Nose & Sinus Issues

Mega-perforation: Pushing the Limits of Septal Perforation Repair

by Dr. Jason Hamilton
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CLINICAL CHALLENGE We have coined the term ‘Mega-perforation’ to refer to a septal perforation that approaches the limits of reparability. Typically perforations greater than 3.0-3.5cm and/or greater than 75% of the anterior septum size fall into this category. MANAGEMENT CONSIDERATIONS The “watch and wait” approach to managing septal peforations is typically the wrong approach because […]

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Septoplasty Complication and Septal Perforation

by Dr. Jason Hamilton
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CLINICAL CHALLENGE Septal perforation (a hole in the nasal septum) is considered a major complication after septoplasty. Septoplasty is typically performed to correct a deviated septum in a patient who complains of nasal obstruction. In a successful case the obstruction is relieved, the septum is straight, and the patient is happy with their newfound nasal […]

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Nose Picking (Rhinotillexis) and Septal Perforations: Why I should stop picking my nose…?

by Dr. Jason Hamilton
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BACKGROUND Nose picking is one of the leading causes of epistaxis (nose bleeds) and a common cause of septal perforations (a hole in the nasal septum). Nose picking (rhinotillexis) is defined as the insertion of the finger and/or object into the nose for the purpose of removing nasal secretions, mucus, crusts and so forth. PATHOLOGIC […]

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Nasal Fractures, Septal Hematoma, and Septal Perforation: Simultaneous Rhinoplasty and Septal Perforation Repair

by Dr. Jason Hamilton
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Nasal Septum Repair/Septal Perforation Surgery/Rhinoplasty CLINICAL CHALLENGE The nose is the most commonly injured facial bone. A fractured nose must be evaluated immediately for the presence of a septal hematoma (a large blot clot involving the nasal septum). If not drained promptly a septal hematoma may lead to infection, septal perforation, and long-term nasal deformity. […]

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Septal Perforation: Long-Term Outcomes

by Dr. Jason Hamilton
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Nasal Septum Repair/Septal Perforation Surgery/Nose Deformity CLINICAL CHALLENGE Septal perforation surgery is likely one of the most difficult reconstructive surgical procedures performed by a nasal reconstructive surgeon. Long-term follow-up is mandatory to insure that the perforation heals well without complications. MANAGEMENT CONSIDERATIONS The complexity of each case is dictated by the cormorbidities present. Patients presenting […]

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Management of Pediatric Septal Perforation

by Dr. Jason Hamilton
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Lithium Battery Causing Septal Perforation/Nasal Septum Repair/Septal Perforation Surgery CLINICAL CHALLENGE Septal perforations can arise from a variety of injuries to the nose. In the pediatric population children placing small objects in the nose is a common cause of injury to the nasal septum. In this case a lithium battery from a small toy was […]

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What Effect Does Cocaine Have on the Nose?

by Dr. Jason Hamilton
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Quick Facts:     i.          Cocaine constricts blood flow to the septum causing a perforation    ii.         Early intervention can prevent a septal perforation   iii.         A septal perforation will never heal on its own once present    iv.         Cocaine can severely damage the […]

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Nasal Saline Irrigation

by Dr. Belinda Mantle
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Doctor, I always have sinus congestion and post nasal drip. People keep telling me to try using nasal saline irrigation. Will it help me? Salt water nasal washes have been used for centuries but recently have been popularized as an alternative to allergy/sinus medications and antibiotics. Nasal congestion and post nasal drainage can result from allergies, […]

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Saddle Nose Deformity and Septal Perforation: Correcting Nasal Collapse

by Dr. Jason Hamilton
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Nasal Septum Repair/Septal Perforation Surgery/ Saddle Nose Deformity Jason S. Hamilton, MD, FACS Director of the Division of Plastic and Reconstructive Surgery Osborne Head and Neck Institute, Los Angeles, CA Ryan Osborne, MD, FACS Director of the Division of Head and Neck Surgery Osborne Head and Neck Institute, Los Angeles, CA   CLINICAL CHALLENGE Septal […]

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Deviated Septum and Septal Perforation

by Dr. Jason Hamilton
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Nasal Septum Repair/Septal Perforation Surgery Jason S. Hamilton, MD, FACS Director of the Division of Plastic and Reconstructive Surgery Osborne Head and Neck Institute, Los Angeles, CA Ryan Osborne, MD, FACS Director of the Division of Head and Neck Surgery Osborne Head and Neck Institute, Los Angeles, CA   CLINICAL CHALLENGE Septal perforations may arise […]

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Hereditary Hemorrhagic Telangiectasia: Nasal Septal Perforation Repair

by Dr. Jason Hamilton
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Nasal Septal Perforation Repair Jason S. Hamilton, MD, FACS Director of the Division of Plastic and Reconstructive Surgery Osborne Head and Neck Institute, Los Angeles, CA Ryan Osborne, MD, FACS Director of the Division of Head and Neck Surgery Osborne Head and Neck Institute, Los Angeles, CA   CLINICAL CHALLENGE HHT is a hereditary disorder […]

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