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1.
Indian J Otolaryngol Head Neck Surg ; 74(Suppl 3): 3824-3831, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36742531

RESUMO

Introduction: We decided to compare dexmedetomidine with propofol regarding several anesthetic and surgical aspects, during stapedotomy done under conscious sedation. Materials and Method: Thirty patients aged 20-50 years with (American Society of Anesthesiology) ASA class I-II, were assigned to two groups of propofol and dexmedetomidine using a random number table. In dexmedetomidine group, patients received dexmedetomidine infusion (0.5 µg/kg/h) and in the control group, propofol was administered (3 mg/kg/h).Time to reach the desired Ramsey Sedation Score (RSS) and time to reach Aldrete score ≥ 9; incidence of inadvertent movement and amnesia; as well as patients' and surgeons' level of satisfaction and degree of bleeding was recorded. Data on hemodynamic variables were monitored and recorded at several intervals. Results: The mean time taken to reach the RSS (2-4) was 10.3 ± 2.1 min in dexmedetomidine group and 3.1 ± 1.2 min in propofol group. Time to reach Aldrete score ≥ 9 for patients sedated with dexmedetomidine was 8.6 ± 2.1 min and for propofol group was 4.6 ± 1.4 min (p value < 0.05).There were also significant differences between two groups in terms of surgeon's satisfaction with sedation, and the amount of intra operative bleeding. Conclusion: According to the results of this study, it can be concluded that dexmedetomidine is a better choice for conscious sedation than propofol. However, the time to reach the required sedation in the dexmedetomidine group was significantly longer.

2.
Iran J Allergy Asthma Immunol ; 19(5): 529-533, 2020 Oct 18.
Artigo em Inglês | MEDLINE | ID: mdl-33463120

RESUMO

The exact mechanisms of Adenoid hypertrophy (AHT) pathogenesis and otitis media with effusion (OME) are unclear but there is increasing evidence that allergies may play a role. We aimed to investigate the prevalence of atopy and the effect of anti-allergic drugs in patients with AHT and OME. In a non-randomized, prospective cross-sectional study, 122 patients younger than 18 years of age with AHT or OME were included. Atopic patients based on clinical symptoms of allergic disorders and/or elevated levels of total serum immunoglobulin E (IgE) were referred to allergists and tested for allergen sensitization by skin prick test (SPT). Atopic patients were treated with nasal corticosteroids and antihistamines. Response to treatment was evaluated by comparing symptoms score before and after the treatment. In this study 122 patients were evaluated, 116 of them had AHT and 30 patients had OME. The mean age of participants was 6.7±2.4 years old and 68 of them (55.7%) were male. Allergic symptoms were observed in 38 patients with AHT (32.7%) and nine patients with OME (30%). Among the total cases, 34 patients (28%) were considered atopic. SPT was performed on 25 (73%) cases of atopic patients, with 11 (44 %) positive results. The mean symptom score of AHT and OME decreased significantly after treatment respectively, (p=0.001, p=0.007). According to this study, atopy was relatively common in patients with AHT and OME. Treatment with nasal corticosteroid and antihistamines were effective in these patients.


Assuntos
Tonsila Faríngea/imunologia , Hipersensibilidade/imunologia , Hipertrofia/imunologia , Otite Média com Derrame/imunologia , Otite Média/imunologia , Criança , Estudos Transversais , Feminino , Humanos , Hipersensibilidade Imediata/imunologia , Imunoglobulina E/imunologia , Masculino , Prevalência , Estudos Prospectivos , Testes Cutâneos/métodos
3.
Eur Arch Otorhinolaryngol ; 277(1): 147-150, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31616975

