Comparative evaluation of preoperative CT Scan and intraoperative endoscopic sinus surgery findings in patients with chronic rhinosinusitis

Chronic rhinosinusitis [CRS] is a common condition in medical practice. The diagnosis generally relies on clinical judgment, but computed tomography [CT] together with sinonasal endoscopy, provide the majority of the objective data. This study was carried out to determine the agreement between preoperative CT findings and intraoperative endoscopic sinus surgery [ESS] findings in patients with CRS. Statistical analysis of collected data from paranasal sinus CTs of 51 patients aged between 15 and 77 who subsequently underwent ESS for CRS at two training hospitals during a 2-year period, was performed. The agreement between CT and ESS findings was assessed by Kappa statistics, Chi-square and t test were also used for data analysis. The most common co-morbidity found among the patients with chronic sinusitis was allergy in 18 [35%] patients. Hypertrophy of the inferior turbinate was the most obvious finding in CT [71%] and during endoscopic evaluation [69%]. No significant correlation was found between clinical symptoms and gender or the length of disease. In 8 unusual patients [one with choanal atresia, one with bone wax in nasal cavity, and 6 with small polyposis], CT could not show the problem. There are good to excellent agreements between the two diagnostic procedures, except for the choanal atresia, which showed no agreement [K = 0]. The results of nasal fossa findings obtained by nasal endoscopy are more conclusive in the elucidation of diagnosis than those obtained by paranasal sinus CTs. In spite of a good agreement between CT and ESS findings in most patients, it seems in some unusual cases, CT may miss many patients

Efficacy of voice laboratory in evaluation of treatment in Dysphonic patients

Evaluations of voice disorders include clinical assessment [subjective] and Voice Laboratory Measurements [VLM] which use objective criteria to evaluate the severity of voice disorders. The purpose of this 2 years prospective team work study [during 2004 - 2006] was to determine the efficacy of voice laboratory analysis in evaluation of treatment in dysphonic patients, in comparison with clinical [subjective] evaluation. This study was done on 50 patients [42 males and 8 females] with voice disorders. All of the patients underwent complete ENT and neurological examinations and also complete voice lab evaluation with Visi pitch instrument and computer speech lab [CSL], both before and after appropriate treatment. Then the results of objective and subjective evaluations compared statically with the last version of SPSS software. We performed at least 5 voice parameters including fundamental frequency, phonation quotient, pitch range, percentage voiced and perturbation. Only 8 patients [16%] had statistically significant improvement in data base of voice lab parameters and the rest patients [84%] although showed some improvement but without statistically significance. Overall, the sensitivity of voice lab was 80%. Some degree of changes was observed in all of the parameters before and after treatment. In the case of perturbation [t = 3.53 and P<0.01] and jitter [t = 2.43 and P<0.05] there was significant differences with good statistical correlations