Assessment of nasal functions and their relationship with cholesteatoma formation in patients with unilateral chronic otitis media.

OBJECTIVES: To evaluate the nasal functions of patients with unilateral chronic otitis media using rhinomanometry, comparing chronic otitis media sides with healthy sides, chronic otitis media patients with cholesteatoma and without cholesteatoma, and patients with healthy individuals. METHODS: This prospective study included 102 patients with unilateral chronic otitis media (48 with and 54 without cholesteatoma). The control group comprised 40 individuals without any ear or nasal pathologies. All patients underwent active anterior rhinomanometry to measure nasal airway resistance and a saccharin test to measure mucociliary transport times. RESULTS: There were no significant differences in nasal airway resistance and mucociliary transport time between the chronic otitis media sides and unaffected sides in the 102 patients (p = 0.72 and p = 0.28, respectively), between the non-suppurative chronic otitis media patients (without cholesteatoma) and chronic otitis media with cholesteatoma patients (p > 0.05), or between the study and control groups (p > 0.05). CONCLUSION: The present study, with a larger sample size compared to previously published literature, supports the conclusion that unilateral nasal obstruction is unlikely to lead to chronic otitis media on the same side. The results also suggest that nasal functions do not contribute to the development of cholesteatoma.

Radiofrequency volumetric tissue reduction for treatment of turbinate hypertrophy in children.

BACKGROUND: Inferior turbinate hypertrophy is one of the most common causes of nasal airway obstruction in children. Medical treatment often produces very little improvement. Radiofrequency therapy has recently been shown to be safe and effective in volumetric tissue reduction of the turbinates in adults, but no report has been published about its use in children. We prospectively evaluated the safety and effectiveness of radiofrequency volumetric tissue reduction (RVTR) for the treatment of nasal obstruction caused by inferior turbinate hypertrophy in children. METHODS: We followed up 93 children less than 9 years of age who underwent RVTR over 12 months. This surgery was performed with other procedures, such as tonsillectomy with or without grommet insertion (57 patients), tympanoplasty (10 patients), or grommet insertion alone (26 patients). Clinical examination, a medical questionnaire, and scores recorded pre- and postoperatively using Gertner-Podoshin plates were used to assess treatment outcomes 1 month, 6 months and 1 year after surgery. RESULTS: No adverse effects were encountered. One primary bleed due to tonsillectomy was the only complication in this group. Eighty-seven children (94%) had significantly improved nasal breathing postoperatively. CONCLUSIONS: The results of this study demonstrate that RVTR is a safe, effective method for the treatment of turbinate hypertrophy in children. In addition, our data demonstrates good patient acceptance over a period of 1 year.

Extirpación de pólipos antrocoanales mediante cirugía endoscópica / No disponible

Los pólipos antrocoanales son estructuras polipoides originadas en el seno maxilar que se extienden a la fosa nasal. Su aparición es independiente de fenómenos alérgicos. En nuestra serie representan un 7,1% del total de intervenciones por poliposis nasosinusal. Deben sospecharse ante la presencia de una obstrucción nasal, sobre todo en niños. Para su estudio es necesario realizar una exploración ORL, endoscopia nasal y TC. La técnica quirúrgica de elección es la cirugía endoscópicana sosinusal, pero puede ser interesante asociar una antrostomía en la fosa canina si no se puede extirpar toda la mucosa patológica. Bajo este supuesto el porcentaje de recidivas que hemos observado es del 11,1%. La estancia media de nuestros pacientes tras la intervención fue de 1,3 días, sin aparecer complicaciones remarcables, por lo que creemos que la intervención puede ser realizada mediante cirugía ambulatoria

Antrochoanal polyps are polypoid structures that arise from the maxillary sinus and extend into the nose. Its appearance is independent from allergic processes. In our sample they represent 7.1% of the sinusal polyposis operations. We must suspect them in patients with nasal obstruction, especially in children. The study of these polyps includes a complete ENT examination, nasal endoscopy and CT-scan. Nowadays endoscopicsinus surgery is the surgical choice, but it would be interesting to add a little antrostomy in the canine fosa if we were not able to complete the surgical removal of all diseased mucosa. Under this assumption ourrelapse rate has been 11.1%. The mean stay of our patients before surgery has been 1.3 days, without any important postoperative complication, so we think that these patients could be operated in an out-patient surgical department