RESUMO

INTRODUCTION: In this study, we decided to investigate the changes in elasticity of the nasal tip using Columellar strut graft versus toung in groove method over a year after rhinoplasty. MATERIALS AND METHODS: In this before-after randomized clinical trial study, 44 candidates for rhinoplasty were enrolled Columellar strut graft group (n = 22) and toung in groove group (n = 22). Also 22 patients who referred to ENT clinic without any previous rhinoplasty and without any decision for it during the next year, considered as control group. One group underwent columellar strut graft and the other one underwent tongue in groove rhinoplasty and in control group participants received no intervention. Nasolabial angle and elasticity of the nasal tip were recorded and compared before the surgery, immediately after the surgery, 3 months and one year after the surgery. RESULT: There was no significant difference between the mean elasticity of the nose and the nasolabial angle before the surgery, immediately after the surgery and 3 months after the surgery between the groups. However, there was significant differences in the mean elasticity of the nose and the nasolabial angle between the groups one year after the surgery (P value < 0.05). Pearson correlation coefficient test showed a significant correlation between nasal tip elasticity 3 months and 1 year after rhinoplasty (P = 0.032, r = 0.459) and nasolabial angle 3 months and 1 year after rhinoplasty (P = 0.045, r = 0.431). CONCLUSION: According to the results, it can be concluded that the both the Columellar strut graft and toung in groove methods improve elastic properties of the nasal tip and nasolabial angle after rhinoplasty compare to the control group.


Assuntos
Nariz/fisiopatologia , Rinoplastia/métodos , Adolescente , Adulto , Elasticidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/cirurgia , Próteses e Implantes , Implantação de Prótese , Técnicas de Sutura , Adulto Jovem
4.
J Craniofac Surg ; 30(3): e224-e226, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30807466

RESUMO

INTRODUCTION: This study compared the subjective measurement of difference between the nasal tip and supra tip (TSD) (using eyes) versus objective measurement of TSD (by a ruler) during rhinoplastic surgery to determine the accuracy of subjective measurements among surgeons with varying degrees of experience. MATERIALS AND METHODS: In this analytical observational study, 40 cosmetic rhinoplasty candidates were involved. Those with the history of rhinoplastic surgery were excluded from the study. At the end of the operation, the surgeon was asked to estimate the TSD subjectively. The researcher, without the intervention of the surgeon, remeasured TSD by a presterile ruler. The researcher recorded both objective and subjective TSD measurements and the experience of the surgeon in rhinoplasty in the checklist. RESULT: Of 40 cosmetic rhinoplasty candidates, 17 were operated by a surgeon with >10 years' experience (group 1), and 23 by a surgeon with <5 years' experience (group 2). The results indicated that 5 surgeries (29.4%) in group 1 and 6 surgeries (26.1%) in group 2, had 0-mm difference in subjective and objective measurement. The difference of <1 mm between subjective and objective measurement was achieved in 13 surgeries (76.5%) in group 1 and 13 surgeries (56.5%) in group 2 (P = 0.191). CONCLUSION: According to the results, it can be concluded that the surgeon's experience is effective in reducing the differences in measurements of TSD in both measurement modes.


Assuntos
Rinoplastia , Cirurgiões/estatística & dados numéricos , Humanos , Nariz/cirurgia , Rinoplastia/normas , Rinoplastia/estatística & dados numéricos
5.
J Craniofac Surg ; 30(3): e192-e195, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30608370

RESUMO

INTRODUCTION: This study aimed to evaluate postsurgical changes of nasal tip and lateral nostril characteristics after semi-tongue-in-groove (TIG) technique in open rhinoplasty surgery. MATERIALS AND METHODS: This prospective observational study was performed in a before-after setting on 22 patients who underwent open rhinoplasty surgery using semi-TIG technique. Postoperative photographs were analyzed for nasal tip and lateral nostril changes at several time points (1, 4, and 12 weeks after surgery) and were compared with preoperative photographs. Nasal tip support change after the surgery was also assessed using a purpose-designed device. RESULTS: In total, 22 patients were studied (20 females, 2 males). The tip support increased by 98%, 291.8%, and 377% at certain time points after the surgery. The tip rotation increased significantly at all measuring time points, postoperatively. The length of upper lip increased at all time points after semi-TIG technique. Columellar show and nostril length and height decreased significantly after the surgery. CONCLUSION: The characteristics of the nasal tip and lateral nostrils along with nasal tip support showed significant improvement after the semi-TIG technique. Therefore, this technique is recommended in selected rhinoplasty cases to achieve more favorable objective results.


