Effects of functional endoscopic sinus surgery on maxillary sinus mucosa

OBJECTIVE: To compare the preoperative and postoperative changes on ciliary surface of maxillary sinus mucosa in patients treated with functional endoscopic sinus surgery. DESIGN: The maxillary mucosa of both the superolateral wall and the ostium were sampled during the operation and 6 to 12 months (mean duration, 7.6 months) after the operation. Ciliary surface was determined using scanning electron microscopy in combination with an image analyzer and was expressed in terms of ciliary area, which is the percentage of mucosal surface occupied by cilia. SETTING: The samples were taken at a hospital-based clinic. An electron microscopic study was performed at Mie University School of Medicine, Mie, Japan. PATIENTS: Sixteen patients (20 maxillary sinuses) undergoing functional endoscopic sinus surgery for treatment of chronic sinusitis. RESULTS: The mean (+/-SD) ciliary area before the surgery was 60.7%+/-28.8% and 39.9%+/-21.5% in the superolateral wall of the maxillary sinus and the ostium of the maxillary sinus, respectively. The ciliary area of the superolateral wall was significantly higher than that of the ostium (P<.001). The mean (+/-SD) postoperative ciliary area value was 74.3%+/-22.6% in the superolateral wall and 51.3%+/-16.1% in the ostium. These postoperative values were significantly higher than the preoperative values (P<.001). CONCLUSIONS: This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration, and the damaged ciliated epithelium could return toward normal with the improvement of ventilation and drainage of the maxillary sinus following functional endoscopic sinus surgery.     

MR-guided endoscopic sinus surgery

We describe an interactive, intraoperative imaging-guided method for performing endoscopic sinus surgery (ESS) within a vertically open MR system. The procedure was performed with intraoperative imaging using a 0.5-T magnet with a 56-cm vertical gap. Interactive control of imaging planes was accomplished by optical tracking with two infrared light-emitting diodes mounted on an aspirator probe. The probe's position defined the location of the orthogonal imaging planes. Twelve patients with varying degrees of sinus disease underwent ESS with MR imaging guidance. Patients had acute and chronic sinusitis, nasal polyposis causing airway obstruction, or tumor requiring tissue biopsy. All procedures were performed with the patients under general anesthesia. The integration of endoscopy with optical tracking and intraoperative interactive imaging allowed localization of anatomic landmarks during ESS. No complications were encountered.     

Frontal sinus surgery in children

Surgery for frontal sinusitis in children is unusual. When required, surgery for ostiomeatal disease or, in certain circumstances, frontal sinus trephination is usually all that is required. Nevertheless, for a few children, surgery of the nasofrontal recess and frontal sinus is required and can be very beneficial. A variety of surgical approaches to the frontal sinus are discussed. Functional endoscopic surgery based upon physiologic principles and the concept of reversible disease is emphasized.     

Long-term follow-up of aviators after functional endoscopic sinus surgery for sinus barotrauma

Prior to endonasal endoscopic advances for the treatment of sinus disease, surgical results for aviators with recurrent sinus barotrauma (RSB) were inconsistent. Between 1988 and 1992, 54 aviators, who were permanently or temporarily grounded, underwent functional endoscopic sinus (FES) surgery in an attempt to return them to active flying status. Follow-up in the immediate postoperative period revealed that 98% of these aviators returned to active flight duty. A questionnaire was mailed to each of these aviators to compare their preoperative and long-term postoperative symptoms and determine their current flying status. Long-term follow-up time ranged from 20 to 72 mo with average of 48 mo. Of the aviators who responded to the survey, 92% have continued their flying duties and do not report difficulties with RSB. We conclude that FES surgery is effective in the short- and long-term management RSB in aviators.     

Effects of syntactic expectations on speech segmentation.

Although the effect of acoustic cues on speech segmentation has been extensively investigated, the role of higher order information (e.g., syntax) has received less attention. Here, the authors examined whether syntactic expectations based on subject-verb agreement have an effect on segmentation and whether they do so despite conflicting acoustic cues. Although participants detected target words faster in phrases containing adequate acoustic cues ("spins" in take spins and "pins" in takes pins), this acoustic effect was suppressed when the phrases were appended to a plural context (those women take spins/*takes pins [with the asterisk indicating a syntactically unacceptable parse]). The syntactically congruent target ("spins") was detected faster regardless of the acoustics. However, a singular context (that woman *take spins/takes pins) had no effect on segmentation, and the results resembled those of the neutral phrases. Subsequent experiments showed that the discrepancy was due to the relative time course of syntactic expectations and acoustics cues. Taken together, the data suggest that syntactic knowledge can facilitate segmentation but that its effect is substantially attenuated if conflicting acoustic cues are encountered before full realization of the syntactic constraint. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Post-operative care for functional endoscopic sinus surgery

