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1.
Niger J Clin Pract ; 25(10): 1725-1730, 2022 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-36308246

RESUMEN

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction involving nasal mucosa characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness, and eyes itching. Tympanometry is a simple, rapid, and objective test that can be easily carried out. The use of tympanometry in clinical setting can improve detection of middle ear effusion and other middle ear abnormalities. AR has been found to be one of the predisposing factors to developing Otitis Media with Effusion (OME) in children. Patients and Methods: A case-control study was used to determine the prevalence of OME among children with AR as cases and those without allergy as controls. The study participants were children aged 4-12 years with clinical diagnosis of AR attending ENT clinics of Aminu Kano Teaching Hospital, whereas controls were children age 4-12 years without history of AR, ear diseases, or other respiratory system related ailments attending general outpatient clinics in Aminu Kano Teaching Hospital. An interviewer-administered score for AR (SFAR) questionnaire was filled out for all the participants, those with score of 6 and above were selected as cases. The two groups had complete ENT examination and tympanometry done, findings were recorded, and analyzed using SPSS version 21. Results: The mean age of the cases was 6.8 ± 2.1 years, whereas it was 7.5 ± 2.6 years for the controls. The mean difference was 0.7 and was not statistically significant (t = 2.35, df = 258, P value = 0.20). Type B tympanogram suggesting OME was found in 7.3% of subjects and in 2.8% of controls. Type C tympanogram suggesting negative middle ear pressure was found in 15.5% of subjects and in 4.6% of controls. Type A tympanogram suggesting normal middle ear pressure was found in 75% of subjects and in 90% of controls. Acoustic reflex was found to be absent in 29.6% of subjects and in 15.4% of controls and this found to be statistically significant (χ2 = 7.77, df = 1, P value = 0.001). The difference between type A, B, and C tympanograms of subjects and that of controls was found to be statistically significant (Type A χ2 = 14.62, df = 4, P value = 0.01, Type B χ2 = 14.06, df = 4, P value = 0.01, Type C χ2 = 17.01, df = 6, P value = 0.01). Type B tympanogram was used as an indicator to suggest OME for the purpose of this study. Conclusion: Participants with AR were found to have more abnormalities of tympanometric parameters and higher prevalence of type B tympanogram suggesting OME than controls.


Asunto(s)
Enfermedades del Oído , Otitis Media con Derrame , Otitis Media , Rinitis Alérgica , Niño , Humanos , Preescolar , Otitis Media con Derrame/diagnóstico , Otitis Media con Derrame/epidemiología , Estudios de Casos y Controles , Nigeria , Rinitis Alérgica/diagnóstico , Rinitis Alérgica/epidemiología , Prurito , Hospitales
2.
Braz. j. otorhinolaryngol. (Impr.) ; 88(3): 406-420, May-June 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1384187

RESUMEN

Abstract Introduction Augmentation rhinoplasty depends mainly on intact stable bony and cartilaginous parts. Many trials have used different materials as a graft to perform the operation and support the nose. Debate exists whether alloplastic or autogenic grafts are more appropriate. Common available alloplastic grafts include silicone, medpor, and gore-tex. Autogenic grafts are usually derived from costal cartilages. Warping, infection, and hypertrophic scars are the main complications of the procedure. Yet no subgroup analysis has been performed to investigate the effect of different risk factors. Objective To investigate the effect of different types of grafts and the association of the income level of the country on surgery complications. Methods A comprehensive literature search of articles was conducted in PubMed, Cochrane Library, Web of Science, and SCOPUS databases through October 2019. We included articles that used autologous or alloplastic grafts in nasal dorsum reconstruction surgery. We performed subgroup analysis according to the type of graft used, region, and income level of the country. A meta-regression analysis model was carried out from the period of 1999-2018, to study the incidence of these complications over time. Results The overall complication rate was 7.1%, which was higher in the alloplastic group (7.8%) than the autogenic group (6.9%). The most common complications were secondary surgery for re-correction (4.1%), infection (2.1%), warping (1.6%), and hypertrophic scars (1.6%). All outcomes were homogeneous (I2 < 50%). Conclusion Patients with autogenic grafts are less liable to develop complications than their peers reconstructed with alloplastic grafts. Moreover, Asian patients are less susceptible to overall rhinoplasty complications. Attention should be noted for low-income countries in which surgical complications are more prone to occur.


