Many difficulties might be encountered during conventional stapes surgery. However, the good exposure provided by the endoscope can facilitate this procedure. The present study addresses the effectiveness of endoscopic stapes surgery with regard to the operation time and patients' convenience and satisfaction. 19 patients underwent endoscopic stapes surgery without packing. 15 patients who experienced the microscopic stapes surgery served as the comparison group. Audiometric results and the patients' satisfaction as measured by visual analog scale in both group were compared. Audiometric results were similar in both groups. Nevertheless, the endoscopic method was accompanied by shorter operation time and more comfort for the patients. Totally endoscopic stapes surgery can be done in much shorter time without major difficulties and without need to pack ear canal after surgery. Far less dissection and incision as well as patients' more satisfaction make this technique as a good alternative to the microscopic approach to stapes surgery.
BackgroundAcute ankle injuries are one of the most common reasons for presenting to emergency departments, but only a small percentage of patients – approximately 15% – have clinically significant fractures. However, these patients are almost always referred for radiography. The Ottawa Ankle Rules (OARs) have been designed to reduce the number of unnecessary radiographs ordered for these patients. The objective of this study was to validate the OARs in the Iranian population.MethodsThis prospective survey was done among 200 patients with acute ankle injury from January 2004 to April 2004 in the Akhtar Orthopedics Hospital Emergency Department. Main outcome measures of this survey were: sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios (positive and negative) of the OARs.ResultsSensitivity of the OARs for detecting 37 ankle fractures (23 in the malleolar zone and 14 in the midfoot zone) was 100% for each of the two zones, and 100% for both zones. Specificity of the OARs for detecting fractures was 40.50% for both zones, 40.50% for the malleolar zone, and 56.00% for the midfoot zone. Implementation of the OARs had the potential for reducing radiographs by 33%.ConclusionOARs are very accurate and highly sensitive tools for detecting ankle fractures. Implementation of these rules would lead to significant reduction in the number of radiographs, costs, radiation exposure and waiting times in emergency departments.
Background While the number of cosmetic surgeries performed per year continues to increase, many candidates have skin problems. Thick-skinned rhinoplasty patients are a real challenge for surgeons. Fear of performing surgery in patients with history of isotretinoin use is another concern. Objectives The present research was an attempt to study the effects of perioperative isotretinoin on rhinoplasty patient outcomes. Methods This research was conducted on 303 rhinoplasty patients in the control and experimental groups from 2012 to 2015. The experimental group patients were requested to consume isotretinoin from two weeks before surgery to two months following the surgery. A comparison was made between the two groups one, three, six, and 12 months after the surgery. Results Statistical tests indicated that satisfaction of patients of the experimental group in the first and third months following the surgery was significantly higher than the control group (p<0.01). Examination of the nose suggests a lack of evidence of soft tissue repair disturbance and cartilaginous deformities. Nine patients from the experimental group needed revision surgery during the study period and the reason for none of the revision surgeries was logically related to intake of isotretinoin. Conclusions Results of this research suggest that isotretinoin cause no evident disturbance to the recovery of rhinoplastic incisions and internal nose structures. Moreover, none of the members of the experimental group showed hypertrophic tissues and cartilaginous deformities, and the repair was satisfactory similar to the control group. However, patients receiving isotretinoin were more satisfied with their operation outcomes with less skin problems.
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