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1.
Artigo em Inglês | MEDLINE | ID: mdl-38334783

RESUMO

PURPOSE: Chronic rhinosinusitis (CRS) is a prevalent chronic disease observed on a global scale. The utilization of endoscopic sinus surgery (ESS) has gained significant recognition as an effective intervention for individuals with CRS and nasal polyps who have not responded to conventional treatments. The need (or not) for revision surgery frequently relies on the promotion of optimal wound healing. The impact of platelet-rich plasma (PRP) on tissue healing has been extensively examined in various surgical fields. METHODS: The present prospective study involved 30 patients suffering with nasal polyposis who underwent endoscopic sinus surgery. 15 patients were assigned to the PRP group, and 15 patients to the control group. The clinical follow-up of the patients took place at specific intervals, at weeks 1, 2, 3, 4, 8, and 12 after the surgical procedure. The evaluator identified the existence of adhesions, crusting, bleeding, granulation and infection using a visual analogue scale score. The patients also completed the SNOT 22 questionnaire prior to surgery and at each postoperative visit. RESULTS: The present study observed a lower incidence of adhesion, infection, hemorrhage and granulation in the PRP group. Furthermore, a statistically significant difference was detected between the groups. CONCLUSION: Based on the findings of the present investigation, it seems that platelet-rich plasma (PRP) is beneficial on wound healing during the early stages following the surgical procedure. The technique is characterized by its limited invasiveness, which contributes to its low risk profile and the achievement of clinically good outcomes.

2.
Int Forum Allergy Rhinol ; 14(1): 96-109, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37394893

RESUMO

BACKGROUND: The heterogeneity of existing studies, along with the fact that there are no published head-to-head trials, are the main reasons for the lack of guidelines regarding the selection of the proper biologic in treatment of chronic rhinosinusitis (CRS) with nasal polyps. The aim of this study is to summarize the current knowledge regarding the efficacy of omalizumab, dupilumab, and mepolizumab in CRS treatment. We also attempt to proceed to an indirect comparison of the agents and try to answer the tricky question: which agent to select and why? METHODS: An extensive search in English literature was conducted in PubMed/Medline, Embase, Google Scholar, and Cochrane Database/Library. Eligibility criteria included papers with full text published in English, adult population studies, clearly described intervention protocol, and documented primary and secondary outcomes. RESULTS: The studies included numbered 37. All agents provided significant improvement in polyp size, sinuses opacification, severity of symptoms, need for surgery and systemic corticosteroids use. Analysis of available systematic reviews, meta-analyses and indirect treatment comparison studies showed that dupilumab appeared to be the most beneficial agent, in terms of primary and secondary outcomes. However, these results are of relatively low level of evidence due to several methodological limitations. CONCLUSIONS: Although the present analysis showed a moderate supremacy of dupilumab, there is still no evidence-based answer to the question "which biologic agent is the most effective in CRS treatment?" Improved statistical methodology, head-to-head trials, and real-life studies could lead to more robust conclusions, establishing the real role of the specific biologic agents.


Assuntos
Anticorpos Monoclonais Humanizados , Produtos Biológicos , Pólipos Nasais , Rinite , Sinusite , Adulto , Humanos , Pólipos Nasais/tratamento farmacológico , Pólipos Nasais/complicações , Omalizumab/uso terapêutico , Sinusite/tratamento farmacológico , Sinusite/complicações , Doença Crônica , Rinite/tratamento farmacológico , Rinite/complicações , Qualidade de Vida
3.
Am J Otolaryngol ; 45(1): 104059, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37774642

