Background: No reliable marker exists to predict septoplasty outcome. Most patients suffering from nasal airway obstruction (NAO) caused by a deviation of the nasal septum report a bothersome mouth breathing and dryness. In this study our aim was to assess, whether mouth breathing could be objectified in these patients and whether mouth breathing could predict septoplasty outcome. Methods: A monocentric, prospective case-control study of 21 patients was conducted. The proportion of mouth breathing was measured in a blinded manner. As a measurement of patient satisfaction, subjective symptoms pre- and postoperatively, were assessed by using VAS, NOSE and SNOT-20 score. In the patient group an additional acoustic rhinometry and a clinical examination of the nose were performed. Results: With a mean of 25% (SD = 20%) the proportion of mouth breathing in patients with NAO did not differ significantly from the proportion in controls without NAO, with a mean of 27% (SD = 23%). Analysis of subjective scores revealed a significant reduction of subjective symptoms after septoplasty. A higher preoperative proportion of mouth breathing correlated with more remaining postoperative NAO. Conclusions: The percentage of mouth breathing is no different in patients with symptomatic septal deviation than in control patients. Mouth breathing in patients with NAO, evaluated for septoplasty, could be a negative predictive factor for patient satisfaction after nasal septoplasty. Mouth breathing in these patients should be observed carefully because more preoperative mouth breathing should make one more hesitant to consider septoplasty.
{"title":"Mouth breathing – A predictor for patient satisfaction after nasal septoplasty?","authors":"C. Bruehlmann, N. Buser, M. Soyka","doi":"10.4193/rhinol/21.045","DOIUrl":"https://doi.org/10.4193/rhinol/21.045","url":null,"abstract":"Background: No reliable marker exists to predict septoplasty outcome. Most patients suffering from nasal airway obstruction (NAO) caused by a deviation of the nasal septum report a bothersome mouth breathing and dryness. In this study our aim was to assess, whether mouth breathing could be objectified in these patients and whether mouth breathing could predict septoplasty outcome. Methods: A monocentric, prospective case-control study of 21 patients was conducted. The proportion of mouth breathing was measured in a blinded manner. As a measurement of patient satisfaction, subjective symptoms pre- and postoperatively, were assessed by using VAS, NOSE and SNOT-20 score. In the patient group an additional acoustic rhinometry and a clinical examination of the nose were performed. Results: With a mean of 25% (SD = 20%) the proportion of mouth breathing in patients with NAO did not differ significantly from the proportion in controls without NAO, with a mean of 27% (SD = 23%). Analysis of subjective scores revealed a significant reduction of subjective symptoms after septoplasty. A higher preoperative proportion of mouth breathing correlated with more remaining postoperative NAO. Conclusions: The percentage of mouth breathing is no different in patients with symptomatic septal deviation than in control patients. Mouth breathing in patients with NAO, evaluated for septoplasty, could be a negative predictive factor for patient satisfaction after nasal septoplasty. Mouth breathing in these patients should be observed carefully because more preoperative mouth breathing should make one more hesitant to consider septoplasty.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43657601","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}
C. Polasky, K. Loyal, C. Idel, David Wetterauer, Mathias, Heidemann, K. Bruchhage, R. Pries
Background: Chronic rhinosinusitis (CRS) affects about 10% of the european population causing considerable disease burden. The inflammatory microenvironment is mainly Th2 driven, but the impact of monocytes is still poorly understood. Aim of this study was to comprehensively investigate the composition of circulating monocytes and T cells in CRSwNP and CRSsNP patients, particularly with regard to the therapeutic herbal monoterpene 1,8-Cineol. Methodology: We analyzed the distribution of CD14 and CD16 classified monocyte subsets and the T-cell subset composition with respect to their PD-1 and PD-L1 expression in the peripheral blood of CRS patients using flow cytometry. Additionally, the M1/M2 like macrophage infiltration in nasal tissue and polyps was examined by immunofluorescence staining. Results: Data revealed a decrease of classical monocytes accompanied by a significant increase of intermediate CD16+ monocytes in CRSwNP and CRSsNP patients compared to healthy donors. PD-L1 expression on overall monocytes was also significantly increased in CRSwNP and CRSsNP patients. CRS patients with a severe drop of the proportion of classical monocytes showed a significant restoration of this subset in response to two-week 1,8-Cineol treatment. Conclusions: Our data indicate a CRS-induced shift of peripheral monocyte subsets to more inflammatory phenotypes that might be reversed by the herbal drug 1,8-Cineol.