Resumo Introdução A feitura de uma rinoplastia de aumento depende principalmente das partes ósseas e cartilaginosas intactas. Muitos estudos usaram enxertos de diferentes materiais para a feitura da cirurgia e como apoio da estrutura nasal. Ainda existem controvérsias em estudos prévios sobre quais tipos de enxertos, se materiais aloplásticos ou autogênicos, seriam os mais adequados. Os enxertos aloplásticos comuns incluem silicone, medpor e gore-tex. Os enxertos autogênicos são geralmente derivados de cartilagens costais. Deformações, infecção e cicatrizes hipertróficas são as principais complicações do procedimento. No entanto, nenhuma análise de subgrupo foi feita para investigar o efeito de diferentes fatores de risco. Objetivo Investigar o efeito de diferentes tipos de enxertos e o nível de renda do país nas complicações cirúrgicas Método Uma pesquisa abrangente de artigos na literatura foi feita nas bases de dados PubMed, Cochrane Library, Web of Science e SCOPUS até outubro de 2019. Foram incluídos artigos que usaram enxertos autólogos ou aloplásticos em cirurgias de reconstrução do dorso nasal. Foi feita uma análise de subgrupos de acordo com o tipo de enxerto usado, região e nível de renda do país. Um modelo de análise de metarregressão foi feito de 1999 a 2018, para estudar a incidência dessas complicações ao longo do tempo. Resultados A taxa global de complicações foi de 7,1%, a qual foi maior no grupo aloplástico (7,8%) do que no grupo autogênico (6,9%). As complicações mais comuns foram cirurgia secundária para recorreção (4,1%), infecção (2,1%), deformidade (1,6%) e cicatrizes hipertróficas (1,6%). Todos os resultados foram homogêneos (I2 < 50%). Conclusão Os pacientes com enxertos autogênicos são menos propensos a desenvolver complicações, em comparação com seus pares com enxertos aloplásticos. Além disso, pacientes asiáticos são menos suscetíveis a complicações gerais da rinoplastia. Merece atenção o fato de que em países de baixa renda as complicações cirúrgicas são mais propensas a ocorrer.

3.
Braz. j. otorhinolaryngol. (Impr.) ; 88(1): 63-82, Jan.-Feb. 2022. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1364578

RESUMEN

Abstract Introduction Edema and ecchymosis after facial plastic surgery are a troublesome concern for both patients and surgeons. Corticosteroid administration is thought to shorten the recovery period and reduce these sequelae. Data regarding the efficacy of corticosteroid administration remains controversial among surgeons. Objective We conducted this systematic review and meta-analysis to determine the effect of preand postoperative corticosteroids on postoperative complications in patients undergoing facial reconstructive surgery supported with different subgroup analysis. Methods A comprehensive literature search of articles was conducted in PubMed, Cochrane Central, SCOPUS, and EBSCO through October 2019. We included all clinical trials in which patients underwent any type of facial plastic surgery to study the effect of corticosteroids on postoperative complications. We performed subgroup analysis according to the types and doses of corticosteroid preparation, in addition to a subgroup analysis of preor postoperative corticosteroid usage. All statistical analysis was performed using the RevMan software. Results Nineteen studies were included in this systematic review, but only 10 of them were eligible for meta-analysis. The periorbital edema and ecchymosis scores were significantly reduced in the corticosteroids group compared to placebo −0.82, 95% CI (−1.37, −0.26), and -0.95, 95% CI (−1.32, −0.57), respectively. However, these significant differences were not maintained at day 3 and 7. Smaller doses of corticosteroid (8 mg and 10 mg) were associated with smaller differences in the mean score of upper and lower eyelid edema and ecchymosis, while the higher doses were associated with greater differences. Furthermore, preoperative corticosteroid usage significantly reduced the intraoperative bleeding when compared to placebo for higher doses > 50 mg per day (p < 0.0001), but not for 8 mg corticosteroid (p = 0.06). Adding postoperative steroid dose to the preoperative one was associated with less edema and ecchymosis than preoperative administration alone. Conclusion This comprehensive meta-analysis confirms a statistically significant benefit of preoperative corticosteroids. Furthermore, continuing the steroids postoperatively is associated with long-term reduction of complications. Higher doses of corticosteroids are associated with a more significant reduction in edema and ecchymosis, but further studies are recommended to determine the postoperative side effects, including surgical site infection and delayed healing.


