Background: The COVID -19 pandemic created a panic situation where patient interaction with the other patients and health care staff had to be restricted to avoid spreading the disease. We planned an innovative strategy to restrict the inflow of patients to those who may need nasal bone manipulation by using Video Clinics (VC). Methods: All consecutive patients presenting to three units of Accident & Emergency (A & E) NHS sites of our trust with suspicion of fractured nasal bones were included in the study group for a period of three months. The impact of VC was studied by calculating the percentage of patients who could be discharged without a recall to the hospital from those attending it, the percentage who finally needed a fracture reduction, and the satisfaction scores of patients with VC. Results: Forty-two patients were offered appointments in VC. Thirty-one could attend VC, out of which thirteen (41.9%) were discharged without a recall. Twenty-three patients were recalled for F2F (Face2Face) clinic, out of which twelve (28.5% of 42) required fracture reduction, and 11 were discharged to home. Ten patients underwent fracture reduction under local anaesthesia, and two were booked for Septorhinoplasty later. Twenty-seven (87.1 %) patients expressed satisfaction with VC, two (6.4%) were lost to follow-up, and the remaining two (6.4%) were not satisfied. Conclusion: VC could effectively filter 41.9% of patients who did not need surgical intervention from the comfort of their homes or workplace by using the available multimedia facility without compromising outcomes and satisfaction scores. The satisfaction score was 87.1% with VC. The clinics helped prevent potential coronavirus exposure by staying safe, and they are recommended in emergencies like COVID -19.
{"title":"Impact of video clinics in the management of fracture nasal bones in COVID times","authors":"V. Narang, V. Eswarappa, N. Calder","doi":"10.4193/rhinol/21.026","DOIUrl":"https://doi.org/10.4193/rhinol/21.026","url":null,"abstract":"Background: The COVID -19 pandemic created a panic situation where patient interaction with the other patients and health care staff had to be restricted to avoid spreading the disease. We planned an innovative strategy to restrict the inflow of patients to those who may need nasal bone manipulation by using Video Clinics (VC). Methods: All consecutive patients presenting to three units of Accident & Emergency (A & E) NHS sites of our trust with suspicion of fractured nasal bones were included in the study group for a period of three months. The impact of VC was studied by calculating the percentage of patients who could be discharged without a recall to the hospital from those attending it, the percentage who finally needed a fracture reduction, and the satisfaction scores of patients with VC. Results: Forty-two patients were offered appointments in VC. Thirty-one could attend VC, out of which thirteen (41.9%) were discharged without a recall. Twenty-three patients were recalled for F2F (Face2Face) clinic, out of which twelve (28.5% of 42) required fracture reduction, and 11 were discharged to home. Ten patients underwent fracture reduction under local anaesthesia, and two were booked for Septorhinoplasty later. Twenty-seven (87.1 %) patients expressed satisfaction with VC, two (6.4%) were lost to follow-up, and the remaining two (6.4%) were not satisfied. Conclusion: VC could effectively filter 41.9% of patients who did not need surgical intervention from the comfort of their homes or workplace by using the available multimedia facility without compromising outcomes and satisfaction scores. The satisfaction score was 87.1% with VC. The clinics helped prevent potential coronavirus exposure by staying safe, and they are recommended in emergencies like COVID -19.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49367511","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. Hayama, Y. Maeda, T. Tsuda, H. Akazawa, A. Nakatani, S. Obata, K. Takeda, H. Inohara
Background: We examined the severity of epistaxis in patients with hereditary haemorrhagic telangiectasia (HHT) and its relationship with the performed activities of daily living. Methodology: This cross-sectional survey included 36 patients with HHT in Japan. An anonymous questionnaire survey was conducted regarding the severity of epistaxis, the measures adopted to prevent epistaxis, and the limitations in the performed activities of daily living. The latter was assessed using a visual analogue scale (VAS). The correlation between epistaxis severity and the VAS score was analysed using Spearman’s rank correlation coefficient. Results: Of the 36 participants surveyed, 94.4% had >1 episode of epistaxis/week. The mean epistaxis severity score (ESS) was 4.3 (range, 0.9–8.4). Limitations in daily life, going out (within a day), meeting with others, eating with others, and going on overnight trips were positively correlated with the ESS. To prevent nosebleeds, 44.4% and 41.7% of the participants used medications and avoided drying their nasal cavities, respectively. Conclusions: Epistaxis impacted the daily life of patients with HHT in proportion to its severity. Nonetheless, less than half of the patients used medications or took precautions. Hence, further educational activities should be considered for medical professionals and patients.
