Pub Date : 2002-06-01DOI: 10.1046/J.1365-2273.2002.00553.X
Y. Jang, T. Koo, S. Chung, Seok-Gun Park
To investigate the clinical significance of bone involvement in chronic rhinosinusitis, 99mTc-MDP bone single photon emission computed tomography (SPECT) was studied in 43 patients diagnosed as having chronic rhinosinusitis. Quantitative isotope uptake indices calculated on SPECT were compared between the patient and a control group, and between patients with a good postoperative outcome and those with a poor outcome. The patient group showed a significantly higher isotope uptake than the control group. The uptake of isotope in the ethmoid sinus areas in patients who had a poor postoperative outcome was significantly higher than those who had a good outcome. Our study suggests that patients with chronic rhinosinusitis have apparent bony involvement, and patients with more severe bone involvement may have a poorer treatment outcome.
{"title":"Bone involvement in chronic rhinosinusitis assessed by 99mTc-MDP bone SPECT.","authors":"Y. Jang, T. Koo, S. Chung, Seok-Gun Park","doi":"10.1046/J.1365-2273.2002.00553.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2002.00553.X","url":null,"abstract":"To investigate the clinical significance of bone involvement in chronic rhinosinusitis, 99mTc-MDP bone single photon emission computed tomography (SPECT) was studied in 43 patients diagnosed as having chronic rhinosinusitis. Quantitative isotope uptake indices calculated on SPECT were compared between the patient and a control group, and between patients with a good postoperative outcome and those with a poor outcome. The patient group showed a significantly higher isotope uptake than the control group. The uptake of isotope in the ethmoid sinus areas in patients who had a poor postoperative outcome was significantly higher than those who had a good outcome. Our study suggests that patients with chronic rhinosinusitis have apparent bony involvement, and patients with more severe bone involvement may have a poorer treatment outcome.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"37 1","pages":"156-61"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74770053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.1046/J.1365-2273.2002.00556.X
D. Roy, N. Guevara, J. Santini, L. Castillo
A congenital nasolacrimal duct cyst is an uncommon condition in the newborn usually treated by ophthalmologists. Prolapse or expansion of the cyst into the nose may lead to respiratory distress and difficulty in feeding as newborns are obligate nose breathers, which needs the involvement of the Otolaryngologist in diagnosis and management. The authors report a series of 8 children presenting with a congenital nasolacrimal duct cyst and dacryocoele and highlight the importance of endoscopic nasal examination of newborns presenting with respiratory problems. Diagnostic studies included intranasal endoscopy and CT scanning of the nasolacrimal system and nose. All the patients were treated by endoscopic marsupialization of the cyst. Nasolacrimal duct abnormality should be considered in the differential diagnosis of neonatal respiratory distress and nasal obstruction. Nasal endoscopy is essential in the work-up of all children with nasal obstruction and respiratory distress. CT scanning is the investigative method of choice. Endoscopic marsupialization followed by lacrimal duct irrigation is effective in the treatment of congenital nasolacrimal duct cyst and results in complete resolution of symptoms.
