Sahin C.,ENT Clinic |
Aras H.I.,Psychiatry Clinic
Journal of Laryngology and Otology | Year: 2015
Objective: This prospective, controlled study investigated the effect on patient anxiety of lidocaine infiltration into nasal packing following septoplasty. Methods: The study included 50 patients who underwent septoplasty operation. Patient anxiety levels were measured 24 hours pre-operatively; 48 hours post-operatively, before saline or lidocaine infiltration; and 15 minutes after lidocaine or saline infiltration into the packing. The patients were asked to mark their level of pain during pack removal on a visual analogue scale. Results: Hamilton Anxiety Scale scores for lidocaine infiltration patients were: 15.1 ± 7.4 pre-operatively; 16 ±7.6 post-operatively, before infiltration; and 13.7 ± 6.6 at 15 minutes after infiltration. The scores for saline infiltration patients were: 16.3 ± 6.8 pre-operatively, 16.4 ± 5.5 before infiltration and 16.1 ± 6.1 after infiltration. The visual analogue scale pain score was 5.3 ± 2.0 in the lidocaine study group and 7.5 ± 1.8 in the control saline group. Conclusion: Infiltration of lidocaine into nasal packing significantly reduced patient pain. Patients developed mild to moderate anxiety before nasal packing removal. Use of techniques without nasal packing can be recommended after septoplasty to ease patient post-operative discomfort. © JLO (1984) Limited 2015.
Sunnergren O.,ENT Clinic |
Brostrom A.,Linkoping University |
Brostrom A.,Health Science University |
Svanborg E.,Linkoping University
Laryngoscope | Year: 2011
Objectives/ Hypothesis: In general, obstructive sleep apnea (OSA) seems to be a progressive disorder whose pathogenesis is not fully understood. One hypothesis is that long-standing snoring vibrations cause a local neuropathy in the upper airway, which predisposes to obstructive events during sleep. The aim of this study was to investigate sensory function in the upper airway in a cohort of subjects comprising nonsnorers, snorers, and untreated subjects with OSA, and to correlate data to apnea-hypopnea index (AHI) and duration of snoring. Study Design: Cross-sectional cohort study. Methods: Subjects were recruited from primary care hypertension clinics. Whole-night respiratory recordings were performed to determine presence and degree of OSA. Three groups were formed based on AHI and snoring history: 1) nonsnorers (n = 25); 2) snorers, AHI < 10 (n = 32); 3) OSA subjects, AHI â 10 (n = 33). Quantitative cold sensory testing of the soft palate and lip was used to assess neuropathy. Results: There were no significant differences concerning lip sensory function between groups. Nonsnorers showed significantly lower thresholds for cold (i.e., better sensitivity) in the soft palate compared to both other groups (P <.01). Snorers had lower thresholds than OSA subjects (P <.05). There were significant correlations (P <.01) between decreased sensory function and AHI (r s =.41) and to duration of snoring (r s =.47). Conclusions: The degree of sensory neuropathy in the upper airway correlates with degree of obstructive sleep disorder. Our results strengthen the hypothesis that snoring vibrations may cause a neuropathy in the upper airway, which contributes to the progression and development of OSA. © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.
Simsek G.,Kirikkale University |
Demirtas E.,ENT Clinic
Journal of Craniofacial Surgery | Year: 2014
Various methods of surgical treatment are defined in nasal deformities that cause nasal obstruction. Open technique septorhinoplasty is a method that is frequently used for this purpose. This study aims to compare surgical results of open technique septorhinoplasty operations with and without osteotomies. In addition, changes in the quality of life of patients before and after treatment were investigated, and the effects of the 2 methods on patients' quality of life were compared. METHODS: Patients with nasal deformity were included in the study. Forty patients with wide nasal dorsum and a prominent hump underwent septorhinoplasty with lateral osteotomy (group 1), and 35 patients with a narrow nasal dorsum and a minimal hump underwent septorhinoplasty without osteotomy (group 2). A Nasal Obstruction Symptom Evaluation (NOSE) questionnaire was used to evaluate disease-specific quality of life for patients in both groups. Basic characteristics, operative parameters, and preoperative and postoperative NOSE scores were compared between the groups. RESULTS: Demographic properties of the groups were similar. Intraoperative parameters and postoperative complications were not different between the groups, with the exception of operation time (which was significantly longer in group 1) and ecchymosis (which was seen in whole cases of group 1 and none of the group 2). Preoperative NOSE scores were similar in both groups. Postoperative NOSE scores were 5 (0-45) in group 1 and 10 (0-45) in group 2 (P > 0.05). The NOSE scores were significantly decreased after the operation in both groups (P < 0.001). The 2 groups were not significantly different when comparing the change in preoperative and postoperative NOSE scores. CONCLUSIONS: Rhinoplasty with or without osteotomy is an effective treatment for alleviating nasal obstruction symptoms. Osteotomy is an integral but not obligatory part of the operation. The addition of the osteotomy procedure in selected cases prolonged the operation time and significantly enhanced patient satisfaction. © 2014 Mutaz B. Habal, MD.
