сумський державний університет, 2017. http://essuir.sumdu.edu.ua/handle/123456789/65614.

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Присередня стінка носової порожнини (носова перегородка) представлена хрящовою та кістковою частинами. Хрящова частина утворена чітко вираженим хрящем носової перегородки, який має форму неправильної чотирикутної пластинки. Передньозадній розмір хряща дорівнює 27,0±1,0 мм, вертикальний - 24,0±0,9 мм, а товщина - 3,0±0,05 мм. Задньонижній його край у вигляді невеликого відростка вклинюється між переднім краєм перпендикулярної пластинки решітчастої кістки та переднім краєм лемеша, Кісткова частина утворена перпендикулярною пластинкою решітчастої кістки. Їїпередньозадній розмір становить 32,0±2,7 мм. Вертикальний розмір біля переднього кінця пластинки становить 21,0±1,0 мм, а біля заднього кінця – 16,0±0,24 мм. Товщина її кісткової стінки дорівнює 2,5±0,07 мм. Перпендикулярна пластинка утворює передньоверхній відділ кісткової частини носової перегородки.

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Alakärppä, A. (Antti). "Primary sinonasal surgery and health-related quality of life in adults." Doctoral thesis, Oulun yliopisto, 2019. http://urn.fi/urn:isbn:9789526222370.

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Abstract Surgery for ear, nose and throat (ENT) diseases most often aims to improve quality of life (QoL). The extent of having QoL as an outcome in papers included in evidence-based medicine databases is not known. In primary sinonasal surgery, the QoL outcomes and predictors and usability of various QoL instruments need more clarification. The aim was to: 1. Find out with a systematic literature review how the Cochrane database currently includes the QoL dimension. 2. Investigate the effect of primary sinonasal surgery on QoL, to identify predictors of QoL outcomes and to compare QoL instruments. In total 160 adults undergoing primary septoplasty (SP) or endoscopic sinus surgery (ESS) were recruited in 2010–2014 with 206 controls for a prospective matched cohort study. QoL was measured with a disease-specific Sino-Nasal Outcome Test–22 (SNOT–22) and generic RAND–36 before surgery and 12 months after surgery. Retrospective Glasgow Benefit Inventory (GBI) was also used. QoL was an outcome measure in 10% (3 out of 30) of trials included in Cochrane databases on most common ENT surgeries. The use of QoL since the year 2000 has increased. The total SNOT–22 score improved in both patient groups after surgery, almost to the level of the controls, In the SP group (N=64) from 34.9 to 19.1 and in ESS (N=70), from 35.1 to 19.3. The control cohort’s SNOT–22 was 17.7 at entry and after follow-up, 15.3 (N=165). RAND–36 and GBI also improved after surgery. The best predictor for a good QoL outcome in multivariate analysis after surgery was a high preoperative (≥20) SNOT–22 score in the SP and ESS groups (adjusted odds ratio 10; 95% confidence interval 1.6–64 and 12; 2.5–55, respectively). In receiver operating characteristic curve analysis, the highest preoperative SNOT–22 total score of 30 was the most sensitive (74%) and specific (70%). GBI seemed to be the most sensitive instrument to detect a change, but the three instruments in this study agreed in only about 10% of the patients who had the worst impact before surgery or best outcome. The results suggest that papers on the Cochrane databases on ENT surgeries have rarely addressed the QoL outcome. Septal deviation and recurrent acute or chronic rhinosinusitis lowered QoL. Primary surgery on these conditions improved QoL almost to the level of the control population, which was not symptom-free either. A high preoperative SNOT–22 total score was the best predictor of a beneficial outcome. The QoL instruments identified different patients experiencing the best improvement after surgery
Tiivistelmä Korva-, nenä- ja kurkkutautien (KNK) kirurgia tähtää useimmiten elämänlaadun (EL) parantamiseen. EL:n huomioinnin yleisyys näyttöön perustuvien tietokantojen sisältämissä tutkimuksissa ei ole tiedossa. Primaareissa nenäleikkauksissa EL:n tulokset, ennustekijät ja eri mittareiden käytettävyys kaipaavat lisätietoja. Tarkoituksena oli 1: Tutkia systemaattisella kirjallisuuskatsauksella miten nykyiset Cochrane-suositukset huomioivat EL:n. 2: Tutkia primaarin nenäkirurgian vaikutus EL:uun, tunnistaa EL:n ennustekijöitä ja vertailla eri mittareita. Yhteensä 160 primaariin nenän väliseinäleikkaukseen (VL) tai sivuonteloiden tähystysleikkaukseen (ESS) tulevaa aikuista ja 206 ikä- ja sukupuolivakioitua verrokkia osallistui etenevään kaltaistettuun kohorttitutkimukseen vv. 2010-2014. EL mitattiin tautispesifillä Sino-Nasal Outcome Test -22:lla (SNOT–22) ja yleisellä RAND–36:lla ennen leikkausta ja 12 kk leikkauksen jälkeen. Kolmantena mittarina käytettiin taannehtivaa Glasgow Benefit Inventoryä (GBI). Cochrane-tietokannan yleisimpien KNK-leikkausten tutkimuksista 10 %:ssa (3 30:stä) sisälsi EL-tuloksia. Vuoden 2000 jälkeen EL:n käyttö on lisääntynyt. SNOT–22 kokonaispistemäärä parani VL- ja ESS-ryhmissä lähes kontrollien tasolle, VL-ryhmässä (N=64) 34.9:stä 19.1:een ja ESS-ryhmässä (N=70) 35.1:stä 19.3:een. Kontrollien SNOT–22 oli alussa 17.7 ja seurannan jälkeen 15.3. Myös RAND–36 ja GBI paranivat leikkauksen jälkeen. Monimuuttuja-analyysissä hyvän EL-tuloksen paras ennustetekijä oli korkea leikkausta edeltävä SNOT–22 sekä VL- että ESS-ryhmissä (vakioitu vetokertoimien suhde 10; 95 % luottamusväli 1.6–64 ja 12; 2.5–55, ryhmittäin). ROC (receiver operating characteristic) -käyräanalyysissä leikkausta edeltävä arvo 30 antoi parhaan herkkyyden (74 %) ja tarkkuuden (70 %). GBI vaikutti herkimmältä aistimaan muutoksen, mutta mittarit olivat samaa mieltä vain noin 10%:ssa niistä potilaista, joilla oli huonoin EL ennen leikkausta tai paras tulos leikkauksen jälkeen. Tulosten mukaan Cochrane-tietokannassa olevat KNK-tautien kirurgian tutkimukset ovat ottaneet harvoin elämänlaadun huomioon. Nenän väliseinän vinous ja toistuva äkillinen tai krooninen sivuontelotulehdus laskivat EL:ua. Näiden tautien primaarikirurgia paransi EL:n lähes samalle tasolle kuin kontrolliryhmällä. Korkea leikkausta edeltävä SNOT–22 –kokonaispistemäärä ennusti parhaiten hyvää tulosta. Eri EL-mittarit tunnistivat eri potilaat, jotka hyötyivät parhaiten leikkauksista

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Borie, Amélie. "Régulation des comportements sociaux par l'action séquentielle de l'ocytocine et de la vasopressine dans le septum latéral." Thesis, Montpellier, 2018. http://www.theses.fr/2018MONTT015/document.

