Key Points Understanding the pathogenesis of rhinosinusitis depends on defining the specific types of rhinosinusitis. Acute bacterial rhinosinusitis (ABRS), chronic rhinosinusitis (CRS), and acute exacerbation of chronic rhinosinusitis (AECRS) are three distinct entities. A number of environmental and host factors…
Key Points Nonallergic rhinitis (NAR) is a chronic, highly prevalent condition that presents with symptoms of nasal congestion, obstruction, and rhinorrhea in the setting of a negative allergen test. In contrast to allergic rhinitis (AR), NAR has a greater predilection…
Key Points The diagnosis of acute rhinosinusitis is made on clinical grounds, and imaging is reserved for cases with suspected intracranial and orbital complications. Computed tomography (CT) is the modality of choice in imaging of chronic rhinosinusitis (CRS) and planning…
Key Points Ciliary activity causes the transport of mucus in the airways, an essential defense mechanism of the respiratory tract. Mucociliary transport can be measured in vivo either by using the saccharine and/or color test or by radioisotope transport testing,…
Key Points Olfaction is important for hazard avoidance and quality of life. Olfactory dysfunction affects 20% of the general population and is most commonly caused by sinonasal disease, upper respiratory tract infections, head trauma, normal aging, and neurodegeneration. Olfactory dysfunction…
Key Points The immune system protects the organism from infectious microbes and avoids responses that produce damage to host tissues. The immune system is divided into the innate and adaptive systems. The adaptive immune system recognizes different specific antigens, adapts…
Key Points Revision rhinoplasty is the process of correcting secondary deformities from primary surgery. Skin thickness must be analyzed and factored into decision making in revision rhinoplasty. Thin skin–soft tissue envelope (SSTE) contracts with time and can reveal minor irregularities.…
Key Points Non-Caucasian patients have differences that extend beyond anatomy. Cultural norms, communication, expectations, and aesthetic definitions all must be considered in this patient group. Anatomic variants preclude certain common surgical maneuvers performed with Occidental patients. Aesthetic goals in non-Caucasian…
Key Points The external approach for rhinoplasty is found almost exclusively in the severely twisted or previously operated nose. Nasofrontal angle modifications can help shorten or lengthen the nasal dorsum. Batten grafts can help correct both internal and external nasal…
Key Points The best results in rhinoplasty are achieved by the most conservative possible techniques that respect the structural quality and relationships of nasal elements and maintain natural and normal-appearing outcomes. Most successful outcomes are achieved primarily through tissue reorientation,…