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1.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-913914

RESUMO

Objectives@#. Fibro-osseous lesions of the paranasal sinuses can present various clinical manifestations. This study aimed to report the long-term clinical course of benign fibro-osseous lesions (BFOLs) in the paranasal sinuses, including clinical and radiologic features. @*Methods@#. Radiologically confirmed BFOLs between 1994 and 2016, with the exclusion of osteoma cases, were retrospectively reviewed. We compared demographic characteristics between the surgery and observation groups. The reasons for the imaging study, radiographic features, histopathology, and clinical course based on serial image scans were analyzed. @*Results@#. In total, 183 subjects were selected from a thorough review of head and neck radiologic tests (n=606,068) at a tertiary referral hospital over 22 years. Patients’ mean age was 28.6±18.1 years, and 56.3% were males. A diagnostic imaging workup was performed in 55.7% of patients due to facial asymmetry, headache, skull mass, or other symptoms related to BFOLs. In other patients (37.7%), BFOLs were found incidentally on computed tomography or magnetic resonance imaging. The most common diagnosis was fibrous dysplasia, followed by ossifying fibroma, based on both radiologic exams and histopathologic results. In total, 42.6% of the patients underwent surgery because of subjective symptoms or esthetic concerns. The patients who underwent surgery were younger (P<0.001) and had a longer follow-up duration (P<0.001) than those who underwent observation. Patients who experienced lesion growth (11.5%) were younger (P<0.001) and had more lesion sites (P=0.018) than those who did not, regardless of surgical treatment. Five patients underwent optic nerve decompression, and one patient experienced malignant transformation. @*Conclusion@#. BFOL in the paranasal sinuses is a rare disease, and most cases were observed without specific treatment. Surgical treatment should be considered in symptomatic patients with aggressive clinical features. Regular observation and management are needed, particularly in younger patients in their teens.

2.
Journal of Rhinology ; : 16-20, 2020.
Artigo | WPRIM (Pacífico Ocidental) | ID: wpr-836283

RESUMO

Background and Objectives@#Chronic rhinosinusitis with nasal polyps (CRSwNP) recurs frequently after endoscopic sinus surgery (ESS). The aim of study was to evaluate the efficacy of triamcinolone-soaked absorbable gelatin foam (gelfoam) as a treatment for recurred polypoid changes after ESS.Subjects and Method: A total of 35 patients and 57 nasal cavities was retrospectively reviewed. All patients underwent triamcinolone- infused gelfoam packing for 1 week under nasal endoscopic guidance. Endoscopic scores were evaluated at 1 week, 1 month, and 3 months. We analyzed clinical characteristics between success and failure groups. @*Results@#Endoscopic scores were significantly improved after triamcinolone-soaked gelfoam packing, and the effects were maintained at 3-month follow-up (1.85±0.61 vs. 0.82±0.77, p<0.001). Duration between surgery and gelfoam packing was shorter in the success group compared to the failure group (8.2±6.9 vs. 13.7±8.4 weeks, p=0.033). Serum eosinophil cationic protein and tissue eosinophil counts were significantly higher in the failure group (p=0.025 and p=0.010, respectively). @*Conclusion@#Triamcinolone-soaked gelfoam packing is an effective and safe method for managing recurrent polypoid change in patients with CRSwNP after ESS. Early intervention contributed to a successful result, and eosinophilic inflammation was associated with poor outcomes.

