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Background Lateral crura surface problems are one of the most difficult challenges in nose tip surgery. Closed preservation rhinoplasty (CPR) is a revolutionary concept that keeps nose tip flexibility and elasticity. By solving lateral crura surface problems and keeping tip flexibility the surgeon will accomplish a sharper supraalar groove transition between the dorsum and the tip. Objectives The convex-concave lateral crura deformity (CCLCD) or S-shaped lateral crura is one of the biggest constraints to accomplishing a beautiful tip and dorsum-tip transition (DTT). This deformity is the reason for the commonly called parenthesis deformity of cephalic malposition. This LLC convex-concave shape creates a C-shaped shadow. This DTT is one of the key areas for accomplishing natural results, and it depends on different nose structures, not just the lower lateral cartilages (LLC). Methods A total of 560 rhinoplasty cases were studied retrospectively between September and December 2023. Three hundred and twenty patients had at least 1 year of follow-up. Patients had follow-up at 2 weeks, 1 month, 3 months, 6 months, and 1 year after surgery. No secondary rhinoplasty was included. Only 2 secondary septoplasty cases were included, without any nose skin undermining in the previous surgery. Surgical details were documented, including the 6 fundamental steps of this technique: (1) mucosal lower lateral incision, (2) dorsum subperichondral dissection and vertical scroll release, (3) lateral crura tail caudal release, lateral crura steal and slide-under flap lateralization, (4) upper lateral caudal resection, (5) vertical scroll reconstruction, and (6) turning point extension graft. Results Three hundred and twenty patients had at least 1 year of follow-up. In total, 516 patients underwent a closed approach and 47 patients an open approach. All patients had subperichondral dissection of the hump envelope. All patients who underwent a closed approach had a low-strip letdown dorsal preservation technique. All patients who underwent an open approach had a structural technique with spreader flaps or grafts at the keystone area. All the patients underwent osteotomies with a piezoelectric device. Twenty-three revisional surgeries were necessary. Conclusions CPR taught us how important ligament and soft tissue preservation are. We learned that the less damage you do to the nose soft tissues and scaffold, the less support you need for it. Surgeons have been overgrafting the lateral crura to solve postoperative problems mainly because of dissection problems and lack of lateral crura support. This paper describes how to solve lateral crura surface problems, keeping the tip flexible and elastic, and also creating a nice and natural supraalar groove transition, by applying 6 surgical maneuvers. Level of Evidence: 4 (Therapeutic) [ABSTRACT FROM AUTHOR]

Septoplasty is among the most frequently performed procedures in the field of otorhinolaryngology. Adhesion is known to be the most common complication occurring after septoplasty. Post-surgical insertion of silicone splints is a widely used measure for the prevention of postoperative complications. Recently, we encountered a case where the silicone splint was dislocated and further displaced to the level of the upper esophageal sphincter. Although it was safely removed using fiberoptic gastroendoscopy, delayed removal could have induced other serious sequelae. Since no similar cases have been previously reported, we believe that this may be a very rare complication induced by a loose absorbable suture. Therefore, we suggest that otorhinolaryngologists should pay attention to the fixation of a silicone splint with sutures under appropriate tension to prevent the dislocation of the silicone splint and its subsequent sequelae. [ABSTRACT FROM AUTHOR]

The Herlyn-Werner-Wunderlich syndrome is a rare congenital disorder with uterus didelphys, unilateral obstructed hemivagina and ipsilateral renal agenesis, more common on right side. HWW syndrome usually presents at puberty with symptoms like pelvic pain, dysmenorrhea and palpable mass due to the associated hematocolpos or hematometra. Delayed presentation in adulthood as infertility can occur in case of incomplete vaginal septum. Short term complications like pyohematocolpos, pyosalpinx, or pelviperitonitis, and long-term complications, such as endometriosis, increased risk of abortion and infertility can occur. Ultrasound is the initial investigation which demonstrates uterine anomaly, renal agenesis and hematocolpos.Magnetic resonance imaging (MRI) is the imaging modality of choice which helps in confirmation of diagnosis, delineation of vaginal septum, communication between 2 cavities and associated pathologies like adenomyosis better.Vaginal septum resection is the treatment of choice for obstructed hemivagina with hematocolpos.We present you a case of 43 years female with cyclical dysmenorrhea starting few years after menarche with uterine didelphys, left sided vaginal septum with hematocolpos and left renal agenesis. Along with this, diffuse bilateral adenomyosis was present which is uncommonly associated with this anomaly as obstruction is at the level of vagina. Patient was diagnosed late due to misdiagnosis and later treated with septal resection for hematocolpos and with hormonal medications for adenomyosis.