Resumo Introdução O edema e a equimose no pós-operatório da cirurgia plástica facial constituem um problema preocupante para pacientes e cirurgiões. Considera-se que a administração de corticosteroides diminua o período de recuperação e reduza essas complicações. Os dados sobre a eficácia da administração de corticosteroides permanecem controversos entre os cirurgiões. Objetivo Fizemos essa revisão sistemática e metanálise para determinar o efeito da administração de corticosteroides nos períodos pré- e pós-operatório sobre as complicações pós-operatórias em pacientes submetidos à cirurgia reconstrutiva facial apoiada em diferentes análises de subgrupos. Método Foi feita uma busca abrangente de artigos nos bancos de dados PubMed, Cochrane Central, Scopus e Ebsco até outubro de 2019. Incluímos todos os ensaios clínicos cujos pacientes foram submetidos a qualquer tipo de cirurgia plástica facial para estudar o efeito dos corticosteroides nas complicações pós-operatórias. Fizemos a análise de subgrupos de acordo com os tipos e as doses de preparação de corticosteroides, além de uma análise de subgrupos de uso de corticosteroides pré ou pós-operatório. Todas as análises estatísticas foram feitas no software RevMan. Resultados Dezenove estudos foram incluídos nesta revisão sistemática, mas apenas 10 deles foram elegíveis para a metanálise. Os escores de edema periorbital e equimoses reduziram significantemente no grupo de corticosteroides em comparação com o placebo: -0,82, IC95% (-1,37, -0,26) e -0,95, IC95% (-1,32, -0,57), respectivamente. Essas diferenças significantes não se mantiveram nos dias 3 e 7. Doses menores de corticosteroides (8 mg e 10 mg) foram associadas a menores diferenças no escore médio de edema e equimoses palpebrais superiores e inferiores, enquanto as doses mais altas foram associadas a diferenças maiores. Além disso, o corticosteroide pré-operatório reduziu significantemente o sangramento intraoperatório quando comparado ao placebo para doses maiores > 50 mg por dia (p < 0,0001), mas não para 8 mg de corticosteroide (p = 0,06). O uso de corticosteroides no pós- e pré-operatório foi associado a uma diminuição maior de edema e equimoses do que no pré-operatório isoladamente. Conclusão Esta metanálise abrangente confirma um benefício estatisticamente significante do uso de corticosteroides no pré-operatório. Além disso, a manutenção dos esteroides no pós-operatório está associada à redução das complicações em longo prazo. Doses mais altas de corticosteroides estão associadas a uma redução mais significativa no edema e nas equimoses, mas estudos adicionais são recomendados para determinar os efeitos colaterais pós-operatórios como infecção do sítio cirúrgico e atraso na cicatrização.