{"title":"Endoscopic marsupialization of congenital nasolacrimal duct cyst with dacryocoele.","authors":"D. Roy, N. Guevara, J. Santini, L. Castillo","doi":"10.1046/J.1365-2273.2002.00556.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2002.00556.X","url":null,"abstract":"A congenital nasolacrimal duct cyst is an uncommon condition in the newborn usually treated by ophthalmologists. Prolapse or expansion of the cyst into the nose may lead to respiratory distress and difficulty in feeding as newborns are obligate nose breathers, which needs the involvement of the Otolaryngologist in diagnosis and management. The authors report a series of 8 children presenting with a congenital nasolacrimal duct cyst and dacryocoele and highlight the importance of endoscopic nasal examination of newborns presenting with respiratory problems. Diagnostic studies included intranasal endoscopy and CT scanning of the nasolacrimal system and nose. All the patients were treated by endoscopic marsupialization of the cyst. Nasolacrimal duct abnormality should be considered in the differential diagnosis of neonatal respiratory distress and nasal obstruction. Nasal endoscopy is essential in the work-up of all children with nasal obstruction and respiratory distress. CT scanning is the investigative method of choice. Endoscopic marsupialization followed by lacrimal duct irrigation is effective in the treatment of congenital nasolacrimal duct cyst and results in complete resolution of symptoms.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"26 1","pages":"167-70"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77631504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-06-01DOI: 10.1046/J.1365-2273.2002.00559.X
J. Wilson, I. Deary, A. Millar, K. MacKenzie
Dysphonia can affect social life and employment, but formal studies of its general health impact are lacking. The aims of this study were (i) to compare self-rated general health status as measured by the SF-36 in a large cohort of dysphonic patients with those from normative groups; and (ii) to examine the differential impact of dysphonia on the various health status domains. The 163 dysphonic voice clinic attendees (38 men, 125 women) were drawn from recruits to a prospective trial of speech therapy efficacy. The Short-Form 36 (SF-36) scores were compared with published data on 744 age-matched healthy controls. Patients with dysphonia had significantly poorer self-reported health than the controls on all eight SF-36 subscales (limitation of physical activity P < 0.05; other seven, all P < 0.001, Student's t-test). We thus conclude that dysphonia in patients without obvious laryngeal disease has an adverse impact on all health status subscales as measured by the SF-36. The study provides further evidence for the inclusion quality of life measures in otolaryngology baseline and outcome assessments.
{"title":"The quality of life impact of dysphonia.","authors":"J. Wilson, I. Deary, A. Millar, K. MacKenzie","doi":"10.1046/J.1365-2273.2002.00559.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2002.00559.X","url":null,"abstract":"Dysphonia can affect social life and employment, but formal studies of its general health impact are lacking. The aims of this study were (i) to compare self-rated general health status as measured by the SF-36 in a large cohort of dysphonic patients with those from normative groups; and (ii) to examine the differential impact of dysphonia on the various health status domains. The 163 dysphonic voice clinic attendees (38 men, 125 women) were drawn from recruits to a prospective trial of speech therapy efficacy. The Short-Form 36 (SF-36) scores were compared with published data on 744 age-matched healthy controls. Patients with dysphonia had significantly poorer self-reported health than the controls on all eight SF-36 subscales (limitation of physical activity P < 0.05; other seven, all P < 0.001, Student's t-test). We thus conclude that dysphonia in patients without obvious laryngeal disease has an adverse impact on all health status subscales as measured by the SF-36. The study provides further evidence for the inclusion quality of life measures in otolaryngology baseline and outcome assessments.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"73 1","pages":"179-82"},"PeriodicalIF":0.0,"publicationDate":"2002-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82137894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.1365-2273.2001.00454.X
M. Botma, A. Aymat, D. Gault, D. Albert
Until recently the options for reconstruction of the microtic ear were unsatisfactory and the ear was often left alone. With recent advances, both autologous rib reconstruction and osseointegration produce good quality results. It is our practice to offer all patients a choice of no surgery, autologous rib cartilage reconstruction or an osseointegrated prosthetic ear. This study reports on parental choice between the reconstructive options as assessed by questionnaire. Earlier patients who have had their surgery were compared with more recent patients who have chosen an option but are awaiting surgery. In the patients who have had surgery, seven (30%) chose a prosthetic ear and 16 (69.5%) chose rib cartilage reconstruction, compared to those patients that are awaiting surgery, four (11%) chose a prosthetic ear and 31 (88.6%) chose rib cartilage reconstruction. The results show a significant increase in the choice for rib cartilage reconstruction in those patients awaiting surgery. Although high quality autologous reconstruction is not widely available we feel it is important that parents are at least informed that it is an alternative to osseointegration and no surgery.