Objective: Accurate management of acute nasoseptal fractures can mitigate cosmetic and functional complications. There is a lack of consensus on the ideal approach to manage acute nasoseptal fractures, which are often addressed with closed nasal and/or septal reduction (CN/SR) but sometimes addressed using an open approach with septoplasty. We aimed to systematically assess and compare outcomes of CN/SR versus open approaches to treat acute nasoseptal fractures., Data Sources: PubMed, Scopus, and CINAHL., Review Methods: Studies evaluating outcomes of adults with acute nasoseptal fractures treated within 3 weeks of injury with either CN/SR or open approach were included. Meta-analysis was performed to examine the pooled frequency of complications including persistent obstruction, cosmetic deformity, and need for revision surgery., Results: Of 1630 unique articles identified, 27 were included (63% retrospective, 29.6% prospective, 7.4% randomized controlled trial). Data included 1117 patients (n = 712 CN/SR, n = 423 open approach), with a mean age of 30.5 years. Patients who underwent CN/SR only were more likely to experience persistent obstruction compared to patients who underwent open approach (22.2% [95% confidence interval, CI, 8.7%-39.5%] vs 5.9% [95% CI, 2.4%-10.7%], P < .0001). Patients who underwent CN/SR were more likely to require revision surgery within 3 years (30.9% [95% CI, 15.8%-48.4%] vs 6.0% [95% CI, 3.3%-9.9%], P < .0001., Conclusion: Patients with nasoseptal fractures who underwent open septoplasty in the acute period were less likely to experience complications. Prospective trials are needed to confirm results of this meta-analysis., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Objective: Toxic shock syndrome (TSS) is a rare but serious complication after sinonasal surgery and a commonly cited consideration for prescribing antibiotics when nasal packing or stents are placed. Most reports are limited to case reports or small series. The aim of this systematic review was to describe the incidence, risk factors, and clinical course of patients who developed TSS as a complication of endoscopic sinus surgery (ESS) and/or septoplasty., Data Sources: A systematic review was conducted using MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library databases., Review Methods: Eligibility criteria were patients of any age who developed TSS as a complication of ESS and/or septoplasty., Results: Twenty-five studies were included in the final review. Seventy cases were identified over 38 years (1982-2020). The pooled incidence of TSS after sinonasal surgery was 0.0003 (0.0002-0.0004, 95% confidence interval, CI) or 30 per 100,000 persons. Among 33 patients with single-subject data, mean age was 33.8 years (29.73-37.87, 95% CI). Seventeen (51.5%) patients had nasal packing, 3 (9.1%) had stents, 5 (15.2%) had both, 7 (21.2%) had none. Fourteen (42.4%) patients had nonabsorbable packing and 5 (15.2%) had absorbable packing. Sixteen (48%) patients received peri-operative antibiotics. Thirty-two (97%) patients had full recovery., Conclusion: The incidence of TSS after sinonasal surgery is very rare. TSS can occur with and without nasal packing and prophylactic antibiotics were not protective. Outcomes were favorable with appropriate recognition and management. Further study is needed to determine which patients are most at risk for TSS., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Background and Objective: Septoplasty and turbinate reduction surgery (STR) is hypothesized to affect pulmonary function by modifying airway dynamics. This study investigates the impact of STR-mediated improvements in nasal patency on pulmonary function tests (PFTs)., Methods: In a prospective analysis, 37 adult patients undergoing STR were enrolled. Peak nasal inspiratory flow (PNIF) and PFT parameters, including forced expiratory flow at 25% (FEF25) and 75% of forced vital capacity (FEF75) and forced expiratory flow between 25 and 75% of the pulmonary volume (FEF25-75), forced vital capacity (FVC), and forced expiratory volume in one second (FEV1), were measured before and after surgery., Results: Significant improvements were observed in PNIF ( p  < .001). Additionally, significant improvements in peripheral airway function occurred, as measured by FEF25, FEF25-75, and FEF75 ( p  < .05), suggesting reduced airway resistance after STR. Notably, a significant positive