Otorhinolaryngology, Head and Neck Surgery

While ballistic parameters of vole captive bolt devices have been reported, there is no investigation on their hazardous potential to cause noise trauma. The aim of this experimental study was to measure the sound pressure levels of vole captive bolt devices. Two different shooting devices were examined with a modular precision sound level meter on an outdoor firing range. Measurements were taken in a semi-circular configuration with measuring points 0°in front of the muzzle, 90°at right angle of the muzzle, and 180°behind the shooting device. Distances between muzzle and microphone were 0.5, 1, 2, 10, and 20 m. Sound pressure levels exceeded 130 dB(C) at any measuring point within the 20-m area. Highest measurements (more than 172 dB[C]) were taken in the 0°direction at the 0.5-m distance for both shooting devices proving the hazardous potential of these gadgets to cause noise trauma.

The recent detection of bacterial biofilms on the sinus mucosa of patients with chronic rhinosinusitis (CRS) has implicated biofilms in the pathogenesis of this condition. Electron microscopy has been the main modality used to document the presence of biofilms on sinus tissue, however, it has inherent problems associated with tissue preparation and sampling. Recently, Confocal Scanning Laser Micrsocopy (CSLM) has emerged as a noninvasive, nondestructive technique for the analysis of biofilms. This study used CSLM as the means of investigating biofilm presence in CRS patients. A prospective study comparing the presence of bacterial biofilms on the sinus mucosa of CRS and control patients was conducted using CSLM. Thirty eight CRS patients undergoing endoscopic sinus surgery and nine control patients were enrolled in this study. Demographic and clinical information was recorded from each patient and intraoperatively, sinus culture specimens and mucosal samples were obtained for microbiologic and microscopic examination. Using previously documented CSLM criteria, bacterial biofilms were found in 17 (44%) of the 38 CRS patients. No biofilm structures were evident in any of the controls. Patients having undergone previous sinus surgery seemed to have a higher incidence of biofilms compared with the incidence for those undergoing their first procedure. The difference however was not statistically significant. No correlation between positive bacterial cultures and biofilm presence was observed. The CSLM detection of biofilms in CRS patients and their absence in controls further supports the hypothesis that biofilms may play a role in the pathogenesis of CRS. This study's lower reported incidence of biofilms compared with that of previous studies might reflect the increased accuracy of biofilm detection with CSLM.

Objective/Hypothesis: Endoscopic sinus surgery is an accepted treatment for medically recalcitrant chronic rhinosinusitis. Effective saline douching may improve long-term outcomes of chronic rhinosinusitis but is often impaired by postoperative ostial stenosis. The aim of this study is to determine a critical ostial size at which douching solution reliably enters the sinus cavities.

To evaluate the time course and extent of the restenosis that occurs after an endoscopic modified Lothrop procedure (EMLP) and to identify factors that contribute to this process. : Retrospective study of prospectively collected data. Seventy-seven consecutive patients undergoing EMLP between November 1998 and June 2005 with frontal ostium measurements documented intraoperatively and at follow-up visits for a minimum of 12 months were included. Data on patient demographics, medical history, comorbidities, and computed tomography scans were collected. Significant restenosis of the frontal sinus neo-ostia was defined as a loss of more than 60% of the original intraoperative area. The mean follow-up in our cohort was 29.2 months. Twenty-two patients were identified with increased stenosis, all of which arose within the first 12 months postsurgery. Nine of these 22 patients required revision EMLP. In all patients, the new frontal ostium narrowed at 1 year by an average of 33% (from 290 ...