4.
Plast Surg (Oakv) ; 30(1): 59-62, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-35096694

RESUMEN

BACKGROUND: Rhinoplasty is one of the most common procedures that act as a challenge for consistent outstanding results. Alar base reduction is a technique of rhinoplasty that is prescribed in many conditions. Wound closure requires using of sutures and there are several types of sutures for this purpose; however, good scar results are necessary for patients'satisfaction. AIM: To evaluate alar base resection scar results after surgical resection using different types of suturing material. METHODS: This is a retrospective cohort study that was conducted at King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia. The study was performed by reviewing patient's records and performing post-operative photography for patient who underwent alar base resection. The patients were divided into 2 groups, the first group of patients had the alar base wound closed with interrupted Polypropylene 6/0 and the other group wound was closed with monocryl 6/0 sutures. Visual analog scale was used to investigate basal views. RESULTS: The study included 80 patients divided into 2 groups, each group included 40 patients, in the first group (Polypropylene group) there were 25% males and 75% females, whereas in the second group (monocryl) there were 15% and 85% males and females, respectively. There were 85% and 82.5% unnoticeable scar reported by the first and second group, respectively; however there was no significant difference between the 2 groups (P = .75). CONCLUSION: Both Polypropylene and monocryl sutures result in the same result for closing alar base wound post surgically.


HISTORIQUE: La rhinoplastie est l'une des principales interventions chirurgicales oú il est difficile de toujours obtenir des résultats remarquables. La réduction de la base des ailes du nez est une technique prescrite pour de nombreuses affections. Plusieurs types de sutures peuvent être utilisées pour fermer les plaies, mais de belles cicatrices s'imposent pour satisfaire les patients. OBJECTIFS: Les chercheurs ont évalué les résultats des cicatrices de la base des ailes du nez après des résections chirurgicales au moyen de divers matériaux de suture. MÉTHODOLOGIE: Étude de cohorte rétrospective réalisée à l'hôpital universitaire du roi Abdulaziz de Riyad, en Arabie saoudite. Les chercheurs ont examiné les dossiers des patients et photographié ceux qui avaient subi une résection de la base des ailes du nez. Les patients ont été divisés en deux groupes de 20 patients: dans le premier, les plaies de la base des ailes du nez ont été fermées par des sutures de polypropylène 6/0 et dans le deuxième, par des sutures de monocryl 6/0. Les chercheurs ont utilisé une échelle analogique visuelle pour évaluer les vues de la base des ailes du nez. RÉSULTATS: L'étude se composait de 80 patients divisés en deux groupes de 40 patients. Le premier groupe (polypropylène) était composé à 25% d'hommes et à 75% de femmes, d'un âge moyen total de 32 ans, et le deuxième (monocryl), à 15 % d'hommes et à 85% de femmes. Les cicatrices n'étaient pas visibles chez 85% et 82,5% des membres du premier et du deuxième groupe, respectivement, mais la différence n'était pas significative (P = 0,75). CONCLUSION: Les sutures de polypropylène et de monocryl donnent le même résultat clinique pour fermer les plaies de la base des ailes du nez.

5.
Braz J Otorhinolaryngol ; 88(1): 63-82, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-32605829

RESUMEN

INTRODUCTION: Edema and ecchymosis after facial plastic surgery are a troublesome concern for both patients and surgeons. Corticosteroid administration is thought to shorten the recovery period and reduce these sequelae. Data regarding the efficacy of corticosteroid administration remains controversial among surgeons. OBJECTIVE: We conducted this systematic review and meta-analysis to determine the effect of pre- and postoperative corticosteroids on postoperative complications in patients undergoing facial reconstructive surgery supported with different subgroup analysis. METHODS: A comprehensive literature search of articles was conducted in PubMed, Cochrane Central, SCOPUS, and EBSCO through October 2019. We included all clinical trials in which patients underwent any type of facial plastic surgery to study the effect of corticosteroids on postoperative complications. We performed subgroup analysis according to the types and doses of corticosteroid preparation, in addition to a subgroup analysis of pre- or postoperative corticosteroid usage. All statistical analysis was performed using the RevMan software. RESULTS: Nineteen studies were included in this systematic review, but only 10 of them were eligible for meta-analysis. The periorbital edema and ecchymosis scores were significantly reduced in the corticosteroids group compared to placebo -0.82, 95% CI (-1.37, -0.26), and -0.95, 95% CI (-1.32, -0.57), respectively. However, these significant differences were not maintained at day 3 and 7. Smaller doses of corticosteroid (8 mg and 10 mg) were associated with smaller differences in the mean score of upper and lower eyelid edema and ecchymosis, while the higher doses were associated with greater differences. Furthermore, preoperative corticosteroid usage significantly reduced the intraoperative bleeding when compared to placebo for higher doses > 50 mg per day (p < 0.0001), but not for 8 mg corticosteroid (p = 0.06). Adding postoperative steroid dose to the preoperative one was associated with less edema and ecchymosis than preoperative administration alone. CONCLUSION: This comprehensive meta-analysis confirms a statistically significant benefit of preoperative corticosteroids. Furthermore, continuing the steroids postoperatively is associated with long-term reduction of complications. Higher doses of corticosteroids are associated with a more significant reduction in edema and ecchymosis, but further studies are recommended to determine the postoperative side effects, including surgical site infection and delayed healing.


