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The benefit and clinical value of CT scan as preoperative assessment for structural functional septorhinoplasty

100%
Mohammed A. A., Alwan A. M., Dawood M. R.
Polski Przegląd Otorynolaryngologiczny
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2024
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vol. 13
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issue 2
8-15
EN
Introduction: Structural functional septorhinolplasty is an operation designed to achieve both aesthetic and functional goals, which were the most important success parameters for patient satisfaction. Different preoperative examination tools are available for assessment. Aim: To evaluate the diagnostic benefit and clinical value of a CT scan, and compare it with other examination tools, such as nasal endoscopy and anterior rhinoscopy for structural functional septorhinoplasty. Material and Methods: A prospective randomized controlled study of 148 consecutive patients seeking for a solution to their primary problem of nasal obstruction, and also for a cosmetic effect within the same operation (structural functional septorhinoplaty). They were divided into 3 groups; CT scan group, endoscopic group, and control group (anterior rhinoscopy). The subjective postoperative assessment was carried out with the Nasal Obstruction Symptom Evaluation scale (NOSE), Rhinoplasty Outcome Evaluation scale (ROE), Visual Analogue Scale (VAS), and SNOT-22 score. Those outcomes at 12-month follow-up were compared to preoperative values. Results: Among 148 patients, there were 77 males (52.02%) and 71 females (47.97%), age range between 19 to 52 years (mean age 23.4 ±2.7 SD). In all 3 groups, there was a significant clinical improvement in nasal symptoms and structural functional septorhinoplasty outcomes, as well as better ROE, NOSE, VAS, and SNOT-22 scores in the CT scan group when compared to the other two groups, with the P-values being 0.01, 0.01, 0.03, and 0.04, respectively. Conclusions: CT scan is of greater benefit than nasal endoscopy and anterior rhinoscopy and constitutes the method of choice as a part of preoperative assessment in detecting any nasal pathology and assessing nasal anatomical structures prior to structural functional septorhinoplasty.
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CORRELATION OF COMPUTED TOMOGRAPHY AND INTRAOPERATIVE FINDINGS WITH CLINICAL SYMPTOMS IN HEAD TRAUMA PATIENTS

88%
Saiediborojeni H., Hemmatpour B., Akrami M., Mahdavikian S., Saiediborojeni S., Mahvar T.
Acta Neuropsychologica
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2021
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vol. 19(4)
491-500
EN
Hematoma in different parts of the brain is one of the most important complications of head injury and is associated with high mortality and morbidity rate. The aim of this study was evaluation of the relationship between Computed Tomography (CT) and intraoperative findings with clinical symptoms in head trauma patients. In this study 95 patients with cerebral hemorrhage due to head trauma, referred to Taleghani Hospital in Kermanshah were studied. After an initial clinical examination, the level of consciousness determined according to the Glasgow Coma Scale (GCS) was recorded. All patients underwent brain CT scan and findings were recorded, including size and location of the hematoma. Patients in all treatment such as surgical procedures under the supervision, and the information on their status was recorded until discharge or death. It was found that most patients (38%) were between 40-20 years: 73% of patients were male, while 27% were female. The outcome of 35 patients (35.4%) were normal, 12 patients (12.3%) had moderate disability, 9 patients (9.2%) had severe disability, 11 patients (10.8%) vegetative state and 31 patients (32.3%) died. There was a significant association between location of the hematoma and hematoma in CT scan and outcome of patients with cerebral hemorrhage caused by trauma (P<0.05). We also found a significant association between size of the hematoma and midline shift in CT scan with outcome of patients with cerebral hemorrhage caused by trauma (P<0.05). The prognosis of patients with traumatic brain injury depends on location of the hematoma; volume of hematoma, midline shift in CT scan and length of trauma to surgery more than 4 hours.
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