Functional analysis of ESM1 by siRNA knockdown in primary and metastatic head and neck cancer cells.

BACKGROUND: Genetic factors play a large role in cancer, and thus, there is a great desire to understand the effects of different genes in cancer and to also develop gene therapy for better treatments. Therefore, the development of alternative diagnosis and therapy modalities is of utmost importance. The aim of our study was to illuminate the role of ESM1 (endothelial cell-specific molecule-1, also known as Endocan) in proliferation and migration of head and neck cancer, thus helping to pave the way for new treatment modalities and predictive biomarkers. METHODS: ESM1 expression was shown with immunofluorescence assay using confocal laser scanning microscope in primary and metastatic head and neck cancer cells. ESM1 expression was knocked down by RNA interference in head and neck cancer cells. Knockdown efficiency was evaluated by quantitative real-time RT-PCR and Western blot. Cell proliferation and migration assays were performed by xCELLigence real-time cell analysis system. RESULTS: Immunofluorescence assay showed nuclear localization and high expression of ESM1 in primary and metastatic head and neck cancer cells. ESM1 mRNA and protein levels were significantly decreased in ESM1-knockdown cells compared to control. ESM1-knockdown cells showed reduced proliferation and migration activity when compared to control cells. CONCLUSION: These findings suggest that ESM1 has roles on proliferation and migration of head and neck cancer cells.

Retrospective air bone gap evaluation of patients with tympanic membrane central perforation.

PURPOSE: The purpose of this study was to evaluate hearing recovery and air-bone gap (ABG) before and after tympanoplasty surgery in patients with tympanic membrane central perforation. METHODS: Histories and audiological assessments of 160 cases (total of 26 ears from 22 patients; 11 men and 11 women) from patients who had undergone tympanoplasty surgery and hearing reconstruction due to tympanic membrane central perforation were evaluated. Pre-postoperative audiograms and the pure tone, air-bone hearing thresholds and ABG gains were evaluated. RESULTS: The mean age of the patients was 38.6 years (± 16.04). The mean postoperative follow-up period was 13.4 months (± 15.5). The mean preoperative ABG was 25.36 dB (± 9.9) and postoperative ABG was 17.36 dB (± 11.68) (p = 0.001). When four groups were compared before surgery and after surgery period as 0-6 months, 6-12 months, 1-2 years and 2 years in terms of pre- and postoperative ABG values, no statistically significant difference was observed (p>0.05). All patients were divided into three groups: < 20 years of age; between the ages of 21-40; and, >41 years of age, and no statistically significant difference were found between the groups (p> 0.05). Surgeries of the patients 21-40 years of age were more successful (ABG gain) than other age groups. No statistically significant gender differences were found in ABG averages (p = 0.33), but clinical results were significantly better in women as compared with men. CONCLUSION: In patients with central tympanic membrane perforation, tympanoplasty surgery with temporal fascia is beneficial in terms of hearing recovery.

Does Tinnitus Lead to Depression?

PURPOSE: The aim of the study was to investigate the correlation between THI (Tinnitus Handicap Inventory) and BDS (Beck Depression Scale). MATERIALS AND METHODS: High frequency thresholds and PTA (Pure Tone Audiometer) thresholds for the patients were measured in 44 patients with tinnitus (bilateral=13; unilateral=31). Tinnitus frequency and intensity were measured using one-pair method with high frequency audiometer Interacoustic AC40. Applied BDS and THI scores are evaluated for all patients. Our findings are analysed statistically with SPSS v.21 and BDS and THI correlation with tinnitus intensity and frequency was executed. RESULTS: The mean value of tinnitus frequency was 10 kHz (min 0.25 kHz, max16 kHz and SD 4.26), mean tinnitus intensity was 50.6 dB (min 15 dB, max 110 dB and SD 26.9 dB) mean THI score was 38.04 (min 10, max 86 and SD 20.03) and mean BDS score was 9.45 (min 0, max 28 and SD 6.49). There was no statistical correlation between THI score and tinnitus frequency (r=0.055, p=0.787). Moderate correlation is obtained between tinnitus frequency and depression (r=0.6, p=0.001). There were weak correlations between tinnitus intensity and THI score and (r=0.3, p=0.09) and between tinnitus intensity and BDS score (r=0.28, p=0.13). Although a statistically significant difference was observed between THI scores of patients with bilateral and unilateral tinnitus (p0.05). High frequency thresholds and UCL scores of ears with tinnitus were not statistically different from ears with no tinnitus (p>0.05). CONCLUSION: No correlation was seen between THI and tinnitus frequency, but a moderate correlation was seem between BDS score and tinnitus frequency. There were also weak correlations between tinnitus intensity and THI and BDS scores.

