Surgical Intervention Outcome for Patients With Acute Vision Loss Due to Allergic Fungal Rhinosinusitis: A Systematic Review and Meta-Analysis.

Allergic fungal rhinosinusitis (AFRS) is a severe type of chronic rhinosinusitis (CRS) characterized by a high risk of acute vision loss resulting from the affection of optic nerves. This vision loss results from direct pressure upon the optic nerve by the sinus tissues and bone degradation. This is why early involvement of a professional is significant so as not to result in a permanent disability. This systematic review and meta-analysis will analyze the efficacy of surgical operations in enhancing visual outcomes in patients with acute vision loss due to AFRS. A systematic search was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using PubMed, Embase, Cochrane Library, and Scopus with the keywords "acute vision loss," "allergic fungal rhinosinusitis," and "surgical intervention." The studies included patients who developed AFRS-related acute vision loss, those assessing the outcomes of the surgical interventions, and those published in English. Two separate researchers extracted data and conducted quality assessments. The data synthesis process employed the R studio software (Posit, Boston, MA). The identified studies for the review constituted 12 and involved 320 patients. The mean pooled event rate regarding acute vision loss of AFRS patients was 33.1%. Ear, nose, and throat surgeries, including functional endoscopic sinus surgery (FESS) and optic nerve decompression, had a mean pooled success in vision recovery of 68%. Early treatment and utilization of other types of corticosteroids were utilized to enhance the results. Hence, early and proper surgery like FESS, optic nerve decompression, and corticosteroid treatment have better visual prognosis in AFRS patients. Standard early diagnosis and management guarantee the prevention of irreversible blindness, which stresses the need for an interdisciplinary approach and further studies.

Thin Skin in Rhinoplasty: Considerations for Camouflaging Dorsal Nasal Irregularities.

Thin skin presents a challenge for achieving optimal aesthetic outcomes and minimizing complications. The review analyzes various materials and techniques employed to achieve this goal. A comprehensive electronic search was conducted across various medical databases, retrieved 965 studies, from which 15 studies were eligible for inclusion in this review with a total number of 679 patients with thin nasal skin. Techniques that promote graft integration, minimize resorption, and provide a smooth dorsal contour are crucial for thin-skinned patients. Diced cartilage with PRP, fascia lata grafts, and laser-assisted rhinoplasty appear to be particularly effective based on the available evidence. Platelet-rich fibrin (PRF) appears to play a role in some techniques by enhancing healing and tissue regeneration. Natural materials, like fascia lata and ligamentous grafts, offer potential benefits but require further exploration. Fat grafting techniques show promise but necessitate more research. This review provides a comprehensive overview of various techniques for addressing dorsal irregularities in rhinoplasty for patients with thin skin. Surgeons can utilize this information to select the most appropriate approach for achieving optimal aesthetic outcomes while minimizing complications.

Knowledge Assessment Regarding the Differences Between Hypothyroidism and Hyperthyroidism Among Saudi Arabia's Adult Population.

Introduction Worldwide, thyroid diseases are among the most prevalent endocrine disorders. According to the Saudi Arabian Ministry of Health (MOH), many thyroid disease cases remain undiagnosed and, as a result, are not treated because the patient has no symptoms or is unaware of them. Hence, this study aims to assess the knowledge about hypothyroidism and hyperthyroidism among Saudi Arabia's population. Methodology A cross-sectional survey was conducted among Saudi adults in five randomly selected regions in Saudi Arabia from December 2022 - January 2023. An Arabic self-administered questionnaire was sent to randomly selected participants via an online link. The questionnaire was composed of four parts: Sociodemographic; knowledge related to hypothyroidism and hyperthyroidism diseases and their differences; knowledge about the thyroid gland in terms of functions and causes of thyroid dysfunction. The Statistical Package for Social Sciences was used for data analysis. Results Out of 996 participants (66.2% women), 70.1% knew the function of the thyroid gland, 66.4% knew that women are more susceptible to thyroid disease, and 49.5% knew the association between thyroid dysfunction and heart disease. Female sex, higher education, and old age were associated with good knowledge, and no differences were evident regarding nationality and residence. The results showed inadequate awareness regarding thyroid diseases in Saudi Arabia, with some parts of this population being very clearly below average. Conclusion Knowledge regarding thyroid disorders was sub-optimal in Saudi Arabia; older women with higher education had the best knowledge. With even larger samples, we recommend that future studies be made to develop clear and decisive public health strategies that can be implemented at once.