scholarly journals The management of postoperative airway after nasal endoscopic sinus surgery

2020 ◽  
Vol 6 (11) ◽  
pp. 1956
Author(s):  
Ashish Sharma ◽  
Nagababu Pyadala
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Internal Diameter ◽  
Nasal Airway ◽  
Nasal Surgery ◽  
Respiratory Parameters ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

<p><strong>Background:</strong> Nasal surgery followed by nasal packing can be vulnerable due to airway complications like, respiratory blockage and dyspnea. Thus the present study aimed to compare the nasal packing with nasal airway after the nasal surgery for the airway management.</p><p><strong>Methods:</strong> A total of 120 patients for fibreoptic endoscopic sinus surgery were included in this study. All subjects were equally divided in to 3 groups; group 1, 40 patients with traditional bilateral nasal packing; group 2, 40 patients with 5 mm internal diameter uncuffed ETT in to one of the nostrils and bilaterally in group 3 40 patients. During postoperative period all data were recorded and analyzed by using statistical analysis software 20.0.</p><p><strong>Results:</strong> In case of group 1 patients cardio-respiratory parameters reported significant variation. Pain and bleeding during removal of nasal airway and discomfort showed significant results among group 1 patients than in group 2 and group 3 patients.</p><p><strong>Conclusions:</strong> This study showed that the new intervention to manage the airway obstruction has benefits as compared to traditional nasal packing with ease of suctioning, oxygen supplementation.</p>

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.

Bioabsorbable dressing impregnated with betamethasone and ciprofloxacin after endoscopic sinus surgery: A randomized, double-blind, placebo-controlled study

2021 ◽  
pp. 014556132110624
Author(s):  
Małgorzata Wierzchowska ◽  
Paulina Kalińczak-Górna ◽  
Błażej Grześkowiak ◽  
Kamil Radajewski ◽  
Jakub Burduk ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Healing Process ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Controlled Study ◽  
Nasal Surgery ◽  
Double Blind ◽  
Nasal Blockage ◽  
Positive Effects ◽  
Mucosal Edema

Background In addition to its hemostatic and stabilization role, biodegradable nasal packing can be used as a carrier for drugs after functional endoscopic sinus surgery (FESS). The aim of this study was to compare the influence of biodegradable synthetic polyurethane foam (NasoPore) soaked with ciprofloxacin, or betamethasone, or both to the same foam soaked with saline after FESS. Methods 120 adults with chronic rhinosinusitis, with and without polyps, directed for bilateral full-house FESS were enrolled for the study. The patients were randomized and blinded into 3 groups, depending on the type of postoperative procedure applied. Thus, NasoPore soaked with antibiotic was provided to the first group; in the second group, the steroid was used; and the combination of both, in the third group. In each case, the aforementioned procedure was administered on one side of the nose, while NasoPore was soaked in saline on the other, at the end of the surgery, respectively. The patients were requested to complete a questionnaire during their postoperative visits at 2, 10, 30, 90, and 180 days, scoring the level of complaints on the VAS scale, separately for each side. The evaluation of the healing process was performed at each visit using rigid endoscopy and subsequently rated on numerical scales. Results Decreased mucosal edema and secretion; reduced Lund-Kennedy score; and favorable influences on facial pressure, nasal blockage, and smell were most evidently seen in the group receiving the antibioticsteroid combination. Conclusions The application of biodegradable nasal packing with betamethasone and ciprofloxacin in sino-nasal surgery has positive effects not only on the healing process but also impacts patient’s comfort. To optimize it, however, further research is needed.

scholarly journals Assessment of Nasal Airflow and Pain, Safety and Cost of an Improvised Nasal Airway (Nasogastric) Tube After Endoscopic Sinus Surgery

2020 ◽  
Vol 35 (2) ◽  
pp. 22
Author(s):  
Josephine Grace Rojo ◽  
Rachel Zita Ramos
Keyword(s):  
Pain Score ◽  
Postoperative Period ◽  
Nasogastric Tube ◽  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Significant Difference ◽  
Group A

ABSTRACT Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods:Design: Quasi - Experimental Prospective Cohort StudySetting: Tertiary Government Training HospitalParticipants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.

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 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 Postoperative airway management after nasal endoscopic sinus surgery: A comparison of traditional nasal packing with nasal airway

2013 ◽  
Vol 7 (1) ◽  
pp. 116 ◽  
Author(s):  
SukhminderJit Singh Bajwa ◽  
Jasbir Kaur ◽  
SS Parmar ◽  
Amarjit Singh ◽  
Sunder Singh
Keyword(s):  
Airway Management ◽  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Nasal Airway

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>

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

Features of postoperative period in patients with chronic venous insufficiency: phlebectomy versus thermal ablation

2020 ◽  
pp. 64-75
Author(s):  
E. Burleva ◽  
O. Smirnov ◽  
S. Tyurin
Keyword(s):  
Postoperative Period ◽  
Chronic Venous Insufficiency ◽  
Thermal Ablation ◽  
Venous Insufficiency ◽  
Clinical Symptoms ◽  
Varicose Veins ◽  
Statistical Processing ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

The purpose of the study was to conduct a comparative assessment of the course of the postoperative period after phlebectomy and thermal ablation in patients with varicose veins of the lower extremities in the system of the great saphenous vein (GSV) with class C2 of chronic venous insufficiency (CVI) — CEAP class C2. Materials and methods: 455 patients (455 limbs) with CEAP class C2. Group 1 (n = 154) received stripping + minimally invasive phlebectomy; Group 2 — endovenous laser ablation (EVLA) of GSV trunk + sclerotherapy of varicose veins; 3 group (n = 150) — radiofrequency ablation (RFA) of the GSV + sclerotherapy. All patients were united by a single tactical solution — the elimination of pathological vertical reflux in GSV. In each group, patients were with similar hemodynamic profile were selected (Group 1 = 63; Group 2 = 61; Group 3 = 61). The course of the postoperative period (from 2 days to 2 months) was compared for pain (visual analog scale — VAS), clinical symptoms of chronic venous insufficiency, degree of satisfaction (Darvall questionnaire), and duration of disability. Statistical processing was carried out using Excel programs for Windows XP, MedCalc® (version 11.4.2.0., Mariakerke, Belgium). Results: Postoperative pain is more pronounced (during day 1 for Group 1–4.0, Group 2–3.0, Group 3–2.0) and more prolonged (up to 4 days) after open surgeries (p < 0.05). The dynamics of the clinical symptoms of CVI (including varicose syndrome and use of compression therapy) could not be fully evaluated in connection with the ongoing sclerotherapy procedures for patients of Groups 2 and 3. Satisfaction of patients with aesthetic aspects was higher than expected in all groups. Reliable statistical differences proved decrease in days of disability (Group 1–14; Group 2–4; Group 3–3) and earlier return to physical activities and work in patients after thermal ablation in comparison with phlebectomy. Conclusion: The study shows that all three methods for eliminating vertical reflux in the GSV can be proposed for a large category of patients with CEAP of class C3 and C2. Medical and social rehabilitation of patients using endovascular thermal ablation technologies proceeds faster, which is beneficial both for the patients and for society.

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