3.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-763315

RESUMO

OBJECTIVES: Endoscopic prelacrimal medial maxillectomy (EPMM) was previously reported to treat maxillary inverted papilloma. This study aimed to compare prelacrimal recess approach with the conventional Caldwell-Luc approach (CLA) to remove benign maxillary sinus tumors and to evaluate the usefulness of this approach based on our experience. METHODS: Ten patients who underwent EPMM at our hospital from January 2013 to December 2017 were reviewed. We also reviewed 30 patients who underwent benign maxillary sinus tumor resection via CLA during the same period. From medical records, postoperative pathological results, complications due to surgery, and recurrence rate were evaluated. RESULTS: There were eight inverted papilloma, one ameloblastoma, and one ossifying fibroma in the EPMM group. In the CLA group, all 30 cases were inverted papilloma. There were no cases of failure at gross total removal during surgery, and no recurrences were observed during follow-up in either groups. Mean follow-up period was 13.0 months in CLA group and 10.8 months in EPMM group. Regarding postoperative complications, 11 patients of the CLA group (37%) and three patients of the EPMM group (30%) had numbness around the cheek and upper lip area after surgery (P=0.715). In the CLA group, there were eight patients who had numbness lasting more than 3 months after surgery, and two patients had numbness for more than 1 year. However, facial numbness disappeared within 3 months in all patients in the EPMM group, in which epiphora was not observed. CONCLUSION: EPMM is the effective surgical approach for resecting benign maxillary sinus tumor compared with CLA. Although facial numbness was reported in EPMM, the duration of numbness was shorter than CLA.


Assuntos
Humanos , Ameloblastoma , Bochecha , Endoscopia , Fibroma Ossificante , Seguimentos , Hipestesia , Doenças do Aparelho Lacrimal , Lábio , Neoplasias do Seio Maxilar , Seio Maxilar , Prontuários Médicos , Papiloma Invertido , Complicações Pós-Operatórias , Recidiva
4.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-762155

RESUMO

PURPOSE: Despite medical and surgical treatments, some cases of nasal polyps (NP) exhibit recidivism. However, the endotype of refractory chronic rhinosinusitis with NP (CRSwNP) remains unclear. Therefore, the objective of this study was to characterize the immunological profile of refractory CRSwNP. METHODS: The control (n =23), primary NP group (pNP, n =70) and refractory NP group (rNP, n =86) were enrolled in this study. Patients who underwent revision surgeries due to failed maximal medical treatment after primary surgery were defined as the rNP group. A total of 18 inflammatory markers were investigated in nasal tissues using multiplex cytokine assay or enzyme-linked immunosorbent assay. RESULTS: The clinical characteristics of rNP included more extensive disease and worse clinical course after surgery. Additionally, rNP subjects showed higher infection rate (mucopurulence and culture-positive rate), more frequent use of antibiotics and suffered from symptomatic bacterial infection, increased asthma morbidity compared to pNP. Cytokine profile analysis showed that levels of Th17-associated mediators (myeloperoxidase, interleukin (IL)-8, IL-17A and IL-23), B-cell activating factor (BAFF) and Th1 cytokine (interferon-γ) were up-regulated in rNP compared to controls and pNP. Human neutrophil elastase-positive cells were also enhanced in rNP compared with pNP. Upregulation of Th17/Th1mediators and BAFF were observed in rNP, regardless of tissue eosinophilia or asthmatic comorbidity. Interestingly, eosinophilic markers, such as eosinophil cationic protein and C-C motif chemokine ligand 24, were up-regulated in asthmatic rNP compared to pNP and controls. Levels of anti-dsDNA immunoglobulin (Ig) G and IgA were up-regulated in rNP and highest in asthmatic eosinophilic rNP among subtypes of rNP. CONCLUSIONS: Our results suggest that Th17/Th1-associated mediators and BAFF may play a role and be a potential therapeutic target in refractory CRSwNP. Additionally, eosinophilic markers and autoantibodies may contribute to refractoriness in asthmatic rNP.


Assuntos
Humanos , Antibacterianos , Asma , Autoanticorpos , Fator Ativador de Células B , Infecções Bacterianas , Comorbidade , Ensaio de Imunoadsorção Enzimática , Proteína Catiônica de Eosinófilo , Eosinofilia , Eosinófilos , Imunoglobulina A , Imunoglobulinas , Interleucina-17 , Interleucinas , Pólipos Nasais , Neutrófilos , Sinusite , Células Th17 , Regulação para Cima
5.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-718724

