This study determined whether coronary artery bypass grafting (CABG) surgery has any effect on olfactory function, employing the Brief Smell Identification Test (B-SIT).All the participants were informed preoperatively about the B-SIT test and the mode of its application. The test was performed by each patient preoperatively (d0) as well as 1 (d1) and 3 (d3) days following the surgery. C-reactive protein (CRP) levels were recorded at the same time as the smell test.This prospective study included 45 patients. The mean age was 67 ± 7.55, and the group was 29% male. The mean durations of cross clamping and cardiopulmonary bypass were 54 ± 32 min and 62.5 ± 37.0 min, respectively. Eleven different odors were tested. Significant differences were observed for several odors: leather between d0 and d3, pine between d0 and d3, onion between d0 and d1, onion between d0 and d3, and soap between d0 and d1. The postoperative CRP levels were significantly higher than the preoperative levels. The correlation analysis determined that the postoperative CRP levels were negatively correlated with the B-SIT score (r = -0.48, p = 0.001).Our findings suggest that patients after CABG are prone to develop olfactory dysfunction in the early postoperative period and that olfactory dysfunction is associated with postoperative CRP levels.Celem niniejszej pracy było zbadanie za pomocą testu B-SIT (Brief-Smell Identification Test™), czy operacje pomostowania aortalno-wieńcowego (coronary artery bypass grafting – CABG) mają wpływ na zmysł węchu.Wszystkim uczestnikom przed operacją przedstawiono informacje o teście B-SIT i sposobie jego wykonania. Test wykonywano u każdego z pacjentów przedoperacyjnie (d0) oraz 1 (d1) i 3 (d3) dni po operacji. Stężenie białka C-reaktywnego (C-reactive protein – CRP) badano w tym samym czasie co zmysł węchu.W prospektywnym badaniu wzięło udział 45 pacjentów. Ich średni wiek wyniósł 67 ± 7,55 roku; 29% badanych stanowili mężczyźni. Czas zakleszczenia i czas użycia płucoserca wyniosły odpowiednio 54 ± 32 minuty i 62,5 ± 37 minut. Przetestowano 11 różnych zapachów. W przypadku kilku z nich wystąpiły znaczące różnice pomiędzy badaniami: skóra (między d1 a d3), sosna (między d0 a d3), cebula (między d0 a d1), cebula (między d0 a d3) oraz mydło (między d0 a d1). Pooperacyjne stężenia CRP były znacznie większe niż stężenia przedoperacyjne. Wykonana analiza korelacji pozwoliła na ustalenie, że pooperacyjne stężenia CRP były negatywnie skorelowane z wynikiem testu B-SIT.Wyniki wskazują, że pacjenci po operacjach CABG są narażeni na zaburzenia węchu we wczesnym okresie pooperacyjnym, a ponadto, że zaburzenia węchu są powiązane z pooperacyjnym stężeniem CRP.
Even a small amount of bleeding during endoscopic sinus surgery can corrupt the endoscopic field and complicate the procedure. Various techniques, including induced hypotension, can minimize bleeding during endoscopic sinus surgery. The aim of this study was to compare the surgical vision quality, haemodynamic parameters, postoperative pain, and other effects of magnesium, a hypotensive agent, with that of dexmedetomidine, which was initially developed for short-term sedation in the intensive care unit but also is an alpha 2 agonist sedative. 60 patients between the ages of 18 and 45 years were divided into either the magnesium group (Group M) or the dexmedetomidine group (Group D). In Group M, magnesium sulphate was given at a pre-induction loading dose of 50 mg kg−1 over 10 min and maintained at 15 mg kg−1 h−1; in Group D, dexmedetomidine was given at 1 mcg kg−1 10 min before induction and maintained at 0.6 mcg kg−1 h−1. Intraoperatively, the haemodynamic and respiratory parameters and 6-point intraoperative surgical field evaluation scale were recorded. During the postoperative period, an 11-point numerical pain scale, the Ramsay sedation scale, the nausea/vomiting scale, the adverse effects profile, and itching parameters were noted. Group D showed a significant