Georgalas C.,University of Amsterdam |
Jovancevic L.,ENT Clinic
Current Opinion in Otolaryngology and Head and Neck Surgery | Year: 2012
Purpose of review: This review aims to characterize gustatory rhinitis using recent advances in pathophysiology and novel surgical and medical management strategies. Recent findings: A significant amount of research has recently focused on the role of capsaicin and its receptors (TRPV1 and VR1), which can be found on sensory c-fibers in human nasal mucosa and play a critical role in the development of nasal hyperresponsiveness to environmental factors. Blocking the nasal sensory nerve stimulation (via the use of capsaicin desensitization) or outgoing parasympathetic innervation (via endoscopic Vidian neurectomy) may control nasal hyperresponsiveness and therefore prevent the induction of rhinitis symptoms. Summary: Gustatory rhinitis is a conspicuous type of food-associated rhinorrhea, which can occasionally be associated with significant quality-of-life impairment. It results from an abnormal gustatory reflex associated with a hyperactive, nonadrenergic, noncholinergic, or peptidergic neural system. The use of nasal ipratropium bromide may be effective, if avoidance is not possible or successful. We have had excellent results with the use of intranasal capsaicin or endoscopic vidian neurectomy (including removal of 4-5 mm of the nerve between pterygopalatine fossa and the sphenoid floor) in patients with nonallergic rhinitis, and these could potentially be used as a last resort in patients with intractable gustatory rhinitis. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Babac S.,ENT Clinic |
Djeric D.,University of Belgrade |
Petrovic-Lazic M.,ENT Clinic |
Arsovic N.,University of Belgrade |
Mikic A.,University of Belgrade
Otology and Neurotology | Year: 2014
OBJECTIVE: To investigate the potential risk factors associated to the treatment failure and recurrence of benign paroxysmal positional vertigo (BPPV). STUDY DESIGN: Prospective cohort study. SETTING: Tertiary referral center. PATIENTS: Four hundred patients with benign paroxysmal positional vertigo, 119 men and 281 women, aged 27 to 88 years. INTERVENTION: Patients were treated once a week, with only one, appropriate, depending on the affected canal, repositioning maneuver (modified Epley, Semont, barbecue/inverted Gufoni, Kim). The control Dix-Hallpike test and the roll test were performed on 7 days. MAIN OUTCOME MEASURES: The treatment outcome and recurrence were evaluated with regard to sex, age, duration of symptoms, etiologic factors, migraines, osteoporosis, vascular risk factors, endocrine diseases, localization of otoconia, and simultaneous involvement of multiple canals. RESULTS: The results indicate that treatment was negatively affected by patients' age, osteoporosis, and head trauma, without them causing recurrent symptoms. The highest number of uncured patients was observed in the 73- to 88-year-old age group (14.8%). The application of more than one maneuver was necessary in 27.5% of cases with primary BPPV and 88.9% with secondary BPPV. The highest treatment success was achieved in the group with BPPV of the posterior semicircular canal (F = 3.668, p = 0.026). The recurrence rate was 15.5%. CONCLUSION: Potential risk factors associated to the treatment failure were as follows: the age older than 50, secondary BPPV, head trauma, the occurrence of osteoporosis, and localization of otoconia in the anterior semicircular canal. The analyzed factors did not have impact on the recurrence. © 2014, Otology & Neurotology, Inc.