Paranasal Sinuses Anatomic Variants and its Association with Chronic Rhinosinusitis in Mongolia

Objective: The aim of this study was to obtain the prevalence of nasosinus anatomic variations in a Mongolian population and to understand their importance and impact on the disease process, as well as their influence on surgical management and outcome. Methods: This study is a prospective review of retrospectively performed normal computed tomography (CT) scans of the nose and paranasal sinuses in the adult Mongolian population. Results: Of all CT scans that were reviewed, 53.7 % were of women patients and 46.3 % were of men patients. The mean age of the study sample was 45.6 ± 16.3 years. The most common anatomic variation after excluding Agger nasi cell was pneumatized crista galli, which was seen in 98.8 % of the scans. Anatomic variants with a potential impact on operative safety included Haller cell (13.3 %), concha bullosa (20.5 %), and paradoxical middle turbinate (27.3 %). In our study, we compared the measurements between the anterior ethmoid artery and adjacent anatomical structures in two groups. Conclusions: A wide range of regional differences in the prevalence of each anatomic variation exists. Understanding the preoperative CT scan is substantially important because it is the road map for the sinus surgeon. Detection of anatomic variations is vital for surgical planning and prevention of complications

The Anatomical and Physiological Basis of the Mongolian Khuumii

Objectives: In order to examine each variety of khuumii used by Mongolians, this study compares the anatomical structures involved in the development of khuumii as well as the characteristics and patterns of their functioning.Methods: 50 people between the ages of 18 and 60 were chosen for the cross-sectional study, using a non-random sampling procedure. Statistical analysis was performed using SPSS23 software using questionnaires, X-ray, endoscopy, and acoustic analysis. Results: During the formation of khuumii sound, thoracic cavity, diaphragm, and lungs regulate the intensity of the air reaching the vocal folds, exert pressure on the airways and vibrate the sound waves through air flows passing through the larynx and vocal folds. The mouth-nose cavity as well as the pharynx are responsible for resonating the sound. Khuumii increases the workload of the cardiovascular system by 70-80%. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. 95.3% of throat singers do not have a sore throat, 88.4% do not experience heavy breathing, and 74.1% have no hoarseness. Conclusion: The Mongolian throat singing khuumii, including mixed voices and multivoice, iss related to the presence of dual vibration sound sources. Its high overtone form of singing (isgeree khuumii) is related to stenosis at the resonance chambers initiation site (ventricular folds level)

Outcomes of Endoscopic Sinus Surgery of Adult Chronic Rhinosinusitis in First Central Hospital of Mongolia

Objective: Evaluate the outcome of endoscopic sinus surgery among chronic rhinosinusitis (CRS) patients and assess the quality of life. Methods: 200 CRS patients aged between 17 to 73 who were operated endoscopic sinus surgery at the Otorhinolaryngology department of First Central Hospital between November 2019 and November 2020, were involved in this study. Subjects were divided into 2 groups: 1) CRS with nasal polyp; 2) CRS without nasal polyp. CT changes were evaluated according to Lund-Mackay, Hoover score, and Hounsfield unit before and after surgery. Results: Of the total subjects analyzed, 56 % were male and 44 % were female. The average age of subjects was 38.4 ± 13.9. The tissue radiodensity of the maxillary sinus decreased in both groups significantly. The mean value of 21.3 ± 6.9 HU preoperatively dropped to 13.5 ± 3.9 HU postoperative in the CRSsNP group, while the CRSwNP group had similar results. The preoperative mean value of 20.3 ± 3.9 HU declined to 12.0 ± 2.2 HU after the procedure. For assessment of paranasal sinus mucosal thickness, the mean value of preoperative imaging study in the CRSsNP group measured as 5.5 ± 1.7mm, and then it reduced by 3.8mm to reach 1.7 ± 1.4 mm after the surgery (p < 0.000). Consequently, the CRSwNP group shows similar outcomes such as the preoperative mean value assessed with a thickness of 5.8 ± 1.4 mm, declined by 4.4 mm and reached an almost normal mucosal thickness of 1.5 ± 1.0 mm after the procedure (p < 0.000). Conclusion: ESS for CRS is effective according to the evaluation of the Lund-Mackay, Hoover, and Hounsfield unit, and it was statistically significant (p < 0.000)

Knowledge of the Adverse Effects of Smoking and Related Changes in Smoking Status during Pregnancy among Female Smokers

No abstract in Englis

A study on structure and functions of organs involved in the formation of Mongolian Khuumii sound

Khuumii (throat or overtone singing) is a unique form of art derived from the nomadic population of Central Asia, which is a type of singing in which the singer manipulates the resonances (or formants) created as air travels from the lungs, past the vocal folds, and out of the lips to produce a melody. A total of 60 participants, aged 18-60 years (54 men and 6 women), were selected by non-random sampling method using cross-sectional study. X-ray, endoscopy, and sound research method were used in the study, and the composition of blood gas was analysed. X-ray examination determined the state during each different types of Khuumii; Shakhaa and Kharkhiraa. As the basic timbre of Shakhaa Khuumii went up progressively the larynx grew and the compression strength increased, while the basic timbre went down, and the larynx became lower. In the case of Kharkhiraa Khuumii, the larynx position was elevated to a relatively small extent compared to Shakhaa Khuumii and the distance between the sublingual bone and the larynx was large. The sublingual bone trunk lowered during Shakhaa Khuumii, while it was slightly elevated during Kharkhiraa Khuumii. The laryngeal endoscopy evaluated the movement of true and false vocal chords, glottal volume, movements of epiglottis and arytenoid cartilage, and mucosa. Furthermore, the sound frequency is 2-4 times higher than that of normal speech, and sound volume is 0.5-1 times higher. The blood gas composition test showed partial pressure (pO2), and saturation of oxygen (SaO2) decreased after performing Khuumii. In the case of Shakhaa and Kharkhiraa Khuumi, it is appropriate to divide Khuumii into two main types according to structural and functional changes in the organs involved

Colonoscopic Polypectomy Preferences of Asian Endoscopists: Results of a Survey-Based Study

Background/Aims: The clinical practice pattern of polypectomy is not well-investigated in Asian countries. We aimed to survey Asian endoscopists about their preferred polypectomy techniques for given conditions and images of polyps. Methods: A survey was performed using questionnaires composed of two parts: a scenario-based questionnaire using scenarios of polyps, which were adopted from the European Society of Gastrointestinal Endoscopy guidelines, and an image-based questionnaire using provided endoscopic images of polyps. Results: A total of 154 endoscopists participated in this survey. The most preferred resection techniques for diminutive (≤5 mm), small (6-9 mm), and benign-looking intermediate (10-19 mm) nonpedunculated polyps were cold forceps polypectomy, hot snare polypectomy, and endoscopic mucosal resection (EMR), respectively, in both the scenario- and image-based questionnaires. For benign-looking large (≥20 mm) nonpedunculated polyps, EMR and endoscopic submucosal dissection (ESD) were preferred in the scenario- and image-based surveys, respectively. In case of malignant nonpedunculated polyps, EMR and ESD were preferred for intermediate-sized and large lesions, respectively, according to the scenario-based survey. However, ESD was preferred in both intermediate-sized and large malignant nonpedunculated polyps according to the image-based survey. Trainee endoscopists, endoscopists working in referral centers, and endoscopists in the colorectal cancer-prevalent countries were independently associated with preference of cold snare polypectomy for removing small polyps. Conclusions: The polypectomy practice patterns of Asian endoscopists vary, and cold snare polypectomy was not the most preferred resection method for polyps <10 mm in size, in contrast to recent guidelines