decrease in intraoperative surgical field evaluation scale scale score and heart rate. The average operation time was 50 min, and Group M had a higher number of prolonged surgeries. No significant difference was found in the other parameters. Due to its reduction of bleeding and heart rate in endoscopic sinus surgery and its positive impacts on the duration of surgery, we consider dexmedetomidine to be a good alternative to magnesium. Uma quantidade, mesmo pequena, de sangramento durante a cirurgia endoscópica pode alterar o campo endoscópico e dificultar o procedimento. Várias técnicas, incluindo hipotensão induzida, podem minimizar o sangramento durante a cirurgia endoscópica. O objetivo deste estudo foi comparar a qualidade da visibilidade cirúrgica, os parâmetros hemodinâmicos, a dor no período pós-operatório e outros efeitos do sulfato de magnésio, um agente hipotensor, com os da dexmedetomidina, inicialmente desenvolvida para sedação em curto prazo em unidade de terapia intensiva, mas que também é um sedativo agonista alfa-2. Foram alocados 60 pacientes entre 18 e 45 anos em dois grupos: Grupo M (magnésio) e Grupo D (dexmedetomidina). No Grupo M, sulfato de magnésio foi administrado pré-indução a uma dose de carga de 50 mg kg−1 por 10 minutos e mantida com 15 mg kg−1 h−1; no Grupo D, dexmedetomidina foi administrada a uma dose de 1 mcg kg−1 10 minutos antes da indução e mantida com 0,6 mcg kg−1 h−1. No período intraoperatório, foram registrados os parâmetros hemodinâmicos e respiratórios e a avaliação do campo cirúrgico com uma escala de seis pontos. Durante o período pós-operatório foram registrados os valores da escala numérica de 11 pontos para avaliar a dor, a escala de sedação de Ramsay, a escala de avaliação de náusea/vômito, o perfil dos efeitos adversos e pruridos. O Grupo D apresentou redução significativa da frequência cardíaca e do escore na escala de avaliação do campo cirúrgico intraoperatório. A média do tempo cirúrgico foi de 50 minutos e o Grupo M apresentou um número maior de cirurgias prolongadas. Não houve diferença significativa em outros parâmetros. Por causa da redução da taxa de sangramento e da frequência cardíaca em cirurgia endoscópica e dos impactos positivos sobre a duração da cirurgia, consideramos dexmedetomidina como melhor opção que o sulfato de magnésio.
The retromolar trigone is a challenging transoral surgical site due to the difficulty of visualization. Our aim is to report a new technique of transoral robotic resection of retromolar trigone tumours. We present three patients with retromolar trigone tumours with pathological diagnosis of squamous cell carcinoma who underwent successful transoral robotic resection. Robotic retromolar trigone resection and concurrent supraomohyoid neck dissections were performed in all patients without any complication. In conclusion, transoral robotic surgery is a safe and feasible technique for resection of malignant retromolar trigone tumours with minimal complications and favourable outcomes. Le difficoltà riscontrate nella corretta esposizione del campo operatorio rendono impegnativo l'approccio transorale al trigono retromolare. Con il presente lavoro é nostra intenzione descrivere un approccio innovativo alla resezione dei tumori interessanti il trigono retromolare, mediante chirurgia robotica transorale. Presenteremo tre casi nei quali pazienti con diagnosi di tumore del trigono retromolare ad istologia squamocellulare, sono stati sottoposti con successo ad una resezione della lesione con metodica robotica transorale. In tutti i pazienti sono stati effettuati simultaneamente, e senza registrare alcuna complicanza, sia la resezione del trigono retromolare mediante chirurgia robotica, che lo svuotamento latero cervicale sovraomoioideo. In conclusione la chirurgia robotica transorale, applicata alla resezione dei tumori maligni del trigono retromolare, é una tecnica sicura, che offre un outcome favorevole con complicanze minime.
