Comparison of NOSE Scores Following Functional Septorhinoplasty Using Autologous versus Cadaveric Rib

2019 ◽  
Vol 35 (01) ◽  
pp. 103-108 ◽  
Author(s):  
Jennifer Fuller ◽  
Patricia Levesque ◽  
Robin Lindsay ◽  
Natalie Justicz
Keyword(s):  
Costal Cartilage ◽  
Septal Cartilage ◽  
Informed Consent Process ◽  
Nasal Airway ◽  
Postoperative Infections ◽  
Time Points ◽  
Nose Scale ◽  
Symptom Evaluation ◽  
Significant Difference

AbstractIn functional septorhinoplasty (FSRP), alternative grafting material is used if septal cartilage is insufficient for reconstructive needs. Autologous costal cartilage (ACC) and irradiated homologous costal cartilage (IHCC) are compared via the Nasal Obstruction Symptom Evaluation (NOSE) scale. One-hundred forty-one patients who underwent FSRP with ACC or IHCC between January 2013 and March 2018 were administered the NOSE scale pre- and postoperatively at 2, 4, 6, and 12 months. There was no significant difference in mean NOSE scores between the ACC and IHCC cohorts at the preoperative visit (68.5 [standard deviation, SD 24.1] and 71.7 [20.1], respectively; p < 0.6) or first postoperative visit (30.4 [26.6] and 33.9 [30.4], respectively; p < 0.6) or subsequent visits. NOSE scores demonstrated a clinically and statistically significant improvement at all follow-up time points for both the ACC and IHCC groups. Patients who underwent grafting with IHCC were significantly older than those with ACC; average age of 55.6 [SD: 17.3] versus 40.1 [SD:12.1]; (p < 0.001). Two IHCC (0.05%) patients had postoperative infections; both resolved with antibiotics, but one required revision surgery. Both ACC and IHCC provide reliable grafting material when septal cartilage is insufficient. In FSRP for nasal airway obstruction, ACC and IHCC both provide a clinically and statistically significant reduction in NOSE scores postoperatively that remain stable between follow-up time points. The authors find no difference in NOSE scores between the ACC and IHCC groups; however, IHCC did have a higher rate of postoperative infection. Both materials should be discussed with patients and are an important part of the informed consent process.

scholarly journals Nasal airway function after Le Fort I osteotomy with maxillary impaction: A prospective study using the Nasal Obstruction Symptom Evaluation scale

2021 ◽  
Vol 48 (1) ◽  
pp. 61-68
Author(s):  
Hyo Seong Kim ◽  
Ji Hwan Son ◽  
Jee Hyeok Chung ◽  
Kyung Sik Kim ◽  
Joon Choi ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Patient Characteristics ◽  
Rank Test ◽  
Nasal Airway ◽  
Le Fort I Osteotomy ◽  
Le Fort ◽  
Nose Scale ◽  
Airway Function ◽  
Symptom Evaluation ◽  
Le Fort I

Background This study evaluated changes in nasal airway function following Le Fort I osteotomy with maxillary impaction according to the Nasal Obstruction Symptom Evaluation (NOSE) scale.Methods This cohort study included 13 patients who underwent Le Fort I osteotomy with maxillary impaction. Nasal airway function was evaluated based on the NOSE scale preoperatively and at 3 months postoperatively. The change in the NOSE score was calculated as the preoperative score minus the postoperative score. If the normality assumptions for changes in the NOSE score were not met, a nonparametric test (the Wilcoxon signed-rank test) was used. Differences in NOSE score changes according to patient characteristics and surgical factors were evaluated using the Kruskal-Wallis test and the Mann-Whitney test.Results Patients ranged in age from 18 to 29 years (mean±standard deviation [SD], 23.00±3.87 years). Three were men and 10 were women. Eleven patients (84%) had an acquired dentofacial deformity with skeletal class III malocclusion. The preoperative NOSE scores ranged from 40 to 90 (mean±SD, 68.92±16.68), and the postoperative NOSE scores ranged from 25 to 80 (53.84±18.83). The cohort as a whole showed significant improvement in nasal airway function following maxillary impaction (P=0.028). Eleven patients (84%) had either improved (n=8) or unchanged (n=3) postoperative NOSE scores. However, nasal airway function deteriorated in two patients. Patient characteristics and surgical factors were not correlated with preoperative or postoperative NOSE scores.Conclusions Nasal airway function as evaluated using the NOSE scale improved after maxillary impaction.

scholarly journals Hypersensitivity relief of MIH-affected molars using two sealing techniques: a 12-week follow-up

