Technology development allows the design and standardization of manual work in human activities which are yet to be observed, especially those of low-volume discrete production, such as in ear, nose ...and throat (ENT) surgery, particularly endoscopic sinus surgery (ESS). The paper considers the possibilities of developing an approach that would be useful for specific ESS manual work analysis and design and its automation in a future. The consideration includes, beside other aspects, initial steps, such as the traditional work motion capture by camera and experiments by Leap Motion Controller, Perception Neuron 2.0 and Emotiv Epoc+.
The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. ...Mucosal samples from maxillary sinus in 40 ACP patients who underwent endoscopic sinus surgery were analyzed histopathologically and by scanning electron microscopy. Results were compared with maxillary mucosa samples of 40 patients without endoscopic and radiological signs of sinus disease. The existence of biofilm and its relation to the degree of histopathological changes according to Terrier classification of chronic mucosal inflammation of maxillary sinus were statistically analyzed. Biofilm was detected in 23 of 40 (57.5%) ACP patients; the incidence was significantly lower in the control group (2/40, 5%). Biofilm was not found in type 1 mucosa according to Terrier classification. In conclusion, biofilm showed a significant incidence in the maxillary sinus mucosa of ACP patients (57.5%). Occasionally, biofilm can be found in patients with no signs of sinus disease, but not on histologically normal mucosa. Results of this study support the theory that biofilm formation does not represent the initial stage of the inflammatory process.
The first attempts to systematize septal distortions have been given by Cottle who defined four groups of septal deformities: subluxation, large spurs, caudal deflection and tension septum. ...Fortunately, the variations of the septal deformities show a certain order, thus enabling more precise classification. Mladina was the first to make user-friendly classification of septal deformities in six basic types. He also described the seventh type, named "Passali deformity", which presents individually, but is always a well-defined combination between some of the previous six types. Mladina types of septal deformities (SD) are divided in two main groups: so called "vertical" deformities (types 1, 2, 3 and 4), and "horizontal" ones (types 5 and 6). This classification was immediately well accepted by rhinologists worldwide and started to be cited from the very beginning. Since then it has been continuously cited increasingly more often, thus making Mladina classification a gold standard whenever clinical researches on nasal septum are concerned. More than forty clinical studies based on this classification have been performed to date. It is extremely important to make a strict distinction between the types of SD since all of them play some specific role in the nasal and general physiology in man.
Kronični rinosinuitis s polipima čini oko 20% slučajeva kroničnog rinosinuitisa. Dijagnoza nosne polipoze prvenstveno je klinička i temelji se na anamnezi i kliničkom pregledu. Endoskopski pregled ...nosa najvažniji je u dijagnostici, jer se njime utvrđuje status polipa. Kompjuteriziranu tomografiju sinusa inicijalno nije potrebno raditi, osim u slučaju sumnje na komplikacije. Kod bolesnika koji nemaju značajnu nosnu opstrukciju polipima i imaju sačuvan osjet mirisa, preporučuje se u terapiju uvesti ispiranje nosa fiziološkom otopinom i intranazalne kortikosteroide (u obzir dolazi i intranazalna primjena kombinacije kortikosteroida i antihistaminika). Ukoliko je nosna opstrukcija značajna i/ili postoji hiposmija ili anosmija, uz gore navedenu terapiju, u obzir dolazne niske silazne doze oralnih kortikosteroida tijekom dva do tri tjedna do dva puta godišnje. Endoskopska operacija sinusa dolazi u obzir ukoliko bolesnici nisu dobro reagirali na konzervativnu terapiju. Biološka terapija je novija opcija za bolesnike s refraktornom bolešću, naročito ukoliko imaju pridruženu i tešku astmu.
