1 3 rd -year resident physician (R3) -ENT Department -HSPM. A crooked nose is the result of deformities that might involve the bony nasal pyramid, the upper and lower lateral cartilages, and nasal septum, causing complaints of aesthetic and/or functional nature.Purpose: To evaluate how satisfied are those patients who underwent rhinoplasty to correct crooked nose, through the questionnaire Rhinoplasty Outcomes Evaluation (ROE). Material and method:A longitudinal study with retrospective analysis of preoperative satisfaction and prospective analysis of postoperative satisfaction of patients who underwent rhinoplasty. ROE questionnaire was applied twice in the same visit aiming at measuring patient satisfaction in both pre and postoperative periods. Nineteen patients who underwent rhinoplasty answered the ROE.Results: For all patients who underwent rhinoplasty, the average preoperative satisfaction score was of 24.6±11.3, while the average postoperative score was of 76.1±19.5 (p<0.0001). Average differences between pre and postoperative satisfaction scores in patients younger than 30 years of age were lower than those reported by ≥30-year-old patients (p=0.05). Conclusion:From the Rhinoplasty Outcomes Evaluation questionnaire, it is possible to demonstrate the impact that rhinoplasty to correct a crooked nose determines the quality of life of patients. Approximately 90% of patients undergoing rhinoplasty believed they achieved a good or excellent postoperative result. Braz J Otorhinolaryngol. 2011;77(4):510-5. ORIGINAL ARTICLE
The ROE questionnaire is a tool for evaluating the outcomes of different surgical indications for correcting nasal deformities. The kind of surgical procedure had no influence on the mean difference between pre- and postoperative satisfaction scores. By using this tool we found that the younger age group reported lower postoperative satisfaction scores than older patients.
Most studies show that objective measures to quantify and determine surgical success in the treatment of nasal obstruction do not correlate with subjective improvement as reported by patients. Aim To evaluate the subjective improvement of nasal symptoms in patients undergoing septoplasty with or without turbinectomy. Materials and methods A prospective study. We evaluated 72 septoplasty patients with or without partial inferior turbinectomy; the patients answered a questionnaire preoperatively and on the 60th day after surgery. Results Septoplasty was done associated with bilateral partial inferior turbinectomy in 83.3% of patients; it was unilateral in 9.7%; there was no need for turbinate reduction in 6.9%. An improvement of all symptoms was observed after surgery. Nasal obstruction had improved in 68 patients (94.4%) by the 60th postoperative day. The average nasal obstruction score in patients with and without allergic symptoms was similar before surgery and on the 60th postoperative day. Older patients had milder preoperative allergic symptoms. Conclusions Nasal symptoms in patients undergoing septoplasty, with or without turbinectomy, improved. Patients with and without allergic symptoms showed a similar improvement of nasal obstruction on the 60th postoperative day.
Velasco LC. Validity of bedside screening tests performed for aspiration detection in patients admitted to a public rehabilitation hospital [thesis]. São Paulo: "Faculdade de Medicina, Universidade de São Paulo"; 2020. Introduction: early detection of dysphagia and specifically aspiration is essential to prevent and reduce complications of hospitalized patients in Rehabilitation Centers. Bedside screening tests are commonly used for the initial evaluation of swallowing in these settings, but they present insufficient and inconsistent sensitivity and specificity. To identify which tests better discriminate aspirating patients would allow defining a better diagnostic approach for these patients. Objective: to determine the validity of various bedside screening tests in detecting aspiration, with Flexible Endoscopic Evaluation of Swallowing (FEES) as the reference test. Methods: a prospective observational study was performed in 150 consecutive patients of a tertiary rehabilitation hospital, submitted to assessment of clinical predictors, the Eating Assessment Tool 10 (EAT-10) questionnaire, an instrument for assessing tongue strength and endurance (Iowa Oral Performance Instrument [IOPI]), Maximum phonation time (MPT) and a swallowing test (Volume-Viscosity Swallow Test [V-VST]). The validity of bedside screening tests in detecting aspiration, as confirmed by FEES, was calculated. Results: of the 144 patients included, 113 (78%) had no aspiration and 31 (22%) had aspiration. The maximum tongue strength presented high sensitivity (92.3%) and low specificity (18.6%) and accuracy (33.1%) to detect aspiration. The V-VST showed a sensitivity, specificity and accuracy for aspiration of 83.3%, 72.6% and 74.8%, respectively. The sensitivity of EAT-10 and TMF for aspiration was 82.8% and 88% and specificity was 57.7% and 32.4%, respectively. Conclusion: the results of the present study suggest that V-VST and EAT-10 are good screening methods for aspiration detection in patients admitted to a rehabilitation center. The IOPI and MPT, despite the excellent sensitivity, have low specificity with low discrimination power between patients who do and do not aspirate.
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