{"title":"How to prevent nasal obstruction after Rhinoseptoplasty. Could a routine turbinate reduction improve the outcomes in Quality of Life of patients?","authors":"B. H. D. Moura","doi":"10.33552/ojor.2019.01.000525","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000525","url":null,"abstract":"Rhinoplasty is often performed to restore nasal function and form. The development or maintenance of nasal obstruction after rhinoplasty is a complication that negatively affects quality of life (QOL), and priority should be given to prevention strategies [1]. However, the available surgical techniques to prevent this obstruction have been empirically developed and are often used based on the surgeon’s preference rather than on objective criteria. Currently, strategies like spreaders grafts, support grafts, reconstruction or repositioning cartilages and even a good septoplasty are used to enlarge the nasal valve [2-6]. Another technique widely used is the Reduction of the inferior turbinate [3,7-9]. Otherwise, an established technique to reduce turbinate with hypertrophy is still debatable [10-13]. Reviews pointed that research in this field appears to be driven by technological advancement rather than by establishment of patientsʹ benefit. Partly, because of the lack of properly conducted randomized controlled trial with long term results. Some articles even question the efficacy of this procedure in cases of nasal obstruction explained for other reasons rather than turbinate hypertrophy isolated [14]. A Recent clinical trial reveal that the association of turbinectomy with septoplasty, though widespread, does not improve the nasal obstruction clinical outcomes and can add risks to patients [15].","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130643017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Localization of Herpetic Viruses Patterns in Sinonasal and Nasopharyngeal Malignant and Benign Tumors","authors":"M. Mahmood","doi":"10.33552/ojor.2019.01.000524","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000524","url":null,"abstract":"Nasopharyngeal cancer is a highly malignant tumor, the primary tumor mass can extend within the nasopharynx and/or extend to the base of the skull, palate, nasal cavity or oropharynx and distant metastases can arise in bone, lung, mediastinum and liver [1,2]. Sinonasal carcinoma could arise from various tissues within the nasal cavity, including lymphoreticular, epithelial and nonepithelial tumors [3]. Sinonasal Papillomas are a rare disease which have an annual incidence of 0.6/105 in defined geographical regions. The investigations of these tumors have shaded the light on a viral agent as an etiological candidate, such as EBV [4]. In addition, an outdoor and industrial occupations are the major risk factors for sinonasal Papillomas development [5]. Inflammatory Polyps lesions are affecting 1-4% of all population [6]. Where they arise as an outgrowth from the mucosal membrane of nasal cavity and paranasal sinuses as a result of an allergic or chronic inflammation [7].","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121320996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Loss of Smell is a Big Loss","authors":"F. Shah","doi":"10.33552/ojor.2019.01.000523","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000523","url":null,"abstract":"Everyone has lasting and permanent memories of smells. The very imagination of good smell will bring to mind the delight of the roses, the jasmine, lavender and other flowers, the bewitching scents of favorite perfumes, the fabulous smells of assorted spices, the rich aromas of fresh fried bread ,the tea, the coffee or the smell of meat sizzling on a barbecue, or the fragrance in your favorite Cologne . Just mere thinking about some of them for a moment is enough to awaken a sense of excitement. No doubt, each and every one of these delights is an incomparable blessing noteworthy. Our sense of smell helps us enjoy life. We delight in the aromas of our favorite foods or the fragrance of flowers. We think that we smell with our noses, but this is a little like saying that we hear with our ear lobes [1]. Our sense of smell is also a warning system, alerting us to danger signals such as a gas leak, spoiled food, or a fire. Any loss of our sense of smell can have a negative effect on our quality of life. Problems with smell increase as people get older, and they are more common in men than women. Many people who have smell disorders also notice problems with their sense of taste .It is amazing to see how does our sense of smell works, sense of smell is one of the most primitive of our senses which is dependent on olfactory cells located within olfactory epithelium high in the roof of the nasal cavity.","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120962664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Endonasal Dacryocystorhinostomy, Our Experience","authors":"A. Nass","doi":"10.33552/ojor.2019.01.000522","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000522","url":null,"abstract":"Toti