2021 ◽  
Author(s):  
Katrin Bekes ◽  
Stefanie Amend ◽  
Julia Priller ◽  
Claudia Zamek ◽  
Tanja Stamm ◽  
...  
Keyword(s):  
Visual Analog Scale ◽  
Clinical Relevance ◽  
Retention Rates ◽  
Glass Ionomer ◽  
Analog Scale ◽  
Time Points ◽  
Clinical Pain ◽  
Molar Incisor Hypomineralization ◽  
Significant Difference

Abstract Objectives The aim of this study was to compare the efficacy in reducing hypersensitivity in molar incisor hypomineralization (MIH)-affected molars immediately and over 12 weeks after sealing using two different materials (composite and glass ionomer). Furthermore, the retention rates of both materials were analyzed. Methods Thirty-nine children with two MIH-affected molars showing hypersensitivity and non-occlusal breakdowns were included. Hypersensitivity was assessed with an evaporative (air) stimulus. Both teeth were sealed by two calibrated operators using a split-mouth design with either Clinpro Sealant in combination with Scotchbond Universal (C) or Ketac Universal (K), respectively. Clinical pain assessments (Schiff Score Air Sensitivity Scale [SCASS], Visual Analog Scale [VAS]) were made at baseline (“pre”), immediately after treatment (“post”), and after 1, 4, 8, and 12 weeks. Paired t tests were calculated in each group between baseline and all other time points. Results Thirty-eight children with 76 molars completed all stages of the study. Regardless of the material used, the application of the sealant decreased hypersensitivity significantly immediately as well as throughout the 12-week recalls (all p values < 0.001). We found no statistically significant difference among both materials chosen in any of the time points evaluated. Furthermore, retention of both materials was comparable in both groups. Conclusions Both sealant materials were able to reduce hypersensitivity successfully immediately and throughout the 12-week follow-up. Furthermore, their performance was similar in terms of retention. Clinical relevance Hypersensitivity can be a major complaint in patients with MIH. This is the first study evaluating hypersensitivity relief of MIH-affected molars using two sealing techniques.

scholarly journals Clinical efficacy of single intraoperative 500 mg methylprednisolone management therapy for thoracic myelopathy caused by ossification of the ligamentum flavum

2020 ◽  
Author(s):  
Xiaoyang Huo ◽  
Jiaming Zhou ◽  
Shiwei Liu ◽  
Xing Guo ◽  
Yuan Xue
Keyword(s):  
Posterior Approach ◽  
Ligamentum Flavum ◽  
Thoracic Myelopathy ◽  
Time Points ◽  
Significant Difference ◽  
Before And After ◽  
Long Term Follow Up ◽  
Frankel Grade

Abstract Background: The objective of our study was to compare clinical outcome and postoperative complications between patients with thoracic myelopathy caused by ossification of the ligamentum flavum (OLF) treated with and without intraoperative methylprednisolone (MP).Methods: This retrospective study enrolled 101 patients who underwent posterior approach surgery for OLF and were followed up at least 1 year. Patients were divided into two groups according to MP use in the operation: MP group (n=47) and non-MP group (n=54). Clinical outcomes and complications were evaluated before and after operation and at the last follow-up. Results: Significant differences were found in modified Japanese Orthopedics Association (mJOA) scores and proportion of Frankel grade (A-C) between the two groups immediately after surgery and at 2-week follow-up. No significant differences were found between the two groups in mJOA score before operation and at the final follow-up. Moreover, no significant differences were observed in recovery rate according to mJOA score at any time points, and there was no significant difference in the proportion of Frankel grade (A-C) between the two groups at final follow-up. There were 13 documented infections: 10 in the MP group and 3 in the non-MP group (P=0.034).Conclusion: Management therapy with intraoperative 500 mg MP showed better recovery of nerve function within 2 weeks in patients with thoracic myelopathy caused by OLF compared with those did not receive MP. However, long-term follow-up results showed that there was no significant difference in neurological recovery between patients with intraoperative MP or not. Moreover, intraoperative MP increased the rate of wound infection.

