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Background: We investigated the relationship between Laryngopharyngeal Reflux (LPR) and maxillary sinus mucosal thickness (MSMT), inferior turbinate mucosal thickness (ITMT), inferior turbinate width (ITW) and nasal septal body thickness (NSBT), which can be signs of chronic rhinosinusitis and allergic rhinitis. Methods: The study, which included 87 patients, was designed as two groups. While 42 of the patients were included in the Laryngopharyngeal Reflux group, 45 were included in the control group. Age and gender information of the patients were noted. MSMT, ITMT, ITW and NSBT values were measured in patients who had Paranasal Sinus Computed Tomography. MSMT, ITMT and ITW were measured as right and left. Both groups were evaluated in terms of these values. Results: Right ITMT, bilateral ITW and MSMT values were found to be significantly higher in the LPR group than in the control group (p < 0.05). MSMT values were higher in males (p < 0.05). The left-ITT and NSBT values were not significantly different between the LPR group and the control group, but both values were higher in the LPR group than in the control group (p > 0.05). In the LPR group, there were positive correlations between ITMT and ITW values of the right side; and left side separately (p < 0.05). Conclusion: It has been shown that Laryngopharyngeal Reflux increases maxillary sinus mucosal thickness, inferior turbinate thickness and width, and nasal septal body thickness, which can be signs of chronic rhinosinusitis and allergic rhinitis. The negative effects of LPR on nasal and paranasal mucosa and structures were demonstrated in this study.
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OBJECTIVES: We investigated the relationship between sphenoid sinus (SS) pneumatization types, carotid canal types and carotid canal-intersinus septa connection. METHODS: The paranasal sinus computed tomography (PNSCT) images of 274 patients (141 males and 133 females) were evaluated retrospectively. SS pneumatization, SS intersinus septation, SS intersinus septa deviation, carotid canal classification, carotid canal dehiscence, carotid canal-intersinus septa connection and presence of Onodi cells were evaluated. RESULTS: In presellar and sellar SS, type 1 carotid canal was detected. However, type 3 carotid canal was detected more in postsellar SS. On the left side, in 26.4% of the postsellar SS, carotid canal dehiscence was detected. On the right side, carotid canal-intersinus septa connection was detected in 55.8% of the postsellar SS and 35.1% of the sellar SS. On the left side, it was detected 58.3% of the postsellar SS and 30.9% of the sellar SS. In postsellar type SS pneumatized cases, right caroid canal-intersinus septa connection increased by 5.4 fold and left carotid canal-intersinus septa connection increased by 7.3 fold compared to presellar type SS pneumatization. In 2≥ intersinus septa group, left carotid canal-intersinus septa connection increased 5.0 fold compared to 'no septa' group. CONCLUSION: In this study, we evaluated SS pneumatization types and their relation with carotid canal types and carotid canal-intersinus septa connections. Type 3 carotid canal (protrudation to SS wall) was detected more in postsellar SS. In these cases, surgeons should be very careful during surgery to avoid damage to the internal carotid artery (ICA).
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Pólipos Nasais , Rinossinusite , Sinusite , Humanos , Microplásticos , Plásticos , Pólipos Nasais/complicações , Sinusite/complicaçõesRESUMO
OBJECTIVE: We aimed to examine the relationship between chronic rhinosinusitis without nasal polyps and microplastics. METHODS: A total of 80 patients participated in this prospectively planned study. The patients were divided into two groups. Group 1 had 50 patients with chronic rhinosinusitis without nasal polyps, whereas Group 2 had 30 healthy volunteers. The age and gender of the participants were noted. Nose Obstruction Symptom Evaluation questionnaire was applied to the patients. The patients performed nasal lavage with saline. Microplastics were examined in the collected nasal lavage fluids, and their numbers were noted. The groups were compared on these values. RESULTS: The mean age was 38.06 ± 14.15 years in the chronic rhinosinusitis group without nasal polyps and 33.60 ± 11.68 years in the control group. There was no significant difference between the groups in terms of age and gender. There was a significant difference in the number of microplastics between the chronic rhinosinusitis group without nasal polyps and the control group (p < 0.001). Microplastics were detected in all participants. CONCLUSIONS: We found more microplastics in patients with chronic rhinosinusitis without nasal polyps. According to this result, we can say that there may be a relationship between chronic rhinosinusitis and microplastics. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:1077-1080, 2024.