{"title":"Epistaxis limits the performed activities of daily living in proportion to its severity: a cross-sectional survey among patients with hereditary haemorrhagic telangiectasia","authors":"M. Hayama, Y. Maeda, T. Tsuda, H. Akazawa, A. Nakatani, S. Obata, K. Takeda, H. Inohara","doi":"10.4193/rhinol/21.028","DOIUrl":"https://doi.org/10.4193/rhinol/21.028","url":null,"abstract":"Background: We examined the severity of epistaxis in patients with hereditary haemorrhagic telangiectasia (HHT) and its relationship with the performed activities of daily living. Methodology: This cross-sectional survey included 36 patients with HHT in Japan. An anonymous questionnaire survey was conducted regarding the severity of epistaxis, the measures adopted to prevent epistaxis, and the limitations in the performed activities of daily living. The latter was assessed using a visual analogue scale (VAS). The correlation between epistaxis severity and the VAS score was analysed using Spearman’s rank correlation coefficient. Results: Of the 36 participants surveyed, 94.4% had >1 episode of epistaxis/week. The mean epistaxis severity score (ESS) was 4.3 (range, 0.9–8.4). Limitations in daily life, going out (within a day), meeting with others, eating with others, and going on overnight trips were positively correlated with the ESS. To prevent nosebleeds, 44.4% and 41.7% of the participants used medications and avoided drying their nasal cavities, respectively. Conclusions: Epistaxis impacted the daily life of patients with HHT in proportion to its severity. Nonetheless, less than half of the patients used medications or took precautions. Hence, further educational activities should be considered for medical professionals and patients.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43858469","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}
T. Tsuda, M. Hayama, Y. Maeda, K. Takeda, S. Nishiike, K. Kawashima, H. Inohara
2 Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan 3 Department of Otolaryngology, Kindai University Faculty of Medicine, Sayama City, Osaka, Japan 4 Department of Otorhinolaryngology–Head and Neck Surgery, Osaka Rosai Hospital, Sakai City, Osaka, Japan 5 Department of Otorhinolaryngology, Osaka Habikino Medical Center, Osaka Prefectural Hospital Organization, Habikino City,
{"title":"Online workshops on the teaching and practice of endoscopic sinus surgery techniques during the COVID-19 pandemic","authors":"T. Tsuda, M. Hayama, Y. Maeda, K. Takeda, S. Nishiike, K. Kawashima, H. Inohara","doi":"10.4193/RHINOL/21.025","DOIUrl":"https://doi.org/10.4193/RHINOL/21.025","url":null,"abstract":"2 Department of Otorhinolaryngology, National Hospital Organization Osaka National Hospital, Osaka City, Osaka, Japan 3 Department of Otolaryngology, Kindai University Faculty of Medicine, Sayama City, Osaka, Japan 4 Department of Otorhinolaryngology–Head and Neck Surgery, Osaka Rosai Hospital, Sakai City, Osaka, Japan 5 Department of Otorhinolaryngology, Osaka Habikino Medical Center, Osaka Prefectural Hospital Organization, Habikino City,","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44410497","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. Felippu, AL Cunha, A.C. Oliveira, T. P. Morsch, M. Limongi, F. Cascio, A. F. Neto
A mucocele is a benign lesion that predominantly affects the paranasal sinuses, with a slow growth rate and expansive pattern. When infected, it is known as mucopyocele. Presentation of a frontal mucopyocele can be found more frequently in adults. In contrast, it is rarely seen in children since pneumatization of the sinuses usually takes place after age 7. This report aims to present one case of a frontal mucopyocele as an important complication of a pansinusitis in a 7-year-old child and discuss the diagnosis, surgical approach, and differentials. Endoscopic endonasal surgery is a safe approach and must be taken into consideration in these situations.