{"title":"Rib graft reconstruction versus osseointegrated prosthesis for microtia: a significant change in patient preference.","authors":"M. Botma, A. Aymat, D. Gault, D. Albert","doi":"10.1046/J.1365-2273.2001.00454.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00454.X","url":null,"abstract":"Until recently the options for reconstruction of the microtic ear were unsatisfactory and the ear was often left alone. With recent advances, both autologous rib reconstruction and osseointegration produce good quality results. It is our practice to offer all patients a choice of no surgery, autologous rib cartilage reconstruction or an osseointegrated prosthetic ear. This study reports on parental choice between the reconstructive options as assessed by questionnaire. Earlier patients who have had their surgery were compared with more recent patients who have chosen an option but are awaiting surgery. In the patients who have had surgery, seven (30%) chose a prosthetic ear and 16 (69.5%) chose rib cartilage reconstruction, compared to those patients that are awaiting surgery, four (11%) chose a prosthetic ear and 31 (88.6%) chose rib cartilage reconstruction. The results show a significant increase in the choice for rib cartilage reconstruction in those patients awaiting surgery. Although high quality autologous reconstruction is not widely available we feel it is important that parents are at least informed that it is an alternative to osseointegration and no surgery.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"37 1","pages":"274-7"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89979287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.1365-2273.2001.00460.X
P. Monnery, W. Smith, A. Hinton
An analysis of 100 patient notes was performed in the South-west Thames Region to determine the accuracy of recording the side of the abnormality in outpatient clinic notes when compared to the findings at direct laryngoscopy. Direct laryngoscopy was felt to be the most accurate method of viewing the larynx. The results were analysed to determine if the specific method of outpatient laryngoscopy or grade of examiner influenced the error rates. Inconsistencies occurred in 29% of the clinic notes when a diagram of the larynx was present. Specialist Registrars made 59% of the errors. Flexible nasendoscopy accounts for more errors than indirect laryngoscopy.
{"title":"Laryngoscopy findings in outpatient notes: the accuracy of the recording of the side of the lesion.","authors":"P. Monnery, W. Smith, A. Hinton","doi":"10.1046/J.1365-2273.2001.00460.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00460.X","url":null,"abstract":"An analysis of 100 patient notes was performed in the South-west Thames Region to determine the accuracy of recording the side of the abnormality in outpatient clinic notes when compared to the findings at direct laryngoscopy. Direct laryngoscopy was felt to be the most accurate method of viewing the larynx. The results were analysed to determine if the specific method of outpatient laryngoscopy or grade of examiner influenced the error rates. Inconsistencies occurred in 29% of the clinic notes when a diagram of the larynx was present. Specialist Registrars made 59% of the errors. Flexible nasendoscopy accounts for more errors than indirect laryngoscopy.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"29 1","pages":"278-80"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77620307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.0307-7772.2001.00463.X
K. Midwinter, A. Ahmed, D. Willatt
Nasendoscopy is used extensively in ENT clinics both as a diagnostic tool and for local postoperative care. Both flexible and rigid fibreoptic scopes are available for the purpose of sinonasal examination. A prospective study of a flexible versus rigid endoscope was carried out, randomly assigning one type of scope to each nostril of 56 patients presenting to clinic with sinonasal symptomatology. Patients awarded each type of scope a pain score on an analogue scale, according to the level of discomfort experienced, and the operator noted the number of structures seen. Significantly more structures were visualized with the rigid scope than the flexible scope (P = 0.05). The pain scores were similarly in favour of the rigid scope, showing a trend to less discomfort. The rigid nasendoscope is the scope of choice for sinonasal examinations in the outpatient clinic based on these data.
