American journal of rhinology最新文献

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Construct validation of a low-fidelity endoscopic sinus surgery simulator. 低保真度鼻窦内窥镜手术模拟器的构建验证。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3245
Randy M Leung, Jerry Leung, Allan Vescan, Adam Dubrowski, Ian Witterick
{"title":"Construct validation of a low-fidelity endoscopic sinus surgery simulator.","authors":"Randy M Leung,&nbsp;Jerry Leung,&nbsp;Allan Vescan,&nbsp;Adam Dubrowski,&nbsp;Ian Witterick","doi":"10.2500/ajr.2008.22.3245","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3245","url":null,"abstract":"<p><strong>Background: </strong>Before a simulator becomes widely accepted, it must be relevant, affordable, and accessible. We have developed a low-cost model emphasizing the basic skills required for endoscopic sinus surgery (ESS). It is noninvasive, free from risk of infection, and an excellent low-pressure learning opportunity. The current study was designed to assess the construct validity of our simulator.</p><p><strong>Methods: </strong>We conducted a stratified randomized crossover-control study. Otolaryngology residents, fellows, and faculty performed predetermined tasks on the model or cadaver, and then switched. Evaluation included hand motion analysis, task time, and blinded expert review.</p><p><strong>Results: </strong>Sixteen subjects at various levels of training participated. Cadaver performance correlated well with level of training and previous experience with ESS. However, model performance did not demonstrate statistically significant correlation.</p><p><strong>Conclusion: </strong>Our model was unable to demonstrate clear construct validity at this time. Materials and structural modifications are in progress. Pending further validation, its low-cost construction possesses potential for integration into otolaryngology residency curricula. Assessment of the simulator's ability to improve surgical skill is also planned.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954941","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}
引用次数: 41
Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis. 上颌窦顽固性鼻窦炎的内镜下大口造口术疗效。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3248
Do-Yeon Cho, Peter H Hwang
{"title":"Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis.","authors":"Do-Yeon Cho,&nbsp;Peter H Hwang","doi":"10.2500/ajr.2008.22.3248","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3248","url":null,"abstract":"<p><strong>Background: </strong>In patients with chronically diseased maxillary sinuses, poor mucociliary clearance may result from long-standing inflammation or scarring from previous surgery. This subset of patients often has persistent sinus disease despite medical therapy and adequate antrostomy. Endoscopic maxillary mega-antrostomy (EMMA) is a mucosal sparing technique that facilitates mucus clearance and sinus irrigation in terminally dysfunctional maxillary sinuses. EMMA involves extending the antrostomy through the posterior half of the inferior turbinate down to the floor of the nose, creating a significantly enlarged antrostomy. This study describes our results of EMMA in recalcitrant maxillary sinusitis.</p><p><strong>Methods: </strong>A retrospective review was performed of patients who underwent EMMA for recalcitrant maxillary sinusitis between July 2005 and September 2007. We studied diagnoses, comorbid factors, clinical efficacy, revision rate, and complications.</p><p><strong>Results: </strong>Twenty-eight patients (average age, 48 years) underwent 42 EMMAs for recalcitrant maxillary sinusitis. Average follow-up was 11 months. All patients had previous maxillary sinus surgery (mean = 2.3). Relevant comorbid factors included prior Caldwell-Luc or maxillofacial surgery (16/42), cystic fibrosis (11/42), asthma (11/42), and IgG deficiency (3/42). The most common symptoms reported were facial pain/pressure and purulent rhinorrhea. At the time of the most recent postoperative examination, 74% of patients reported complete resolution of symptoms while 26% reported partial symptomatic improvement. There were no complications and the revision rate was 0%.</p><p><strong>Conclusion: </strong>Maxillary sinuses that appear to be terminally diseased may be rehabilitated surgically without the need for surgical stripping. EMMA is an effective and safe treatment option for the management of recalcitrant maxillary sinus disease.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27953084","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}
引用次数: 96
In vivo laser tissue welding in the rabbit maxillary sinus. 兔上颌窦体内激光组织焊接。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3244
