To compare conventional osteotomy with the piezosurgery medical device, in terms of postoperative edema, ecchymosis, pain, operation time, and mucosal integrity, in rhinoplasty patients. In this prospective study, 49 rhinoplasty patients were randomly divided into two groups according to osteotomy technique used, either conventional osteotomy or piezosurgery. For all patients, the total duration of the operation was recorded, and photographs were taken and scored for ecchymosis and edema on postoperative days 2, 4, and 7. In addition, pain level was evaluated on postoperative day 2, and mucosal integrity was assessed on day 4. All scoring and evaluation was conducted by a physician who was blinded to the osteotomy procedure. In the piezosurgery group, edema scores on postoperative day 2 and ecchymosis scores on postoperative days 2, 4, and 7 were significantly lower than in the conventional osteotomy group (p < 0.05). On postoperative day 2, the pain level was lower in the piezosurgery group than in the conventional osteotomy group (p < 0.05). In an endoscopic examination on postoperative day 4, while 24% of the patients in the conventional osteotomy group had mucosal damage, no such damage was observed in the piezosurgery group. When total operation duration was compared, there was no significant difference between the groups (p > 0.05). Piezosurgery is a safe osteotomy method, with less edema (in the early postoperative period) and ecchymosis compared with conventional osteotomy, as well as less pain, a similar operation duration, and no mucosal damage.
The aim of this study is to show if cyclosporine has an antiallergic role in a rat model of ovalbumin-induced allergic rhinitis. The 54 rats were divided into six equal groups. The first group was a negative control group without induced allergic rhinitis; the second group a positive control with induced allergic rhinitis not receiving treatment. The remaining four groups, after induction of allergic rhinitis, received intranasal cyclosporine treatment in doses of 0.05, 0.1, or 0.2% or nasal steroid treatment. In the biochemical examination, on the surface of the tissue tumor necrosis factor (TNF) interferon (IFN), interleukin (IL)-5, IL-13, as well as IL-2, IL-4, IL-17A, and IgE were studied. Histologically, ciliary loss, increase of goblet cells, vascular congestion, and the degree of eosinophil infiltration were rated. In all treatment groups, on average, a significant reduction in all histological and biochemical values was found compared to the positive control group. Comparing each of the three cyclosporine-using groups with the group of nasal corticosteroid did not show any significant difference in the average scores. Cyclosporine nasal drops are effective to be used in an animal model of experimental allergic rhinitis without systemic effects.
Crushing with intrinsic stripping is an effective and easy technique; when compared to crushing alone; this technique provides a significantly more decrease in middle concha volumes as demonstrated both by the CT and by endoscopic evaluations.
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A prospective study to evaluate long term results of crushing technique in concha bullosa surgery with radiographic and endoscopic methods and to determine the type of concha bullosa in which crushing technique is more effective. 71 patients who underwent concha bullosa surgery with septoplasty were included in the study. All concha bullosa were divided into three groups according to their types (Group 1 lamellar type, Group 2 bulbous type, Group 3 extensive type). Crushing of the pneumatized middle turbinate was done under endoscopic view. All the patients had an endoscopic nasal examination and middle turbinates were photographed and axial and coronal paranasal computed tomography (CT) scans were taken before the surgery and approximately 2 years after the surgery. Preoperative and postoperative measurements were compared using paired t test and One-way ANOVA. Mean age of the 71 patients were as follows: 38 males, mean age 30.2 (range 20-44) years; 33 females, mean age 27.6 (range 18-40) years. The patients were followed for 22.7 (range 20-26) months. In all groups, the postoperative endoscopic grading scores and CT volumes were significantly reduced (p < 0.0001). Comparison between groups showed significant post operative reduction in both CT volumes and in endoscopic scoring for group 2 (bulbous type) (p < 0.0001). Crushing is a simple and safe method in concha bullosa surgery. There was no recurrance in long-term outcomes. This method can be used in all types of concha bullosa effectively and provides more volume reduction in bulbous type concha bullosa.
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