Asunto(s)
Rinoplastia , Cirugía Plástica , Corticoesteroides , Equimosis/etiología , Equimosis/prevención & control , Edema/etiología , Edema/prevención & control , Humanos , Complicaciones Posoperatorias/prevención & control
6.
Braz J Otorhinolaryngol ; 88(3): 406-420, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-32888894

RESUMEN

INTRODUCTION: Augmentation rhinoplasty depends mainly on intact stable bony and cartilaginous parts. Many trials have used different materials as a graft to perform the operation and support the nose. Debate exists whether alloplastic or autogenic grafts are more appropriate. Common available alloplastic grafts include silicone, medpor, and gore-tex. Autogenic grafts are usually derived from costal cartilages. Warping, infection, and hypertrophic scars are the main complications of the procedure. Yet no subgroup analysis has been performed to investigate the effect of different risk factors. OBJECTIVE: To investigate the effect of different types of grafts and the association of the income level of the country on surgery complications. METHODS: A comprehensive literature search of articles was conducted in PubMed, Cochrane Library, Web of Science, and SCOPUS databases through October 2019. We included articles that used autologous or alloplastic grafts in nasal dorsum reconstruction surgery. We performed subgroup analysis according to the type of graft used, region, and income level of the country. A meta-regression analysis model was carried out from the period of 1999-2018, to study the incidence of these complications over time. RESULTS: The overall complication rate was 7.1%, which was higher in the alloplastic group (7.8%) than the autogenic group (6.9%). The most common complications were secondary surgery for re-correction (4.1%), infection (2.1%), warping (1.6%), and hypertrophic scars (1.6%). All outcomes were homogeneous (I2 < 50%). CONCLUSION: Patients with autogenic grafts are less liable to develop complications than their peers reconstructed with alloplastic grafts. Moreover, Asian patients are less susceptible to overall rhinoplasty complications. Attention should be noted for low-income countries in which surgical complications are more prone to occur.


Asunto(s)
Cicatriz Hipertrófica , Cartílago Costal , Rinoplastia , Cicatriz Hipertrófica/etiología , Cicatriz Hipertrófica/cirugía , Cartílago Costal/trasplante , Humanos , Nariz/cirugía , Estudios Retrospectivos , Rinoplastia/efectos adversos , Rinoplastia/métodos , Trasplante Autólogo/efectos adversos
7.
Niger J Clin Pract ; 24(6): 802-807, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34121725

RESUMEN

BACKGROUND: Cerebral palsy (CP) is a commonly occurring disorder of movement and posture that starts in early childhood. It is accompanied by other disturbances including hearing loss which has been shown to worsen the quality of life of the patients due to problems associated with speech and language acquisition. Several factors are responsible for developing hearing loss in CP. AIMS: To determine the factors that can help in early diagnosis and treatment of hearing loss in children with cerebral palsy. METHODOLOGY: This was a hospital based cross-sectional study conducted among 165 randomly selected children with CP. An interviewer-administered questionnaire was used to obtain relevant sociodemographic and clinical information. The data collected was analyzed using Statistical Product and Services Solution (SPSS) version 21. RESULTS: The age range of the participants was 1-12 years, with a mean age and standard deviation (SD) of 4.49 ± 2.85. The male to female ratio was 2:1. The commonest type of CP encountered was of spastic variety seen in 47.3%, while the least encountered variety was of the ataxic type, seen in only 4.2%;46.7% of the children were reported to have hearing impairment by their guardian. Other comorbidities reported included epilepsy (33.9%), speech impairment (27.3%), mental retardation (17.0%) and visual impairment (8.5%). A statistically significant association was found between the presence of comorbidities (P = 0.05) and hearing loss among children with CP. CONCLUSION: Hearing impairment is common among children with CP. Several factors are associated with the development of hearing loss among children with CP. However, only presence of comorbidities was found to be a significant determinant of hearing loss among children with CP.


