International forum of allergy & rhinology
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Int Forum Allergy Rhinol · Mar 2016
Randomized Controlled TrialEndoscopic sphenopalatine ganglion blockade efficacy in pain control after endoscopic sinus surgery.
The objective of this study was to evaluate the efficacy of bilateral endoscopic injection of lidocaine with epinephrine in the sphenopalatine ganglion at the end of endoscopic sinus surgery (ESS) in controlling postoperative pain and rescue analgesic requirements. ⋯ Sphenopalatine ganglion injection of lidocaine at the end of surgery is safe, simple, noninvasive, and an effective method of short-term pain control after sinus surgery.
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Int Forum Allergy Rhinol · Nov 2014
Randomized Controlled Trial Comparative StudyHemostatic effect of hot saline irrigation during functional endoscopic sinus surgery: a randomized controlled trial.
The endoscopically magnified operative field in functional endoscopic sinus surgery (FESS) makes even a small amount of bleeding a potentially significant hindrance. It is thought that irrigation with hot saline during surgery may improve surgical field of view by producing a hemostatic effect. Our objective was to assess the effectiveness of hot saline irrigation (HSI) compared to room temperature saline irrigation (RTSI) in the control of intraoperative bleeding during FESS. ⋯ HSI may be beneficial in improving surgical field of view in FESS after 2 hours of operating time. A significant reduction in rate of blood loss may be attained with HSI.
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Int Forum Allergy Rhinol · Dec 2018
Case ReportsTechnique for reconstruction of large clival defects through an endoscopic-assisted tunneled retropharyngeal approach.
Reconstruction of the clivus and posterior cranial base defects following endoscopic skull-base surgery can be particularly challenging. Commonly, defects in this region are repaired with pedicled mucoperichondrial flaps from the sinonasal cavity. Complex and large defects often require regional or free flaps, particularly when intranasal flaps have been exhausted. While there are no primary barriers to routing flaps into the clivus or nasopharynx in large open approaches, secondary surgical corridors are necessary during endoscopic cases for routing of free flaps. Routing of free-flap pedicles for endoscopic cranial base reconstruction has been described through secondary surgical corridors created through the maxillary sinus and infratemporal fossa. Here we describe the technique of a more direct pedicle route to the clivus through the retropharyngeal space. ⋯ The retropharyngeal space offers a direct route for tunneling free flaps for the repair of large clival defects during endoscopic skull-base surgery. Several advantages include a less circuitous pedicle route, mucosalization of the fascial flap, avoidance of midfacial degloving, and avoidance of potential disruption of the maxillary sinus.
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Int Forum Allergy Rhinol · Jan 2019
Resveratrol and ivacaftor are additive G551D CFTR-channel potentiators: therapeutic implications for cystic fibrosis sinus disease.
Mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene result in defective Cl- transport and cause chronic bacterial infections in the upper and lower airways of cystic fibrosis (CF) patients. Ivacaftor is a CFTR potentiator that improves Cl- transport in CF patients with at least 1 copy of the G551D mutation. Resveratrol is also a potent CFTR potentiator that increases determinants of mucociliary transport. The objective of this study is to determine whether resveratrol and ivacaftor improve Cl- secretion in G551D CFTR over either agent alone. ⋯ Additive improvement in G551D CFTR-mediated Cl- secretion suggests that resveratrol could enhance ivacaftor therapy in these patients and improve CF-related rhinosinusitis.