The objective of the study was to evaluate the outcome of septoplasty without inferior turbinectomy in patients with septum deviation and nasal obstruction. After exclusion of allergic rhinitis, this study included 30 patients with deviated nasal septum and hypertrophied inferior nasal turbinate who were prepared for septoplasty without turbinectomy. After full history taking and complete otorhinological examination, all patients graded their extent of obstruction using the Nasal Obstruction Symptoms Evaluation scale and underwent CT scans to evaluate the side and shape of deviation, thickness of the medial and lateral mucosa and inferior conchal bone on both the concave and convex sides. Postoperative (PO) follow-up consisted of evaluation of surgical outcome, nasal obstruction grading and patient's satisfaction. CT imaging was repeated for evaluation of the previous items and to compare with preoperative data. All surgeries were conducted smoothly without intraoperative complications and all were managed as day surgery. The mean duration of follow-up was 20.1 ± 4.4 months. All patients showed progressive significant decline of nasal obstruction symptoms and only eight patients still had mild symptoms. Patients' satisfaction scores showed significant progressive increase reaching a peak at the 12th month. Preoperative CT confirmed the presence of hypertrophied mucosa on the concave septal side with significantly thicker medial and non-significantly thicker lateral mucosa on the concave side compared to the convex side. At the 12th month PO, mean medial mucosal thickness significantly decreased on the concave side with significant increase on the convex side, but the effect was significantly pronounced on the concave side. Mean lateral mucosal thickness was significantly decreased on the concave and non-significantly increased on the convex side. Conchal bone thickness showed non-significant change despite the diminution on both sides In the absence of allergic rhinitis, septoplasty without turbinectomy significantly improves nasal obstruction-related manifestations and approaches high patient satisfaction with associated reduction of hypertrophied mucosa and spares turbinectomy-related complications.
The multidisciplinary coded dataset standard approach can improve the accuracy of both data capture and information flow, and, thus, ultimately create a more reliable dataset for use outcomes and health planning.
Background: Congenital pulmonary artery anomalies are variable and need proper diagnosis and treatment. CT angiography with multiplanar reconstruction has the main role in the assessment of these anomalies and this noninvasive method should be the method of choice for preoperative planning and postoperative follow up. The aim of the study is to assess the value of MDCT in the detection of pulmonary arteries anomalies in the pediatric population with complex congenital heart disease in conjunction with echocardiography as an alternative to conventional angiography and to determine the superiority of MDCT in the assessment of other abnormalities such as airway anomalies. Results: In our retrospective study, 52 patients (28 male and 24 females, aged 1 day to 4 years: mean age 2 years) were examined with contrast-enhanced CT. CT examinations were done using a 128-section CT scanner (Siemens Somatom Definition AS) using non-ionic iodinated contrast media. 2D and 3D reconstructions were performed. The correlation was made with echocardiograms. All imaging studies were reviewed. The echo was done to all patients. Surgery and/or catheter angiography performed to all patients, their findings were reviewed and compared to CTA findings. Other abnormalities such as congenital airway anomalies are detected using axial MDCT images and reconstructed imaging techniques. MDCT was accurate in revealing pulmonary artery anomalies. The commonest pulmonary artery anomaly was atresia, stenosis then hypoplasia. These anomalies may be isolated or associated with other congenital heart diseases. In the current study, MDCT could diagnose all cases of pulmonary arterial anomalies with 96% sensitivity, 100% specificity, 98% accuracy, 100% positive, and 94% negative predictive values. CT scans provide accurate information to assess complex spatial relationships of vascular airway compression frequently associated with CHD in the pediatric population. Conclusion: MDCT scanner can be an alternative to diagnostic conventional angiography for the non-invasive assessment of the pulmonary artery. Higher quality multiplanar and 3D reconstruction achieved by the MDCT scanners offer a rapid, reliable and non-invasive technique that can be used for the evaluation and preoperative assessment of thoracic vascular and extra-vascular anatomy in infants and children with suspected congenital heart disease. CT technologies are constantly developing collaboration between radiologists, pediatric cardiologists, and anesthesiologists, which is essential for improving CT performance.
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