first describe the external Dacryocystorhinostomy (DCR) in the early 20th century [1], the technique is applicable to patients complaining of tearing and demonstrating obstruction of the lacrimal outflow system. The procedure consists of creating a fistula directly from the lacrimal sac into the nose and bypassing the nasolacrimal duct. Caldwell first described the endonasal approach to the lacrimal sac [2], in 1893, and later in 1911 West introduce it [3], however, its use remained limited due to difficulties in visualizing the endonasal structures during the operation. The introduction of the microscopes and the rigid endoscopes provided the catalyst for endonasal Dacryocystorhinostomy (DCR). In our hospital (Tripoli medical center, Tripoli, Libya), we start this kind of surgery in collaboration with the Ophthalmological department in 2006. We present our experience with 32 patients underwent this operation. Materials and Methods A total of 32 patients with nasolacrimal duct obstruction were treated consecutively by microscopic and endoscopic endonasal DCR. All patients were females (100%). Patients ages ranged from 22 to 70 years. Patients were usually referred by an ophthalmologist with a history of epiphora and nasolacrimal duct obstruction, all patients has either sicca or post-saccal stenosis. There were 3 cases of Dacryocele, 4 cases needed nasal septal surgery and one patient with rhinolith needed removal of the nasal pathology during the surgery. Pre-operatively, a detailed clinical examination was carried out by an ophthalmologist and an ENT surgeon, including regurgitation testing and lacrimal syringing and probing. Endoscopic evaluation was performed in every case, in order to check for access, deviated nasal septum, turbinate hypertrophy or any other associated pathology. General anesthesia was used in all patients. Online Journal of Otolaryngology and Rhinology Open Access","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115850758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Vestibular Migraine-A Diagnostic Dilemma (A Case Report with Review of Literature)","authors":"R. Nayar","doi":"10.33552/ojor.2019.01.000521","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000521","url":null,"abstract":"Migraine is one of the common forms of primary headache. Each patient with migraine on this planet is a variant. The term Vestibular Migraine (VM) is used for patients with a past or current history of migraine, presenting with dizziness as the predominant symptom with or without headache. Prosper Meniere, the French physician who first described the vertiginous syndrome that now goes after his name, was a victim of severe migraine himself .The relationship between these two illnesses was suspected, and written about for many years, under various names such as Migraine -Anxiety Related Dizziness (MARD), Migraine-induced Vertigo or Migrainous Vertigo. But it was only in the year 2001 that the International Headache Society and Barany Society reached a consensus on the diagnostic criteria of Vestibular Migraine. Diagnosing vestibular migraine is a challenging task, as Migraine can be present in association with Meniere’s disease [6], BPPV, Epilepsy and often Audio-vestibular investigations and imaging are needed to exclude other peripheral and central vestibular disorders [7].","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129181026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Bedoya, J. Enseñat, Isam Alobidt, C. Langdon
{"title":"Functional Outcomes in Endoscopic Endonasal Surgery of the Skull Base, A rising challenge","authors":"David Bedoya, J. Enseñat, Isam Alobidt, C. Langdon","doi":"10.33552/ojor.2019.01.000520","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000520","url":null,"abstract":"Extended endonasal endoscopic approaches (EEEA) for skull base lesions have been increasing over the last decade. Determinants for this development are the enhanced understanding of the endoscopic anatomy, improvement of imaging systems and specific instruments, and the use of vascularized flaps for reconstruction [1]. This EEEA can cause postoperative morbidity related to the reconstruction, like crusting and posterior rhinorrhea, especially in those cases requiring an endonasal flap [2,3]. The healing process start the first week with a reepithelization by stratified epithelium, then hair cells appear in the third week and complete recovery of the sinus epithelium occurs within 6-8 weeks [4]. Given this, [5] conclude that one must wait at least three months to assess the clinical and postoperative symptoms. Regarding quality of life (QOL) after EEEA evidence have shown that the morbidity is related to the extension of the approach. [6] reported a negative impact in QOL after the use of nasoseptal flap which is commonly associated to extended approaches. The latter was mainly due to an increased tendency to headaches and reduced smell; however, recovery