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At least 19 recordsLinked to original sources

Histological analysis of the postnatal development of the nasal septum.

The importance of the growth in the nasal septum for the development of the facial skeleton has often been stressed. An increase in dimension is well-known from radiographs. It was the purpose of the present study to describe the normal pattern of the growth sites of the nasal septum according to age and sex by histological and microradiographical examination of human autopsy material. The nasal septum was removed from 66 boys and 57 girls who had died in accidents. Decalcified sections for conventional histology as well as undecalcified sections for microradiography were prepared. The superior surface and posterior margin of the vomer as well as the vomeroethmoidal and the vomeromaxillary sutures were studied. It was obvious that increase in size of the vomer could mainly be ascribed to apposition on the superior surface and the posterior margin. This was seen until adult age. After the ethmoid bone was ossified, the connection between the vomer and the perpendicular plate of the ethmoid bone was a slightly sinuous suture in which growth occurred until puberty. The growth pattern implied that a forward, downward sliding of the vomer must take place in relation to the ethmoid bone and the cartilaginous septum. Frontal sections revealed that, after the establishment of the suture between the vomer and the perpendicular plate of the ethmoid, a cartilage island was embedded in the vomer surrounded by thin, fenestrated cortical bone blades. This cartilage still persisted in specimens from adults. There is, on the basis of the present findings, no reason to believe that the septal cartilage plays a major role in the forward, downward growth of the maxillary complex in homo.

Adolescent

Surgical correction of cartilaginous nasal septum deformities.

Septal cartilage deviations which are usually present in deformities of the cartilaginous nasal septum are corrected by scarification on the concave side of the curvature. Histological studies indicated that this procedure was best adapted to the structure of the elastic fibres constituting the cartilaginous nasal septum. Follow-up examinations in 33 patients who having undergone surgery showed nasal breathing to be unobstructed bilaterally in all cases; in 29 patients an aesthetically satisfactory nasal shape was restored and full re-alignment of the cartilaginous nasal septum was obtained.

Adolescent

Chondrosarcoma of the nasal septum extending into the maxillary sinus.

A case of chondrosarcoma of the nasal septum extending into the maxillary sinus is presented. These cartilaginous tumors are rare in the head and neck, with only 21 reported in the maxilla and four in the nasal septum. Careful histologic analysis is required for correct diagnosis. The present case was treated with an en bloc ethmoidectomy and medial maxillectomy, followed by fast neutron radiation therapy. The therapeutic program is analyzed for opportunity to provide an excellent chance of cure.

Adult

Malignant tumours of the nasal septum.

(1) Primary malignant tumours of the nasal septum are rare. (2) Forty-three cases of primary malignant septal tumours are presented and analyzed. (3) This present series is compared with the 97 previously reported cases. (4) The commonest primary malignant tumour at this site is squamous cell carcinoma. (5) The aid of a computer has been utilized to assess survival trends. (6) The overall 5-year survival in this group is 58 per cent. (7) Prognosis is not significantly affected by different treatment protocols. (8) Prognosis is significantly worse in patients with late stage tumours and in patients who have radiological abnormalities in their paranasal sinus x-rays.

Adult

Light- and electron-microscopic observations on the closure of the secondary palate with the primary palate and the nasal septum.

Closure between the secondary palate and the primary palate and between the former and the nasal septum was studied in the Syrian golden hamster at light- and electron-microscopic level. Sequential changes in the epithelia before, during and after the closure of the primary and the secondary palate were described. A characteristic epithelial thickening was observed prior to epithelial fusion between the nasal septum and the secondary palatal shelf. Fusion of the opposing epithelia was characterized by formation of desmosomes. An unilateral or bilateral empty space was observed on each side of the epithelial seam, and it was suggested that this may represent the incisive foramen in the adult.

Animals

[Headache caused by distortion of the nasal septum and respiratory disturbances of the nasal cavity].

Head and facial pain of unknown origin may be caused by defective aeration of nose and sinus. The reason is a chronic irritation of the mucosa or direct contact between septum and conchal mucosa. A secondary reaction to the impaired breathing through the nose may be an irritation of the sinus without causing a full-grown sinusitis. Diagnosis and therapy are possible by rhinoscopy, sinumanometry and sinuscopy in one appointment.

Bone Diseases

Surgery of the nasal septum.

A modification of the 'maxilla-premaxilla' approach for nasal septum surgery is described. With this modification the mucosal elevation in the area of the two inferior tunnels is performed from above along the crests of the vomer, maxillary and premaxillary bones, instead of from below through the undermined base of the nose as in the 'maxilla-premaxilla' approach. This mucosal elevation is performed under direct vision in the intraseptal area instead of by blind elevation as in the 'maxilla-premaxilla' approach where the progress of the elevator beneath the nasal mucosa is followed through the nasal chambers. It gives the surgeon the increased advantage of working under the perichondrium and periosteum and of overcoming any difficulty arising from malformations in the anterior (caudal) area of the septal cartilage, premaxillary wings and maxillary crest. With this modification, extensive undermining of the base of the nose is also avoided. Finally the septal framework is fully exposed as in the 'maxilla-premaxilla' approach but in a more easy and safe way while all the advantages of the 'maxilla-premaxilla' approach are preserved.

Humans

Distribution of epithelia and glands of the nasal septum mucosa in the rat.

