Endoscopic Dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique.

BACKGROUND: Dacrocystorhinostomy (DCR) is an operation used to treat nasolacrimal duct obstruction. Essentially there are two approaches: external and endoscopic. Several modalities are used in endoscopic DCR; all aiming to improve success rate, reduce complications, and shorten operative time. Both kerrison punch and drill are widely used in endoscopic DCR with non-conclusive knowledge about differences in operative details as well as on the outcome. The aim of this study is to compare between powered (drill) and non-powered (kerrison punch) DCR to clarify the superiority of one over the other. METHODS: A retrospective chart review of 59 patients who underwent endoscopic DCR procedure at our institution from June 2013 until July 2014 (34 kerrison punch and 32 powered drill). Operative details, surgical outcome and complications were compared between both groups. RESULTS: A total of 66 endoscopic DCRs were performed on 59 patients. Procedure success rate among kerrison punch group was 87.88% vs. 90.9% in powered drill group (p = 0.827), while complications for both groups were statistical not significant (p = 0.91). The mean operating time among kerrison punch group was significantly lower than in powered drill group (75 min vs. 125 min, p = 0.0001). CONCLUSION: Kerrison punch showed significant reduction in operating time when compared to powered drill for endoscopic DCR. No statistically significant difference was found between both groups regarding procedures' success rate and complication.

Immunoblotting technique: a new accurate in vitro test for detection of allergen-specific IgE in allergic rhinitis.

Allergic rhinitis is the most common manifestation of an atopic reaction to inhaled allergen. It accounts for 80% of rhinitis in children and 30% in adults. The objective of the study is to evaluate the presence of serum-specific IgE to a variety of common allergens using a new immunoblotting technique in order to detect the specific allergen causing allergic rhinitis. The study included 32 patients with allergic rhinitis (20 females and 12 males) with age ranging from 15 to 60 years. Measurement of specific IgE by immunoblotting technique was performed to patients with positive skin test. Overall diagnostic performance of immunoblot test in comparison to skin test in detection of all studied allergens showed 56.1% sensitivity, 100.0% specificity, 100.0% positive predictive value, 93.9% negative predictive value and 94.4% diagnostic accuracy. It may help in proper diagnosis and determination of the specific causative allergen through an easy and inexpensive way.

Preoperative intravenous dexamethasone combined with glossopharyngeal nerve block: role in pediatric postoperative analgesia following tonsillectomy.

Tonsillectomy is one of the most frequently performed ambulatory surgical procedures in children (Litman et al. in Anesth Analg 78:478-481, 1994). Several techniques have been described for alleviation of pain (Ginstrom et al. in Acta Otolaryngol 125:972-975, 2005). the objective of this study determination of the postoperative analgesic efficacy of the pre-surgical intravenous administration of dexamethasone together with glossopharyngeal nerve block (GNB) in children undergoing tonsillectomy. Prospective double blind randomized control study using both pre-operative injection of 0.5 mg/kg dexamethasone iv and 3 ml of 0.5% bupivacaine local injection for bilateral glossopharyngeal nerve block. Patients in group B had significantly less visual analogue scale values, longer absolute analgesia time, lesser swallowing difficulty and they were discharged earlier from the hospital when compared to patients in both groups D and G. Using both pre-operative dexamethasone IV injection with GNB has reduced postoperative pain and morbidity to a great extent than using either alone.