Objective The aim of this study was to evaluate the developmental relationship between the volumes of paranasal sinuses and adenoid tissue by using a 3‐dimensional (3D) reconstruction technique. Study Design Cross‐sectional study. Setting Tertiary referral center. Subjects and Methods Multislice computed tomography (MSCT) images were obtained using 3D reconstructions and a volume‐rendering technique (VRT) in 69 boys and 35 girls aged 3 to 16 years, and bilateral maxillary, frontal, and sphenoid sinus volumes, as well as adenoid tissue volume marked in axial‐coronal‐sagittal planes, were calculated. The patients were grouped in 3 categories according to adenoid tissue volumes, and comparisons were made. Results There was no significant difference between the right maxillary volume and left maxillary volume ( P =. 93). No significant difference was noted between the groups in terms of age and gender. There was no significant correlation between frontal, sphenoid, right and left maxillary, or total maxillary sinus volumes in all 3 groups of patients. Conclusion When classified according to adenoid tissue size, it was observed that increasing adenoid tissue volumes did not significantly affect the development of paranasal sinuses. Developmentally, there are no statistically significant correlations between the volumes of paranasal sinuses and adenoid tissues.
The anatomy of the nasal passages, pharynx, and larynx and evaluation of mucous membranes and laryngeal function is well observed by transnasal fiberoptic laryngoscopy (TFL). In this procedure, to provide good local infiltrative analgesia, medication such as anesthetics is important for the otolaryngologist. The aim of this study was to evaluate the efficacy of lidocaine (L) spray, compared with levobupivacaine solution, used for local anesthetic in patients undergoing TFL for complete examination.Sixty-two subjects (39 men and 23 women; mean age, 36 ± 7 years) were enrolled in the study. Patients were randomly classified into two groups as levobupivacaine hydroclorur (LB) and L groups. A standard flexible transnasal fiberoptic 4.2-mm-diameter laryngoscope was passed through the nasal cavity and into the aerodigestive tract. Patients were asked to evaluate the intensity of the pain they experienced during the TFL, using a visual analog scale (VAS) and Ramsay sedation scale.Demographic data were similar in both groups. There was no difference in VAS and Ramsay scores between both groups (p > 0.05).Our findings indicated that topical levobupivacaine seems to be an effective medication for anesthesia of the nasal mucosa and may be used to allow complete examinations involving TFL.
Summary Objectives/Aim The primary objective of this study is to evaluate the effects of topically applied ketamine or tramadol on early postoperative pain scores in children undergoing tonsillectomy. The secondary aim of the study is to assess nausea, vomiting, difficulty in swallowing, and sore throat characteristics of the patients. Background Tonsillectomy surgery is frequently associated with postoperative pain, which usually requires substantial consumption of analgesics including opioids. Safe and effective post‐tonsillectomy pain control is still a clinical dilemma, in spite of the use of various surgical and anesthetic techniques. Methods A total of 60 children, aged between 4 and 10 years, scheduled for tonsillectomy, were randomly assigned to one of three groups. Study drugs were administered to both tonsillar fossae for 5 min. In 5 ml artificial saliva, Group K ( n = 20) received 0.4 ml (20 mg) ketamine and Group T ( n = 20) received 0.8 ml tramadol HCl solution. Group C ( n = 20) received only 5 ml saline as a control. Ramsay Sedation Scale and FACES PRS Score, nausea, vomiting, difficulty in swallowing, and sore throat were evaluated. Results There was no difference among the groups in terms of baseline characteristics, including age, sex, and ASA profile ( P > 0.05 for all). Systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, respiratory rate, and saturation of peripheral oxygen (SpO 2 ) values were not significantly different among the groups in all time points ( P > 0.05 for all). There was a statistically significant difference among the groups according to Ramsay Sedation Scales in 40th minute ( P < 0.001). There were statistically significant differences among the groups in terms of Wong‐Baker FACES Pain Rating Scale Score in all time points ( P < 0.004 for all). There was a statistically significant difference among the groups in terms of rescue analgesia necessity in 5th and 10th minute ( P < 0.001 and P = 0.003). There was a statistically significant difference among the groups in terms of sore throat in 5th and 10th minute ( P < 0.001 for both). Neither rescue analgesia necessity nor sore throat characteristics was different between the Group T and Group K in all time points. Conclusion Topical tramadol and ketamine seem to be safe, effective, and easy analgesic approach for decreasing tonsillectomy pain.
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