Postoperative Hemorrhage after Endoscopic Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P80-P80
Author(s):  
Troy D. Woodard ◽  
James A Stankiewicz
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Tertiary Care ◽  
Care Facility ◽  
Postoperative Hemorrhage ◽  
Sinus Surgery ◽  
Complication Rates ◽  
Tertiary Care Facility ◽  
Significant Difference ◽  
Extent Of Surgery ◽  
The Mean

Objective 1) Identify complication rates of patients that underwent endoscopic sinus surgery and developed postoperative hemorrhage. 2) Determine if there is a correlation of preoperative variables with the development of this complication. Methods Retrospectively review patients who had functional endoscopic sinus surgery and developed postoperative hemorrhage from 1987 to 2007 in an university tertiary care facility. Analyze baseline characteristics and preoperative clinical variables for significant correlations. Results 29 of 5000 endoscopic cases resulted in postoperative hemorrhage (.58% complication rate). The mean age of the patients was 50 years old and there were equal proportions of male and female patients. While the extent of surgery demonstrated no significant difference among the patients, hemorrhage was most likely to occur in patients with previous surgery. An overwhelming majority of patients required a surgical procedure to control the bleeding. Hemorrhage was primarily isolated on the patient's right side and involved the sphenopalatine or posterior septal arteries. Conclusions Endoscopic sinus surgery has vastly increased in popularity. However, there still is a paucity of information in the literature on complications associated with endoscopic sinus surgery, particularly postoperative hemorrhage. The results from this study provide identifying characteristics that predispose patients to develop this complication and what methods can be successfully utilized to treat this complication.

scholarly journals Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
T Test ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
P Value ◽  
Psychological Dysfunction ◽  
Significant Difference ◽  
The Mean ◽  
Snot 22

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.

scholarly journals Accidental childhood poisoning in Paediatrics department of a tertiary care facility: A retrospective review

2020 ◽  
Vol 47 (3) ◽  
Author(s):  
D.C. Obu ◽  
M.C. Orji ◽  
U.V. Muoneke ◽  
U.V. Asiegbu ◽  
G.O. Ezegbe
Keyword(s):  
Tertiary Care ◽  
Care Facility ◽  
Accidental Poisoning ◽  
Female Ratio ◽  
The Public ◽  
Tertiary Care Facility ◽  
Childhood Poisoning ◽  
The Mean ◽  
The Relationship ◽  
Male To Female

Background: Accidental childhood poisoning is a recognized preventable cause of morbidity and mortality among children worldwide. This studywas aimed at determining the prevalence, pattern, and outcome of childhood poisoning among children in Abakaliki, Ebonyi State. Material and Methods: Medical records of all cases of accidental childhood poisoning admitted into Children’s emergency room (CHER) of the health facility of study between January 2014 and December 2018 were retrospectively identified and relevant data extracted and analyzed usingSPSS version 22. Results: Out of the 7,700 children that presented to CHER over a 5- year period, 42 were cases of poisoning, giving prevalence rate of 0.5%. Of the 42 cases, only 20 case notes were retrieved. The male to female ratio was 2.3:1 while the ages ranged between 6months and 14 years with the mean age of 3.06±2.88. Kerosene poisoning had the highest proportion of 50.0% (10/20) with the overall mortality rate of 5.0% (1/20).The relationship between age, place of residence and outcome in poisoned children was statistically significant (p = 0.038, 0.045 respectively). Conclusion: Accidental childhood poisoning is common in Abakaliki. Kerosene still remained the major agent while male toddlers were most  vulnerable. There is need to intensify enlightenment campaigns and education of the public about the hazard of improper storage of kerosene and other implicated substances at home. Keywords: Accidental poisoning, Childhood, Kerosene

Outcomes of Concurrent Functional Endoscopic Sinus Surgery and Rhinoplasty: A Meta-analysis

2020 ◽  
pp. 194589242098067
Author(s):  
Benjamin F. Bitner ◽  
Karthik R. Prasad ◽  
Khodayar Goshtasbi ◽  
Brandyn S. Dunn ◽  
Edward C. Kuan
Keyword(s):  
Patient Satisfaction ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Complication Rates ◽  
Medical Problems ◽  
Random Effects Models ◽  
Ovid Medline ◽  
Significant Difference

