Long-Term Evaluation of Nasal Septoplasty Followed by Inferior Turbinate Cauterization for the Treatment of Nasal Obstruction Using Objective and Subjective Methods

Abstract Introduction Nasal septoplasty is considered the treatment of choice for nasal obstruction due to septal deviation. An ongoing discussion among rhinologists is whether it is reasonable to perform objective measurements of nasal patency pre or postoperatively routinely. Objective The primary aim of this study was to identify the short- and long-term functional benefits for patients undergoing septal surgery, as assessed by acoustic rhinometry (AR). The secondary goal was to evaluate the short- and long-term perception of symptom relief and disease-specific quality of life (QoL) outcomes on the part of the patients. Methods This was a prospective observational study in which AR was utilized for the assessment of nasal patency preoperatively and 1, 6 and 36months after septoplasty. Total 40 patients who underwent septoplasty filled out the Nasal Obstruction Septoplasty Effectiveness (NOSE) questionnaire and the Glasgow Benefit Inventory (GBI) to assess their subjective improvement in nasal obstruction symptoms and the changes in their QoL. Results There were statistically significant improvements in nasal patency, mean postoperative NOSE and GBI scores postoperatively. However, there was no correlation between the mean NOSE and GBI scores and the AR measurements. Furthermore, the GBI scores tended to decrease as the postoperative period increased. Conclusion The present study confirms that septoplasty significantly increases nasal patency and causes a significant subjective improvement in nasal obstruction symptoms. The absence of a statistically significant correlation among the objective measurements, the symptom scores, and the patients' low GBI scores indicates that factors other than the anatomical findings may also contribute to the patients' perception of QoL.

The incidence of cystoid macular edema in patients with or without diabetes after uncomplicated phacoemulsification:A four-year study / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM:To report the incidence of post-operative c ystoid macular edema ( pCME ) in patients with or without diabetes and its correlation with c umulative dissipated energy ( CDE ) and phaco -time after uncomplicated phacoemulsification.?METHODS:In the study 116 nondiabetic ( Group A) and 101 d iabetic patients ( Grou p B) underwent phacoemulsification.Preoperatively none of the groups ( A+B ) had signs of maculo pathy or diabetic macular edema documented by spectral-domain optical coherence tomography ( SD -OCT ) and fundus fluore scein angiography ( FFA ) . Phaco metrics were documented after surgery.FFA was performed two months after each operation . Patients with indications of pCME were reassessed with SD-OCT.?RESULTS: The incidence o fpCME after uncomplicated pha coemulsification was statistically significant difference between the two groups (15.8% in Group B versus 6.9%in Group A, P =0.03 <0.05).The subclinical pCME appeared in 19 out of 24 patients.There was a significant correlatio n between parametric values ( CDE, phaco -time, hardness of the lens ) and pCME occurrence. Glycosylated Hemoglobin ( HbA1c ) blood level s was statistically significant difference ( P =0.005 <0.05 ) between the patients who developed or not pCME. Cystoid mac ular edema did not correlate with the axial length of the eye.? CONCLUSION: There was statis itcally significant differen ce in the incidence of pCME after uneventful phacoemulsification between nondiabetic subjects and diabetics. Most of these patients with pCME had subclinical appearance.CDE and phaco-time data were important factors and predictors to pCME.Good glycemic controls prevent the incidence of pCME.