Evaluation of outcomes in patients given dexmedetomidine in functional endoscopic sinus surgery.

OBJECTIVES: We aimed to evaluate the effects of dexmedetomidine hydrochloride (DEX) on hemodynamic parameters and on surgeon and patient satisfaction during functional endoscopic sinus surgery (FESS). METHODS: Forty patients who were to undergo FESS were enrolled in this randomized, prospective, controlled study. In the DEX group, conscious sedation was induced with an infusion of 1 microg/kg of DEX 10 minutes before surgery, followed by an infusion of DEX at 0.2 microg/kg per hour. A control group was given identical amounts of saline solution. During the procedure, hemodynamic data were recorded. The patients evaluated their pain on a visual analog scale (VAS). Intraoperative bleeding was rated on a 6-point scale for evaluation of operative field visibility. RESULTS: We observed that the DEX group had lower bleeding scores (p = 0.019). The heart rates were lower in the DEX group at the time of induction (p = 0.052) and in the 1st (p = 0.009) and 20th minutes (p = 0.039) of induction. The mean blood pressure values were lower in the DEX group in the 5th (p < 0.001), 45th (p = 0.003), and 60th (p = 0.05) minutes of induction. The VAS score was lower in the DEX group in the 30th postoperative minute (p = 0.001); however, the VAS score was lower in the control group after the 12th hour (p < 0.001). Postoperative side effects such as nausea, tachycardia, hypotension, and vomiting were significantly less frequent in the DEX group (p < 0.001). CONCLUSIONS: We observed that the intraoperative bleeding, hemodynamic stability, and VAS scores were better and the side effects were less frequent in the DEX group.

Hearing evaluation in preeclamptic patients.

OBJECTIVE: To evaluate the pathological effects of preeclampsia on hearing levels in pregnant women by pure-tone audiometry and brainstem auditory-evoked potentials (BAEPs). METHODS: Both ears in 30 preeclamptic patients and 38 women with uncomplicated pregnancy matched by maternal age and gestational age were investigated based on BAEPs and pure-tone audiometry. Hearing thresholds were within the normal ranges in all subjects prior to pregnancy. We compared the results of hearing levels and auditory pathway functions between the two groups. RESULTS: Statistically significant differences in pure-tone audiometry results were found between the two groups (p < 0.05). However, these results were not clinically significant because all pure-tone thresholds were lower than 20 dB (normal hearing abilities). The differences between BAEPs were not statistically significant (p > 0.05). CONCLUSION: This study suggests that preeclampsia does not markedly affect hearing function unless it causes secondary vascular occlusion of microcirculation related to hearing.

Combined aplasia of sphenoid, frontal, and maxillary sinuses accompanied by ethmoid sinus hypoplasia.

OBJECTIVE: To report the case of a woman who had combined aplasia of sphenoid, frontal, and maxillary sinuses accompanied by ethmoid sinus hypoplasia. METHODS AND RESULTS: A 47-year-old woman presented with complaints of headache, nasal obstruction, and postnasal drainage. She had no previous history of either facial trauma or systemic diseases affecting the skeletal system. She had a history of functional endoscopic sinus surgery twice in an other institution. However, the surgeries did not significantly alter her symptoms. Coronal and axial computed tomographic scans of the nose and the paranasal sinuses showed poorly developed frontal, sphenoid sinuses, ethmoid cells, and very severe and profound hypoplasia (aplasia) of bilateral maxillary sinuses. CONCLUSIONS: To our knowledge, this patient seems to be the first case having combined aplasias of the sphenoid, frontal, and maxillary sinuses with hypoplastic ethmoid cells without any systemic or skeletal disease.

A rhinolith surrounded by a nasal polyp.

Rhinoliths are uncommon mineralized nasal mass in children and adolescents. We reported a case of unilateral rhinolith that presented as a nasal polyp. A 29-year-old woman who had right-sided nasal purulent discharge, nasal obstruction, intermittent epistaxis, and posterior nasal drip for 6 months was admitted to our department. Nasal examination revealed a nasal mass between the inferior turbinate and the nasal septum, presenting as a nasal polyp or a nasal tumor. Paranasal sinus computed tomographic scan confirmed a calcified mass in soft tissue. We removed the rhinolith and the soft tissue that was around it with a transnasal endoscopic approach. Histologic analysis of the soft tissue identified inflammatory nasal polypoid tissue.