ABSTRACT
OBJECTIVE To assess the guideline role of preoperative subjective and objective assessment on nasal obstruction in chronic rhinosinusitis(CRS) patient during perioperative period. METHODS The patients with CRS who's chief complaint was nasal obstruction were divided into experimental group and control group according to different doctors. Visual analog scale, rhinomanometry and acoustic rhinometry were used to assess subjective and objective nasal obstruction, and nasal endoscopy and sinus CT examination were applied to evaluate the condition of nasal cavity and nasal sinuses. Patients were taken corresponding appropriate strategies in experimental group, but conventional empirical measures in control group during perioperative period. Postoperative follow-up were performed in 6 months and 1 year. SPSS21.0 was used for statistical analysis. RESULTS There was no statistical difference in nasal obstruction symptom score, total rhinomanometry before operation between experimental group and control group(P>0.05). There were statistical difference between the 2 groups after operation in nasal obstruction symptom score, total rhinomanometry. At the 2 postoperative time points (6 months, 1 year after operation) compared with preoperative period, significant differences were found in the parameters evaluated between the two groups(P<0.05). The curative effect in different postoperative time showed statistical significance(P<0.05). CONCLUSION Preoperative subjective and objective assessment for nasal obstruction can be used not only in the evaluation of severity and treatment effect, but also in the guideline of perioperative treatment for CRS combined with nasal endoscopy and sinus CT examination, which can improve nasal obstruction and the treatment effect of CRS.
ABSTRACT
Although not being the most frequent nasal septal deviations, those of the caudal septum account for many complaints. The correction of such defects has always been the subject of much controversy, and several different operative techniques have been described. AIM: To assess the efficacy of a surgical technique for correcting caudal septal deviations. MATERIALS AND METHODS: Prospective study with preliminary reports of 10 patients who answered a standardized, specific questionnaire (the Nasal Obstruction Symptom Evaluation, or NOSE), underwent acoustic rhinometry and had their noses photographed. Caudal deviations were then corrected through a surgical technique whereby the entire deviated portion is removed and a straight cartilage segment is placed between the medial crura of the alar cartilages, through a retrograde approach, to support the nasal tip. Sixty days after all patients were reassessed. RESULTS: As for the NOSE questionnaire, mean pre-operative and post-operative scores were 82.39 and 7.39 respectively (p<0.001). Pre-operative acoustic rhinometry showed mean minimum cross-sectional area (MCA) values of 0.352 and 0.431 cm2, whereas mean post-operative values were 0.657 and 0.711 cm2(p<0.0001). CONCLUSIONS: The study results prove, both subjectively (patient satisfaction as measured with a standardized questionnaire) and objectively (acoustic rhinometry findings), that the proposed technique for correction of caudal septal deviation is safe and effective.
Os desvios situados na parte caudal do septo nasal, apesar de não serem os mais frequentes, são causadores de muitas queixas, e sua correção sempre gerou muitas controvérsias. OBJETIVO: Avaliar, com resultados preliminares, a eficácia de uma técnica cirúrgica para correção dos desvios caudais do septo nasal. MATERIAL E MÉTODO: Ensaio Clínico prospectivo com 10 pacientes que responderam a um questionário padronizado - Nasal Obstruction Symptom Evaluation (NOSE) -, foram submetidos ao exame de Rinometria Acústica e fotografados. Tiveram, então, os desvios caudais corrigidos cirurgicamente por uma técnica na qual toda a porção do desvio é retirada e uma parte sem desvios da cartilagem é recolocada entre as cruras mediais das cartilagens alares por via retrógrada para a sustentação da ponta nasal. Apos 60 dias os pacientes foram reavaliados. RESULTADOS: Quanto ao Questionário NOSE a média dos valores pré-operatórios foi de 82,39 e a média no pós-operatório foi de 7,39 (p < 0,001). Quanto aos resultados da Rinometria Acústica a média dos valores da área de secção transversa mínima ou MCA no pré-operatório foi de 0,352 e 0,431cm2. No pós-operatório a média dos valores foi de 0,657 e 0,711 cm2,(p < 0,0001). CONCLUSÕES: Apesar de serem ainda resultados iniciais, estes mostram que a técnica apresentada para correção dos desvios caudais do septo nasal é eficaz.
