Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.377
Filtrar
1.
J Laryngol Otol ; 133(12): 1046-1049, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31679530

RESUMO

OBJECTIVE: There are few detailed studies about peripheral branch resection of the posterior nasal nerves in the inferior turbinate; thus, this study aimed to investigate this. METHODS: Patients who underwent submucosal turbinoplasty with or without resection of the peripheral branches of posterior nasal nerves in the inferior turbinate were included. RESULTS: The resection of the posterior nasal nerves with turbinoplasty significantly reduced detection and recognition thresholds on olfactory testing. The rhinorrhoea severity, detection threshold and recognition threshold were significantly lower after resection of the posterior nasal nerves with turbinoplasty than after turbinoplasty alone, although there were no significant differences between the two groups before surgery. CONCLUSION: This is the first study to show that the resection of the peripheral branches of the posterior nasal nerves in the inferior turbinate with turbinoplasty more effectively inhibits allergic symptoms compared with turbinoplasty alone. It also showed that the resection of the peripheral branches of the posterior nasal nerves can inhibit olfactory dysfunction.


Assuntos
Transtornos do Olfato/cirurgia , Conchas Nasais/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Olfato/diagnóstico , Transtornos do Olfato/etiologia , Rinite Alérgica/complicações , Rinite Alérgica/cirurgia , Olfato/fisiologia , Resultado do Tratamento , Conchas Nasais/inervação , Adulto Jovem
2.
Facial Plast Surg Clin North Am ; 27(4): 465-475, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31587766

RESUMO

Empty nose syndrome (ENS) is a controversial condition associated with disruption of nasal airflow caused by excessive loss of turbinate tissue. ENS arises after total or near-total inferior turbinate resection. Patients present with intense fixation on the perception of nasal obstruction. Diagnostic tools to assess for empty nose syndrome include a validated patient questionnaire and the office cotton test. Treatment involves topical moisturization, behavioral/psychiatric assessment/treatment, and surgical reconstruction. Current data show promising long-term efficacy after surgical intervention. Postprocedural ENS is best prevented by minimizing inferior and middle turbinate tissue loss.


Assuntos
Deformidades Adquiridas Nasais/diagnóstico , Deformidades Adquiridas Nasais/cirurgia , Rinoplastia/efeitos adversos , Rinoplastia/métodos , Conchas Nasais/cirurgia , Derme Acelular , Materiais Biocompatíveis/uso terapêutico , Cartilagem/transplante , Humanos , Doença Iatrogênica , Deformidades Adquiridas Nasais/etiologia , Deformidades Adquiridas Nasais/terapia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Reoperação/métodos , Síndrome
6.
J Craniofac Surg ; 30(5): 1479-1483, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31299748

RESUMO

INTRODUCTION: Modern rhinoplasty has an aesthetic and a functional component that cannot be separated. Functional rhinoplasty generally concentrates on optimizing nasal airflow. Numerous techniques have been described for correction of each pathology. There seems to be a consensus on the benefit of surgery to patients with nasal obstruction. Present study aimed to determine if specific airway pathologies have differential effects on patient complaints and techniques addressing them have differential effects on perceived benefit from surgery. PATIENTS/METHOD: The records of 300 patients complaining nasal obstruction and had computerized tomography (CT) between April 2015 and April 2018 were retrospectively reviewed. Based on surgical notes, surgical techniques used for each patient were recorded. A survey using Nasal Obstruction Symptom Evaluation (NOSE) scale is done by phone. After descriptive statistics, preoperative complaint-diagnosed pathology, and postoperative relief-treated pathology relationships were evaluated. RESULTS: Preoperative and postoperative NOSE scores showed statistically significant difference (P <0.001). The CT analysis showed that septal deviation rate among patients complaining nasal obstruction is 85%, internal valve insufficiency rate is 34.4%, mild and severe inferior turbinate hypertrophy was 71% and 6%, respectively. Bullous and total concha bullosa of middle turbinate was 17.3%. Nearly 90% of patients had 2 or more types of pathology in CT analysis. Preoperative and postoperative NOSE scores showed no statistically significant relationship with singular intranasal pathologies and techniques used for correcting them, respectively. CONCLUSION: Despite general fall in NOSE scores in the whole study group, treatment of a specific pathology does not change NOSE score more than a patient who already does not have the pathology. None of the pathologies or treatments addressing them have a dominating effect on preoperative complaints or obtained relief after the surgery. So, success of functional rhinoplasty cannot rely on correction of a specific pathology. A comprehensive analysis and correction of every pathology is paramount.


