Primary rhinoplasty in unilateral incomplete cleft lip nose: A 4-year follow up.

OBJECTIVE: The aim of this study was to assess aesthetic result and parents' satisfaction of primary rhinoplasty in unilateral incomplete cleft lip patients. METHODS: Thirty-two consecutive unilateral incomplete cleft lip nose patients were operated in the tertiary hospital from 2012 to 2014. Primary rhinoplasty was done following the principle of the modified McComb repair. Nostril height, dome height, alar base width, nostril height to width ratio, dome height to nostril width ratio, nasolabial angle and columella deviation were measured on preoperative and 4-year postoperative photographs. Visual analogue scale (VAS) was assessed for each parent before the surgery and 4-year postoperatively. RESULTS: The preoperative and postoperative photographic analysis revealed significant improvement in nostril height ratio and dome height ratio. Nostril height to width ratio and dome height to nostril width ratio significantly increased. Alar base width significantly decreased. The nasolabial and columella deviation angles improved significantly. The mean parent-related satisfactory assessment based on the VAS showed statistically improved scores postoperatively. CONCLUSION: We believe this technique with minimal dissection could improve symmetry and satisfaction, although every individual surgeon could choose his preferable technique based on the components of correction that he is capable of executing reliably while considering the long-term outcomes.

Effect of Paracetamol versus Ibuprofen in Adenotonsillectomy.

INTRODUCTION: The present study aimed to compare the effects of paracetamol and ibuprofen on pain, bleeding, nausea, and vomiting following adenotonsillectomy in children. MATERIALS AND METHODS: This was a prospective, double-blinded, randomized clinical trial. Block randomization was used to assign 50 patients to two groups of paracetamol and ibuprofen. In the paracetamol group, subjects received 15 mg/kg oral paracetamol 30 minutes before the induction of anesthesia, followed by the same dosage every 6 hours postoperatively. Meanwhile, the ibuprofen-treated group took 10 mg/kg oral ibuprofen 30 minutes before and every 6 hours after the operation. The subjects in both groups received the medication for three postoperative days. The postoperative pain score was assessed 6 hours after the surgery and during the second and the third postoperative days. Nausea and vomiting episodes were recorded in the first postoperative day and first postoperative week. RESULTS: Based on the results, intraoperative and postoperative bleeding in both groups was not significantly different. The mean score of pain in the first postoperative day (6 hours after the surgery) and the second and the third postoperative days did not show any statistical difference. The ibuprofen group experienced fewer vomiting episodes, compared to the paracetamol group during the first postoperative day (P=0.011). Vomiting episodes in the first postoperative week did not illustrate any significant difference. CONCLUSION: As evidenced by the results of the current study, Ibuprofen had the same effect on the alleviation of postoperative pain, caused fewer vomiting episodes, and did not cause excessive bleeding as an NSAID. Therefore, oral administration of ibuprofen is suggested for pain relief and management of other complications following adenotonsillectomy in children.

Treatment of Head and Neck Venous Malformations with Sodium Tetradecyl Sulfate.

OBJECTIVE: The purpose of this study was to discuss the clinical outcomes and complications of treating venous malformations with sclerotherapy, with sodium tetradecyl sulfate as the sclerosing agent. STUDY DESIGN: Case series with planned data collection. SETTING: Amiralam Hospital-a referral otolaryngology-head and neck surgery hospital affiliated with Tehran University of Medical Sciences. SUBJECTS AND METHODS: A total of 345 patients with venous malformations were treated with sclerotherapy with sodium tetradecyl sulfate 3% (1 mL for every 1 cm3 of the lesion). The venous malformation location, treatments before the current sclerotherapy with sodium tetradecyl sulfate, the number of sclerotherapy sessions, and complications resulting from sclerotherapy were recorded. Follow-up assessments were done for a minimum of 1 year following the procedure. A favorable outcome was defined as a 50% decrease in the lesion size based on clinical and radiologic assessments. RESULTS: A total of 759 injection sessions were documented, ranging from 1 to 6 injections per patient (mean = 3.1). The follow-up duration ranged from 12 to 84 months (mean = 55 months). Based on clinical assessment, a 50% reduction of size was reported for 95.6% of the patients. According to the imaging before and after the procedures, a 50% reduction of size was seen among 67.3% of the patients. CONCLUSION: The results of the study showed that the use of sodium tetradecyl sulfate as a sclerosing substance can effectively reduce the size of venous malformation lesions.

Rate of Occult Cervical Lymph Node Involvement in Supraglottic Squamous Cell Carcinoma.

INTRODUCTION: To assess the rate of cervical lymph node involvement in patients with supraglottic squamous cell carcinoma (SCC) with no lymph node in clinical assessments and radiological studies. MATERIALS AND METHODS: Fifty-six patients who underwent elective dissection of the cervical lymph node of the second through fourth level were enrolled, and pathologic evaluation of the dissected lymph nodes was performed. Lymph node involvement and association between tumor grade, smoking and gender with lymph node involvement were assessed. RESULTS: The rate of the occult neck metastasis in this series was 37.5%. There was no statistically significant association between lymph node involvement and tumor grade, smoking, or gender. CONCLUSION: Based on the results of our study, we recommend elective bilateral neck dissection in all stages of N0 supraglottic SCC patients.