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Nasotracheal intubation is routinely used in patients undergoing oral and maxillofacial surgery when intermaxillary fixation is needed either intraoperatively or postoperative. Various complications can occur such as epistaxis, turbinectomy, retropharyngeal dissection, tympanites, and nasal alar pressure sores or necrosis, especially when there is a prolonged nasotracheal intubation. The first report of a nasal alar necrosis after prolonged nasotracheal intubation was published by Hatcher et al in 1968. Since then several reports of skin necrosis of the nasal alar region have been published and attributed to a prolonged operation or the technique used in tube placement. Pressure ulcers are a localized damage to the skin and underlying soft tissue and usually appear immediately after the procedure. They start with nonblanchable erythematous intact skin and can evolve to partial thickness loss of skin with exposed dermis and scab formation during the healing process. They may be painful and can cause a cosmetic problem for patients. The literature has several studies of nasal alar necrosis after nasotracheal intubation for head and neck reconstructive surgery, but there is no description of this complication after orthognathic surgery. This paper describes the occurrence of skin nasal alar necrosis following a bimaxillary jaw correction and highlights recommendations for its management and prevention.
This article was published in the following journal.
Name: The Journal of craniofacial surgery
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Nasotracheal intubation can cause injury and hemorrhage of nasal mucosa and nasal alar. The investigators measure the actual pressure at the angle between nasotracheal tube and nasal alar,...
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The aim of this prospective and observational study is to describe the conditions of orthognathic procedures performed in Toulouse Teaching Hospital over a one-year period, the outpatient-...
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Hyaline cartilages in the nose. There are five major nasal cartilages including two lateral, two alar, and one septal.
An ulceration caused by prolonged pressure on the SKIN and TISSUES when one stay in one position for a long period of time, such as lying in bed. The bony areas of the body are the most frequently affected sites which become ischemic (ISCHEMIA) under sustained and constant pressure.
Surgery performed to repair or correct the skeletal anomalies of the jaw and its associated dental and facial structures (e.g. CLEFT PALATE).
A surgical specialty concerned with correcting conditions related to malposition of the jawbones and other related MAXILLOFACIAL ABNORMALITIES (e.g., CLEFT PALATE; RETROGNATHISM).
Surgery performed on the ear and its parts, the nose and nasal cavity, or the throat, including surgery of the adenoids, tonsils, pharynx, and trachea.
Surgery is a technology consisting of a physical intervention on tissues. All forms of surgery are considered invasive procedures; so-called "noninvasive surgery" usually refers to an excision that does not penetrate the structure being exci...
Dentistry is the study, management and treatment of diseases and conditions affecting the mouth, jaw, teeth and their supporting tissues (Oxford Medical Dictionary) The work of a dentist ranges from regular patient check-up to orthodontics and surgery....
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