Objective: To compare the effectiveness of radiofrequency thermal ablation with those of microdebrider-assisted turbinoplasty, we designed a prospective, randomized clinical study.
Methods:Forty patients suffering from nasal obstruction due to bilateral inferior turbinate hypertrophy were enrolled. Half of the patients were operated by radiofrequency thermal ablation, while the other half underwent microdebrider-assisted turbinoplasty. The outcomes of both techniques were compared in terms of symptomatology, nasal patency, and mucociliary transport.Results: A statistically significant difference existed between the two groups with respect to nasal obstruction and the frequency of obstruction at the first post-operative week and first and third post-operative months (p<0.05). Rhinomanometry detected a significant decrease in nasal resistance values in both surgical groups compared to the preoperative values. The mucociliary transport time was significantly prolonged in the first postoperative week and first postoperative month in microdebrider-assisted inferior turbinoplasty group.
Conclusion:Both radiofrequency thermal ablation and microdebrider-assisted turbinoplasty are effective techniques for treating inferior turbinate hypertrophy. The treatment modality should be individually determined, and parameters such as tissue healing, volume reduction, and mucociliary activity must be taken into account.
In order to evaluate the effects of lateral osteotomies performed during rhinoplastic surgery on the lacrimal drainage system, a new technique for imaging the lacrimal passages, Active Transport Dacryocystography, was applied in a total of 16 patients. In all cases, free passage of contrast media from the punctum to the inferior meatus was observed. We did not record any pathologic alteration such as mucosal edema or discontinuity of the bony structure that would have resulted in nasolacrimal obstruction.
Objectives: The purpose of this study was to determine the clinical characteristics of carotid body tumors and to analyze the benefits of different treatment modalities. Subjects and Methods: The clinical records of 13 patients with paragangliomas treated during the period of 1995–2005 were reviewed for age at diagnosis, sex, initial symptoms, duration of symptoms, evidence of secretory function, family history, radiographic studies, pre- and posttreatment cranial nerve deficits, multicentric tumors, angiography, operative procedures and findings, and complications. The diagnoses were established by computerized tomography and magnetic resonance imaging scanning. Angiography was performed on 3patients with carotid body tumor. Results: All of the patients were followed up for a duration ranging from 16 months to 9 years. The median follow-up was 5 years. Of all 18 head and neck tumors confirmed in 13 patients, 16 were in the carotid body, 1 in the vagus nerve and 1 in the middle ear cleft. Four patients had multiple paragangliomas, 2 bilateral synchronous and 1 bilateral asynchronous paragangliomas. The remaining patient had 3 asynchronous paragangliomas, i.e. left jugulotympanic, right carotid body and left vagal paraganglioma. All patients underwent successful surgical resection of the tumor after appropriate preoperative investigation. Conclusion: This study shows that surgical treatment is acceptably safe and effective in treating these neoplasms.
Paragangliomas are unusual tumors that are sometimes familial. We treated a family who exhibited multiple head and neck paragangliomas (HNPGs) and pheochromocytomas. The purpose was to determine the clinical characteristics of paragangliomas with familial history and to define a better standardized proceeding in the management of these tumors. Patients diagnosed with head and neck paragangliomas and identified retrospectively through clinical otolaryngology practices were given a medical and family history questionnaire. We studied a family who exhibited familial paragangliomas. This relationship was examined by reviewing the medical records of family members with verified tumors, carrying out neck computed tomography or magnetic resonance imaging on their relatives to look for tumors that had been unrecognized in the past. All patients underwent a complete head and neck examination. The initial evaluation usually included CT and/or MRI. Computed tomography and magnetic resonance imaging contributed additional information about tumor extension. Angiography was performed in every patient with carotid body tumor, with one undergoing therapeutic embolization to reduce the tumor size. Eleven tumors were identified in four patients with a familial history. Familial disease was initially determined by pedigree analysis. Four patients with a median age of 31 years (range: 25-42) underwent surgery. Median follow-up was 5 years (range 2-14); carotid angiography provided essential mainstays for the definite diagnosis. All patients underwent successful surgical resection of the tumor after the appropriate preoperative preparation. There were no perioperative deaths or hemiplegia. Three patients had bilaterality carotid body paragangliomas. One patient had three paragangliomas, and two patients had bilateral carotid body paragangliomas associated with pheochromocytoma. Clinically functioning tumors and malignant tumors were not identified, and none of the patients died after surgery. During follow-up, none of the patients developed recurrence or metastatic disease. The carotid body paraganglioma (CBPG) and glomus vagale manifested as asymptomatic neck masses. The clinical pheochromocytomas typically present with uncontrolled hypertension. In conclusion, paragangliomas are rare, with multicentricity being more common in patients with a familial history. In patients with familial paragangliomas, high-resolution computed tomography and magnetic resonance imaging are recommended for early screening and contributed additional information about the tumor extension and definitive treatment. Early surgery is recommended to minimize major risks.
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