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Contexte : L’ocytocine (OT) et la vasopressine (VP) modulent les comportements sociaux. Leurs rôles ont été étudiés indépendamment l’un de l’autre mais des effets combinatoires de ces deux peptides sont à envisager puisqu’ils sont tous les deux libérés au cours des comportements sociaux. Dans le septum latéral (SL), une structure cérébrale intégrant des informations sociales, l’ocytocine et la vasopressine sont libérées au cours des interactions sociales et modulent la reconnaissance ainsi que la discrimination sociale.Objectif : Comprendre la fonction duale de l’ocytocine et de la vasopressine mise en jeu lors des interactions sociales dans un cadre physiologique et pathologique. Méthode : Chez la souris mâle, nous avons utilisé l’activité électroencéphalographique (EEG) comme marqueur et avons caractérisé des traces EEG dépendantes de l’OT et de la VP. Nous avons manipulé le système OT et le système VP au sein du septum au cours d’un protocole de reconnaissance/discrimination sociale en utilisant des outils pharmacologiques ou optogénétiques. Des expériences d’électrophysiologie sur tranche ont permis de caractériser la réponse électrophysiologique des neurones du septum latéral à l’application de chacun de ces peptides.Résultats : L’étude de l’activité EEG nous a permis de discriminer des effets induits par l’action septale de l’OT et la VP dans la bande de fréquence theta. Ces résultats suggèrent que la VP serait libérée dans le septum au cours de la première rencontre avec un juvénile alors que l’OT serait libérée au cours du processus d’habituation. La modulation de l’action de l’OT et de la VP sur le SL démontre que l’activation des récepteurs V1a au cours de la première rencontre est essentielle à la discrimination sociale tandis que l’activation des récepteurs à l’OT au cours du processus d’habituation permet de regain d’intérêt lorsqu’un nouveau juvénile sera présenté. Nous montrons aussi que l’OT et la VP modulent l’activité électrique de la quasi-totalité des neurones septaux. La nature de ces modulations définit 3 catégories de neurones qui communiquent entre eux via des signaux GABAergiques. Chez la souris Magel2KO, un modèle murin de troubles des comportements sociaux, la balance des effets septaux de l’OT et de la VP est altérée. Ceci suggère que cette régulation pourrait être impliquée dans certaines conditions pathologiques.Conclusion : Ces résultats mettent en évidence qu’il est essentiel, lorsque l’on étudie l’ocytocine, d’étudier le système vasopressinergique. Avec cette approche, nous avons montré que l’activation séquentielle du SL par l’OT et la VP est importante pour la régulation des interactions sociales. De plus, cette séquence d’évènements est altérée dans un modèle animal présentant des troubles sociaux
Context : Oxytocin (OT) and vasopressin (VP) modulate social behaviors. The roles of OT and VP have been interrogated so far in isolation whereas combinatorial effects are anticipated as both hormones are secreted during social behavior. In the lateral septum (LS), a brain area processing behavioral social cues, OT and VP are released during social interaction and modulate social recognition or discrimination. Aim : To understand the dual function of OT and VP during social behavior in physiological and pathological conditions. Methods : In male mice, we used electroencephalographic (EEG) activity as a readout to characterize OT and VP dependent electrophysiological signatures and their sequence. We manipulated OT and VP systems to LS during social recognition/discrimination paradigm using pharmacology and optogenetic tools. Using slice electrophysiology, we characterized electrophysiological responses of LS neurons to both of these hormons.Results : Measurement of EEG theta activity allowed us to discriminate between OT and VP dependent LS modulation and indicated that VP would be released in the LS during 1st encounter with a juvenile while OT would be released during the habituation process. Modulation of OT and VP actions on the LS demonstrate that V1a activation during 1st encounter is essential for social discrimination and OT receptor activation during the habituation process allows the regain of interest for a new juvenile. We also demonstrated that OT and VP modulate electrical activity of almost all LS neurons. The nature of this modulation define 3 neuronal categories that communicate with each other through GABAergic signalling. Magel2KO mouse, which features social deficits, presents an altered balance of LS regulation by OT and VP. It suggests that this regulation could be involved in some pathological symptomatology.Conclusions : These results shed a light on the necessity to study vasopressin along with oxytocin. Doing this, we showed that vasopressinergic and oxytocinergic activation of the LS are sequentially important during the social recognition paradigm. Futhermore, this sequence of events is impaired in a mouse model featuring deficits of OT and social disabilities

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Hartman, Christopher Henry. "Nasal septal deviation and craniofacial asymmetries." Thesis, University of Iowa, 2015. https://ir.uiowa.edu/etd/1620.

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Introduction: Nasal septal deviation may contribute to facial asymmetry. The purpose of this study was to assess the relationship between nasal septal deviation and facial asymmetry using three-dimensional geometric morphometric methods. Methods: Computed tomographic scans were made of n=55 adult subjects, and septal deviation was calculated as a percentage of septal volume relative to the volume of a modeled non-deviated septum. Skeletal landmarks representing nasal, palatal, and lateral facial regions were recorded, and landmark data was superimposed using Procrustes analysis. ANOVA/MANOVA tests determined degree of overall fluctuating and directional asymmetry. Finally, correlation analysis and multivariate regression were used to examine relationship between septal deviation and asymmetry of the individual facial regions. Results: Septal deviation was significantly correlation with lateral deviation of the nasal floor, vertical and lateral asymmetry of the anterior palate and width asymmetry of the posterior posterior palate and posterior alveolar thickness, but was uncorrelated with the overall magnitude of asymmetry. There was no correlation between septal deviation and lateral facial asymmetry. Conclusion: Nasal septal morphology is linked to nasal and palatal asymmetry. Deviated growth of the septum may pre-dispose patients to dental and skeletal asymmetries that have important orthodontic considerations.

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Swenson, Karl Edward. "Nasal septal deviation in a longitudinal growth sample." Thesis, University of Iowa, 2012. https://ir.uiowa.edu/etd/2995.

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Objective: This retrospective longitudinal study attempts to determine the ontogenetic patterning of nasal septal deviation and if there is a relationship between a deviated septum and facial form growth and development. Methods: Nineteen females and twenty males were selected from the Iowa Facial Growth Study. Eighteen lateral cepalometric variables were analyzed and septal deviation was quantified using a percentage of deviation. A generalized Procrustes analysis was used to scale landmarks and generate principal components. Pearson correlation coefficients were used to analyze differences in shape. A Mann Whitney U-Test was used to analyze changes in septal deviation. Results: The first three principal components explained 56.23% of the variance. Only PC1 was significantly correlated with centroid size (r=0.82, P<0.0001). Mean percentage of septal deviation (0.620% ± 0.463%) was present at the youngest age group (3-4.9 years) and increased in each age group until adulthood, defined as over the age of 20 (0.991% ± 0.519). None of the first three principal components were found to be correlated to percentage of septal deviation. Conclusions: Nasal septal deviation has been found to increase in a longitudinal sample of subjects of northern European descent. Nasal septal deviation represents a disjunction in the growth of the nasal septum with the rest of the face. The amount and timing of nasal septal deviation that can cause nasal obstructions leading to vertical growth changes was not analyzed in this study and will require future study.

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Silva, Daniela Brunelli e. "Há relação entre a posição de decúbito e a presença de desvio septal unilateral?" reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2014. http://hdl.handle.net/10183/104128.

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Objetivo: indivíduos com alterações anatômicas estruturais, como desvio septal, tendem a ter piora da percepção de obstrução nasal ao mudar da posição sentada para a deitada. A resistência nasal aumenta no decúbito dorsal e no lado do decúbito lateral. Este estudo tem o objetivo de verificar se pacientes com desvio septal nasal unilateral tem decúbito lateral preferencial. Metodologia: estudo de prevalência realizado no Serviço de Otorrinolaringologia do Hospital de Clínicas de Porto Alegre. Indivíduos selecionados responderam a um questionário padrão e ao questionário Nasal Obstruction Septoplasty Effectiveness (NOSE) e após foram submetidos à endoscopia nasal. O resultado da avaliação da videoendoscopia nasal foi comparado de forma cega com a presença de lateralidade preferencial no decúbito e em relação à presença ou não de obstrução nasal unilateral. Resultados: 40 indivíduos selecionados, sendo 20 participantes no grupo sem obstrução nasal e 20 no grupo com obstrução nasal. A concordância interexaminador foi de 0,9 (p <0,01) para estabelecer se havia desvio septal e qual o lado (direita ou esquerda). Pacientes com desvio septal detectados à endoscopia, têm lado preferencial de decúbito (p< 0,01), assim como o lado preferencial tem relação com a presença de obstrução nasal ipsilateral (p<0,01). Conclusão: pacientes com desvio septal unilateral têm preferência pelo decúbito lateral, para o lado da obstrução nasal. São necessários outros estudos que venham confirmar estes achados e estabelecer a preferência de lateralidade no decúbito dos pacientes como um indicativo da presença e impacto da obstrução nasal unilateral.

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Hulterström, Anna Karin. "Silicone obturators and the bacterial flora in symptomatic nasal septal perforations." Doctoral thesis, Umeå universitet, Tandteknikerprogrammet, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-60831.