{"title":"Frontal mucopyocele with bone erosion in a 7-year-old child - exclusively endoscopic endonasal approach - a case report","authors":"A. Felippu, AL Cunha, A.C. Oliveira, T. P. Morsch, M. Limongi, F. Cascio, A. F. Neto","doi":"10.4193/RHINOL/20.090","DOIUrl":"https://doi.org/10.4193/RHINOL/20.090","url":null,"abstract":"A mucocele is a benign lesion that predominantly affects the paranasal sinuses, with a slow growth rate and expansive pattern. When infected, it is known as mucopyocele. Presentation of a frontal mucopyocele can be found more frequently in adults. In contrast, it is rarely seen in children since pneumatization of the sinuses usually takes place after age 7. This report aims to present one case of a frontal mucopyocele as an important complication of a pansinusitis in a 7-year-old child and discuss the diagnosis, surgical approach, and differentials. Endoscopic endonasal surgery is a safe approach and must be taken into consideration in these situations.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42370991","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: Nasal irrigation is commonly recommended as an adjuvant treatment for blocked nose. In the present study, the safety and efficacy profile of Stérimar Blocked Nose (SBN), a hypertonic seawater solution enriched with manganese and copper salts, has been evaluated on nasal epithelium, in vitro. Methodology: 3D reconstituted human nasal epithelium tissue model, MucilAir™, has been used to investigate the safety of SBN on nasal epithelium by measuring trans-epithelial electrical resistance (TEER), cytotoxicity (lactate dehydrogenase (LDH) release) and phlogosis-related effects (interleukin-8 secretion). Efficacy assessment was measured by ciliary beat frequency (CBF), mucociliary clearance (MCC) and antimicrobial activities (against Staphylococcus aureus and Pseudomonas aeruginosa). Results: Four-day SBN treatment did not compromise the nasal epithelium integrity as TEER values were over the tissue integrity limit. SBN treatment did not exert cytotoxic (LDH release) or pro-inflammatory effects (IL-8 secretion). SBN treatment significantly increased the CBF and MCC rates compared to untreated cells. SBN treatment exerted a bactericidal effect on S. aureus and P. aeruginosa cultures, whereas seawater not enriched in copper and manganese had only a bacteriostatic effect. Conclusions: The results demonstrate that SBN is a safe formula for use on human nasal epithelium. The results also suggest a better potential therapeutic role for SBN in comparison to not-enriched seawater when used to control nasal congestion and inhibit bacterial growth which may cause nasal congestion.
{"title":"Efficacy and safety evaluation of a hypertonic seawater solution enriched with manganese and copper salts","authors":"S. Constant, A. Saaid, M. Jiménez-Chobillon","doi":"10.4193/RHINOL/21.021","DOIUrl":"https://doi.org/10.4193/RHINOL/21.021","url":null,"abstract":"Background: Nasal irrigation is commonly recommended as an adjuvant treatment for blocked nose. In the present study, the safety and efficacy profile of Stérimar Blocked Nose (SBN), a hypertonic seawater solution enriched with manganese and copper salts, has been evaluated on nasal epithelium, in vitro. Methodology: 3D reconstituted human nasal epithelium tissue model, MucilAir™, has been used to investigate the safety of SBN on nasal epithelium by measuring trans-epithelial electrical resistance (TEER), cytotoxicity (lactate dehydrogenase (LDH) release) and phlogosis-related effects (interleukin-8 secretion). Efficacy assessment was measured by ciliary beat frequency (CBF), mucociliary clearance (MCC) and antimicrobial activities (against Staphylococcus aureus and Pseudomonas aeruginosa). Results: Four-day SBN treatment did not compromise the nasal epithelium integrity as TEER values were over the tissue integrity limit. SBN treatment did not exert cytotoxic (LDH release) or pro-inflammatory effects (IL-8 secretion). SBN treatment significantly increased the CBF and MCC rates compared to untreated cells. SBN treatment exerted a bactericidal effect on S. aureus and P. aeruginosa cultures, whereas seawater not enriched in copper and manganese had only a bacteriostatic effect. Conclusions: The results demonstrate that SBN is a safe formula for use on human nasal epithelium. The results also suggest a better potential therapeutic role for SBN in comparison to not-enriched seawater when used to control nasal congestion and inhibit bacterial growth which may cause nasal congestion.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49189574","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}
R. Pieruzzini, C. Ayala-Grosso, J. de Jesus Navas, W. Rodríguez, N. Parra, E. Luque, A. Sánchez-Gago, S. Gonzalez, A. Hagobian, A. Grullón, K. Díaz, M. Morales, M. De Jesus, S. Peña, L. Rodríguez, L. Peña, A. Asaro, M. Magris
