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Article
Effect Of Nasal Polyps On Spirometric Values Pre And Post Operative Comparison
تقییم تأثیر السلیلات ألجیبیھ الانفیھ على وظائف المجاري التنفسیھ السفلى قبل وبعد الاستئصال الجراحي (دراسھ مقارنة)

Authors: Hameed D.Hussain --- Sajad Y. Alhelo
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2013 Volume: 3 Issue: 2 Pages: 41-46
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background: Nasal breathing can be crucial to the proper functioning of the lower airway. Nasal obstruction (N.O.)may play an important role in modulating lower airway and lung function.Objective: the study was designed to assess the influence of nasal polyps on spirometeric value and to evaluate theeffect of surgical polypectomy on pulmonary function depend on spirometeric test. Setting: otolaryngology, headand neck surgery center in Al-Sadder teaching hospital in Al Najaf governorate.Patients: Fourty four patients (29men and 15 women) from 20-50 years old were enrolled in this study after taking their consent. All patients hadnasal polyps for many years.Methods: Prospective study of patients who had nasal polyps. All patients underwent spirometeric test preoperatively,only those with abnormal spirometeric value were included in this study. Patients were divided into twogroups according to the presence or absence of chest symptoms as group I and group II respectively. Patients thenwere treated surgically by different surgical methods and followed up for a period of 2-4 months and were assessedfor the improvement of pulmonary function by spirometery.Results: fourty seven patients (39%) of 120 patients with nasal polyps had abnormal spirometery, 3 patients werelost in follow-up. Treatment of both groups improved nasal breathing function in 81% with improvement ofpulmonary function in 11 patients (34.37%) of group I (32 patients) and 6 patients (50%) in group II (12 patients)with overall improvement of spirometery in 44 patients (38.6%).Conclusion: this study presents an evidence for the existence of correlation between nasal polyps and lower airwaydisorders, and shows that effective surgical polypectomy may improve pulmonary function in lower airway diseasepatients with nasal polypsKey words: nasal polyps, spirometry, paranasal sinuses

دراسة مقارنھ للمرضى المصابین بالسلیلات الانفیھ،أجریت في مركز النجف التخصصي في الأنف والأذن والحنجرة في مدینة الصدر الطبیة للفترة. من أیار 2010 ولغایة أیار 2011الھدف لتقییم تأثیر استئصال السلیلات الانفیھ جراحیا على تحسین وظائف الرئھ و ذلك باستخدام جھاز فحص وظائف الرئھ كوسیلة اساسیھ في متابعةنتائج علاج المرضى.50 سنھ.قسم المرضى إلى فئتین اعتمادا على وجود أو عدم وجود - المنھجیة اجریت على 44 مریضا ( 29 ذكرا ، 15 أنثى) تتراوح أعمارھم بین 20أعراضصدریة .النتائج:اظھرت الدراسة دلالھ قویھ على وجود علاقة بین السلیلات الانفیھ و إمراض الجھاز التنفسي وخصوصا الربو القصبي. وأنتجت تحسنا ملحوظا50 %) على التوالي. ، % في وظائف الرئة في الفئتین الأولى والثانیة ( 34التوصیات:نقترح تضمین فئة الاطفال في دراسة لاحقة،ننصح باجراء فحص وظائف الرئة قبل العملیة لكل المرضى المصابین بالسلیلة الانفیة


Article
Malignant tumours of nasal cavity and paranasal sinuses in north of lraq a fifteen years retrospective study

Authors: Q Radwan قحطان رضوان --- Daoud S. Allos داود الوس
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2005 Volume: 31 Issue: 1 Pages: 17-21
Publisher: Mosul University جامعة الموصل

