Uvulopalatopharyngoplasty for nasal blockage 21 years after total rhinectomy.

BACKGROUND: Total rhinectomy is an invasive procedure that significantly impairs the intranasal turbulence, humidification and heating of inspired air. The use of uvulopalatopharyngoplasty for the treatment of sleep-disordered breathing disorders such as primary snoring and obstructive sleep apnoea has diminished over the past years because of the emergence of less invasive procedures and alternative therapeutic options. This clinical record presents the treatment of a long-term side effect of total rhinectomy using uvulopalatopharyngoplasty. CASE REPORT: In 1997, a 62-year-old male underwent total rhinectomy for a nasal schwannoma, followed by rehabilitation with a nasal prosthesis. Twenty-one years later, he presented with severe complaints of nasal blockage and breathing difficulties during both daytime and night-time. Clinical examination revealed no major anomalies besides significant velopharyngeal narrowing. Thus, in 2019, uvulopalatopharyngoplasty was performed to re-establish velopharyngeal patency. Hereafter, the symptoms of nasal blockage disappeared, resulting in an improved quality of life. CONCLUSION: Uvulopalatopharyngoplasty may prove useful to treat selected patients with daytime breathing difficulties due to velopharyngeal narrowing.

Electroacupuncture for postoperative pain after nasal endoscopic surgery: study protocol for a pilot randomized controlled trial.

BACKGROUND: Postoperative pain is common after nasal endoscopic surgery. It interferes with the quality of sleep and delays postoperative recovery. Acupuncture is an effective tool for pain management. However, electroacupuncture specifically for the relief of postoperative pain after nasal endoscopic surgery has not yet been studied in a randomized controlled trial. METHODS/DESIGN: This randomized sham-controlled patient- and assessor-blind pilot trial has been designed to evaluate the efficacy and safety of electroacupuncture in managing postoperative pain following nasal endoscopic surgery to treat sinusitis due to nasal polyps. Altogether, 30 participants will be randomly allocated to an electroacupuncture or non-invasive sham control in a 1:1 ratio. Treatment will occur within 2 h before the operation, immediately after the operation upon arrival in the recovery ward, and once daily for 3 days. The primary outcome is the pain numerical rating scale, which will be analyzed using the area under the curve. The secondary outcome measures include heart rate and blood pressure after the operation, sleep quality during the hospital stay (actigraph), quality of recovery, and the 36-item short form health survey. This trial will use an intention-to-treat analysis. DISCUSSION: This pilot randomized controlled trial will explore the feasibility of the further clinical application of electroacupuncture for the management of postoperative pain. It will inform the design of a further full-scale trial. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1900024183. Registered on 29 June 2019.

[Effects of hyperbaric oxygen on mucosal inflammatory response after nasal surgery in rabbits].

Objective:To observe the effect of hyperbaric oxygen therapy for the inflammation of rabbit nasal in postoperation period, to investigate the clinical feasibility of hyperbaric oxygen therapy in reducing the inflammatory reaction and promoting mucosal healing in nasal recovery stage after surgery.Method:A total of 16 Japanese white rabbits were randomly assigned to hyperbaric oxygen group and non hyperbaric oxygen group, with 8 in each, and another 5 was divided into normal control group. The non hyperbaric oxygen group was in the normal atmospheric environment, the hyperbaric oxygen group was given hyperbaric oxygen treatment on the fifth day after the operation. All the animals were sacrificed to observe the morphological changes and pathological changes of the mucosa in the bilateral inferior turbinate surgery area at sixth weeks after operation. The normal control group was taken the same part of mucosa.Result:Specimen: hyperbaric oxygen group postoperative empyema in 2 side, 8 side of non hyperbaric oxygen group, hyperbaric oxygen group was significantly reduced compared with non hyperbaric oxygen group, the difference was statistically significant (P< 0.05). Pathological changes: in the hyperbaric oxygen group, the infiltration of inflammatory cells was mild in 12 sides and moderate in 4 sides; the non hyperbaric oxygen group was mild in 1 sides, moderate in 13 sides, and severe in 2 sides, the hyperbaric oxygen group was significantly lower than the non hyperbaric oxygen group, the difference was statistically significant (P< 0.01).Conclusion:Under the condition of this experiment, hyperbaric oxygen therapy can significantly reduce the inflammatory response of rabbit nasal mucosa after operation, and reduce the accumulation of purulent secretion.