A histotopographic study of the nasal septum mucosa in rats was made using semi-serial sections stained with PAS-hematoxylin, reconstructed in form of maps representing the structure in a sagittal plane. The stratified squamous, respiratory and olfactory epithelia and Masera's organ cover 14.8, 43.6, 41.6 and 1.8%, respectively, of the septal surface (117.1 mm2). In the vestibular region, only ducts of PAS-negative glands of the respiratory region are found, and below the septum there is the infraseptal gland with PAS-negative acini. In the respiratory region, PAS-negative acinous glands form two groups: the superior and the inferior one occupying 10.5 and 1.5%, respectively, of the septal area. PAS-positive acinous glands are in the inferior half of the respiratory region and in a small anteroinferior portion of the olfactory region. Besides goblet cells broadly distributed, the respiratory epithelium presents scattered intraepithelial PAS-positive glands which are concentrated in the anterior portion and close to the nasopharyngeal duct. In the olfactory region prevail Bowman's PAS-positive glands which are also present in the mucosa of Masera's organ, but are not seen in the olfactory mucosa of Jacobson's organ. In the latter, PAS-positive glands are found in the respiratory mucosa. Globular leukocytes, cells of connective tissue origin, are constantly infiltrating the superior regions of the respiratory and olfactory epithelia, being more numerous in female rats.

Animals

[Reconstruction of the nasal septum combined with septal dermoplasty in Rendu-Osler-Weber's disease (author's transl)].

Severe and recurrent epistaxis in cases of Rendu-Osler-Weber's disease can be treated best by septal dermoplasty and intranasal skin grafting beyond the septum to include the upper lateral cartilage and interior turbinate as well as the floor of the anterior part of the nose. Combined with a large defect of the nasal septum the dermoplasty alone with the lining of the anterior part of the nose with split-thickness skin grafts is not without problems because of the excessive dryness and the severe and in part malodorous crusting of the nasal cavity. The necessary removal of the crustings can effect recurrent epistaxis. In this case, the reconstruction of the large septal defect with a frontotemporal flap is recommended. The temporal part of this pedicled forehead flap is taken from a region, which is only slightly affected by the teleangiectasias. Four weeks after the implantation of the frontotemporal flap into the septal defect the pedicle of the flap can be transected and removed. The functional result of this reconstruction of the nasal septum combined with the dermoplasty is satisfying.

Epistaxis

Carcinomas of the nasal septum.

Fourteen new cases of primary squamous cell carcinoma of the nasal septum are presented. Their inclusion brings the total reported in the literature to 97. Early, confined neoplasms are amenable to cure by surgical excision, external irradiation or radium implants. Prognosis does not correlate with histological grade of the neoplasm but is inversely related to the size of the carcinoma at the time of diagnosis and the presence of metastases.

Adult

Ultrastructure of the anterior medial glands of the rat nasal septum.

The anterior medial glands lying in the submucosa of the rat nasal septum were studied by light and electron microscopy. The glands consist of a single long duct, which is studded with numerous solitary acinar formations connected perpendicularly to the main duct by short intercalated ducts. Proximal acini (those furthest from the stoma of the main duct) consist of typical serous cells with many dense secretory granules and an extensive rough endoplasmic reticulum. The most distal acini consist of cells whose major feature is the enwrapment of each mitochondrion by a cisternal profile of rough endoplasmic reticulum. Myoepithelial cells are absent from proximal acini, but are abundant on distal acini. Intracellular nerve terminals are extremely common, particularly in distal acini. The main ducts resemble, to a degree, the striated ducts of salivary glands.

Animals

[Headache caused by deformation of the nasal septum and by deviation disorders of the nasal cavity].

In case of uncertain pain of the frontal, nasal and maxillary area one must search for disturbed ventilation of the nose or its communications. Particularly so, if no radiological evidence is found. Anatomical changes may cause a primary irriation of the mucosa, when ventilation is distirubed or when there is direct contact between septum and conchal mucosa. As a reaction to such primary disturbance, ventilation to the maxillary sinuses may be inhibited, thus causing a secondary irriation. Thus a recidivating acute maxillary pain may occur without a real sinusitis, because of a hypoxia of the sinus. Rhinoscopy resp. nasal endoscopy will clear up anatomical primary causes. Conchal contact should be eliminated by lateroposition or by pinching. The septum deviation should be corrected if by nasal drops or spray the pains may be eliminated. Sinus obstruction may be diagnosed by rhinomanometry and sinuscopy and may be simultaneously treated by a small drainage tube.

Headache

Pleomorphic adenoma of the nasal septum.

A brief review of the world literature on pleomorphic adenoma of the nasal septum is presented. One further case is reported, treated by surgical excision via lateral rhinotomy. Alternative surgical approaches are considered.

Adenoma, Pleomorphic

A longitudinal study of facial growth in Papio cynocephalus after resection of the cartilagenous nasal septum.

The present study evaluates in Papio cynocephalus the effectiveness of varying the amount of nasal septum resected and the age at surgery in an attempt to develop a technique which may have clinical value for the human condition. The analysis of interdental dimensions by graphical techniques demonstrates that a critical age exists at which total septum resection leads to maximum growth arrest of the premaxilla. Comparisons of linear regression curves for operated and control animals confirm these findings and also demonstrate the existence of sexual dimorphism in premaxillary growth rates.

Age Factors

Density of mucous glands in the normal adult nasal septum.

The entire mucosa from 13 normal nasal septa was stained by the PAS-alcian blue whole-mount method, and the mean density of glandular orifices in 13 localities was determined quantitatively by counts in 4 mm2 fields. The median density within the entire material was 8.4 glands/mm2, with an interindividual variation of +/- 1 gland/mm2. The median number was 15,900 glands, range 10,800-21,800. The distribution of the glands is regular, with little variation between the localities. Density is somewhat, but significantly lower in the posterior quarter of the septum, and there was a significant increase in density into the infero-superior direction.

Aged