Assuntos
Obstrução Nasal , Adolescente , Adulto , Feminino , Humanos , Hipertrofia/cirurgia , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/cirurgia , Período Pós-Operatório , Estudos Retrospectivos , Rinoplastia/métodos , Tomografia Computadorizada por Raios X , Conchas Nasais/cirurgia , Adulto Jovem
7.
J Med Case Rep ; 13(1): 215, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-31303177

RESUMO

BACKGROUND: Recurrent respiratory papillomatosis is a chronic disease of viral origin affecting the larynx, trachea, and lower airways. Inverted papilloma, most commonly originating from the lateral nasal wall, is typically a single, expansile, locally aggressive tumor that remodels bone around the site of origin. CASE PRESENTATION: We report a case of histopathologically proven inverted papilloma occurring in a 50-year-old Caucasian man with recurrent respiratory papillomatosis affecting his nasal cavity, larynx, and trachea. This constitutes the first report of nasal involvement in recurrent respiratory papillomatosis. Viral in situ hybridization studies demonstrated evidence of human papillomavirus in both the septum and middle turbinate subsites. Repeat nasal excision with margin analysis is planned. CONCLUSIONS: This report emphasizes the importance of considering a broad differential diagnosis in patients with papillomata, and obtaining comprehensive histopathologic evaluation of lesions in multiple subsites in order to rule out inverted papilloma or overt malignant transformation, particularly if high-risk human papillomavirus (HPV) subtypes are identified. LEVEL OF EVIDENCE: 4.


Assuntos
Neoplasias Nasais/complicações , Papiloma Invertido/complicações , Infecções por Papillomavirus/complicações , Infecções Respiratórias/complicações , Transformação Celular Neoplásica/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Septo Nasal/patologia , Septo Nasal/cirurgia , Neoplasias Nasais/patologia , Neoplasias Nasais/cirurgia , Papiloma Invertido/patologia , Papiloma Invertido/cirurgia , Papillomaviridae/isolamento & purificação , Conchas Nasais/patologia , Conchas Nasais/cirurgia
9.
Lancet ; 394(10195): 314-321, 2019 07 27.
Artigo em Inglês | MEDLINE | ID: mdl-31227374

RESUMO

BACKGROUND: Septoplasty (surgical correction of the deviated nasal septum) is the most frequently performed ear, nose, and throat operation in adults, but no randomised controlled trials or non-randomised comparative studies on the effectiveness of septoplasty have been published. Consequently, health-care providers, health insurance companies, and policy makers are concerned about the effectiveness of the procedure. We aimed to assess the effectiveness of septoplasty for nasal obstruction in adults with a deviated septum. METHODS: We did this open, multicentre, pragmatic, randomised controlled trial in 16 secondary and two tertiary referral hospitals in the Netherlands. Adults (aged ≥18 years) with nasal obstruction, a deviated septum, and an indication to have septoplasty done were randomly allocated (1:1) to receive either septoplasty with or without concurrent turbinate surgery or non-surgical management. Patients were stratified by sex, age (<35 years or ≥35 years), and deviation severity (mild, moderate, or severe). The primary outcome was health-related quality of life, measured with the validated Glasgow Health Status Inventory at 12 months. Analyses were done on an intention-to-treat basis. The trial is registered with the Netherlands Trial Register, number NTR3868. FINDINGS: Between Sept 2, 2013, and Dec 12, 2016, we randomly assigned 203 participants to receive either septoplasty with or without concurrent turbinate surgery (n=102) or non-surgical management (n=101). 189 participants were analysed at 12 months. At 12 months, mean score on the Glasgow Health Status Inventory of patients assigned to septoplasty was 72·2 (SD 12·2) and for those assigned to non-surgical management was 63·9 (SD 14·5, mean difference 8·3 [95% CI 4·5-12·1], favouring septoplasty). Septal abscess occurred in one surgical patient and septal perforation in two surgical patients. No side-effects of nasal medication were reported. INTERPRETATION: Septoplasty is more effective than non-surgical management for nasal obstruction in adults with a deviated septum. This effect was sustained up to 24 months of follow-up. FUNDING: The Netherlands Organisation for Health Research and Development (ZonMw).