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Abstract

Objectives: To identify the different pathological types of malignant tumors of nasal cavity' and paranasal sinuses, their different clinical aspects, treatment received and prognosis in north of Iraq.Design : Retrospective study.Settings: Files of patients treated in the hospital of oncology and nuclear medicine in Mosulover 15 years period (1980-1994).Main outcome measures: Types, incidence, age and sex distribution, anatomical sites, clinical presentation, staging, method of treatment and prognosis.Results: They constituted 0.51% of all malignancies and 2.13 % of head and neck cancers.Sinus tumours affected both sexes equally as well as both sides. Nasal cavity tumours weremore common in male (male/female=1.4/1) and in the right side (right/left=1.33/1).Thecommonest age at presentation was the fifth decade.The most common presenting symptom was facial and nasal pain with average delay indiagnosis of about 8.5 months. Tumours of epithelial origin formed the majority ofcases (85.68%).All maxillary and ethmoidal cases were advanced at time of diagnosis (T3 or T4), while 60%of nasal cavity tumours were T1 and T2. 21.87% of patients had palpable cervical lymph nodes at presentation.The majority of patients received radiotherapy alone, few cases had surgery alone or both, but prognosis was generally unsatisfactoryconclusion: Malignant tumours of nose and sinuses are rare in north of lraq, are usuallyadvanced at presention , and carry poor prognosis.keywords: Malignant Tumours , Nasal Cavity , Paranasal Sinuses


Article
Functional Endoscopic Sinus Surgery: Experience with Fifty Patients Suffering From Chronic Rhinosinusitis, A descriptive study
جراحة الجيوب الأنفية الناظورية: تجربة مع خمسين مريض يعانون من التهاب الجيوب الأنفية المزمن, دراسية وصفية

Authors: Ehab Taha Yaseen د. إيهاب طه ياسين --- Ali Abed د. علي عبد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2013 Volume: 26 Issue: 3 Pages: 267-272
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Background: Chronic rhinosinusitis (CRS) can be considered as one of the most frequent problems that can be faced in the practice of otolaryngology. The cornerstone of accurate diagnosis and treatment of chronic rhinosinusitis is a thorough history and complete physical examination, including nasal endoscopy supported by CT examination.Objectives: To identify the commonest age group affected by CRS, the symptoms and signs of CRS, to compare the findings of CT scans with endoscopic and operative findings and to reveal the most common operative steps performed in functional endoscopic sinus surgery (FESS).Patients and method: A cross sectional descriptive study conducted in Al-Yarmouk Teaching Hospital enrolled 50 patients presented with medically resistant CRS. Data collected from the patients using a questionnaire formula and all of them were subjected to endoscopic examination. CT scan of the nose and paranasal sinuses in coronal view was arranged for all of them. All the patients subjected to endoscopic sinus surgery.Results: The commonest age group affected by CRS was in those between 21-30 years (40%), the mean age was 30.4 years with male to female ratio 1.27:1. The commonest chief complaint was nasal obstruction (46%). The commonest endoscopic finding was septal deviation (86%). The commonest CT finding was inferior turbinate hypertrophy (72%).Uncinectomy and middle meatal antrostomy were the commonest surgical procedures performed (94%).Conclusions: The commonest age group affected by CRS is 21-30 years. Males are more affected by CRS than females. Nasal obstruction is the commonest symptoms suffered by the patients. Septal deviation is the commonest endoscopic finding. Hypertrophy of the inferior turbinate is the commonest CT finding. Uncinectomy and middle meatal antrostomy are the commonest surgical procedures done.Key words: Chronic rhinosinusitis, CT, Endoscopic sinus surgery, paranasal sinuses.