RESUMO

PURPOSE: We investigated the effects of an internal nasal dilator on nasal airflow and cardio-respiratory capacity in adult endurance athletes, while performing controlled exhaustive physical exercise. METHODS: Prospective observational study. Participants were 38 adult endurance athletes, 23 with and 15 without nasal valve compromise. Nasal patency was objectively evaluated with anterior rhinomanometry, acoustic rhinometry and peak nasal inspiratory flow (PNIF). Maximum oxygen uptake (VO2max), maximum pulmonary ventilation, time to exhaustion and total time of nasal respiration were recorded during a submaximal treadmill test. Dyspnea intensity and fatigue perception were evaluated using a labeled visual analog scale. All assessments were performed with and without the application of the internal nasal dilator. RESULTS: All the parameters related to aerobic capacity were significantly reduced in the group of athletes with nasal valve compromise (p. <0.05 for all variables). The internal nasal dilator improved statistically significantly the nasal patency (p. <0.001), VO2max and aerobic performance and self-rating of dyspnea and fatigue (p. <0.05 for all parameters) only in athletes with nasal obstruction. PNIF correlated significantly with VO2max (rho = 0.4, p. <0.05). CONCLUSIONS: Internal nasal dilation improves nasal patency and aerobic performance during submaximal exercise in adult endurance athletes with nasal obstruction symptoms due to nasal valve compromise.


Assuntos
Obstrução Nasal , Adulto , Humanos , Obstrução Nasal/etiologia , Consumo de Oxigênio , Dilatação , Oxigênio , Atletas , Dispneia/etiologia , Fadiga
4.
Allergy ; 2023 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-38108602

RESUMO

Following the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) treatment algorithm for chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP), patients suffering from severe uncontrolled CRSwNP are recommended to receive oral corticosteroids, (revision) sinus surgery, systemic biologicals and/or aspirin treatment after desensitization (ATAD). Given the major differences in indications, outcomes, practical considerations, risks and costs of these key pillars of treatment, there is a growing need to define criteria for each treatment option and list the clinically relevant and major considerations for them. This EUFOREA document therefore provides an expert panel overview of the expected outcomes, specific considerations and (contra)indications of the five major treatment arms of severe uncontrolled CRSwNP: oral corticosteroids, primary and revision sinus surgery, biological treatment and ATAD. This overview of treatment considerations is needed to allow physicians and patients to consider the different options in the context of providing optimal and personalized care for severe uncontrolled CRSwNP. In conclusion, the five major treatment options for severe uncontrolled CRSwNP have intrinsic advantages, specific indications and considerations that are of importance to the patient, the physician and the society. This EUFOREA statement supports the unmet need to define criteria for the indication of every treatment pillar of CRSwNP.

5.
Indian J Otolaryngol Head Neck Surg ; 75(4): 3353-3363, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38027532

RESUMO

Biphenotypic sinonasal sarcoma (BSNS) is a rare malignant tumour of the upper nasal cavity and ethmoid sinuses that presents predominantly in middle aged female patients and show a characteristic infiltrative and hypercellular proliferation of spindle cells that demonstrate a specific immunoreactivity. We present three cases with BSNS that had different presenting complaints, either sinonasal or orbital problems, underwent endoscopic surgical treatment and/or radiotherapy and have been disease free on long follow up. A systematic review of all published cases was performed to identify all BSNS cases known at present. BSNS requires prompt and correct diagnosis with accurate surgical resection as well as consideration of radiotherapy. Our three cases confirm the findings of the literature and support that BSNS is an aggressive but treatable malignant disease of the sinonasal tract.

6.
Artigo em Inglês | MEDLINE | ID: mdl-38032485

RESUMO

PURPOSE: Posterior epistaxis is a common emergency in ENT practice varying in severity and treatment. Many management guidelines have been proposed, all of which are a product of retrospective analyses due to the nature of this pathology, as large-scale double-blind studies are impossible-even unethical-to conduct. The purpose of this review is to perform a thorough analysis and comparison of every treatment plan available and establish guidelines for the best possible outcome in accordance to every parameter studied. Given the extensive heterogeneity of information and the multitude of studies on this topic, along with the comparison of various treatment options, we opted for a literature review as our research approach. METHODS: A review of the literature was performed using PubMed Database and search terms included "posterior epistaxis", "treatment", "management", "guidelines", "algorithm" "nasal packing", "posterior packing", "surgery", "SPA ligation", "embolization", "risk factors" or a combination of the above. RESULTS: Initial patients' assessment invariably results in most cases in posterior packing. There seems to be a superiority in recent literature of early surgery over nasal packing as a definitive treatment. Embolization is usually used after surgery failure, except for specific occasions. CONCLUSION: Despite the vast heterogeneity of information, there seems to be a need for re-evaluation of the well-established treatment plans according to more recent studies. Suggested treatment algorithm for posterior epistaxis. ABC Airway-Breathing-Circulation, ECA external carotid artery, AEA anterior ethmoidal artery, BT blood transfusion, FA facial artery, HB haemoglobin, IMA internal maxillary artery, SPA sphenopalatine artery.