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Background A perforation in the nasal septum can cause symptoms such as bleeding, obstruction, crusts and pain, and can be a challenge to treat. Surgery is the treatment of choice, but disease, size of the perforation, or the patient’s wish may contradict surgery. A custom-made silicone obturator is a successful treatment option, but little is known how this treatment affects the microbial flora. The purposes of this thesis were (i) to investigate the microbial flora around symptomatic nasal septal perforations before treatment, (ii) during and after a 12-month treatment period with a custom-made obturator, (iii) to compare the microbial flora around symptomatic perforations with the flora from the same area of the septum in healthy individuals, (iv) to investigate the microbial colonization of the silicone obturator, and (v) also to investigate the water sorption, solubility and if the wettability of silicones are affected by water. The hypotheses were (i) that the bacterial flora around symptomatic perforations would not differ from that found in healthy individuals, apart from a possible presence of Helicobacter pylori; (ii) the bacterial flora would change in composition during the course of treatment and that microorganisms and proteins could be seen on the surface of the silicone obturators; (iii) a material that has adsorbed water would also show an increase in wettability and the surface free energy of the material. Methods Twenty-seven patients and 101 healthy individuals volunteered. Swabs were made around the rim of the perforation, or on the septum in the locus Kisselbachi area in the healthy individuals. Bacteria and fungi were isolated and identified with standard laboratory techniques. A biopsy of the granulated tissue at the perforation was taken and cultivated for Helicobacter pylori. Swabs were also taken three, six and twelve months after inserting the obturator. The obturator was analysed after being used twelve months in the nose. Seven silicones were tested for water sorption and solubility according to ISO standards 1567:1999 and ISO 10477:2004. The change in wettability was examined by measuring the contact angle with a contact goniometer at various stages of the sorption/solubility test. Results Staphylococcus aureus was present in 88% of the untreated patients. With treatment a significant reduction of S. aureus occurred to 54.5% (p<0.05). In the healthy group S. aureus was present in 13% of the subjects. No Helicobacter pylori could be cultivated from the biopsies taken of the granulated tissue at the perforation. The flora round the untreated perforation was dominated by S. aureus with few other bacterial species detected. In the healthy group there was a diversified flora with both aerobic and anaerobic bacteria. SEM revealed a rough surface on the silicone obturator and crazing of the silicone surrounding the pigment granules. Both bacteria and proteins could be seen on the obturators in SEM. Candida albicans was detected in one obturator, but not in the mucosal swab at the corresponding time. That patient had, however, been treated for Candida in the nose six months prior to the last visit in the study. Wettability was affected but did not increase with amount of adsorbed water. Some materials showed an increase and some a decrease in the surface-free energy. The tested addition silicones showed little sorption and solubility. Conclusions The patients with symptomatic perforations of the nasal septum had a bacterial flora totally dominated by S. aureus. The massive presence of S. aureus around symptomatic perforations may have an impact on the persistence of the granulated and inflamed tissue present in symptomatic perforations, thus forming a vicious circle with bleeding and crustation. S. aureus dominance in the mucosa surrounding symptomatic perforations was diminished by using a custom-made obturator. The microbial flora became more diversified with the treatment, although not resembling the flora in healthy individuals. The microbial flora of the obturators was similar, but not the same as the corresponding mucosal flora. The discovery of Candida in the obturator of a patient who had been treated for Candida in the nose six months earlier suggests that obturators need to be exchanged when fungal infections are being treated to prevent the fungus from re-infecting the patient at a later stage. The silicone had a rough surface and a poor wettability, both aspects favours colonization of microorganisms. The silicone was negatively affected by the colouring pigments, this should be considered when colouring is not necessary. The slight, but existing solubility of silicones emphasises the importance of using medical grade silicones that are more purified than industrial silicones.

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BONFIM, Suely de Fátima Santos Freire. "Lesão de septo nasal em neonatos pré-termo no uso de prongas nasais." Universidade Federal de Pernambuco, 2012. https://repositorio.ufpe.br/handle/123456789/10774.

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Submitted by Heitor Rapela Medeiros (heitor.rapela@ufpe.br) on 2015-03-05T16:49:35Z No. of bitstreams: 2 DISSERTACAO 21 de FEV.2013[1].pdf: 2641667 bytes, checksum: 1eb8414a8038281dbc019e6f4516b3db (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5)
Made available in DSpace on 2015-03-05T16:49:35Z (GMT). No. of bitstreams: 2 DISSERTACAO 21 de FEV.2013[1].pdf: 2641667 bytes, checksum: 1eb8414a8038281dbc019e6f4516b3db (MD5) license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Previous issue date: 2012
O aumento da sobrevida de neonatos prematuros tem sido proporcionado pelos avanços tecnológicos, destes, a ventilação com pressão positiva contínua com prongas nasais constitui alternativa para neonatos com problemas respiratórios. Contudo, evidências científicas mostram ocorrências de lesões nasais pelo uso de prongas. Nesse contexto, esse estudo objetiva avaliar a incidência e os fatores de risco associados à lesão de septo nasal em neonatos prematuros utilizando prongas nasais reutilizadas e novas. O estudo é do tipo coorte de intervenção terapêutica aberta, a população inclui neonatos com idade gestacional abaixo de 37 semanas admitidos na unidade neonatal de um hospital universitário do Recife-PE, Nordeste do Brasil. A amostra foi de 70 neonatos, divididos no grupo de expostos, 39 recém-nascidos utilizando prongas nasais reutilizadas e não expostos, 31 utilizando prongas novas. Os dados foram coletados em prontuários, para caracterização da amostra; pela utilização de instrumentos voltados à avaliação da aplicação da ventilação não invasiva e assistência de enfermagem aos neonatos em uso de prongas; e pela avaliação do septo nasal. O processamento e análise foram realizados pelo software SPSS versão 17.0. Como produtos dessa dissertação foram elaborados três artigos. O primeiro artigo “Prevenção de lesão de septo nasal em neonatos pré-termo em uso de prongas nasais: revisão integrativa da literatura” investigou as evidências científicas relacionadas aos cuidados de enfermagem na prevenção de lesão de septo nasal em prematuros. Os resultados mostraram aspectos da qualidade e adequação da pronga nasal e a necessidade de monitorização do neonato pela equipe de enfermagem. O segundo “Cuidados de Enfermagem ao prematuro na prevenção de lesões nasais: validação de instrumento” validou um instrumento voltado à prevenção de lesão nasal obtendo índice de concordância de 80% dos juízes. O terceiro constitui o artigo original “Lesão de septo nasal em neonatos pré-termos no uso de prongas nasais”, cujos resultados evidenciaram que 62,9% dos neonatos apresentaram lesão de septo nasal e que a associação de prongas nasais reutilizadas e novas não constituiu fator de risco para a ocorrência de lesões nasais. O tempo de permanência do neonato no uso da ventilação não invasiva com prongas foi o único fator associado à ocorrência e severidade dessas lesões. Infere-se que os cuidados de enfermagem na aplicação da terapêutica e no acompanhamento diário dos prematuros em uso de pronga realizados durante o estudo, possam ter minimizado a incidência das lesões nos neonatos. A educação em saúde no serviço pode contribuir para adequação das práticas de cuidados de enfermagem garantindo assistência de qualidade.

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Coles, Yvette Marie. "Fatigue testing of human septal cartilage and the implications for tissue engineering patient specific nasal scaffolds." Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/22664.

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In nasal reconstruction, septal cartilage is widely considered the optimal source of grafting material. Significant interest surrounds the production of neocartilage constructs from resorbable scaffolds to replace septal autografts; mimicking their functional gradient and patient specific properties. A reliable method needs to be established to assess septal constructs against a native tissue benchmark, closely replicating the in vivo loading profile as the scaffold is resorbed and native cartilage formed. Many studies have endeavoured to define the composition and biomechanical properties of mature septal cartilage and examine how these properties vary with age, gender, location and axes of loading. Mechanical testing has been performed primarily with static compressive loading and in some cases using cadaveric or previously frozen tissue. Collaborating surgeons indicate that postoperatively, the most common mode of graft failure is fatigue, typically occurring months after the operation. Although the effects of fatigue have been widely studied for articular cartilage, comprehensive literature review has identified no such research on septal cartilage. This thesis presents a new methodology to assess septal constructs against a native cartilage benchmark and to gather important design parameters for the development of functionally graded and patient specific nasal constructs. A method has been devised to simulate the recurrent low strain dynamic loading associated with typical graft failure. Through cyclic compressive testing of 17 human septal cartilage specimen; age and gender were shown to have a significant effect on septal cartilage strength in fatigue. The rate of cartilage stiffening under low and moderate strain cyclic loading was shown to be a significant and age-dependent property. Histological examination indicated differences in the cellular density and organisation between different septal regions and differences between properties recorded through the medial and 2 orthogonal axis are observed. The effect of these numerous factors on septal cartilage strength has not been previously examined in fatigue and the results of the experiments in this thesis raise interesting considerations for the development of patient specific and functionally graded nasal scaffolds.

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NOUR, CHRISTIAN. "Ventilation a domicile par masque nasal chez sept patients porteurs d'une insuffisance respiratoire obstructive." Aix-Marseille 2, 1990. http://www.theses.fr/1990AIX20277.

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Dwyer, Derek T. "A heuristic algorithm for U.S. naval mission resource allocation." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Sept/08Sep%5FDwyer.pdf.

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Thesis (M.S. in Operations Research)--Naval Postgraduate School, September 2008.
Thesis Advisor(s): Salmeron, Javier. "September 2008." Description based on title screen as viewed on November 3, 2008. Includes bibliographical references (p. 57-58). Also available in print.

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Brown, Cinda L. "Improved methodology for developing cost uncertainty models for naval vessels." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Sept/08Sep%5FBrown.pdf.

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Thesis (M.S. in Systems Engineering)--Naval Postgraduate School, September 2008.
Thesis Advisor(s): Kujawski, Edouard. "September 2008." Description based on title screen as viewed on November 03, 2008. Includes bibliographical references (p. 60-63). Also available in print.

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Wolff, Michelle Lavinsky. "Efeito da cirurgia dos cornetos inferiores na rinosseptoplastia : ensaio clínico randomizado com avaliação de qualidade de vida e medidas de rinometria acústica." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2012. http://hdl.handle.net/10183/143342.