Assuntos
Corticosteroides/uso terapêutico , Obstrução Nasal/terapia , Septo Nasal/cirurgia , Deformidades Adquiridas Nasais/terapia , Conchas Nasais/cirurgia , Conduta Expectante/métodos , Adulto , Idoso , Feminino , Humanos , Análise de Intenção de Tratamento , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Nasais/métodos , Países Baixos , Qualidade de Vida , Resultado do Tratamento , Conchas Nasais/patologia , Adulto Jovem
10.
Rhinology ; 57(5): 352-357, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31162492

RESUMO

BACKGROUND: Turbinoplasty is a common procedure in patients with nasal obstruction and hypertrophy of the nasal turbinates. A general recommendation regarding the necessity of turbinoplasty in functional rhinosurgery is still missing. For the first time, the value of turbinoplasty in septo- and septorhinoplasty regarding patient satisfaction as well as objective data in rhinomanometry and acoustic rhinometry was analyzed in a prospective randomized controlled trial. METHODOLOGY: 73 patients with nasal obstruction due to septal deviation and / or a deviated nose were included in the study. After randomization, anterior turbinoplasty was or was not performed during septo- or septorhinoplasty. Pre- and postoperative rhinomanometry and acoustic rhinometry were accomplished. NOSE© and SNOT 20 questionnaires were completed by the patients before and 9 months after surgery. Additionally, the patients were asked about their subjective satisfaction. RESULTS: 81% of the patients were subjectively satisfied with the postoperative improvement of nasal breathing. There was a significant improvement in the values of NOSE© and SNOT 20 questionnaires with no relevant difference between the two study groups. Acoustic rhinometry and rhinomanometry showed values in MCA1 and 2, Vol 1 and Vol 2 as well as higher nasal flows with no statistically significant difference between the two study groups. CONCLUSIONS: Patient satisfaction after functional septo- and septorhinoplasty is high and does not seem to be affected by turbinate surgery. There was no statistically significant difference in the postoperative results regarding objective rhinological measurements with or without turbinoplasty. As extensive resections of the turbinates can have a negative impact on nasal physiology, the indication for turbinoplasty must be considered carefully.


Assuntos
Obstrução Nasal , Rinoplastia , Conchas Nasais , Humanos , Obstrução Nasal/cirurgia , Septo Nasal/cirurgia , Estudos Prospectivos , Rinoplastia/métodos , Resultado do Tratamento , Conchas Nasais/cirurgia
11.
Curr Opin Otolaryngol Head Neck Surg ; 27(4): 237-242, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31116142

RESUMO

PURPOSE OF REVIEW: To discuss the proposed pathophysiology of empty nose syndrome (ENS), summarize and evaluate the role of validated diagnostic tools in the diagnosis of ENS, and review the medical and surgical treatment strategies for patients with ENS. RECENT FINDINGS: Historically, ENS has been associated with a reduction in nasal turbinate size; new data suggest that impaired trigeminal nerve function may also play a role in the pathophysiology of the disease. The newly validated empty nose syndrome 6 item questionnaires and Cotton test are steps forward to standardize the diagnosis of ENS. Finally, there has been a marked increase in surgical treatment strategies to reconstitute turbinate volume with various implant materials. SUMMARY: The diagnosis of ENS remains controversial but the last several years have seen a rejuvenation of interest in this disease entity. The validated empty nose syndrome 6 item questionnaires and Cotton test provide a standardized and objective means by which to characterize ENS. Prevention of iatrogenic ENS through avoidance of excessive turbinate reduction remains critical in preventing paradoxical nasal obstruction. Nasal humidification, patient education, and treatment of possible concomitant medical conditions (e.g., depression) constitute first lines of treatment. We support the cautious use of these screening tools as adjuncts to clinical decision-making. Although injectable implants to augment turbinate volume show promise as a therapeutic surgical technique, there is insufficient data to fully support their use at this time.


