RESUMEN
OBJECTIVE: To determine the relationship between severe tinnitus and inflammation using the neutrophil-to-lymphocyte ratio as a marker of stress. METHODS: A total of 107 patients who had been suffering with severe tinnitus (tinnitus handicap inventory scale grades of 3-5) for at least 2 weeks were recruited. Patients underwent detailed ENT examinations and audiometric tests to exclude a relevant pathological cause of the tinnitus. Patients with systemic diseases, malignancy or inflammatory diseases that could alter neutrophil-to-lymphocyte ratio were excluded. A total of 107 age- and sex-matched healthy control participants were also recruited. Routine laboratory test results and neutrophil-to-lymphocyte ratio were compared between the patients and controls. RESULTS: Lipid profile, liver function, white blood cell count, haemoglobin level, mean corpuscular volume, and vitamin B12 and folate levels were similar among the patients and controls. However, mean neutrophil-to-lymphocyte ratio was significantly higher among the patients than the controls (p < 0.05). CONCLUSION: The findings of this novel study suggest that neutrophil-to-lymphocyte ratio should be considered during the evaluation of tinnitus patients as a potential clinical marker of tinnitus. Further studies are required to verify the findings.
Asunto(s)
Linfocitos/patología , Neutrófilos/patología , Acúfeno/diagnóstico , Adulto , Audiometría , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Humanos , Recuento de Leucocitos , Masculino , Estudios ProspectivosRESUMEN
OBJECTIVE: To evaluate the safety and effectiveness of radiofrequency dissection in conventional 'open' total thyroidectomy. METHODS: Thirty-nine patients scheduled for conventional total thyroidectomy were included in a prospective randomised study. Patients were randomly assigned to one of two groups: a radiofrequency dissection method was used in one group, and a knot tying technique was used in the other. RESULTS: Significantly fewer surgical instruments and materials were required for the radiofrequency dissection group than the knot tying group (p < 0.01). There were no significant differences between the two groups in mean operative time, blood loss, post-operative drainage and pain, recurrent palsy, and hypocalcaemia (p > 0.05). CONCLUSION: Radiofrequency dissection is a safe alternative to the knot tying technique, and enables a significant reduction in the number of surgical instruments required for the operation.
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Pérdida de Sangre Quirúrgica/prevención & control , Hemostasis Quirúrgica/instrumentación , Técnicas de Sutura/instrumentación , Tiroidectomía/métodos , Adulto , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Hemostasis Quirúrgica/métodos , Humanos , Ligadura/instrumentación , Masculino , Persona de Mediana Edad , Instrumentos Quirúrgicos/estadística & datos numéricos , Enfermedades de la Tiroides/patología , Enfermedades de la Tiroides/cirugía , Tiroidectomía/economía , Resultado del TratamientoRESUMEN
BACKGROUND: To investigate the role of peak nasal inspiratory flowmetry (PNIF) in evaluating inspiratory improvements in patients who underwent both septoplasty and inferior turbinate coblation by radiofrequency (ITC-RF). METHODS: One hundred and eight patients underwent both Cottle's septoplasty and ITC-RF. PNIF measurements were performed in all patients in the preoperative period and 6 months postoperatively. All measurements were made both before and after decongestion of the nasal cavity with oxymetazoline spray. RESULTS: Mean preoperative PNIF measurements differed significantly: 104.3 ± 33.6 L/min vs 136.1 ± 27.7 L/min before and after oxymetazoline decongestion, respectively. Mean postoperative PNIF measurements were 139.2 ± 30.8 L/min and 151.2 ± 32.3 L/min before and after decongestion, respectively. Preoperatively the mean difference between before and after decongestion was 32.1 ± 16.3 L/min. Postoperatively the mean difference was 11.8 ± 11.1 L/min. CONCLUSION: PNIF can be used in the assessment of ITC-RF outcomes with the aid of nasal decongestants, even in patients who also underwent septoplasty.
Asunto(s)
Ablación por Catéter , Inhalación/fisiología , Descongestionantes Nasales , Obstrucción Nasal/terapia , Oximetazolina , Rinoplastia , Adolescente , Adulto , Estudios de Cohortes , Femenino , Humanos , Capacidad Inspiratoria/fisiología , Masculino , Persona de Mediana Edad , Obstrucción Nasal/fisiopatología , Tabique Nasal/cirugía , Reología , Resultado del Tratamiento , Cornetes Nasales/cirugía , Adulto JovenRESUMEN
OBJECTIVE: This study aimed to investigate the biomechanical qualities of the perichondrium and cartilage, and to determine the strength of the septal cartilage against bending forces. STUDY DESIGN: This paper describes an experimental cadaver study. MATERIALS AND METHODS: The nasal septal cartilages of 14 fresh cadavers (8 hours postmortem) were excised from the cadavers and cut into two strips: one with the perichondrium (group A) and one without perichondrium (group B). A bending test was then performed on the strips. RESULTS: The deflection of group A strips was larger than the deflection of group B strips. Flexural strength was also larger in group A strips compared to group B strips. The average modulus of elasticity was 122% higher in group A compared to group B. All conducted tests revealed statistically significant differences between groups. CONCLUSION: This study objectively shows that the perichondrium provides the cartilage with a 25% bending strength.
