Dataset Information

Isolated nasal septum necrosis caused by Aspergillus flavus in an immunocompromised child.

ABSTRACT: Nontraumatic isolated nasal septal aspergillosis in the absence of sinusitis is a rare but serious infection in immunocompromised patients. Adequate management requires early diagnosis, prompt empiric antifungal therapy, and surgical debridement to prevent progression of life-threatening complications. With the increasing population of immunocompromised children, it is essential for timely management that clinicians have a high index of suspicion for this unusual presentation of aspergillosis.

SUBMITTER: Naeem F

PROVIDER: S-EPMC3873770 | biostudies-literature | 2011 Jul

REPOSITORIES: biostudies-literature

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Isolated nasal septum necrosis caused by Aspergillus flavus in an immunocompromised child.

Naeem Fouzia F Rubnitz Jeffrey E JE Hakim Hana H

The Pediatric infectious disease journal 20110701 7

Nontraumatic isolated nasal septal aspergillosis in the absence of sinusitis is a rare but serious infection in immunocompromised patients. Adequate management requires early diagnosis, prompt empiric antifungal therapy, and surgical debridement to prevent progression of life-threatening complications. With the increasing population of immunocompromised children, it is essential for timely management that clinicians have a high index of suspicion for this unusual presentation of aspergillosis. ...[more]

PMID: 21245776

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Project description:ImportanceThe rabbit is the primary animal model used to investigate aspects of nasal surgery. Although several studies have used this model, none has provided a comprehensive analysis of the surgical anatomy and techniques used to gain access to the rabbit nasal fossae and septum.ObjectiveTo describe and optimize the surgical anatomy and approach to the rabbit nasal vault and septal cartilage.Design, setting, and participantsIn an ex vivo animal study conducted at an academic medical center, preliminary cadaveric dissections were performed on rabbit head specimens to establish familiarity with relevant anatomy and rehearse various approaches. Live Pasteurella-free New Zealand white rabbits (3.5-4.0 kg) were used to further develop this surgical technique developed here. Access of the nasal vault was gained through a midline nasal dorsum incision and creation of an osteoplastic flap with a drill. Submucosal resection was performed with preservation of the mucoperichondrium. All rabbits were monitored daily for 4 weeks in the postoperative period for signs of infection, pain, and complications. The study was conducted from June 1, 2014, to December 1, 2014.Main outcomes and measuresSurgical anatomy and techniques used to gain access to the rabbit nasal vault and harvest septal cartilage.ResultsFour Pasteurella-free New Zealand white rabbits (Western Organ Rabbit Co), ranging in age from 9 to 12 months and weighing between 3.5 and 4.0 kg, were used in this study. Initial dissections demonstrated the feasibility of harvesting septal cartilage while preserving the mucoperichondrial envelope. Access to the nasal vault through this 3-osteotomy approach allowed for maximal exposure to the nasal cavity bilaterally while maintaining the integrity of the mucoperichondrium following septal cartilage harvest. The maximum amount of bulk, en bloc, cartilage harvested was 1.0?×?2.5 cm. Following surgical dissection, all animals maintained adequate airway patency and support to midface structures. Furthermore, all specimens preserved the integrity of the mucoperichondrium, septum, vascular anatomy, and airway dynamics. No operative complications, postoperative airway compromise, or infections were observed.Conclusions and relevanceAccess to the rabbit nasal vault and septal cartilage is feasible through a variety of surgical approaches and techniques. To date, this is the first study to meticulously document and review the surgical approaches to the rabbit nasal cavity. This approach describes a novel, 3-osteotomy method of accessing the nasal cavity bilaterally and successfully harvesting rabbit septal cartilage in a submucoperichondrial plane. The ability to preserve native anatomy and function allows for improved outcomes in translational and animal guided clinical research.Level of evidenceNA.

Dataset Information

Isolated nasal septum necrosis caused by Aspergillus flavus in an immunocompromised child.

Publications

Isolated nasal septum necrosis caused by Aspergillus flavus in an immunocompromised child.

Similar Datasets

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