No abstract

A higher incidence of pharyngeal acid reflux events was found in patients with CRS (29 of 33, 88%) compared with the control patients (11 of 20, 55%). The difference was statistically significant (P = .01). The fluorometric pepsin assay was correlated to the results of 24-hour dual-probe monitoring for LPR diagnosis with a 100% sensitivity and 92.5% specificity. These data suggest that an association between CRS and LPR is present and that the detection of pepsin in nasal lavage fluid may provide a noninvasive and feasible method of LPR screening.

Patients with paranasal sinus foreign body are not commonly seen in otolaryngological practice; glass in the frontal sinus as a complication of maxillofacial trauma should be very rare, and papers dealing with this issue appear to be rare in the English literature. To elucidate the diagnostic pitfalls and the treatment aspects we present three cases of glass in the frontal sinus which occurred as a result of road traffic accidents.

The aim of this study was to evaluate the long-term results and the factors influencing the success in patients with nasolacrimal duct obstruction treated with intranasal endoscopic dacryocystorhinostomy (DCR) and silicone tube intubation (STI). We prospectively investigated 158 patients with lacrimal obstruction in two groups, one of which comprised 108 patients treated primarily with intranasal endoscopic DCR by experienced surgeons and the other comprised 50 patients who were operated on by inexperienced surgeons. In a mean follow-up time of 49 months the surgical success was 94.4% in experienced hands and 58.0% in inexperienced hands. The endoscopic examination of six patients with failure in the first group revealed granulation tissue around the tube in four, atonic sac in one and persistence of bone that was supposed to have been excised in the nasal cavity in one. There were 21 failures out of 50 patients in the second group: granulation tissue in 2 cases, fenestration to the nasolacrimal duct instead of the sac in 6 cases, synechia between the lateral nasal wall and the middle turbinate in 2 cases, bony spicles causing obstruction in 5 cases and fenestration anterior to the sac in 2 cases. In 4 cases no reasons were found for failure, but perhaps the small fenestration and failure to remove the medial half of the membranous sac wall was the reason. DCR and STI can be performed for primary treatment in lacrimal obstruction. There is a learning curve for the operation. False localization of the lacrimal sac, granulation tissue formation around the tubes, retained bony spicles, inadequate removal of the medial wall of the sac and the synechia between the lateral wall and the middle turbinate are the most common causes of failure.

Acute invasive fungal rhinosinusitis (AIFR) is a potentially fatal infection that affects immunocompromised patients. Early diagnosis and treatment, including aggressive surgical debridement, antifungal medication, and correction of underlying predisposing factors are essential for recovery. The aim of this study was to review our experience with AIFR. The records of 19 patients histopathologically diagnosed with invasive fungal rhinosinusitis were retrospectively reviewed. Demographic data, presenting symptoms and signs, underlying diseases, and outcomes of the patients are presented and invasive fungal rhinosinusitis is discussed in light of the current literature.

No abstract

A prospective randomized study was designed to compare the effect of different irrigation solutions on mucociliary clearance and nasal patency and to compare the limitations of the used solutions, such as nasal burning by a visual analog scale. Forty-five patients who underwent septoplasty were divided into three groups postoperatively. Each group was administered with 2.3% buffered hypertonic seawater, buffered isotonic saline solution and non-buffered isotonic saline, respectively, as irrigation fluid. Saccharine test and acoustic rhinometer were used to determine mucociliary activity and nasal patency. Patients were asked about the burning sensation using a 10-cm visual analog scale. There was no significant difference in saccharine clearance time (SCT) on the 5th postoperative day between the three groups (P = 0.07). On the 20th day, there was a significant difference in SCT between the hypertonic buffered seawater group and non-buffered isotonic saline (P = 0.003). Buffered hypertonic seawater improved nasal airway patency more than the buffered isotonic saline (P = 0.004). Buffered hypertonic solutions used after endonasal surgery have been advantageous for both mucociliary clearance and postoperative decongestion.

In order to elucidate the blood gas and heart rate changes caused by bilateral nasal packing, 21 healthy subjects who had had septoplasty or septorhinoplasty were investigated with pre- and post-operative blood gas measurements and 24-h Holter monitoring. Nasal packing caused a significant decrease in O2 saturation (P < 0.05), a borderline decrease in PO2 (P = 0.09), insignificant changes in PCO2, pH and HCO3 (P > 0.05), a significant increase in minimum and mean heart rates (P < 0.05) and insignificant changes in maximum heart rates; however, further research is necessary to elucidate the direct cause-and-effect relationship. No serious arrhythmias were observed. Although these changes may be within normal levels for healthy subjects, they may have serious consequences for patients with cardiopulmonary diseases.