Asunto(s)
Módulo de Elasticidad/fisiología , Cartílagos Nasales/fisiopatología , Tabique Nasal/fisiopatología , Resistencia a la Tracción/fisiología , Cadáver , Femenino , Humanos , Masculino , Docilidad/fisiologíaRESUMEN
OBJECTIVE: To compare the efficacy and safety of radiofrequency (RF) and cold dissection (CD) tonsillectomy. STUDY DESIGN: Prospective, double-blind, controlled clinical study. PATIENTS AND METHODS: One hundred and fourteen patients underwent tonsillectomy. The RF and CD techniques were used for the right and left tonsils, respectively; the patients and examining physicians were blinded to this information to avoid bias. We compared operation times, intraoperative bleeding, and postoperative pain associated with the respective techniques. RESULTS: The RF and CD techniques required similar operation times. Intraoperative bleeding was lower after RF dissection than after CD. The severity of pain did not differ between the two techniques on postoperative day 1, but was significantly lower for the CD technique than the RF technique on postoperative days 5 and 10. CONCLUSION: The RF technique is superior to CD regarding intraoperative bleeding, but not regarding operation time or time to return to a painless dietary regimen.
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Ablación por Catéter/métodos , Criocirugía/métodos , Disección/métodos , Tonsila Palatina/cirugía , Tonsilectomía/métodos , Tonsilitis/cirugía , Adolescente , Adulto , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Niño , Enfermedad Crónica , Método Doble Ciego , Femenino , Humanos , Hipertrofia/cirugía , Masculino , Persona de Mediana Edad , Tempo Operativo , Dolor Postoperatorio , Tonsila Palatina/patología , Adulto JovenRESUMEN
Neck masses can be classified into three main categories: congenital, inflammatory and neoplastic. Our aim was to determine the distribution of diagnosis in patients who were followed-up for a neck mass and had undergone surgery for diagnostic indications. Six hundred and thirty cases referred to the Otorhinolaryngology and Head Neck Surgery Department of Haseki Research and Training Hospital between January 2005 and February 2012 with a neck mass who underwent excisional or incisional biopsy to establish a histopathologic diagnosis were retrospectively evaluated. Patients with a diagnosis of upper aerodigestive tract malignancy were excluded from the study. As well as the patients with thyroid masses were excluded. Only unknown primary neck masses were included in the study. The neck masses were categorized as inflammatory (33.49 %), congenital (18.9 %) or neoplastic (47.6 %). Neoplastic masses were either benign (51 %) or malignant (49 %) tumors. The most common causes were tuberculous lymphadenitis (40.28 %) among inflammatory masses, thyroglossal duct cysts (32.77 %) among congenital masses, pleomorphic adenoma (22.33 %) among benign neoplastic masses, and lymphoma (20 %) among malignant neoplastic masses. The most common types of mass were congenital in the 0-20 year age group, benign neoplastic in 21-40-year-old and malignant neoplastic in the >40-year group. Any neck mass, especially in an elderly patient, should be managed with caution as a considerable proportion may be malignant. In children and adolescents, a neck mass requiring surgery is most likely to be congenital. Tuberculosis should be considered as a cause of a neck mass due to a long-term inflammatory process in a developing country.
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Anomalías Congénitas/epidemiología , Neoplasias de Cabeza y Cuello/epidemiología , Inflamación/epidemiología , Cuello , Absceso/epidemiología , Adenoma Pleomórfico/epidemiología , Adolescente , Adulto , Branquioma/epidemiología , Niño , Preescolar , Diagnóstico Diferencial , Quiste Epidérmico/epidemiología , Femenino , Humanos , Lactante , Linfadenitis/epidemiología , Linfoma/epidemiología , Masculino , Estudios Retrospectivos , Neoplasias de las Glándulas Salivales/epidemiología , Sialadenitis/epidemiología , Quiste Tirogloso/epidemiología , Tuberculosis Ganglionar/epidemiología , Turquía/epidemiología , Adulto JovenRESUMEN
An antrochoanal polyp (ACP) is a benign polypoid lesion originating from the maxillary sinus and extending to the choana. The objective of our study is to assess etiological and associated features of ACPs, and outcome following surgical treatment. Thirty-four patients who had received surgical treatment for ACPs were followed for 35 ± 17.7 months. Factors including patient age, gender, history of allergic rhinitis, chronic sinusitis, nasal septal deviation, turbinate hypertrophy, concha bullosa, accessory ostia, as well as the origin of the polyp, the surgical technique used and any recurrence, were evaluated. Overall, there were 12 females and 22 males. Mean age was 24.94 ± 8.08. Septal deviation was present in 50 %, turbinate hypertrophy in 32.3 %, concha bullosa in 17.6 %, mucous retention cyst in 32.3 %, allergic rhinitis in 44.11 %, and chronic sinusitis in 20.5 %. An accessory ostia was observed in 97.05 %. The functional endoscopic sinus surgery (FESS) approach was used in 31 cases, and three cases had combined FESS and Caldwell Luc procedures. The mean follow-up time was 35.8 ± 17.7 months. Two cases, who had been treated with FESS alone, experienced a recurrence. In conclusion, the commonest predisposing factors for ACPs are chronic inflammatory pathologies such as chronic sinusitis and allergic rhinitis. ACP left the maxillary sinus via an accessory ostium in 97.5 % of the cases. The FESS procedure is a safe and reliable method, and can be combined with the Caldwell Luc procedure when the origin of the maxillary component cannot be properly cleaned. In order to prevent recurrence, total extirpation of the maxillary component is essential.