Long-term results of one staged multilevel surgery with tongue suspension surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea.

UNLABELLED: The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study. SETTING: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with ≥ 50 % retropalopharyngeal obstruction on the Müller maneuver, were treated with palatal surgeries (PS) and patients, with ≥ 50 % retropalopharyngeal obstruction on the Müller maneuver with ≥ 50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 ± 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 ± 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.

The protective role of thymoquinone in the prevention of gentamicin ototoxicity.

OBJECTIVE: To investigate the potential protective effect of thymoquinone in gentamicin-induced ototoxicity through auditory brain stem responses (ABR) testing and histomorphological evaluation of the cochlea. METHODS: This study was conducted on 48 adult female Sprague-Dawley rats that were randomized into 4 groups. Group 1 received intraperitoneal gentamicin; group 2 received intraperitoneal gentamicin plus corn oil solution; group 3 received intraperitoneal thymoquinone; and group 4 received intraperitoneal gentamicin plus thymoquinone. All groups received the drugs (once daily) in the above-mentioned protocols over 15 days. After conducting repeated ABR measurements, the rats were sacrificed, and their cochleae were isolated. RESULTS: ABR thresholds were preserved in the gentamicin plus thymoquinone group when compared with the group receiving gentamicin alone. There were fewer TUNEL-positive cells and caspase-3 and caspase-9 expressions were weaker in the inner and outer hairy cells of the organ of Corti in the gentamicin plus thymoquinone group compared with the group receiving gentamicin alone. CONCLUSION: The ABR values and number of apoptotic cells did not significantly increase in the group receiving gentamicin plus thymoquinone when compared to the group receiving gentamicin alone. Again, the cochlear histomorphological findings were supportive of the auditory findings. In light of these findings, we conclude that gentamicin-induced ototoxicity may be prevented by thymoquinone use in rats.

Pancreatic surgery in elderly patients: results of 329 consecutive patients during 10 years.

Introduction: There is a progressive shift from a younger population to an older population throughout the world. With the population age shift, surgeons will be more encountered with older patient profiles. We aim to determine age-related risk factors of pancreatic cancer surgery and the effect of patient age on outcomes after pancreatic surgery. Materials and methods: A retrospective review was conducted with data obtained from consecutive 329 patients whose pancreatic surgery was performed by a single senior surgeon between January 2011 and December 2020. Patients were divided into three groups based on age: patients younger than 65 years old, between 65 and 74 years old, and older than 74 years old. Demographics and postoperative outcomes of the patients were evaluated and compared between these age groups. Results: The distribution of a total of 329 patients into the groups was 168 patients (51.06%) in Group 1 (age <65 years old), 93 patients (28.26%) in Group 2 (age ≥65 and <75 years old), and 68 patients (20.66%) in Group 3 (age ≥75 years old). The overall postoperative complications were statistically significantly higher in Group 3 than in Group 1 and Group 2 (p = 0.013). The comprehensive complication index of the patients in each group was 23.1 ± 6.8, 20.4 ± 8.1, and 20.5 + 6.9, respectively (p = 0.33). Fisher's exact test indicated a significant difference in morbidity in patients with ASA 3-4 (p = 0.023). In-hospital or 90-day mortality was observed in two patients (0.62%), one from Group 2 and one from Group 3. The 3-year survival rates for each group were 65.4%, 58.8%, and 56.8%, respectively (p = 0.038). Conclusion: Our data demonstrate that comorbidity, ASA score, and the possibility of achieving a curative resection do have significantly more impact than age alone.

