Effectiveness of the piezoelectric knife as a tool for nasal beak reduction in patients with chronic rhinosinusitis - a pilot study.

AIM: The aim of this study was to evaluate the safety and efficacy of the piezoelectric knife as a new tool for frontal beak surgery in patients with chronic rhinosinusitis (CRS) both in terms of imaging and perception of symptoms' outcomes. MATERIALS AND METHODS: The study involved 28 patients with CRS who underwent endoscopic sinus surgery (ESS) using a piezoelectric knife in the frontal recess region. Assessment of sinus imaging and patients' quality of life (QoL) was performed before and after surgery with the Lund-Kennedy and Lund-Mackay systems and the 22-item Sino-Nasal Outcomes Test (SNOT-22). RESULTS: Median scores on the Lund-Kennedy and Lund-Mackay systems decreased within 24 weeks after surgery with piezo knife assistance by 4 and 5 points, respectively. QoL improved with SNOT-22 scores decreasing by 35.5 points. CONCLUSIONS: ESS with the piezoelectric knife used for frontal beak reduction turned out to be a safe procedure. In the studied group of patients, the improvement was observed in terms of imaging, patients' perceptions of symptoms, and QoL outcomes. Therefore, the piezoelectric knife might be a valuable supporting tool in ESS in patients with CRS, although further observation is needed.

Health care system efficiency in otolaryngological surgeries during COVID-19 pandemic in years 2020-2021 compared to years 2018-2019: data from the Military Institute of Medicine in Warsaw.

<b>Introduction:</b> Coronavirus disease 19 (COVID-19) pandemic had a great impact on the health care system. This resulted not only from changes in the way medical facilities operated but also from the need to treat a huge number of patients. On the other hand, uninfected people feared visiting the doctor.</br></br> <b>Aim:</b> The aim of the study was to assess the impact of the COVID-19 pandemic on the diagnostics and treatment of patients with head and neck cancer.</br></br> <b>Materials and methods:</b> This retrospective study involved analysis of data of patients from a single hospital unit who underwent surgical procedures due to head and neck cancer during the COVID-19 pandemic in years 2020-2021 (pandemic group) compared to years 2018-2019 (pre-pandemic group).</br></br> <b>Results:</b> Patients in the pandemic group (n = 123) were older and were more likely to have grade 3 cancer than patients in the pre-pandemic group (n = 116). Cancer stages were similar in both groups. During the pandemic, time from the first outpatient visit to surgery was longer (median 1.6 vs. 0.8 months), while time to radiotherapy was shorter (median 50.5 vs. 63 days) than in the pre-pandemic period.</br></br> <b>Conclusion:</b> During the pandemic, patients had to wait slightly longer for surgery but not for radiotherapy when compared with the pre-pandemic period. Despite this, they did not have more advanced disease.

The impact of intraoperative antiseptic nasal irrigation during endoscopic sinus surgery on early postoperative results.

The main objective of the study was to determine the validity of intraoperative antiseptic treatment during endoscopic sinus surgery and the impact of such a treatment on the postoperative outcomes. Fifty-five patients with chronic sinusitis, qualified for surgical treatment were enrolled into the trial. It was designed as a prospective, randomized, blinded study. The surgical procedures were performed on both sides, in the same scope. In the next stage, after opening, one side was flushed with saline solution, and the other side with octenidine solution. The analysis showed a statistically significant reduction in postoperative crusting measured using the Lund-Kennedy scale between the test and the control group. Intraoperative lavage of the paranasal sinuses in both control and study group showed an effect on decreasing the total number of positive postoperative cultures relative to preoperative ones. Study showed a beneficial effect of the intervention consisting in rinsing with Octenisept on the reduction of crusting in the postoperative assessment.

Early or late tracheotomy in patients after multiple organ trauma.

