Sinonasal tract malignancies: prognostic factors and surgery outcomes

WOS: 000333960400009PubMed: 24693395Background: Cancers of the sinonasal region are rare and its survival rate remains poor because most of the patients are asymptomatic and diagnosed in advanced stages with surrounding important structures. Objectives: This study attempted to analyze the clinical and histological features in addition to survival and prognostic factors of surgical treatment of sinonasal cancers. Patients and Methods: A retrospective cohort study, involving 36 patients with sinonasal cancer who were treated with surgery in our hospital between 2000 and 2010, was performed. Patients were selected based on the convenience sampling. Patients treated with radiotherapy and/or chemotherapy were excluded from the analysis. Clinical symptoms and histologic findings of patients as well as malignant tumor staging and its prognosis were collected from archives. Results: We found that overall 3 and 5-year survival rates of subjects were 52.8%, and 41.6%, respectively. There was a negative correlation between the clinical stage and survival. There was a significant difference between infrastructural and suprastructural localization in 5-year survival rate (P = 0.018). in the present study, there was a strong relationship between the local control and overall survival (P 0.05). Conclusions: the present study has demonstrated that clinical stage, suprastructural tumor, and the presence of tumor-positive resection margins are the most significant prognostic factors affecting local tumor control and survival. As a result of this study, these tumors should be treated in early stages by surgical margin of resection followed by adjuvant radiotherapy

Effect of Nasopharyngeal Irrigation on Early Eustachian Tube Functions in Patients Undergoing Adenoidectomy: A Clinical Prospective Study

Objective:The hypertrophic adenoid tissue can cause to eustachian tube dysfunction by mechanical or inflammatory effect both of which block the nasopharyngeal ostium of the eustachian tube. Adenoidectomy, with or without tonsillectomy, is the most common surgical procedure in children. In this study, we aimed to investigate whether nasopharyngeal irrigation for hemorrhage control in adenoidectomy patients has an effect on eustachian tube functions.Method:Patients who underwent adenoidectomy for adenoid hypertrophy evaluated on both the preoperatively and on the postoperative first day by otomicroscopic examination and with tympanometry for eustachian tube functions. Patients were divided into two groups according to nasopharyngeal irrigation type after surgery. Group 1 was the transnasal pressure irrigation group; group 2 was transoral passive irrigation group. Tympanometry was used to measure pressure, volumetric, and compliance values to compare pre- and postoperative values.Results:40 patients were included in the study. There was no significant difference between the age and sex distributions of the patients. Volume and compliance values between the groups were similar before and after the surgery. The mean pressure values of the tympanometry parameters were highly significantly different for the right ear and moderately different for the left ear in group 1; were significantly different for the right ear and highly significantly different for the left ear in group 2. Postoperative tympanometry types were seen as bilateral type C in 7 patients, as right side type C in 4 patients, as bilateral type B in 2 patients, as left side type C in 4 patients in group 1. However, in group 2, right side type B, left side type B and bilateral type C tympanogram were observed in 1 patient, 2 patients and 12 patients, respectively.Conclusion:In this study, we observed that the nasopharyngeal irrigation to control bleeding after adenoidectomy had adverse effect on the eustachian tube functions but larger series of studies are needed to confirm this

Effects of oral sotretinoin on normal and wounded nasal mucosa: An experimental study

WOS: 000450099400016PubMed: 30382397BackgroundWe aimed to investigate the effect of systemic isotretinoin therapy on normal and wounded nasal septal mucosa histopathologically in an experimental rabbit model.MethodsCircular mucosal defect with a 7mm diameter was made in the left septum of 12 New Zealand white rabbits. The rabbits were divided into two groups (six rabbits in each group) oral isotretinoin was given with olive oil at the operation day to the first group. The control group was only oil given group. The harvested septum mucosas were divided into four groups (1wounded-drug given side, 2unwounded and drug-given side, 3wounded-control and 4unwounded-control side). The diameter of the defect, mucosal thickness, epithelial thickness, ciliated cell level, goblet cell level and inflammation were evaluated every week for 4weeks.ResultsAt both wounded and normal side, thinning of normal respiratory ciliated epithelium was observed in the postoperative period. In study group at the wounded side; mean mucosal thickness was measured 139.66 mu (26.24), and in the control group, mean mucosal thickness was 238.33 mu (+/- 39.7) at the wounded side. (p<0.001). The difference between the groups in thickness of normal septal mucosa was also statistically significant (p=0.016) [190 mu (+/- 14.6) and 256.66 mu (+/- 44.66)]. The average cilia level was observed 1.16 in the wounded study group, while the average level was 2.33 in the wounded control group (p=0.012). Average score measurements of the regenerated mucosa suggested that isotretinoin-given wounded animals have reduced goblet cell recovery, compared to the control both on the regenerated and unwounded mucosas (p=0.007, p=0.002, respectively). Inflammation was significantly higher in the wounded isotretinoin group (p=0.018).Conclusion Oral isotretinoin has negative effects on epithelial and ciliary regeneration, significantly reduces mucosal thickness and goblet cell counts of the normal and regenerated mucosa, causes severe inflammation and significant reactive changes

Repeated atmospheric pressure alteration effect on the cochlea in rats: Experimental animal study

OBJECTIVE: This study aimed to evaluate the effects of repeated pressure alterations on cochlear structures in rats in an attempt to understand indirectly the inner ear status of flight crew who are repeatedly exposed to pressure alterations. METHODS: There were 12 adult Wistar albino rats equally divided into 2 groups: Group 1 (controls) and Group 2 (study group). The animals in Group 2 were exposed to repeated pressure changes in a pressure cabin which is regulated by manometers. The animals in Group 1 were placed in the cabin without being exposed to pressure changes. Auditory brainstem response (ABR) testing was performed in all animals at the beginning and at the end of the study. After 12 wk the animals were sacrificed and their cochleas were investigated using scanning electron microscopy (SEM). RESULTS: In the study group, hearing decreases at 2 kHz, 4 kHz, 6 dB at 8 kHz, and 32 kHz were encountered at the end of 3 mo. On SEM evaluation of the control group, the outer hair cells (OHC) and stereocilia were normal throughout the cochlea. In the study group, there were irregularities in lateral surface connections and separations, collapse, and adhesions in the basal segment of the cochlea and partial loss of stereocilia throughout the cochlea. CONCLUSION: Repeated alterations in the atmospheric pressure can lead to damage in the inner ear with subtle or evident hearing loss. Frequent flyers like air workers may be at risk of inner ear damage, which may be considered an occupational health problem