Background: Smell and taste disorders are reported very frequently and at an early stage in SARS-CoV-2 infectious disease. These symptoms could be sensitive and specific to establish possible severity of the infection, and may suggest the flow of decisions as to further therapy. Objective: We asked whether smell and taste impairment are earlier and more sensitive symptoms than the RT-PCR molecular assays for SARS-CoV-2 detection. Methods: Subjects (N=275) with a probable COVID-19 diagnosis were classified as follows: Symptomatic with chemosensory dysfunction, symptomatic without chemosensory dysfunction, and asymptomatic. Validated unbiased testing of the chemosensory dysfunction was performed by means of the Venezuelan Olfactory Test and taste test. Nasal swabs and blood samples were analyzed by RT-PCR molecular analysis a rapid diagnostic test to detect the SARS-CoV-2 virus and viral antibodies, respectively. Smell and taste testing and RT-PCR were performed every 3 to 5 days to patients until full recovery. Results: Out of 144 patients that were positive for SARS-CoV-2: 45.83% had COVID-19 symptoms, smell and taste disorders; 23.61% had COVID-19 symptoms but not smell or taste disorders, and 30.55% were asymptomatic. Mild hyposmia and hypogeusia were frequently associated with SARS-CoV-2 symptoms. Recovery from chemosensory dysfunction occurred between day 3 and 14. RT-PCR becomes negative after 21 days. The Venezuelan Olfactory Test and taste test has a 61.68% positive predictive value, 45.83% sensitivity, and 68.7% specificity for SARS-CoV-2. Conclusions: Smell and taste disorders are associated symptoms with SARS-CoV-2 infection, but not a predictor of the disease, as compared to the molecular RT-PCR test.
{"title":"What smell and taste disorders by SARS-CoV-2 do we know? Predictive value of the Venezuelan Olfactory Test and RT-PCR molecular analysis in COVID-19 infection","authors":"R. Pieruzzini, C. Ayala-Grosso, J. de Jesus Navas, W. Rodríguez, N. Parra, E. Luque, A. Sánchez-Gago, S. Gonzalez, A. Hagobian, A. Grullón, K. Díaz, M. Morales, M. De Jesus, S. Peña, L. Rodríguez, L. Peña, A. Asaro, M. Magris","doi":"10.4193/rhinol/21.003","DOIUrl":"https://doi.org/10.4193/rhinol/21.003","url":null,"abstract":"Background: Smell and taste disorders are reported very frequently and at an early stage in SARS-CoV-2 infectious disease. These symptoms could be sensitive and specific to establish possible severity of the infection, and may suggest the flow of decisions as to further therapy. Objective: We asked whether smell and taste impairment are earlier and more sensitive symptoms than the RT-PCR molecular assays for SARS-CoV-2 detection. Methods: Subjects (N=275) with a probable COVID-19 diagnosis were classified as follows: Symptomatic with chemosensory dysfunction, symptomatic without chemosensory dysfunction, and asymptomatic. Validated unbiased testing of the chemosensory dysfunction was performed by means of the Venezuelan Olfactory Test and taste test. Nasal swabs and blood samples were analyzed by RT-PCR molecular analysis a rapid diagnostic test to detect the SARS-CoV-2 virus and viral antibodies, respectively. Smell and taste testing and RT-PCR were performed every 3 to 5 days to patients until full recovery. Results: Out of 144 patients that were positive for SARS-CoV-2: 45.83% had COVID-19 symptoms, smell and taste disorders; 23.61% had COVID-19 symptoms but not smell or taste disorders, and 30.55% were asymptomatic. Mild hyposmia and hypogeusia were frequently associated with SARS-CoV-2 symptoms. Recovery from chemosensory dysfunction occurred between day 3 and 14. RT-PCR becomes negative after 21 days. The Venezuelan Olfactory Test and taste test has a 61.68% positive predictive value, 45.83% sensitivity, and 68.7% specificity for SARS-CoV-2. Conclusions: Smell and taste disorders are associated symptoms with SARS-CoV-2 infection, but not a predictor of the disease, as compared to the molecular RT-PCR test.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43329881","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: Dupilumab (anti-IL-4R) is a novel biological agent approved for treatment of severe asthma with chronic rhinosinusitis. Beneficial effects on hearing have only been sparsely decribed. Case presentation: In this case story we present a 48-year woman, who experienced remarkably improved hearing and reduction of tinnitus after initiation of Dupilumab. Progress was monitored by respiratory physicians in collaboration with rhinologists and audiologists. SNOT-22 score improved from 83 to 27 and audiograms obtained before and during treatment illustrate a reduced air-bone gap and an improvement of speech recognition threshold from 25 dB (both ears) to 15 and 10 (left and right ear respectively). Conclusions: This case story implies a beneficial effect of Dupilumab treatment in patients with united airway disease with hearing impairment. The authors suggest an additional otological perspective in addition to standard monitoring.