Assuntos
Doenças Nasais/fisiopatologia , Doenças Nasais/cirurgia , Conchas Nasais/fisiopatologia , Conchas Nasais/cirurgia , Técnicas de Diagnóstico do Sistema Respiratório , Humanos , Doenças Nasais/diagnóstico , Inquéritos e Questionários , Síndrome
12.
Otolaryngol Head Neck Surg ; 161(3): 522-528, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31039072

RESUMO

OBJECTIVE: To compare surgical outcomes between 2 techniques for cribriform cerebrospinal fluid leak (CSF) repair with middle turbinate preservation (MTP) vs middle turbinate resection (MTR). A secondary outcome is to examine the effectiveness of collagen dura matrix (CDM) as a grafting material for repair of isolated cribriform skull base defects. STUDY DESIGN: A retrospective chart review was performed of consecutive patients who underwent cribriform CSF repair at Emory University over the past 15 years. SETTING: Tertiary care rhinology practice. SUBJECTS: Adult patients with cribriform defects limited to the cribriform plate that did not extend lateral to the middle turbinate (MT) and were reconstructed with a free graft (mucosal or synthetic). METHODS: Patients were stratified into 2 primary groups by surgical technique: MTP vs MTR. A subset of patients underwent repair with CDM alone and was analyzed separately for CSF repair failure rate. RESULTS: Of 68 patients identified with cribriform defects, 42 underwent repair with MTP and 26 underwent repair with MTR. Average follow-up time was 495 days. Patients with idiopathic intracranial hypertension were also equally distributed (P = .20). Primary CSF leak repair success was 95.6%, with 100% of leaks ultimately repaired. A subset of 39 patients underwent repair with CDM alone, with a primary repair success rate of 94.9%. CONCLUSIONS: We present an effective method for repair of cribriform CSF leaks while preserving the MT. CDM can be successfully used as a free graft alone for repair of isolated cribriform CSF leaks.


Assuntos
Vazamento de Líquido Cefalorraquidiano/cirurgia , Conchas Nasais/cirurgia , Adulto , Idoso , Osso Etmoide , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
13.
Tidsskr Nor Laegeforen ; 139(9)2019 May 28.
Artigo em Norueguês, Inglês | MEDLINE | ID: mdl-31140260

RESUMO

BACKGROUND: Osteomyelitis was determined in two patients following radiofrequency turbinoplasty. This is a rare complication of the procedure, and we have found no other case reports concerning osteomyelitis as a specific complication of radiofrequency turbinoplasty. CASE PRESENTATION: Two patients underwent radiofrequency turbinoplasty. Postoperatively they presented with clinical features such as a faecal smell in the nose, crusting and local necrosis of the inferior turbinates, which led to the clinical and histological diagnosis of osteomyelitis. The infections were polymicrobial, as verified by bacterial growth in the nasal biopsies. They were treated with surgical debridement, local and systemic antibiotics and nasal saline irrigation. INTERPRETATION: The patients underwent surgery that involved the use of more insertion channels than recommended by the distributor of the surgical equipment, and local anaesthesia included adrenaline. These two factors may well have caused or increased the likelihood of developing osteomyelitis. One patient has an open nose giving rise to no concern after treatment; the other patient has developed empty nose syndrome on the right side. We report these cases in order to raise and aid awareness regarding this possible complication of radiofrequency turbinoplasty.


Assuntos
Osteomielite/etiologia , Terapia por Radiofrequência , Rinoplastia , Conchas Nasais/cirurgia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Osteomielite/cirurgia , Complicações Pós-Operatórias/tratamento farmacológico , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/microbiologia , Complicações Pós-Operatórias/cirurgia , Terapia por Radiofrequência/efeitos adversos , Terapia por Radiofrequência/métodos , Rinoplastia/efeitos adversos , Rinoplastia/métodos
14.
Am J Otolaryngol ; 40(5): 650-652, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31130268

