MATERIAL AND METHODS: A prospective, quasi-experimental physiological study. Selected healthy subjects were observed electrocardiographically for 60 s continuously in three equal phases of 20 s each - baseline phase, nasoendoscopic phase, and recovery phase (post-nasoendoscopy). Heart rate fluctuations were charted, followed by identification of a positive nasocardiac reflex group of subjects and a negative group. Analyses against multiple variables were done.
RESULTS: A total of 53 subjects were analysed. Heart rate during the baseline phase was 81.0 ± 9.9, nasoendoscopic phase was 72.7 ± 10.1, and recovery phase was 75.2 ± 9.6. Sixteen subjects (30.2%) had a positive nasocardiac reflex, and they remained in sinus rhythm with no occurrences of skipped beats, atrioventricular blocks or asystoles. One subject (1.9%) developed temporary ectopic premature ventricular contractions after nasoendoscopy. No variables were found affecting the incidence of a nasocardiac reflex in our study.
CONCLUSIONS: The pattern of heart rate dynamics was consistent as heart rates drop rapidly upon endoscope insertion and recover in some measure after its withdrawal. Although all our subjects remained asymptomatic, clinicians should not overlook the risks of a severe nasocardiac reflex when performing nasoendoscopy. We recommend that electrical cardiac monitoring be part of the management of vasovagal responses during in-office endonasal procedures.
METHODS: This was a prospective cohort study. Each patient underwent pre- and post-shift voice analysis.
RESULTS: Among 42 teleoperators, 28 patients (66.7 per cent) completed all the tests. Female predominance (62 per cent) was noted, with a mean age of 40 years. Voice changes during working were reported by 48.1 per cent. Pre- and post-shift maximum phonation time (p < 0.018) and Voice Handicap Index-10 (p < 0.011) showed significant results with no correlation noted between subjective and objective assessment.
CONCLUSION: Maximum phonation time and Voice Handicap Index-10 are good voice assessment tools. The quality of evidence is inadequate to recommend 'gold standard' voice assessment until a better-quality study has been completed.
METHODS: In this case-control observational study, 32 adults with post-TBI olfactory dysfunction (cases) were matched with 32 TBI patients with intact olfactory function (controls). All subjects self-rated their olfactory function using the Visual Analogue Scale (VAS). Cases also underwent objective olfactory function assessment with the Sniffin' Sticks test, which generated a Threshold, Discrimination, and Identification (TDI) score. QoL was assessed with the Questionnaire for Olfactory Disorders (QOD). Factors evaluated included age, gender, smoking, TBI severity and duration, lesion localisation, and Disability Rating Scale (DRS) score.
RESULTS: Cases had a higher mean QOD score than controls at 26.31 ± 14.37 and 9.44 ± 8.30, respectively (F = 16.426, p
METHOD: Prevalence of the anterior ethmoid genu, its morphology and its relationship with the frontal sinus drainage pathway was assessed. Computed tomography scans with multiplanar reconstruction were used to study non-diseased sinonasal complexes.
RESULTS: The anterior ethmoidal genu was present in all 102 anatomical sides studied, independent of age, gender and race. Its position was within the frontal sinus drainage pathway, and the drainage pathway was medial to it in 98 of 102 cases. The anterior ethmoidal genu sometimes extended laterally and formed a recess bounded by the lamina papyracea laterally, by the uncinate process anteriorly and by the bulla ethmoidalis posteriorly. Distance of the anterior ethmoidal genu to frontal ostia can be determined by the height of the posterior wall of the agger nasi cell rather than its volume or other dimensions.
CONCLUSION: This study confirmed that the anterior ethmoidal genu is a constant anatomical structure positioned within frontal sinus drainage pathway. The description of anterior ethmoidal genu found in this study explained the anatomical connection between the agger nasi cell, uncinate process and bulla ethmoidalis and its structural organisation.