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Query: UMLS:C0001511 (Adhesion)
 5,955 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The middle turbinate is often carefully preserved at Functional Endoscopic Sinus Surgery (FESS). However there is no clear understanding of its importance and its presence may prevent good access to the middle meatus to the detriment of the surgical result. In addition its bulk may cause symptoms of nasal obstruction and prevent paranasal sinus drainage. Adhesions and stenosis have been reported at the middle meatus following its preservation. We undertook a prospective study of 50 consecutive patients all of whom underwent resection of the anterior half of the middle turbinate at the time of Functional Endoscopic Sinus Surgery. The patients were asked to complete a symptom score sheet before and ten weeks after surgery. The parameters considered were nasal obstruction, nasal congestion, discharge, facial pain and headache. Non parametric analysis of the results indicated a significant improvement in all patient symptom scores and no postoperative complications were noted. We conclude that partial resection of the middle turbinate is a useful modification of accepted endoscopic sinus surgery techniques.
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PMID:Partial resection of the middle turbinate at functional endoscopic sinus surgery. 1021 42

We analyzed the clinical course of eight female patients of oculomotor nerve palsy due to unruptured internal artery posterior (IC-PC) communicating artery aneurysm in order to speculate on the mechanism of aneurysmal rupture. Seven of the eight patients had preceding headache or ophthalmalgia, three of them deteriorated oculomotor nerve palsy and one showed worsening of ophthalmalgia. These deteriorations occurred between three to seven days after the first clinical symptom appeared. Neck clipping of aneurysm was performed for all eight patients. These aneurysms were profiled except for one patient whose aneurysm ruptured before operation. None of these seven patients had subarachnoid hemorrhage in the operative field. The patients who showed clinical deterioration had fragile aneurysm wall, wall with bleb, and one aneurysm showed minor blood leakage during operative manipulation. In the four patients who did not show clinical deterioration, aneurysm attached oculomotor nerve, these aneurysm walls were arteriosclerotic and we could not find the fragile portion during operation. Repeated minor bleeding near the oculomotor nerve or direct aneurysmal compression are the main causes of oculomotor nerve palsy with unruptured IC-PC aneurysm. Adhesion or stimulation of aneurysm on the upper border of cavernous sinus cause the headache or ophthalmalgia and these deteriorations are thought to occur gradually. However, these deteriorations occur more rapidly than ever thought and reflect acute aneurysmal growth and its direct affect on the oculomotor nerve. IC-PC aneurysm is the only aneurysm we can observe its aneurysmal growth by its unique clinical presentation. From this study, we conclude that the deterioration of oculomotor nerve palsy, preceding headache or ophthalmalgia reflects rapid growth of unruptured IC-PC aneurysm. We neurosurgeons consider it to be an urgent rupture period and should introduce surgical management to prevent its rupture and the devastating consequence of subarachnoid hemorrhage.
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PMID:[Clinical analysis of the mechanism of oculomotor nerve palsy caused by unruptured internal carotid artery posterior communicating artery aneurysm]. 1180 16

This systematic review applied meta-analytic procedures to evaluate the curative effect of trans-septal suturing versus nasal packing after septoplasty. Computerized search of the published literature in PubMed, EMBASE, CENTRAL, Cochrane Database of Systematic Reviews, WANFANG, CNKI databases. Randomized trials investigating trans-septal suturing versus nasal packing following septoplasty in patients with deviated nasal septum. Adhesion, septal hematoma, bleeding, septal perforation, infection, pain, headache, or residual septal deviation per randomized patients. 19 randomized controlled trials of 1845 subjects were included. Meta-analysis showed that postoperative pain, headache, and adhesion were significantly lower in trans-septal suturing group. Nasal packing and trans-septal suturing technique appear to be equivalent with regard to postoperative bleeding, hematoma, septal perforation, infection, and residual septal deviation. Trans-septal suturing technology is not only associated with less patient pain, headache, and lower occurrence rate of adhesion after septoplasty but it also relates to higher patient satisfaction and an improved quality of life. The suturing technology can be used as a substitute for traditional nasal packing of the first-line treatment. More well-designed studies are needed to confirm the effect of trans-septal suturing following septoplasty.
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PMID:Comparison on effectiveness of trans-septal suturing versus nasal packing after septoplasty: a systematic review and meta-analysis. 2891 2