Introduction Chronic rhinosinusitis (CRS) and functional nasal airway obstruction are common but distinct medical problems which affect quality of life. In certain instances, patients often benefit from concomitant functional septorhinoplasty, or elect for cosmetic rhinoplasty, in addition to functional endoscopic sinus surgery (FESS) and prefer combining procedures. Determining outcomes of combined surgery is important when discussing risks and benefits with patients. Methods A thorough literature search of articles published in PubMed, Ovid MEDLINE, and Cochrane databases. Patients were categorized as either having FESS or rhinoplasty alone or combined. Binary random-effects models were applied to calculate odds ratios (ORs) for outcomes including complications, recurrence, and satisfaction. Results Of the 55 screened articles, 6 were included in the analysis, and of these, 6 (405 patients), 2 (90 patients), 4 (290 patients), and 3 (190 patients) provided data for postoperative complications, recurrence of CRS symptoms, revision rates, and patient satisfaction, respectively. Major complications were observed in 11 (5.8%) total combined cases, 0 (0%) FESS cases, and 6 (3.5%) rhinoplasty cases with no statistical difference between combined cases and rhinoplasties (OR 1.37, 95% CI 0.45–4.16, p = 0.58). Recurrence of CRS symptoms was noted in 35.6% combined cases and 28.9% FESS cases (OR 1.42, 95% CI 0.55–3.64, p = 0.47). There was no observed difference in revision rates between combined and isolated rhinoplasties (OR 1.00, 95% CI 0.43–2.32, p = 1). Lastly, 91.6% of patients were satisfied with results of combined cases compared to 87.4% of patients in standalone cases (OR 1.57, 95% CI 0.61–4.03, p = 0.35). Conclusion Aggregate evidence demonstrates similar risk in complication rates in combined surgical cases compared to stand-alone rhinoplasty. There appears to be no significant difference in recurrence of symptoms, revision rates or patient satisfaction.

Nurse-Led Neonatal Follow-Up Clinic: A New Emerging Concept in a Developing Country

2020 ◽  
Vol 34 (1-2) ◽  
pp. 19-23
Author(s):  
Poonam Joshi ◽  
Bindu Sarojini ◽  
Meena Joshi ◽  
Anu Thukral
Keyword(s):  
Developing Countries ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Newborn Care ◽  
Care Facility ◽  
Essential Newborn Care ◽  
Tertiary Care Facility ◽  
Neonatal Assessment ◽  
The Mean

Objective: To investigate the feasibility and acceptance of nurse-led neonatal follow-up clinic (NLNFC) in a tertiary care facility. Materials and Methods: In a prospective observational study, total 105 stable mother-neonate dyads were independently followed up in both nurse led and neonatologist run follow-up clinics. The outcome was measured in terms of agreement between the nurse and neonatologist in the domains of neonatal assessment, counselling mothers on essential newborn care (ENC) and giving advice ( P < 0.05) and mothers’ acceptability for NLNFC. Results: Agreement between the trained neonatal nurse and neonatologist varied between 87 and 100%. The most unanimity was observed in neonatal assessment and counselling on ENC (93.3%-100%) followed by prescribing treatment (87%). The mean acceptability scores of the mothers for NLNFC was 33.13 ± 2.6 (25-35, maximum possible score 35). Conclusion: Establishing NLNFCs in developing countries is feasible. Nurses can be entrusted with the responsibility of following up stable neonates here and mothers will surely be satisfied with this type of clinic.

Treatment-Resistant Bipolar Disorder: A Comparison of Rapid Cyclers and Nonrapid Cyclers

CNS Spectrums ◽  
2003 ◽  
Vol 8 (12) ◽  
pp. 948-952 ◽  
Author(s):  
Dong Vo ◽  
David L. Dunner
Keyword(s):  
Lithium Treatment ◽  
Tertiary Care ◽  
Care Facility ◽  
Treatment Resistance ◽  
Rapid Cycling ◽  
Treatment Resistant ◽  
Tertiary Care Facility ◽  
Significant Difference ◽  
Persistent Depression ◽  
Bipolar Patients

ABSTRACTBackground: We investigated clinical factors to determine their relationship to treatment resistance among bipolar patients who had a consultation at a tertiary care facility.Methods: Patients were separated into two categories: rapid-cycling disorders and nonrapid-cycling disorders. We hypothesized that there would be less usage of lithium carbonate among nonrapid-cycling treatment-resistant patients than among rapid cyclers and also that there would be higher rates of comorbidity seen among nonrapid-cycling than rapid-cycling patients in order to account for these particular patients being treatment resistant.Findings: Continued recyling and persistent depression characterized rapid cyclers, whereas persistent depression characterized nonrapid cyclers. Less than 30% of patients had adequate lithium treatment and there was no significant difference comparing rapid cyclers with non-rapid cyclers. Rates of comorbidity were also not significantly different between these groups. We also assessed a number of other factors.Conclusion: Some of these factors were significant, but when a Bonferonni correction was applied, these significant differences were not maintained. The study of treatment resistance among nonrapid-cycling bipolar patients merits further research.

