ABSTRACT
BACKGROUND: Clinical measurement of the severity of allergic rhinitis (AR) can be assessed by symptoms score and patient quality of life (QoL). The magnitude of change in both symptoms and patient QoL should be considered in the management of AR. OBJECTIVE: The aim of this study was to determine the minimal clinically important difference (MCID) in AR in Thai population. METHODS: This prospective study recruited AR patients that attended our clinic during September 2011 to February 2012. The Rhinoconjunctivitis Quality of Life (Rcq-36) questionnaire was used to evaluate patient QoL. The Global Rating of Change Scale (GRCS) was used to assess improvement or deterioration in condition. The MCID was determined using an anchor-based method based on the GRCS, which was compared to the MCID determined by a distribution-based method based on the standard deviation (SD). RESULTS: Three hundred seventy-two patients with chronic rhinitis were recruited. Eighty-four of those had positive skin prick test and be diagnosed as AR. Of those, 79 completed the study and were included in the final analysis. A change of 2 points on the GRCS yielded an MCID for overall QoL of 0.21 ± 0.57. When applying the distribution-based method, an SD of 1.5 SD yielded an MCID for QoL of 0.27. For the rhinitis symptoms domain, the MCID was 0.42 ± 0.72. CONCLUSIONS: The MCID for overall QoL and rhinitis symptoms in Thai AR patients was found to be 0.21 ± 0.57 and 0.42 ± 0.72, respectively. MCID can be applied for determining the clinical significance of treatment efficacy in AR.
Subject(s)
Humans , Asian People , Methods , Prospective Studies , Quality of Life , Rhinitis , Rhinitis, Allergic , Skin , Treatment OutcomeABSTRACT
gained widespread acceptance. This study presents one case of a skull base defect after the resection of esthesioneuroblastoma. A 19-year-old man patient with a history of recurrent epistaxis was evaluated by endoscope and esthesioneuroblastoma of the right cribriform area was identified. The tumor was resected endoscopically and the skull base defect repaired by a combination of septal cartilage, temporal fascia and mucosal grafts. The septal cartilage free graft was placed above the anterior cranial fossa. This cartilage free graft served as a new framework for the anterior cranial fossa defect, which prevented a leakage of cerebrospinal fluid. The temporal fascia graft was put above the anterior cranial fossa, but beneath the septal cartilage graft in order to help mucosal migration during the healing period. After a six month postoperative period, there was neither evidence of CSF leakage nor a recurrence of the tumor. An endoscopic approach provides a safe and effective means for repairing the anterior skull base defect in selected cases.Chiang Mai Med Bull 2001;40:(3):155-161.
ABSTRACT
Solitary infection of the sphenoid sinus is an uncommon condition. A series of 13 patients with isolated sphenoid sinusitis was reported. A retrospective chart review was performed with special attention given to patients who presented signs, symptoms, culture results and radiographic findings. There were five patients with acute infection and eight with chronic infection. The predominant presenting symptoms were severe unexplained headache, cranial nerve palsies and visual impairment. Eight patients had underlying diseases. Computerized tomography and sinus endoscopy proved to be most useful diagnostic studies. Staphylococcus spp. and Gram negative organisms were responsible. Eleven patients were improved or cured. One patient died from septicemia. Early diagnosis and aggressive therapy, including surgical drainage, were important in preventing fatal complications and should not be delayed. Chiang Mai Med Bull 2545;41(1):1-6.