Asunto(s)
Parálisis Cerebral , Pérdida Auditiva , Parálisis Cerebral/complicaciones , Parálisis Cerebral/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Pérdida Auditiva/diagnóstico , Pérdida Auditiva/epidemiología , Pérdida Auditiva/etiología , Humanos , Lactante , Masculino , Nigeria/epidemiología , Calidad de Vida
8.
Artículo en Inglés | MEDLINE | ID: mdl-33582670

RESUMEN

INTRODUCTION: Nasal dorsum irregularities may occur after nasal trauma or as a postrhinoplasty complication. Here, we present a novel technique using temporalis fascia (TF) grafting for primary and revision rhinoplasty to repair the nasal dorsum, hide nasal irregularities, and improve nasal contouring. METHODS: This prospective cohort study was conducted from January 2019 to June 2019 and evaluated nasal dorsal contouring using the TF in a tubed form. The outcome variables were patient satisfaction, dorsal irregularity, and contour definition. The predictor variable was the use of tubed TF for dorsal augmentation. Other associated variables were age, sex, indication for surgery, surgery type, and graft size. Patient satisfaction was evaluated using the Rhinoplasty Outcome Evaluation questionnaire. A rhinoplasty specialist other than the surgeon who performed the procedure evaluated the dorsal augmentation outcomes by inspection and palpation of the dorsum. All statistical analyses were performed using the SPSS software. RESULTS: Seventy-four patients (21.6% men and 78.4% women) were treated with the tubed TF. The mean age was 28.97 years. Thin skin was the most common indication (48.6%) for using TF. The graft size was 2-5 cm; inspection and palpation revealed no irregularities. No reception site complications occurred. One patient had a mild hematoma at the donor site. The mean patient satisfaction score was 10.14 preoperatively and 19.95 postoperatively (p = 0.001). DISCUSSION/CONCLUSIONS: Our novel technique of using the TF graft in a tubed form was easy to perform. Furthermore, the tubed TF covers all irregularities, is good for dorsal augmentation, and improves dorsal contouring and definition.


Asunto(s)
Nariz , Rinoplastia , Adulto , Fascia/trasplante , Femenino , Humanos , Masculino , Nariz/cirugía , Satisfacción del Paciente , Estudios Prospectivos
9.
Cureus ; 12(8): e9769, 2020 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-32944480

RESUMEN

Background Open rhinoplasty, including the transcolumellar approach, is commonly performed as it has fewer side effects and provides superior anatomical control to the surgeons compared to closed rhinoplasty. However, the postoperative scar outcomes, such as scar appearance, vary depending on the type of suture used in wound closure, and the optimal suture type is not firmly established. Objective To compare the impact of catgut versus polypropylene sutures on the postoperative transcolumellar scar outcomes and patient satisfaction following open rhinoplasty. Methods This retrospective cohort study, including 100 patients who underwent transcolumellar open rhinoplasty, was conducted at otolaryngology department of King Abdulaziz University Hospital, Riyadh, KSA. The patients were divided into two groups: the propylene suture group (group 1), which included 15 males and 35 females with a mean age of 31.5 years and underwent surgery using propylene sutures, and the catgut suture group (group 2), which included 10 males and 40 females with a mean age of 30.5 years and underwent surgery using catgut sutures. The postoperative transcolumellar scar outcomes, as determined by visual analogue scale (VAS) and Stony Brook Scar Evaluation Scale (SBSES) scores, and patient satisfaction, as assessed using a self-assessment scale, were compared between groups. Results The scars were unnoticeable in the majority of both groups: 88% in group 1 and 86% in group 2. The VAS and SBSES scores did not significantly differ between groups. Patients' satisfaction rates were also comparable and did not significantly differ between groups (p = 0.341). Conclusion Both catgut and polypropylene sutures lead to similar outcomes and patient satisfaction rates in terms of postoperative rhinoplasty transcolumellar scars. Thus, catgut may be the optimal suture for closing transcolumellar incisions following open rhinoplasty.