Current Indications for Pediatric Endoscopic Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P63-P63
Author(s):  
Rahul K Shah ◽  
George H Zalzal ◽  
Maria T Pena
Keyword(s):  
Cystic Fibrosis ◽  
Blood Clot ◽  
Tertiary Care ◽  
Care Facility ◽  
Acute Sinusitis ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Intracranial Complication ◽  
Tertiary Care Facility

Objective To describe current indications, sinonasal pathologies, and outcomes of endoscopic sinus surgeries (ESS) in children. Methods Retrospective chart review of children that underwent ESS at a children's tertiary care facility from July 2004 to June 2007 was performed. Demographic data, clinical profiles, surgical procedures including revisions, and complications were analyzed. Results 117 ESS were performed on 88 children (mean age 9.6 years) and 4 adults; 64 were male. The most common indications for ESS in descending order were: chronic rhino-sinusitis (CRS) (n=29), subperiosteal periorbital abscess (n= 20), sinonasal neoplasm (n= 11), intracranial complication from acute sinusitis (n=8), CRS with cystic fibrosis (n=8), complicated acute sinusitis (n=6), allergic fungal sinusitis (n=5), antrochonal polyps (n=2), invasive fungal sinusitis (n=1), and other pathologies (n=2). 21 children underwent an average of 2.2 sinus procedures. Majority of revisions were on patients with tumors (46%), allergic fungal sinusitis (40%), intracranial complication from acute sinusitis (38%), complicated acute sinusitis (33%), subperiosteal periorbital abscess (15%), CRS with cystic fibrosis (13%), and CRS (10%). Two children had excessive bleeding requiring another anesthetic to complete the procedure; 1 patient had airway obstruction from a tracheal blood clot requiring bronchoscopy. Conclusions More than 2/3rds of patients had ESS for indications other than uncomplicated CRS. Approximately 1/4 required revision surgeries reflecting the complexity of sinonasal pathologies seen in children compared with adults. Otolaryngologists performing pediatric ESS must not only be skilled in sound surgical technique, but must have appropriate interdisciplinary professional support to address the associated clinical problems seen in children.

scholarly journals Role of stroboscopy in evaluation of patients with vocal abnormalities

2021 ◽  
Author(s):  
Yashveer Jayantha Kedilaya ◽  
Ashly Alexander ◽  
Abhishek Malviya ◽  
Akshay V. Tamrakar
Keyword(s):  
Vocal Fold ◽  
Tertiary Care ◽  
Care Facility ◽  
Central India ◽  
Wave Pattern ◽  
Post Treatment ◽  
Vocal Fold Vibration ◽  
Tertiary Care Facility ◽  
Significant Difference ◽  
Chronic Laryngitis

<p class="abstract"><strong>Background:</strong> Stroboscopy is an examination in which strobe light is combined with laryngoscopy, to visualize the vocal fold vibration. It makes use of the Talbot’s law for visualizing the vibrating vocal fold having frequency of around 250 times per sec. This technique was used for studying voice abnormalities and evaluate related pathologies. The aim and objective was to evaluate patients with vocal abnormalities with the help of stroboscope and to study the mucosal wave pattern pre and post treatment of vocal cord pathologies.</p><p class="abstract"><strong>Methods:</strong> A prospective observational study was conducted at a tertiary care facility in central India. 50 patients with vocal abnormalities for more than 2 weeks were subjected to stroboscopy. Written informed consent from eligible patients was obtained and they were evaluated by stroboscopy using Karl Storz stroboscope with 70 degree 8 mm telescope, model no.: 20140020032. A second follow up stroboscopy was done two months post treatment and the parameters were recorded.</p><p class="abstract"><strong>Results:</strong> VC nodule was observed as the most common pathology followed by vocal polyp, carcinoma and chronic laryngitis. It was also observed that there was statistically significant difference (p&lt;0.001) in pre and post treatment findings of different parameters of voice evaluated using stroboscopy.</p><p class="abstract"><strong>Conclusions:</strong> Video stroboscopic evaluation proved to be a useful and reliable tool for evaluation and treatment of the patients with voice abnormalities as the changes in pre and post treatment voice parameters were found to be statistically significant.</p>

scholarly journals Safety of human olfactory mucosal biopsy for the purpose of olfactory ensheathing cell harvest and nerve repair: a prospective controlled study in patients undergoing endoscopic sinus surgery

2016 ◽  
Vol 54 (2) ◽  
pp. 183-191
Author(s):  
Peter J. Andrews ◽  
Anne-Lise Poirrier ◽  
Valerie J. Lund ◽  
David Choi
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Olfactory Mucosa ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Complication Rates ◽  
Sense Of Smell ◽  
Significant Difference ◽  
Nasal Function ◽  
Prospective Controlled Study