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Pólipos Nasais , Rinite , Rinossinusite , Sinusite , Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Microplásticos , Plásticos , Rinite/complicações , Sinusite/complicações , Doença CrônicaRESUMO
Introduction Tonsillectomy is among the most common otolaryngological surgeries. Objective To evaluate and compare three tonsillectomy techniques: cold steel dissection (CSD), monopolar electrocautery (MEC), and coblation. Methods The present study retrospectively reviewed the medical records of patients who underwent tonsillectomy between January 2014 and January 2016. Postoperative visual analog scale (VAS) pain scores, analgesic use, surgical duration, time to return to normal activity, and postoperative bleeding status were noted. Results The CSD group had less analgesic use and shorter return to normal activity than the MEC group ( p = 0.037 and p < 0.001, respectively). The coblation group had lower VAS pain scores than the MEC group only at 1 hour to 4 hours postsurgery ( p < 0.016). The postoperative bleeding rate was similar in all groups ( p = 0.096). Conclusion Cold steel dissection tonsillectomy is associated with less postoperative pain and shorter recovery than MEC. Coblation is better than MEC in terms of postoperative pain at 1 hour to 4 hours only, whereas CSD is associated with less postoperative pain than coblation at 2 days to 7 days.
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Objectives The authors examined the structural differences in the paranasal sinus region at sphenoid sinus in the pediatric population. Methods Paranasal sinus computed tomography (PNSCT) images of 86 pediatric subjects (30 males, 56 females) were included. In 13 to 15 years of age group ( n =34) and ≥16 years of age group ( n =52), sphenoid sinus pneumatization (SSP), optic canal and carotid canal classifications and dehiscence evaluation were performed. Results In both sexes, type 1 and type 2 SS pneumatization were observed more frequently on both the right and left sides. On the right side, type 2> type 1; on the left side type 1> type 2 optic canals were detected in both gender. Type 3 optic canals were detected in 8.8 to 14.7% of the 13 to 15 years of age group; and 11.5 to 17.3% of ≥16 years of age group. Type 4 optic canals were detected in 2.9% of the 13 to 15 years of age group and 1.9% of the ≥16 years of age group bilaterally. Optic canal dehiscence was detected in 26.5% of the 13 to 15 years of age group and 17.3% of the ≥16 years of age group. Type 1 and type 2 carotid canals are most common in children, the percentages for type 3 carotid canals were 1.8 to 3.6% in children. Conclusion In pneumatized SS, optic canal classifications got increased values which showed protrusion into the sphenoid sinus wall. Therefore, in children, the surgeons must be very careful for optic canal being nearer to the sphenoid sinus walls.
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OBJECTIVE: We aimed to investigate the relationship between microplastics, which are a worldwide health and environmental issue, and their relationship to allergic rhinitis. MATERIALS AND METHODS: A total of 66 patients participated in this prospective study. The patients were divided into two groups. While there were 36 patients with allergic rhinitis in group 1, there were 30 healthy volunteers in group 2. The participants' age, gender and Score for Allergic Rhinitis results were noted. Microplastics were examined in the nasal lavage fluids of the patients and their numbers noted. The groups were compared on these values. RESULTS: There was no significant difference between the groups in terms of age and gender. There was a significant difference between the allergic rhinitis group and the control group in terms of the Score for Allergic Rhinitis results (p < 0.001). In the allergic rhinitis group, the microplastic density in the nasal lavage was significantly higher than in the control group (p = 0.027). Microplastics were detected in all participants. CONCLUSIONS: We found more microplastics in allergic rhinitis patients. According to this result, we can say that there is a relationship between allergic rhinitis and microplastics.
