American journal of rhinology
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Randomized Controlled Trial Comparative Study
Comparison of laryngeal mask with endotracheal tube for anesthesia in endoscopic sinus surgery.
The purpose of this study was to compare surgical conditions, including the amount of intraoperative bleeding as well as intraoperative blood pressure, during functional endoscopic sinus surgery (FESS) using flexible reinforced laryngeal mask airway (FRLMA) versus endotracheal tube (ETT) in maintaining controlled hypotension anesthesia induced by propofol-remifentanil total i.v. anesthesia (TIVA). ⋯ In summary, our results indicate that airway management using FRLMA during controlled hypotension anesthesia provided better surgical conditions in terms of quality of operative field and blood loss and allowed for convenient induced hypotension with low doses of remifentanil during TIVA in patients undergoing FESS.
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Comparative Study
Sonography versus plain x rays in diagnosis of nasal fractures.
The standard imaging procedure for suspected nasal fractures has been radiography (XR). However, its usefulness for clinical decision making is highly controversial. High-resolution ultrasonography now offers a promising new diagnostic imaging option. In this study we compared the diagnostic value of high-resolution ultrasonography and conventional XR in the evaluation of suspected nasal fractures. ⋯ When available, US should be the first-line imaging procedure in the evaluation of nasal fractures.
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Comparative Study
Does nasal irrigation enter paranasal sinuses in chronic rhinosinusitis?
Nasal irrigation is widely used in treating sinonasal diseases. Not only does it remove static secretions and promote mucociliary clearance, but, in chronic rhinosinusitis, nasal flush is also a potential route for topical drug administration into paranasal sinuses. A clinical study was conducted to investigate how well nasal irrigation could reach paranasal sinuses with the ostiomeatal units blocked in chronic rhinosinusitis. This study was performed to (1) assess the ability of a nasal douche and spray to deliver a solution into the paranasal sinuses in chronic rhinosinusitis and (2) compare the performance of the two techniques. ⋯ Nasal douche and spray is not effective in delivering a nasal irrigation solution into paranasal sinuses in chronic rhinosinusitis.
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Comparative Study
Clinical utility of intraoperative volume computed tomography scanner for endoscopic sinonasal and skull base procedures.
Intraoperative surgical navigation has become widely accepted as an important tool for improvement of surgical outcomes and reduction of complication in endoscopic sinus surgery (ESS). The purpose of this study was to assess the clinical utility of intraoperative volume computed tomography (CT) scanning in endoscopic sinonasal and skull base procedures. ⋯ Intraoperative volume CT scanning was successfully performed in 25 patients undergoing ESS. Because additional surgical intervention was performed in 24% of cases, this technology may have an important role in endoscopic sinonasal and skull base procedures.
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Comparative Study
Functional endoscopic dilatation of the sinuses: patient satisfaction, postoperative pain, and cost.
The purpose of this study was to determine how functional endoscopic dilatation of the sinuses (FEDS) compares with functional endoscopic sinus surgery (FESS) in a select group of patients with respect to (1) elimination of symptoms, (2) patient satisfaction, (3) postoperative narcotic use, and (4) cost. A retrospective study was performed of 70 patients with chronic rhinosinusitis who underwent FEDS or FESS as primary or revision treatment. ⋯ Both FEDS and FESS resulted in significant improvement in SNOT-20 scores for selected patients with mild disease. Patient satisfaction and postoperative narcotic use of FEDS compare favorably with FESS. Cost of FEDS was comparable with FESS for primary procedures but was less than FESS for revision procedures. Long-term efficacy and final cost of FEDS remain to be addressed, taking into account the need for revision procedures after initial FEDS, by means of long-term studies and objective outcome measures.