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Introdução: O efeito da redução cirúrgica dos cornetos inferiores durante a rinosseptoplastia não é conhecido. São escassos os estudos que avaliaram os resultados de rinosseptoplastia através de instrumentos de qualidade de vida. Objetivo principal: Avaliar o efeito da redução cirúrgica dos cornetos inferiores sobre a qualidade de vida e sobre medidas de rinometria acústica de pacientes submetidos a rinosseptoplastia primária. Objetivos secundários: 1) Correlacionar as medidas objetivas de área da cavidade nasal aferidas por rinometria acústica com medidas subjetivas de qualidade de vida relacionadas à obstrução nasal; e 2) Avaliar os resultados cirúrgicos de pacientes submetidos à cirurgia da ponta nasal usando técnica de divisão vertical do domus utilizando escalas de qualidade de vida específicas. Delineamento: Ensaio clínico randomizado. População: Foram incluídos indivíduos com idade maior ou igual a 16 anos com obstrução nasal, candidatos a rinosseptoplastia primária funcional e estética. Intervenção: Rinosseptoplastia com ou sem redução dos cornetos inferiores. Desfechos: Mudança relativa [(escore pós-operatório – escore pré-operatório)/escore préoperatório] nos seguintes instrumentos: escore de qualidade de vida específico para obstrução nasal, com o Nasal Obstruction Symptom Evaluation na língua portugesa (NOSE-p); Rhinoplasty Outcomes Evaluation (ROE), específico para avaliação de resultados em rinoplastia; escore de qualidade de vida geral, World Health Organization Quality of Life Instrument-bref (WHOQOL-breve); escalas análogo-visuais para obstrução nasal (EAV); e medidas de área da cavidade nasal aferidas por rinometria acústica. Os desfechos foram avaliados aos 3 meses pós-operatórios, de forma cegada. Resultados: Foram incluídos 50 pacientes, predominantemente caucasianos com rinite alérgica moderada/severa. A média da idade foi 32 ± 12 anos, e 58% eram mulheres. A rinosseptoplastia esteve associada a melhora da qualidade de vida geral e específica, independentemente da realização ou não de cirurgia nos cornetos inferiores (P < 0,001). Não houve diferença entre os grupos nos escores NOSE-p (-75 vs. -73%; P = 0,893), em todos os domínios do WHOQOL-breve (P > 0,05) e nas medidas de rinometria acústica (P > 0,05). Na análise multivariada, após ajuste para uso de corticoide e fratura nasal prévia, não houve modificação desses resultados. O uso de corticosteroide tópico no terceiro mês pós-operatório foi menos prevalente entre os pacientes submetidos à redução cirúrgica dos cornetos inferiores quando comparado ao grupo controle [6 (24%) vs. 13 (54%), P = 0,03]. Não houve correlação entre os escores do questionário NOSE-p e as medidas de rinometria acústica (ρ = 0,054-0,247; P > 0.05). Entre os pacientes submetidos a divisão vertical do domus, a avaliação pós-operatória demonstrou melhora significativa dos escores médios nas escalas ROE, NOSE-p e EAV (76 ± 17, 23 ± 18 e 78 ± 21) quando comparados aos escores pré-operatórios (30 ± 17, 74 ± 21 e 20 ± 24, respectivamente; P < 0.001). Conclusão: 1) A redução cirúrgica dos cornetos inferiores durante a rinosseptoplastia não esteve associada a incremento nas medidas de qualidade de vida geral e específica e de rinometria acústica; a menor a necessidade de uso de corticosteroide tópico pós-operatório observada após essa intervenção deve ser confirmada em futuros estudos com maior seguimento. 2) As dimensões da cavidade nasal não estão correlacionadas a medidas de qualidade de vida específicas para obstrução nasal e provavelmente estimam aspectos diferentes da via aérea nasal. 3) A técnica de divisão vertical do domus para cirurgia da ponta nasal esteve associada a melhora em desfechos de qualidade de vida em curto prazo.
Introduction: The effects of inferior turbinate reduction during rhinoseptoplasty are unknown. Data evaluating the results of rhinoseptoplasty through quality of life outcomes are scarce. Main objective: To evaluate the effects of inferior turbinate reduction during primary rhinoseptoplasty on quality-of-life outcomes and nasal airway cross-sectional area. Secondary objectives: 1) To correlate objective measures of nasal cavity area, as measured through acoustic rhinometry, with subjective measures of quality of life related to nasal obstruction; and 2) To assess surgical outcomes of patients who underwent vertical division of domus for nasal tip refinement using specific quality of life instruments. Design: Randomized clinical trial. Subjects: Individuals over 16yr with nasal obstruction, eligible to functional and aesthetic rhinoseptoplasty. Intervention: Rhinoseptoplasty with or without inferior turbinate reduction. Outcomes: Relative change ([postoperative – preoperative] / preoperative score) on the following instruments: Nasal Obstruction Symptom Evaluation in the Portuguese language (NOSE-p), a quality-of-life instrument specifically related with nasal obstruction symptoms; Rhinoplasty Outcomes Evaluation (ROE), specifically designed to assess rhinoplasty results; a general quality-of-life instrument, World Health Organization Quality of Life Instrument-bref (WHOQOL-bref); nasal obstruction visual analogue scales; and nasal area measurements in acoustic rhinometry. Outcomes were blindly assessed 3 months postoperatively. Results: 50 patients were included, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32 ± 12 yr, and 58% were female. Rhinoseptoplasty improved specific and general quality-of-life scores, irrespective of inferior turbinate surgery (P < 0.001). There was no difference between subjects submitted or not to turbinate reduction in NOSE-p scores (-75% vs. -73%; P = 0.893), in any of the WHOQOL-bref score domains (P > 0.05), and in acoustic rhinometry recordings (P > 0.05). Multivariable analysis, adjusted for postoperative topical corticosteroid use and previous nasal fracture, had no effect on these results. Fewer patients in the inferior turbinate reduction group were using topical corticosteroids 3 months after surgery (6 [24%] vs. 13 [54%], P = 0.03). There was no significant correlation between NOSE-p scores and acoustic rhinometry recordings (ρ = 0.054-0.247; P > 0.05). Among patients undergoing vertical dome division (n=44), mean postoperative ROE, NOSE-p and VAS scores improved significantly in postoperative evaluation (76 ± 17, 23 ± 18 and 78 ± 21) when compared to preoperative scores (30 ± 17, 74 ± 21 and 20 ± 24 respectively; P < 0.001). Conclusion: 1) Turbinate reduction during primary rhinoseptoplasty did not improve short-term general and specific quality-of-life outcomes and acoustic rhinometry recordings; the role of turbinate reduction in sparing chronic corticosteroid use should be confirmed in long-term follow-up studies. 2) The size of the nasal cavity and quality-of-life scores are not correlated and these measures may assess different aspects of the nasal airway. 3) Vertical dome division for nasal tip refinement resulted in short-term significant improvement of specific quality-of-life outcomes.

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Spearow, William Howard. "A dynamic model of the work force at the Naval Air Weapons Station China Lake." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Sept/08Sep%5FSpearow.pdf.

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Thesis (M.S. in Systems Engineering Management)--Naval Postgraduate School, September 2008.
Thesis Advisor(s): Rhoades, Mark M. "September 2008." Description based on title screen as viewed on November 7, 2008. Includes bibliographical references (p. 59). Also available in print.

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Sylvester, Edward. "The U.S.-Saudi partnership is this marriage headed for divorce?" Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Sept/08Sep%5FSylvester.pdf.

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Thesis (M.A. in Security Studies (Middle East, South Asia, Sub-Saharan Africa))--Naval Postgraduate School, September 2008.
Thesis Advisor(s): Russell, James. "September 2008." Description based on title screen as viewed on November 5, 2008. Includes bibliographical references (p. 65-71). Also available in print.

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Chery, Joseph Erol. "Adjusting to random demands of patient care : a predictive model for nursing staff scheduling at Naval Medical Center San Diego /." Thesis, Monterey, Calif. : Naval Postgraduate School, 2008. http://edocs.nps.edu/npspubs/scholarly/theses/2008/Sept/08Sep%5FChery.pdf.

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Thesis (M.S. in Operations Research)--Naval Postgraduate School, September 2008.
Thesis Advisor(s): Fricker, Ronald D. "September 2008." Description based on title screen as viewed on November 5, 2008. Includes bibliographical references (p. 43-46). Also available in print.

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Santos, Yannice Tatiane da Costa. "Caracteriza??o do conte?do de fossas e tanques s?pticos na cidade de Natal." Universidade Federal do Rio Grande do Norte, 2009. http://repositorio.ufrn.br:8080/jspui/handle/123456789/15965.