RESUMO

OBJECTIVES: Middle vault deviation has a significant effect on the aesthetic and functional aspects of the nose, and its management continues to be a challenge. Spreader graft and its modification techniques have been focused, but there has been scarce consideration for removing surplus portion and balancing the upper lateral cartilage (ULC). This study aimed to report the newly invented triangular-shaped resection technique (“triangular resection”) of the ULC and to evaluate its efficacy for correcting middle vault deviation. METHODS: A retrospective study included 17 consecutive patients who presented with middle vault deviation and underwent septorhinoplasty by using triangular resection at a tertiary academic hospital from February 2014 and March 2016. Their outcomes were evaluated pre- and postoperatively including medical photographs, acoustic rhinometry and subjective nasal obstruction using a 7-point Likert scale. RESULTS: The immediate outcomes were evaluated around 1 month after surgery, and long-term outcomes were available in 12 patients; the mean follow-up period was 9.1 months. Nasal tip deviation angle was reduced from 5.66° to 2.37° immediately (P < 0.001). Middle vault deviation also improved from 169.50° to 177.24° (P < 0.001). Long-term results were 2.49° (P=0.015) for nasal tip deviation and 178.68° (P=0.002) for middle vault deviation. The aesthetic outcome involved a complete correction in eight patients (47.1%), a minimally visible deviation in seven patients (41.2%) and a remaining residual deviation in two patients (11.8%). Pre- and postoperative minimal cross-sectional areas (summation of the right and left sides) were 0.86 and 1.07, respectively (P=0.021). Fifteen patients answered about their nasal obstruction symptoms and the median symptom score had alleviated from 6.0 to 3.0 (P=0.004). CONCLUSION: Triangular resection of the ULC is a simple and effective method for correcting middle vault deviation and balancing the ULCs without complications as internal nasal valve narrowing.


Assuntos
Humanos , Cartilagem , Seguimentos , Métodos , Cartilagens Nasais , Obstrução Nasal , Nariz , Deformidades Adquiridas Nasais , Estudos Retrospectivos , Rinometria Acústica , Rinoplastia , Transplantes
6.
Journal of Rhinology ; : 75-79, 2018.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-718270

RESUMO

BACKGROUND AND OBJECTIVES: To investigate the common site of recurrent epistaxis after initial intervention such as packing and cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. SUBJECTS AND METHOD: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis between October 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. We performed electrocautery when a bleeding site was found. RESULTS: The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septum around the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication during the one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxis after electrocautery and underwent endoscopic sphenopalatine artery ligation. CONCLUSION: In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examination through a surgical approach and electrocautery for suspected bleeding are effective.


Assuntos
Humanos , Artérias , Cauterização , Eletrocoagulação , Epistaxe , Hemorragia , Hospitalização , Ligadura , Métodos , Salas Cirúrgicas , Estudos Retrospectivos , Conchas Nasais
7.
Journal of Rhinology ; : 59-62, 2018.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-714771

RESUMO

Retention cyst of the maxillary sinus is a benign lesion produced from obstruction of a seromucous gland or duct. It is mostly asymptomatic but sometimes is accompanied by facial pain, headache, nasal obstruction, and other symptoms. However, there are some debates on whether the symptoms are directly related with retention cyst. These cysts typically do not require treatment. However, when accompanied by symptoms, treatment can be administered for diagnostic and therapeutic purposes. We report a case in which facial pain is caused by a maxillary retention cyst suspended from an infraorbital nerve.


Assuntos
Dor Facial , Cefaleia , Seio Maxilar , Obstrução Nasal , Neoplasias dos Seios Paranasais
8.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-41400

RESUMO

OBJECTIVES: This study evaluated whether the symptoms of laryngopharyngeal reflux (LPR) change after multilevel surgery for obstructive sleep apnea (OSA). METHODS: Patients who underwent multilevel surgery for OSA between April 2009 and September 2014 were enrolled in this study. All patients underwent preoperative polysomnography prior to surgery and were asked to complete the reflux symptom index (RSI) questionnaire before and after surgery. RESULTS: Of 73 enrolled patients, 24 (33%) reported an RSI score >13 and were thus classified as having reflux. The mean RSI score before surgery was 11.48±7.95; this number decreased to 4.95±6.19 after surgery (P < 0.001). The rate of positive RSI responses was 33% before surgery and 9% after surgery. Each variable that comprised the RSI improved significantly after surgery, except for difficulty with swallowing. Regarding the degree of RSI improvement after surgery, there were no significant differences between subgroups according to sex, age, body mass index, OSA severity, or surgical outcome. CONCLUSION: LPR symptoms are prevalent in OSA patients. Treatment for OSA using multilevel surgery potentially reduces the symptoms of LPR.