7.
J Clin Med ; 12(17)2023 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-37685680

RESUMO

Dysphagia is the main impairment arising from glossectomy for tongue cancer treatment. The study aimed to determine if an eight-week training protocol paired with accuracy tasks and swallowing exercises is effective and can improve tongue strength and swallowing in patients after tongue resection. Maximum isometric pressures, tongue endurance, swallowing pressures, mealtime duration, and oropharyngeal swallow function were studied in patients with moderate to severe dysphagia after glossectomy. Twenty-five (25) patients and thirty-one (31) healthy participants were enrolled in the study. The therapy group (TG) consisted of seventeen (17) patients who followed an 8-week treatment protocol and had multiple measurements. The follow-up control group (FUG) consisted of eight non-treated patients who had a baseline and an 8-week follow-up examination. Healthy participants served as the reference group (RF). Maximum isometric pressures, endurance, and swallowing pressures increased significantly in the TG versus the FUG. Significant improvement was documented in the TG regarding the EAT-10 questionnaire, the Penetration-Aspiration Scale scores at thickened and solid boluses, and post-swallow residues at thickened and solid boluses. The treatment protocol with tongue strength exercises combined with accuracy tasks and swallowing exercises improves the post-operative swallowing function in patients after glossectomy. Patients in the TG had more significant and quicker improvement in pressures and endurance compared to FUG.

8.
Folia Phoniatr Logop ; 2023 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-37497950

RESUMO

INTRODUCTION: Research on VOT production of stops in children with CI vs NH has reported conflicting results. Effects of age and place of articulation on VOT have not been examined for children with CI. The purpose of this study was to examine VOT production by Greek-speaking children with CI in comparison to NH controls, with a focus on the effects of age, type of stimuli, and place of articulation. METHODS: Participants were 24 children with CI aged from 2;8 to 13;3 years and 24 age- and gender-matched children with NH. Words were elicited via a picture naming task and nonwords were elicited via a fast mapping procedure. RESULTS: For voiced stops, children with CI showed longer VOT than children with NH whereas VOT for voiceless stops was similar to NH peers. Also, in both voiced and voiceless stops the VOT differed as a function of age and place of articulation across groups. Differences as a function of stimuli type were only noted for voiced stops across groups. DISCUSSION/CONCLUSIONS: For the voiced stop consonants, which demand more articulatory effort, VOT production in children with CI was longer than in children with NH. For the voiceless stop consonants, VOT production in children with CI is acquired at a young age.

9.
Ear Nose Throat J ; 102(7): 428-429, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33909486

RESUMO

Mucormycosis is a type of fungal infection more prevalent among immunosuppressed patients, requires prompt identification and surgical treatment, as it can is associated with local and distant spread. This case is aiming to highlight the importance of early identification of subtle symptoms in immunocompromised patients. The clinician should be aware of fungal sinusitis, consider it in the differential diagnosis, and seek for an ear, nose, and throat opinion.


Assuntos
Infecções por HIV , Mucormicose , Sinusite , Humanos , Infecções por HIV/complicações , Sinusite/complicações , Sinusite/diagnóstico , Sinusite/microbiologia , Mucormicose/complicações , Cefaleia/etiologia , Nariz/cirurgia , Hospedeiro Imunocomprometido
10.
Maedica (Bucur) ; 18(4): 672-678, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38348084

RESUMO

Background: Platelet-rich fibrin is a second-generation platelet concentrate. It is rich in platelets, cytokines, growth factors and leukocytes. Compared to platelet-rich plasma, it releases growth factors for a more extended amount of time. Methods:A literature review was conducted on the applications of platelet-rich fibrin in otolaryngology. Only articles written in English were further considered for the study; all others were excluded. Also, articles relating to oral and maxillofacial surgery were removed. Results: Twenty-five studies were deemed appropriate for inclusion in the present review. Conclusion:Based on the current data, platelet-rich fibrin appears to be a safe, healing-promoting material. It is a cost-effective, autologous material with enormous therapeutic application potential in the future. However, further clinical research is required before conclusive conclusions can be drawn about its usefulness.

