Effect of Middle Turbinate Intervention on Outcomes of Middle Meatal Endoscopic Surgery
Issue:
Volume 1, Issue 2, December 2015
Pages:
13-19
Received:
28 August 2015
Accepted:
22 September 2015
Published:
24 September 2015
DOI:
10.11648/j.ijo.20150102.11
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Abstract: Back ground and objectives: Middle turbinate position, bulk, and shape play a significant role in the determination of drainage and ventilation at the middle meatus. The middle turbinate constitutes the corner stone for the performance of drainage as well as ventilation functions at the area of ostiomeatal complex and as one of major aims of middle meatal endoscopic surgery is providing the sufficient drainage and ventilation at the level of this complex thus the middle turbinate should be assessed properly before the surgery regarding its position, size, and shape which may predispose for sinusitis via the obliteration of ostiomeatal complex. In addition among the normal middle turbinate which may lateralize post-operatively and subsequently result in the re-obstruction of the drainage and ventilation at the middle meatal area therefore for the purpose of maintenance of sufficient drainage and ventilation after middle meatal endoscopic surgery it is suggested to interfere with the normal middle turbinate. For this reason the serial analytic coherent clinical study was planned prospectively to postulate for which technique is the best among previously mentioned three techniques and compared furtherly with non-interfered middle turbinate cases. Patients and methods: Sixty patients aged 14-63 years of chronic sinusitis, presented with clinical as well as radiological evidences of maxillo-ethmoidal sinusitis with or without frontal and sphenoidal involvement at ENT OPD –Al-tarahom private center Elbyda city- Libya at period in between July 2013 to March 2015 who operated by FESS, and the patients divided into four groups; group-A (n=16 ), group-B (n=18), group-C (n=6), and group-D (n=20), which include those patients who proceeded after middle meatal endoscopic surgery by the different techniques. The four groups were compared in relation to post-operative patency persistence of ipsilateral middle meatus and correlated to the incidence of sinusitis recurrence after the surgery. Results and Conclusion: 49% of the patients who underwent just medialization of ipsilateral middle turbinate without any further fixations developed recurrence of sinusitis due to re-obliteration of middle meatus either by synaechia between middle turbinate and lateral wall or by extreme lateralization of the middle turbinate as compared to the other groups among which all patients got complete improvement without any evidences of recurrence of sinusitis after one year of follow up apart of 12% of patients at group-B who presented with evidences of sinusitis recurrence after 3-6 months postoperatively. Broadly speaking, the intervention with the normal middle turbinate can be considered as one of important steps during the middle meatal endoscopic surgery that may help significantly toward the improvement of outcomes of this commonly performed procedure.
Abstract: Back ground and objectives: Middle turbinate position, bulk, and shape play a significant role in the determination of drainage and ventilation at the middle meatus. The middle turbinate constitutes the corner stone for the performance of drainage as well as ventilation functions at the area of ostiomeatal complex and as one of major aims of middle...
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Resolving of Tonsillectomy Dilemma Among Children Under Age of Three Years
Issue:
Volume 1, Issue 2, December 2015
Pages:
20-26
Received:
28 August 2015
Accepted:
25 September 2015
Published:
29 September 2015
DOI:
10.11648/j.ijo.20150102.12
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Abstract: Backgrund and objectives: Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. One of big issues regarding this procedure is the most suitable age for the surgery. This point is creating a lot of controversies particularly at extreme age groups i.e. less than three years and more than sixty years. Although the extreme old age groups are considered as risky for any surgical procedures specially for tonsillectomy due to lack of proper body tissues tolerance and response to post-tonsillectomy bleeding as well as upper air way edema and obstruction but those age groups are still at lesser incidence of morbidity and mortality as compared to infantile age groups who take the wider spectrum of ENT surgeons’ concentration, discussions, and researches regarding this issue. Therefore this study was conducted prospectively to confirm whether the tonsillectomy can be performed safely before age of three years with non-significant difference regarding post-operative morbidity and mortality as compared to the other age group of three years or more. Patients and methods: 648 children aged from 8 months through 8 years presented at ENT department - Althowra central teaching hospital and Altarahom private center – Elbyda city – Libya at period in between September 2005 to October 2012 with different indications for tonsillectomy. 241 patients were under age of three years who represent group-A while remaining 407 at age from three years and above and constitute group-B. As prospective analytic study, both groups compared in relation to intra-operative time consumption and whether there is any significant difference between two groups regarding the incidence of serious postoperative complications occurrence. In addition both groups compared for any significant difference regarding the period of postoperative hospitalization which can be used as objective indicator to measure the postoperative morbidity rate. Results: This presenting study confirmed that the tonsillectomy procedure is an easy procedure among children younger than three years of age as in older children; this can be indicated by the appearance of non-significant difference between both groups regarding the intra-operative time consumption. On the other hand this procedure approved to be a safe procedure among children with age below three years as in older children; this was illustrated by the presence of non-significant difference between group-A and group-B regarding the serious suspected post-tonsillectomy complications namely post-tonsillectomy hemorrhage, aspiration, air way obstruction, negative pressure pulmonary edema, dehydration, and metabolic as well as nutritional deficiencies. Conclusion: Generally speaking the tonsillectomy is a safe procedure which can be performed successfully among children at different age groups with low incidence of post-tonsillectomy complications as compared to adults.
Abstract: Backgrund and objectives: Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. One of big issues regarding this procedure is the ...
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Modification of Single Puncture Arthrocentesis-A Technical Note
Surej Kumar L. K.,
Varun Menon. P.,
Suvy Manuel
Issue:
Volume 1, Issue 2, December 2015
Pages:
27-28
Received:
7 October 2015
Accepted:
4 November 2015
Published:
21 December 2015
DOI:
10.11648/j.ijo.20150102.13
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Abstract: Arthrocentesis is a simple conservative surgical procedure with minimal invasion performed to flush the inflammed TMJ. This treatment modality has been well in practice since over two decades now. Recently, the concept of single puncture arthrocentesis has been introduced and is gaining wide popularity. We believe that the concept of single puncture has revolutionized the traditional technique of arthrocentesis. Here we demonstrate a modified dual needle device for single puncture arthrocentesis and our modifications of using a smaller gauge needle as well as change in angulation definitely have an added advantage over conventional single puncture technique.
Abstract: Arthrocentesis is a simple conservative surgical procedure with minimal invasion performed to flush the inflammed TMJ. This treatment modality has been well in practice since over two decades now. Recently, the concept of single puncture arthrocentesis has been introduced and is gaining wide popularity. We believe that the concept of single punctur...
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