Assuntos
Nariz/cirurgia , Rinoplastia/métodos , Adulto , Feminino , Humanos , Lábio/anatomia & histologia , Masculino , Nariz/anatomia & histologia , Período Pós-Operatório , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
6.
Eur Arch Otorhinolaryngol ; 276(2): 397-400, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30483942

RESUMO

INTRODUCTION: This study was attempted to investigate the relationship between radiologic and endoscopic findings and pre- and post-operative olfactory scores in chronic rhinosinusitis with nasal polyps. MATERIALS AND METHODS: In this study, 40 patients aged 19-64 years with chronic rhinosinusitis with nasal polyps (CRSwNP) undergoing endoscopic sinus surgery were involved. The patients' olfactory status was evaluated using Smell Identification Test (Iran SIT) before and 3 months after the surgery. Patients' nasal endoscopic signs were recorded using Modified Lund-Kennedy scoring system before and 3 months after the surgery and radiological symptoms were recorded based on Lund-Mackay CT scoring before the surgery. Then the relationship between olfactory status and endoscopic and radiological findings was investigated. RESULTS: With respect to mean of olfactory score, a significant difference was observed before and after the surgery (p value = 0.001). There was a significant difference between means of pre- and post-operative endoscopy scores (p value = 0.001). Pre-operative endoscopic and CT scan scores had a negative correlation with pre- and post-operative olfactory scores (p value < 0.05). Pre-op. olfactory scores had negative correlation with post-op. endoscopy scores (p value = 0.02). Post-op. olfactory scores had negative correlation with post-op. endoscopy scores but was not statistically significant (p value = 0.22). CONCLUSION: Our results revealed that pre-operative endoscopy and radiology findings were consistent with the olfactory status of patients with CRSwNP before and after endoscopic sinus surgery.


Assuntos
Endoscopia , Pólipos Nasais/cirurgia , Transtornos do Olfato/cirurgia , Seios Paranasais/diagnóstico por imagem , Rinite/cirurgia , Sinusite/cirurgia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pólipos Nasais/complicações , Transtornos do Olfato/etiologia , Seios Paranasais/cirurgia , Rinite/complicações , Sinusite/complicações , Tomografia Computadorizada por Raios X , Adulto Jovem
7.
J Craniofac Surg ; 29(8): 2110-2113, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30334917

RESUMO

INTRODUCTION: Rhinoplasty is a common plastic surgery that potentially has some complications such as postoperative deformities and breathing problems. A humpy nose is among the main reasons for rhinoplasty. Nasal valve (the narrowest part of the nasal airway) collapse may be occurred after nasal hump removal. Spreader graft is essential after more than 3 mm nasal hump removal. But the value of this graft is unknown for patients with nasal hump smaller than 3 mm. Mattress suture is another technique for widening the nasal valve angle. This study compares the effects of spreader graft and mattress suture technique on postoperative deformity and nasal valve patency in patients with nasal hump smaller than 3 mm as compared with control group (no graft and suture). METHODS: In this clinical trial study 210 patients who underwent rhinoplasty with 2 different techniques involved. Their postoperative deformity and nasal valve patency were evaluated by subjective (questionnaire and digital photography) method before and after rhinoplasty during 6 months follow-up. RESULTS: Statistically, nasal obstruction had no significant difference before and after rhinoplasty and no significant difference was observed between spreader graft and mattress sutures (P > 0.05), but significantly better results than control group (P < 0.05). CONCLUSION: In this study the results of nasal valve patency of 2 techniques were similar. Because of several considerations in spreader graft technique such as needing to septoplasty in this technique even in patients without septal deviation that causes longer surgical duration, excessive blood loss, it is recommended to use Mattress suture in patients with nasal hump smaller than 3 mm.