{"title":"Effects on hearing and tinnitus following Dupilumab treatment of severe asthma with chronic rhinosinusitis - a case report","authors":"M. Thorsberger, C. Porsbjerg, J. Yde, K. Aanaes","doi":"10.4193/RHINOL/21.002","DOIUrl":"https://doi.org/10.4193/RHINOL/21.002","url":null,"abstract":"Background: Dupilumab (anti-IL-4R) is a novel biological agent approved for treatment of severe asthma with chronic rhinosinusitis. Beneficial effects on hearing have only been sparsely decribed. Case presentation: In this case story we present a 48-year woman, who experienced remarkably improved hearing and reduction of tinnitus after initiation of Dupilumab. Progress was monitored by respiratory physicians in collaboration with rhinologists and audiologists. SNOT-22 score improved from 83 to 27 and audiograms obtained before and during treatment illustrate a reduced air-bone gap and an improvement of speech recognition threshold from 25 dB (both ears) to 15 and 10 (left and right ear respectively). Conclusions: This case story implies a beneficial effect of Dupilumab treatment in patients with united airway disease with hearing impairment. The authors suggest an additional otological perspective in addition to standard monitoring.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45180636","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: The aim of the study was to assess, whether there is a difference in aesthetic and functional patient satisfaction between closed nasal reductions with intraoperative Cone-Beam Computed Tomography (CBCT) and without using intraoperative medical imaging. Methods: A monocentric, retrospective cohort study of 43 patients (20 patients treated with intraoperative CBCT and 23 patients treated without intraoperative imaging) was conducted. Subjective postoperative aesthetic and functional aspects of the nose were assessed. Additionally, questions comparing the aesthetics and function of the nose before and after the accident and on the desire of revision surgery were asked. Results: Both the SCHNOS-C and total SCHNOS score in the non-CBCT group were higher than the respective scores of the CBCT-group. The comparison of SCHNOS-C between male subjects of the two groups showed no statistical significance. The comparison of SCHNOS-C between male and female subjects over both groups showed significantly higher scores for female subjects. Conclusions: Patients undergoing surgery with intraoperative CBCT imaging showed better aesthetical outcomes than patients, treated without intraoperative imaging. However, the difference showed no clinical importance, so that both strategies appear to have comparable outcomes regarding postoperative aesthetics and function of the nose. Gender instead of the different strategies could contribute to the demonstrated differences. Female subjects seem to be less satisfied with the aesthetics of their nose postoperatively, potentially being more sensitive to remaining nasal deformities after surgery.
