161 patients treated with septoplastic operations for nasal stenosis were examined 25–64 months postoperatively. Surgery was inadequate in 32 cases (20%); in 23 this was due to the septum operation itself, in 9 to unsatisfactory or no correction of the alar insufficiency. Preoperative anterior dislocations were corrected in 64 of 76 cases, deflection of the nose in 43 of 75 cases. Late complications were few: anterior dislocations in 3 cases; small columellar retractions in 7 cases; small septal perforations in 4 cases, and saddle nose deformity in 3 cases. 35% of the patients were not satisfied with the result, but in 14 patients (9%) this was not justified according to our examination. In a further 11 % the reasons for dissatisfaction were not related to the result of the operation.
The objective of this study was to assess symptoms and signs in patients with maxillary sinusitis and a bacteriological diagnosis obtained by sinus aspiration or lavage. Designed as a prospective cohort study in general practice, the study included 174 patients, aged 18-65 years, suspected of having acute maxillary sinusitis by their general practitioner. The main outcome measures were the independent association of symptoms, signs, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) concentration and confirmed infection with the predominant bacterial pathogens Streptococcus pneumoniae and Haemophilus influenzae. The predominant organisms found in patients with acute maxillary sinusitis were S. pneumoniae and H. influenzae. Body temperature >38 degrees C and maxillary toothache were significantly associated with the presence of S. pneumoniae and H. influenzae. Positive bacteriological culture results were significantly associated with increasing ESR and CRP values. None of the symptoms and signs, with the exception of body temperature >38 degrees C and maxillary toothache, were particularly sensitive indicators of the specific aetiology in patients with acute maxillary sinusitis. Elevated ESR and CRP values were significantly associated with positive bacteriological culture results. On the other hand, absence of these symptoms and signs did not exclude the presence of acute maxillary sinusitis.
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