Effects of the Largest Metastatic Lymph Node Size on the Outcomes of Patients who Underwent Pancreaticoduodenectomy for Pancreatic Ductal Adenocarcinoma.

Objectives: Prognostic importance of metastatic lymph nodes in pancreatic cancer is always garnered attention due to dismal prognosis, with some quantitative factors drawing attention for significantly predicting outcomes. Size is one of the easy approach morphological characteristics of the lymph node, and data for effect of largest metastatic lymph node (LMLN) size on survival outcomes are lacking in pancreatic cancer. We aim to evaluate the effect of LMLN size on the prognosis of patients with pancreatic ductal adenocarcinoma (PDAC). Methods: This retrospective study evaluates the effect of LMLN size on survival outcomes by grouping the patients who were surgically treated for PDAC, according to their lymph node stage and calculated cutoff value for LMLN size, between February 2015 and May 2020. Results: In the study cohort of 131 patients, the mean age was 63.9±10.8 years and 77 patients were female. Ninety-nine of the patients had pN1, 32 had pN2 stage disease. The optimal cutoff point of LMLN size for predicting the prognosis was calculated as 7.5 mm (sensitivity = 81% and specificity = 81%). 34 (34.3%) of pN1 and 7 (21.9%) of pN2-staged patients had lymph node smaller than 7.5 mm. Three-year survival was significantly longer for patients whose LMLN size was <7.5 mm (56.2-18.2%, p<0.001). Whereas, the patients with LMLN size <7.5 mm had statistically significant longer median survival rate in the subgroup of patients with pN1 lymph node stage, no significant difference in median survival rates was observed between subgroups of pN2 patients (p=0.237). Conclusion: The present study demonstrated that the LMLN size was one of the potential predictors of survival in patients with PDAC.

Does Nasal Septal Deviation Affect the Eustachian Tube Function and Middle Ear Ventilation?

OBJECTIVE: Our aim is to evaluate the effect of nasal septal deviation on the middle ear pressure and Eustachian Tube (ET) functions with regard to the side of deviation. METHODS: A prospective randomized clinical trial was conducted. Overall, 50 patients (22 female, 28 male) undergoing septoplasty because of nasal septum deviation were included. The nasal obstruction symptom evaluation (NOSE) scale was used to evaluate surgical satisfaction. Middle ear ventilation and the ET functions of a total of 100 ears were assessed with basal tympanometry and insufflation tests (Valsalva and Toynbee). The tests were performed on the operation day and eight weeks after surgery. The ears were divided into two groups: the affected side (the side of nasal obstruction) (Group 1) and the contralateral side (Group 2). The study parameters obtained before and after septoplasty were compared. RESULTS: The NOSE scores decreased after septoplasty (12.48±4.78/7.56±3.4) (p<0.001). There were 20 functional ETs (40%) in the affected side preoperatively, which increased to 36 ears (72%) postoperatively, and functional tubes increased to 35 (70%) from 29 (58%) after surgery in the contralateral side. The changes in the tympanometry results were statistically significant for both the affected side (-33.56 daPA/-21.18 daPA) and contralateral side (29.24daPA/-24.96daPA) (p<0.05), but the alteration in the side of deviation was more evident. CONCLUSION: Our study shows that septoplasty may have a beneficial effect on middle ear ventilation and ET functions.

Psychometric Properties of the Turkish Version of the Satisfaction with Amplification in Daily Living Questionnaire in Hearing Aid Users.