{"title":"Impact of intraoperative Cone-Beam Computed Tomography use on patient satisfaction after closed nasal reduction","authors":"C. Bruehlmann, M. Blumer, M. Soyka","doi":"10.4193/RHINOL/21.018","DOIUrl":"https://doi.org/10.4193/RHINOL/21.018","url":null,"abstract":"Background: The aim of the study was to assess, whether there is a difference in aesthetic and functional patient satisfaction between closed nasal reductions with intraoperative Cone-Beam Computed Tomography (CBCT) and without using intraoperative medical imaging. Methods: A monocentric, retrospective cohort study of 43 patients (20 patients treated with intraoperative CBCT and 23 patients treated without intraoperative imaging) was conducted. Subjective postoperative aesthetic and functional aspects of the nose were assessed. Additionally, questions comparing the aesthetics and function of the nose before and after the accident and on the desire of revision surgery were asked. Results: Both the SCHNOS-C and total SCHNOS score in the non-CBCT group were higher than the respective scores of the CBCT-group. The comparison of SCHNOS-C between male subjects of the two groups showed no statistical significance. The comparison of SCHNOS-C between male and female subjects over both groups showed significantly higher scores for female subjects. Conclusions: Patients undergoing surgery with intraoperative CBCT imaging showed better aesthetical outcomes than patients, treated without intraoperative imaging. However, the difference showed no clinical importance, so that both strategies appear to have comparable outcomes regarding postoperative aesthetics and function of the nose. Gender instead of the different strategies could contribute to the demonstrated differences. Female subjects seem to be less satisfied with the aesthetics of their nose postoperatively, potentially being more sensitive to remaining nasal deformities after surgery.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47120115","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: Chronic rhinosinusitis with nasal polyps (CRSwNP) afflicts 2-4% of the population and comes with a long time burden of disease and high societal costs. The current treatment consists of medical treatment alone or in combination with endoscopic sinus surgery. No consensus exists on the right timing and extent of disease that warrants surgery. Furthermore, there is lack of clinical knowledge about the benefit of surgery over medication only. The current study evaluates the clinical effectiveness and cost-effectiveness of endoscopic sinus surgery in addition to medical treatment versus medication alone in the adult patient group with nasal polyps (CRSwNP). Methods: The PolypESS trial is designed as a prospective, randomised, multicentre trial in adult patients with CRSwNP selected for primary or revision endoscopic sinus surgery by their otorhinolaryngologist. Patients are randomly assigned to endoscopic sinus surgery in addition to medication or medical therapy only. This paper details the statistical analysis plan (SAP) of this trial and was submitted before outcome data were available. Results: The primary outcome of the trial is disease-specific Health-Related Quality of Life quantified by the SNOT-22 at 12-months follow-up. Secondary outcomes consist of generic and disease-specific Health-Related Quality of Life, objective signs of disease and adverse events of treatment. Subgroup analyses will be performed to verify if treatment effects differ among patient phenotypes. Analyses will be completed according to this pre-specified SAP. The main analysis will be performed as a standard ITT analysis. Discussion: The PolypESS trial will show whether addition of endoscopic sinus surgery to medical treatment improves the disease-specific Health-Related Quality of Life quantified by the SNOT-22 at 12-months follow-up. Unforeseen deviations from the SAP at the time of analysis will be motivated and discussed in the final publication of the primary outcome of this study.
{"title":"Endoscopic sinus surgery in adult patients with Chronic Rhinosinusitis with nasal polyps (PolypESS) - statistical analysis plan for a multicentre randomised controlled trial","authors":"E. Lourijsen, M. Vleming, S. Reitsma, W. Fokkens","doi":"10.4193/RHINOL/20.092","DOIUrl":"https://doi.org/10.4193/RHINOL/20.092","url":null,"abstract":"Background: Chronic rhinosinusitis with nasal polyps (CRSwNP) afflicts 2-4% of the population and comes with a long time burden of disease and high societal costs. The current treatment consists of medical treatment alone or in combination with endoscopic sinus surgery. No consensus exists on the right timing and extent of disease that warrants surgery. Furthermore, there is lack of clinical knowledge about the benefit of surgery over medication only. The current study evaluates the clinical effectiveness and cost-effectiveness of endoscopic sinus surgery in addition to medical treatment versus medication alone in the adult patient group with nasal polyps (CRSwNP). Methods: The PolypESS trial is designed as a prospective, randomised, multicentre