Medical treatment of nasal polyps: a review

Nasal polyp is macroscopic edematous mass and it is a most common nasal complaint of the patients. The exact etiology is still unknown and controversial, but the main causes are assumed to be the inflammatory conditions and allergy. Their clinical presentations are obstruction, rhinorrhea, postnasal drip. Nasal polyp is more common in allergic patients with asthma. Treatment of this complication is associated with both medical treatment and surgery. Corticosteroids [systemic and topical] are shown to be beneficial in reducing the size of nasal polyp. Corticosteroids are also used as a primary treatment and postoperative management for avoiding recurrence. The rate of leukotrienes is increased in polyps. It is reported that leukotriene receptor antagonists [antileukotriene] have a beneficial effect on nasal polyp treatment. Montelukast is an antileukotriene. It can be used to modify the symptoms of nasal polyp. There is no significant difference between corticosteroids and montelukast clinical efficacy

effect of nasal surgery on apnea-hypopnea index

One of the factors, which is involved in obstructive sleep apnea, is anatomic or inflammatory pathologies of nasal airway obstruction. Thus, it is logical to observe improvement of polysomnographic parameters of sleep-disordered breathing after nasal surgery. The authors performed a review of the literature, up to 2013, to determine the impact of nasal surgery on obstructive sleep apnea. Most current idea in this field is based on case series studies while randomized controlled trials evaluating the effect of surgery for nasal obstruction on sleep apnea are few and far between. According to these studies, surgery for nasal obstruction does not improve objective parameters of sleep apnea. Although nasal obstruction is one of the factors involved in obstructive apnea, one has to keep in mind that surgery will not result in major reduction of obstructive sleep apnea severity to relieve nasal obstruction. Detailed upper airway analysis has to be considered when surgery is an option for obstructive sleep apnea. Thus, nasal surgeries are beneficial when they are part of a multilevel approach in obstructive sleep apnea treatment

[ effect of cardiopulmonary pump on hearing loss after cardiopulmonary bypass graft]

Coronary artery bypass graft is one of the most common surgeries in hospitals. Almost 50% of patients have complications. One of these complications is hearing loss. Coronary artery bypasses grafting patients having inclusion criteria participated. One day before surgery, One day after surgery and if patients had hearing loss, the nest week otoacoustic emission test was done. Patients were divided in to two groups: on pump and off pump bypass surgeries. Hearing loss occurred in 12%. Hearing loss in on-pump patients was 14.3% and in off-pump was 6/7% [p=0.09]. The relation of preoperative OAE test and final OAE was tested and it was significant [p<0.005]. In male patients, hearing loss in on-pump operation was 18/6% [p=0.002] and in females in on-pump operation was 7/4% and in off-pump operation was 18.2% [p=0.1]. Hearing loss occurred in 4/2% in 1500, 2000 HZ; 12./5% in 2500, 3000 HZ and 83/3% in 3500, 4000 HZ. It after coronary artery bypass graft is rather Frequents [12%] and is more common in on-pump surgery, and occurs in high frequency, hearing loss is more common in male patients