11.
J Clin Med ; 11(17)2022 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36079145

RESUMO

Existing data suggest that people with multiple sclerosis (pwMS) are at an elevated risk for experiencing olfactory impairment. We investigated if smell dysfunction can be used as an MS disease marker. This is a cross-sectional, case−control study. All data were collected prospectively from 171 participants, 115 pwMS and 56 controls (age and sex stratified and matched to the patients), who reported smell, taste, and nasal breathing, and completed the Greek-validated questionnaires for nasal obstruction (NOSE), nasal-symptoms QoL (SNOT-22), and olfaction-associated QoL (QOD). The smell was assessed with the "Sniffin' sticks" (odor threshold (OT), discrimination (OD), identification (OI) test, and total TDI). We recorded the pwMS disease characteristics (Expanded Disability Status Scale-EDSS, the disease type and duration), cognitive function, emotional status, fatigue, and impact of MS in everyday activities. A TDI < 30.75 (hyposmia) was detected in 30.8% of the patients. The patients' OD and TDI scores were significantly lower than the controls' (p = 0.005, and 0.015, respectively). The hyposmia correlated with disease severity and duration. The EDSS score correlated negatively with OD (r = −0.299, p = 0.001) and TDI (r = −0.242, p = 0.01). The disease duration correlated negatively with OD (r = −0.305, p = 0.001, OI (r = −0.253, p = 0.008) and TDI (r = −0.3, p = 0.001). The information processing speed (SDMT) correlated with OD, OT, and TDI (r = 0.302, p = 0.002; r = 0.242, p = 0.016; r = 0.326, p = 0.001). The olfactory function is changing in MS in accordance with disease progression.

12.
Am J Case Rep ; 23: e935876, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35913898

RESUMO

BACKGROUND Sinonasal undifferentiated carcinomas (SNUC) are highly malignant and rare lesions. Therapeutic efforts often provide frustrating results. Their course is characterized by indolent progression, until it culminates in extensive local infiltration of adjacent anatomical structures or cervical lymphadenopathy in approximately one-third of patients upon admission. It most frequently affects males, with a sex ratio of 3: 1. The age at manifestation tends to be about 40-50 years. CASE REPORT We report the case of a 41-year-old man with intracranial expansion of SNUC. Two previous sinus surgeries were performed endoscopically because the lesion at that moment was exclusively located endonasally. Within the last few months, he had been having persistent headaches. Magnetic resonance imaging (MRI) revealed an anterior cranial fossa lesion. Therefore, he underwent a bifrontal craniotomy and excision of the space-occupying lesion (SOL). The osseous defect of the skull base was covered with a titanium mesh. Finally, we performed a duraplasty using a pericranial flap and fat tissue taken from his abdomen. Postoperatively, his wound was dehisced. We proceeded then to a frontal craniectomy with surgical debridement, subgaleal empyem and epidural abscess removal, and copious irrigation with oxygen peroxide. Enterococcus spp. were isolated from pus cultures. Despite receiving bacteria-focused antibiotics, he unfortunately developed sepsis and died. The histopathologic findings revealed a SNUC, which is the criterion standard for diagnosis. CONCLUSIONS Multimodal treatment offers the best prognosis to patients with SNUC. Combined operations by otolaryngologists and neurosurgeons provide the necessary radicality. There is high risk of wound healing disorders, especially when local irradiation had been administered.


Assuntos
Carcinoma , Neoplasias do Seio Maxilar , Adulto , Carcinoma/patologia , Carcinoma/cirurgia , Terapia Combinada , Humanos , Masculino , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/terapia , Base do Crânio/patologia
13.
Am J Otolaryngol ; 43(5): 103541, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35772332

