Rhinology
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This paper describes a new method to assess nasal pH in nasal exhaled breath condensate in adults. The study included 19 healthy, non-smoking, adult volunteers without current upper respiratory disease, COPD or asthma. Expiratory breath condensate (EBC) was collected from the nose and mouth respectively. ⋯ The nasal EBC-pH was well in agreement with data from previous studies, which measured pH directly on the nasal mucosa with an electrode. In conclusion, this paper describes a method to measure pH in nasal exhaled breath condensate (EBC) in healthy adults during tidal breathing. The nasal EBC-pH related well to previous data from intranasal pH measurements suggesting that nasal EBC-pH could have a role in monitoring pH alterations in the nasal mucosa such as nasal inflammation.
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Juvenile angiofibroma (JNA) is a rare benign but locally aggressive tumour of the nasopharynx that primarily occurs in adolescent males. We report a series of 6 consecutive cases operated by exclusive endoscopic approach between from March 1996 and June 2003. All were male. ⋯ Based upon the recent international literature, endonasal surgery combined with a preoperative embolization of the arterial supply is indicated for small and middle size JNAs but also for large tumours extended to the pterygopalatine fossa and medial aspect of the infratemporal fossa. Minimal intracranial extension is not an absolute contraindication if there is no clinical or radiological involvement of the cavernous sinus. A tridimentional guiding system can be of some help in large tumours.
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Randomized Controlled Trial Multicenter Study Comparative Study
Nasal fracture reduction: local versus general anaesthesia.
To investigate the outcomes from nasal fracture reduction performed under local anaesthesia (LA) and general anaesthesia (GA). ⋯ This trial clearly shows LA to be as effective as GA in the first line management of nasal fractures. The degree of septal displacement and presence of nasal tip deviation were associated with persistent nasal deformity following nasal fracture reduction.
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Randomized Controlled Trial Comparative Study
Effect of a balanced anaesthetic technique using desflurane and remifentanil on surgical conditions during microscopic and endoscopic sinus surgery.
Controlled hypotension is used to improve surgical conditions during microscopic and endoscopic sinus surgery. Several drug combinations are suitable to provide deep and predictable level of anaesthesia combined with an exact control of intraoperative blood pressure. However, only little is known about the relative importance of the level of hypnosis on the one hand and analgesia on the other hand. ⋯ Balanced anaesthesia using high dose of desflurane offers small but statistically significant advantages with respect to dryness of the operating site compared to an opioid-accentuated anaesthesia technique. However, since the opioid-accentuated anaesthetic group had a faster immediate recovery both techniques are equally effective for microscopic and endoscopic sinus surgery.
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Most studies on nasal dilators have used Breathe Right or Nozovent. Both devices dilate the nasal valves, reduce nasal resistance, and improve nasal airflow. The use of dilators improves airflow most on inspiration, as the valve is stabilised and prevented from collapse. ⋯ During exercise, nasal dilators delay the onset of oronasal breathing, and can have only small effects on performance thereafter. Nozovent and Breathe Right can reduce snoring, and improve otherwise obstructed breathing during sleep in selected patients. It is a challenge to find those patients, and one way could be to perform polysomnography with and without nasal dilator.