Could nasal septal deformities type 5 and 6 be a predictive factor of the indi- vidual genetic predilection for the onset of an acute coronary syndrome?.

OBJECTIVES: the possible impact of nasal septal deformities (SD) on cardiac pathology has not been well studied, despite growing evidence among data showing that upper air-way obstruction has a negative effect on cardiac function in general and a "deviated nasal septum" being considered one of the most frequent factors responsible for impaired nasal breathing. METHODS: a retrospective, case-control, double-blind study was performed on 249 patients who survived an acute coronary syndrome (ACS) attack. All patients underwent coronary angiography and were divided into coronary angiography positive (123 pts) and coronary angiography negative (126 pts) groups. The quality of nasal breathing was not considered in this study, but morphological aspects of the nasal septum (nasal septal deformities) were observed by anterior native rhinoscopy and endoscopic examination of the nose following the application of superficial anaesthesia. Mladina classification of nasal septal deformities was used. RESULTS: there was a statistically significant difference between coronary angiography negative and positive patients in Mladina type 1 to Mladina type 7 groups (p=0.000, X²=54.605). The incidence of nasal SD types 5 and 6 was higher in the group of ACS patients with the positive coronary angiography, whereas general distribution of the particular types of nasal septal deformities as they appear in the general population was found in the coronary angiography negative group. CONCLUSION: the fact that types 5 and 6 are inherited deformities and not related to trauma against the nose suggests the possible genetic predisposition for the onset of ACS with positive coronary angiography.

Osteoma of the internal auditory canal.

Osteomas of the internal auditory canal, inaccesible to clinical examination, are rare lesions. There are only 14 cases of osteomas and exostoses of the internal auditory canal reported in the international medical literature. A patient with an osteoma of the internal auditory canal is presented, along with differential diagnosis and possible etiologic factors for the lesion. The auditory brainsteam evoked response testing showed increased absolute latencies of 1 wave and discrepancy of the wave morphology due to bony compression of the eight nerve in the internal auditory canal. Computed tomography showed a bony growth in the internal auditory canal. Magnetic response showed no abnormalities. No surgery was performed since the symptoms improved by conservative therapy.

CO2 laser anterior turbinectomy in the treatment of non-allergic vasomotor rhinopathia. A prospective study upon 78 patients.

Preliminary results obtained in the treatment of non-allergic vasomotor rhinopathia by CO2 laser are presented. A group of 78 subjects, 35 males and 43 females, aged 18-48 years, mean age 27.6 years, were followed: subjective assessment of nasal breathing quality, anterior rhinomanometry, cytologic findings and saccharine test of nasal clearance. The parameters were observed preoperatively and after surgery. A 400 CO2 Surgical Laser Coherent Medical was used (power density, 140 w/cm2). The beam was applied upon the upper medial quadrant of the head of inferior turbinate by a continuous pulse (7-10 sec) through a Carl Zeiss surgical microscope, at a 10x magnification and focal length of 400 mm. The mean preoperative values of the anterior rhinomanometry were 0.669 and 0.851 Pa sec/ccs for inspiration and expiration, respectively. After the surgery, the mean values were even better, i.e. 0.361 Pa sec/ccs for inspiration, and 0.456 Pa sec/ccs for expiration. The morphological and functional conditions of nasal mucosa were also examined. The former was evaluated using cytologic smears of the nasal mucosa layer, and the latter by the saccharine test of nasal clearance. Normal cytologic findings were found preoperatively in 87% of all cases studied. Saccharine test was normal in 67% of cases. After laser surgery, the cytologic findings and saccharine test results were normal in 92% and 89% of cases, respectively. The subjective patients' assessment of nasal patency pointed to obvious success in 41 out 45 subjects treated.

[Branchial cyst and fistula of the first branchial cleft. Apropos of a case]. / Kyste branchial et fistule du premier sillon branchial. Présentation d'un cas.

We describe a case of a fistula from the first branchial cleft. At the otorhinolaryngology clinic of the Faculty of Medicine at the University of Zagreb we have operated on more than 100 cases of congenital abnormalities of the branchial arches. However, it is only recently that we had the first case of fistula from the first branchial cleft. We report the clinical aspects and operative course in detail.