Benjamin S Bleier, James N Palmer, Michael A Gratton, Noam A Cohen
{"title":"In vivo laser tissue welding in the rabbit maxillary sinus.","authors":"Benjamin S Bleier,&nbsp;James N Palmer,&nbsp;Michael A Gratton,&nbsp;Noam A Cohen","doi":"10.2500/ajr.2008.22.3244","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3244","url":null,"abstract":"<p><strong>Background: </strong>One of the challenges in the current expansion of endoscopic sinonasal surgery is the ability to adequately reconstruct the skull base. Laser tissue welding (LTW) uses laser energy coupled to a biological solder to produce tissue bonds with burst thresholds exceeding human intracranial pressure. This technology could be used to reduce the rate of postoperative cerebrospinal fluid (CSF) leak. We performed this study to determine whether LTW can create durable tissue bonds in sinonasal mucosa that support normal wound healing and produce minimal collateral thermal injury.</p><p><strong>Methods: </strong>Bilateral maxillary sinus mucosal incisions were made in 20 New Zealand white rabbits and one side was repaired using LTW. Burst pressure thresholds were measured on postoperative days 0, 5, and 15 and were compared with control using a two- way ANOVA and a post hoc Tukey test. Welds were examined histologically for thermal injury, inflammation, and fibroplasia and graded on a 4-point scale by three blinded observers.</p><p><strong>Results: </strong>The burst pressures of the LTW group were significantly higher than control on postoperative day 0 (120.85 mm Hg, N = 4, SD = 47.84 versus 7.85 mm Hg, N = 4, SD = 0.78), and day 5 (132.56 mm Hg, N = 8, SD = 24.02 versus 41.7 mm Hg, N = 8, SD = 7.2; p < 0.05). By postoperative day 15 there was no significant difference between LTW (169.64 mm Hg, N = 8, SD = 18.49) and control (160.84 mm Hg, N = 8, SD = 14.16) burst thresholds. There was no evidence of thermal injury to the surrounding tissue in any group as well as no difference between experimental group and control with respect to inflammation or fibroplasia.</p><p><strong>Conclusion: </strong>This is the first in vivo study showing that LTW is capable of producing tissue bonds exceeding human intracranial pressure with negligible thermal injury in sinonasal tissue. Welding can be performed endoscopically using a fiberoptic cable and may be useful in CSF leak and skull base repair.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954937","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}
引用次数: 15
Balloon catheter dilatation for frontal sinus ostium stenosis in the office setting. 球囊导管扩张治疗额窦口狭窄。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3240
Amber Luong, Pete S Batra, Samer Fakhri, Martin J Citardi
{"title":"Balloon catheter dilatation for frontal sinus ostium stenosis in the office setting.","authors":"Amber Luong,&nbsp;Pete S Batra,&nbsp;Samer Fakhri,&nbsp;Martin J Citardi","doi":"10.2500/ajr.2008.22.3240","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3240","url":null,"abstract":"<p><strong>Background: </strong>Frontal sinus ostium stenosis (FSOS) is problematic even for expert surgeons. Balloon catheter (BC) technology has been recently introduced to rhinology. The aim of this study is to assess technical feasibility and effectiveness of BC dilatation of FSOS in the office setting.</p><p><strong>Methods: </strong>This retrospective, multi-institutional case series describes all patients who underwent BC dilatation of FSOS in the office setting in the year ending December 31, 2007.</p><p><strong>Results: </strong>Six adult patients underwent a total of seven BC dilatations of FSOS in the clinical setting. The pretreatment ostium size was 1-2 mm. Four of the dilatations were performed with a 5-mm lacrimal BC (LacriCATH, Quest Medical, Allen, TX) and three dilatations were executed with a 7-mm sinus BC (SinuCATH, Quest Medical). All procedures were performed using topical anesthesia only. No complications occurred. Five of the six dilated FSOS dilatations were deemed successful after one BC dilatation. One ostium contracted >50% and required repeat BC dilatation. All ostia have remained patent with a follow-up range of 4-9 months. No subject has required formal surgical revision.</p><p><strong>Conclusion: </strong>This preliminary report describes BC of FSOS in the office setting. The technique may serve as a safe and feasible alternative, potentially avoiding formal revision sinus surgery in select patients.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3240","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954936","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}
引用次数: 46