RESUMO

INTRODUCTION: Inferior turbinate hypertrophy is a common reason of nasal obstruction. One of the most preferred surgical metod is radiofrequency tecnique. Coblation submucosal reduction turbinator (SCT);new surgical device; started to use recently. Since the method is new, very few study has been done yet. We compare coblation radiofrequency (CR) with SCT. MATERIAL AND METHODS: Patients with only inferior turbinate hypertrophy but no other diseases included in study. Paranasal CT was made to all patient to rule out turbinate bone hypertrophy. Group 1 32 patient; performed CR. Group 2 25 patients performed SCT. To all patients preoperative and 3 weeks later post operative mucosiliary activity test was performed. Nasal flow was measured with nasal flow meter preoperatively and 3 weeks post operatively. VAS and NOSE was measured. Results compared between two groups. SCT performed under general; CR performed under local anesthesia. RESULTS: There was significant nasal flow changes in CR group. (p < 0.001) There was no difference in pre-and-post operatively saccharin test results in CR group. (p = 0.385) There was slightly nasal flow gain in SCT group but this was not statistically significant. (p < 0.192) Also there was no statistically significant changes in pre-and-post operatively saccharin test results in SCT group. (p = 0.167) There was no difference between two groups in terms of post operative nasal flow values and mucociliary activity. (respectively p = 0.562, p = 0.355). (Table 2). Both two tecnique has significant increase in VAS and NOSE scores. (p < 0.001). CONCLUSIONS: According to our study two tecnique is suitable and safe for nasal mucociliary activity. Tecniques has positive effect on nasal flow, VAS and NOSE scores.


Assuntos
Ablação por Cateter/instrumentação , Ablação por Cateter/métodos , Obstrução Nasal/cirurgia , Conchas Nasais/cirurgia , Adulto , Distribuição de Qui-Quadrado , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Hipertrofia/patologia , Hipertrofia/cirurgia , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/fisiopatologia , Estudos Prospectivos , Recuperação de Função Fisiológica , Rinomanometria/métodos , Medição de Risco , Índice de Gravidade de Doença , Método Simples-Cego , Centros de Atenção Terciária , Resultado do Tratamento , Conchas Nasais/patologia , Adulto Jovem
15.
Ann Anat ; 224: 28-32, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30953809

RESUMO

PURPOSE: To provide a review of the anatomy of the lacrimal drainage system and lateral wall of the nose pertaining to endoscopic dacryocystorhinostomy. METHODS: The authors performed a PubMed search of articles published pertaining to the anatomy of the lateral wall of the nose and the anatomy of endonasal and external dacryocystorhinostomy surgery. RESULTS: The article covers the regional surface and surgical anatomy for endoscopic dacryocystorhinostomy (DCR), including the maxillary line, middle turbinate, agger nasi air cell, lacrimal sac and fossa and the upper portion of the nasolacrimal drainage system. It also explores the dimensions and location of bony ostium formation to ensure full exposure and marsupialisation of the lacrimal sac. Finally, it covers the anatomy of potential complications of endoscopic DCR surgery including penetration of the skull base and orbit, inadvertent entry to the maxillary sinus and breach of the skin. CONCLUSION: A good understanding of the anatomy of the lacrimal drainage system and the lateral wall of the nose will increase the likelihood of successful surgery and minimize the risk of complications and damage to neighbouring structures such as the orbit and skull base.


Assuntos
Dacriocistorinostomia/normas , Endoscopia/normas , Aparelho Lacrimal/anatomia & histologia , Dacriocistorinostomia/efeitos adversos , Endoscopia/efeitos adversos , Humanos , Aparelho Lacrimal/cirurgia , Maxila/anatomia & histologia , Maxila/cirurgia , Mucosa Nasal/anatomia & histologia , Mucosa Nasal/cirurgia , Retalhos Cirúrgicos , Conchas Nasais/anatomia & histologia , Conchas Nasais/cirurgia
16.
Otolaryngol Head Neck Surg ; 161(2): 343-347, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31010383

RESUMO

OBJECTIVES: Use decision analysis techniques to assess the potential utility gains/losses and costs of adding bilateral inferior turbinoplasty to tonsillectomy/adenoidectomy (T/A) for the treatment of obstructive sleep-disordered breathing (oSDB) in children. Use sensitivity analysis to explore the key variables in the scenario. STUDY DESIGN: Cost-utility decision analysis model. SETTING: Hypothetical cohort. SUBJECTS AND METHODS: Computer software (TreeAge Software, Williamstown, Massachusetts) was used to construct a decision analysis model. The model included the possibility of postoperative complications and persistent oSDB after surgery. Baseline clinical and quality-adjusted life year (QALY) parameters were estimated using published data. Cost data were estimated from Centers for Medicare and Medicaid 2018 databases ( www.cms.gov ). Sensitivity analyses were completed to assess for key model parameters. RESULTS: The utility analysis of the baseline model favored the addition of turbinoplasty (0.8890 vs 0.8875 overall utility) assuming turbinate hypertrophy was present. Sensitivity analysis indicated the treatment success increase (%) provided by concurrent turbinoplasty was the key parameter in the model. A treatment success increase of 3% of turbinoplasty was the threshold where concurrent turbinoplasty was favored over T/A alone. The incremental cost-effectiveness ratio (ICER) of $27,333/QALY for the baseline model was favorable to the willingness-to-pay threshold of $50,000 to $100,000/QALY for industrialized nations. CONCLUSIONS: The addition of turbinoplasty for children with turbinate hypertrophy to T/A for the treatment of pediatric oSDB is beneficial from both a utility and cost-benefit analysis standpoint even if the benefits of turbinoplasty are relatively modest.