The analysis of the study group of 124 patients revealed a statistically significant shortening of mechanical ventilation requirement period in patients in whom tracheotomy had been performed before hospitalization day 10 (G1). The average length of mechanical ventilation was shorter by 20.3 days in G1 as compared to G2. On average, the duration of ICU stay was shorter by 39.4 days in G1 as compared to G2. Total hospitalization time was also significantly shorter in this group of patients (G1). The overall length of hospital stay for patients in whom tracheotomy had been performed prior to hospitalization day 10 was on average 43.1 days shorter as compared to patients in whom the procedure had been performed at a later date. Tab. I. provides the comparison of the results obtained in both study groups. Statistically significant differences (p < 0.05) were demonstrated between G1 and G2 regarding the length of the mechanical ventilation, the length of ICU stay, and length of hospitalization. null null No statistically significant differences were observed in mortality rates between the study groups (Fig. 1.) (P = 0.256). The mortality rate in early tracheotomy group (G1) was lower and amounted to 2%. In patients in whom tracheotomy was performed on day 10 or later (G2), the mortality rate was slightly higher and amounted to 9%. In some patients, initiation of treatment was required due to pneumonia developing as a complication in mechanically ventilated patients and referred to as ventilator-associated pneumonia. This complication developed in 6 patients in G1 and 26 patients in G2. The study assessed the relationship between the occurrence of this complication and the timing of tracheotomy. Pneumonia was significantly more frequent in patients in whom tracheotomy had been performed on hospitalization day 10 or later (P = 0.011). null null The comparison of results is presented in Tab. II.</br> </br>Another analyzed aspect of the study consisted in the results obtained by the patients in the baseline evaluation of the level of consciousness as assessed using the Glasgow Coma Scale (GCS). Data were checked for potential correlation between the GCS scores and the timing of the tracheotomy and the lengths of mechanical ventilation, ICU stay, and hospitalization. Correlation between GCS scores and the duration of stay within the ICU was demonstrated with a statistically significant correlation coefficient (Spearman's rank coefficient in the range of -0.4 to -0.2). </br> </br>ICU stay and total hospitalization lengths were shorter in patients with higher baseline GCS scores compared to patients with lower baseline GCS scores. The results are illustrated graphically (Fig. 2., 3.).

Intranasal steroid therapy - EPOS 2020.

INTRODUCTION: Due to their strong, multidirectional anti-inflammatory activity, intranasal glucocorticoids are the mainstay of treatment in rhinosinusitis, including acute rhinosinusitis, chronic rhinosinusitis, and chronic rhinosinusitis with nasal polyps, as well as allergic rhinitis. Owing to its high systemic safety and high anti-inflammatory efficacy, mometasone furoate - a new-generation intranasal glucocorticoid - was approved in 2019 as an over-the-counter medication for Polish patients diagnosed with allergic rhinitis. Scientific societies and expert groups recommend the use of intranasal glucocorticoids in a much broader range of indications. In February 2020, an updated version of the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS 2020) was published. AIM: This article discusses the role of nasal glucocorticoids in regimens used in the treatment of nasal sinusitis as published in EPOS 2020 with Polish country-specific realities being taken into account.

Comparison of quality of life before and after open septorhinoplasty with the WHOQOL-BREF questionnaire.

INTRODUCTION: The study aimed to assess the influence of rhinoplasty on the quality of different aspects of life. The study group included 79 patients with congenital or posttraumatic nasal deformities (38 males, 41 females) aged from 17 to 49 (mean age 20 years) with open septorhinoplasty. MATERIALS AND METHODS: Quality of life was assessed before and 3 months after surgery, using the WHOQOL-BREF questionnaire. Other patient data including demographic data, other surgeries and comorbidities were also registered. Completion of 71 preoperative and 70 postoperative questionnaires was accomplished. R esults showed statistically significant differences in the quality of life in all domains. DISCUSSION AND CONCLUSION: Based on the conducted studies and after analysis of available literature, it may be concluded that functional and plastic surgeries including septorhinoplasty have an influence on the quality of life. To control postoperative results, tools evaluating this aspect should be used.