{"title":"Alteration of blood monocyte subsets in chronic rhinosinusitis with regard to anti-inflammatory 1,8-Cineol treatment","authors":"C. Polasky, K. Loyal, C. Idel, David Wetterauer, Mathias, Heidemann, K. Bruchhage, R. Pries","doi":"10.4193/rhinol/21.032","DOIUrl":"https://doi.org/10.4193/rhinol/21.032","url":null,"abstract":"Background: Chronic rhinosinusitis (CRS) affects about 10% of the european population causing considerable disease burden. The inflammatory microenvironment is mainly Th2 driven, but the impact of monocytes is still poorly understood. Aim of this study was to comprehensively investigate the composition of circulating monocytes and T cells in CRSwNP and CRSsNP patients, particularly with regard to the therapeutic herbal monoterpene 1,8-Cineol. Methodology: We analyzed the distribution of CD14 and CD16 classified monocyte subsets and the T-cell subset composition with respect to their PD-1 and PD-L1 expression in the peripheral blood of CRS patients using flow cytometry. Additionally, the M1/M2 like macrophage infiltration in nasal tissue and polyps was examined by immunofluorescence staining. Results: Data revealed a decrease of classical monocytes accompanied by a significant increase of intermediate CD16+ monocytes in CRSwNP and CRSsNP patients compared to healthy donors. PD-L1 expression on overall monocytes was also significantly increased in CRSwNP and CRSsNP patients. CRS patients with a severe drop of the proportion of classical monocytes showed a significant restoration of this subset in response to two-week 1,8-Cineol treatment. Conclusions: Our data indicate a CRS-induced shift of peripheral monocyte subsets to more inflammatory phenotypes that might be reversed by the herbal drug 1,8-Cineol.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41710223","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}
This paper provides a brief historical background of saline nasal irrigation (SNI), main modes of SARS-COV-2 transmission and entry, and anti-infective properties of saline. It reviews the protective evidence associated with SNI and gargling against viral upper respiratory tract infection (URTI). SARS-CoV-2 presents as an URTI transmitted mainly via respiratory droplets and aerosols to the oro-nasal mucosa and indirectly after touching these entry sites from contaminated fomites. It can potentially be transmitted from the conjunctival mucosa to the nasal mucosa or from resuspension and inhalation from the facial area around the nose. SNI has antiviral, anti-inflammatory and mucociliary restorative properties. Numerous randomized controlled trials have reported that SNI, with and without gargling, prevents and treats viral URTI. Based on biological rationale and anecdotal evidence we suggest a protocol: Soap and Water to the Hands and Face-Eye Rinse Nasal Irrigation and Gargling with Saline (SWHF-ERNIGS) may limit the transmission SARS-CoV-2, and prevent and treat COVID-19 infection. Clinical considerations of the protocol are presented. The protocol is safe, straightforward and can be easily performed by healthcare workers and the general public; it uses readily available salt, water and soap. Formal studies of effectiveness and application of the protocol are warranted.
{"title":"Soap and Water to Hands and Face, -Eye Rinse, Nasal Irrigation and Gargling with Saline for COVID-19 with anecdotal evidence","authors":"S. Parviz, L. Duncan, D. Rabago","doi":"10.4193/rhinol/21.040","DOIUrl":"https://doi.org/10.4193/rhinol/21.040","url":null,"abstract":"This paper provides a brief historical background of saline nasal irrigation (SNI), main modes of SARS-COV-2 transmission and entry, and anti-infective properties of saline. It reviews the protective evidence associated with SNI and gargling against viral upper respiratory tract infection (URTI). SARS-CoV-2 presents as an URTI transmitted mainly via respiratory droplets and aerosols to the oro-nasal mucosa and indirectly after touching these entry sites from contaminated fomites. It can potentially be transmitted from the conjunctival mucosa to the nasal mucosa or from resuspension and inhalation from the facial area around the nose. SNI has antiviral, anti-inflammatory and mucociliary restorative properties. Numerous randomized controlled trials have reported that SNI, with and without gargling, prevents and treats viral URTI. Based on biological rationale and anecdotal evidence we suggest a protocol: Soap and Water to the Hands and Face-Eye Rinse Nasal Irrigation and Gargling with Saline (SWHF-ERNIGS) may limit the transmission SARS-CoV-2, and prevent and treat COVID-19 infection. Clinical considerations of the protocol are presented. The protocol is safe, straightforward and can be easily performed by healthcare workers and the general public; it uses readily available salt, water and soap. Formal studies of effectiveness and application of the protocol are warranted.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44106347","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}
Pott's puffy tumor is considered as a rare clinical entity. It is developed as a rare complication of frontal sinusitis. In addition, the trauma to the frontal area is another suggested cause. The Pott's puffy tumor is presented as a forehead swelling due to sub-periosteal collection. Although, the Pott's puffy tumor is a rare condition but at the same time, it can be serious because it may lead to life threatening complications namely, extradural abscess, subdural abscess, meningitis, encephalitis, and brain abscess. Thus, the Pott's puffy tumor is classified as a very significant surgical emergency.
