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Comparative study on the use of hypertonic saline vs. isotonic saline nasal irrigation following endoscopic sinus surgery

100%
Dawood M. R., Mohammed Z. S.
Polski Przegląd Otorynolaryngologiczny
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2022
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vol. 11
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issue 1
14-20
EN
Introduction: Various nasal saline solutions have been widely used following endoscopic sinus surgery. Irrigation solutions minimize synechia formation, improve mucosal healing and enhance the removal of infective debris and crusts. Aim: This study aims to compare the efficacy of hypertonic and isotonic saline solutions in nasal irrigation following, endoscopic sinus surgery. Material and methods: Forty patients who underwent endoscopic sinus surgery were randomly and evenly sorted into: group “A”, which received hypertonic saline nasal irrigation, and group “B”, which received isotonic nasal irrigation The outcomes were assessed for mucociliary clearance (MCT), Lund-Kennedy endoscopic score for crusts and mucosal edema, while nasal obstruction, nasal discharge and facial pain were analyzed by SNOT22, whereby their severity was assessed by means of visual analog score. The patients were followed up for 3 weeks. Results: There was a significant difference in improvement in both groups. Group “A” MCT value on day 7 was P = 0.023, day 14 P = 0.002, and day 21 P = 0.009: for mucosal edema P = 0.009, P = 0.001, P = 0.025; and, for crusts P = 0.015, P = 0.010, P = 0.011: and, for nasal obstruction P = 0.006, P = 0.0001, P = 0.0001 respectively; and for nasal discharge and facial pain P = 0.010, P = 0.047, and P = 0.0062, P = 0.028 for days 14, and 21, respectively. Conclusion: Better results in MCT, nasal mucosal edema, crusts, nasal obstruction, discharge, and facial pain/pressure were achieved with the usage of hypertonic saline nasal irrigation.
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Wyniki badania endoskopowego a obraz TK nosa i zatok przynosowych w przewlekłym zapaleniu błony śluzowej nosa i zatok – badanie porównawcze

81%
Dawood M. R., Hamad A. K., Hussien M. A.
Polski Przegląd Otorynolaryngologiczny
|
2023
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vol. 12
|
issue 3
13-18
PL
Wstęp: Przewlekłe zapalenie błony śluzowej nosa i zatok przynosowych (ang. chronic sinusitis; CRS) jest chorobą często spotykaną w praktyce laryngologicznej, jednak wciąż nieposiadającą uzgodnionej metodologii diagnostycznej. W charakterze metod diagnostycznych z powodzeniem stosuje się badania endoskopowe nosa i tomografię komputerową zatok. Cel: Ocena korelacji między endoskopią nosa a obrazowaniem TK zatok w diagnostyce CRS. Materiał i metody: Niniejsze badanie było prospektywnym, randomizowanym badaniem z udziałem 80 pacjentów zgłaszających się do ambulatoryjnej przychodni laryngologicznej w okresie od marca 2018 r. do kwietnia 2019 r. i spełniających określone w wytycznych kryteria diagnostyczne CRS. Użytymi metodami diagnostycznymi były endoskopia nosa z oceną w systemie punktacji Lund-Kennedy’ego z następczą tomografią komputerową zatok z oceną w systemie punktacji Lund-Mackaya przed upływem 1 tygodnia. Obie metody porównano pod względem wyników, ze szczególnym uwzględnieniem wyników patologicznych, a także pod względem swoistości, czułości, dodatniej i ujemnej wartości predykcyjnej oraz pod względem danych dotyczących wariantów anatomicznych. Wszystkie wyżej wymienione parametry zostały poddane analizie statystycznej. Wyniki: U pacjentów obserwowano niedrożność nosa (92,5%), zatoki szczękowej (82,5%), zmętnienie i obrzęk błony śluzowej (83,75%) w badaniu TK oraz śluzowo-ropną wydzielinę z przewodu środkowego (73,75%) w endoskopii nosa. Związek między wynikami diagnostycznego badania endoskopowego a tomografią komputerową charakteryzował się wartością P = 0,001 w teście t-Studenta oraz współczynnikiem korelacji Pearsona r = 0,734. Dokładność diagnostyczna endoskopii nosa wyniosła 95% przy czułości 91,6% (95% CI: 87,38–93,67%), swoistości 88,3% (95% CI: 85,91–89,59%), dodatniej wartości predykcyjnej 81,7% i ujemnej wartości predykcyjnej 79,87%. Wnioski: Stwierdzono silną i statystycznie istotną korelację między wynikami badania endoskopowego nosa a obrazami TK zatok, a także między objawami niedrożności nosa a wynikami badania endoskopowego nosa przy braku istotnych różnic w danych dotyczących wariantów anatomicznych.
3
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Endoscopic finding versus CT nose and paranasal sinuses appearance in chronic rhinosinusitis: A comparative study

81%
Dawood M. R., Hamad A. K., Hussien M. A.
Polski Przegląd Otorynolaryngologiczny
|
2023
|
vol. 12
|
issue 3
13-18
EN
Introduction: Chronic rhinosinusitis (CRS) is a common disease encountered in otorhinolaryngology field, however, there is no consensus about its definitive diagnostic method. Nasal endoscopy and sinus CT scan are successfully used as diagnostic modalities. Aim: To evaluate the correlation between nasal endoscopy as compared to sinus CT in CRS diagnosis. Material and methods: A prospective randomized study, in which, 80 patients attended outpatient ENT clinic, from March 2018 to April 2019, whom met the diagnostic criteria of CRS guidelines, were recruited, and the diagnostic modalities were; nasal endoscopy using Lund-Kennedy scoring system, followed with sinus CT scan using Lund-Mackay scoring system within 1 week. Both modalities were compared, with focus on pathological findings, as well as, the specificity, sensitivity, positive predictive value and negative predictive values, in addition, to the anatomic variations data. All the above-mentioned respective parameters were statistically analyzed. Results: Nasal obstruction (92.5%), maxillary sinus (82.5%) with mucosal thicken opacity (83.75%) by CT scan, and muco-purulent middle meatus discharge (73.75%) by nasal endoscopy. The association between diagnostic endoscopy and CT scan had P value = 0.001 by Student-t-test, and r = 0.734 by Pearson`s correlation coefficient. Diagnostic accuracy of nasal endoscopy was 95%, sensitivity was 91.6 % (95% CI 87.38–93.67%), specificity was 88.3% (95% CI 85.91–89.59%), while positive predictive value 81.7% and negative predictive value was 79.87%. Conclusion: Strong and statistical correlation between the nasal endoscopic and sinus CT findings, also between nasal obstruction symptom and nasal endoscopy, while, no significant difference on anatomical variants data.
4
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The benefit and clinical value of CT scan as preoperative assessment for structural functional septorhinoplasty

81%
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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