Assuntos
Cartilagens Nasais/transplante , Obstrução Nasal/epidemiologia , Deformidades Adquiridas Nasais/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Rinoplastia/métodos , Técnicas de Sutura , Adulto , Feminino , Humanos , Masculino , Septo Nasal/cirurgia , Rinoplastia/efeitos adversos , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
8.
Eur Arch Otorhinolaryngol ; 275(5): 1235-1237, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29516178

RESUMO

INTRODUCTION: The nasal tip refinement is the most difficult stages of rhinoplasty surgery; whereas, the most important part in terms of beauty and performance is the projection refinement. Lateral crural overlay (LCO) is a common technique in rhinoplasty used to reduce nasal tip projection and increase nasal tip rotation. Given the important role of lower lateral cartilage (LLC) in the non-collapse of nasal external valve and air passage, it is necessary to evaluate the changes in nasal elasticity caused by surgery. MATERIALS AND METHOD: The design of this quasi experimental study was self-control (before-after). Tip plasty was performed on twenty-four samples (12 cases of rhinoplasty) using LCO technique. To examine the elasticity, the strain index of each ala was measured by a mechanical device, invented by the author, before and after the operation. RESULTS: Out of 24 samples 12 were female and 12 were male. The mean strain index of nasal ala before and after the surgery was 0.24 ± 0.046 and 0.19 ± 0.040 respectively (P < 0.001). The mean strain index of nasal ala before and after surgery for female was 0.27 ± 0.046 and 0.20 ± 0.050 respectively (P = 0.004). For male, it was 0.20 ± 0.018 before and 0.18 ± 0.020 after the surgery. (P < 0.001). CONCLUSION: Using LCO surgical technique for nasal tip refinement can lead to nasal elasticity increase regardless of gender; although, LLC is cut during implementing this technique.


Assuntos
Nariz , Rinoplastia , Adulto , Cartilagem/cirurgia , Elasticidade , Feminino , Humanos , Masculino , Nariz/patologia , Nariz/cirurgia , Avaliação de Resultados em Cuidados de Saúde , Rinoplastia/efeitos adversos , Rinoplastia/métodos , Rotação
9.
J Diabetes Metab Disord ; 17(2): 173-179, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30918852

RESUMO

PURPOSE: Diabetes mellitus (DM) is a heterogeneous group of metabolic disorders characterized by chronic hyperglycemia that results by relative or absolute insulin deficiency. Hearing disorders is common otological disorders in diabetic patients. This study aimed to investigate the frequency of hearing impairment among DM patients and its association with diabetes complications and blood sugar control. METHODS: This analytical cross-sectional study was conducted from 2016 to 2017 on 81 patients with type 2 diabetes mellitus (T2DM), aged 40-65 years who were referred to Yazd diabetic research center. Air conduction pure tone hearing thresholds were obtained for each ear at frequencies of 250, 500, 1000, 2000, 4000 and 8000 Hz. We defined hearing impairment as the pure-tone average ≥ 25 dB hearing level of pure-tone thresholds at low frequencies (500; 1000; and 2000 Hz) and high frequencies (4000 and 8000 Hz. The demographic data and diabetes complications frequency were gathered. All statistical analysis was done in SPSS 22. RESULTS: The mean (±SD) age of participants was 56.38 ± 5.68 years (range 40-65 years), 32(39.5%) were males and 49(60.5%) were females. The prevalence of hearing loss in high frequency in right ear was higher in male (p value = 0.047). The grade of diabetic retinopathy and nephropathy were significantly associated with hearing impairment in high frequency in both ears (p value<0.05). Finally, the results showed that even after adjustment of confounding variables using logistic regression analysis there were no relationship between hearing impairment and variables in both ears. CONCLUSION: The hearing impairment was associated with diabetes complications as retinopathy and nephropathy. The association was significant in high frequency.