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Rinite Alérgica , Rinite , Humanos , Microplásticos , Plásticos , Estudos Prospectivos , Rinite Alérgica/diagnóstico , Líquido da Lavagem NasalRESUMO
Introduction Coronavirus Disease-2019 (COVID-19) causes olfactory loss one of the initial diagnostic criteria. The brief smell identification test (BSIT) is an objective test frequently used in olfactory dysfunction. This study aimed to observe the changes in olfactory functions and clinical features in a short time in COVID-19. Methods In this prospective study involving 64 patients, the BSIT was performed at two different times; at the time of first application and on the 14th day. Demographic features, laboratory findings, body mass index (BMI), blood oxygen saturation values (SpO2), complaints at first admission, fever, follow-up place, and treatment schemes were noted. Results There was a significant difference between the BSIT scores at the first admission and when the polymerase chain reaction (PCR) became negative on the 14th day (p<0.001). Low oxygen saturation values at first admission were associated with low BSIT scores. No relationship was found between olfactory functions and complaints at admission, fever, follow-up place, and treatment schemes. Conclusion As a result, negative effects of COVID-19 on olfactory functions have been demonstrated even in the short follow-up period. In addition, low saturation values at first admission were associated with low BSIT scores.
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We examined the relationship between nasal septal deviation (SD) angle and maxillary sinus volumes by examining the paranasal sinus computed tomography (PNSCT) images in children. In this retrospective study, PNSCT images of 106 children with one-sided nasal SD were included. According to the SD angle, two groups were identified: Group 1 (n = 54): SD angle ≤ 11°, Group 2 (n = 52): SD angle > 11°. There were 23 children between 9 and 14 years and 83 children between 15 and 17 years. Maxillary sinus volume and mucosal thickening were evaluated. In 15- to 17-year age group, maxillary sinus volumes of males were higher than females bilaterally. For each of the males and females, ipsilateral maxillary sinus volume was significantly lower than the contralateral side in all children and in 15- to 17-year age group. In each of the SD angle values (≤11 or >11) separately, ipsilateral maxillary sinus volume was lower; and in the SD angle > 11° group, maxillary sinus mucosal thickening values were higher than those of the contralateral side. In young children in 9- to 14-year age group, bilateral maxillary sinus volumes decreased, in this group maxillary sinus volume was not affected according to the SD. However, in 15- to 17-year age groups, maxillary sinus volume was lower on the ipsilateral SD side; and ipsilateral and contralateral maxillary sinus volumes of the males were significantly higher than those in the females. SD should be treated at an appropriate time to prevent SD-related maxillary sinus volume shrinkage and rhinosinusitis.
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Seio Maxilar , Deformidades Adquiridas Nasais , Masculino , Feminino , Humanos , Criança , Pré-Escolar , Seio Maxilar/diagnóstico por imagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Septo Nasal/diagnóstico por imagemRESUMO
OBJECTIVES: We investigated the peripheral and central olfactory regions in children with epilepsy using cranial MRI. METHODS: In this retrospective study, cranial MRI images were obtained from 23 children with epilepsy and 23 healthy controls. Olfactory bulb (OB) volume and olfactory sulcus (OS) depth in the peripheral olfactory region and insular cortex and corpus amygdala areas in the central olfactory region were measured. RESULTS: There was no significant difference in the OB volume and OS depth in the peripheral olfactory regions in the two groups (p > 0.05). In the central olfactory region, the insular cortex and corpus amygdala areas in the epilepsy group were significantly smaller than those in the control group (p < 0.05). In both groups, the OS depth on the right side was significantly higher than that on the left side (p < 0.05). In the epilepsy group, there were positive correlations between each of the OB volumes, OS depths, insular cortex areas, and corpus amygdala areas bilaterally (p < 0.05). In both groups, there were positive correlations between the OB volume and OS depth, OS depth and insular cortex area and insular cortex area and corpus amygdala areas (p < 0.05). CONCLUSION: A change in the central olfactory region in epileptic patients may be related to central tissue damage due to epilepsy. This finding has important implications for epilepsy patients, with early diagnosis and treatment potentially preventing a reduction in the volumes/depths of components of the central olfactory region in the pediatric population.