Assuntos
Humanos , Índice de Massa Corporal , Deglutição , Refluxo Laringofaríngeo , Polissonografia , Apneia Obstrutiva do Sono
9.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-106632

RESUMO

OBJECTIVES: Compliance with continuous positive airway pressure (CPAP) treatment remains a primary concern for improving treatment outcomes of obstructive sleep apnea. There are few studies that have considered the role of upper airway anatomy on the compliance with CPAP. We hypothesized that upper airway anatomy would influence the compliance with CPAP. METHODS: One hundred out of 161 consecutive patients were enrolled in this study. The following possible determinants were tested against CPAP use: demographic and anthropometric data, minimal cross-sectional area on acoustic rhinometry, cephalometric and polysomnographic data, questionnaires of Epworth sleepiness scale and Beck depression index, and histories of previous upper airway surgery, degree of nasal obstruction, daily cigarette consumption, and weekly frequency of alcohol intake. RESULTS: Univariate analysis showed that histories of previous upper airway surgery and less frequent alcohol consumption, and longer mandibular plane-hyoid length (MP-H) on cephalometry were associated with longer average daily CPAP use. After adjustment for the confounding factors with multiple linear regression analysis, alcohol consumption and MP-H were still associated with the compliance with CPAP significantly. CONCLUSION: To improve compliance with CPAP, careful evaluations of upper airway problems and life style are important before initiating CPAP.


Assuntos
Humanos , Consumo de Bebidas Alcoólicas , Cefalometria , Complacência (Medida de Distensibilidade) , Pressão Positiva Contínua nas Vias Aéreas , Depressão , Estilo de Vida , Modelos Lineares , Obstrução Nasal , Rinometria Acústica , Apneia Obstrutiva do Sono , Produtos do Tabaco
10.
Journal of Rhinology ; : 6-16, 2016.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-113518

RESUMO

BACKGROUND AND OBJECTIVES: Obstructive sleep apnea syndrome(OSAS) is characterized by repeated apnea, hypopnea, and micro-arousals during sleep. Among various treatment modalities of OSAS, continuous positive airway pressure(CPAP) treatment is the most effective and successful. The aim of this study was to compare efficacy and safety of newly developed Korean CPAP with standard CPAP in OSAS patients. MATERIALS AND METHOD: In total, 20 of 26 recruited OSAS patients completed the study. All subjects first used the standard CPAP for 4 weeks. After an at least 2 week wash-out period, the subjects used the newly developed CPAP for 4 weeks. Polysomnography, questionnaires associated with sleep, lipid profile, pulmonary function test, cardiac marker, and physical examinations were evaluated at baseline and were followed-up after each treatment. RESULTS: After treatment with the newly developed CPAP, the apnea-hypopnea index was decreased from 53.2/hr to 2.5/hr and was equivalent to that of the standard CPAP. Most of the changes in questionnaire scores, laboratory findings, and physical examinations after newly developed CPAP treatment were equivalent to those with standard CPAP. No serious adverse events were observed during the study. CONCLUSION: The efficacy and safety of a newly developed CPAP are equivalent to those of standard CPAP in OSAS patients.