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Made available in DSpace on 2014-12-17T15:03:24Z (GMT). No. of bitstreams: 1 YTCS_DISSERT.pdf: 5384825 bytes, checksum: aa8710a0ccd842fef87d4421af582dca (MD5) Previous issue date: 2009-12-18
Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior
Only 32% of the population of Natal is attended by sewage, while the remaining population use pits and septic tanks. The characterization of the contents of septic tanks and pits contributes to the performance of such system and may guide the decision on treatment of these contents. The main of this research is to characterize the contents of interior residential pits and septic tanks in the greater Natal, with the following specific goals: to develop and manufacture a sampler capable of collecting a representative sample of the entire column (the surface scum, the clarified liquid and sludge bottom); to compare the contents of the tanks with the pits; to compare the contents of the septage from vacuum trucks; to relate the composition content with socioeconomic characteristics of households; to compare the content in both chambers of the septic tanks in series; to assess the situation of the content before and six months after the cleanness; and ultimately propose a pilot scale plant for treatment of septage. Once the sampler was developed, samples were collected within 14 septic tanks and 10 pits in many districts of Natal. Medians of the 24 systems were obtained: temperature, pH, conductivity, oil and grease, total solids, total suspended solids and sediments of 28.0 ?C, 6.95; 882 mS/cm, 75.2 mg/L; 10,169 mg/L, 6,509 mg/L and 175 mL/L respectively; 111.0 mgN/L for ammonia, 130.5 mgN/ L for organic nitrogen, 0.2 mgN/L for nitrite, 0.4 mg/L for nitrate; 8935 mgO2/L for COD, 29.2 mgP/L for total phosphorus, thermotolerant coliforms from 9.95 E +06 CFU/100mL helminth eggs and 9.2 eggs/L with a maximum concentration of 688 eggs/L and minimum of 0 eggs/L. Medians of organic nitrogen and TKN were significantly different between groups of tanks and pits. The systems with cleanness gap from 11 and 20 years presented the higher concentrations for most variables. The effluent from the toilets and bathrooms participate more effectively in contributing fractions of solids, alkalinity, nitrogen, COD, total phosphorus, thermotolerant coliforms and helminth eggs. The systems used by socioeconomics class with income from R$ 3,700.00 to R$ 7,600.00, presented higher concentrations for COD, nitrogen, solids and helminth eggs. The first of the two chambers had always presented higher concentrations over the second compartment. The analysis of variance for most variables, showed that the values of septic tanks, pits and septage from vacuum trucks belong to the same group. In the samples taken after cleanness, the median of pH and temperature increased, while alkalinity, COD, organic nitrogen, total phosphorus, ammonia and helminth eggs decreased. The oils and greases and thermotolerant coliforms had slightly varied due to the continuous release of sewage into the systems that maintained their steady state concentrations.
Apenas 32% da popula??o de Natal ? coberta por rede coletora de esgotos, sendo as fossas e tanques s?pticos os mecanismos de disposi??o de esgotos comumente utilizados pelo restante da popula??o. A caracteriza??o do conte?do de fossas e tanques colabora para o conhecimento sobre o tratamento desses res?duos no pr?prio domic?lio, al?m de enriquecer as informa??es a respeito deste conte?do. O objetivo geral desta pesquisa ? caracterizar o conte?do do interior de fossas e tanques s?pticos residenciais da cidade de Natal, tendo como metas espec?ficas desenvolver e fabricar um amostrador capaz de coletar uma amostra representativa de toda a coluna dos tanques s?pticos e fossas, que contemple a escuma da superf?cie, o l?quido clarificado e o lodo presente no fundo; comparar o conte?do dos tanques com os das fossas; comparar o conte?do com os res?duos dos caminh?es limpa-fossa; avaliar a composi??o do conte?do e relacionar com as caracter?sticas s?cio-econ?micas dos domic?lios; comparar a qualidade do conte?do nas duas c?maras dos tanques s?pticos em s?rie; avaliar a situa??o do conte?do antes e decorridos seis meses ap?s o esgotamento e, por fim, propor uma esta??o, em escala piloto, para o tratamento dos res?duos gerados por tanques s?pticos e fossas. Com o amostrador desenvolvido foram coletadas amostras do interior de 14 tanques s?pticos e 10 fossas em bairros de Natal. O conte?do dos 24 sistemas obteve medianas para temperatura, pH, condutividade el?trica, ?leos e graxas, s?lidos totais, s?lidos suspensos totais e sediment?veis de 28,0?C; 6,95; 882 mS/cm; 75,2 mg/L; 10.169 mg/L; 6.509 mg/L e 175 mL/L respectivamente; 111,0 mgN/L para am?nia, 130,5 mgN/L para nitrog?nio org?nico, 0,2 mgN/L para nitrito, 0,4 mg/L para nitrato; 8.935 mgO2/L para DQO, 29,2 mgP/L para f?sforo total; coliformes termotolerantes de 9,95E+06 UFC/100mL e ovos de helmintos 9,2 ovos/L com concentra??o m?xima de 688 ovos/L e m?nima de 0 ovos/L. Houve diferen?a estat?stica significativa para nitrog?nio org?nico e NTK entre os grupos dos tanques e fossas. A classe com tempo de esgotamento entre 11 a 20 anos apresentou para a maioria das vari?veis concentra??es bem mais elevadas. O efluente oriundo dos banheiros e sanit?rios participou mais efetivamente na contribui??o das fra??es dos s?lidos, alcalinidade, fra??es nitrogenadas, DQO, f?sforo total, coliformes termotolerantes e ovos de helmintos. A classe com renda entre R$ 3.700,00 a R$ 7.600,00, apresentou maiores concentra??es para DQO, nitrog?nio, s?lidos e ovos de helmintos. A primeira c?mara dos tanques s?pticos de duas c?maras em s?rie apresentou conte?do mais concentrado em rela??o ao segundo compartimento. Nas an?lises de vari?ncia a maioria das vari?veis apontou que os valores de fossas, tanques s?pticos e res?duos de carros limpa-fossa pertencem ao mesmo grupo. Na amostragem ap?s o esgotamento, o pH e temperatura aumentaram suas medianas, enquanto que alcalinidade, DQO, nitrog?nio org?nico, f?sforo total, am?nia e ovos de helmintos diminu?ram. Os ?leos e graxas e coliformes termotolerantes variaram pouco devido ao lan?amento cont?nuo de esgoto dentro dos sistemas que mantinham suas concentra??es est?veis

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Moura, Bianca Hocevar de. "O papel da turbinectomia inferiorparcial endoscópica narinosseptoplastia : um ensaio clínico randomizado com avaliação de qualidade de vida." reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2017. http://hdl.handle.net/10183/165669.

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Objetivos: Avaliar o papel da turbinectomia inferior parcial endoscópica (TIPE) na rinosseptoplastia primária sobre os desfechos de qualidade de vida, complicações e tempo cirúrgico. Delineamento: Ensaio clínico pragmático, randomizado, duplo-cego em um centro único e de grupos paralelos. Métodos: Indivíduos maiores de 16 anos, com queixas estéticas e obstrução nasal, candidatos à rinosseptoplastia primária, avaliados entre março de 2014 e maio de 2015, em um Hospital Terciário Universitário no Brasil. Pacientes elegíveis foram randomizados para receberem ou não TIPE concomitantemente à cirurgia. Desfechos: Diferença absoluta dos escores pré e pós-operatórios em qualidade de vida específica, pela aplicação dos questionários Nasal Obstruction Symptom Evaluation Portuguese (NOSE-p) e Rhinoplasty Outcome Evaluation (ROE), e geral, através de aplicação do World Health Organization Quality of Life (WHOQOL)-breve. Os desfechos eram cegados e acessados somente três meses após a cirurgia. O protocolo foi registrado no ClinicalTrials.gov (NCT02231216). Resultados: 50 pacientes foram incluídos, maioria caucasiana com rinite alérgica com sintomas moderados a severos. A média de idade foi 36 (±14,5) anos. Os escores de qualidade de vida específicos e gerais melhoraram independentemente da intervenção TIPE (p < 0,001). ANCOVA foi aplicada para controlar potenciais fatores confundidores. Não houve divergência entre a diferença absoluta nos pacientes submetidos ou não a TIPE nos escores NOSE-p (-50,5 vs. -47,6; p=0,723); ROE (47 vs. 44,8; p= 0,742) e todos os domínios do WHOQOL-breve (p > 0,05). Não houve diferença entre os grupos sobre a presença de complicações. O tempo cirúrgico foi maior no grupo TIPE (212 minutos ± 7,8 vs. 159,1 ± 5,6; p ˂ 0,001). Conclusão: A redução das conchas inferiores através da TIPE durante a rinosseptoplastia primária não melhorou, em curto prazo, a qualidade de vida geral nem específica. O uso de TIPE aumenta o tempo cirúrgico consideravelmente, sem adicionar benefício aos escores avaliados. Não houve diferença na incidência de complicações no pós-operatório, sugerindo a segurança da técnica.
Objectives/Hypothesis: To evaluate the impact of endoscopic partial inferior turbinectomy (EPIT) associated with primary Rhinoseptoplasty on quality of life outcomes (QOL), complications, and surgical duration. Study Design: Randomized clinical trial. Methods: Individuals with nasal obstruction aged ≥ 16 years who were candidates for functional and aesthetics primary Rhinoseptoplasty were evaluated from March 2014 through May 2015 at a tertiary university hospital in Brazil. Eligible participants were randomly allocated to rhinoseptoplasty with or without EPIT. Outcomes: Absolute change (postoperative –preoperative) in the following QOL scores: Nasal Obstruction Symptom Evaluation-Portuguese (NOSE-p), Rhinoplasty Outcome Evaluation (ROE) and World Health Organization Quality of Life (WHOQOL)-bref (to measure general QOL). Outcomes were blindly assessed 3 months postoperatively. The protocol was registered at ClinicalTrials.gov (NCT02231216). Results: Fifty patients were studied. Most were Caucasian and had moderate/severe allergic rhinitis symptoms. Mean age was 36 (±14.5) years. Rhinoseptoplasty was associated with improvement in all QOL scores irrespective of turbinate intervention (P <0.001). ANCOVA was conducted to control for potential confounders. There was no difference between the groups in absolute score changes for NOSE-p (-50.5 vs. -47.6; P=0.723); ROE (47 vs. 44.8; P = 0,742), and all WHOQOL-bref score domains (P >0.05). There were no differences between the groups regarding presence of the complications. Surgical duration was higher in the EPIT group (212 minutes ± 7.8 vs. 159.1 ± 5.6; p ˂ 0.001). Conclusions: Turbinate reduction through EPIT during primary rhinoseptoplasty did not improve short-term general and specific QOL outcomes. The use of EPIT increases surgical time considerably without improving QOL scores. There was no difference in postoperative incidence of complications, suggesting that EPIT is a safe technique.