{"title":"A randomised trial of flexible versus rigid nasendoscopy in outpatient sinonasal examination.","authors":"K. Midwinter, A. Ahmed, D. Willatt","doi":"10.1046/J.0307-7772.2001.00463.X","DOIUrl":"https://doi.org/10.1046/J.0307-7772.2001.00463.X","url":null,"abstract":"Nasendoscopy is used extensively in ENT clinics both as a diagnostic tool and for local postoperative care. Both flexible and rigid fibreoptic scopes are available for the purpose of sinonasal examination. A prospective study of a flexible versus rigid endoscope was carried out, randomly assigning one type of scope to each nostril of 56 patients presenting to clinic with sinonasal symptomatology. Patients awarded each type of scope a pain score on an analogue scale, according to the level of discomfort experienced, and the operator noted the number of structures seen. Significantly more structures were visualized with the rigid scope than the flexible scope (P = 0.05). The pain scores were similarly in favour of the rigid scope, showing a trend to less discomfort. The rigid nasendoscope is the scope of choice for sinonasal examinations in the outpatient clinic based on these data.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"13 1","pages":"281-3"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75314681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.1365-2273.2001.00473.X
A. Tsikoudas, J. Homer
The distribution of nasal drugs specifically to the middle meatus is of vital importance in the treatment of rhinosinusitis and nasal polyposis. It is widely assumed that the intranasal distribution is superior with nasal drops rather than spray delivery. However, a comparison of nasal spray and drop delivery specifically to this area has not been studied before. This study aims to compare semiquantitatively the intranasal distribution of nasal sprays and drops to the middle meatus in vivo. A novel method was used whereby a neurosurgical patty was placed in the middle meatus. Topical nasal drops and aqueous sprays dyed with methylene blue (0.1% v/v) were administered in a standardized fashion in normal volunteers. The subsequent absorption of administered dye was classified on a four-point scale. A randomized prospective cross-over design was used for the study. We found that there was no difference in the delivery of nasal drug to the middle meatus between either method of drug administration (P > 0.2). The perceived superiority of nasal drops may therefore be as a result of the acknowledged systemic effect of betamethasone drops.
{"title":"The delivery of topical nasal sprays and drops to the middle meatus: a semiquantitative analysis.","authors":"A. Tsikoudas, J. Homer","doi":"10.1046/J.1365-2273.2001.00473.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00473.X","url":null,"abstract":"The distribution of nasal drugs specifically to the middle meatus is of vital importance in the treatment of rhinosinusitis and nasal polyposis. It is widely assumed that the intranasal distribution is superior with nasal drops rather than spray delivery. However, a comparison of nasal spray and drop delivery specifically to this area has not been studied before. This study aims to compare semiquantitatively the intranasal distribution of nasal sprays and drops to the middle meatus in vivo. A novel method was used whereby a neurosurgical patty was placed in the middle meatus. Topical nasal drops and aqueous sprays dyed with methylene blue (0.1% v/v) were administered in a standardized fashion in normal volunteers. The subsequent absorption of administered dye was classified on a four-point scale. A randomized prospective cross-over design was used for the study. We found that there was no difference in the delivery of nasal drug to the middle meatus between either method of drug administration (P > 0.2). The perceived superiority of nasal drops may therefore be as a result of the acknowledged systemic effect of betamethasone drops.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"19 1","pages":"294-7"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90430928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.0307-7772.2001.00469.X
P. Walshe, C. Harkin, S. Murphy, C. Shah, A. Curran, D. Mcshane
Epistaxis can be particularly difficult to treat when a patient has a coagulopathy, even if the area bleeding is visible. Where routine measures fail to arrest the bleeding (e.g., nasal cautery and packing), the application of fibrin glue is successful in stopping the bleeding without having to address the underlying coagulopathy. Ten patients with epistaxis secondary to an underlying coagulopathy were treated by local application of fibrin glue to the area bleeding. The bleeding stopped immediately in all patients when the fibrin glue was applied. No patients suffered complications. Fibrin glue application should be considered as a cost-effective means of controlling epistaxis from an identifiable area in the nasal cavity in patients with a coagulopathy.
