It may be necessary to adopt an early full septorhinoplasty approach in the initial treatment of nasal fractures to reduce the post first operation deformity/obstruction rates.
A total of 22.6 per cent of clients (47 of 208) had asymmetrical hearing loss, with the left side having the greater loss in 60 per cent of cases. We believe that asymmetrical hearing loss should be included in compensation considerations, both on medical and legal grounds.
(5.5%) of the patients was unaltered by the result as they were continued on a high dose of prednisone despite a negative result. These patients were subsequently diagnosed with polymyalgia rheumatica.The optimum rate of positive biopsies produced in an institution depends on a number of factors: clinical acumen in selecting appropriate patients for a biopsy, patient demographics and availability of services at the institution. The percentage of positive biopsies reported in the literature range from 20 to 82%.
10The American College of Rheumatology (ACR) had developed a five-point scoring system with equal weight for the following criteria: age >50 years, erythrocyte sedimentation rate >50 mm/h, superficial temporal artery tenderness, temporal headache and positive histology with TAB.11 Studies aimed at determining the efficacy of the ACR criteria 11,12 in directing appropriate selection of patients for a biopsy found that patients who had an ACR score of Յ2 necessitated a biopsy for confirming the diagnosis, whereas for patients who had a score of Ն3, a biopsy added little value. However, majority of the studies in the literature are retrospective in nature and therefore rely on the completeness of medical records. It is often unclear if a standard approach was taken to the clinical diagnosis of GCA and the specific diagnostic criteria that were utilized in selecting a patient for a biopsy.TAB is a valuable test that contributes to the management of patients with clinical suspicion of GCA as it delineates between patients who need to remain on high-dose steroids for an extended period of time and those who do not require high-dose steroids, thereby avoiding the adverse side effects. Our study confirms the value of TAB in the management of a difficult-to-identify clinical syndrome, which are patients with GCA.
References
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