Squamous metaplasia and chronic rhinosinusitis: a clinicopathological study. 鳞状皮化生和慢性鼻窦炎:临床病理研究。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3236
Robert G Mynatt, Jennifer Do, Christine Janney, Raj Sindwani
{"title":"Squamous metaplasia and chronic rhinosinusitis: a clinicopathological study.","authors":"Robert G Mynatt,&nbsp;Jennifer Do,&nbsp;Christine Janney,&nbsp;Raj Sindwani","doi":"10.2500/ajr.2008.22.3236","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3236","url":null,"abstract":"<p><strong>Background: </strong>The significance of squamous metaplasia (SM) in chronic rhinosinusitis (CRS) is unknown. The objectives of this study were to determine the prevalence of SM in histopathological specimens from patients with CRS and to correlate these histological findings with clinical features.</p><p><strong>Methods: </strong>We reviewed the clinical records and pathological slides from 87 consecutive patients who underwent endoscopic sinus surgery for CRS. Demographic and clinical data, preoperative Chronic Sinusitis Survey (CSS) scores, and sinus CT stage were evaluated. Pathological slides were graded by a pathologist to characterize the degree of inflammation and SM, when present. CRS patients with and without SM were compared using student's t-test and chi2 test.</p><p><strong>Results: </strong>Evaluation of the pathology slides revealed that 18.4% of specimens had SM present, whereas only 2.2% of pathology reports noted this. Histological grading of chronic inflammation showed significantly greater severity in specimens with SM (n = 16) when compared with the cohort without SM (n = 75; 100.0% versus 77.5%, respectively; p = 0.016). There was no difference in preoperative CT stage or the presence of hyperostosis on imaging, CSS scores, duration of CRS symptoms, or other clinical features between those with SM and those without SM (p > 0.05). Immunodeficiency was the only comorbidity more prevalent in the metaplastic group (12.5% versus 0%, respectively; p = 0.003).</p><p><strong>Conclusion: </strong>SM is present in approximately 18% of routine CRS specimens. It has a positive correlation with the severity of inflammation noted histologically in CRS but does not correlate with disease severity or chronicity, clinically.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954400","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}
引用次数: 14
Sonography versus plain x rays in diagnosis of nasal fractures. 超声与x线平片对鼻骨折的诊断价值。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3239
Robert Gürkov, Dirk Clevert, Eike Krause
{"title":"Sonography versus plain x rays in diagnosis of nasal fractures.","authors":"Robert Gürkov,&nbsp;Dirk Clevert,&nbsp;Eike Krause","doi":"10.2500/ajr.2008.22.3239","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3239","url":null,"abstract":"<p><strong>Background: </strong>The standard imaging procedure for suspected nasal fractures has been radiography (XR). However, its usefulness for clinical decision making is highly controversial. High-resolution ultrasonography now offers a promising new diagnostic imaging option. In this study we compared the diagnostic value of high-resolution ultrasonography and conventional XR in the evaluation of suspected nasal fractures.</p><p><strong>Methods: </strong>A prospective single-blinded study was performed. Ultrasound (US) and XR findings in 80 patients with suspected nasal fractures were compared with the definite clinical diagnosis with respect to sensitivity, specificity, and accuracy.</p><p><strong>Results: </strong>For detection of fractures of the nasal dorsum, both modalities had high sensitivity (98 and 88% for US and XR, respectively) and specificity (95% for both US and XR). In lateral nasal wall fractures, specificity was higher for XR (75% versus 94%). Sensitivity was significantly higher for the US examination (98% versus 28%). In summary, the accuracy was higher for US.</p><p><strong>Conclusion: </strong>When available, US should be the first-line imaging procedure in the evaluation of nasal fractures.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954403","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}
引用次数: 39
Attachment-oriented endoscopic surgical strategy for sinonasal inverted papilloma. 鼻内窥镜治疗鼻窦内翻性乳头状瘤的方法。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3243
Roee Landsberg, Oren Cavel, Yoram Segev, Avi Khafif, Dan M Fliss