10.
J Oral Maxillofac Surg ; 78(12): 2299.e1-2299.e8, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32668196

RESUMEN

PURPOSE: Alar base reduction was first performed in 1892, when Robert Weir began performing surgery to correct nasal flaring. Our study objective was to investigate scar outcomes after alar base reduction with different surgical approaches. MATERIALS AND METHODS: We performed a retrospective cohort study of patients who underwent alar base reduction at King Abdulaziz University Hospital. The primary predictor variable was wound incision in the alar-facial groove; other variables were age, gender, and time interval. The outcome variable, scar status, was assessed subjectively (unnoticeable, noticeable but acceptable, or noticeable and unacceptable) and objectively by rhinoplasty surgeons using Stony Brook Scar Evaluation Scale scores. Paired t tests were used, with P ≤ .05 considered statistically significant. RESULTS: A total of 70 patients were included, with 35 in each of 2 groups. The incision for alar reduction was placed in the alar-facial groove in group 1; the incision was placed 1 to 2 mm anterior to the alar-facial groove in group 2. Group 1 consisted of 14 men (40%) and 21 women (60%); group 2 consisted of 8 men (22.9%) and 27 women (77.1%). The average Stony Brook Scar Evaluation Scale scores for groups 1 and 2 were 4.62 and 4.48, respectively, and did not differ significantly (P = .196). During subjective scar assessment, 85.7% of patients from group 1 reported that their scars were unnoticeable whereas 14.3% reported that they were noticeable but acceptable. In group 2, 82.9% of patients reported unnoticeable scars whereas 17.1% reported noticeable but acceptable scars. Thus, no significant differences were observed in the subjective assessment between the 2 groups (P = .286). CONCLUSIONS: Alar resection along the alar-facial groove ensures better scar outcomes and hides the scar within that groove, especially in patients with a deep facial groove. Future studies should focus on the best method for limiting scarring in patients without deep facial grooves.


Asunto(s)
Rinoplastia , Herida Quirúrgica , Cicatriz/prevención & control , Femenino , Humanos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento
11.
Saudi Med J ; 41(6): 635-639, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32518931

RESUMEN

OBJECTIVES: To demonstrate the correction of overhanging alar with the vestibular triangular excision technique using preoperative and postoperative photographs.   Methods: This descriptive retrospective study was conducted at King Abdulaziz University Hospital, Riyadh, Saudi Arabia. Fifty patients who underwent open rhinoplasty with the vestibular triangular excision technique were retrospectively assessed. Preoperative and postoperative photographs were examined to evaluate the alar-columellar relationship. Patients included had undergone either primary or revision rhinoplasties between January 2013 and March 2018 and had a thick hanging alar with a grade IV Gunter's rating for alar-columellar discrepancies. Patient outcomes and satisfaction were subjectively assessed using the rhinoplasty outcome evaluation (ROE) scale and visual analog scale (VAS) by independent analysis of the right lateral, left lateral, and frontal view photographs by 2 rhinoplasty surgeons, both preoperatively and 1-year postoperatively. Statistical significance was calculated by Wilcoxon signed-rank tests.  Results: Patients' ages ranged from 18 to 37 years (mean, 26.34). The study included 22 men (44%) and 28 women (56%). Mean preoperative and postoperative ROE scores were 10.12 and 19.3 and VAS scores 5.14 and 7.94. P-values for preoperative and postoperative comparison of both ROE and VAS were statistically significant (p=0.001).  Conclusion: Caring of alar soft tissue during rhinoplasty is important to correct overhanging alar to improve nasal appearance and patient satisfaction. The sail excision technique is reliable and simple and provides good patient satisfaction.