الخلفية: أن التهاب الجيوب الأنفية المزمن قد يكون من المشاكل المتكررة التي تواجه أطباء الأنف والأذن والحنجرة. وأن حجر الأساس لتشخيص وعلاج التهاب الجيوب الأنفية المزمن هو من خلال التأريخ المرضي المفصل مع الفحص ألسريري الكامل متضمنا ً الفحص بناظور الأنف الصلب.الأهداف: شكلت هذه الدراسة لمعرفة الفئة العمرية الأكثر عرضة لالتهاب الجيوب الأنفية المزمن و المقارنة بين نتائج الفحص بناظور الأنف الصلب و نتائج الفحص بالمفراس و تمييز الخطوات الجراحية الأكثر شيوعا في جراحة الجيوب الأنفية الناظورية.طريقة البحث: إن هذه الدراسة المقطعية الوصفية صممت لأخذ خمسون مريضا" أختيروا من المرضى الذين يراجعون أستشارية الأنف والأذن والحنجرة في مستشفى اليرموك التعليمي خلال الفترة بين تشرين الأول 2010 و تشرين الأول 2011. جميعهم يعانون من التهاب الجيوب الأنفية المزمن الغير مستجيب للعلاج التحفظي، أعتمد التشخيص على التاريخ المرضي للحالة والفحص السريري بناظور الأنف الصلب والدراسة الشعاعية بواسطة المفراس للجيوب الأنفية. تم إجراء جراحة الجيوب الأنفية الناظورية لجميع المرضى.النتائج: تبين أن المعدل العمري للمرضى 30.4 سنة, وكانت نسبة الذكور للإناث 1.27الى 1, و كانت الفئة العمرية (21-30) سنة تشكل 40% من المرضى. كان انسداد الأنف يمثل الشكوى الرئيسية لمعظم المرضى و بنسبة 46%. كانت الفترة الزمنية للمعاناة المرضية لأغلبية المرضى تتراوح بين (1-2) سنة و بنسبة 56%.أشارت نتائج الفحص الناظوري إلى ما يلي:انحراف الحاجز الأنفي هو الأكثر شيوعا حيث وجد في 86% من المرضى.تضخم الرفوف الأنفية السفلى وجد في 72% من المرضى. زوائد لحمية في الصماخ الأنفي الأوسط 54%، تضخم الرفوف الأنفية الوسطى 24%. توسع الفقاعة الغربالية 22%، بينت نتائج الفحص بالمفراس إن تضخم الرفوف الأنفية السفلى هو الأكثر شيوعا حيث وجد في 72% من المرضى بينما تثخنات الأغشية المخاطية وجدت في 62% من المرضى. تم ﺇجراء الخطوات الجراحية التالية في الجراحة الناظورية:استئصال الساقية المعلقة, تفويه الصماخ الأنفي الأوسط لـ 94% من المرضى.استئصال الجيوب الغربالية الأنفية الأمامية ل 86% من المرضى.أستئصال الجيوب الغربالية الأنفية الخلفية 74% من المرضى.استئصال زوائد لحمية ل 54% من المرضى.تقليم الرف الأنفي الأوسط ل 26% من المرضى.تعديل الحاجز الأنفي ل 18% من المرضى.الاستنتاج: أكثر فئة عمرية متأثرة بالتهاب الجيوب الأنفية المزمن هي الفئة العمرية 21 – 30 سنة.-نسبة التهاب الجيوب الأنفية المزمن لدى الذكور هي أعلى من النساء.-انسداد الأنف يمثل الشكوى الرئيسية لمعظم المرضى.-إن انحراف الحاجز الأنفي هو الأكثر شيوعا بين نتائج فحص الأنف بالناظور.-تضخم الرفوف الانفية السفلى هو الاكثر شيوعا بين نتائج الفحص الشعاعي بالمفراس.


Article
Co-Existence of Anatomical Variants and Rhinosinusitis on Multi-Sliced Computed Tomography

Authors: Abdullateef Aliasghar --- Meethaq Muhi Abdullah --- Muhamed Dheia
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2016 Volume: 15 Issue: 1 Pages: 79-85
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Computed tomography (CT) is mandatory and a medicolegal requirement to evaluate rhinosinusitis and provides a road map regarding anatomical variants and endoscopic treatment of rhinosinusitis. OBJECTIVE: To identify coexistence between anatomical variants of nasal constituents and rhinosinusitis by using multi-sliced CT and to ascertain the value of CT as a road map prior to functioning endoscopic sinus surgery. PATIENTS AND METHODS: This is a cross sectional study was done on 87 patients referred for CT scan of the paranasal sinuses. The patients were clinically suspected to have sinonasal diseases. The sample of this study was consist of 52 males and 35 females. The age of patients ranged from 12 - 60 years. All patients were examined by using 64 multi-slice CT scan of paranasal sinus including axial sections and coronal reformat. RESULTS: 76 patients were had diseased sinuses, we discovered 5 abnormalities; mucosal thickening, opacification, air fluid level, mucosal polyp and cyst. The most commonly involved sinus was the maxillary (62 patients) followed by anterior ethmoid, and the commonest abnormality was mucosal thickening. Types of variations include; nasal septal deviation(52.4%), concha bullosa(49%), enlarged ethmoidal bullae (15.9%), large Aggar nasi (15.9%), Haller cells(19.1%), bent uncinate process(11.4%), Onodi cells (11.4%), paradoxical middle turbinate(9.1%), maxillary sinus hypoplasia (7.9%), pneumatized crista galli (6.8%), and both pneumatized nasal septum and asymmetrical ethmoid roof were of (3.4%). The total number of patients having anatomical variants but not associated with sinonasal mucosal abnormalities were (17.1%), while (82.9%) of patients were associated with sinonasal abnormalities. CONCLUSION: The study reveals correlation between certain anatomical variations and specific sinonasal mucosal abnormalities that may interfere with the drainage of the sinus secretions and subsequent secondary infection. Another group of variants were discovered that may lead to intra-operative complications if surgery indicated.