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Yeh, Fang-Tzu, and 葉芳慈. "Three-dimensional Reconstruction System of Intelligent Automatic Detection of Nasal Vestibule and Nasal Septum in Computed Tomography Images." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/16376431035084518654.

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碩士
國立臺灣科技大學
自動化及控制研究所
100
This study entitled “Three-dimensional Reconstruction System of Intelligent Automatic Detection of Nasal Vestibule and Nasal Septum in Computed Tomography Images” attempted to combine the image processing technology to capture the computed tomography image signal and the back-propagation network for the automatic capturing of the nasal vestibule and nasal septum areas in computed tomography images. Moreover, it reconstructed the three-dimensional images by combining the two areas with skull and nose to measure the three-dimensional information. The present medical diagnosis often relies on computed tomography images to manually select the areas for reference, and use the software to conduct the three dimensional reconstruction measurement of the selected area for the reference of the pre-operational judgment. Therefore, this study developed a three-dimensional reconstruction system of intelligent automatic detection of nasal vestibule and nasal septum in computed tomography images. The proposed system employs the image processing technology combined with back-propagation network to segment the nasal vestibule and nasal septum areas, and mark each computed tomography image individually for the three dimensional reconstruction of the nasal vestibule and nasal septum areas. Finally, the representative points of three operational risky areas, including brain, eye rim internal side and the eye rim lower edge, were marked in order to measure the distance between intranasal information and marked points. The system could assist doctors in pre-operation analysis and judgment with more nasal information to reduce errors caused by human factors. The overall detection rate of the proposed three-dimensional measurement system of intelligent automatic detection of nasal vestibule and nasal septum in computed tomography images reached 99.7%. The three-dimensional image presentation combined with the skull and nose has been confirmed by doctors of the Department of Otolaryngology - Head and Neck Surgery, at Tri-Service General Hospital as valuable in reference. The study findings can facilitate the pre-operation diagnosis and judgment of doctors, as well as help to improve medical quality and the development of the medical industry.

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Kuo, Chung Ting, and 郭俊廷. "The Study of Bovine Pituitary Extract for the Culture of Bovine Nasal Septum Chondrocytes." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/06948337118659259849.

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碩士
國立中正大學
化學工程研究所
91
Abstract In the study, effects of concentration of bovine pituitary extract and composition of polyglycolide (PGA)poly(lactide-co-glycolide) (PLGA) 85/15 scaffolds on chondrocytes culture were investigated. Bovine pituitary was broken to pieces by using duall tissue grinder, and was purified and concentrated to obtain pituitary extract, which was added into the culture system of chondrocytes. Pure PGA or PLGA 85/15 microcarriers with diameters of about 400 m were put into spinner flasks with primary chondrocytes for 12-day suspension culture by 60 rpm. Porous cylindrical scaffolds composed of various PGAPLGA compositions with diameter of about 7.5 mm and height of about 2.5 mm were prepared by solvent castingparticulate leaching method. 4.5´106 cells/ml was seeded into each scaffold by direct injection, and the scaffold was fixed by cotton wires in spinner flasks to proceed 28-day suspension culture. Another 28-day culture was proceeded with various porosities of scaffolds with coating of 0.1  collagen type I or 0.1  human fibronectin. Experimental results showed that the rate of chondrocytes growth for PGA microcarrier is faster than that for PLGA microcarrier. Chondrocytes density, and excretion of glycosamino- glycan and type II collagen increased with the concentration of pituitary. The higher the percentage of PGA in scaffolds, the better the environment for chondrocytes growth. Appearance of cells is approximately spherical shape. High porosity of scaffolds is beneficial to the chondrocytes growth. However, coating of collagen type I or human fibronectin has no obvious advantages to the chondrocytes growth.

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Chi-Fen, Chang, and 張綺芬. "Ultrastructural and Histochemical Studies onthe Anterior Medial Gland of nasal septum in the Rat and the Gerbil." Thesis, 2003. http://ndltd.ncl.edu.tw/handle/85479612188989074113.

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碩士
國立臺灣大學
解剖學暨細胞生物學研究所
91
The anterior medial gland (AMG) is located in the submucosa of the respiratory portion of the mammalian nasal septum. In rodent, AMG is characterized by the presence of four to five parts and each part consists of a long main duct connecting to the striated duct and intercalated duct on which numerous acini studded. Excluding the second of rat or third of gerbil main duct, which opens into the vestibule, other main ducts open into anterior respiratory portion of nasal septum. A major function of the AMG is suggested to provide fluid for humidification of inspired air. Due to the tremendous variation in the environmental air humidity, on which rats and gerbils depend to live, we expected that multiplicity or variation on ultrastructure and histochemistry of AMG acinar cells does exit in these two species. The present study, therefore, attempts to differentiate the morphology and histochemical properties of the AMG between gerbils and rats. A total of 40 male rats (16-24wk old, 400g b.w.) and 40 male gerbils (16-24wk old, 75-90g b.w.) were used in the present study. After cardiovascular perfusion with fixatives, AMGs were dissected out and divided into anterior, medial and posterior portions. Ultrastructure of acinar cells was examined by electron microscopy. Various lectins, including DBA (Dolichos biflorus), UEA (Ulex europeus), WGA (Triticum vulgaris), Con A (Concanavalin A), etc., were applied to assess the glycoconjugates content of the acinar cells at light microscopic level. The major differences on the ultrastructure of rat and gerbil AMG acini cells were: (1) The nucleus of rat AMG acini cells was irregular in shape, but that of gerbil is round or elliptical; (2) Secretory granules of rat AMG acini cells contained homogenous content with various electron density and can be divided into three type: high, low and moderate electron density secretory granules, while the gerbil has only two types of granules with either internal lamellar structure or vesicle assembly; (3) Mitochondria distributed among the compactly and parallel arranged rER in rat AMG acinar cells; but they were distributed randomly in the cytoplasm of gerbil AMG acinar cells; (4) Myoepithelial cells are present in acinar cells of medial and posterior portion of AMG of rat; but not in gerbil; (5) Nerve terminals were demonstrated in the medial and posterior portion rat AMG while nerve terminals were observed through all of the gerbil AMG. Lectin histochemistry indicated that: (1) Acinar cells, from either rat or gerbil AMG, showed no reactivity toward UEA and expressed strong reactivity toward Con A; and (2) Varying degrees of reactivity toward different lectins, including DBA, PNA and SBA, were recognized in both rat and gerbil AMG acinar cells. All these results suggested that acinar cells of AMG express different affinity toward different lectins and that abundant mannose residues exist in the cytoplasm of acinar cells.

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Portada, Pedro Nuno Evaristo Soares. "Cirurgia do septo nasal." Master's thesis, 2019. http://hdl.handle.net/10451/43567.

