Rhinopathic migraine: evaluation and surgical treatment

The concept of rhinopathic migraine has evolved during the last few years, although its pathophysiology and treatment are still controversial. This prospective study was conducted to assess the efficacy of endoscopic sino-nasal surgery in its treatment. Fifty patients with diagnosed migraine who failed to improve after full neurological work up and treatment underwent complete sino-nasal evaluation. Thirty-five patients met the diagnostic criteria of rhinopathic migraine [chief complaint of migraine, positive response to nasal anesthetic and the absence of significant sino-nasal symptoms]. Endoscopy and sinus computed tomography revealed either anatomic variations [e.g. septal deviation, 71.4% and concha bullosa, 25.7%] and/or mucosal disease [e.g. thickening, 40% and retention cyst, 11.4%] in all 35 patients. Endoscopic surgery, tailored to the pathology of each patient, succeeded in eliminating or significantly reducing migraine attacks in 32 patients [91.5%], while 3 patients [8.5%] failed, to improve [mean follow-up period of 24 months]. We conclude that endoscopic sino-nasal surgery is highly effective in eliminating rhinopathic migraine in carefully selected cases

Perichondrium versus composite cartilage perichonderial graft in revision tympanoplasty

Numerous grafting materials could be used in tympanoplasty either autografts or homografts. Still, temporalis fascia and perichondrium are the most common grafts to be used. Cartilage has shown promising results as a graft material to close perforations. It has more rigid quality and tends to resist resorption and retraction. In this study, we used perichondrial cartilage composite graft [PCCG] in comparison with perichondrium. The inclusion criteria included 30 patients with large, recurrent, safe perforations and bad E.T. function. They were divided according to graft type into 2 equal groups. PCCGs gave better results as regards correction of E.T. function and prevention of graft retraction. In conclusion we found that the perichondrium and PCCG are suitable and efficient grafting materials in revision tympanoplasty

Assessment of the pharynx by acoustic pharyngometry in normal subjects and obstructive sleep apnoea patients

This prospective controlled study included 40 middle aged subjects of both sexes divided into two groups: Group A included 20 normal subjects and group B included 20 patients suffering from snoring with or without obstructive sleep apnea. Both groups were investigated by acoustic pharyngometer, by which the cross sectional area of different segments of the pharynx was recorded and analyzed for the standardization of normal curve by standard operating procedure. Acoustic pharyngometry proved to be an easy method to assess the possible level[s] of obstruction

Central venous catheter in bone marrow transplant [BMT] patients experience in 75 patients

In this study, mechanical and infectious complications related to externalized central venous catheters [Hickman] inserted in 75 patients who underwent BMT were analyzed. The number of lines infected was 17. Catheter related septicemia was recorded in seven patients. Tunnel infection was documented in five cases. The overall incidence of mechanical complications was 23%. It was concluded that Hickman central venous lines are essential components of care in patients undergoing BMT and have relatively low complications rate