Otolaryngology - Head and Neck Surgery

Nasal polyposis has a great impact on the quality of life. The aim of this study was to evaluate the association between quality of life and atopy, sinus opacification, and nasal patency in severe nasal polyposis.

One hundred nine patients completed the Medical Outcome Study Short Form‐36 (SF‐36) survey. Symptoms, polyp size, atopy, nasal patency, and sinus opacification were also scored.

Patients showed worse scores in all SF‐36 domains, except for physical functioning, compared with Spanish population. Atopic patients had worse scores in role physical, body pain, vitality, and mental health than nonatopic patients. Atopic patients showed lower physical component summary (44.7 ± 1.1) and mental component summary (38.4 ± 1.0) than nonatopic patients (48.3 ± 1.6, 40.6 ± 1.3; P < 0.05), respectively. There were no correlations between quality of life and symptoms, polyp size, CT scan, nasal patency, and atopy.

Nasal polyposis has a considerable impact on quality of life and atopy worsens this impact.

C‐4

To document the anatomic relationship of the posterosuperior segment of the tympanic membrane.

Point‐prevalence study of postmortem material.

One hundred seventy temporal bones from adults without history of otologic pathology were studied. The anatomic details of the tympanic membrane were observed, histology was documented on 30 sectioned bones, and, with the use of the scanning electron microscope, lamina propria was studied in 40 bones.

We established that the posterosuperior quadrant was the largest, representing 28.7 percent of the total area of the eardrum. This feature implies that this quadrant is more likely than are the other quadrants to exhibit changes prompted by pressure challenges. We also verified that the posterosuperior part of tympanic sulcus, above the chorda tympanic nerve, lost its depth in an unexpected way in 60 percent of the cases. In association, we established that at this level there was a decrease in annulus caliber. In 25 percent of cases, by the absence of the circular fibers of lamina propria, the posterosuperior quadrant had only the radial fiber layer.

Anatomic and morphologic details in posterosuperior quadrant were newly described and may explain the greater incidence of retraction pockets and marginal perforations that provide origin for the cholesteatoma.

To test whether intranasal ciprofloxacin/dexamethasone or dexamethasone alone affects the course of acute bacterial rhinosinusitis in mice.

We performed a randomized, double‐blind, parallel, placebo‐controlled study in mice.

Three groups of 10 C57B1/6 mice were infected with Streptococcus pneumoniae, and then 1 day later randomized to treatment with placebo, ciprofloxacin plus dexamethasone, or dexamethasone. The mice were killed 3 or 10 days after treatment was begun.

The placebo‐treated mice became infected and developed an inflammatory cell infiltration in their sinuses. None of the treatments significantly affected the course of the illness.

The lack of topical, intranasal efficacy of ciprofloxacin and dexamethasone could be attributed to subpotent dosage, rapid nasal clearance, or inability of the drops to reach the site of infection. Treatment with dexamethasone neither improved nor worsened the bacterial infection.

The study goal was to compare the laser spot size created using reflective and refractive micromanipulators with a CO₂ laser and to determine the sensitivity of spot size to laser power.

A CO₂ laser and operating microscope (400‐mm focal length) was coupled to either a reflective (Cassegrain‐like) or refractive micromanipulator. Laser spot size was determined by measuring the region of ablation created by laser irradiation of wood (dry tongue depressors), exposed photographic film, and agar gel using optical micrometry. Laser power varied from 0.5 to 20 W with pulse durations of 0.1 and 0.5 second.

The reflective micromanipulator demonstrated overall smaller spot sizes for a given laser power and lower incremental change in spot size with increasing power. The reflective design demonstrated less sensitivity to increases in laser power.

Micromanipulator optical design can result in significant differences in laser spot size. The reflective device used in this study demonstrated less sensitivity to increasing laser power.

Determine patient factors associated with the success and complications of using the Pillar palatal implants for snoring management.

Retrospective series of 79 consecutive adult patients receiving Pillar implants for snoring management between January 2005 and December 2007. Multiple regression analysis was used to determine factors associated with initial and final bed partner satisfaction with the snoring result, and factors associated with Pillar‐related complications.

A total of 64 of 79 (81%) bed partners reported snoring improvement in patients after initial Pillar implantation; however, only 31 (39%) were satisfied with the level of reduction. Following secondary procedures, the number of satisfied bed partners improved to 52 (66%). Factors associated with final bed partner satisfaction included lower initial apnea‐hypopnea index (AHI) (P = 0.029), Friedman tongue position I or II (P = 0.008), and shorter follow‐up time (P = 0.001). Sixteen patients (20%) experienced procedure‐related complications. Factors associated with Pillar complications included female gender (P = 0.001) and placement under general anesthesia (P = 0.009).

Initial AHI values and tongue position scores are important determinants of final snoring success. Pillar implants placed in women and under general anesthesia may have a higher risk of poor placement and extrusion.

The objective of this study was to analyze the expression of proliferative markers and p53 in keratocystic odontogenic tumor (KCOT) sporadic type and KCOT associated with nevoid basal cell carcinoma syndrome (NBCCS).

We performed a cross‐sectional study. A total of 19 patients with KCOT were selected from the Oral Pathology Laboratory archives, Central University of Venezuela, from 1995 to 2005.

Twelve cases corresponded to sporadic KCOT, and seven cases were associated with NBCCS. Immunohistochemical analysis for p53, proliferating cell nuclear antigen (PCNA), and Ki‐67 was performed in all 19 cases.

Of the seven cases associated with NBCCS, six (86%) were positive for PCNA. From the 12 sporadic cases, nine (75%) were positive for PCNA. Only one case of sporadic KCOT showed Ki‐67 positivity. Five of 12 (42%) cases of sporadic KCOT were positive for p53, and only one (14%) case associated with NBCCS was positive for p53.

On the basis of the analysis of the expression of PCNA, Ki‐67, and p53, there appears to be no evidence to indicate higher aggressiveness in growth and infiltrative behavior in syndromic KCOT compared with the sporadic type. Therefore, surgical treatment may be approached in the same manner in KCOT sporadic and syndromic with the goal of minimizing recurrence.