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Epilepsia , Transtornos do Olfato , Criança , Epilepsia/diagnóstico por imagem , Humanos , Córtex Insular , Imageamento por Ressonância Magnética , Bulbo Olfatório , Estudos Retrospectivos , OlfatoRESUMO
Objective We investigated the effects of vitamin D deficiency in the peripheral and central smell regions by magnetic resonance imaging (MRI). Methods This retrospective study included 29 patients (12 males, 17 females) with 25-dihydroxy vitamin D3 [25(OH) 2 D 3 ] deficiency (group 1) and 34 subjects without 25(OH) 2 D 3 deficiency (14 males, 20 females) (group 2). Using cranial MRIs, the peripheral (olfactory bulb [OB] volume and olfactory sulcus [OS] depth) and central (insular gyrus and corpus amygdala) smell regions were evaluated. Results The OB volume and OS depth values of the 25(OH) 2 D3 deficiency group were significantly lower than those of the control group ( p < 0.05). For the central smell regions, the insular gyrus and corpus amygdala areas of the 25(OH) 2 D3 deficiency group were nonsignificantly lower than those in the control group ( p > 0.05). There were positive correlations between OB volumes, OS depths, and insular gyrus and corpus amygdala areas bilaterally in the 25(OH) 2 D3 deficiency group separately and in all subjects (groups 1 and 2) ( p < 0.05). In the 25(OH) 2 D3 deficiency group, as the 25(OH) 2 D3 values became lower, the insular gyrus area values decreased bilaterally ( p < 0.05). In females, the corpus amygdala area values were lower than in males ( p < 0.05). Conclusion Since vitamin D3 deficiency affected the peripheral and central smell regions negatively, we recommend evaluating patients' vitamin D levels as a health policy to prevent vitamin D3 deficiency-related cranial smell region problems. Moreover, sunlight exposure is very important to increase vitamin D levels, and the public should be informed about this topic.
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PURPOSE: The purpose of this study is to evaluate the effect of the different surgical techniques of expansion sphincter pharyngoplasty (ESP) on the dimensions of the oropharyngeal airway. METHODS: The techniques that were evaluated included the preservation and transection of the palatopharyngeus (PP) and superior pharyngeal constrictor (SPC) muscle attachment and transposition of the PP muscle to the hamulus of the medial pterygoid plate and the palatal musculature. Surgical techniques were applied in twenty half heads. RESULTS: The preservation of the PP-SPC attachment inhibited the transposition of the PP muscle to the hamulus and resulted in comparable enlargement in the medial-lateral dimension in the oropharyngeal airway when the PP muscle was transposed to the palatal musculature. After transection of the PP-SPC attachment, significant enlargement was observed in anterior-posterior and medial-lateral directions in the oropharyngeal airway when the PP muscle was transposed both to the hamulus and the palatal musculature. The distances measured after both the transposition techniques were similar. CONCLUSION: The present study is a basic study demonstrating how different techniques of ESP affect the position of the soft palate. The PP-SPC attachment can be transected in the patients with anterior-posterior palatal and lateral wall collapse to pull the soft palate anteriorly in addition to prevent the lateral wall collapse. The PP-SPC attachment can be preserved in the patients with only lateral wall collapse. Nevertheless, the clinical consequences of these static changes need to be evaluated in clinical studies.