Subject(s)
Adolescent , Female , Humans , Male , Nasal Cartilages/surgery , Nasal Septum/surgery , Rhinoplasty/methods , Nasal Obstruction/surgery , Prospective Studies , Rhinometry, Acoustic , Severity of Illness Index , Surveys and Questionnaires , Treatment OutcomeABSTRACT
OBJECTIVE To investigate the correlation between nasal obstruction score, Lund-Mackay score,congestion index and tissue remodeling degree of nasal mucosa in patients with chronic rhinosinusitis(CRS) and to study the role of diagnosing remodeling.METHODS Forty-three patients with CRS who underwent endoscopic surgery were studied.Congestion index of nasal mucosa was obtained by acoustic rhinometry.Nasal obstruction score was obtained by visual analogue scale.CT score was obtained by Lund-Mackay.The mucosa specimen of uncinate process from nasal cavity of the patients was used to evaluate the fibrosis degree.Statistical analysis was performed using SPSS11.5.RESULTS Nasal obstruction and Lund-Mackay score had no correlation with fibrosis degree of mucosa(r=0.77,P=0.40),whereas congestion index of nasal mucosa had a negative correlation with fibrosis degree of mucosa(r=-0.348, P=0.022).CONCLUSION Nasal congestion index can reflect the degree of remodeling in submucosal tissue.Nasal congestion index with obstruction symptoms and CT scan can be used to guide the CRS treatment strategies.
ABSTRACT
OBJECTIVE To study how to properly evaluate the curative effect of chronic sinusitis and nasal polyps management with endoscopic sinus surgery(ESS). METHODS Nasal airway resistance, olfactory function, the morphological character of mucosa in nasal and sinus cavity after ESS were surveyed by anterior rhinomanometry,T&T olfactometer standard odors for measuring olfactory sense,acoustic rhinometry and scoring measure of mucosa. RESULTS After ESS, nasal airway resistance decreased and olfactory functions improved obviously. The morphological characters of mucosa in nasal and sinus cavity affect the surgical result directly. CONCLUSION As the determining methods of nasal function after/before ESS,anterior rhinomanometry,T&T olfactometer standard odors,acoustic rhinometry and scoring measure of mucosa can be used to comprehensive estimate the curative effect of ESS objectively.
ABSTRACT
Objective To discuss the significance of acoustic rhinometry(AR) and rhinomanometry(RM) in the evaluation of surgical treatment of nasal septal deviation.Methods Fifty-one patients of nasal septal deviation were recruited,and seventy-two nasal cavities were tested(twenty-one patients with narrowing of double sides).Visual analogue scale(VAS) was used to estimate the degree of nasal obstruction.AR and RM were used to obtain the data of nasal airway resistance(NAR),nasal cavity 0-5cm volume(NCV0-5) and nasal minimal cross-sectional area(NMCA).The data were used to assess the airflow function of nasal cavity.Each patient was tested at the time both before surgery and 12 weeks after surgery.The pre-and post operative data were used to calculate paired t-test by SPSS 16.0,and to disclose the correlation among ?NCV,?NMCA,?NAR and ?VAS.Results The preoperative data showed that NCV0-5 was 4.07?0.91cm3,NMCA 0.33?0.08cm2,NAR 1.14?0.34kPa?s?L-1,and VAS 7.36?1.23;and the postoperative data showed that NCV0-5 was 7.29?0.68cm3,NMCA 0.56?0.08cm2,NAR 0.35?0.12kPa?s?L-1,and VAS 1.14?0.91.Significant differences existed in NCV0-5,NMCA,NAR and VAS(P