{"title":"The use of fibrin glue in refractory coagulopathic epistaxis.","authors":"P. Walshe, C. Harkin, S. Murphy, C. Shah, A. Curran, D. Mcshane","doi":"10.1046/J.0307-7772.2001.00469.X","DOIUrl":"https://doi.org/10.1046/J.0307-7772.2001.00469.X","url":null,"abstract":"Epistaxis can be particularly difficult to treat when a patient has a coagulopathy, even if the area bleeding is visible. Where routine measures fail to arrest the bleeding (e.g., nasal cautery and packing), the application of fibrin glue is successful in stopping the bleeding without having to address the underlying coagulopathy. Ten patients with epistaxis secondary to an underlying coagulopathy were treated by local application of fibrin glue to the area bleeding. The bleeding stopped immediately in all patients when the fibrin glue was applied. No patients suffered complications. Fibrin glue application should be considered as a cost-effective means of controlling epistaxis from an identifiable area in the nasal cavity in patients with a coagulopathy.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"58 1","pages":"284-5"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72550774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.1365-2273.2001.00470.X
G. Zambetti, M. Moresi, R. Romeo, F. Filiaci
Nasal resistance (NR) depends on the geometrical features and tortuosity of the nasal airway and on the air flow. Knowing the longitudinal distribution of cross-sectional areas (CSAs) in the nasal cavity (which can be obtained using acoustic rhinometry) and the laminar nasal resistance (obtainable by processing the rhinomanometric results), it is possible to calculate, utilizing a mathematical model elaborated on the basis of fluid dynamics, the differential nasal resistance (NRdiff) and the cumulative nasal resistance (NRcum), thus localizing the position at which the highest resistance is concentrated and the related longitudinal distribution. Using a mathematical model, we integrated the sigmoid curves DeltaP/Q of rhinomanometry with the cross-sectional areas obtained using acoustic rhinometry, thus obtaining the normal distribution of differential and cumulative nasal resistances. Afterwards, we empirically reduced the cross-sectional areas corresponding to the head, body, tail and the whole inferior turbinate, recalculating the differential and cumulative nasal resistance distribution curves. The results show that reduction of up to 50% of cross-sectional areas does not substantially affect the resistivity role of the nasal valve, while greater reductions move the highest resistivity point to an area at the junction of the body and the head of the inferior turbinate. The study of the differential nasal resistance trend curves as a function of the reduction of cross-sectional areas shows that the resistance variation of the body and the whole inferior turbinate prevail with reductions of up to 40%, while the variation of cross-sectional areas of the body bordering the inferior turbinate head is predominant with higher reductions. The cross-sectional areas of the nasal airway cavity with highest resistivity are mainly located in an anterior position, where the differential nasal resistances are higher, but there are substantial variations produced by reducing the cross-sectional area of the posterior nasal airway. A similar model can produce provisional values for the results obtainable with functional nasal surgery.