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Faringe/cirurgia , Humanos , Palato Mole/cirurgia , Músculos Faríngeos/cirurgia , Apneia Obstrutiva do Sono , Resultado do TratamentoRESUMO
OBJECTIVES: The objectives of the present study were to evaluate the vestibular impairment in children with acute otitis media (AOM) and dizziness by using video head impulse test (vHIT) and to compare their results with healthy children. METHODS: The study included two groups of subjects. The patient group consisted of 34 pediatric patients with AOM and dizziness and the control group consisted of 35 healthy children, age between 4 and 15. The age, gender, mean vHIT gains and gain asymmetry values were compared between groups for each canal. In both groups, mean vHIT gains were compared between the right and left sides. Additionally, mean vHIT gains and the presence of saccades according to AOM stages were analyzed. RESULTS: The comparison of vHIT gains between affected and unaffected sides in patients revealed a significant decrease only in the anterior canal plane on the affected side. Covert saccades were observed in 32% of the patients. When comparing the AOM stages and the presence of saccades in patients, no difference was detected between stages. CONCLUSION: vHIT is a useful vestibular test for the evaluation of vestibular impairment in children with an applicability rate of 92% in healthy children and 70% in patients with AOM and dizziness. The patients with AOM and dizziness are presented with a decrease in vHIT gains and the presence of cover saccades only in vertical canal planes, supporting that slight vestibular impairment in these patients may represent pathologic vHIT results only in vertical canal planes.
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Teste do Impulso da Cabeça , Otite Média , Adolescente , Criança , Pré-Escolar , Tontura , Humanos , Otite Média/complicações , Otite Média/diagnóstico , Reflexo Vestíbulo-Ocular , Canais Semicirculares , VertigemRESUMO
BACKGROUND: Bleeding during rhinoplasty leads to many undesirable effects, such as loss of vision in the surgery area, complications during the procedure, and postoperative complications. The most important effect that increases bleeding is hemodynamic changes during surgery. Considering that osteotomy is the most challenging process in rhinoplasty, this study aimed to examine the hemodynamic changes during osteotomy and changes in the depth of anesthesia. METHODS: A total of 50 patients, aged 18 to 65 years with an ASA (American Society of Anesthesiology) score of 1 and 2, who underwent osteotomy during rhinoplasty under general anesthesia, were examined retrospectively. After routine monitoring, the patients underwent general anesthesia induction and endotracheal intubation. Before the surgery, they received remifentanil 1âµg/kg as an intravenous bolus followed by 0.5âµg/(kg·min) as intravenous infusion until the end of the surgery. The hemodynamic parameters and depth of anesthesia [bispectral index (BIS) values] of the patients were examined before anesthesia, 10âminutes before osteotomy, during osteotomy, and 10âminutes after osteotomy. RESULTS: A significant difference was found in heart rate (beats/min), systolic and diastolic blood pressures (mm Hg), and BIS values of the patients measured before, during, and after osteotomy (P < 0.001). The heart rate, systolic and diastolic blood pressures, and BIS values were significantly higher during osteotomy. Until the 10th minute after osteotomy, all 4 parameters nearly reached the values measured before osteotomy. CONCLUSIONS: Osteotomy directly affects hemodynamic parameters and depth of anesthesia. Hence, it is of utmost importance that the analgesic need and depth of anesthesia are adequately monitored and adjusted during osteotomy. By suppressing hemodynamic stress responses, the amount of bleeding can be reduced, thus increasing the surgical success and the patient's comfort.
