Nasal septal suture technique versus nasal packing after septoplasty.

BACKGROUND: The aim of this study was to compare eustachian function and blood gas changes with nasal packing (NP) and nasal septal suturing (NSS) after septoplasty. METHODS: Eighty patients who have nasal septal deviation and who otherwise are healthy were studied. Forty of these patients had finger glove NPs in their nasal cavities for 48 hours after septoplasty. Another 40 patients had NSS performed after septoplasty. Acoustic tympanometry and pH, P(CO2), and P(O2) analyses of arterial blood were performed preoperatively and 48 hours postoperatively. RESULTS: We observed a statistically significant increase in middle ear pressure (p < 0.001) and a significant reduction of P(O2) (p < 0.001) and increase of P(CO2) (p = 0.041) in the NP group but no difference in the NSS group, postoperatively. CONCLUSION: NSS should be preferred as an alternative to intranasal packing.

Evaluation of nasal airway resistance during rapid maxillary expansion using acoustic rhinometry.

The purpose of this study was to evaluate nasal airway resistance (NAR) during rapid maxillary expansion (RME) using acoustic rhinometry (AR). The sample comprised 22 children (13 girls and nine boys) with maxillary constriction. The mean age was 12.9 +/- 1.54 years and all patients were found to have normal nasal cavities following anterior rhinoscopic examination. A modified bonded splint type RME appliance was used for expansion. AR was used to measure NAR before (T1), during (T2) and after (T3) expansion, and at the end of retention (T4). Each AR recording was performed, for each patient, with and without the use of a decongestant. Subjective evaluation of reported changes in nasal breathing were also undertaken at T3. The results showed that NAR was significantly reduced with the use of RME, with the main decrease observed during expansion (P < 0.05). The use of a decongestant was not found to have any effect on the results. Subjective evaluation showed that 59 per cent of patients considered that their nasal breathing had improved following RME.

Higher glutathione transferase GSTM1 0/0 genotype frequency in young thyroid carcinoma patients.

OBJECTIVE: Glutathione S-transferases (GSTs) comprise a large supergene family and detoxify a variety of endogenous and exogenous electrophilic compounds. Since many GSTs are polymorphic, there has been considerable interest in determining whether particular allelic variants are associated with altered risk for various disorders. RESEARCH DESIGN AND METHODS: In this study the association between the variant GSTM1 0/0 genotype and thyroid carcinoma was investigated. A hospital-based, case-controlled study was carried out. Polymorphisms of GSTM1 0/0 (i.e. the null allele of GSTM1) in samples from 32 cases and 44 controls were detected by polymerase chain reaction (PCR) methodology. The proportions of GSTM1 deleted genotype in cases and controls were 59.4% and 54.5%, respectively. RESULTS: There were significant increments of GSTM 0/0 genotype frequency in a group of patients aged under 40 (p = 0.033, odds ratio (OR) = 4.78, 95% confidence interval (CI) = 1.30-7.13) and in former smokers compared with controls (p = 0.039, OR 2.45, 95% CI 0.216-4.72). CONCLUSION: GSTM1 deleted genotype may be a useful genetic biomarker for thyroid carcinoma susceptibility in young subjects. The absence of this enzyme seems to have a role in the development of thyroid carcinoma; however, the mechanism still needs further study.

Diabetic ketoacidosis and rhino-orbital mucormycosis.

Mucormycosis often develops in immunocompromised patients, particularly in patients with diabetic ketoacidosis. Unless early diagnosis and treatment is established mucormycosis leads rapidly to death. A 38-year-old woman was admitted to the hospital with a severe diabetic ketoacidosis. Her clinical status improved in 4 days as a result of aggressive medical treatment. She has complained left cheek pain on the 10th day and had a swelling of her left cheek, facial edema, a black eschar on the palate and nasal cavity in association with visual disturbance and total ophthalmology in a short time. CT scan revealed left orbital cellulitis and pansinusitis. Excessive surgical treatment was performed and liposomal amphotericin-B, 4 mg/(kg day) was applied. Extensive fungal invasion of the orbit and the sinuses was demonstrated in the pathological species and Rhizomucor species were yielded with culture. Repeated superficial debridement was also performed. After 10 weeks, she was discharged with suggestion of insulin treatment and liposomal amphotericin-B with progressively decreasing doses. At the 13th month following the presentation, the patient was free of disease as confirmed by serial imaging and under good glycaemic control with insulin treatment. Although mucormycosis is a fatal infection, early diagnosis and aggressive treatment may decrease mortality.