1.Determining the severity of symptoms among patients with eosinophilic chronic rhinosinusitis with nasal polyposis versus non-eosinophilic chronic rhinosinusitis with nasal polyposis at the Veterans Memorial Medical Center
Geoffrey John S. Hizon ; Jay P. Espanto ; Kathleen M. Rodriguez-Labrador
Philippine Journal of Otolaryngology Head and Neck Surgery 2024;39(2):17-20
Objective:
To compare the severity of symptoms of patients diagnosed with Eosinophilic Chronic Rhinosinusitis with Nasal Polyposis (eCRSwNP) versus Non - Eosinophilic Chronic Rhinosinusitis with Nasal Polyposis (non-eCRSwNP) using the Filipino Sinonasal Outcome Test (Filipino SNOT 22) and determine the most common symptoms experienced by patients with eCRSwNP versus non-eCRSwNP.
:
Methods
Design:
Cross-Sectional Study
Setting:
Tertiary Government Training Hospital
Participants:
A total of 68 patients diagnosed with Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) from November 7, 2018 to August 31, 2022 were included in the study.
Results:
Of the 68 patients included in the study, 33 (48.5%) had non-eCRSwNP while 35 (51.5%) had eCRSwNP. The age of the patients with non-eCRSwNP group was 50.6 + 18.45 and those with eCRSwNP was 52.9 + 16.6 years old. Non-eCRSwNP patients had a lower mean Filipino SNOT 22 score of 39.7 ± 16.1 compared with eCRSwNP with a score of 62.7± 13.5. The non-eCRSwNP patients had symptom severity classified as mild in 2 (6.1%), moderate in 25 (75.8%) and severe in 6 (18.2%) based on Filipino SNOT-22. Among the eCRSwNP group, majority of the patients, 29 (82.9%) were classified as severe, 6 (17.1%) as moderate, and none with mild severity. Using the Filipino SNOT 22, the most common symptoms of patients with eCRSwNP were item 2 (baradong ilong; nasal blockage) at 28.6%, then item 7 (malapot na sipon; thick nasal discharge) at 25.7%, Item 8 (pagbabara ng tenga; ear fullness) and item 12 (pagkawala/ pagkabawas ng panlasa/ pang amoy; decreased sense of smell/taste) were tied at 14.3%, item 13 (hirap sa pagtulog; difficulty falling asleep) at 25.7%, and item 17 (pagkapagod; fatigue during the day) at 31.4% while patients with no-eCRSwNP were noted with item 2 (baradong ilong; nasal blockage) at 48.5%, followed by item 4 (hindi tumitigil na pagtulo ng sipon; runny nose) at 21.2%, item 11 (pananakit ng mukha; facial pain) at 33.3%, Item 7 (malapot na sipon; thick nasal discharge) at 18.2%, and item 20 (pagiging irritable/pagkainis; irritability) at 21.2%.
Conclusion
Our present study suggests that the higher the SNOT 22 score, the more likely it is to be eosinophilic chronic rhinosinusitis. Although nasal blockage was the most common symptom found in both patients with eCRSwNP and non-eCRSwNP, patients with thick nasal discharge, decreased sense of smell/taste and ear fullness were more likely to be suffering from eCRSwNP, while patients with runny nose, facial pain and thick nasal discharge were more likely to have non-eCRSwNP.
Sinusitis
;
Endoscopic Surgical Procedure
;
Endoscopy
;
SNOT-22
;
Sino-Nasal Outcome Test
;
Nasal Blockage
;
Nasal Obstruction
4.Comparison of septoplasty with three high
Journal of Central South University(Medical Sciences) 2021;46(1):69-74
OBJECTIVES:
To compare the operation time, subjective and objective outcomes of septoplasty with three high-tension line resection and two high-tension line resection.
METHODS:
A prospective randomized controlled study was conducted to identify patients with septal deviation and symptomatic nasal obstruction. The patients were classified into a three high-tension line resection and senior physician group (Group A), a two high-tension line resection and senior physician group (Group B), a three high-tension line resection and junior physician group (Group C), a two high-tension line resection and junior physician group (Group D). In addition, according to whether there were the anterior deviation, some of patients were also divided into a three high-tension line resection and anterior deviation group (Group E) and a two high-tension line resection and anterior deviation group (Group F). The operation time was recorded. The patients completed the Nasal Obstruction Symptom Evaluation (NOSE) Scale (subjective symptom), nasal endoscopy (bodily sign) and rhinomanometry (objective examination) before and 6 months after septoplasty. The operation time and the efficacy were compared between three high-tension line resection operation and two high-tension line resection operation.