In summary, functional endoscopic sinus surgery has become a widespread tool for the treatment of chronic sinus conditions. Within the office, under local anesthesia, aggressive post-operative care can greatly diminish the need to return to the operating room for revision endoscopic sinus surgery. Under local anesthesia, most limited procedures performed in the operating room can also be performed in the office. Effective post-operative care is critical to obtain the best possible results. Any and all means necessary must be taken to assure expert, detailed, and timely post-operative care.     

Effects of perceived disability on persuasiveness of computer-synthesized speech.

Are perceptions of computer-synthesized speech altered by the belief that the person using this technology is disabled? In a 2x2 factorial design, participants completed an attitude pretest and were randomly assigned to watch an actor deliver a persuasive appeal under 1 of the following 4 conditions: disabled or nondisabled using normal speech and disabled or nondisabled using computer-synthesized speech. Participants then completed a posttest survey and a series of questionnaires assessing perceptions of voice, speaker, and message. Natural speech was perceived more favorably and was more persuasive than computer-synthesized speech. When the speaker was perceived to be speech-disabled, however, this difference diminished. This finding suggests that negatively viewed assistive technologies will be perceived more favorably when used by people with disabilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment outcome of 1,000 cases of endoscopic sinus surgery

To assess the treatment outcome of endoscopic sinus surgery (ESS), 1,000 patients with chronic sinusitis and nasal polyp treated between November 1991 and January 1995 were included in this study. Among them, 754 patients (64.8%) had previous operations from 1 to 25 times with an average of 3.7. Before ESS, axial and coronal CT scans were obtained (window width: 1,000 HU, window level: +90 HU; section thickness: 2 mm with 12 to 16 sections). Patients with clinical stages from I to IV were 9.9%, 21.0%, 15.0% and 54.1% respectively. Bilateral ESS was performed in 95% patients, septoplasty in 27.6%, middle meatal antrostomy in 78.5%. The clinical cure rate was 84.0%, 557 patients were considered as primary healing, 283 patients delayed healing and 160 patients had persistent inflammation. Complications were noted in 18 patients. Bleeding during ESS varied from 10 to 1,800 ml (average 180 ml). The indications, preoperative evaluation, control of bleeding, prevention of complications and prognosis were discussed in detail. The article indicated that the important factors to increase the cure rate are postoperative follow-up and systematic treatment.     

Effect of sinus surgery on pulmonary function in patients with cystic fibrosis

The rare case of neurilemmoma of the larynx was presented. The difficulties in histopathologic diagnosis of such tumors were emphasized. The tumor was removed by surgery from external approach.     

Pediatric functional endoscopic sinus surgery: postoperative care

An effective postoperative care regimen is vital for a successful outcome. Children pose special postoperative challenges due to small anatomy, differences in underlying causes of sinus disease, and difficulties encountered with sinonasal cleansing and debridement. This article provides the clinician with a chronologic guide on how to manage the child after functional endoscopic sinus surgery.     

Effects of pitch and speech rate on personal attributions.

In 3 experiments, 61 undergraduates listened to recordings of male speakers answering 2 interview questions and rated the speakers on a variety of semantic differential scales. The recordings had been altered so that the pitch of the speakers' voices was raised or lowered by 20% or left at its normal level, and speech rate was expanded or compressed by 30% or left at its normal rate. The results provide clear evidence that listeners use these acoustic properties in making personal attributions to speakers. Speakers with high-pitched voices were judged less truthful, less emphatic, less "potent" (smaller, thinner, faster), and more nervous. Slow-talking speakers were judged less truthful, less fluent, and less persuasive and were seen as more "passive" (slower, colder, passive, weaker) but more "potent." However, the effects of the acoustic manipulations on personal attributions also depended on the particular question that elicited the response. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Follow-up results of 415 patients after endoscopic sinus surgery

Endoscopic sinus surgery (ESS) is a method used with success in the treatment of chronic inflammatory paranasal sinus diseases. Between February 1991 and June 1995 the Messerklinger technique for ESS was used in 415 patients who had been pre-operatively evaluated in detail according to the staging system used in our clinic. Average post-operative follow-up was 23 months. Our general success rate was found to be 86.3% upon evaluating the subjective improvements in the patients' symptoms in the post-operative period. The major and minor complication rates in our series were 0.24 and 20.24%, respectively.     