{"title":"Pott's puffy tumor: as a very rare and unpredicted complication of ipsilateral pan sinusitis - case presentation and review of articles","authors":"K. Bofares, Z.A. Haqqar, I. M. Ali","doi":"10.4193/rhinol/21.036","DOIUrl":"https://doi.org/10.4193/rhinol/21.036","url":null,"abstract":"Pott's puffy tumor is considered as a rare clinical entity. It is developed as a rare complication of frontal sinusitis. In addition, the trauma to the frontal area is another suggested cause. The Pott's puffy tumor is presented as a forehead swelling due to sub-periosteal collection. Although, the Pott's puffy tumor is a rare condition but at the same time, it can be serious because it may lead to life threatening complications namely, extradural abscess, subdural abscess, meningitis, encephalitis, and brain abscess. Thus, the Pott's puffy tumor is classified as a very significant surgical emergency.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48936440","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}
S. Zinreich, F. Kuhn, D. Kennedy, M. Solaiyappan, A. Lane, N. London, W. Hosemann
Objective: The microanatomy of the fronto-ethmoidal transition region has been addressed in several classifications. CT stereoscopic imaging (3DCTSI) provides improved display and delineates three defined complex “spaces”, the Frontal Sinus/Frontal Recess Space, the Infundibular Space of the Ethmoid Uncinate Process, and the Ethmoid Bulla Space (FSRS, IS-EUP, EB), none of which were adequately described with the “cell” terminology. We present details on the 3D microanatomy, variability, and prevalence of these spaces. Methods: 3D stereoscopic imaging displays (3DCTSI) were created from 200 datasets. The images were analyzed and categorized by a radiologist (SJZ), and consultant otolaryngologists, focusing on 3D microanatomy of the fronto-ethmoidal transition, the frontal recess/frontal sinus, and drainage pathways, in comparison to established anatomical classification systems. Results: The anterior ethmoid is subdivided into seven groups with the following core properties and prevalence: 1. The horizontal roof of the IS-EUP is attached to the superior half of the frontal process of the maxilla (19%); 2. The IS-EUP extends into the frontal recess (6.5%); 3. The IS-EUP extends into the frontal recess and the frontal sinus (18.5%); 4. A bulla is seen in the medial frontal sinus (3%); 5. The ethmoid bulla and supra bullar space extend into the frontal sinus (7%); 6. Lamellae extend into the FSRS antero-superiorly (25%); 7. FSRS expansion expands below the upper half of the frontal process of the maxilla (FSRS) (21%). Conclusion: 3-D analysis of the detailed anatomy provides important new anatomic information with the increased focus on precision surgery in the region.