RESULTS:
There was no significant difference in the operation time between the Group A and the Group B (
CONCLUSIONS
The effect of septoplasty with two high-tension line resection is as good as septoplasty with three high-tension line resection. The septoplasty with two high-tension line resection is more suitable to junior physician because it is easier and the operation time is shorter.
Humans
;
Nasal Obstruction/surgery*
;
Nasal Septum/surgery*
;
Prospective Studies
;
Rhinoplasty
;
Treatment Outcome
5.Assessment of nasal airflow and pain, safety and cost of an improvised nasal airway (nasogastric) tube after endoscopic sinus surgery
Josephine Grace C. Rojo ; Rachel Zita H. Ramos
Philippine Journal of Otolaryngology Head and Neck Surgery 2020;35(2):22-26
Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP).
Methods:
Design: Quasi - Experimental Prospective Cohort Study
Setting: Tertiary Government Training Hospital
Participants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone.
Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A.
Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.
stents
;
nasal obstruction
;
nasal polyps
;
sinusitis
6.The Effect of Long-Term Follow up on Outcome of Pediatric Endoscopic Sinus Surgery
Sanghyub KIM ; Young Jun CHUNG ; Ji Hun MO
Journal of Rhinology 2019;26(1):32-37
BACKGROUND AND OBJECTIVES: Chronic pediatric sinusitis continues to be a challenging problem to otolaryngologists and has been reported to show worse prognosis than that of adults. However, most studies were performed with short-term follow-up. In this study, we aimed to assess the clinical outcome of pediatric endoscopic sinus surgery (ESS) with a longer follow-up and to determine the effect of age on postoperative outcome. SUBJECTS AND METHOD: A retrospective analysis was performed on pediatric patients than 15 years with ESS younger from 2005 to 2014 in a tertiary referral hospital. All patients completed a questionnaire regarding symptoms before to from 1 to 9 years after surgery. Telephone survey was performed to evaluate symptoms including nasal obstruction, nasal discharge, PND, and headache at 1 to 9 years after surgery. RESULTS: Seventy-one pediatric patients with bilateral chronic sinusitis were treated with ESS. They showed gradual symptom improvement from 5 year after surgery for the following: nasal obstruction (p=0.032), PND (p=0.005), and headache (p=0.048). However, there was improvement in rhinorrhea after 9 years (p=0.042). In addition, when analyzed in terms of age, the outcome was poor in children younger than 13 years (p=0.003) compared with the older age group. Multivariate analysis showed that preoperative nasal obstruction was dependent on AR, and postoperative symptoms were dependent on presence of AR and involuntary smoking. Nasal discharge was dependent on presence of AR and involuntary smoking preoperatively and postoperatively. These suggest the importance of AR and involuntary smoking as risk factors for prognosis. CONCLUSION: Chronic pediatric sinusitis showed gradual improvement after ESS and should be more carefully monitored on a long-term basis. We should keep in mind that long-term follow-up is needed for pediatric ESS cases.
Adult
;
Child
;
Follow-Up Studies
;
Headache
;
Humans
;
Methods
;
Multivariate Analysis
;
Nasal Obstruction
;
Prognosis
;
Retrospective Studies
;
Risk Factors
;
Sinusitis
;
Telephone
;
Tertiary Care Centers
;
Tobacco Smoke Pollution
7.Usefulness of Unilateral Nasal Packing for Recurred Septal Deviation within a Month after Septoplasty: Preliminary Study
Yoon Hee LEE ; Jin Soon CHANG ; Joo Hyun JUNG ; Seon Tae KIM ; Il Gyu KANG
Journal of Rhinology 2019;26(1):16-20
BACKGROUND AND OBJECTIVES: To investigate the effect of unilateral nasal packing on the correction of recurred septal deviation after septoplasty. MATERIALS AND METHOD: We analyzed 12 patients who had undergone septoplasty and developed septal deviation recurrence. Polyvinylacetate and Vaseline gauze were inserted into the nasal passage on the convex side of the septum for 4 days in order to shift the septum to the midline. We analyzed nasal symptoms, acoustic rhinometric results, and endoscopic findings before and after unilateral packing in order to evaluate the treatment outcomes. RESULTS: Ten (83%) out of 12 patients showed improvements in nasal obstruction, acoustic rhinometric results, and endoscopic findings. The mean visual analogue scale (VAS) score for nasal obstruction was 5.25±1.60 before and 2.08±1.50 after packing (p=0.004). The minimal cross-sectional area (MCA) improved from 0.17±0.14 to 0.27±0.13 (p=0.002), and the mean endoscopic score improved from 2.0±0.43 to 1.08±0.29 (p=0.002). CONCLUSION: Unilateral nasal packing was a safe, easy, and effective method for correcting recurred septal deviation after septoplasty.
