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Mantova, Italy

Scattolin A.,Villa Donatello Clinic | Orlando N.,Villa Donatello Clinic | D'Ascanio L.,Carlo Poma Civil Hospital
Facial Plastic Surgery | Year: 2013

Spreader grafts (SGs) have been widely used for both aesthetic and functional reasons to prevent middle vault collapse and treat internal nasal valve insufficiency. Although SG precise fixation can be easily achieved in open rhinoplasty, the difficulties of SG placement in closed rhinoplasties can be discouraging. In the present report, we describe a new custom-made SG (called rail spreader) and the personal easy method of application of such graft in endonasal rhinoplasty. The technical details and results are reported along with the advantages of our technique over previously described approaches. © 2013 Georg Thieme Verlag KG Stuttgart, New York.

D'Ascanio L.,Carlo Poma Civil Hospital | Rebuffini E.,University of Ferrara
Journal of Laryngology and Otology | Year: 2014

Abstract Objective: To report a unique case of unilateral blindness secondary to transnasal endoscopic surgery and stenting for right choanal atresia. Case report: A 24-year-old man was referred with right eye blindness and acute headache, occurring immediately after transnasal endoscopic surgical repair of unilateral right choanal atresia with placement of an endonasal stent. Maxillo-facial computed tomography with three-dimensional reconstruction showed the endonasal stent entering the right nostril, passing through the lamina papyracea into the orbit and running anterior to the optic foramen towards the superior orbital fissure. Despite stent removal and medical treatment (ceftriaxone and dexamethasone), permanent right eye blindness secondary to an irreversible lesion of the optic nerve was diagnosed. At three-month follow up, an uncommon, complete fibrous obliteration of the right nasal fossa was noticed. Conclusion: To the best of our knowledge, this is the only published report of unilateral blindness following transnasal endoscopic stenting for right choanal atresia. Causes of this complication, and ways of avoiding it, are discussed. Copyright © JLO (1984) Limited 2014.

D'Ascanio L.,Carlo Poma Civil Hospital | Cappiello L.,Carlo Poma Civil Hospital | Piazza F.,Carlo Poma Civil Hospital
Journal of Laryngology and Otology | Year: 2013

Background: Septoplasty is one of the most common otolaryngological operations. It is often dismissed as a simple procedure, despite the wide range of potential complications. We describe the first reported case of unilateral hemiplegia as a complication of septoplasty. Methods and results: A 51-year-old man presented with right hemiplegia following a septoplasty and turbinoplasty procedure carried out elsewhere. Cranial imaging showed a breakthrough fracture of the left sphenoid sinus anterior wall and clivus, with a haemorrhagic area in the left paramedian pons, which was responsible for the patient's right hemiplegia. Despite neurological and physiotherapeutic rehabilitation, the patient gained only partial recovery from his right hemiplegia. Conclusion: Good intra-operative visualisation and appropriate surgical technique are essential to prevent complications and achieve a functional nasal airway. The importance of the presented case to the pre-operative informed consent process is underlined. © JLO (1984) Limited 2013.

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