A novel technique in septal perforation: Fascia lata and costal cartilage sandwich graft.

BACKGROUND: Nasal septum perforation (NSP) is an anatomical defect of the mucosa, cartilage/bone of nasal septum and septoplasty is the most common cause of it. A perforated septum rarely heals on its own, it is more likely to get worse. The success for large perforations is approximately 78%, it is harder to be successful in vertically larger perforations. We introduce a new technique to close large perforations by the fascia lata and costal cartilage sandwich graft (FLSG). The main advantage of this technique is that the fascia lata eliminates the opening between the septal mucosal flaps in case the septal mucosal flaps may not meet each other. PATIENTS AND METHODS: 16 cases presenting with nasal septum perforation were repaired with the FLSG technique. Grafts were harvested, the perforation was accessed through open rhinoplasty approach, FLSG is inserted and sutured. RESULTS: 16 cases consisting of 9 males (56.25%) and 7 females (43.75%) were operated. The age range was between 20 and 43 years (mean 32.6 ± 6.94). 3 cases (18.75%) had medium and 13 cases (81.25%) had large NSP. 8 cases (50%) were smokers. Nine month postoperatively, all medium NSP were closed. During this period, 14 NSP (87.5%) medium size NSP achieved complete closure, while the remaining two NSP that were yet to close had large defects (>2 cm) and smokers. CONCLUSION: FLSG is an effective, easy, and novel technique in NSP repair and the postoperative controls have proven a high success rate even in large NSP.

Does the radioactive iodine dose affect smell, taste sensation and nose function?

OBJECTIVE: To detect whether the adverse effects of post-operative radioactive iodine therapy following differentiated thyroid cancer on smell, taste and nasal functions were associated with radioactive iodine dose. METHODS: Fifty-one patients who had undergone total thyroidectomy because of differentiated thyroid cancer were divided into two groups depending on the post-operative radioactive iodine therapy dose: low dose group (50 mCi; 21 patients) and high dose group (100-150 mCi; 30 patients). The Sniffin' Sticks smell test, the Taste Strips test and the 22-item Sino-Nasal Outcome Test were performed on all patients one week before therapy, and at two months and one year following therapy. RESULTS: Statistically significant differences were detected in the Sniffin' Sticks test results, total odour scores, total taste scores and Sino-Nasal Outcome Test results between the assessment time points. There was no statistically significant difference between the low and high dose groups in terms of odour, taste or Sino-Nasal Outcome Test scores either before or after therapy. CONCLUSION: Radioactive iodine therapy has some short- and long-term adverse effects on nasal functions and taste and odour sensations, which affect quality of life. These effects are not dose-dependent.

Nodule or pseudonodule? Differentiation in Hashimoto's thyroiditis with sonoelastography.

Fine needle aspiration biopsy (FNAB) is the gold standard for the diagnosis of lymphoma in Hashimoto's thyroiditis and is able to differentiate between benign, inflammatory or malignant nodules, classifying them as either true nodules or pseudonodules. This technique is, however, invasive. The present study aimed to differentiate pseudonodules from true nodules by sonoelastography, a non-invasive technique, in 54 patients with Hashimoto's thyroiditis. The accuracy of sonoelastography to differentiate between true or pseudonodules was compared with the gold standard FNAB and with grey scale ultrasonography. The nodules were categorized into three groups: non-demarcated hypoechogenic, demarcated hyperecho genic, and demarcated hypoechogenic. Sono elastography findings were concordant with the cytopathological results and demonstrated that sono elastography was able to detect true thyroid nodules often misdiagnosed by conventional grey scale ultrasonography. Sonoelastography was found to have increased sensitivity for true nodule diagnosis compared with conventional grey scale ultrasonography and may eliminate unnecessary FNABs being carried out.