{"title":"Study and application of a mathematical model for the provisional assessment of areas and nasal resistance, obtained using acoustic rhinometry and active anterior rhinomanometry.","authors":"G. Zambetti, M. Moresi, R. Romeo, F. Filiaci","doi":"10.1046/J.1365-2273.2001.00470.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00470.X","url":null,"abstract":"Nasal resistance (NR) depends on the geometrical features and tortuosity of the nasal airway and on the air flow. Knowing the longitudinal distribution of cross-sectional areas (CSAs) in the nasal cavity (which can be obtained using acoustic rhinometry) and the laminar nasal resistance (obtainable by processing the rhinomanometric results), it is possible to calculate, utilizing a mathematical model elaborated on the basis of fluid dynamics, the differential nasal resistance (NRdiff) and the cumulative nasal resistance (NRcum), thus localizing the position at which the highest resistance is concentrated and the related longitudinal distribution. Using a mathematical model, we integrated the sigmoid curves DeltaP/Q of rhinomanometry with the cross-sectional areas obtained using acoustic rhinometry, thus obtaining the normal distribution of differential and cumulative nasal resistances. Afterwards, we empirically reduced the cross-sectional areas corresponding to the head, body, tail and the whole inferior turbinate, recalculating the differential and cumulative nasal resistance distribution curves. The results show that reduction of up to 50% of cross-sectional areas does not substantially affect the resistivity role of the nasal valve, while greater reductions move the highest resistivity point to an area at the junction of the body and the head of the inferior turbinate. The study of the differential nasal resistance trend curves as a function of the reduction of cross-sectional areas shows that the resistance variation of the body and the whole inferior turbinate prevail with reductions of up to 40%, while the variation of cross-sectional areas of the body bordering the inferior turbinate head is predominant with higher reductions. The cross-sectional areas of the nasal airway cavity with highest resistivity are mainly located in an anterior position, where the differential nasal resistances are higher, but there are substantial variations produced by reducing the cross-sectional area of the posterior nasal airway. A similar model can produce provisional values for the results obtainable with functional nasal surgery.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"38 1","pages":"286-93"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74645133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2001-08-01DOI: 10.1046/J.1365-2273.2001.00484.X
H. Vuyk, P. Lohuis
Although it is well established that conventional treatment modalities generally result in high cure rates for non-melanoma skin cancer, it has been demonstrated over recent decades that the highest overall cure rates are achieved using Mohs micrographic surgery. The key to Mohs surgery is the excision and control of complete peripheral and deep resection margins in one plane, allowing orientation, mapping and re-excision of microscopic tumour extension. These extensions can be followed without sacrificing inappropriate amounts of normal tissue, yielding high cure rates and maximum preservation of tissue. These qualities make Mohs surgery an important and reliable treatment for skin cancer of the face, in particular when it concerns large, aggressive or recurrent carcinoma in cosmetic and functionally important areas. In an 8-year study period, 369 basal cell carcinomas (BCCs) and 56 squamous cell carcinomas (SCCs) of the face were treated in our department using Mohs surgery. With a follow-up ranging from 3 months to 99 months (mean 33 months), none of the BCCs recurred and only one (2%) of the SCCs recurred a few months postoperatively. These favourable cure rates using the modality of Mohs surgery are the reason for highlighting this technique in the current review.
{"title":"Mohs micrographic surgery for facial skin cancer.","authors":"H. Vuyk, P. Lohuis","doi":"10.1046/J.1365-2273.2001.00484.X","DOIUrl":"https://doi.org/10.1046/J.1365-2273.2001.00484.X","url":null,"abstract":"Although it is well established that conventional treatment modalities generally result in high cure rates for non-melanoma skin cancer, it has been demonstrated over recent decades that the highest overall cure rates are achieved using Mohs micrographic surgery. The key to Mohs surgery is the excision and control of complete peripheral and deep resection margins in one plane, allowing orientation, mapping and re-excision of microscopic tumour extension. These extensions can be followed without sacrificing inappropriate amounts of normal tissue, yielding high cure rates and maximum preservation of tissue. These qualities make Mohs surgery an important and reliable treatment for skin cancer of the face, in particular when it concerns large, aggressive or recurrent carcinoma in cosmetic and functionally important areas. In an 8-year study period, 369 basal cell carcinomas (BCCs) and 56 squamous cell carcinomas (SCCs) of the face were treated in our department using Mohs surgery. With a follow-up ranging from 3 months to 99 months (mean 33 months), none of the BCCs recurred and only one (2%) of the SCCs recurred a few months postoperatively. These favourable cure rates using the modality of Mohs surgery are the reason for highlighting this technique in the current review.","PeriodicalId":10694,"journal":{"name":"Clinical otolaryngology and allied sciences","volume":"20 1","pages":"265-73"},"PeriodicalIF":0.0,"publicationDate":"2001-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82146408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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