BACKGROUND: Assessing hearing aid satisfaction is important for hearing aid adaptation in individuals who have hearing loss. Each user should be compared to oneself during the adaptation of the hearing aid and the determination of the satisfaction level, because, each user has their own demands and expectations. Therefore, the survey evaluations which reveal the personal preferences and expectations gain importance in the determination of the benefit and satisfaction rate for hearing aid users. PURPOSE: The purpose of this study was to evaluate the reliability of the Turkish version of the Satisfaction with Amplification in Daily Living (TSADL) among hearing aid users. RESEARCH DESIGN: The original Satisfaction with Amplification in Daily Living (SADL) questionnaire was translated from English to the TSADL. Linguistic adaptation attempted to ensure equivalency, both grammatically and idiomatically, and was assessed by investigators related to the field. STUDY SAMPLE: One hundred and sixty hearing aid users with sensorineural hearing loss, aged 18 to 90 yr (54.51 ± 18.21), who had been using a hearing aid regularly for more than 6 mo participated in the study; seventy three (45.10%) were male and 87 (54.30%) were female. DATA COLLECTION: Participants completed the TSADL twice, 3 mo apart (long enough to forget their replies in the first application but short enough to prevent any changes to the measured properties). RESULTS: When factor analysis of the questionnaire was performed, subdimension factor loadings were found to range from 0.744 to 0.854 for "Positive Effect," 0.62 to 0.985 for "Personal Image," and 0.903 to 0.913 for "Adverse Features"; the factor loading of "Service and Cost" was 0.983. Because all factor loadings were above 0.30, no items were excluded from the Turkish version of the questionnaire. Although the TSADL retained the original four factors, because of differences in Turkish social structures and perspectives, questions #12 and #15 revealed an association between the "Service and Cost" and "Positive Effects" subdimensions. CONCLUSIONS: The SADL-TR scale can be reliably used in clinical studies to rapidly assess patient satisfaction, compare satisfaction levels, determine normative satisfaction level, compare various amplifications, and gather administrative outcome data.

Effects of early postoperative nasal decongestant on symptom relief after septoplasty.

BACKGROUND: A randomized, prospective, double-blinded clinical study was conducted at a single, tertiary referral center. The aim of the study was to evaluate the effects of nasal decongestant use in the early postoperative period after septoplasty. METHODS: After septoplasty, patients who met the study inclusion criteria were randomized into 2 groups to receive either physiologic saline irrigation (saline group) or physiologic saline irrigation plus oxymetazoline hydrochloride 0.05% nasal spray (saline+oxymetazoline group). Visual analog scale (VAS) scores for bleeding, pain, and nasal crusting; Nasal Obstruction Symptom Evaluation (NOSE) scores; and rhinomanometric measurements were assessed pre- and postoperatively. RESULTS: The VAS scores for bleeding and nasal crusting of patients in the saline+oxymetazoline group were significantly lower compared with the saline group (p < 0.005). VAS scores for pain were similar between the groups (p > 0.05). Total nasal resistance and NOSE scores of patients in the saline+oxymetazoline group were significantly lower than in saline group after surgery (p < 0.005). CONCLUSION: The use of nasal decongestant sprays in the very early postoperative period is beneficial to reduce the postsurgical nasal crusting and bleeding symptoms and also for decreasing nasal resistance in this edematous period.

The effect of different nasal irrigation solutions following septoplasty and concha radiofrequency: a prospective randomized study.

INTRODUCTION: Nasal irrigation solutions are widely used following endonasal surgery. These irrigation solutions remove infective debris and crusts, reducing the probability of synechia formation, and accelerate mucosal healing. OBJECTIVE: The aim of the present study was to compare the effects of nasal irrigation solutions with different contents following septoplasty and concha radiofrequency. METHODS: The present study was a prospective, randomized, controlled simple blind study of 120 patients who underwent septoplasty and bilateral concha radiofrequency. Patients were divided into four groups according to the nasal irrigation solution used: tap water, buffered isotonic saline, saline with xylitol, and hypertonic sea water. Patients were examined on the 7th and 15th postoperative days. A saccharine test was applied to determine mucociliary activity preoperatively and on the 7th and 15th postoperative days. Patients were asked about drying and obstruction using a 10cm visual analog scale. In addition, patients were examined to determine the crusting score. RESULTS: There was no significant difference found in the preoperative and 7th and 15th postoperative days' mucociliary clearance times among the four groups. The crusting score was found to be significantly lower in the hypertonic sea water group (p<0.001). Drying and obstruction on the 7th and 15th postoperative days were found to be significantly more comfortable in the hypertonic sea water group (p<0.001). CONCLUSION: Hypertonic sea water is the recommended irrigation solution, as it is associated with less crusting, drying, and obstruction in the nose for the postoperative period following septoplasty and concha radiofrequency.