Assuntos
Adenoidectomia , Análise Custo-Benefício , Técnicas de Apoio para a Decisão , Síndromes da Apneia do Sono/cirurgia , Tonsilectomia , Conchas Nasais/cirurgia , Criança , Humanos , Resultado do Tratamento
17.
Ear Nose Throat J ; 98(6): E51-E57, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30974993

RESUMO

Coblation is a novel technology and has a wide application in the field of otorhinolaryngology. We conducted a randomized, noncontrolled study to compare the effectiveness of 2 types of wands used for turbinoplasty for nasal obstruction due to inferior turbinate hypertrophy. Reflex Ultra and Turbinator wands were compared on a total of 150 patients. These patients were divided into a group of 75 patients each in a randomized manner. Results were compared based on the visual analog scale, and objective assessment was done on the basis of endoscopic assessment, that is, Nasal Endoscopic Score (NES). Assessment was done on postoperative day 7, first month, third month, and first year. Both groups demonstrated significant and similar results in long term, but an immediate improvement at 1 week was seen in the Turbinator group. Hence, we conclude that coblation turbinoplasty is an effective technique for turbinate reduction and both wands are equally effective in long term. However, Reflex Ultra has the advantage of mucosal preservation and minimal morbidity, and Turbinator has the advantage of immediate relief in nasal symptoms.


Assuntos
Obstrução Nasal/cirurgia , Procedimentos Cirúrgicos Nasais/instrumentação , Ablação por Radiofrequência/instrumentação , Conchas Nasais/cirurgia , Feminino , Humanos , Hipertrofia , Masculino , Procedimentos Cirúrgicos Nasais/métodos , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Ablação por Radiofrequência/métodos , Distribuição Aleatória , Resultado do Tratamento , Conchas Nasais/patologia , Escala Visual Analógica
18.
Ann Otol Rhinol Laryngol ; 128(7): 601-607, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30818962

RESUMO

OBJECTIVES: Empty nose syndrome (ENS) is thought to have multiple etiologies, one of which is a postsurgical phenomenon resulting from excessive loss of nasal tissues, particularly the inferior turbinate. Given that the inferior turbinate is instrumental in maintaining nasal homeostasis in different environments, it is believed that ENS symptoms arise only in more arid regions of the world. The aim of this study was to recruit an international population of individuals with ENS to investigate the association of local climate factors on the incidence and severity of ENS-specific symptoms. METHODS: A cross-sectional study was performed of individuals from an international ENS database. ENS status was determined on the basis of a positive ENS questionnaire score (Empty Nose Syndrome 6-Item Questionnaire) and sinus computed tomographic imaging with supporting medical documentation. Participants completed a survey encompassing demographic, geographic, and symptom indicators. Climate variables were collected from global climate databases. Participant location was classified according to the Köppen-Geiger climate system. Pearson correlation analysis was performed using α = 0.05 to determine significance. RESULTS: Fifty-three individuals with ENS were included. Participants were distributed across 5 continents and 15 countries (representing 4 distinct Köppen-Geiger zones). Although local climate factors varied significantly within this cohort, no significant association was found between Empty Nose Syndrome 6-Item Questionnaire symptom severity and these climate factors. However, most study participants reported exacerbation of their ENS symptoms in response to dry air (94%), air conditioning (64%), changes in season and weather (60%), and transitioning between indoors and outdoors (40%). This suggests that everyday local environmental factors may influence the well-being of these patients more than global, climate-level shifts. CONCLUSIONS: ENS symptom severity does not appear to be related to climate or geographic factors. These findings deviate from the traditional dogma that ENS is experienced only in arid regions (or precluded in humid regions) and highlight the importance of recognizing this condition independent of geographic location.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Obstrução Nasal/cirurgia , Doenças Nasais/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Conchas Nasais/patologia , Adulto , Ar Condicionado/estatística & dados numéricos , Atrofia/epidemiologia , Clima , Estudos Transversais , Feminino , Humanos , Umidade , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Nasais/efeitos adversos , Doenças Nasais/etiologia , Complicações Pós-Operatórias/etiologia , Estações do Ano , Índice de Gravidade de Doença , Inquéritos e Questionários , Síndrome , Conchas Nasais/cirurgia , Tempo (Meteorologia) , Adulto Jovem
19.
Ear Nose Throat J ; 98(1): 32-36, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30834785