10.
Eur Arch Otorhinolaryngol ; 274(9): 3513-3518, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28685311

RESUMO

It has been shown that nasal packing after septoplasty is associated with several complications. Our aim was to compare post-septoplasty nasal packing and trans-septal suturing, in terms of complications and outcome of operation. This randomized clinical trial was performed on patients with deviated nasal septum who were candidates for septoplasty. Patients were visited three times after operation (on the first 48 h, first week, and third post-operative month). Participants were checked for having common complications. Rhinomanometric evaluation was performed to measure nasal air flow and airway resistance, as indicators of operation efficacy, both prior to and after surgery. A total of 72 patients were allocated into the two trial arms. Patients in nasal pack group reported higher pain scores on the first 48 h (P < 0.001) and one week after surgery (P < 0.001). Epiphora (P = 0.028), sleep disturbance (P = 0.012), and dyspnea (P < 0.001) were also more commonly observed in patients using nasal pack. Objective evaluation of bleeding demonstrated that more severe bleeding occurred in patients with trans-septal sutures (P = 0.001). No differences were found comparing the indices of rhinomanometry between the two groups. Using trans-septal sutures after septoplasty compared to nasal packing, might be associated with lower frequencies of several specific complications and a lower rate of patients' discomfort. Nevertheless, increase in the risk of bleeding and hematoma was noted in the trans-septal suture group. No differences were observed between the nasal air flow and resistance of patients in the two groups.


Assuntos
Bandagens , Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Hemorragia Pós-Operatória/terapia , Rinoplastia/efeitos adversos , Técnicas de Sutura/instrumentação , Suturas , Adulto , Feminino , Humanos , Masculino , Cuidados Pós-Operatórios/métodos , Hemorragia Pós-Operatória/diagnóstico , Rinomanometria
11.
Iran J Otorhinolaryngol ; 29(91): 69-74, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28393053

RESUMO

INTRODUCTION: Bleeding is a common concern during functional endoscopic sinus surgery (FESS) that can increase the risk of damage to adjacent vital elements by reducing the surgeon's field of view. This study aimed to explore the efficacy of topical tranexamic acid in reducing intraoperative bleeding. MATERIALS AND METHODS: This double-blind, randomized clinical trial was conducted in 60 patients with chronic rhinosinusitis with polyposis (CRSwP) who underwent FESS. Patients were randomly divided into two groups; tranexamic or saline treatment. During surgery, normal saline (400 mL) or tranexamic acid (2 g) in normal saline with a total volume of 400 mL were used in the saline and tranexamic groups, respectively, for irrigation and suctioning. The surgeons' assessment of field of view during surgery and intraoperative blood loss were recorded. RESULTS: Mean blood loss was 254.13 mL in the saline group and 235.6 mL in the tranexamic group (P=0.31). No statistically significant differences between the two groups were found in terms of other investigated variables, such as surgical field quality based on Boezzart's scale (P=0.30), surgeon satisfaction based on a Likert scale (P=0.54), or duration of surgery (P=0.22). CONCLUSION: Use of tranexamic acid (2 g in 400 mL normal saline) through washing of the nasal mucosa during FESS did not significantly reduce blood loss or improve the surgical field of view. Further studies with larger sample sizes and higher drug concentrations, and using other methods of administration, such as spraying or applying pledgets soaked in tranexamic acid, are recommended.

12.
Am J Rhinol Allergy ; 31(1): 48-50, 2017 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-28234154

RESUMO

OBJECTIVE: We proposed a novel technique for the quantitative examination of tip recoil. The technique measures nasal tip strain as an objective measure of tip recoil. We used the term tip recoilometry to refer to this measurement technique. DESIGN: We performed case studies in two phases. Phase 1 included 30 candidates with normal tip recoil and 30 candidates with weak tip recoil. Phase 2 included 40 patients who had undergone open rhinoplasty surgery by either columella strut or caudal extension graft methods. We evaluated tip support of patients 1 year after the surgery. RESULTS: The nasal tip strain of normal target group before any surgery was 0.158 and that of the patients with nasal tip ptosis was 35% more than that of the normal target group. The methods columella strut and caudal extension graft achieved 43% and 74% nasal tip strain reduction, respectively. CONCLUSION: The proposed technique can help a surgeon to select a proper plan and to evaluate the success of the surgery.