Assuntos
Humanos , Apneia , Pressão Positiva Contínua nas Vias Aéreas , Métodos , Exame Físico , Polissonografia , Testes de Função Respiratória , Apneia Obstrutiva do Sono
11.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-643516

RESUMO

BACKGROUND AND OBJECTIVES: Skull base osteomyelitis (SBO) typically evolves as a complication of malignant otitis externa (MOE) in diabetic patients and involves the temporal bone. Central SBO (CSBO), which mainly involves the sphenoid or occipital bones, has clinicaland radiological characteristics similar to those of SBO but without coexisting MOE. We investigated a group of patients with CSBO and studied the clinical course of CSBO. SUBJECTS AND METHOD: Medical records of patients who were diagnosed with CSBO were retrospectively analyzed from 1999 to 2014. RESULTS: Ten patients (mean age; 60.5 years) were identified. There were five males and five females. All patients suffered from headache, and six patients had cranial nerve palsy including oculomotor (20%), abducens (10%), vestibulocochlear (10%), glossopharyngeal (20%), vagus (30%) and hypoglossal (10%) nerve. Patients had underlying diseases including diabetes mellitus (40%), immunosuppression status after liver transplantation (10%) and cardiovascular disease (40%). Four patients received endoscopic biopsy and debridement for diagnostic and curative intent. Patients were treated with intravenous antibiotics for 5.1 weeks in average and oral antibiotics for 17 weeks. Mean follow-up period was 12.4 months and the mortality rate was zero. 40% of patients had residual neurologic deficit. The earliest sign of improving CSBO was headache (mean; 3.1 weeks) and the erythrocyte sedimentation rate was the latest improving sign (mean; 4 months). CONCLUSION: CSBO was diagnostic and therapeutic challenge to the clinicians. The timely diagnosis and long-term antibiotics therapy could avoid a mortality case and minimize the permanent neurologic deficit.


Assuntos
Feminino , Humanos , Masculino , Antibacterianos , Biópsia , Sedimentação Sanguínea , Doenças Cardiovasculares , Doenças dos Nervos Cranianos , Desbridamento , Diabetes Mellitus , Diagnóstico , Seguimentos , Cefaleia , Terapia de Imunossupressão , Transplante de Fígado , Prontuários Médicos , Mortalidade , Manifestações Neurológicas , Osso Occipital , Osteomielite , Otite Externa , Estudos Retrospectivos , Base do Crânio , Crânio , Osso Temporal
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-83881

RESUMO

PURPOSE: To evaluate the efficacy and safety of once-daily ciclesonide in comparison to both levocetirizine alone, and a ciclesonide/levocetirizine combination in patients with seasonal allergic rhinitis (SAR) and perennial allergic rhinitis (PAR). METHODS: Subjects exhibiting moderate to severe allergic rhinitis for longer than 1 year were randomized in an open-label, 3-arm, parallel group, multicenter study. Subjects received 200 microg ciclesonide, 5 mg levocetirizine, or a combination of both. Changes from baseline until the end-of-study visit (2 weeks following) were evaluated by reflective total nasal symptom scores (rTNSSs), reflective total ocular symptom scores (rTOSSs), physician-assessed overall nasal signs and symptoms severity (PANS), and rhinoconjunctivitis quality-of-life questionnaires (RQLQ). RESULTS: Significant improvements in rTNSS, PANS, and RQLQ in the ciclesonide monotherapy group were observed in comparison to the levocetirizine alone group. Three individual symptoms of rTNSS, including runny nose, nasal itching, and congestion, were improved in the ciclesonide-treated group. rTOSS scores for ciclesonide monotherapy improved from baseline, but no superiority over levocetirizine was shown. The absolute score and changes in rTNSS and PANS were positively correlated. Ciclesonide spray was more effective than levocetirizine in reducing nasal symptoms in both SAR and PAR patients. Ciclesonide and levocetrizine were well tolerated alone and in combination. CONCLUSIONS: Our results provide support for an AR and its Impact on Asthma (ARIA) recommendation stipulating that ciclesonide is superior to levocetirizine for the treatment of AR, with tolerable safety. Addition of levocetirizine to ciclesonide did not give further clinical benefit over monotherapy.


Assuntos
Humanos , Asma , Estrogênios Conjugados (USP) , Nariz , Prurido , Rinite , Rinite Alérgica Sazonal , Inquéritos e Questionários
13.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-115812

RESUMO

No abstract available.

