Morganella morganii in sinonasal region: A rare case report

Morganella morganii is a gram negative pathogen andmay cause potentially lethal disease especially in patientswith underlying or immunosuppressive disease. It is commonlyfound in long-term urinary catheter used and immunesystem deficiency patients as nosocomial disease.Involving other systems such as skin, skeletal systemand central nervous system can be seen too. Sporadicoccurrence is rare and can be seen in any system by variouscauses like AIDS, snake bites and poisoning. In thiscase we present sporadic Morganella morganii infectionon sinonasal region with the presence of sinusitis, sinocutaneousfistula, preseptal cellulitis and hard palate defecton 58 year old male diabetic patient. Microbiologicalassessment from open wound and sinuses were reportedas Morganella morganii. To our knowledge, this is the firstcase of sino-nasal Morganella morganii infection with sino-cutaneous fistula, preseptal cellulitis and maxillofacialbone destruction. J Clin Exp Invest 2013; 4 (3): 383-386Key words: Morganella Morganii, sino-nasal fistula, preseptalcellulitis, bone destructio

Septoplasty: Under general or sedation anesthesia. Which is more efficacious?

WOS: 000339973800014PubMed ID: 24384631The objective of the study was to assess the more efficacious anesthesia method in septal surgery. The prospective study was conducted at an academic secondary referral center. A prospective chart review of 60 patients, between the ages of 16 and 65, who underwent septal surgery under general (GA) or sedation (SDA) anesthesia during 1-year period was done. Mean age of the patients was 44.30 +/- A 13.29. Patients were divided into two groups according to the anesthesia method: general (group 1) or sedation (group 2). Intraoperative hemodynamic variables, surgery time, intraoperative blood loss volume, length of hospital stay, postoperative vomiting and nausea, postoperative pain score according to the visual analog scale (VAS) and cost analysis of each method were compared. Thirty-six males and 24 females with a mean age 44.30 +/- A 13.29 were included to the study. Total operation time, operation time, intraoperative and postoperative bleeding volume, postoperative nausea and vomiting, duration of hospital stay after surgery, were better in group 2. Postoperative pain scores and patient satisfaction about surgery were not statistically different. Cost of anesthesia in group 1 per patient was $44.35 +/- A 10.81 and in group 2,$16.29 +/- A 11.88 (p < 0.01). Hospital stay after surgery was much longer in group 1 than group 2 (p < 0.01). Using SDA is better in many ways including cost-effectiveness than using GA for septoplasty operation

Uncinatotomy: Performing endoscopic sinus surgery without an uncinectomy

WOS: 000347954400047PubMed ID: 25569389Background: The results of endoscopic sinus surgery performed for chronic rhinosinusitis are controversial. For a better surgical outcome, different surgical techniques involving an uncinectomy as the primary step of the operation have been proposed. The surgery should resolve the pathophysiologic problems caused by the disease and preserve the normal anatomy and physiology. We developed a technique to remove the pathology localized to isolated maxillary and anterior ethmoid cells, without excising the uncinate process. The infundibular area was exposed with medialization of the uncinate with a bipedicle flap prepared 1.5 cm from the insertion of the uncinate to the nasal wall, and then the sinus pathology was removed. At the end of the surgery, the uncinate was returned to its original position. Methods: We performed this new technique to 3 patients and evaluated postoperative results. Results: Primary disease was eradicated, and no complication was noted. Conclusions: With this technique, it is possible to perform all steps of sinus surgery without excising any anatomic structure

Comparison of nasal mucociliary clearance in adenoid hypertrophy with or without otitis media with effusion

WOS: 000338608100034PubMed ID: 24837868Objective: To investigate pre- and postoperative mucociliary clearance in patients with adenoid hypertrophy or combined with otitis media with effusion. Methods: Patients were divided into two groups: Group 1-patients with adenoid hypertrophy (AH), and Group 2 patients with AH and otitis media with effusion (AHOME). In all patients, AH size was recorded, and the Andersen saccharin and methylene blue tests were conducted before and 1 month after surgery to obtain mucociliary clearance time (MCT). Nasal cavity length was measured intraoperatively to establish mucociliary clearance velocity (MCV). Patients with allergic rhinitis, active infection, and history of nasal or ear surgery were excluded. Results: This study included 64 patients with a mean age of 8.34 +/- 2.98 years (range: 3-18 years). Pre- and postoperative MCT were 14.60 +/- 4.83 and 9.48 +/- 2.63 min in Group 1 and 16.03 +/- 4.31 and 12.12 +/- 3.78 mm-in Group 2, respectively. Pre- and postoperative MCV were 0.77 +/- 0.30 and 1.16 +/- 0.42 mm/min in Group 1 and 0.67 +/- 0.16 and 0.89 +/- 0.28 mm/min in Group 2, respectively. MCT and MCV were significantly improved postoperatively in both groups (p < 0.001). In addition, the postoperative MCT and MCV of Group 1 were significantly better than those of Group 2(p < 0.001). Exposure to cigarette smoking and adenoid size had negative correlations with mucociliary clearance. Conclusions: Otitis media was associated with impaired mucociliary clearance and further studies should be performed to demonstrate the causes of this deficiency