Assuntos
Septo Nasal/anatomia & histologia , Rinoplastia/métodos , Adulto , Biometria , Humanos , Pessoa de Meia-Idade , Septo Nasal/cirurgia , Próteses e Implantes , Adulto Jovem
13.
Int J Pediatr Otorhinolaryngol ; 89: 38-41, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27619026

RESUMO

OBJECTIVE: Although tonsillectomy is one of the most common surgeries performed in pediatric, it has potential major complications such as pain and bleeding. This study aimed to compare the bleeding and pain after tonsillectomy in bipolar electrocautery tonsillectomy versus cold dissection. METHODS: This double blind clinical trial was conducted on 70 pediatric patients who were candidate of tonsillectomy. Patients were divided into two groups of including bipolar cautery (BC) and cold dissection (CD). operation time, intraoperative blood loss, and postoperative bleeding and pain were evaluated in the current study. RESULTS: In both of the CD and BC groups, no significant difference was found in terms of sex and age. The average amount of the intraoperative blood loss in BC group was 14.086 ± 5.013 ml and in CD group was 26.14 ± 4.46 ml (p. v = 0.0001). The mean time of operation in BC group was 19 ± 2.89 min and in CD group was 29.31 ± 5.29 min (p. v = 0.0001). patients were evaluated in terms of pain on the first, third, fifth, and seventh days after the operation. No statistically significant difference was found between two groups. Moreover, Compared pain scores in all times across two groups, no significant difference was found. In terms of postoperative bleeding, none of the patients in both groups had bleeding during follow-up. CONCLUSION: Our study showed that bipolar electrocautery tonsillectomy can significantly reduce the operation time and intraoperative blood loss; however, postoperative pain and blood loss were similar in both techniques. We recommend bipolar electrocautery as the most suitable alternative method for tonsillectomy, especially in children.


Assuntos
Adenoidectomia/métodos , Dissecação/métodos , Eletrocoagulação/métodos , Dor Pós-Operatória/epidemiologia , Hemorragia Pós-Operatória/epidemiologia , Síndromes da Apneia do Sono/cirurgia , Tonsilectomia/métodos , Tonsilite/cirurgia , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Criança , Pré-Escolar , Temperatura Baixa , Método Duplo-Cego , Feminino , Humanos , Masculino , Duração da Cirurgia , Estudos Prospectivos , Recidiva
14.
15.
Iran J Otorhinolaryngol ; 28(86): 197-202, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27429948

RESUMO

INTRODUCTION: The human papilloma virus (HPV) can play a role in the development of head and neck squamous cell carcinoma (SCC). Our aim was to assess the prevalence of HPV DNA in SCC of the larynx. The impact of HPV infection on patient survival was also evaluated. MATERIALS AND METHODS: This case-control study was performed in 44 patients with SCC of the larynx (case group), while the control group comprised samples obtained from cadavers with no previous history of malignancy. A preliminary pathologic evaluation was performed on all samples in the control group (36 samples) to ensure the absence of dysplasia or malignancy. Polymerase chain reaction (PCR) was used to detect HPV DNA. After completing the treatment protocol, patients were followed to assess the impact of HPV infection on overall survival (OS). RESULTS: PCR evaluation in the case group showed that HPV DNA was successfully isolated from 11 (25%) samples, while only two (5.6%) HPV DNA-positive were obtained from cadavers. According to these results, a significant difference was obtained in the prevalence of HPV DNA and laryngeal SCC between cases and controls (P=0.031). No statistically significant difference was observed in the OS of patients with or without HPV infection in the case group (P=0.235). CONCLUSION: Based on these results, we suggest that the prevalence of HPV infection is higher in laryngeal SCC subjects compared with healthy individuals. Although a longer OS was seen in HPV-positive patients, survival analysis did not show a significant difference in the comparison of HPV-positive and negative findings in SCC patients.

16.
J Craniofac Surg ; 27(4): 970-2, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27171969

RESUMO

Intraoperative bleeding reduction during functional endoscopic sinus surgery is a key factor in preventing surgery complications. That is implemented through prescribing systemic corticostroid before surgery. This study aimed to explore an efficient nasal Furosemide versus systematic corticosteroids to reduce intraoperative bleeding.