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Rinoplastia , Adolescente , Adulto , Idoso , Anestesia Geral , Pressão Sanguínea/efeitos dos fármacos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Hemodinâmica/efeitos dos fármacos , Humanos , Infusões Intravenosas , Intubação Intratraqueal , Masculino , Pessoa de Meia-Idade , Osteotomia , Remifentanil/farmacologia , Estudos Retrospectivos , Adulto JovemRESUMO
BACKGROUND: There are neuro-ophthalmologic findings in patients with communicant hydrocephalus (CH). PURPOSE: To investigate the relationships of the optic canal and carotid canal classifications at sphenoid sinus and anterior clinoid process (ACP) pneumatization in patients with CH. MATERIAL AND METHODS: In this multicentric retrospective cross-sectional study, the cranial computed tomography (CT) images of 38 patients with CH (20 men, 18 women) and 40 controls (25 men, 15 women) were included. Optic and carotid canal classification at sphenoid sinus, ACP pneumatization, and sphenoid sinus septation were evaluated. RESULTS: In the CH group, type 3 optic canal was detected in 21.1% of the patients and type 4 optic canal was detected in 2.6% of the patients on the left side which was significantly different from the control group (P<0.05). In the CH group, type 3 carotid canal was detected in 21.1% of the patients (left) and 18.4% of the patients (right). ACP pneumatization was present in 13.2% of the patients in the CH group bilaterally. There were positive correlations between optic canal classifications and ACP pneumatization (P<0.05). There were also positive correlations between the right and left carotid canal classifications and ACP pneumatization (P<0.05). CONCLUSION: To avoid complications, CT should be evaluated carefully in patients with CH before surgical interventions in sphenoid sinuses and surgeons should work carefully in the sphenoid sinus or adjacent structures. The protrusion possibility of the optic canal or carotid canal to the sphenoid sinus may be higher in pneumatized ACP patients.
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Hidrocefalia/diagnóstico por imagem , Osso Esfenoide/anatomia & histologia , Osso Esfenoide/diagnóstico por imagem , Seio Esfenoidal/anatomia & histologia , Seio Esfenoidal/diagnóstico por imagem , Osso Temporal/anatomia & histologia , Osso Temporal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
The aim of this prospective study was to analyze the voice and quality-of-life outcomes of microscopic diode laser surgery (MDLS). The study was conducted on a series of 46 patients with Tis-T1a glottic carcinoma treated with microscopic endolaryngeal diode laser surgery. Patients were asked to complete the Voice Handicap Index and quality-of-life questionnaires of the European Organization for Research and Treatment of Cancer. When comparing the pre- and postoperative scores, there were significant difference on the physical scores (P = .014) of the patients who underwent type III cordectomy and functional (P = .022), emotional (P = .002), and overall scores (P = .005) of the patients who underwent type IV cordectomy, in the direction of better quality of voice after MDLS. The postoperative functional, physical, emotional, and overall scores of groups were significantly increased with the extension of resection.
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Carcinoma/cirurgia , Neoplasias Laríngeas/cirurgia , Lasers Semicondutores/uso terapêutico , Microscopia Confocal/métodos , Qualidade de Vida , Qualidade da Voz , Adulto , Idoso , Carcinoma/patologia , Carcinoma/fisiopatologia , Feminino , Glote/patologia , Glote/fisiopatologia , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/fisiopatologia , Laringectomia/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Período Pós-Operatório , Estudos Prospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: The objectives of the study were to evaluate the vestibular impairment in children with otitis media with effusion (OME) and dizziness by using vHIT test, and to compare their results with healthy children. METHODS: The study population consisted of 30 pediatric patients with OME and dizziness and 30 healthy children, age between 4 and 15. Otoscopic and tympanometric examination and vHIT testing were performed to all subjects. vHIT test parameters were compared between pediatric patients with OME and dizziness and healthy children. Additionally, the differences of the mean vHIT gains between tympanogram types, otoscopic findings and the presence of saccades were analyzed. RESULTS: The mean vHIT gains and gain asymmetry values of patients with OME and dizziness and healthy children were comparable. No significant difference was observed between the mean vHIT gains of patients with type B and type C2 tympanogram. Covert saccades were observed in 57% of the patients with OME and dizziness. None of the patients had over saccades and none of the healthy children had saccades. CONCLUSION: Our study is a preliminary study analyzing the vestibular impairment in children with OME and dizziness using vHIT test. Based on our results, it can be assumed that the children with OME and dizziness usually don't have a great vestibular impairment that can be detected with vHIT test. The covert saccades detected in this patient group are accepted as a sign of slight vestibular impairment.