Article
Major inflammatory patterns of chronic sinonasal diseases and their accompanied anatomical variations; CT scan review

Author: Dr. Qays Ahmed Hassan AL-Timimy
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2015 Volume: 11 Issue: 2 Pages: 101-107
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Because of wide use of Functional Endoscopic Sinus Surgery (FESS) technique in the recent years and basic role of coronal computed tomography (CT) scan in demonstrating the normal drainage route of para-nasal sinuses, identifying the major patterns of inflammatory sinonasal disease and accompanied anatomical variations is essential for appropriate preoperative surgical planning. In review of publisthed literature, there is no data on CT patterns of chronic inflammatory sinonasal disease and their accompained anatomical variations of nose and PNS in our local population.Objectives: was to determine the frequency of CT patterns and variations in patients with sinonasal symptoms.Methods: This was a cross sectional descriptive study conducted on 404 consecutive patients with clinical manifestations of chronic rhinosinusitis referred to radiology department of Alkindy teaching hospital. Coronal and if needed axial CT scan were taken from them. CT scans were reviewed and inflammatory patterns and accompanied anatomical variations were specified.Results: Five major recurring patterns of inflammation including infundibular 23.76%, ostiomeatal unit (OMU) 21.78%, sphenoethmidal recess (SER) 7.92%, sinonasal polyposis 19.80% and sporadic 20.79% were seen. Special pattern was noted in 3.96% while normal CT examination was noted in 9.90%. The total percentage was more than 100% due to simultaneous occurance of more than one pattern in the same case. In 73.2% of cases accompanied anatomical variation including septal deviation (34%), concha bullosa (26%), Agger nasi cell (13%), giant bulla ethmoidalis (12%), Haller cell (8%), pneumatization of uncinate process (5%), paradoxic middle turbinate (4%), and Onodi cell (2%) were seen.Conclusion: In this study, the concept of the major inflammatory patterns of sinonasal disease was introduced and their frequncies in our local poluplation were reported. By applying these patterns to the radiological report, more tailored and safe endoscopic sinus surgery could be possible.


Article
Haemangioma of the Nose and Paranasal Sinuses

Authors: Adil H. Ibrahim --- Alaa Ch. Mutar --- Nazar J Metib
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2695-2701
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Haemangiomas, are rapidly growing benign vascular tumors rarely seen in paranasal sinuses. They are of two major types, capillary and cavernous depending on the dominant vessel size on microscopy. The sinonasal cavity is an uncommon site of haemangiomas of the head and neck. Most nasal haemangiomas arise from the nasal septum or vestibule and are of lobular capillary type. Only a few arise from lateral wall of the nose or the inferior turbinate and these are usually cavernous.Objective: To assess the sinonasal haemangioma and to increase awareness about its clinical presentation and management. Methods: A retrospective study was conducted in the Department of ENT at Al-Hussein Teaching Hospital, Karbala, from December 2013 to December 2015. Ten cases of sinonasal haemangiomas were collected. Evaluation of the patients done according to age, sex, occupation, complaints regarding headache, nasal obstruction, epistaxis, nasal discharge, feeling of nasal mass ,radiologic assessment and pathologic diagnosis . Endoscopic sinus surgery was performed under general anesthesia for all patients, the masses excised completely and sent for histopathological study.Results: Ten patients were collected. Four patients were males and six patient females with female to male ratio 1.5:1. The age range was 14 to 50 years with a mean age of 32 years. Nine patients (6 females) and (3 males) presented with nasal obstruction and epistaxis. Four patients with left sided nasal obstruction, five patients with right sided nasal obstruction, and only one patient with absolute bilateral nasal obstruction without epistaxis. Conclusion: Sinonasal haemangiomas are extremely rare especially cavernous type. Sinonasal tumors with bone erosion should not always be presumed to be malignant .Endoscopic sinus surgery with complete removal is the treatment of choice.

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