Assuntos
Endoscopia/métodos , Furosemida/administração & dosagem , Hemorragia/tratamento farmacológico , Complicações Intraoperatórias/tratamento farmacológico , Pólipos Nasais/cirurgia , Doenças dos Seios Paranasais/cirurgia , Prednisolona/administração & dosagem , Administração Oral , Administração Tópica , Adulto , Perda Sanguínea Cirúrgica/prevenção & controle , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios
17.
J Craniofac Surg ; 27(3): 548-51, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27159854

RESUMO

OBJECTIVE: Obtaining adequate hemostasis during otolaryngology operations is necessary because a small amount of blood can be problematic and obscure the visual field. The authors aimed to compare the efficacy of combined greater palatine canal (GPC) and transnasal injection of lidocaine + epinephrine to transnasal injection alone in patients who underwent septoplasty. METHODS: Patients with nasal septum deviation who were eligible for surgical correction of deviations were enrolled. Transnasal injections of 2 mL of 1% lidocaine + epinephrine 1:100,000 were performed in both groups and for patients in the combination group the same solution was also injected in the GPC. Objective (amount of suctioned blood) and subjective (intraoperative bleeding score) assessments were done during operation. Close hemodynamic monitoring was performed for all patients. RESULTS: A total of 50 patients were enrolled and randomly allocated to study groups. No significant differences were observed in systolic and diastolic blood pressure, heart rate, and mean arterial pressure of study subjects between 2 groups. The amount of bleeding in patients who received GPC injection and their counterparts in the other arm of the trial were 34.64 ±â€Š26.66 and 100.48 ±â€Š20.90 mL, respectively (P < 0.001). The mean intraoperative bleeding score in combination group was 0.79 ±â€Š0.42 and significantly lower than the corresponding figure in monotherapy group, which was 1.75 ±â€Š0.41 (P < 0.001). CONCLUSIONS: Based on the findings of the current study, the authors suggest that combined GPC and transnasal injection of lidocaine and epinephrine is a safe and effective method for reducing bleeding during septoplasty.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Epinefrina/administração & dosagem , Técnicas Hemostáticas , Septo Nasal/cirurgia , Rinoplastia/métodos , Adulto , Anestésicos Locais/administração & dosagem , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Injeções , Lidocaína/administração & dosagem , Masculino , Nariz , Estudos Prospectivos , Resultado do Tratamento , Vasoconstritores/administração & dosagem
18.
PLoS One ; 11(2): e0148149, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26829393

RESUMO

Sudden sensorineural hearing loss (SSNHL) is a common otological disorder characterized by a hearing loss greater than 30 dB over three consecutive frequencies, in less than 72 hours. It has been established that platelet parameters, such as mean platelet volume, are associated with ischemic heart events, whose clinical manifestations are similar to those of SSNHL. Hence, we aimed to determine if the platelet count, mean platelet volume and platelet distribution width are related to the occurrence and severity of sudden sensorineural hearing loss. A case-control prospective study was conducted in a teaching hospital in Iran. One hundred-eight patients with SSNHL and an equal number of healthy, age- and sex-matched controls were enrolled in the study. Peripheral venous blood samples were collected from the subjects, and the platelet count, mean platelet volume and platelet distribution width were measured with an automated blood cell counter. Analysis of the audiometry and hematological test results using SPSS22 software showed no statistical correlation between the platelet parameters and the occurrence of SSNHL, but correlation coefficients showed a significant correlation between PDW and hearing loss severity in patients group. However, further investigation is required to unequivocally establish the absence of correlation between the platelet parameters and occurrence of SSNHL.


Assuntos
Plaquetas/metabolismo , Perda Auditiva Neurossensorial/sangue , Estudos de Casos e Controles , Demografia , Feminino , Humanos , Irã (Geográfico) , Masculino , Volume Plaquetário Médio , Pessoa de Meia-Idade , Contagem de Plaquetas , Análise de Regressão
19.
Eur Arch Otorhinolaryngol ; 273(6): 1405-10, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26153378