Acoustics
;
Humans
;
Methods
;
Nasal Obstruction
;
Petrolatum
;
Recurrence
;
Rhinometry, Acoustic
8.Effects of Orogastric Tubes on the Videofluoroscopic Swallowing Study Findings in Infants
Myo Jing KIM ; Sung Min KANG ; Kyeong Woo LEE ; Sook Joung LEE ; Young Hwan KIM
Journal of the Korean Dysphagia Society 2019;9(2):77-83
OBJECTIVE: An orogastric tube is used frequently in infants because infants are obligate nose breathers and nasogastric tubes can cause partial nasal obstruction. This study examined whether the presence of an orogastric tube could affect the swallowing parameters assessed by a videofluoroscopic swallowing study in infants with dysphagia caused by a variety of reasons. METHODS: Tests were conducted in 15 infants aged less than 150 days after birth who used an orogastric tube due to dysphagia. Two tests were conducted. The first was conducted with an orogastric tube inserted. Subsequently, the orogastric tube was removed with a 5-minute break before the second test. Skilled physiatrists then analyzed the recorded video. The number of sucks required for one swallow, abnormalities of the pharyngeal phase, and penetration-aspiration scales were evaluated. RESULTS: After removing the orogastric tube, the number of sucks required for one swallow reduced significantly (2.50±1.73 vs. 3.45±2.54, P=0.04). On the other hand, no statistical significance was observed in the results of the pharyngeal phase and penetration-aspiration scale (5.60±3.16 vs. 5.9±3.81, P=0.41) with and without the orogastric tube. CONCLUSION: These findings showed that the insertion or non-insertion of an orogastric tube might not affect the swallowing abnormalities in the pharyngeal phase and the risk of aspiration. In addition, an orogastric tube may have a negative effect on the swallowing function in the oral phase.
Deglutition Disorders
;
Deglutition
;
Hand
;
Humans
;
Infant
;
Nasal Obstruction
;
Nose
;
Parturition
;
Weights and Measures
9.Two Cases of Recurrent Nasal Polyps in Siblings-Woakes' Syndrome
Chang Bae LEE ; Nam Yoon JUNG ; Young Jin LOH ; Woo Yong BAE
Korean Journal of Otolaryngology - Head and Neck Surgery 2019;62(4):250-254
Woakes' syndrome is a group of disease which include recurrent nasal polyps resulting in the broadening of the nasal pyramid, the onset of hypoplasia of frontal sinus and bronchiectasis, as well as the production of mucous discharge. Children and young adults are mostly susceptible to Woakes' syndrome due to the plasticity of the bone. Even though the exact etiology is unknown, genetic factor is thought to be influential because it is often diagnosed in siblings. Otolaryngologically, the mainstream method of removing nasal polyp by endoscopic sinus surgery as well as topical or systemic treatment can be helpful. We report two siblings who visited our clinic both complaining of nasal obstruction. The patients presented with recurrent nasal polyps and showed signs of bronchiectasis, which led to the diagnosis of Woakes' syndrome. These rare cases are presented here with a review of related literature.
Bronchiectasis
;
Child
;
Diagnosis
;
Fibrinogen
;
Frontal Sinus
;
Humans
;
Methods
;
Nasal Obstruction
;
Nasal Polyps
;
Plastics
;
Siblings
;
Young Adult
10.A Case of Septal Abscess and Sphenoid Sinusitis after Dental Implant
Jun LEE ; Su Jin KIM ; Myoung Su CHOI
Korean Journal of Otolaryngology - Head and Neck Surgery 2019;62(4):242-245
A nasal septal abscess results from the collection of purulent fluid between the cartilage of bony septum and overlying mucoperichondrium or mucoperiosteum. Unless early diagnosis and surgical treatment are performed, serious complications such as cavernous sinus thrombophlebitis, sepsis, and saddle nose may occur. We report a case of septal abscess and sphenoid sinusitis that occurred after dental implant. A 74-year-old female with diabetes and liver cirrhosis was referred to the hospital for management of rapidly aggravated perinasal pain, nasal obstruction, and headache. The patient had undergone dental implant in the right upper incisor area 6 days ago. A CT revealed septal abscess and bilateral sphenoid sinusitis. The patient was operated upon to drain septal abscess, and both sphenoid sinuses were opened widely.
Abscess
;
Aged
;
Cartilage
;
Cavernous Sinus Thrombosis
;
Dental Implants
;
Early Diagnosis
;
Female
;
Headache
;
Humans
;
Immunocompromised Host
;
Incisor
;
Liver Cirrhosis
;
Nasal Obstruction
;
Nasal Septum
;
Nose
;
Sepsis
;
Sphenoid Sinus
;
Sphenoid Sinusitis


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