Asunto(s)
Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/cirugía , Satisfacción del Paciente , Rinoplastia/métodos , Adolescente , Adulto , Estética , Femenino , Humanos , Masculino , Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/diagnóstico por imagen , Evaluación del Resultado de la Atención al Paciente , Fotograbar , Estudios Retrospectivos , Arabia Saudita , Escala Visual Analógica , Adulto Joven
12.
Transbound Emerg Dis ; 57(5): 340-7, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20642494

RESUMEN

A cross-sectional sero-epidemiological study was conducted in seven districts of the South Omo zone, south-western Ethiopia, between October 2008 and May 2009 with the objective of determining the seroprevalence of foot-and-mouth disease (FMD) in cattle and identifying the potential risk factors associated with the disease. In total, 770 cattle sera samples were collected and submitted to the National Veterinary Institute (NVI), Debre Zeit, Ethiopia, for screening using the 3ABC-ELISA. The overall seroprevalence of 8.18% (n=63) was recorded in the study. The highest district-level prevalence was observed in Bennatsemay district (30.2%), and the lowest prevalence was in Malle and Debub Aari districts, each with prevalence of 6.3%. The difference in seropositivity of FMD in the studied districts was found to be statistically significant. From the various risk factors analysed, age of animal, contact history with wild animals, distance of the herd from parks and wild animals' sanctuary and movement pattern of herds in search of pasture and water from area to area were found to be significantly associated (P<0.05) with the seroprevalence of FMD. The results of this study showed that FMD is an important cattle disease in the study areas. Thus, an appropriate control strategy has to be designed and applied, which could involve regulation of transboundary cattle movement, prevention of contact with wildlife and vaccination against the circulating virus strain.


Asunto(s)
Fiebre Aftosa/epidemiología , Secuencia de Aminoácidos , Animales , Bovinos , Chlorocebus aethiops , Clonación Molecular , Estudios Transversales , Etiopía/epidemiología , Fiebre Aftosa/sangre , Fiebre Aftosa/prevención & control , Regulación Viral de la Expresión Génica , Datos de Secuencia Molecular , Filogenia , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Riesgo , Estudios Seroepidemiológicos , Células Vero , Proteínas Virales/química , Proteínas Virales/genética
13.
Trop Anim Health Prod ; 40(8): 657-66, 2008 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18975131

RESUMEN

Serum enzymes were studied in 163 apparently healthy goats from three indigenous goat breeds of Ethiopia. The effect of breed, age, sex and season on alanine aminotransferase (ALT) / glutamic pyruvic transaminase (GPT), aspartate aminotransferase (AST) / glutamic oxalacetic transaminases (GOT), alkaline phosphatase (ALP) and acid phosphatase (AcP) levels was assessed. The mean serum enzymes levels of the indigenous Arsi-Bale, Central Highland and Long-eared Somali goat breeds ranged from 14.0-20.2 iu L(-1) for ALT/GPT, from 43.2-49.3 iu L(-1) for AST/GOT, from 83.7-98.8 iu L(-1) for ALP, and from 2.99-4.23 iu L(-1) for AcP, were within the normal range for goats elsewhere. Breed had significant influence on AST/GOT values. Sex had significant effect on ALT/GPT for Arsi-Bale goats with higher values in males than females. Age was significant on all serum enzymes studied in the Arsi-Bale goats and on ALP in the Central Highland goats. Season had significant influence on all serum enzymes except for ALT/GPT in the Arsi-Bale goats. The serum enzyme levels of these indigenous goat breeds can be used as normal reference values for Ethiopian goat breeds adapted to similar agro-ecology and production system.


Asunto(s)
Cabras/sangre , Fosfatasa Ácida/sangre , Factores de Edad , Alanina Transaminasa/sangre , Fosfatasa Alcalina/sangre , Animales , Aspartato Aminotransferasas/sangre , Cruzamiento , Etiopía , Femenino , Cabras/genética , Masculino , Valores de Referencia , Estaciones del Año , Factores Sexuales
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