American journal of rhinology & allergy
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Am J Rhinol Allergy · Jul 2009
Randomized Controlled Trial Comparative StudyEffect of intraoperative injection of 0.25% bupivacaine with 1:200,000 epinephrine on intraoperative blood loss in FESS.
This study was designed to compare differences in intraoperative blood loss, mean arterial blood pressure (MABP), and duration of surgery when 0.25% bupivacaine with 1:200000 epinephrine is injected, preoperatively, versus normal saline (NS), during functional endoscopic sinus surgery (FESS). ⋯ There was no significant reduction in intraoperative blood loss during FESS when local anesthetic containing epinephrine was used compared with infiltration with NS. More importantly, Part II shows a significantly higher MABP associated with infiltration of epinephrine. Parts I and II did not show a significant difference in preoperative MABP or duration of surgery.
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Sternberg's (lateral craniopharyngeal) canal was originally described in anatomic studies as a membranous space in the lateral wall of the sphenoid sinus. The canal has been etiologically associated with lateral sphenoid sinus "spontaneous" cerebrospinal fluid (CSF) leaks. A patent Sternberg's canal has been reported in up to 4% of adults, and persistent vestiges have been reported in up to 30%. However, no modern studies analyzing high-resolution CT scans have been published. ⋯ Sternberg's canal as historically defined is not nearly as prevalent as previously reported. Furthermore, the presence of arachnoid pits in all sphenoid CSF leaks and the predominant leak location lateral to the sites of fusion of ossification centers suggests that the leaks are acquired. Contributing factors may include arachnoid pits/weaknesses in the skull base and intracranial hypertension.
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Am J Rhinol Allergy · Jan 2009
Multicenter Study Comparative StudyEndoscopic endonasal resection of esthesioneuroblastoma: a multicenter study.
This study reports the combined experience of the University of Miami and University of Pittsburgh with endoscopic endonasal resection of esthesioneuroblastoma (ENB). A retrospective case series review was performed in a tertiary care university hospital. ⋯ In experienced hands and carefully selected patients, endoscopic resection of ENB respects the principles of oncologic surgery, providing an adequate exposure for margin assessment as well as reliable reconstruction of the anterior skull defect with a relatively low morbidity.
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Am J Rhinol Allergy · Jan 2009
Comparative StudyDeleterious effect of smoking and nasal septal deviation on mucociliary clearance and improvement after septoplasty.
To investigate the effect of septal deviation, septoplasty, and smoking upon nasal mucociliary clearance by using saccharine test. ⋯ Nasal septal deviation and smoking deteriorates nasal MCC time and this result can be shown easily with the saccharine test. Properly performed septoplasty surgery decreases nasal MCC time during the late postoperative period but MCC times are still longer than normal. The saccharine test can be used for following up the effect of septoplasty upon nasal mucosa.