occurs over time especially in those patients with secreting pituitary tumors. Since the use of endoscopic skull base surgery, there have been great efforts to develop specific QOL questionnaires for EEEA and pituitary surgery (Table 1) Until now, the following tests have been applied in English literature; Quality of Life-Assessment of Growth Hormone Deficiency in Adults [7], Hypopituitarism Quality of Life Satisfaction (QLS-H) [8], Previous Skull Base Quality of Life (ASB-QOL) [9], Hormone Deficiency-Dependent Quality of Life ( HDQOL) [10], Acromegaly Quality of Life (ACROQOL) [11], Pituitary Adenoma Quality of Life (PA-QOL) [12], Cushing Quality of Life [13], Addison Quality of Life (AddiQOL) [14], or ASK nasal inventory [15]. Handicaps for these tests are that they do not include specific areas about quality of life and cancer, visual defects, hormonal deficiency or sinonasal symptoms. Here, we will discuss the impact of EEEA regarding the following topics:","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"213 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133109219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hearing Health Programs for Schoolchildren","authors":"A. Lacerda","doi":"10.33552/ojor.2019.01.000519","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000519","url":null,"abstract":"Hearing is fundamental for the development of language. When hearing loss (HL) is present, problems in communicative processes may occur, hindering global cognitive development, learning and interpersonal relationships, thus harming school development and, consequently, the professional performance of the affected population [1-3]. For the World Health Organization (WHO) [4], hearing impairment may bring about social and economic overburden to individuals, family members and society, that is why prevention is essential. Still according to the WHO [5], about 10% of the population in any countries has some kind of disability, and hearing impairment takes up 1.5% of that. For the Global Burden of Disease (2005) [6], 278 million individuals around the globe suffer from some kind of moderate to severe hearing impairment in both ears. From that population, 80% live in developing countries, and about 50% of the observed hearing impairments can be avoided by prevention, early diagnosis and treatment. In Brazil, for example, studies show rates of hearing loss among students of up to 39.4% in some cities [7]. In view of such high rates in several Brazilian regions, Hearing Health Programs for Schoolchildren must be implemented as an integrating part of the primary health care.","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126985029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Mastoidectomy in the Repair of Tympanic Perforation in Patients with Chronic Non-Cholesteatomatous Otitis Media with Sclerotic Mastoid Bone","authors":"J. Machado","doi":"10.33552/ojor.2019.01.000518","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000518","url":null,"abstract":"","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133914151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does Acoustic Overlay of Music Improve Aerosol Penetration into Maxillary Sinuses?","authors":"Laurent Navarro, L. Leclerc, J. Pourchez","doi":"10.33552/OJOR.2019.01.000517","DOIUrl":"https://doi.org/10.33552/OJOR.2019.01.000517","url":null,"abstract":"Chronic rhinosinusitis (CRS) is a common disorder characterized by mucosal inflammation of the nose and paranasal sinuses. Recent years have seen numbers of findings and improvements in CRS treatment using nebulization process. Targeting delivery of nebulized antibiotics into the maxillary sinuses, the sites of infection, could improve clinical outcomes in patients with CRS. Thus, nasal drug delivery by nebulization is widely used in sinus disorders, because of its safety and convenience and due to its advantages as a painless therapy. However, the nebulization conditions to facilitate penetration of aerosols into the sinus cavities are not well established. The practice of aerosol therapy to treat CRS has not been studied thoroughly, despite few works have shown clinical benefit. This paper demonstrates that the music signal superimposed to aerosol provides a considerable innovative solution for the treatment of CRS patients. It encompasses frequency values among which the resonance frequency of the maxillary sinuses of patients regardless the initial sinus anatomy of the patient and the pathology stage and is thus more efficient to deliver the aerosol into the maxillary sinuses. \"Music heals\". This adage is generally studied by neuropsychologists and music therapists based on psychological approaches [1]. Unfortunately, one knows that it is difficult to prove since it is hardly measurable [2]. Moreover, in these studies, music is used traditionally through speakers or headphones as it was designed for. In the meantime, it is well known that music has complex features in terms of signal