Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4450_Библиотеки_им_академика_М_И_Перельмана
.pdf
Fig. 2.60Irregularity of the bony pyramid.
The bony dorsum or the lateral bony wall is irregular.
Irregularities do not always cause symptoms and might
only be noticed on palpation. In some cases, they are
clearly visible, and tender on palpation. Irregularities can
be made more evident by stretching the overlying skin.
They are usually caused by traumatic fractures, but may
also be due to incomplete or asymmetrical hump removal
with insufficient smoothing of the dorsum. Furthermore,
they may result from inadequate repositioning of the bony
walls after osteotomies.
Lateral Step (▶ Fig. 2.61)
Fig. 2.61Lateral step. On the lateral wall of the bony pyramid, a ridge is visible and
palpable.
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
On the lateral bony wall, a ridge or groove is visible and/or
palpable. This deformity is mostly caused by a high lateral
osteotomy and (too much) infraction of the bone.
Defect of the Bony Pyramid (▶ Fig. 2.62)
Fig. 2.62Defect of the bony pyramid. A defect of the lateral wall or dorsum of the bony
pyramid is visible and/or palpable.
A defect of the bony pyramid may occur after severe
trauma with multiple fractures and dislocation or necrosis
of bony fragments.
Open Roof (▶ Fig. 2.63)
Fig. 2.63Open roof. A defect of the bony dorsum. This abnormality is usually caused by
a hump resection without proper reconstruction of the dorsum.
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
The bony dorsum is defective. This is most commonly due
to a hump resection without adequate closure of the
resulting defect of the bony pyramid. An open roof is
usually diagnosed by palpation. Large defects are
sometimes visible too. Various neuralgic symptoms may
occur. We then speak of an “open roof syndrome” (see ▶
Open Roof Syndrome).
Asymmetry of the Cartilaginous Pyramid (▶ Fig. 2.64)
Fig. 2.64Asymmetry of cartilaginous pyramid.
The lateral walls (i.e., triangular cartilages) are unequal in
position and length. The cartilaginous septum is usually
deformed, too; it is either dislocated or defective. Both
function and nasal aesthetics are impaired. This asymmetry
results mostly from trauma or impaired nasal growth.
Dorsal Step (see ▶ Fig. 2.55 and ▶ Fig. 2.56)
A dorsal step is due to disruption of the junction between
the triangular cartilages and the nasal bones. The
attachment of the cranial margin of the triangular cartilage
to the undersurface of the caudal border of the nasal bone
is disrupted. A depression at the upper part of the
triangular cartilage is visible and palpable.
Atrophy of the Cartilaginous Pyramid (▶ Fig. 2.65)
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Fig. 2.65Atrophy of the cartilaginous pyramid.
The triangular cartilages are atrophied and partially
missing, having been replaced by scar tissue. The lateral
soft or hinge area may be scarred, atrophied, and
retracted. The lateral wall of the valve is weakened and
collapsible, which may cause impairment of inspiratory
breathing. This pathology is usually the result of (repeated)
trauma, a dorsal hematoma, and/or infection.
2.2.5Lobule
Low, Wide Lobule (▶ Fig. 2.66)
Fig. 2.66Low and wide lobule.
The lobule is low and wide at all levels (tip, nares, and
base). The tip is broad and underprojected or depressed.
The alae are convex, the columella short, the nostrils more
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
or less round. The vestibules are wide and low. The tip
index is large. A low and wide lobule is normal among black
people and, to a lesser degree, Asians. In Caucasians, it is
only seen in newborns and infants. The condition may also
be caused by retardation of nasal growth after trauma or a
septal abscess at a young age (see also ▶ Childhood Septal
Abscess and ▶ Fig. 1.118a-h).
High, Narrow Lobule (▶ Fig. 2.67)
Fig. 2.67High and narrow lobule.
The lobule is prominent and narrow, the tip narrow and
pointed, the alae long and stretched, and the columella
long. The nostrils are narrow and the vestibules high and
narrow. The tip index is small. A high, narrow lobule is
common in Caucasians, especially in combination with
dolichocephaly (see also ▶ Fig. 2.11 and ▶ Fig. 2.12).
Tip
Broad Tip (▶ Fig. 2.68)
Данная книга находится в списке для перевода на русский язык сайта https://meduniver.com/
Соседние файлы в папке Библиотека им академика М.И. Перельмана