Introduction Septoplasty is one of the most common surgical procedures in rhinology practice. Two major problems encountered after septoplasty are pain and bleeding. Preoperative administration of analgesics before the surgical stimulus, which is the main concept of preemptive analgesia, decreases postoperative pain. Objective The present study was designed to investigate whether preincisional lidocaine infiltration to the subperichondrial area during septoplasty surgery reduced or not postoperative pain and analgesic use. Methods The present prospective, randomized, placebo controlled, double-blind trial was conducted on 64 consecutive patients with nasal septum deviation. Patients were randomly divided into 2 groups; the study group received 2% 20 mg lidocaine/cc (n = 31), and the control group received 6 cc 0.9% NaCl (n = 33). A standard questionnaire was given to each patient to mark his or her pain score between 0 and 10 at the 1st, 3rd, 6th, 12th, and 24th hours. Results The mean and the range of visual analogue scale (VAS) scores of the patients in the study group at the 1st, 3rd, 12th, and 24th hours were 4.03 ± 3.08 (0–10); 3.42 ± 2.39 (0–8); 2.97 ± 2.22 (0–8); 2.87 ± 2.61 (0–9); and 1.94 ± 2.06 (0–9) respectively. The mean and the range of VAS scores of the patients in the control group at the 1st, 3rd, 12th, and 24th hours were 4.12 ± 2.7 (0–10); 3.45 ± 2.4 (0–10); 2.94 ± 2.7 (0–10); 2.79 ± 2.34 (0–10); and 1.5 ± 1.8 (0–6), respectively. The statistical analysis revealed no significant difference among the groups. Conclusion The preemptive local anesthetic administration to the incision area and under the mucoperichondrial flap before septoplasty does not decrease the level of postoperative pain.
ABS TRACT Objective: Although corona virus disseminates by aerosol or droplet and colonizes in nasal cavity and nasopharynx, symptoms related to upper respiratory tract are uncommon in coronavirus-disease-2019 . In this report we aimed to classify the patients applying to COVID-19 outpatient clinics according to ear-nose-throat (ENT) specific and COVID-19 specific symptoms and to compare these patients' prognosis. Material and Methods: Sixty-five patients with COVID-19 were included to the study. The patients were classified according to their presenting symptoms. The symptom categories were COVID-19 specific (Group 1) and Covid-19+ENT specific (Group 2) symptoms. As specific symptoms of COVID-19; fever, cough, headache, myalgia and dyspnea were assumed. Mild ENT symptoms were also included to this group. As otolaryngology-specific symptoms; dysfunction in smell, nasal congestion, runny nose, sneezing, postnasal drip, sore throat, dysphagia, dysphonia, hearing loss, tinnitus, dizziness/vertigo and aural fullness were considered. C-reactive protein, leukocyte, lymphocyte, platelet levels in peripheral blood, and oxygen saturation levels were also recorded. The symptom scores were analyzed by visual analog scale scoring system. Results: The most common presenting symptom of the patients in Group 1 was fever followed by constitutional symptoms and cough, whereas the most common presenting symptom in Group 2 was constitutional followed by myalgia and fever. Olfactory dysfunction was prevalent in the patients in Group 2 with a significant difference. Average nasal symptom scores of the patients in Group 2 were; none: 3, mild: 0, moderate: 25, severe: 12 and the difference was statistically significant. Oral cavity/oropharynx symptoms were again more prevalent in Group 2. The average ear symptom scores of the patients among groups did not differ significantly. Fourteen of the patients in Group 1 had better prognosis and 15 had worse outcome. In Group 2 better prognosis was seen in 25 patients and worse prognosis was detected in 11 patients. Conclusion: The evaluation of the parameters concluded that although the patients with ENT predominant symptoms were doing better than the patients with more systemic symptoms, the difference was not statistically significant.
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