RESUMO

OBJECTIVE: The aim of this study was to investigate our experience in the management of silent sinus syndrome. MATERIAL AND METHODS: The records of all patients treated for silent sinus syndrome between 2011 and 2021 were evaluated retrospectively. Data were collected on epidemiological parameters (age, gender), referral specialty, imaging findings, surgical approach, and management. RESULTS: In total, nine cases made up our final study sample (5 men, 4 women; male-female ratio 1:0.8). Their mean age was 39 years (range: 19-71 years). Besides the typical imaging findings (orbital floor depression, maxillary sinus atelectasis with ostium occlusion), lateralization of the uncinate process could be seen in seven cases (77.8 %) and ipsilateral septal deviation in six cases (66.6 %). Four cases were managed by means of middle meatal antrostomy and five with additional reconstruction of the orbital floor (transconjuctival approach in two cases, endonasal endoscopic approach in three cases). Enopthalmus recovered in all cases; diplopia (3 cases) recovered completely in two cases and partly in one case. CONCLUSION: Reduced surgical invasiveness in silent sinus syndrome, with management of the cause (maxillary sinus hypoventilation) and the sequel (orbital floor depression) using the same endoscopic approach, is associated with an acceptable clinical outcome.


Assuntos
Enoftalmia , Doenças dos Seios Paranasais , Adulto , Enoftalmia/complicações , Enoftalmia/cirurgia , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Doenças dos Seios Paranasais/complicações , Doenças dos Seios Paranasais/diagnóstico por imagem , Doenças dos Seios Paranasais/cirurgia , Estudos Retrospectivos , Síndrome
14.
J Clin Med ; 11(9)2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35566413

RESUMO

OBJECTIVE: The aim of this study was to investigate the long-term oncologic outcome and review the state of the art in the management of olfactory neuroblastomas. MATERIAL AND METHODS: The records of all patients treated for olfactory neuroblastomas in two academic departments between 1975 and 2012 were evaluated retrospectively. Data on epidemiological parameters were collected (age, gender), along with staging (Kadish, Morita), histologic grading (Hyams), time and form of treatment, locoregional control, and disease-specific and overall survival. Patients with other malignant diseases, distant metastases of olfactory neuroblastomas at the time of initial diagnosis, a follow-up time of less than 5 years, or insufficient clinical-pathological data were excluded from further analysis. RESULTS: In total, 53 cases made up our final study sample (26 men, 27 women; male-female ratio 0.96:1). Their mean age was 48.6 years (range: 10-84 years). The mean follow-up time was 137.5 months (4-336 months, SD: 85.0). A total of 5 out of 53 study cases (9.4%) showed metastatic involvement of the neck at the time of initial presentation. Local recurrence was detected in 8/53 (15.1%) and regional recurrence in 7/53 of our study cases (13.2%). Three patients (42.8%) from the group of cases with surgery as the sole form of management (7/53, 13.2%) died due to the disease. The cumulative disease-specific survival and overall survivalfor the whole group of patients were 88.6% and 63.6%, respectively. The cumulative disease-specific survival stratified by Kadish A/B vs. Kadish C/D as well as Hyams I/II vs. Hyams III/IV showed superior results for limited tumors, albeit without significance, and low-grade tumors (highly significant difference). CONCLUSION: Craniofacial or sometimes solely endoscopically controlled resection can warrant resection of the olfactory neuroblastoma with wide margins. However, locoregional failures and distant metastases can occur after a long period of time. The non-negligible incidence of regional recurrences, partly in unusual localizations, leads us to consider the need to identify the "recurrence-friendly" cases and to perform individualized elective irradiation of the neck in cases with high-risk features.

