Nasal obstruction can be evaluated by objective and subjective methods. We sought to determine normative peak nasal inspiratory flow meter (PNIF) measurements of a healthy population in Turkey and to investigate the importance of PNIF in surgery for nasal septal deviation as well as to investigate the correlation of PNIF with subjective methods. In a total of 269 patients, 50 patients underwent septoplasty and 219 control subjects were enrolled in the study. Data on preoperative and postoperative PNIF measurements, nasal septal indices, and subjective measurements (visual analogue scale, VAS) were recorded. Mean PNIF value was 137.8 L/min in control subjects. Postoperative PNIF, VAS, and nasal septal index data were statistically significantly higher in the study group as compared with those of preoperative data. We found PNIF, VAS, and nasal septal indices of the control group to be consistent with postoperative data and to be higher than preoperative data of the study group. We identified a normal PNIF range for the healthy Turkish population and we saw that the data were compatible with VAS scores. PNIF seems to be a very effective method in the evaluation of nasal obstruction and in deciding operation.
An antrochoanal polyp (ACP) is a benign polypoid lesion originating from the maxillary sinus and extending to the choana. The objective of our study is to assess etiological and associated features of ACPs, and outcome following surgical treatment. Thirty-four patients who had received surgical treatment for ACPs were followed for 35 ± 17.7 months. Factors including patient age, gender, history of allergic rhinitis, chronic sinusitis, nasal septal deviation, turbinate hypertrophy, concha bullosa, accessory ostia, as well as the origin of the polyp, the surgical technique used and any recurrence, were evaluated. Overall, there were 12 females and 22 males. Mean age was 24.94 ± 8.08. Septal deviation was present in 50 %, turbinate hypertrophy in 32.3 %, concha bullosa in 17.6 %, mucous retention cyst in 32.3 %, allergic rhinitis in 44.11 %, and chronic sinusitis in 20.5 %. An accessory ostia was observed in 97.05 %. The functional endoscopic sinus surgery (FESS) approach was used in 31 cases, and three cases had combined FESS and Caldwell Luc procedures. The mean follow-up time was 35.8 ± 17.7 months. Two cases, who had been treated with FESS alone, experienced a recurrence. In conclusion, the commonest predisposing factors for ACPs are chronic inflammatory pathologies such as chronic sinusitis and allergic rhinitis. ACP left the maxillary sinus via an accessory ostium in 97.5 % of the cases. The FESS procedure is a safe and reliable method, and can be combined with the Caldwell Luc procedure when the origin of the maxillary component cannot be properly cleaned. In order to prevent recurrence, total extirpation of the maxillary component is essential.
Neck masses can be classified into three main categories: congenital, inflammatory and neoplastic. Our aim was to determine the distribution of diagnosis in patients who were followed-up for a neck mass and had undergone surgery for diagnostic indications. Six hundred and thirty cases referred to the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital between January 2005 and February 2012 with a neck mass who underwent excisional or incisional biopsy to establish a histopathologic diagnosis were retrospectively evaluated. Patients with a diagnosis of upper aerodigestive tract malignancy were excluded from the study. As well as the patients with thyroid masses were excluded. Only unknown primary neck masses were included in the study. The neck masses were categorized as inflammatory (33.49 %), congenital (18.9 %) or neoplastic (47.6 %). Neoplastic masses were either benign (51 %) or malignant (49 %) tumors. The most common causes were tuberculous lymphadenitis (40.28 %) among inflammatory masses, thyroglossal duct cysts (32.77 %) among congenital masses, pleomorphic adenoma (22.33 %) among benign neoplastic masses, and lymphoma (20 %) among malignant neoplastic masses. The most common types of mass were congenital in the 0-20 year age group, benign neoplastic in 21-40-year-old and malignant neoplastic in the >40-year group. Any neck mass, especially in an elderly patient, should be managed with caution as a considerable proportion may be malignant. In children and adolescents, a neck mass requiring surgery is most likely to be congenital. Tuberculosis should be considered as a cause of a neck mass due to a long-term inflammatory process in a developing country.
We aimed to investigate the relationships among concha bullosa (CB), nasal septal deviation (NSD), and sinus disease. We retrospectively reviewed paranasal sinus computed tomography scans obtained from 296 patients—132 men and 164 women, aged 17 to 76 years (median: 39)—who had been evaluated over a 19-month period. CBs were classified as lamellar, bulbous, and extensive. In cases of bilateral CB, the larger side was designated as dominant. In all, 132 patients (44.6%) exhibited pneumatization of at least one concha, 176 (59.5%) had NSD, and 187 (63.2%) had sinus disease. Some 89 of 106 patients with unilateral or one-side-dominant CB (84.0%) had NSD, 89 of 132 patients with CB (67.4%) had sinus disease, and 109 of the 176 patients with NSD (61.9%) had sinus disease. We found a statistically significant relationship between CB and contralateral NSD, but no significant relationship between CB and sinus disease or NSD and sinus disease. While CB is a common anatomic problem that may accompany NSD, a causal relationship between CB or NSD and sinus disease is dubious.
The objective of this study is to investigate the effect of intratympanic injection of vitamin C on cisplatin-induced ototoxicity. The study included 24 albino adult female rats (48 ears). The study animals were divided into four groups each of which was composed of six animals including a control (intraperitoneal cisplatin), a cisplatin-saline (saline intratympanic + intraperitoneal cisplatin), a C vit (intratympanic vitamin C) and a cisplatin-C vit group (intraperitoneal cisplatin + intratympanic vitamin C). As two animals had died due to cisplatin-induced ototoxicity (one in the control and one in the cisplatin-saline group) they were excluded from the study. The experiment was terminated, performing distortion product otoacoustic emission (DPOAE) measurement prior to procedures and at the end of the experiment. The results of the statistical analysis were evaluated. In the cisplatin-C vit group, there were no significant decreases in DPOAE amplitudes at 2 kHz (p > 0.05). Although a decrease was observed in DPOAE amplitudes at 2.8, 4, 6, and 8 kHz frequencies, these amplitude reductions were significantly lower than the control group (p < 0.05). Intratympanic vit C infusion provided a protective effect against cisplatin-induced ototoxicity primarily at 2 kHz and at other frequencies (2.8, 4, 6, and 8 kHz), and it did not produce a toxic effect in the cochlea.
PNIF can be used in the assessment of ITC-RF outcomes with the aid of nasal decongestants, even in patients who also underwent septoplasty.
This study aimed to prospectively evaluate patient satisfaction by means of the Rhinoplasty Outcome Evaluation (ROE) questionnaire before and after functional septorhinoplasty. We carefully selected 62 patients (mean age, 31.8 years; 28 men, 34 women) who underwent open functional septorhinoplasty in the Otorhinolaryngology and Head Neck Surgery Department of Suşehri State Hospital. Satisfaction analyses were carried out by means of the ROE questionnaire both before the surgery and at least 4 weeks after the surgery. Patients were divided according to age (≤ 25 vs >25 years) and follow-up duration (≤ 6 vs >6 months). In addition, patients were grouped according to their satisfaction scores: 0 to less than 50, bad outcome (group B); 50 to less than 75, good outcome (group G); and 75 or greater, perfect outcome (group P). The mean satisfaction score in all the patients significantly increased after functional septorhinoplasty (from 24.8 ± 14.6 to 70.1 ± 17.3; P < 0.001). Moreover, the increment in mean satisfaction scores did not differ with age or follow-up duration. We conclude that the ROE questionnaire can help surgeons select suitable candidates for functional septorhinoplasty who will most benefit from the surgery.
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