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Objective: The study aimed to compare the applicability of classic lateral lamellectomy versus submucosal conchoplasty techniques in managing concha bullosa during and after functional endoscopic sinus surgery. Methods: The study randomly divided 56 patients with bilateral concha bullosa into two groups. One group of patients underwent the submucosal conchoplasty technique and the other group underwent the lateral lamellectomy technique. The study compared the intra-operative findings, including the time required for each technique, the amount of intra-operative bleeding and the post-operative endoscopic outcome of the middle meatus and middle turbinate stability. Results: Submucosal conchoplasty was significantly more time-consuming than the lateral lamellectomy technique (p = 0.001*). The difference in the intra-operative amount of bleeding was (p = 0.086*). The lateral lamellectomy group showed a higher rate of synechia formation in the middle meatus (p = 0.012*). Conclusion: Submucosal conchoplasty is a valid technique for managing concha bullosa with better post-operative endoscopic outcomes. [ABSTRACT FROM AUTHOR]

Background: Dexmedetomidine is associated with good perioperative hemodynamics together with decreased opioid requirements. Furthermore, propofol has been used to achieve hypotensive anesthesia as a part of total intravenous anesthesia. Aims: This study was performed to compare dexmedetomidine and propofol on the adequacy of hypotensive anesthesia during transsphenoidal resection of pituitary tumors. Patients and Methods: A total of 110 cases were included in this prospective randomized study. They were randomized into two equal groups; Group D commenced on Dexmedetomidine, and Group P, which received propofol. Comparing intraoperative hemodynamic parameters and the Boezaart Bleeding Scale was our primary outcome. The secondary outcomes included isoflurane and propranolol consumption, recovery, postoperative analgesic profile. Statistical Analysis: IBM's SPSS Statistics (Statistical Package for the Social Sciences) for Windows (version 25, 2017) was used for the statistical analysis of the collected data. Shapiro–Wilk test was used to check the normality of the data distribution. The quantitative variables were expressed as mean and standard deviation, whereas the categorical variables were expressed as frequency and percentage. Independent sample t and Mann − Whitney tests were used for the comparison of parametric and nonparametric continuous data, respectively. For pair-wise comparison of data (within-subjects), the follow-up values were compared to their corresponding basal value using the paired samples t-test or Wilcoxon matched-pairs signed-ranks test. Fisher exact and Chi-square tests were used for inter-group comparison of nominal data using the crosstabs function. Results: Age, gender, body mass index, and systemic comorbidities did not significantly differ between the two groups. Furthermore, heart rate and blood pressure were comparable at baseline, during operation, and after extubation. Boezaart score, blood loss, isoflurane, and propranolol consumption were also comparable between the two groups. Group D expressed significantly longer emergence and extubation times than Group P. Nevertheless, cases in the same group expressed lower Visual Analog Scale values and postoperative analgesic requirements. Conclusion: Although Dexmedetomidine and propofol are associated with comparable intraoperative hemodynamic changes, the former drug appears to be superior regarding pain control, postoperative analgesic requirement. [ABSTRACT FROM AUTHOR]

Objective of the study: Evaluate some of the non atretic indications for endoscopic infantile nasal surgery regarding surgical technique, safety, and success. Patients and Methods: Retrospective analysis of 14 infants required endoscopic nasal surgery for severe non atretic nasal blockage in ORL department mansoura university hospital between 2010 and 2017, their age ranged between 1 month and 19 months, 8 female and 6 males. The indications were nasal obstruction due to craniofacial anomaly (Cruozon syndrome) 3 cases, post traumatic nasal adhesions 10 cases, and congenital pyriform aperture stenosis in 1 case. Endoscopic nasal surgery was conducted to perform widening of the nasal airway through bilateral partial inferior turbinectomy in Cruozon syndrome, nasal adhesolysis with or without stenting in post traumatic nasal adhesions, or trans nasal correction of pyriform aperture stenosis. Results: All patients showed postoperative improvement without restenosis or complications during follow up period in all study groups, only one patient of nasal adhesions group showed restenosis and didn't complete the follow up. Conclusion: TVarious non atretic indications for infantile endoscopic surgery as nasal adhesions, nasal obstruction in crouzon syndrome and CPAS could properly managed with endoscopic surgery. Careful management of nasal obstruction during neonatal care with delicate handling is very important to avoid unnecessary complications as nasal adhesions. Proper knowledge and experience with endoscopic surgery in this age is mandatory regarding the preoperative preparation and planning, operative technique, and post operative follow up. The technique is challenging and required good experience yet it is rewarding and mostly successful. [ABSTRACT FROM AUTHOR]