No abstract

Our databank is the largest prospectively studied series of nasal-fracture management from Ireland. The incidence of nasal fracture in the southeast of Ireland is 0.37%. Age, gender, mode of injury, and type of sport influenced the satisfaction rates in this study. This type of service may not be practical in all ENT departments, but a regional center may be an idea worth considering.

The impact of the COVID-19 pandemic has resulted in widespread disruption to routine surgical services across the globe. As the peak of the initial pandemic passes, surgeons will increasingly resume elective work to address the backlog. Whilst urgent cases such as cancer work will be prioritized, the safe resumption of facial plastic surgery will remain an ongoing challenge; particularly if there are secondary waves of infection. Rhinoplasty and nasal reconstructive surgery in particular poses a unique challenge to address due to the due to the potential for aerosolizing the virus. A task force of facial plastic surgeons from the European Academy of Facial Plastic Surgery has collaborated to create this document detailing recommendations for resuming a safe facial plastic surgery practice. These include the need to embrace telemedicine, advice on surgical prioritization, planning of clinical area flow plans, advice on pre-/peri-and postoperative care as well as recommendations on training for residents and well-being for surgeons. The recommendations have been made in line with the best available evidence in the literature and are applicable to facial plastic surgery colleagues from around the world in order to resume a safe practice.

Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region. Some authors, however, have claimed a paucity of evidence that such untoward effects of surgery are frequent. Research has shown that surgical intervention limited to certain areas of the bony and cartilaginous nasal framework is less likely to affect natural growth patterns. There is a growing consensus toward early intervention, especially in a select group of patients, where deferring the surgery may turn out to be the poorer option in the short and the long term, and suggestions have been made that conservative guidelines may be employed to minimize the unwarranted results. This article presents our experience with septorhinoplasty in children over the last two decades in an academic setting. We have retrospectively studied the pediatric patients who underwent septorhinoplasty at the Academic Medical Centre, Amsterdam, Netherlands. There were 106 children aged between 3 and 19 years who underwent nasal surgery between February 1994 and August of 2007. Sixty-six of these were boys and 40 were girls. Their follow-up ranged from 12 to 157 months with a mean follow-up period of 53 months. Eighteen patients underwent revision surgery. The clinical circumstances, indications for surgery, extent of surgical interference, and outcome in 106 patients are discussed. Importantly, the patients in this series have been followed for variable periods after puberty and adolescence, allowing for assessment beyond the nasal and midfacial growth spurts. Based on our experience, we have outlined the clinical guidelines that we follow for surgery in this age group of patients.

Sublingual hematoma secondary to excessive anticoagulation is a rare, life-threatening condition. Reports in the literature have emphasized the importance of a prompt reversal of the causative coagulopathy by intravenous administration of vitamin K and fresh frozen plasma. In the event of an unstable airway, surgical intervention via tracheostomy or cricothyroidectomy is advocated. We report a case of sublingual hematoma that was treated conservatively, and we discuss the presentation and management of this entity.