Background: Nasal olfactory mucosa is an accessible source of olfactory ensheathing cells for spinal cord regeneration. However, safety of the biopsy technique and the effects on sense of smell and nasal function have not been robustly assessed in the form of a prospective controlled study. Methodology: National Health Service ethical approval was granted for this study of 131 patients. The primary outcome measure was olfactory function and the secondary outcomes included postoperative complication rates as well as the SNOT 22, NOSE scale scores and surgeon reported (Lund-Kennedy score) nasal function outcomes. Results: 65 patients underwent functional endoscopic sinus surgery (FESS) and superior turbinate biopsy, and 66 patients underwent FESS only as the control group. There was no significant difference in complication rates between the two groups. All Olfactory function outcomes were unaffected following olfactory biopsy. We demonstrated that the patients quality of life and nasal patency as well as surgeon reported outcome measurements remain unaffected following olfactory harvesting. Conclusions: We have uniquely provided level 2a evidence for the safety of endoscopic biopsy of olfactory mucosa, which does not affect nasal function or the sense of smell compared to standard FESS without biopsy.

scholarly journals Comparison of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 9 (34) ◽  
pp. 91-95
Author(s):  
Ramiya Ramachandran Kaipuzha ◽  
Nirmal Coumare Venkataramanujam ◽  
Padmanabhan Karthikeyan ◽  
Davis Thomas Pulimoottil
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Mucosal Injury ◽  
Sinus Surgery ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time ◽  
Sinonasal Polyposis

AbstractOBJECTIVE. To study and compare the benefits of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery in terms of subjective and objective improvement in symptoms of nasal polyposis.MATERIAL AND METHODS. This study involved 60 patients with bilateral sinonasal polyposis scheduled to undergo Endoscopic Sinus Surgery. The patients were randomized into two groups: Group A -Conventional endoscopic sinus surgery and Group B -Microdebrider-assisted endoscopic sinus surgery.RESULTS. There was a significant difference in the mean VAS at 3 months postoperatively in Group B, but no significant difference at 6 months postoperatively following either of the two methods. The mean time for surgery (p<0.01) and the mean intraoperative blood loss (p<0.01) were significantly lower in Group B.CONCLUSION. A well-trained surgeon with proper anatomical knowledge, good instruments, hypotensive anaesthesia, minimal mucosal injury and regular proper follow-up will have similar postoperative results with both methods.

scholarly journals A Pilot Testing of the Effect of Guided Meditation on Anxiety, Depression and Sleep Quality among COVID-19 Patients Admitted in a Tertiary Care Facility

2021 ◽  
pp. 11-21
Author(s):  
Devanshi Chowdhary ◽  
Suman Dabas ◽  
. Vanita ◽  
Poonam Joshi ◽  
Anjan Trikha
Keyword(s):  
Sleep Quality ◽  
Tertiary Care ◽  
Care Facility ◽  
Routine Care ◽  
Anxiety And Depression ◽  
Control Groups ◽  
Tertiary Care Facility ◽  
Significant Difference ◽  
And Control ◽  
Anxiety Depression

Hospitalization of COVID- 19 patients may lead to the development of varied levels of anxiety, depression, and sleep disturbances. The present study was conceptualized to investigate the effect of guided meditation on anxiety, depression, and sleep quality among the hospitalized Covid-19 patients in a tertiary care facility. Materials and Methods: A total of 60 COVID-19 patients were conveniently enrolled and randomized to experimental (30) and control arms (30) using a computer-generated random table and opaque sealed envelope technique in a selected COVID unit of a tertiary care facility. The subjects were enrolled in accordance to the inclusion criteria. Intervention: The guided meditation was an audio recording of Sri Sri Ravi Shankar of 20 minutes duration. The intervention was provided twice a day to the experimental group for consecutive 5 days. A close watch was kept on the vital signs of the subjects during the intervention using a pulse oximeter. At the same time, the control group continued to receive the standard routine care. Results: There was a significant difference observed in the post-test anxiety and depression scores in the experiment and control groups (4.83±3.68 vs. 12.37±3.9 p=0.001 and 7.90±2.41 vs.12.67±2.65 p=0.001). A significant difference was also observed in the global sleep quality index (median (IQR)) in the experimental and control groups (11(9-14) vs. 15(10.75-17) p= 0.01). Conclusion: The guided meditation was effective in improving the global sleep quality index and alleviating the anxiety and depression to great extent as compared to the standard routine care provided to COVID-19 patients admitted in a tertiary care facility.

Sign in / Sign up

Export Citation Format

Share Document