14.
Journal of Rhinology ; : 75-81, 2015.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-14850

RESUMO

BACKGROUND: Obstructive sleep apnea (OSA) is characterized by repeated apnea, hypopnea, and micro-arousals during sleep. Many studies have described correlations between OSA and multiple systemic diseases, such as cardiovascular, cerebrovascular, and metabolic diseases. The aim of this study was to determine whether the compliance of continuous positive airway pressure (CPAP) affects the short-term systemic responses in OSA patients. METHODS: Twenty-four newly diagnosed OSA patients were enrolled. All subjects used CPAP for 4 weeks. The subjects were divided into two groups according to the rate of using CPAP over 4 hours per night. Complete blood cell count, coagulation results, blood chemistry, lipid profiles, and pulmonary function results were evaluated at baseline, and were followed up after 4 weeks. RESULTS: After CPAP treatment, WBC count, hemoglobin, hematocrit, albumin, AST, ALT, Cl, and peak expiratory flow rate (PEFR) were significantly changed in the higher compliance group (n=14), whereas platelet count and triglyceride levels were significantly changed in the lower compliance group (n=10). In multivariate analysis, the changes in WBC count, hemoglobin and hematocrit were statistically significant between the higher compliance and lower compliance groups (p=0.0056, 0.0016, and 0.0051). CONCLUSION: The compliance of CPAP affects the short-term systemic responses in OSA patient.


Assuntos
Humanos , Apneia , Contagem de Células Sanguíneas , Química , Complacência (Medida de Distensibilidade) , Pressão Positiva Contínua nas Vias Aéreas , Hematócrito , Doenças Metabólicas , Análise Multivariada , Estresse Oxidativo , Pico do Fluxo Expiratório , Contagem de Plaquetas , Apneia Obstrutiva do Sono , Triglicerídeos
15.
Journal of Rhinology ; : 82-88, 2015.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-14849

RESUMO

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea. MATERIALS AND METHOD: A series of eight surveys were sent to the board members of the Korean Rhinologic Society via e-mail between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously. RESULTS: The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was preferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS. CONCLUSION: The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.


Assuntos
Anestesia Geral , Anônimos e Pseudônimos , Antibacterianos , Protocolos Clínicos , Inquéritos e Questionários , Correio Eletrônico , , Hospitalização , Hipersensibilidade , Coreia (Geográfico) , Seios Paranasais , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Sinusite
16.
Journal of Rhinology ; : 103-106, 2015.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-14846

RESUMO

Since its introduction in 2006, balloon sinuplasty has been a controversial procedure among rhinologists. It is considered to be a minimally invasive procedure for the treatment of chronic rhinosinusitis. However, some sinus surgeons prefer to use conventional sinus surgery. Nevertheless, the current evidence indicates that balloon sinuplasty results in the reduction of surgery duration, hospital stay, postoperative pain and the facilitation of early wound healing. Herein, we report the first case in Korea of the successful dilatation of the sinuses using balloon sinuplasty in a 39-year-old woman with recurrent headache episodes that were aggravated during airplane travel.


Assuntos
Adulto , Feminino , Humanos , Aeronaves , Cateterismo , Dilatação , Cefaleia , Coreia (Geográfico) , Tempo de Internação , Dor Pós-Operatória , Cicatrização
17.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-93545

RESUMO

OBJECTIVES: Although biofilms have been implicated in poor prognosis after endoscopic sinus surgery (ESS), traditional methods detecting biofilm such as scanning electron microscope and confocal scanning laser microscope were rarely used in the practice. The aims of this study was to determine whether the presence or absence of a biofilm detected by hematoxylin and eosin (H&E) staining followed by light microscopy (LM) that is widely used in daily practice, predicts surgical outcomes after ESS. METHODS: Retrospective analysis of prospectively collected data. Fifty-five consecutive adult patients (>18 years) who underwent ESS for chronic rhinosinusitis with a minimum of 12-months of follow-up were enrolled in this study. Random sinonasal mucosal samples were assessed for biofilm presence using H&E staining with LM. Three independent observers scored whether a biofilm was present or absent based on H&E staining/LM, and the interrater variability was calculated. Pre- and postoperative sinus symptoms and sinonasal mucosal grading were assessed. RESULTS: Biofilms were present in 28 patients (51%), and the intraclass correlation coefficient according to H&E staining/LM was 0.731. The presence of a biofilm was associated with a higher preoperative Lund-MacKay computed tomography score (22.3 for biofilm-positive patients vs. 18.6 for biofilm-negative patients; P=0.021) and persistent inflammation (mucosal edema and discharge) after ESS (P<0.05). CONCLUSIONS: The presence or absence of a biofilm based on H&E staining/LM is correlated with disease severity and surgical outcomes after ESS. H&E staining/LM for detecting biofilm could be practical and cost-effective methods for predicting prognosis of ESS.


