Role of CT virtual endoscopy in tracheobronchial foreign body inhalation

As foreign bodies [FBs] in respiratory tract are usually in children, history is always vague. Current practice is diagnosis by conventional X-ray. Because most of inhaled FBs are radiotranslucent, rigid endoscopy is carried out for diagnostic purpose in high percentage of cases. The aim of this work is to evaluate a new CT technique called virtual endoscopy to avoid undue rigid endoscopy, which carries hazards for patients. This study was carried out, between January 2000 and 2002, on 34 patients [mean age 19 months +/- 15.5] with suspected history of foreign body inhalation. Conventional X-ray study detected only 2 cases [5.9%] with radiopaque FB. By virtual bronchoscopy, 21 cases [61.8%] diagnosed as having inhaled FB compared to 20 cases [58.8%] diagnosed by rigid endoscopy. 13 Cases [38.2%] diagnosed by virtual bronchoscopy as having no FB intialation compared to 14 cases [41.2%] diagnosed by rigid endoscopy. We can conclude that CT virtual endoscopy, which is more safer than rigid one, has high sensitivity [95%], specificity [85.7%], predictive value of positive test [90.5%], predictive value of negative test [92.3%] and diagnostic accuracy [91.2%]. If CT virtual endoscopy is available; we strongly recommend it for every patient with suspected FB inhalation and negative X-ray finding

Frontal sinus oblitration with bioglass

Many alloplastic materials have been used in clinical frontal sinus obliteration. It has been difficult to find reliable obliteration material without short- or long term complications. Most common problem in frontal sinus obliteration is the resorption of occlusion material. This study was made to evaluate the efficacy of Bioglass as an alternative to autologous fat in the obliteration of the frontal sinus. Standard surgical techniques were used to obliterate the frontal sinus. Eight patients underwent Bioglass frontal sinus obliteration. There were 2 women and 6 men in the series with age ranges from 30 to 55 [mean, 38 years]. Two patients underwent obliteration for chronic infections with mucopyocele. Follow-up radiographs were obtained at 3, 6 and 12 months after obliteration of the sinus with Bioglass. No patient has developed clinical or radiographic evidence of recurrent frontal sinusitis. No implant has been rejected. Seven patients reported complete resolution of all symptoms. Bioglass had demonstrated efficacy in obliteration of frontal sinus. The material has the advantage that it takes well, no reaction or rejection and it is also of reasonable expense. The obstruction of the frontonasal duct by this material was ensured. Bioglass offers the advantages of no donor site morbidity and the potential for complete osseointegration