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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2019
Tratamentos cirúrgicos para a obstrução da via aérea nasal são comuns na prática em otorrinolaringologia. A cirurgia do septo nasal é a terceira cirurgia mais realizada em ORL nos Estados Unidos da América. É uma técnica que se tem sofrido alterações nos últimos dois séculos, nos quais foram derrubados muitos dos obstáculos inerentes à mesma. Elaborou-se esta revisão de forma a rever quais foram os avanços ao longo do tempo, que opções existem nos dias de hoje, tentar perceber quais são alguns dos próximos passos e qual o rumo a seguir no futuro. A técnica endoscópica melhorou bastante os resultados por meio de uma identificação mais exata da patologia, minimizar o risco hemorrágico intraoperatório, bem como representar uma ótima ferramenta pedagógica. No futuro, as indicações para Tomografia Computorizada dos seios perinasais podem alargar com o avanço da técnica de baixa radiação, bem como a redução de custos da mesma. A cirurgia do septo nasal evoluiu bastante ao longo dos anos com o aparecer de variadas técnicas. Continua, no entanto, a ser um procedimento desafiante para o otorrinolaringologista. Não há um plano único que sirva todos os doentes. É essencial uma boa avaliação da localização e gravidade das alterações e planear caso a caso.
Surgical treatment for Nasal airway obstruction are common practice in otolaryngology. The surgery of the nasal septum is the third most performed in otolaryngology, in the USA. This technique has changed over the last two centuries, in which many obstacles were tackled. An article review was carried out in order to revisit the advances through time, what options are available today, try to understand some of the next steps and what is the course for the future. Endoscopy was a major improve for the results due to a more exact identification of the pathology, minimizing the intraoperatory hemorragic riscs, and stand as a prime teaching tool. In the future, the indication for the perinasal sinus computorized tomography can widen with the enhancement of the low dose radiation technique, as well as the costs of it. The surgery of the nasal septum has evolved a lot through the years, and with the advent of many techniques. It still remains challenging for the otolaryngologist. There is no sigle plan that suits every patient. A good evaluation of the location and severity of the deviation is essencial, as well as planning each case individually.

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Miranda, João Soares Madeira Martins. "Septoplastia na correção do desvio do septo nasal." Master's thesis, 2020. http://hdl.handle.net/10451/46877.

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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
O septo nasal é um componente do nariz importante do ponto de vista funcional, estético e estrutural. O desvio do septo nasal, apesar de ser comum na população geral, é uma das principais causas de obstrução nasal. Esta doença tem um elevado impacto na qualidade de vida e é uma fonte importante de comorbilidade. A correção cirúrgica do desvio septo nasal teve, desde cedo, um papel fundamental no tratamento desta doença. Ao longo da história, esta cirurgia foi sofrendo várias modificações, desde os procedimentos rudimentares dos antigos egípcios até à septoplastia moderna, atualmente um dos procedimentos cirúrgicos otorrinolaringológicos mais frequentemente realizados no mundo. Este artigo procura sistematizar a literatura relativamente a esta técnica, descrevendo as suas indicações, tipos de abordagem e variantes do procedimento, assim como as suas complicações e benefícios.
The nasal septum is an important functional, aesthetic and structural component of the nose. The deviation of the nasal septum, although common in the general population, is one of the main causes of nasal obstruction. This disease has a high impact on quality of life and is an important source of comorbidity. The surgical correction of the deviated nasal septum had, early on, a fundamental role on the treatment of this disease. Throughout history, this operation went through several modifications, from the rudimentary procedures of the ancient Egyptians to the modern-day septoplasy, which is nowadays one of the most frequently performed ear, nose and throat surgical procedures in the world. This article aims to systematize the literature regarding this technique, describing its indications, types of approaches and variations of the procedure and also its complications and outcomes.

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42

Miranda, João Soares Madeira Martins. "Septoplastia na correção do desvio do septo nasal." Master's thesis, 2020. http://hdl.handle.net/10451/46877.

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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020
O septo nasal é um componente do nariz importante do ponto de vista funcional, estético e estrutural. O desvio do septo nasal, apesar de ser comum na população geral, é uma das principais causas de obstrução nasal. Esta doença tem um elevado impacto na qualidade de vida e é uma fonte importante de comorbilidade. A correção cirúrgica do desvio septo nasal teve, desde cedo, um papel fundamental no tratamento desta doença. Ao longo da história, esta cirurgia foi sofrendo várias modificações, desde os procedimentos rudimentares dos antigos egípcios até à septoplastia moderna, atualmente um dos procedimentos cirúrgicos otorrinolaringológicos mais frequentemente realizados no mundo. Este artigo procura sistematizar a literatura relativamente a esta técnica, descrevendo as suas indicações, tipos de abordagem e variantes do procedimento, assim como as suas complicações e benefícios.
The nasal septum is an important functional, aesthetic and structural component of the nose. The deviation of the nasal septum, although common in the general population, is one of the main causes of nasal obstruction. This disease has a high impact on quality of life and is an important source of comorbidity. The surgical correction of the deviated nasal septum had, early on, a fundamental role on the treatment of this disease. Throughout history, this operation went through several modifications, from the rudimentary procedures of the ancient Egyptians to the modern-day septoplasy, which is nowadays one of the most frequently performed ear, nose and throat surgical procedures in the world. This article aims to systematize the literature regarding this technique, describing its indications, types of approaches and variations of the procedure and also its complications and outcomes.

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43

Fernandes, Bárbara Adriana Sarmento Dias. "Septo nasal - variabilidade fetal e alterações genéticas e/ou congénitas." Master's thesis, 2018. https://hdl.handle.net/10216/113746.

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Fernandes, Bárbara Adriana Sarmento Dias. "Septo nasal - variabilidade fetal e alterações genéticas e/ou congénitas." Dissertação, 2018. https://hdl.handle.net/10216/113746.

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"Optimization of the construction of VIP toilet sanitation at clinics in rural area." Thesis, 2009. http://hdl.handle.net/10413/1615.

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Magalhães, Bruno Miguel Silva. "When breathing is a burden [ : Sinonasal variations and diseases affecting the human skull in three Portuguese identified osteological collections (19th-20th centuries) ]." Doctoral thesis, 2018. http://hdl.handle.net/10316/85963.