Safety of trastuzumab in HER2-positive primary breast cancer in Japan: Initial safety report for the large-scale cohort study (JBCRG C-01).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 613-613 ◽  
Author(s):  
Naohito Yamamoto ◽  
Hiroyasu Yamashiro ◽  
Hiroji Iwata ◽  
Norikazu Masuda ◽  
Shoichiro Ohtani ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Large Scale ◽  
Univariate Analysis ◽  
Concurrent Chemotherapy ◽  
Her2 Positive ◽  
Time Points ◽  
Significant Difference ◽  
The Mean

613 Background: The global randomized trials with trastuzumab (H) shows increased cardiotoxicity in patients (pts) with HER2 positive early breast cancer (BC). Safety in Japanese has not been fully evaluated. We evaluated the safety, especially focused on cardiotoxicity, of H adjuvant (adj) therapy in an observational study in Japan (UMIN000002737). Methods: Pts with histopathologically confirmed HER2 positive invasive BC were registered. Women with stage I-IIIC disease who received H as neo-adj and/or adj therapy were eligible. Mean LVEF at 3, 6, 9 and 18 months (M) was evaluated. The time points represent examination on day 60-120, 150-210, 240-330 and 455-635, respectively. Results: A total of 2024 pts were registered from 56 institutes between July 2009 and June 2011. Data of 1875 pts were collected and finalized by September 2012, and 1800 of them were analyzed for safety. The median follow-up was 35 M. The mean age was 54.5 years. Elderly pts ≥60 years were 32.7%. Treatments after surgery were: concurrent chemotherapy (CT) and H in 20.1%, sequential CT and H in 43.5% and H monotherapy in 35.9%. Adverse events (AEs) associated with H were reported in 350 pts (19.4%) and grade (G) 3/4 AEs in 12 pts (0.7%). G 3/4 cardiotoxicity was reported in 7 pts (dysfunction, 4pts; angina, 1 pt; myocardial infarction, 1 pt and heart failure, 1 pt). The mean LVEF at the baseline was 69.4%. Mean LVEF at 3, 6, 9 and 18M were 66.9%, 66.3%, 65.3% and 66.3%, respectively. Compared to the baseline, LVEF decreased with significant difference at all time points (p<0.0001). LVEF decrease ≥10% occurred in 177 pts (during H treatment,130 and after H treatment, 47). Follow-up data were available in 66 pts: 34 pts recovered to the baseline. Mean time to recover was 262 days. The univariate analysis showed using anthracycline (odds ratio 2.312, p=0.003) was the only risk factor for cardiotoxicity. However, elderly, radiation concurrent/sequential treatment with CT and H had no impact. Conclusions: From our study, we found the AE profiles of H were consistent with previously known AEs. We found using anthracycline was the risk factor for cardiotoxicity at the moment. We should carefully follow pts and watch long-term safety. Clinical trial information: 000002737.

scholarly journals The Influence of Overnight Orthokeratology on Ocular Surface and Meibomian Gland Dysfunction in Teenagers with Myopia

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Xiu Wang ◽  
Jing Li ◽  
Rui Zhang ◽  
Na Li ◽  
Yi Pang ◽  
...  
Keyword(s):  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Ocular Surface Disease Index ◽  
Time Points ◽  
Meniscus Height ◽  
Significant Difference ◽  
Before And After

Purpose. The aim of this study was to investigate the effect of overnight orthokeratology (OOK) on ocular surface and meibomian gland dysfunction in teenagers with myopia. Methods. A total of 59 subjects were recruited in this prospective study. The following tests were performed before and after 1, 3, 6, 12, and 24 months of OOK lens wear, including ocular surface disease index (OSDI) questionnaire, slit-lamp examination, and Keratograph 5M. Results. No infectious keratitis occurred during the study. OSDI scores increased gradually and reached the maximum at 6 months of OOK wear (P<0.001). The meniscus height was significantly increased at 1 and 3 months after the initiation of OOK (P=0.006, P=0.035). The corneal fluorescein staining at 1, 3, 6, 12, and 24 months after wearing OOK were all increased than the prewearing level with significant difference (P=0.014, P=0.036, P<0.001, P<0.001, and P=0.008, respectively). The first and the average tear film NIKBUT were all higher than the prewearing level, but there was no significant difference between every follow-up time points (P>0.05). The lid margin abnormalities were significantly increased (P=0.003, P=0.038, and P=0.015) at 6, 12, and 24 months after the initiation of OOK. There was no significant difference in the meibomian gland orifice scores at each follow-up time points compared to the prewearing level (P>0.05). The meibomian gland lipid secretion scores after wearing OOK were higher than those of the prewearing level, however, without statistically significant difference (P>0.05). No significant differences of the degree of difficulty of lipid excretions were detected after the initiation of OOK (P>0.05). There was no significant difference in meibomian gland dropout scores between all follow-up time points and the prewearing level (P=1.000). Conclusion. OOK increased the symptoms of dry eye and decreased the function of tear film by affecting the meniscus height and BUT. OOK did not affect the function of meibomian glands.Clinical Study registration number: ChiCTR18000185708.

scholarly journals Association of serum uric acid levels with COVID-19 severity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fang Hu ◽  
Yifan Guo ◽  
Jianghong Lin ◽  
Yingjuan Zeng ◽  
Juan Wang ◽  
...  
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Linear Regression Analysis ◽  
Healthy Controls ◽  
Time Points ◽  
Female Patients ◽  
Significant Difference ◽  
Severe Group ◽  
Male Patients

Abstract Aims Hyperuricemia has attracted increasing attention. However, limited concern has been paid to the potential dangers of lowering serum uric acid (SUA). We observed lower levels of SUA in patients with COVID-19. Therefore, we aim to explore whether patients with COVID-19 had SUA lower than normal and the relationship of SUA and the severity of COVID-19. Methods This was a case–control study based on 91 cases with COVID-19 and 273 age- and sex-matched healthy control subjects. We first compared SUA levels and uric acid/creatinine (UA/Cr) ratio between patients with COVID-19 and the healthy controls. Then, we examined the association of SUA levels and UA/Cr ratios with COVID-19 severity in COVID-19 cases only, defined according to the fifth edition of China’s Diagnosis and Treatment Guidelines of COVID-19. Results SUA levels in patients with COVID-19 were 2.59% lower, UA/Cr ratios 6.06% lower at admission compared with healthy controls. In sex stratified analysis, levels of SUA and UA/Cr were lower in male patients with COVID-19 while only level of SUA was lower in female patients with COVID-19. Moreover, SUA and UA/Cr values were 4.27 and 8.23% lower in the severe group than that in the moderate group among male COVID-19 patients. Bivariate and partial correlations analysis showed negative correlations between SUA or UA/Cr ratio and COVID-19 after adjusting for age, sex, BMI and eGFR. A multiple linear regression analysis showed that SARS-CoV-2 infection and male sex were independent risk factors associated with lower SUA levels. Male patients with COVID-19 accompanied by low SUA levels had higher risk of developing severe symptoms than those with high SUA levels (incidence rate ratio: 4.05; 95% CI:1.11, 14.72) at admission. Comparing SUA and UA/Cr ratio at three time points (admission, discharge, and follow-up), we found that male patients experienced severe symptoms had lower SUA and UA/Cr ratio levels comparing to moderate patients, but no significant difference between three time points. On the contrary, female patients had lower SUA and UA/Cr ratio at discharge than those at admission, but no significant difference of SUA and UA/Cr ratio between moderate and severe group. Conclusion Patients with COVID-19 had SUA and UA/Cr values lower than normal at admission. Male COVID-19 patients with low SUA levels had a significantly higher crude risk of developing severe symptoms than those with high SUA levels. During disease aggravation, the level of SUA gradually decreased until discharge. At the follow-up exam, the level of SUA was similar to the levels at admission.

scholarly journals Ureteric stenting versus non-stenting following uncomplicated ureteroscopic lithotripsy: A Prospective randomized trial.

2019 ◽  
Author(s):  
Saddam Al Demour ◽  
Adel Alrabadi ◽  
Abedallatif AlSharif ◽  
Mera Ababneh ◽  
Motaz Melhem ◽  
...  
Keyword(s):  
Operative Time ◽  
Flank Pain ◽  
Ureteroscopic Lithotripsy ◽  
Time Points ◽  
Ureteric Stenting ◽  
Significant Difference ◽  
Analgesia Requirement ◽  
Group 3 ◽  
Group 2

Abstract Background: There is no consensus about whether a double-J ureteric stent (DJ-US) should be placed following uncomplicated ureteroscopy for stone retrieval. This study aimed to compare three groups of patients who underwent uncomplicated ureteroscopic lithotripsy (URSL) and to evaluate whether stents could be eliminated after the procedure. Methods: A total of 105 patients underwent uncomplicated URSL for ureteric stones were prospectively randomized into three groups: group 1 (34 patients) with DJ-US, group 2 (35 patients) with DJ-US on extraction string, and group 3 (36 patients) with no DJ-US after the procedure. The outcomes measured were; postoperative Visual Analog Score (VAS) for flank pain and dysuria score, urgency, frequency, suprapubic pain, hematuria, analgesia requirement, operative time, re-hospitalization, and return to normal physical activity.Results: Mean operative time was significantly longer in groups 1 and 2 compared to group 3 [mean time ± SD, 22.2 ± 9.1 min, 20.2 ± 6 min, 15.1 ± 7.1 min respectively, p<0.0001]. The results of the VAS for flank pain and dysuria scores, urgency, frequency, hematuria, and suprapubic pain showed a significant difference at all time points of follow-up, with significantly higher in groups 1 and 2 compared to group 3. Further analysis showed that measured outcomes, and analgesia need for groups 1 and 2 were similar, at all time points except at week 1 and 1 month where group 2 patient’s had less symptoms.Conclusion: DJ-US placement appear to be unnecessary in procedures considered uncomplicated by operating urologists during surgery. The advantages of DJ-US with extraction string over DJ-US only include earlier and easy removal with earlier relief of symptoms, and less analgesia requirements.

scholarly journals No difference in learning retention in manikin-based simulation based on role

2016 ◽  
Vol 30 (1) ◽  
pp. 20-24 ◽  
Author(s):  
Dominic Giuliano ◽  
Marion McGregor DC
Keyword(s):  
Repeated Measures ◽  
Critical Role ◽  
Learning Retention ◽  
Time Points ◽  
Repeated Measures Analysis ◽  
Significant Difference ◽  
Simulation Based ◽  
Data Points

Objective: We evaluated learning retention in interns exposed to simulation. It was hypothesized that learning would degrade after 6 months and there would be a difference in retention between interns who played a critical role versus those who did not. Methods: A total of 23 groups of 5 to 9 interns underwent a cardiac scenario twice during 1 simulation experience and again 6 months later. We captured 69 recordings (23 before debrief at baseline [PrDV], 23 after debrief at baseline [PoDV], and 23 at 6-month follow-up [FUV]). Students were assigned different roles, including the critical role of “doctor” in a blinded, haphazard fashion. At 6-month follow-up, 12 interns who played the role of doctor initially were assigned that role again, while 11 interns who played noncritical roles initially were newly assigned to doctor. All videos of intern performance were scored independently and in a blinded fashion, by 3 judges using a 15-item check list. Results: Repeated-measures analysis of variance for interns completing all 3 time points indicated a significant difference between time points (F2,22 = 112, p = .00). Contrasts showed a statistically significant difference between PrDV and PoDV (p = .00), and PrDV and FUV (p = .00), but no difference between PoDV and FUV (p = .98). This was consistent with results including all data points. Checklist scores were more than double for PoDV recordings (16) and FUV (15), compared to PrDV recordings (6.6). Follow-up scores comparing old to new doctors showed no statistically significant difference (15.4 vs 15.2 respectively, t21 = 0.26, p = .80, d = .11). Conclusions: Learning retention was maintained regardless of role.

scholarly journals Morphological Analysis of Nose in Patients of Tessier No. 0 Cleft With a Bifid Nose in China

2021 ◽  
Vol 9 ◽  
Author(s):  
Xin Wang ◽  
Huan Wang ◽  
Jianjun You ◽  
Ruobing Zheng ◽  
Yihao Xu ◽  
...  
Keyword(s):  
Costal Cartilage ◽  
Medial Canthus ◽  
Cartilage Transplantation ◽  
Nasal Bridge ◽  
Nasal Tip ◽  
Silicone Prosthesis ◽  
Nasolabial Angle ◽  
Significant Difference ◽  
Bridge Length

Objective: Facial cleft involves complex malformations. No study assessed the facial deformity of Tessier No. 0 cleft with a bifid nose. Thus, we used anthropometric measurements to access the nose in patients.Methods: A total of 24 bifid nose deformities underwent surgery at our institution between 2010 and 2019. Standardized photographs were taken preoperatively and postoperatively. Landmarks were identified on these images; measurements for nasal analysis were performed and compared with the established Chinese norms. Surgical method differences were also analyzed.Results: The median follow-up time was 2.51 years. Postoperatively, there is a significant difference in comparison with preoperative in the nasal index, medial canthus and nose width index, nasolabial angle, nasofacial angle, ala length and nasal bridge length index, nasal tip protrusion and nasal width index, and nasal width and ala length index. Furthermore, the medial canthus and nose width index, and nasal width and ala length index were significantly larger in ordinary people, while ala length and nasal bridge length index and nasal tip protrusion and nasal width index were smaller. After surgery, most angles and index were standard except the nasolabial angle in the females, and ala length and nasal bridge length index in the males. Moreover, as for the group of costal cartilage transplantation, most index and angles have improved after surgery including nasolabial angle, nasofacial angle, ala length and nasal bridge length index, nasal tip protrusion and nasal width index, and nasal width and ala length index. However, only nasal tip protrusion and nasal width index, columella length and nasal tip protrusion index, and nasal width and ala length index in the silicone prosthesis group implantation has significance. Costal cartilage transplantation can also better improve ala length and nasal bridge length index than the silicone prosthesis implantation.Conclusion: Most defects can be repaired with surgery, but the outcome has a lack of evaluation. Thus, anthropometric assessment can serve as a material for nasal and reconstructive surgery.

Sign in / Sign up

Export Citation Format

Share Document