RESUMO

Some studies have shown that post-tympanostomy tube otorrhea (PTTO) is a common complication after tympanostomy tube insertion. There are wide range of controversies about the incidence of PTTO and different methods of preventive treatment. The aim of this study was to determine the incidence of early PTTO in persistent otitis media with effusion in our centers. We also investigated the effect of preventive treatments on the incidence of early PTTO in children with persistent otitis media with effusion. This multi-central study comprised 536 ears belonging to children with otitis media and effusion for at least 3 months, referred for complications arising from post-tympanostomy tube insertion. The patients were randomly divided into three treatment and control groups. In the first group of patients, the middle ear cavity was irrigated with isotonic saline after myringotomy. The second group received oral amoxicillin three times a day for 7 days postoperatively. The third group had similar treatment as the second group, in addition to topical ciprofloxacin drop, 4 drops three times a day for 3 days after operation. The control group did not undergo any treatment. Early post-tympanostomy tube otorrhea was detected in 6 ears (1.1 %), including 3 (2.2 %) from the control group and 3 (2.3 %) from the first group. There was no statistically significant difference in early PTTO between integrated treatment groups and control group (P = 0.111). As the total rate of early post-tympanostomy tube otorrhea was very low, there was no significant difference between the 3 treatment groups and control group. Our study did not support the routine use of preventive therapy. A period of at least 3 months watchful waiting before tympanostomy tube insertion may help reduce the incidence of PTTO.


Assuntos
Ventilação da Orelha Média/efeitos adversos , Otite Média com Derrame/cirurgia , Otite Média Supurativa/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Amoxicilina/administração & dosagem , Antibacterianos/administração & dosagem , Criança , Pré-Escolar , Ciprofloxacina/administração & dosagem , Feminino , Humanos , Incidência , Masculino , Ventilação da Orelha Média/métodos , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Próteses e Implantes/efeitos adversos , Resultado do Tratamento
20.
Noise Health ; 17(77): 209-15, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26168951

RESUMO

In mastoid surgeries, contralateral ear noise exposure is a known, identified factor leading to high-frequency hearing loss due to the wide variety of surgical devices that may be used during the surgery. However, the hearing threshold recovery time after this trauma was uncertain. The present study aimed to assess this time. In this prospective survival analysis study, 28 consecutive patients with chronic otitis media who were undergoing tympanomastoidectomy were assessed. Standard pure-tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE) were measured in all contralateral ears before and 6 h, 24 h, 48 h, 72 h, and 96 h after the surgery. Based on the PTA postoperative hearing loss, survival rates at frequencies of 3000 Hz, 4000 Hz, 6000 Hz, and 8000 Hz were 44.4%, 36.4%, 51.7%, and 47.4%, 24 h after surgery; 11.1%, 9.1%, 10.3%, and 13.2%, 48 h after surgery; and 0%, 0%, 3.4%, and 2.6%, 72 h after surgery, respectively. Based on the PTA and DPOAE, survival rates at all frequencies were 0%, 96 h after the surgery. According to the PTA, mean hearing recovery times were 61.98 ± 26.76 h (3000 Hz), 62.73 ± 26.50 h (4000 Hz), 67.08 ± 25.90 h (6000 Hz), 70.70 ± 24.13 h (8000 Hz), and with regard to DPOAE the recovery times were 58.58 ± 28.39 h (2000 Hz), 63.32 ± 28.83 h (4000 Hz), 65.22 ± 29.13 h (6000 Hz), and 75.14 ± 22.70 h (8000 Hz), respectively. To conclude, high-frequency hearing loss usually occurs following mastoid surgeries that is mainly temporary and reversible after 72 h.


Assuntos
Limiar Auditivo , Perda Auditiva de Alta Frequência/etiologia , Perda Auditiva Provocada por Ruído/etiologia , Processo Mastoide/cirurgia , Procedimentos Cirúrgicos Otológicos , Adolescente , Adulto , Audiometria de Tons Puros , Colesteatoma/cirurgia , Feminino , Perda Auditiva de Alta Frequência/epidemiologia , Perda Auditiva Provocada por Ruído/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Otite Média/cirurgia , Emissões Otoacústicas Espontâneas , Estudos Prospectivos , Instrumentos Cirúrgicos , Adulto Jovem
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