Endoscopic versus Caldwell-Luc approach in chronic maxillary sinusitis: comparison of symptoms at one-year follow-up.

The aim of this prospective randomized study was to compare functional endoscopic sinus surgery (FESS) with the standard Caldwell-Luc (C-L) procedure in relieving the symptoms of chronic maxillary sinusitis. One hundred and fifty consecutive adult patients were operated after the failure of treatment with antimicrobials and repeated antral irrigations: 143 patients were available for the follow-up examination, at a median of 12 months after the operation. The patients' global evaluation showed marked improvement in 50.7% of the C-L group and in 76.7% of the FESS group. Overall subjective symptoms deteriorated in 5.5% of C-L operated patients, but not at all in the FESS group. Patients' compliance, asked post-operatively, was 80.2% in C-L patients and 93.0% in FESS patients.

Diagnostic value of plain radiographs in chronic maxillary sinusitis: a comparison between radiological and endoscopic findings in 75 patients.

Preoperative radiologic and intraoperative endoscopic findings of maxillary and ethmoid sinuses were compared in 75 adult patients, in whom 135 chronically inflamed maxillary sinuses were operated using functional endoscopic sinus surgery (FESS). At sinoscopy, secretion was found in 91% (41/45) of the radiologically opacified antra and in 47% (31/65) of the antra with moderate or marked mucosal swelling in plain radiographs. Antral fluid level in radiographs was a relatively rare (23%) finding and showed secretion as reliably as opacification. Radiographic detection of secretion in maxillary sinuses with mucosal thickening is difficult. There was a fair correlation in both antral and ethmoidal mucosal changes with the mucosal findings in antroscopy and endoscopic ethmoid surgery.

Mequitazine and dexchlorpheniramine in perennial rhinitis. A double-blind cross-over placebo-controlled study.

The therapeutic effect and adverse reactions of two antihistamines, mequitazine and dexchlorpheniramine were double-blindly compared both to placebo, to each other and to the pre-treatment status in 29 adult patients suffering from perennial rhinitis. Dexchlorpheniramine relieved the rhinitis symptoms significantly (p less than 0.01) better compared to placebo while mequitazine did not differ from placebo. 20 out of 29 patients chose dexchlorpheniramine as their favourite drug. Dexchlorpheniramine reduced all the separate symptoms studied (obstruction, rhinorrhoea, sneezing) significantly, mequitazine relieving merely rhinorrhoea. In anterior rhinoscopy mucosal congestion was reduced both by dexhlorpheniramine (p less than 0.01) and by mequitazine (p less than 0.05) but secretion or lividity showed no difference between the active drugs and placebo. The occurrence of side-effects was not significantly different between the drugs. In controlling perennial rhinitis symptoms mequitazine was markedly inferior to dexchlorpheniramine and only slightly better than placebo.

Otoscopic diagnosis of middle ear effusion in acute and non-acute otitis media. I. The value of different otoscopic findings.

To determine the value of different pneumotoscopic findings in diagnosing the middle ear effusion (MEE) of acute (AOM) and non-acute otitis media, 11,804 ear-related visits of 2,911 unselected children at ages 0.5-2.5 years were analysed. About half of these were examined by an otolaryngologist in one, and half by a pediatrician in another, urban area. Myringotomy was always performed when MEE was suspected, and it confirmed the presence of MEE in 85% (otolaryngologist) and 82% (pediatrician) of altogether 5,462 acute and in 69% (both doctors) of 1,092 non-acute cases suspected. Redness of the tympanic membrane (TM) was found in only 18% and 27% of the visits with AOM, and it predicted MEE with only 60% and 51% probability, if seen in acute visits. Cloudiness of the TM was noticed in 81% and 67% of the visits with AOM; its specificity and the other calculated variables were good in regard to the diagnosing of MEE, especially in acute cases in both groups. Distinctly impaired mobility of the TM was of about the same diagnostic value, but its position reliably indicated MEE only when bulging. In AOM the colour or mobility of the TM was normal very rarely, but the position was normal in a third of the cases. Thus, although there were differences in the incidences of different otoscopic findings in the two study groups, the diagnostic value of certain pneumatic otoscopic findings, especially cloudiness and distinct hypomobility of the TM, seemed to be good in both groups.