The aim of this cross-sectional study was to determine the signs of biofilm in the maxillary sinus of patients with antrochoanal polyps (ACP), and status of the mucosa on which the biofilm occurred. ...Mucosal samples from maxillary sinus in 40 ACP patients who underwent endoscopic sinus surgery were analyzed histopathologically and by scanning electron microscopy. Results were compared with maxillary mucosa samples of 40 patients without endoscopic and radiological signs of sinus disease. The existence of biofilm and its relation to the degree of histopathological changes according to Terrier classification of chronic mucosal inflammation of maxillary sinus were statistically analyzed. Biofilm was detected in 23 of 40 (57.5%) ACP patients; the incidence was significantly lower in the control group (2/40,5%). Biofilm was not found in type 1 mucosa according to Terrier classification. In conclusion, biofilm showed a significant incidence in the maxillary sinus mucosa of ACP patients (57.5%). Occasionally, biofilm can be found in patients with no signs of sinus disease, but not on histologically normal mucosa. Results of this study support the theory that biofilm formation does not represent the initial stage of the inflammatory process. Key words: Antrochoanal polyp; Biofilm; Maxillary sinus Cilj ovog presjecnog istrazivanja bio je utvrditi postoje li znakovi biofilma u maksilarnom sinusu u bolesnika s antrokoanalnim polipima (ACP) i utvrditi status sluznice na kojoj se biofilm javlja. Uzorci sluznice maksilarnog sinusa 40 bolesnika s ACP-om koji su podvrgnuti endoskopskoj operaciji sinusa analizirani su patohistoloski i skenirajucom elektronskom mikroskopijom. Rezultati su usporedeni s 40 bolesnika bez endoskopskih i radioloskih znakova sinusne bolesti. Analizirana je i statisticki obradena prisutnost biofilma i njegova povezanost sa stupnjem patohistoloskih promjena prema Terrierovoj klasifikaciji kronicne upale sluznice maksilarnog sinusa. Biofilm je pronaden u 23 od 40 bolesnika (57,5%) s ACP-om, a statisticki znacajno rjede u bolesnika kontrolne skupine (2 od 40,5%). Biofilm nije pronaden na sluznici tipa 1 prema Terrierovoj klasifikaciji. Ovo je istrazivanje pokazalo znacajnu incidenciju biofilma na sluznici maksilarnog sinusa u bolesnika s ACP-om (57,5%). Sporadicno se biofilm moze naci i u asimptomatskih bolesnika (bez klinickih, endoskopskih i radioloskih znakova sinusne bolesti), ali ne i na normoplasticnoj sluznici. Rezultati ovog istrazivanja podupiru pretpostavku da stvaranje biofilma ne predstavlja pocetnu fazu upalnog procesa. Kljucne rijeci: Antrokoanaln i polip; Biofilm; Maksilarni sinus
Aims: Inadequate surgical frontal sinus drainage in chronic sinusitis cases refractory to conservative treatment results in a poor clinical response and is associated with recurrent frontal recess ...stenosis. Endonasal frontal sinus drainage procedures are classified according to Draf into three groups: DrafIIb enables unilateral orbit to septum drainage and the IIc is the extension of the IIb across the midline. The purpose of our report is to review chronic sinusitis cases treated at our Department using the standard (IIb) or modified (IIc) procedure and compare results. Methods: Patient- and surgery-related data were retrieved on patients operated between 2013 and 2016 for chronic frontal sinusitis using the standard/modified DrafIIb procedure.The modified IIb (i.e. IIc) procedure was performed so that both frontal sinus ostia were visualized by performing an intersinusseptectomy: the aim was to provide drainage to both frontal sinuses simultaneously. Results: In the observed period, 26 patients were treated: 12 using the modified DrafIIb (IIc) and 14 using the standard DrafIIb procedure. There were no significant differences between groups regarding age, sex, number of previous procedures or follow-up period. All patients had an uneventful postoperative recovery and there were no cases of re-stenosis observed in the DrafIIc group; there were seven cases of restenosis in the DrafIIb group.
Hereditary hemorrhagic telangiectasia (HHT) is a rare, autosomal dominant disorder characterized by recurrent epistaxis, telangiectasias, and multiorgan vascular dysplasia. Various modalities exist ...for the treatment of HHT-related chronic epistaxis, although no method is preferred over another. The aim of this study was to review the effectiveness of diode laser photocoagulation in the treatment of epistaxis in patients with HHT. The study included 17 patients (7 men, 10 women) treated with diode laser photocoagulation from year 2008 to 2012. All patients met the Curaçao criteria for a diagnosis of HHT. Patients were followed for 1 year. Treatment success was assessed using a custom questionnaire and total blood counts. After laser photocoagulation, the frequency and intensity of bleeds were reduced significantly and average hemoglobin concentrations improved at the 4-month assessment. After laser treatment, no patient required septodermoplasty; therefore, we suggest that every patient with HHT should be treated with laser photocoagulation. Diode laser treatment is a simple and effective procedure that should be considered when treating HHT.
PDF