{"title":"Supplements and refinements to current classifications and nomenclature of the fronto-ethmoidal transition region by systematic analysis with 3D CT microanatomy","authors":"S. Zinreich, F. Kuhn, D. Kennedy, M. Solaiyappan, A. Lane, N. London, W. Hosemann","doi":"10.4193/rhinol/21.039","DOIUrl":"https://doi.org/10.4193/rhinol/21.039","url":null,"abstract":"Objective: The microanatomy of the fronto-ethmoidal transition region has been addressed in several classifications. CT stereoscopic imaging (3DCTSI) provides improved display and delineates three defined complex “spaces”, the Frontal Sinus/Frontal Recess Space, the Infundibular Space of the Ethmoid Uncinate Process, and the Ethmoid Bulla Space (FSRS, IS-EUP, EB), none of which were adequately described with the “cell” terminology. We present details on the 3D microanatomy, variability, and prevalence of these spaces. Methods: 3D stereoscopic imaging displays (3DCTSI) were created from 200 datasets. The images were analyzed and categorized by a radiologist (SJZ), and consultant otolaryngologists, focusing on 3D microanatomy of the fronto-ethmoidal transition, the frontal recess/frontal sinus, and drainage pathways, in comparison to established anatomical classification systems. Results: The anterior ethmoid is subdivided into seven groups with the following core properties and prevalence: 1. The horizontal roof of the IS-EUP is attached to the superior half of the frontal process of the maxilla (19%); 2. The IS-EUP extends into the frontal recess (6.5%); 3. The IS-EUP extends into the frontal recess and the frontal sinus (18.5%); 4. A bulla is seen in the medial frontal sinus (3%); 5. The ethmoid bulla and supra bullar space extend into the frontal sinus (7%); 6. Lamellae extend into the FSRS antero-superiorly (25%); 7. FSRS expansion expands below the upper half of the frontal process of the maxilla (FSRS) (21%). Conclusion: 3-D analysis of the detailed anatomy provides important new anatomic information with the increased focus on precision surgery in the region.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70416787","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}
C.B. Meerwien, A. Pangalu, S. Pazahr, L. Epprecht, M. Soyka, D. Holzmann
161 To the Editor: In combination with paranasal sinus computed tomography (CT), cross-sectional imaging with magnetic resonance imaging (MRI) is mandatory for staging and restaging of primary sinonasal malignancies . In the initial staging, MRI defines tumour size, provides information on extension into adjacent compartments of the sinonasal tract (in particular orbit, anterior or middle cranial fossa, leptomeningeal and brain parenchyma) and consecutively helps to determine the clinical T category. Furthermore, MRI delineates tumour from surrounding tissue (e. g. retention of mucus, reactive polyps) and may even identify perineural spread and bone marrow infiltration . The signal intensity of tumours varies depending on their cellularity, mucin content and presence of hemorrhage. However, even state-ofthe-art cross-sectional imaging may fail to correctly identify orbital or skull base infiltration. Thus, both, false-positive and false-negative findings must be considered. Common pitfalls particularly include 1) the discrimination of bony pressure erosion and bony infiltration of the anterior skull base or the medial orbital wall and 2) the discrimination of reactive dural enhancement and dural infiltration by tumour . Based on these difficulties and in analogy to upper aero-digestive tract squamous cell carcinomas, we recently suggested an obligatory exploration of all sinonasal tumours under general anesthesia and targeted biopsy, if necessary . Besides its role in the initial staging (Figure 1), MRI is also important in the restaging setting, where tumour persistence or recurrence and treatment-associated alterations may be challenging
{"title":"The Zurich magnetic resonance imaging protocol for standardized staging and restaging of sinonasal tumours","authors":"C.B. Meerwien, A. Pangalu, S. Pazahr, L. Epprecht, M. Soyka, D. Holzmann","doi":"10.4193/rhinol/21.038","DOIUrl":"https://doi.org/10.4193/rhinol/21.038","url":null,"abstract":"161 To the Editor: In combination with paranasal sinus computed tomography (CT), cross-sectional imaging with magnetic resonance imaging (MRI) is mandatory for staging and restaging of primary sinonasal malignancies . In the initial staging, MRI defines tumour size, provides information on extension into adjacent compartments of the sinonasal tract (in particular orbit, anterior or middle cranial fossa, leptomeningeal and brain parenchyma) and consecutively helps to determine the clinical T category. Furthermore, MRI delineates tumour from surrounding tissue (e. g. retention of mucus, reactive polyps) and may even identify perineural spread and bone marrow infiltration . The signal intensity of tumours varies depending on their cellularity, mucin content and presence of hemorrhage. However, even state-ofthe-art cross-sectional imaging may fail to correctly identify orbital or skull base infiltration. Thus, both, false-positive and false-negative findings must be considered. Common pitfalls particularly include 1) the discrimination of bony pressure erosion and bony infiltration of the anterior skull base or the medial orbital wall and 2) the discrimination of reactive dural enhancement and dural infiltration by tumour . Based on these difficulties and in analogy to upper aero-digestive tract squamous cell carcinomas, we recently suggested an obligatory exploration of all sinonasal tumours under general anesthesia and targeted biopsy, if necessary . Besides its role in the initial staging (Figure 1), MRI is also important in the restaging setting, where tumour persistence or recurrence and treatment-associated alterations may be challenging","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44019749","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}