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Tese de Doutoramento em Antropologia, ramo de especialização em Antropologia Biológica apresentada à Faculdade de Ciências e Tecnologia da Universidade de Coimbra
The external nose, nasal cavity, and paranasal sinuses represent key structures whose normal functions may be impaired by several variations and diseases of the upper respiratory tract. Nevertheless, its study in past populations has been neglected. The main aim of the current study is to investigate systematically the osseous changes affecting the sinonasal anatomy of the human skull, as well as its possible impact on craniofacial morphology. Three identified osteological collections from Coimbra and Lisbon comprising 2024 individuals (males=52.7%, females=47.3%; mean age at death=47.81), who lived between 1804 and 1981 were studied. New macroscopic methodologies were structured for recording paradoxical curvatures of the middle turbinate, nasal septal deviations, and spicules on the middle turbinate, whilst computed tomography scanning was used to complement the differential diagnosis. Nasal trauma was recorded in 8.4% (148/1770) of the individuals and the higher frequency in males shows statistically significant differences. The increased age at death also plays a statistical significant role in individuals presenting nasal fracture. A lateral impact force trauma was recorded in 61.5% (91/148) of the individuals, whilst 12.8% (19/148) show other fractures on the facial skeleton. Although the differential diagnosis is limited by the nonspecific location of nasal and facial fractures concerning blows and falls, frequency of lateral impact shows that interpersonal and intimate partner violence may have played an important role in males and females, respectively. The five nasal variations investigated presented prevalence of 38.5% (hypertrophy of the middle turbinates), 50.5% (paradoxical curvature of the middle turbinates), 17.9% (accessory turbinates), 94.8% (septal deviations), and 14.2% (septal spurs), showing that all are fairly common. The nasal septal deviation index and septal spurs present a higher frequency in males, with statistically significant differences. The fact that adult age does not play a significant role in the presence of the nasal variations studied shows that its development may have occurred during early age and is consistent with the hypothesis that genetics may play an important role in their presence. New bone formations on the middle turbinates and within the maxillary sinuses show prevalence of 59.3% and 49.8%, respectively, both showing statistically significant sexual differences with higher frequency in females. Clinical and palaeopathological literature confirm that these osseous alterations are highly consistent with rhinitis and chronic maxillary rhinosinusitis. The high prevalence of bone formations in both anatomical structures may be related to several reasons, including being the first line of defence against numerous external aggressions, indoor (e.g., smoke due to unprocessed biomass fuels burnt during cooking) and outdoor (e.g., industrialisation) air pollution, insalubrity and lack of hygienic conditions, or mucociliary dysfunction. Clinical studies also state that the nasal anatomical variations may play an important role in sinonasal disease. In the present study, hypertrophy and paradoxical curvature of the middle turbinates are statistically associated with the presence of spicules in the same osseous structure, whilst none of the variations studied are associated with the presence of bone formations within the maxillary sinuses, which is in accordance with most of the clinical literature. Also, although several factors may have played a role on sinonasal disease in the same individual, their relative importance is impossible to study in skeletal remains. The presence of concha bullosa and maxillary rhinosinusitis suggests an effect on craniofacial morphology, since six measurements and two indices revealed a pattern of increased facial breadth in individuals presenting those osseous alterations. This may be related to the development of both concha bullosa and maxillary rhinosinusitis during growth of the facial and cranial bones and anatomical structures, playing a role in its development. Finally, a miscellaneous of osteoblastic and osteoclastic bone alterations was observed on the anatomical structures studied. New cases consistent with leprosy and the first known evidence of possible teaching of modern dacryocystorhinostomy were discussed. The current work brings a new perception of sinonasal morphology and disease in past populations, showing that its presence was frequent in Portugal during the 19th and 20th centuries. Simultaneously, new methodological approaches are expected to facilitate future research understanding sinonasal morphology and disease and its impact on human life.
O nariz externo, cavidade nasal e seios paranasais são estruturas chave cujo normal funcionamento pode ser dificultado por diversas variações e doenças do trato respiratório superior. O seu estudo em populações do passado tem sido, no entanto, negligenciado. O presente trabalho tem como objetivo principal o estudo sistemático das alterações ósseas que afetam a anatomia sinonasal do crânio humano, assim como o seu possível impacto na morfologia craniofacial. Três coleções osteológicas identificadas provenientes de Coimbra e Lisboa que incluem 2024 indivíduos (sexo masculino=52,7%, sexo feminino=47,3%; idade à morte média=47,81) que viveram entre 1804 e 1981 foram estudadas. Novas metodologias macroscópicas são descritas para o registo da curvatura paradoxal, do desvio do septo nasal e de espículas ósseas na concha nasal média. Foi também utilizada a tomografia axial computorizada como meio complementar de diagnóstico diferencial. O trauma nasal foi registado em 8,4% (148/1770) dos individuos que fazem parte da base de estudo e a maior frequência no sexo masculino representa diferenças estatísticas significativas, assim como o aumento da idade à morte nos indivíduos que apresentam fratura nasal. A maior parte destes indivíduos (61,5%, 91/148) evidencia o resultado provável de uma força de impacto lateral, enquanto 12,8% (19/148) apresentam outras fraturas no esqueleto facial. Apesar do diagnóstico diferencial destas lesões ser limitado pela localização não específica das fraturas identificadas tendo em conta a sua origem violenta ou não violenta, a frequência da força de impacto lateral mostra que a violência interpessoal e doméstica parecem desempenhar um papel importante nos resultados obtidos. Todas as cinco variações nasais estudadas apresentam prevalências elevadas de 38,5% (hipertrofia das conchas médias), 50,5% (curvatura paradoxal das conchas médias), 18% (concha acessória), 94,8% (desvios septais) e 14,2% (esporões septais). Para além disso, o índex de desvio do septo e os esporões septais apresentam uma maior frequência no sexo masculino com relevância estatística. O facto da idade adulta não desempenhar um papel significativo na presença das variações estudadas mostra que o seu desenvolvimento parece acontecer durante o crescimento e é consistente com a hipótese de que a genética pode desempenhar um papel decisivo na sua presença. As formações ósseas nas conchas médias e no interior dos seios maxilares apresentam uma prevalência de 59,3% e 49,8%, respetivamente, ambas mais elevadas no sexo feminino e com diferenças estatísticas significativas. Os dados clínicos e paleopatológicos confirmam que estas alterações ósseas são altamente altamente consistentes com a presença de rinite e rinossinusite maxilar crónica. A alta prevalência destas formações ósseas parece estar associada a várias razões, incluindo o facto da área sinonasal ser a primeira linha de defesa contra numerosas agressões externas, a poluição do ar interior (e.g., devido ao fumo proveniente da queima de combustíveis não processados ao cozinhar em lareiras abertas) e exterior (e.g., industrialização), insalubridade e falta de condições de higiene ou a disfunção mucociliar. Estudos clínicos mostram também que as variações nasais podem estar na origem da doença sinonasal. No presente estudo, a hipertrofia e a curvatura paradoxal da concha média mostram uma associação estatística significativa com a presença de espículas naquela estrutura óssea, enquanto nenhuma das variações estudadas apresenta associação com as formações ósseas nos seios maxilares, o que está em acordo com a maior parte dos estudos clínicos que se debruçam sobre este tema. Embora vários fatores possam ter desempenhado um papel na doença sinonasal no mesmo indivíduo, a sua importância relativa é impossível de estudar em coleções osteológicas. A concha bolhosa e a rinossinusite maxilar evidenciam também uma associação estatisticamente significativa com o desenvolvimento de um padrão de maior largura da face, muito provavelmente porque ambas se desenvolveram durante o período de crescimento dos ossos e estruturas faciais, desempenhando um papel importante no seu desenvolvimento. Foi ainda registada uma miscelânea de alterações osteoblásticas e osteoclásticas nas estruturas ósseas estudadas. Novos casos consistentes com a presença de lepra ou o primeiro caso conhecido de possível ensino da dacriocistorrinostomia moderna são discutidos. O presente estudo sugere uma nova perceção da morfologia e doença sinonasal em populações do passado, mostrando que a sua presença era já frequente em Portugal durante os séculos XIX e XX. Com a utilização de novas metodologias espera-se facilitar futuros trabalhos científicos na área de forma a ser melhor entendida a morfologia e patologia sinonasal e o seu impacto nos seres humanos.
CIAS - Centro de Investigação em Antropologia e Saúde

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47

Netshinombelo, Muthuphei. "Development of guidelines for post care management at selected hospitals of KwaZulu-Natal Province, South Africa." Thesis, 2019. http://hdl.handle.net/11602/1411.

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Abstract:

Department of Advanced Nursing Science
PhDH
Background: Despite measures to curb unwanted pregnancies and to sustain and expand abortion services, a high number of complications and deaths still occur. The failure of these measures is evidenced by the high number of women who are admitted to the public hospitals of KwaZulu-Natal Province with complications from induced abortions. KwaZulu-Natal Department of Health has repositioned Family Planning to a key priority in its health program in order to improve the situation for women. However, in order to improve the situation, it is necessary to understand the underlying causes. This study sought to identify challenges that affect women's access to Post Abortion Care (PAC) services in KwaZulu-Natal Province, South Africa. It also sought to shed light on the challenges faced by those who render PAC services, as well as assess the skills of those workers as observed while they provided PAC services. After conducting the research on challenges related to access and rendering of post abortion care services, the researcher identified a need to develop guidelines for management of unsafe and induced abortion complications, with the aim to improve the life expectancy of women and prevent maternal deaths. Therefore, an outcome of the study was the development of a PAC management guideline. Purpose: The purpose of the study was two-fold: Phase 1: to explore the challenges faced by women when accessing PAC, and the health care workers who render PAC services, and to assess the PAC skills of the health care workers; Phase 2: to use the findings of Phase 1 to develop guidelines for post abortion care management at selected Hospitals of KwaZulu-Natal Province, South Africa. Methods: The design of the study was guided by the Andersen model of Health Care Utilization. The model focuses on the contextual factors - enabling factors, predisposing factors and need factors - that influence the individual's utilization of health care services. Five districts of KwaZulu-Natal Province, South Africa were selected for the study. A convergent parallel mixed method was used to collect and interpret the data. A qualitative study was used to explore perceptions and challenges of women when accessing PAC; this was carried out by means of in-depth interviews with 23 women who accessed PAC services. Five Focus Group Discussions (FGD) were carried out with 50 health care workers to explore the challenges they experienced when managing abortion complications. A quantitative approach was used for direct skills observation of 92 health care workers. Thematic analysis was used to analyse the qualitative data; descriptive statistics were used to analyse the quantitative data. Results: From the in-depth interview data, several main themes were identified. Women who accessed PAC identified a lack of facilities that offered PAC service, distance from the community to the hospital that provided PAC service, lack of transport, shortage of staff, unskilled staff, shortage of equipment, long waiting queues, stigma and discrimination as challenges associated with delay or avoidance of access to post abortion care services. The main themes raised by the health care providers were lack of support from the management, shortage of staff, lack of training, burnout, unavailability of the guidelines or protocols and shortage of equipment. The quality of PAC services was perceived as poor by both the women seeking care and the health care workers. The main concerns raised by the women were lack of respect, lack of privacy, sharing of bed and insufficient time with the health care provider. The results confirmed that guidelines are needed for the management of post abortion care services. The findings from the qualitative and quantitative parts of the study were used by an expert group to develop PAC management guidelines. The development of the guidelines was in accordance with the WHO models, PICOS & GRADES. The guidelines were validated by the group using a close-ended checklist, analysed with simple descriptive statistics. Conclusion: This study concludes that access to comprehensive quality post abortion care must be provided for all women at times of need. Quality PAC services should be rendered by skilled health care workers in a facility which is accessible and well equipped with functional equipments and updated guidelines. Recommendations: The study therefore recommends that measures should be taken to ensure the provision of quality PAC services. The PAC services should be accessible with the increased number of facilities, adequate trained health care workers with functional equipment and guidelines. Health care workers must receive training and management support to enhance quality PAC services. Privacy and respect must be maintained during provision of PAC services to ensure quality of care and increase demand. There must be continuous community awareness about PAC services which will encourage early-seeking behavior, and reduce fear of stigma and discrimination by the providers of PAC services before the complications arises. This study did not cover all the districts to identify the challenges on delaying PAC service. Therefore, this study recommends additional clinical, operations and community research which will give broader details and understanding on the challenges that cause delay for seeking immediate post abortion care services.
NRF

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48

Liebenberg-Barkhuizen, Estelle Juliana. "The Iconography of the 'indigene' in Mary Stainbank's sculpture c 1920-1940." Thesis, 2002. http://hdl.handle.net/10500/879.

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Dissertations / Theses on the topic 'Nasal Septum'

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