15.
Allergol Immunopathol (Madr) ; 50(2): 65-74, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35257547

RESUMO

INTRODUCTION AND OBJECTIVES: Pollen calendars have been proved clinically important in allergic disease management, as differences in airborne allergens exist not only between different countries but also between regions of the same country as well. This study aims to provide new data regarding the atmospheric pollen and fungi content of a Mediterranean region (Western Thrace/North-East Greece) and discuss seasonal trends, differences in pollen grains and fungi spores' circulation over the years, and correlations with climate parameters. MATERIAL AND METHODS: A 7-day continuously running volumetric trap was used to collect circulating pollen grains and fungi spores. Pollen taxa and fungi were characterized by standard protocols and counted as grains /m3 and average total grains and spores. The primary allergenic pollen season was discovered, and their 10-day averages were measured over time. Correlations with temperature, rain, and humidity were assessed by single linear regression analysis. RESULTS: Pollen grains from nine pollen families were identified, including five arboreal, two nonarboreal taxa, and spores from two fungi species. The three most prevalent taxa were Oleaceae, Poaceae, Pinaceae, and Cladosporium in the fungi. Peak pollen concentrations were detected during April and May, with daily averages exceeding 170 grains/m3. Poaceae presented the longest pollen season of 342 days and Oleaceae the shortest, extending to only 110 days, during the 3years. Cladosporium was the fungus with the highest spore concentration (180,129.9 spores) compared with Alternaria (28,026.1 spores). Correlations with meteorological parameters showed variable associations among different taxa, with rainfall and relative humidity being the most significant determinants. CONCLUSION: In this study, the pollenic and fungal spectrum of a Mediterranean region and information that can be proved clinically significant for the appropriate diagnostic and therapeutic approach of allergic patients was presented.


Assuntos
Alérgenos , Pólen , Alérgenos/análise , Alternaria , Monitoramento Ambiental , Grécia/epidemiologia , Humanos , Estações do Ano
16.
Allergol. immunopatol ; 50(2): 65-74, mar. 03, 2022. ilus, graf, tab
Artigo em Inglês | IBECS | ID: ibc-203102

RESUMO

Pollen calendars have been proved clinically important in allergic disease management, as differences in airborne allergens exist not only between different countries but also between regions of the same country as well. This study aims to provide new data regarding the atmospheric pollen and fungi content of a Mediterranean region (Western Thrace/North-East Greece) and discuss seasonal trends, differences in pollen grains and fungi spores’ circulation over the years, and correlations with climate parameters.A 7-day continuously running volumetric trap was used to collect circulating pollen grains and fungi spores. Pollen taxa and fungi were characterized by standard protocols and counted as grains /m3 and average total grains and spores. The primary allergenic pollen season was discovered, and their 10-day averages were measured over time. Correlations with temperature, rain, and humidity were assessed by single linear regression analysis.Results Pollen grains from nine pollen families were identified, including five arboreal, two nonarboreal taxa, and spores from two fungi species. The three most prevalent taxa were Oleaceae, Poaceae, Pinaceae, and Cladosporium in the fungi. Peak pollen concentrations were detected during April and May, with daily averages exceeding 170 grains/m3. Poaceae presented the longest pollen season of 342 days and Oleaceae the shortest, extending to only 110 days, during the 3years. Cladosporium was the fungus with the highest spore concentration (180,129.9 spores) compared with Alternaria (28,026.1 spores). Correlations with meteorological parameters showed variable associations among different taxa, with rainfall and relative humidity being the most significant determinants.Conclusion In this study, the pollenic and fungal spectrum of a Mediterranean region and information that can be proved clinically significant for the appropriate diagnostic and therapeutic approach of allergic patients was presented


Assuntos
Humanos , Monitoramento Ambiental/métodos , Alérgenos/classificação , Pólen/classificação , Grécia , Estações do Ano
17.
Acta Otorhinolaryngol Ital ; 42(1): 55-62, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35129538

RESUMO

OBJECTIVE: Stenosed sphenoid sinus ostia are among the most common findings in revision endoscopic sinus surgery. This study sought to identify the optimal intraoperative sphenoidotomy size for prevention of postoperative stenosis. METHODS: 32 patients affected by chronic rhinosinusitis not associated with nasal polyps (CRSsNP) underwent 52 sphenoidotomies. Sphenoidotomy size was assessed using a ruler intraoperatively and at the first, third and sixth months postoperatively. Ostia sizes, SNOT-22 questionnaire findings, episodes of recurrent sinusitis and need for revision surgery were recorded. RESULTS: All sphenoidotomies exhibited a significant size reduction (mean 43.4 ± 6.8%) at the first month postoperatively, with a tendency to enlarge at 3 months and stabilise at 6 months. Ostia larger than 61.3 mm2 did not exhibit stenoses postoperatively. Stenosis was observed in 11 sphenoidotomies (21.2%); however, only five presented with recurrent symptoms (9.6%), while three required revision sphenoid surgery (5.8%). CONCLUSIONS: Sphenoidotomy size significantly reduced during the first postoperative month and then stabilised. A baseline sphenoidotomy size of 61.3 mm2 at the time of the operation seemed sufficient to prevent ostium stenosis. Half of stenosed ostia presented with recurrent symptoms.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Doença Crônica , Endoscopia , Humanos , Cinética , Pólipos Nasais/complicações , Pólipos Nasais/cirurgia , Rinite/complicações , Rinite/cirurgia , Sinusite/complicações , Sinusite/cirurgia , Seio Esfenoidal/cirurgia
18.
Eur Arch Otorhinolaryngol ; 279(4): 1899-1910, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125283