M. Lilja, P. Virkkula, S. Hammarén-Malmi, A. Laulajainen-Hongisto, L. Hafrén, P. Kauppi, J. Sahlman, W. Fokkens, S. Reitsma, S. Toppila-Salmi
Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and paranasal sinuses characterized by intense inflammation, decreased health-related quality of life (HRQoL), and in severe cases high frequency of co-morbidities and recurrence despite treatment. Conservative treatment consists of nasal lavage, intranasal corticosteroids, and courses of oral corticosteroids, and antibiotics in exacerbations. Endoscopic sinus surgery (ESS) and/or biological therapy is considered if appropriate conservative treatment is not sufficient. The optimal extent of ESS in recalcitrant CRSwNP is not known. The aim of this randomized controlled trial is to evaluate and compare the efficacy and safety of limited ESS with partial ethmoidectomy with extended ESS with total ethmoidectomy in patients with severe CRSwNP. Methods: AirGOs Operative is a randomized controlled trial. It is an investigator-driven multicenter trial led by Helsinki University Hospital. The two surgery arms are compared. The primary outcome is the change in the SNOT-22 score at the 12-month follow-up. Secondary outcomes include the change in the SNOT-22 score at 24-months follow-up, the changes in polyp score, Lund-Mackay (LM) CT score, health-related quality of life (HRQoL), loss of productivity, nasal patency (peak nasal inspiratory flow (PNIF) ± acoustic rhinometry (ARM), olfaction test (Sniffin’ Sticks, identification), lung function (spirometry and PEF) and findings in pathological analysis at 12/24-months follow-up. Discussion: AirGOs Operative trial will lead to a better understanding of the optimal extent of ethmoidectomy in the treatment of recalcitrant severe CRSwNP.
{"title":"The extent of endoscopic sinus surgery in patients with severe chronic rhinosinusitis with nasal polyps (AirGOs Operative)","authors":"M. Lilja, P. Virkkula, S. Hammarén-Malmi, A. Laulajainen-Hongisto, L. Hafrén, P. Kauppi, J. Sahlman, W. Fokkens, S. Reitsma, S. Toppila-Salmi","doi":"10.4193/rhinol/21.029","DOIUrl":"https://doi.org/10.4193/rhinol/21.029","url":null,"abstract":"Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory disease of the nose and paranasal sinuses characterized by intense inflammation, decreased health-related quality of life (HRQoL), and in severe cases high frequency of co-morbidities and recurrence despite treatment. Conservative treatment consists of nasal lavage, intranasal corticosteroids, and courses of oral corticosteroids, and antibiotics in exacerbations. Endoscopic sinus surgery (ESS) and/or biological therapy is considered if appropriate conservative treatment is not sufficient. The optimal extent of ESS in recalcitrant CRSwNP is not known. The aim of this randomized controlled trial is to evaluate and compare the efficacy and safety of limited ESS with partial ethmoidectomy with extended ESS with total ethmoidectomy in patients with severe CRSwNP. Methods: AirGOs Operative is a randomized controlled trial. It is an investigator-driven multicenter trial led by Helsinki University Hospital. The two surgery arms are compared. The primary outcome is the change in the SNOT-22 score at the 12-month follow-up. Secondary outcomes include the change in the SNOT-22 score at 24-months follow-up, the changes in polyp score, Lund-Mackay (LM) CT score, health-related quality of life (HRQoL), loss of productivity, nasal patency (peak nasal inspiratory flow (PNIF) ± acoustic rhinometry (ARM), olfaction test (Sniffin’ Sticks, identification), lung function (spirometry and PEF) and findings in pathological analysis at 12/24-months follow-up. Discussion: AirGOs Operative trial will lead to a better understanding of the optimal extent of ethmoidectomy in the treatment of recalcitrant severe CRSwNP.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44122011","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}
Background: Middle turbinate lateralisation is the most common minor post-operative complication following functional endoscopic sinus surgery. This study aimed to compare the outcome between Conchopexy suture and Bolgerization method in preventing middle turbinate lateralisation. Methodology: This was a prospective, comparative and interventional study conducted from May 2018 to November 2019 at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A total of 68 patients were divided equally into two groups. Following functional endoscopic sinus surgery, the middle turbinate was medialised either by Conchopexy suture or Bolgerization technique. Postoperative assessment was done on the second and 12th week of surgery, where the position of the middle turbinate and status of the sinus cavity were assessed using perioperative sinus endoscopic (POSE) score. Chi-square test and unpaired t test were used for comparison of postoperative results between two groups taking p value of < 0.05 as statistically significant. Results: Lateralised middle turbinate and mean POSE score was 5/34 (14.8%) and 2.1±1.25, respectively, in Conchopexy group whilst in Bolgerization group it was 6/34 (17.6%) and 2.5±1.46. However, the observed differences were not statistically significant. Conclusion: Conchopexy suture and Bolgerization techniques were equally effective in preventing middle turbinate lateralisation. Hence, either of these techniques could be used as an adjunct to FESS to avoid middle turbinate lateralisation.
