Long-term outcome of budesonide middle meatus treatment for chronic rhinosinusitis patients following endoscopic sinus surgery / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the long term clinical effect of budesonide treatment in middle meatus for chronic rhinosinusitis(CRS) following endoscopic sinus surgery (ESS).@*METHOD@#A total number of 53 patients with CRS received ESS were divided into two groups according to budesonide treatment: budesonide-treated group with 21 cases (39.6%) and control group with 32 cases (60.4%). Gelatin sponges soaked with 1 ml budesonide suspension were put in middle meatus in budesonide-treated group, while only gelatin sponges were put in middle meatus in control group. Visual analogy score (VAS), sino-nasal outcome test-22 (SNOT-22) and Lund-Kennedy endoscopic scale were carried out before ESS and two years after ESS.@*RESULT@#In budesonide-treated group, there were a statistical difference before and after ESS in the VAS, SNOT-20 and Lund-Kennedy score (P<. 05). In control group, difference was also significant in VAS, SNOT-20 and Lund-Kennedy score before and after ESS (P < 0.05). The VAS gap of post-operative and pre-operative in two groups are significantly different (P<. 05). However, there was no significant difference in the SNOT-20 and Lund-Kennedy endoscopic scale gap before or after the operation between two groups.@*CONCLUSION@#It is safe, convenient and practicable to perform budesonide treatment in middle meatus following ESS, which can significantly ease the post-operative discomfort of nose.

Comparative study on packing with or without Merocel after endoscopic sinus surgery / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the clinical effect of nasal packing with or without Merocel after endoscopic sinus surgery (ESS) in short and long term.</p><p><b>METHOD</b>A total of 112 patients with chronic rhinosinusitis who received endoscopic sinus surgery were randomly divided into two groups: packed group and non-packed group. In packed group, there were 37 cases, of which 10 cases were combined with allergic rhinitis and 11 cases received correction of nasal septum at the same time. In non-packed group, there were 75 cases, of which 15 cases were combined with allergic rhinitis and 26 cases received correction of nasal septum at the same time.Visual analogue score (VAS), Nasal bleeding and sinonasal outcome Test-22 (SNOT-22) were used to evaluate the clinical effect between two groups in short and long term respectively.</p><p><b>RESULT</b>The VAS of nasal obstruction, rhinodynia, dysphoria, epiphora, itching, sneeze, headache and facial pain in non-packed group were significantly lower than those in packed group (P < 0.05). Within 48 hours after ESS, the amounts of nasal bleeding were 0-45 ml (median 3 ml) in packing group and 0-18 ml (median 2 ml) in non-packing group. There were significant difference between two groups (Z = -3.54, P = 0.00). The difference value of postoperative and preoperative SNOT-22 of the packed group was 38.47 ± 20.25 and the non-packed is 41.03 ± 22.73 six months after ESS (t = 0.58, P = 0.56). Each group had one case of nasal adhesion. And as for middle turbinate dislodgement, there was one case in the packed group and two cases in the unpacked group. There was no case of nasal septum hematoma in the packed group, but two cases in the un-packed group. The results showed that there was no significant difference of clinical effect between the postoperative packing and unpacking groups.</p><p><b>CONCLUSIONS</b>It is safe and practicable to manage chronic rhinosinusitis without nasal packing after ESS, which in short term not only decrease discomfort, but also reduce nasal bleeding. Also, there is no significant difference of clinical effect between the postoperative packing and unpacking groups in long the term.</p>

Complications and treatment for button battery in the nose / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the injury of button battery to nose and discuss its management.@*METHOD@#Thirteen cases with button battery in nose were reviewed. After the removal of button battery, nasal cavity irrigations were carried out carefully by nasal endoscopy in all cases. Gelfoam full of erythromycin eye ointment was used to cover the injured mucous membrane.@*RESULT@#Among all the cases, 10 got full recovery without any complication. There are 2 cases of synechia nasal and 1 case of septum perforation.@*CONCLUSION@#Removal as soon as possible, careful cleaning and systemic drug are necessary. Nose bleed, septum perforation, adhesion and rhinostenosis should be noticed.