{"title":"Attachment-oriented endoscopic surgical strategy for sinonasal inverted papilloma.","authors":"Roee Landsberg,&nbsp;Oren Cavel,&nbsp;Yoram Segev,&nbsp;Avi Khafif,&nbsp;Dan M Fliss","doi":"10.2500/ajr.2008.22.3243","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3243","url":null,"abstract":"<p><strong>Background: </strong>It is well documented that inverted papillomas (IP) have a localized attachment site. Still, instead of concentrating on the attachment site, endoscopic surgeons often perform an extended resection similar to the one achieved after external surgery.</p><p><strong>Objective: </strong>Our objective was to evaluate an attachment-oriented endoscopic surgical strategy and to determine IP attachment diameter and location.</p><p><strong>Methods: </strong>A prospective study was conducted. Thirty-three consecutive patients who underwent endoscopic IP excision (2001--2007) were enrolled. Thirty patients had adequate follow-up. Attachment diameters were measured in 25/33 patients. Surgery included debulking, identifying the precise mucosal attachment site, subperiosteal dissection and excision of the attachment, frozen section control, and resection/drilling of underlying bone.</p><p><strong>Results: </strong>The mean measured attachment diameter (n = 25) was 8.4 +/- 6 mm (range, 3-23 mm). Attachment locations included maxillary sinus (39%), ethmoid sinus (21%), nasal cavity (21%), frontal sinus (6%), sphenoid sinus (6%), lamina papyracea (3%), and cribriform plate (3%). The mean follow-up (n = 30) was 40 +/- 21 months. Three patients had Krouse stage 1, 10 patients had stage 2, and 17 patients had stage 3. Nine patients had undergone previous surgeries. After attachment-oriented endoscopic surgery, three patients had persistent disease. Nasolacrimal duct stenosis was the only complication (n = 1).</p><p><strong>Conclusion: </strong>Even advanced IP have small attachments. Their Identification facilitates efficacious resection with minimal morbidity.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3243","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954939","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}
引用次数: 40
The efficacy of topical antibiofilm agents in a sheep model of rhinosinusitis. 外用抗生素膜剂对羊鼻窦炎模型的疗效观察。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3232
Tong Le, Alkis Psaltis, Lor Wai Tan, Peter-John Wormald
{"title":"The efficacy of topical antibiofilm agents in a sheep model of rhinosinusitis.","authors":"Tong Le,&nbsp;Alkis Psaltis,&nbsp;Lor Wai Tan,&nbsp;Peter-John Wormald","doi":"10.2500/ajr.2008.22.3232","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3232","url":null,"abstract":"<p><strong>Background: </strong>Biofilms have been shown to be resistant to conventional antibiotic treatment. This study uses a sheep biofilm model developed by our department to investigate several novel topical anti-biofilm treatments.</p><p><strong>Methods: </strong>Staphylococcal biofilms were grown in 54 sheep frontal sinuses over 8 days: Each sinus was randomized to (1) no intervention, (2) single mupirocin flush, (3) regular 12-hourly mupirocin flushes for 5 days, (4) Citric Acid Zwitterionic Surfactant (CAZS) via hydrodebrider, (5) gallium nitrate, (6) CAZS with gallium nitrate, (7) CAZS with mupirocin, and (8) saline regular flushes. Sheep were sacrificed and the sinus mucosa harvested 1 or 8 days after treatment to assess treatment and any biofilm regrowth. Confocal scanning laser microscopy was used to confirm the presence or absence of biofilms, and the extent of biofilm reduction was quantitated using fluorescent in situ hybridization and colony forming unit counts.</p><p><strong>Results: </strong>In the control sheep biofilm coverage averaged 31.7%. Saline and mupirocin b.d. washes for 5 days had 23% and 0.84% coverage, respectively, when harvested on day 8. A single mupirocin and gallium wash had 7.7% and 16.2% on day 1 and 5.88% and 16.0% on day 8. CAZS with hydrodebrider had 6.66% on day 1 but 21.95% on day 8 whereas CAZS with hydodebrider and gallium had 13.3% on day 8.</p><p><strong>Conclusion: </strong>This study shows that regular treatment with mupirocin produced the most marked reduction in biofilm surface area coverage (0.84% and 1.25%) with sustained effects over the 8-day follow-up period.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3232","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27953328","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}
引用次数: 67
Postoperative antibiotic care after functional endoscopic sinus surgery. 功能性内窥镜鼻窦手术后的抗生素护理。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3241
Rong-San Jiang, Kai-Li Liang, Kung-Yaun Yang, Jiun-Yih Shiao, Mao-Chang Su, Chung-Han Hsin, Jen-Fu Lin