{"title":"Conchopexy Suture versus Bolgerization in preventing middle turbinate lateralisation following FESS","authors":"R. Mahaseth, U. Gurung, B. Pradhan","doi":"10.4193/rhinol/21.020","DOIUrl":"https://doi.org/10.4193/rhinol/21.020","url":null,"abstract":"Background: Middle turbinate lateralisation is the most common minor post-operative complication following functional endoscopic sinus surgery. This study aimed to compare the outcome between Conchopexy suture and Bolgerization method in preventing middle turbinate lateralisation. Methodology: This was a prospective, comparative and interventional study conducted from May 2018 to November 2019 at Tribhuvan University Teaching Hospital, Kathmandu, Nepal. A total of 68 patients were divided equally into two groups. Following functional endoscopic sinus surgery, the middle turbinate was medialised either by Conchopexy suture or Bolgerization technique. Postoperative assessment was done on the second and 12th week of surgery, where the position of the middle turbinate and status of the sinus cavity were assessed using perioperative sinus endoscopic (POSE) score. Chi-square test and unpaired t test were used for comparison of postoperative results between two groups taking p value of < 0.05 as statistically significant. Results: Lateralised middle turbinate and mean POSE score was 5/34 (14.8%) and 2.1±1.25, respectively, in Conchopexy group whilst in Bolgerization group it was 6/34 (17.6%) and 2.5±1.46. However, the observed differences were not statistically significant. Conclusion: Conchopexy suture and Bolgerization techniques were equally effective in preventing middle turbinate lateralisation. Hence, either of these techniques could be used as an adjunct to FESS to avoid middle turbinate lateralisation.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43668396","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}
Objective: To investigate the incidence, comorbidity and recovery period of smell and taste loss in patients with COVID-19 infection, who were treated as outpatient or admitted to the hospital. Methods: 103 patients with COVID-19 infection were recruited from a COVID-19 Test Centre (CTC) and hospital wards. Subjects filled in an online self-report survey retrospectively at least six months after recruitment. The following epidemiological and clinical outcomes have been studied: age, gender, comorbidities, general and otolaryngological symptoms and recovery of the olfactory or gustatory loss. Results: All patients suffered from mild to severe respiratory disease. A high frequency of smell and taste dysfunctions was reported (71.2% and 78.9% respectively). 33% of the patients reported anosmia and 33% reported ageusia. The most frequent symptoms were fever, loss of smell and taste, dyspnoea and headache. The most common comorbidities were hypertension, obesity and diabetes. Males suffered 2.6 times more often from olfactory dysfunction than females. No statistical difference with regard to recovery time were found between man and women. There was a significant difference in the sense of taste scores before COVID-19 infection and during COVID-19 infection. Smell and taste dysfunction was related to clinical course of the infection. There was no difference in recovery of smell and taste recovery between CTC, ward and ICU patients. 87.2% of the patients reported to have recovered from their smell and taste dysfunctions after 4 months. Parosmia after recovery of loss of smell has been reported by 13% of the patients. Conclusion: After 4 months, 87% of the patients with COVID-19 infection had recovered from their smell and taste loss. The smell dysfunction was related to the clinical course of the disease but it seems that there is no difference in recovery time of smell dysfunction between patients with severe and critical course disease.