Assuntos
Adulto , Humanos , Biofilmes , Edema , Amarelo de Eosina-(YS) , Seguimentos , Hematoxilina , Inflamação , Microscopia , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos
18.
Journal of Rhinology ; : 96-102, 2014.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wpr-149399

RESUMO

The basic principles of surgery for chronic rhinosinusitis are ventilation of the sinus ostia and conservation of the sinonasal mucosa. Since its introduction in 2006, balloon sinuplasty has been considered controversial by rhinologists. Balloon sinuplasty is a minimally invasive procedure for the treatment of chronic rhinosinusitis. However, some criticism has originated from the familiarity and preference many sinus surgeons have for conventional sinus surgery. Independent of this controversy, the current evidence supports the feasibility, safety, and efficacy of balloon sinuplasty. Furthermore, there has been increased interest in this procedure among physicians as well as patients. The objective of this review is to present and discuss the surgical technique, treatment outcomes and controversy associated with balloon sinuplasty.


Assuntos
Humanos , Cateterismo , Mucosa , Seios Paranasais , Reconhecimento Psicológico , Ventilação
19.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-173823

RESUMO

OBJECTIVES: Pregabalin is used to treat neuropathic pain and has shown analgesic properties in postoperative pain. The aim of this study was to investigate the effectiveness and safety of pregabalin in reducing postoperative pain in patients after septoplasty. METHODS: Forty-seven patients scheduled for elective septoplasty were randomly assigned to groups that received either pregabalin (150 mg) or placebo, both one hour before surgery and 12 hours after the initial dose. Pain (verbal numerical rating scale, VNRS) and side effect assessments were performed at 6, 12, 12 to 24, and 24 to 48 hours postoperatively. RESULTS: From 1 to 12 hours postoperatively, VNRS scores for pain were lower in the pregabalin group (n=24) than in the placebo group (n=23; P<0.05). The number of patients who needed rescue analgesics was lower in the pregabalin group (P=0.042). The incidence of nausea and vomiting did not differ between groups (P=0.666), and the incidence of sedation was higher in the placebo groups (P=0.022). CONCLUSION: The perioperative administration of oral pregabalin (150 mg twice) is an effective and safe way to reduce early postoperative pain in patients undergoing septoplasty.


Assuntos
Humanos , Analgesia , Analgésicos , Incidência , Náusea , Neuralgia , Dor Pós-Operatória , Vômito , Pregabalina
20.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-173814

RESUMO

A 60-year-old woman suffered from recurrent femur neck fracture. Laboratory data showed serum hypophosphatemia, elevated alkaline phosphatase, normal serum calcium levels, and normal parathyroid hormone levels. Radiological examinations revealed a tumor in the right maxillary alveolar bone. The nasal cavity mass was removed, and the histological features were those of glomangiopericytoma. After removal of the tumor, some of the laboratory data normalized. Based on the clinical features, histopathological diagnosis and postoperative course of events, a diagnosis of glomangiopericytoma causing oncogenic osteomalacia was confirmed. We report a case of oncogenic osteomalacia caused by sinonasal glomangiopericytoma.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Fosfatase Alcalina , Cálcio , Diagnóstico , Fraturas do Colo Femoral , Hemangiopericitoma , Hipofosfatemia , Cavidade Nasal , Osteomalacia , Hormônio Paratireóideo
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