Association of Oral Antireflux Medication With Laryngopharyngeal Reflux and Nasal Resistance.

Importance: Laryngopharyngeal reflux (LPR) is thought to be a potential exacerbating factor in upper airway diseases. Objective: To describe the effect of pharmacologic therapy of laryngopharyngeal reflux on nasal resistance. Design, Setting, and Participants: Prospective observational study performed between August 30, 2014, and October 1, 2015, at a tertiary care academic center including 50 patients with Reflux Symptom Index higher than 13 and Reflux Finding Score higher than 7 and 50 controls with no history of LPR and nasal disease. Interventions: Oral antireflux medication was given to the LPR group for 12 weeks. Main Outcomes and Measures: The measurements of total nasal resistance (TNR) were performed by means of active anterior rhinomanometry technique and Nasal Obstruction Symptom Evaluation (NOSE) was assessed. Results: The LPR group had 29 (58%) women and a median age of 41.5 years (range, 18-64 years). The control group had 27 (54%) women and a median age of 38.5 years (range, 19-63 years). After treatment, a significant decrease was observed in all parameters. The median (range) TNR scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median TNR score of the control group was 0.20 (range, 0.11-0.32). Whereas the TNR scores of the LPR group were higher than those of the control group before treatment (difference, -0.77; 95% CI, -0.10 to 0.05), they were almost the same after treatment (difference, 0.01; 95% CI, -0.01 to 0.03). The median (range) NOSE scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median NOSE score of the control group was 0.20 (range, 0.11-0.32). Conclusions and Relevance: In this study, laryngopharyngeal reflux had a negative effect on nasal resistance and nasal congestion. Treatment was associated with improved subjective and objective nasal findings.

Evaluation of Acoustic Reflex and Reflex Decay Tests in Geriatric Group.

OBJECTIVE: To determine average acoustic reflex thresholds in geriatric groups by assessing ipsilateral and contralateral acoustic reflex and reflex decay tests. METHODS: A total of 25 elders between ages 65-84 years (74.3±5.4) and 25 individuals between ages 18-45 years (30.4±4.2) were recruited for the study. After ear, nose, and throat examination, ipsilateral and contralateral acoustic reflex thresholds at 500, 1000, 2000, and 4000 Hertz (Hz) were determined and a reflex decay test at contralateral 500 Hz was conducted. Ipsilateral acoustic reflex thresholds were obtained with high-frequency band, low-frequency band, and wide band noise, and the results were compared with ipsilateral acoustic reflexes at 500, 1000, 2000, and 4000 Hz. RESULTS: There was no statistically significant difference between the two groups in ipsilateral and contralateral acoustic reflex measurements at 500, 1000, 2000, and 4000 Hz (p>0.05). Negative reflex decay was obtained in all participants and no statistically significant difference between the two groups was observed in terms of reflex decay thresholds (p>0.05). Acoustic reflex with high-frequency band noise was observed in five of nine elders whose acoustic reflexes were not obtained at 2000 and 4000 Hz, whereas acoustic reflex with low-frequency band noise was observed in one of six elders who did not show reflexes at 500 and 1000 Hz. CONCLUSION: It was concluded that although some changes were observed due to age, middle ear and stapes muscles work normally in geriatric group. In the reflex decay test, reliable results were obtained at contralateral 500 Hz. Acoustic reflex measurements with low- and high-frequency band noise may also be used to assess middle ear functions.

Chronologic presentation of a severe case of progressive hemifacial atrophy (parry-romberg syndrome) with the loss of an eye.

