Rhinology
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Review Meta Analysis Comparative Study
Total intravenous anaesthesia versus inhaled anaesthesia for endoscopic sinus surgery: a meta-analysis of randomized controlled trials.
Total intravenous anaesthesia (TIVA) with propofol, compared to inhaled anaesthesia (IA), has been proposed to reduce bleeding and improve surgical field quality during endoscopic sinus surgery (ESS), but prior meta-analyses have not been conclusive. We performed an updated meta-analysis to determine the benefit of TIVA versus IA during ESS. ⋯ TIVA with propofol, in comparison to IA, may improve surgical field quality, reduce blood loss, and decrease operative time for ESS. Remifentanil is the preferred short-acting opioid for TIVA in ESS.
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Review
Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review.
The status of current evidence for the effectiveness of septoplasty is unclear. This systematic review evaluates the effectiveness of a) septoplasty (with or without concurrent turbinate surgery) versus non-surgical management, and b) septoplasty with concurrent turbinate surgery versus septoplasty alone, for nasal obstruction due to a deviated nasal septum in adults. ⋯ Despite the routine application of septoplasty in clinical practice, the current body of evidence does not support firm conclusions on its effectiveness.
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Review
Septoplasty for nasal obstruction due to a deviated nasal septum in adults: a systematic review.
The status of current evidence for the effectiveness of septoplasty is unclear. This systematic review evaluates the effectiveness of a) septoplasty (with or without concurrent turbinate surgery) versus non-surgical management, and b) septoplasty with concurrent turbinate surgery versus septoplasty alone, for nasal obstruction due to a deviated nasal septum in adults. ⋯ Despite the routine application of septoplasty in clinical practice, the current body of evidence does not support firm conclusions on its effectiveness.
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Review Case Reports
A Pott's puffy tumour as a late complication of a frontal sinus reconstruction: case report and literature review.
A Pott's Puffy Tumour (PPT) is a rare clinical entity, which, traditionally has been described as an acute abscess with periosteitis secondary to osteomyelitis of the external table of the frontal bone of the skull, complicating an acute frontal sinusitis. The aim of this article is to present a case of progressively evolving PPT, which emerged during the course of a common rhinitis, in a patient who, thirty years previously, had undergone a reconstruction of the frontal sinus involving osteosynthesis. ⋯ Frontal sinus obliteration was undertaken using methyl methacrylate, preferable in this case to hydroxyapatite, due to the direct communication with the neighbouring sinus cavities and the presence of defective bone in the superior orbit. A review of literature available on Medline up to January 2008 reveals that this is the third published case of PPT complicating a frontal reconstruction.
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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.