{"title":"Postoperative antibiotic care after functional endoscopic sinus surgery.","authors":"Rong-San Jiang,&nbsp;Kai-Li Liang,&nbsp;Kung-Yaun Yang,&nbsp;Jiun-Yih Shiao,&nbsp;Mao-Chang Su,&nbsp;Chung-Han Hsin,&nbsp;Jen-Fu Lin","doi":"10.2500/ajr.2008.22.3241","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3241","url":null,"abstract":"<p><strong>Background: </strong>Antibiotics are used routinely in the postoperative care of functional endoscopic sinus surgery (FESS), but their efficacy has not been well evaluated.</p><p><strong>Methods: </strong>Patients with chronic rhinosinusitis who underwent FESS were enrolled in this study. They were randomly divided into two groups: a study group and a control group. In the study group, patients took amoxicillin/clavulante for 3 weeks after FESS. In the control group, no antibiotic was given after FESS. Before FESS, all patients filled out a symptom questionnaire and received nasal endoscopy. Swab specimens were taken from the middle meati for bacterial cultures. These procedures were done again 3 weeks after FESS.</p><p><strong>Results: </strong>Seventy-one patients completed the study. Thirty-one patients were in the study group, and 40 patients were in the control group. The symptom scores significantly decreased after surgery in both groups, but bacteria identified before and after FESS were statistically different in both groups. There were no differences in the symptom and endoscopic scores, rates of bacterial culture, and drug sensitivity to amoxicillin/clavulante between the two groups after FESS.</p><p><strong>Conclusion: </strong>This study showed that postoperative care with amoxicillin/clavulante did not improve the short-term outcome of FESS on chronic rhinosinusitis or decrease bacterial growth 3weeks after FESS, although the long-term influence was not evaluated in this study.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954402","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}
引用次数: 46
Analysis of transnasal endoscopic versus transseptal microscopic approach for excision of pituitary tumors. 经鼻内镜与经鼻中隔显微入路在垂体肿瘤切除术中的应用分析。
American journal of rhinology Pub Date : 2008-11-01 DOI: 10.2500/ajr.2008.22.3246
Thomas S Higgins, Chad Courtemanche, Daniel Karakla, Barry Strasnick, Ran Vijay Singh, Joseph L Koen, Joseph K Han
{"title":"Analysis of transnasal endoscopic versus transseptal microscopic approach for excision of pituitary tumors.","authors":"Thomas S Higgins,&nbsp;Chad Courtemanche,&nbsp;Daniel Karakla,&nbsp;Barry Strasnick,&nbsp;Ran Vijay Singh,&nbsp;Joseph L Koen,&nbsp;Joseph K Han","doi":"10.2500/ajr.2008.22.3246","DOIUrl":"https://doi.org/10.2500/ajr.2008.22.3246","url":null,"abstract":"<p><strong>Background: </strong>The traditional method of pituitary tumor excision is transseptal microscopic excision; however, the transnasal transsphenoidal endoscopic approach has shown comparable results with the transseptal microscopic approach at some institutions. The objective of this study is to compare the two types of sellar and parasellar mass resection: transnasal transsphenoidal endoscopic excision versus transseptal microscopic excision.</p><p><strong>Methods: </strong>A retrospective cohort analysis was performed on subjects who were referred to a tertiary hospital for surgical management of sellar or parasellar masses. The two groups of patients either underwent a transnasal endoscopic approach with endoscopic excision or transseptal microscopic excision. Demographics, tumor characteristics, operative details, length of hospital stay, intraoperative and postoperative complications, level of postoperative pain, recurrence rate, use of computed tomography (CT) image guidance, and length of follow-up were gathered. The data between the two groups were then compared.</p><p><strong>Results: </strong>The analysis included 19 subjects who underwent endoscopic excision and 29 subjects who underwent transseptal microscopic excision. Null macroadenoma was the most common sellar mass followed by prolactinoma. There were no statistical differences in rates of perioperative complications and suprasellar or cavernous sinus invasion. Patients who underwent an endoscopic approach had shorter operative times, lower estimated blood loss, less lumbar drain use, less pain, and a shorter postoperative hospital stay (p < 0.05).</p><p><strong>Conclusion: </strong>The two approaches show similar intraoperative characteristics and immediate complication rates. Transnasal transsphenoidal endoscopic excision is a reasonable alternative to the traditional method of sellar mass excision.</p>","PeriodicalId":72175,"journal":{"name":"American journal of rhinology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ajr.2008.22.3246","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"27954943","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}
引用次数: 92
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