{"title":"Self-reported olfactory and gustatory dysfunction in patients with COVID-19 infection","authors":"D. Kooper, H. Coerts, H. Mkadmi","doi":"10.4193/rhinol/20.088","DOIUrl":"https://doi.org/10.4193/rhinol/20.088","url":null,"abstract":"Objective: To investigate the incidence, comorbidity and recovery period of smell and taste loss in patients with COVID-19 infection, who were treated as outpatient or admitted to the hospital. Methods: 103 patients with COVID-19 infection were recruited from a COVID-19 Test Centre (CTC) and hospital wards. Subjects filled in an online self-report survey retrospectively at least six months after recruitment. The following epidemiological and clinical outcomes have been studied: age, gender, comorbidities, general and otolaryngological symptoms and recovery of the olfactory or gustatory loss. Results: All patients suffered from mild to severe respiratory disease. A high frequency of smell and taste dysfunctions was reported (71.2% and 78.9% respectively). 33% of the patients reported anosmia and 33% reported ageusia. The most frequent symptoms were fever, loss of smell and taste, dyspnoea and headache. The most common comorbidities were hypertension, obesity and diabetes. Males suffered 2.6 times more often from olfactory dysfunction than females. No statistical difference with regard to recovery time were found between man and women. There was a significant difference in the sense of taste scores before COVID-19 infection and during COVID-19 infection. Smell and taste dysfunction was related to clinical course of the infection. There was no difference in recovery of smell and taste recovery between CTC, ward and ICU patients. 87.2% of the patients reported to have recovered from their smell and taste dysfunctions after 4 months. Parosmia after recovery of loss of smell has been reported by 13% of the patients. Conclusion: After 4 months, 87% of the patients with COVID-19 infection had recovered from their smell and taste loss. The smell dysfunction was related to the clinical course of the disease but it seems that there is no difference in recovery time of smell dysfunction between patients with severe and critical course disease.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44234016","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}
A. Rosenbaum, S. Palma, T. Muñoz, F. García-Huidobro, C. Gonzalez, J. Varas, C. Callejas
Background: The purpose of this study is to develop and validate a low-cost simulation model and training program for the acquisition of basic skills in endoscopic sinus surgery. Methodology: Experimental study. An eight-task low-cost simulation model was developed based on feeding bottles. Junior residents, general otolaryngologists, and fellowship-trained rhinologists (experts) were recorded performing each task. Operative time and number of errors were measured. Videos were evaluated by two blinded experts using a validated global rating scale (GRS) and a specific rating scale (SRS). A group of residents completed a six-session training program and then were recorded and evaluated using the same methodology. Results: Twenty-five participants were recruited. Statistically significant higher scores in the GRS and SRS and lower operative time and errors at higher levels of expertise were found. A significant correlation between SRS and GRS was found. Seven residents completed the training program. A significant improvement of SRS and GRS scores and reduction of operative time and errors were observed after training. Moreover, compared to experts, statistically significant fewer errors were made by residents after training, and no significant differences were found in terms of performance quality and operative time among these groups. Conclusions: Our low-cost simulation model can be accurately used as a validated objective assessment and training tool for basic endoscopic skills necessary for FESS, and can be potentially used in any otolaryngology surgical training program for residents.
{"title":"Low-cost simulation training program for endoscopic sinus surgery: optimizing the basic skills level","authors":"A. Rosenbaum, S. Palma, T. Muñoz, F. García-Huidobro, C. Gonzalez, J. Varas, C. Callejas","doi":"10.4193/rhinol/21.011","DOIUrl":"https://doi.org/10.4193/rhinol/21.011","url":null,"abstract":"Background: The purpose of this study is to develop and validate a low-cost simulation model and training program for the acquisition of basic skills in endoscopic sinus surgery. Methodology: Experimental study. An eight-task low-cost simulation model was developed based on feeding bottles. Junior residents, general otolaryngologists, and fellowship-trained rhinologists (experts) were recorded performing each task. Operative time and number of errors were measured. Videos were evaluated by two blinded experts using a validated global rating scale (GRS) and a specific rating scale (SRS). A group of residents completed a six-session training program and then were recorded and evaluated using the same methodology. Results: Twenty-five participants were recruited. Statistically significant higher scores in the GRS and SRS and lower operative time and errors at higher levels of expertise were found. A significant correlation between SRS and GRS was found. Seven residents completed the training program. A significant improvement of SRS and GRS scores and reduction of operative time and errors were observed after training. Moreover, compared to experts, statistically significant fewer errors were made by residents after training, and no significant differences were found in terms of performance quality and operative time among these groups. Conclusions: Our low-cost simulation model can be accurately used as a validated objective assessment and training tool for basic endoscopic skills necessary for FESS, and can be potentially used in any otolaryngology surgical training program for residents.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47083656","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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