RESUMO

The aim of this study is to investigate the novel use of sleep monitoring applications in simple snorers undergoing concha radiofrequency surgery and to compare and correlate the pre- and postoperative symptoms of these patients using the Nasal Obstruction Symptom Evaluation (NOSE) scale. In this retrospective analysis, we have selected 18 consecutive patients with no comorbid sleep or medical disorders suffering from chronic nasal blockage and habitual snoring due to isolated submucous inferior turbinate hyperplasia. After a median follow-up of 8.3 months, the NOSE scale and snoring sound intensity levels monitored by the smart phone application showed statistically significant improvements after the surgical procedure ( P < .05), and we also detected a positive correlation between the levels of snoring percentage and the total NOSE scores ( P < .05). We hypothesize that sleep monitoring applications could be easily used as portable monitors for basic home sleep studies in conjunction with a comprehensive sleep evaluation. Alternatively, such applications may simply be used for objective monitoring of the postoperative success of surgical interventions in the upper respiratory tract region such as concha reduction surgeries as presented herein.


Assuntos
Obstrução Nasal/fisiopatologia , Polissonografia/estatística & dados numéricos , Ronco/fisiopatologia , Conchas Nasais/patologia , Adulto , Feminino , Humanos , Hipertrofia , Masculino , Obstrução Nasal/complicações , Obstrução Nasal/cirurgia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Polissonografia/instrumentação , Polissonografia/métodos , Período Pós-Operatório , Período Pré-Operatório , Estudos Retrospectivos , Índice de Gravidade de Doença , Sono/fisiologia , Smartphone , Ronco/etiologia , Ronco/cirurgia , Conchas Nasais/cirurgia , Adulto Jovem
20.
Eur Arch Otorhinolaryngol ; 276(6): 1671-1675, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30877421

RESUMO

AIM: To evaluate the effect of inferior turbinate outfracture on nasolacrimal transit time by saccharin test. MATERIALS AND METHODS: Twenty patients who underwent septoplasty + unilateral radiofrequency ablation and outfracture of inferior turbinate were enrolled into study. They had no complaints about their eyes and denied previous ocular surgery. Their nasolacrimal saccharin transit times (NSTTs) were estimated preoperatively and postoperatively in the 1st and 2nd months. The non-fractured side eye was measured only once preoperatively. The fractured-side eye was measured three times. These times were compared statistically. RESULTS: There were 8 men and 12 women. Mean age was 29.04. Killian incision was used in 14 and hemitransfixion incision was used in 6 patients. Median NSTT was 484, 461, 490 and 446 s for the non-fracture side, preoperatively and postoperatively in the 1st and 2nd months, respectively. There was no statistically significant difference between the two eyes preoperatively, and in the fractured side preoperatively and postoperatively in the 2nd month. There were significant differences between median NSTT in postoperative 1st month and median NSTT in the preoperative measure, and between postoperative 1st and 2nd months (p < 0.05). Median NSST in the 1st month was longer than the others. CONCLUSION: Outfracture of inferior turbinate had no permanent effect on NSTT 2 months after surgery in patients that had a healthy nasolacrimal system.


Assuntos
Depuração Mucociliar , Obstrução Nasal/cirurgia , Ducto Nasolacrimal , Complicações Pós-Operatórias/diagnóstico , Rinoplastia , Sacarina/farmacologia , Conchas Nasais/cirurgia , Adulto , Feminino , Humanos , Masculino , Ducto Nasolacrimal/fisiopatologia , Ducto Nasolacrimal/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/fisiopatologia , Reprodutibilidade dos Testes , Rinoplastia/efeitos adversos , Rinoplastia/métodos , Edulcorantes/farmacologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA