scholarly journals Comparative study of hypertonic saline nasal douching versus normal saline nasal douching in post operative endoscopic sinus surgery patients

2019 ◽  
Vol 5 (3) ◽  
pp. 598
Author(s):  
Smruti Milan Tripathy ◽  
Rakhee Panda
Keyword(s):  
Hypertonic Saline ◽  
Endoscopic Sinus Surgery ◽  
Isotonic Saline ◽  
Sinus Surgery ◽  
Post Operative Period ◽  
Significant Difference ◽  
Group 2 ◽  
Snot 22 ◽  
Clearance Test ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Nasal douching is routinely done in the post operative functional endoscopic sinus surgery (FESS) patients. Douching helps to clear the nasal cavity of crusts, clots and any infected debris and also promotes quicker mucosal healing.</p><p class="abstract"><strong>Methods:</strong> A total of 60 patients who underwent FESS in the ENT department were selected for the study. Patients were randomly allocated into two groups. Group 1 patients were subjected to nasal douching using hypertonic saline (3%) in the post operative period while the group 2 patients used isotonic saline (0.9%) for nasal douching. Patients were followed up on the 7<sup>th</sup>, 15<sup>th</sup> and 30<sup>th</sup> post operative day and various parameters were compared using nasal endoscopy, saccharine clearance test, sinonasal outcome test questionnaire (SNOT-22) and visual analogue scale (VAS).  </p><p class="abstract"><strong>Results:</strong> Group 1 patients who used hypertonic saline for nasal douching had a better symptom score on 30<sup>th</sup> post operative day in SNOT-22 and VAS (p&lt;0.05 in both) as compared with the group 2 patients who used isotonic saline for nasal douching. More patients in group 1 had a healthy and normal appearance of nasal mucosa on endoscopic examination as compared with group 2. There was not much significant difference in the mucocilliary clearance test (MCT) scores of both the group patients.</p><p class="abstract"><strong>Conclusions:</strong> Patients who used hypertonic saline for douching in the post operative period were found to have lesser crusting, nasal obstruction as compared to those who used isotonic saline for douching.</p>

scholarly journals Double-blind, randomised controlled trial on the efficacy of saline nasal irrigation with sodium hyaluronate after endoscopic sinus surgery

2019 ◽  
Vol 133 (4) ◽  
pp. 300-308 ◽  
Author(s):  
F Mozzanica ◽  
A Preti ◽  
R Gera ◽  
C Bulgheroni ◽  
A Cardella ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Sodium Hyaluronate ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Double Blind ◽  
Nasal Irrigation ◽  
Post Operative Period ◽  
Group 2 ◽  
Group 1

AbstractObjectiveThere is a growing interest in sodium hyaluronate for the clinical management of patients who undergo functional endoscopic sinus surgery for chronic rhinosinusitis, because of the mucosal regenerative properties of this macromolecule. However, its role in post-operative care is still debated. This study aimed to evaluate the effect of sodium hyaluronate administered via nasal irrigation with saline, in the post-operative period, after functional endoscopic sinus surgery.MethodsA multicentric, prospective, randomised, double-blind, parallel group study was conducted on 56 consecutive patients who underwent functional endoscopic sinus surgery for chronic rhinosinusitis without polyps. Group 1 received the standard therapy of normal saline; group 2 received saline plus sodium hyaluronate.ResultsBoth objective and subjective measurements, in terms of endoscopic appearance and patient-reported satisfaction, were significantly better in group 2 compared to group 1.ConclusionSodium hyaluronate may be a useful adjunct to nasal saline irrigation in the early post-operative period following functional endoscopic sinus surgery.

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.

Use of Fibrin Glue as a Hemostatic in Endoscopic Sinus Surgery

2005 ◽  
Vol 114 (3) ◽  
pp. 237-241 ◽  
Author(s):  
Michael Vaiman ◽  
Nathan Shlamkovich ◽  
Ephraim Eviatar ◽  
Samuel Segal
Keyword(s):  
Fibrin Glue ◽  
Endoscopic Sinus Surgery ◽  
Second Generation ◽  
Postoperative Bleeding ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Special Treatment ◽  
Nasal Bleeding ◽  
Group 2 ◽  
Group 1

Endoscopic sinus surgery (ESS), especially when combined with turbinectomy and/or with submucous resection of the septum, may involve postoperative bleeding that might end with nasal packing. Nasal packing causes pain, rhinorrhea, and inconvenience and may not stop the postoperative bleeding. The aim of our study was to compare the hemostatic properties of the second-generation surgical sealant Quixil (Crosseal) with those of nasal packing in ESS. We performed a prospective randomized trial in 64 consecutive patients who underwent ESS and presented excessive intraoperative and/or postoperative bleeding. They were allocated by the sealed-envelope method into two groups. A routine ESS procedure was ended with Merocel nasal packing in group 1, and with aerosol application of Quixil sealant at the operative site in group 2. The hemostatic effects were evaluated objectively in the clinic by anterior rhinoscopy and endoscopy and assessed subjectively by the patients at follow-up visits. In group 1, various types of postoperative bleeding occurred in 25% of patients. In group 2 there was no postoperative bleeding, except for 1 case of late hemorrhage (3.12%). Drainage and ventilation of the paranasal sinuses were not impaired. There were no allergic reactions to the glue. We conclude that aerosol application of fibrin glue can be readily performed in ESS, requires no special treatment (antibiotics), and appears to have an adequate hemostatic effect. The use of this second-generation glue in ESS appears to stop nasal bleeding well and to be relatively safe and convenient.

scholarly journals Comparison of Three Surgical Techniques in Pilonidal Sinus Surgery

2018 ◽  
Vol 119 (4) ◽  
pp. 148-155 ◽  
Author(s):  
Abdulcabbar Kartal ◽  
Hüseyin Onur Aydın ◽  
Mehmet Oduncu ◽  
Murat Ferhat Ferhatoğlu ◽  
Taner Kıvılcım ◽  
...  
Keyword(s):  
Pilonidal Sinus ◽  
Primary Closure ◽  
Sinus Surgery ◽  
Pilonidal Sinus Disease ◽  
Transposition Flap ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Our study aims to compare the surgical outcome of Limberg transposition flap, Karydakis flap, and primary closure after excision to treat sacrococcygeal pilonidal sinus disease. A total of 634 patients with pilonidal sinus who underwent surgery were evaluated retrospectively from January 2014 to January 2016. The patients were divided into three groups. Limberg transposition flap (LTF) was performed in 131 patients (group 1), Karydakis flap (KF) was performed in 232 patients (group 2) and primary closure (PC) after excision was performed in 271 patients (group 3). Patient demographics, operative and postoperative outcomes were recorded and analyzed retrospectively. The mean age (p=0.98), sex ratio (p=0.74) and removed sinus volume (p=0.67) were not statistically different between groups. Mean operative time was 54.3 ± 6.4 min for group 1, 46.8 ± 10.5 min for group 2, and 26.9 ± 5.8 min for group 3 respectively (p=0.01). When the length of hospital stay was compared, there was a significant difference in favor of primary closure (p=0.01). Regarding early surgical complication, Karydakis flap technique was superior to other groups (p<0.001). The recurrent rate was higher in the primary closure group (p<0.001). In our study, the primary closure method regarding the duration of surgery and hospitalization; Karydakis method regarding postoperative complications (seroma, hematoma, wound dissociation, infection, recurrence) were superior to the other two methods.

scholarly journals Quality of life after endoscopic sinus surgery or balloon sinuplasty: a randomized clinical study

2014 ◽  
Vol 52 (4) ◽  
pp. 300-305
Author(s):  
A.J. Bizaki ◽  
R. Taulu ◽  
J. Numminen ◽  
M. Rautiainen
Keyword(s):  
Quality Of Life ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Balloon Sinuplasty ◽  
Randomized Clinical Study ◽  
Material Cost ◽  
Computer Tomography Scan ◽  
Significant Difference ◽  
Snot 22

Objectives: To conduct the first prospective randomized controlled trial that evaluates and compares the clinical outcome and impact of ballonsinuplasty and endoscopic sinus surgery (ESS) on the quality of life of patients suffering from chronic or recurrent rhinosinusitis (CRS) of the maxillary sinus. Methods: Adult patients with symptomatic chronic or recurrent rhinosinusitis without severe findings in the sinuses, as documented in the sinus’ Computer Tomography scan and clinical exam, were randomized in 2 groups: ESS and Balloon Sinuplasty.The main variable in our study is the Sinonasal Outcome Test-22 (SNOT 22) and its parameters. These parameters were analysed preoperatively and at 3 months, postoperatively. Results: There was a subjective improvement in symptoms after surgery. We also noticed an objective improvement in the quality of life of our patients seen as a decrease in the total SNOT 22 score. Both balloon sinuplasty and ESS significantly improved almost all the parameters of SNOT22, with no significant difference being found between these two groups. Conclusion: Both balloon sinuplasty and endoscopic sinus surgery improved the quality of life of patients with mild chronic or recurrent rhinosinusitis. However, the remarkably higher material cost of balloon sinuplasty compared to ESS sets limits on its broad use. There is an obvious need for further study to find out if, as an office procedure, balloon sinuplasty could deliver cost-savings high enough to cover the higher material cost of balloon sinuplasty. Our study was, however, too small to enable firm conclusions to be drawn.

scholarly journals Prospective, randomised controlled trial comparing intense endoscopic cleaning versus minimal intervention in the early post-operative period following functional endoscopic sinus surgery

2011 ◽  
Vol 125 (6) ◽  
pp. 585-589 ◽  
Author(s):  
J M Fishman ◽  
S Sood ◽  
M Chaudhari ◽  
P Martinez-Devesa ◽  
L Orr ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Outcome Measure ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Minimal Intervention ◽  
Post Operative Period ◽  
Significant Difference ◽  
Randomised Controlled

AbstractObjective:There is currently no standardised management protocol following functional endoscopic sinus surgery. This study assessed frequent endoscopic cleaning versus minimal intervention in the early post-operative period following such surgery.Study design:Prospective, randomised controlled, single-blinded, within-subject trial involving 24 patients with bilateral chronic rhinosinusitis undergoing bilateral functional endoscopic sinus surgery.Main outcome measure:The primary outcome measure was ethmoid cavity healing, based on endoscopic appearance, graded using a modified Lund–MacKay endoscopic score.Secondary outcome measure:Lund–MacKay symptom score before and after surgery.Results:There was no overall statistically significant difference between the two groups (p = 0.37). Subgroup analysis revealed a significant effect of regular suction clearance on adhesions at three months (p = 0.048), but not on oedema, polyps, granulation, discharge or crusting.Conclusion:There is no evidence from this study to support frequent endoscopic cleaning in the early post-operative period after functional endoscopic sinus surgery. Less intensive post-operative management is recommended, resulting in decreased patient morbidity and fewer post-operative follow-up appointments.

scholarly journals In Vivo Histomorphologic Structure of Cornea after FemtoLASIK Using Various Femtosecond Laser Systems

2018 ◽  
Vol 15 (3) ◽  
pp. 264-272
Author(s):  
A. V. Doga ◽  
I. A. Mushkova ◽  
A. N. Karimova ◽  
E. V. Kechin
Keyword(s):  
Corneal Thickness ◽  
Corneal Stroma ◽  
Excimer Laser Ablation ◽  
Post Operative Period ◽  
Significant Difference ◽  
Laser Systems ◽  
Corneal Structure ◽  
Group 2 ◽  
Group 1

Purpose:to compare in vivo histomorphologic structure of cornea after the FemtoLASIK procedure using femtolaser systems Femto Visum (Russia) and Femto LDV Z6 (Switzerland).Patients and methods:The study was carried for 70 eyes from 70 patients with low to moderate myopia after FemtoLASIK procedure. Group 1 (Femto Visum) included 36 eyes (n = 36) there the flap were formed using femtolaser Femto Visum («Optosystems», Russia), group 2 (Femto LDV Z6) included 34 eyes (n = 34) and Femto LDV Z6 was used («Ziemer Ophthalmic Systems AG», Switzerland). The excimer laser ablation was performed with Microscan Visum system («Optosystems», Russia) in both groups. The Femto Visum and Femto LDV Z6 groups were comparable in terms of pre-operative data (age, sex, corneal curvature, central corneal thickness, sphere, cylinder, spherical equivalent) (p > 0.05). In vivo histomorphological structure of the cornea was examined using confocal microscope Confoscan 4 (Nidek, Japan) 1 week, 1, 3, 6, and 12 months after FemtoLASIK. The endothelial cell density (ECD) was measured with endothelial microscope (EM-3000, Tomey, Japan) before surgery and 12 months after FemtoLASIK.Results:The main in vivo histomorphological cornea changes occurred in the anterior and middle layers of the corneal stroma during post-operative period in both groups (Femto Visum and Femto LDV Z6). The underlying corneal structures remained intact. There was no statistically significant difference between the two groups (p > 0.05). Twelve months postoperatively, the loss of ECD was 0.31 % in the Femto Visum group and 0.33 % in the Femto LDV Z6 group (p > 0,05).Conclusions:FemtoLASIK procedures using Femto Visum (Russia) and Femto LDV Z6 (Switzerland) lead to similar histomorphological cornea changes in post-operative period (p > 0.05) and they are safe for corneal structure in the treatment of myopia.

Effectiveness of Cabergoline Treatment in Patients with Acromegaly Uncontrolled with SSAs: Experience of a Single Tertiary Center

2020 ◽  
Author(s):  
Serdar Sahin ◽  
Mehmet Cem Fidan ◽  
Ozge Polat Korkmaz ◽  
Emre Durcan ◽  
Hande Mefkure Ozkaya ◽  
...  
Keyword(s):  
Economic Cost ◽  
Ease Of Use ◽  
Pathologic Examination ◽  
Resonance Imaging ◽  
Proliferation Indices ◽  
Post Operative Period ◽  
Tertiary Center ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Abstract Purpose To evaluate the effectiveness of cabergoline and the parameters affecting cabergoline response as add-on treatment to somatostatin analaogues (SSA) in patients with acromegaly uncontrolled with SSAs. Material and Method One hundred and twenty-nine acromegalic patients uncontrolled with SSA who had cabergoline added to their treatment were included in this retrospective study. Patients were divided into the SSAs + cabergoline-responsive (group 1) and non-responsive groups (group 2), and biochemical, pathologic, and radiologic parameters were assessed. Results IGF-1 normalization was achieved in 75 of 129 patients (58%) when cabergoline was added to the SSA treatment. Female patients were significantly higher in group 1 compared to group 2 (p=0.006). Group 1 had significantly smaller pre- and post-cabergoline tumor size (p=0.011, p=0.007 respectively), lower levels of IGF-1 in pre-and post-operative period (p=0.040, p=0.001), and lower levels of IGF-1 in pre- and post-cabergoline treatment (p<0.001). Cavernous invasion on sellar magnetic resonance imaging, dural invasion in pathologic examination were not significantly different between the groups. Sellar invasion in pathologic examination was significantly higher in group 1 (p=0.011). No significant difference was found in proliferation indices between two groups. The presence of fibrous bodies was significantly lower in group 1 (p=0.010). Conclusion Cabergoline can be added to the treatment of acromegalic patients uncontrolled with SSAs due to its ease of use and low economic cost, especially in patients with acromegaly who have small adenomas and no fibrous bodies.

scholarly journals Evaluation of the Effect of Conventional Rhinoplasty with Autospreader Flap and Let-Down Technique on Nasal Functions

2021 ◽  
Author(s):  
Burak Mustafa Taş ◽  
Burak Erden
Keyword(s):  
Quality Of Life ◽  
Significant Difference ◽  
Quality Of Life Scale ◽  
Life Scale ◽  
Sinonasal Outcome Test ◽  
Group 2 ◽  
And Gender ◽  
Snot 22 ◽  
Group 1

AbstractLet-down technique, in which high septal strip resection is performed, and conventional rhinoplasty using autospreader flaps were compared regarding nasal functions with Nasal Obstruction Symptom Evaluation (NOSE) and Sinonasal Outcome Test-22 (SNOT-22) quality-of-life scale questionnaires. A total of 54 patients who were included in the study were divided into two groups: group 1 (autospreader group; n = 27) and group 2 (let-down group; n = 27). Open technical septorhinoplasty operation using an autospreader flap was performed in group 1. Let-down rhinoplasty was applied in group 2. NOSE and SNOT-22 scales were filled for the groups in the preoperative and postoperative periods and were compared. Postoperative values were found to be significantly lower than preoperative values in both groups (p < 0.001). When the groups were compared in between, no significant difference was seen according to the scales (p > 0.05). There was also no significant difference between the groups regarding age and gender. Although there was no significant difference between the two techniques, both NOSE and SNOT-22 quality-of-life scales have shown improvement both in conventional rhinoplasty with autospreader flap and let-down technique.

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