RESUMO

PURPOSE: The purpose of this study was to investigate the changes in voice nasality after septoplasty and turbinate hypertrophy reduction and to evaluate the effect of these changes on patients' voice-related quality of life. METHODS: Sixty patients with nasal obstruction symptoms caused by septal deviation and inferior turbinate hypertrophy who underwent septoplasty and inferior turbinate hypertrophy reduction and 25 healthy controls were included. Active anterior rhinomanometry and acoustic rhinometry were utilized for the evaluation of nasal patency and nasometry was used for quantitative assessment of nasalance. All participants completed validated questionnaires for assessing nasal obstruction symptom severity, psychological status and the impact of voice performance on their quality of life preoperatively and 6 months after septoplasty. RESULTS: Patients presented preoperatively statistically significantly lower nasalance scores and higher VHI scores than controls (p < 0.05). Septoplasty and inferior turbinate hypertrophy reduction led to improvement of nasalance for the nasal text and the physical subscale of the VHI scores. Postoperatively, there were no statistically significant differences in nasalance and VHI scores between patients and controls. Significant correlations were found only for the baseline and the postoperative nasalance scores for the nasal text and the total nasal cavity volume (p < 0.05). Postoperatively, patients who presented significant improvement of nasal obstruction symptoms and resolution of stress levels were more likely to positively evaluate the impact of their voice quality on their daily life (OR: 2.32, 95% CI 1.08-5.15, p = 0.041 and OR: 3.06, 95% CI 1.15-7.04, p = 0.038, respectively). CONCLUSION: Septoplasty and inferior turbinate hypertrophy reduction may increase the nasal resonance, but in the long term, this change appears not to be significant enough. The severity of nasal obstruction symptoms and psychological status mainly affect the patients' perceptual assessment regarding the effect of voice performance on their quality of life.


Assuntos
Obstrução Nasal , Rinoplastia , Humanos , Hipertrofia/complicações , Hipertrofia/cirurgia , Obstrução Nasal/complicações , Obstrução Nasal/diagnóstico , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Estudos Prospectivos , Qualidade de Vida , Rinoplastia/efeitos adversos , Resultado do Tratamento , Conchas Nasais/cirurgia
19.
J Clin Med ; 10(5)2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33801170

RESUMO

A significant proportion of people infected with SARS-CoV-2 report a new onset of smell or taste loss. The duration of the chemosensory impairment and predictive factors of recovery are still unclear. We aimed to investigate the prevalence, temporal course and recovery predictors in patients who suffered from varying disease severity. Consecutive adult patients diagnosed to be infected with SARS-CoV-2 via reverse-transcription-polymerase chain reaction (RT-PCR) at two coronavirus disease-2019 (COVID-19) Reference Hospitals were contacted to complete a survey reporting chemosensory loss, severity, timing and duration, nasal symptoms, smoking, allergic rhinitis, chronic rhinosinusitis, comorbidities and COVID-19 severity. In a cross-sectional study, we contacted 182 patients and 150 responded. Excluding the critically ill patients, 38% reported gustatory and 41% olfactory impairment (74% severe/anosmia). Most of the patients (88%) recovered their sense of smell by two months (median: 11.5 days; IQR: 13.3). For 23%, the olfactory loss lasted longer than a month. There were no significant differences in the prevalence and duration of chemosensory loss between groups of varying COVID-19 severity, and sexes (all p > 0.05). Moderate hyposmia resolved quicker than more severe loss (p = 0.04). Smell and taste loss are highly prevalent in COVID-19. Most patients recover fast, but nearly one out of ten have not recovered in two months.

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