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Tontura/fisiopatologia , Teste do Impulso da Cabeça/métodos , Otite Média com Derrame/fisiopatologia , Doenças Vestibulares/diagnóstico , Testes de Impedância Acústica , Estudos de Casos e Controles , Criança , Tontura/complicações , Feminino , Humanos , Masculino , Otite Média com Derrame/complicações , Otoscopia , Reflexo Vestíbulo-Ocular , Movimentos SacádicosRESUMO
AIM: The present study aimed to compare edema and ecchymosis in the early and late postoperative periods following the application of different surgical techniques (open and endonasal) and different types of lateral osteotomy (internal and external). METHODS: The files and photographs of a total of 120 patients whose records were regularly maintained/updated and who underwent septorhinoplasty operation with the same surgeon were retrospectively evaluated. Sixty-nine (57.5%) patients were women and 51 (43.5%) were men. The patients were divided into 4 different groups according to the operations they underwent as follows--Group I: open technique septorhinoplastyâ+âinternal/continuous lateral osteotomy; Group II: endonasal rhinoplastyâ+âinternal/continuous lateral osteotomy; Group III: open technique septorhinoplastyâ+âexternal/perforating lateral osteotomy; and Group IV: endonasal rhinoplastyâ+âexternal/perforating lateral osteotomy. Postoperative edema and ecchymosis, and lateral nasal wall mucosal damage because of osteotomy were evaluated. RESULTS: Postoperative second day edema and ecchymosis scores were statistically significantly better in patients in Group II compared with the patients in Group I (Pâ=â0.010 and Pâ=â0.004, respectively). Postoperative first day edema and postoperative seventh day ecchymosis scores were statistically significantly better in the patients in Group IV compared with the patients in Group III (Pâ=â0.025 and Pâ=â0.011, respectively). Intraoperative bleeding was similar in all groups. The nasal tip was more flexible in patients who underwent closed technique rhinoplasty. Unilateral mucosal damage occurred in 3 patients (4%) with internal lateral osteotomy, whereas no mucosal damage was present in patients with external osteotomy. CONCLUSIONS: The difference in the rate of edema and ecchymosis in the early postoperative period between the closed technique rhinoplasty and the open surgical approach was statistically significant, whereas osteotomy did not cause a significant difference. According to these results, the authors suggest endonasal surgery to prevent the development of edema and ecchymosis, whereas the choice of lateral osteotomy should be dependent on the experience of the surgeon.
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Equimose/etiologia , Edema/etiologia , Osteotomia/efeitos adversos , Complicações Pós-Operatórias , Rinoplastia/efeitos adversos , Adolescente , Adulto , Equimose/diagnóstico , Edema/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cavidade Nasal , Estudos Retrospectivos , Adulto JovemRESUMO
A clinicopathological analysis of multicentricity in patients treated with either supraglottic horizontal laryngectomy or supracricoid partial laryngectomy for supraglottic squamous cell carcinoma of the larynx was conducted. This study included 63 patients who underwent supracricoid partial laryngectomy or supraglottic horizontal laryngectomy for T2 or T3 supraglottic laryngeal squamous cell carcinoma. The patients were divided into two groups: Group 1 included patients with one focus of the tumor (monocentric), and Group 2 included patients who had more than one focus of the tumor (multicentric) diagnosed after pathology examination. Forty-eight (76.2 %) of the patients had one focus of the tumor (Group 1) and 15 (23.8 %) of the patients had more than one focus of the tumor (Group 2). The rates of lymph node metastasis in Group 1 and Group 2 were 12.5 and 60 %, respectively. The second focus was invasive in seven (46.6 %) of the patients, carcinoma in situ in six (40 %) of the patients, and both invasive and carcinoma in situ in two (13.3 %) patients. The overall 3- and 5-year survival rates of Groups 1 and 2 were 77.1-66.7 % and 56.2-46.7 %, respectively. With regard to survival rates, no statistically significant difference was observed between Group 1 and Group 2 (p = 0.576). The lack of statistical significance might have been associated with the low sample size. Although multicentric tumors of the supraglottic larynx have high incidence of nodal metastasis, no significant increase in the rate of recurrence was determined.