Does Septoplasty Improve Heart Functions of Patients With Septum Deviation in Terms of Echocardiography Findings?

OBJECTIVE: The authors aimed to determine pulmonary artery pressure and right heart functions in patients with nasal septum deviation (NSD) with echocardiography (EchoCG) and compare the postoperative changes of EchoCG parameters with preoperative findings. METHODS: Seventy-six patients who underwent septoplasty composed the study group. Average age of patients was 23.50 ranging between 18 and 48 years of age. There were 53 males (69.7%) and 23 females (30.3%). Mean pulmonary artery pressure, tricuspid annular-plane systolic excursion, right ventricular diameter, and e/a ratio were measured by EchoCG preoperatively and same parameters were reobtained 3 months after surgery. RESULTS: Mean pulmonary artery pressure reduced from 23.88 ± 6.36 to 19.80 ±3.95 mm Hg and tricuspid annular-plane systolic excursion increased from 22.36 ±3.85 to 23.57±3.00 3 months after surgery. It represented statistically significant improvement at right heart functions postoperatively (P < 0.001). Although they were not statistically significant, there was also some improvement in right ventricular diameter and e/a ratio values postoperatively. CONCLUSION: Nasal septum deviation was associated with higher PAP values, which were improved after surgery. Although at a lower extent, a negative effect of NSD on right heart functions was also suspected. Thus, treatment of NSD without delay was proposed, not only to treat the nasal symptoms but possible future cardiovascular complications as well.

Early Results and Description of a New Modification of Spreader Graft to Enlarge Nasal Valve Area: Modified Triangular Spreader Graft.

OBJECTIVE: Nasal valve area is an important, functional part of nose and there are several different methods that have been used to enlarge that area for a better breathing function. In this study, the authors aimed to study the efficacy of a new spreader graft modification that was crafted in a triangular shape to enlarge nasal valve area. METHODS: Twenty-two patients who underwent rhinoplasty operation with this new technique composed the study group. Average age of patients was 21.4 ±â€Š2.1, 13 of them were men (59%) and 9 of them were women (41%). Same surgeon operated all 22 patients with the same technique that included usage of modified triangular spreader graft. Surgical outcomes were assessed by visual analog scale and nasal obstruction symptom evaluation scale preoperatively and 3 months postoperatively. RESULTS: None of the patients had complications or aesthetic deformities according to surgeon after surgery. Average of nasal obstruction symptom evaluation scale score was 64.3 before surgery which reduced to 17.9 at postoperative third month. Also average visual analog scale score was 2.6 before surgery and it was 8.1 3 months after surgery indicating a better breathing sensation (P < 0.001). CONCLUSIONS: Modified triangular spreader graft usage is a safe and effective method to enlarge nasal valve area with satisfactory aesthetic outcomes and good functional results because of its compatibility with anatomic position of nasal valve area.

Comparison of Clinical Results in Nasal Tip Augmentation Either Via Face to Face or Back to Back Technique With Autogenous Auricular Conchal Cartilage.

OBJECTIVE: To compare the objective and subjective findings between patients who underwent nasal tip augmentation surgery via two different methods using autogenous auricular conchal cartilage. MATERIALS AND METHODS: This study included the data of 21 patients who underwent nasal tip augmentation surgery. The patients were randomly divided in two groups according to the technique used to form a double layer columellar strut graft; either face to face (group 1) and back to back (group 2). All patients were assessed via nasal obstruction symptom evaluation scale (NOSE) and via acoustic rhinometry and rhinomanometry at preoperative and postoperative 1st and 6th months. RESULTS: There was statistically significant improvement in symptom score in both patient groups with no difference inbetween. Total nasal resistance decreased nonsignificantly at the end of 6th month in both groups; 13.1 Pa/cm3 to 8.6 Pa/cm3 and 10.3 Pa/cm3 to 9.5 Pa/cm3 respectively. There was no significant increment in MCA values for both groups except left MCA1. CONCLUSIONS: We achieved good results in tip augmentation via both techniques. An autogenous conchal cartilage is a good alternative to replace lacking caudal septal cartilage. It provides safe and stable support to the nasal tip. However, further comprehensive studies with larger sample size and long follow-up are required to elucidate any difference between these two techniques.

[The effects of CO2 laser posterior cordotomy on quality of life in patients with bilateral vocal cord paralysis]. / Iki tarafli vokal kord paralizili hastalarda CO2 lazer posteriyor kordotominin yasam kalitesine etkisi.

OBJECTIVES: In this study, we evaluated the effects of CO2 laser posterior transverse cordotomy on the quality of life in patients with bilateral vocal cord paralysis (BVCP). PATIENTS AND METHODS: Between April 2009 and October 2011, 14 patients with BVCP who underwent unilateral CO2 laser posterior cordotomy were included. The functional outcome of the procedure was assessed by the changes in the subscales of the Quality of Life Survey (SF-36). Postoperative glottic space and voice quality were evaluated using an arbitrary classification system. RESULTS: There was a statistically significant improvement in all parameters of SF-36 subscales after surgery, except the emotional role functioning and mental health component subscales. No significant correlation was found between the findings of the SF-36 subscales and stages of glottic space. No correlation was observed between the changes in the SF-36 subscales and voice quality. There was a significant correlation between the stages of glottic space and voice quality (p=0.036). CONCLUSION: The CO2 laser surgery is a safe and effective surgical modality which improves quality of life in the patients with BVCP. It can be also suggested that a considerable amount of tissue ablation is not necessarily required with this surgery and this helps to prevent impairment of voice quality.