correlation was found between the change in PNIF (∆PNIF) and the change in various PFT measurements (∆PFT) ( p  < .05). FVC and FEV1 did not show significant changes., Conclusions: These findings suggest that improving nasal patency through STR can affect lower airway resistance, potentially benefiting patients with nasal obstruction. The observed positive correlation between ∆PNIF and ∆PFT warrants further investigation into the underlying mechanism., Level of Evidence: Level III., Competing Interests: This Declaration of Interest takes effect upon acceptance of the Submission entitled “Septoplasty‐mediated Improvements in Nasal Patency and Pulmonary Function: A Prospective Study” for publication. We, the authors of the manuscript, hereby declare the following: There are no conflicts of interest associated with this research. We confirm that no significant financial support was received that could have influenced the study's outcome. All named authors have reviewed and approved the final manuscript for submission. We further confirm that all individuals meeting the authorship criteria are included and listed in the correct order. Intellectual property considerations have been addressed, and there are no impediments to publication, including timing, due to intellectual property concerns. We have ensured compliance with our respective institutions' regulations regarding intellectual property. The corresponding author, Francisco Alves de Sousa, will serve as the primary point of contact throughout the editorial process. This includes communication with the editorial team and other authors regarding manuscript revisions and final proof approval. We confirm that Francisco Alves de Sousa provided a current and accurate email address accessible to all authors., (© 2025 The Author(s). Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Objective This study aimed to assess the improvement of the quality of life (QoL) through the Sinonasal Outcome Test (SNOT-22) questionnaire among patients undergoing septoplasty or septorhinoplasty with and without turbinoplasty and the possible influence of age and sex. Methods We conducted an observational, analytical, prospective cohort study, between 2013 and 2016, involving 99 patients diagnosed with nasal obstruction due to septal deviation and turbinate hypertrophy. The diagnosis, degree of obstruction, sex, and age of the patients were analyzed. Four types of surgery were performed: septoplasty (S), septorhinoplasty (SRP), S plus turbinoplasty (T), and SRP plus T. The QoL was measured using the SNOT-22 questionnaire, before surgery and four months later. The sum of the scores obtained for each of the 22 indicators was calculated, as well as the differences in these values before and after surgery. Shapiro-Wilk normality tests, boxplot charts, t-tests, paired t-tests, and Kruskal-Wallis tests were used to compare the SNOT-22 parameters and covariables. We applied the Poisson multiple regression model to adjust for differences linked to patients' age and sex. Results Most of the patients in our cohort were male. The average SNOT-22 score pre and post-test were 53.59 ± 18.58 and 8.46 ± 9.90 (p = 0.00001), respectively; the differences were significant for each studied surgery. The differences in QoL were significant for each studied surgery and the difference between pre and post-surgery scores was greater for procedures that included turbinoplasty. The comparison between the procedures involving S alone versus S+T reached a significance level (p = 0.053). In the analysis of the different subcomponents of QoL in SNOT-22, sleep function showed the greatest improvement after S+T surgery. The multivariable Poisson regression model revealed that the biggest difference before and after surgery was related to female gender vs. males, and S+T surgeries vs. S-only surgery Conclusions The SNOT-22 questionnaire proved to be useful in assessing the improvement in QoL after nasal surgery. Both septoplasty and functional septorhinoplasty enhance QoL. However, septoplasty combined with turbinoplasty (S+T) results in greater improvements in QoL and sleep function regardless of age, with the most significant improvement observed in women., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethics Committee-Hospital Carlos Andrade Marín (CEISH-HCAM) issued approval PI-2024-0101. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2025, Ríos-Deidán et al.)