properties, especially if regarded as a random signal. In short, music belongs to the class of pseudo-stationarity signals which implies some statistical randomness but also some stationarity. In addition, music has a large frequency spectrum which is mainly linked to the human ear's response of 20Hz to 20kHz. Most of the musical information lies in the 40Hz-16kHz range, and this range depends a lot on the musical style. These characteristics can be exploited when such frequency ranges must be used for medical treatments like nebulization process. Instead of using ear-fatiguing signals like sinusoidal, or sum of sinusoidal, signals. Then, music can be used for its characteristics as a signal. Patients are more likely to accept the presence and the hearing of a signal if it is music. Chronic rhinosinusitis (CRS) is a disorder characterized by mucosal inflammation of the nose and paranasal sinuses. This common disease is marked by chronic sinonasal symptoms persisting for greater than 12 weeks that above all diminish patients' quality of life. It is a significant and increasing health problem which results in a large financial burden on society. CRS reportedly affects 5% to 13% of the general population in the United States, Europe and China [3]. Recent years have seen numbers of findings and improvements in CRS treatment using nebulization process [4-5]. Targeting","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"173 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131486973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An Audit of the Predictive value of SNOT 22 Test in Evaluating Nasal Surgeries Emersons Green /Devizes NHS Treatment Centers-UK","authors":"S. Gendy","doi":"10.33552/ojor.2019.01.000515","DOIUrl":"https://doi.org/10.33552/ojor.2019.01.000515","url":null,"abstract":"The Sino-Nasal Outcome Test (SNOT-22) has been widely adopted in clinical practice and has been declared as the most suitable sinonasal outcome scoring system. It is simple disease specific encompassing 22 symptoms reflecting health burden of the rhinological patients. Samir Gendy* Department of Otolaryngology, Emerson’s Green NHS treatment Centre, UK Introduction The Sino-Nasal Outcome Test (SNOT-22) has been widely adopted in clinical practice and has been declared as the most suitable sinonasal outcome scoring system. It is simple disease specific encompassing 22 symptoms reflecting health burden of the rhinological patients. Each item quantifies symptoms severity from 0 (no problem) to 5 (worst symptom). The sum of each item results in a maximum score of 110. High score indicates poor outcome. The SNOT-22 is a validated questionnaire of disease specific, quality of life related measures of sinonasal function that has demonstrated good reliability, validity, and responsiveness and is been used in various rhinological procedures for example septoplasty, functional endoscopic sinus surgery, endoscopic turbinoplasty. SNOT-22 is recommended by the European position paper on rhinosinsuitis and nasal polyps EPOS 2012 as the most adequate tool to evaluate the effectiveness of surgery for chronic rhino sinusitis [1]. This audit reflects a single surgeon experience of using SNOT-22 in evaluating a cohort of patients with rhinological disease comparing the preoperative and postoperative scoring to reflect the outcome of various rhinological procedures. Materials and Methods A Total of 15 patients were randomly selected who hard various nasal surgeries performed by named ENT surgeon at Emerson's Green/Devizes NHS Treatment Centres in the period from May 2018 to November 2018. Every patient was seen preoperatively in the outpatient clinic where he/she scored his/her symptoms using the SNOT 22 questionnaire chart, 6 weeks postoperatively he/she scored again her symptoms using SNOT-22 questionnaire unaware of their preoperative SNOT-22 scores. The cohort age varied from the youngest of 20 years old to the oldest of 65 years old, various rhinological procedures was performed including: Septoplasty with or without turbinoplasty, FESS polypectomy, and endoscopic turbinoplasty. All patients had a preoperative counselling and received an information leaflet about their nasal procedure in addition to SNOT-22 questionnaire chart. A routine blood investigation, informed consent was signed in the clinic. Postoperatively all patients received oxymetazoline nasal drops 0.05% 2 drops twice daily for 5 days followed by isotonic sterimar nasal sprays for 2 weeks, A 10 days course of 500 mg clarithromycin antibiotic 12 hourly was prescribed in selected FESS polypectomy patients where signs of active infection was illustrated intra-operatively. All patients were seen 6 weeks postoperatively to assess their symptoms clinically and by SNOT22 questionnaire chart. Samir Gendy ","PeriodicalId":365490,"journal":{"name":"Online Journal of Otolaryngology and Rhinology","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122320195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}