American journal of rhinology & allergy
-
Am J Rhinol Allergy · Mar 2016
ReviewSystematic review of the effectiveness of perioperative prophylactic antibiotics for skull base surgeries.
Perioperative antibiotics are commonly used in endoscopic skull base surgeries as prophylaxis for infectious complications, e.g., meningitis. The role of perioperative prophylactic antibiotics in endoscopic sinus surgery is unclear, and the routine use of prophylactic antibiotics in endoscopic skull base surgery is also highly debated. Currently, there is no formal recommendation for perioperative antibiotic use in skull base surgery, and regimens vary greatly from one institution to the next. ⋯ Despite institutional variability in antibiotic regimens, meningitis rarely occurs after skull base procedures and seems to be encountered most frequently in open craniofacial surgeries. A systematic review revealed a limited number of published studies, all observational in study design, which precluded a formal meta-analysis. A novel large-scale randomized-controlled clinical trial is needed to evaluate antibiotic selection and need in endoscopic skull base surgery.
-
Am J Rhinol Allergy · Mar 2016
Differences in the Sino-Nasal Outcome Test 22 and visual analog scale symptom scores in chronic rhinosinusitis with and without nasal polyps.
Chronic rhinosinusitis (CRS) with and without polyps has a high impact on health-related quality of life (HRQL), but the difference in HRQL and symptom presentation between two clinical phenotypes of CRS has not been specifically evaluated before now. ⋯ With controlling of covariates that may influence the severity of the disease, this study showed significant differences in symptom patterns and different aspects of HRQL impairment between patients with CRSwNP and patients with CRSsNP, however, with no difference in the total HRQL score.
-
Am J Rhinol Allergy · May 2015
Historical ArticleManaging cerebrospinal fluid rhinorrhea after lateral skull base surgery via endoscopic endonasal eustachian tube closure.
A cerebrospinal fluid (CSF) leak, commonly presenting as rhinorrhea, is a well-recognized complication of lateral skull base surgery. Failure of conservative treatment measures in these cases necessitates surgical intervention. ⋯ Endoscopic endonasal eustachian tube closure is a safe, minimally invasive and effective method for obliteration of the eustachian tube orifice. The algorithm for management of recalcitrant postoperative CSF rhinorrhea after lateral skull base surgery should include endoscopic endonasal closure of the eustachian tube.
-
Am J Rhinol Allergy · May 2015
Comparative StudyEndoscopic binostril versus transnasal transseptal microscopic pituitary surgery: Sinonasal quality of life and olfactory function.
There have been few comparative studies on olfactory function and sinonasal-specific quality of life (QOL) after endoscopic or microscopic surgery using a transsphenoidal approach (TSA). ⋯ Transnasal transseptal microscopic pituitary surgery confers a better early postoperative sinonasal QOL with a comparable olfactory outcome compared with the endoscopic approach. Although many believe that an endoscopic approach is less invasive, preservation of the sinonasal mucosa proves to be more important in terms of sinonasal QOL than use of an endoscope or microscope.
-
Am J Rhinol Allergy · Mar 2015
Clustering of chronic rhinosinusitis symptomatology reveals novel associations with objective clinical and demographic characteristics.
Chronic rhinosinusitis (CRS) is associated with varied head and neck symptomatology and quality-of-life impairments that are not necessarily correlated with each other or with objective measures of disease. ⋯ Variability in SNOT-22 scores from CRS patients may be explained by the independent presence of sleep, nasal, otologic, and emotional function symptoms, with which we find novel clinical and demographic associations. These findings may represent clinical evidence for distinct pathophysiologic processes that differentially cause specific CRS symptomatology.