Interpretation of the dilated pupil during endoscopic sinus surgery

This article describes the anatomy of the visual pathways and how they should be assessed under anaesthesia. The differential diagnosis of asymmetrical pupils is illustrated with clinical examples and a strategy as to how they should be examined.     

Effects of speech intelligibility level on concurrent visual task performance

Four experiments were performed to determine if changes in the level of speech intelligibility in an auditory task have an impact on performance in concurrent visual tasks. The auditory task used in each experiment was a memory search task in which subjects memorized a set of words and then decided whether auditorily presented probe items were members of the memorized set. The visual tasks used were an unstable tracking task, a spatial decision-making task, a mathematical reasoning task, and a probability monitoring task. Results showed that performance on the unstable tracking and probability monitoring tasks was unaffected by the level of speech intelligibility on the auditory task, whereas accuracy in the spatial decision-making and mathematical processing tasks was significantly worse at low speech intelligibility levels. The findings are interpreted within the framework of multiple resource theory.     

Endoscopic sinus surgery for chronic sinusitis in children

Anatomical features show maxillary sinus to be most commonly involved during childhood chronic sinusitis. Fifty-one cases who failed to respond to medications and irrigation were selected to undergo the middle meatal antrostomy under endoscopy. The majority of them had maxillary sinusitis. 10 cases had middle turbinate edema and polyps. 6 had ethmoiditis. After operations, signs of headache eliminated in 20 cases, nasal obstruction in 43 cases and yellowish discharge in 37 cases. The operative results were satisfactory. It is demonstrated that endoscopic sinus surgery is an ideal therapy for the treatment of childhood chronic maxillary sinusitis at present.     

Local and regional anesthesia for functional endoscopic sinus surgery

An effective topical and regional anesthetic technique using 25% cocaine paste combined with intravenous midazolam hydrochloride was used in 554 patients undergoing functional endoscopic sinus surgery. The operative fields were excellent and all procedures were completed with little patient disturbance. Patients recovered rapidly from sedation and were usually fit for discharge on the same day. There were no anesthetic complications. The major surgical complication rate was 0.5%.     

Effects of induced elation-depression on speech in the initial interview.

Examined the relationship between induced mood states of elation or depression and interviewee verbal behavior. Affective states were manipulated through the use of an autosuggestion technique (mood induction procedure; MIP). Ss were 45 female college students, ages 17-23, assigned to 1 of 3 treatment conditions: elation, depression, or neutral mood induction. Data consisted of 15 telephone dialogues elicited by an automated initial interview in each of the 3 mood conditions, with the MIP occurring midway in the interview. Criterion measures indicated that the MIP did successfully produce authentic emotional responses in the interviewee; postinterview questioning revealed that the interviewees did not discern the automated nature of the interviewer. Elation was found to evoke shorter response latencies, faster speech and articulation rates, and fewer silent pauses (2 sec or longer) than in a control group. Depression was positively related to silent pauses. Findings are discussed in terms of previous psycholinguistic research on the "cognitive" role of speech timing. (1 p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ciliary beat frequency, olfaction and endoscopic sinus surgery

OBJECTIVE: This article reports that competitive hybridization using entire chromosome specific libraries as probe and human genomic DNA as the competitor allows intense and specific fluorescent staining of human chromosome in metaphase. This general approach is called "chromosome painting". METHODS: The probes comprising chromosomes 2, 5, 6, 7, 13, 14, X specific libraries were used to analyse five cases which had been suspected of subtle translocation and deletion in karyotype analysis by G-banding of metaphase cells. The authors selected entire chromosome-specific DNA libraries hybridizing with the five cases. Unlabeled human genomic DNA was used to inhibit the hybridization of sequences in the library that bind to multiple chromosome. RESULTS: The target chromosome was made at least 20 times brighter parunit length than the others. Translocations and deletions were detected clearly in metaphase and were consistent with G-banding. However, the result was clearer and the detection easier, compared with G-banding. CONCLUSION: Chromosome painting is very powerful for identification of chromosome structural aberrations. Translocation and deletion involving these chromosomes can be strikingly visualized. The hybridization intensity and specificity are such that even very small portions of the involved chromosome can be detected. This technique is especially useful in settings where high-quality banding is difficult.