trial in adult patients with CRSwNP selected for primary or revision endoscopic sinus surgery by their otorhinolaryngologist. Patients are randomly assigned to endoscopic sinus surgery in addition to medication or medical therapy only. This paper details the statistical analysis plan (SAP) of this trial and was submitted before outcome data were available. Results: The primary outcome of the trial is disease-specific Health-Related Quality of Life quantified by the SNOT-22 at 12-months follow-up. Secondary outcomes consist of generic and disease-specific Health-Related Quality of Life, objective signs of disease and adverse events of treatment. Subgroup analyses will be performed to verify if treatment effects differ among patient phenotypes. Analyses will be completed according to this pre-specified SAP. The main analysis will be performed as a standard ITT analysis. Discussion: The PolypESS trial will show whether addition of endoscopic sinus surgery to medical treatment improves the disease-specific Health-Related Quality of Life quantified by the SNOT-22 at 12-months follow-up. Unforeseen deviations from the SAP at the time of analysis will be motivated and discussed in the final publication of the primary outcome of this study.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46555628","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: The acute onset of olfactory and/or gustatory dysfunction is a frequent complaint during the COVID-19 pandemic. It is predominantly reported by subjects with asymptomatic to mild disease severity during the early stage of the infection. The high prevalence of anosmia/dysosmia and/or ageusia/dysgeusia in this current era implements a strong correlation with a SARSCoV-2 infection and these symptoms could therefore be seen as important prodromes. The purpose of this study was to outline the occurrence, epidemiology and clinical course of olfactory and/or gustatory disorders in (suspected) COVID-19 cases and to analyse the diagnostic significance of these neurosensory dysfunctions. Methods: An online questionnaire was carried out which addressed 500 participants with new onset olfactory and/or gustatory impairment during the COVID-19 pandemic. Results: Acute olfactory and gustatory loss was reported by 487 (97.4%) and 464 (92.8%), respectively. A significant higher prevalence of neurosensory complaints was reported by women and people of younger age. The most prevalent concurrent symptoms were fatigue, headaches, nasal congestion, dry cough, rhinorrhoea and sneezing. The recovery rate after 8 weeks was 41.9% for olfactory impairment and 53.7% for gustatory impairment. Among the 93 subjects tested, 82 (88.2%) tested positive for SARSCoV-2. Conclusion: Olfactory and/or gustatory disorders are prevalent clinical findings during the COVID-19 pandemic. Neurosensory impairments, isolated or in association with other mild complaints, need to be addressed as potential symptoms of a SARS-CoV-2 infection and should be implemented as clinical markers.
{"title":"The clinical course and diagnostic relevance of olfactory loss in a SARS-CoV-2 infection","authors":"M. Bauwens, S. Claeys","doi":"10.4193/RHINOL/20.081","DOIUrl":"https://doi.org/10.4193/RHINOL/20.081","url":null,"abstract":"Background: The acute onset of olfactory and/or gustatory dysfunction is a frequent complaint during the COVID-19 pandemic. It is predominantly reported by subjects with asymptomatic to mild disease severity during the early stage of the infection. The high prevalence of anosmia/dysosmia and/or ageusia/dysgeusia in this current era implements a strong correlation with a SARSCoV-2 infection and these symptoms could therefore be seen as important prodromes. The purpose of this study was to outline the occurrence, epidemiology and clinical course of olfactory and/or gustatory disorders in (suspected) COVID-19 cases and to analyse the diagnostic significance of these neurosensory dysfunctions. Methods: An online questionnaire was carried out which addressed 500 participants with new onset olfactory and/or gustatory impairment during the COVID-19 pandemic. Results: Acute olfactory and gustatory loss was reported by 487 (97.4%) and 464 (92.8%), respectively. A significant higher prevalence of neurosensory complaints was reported by women and people of younger age. The most prevalent concurrent symptoms were fatigue, headaches, nasal congestion, dry cough, rhinorrhoea and sneezing. The recovery rate after 8 weeks was 41.9% for olfactory impairment and 53.7% for gustatory impairment. Among the 93 subjects tested, 82 (88.2%) tested positive for SARSCoV-2. Conclusion: Olfactory and/or gustatory disorders are prevalent clinical findings during the COVID-19 pandemic. Neurosensory impairments, isolated or in association with other mild complaints, need to be addressed as potential symptoms of a SARS-CoV-2 infection and should be implemented as clinical markers.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42442852","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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