Progressive hemifacial atrophy, also known as Parry-Romberg syndrome, is a slowly advancing degenerative disease that mostly affects the cutaneous, subcutaneous fatty tissue, muscle tissue, and bone structures on one side of the face. We describe the chronological progression of this very rare syndrome from early childhood until adulthood in a patient who developed severe atrophy and lost one eye. We also discuss the aetiology and pathophysiology of this syndrome.

The effect of different nasal irrigation solutions following septoplasty and concha radiofrequency: a prospective randomized study / Efeito de diferentes soluções para irrigação nasal após septoplastia e radiofrequência das conchas nasais: estudo prospectivo e randomizado

Abstract Introduction Nasal irrigation solutions are widely used following endonasal surgery. These irrigation solutions remove infective debris and crusts, reducing the probability of synechia formation, and accelerate mucosal healing. Objective The aim of the present study was to compare the effects of nasal irrigation solutions with different contents following septoplasty and concha radiofrequency. Methods The present study was a prospective, randomized, controlled simple blind study of 120 patients who underwent septoplasty and bilateral concha radiofrequency. Patients were divided into four groups according to the nasal irrigation solution used: tap water, buffered isotonic saline, saline with xylitol, and hypertonic sea water. Patients were examined on the 7th and 15th postoperative days. A saccharine test was applied to determine mucociliary activity preoperatively and on the 7th and 15th postoperative days. Patients were asked about drying and obstruction using a 10 cm visual analog scale. In addition, patients were examined to determine the crusting score. Results There was no significant difference found in the preoperative and 7th and 15th postoperative days' mucociliary clearance times among the four groups. The crusting score was found to be significantly lower in the hypertonic sea water group (p < 0.001). Drying and obstruction on the 7th and 15th postoperative days were found to be significantly more comfortable in the hypertonic sea water group (p < 0.001). Conclusion Hypertonic sea water is the recommended irrigation solution, as it is associated with less crusting, drying, and obstruction in the nose for the postoperative period following septoplasty and concha radiofrequency.

Resumo Introdução Soluções para irrigação nasal são amplamente usadas após cirurgias endonasais. Essas soluções removem os resíduos e crostas, reduzem a probabilidade de formação de sinéquias e aceleram a cicatrização da mucosa. Objetivo O objetivo do presente estudo foi comparar os efeitos das soluçoes para irrigaçao nasal com diferentes conteudos apos septoplastia e turbinoplastia com radiofrequencia. Método O presente estudo foi um estudo cego simples, randomizado, controlado e prospectivo de 120 pacientes submetidos a septoplastia e turbinoplastia bilateral com radiofrequencia. Os pacientes foram divididos em quatro grupos de acordo com a soluçao nasal utilizada: agua da torneira, soluçao salina isotonica tamponada, soluçao salina com xilitol e agua do mar hipertonica. Os pacientes foram examinados no 7° e 15° dias do pos-operatorio. O teste de sacarina foi utilizado para determinar a atividade mucociliar pre-operatoria e no 7° e 15° dias do pos-operatorio. Os pacientes foram questionados sobre a sensaçao de secura e obstruçao nasais utilizando uma escala visual analógica de 10 cm. Alem disso, os pacientes foram examinados para determinar o escore em relaçao a crostas. Resultados Não houve diferença significativa entre o pré-operatório e o sétimo e 15° dias do pós-operatório dos tempos de clearance mucociliar entre os quatro grupos. Verificou-se que o escore em relação a crostas foi significativamente menor no grupo que usou água do mar hipertônica (p < 0,001). As sensações de secura e obstrução nasais no sétimo e 15° dias do pós-operatório mostraram-se significativamente mais confortáveis no grupo água do mar hipertônica (p < 0,001). Conclusão A água de mar hipertônica é a solução de irrigação recomendada, pois está associada a menor incidência de crostas, secura e obstrução nasais no pós-operatório de cirurgia de septoplastia e das conchas nasais com radiofrequência.