Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to ...Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to the sella, it entails complications such as nasal bleeding, impaired olfactory function, atrophic rhinitis, synechiae, etc. No studies have yet reported potential morbidities such as empty nose syndrome (ENS), although patients have a relatively empty nasal cavity after surgery. Therefore, we sought to verify the percentage of patients who truly met the diagnostic criteria for ENS after endoscopic transnasal sellar surgery, determine the variation between pre- and postoperative scores in each Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) item, and further evaluate the symptoms that may affect the patients the most after surgery. Methods: Between March 2015 and January 2019, eventually 11 patients who underwent extended endoscopic transnasal sellar surgery in Shin Kong Wu Ho-Su Memorial Hospital, a tertiary referral medical center in Taipei, Taiwan, were enrolled. The patients completed the recently validated ENS6Q after surgery. Results: One patient met the objective diagnostic criteria for ENS (score ≥ 11 in ENS6Q). Significant differences were observed in the pre- and postoperative total ENS6Q scores. The pre- and postoperative scores of “nose feeling too open” and nasal crusting showed statistically significant differences. Further, compared with the other items, the postoperative score of nasal crusting increased most obviously, and it may be the most apparent operation-related symptom. Conclusion: This study is the first to report the possibility of developing ENS after endoscopic transnasal sellar surgery. Although the transnasal endoscopic approach is a safe and minimally invasive procedure for the treatment of sellar lesions, possible complications such as ENS should be considered.展开更多
In the semi-arid tropics (SAT),33% areas are occupied by Alfisols and related soils. In SAT these soils have low structural stability and thereby tend to form seal and crusts at the surface. Due to this a large propor...In the semi-arid tropics (SAT),33% areas are occupied by Alfisols and related soils. In SAT these soils have low structural stability and thereby tend to form seal and crusts at the surface. Due to this a large proportion of the rain that falls on Alfisols during the early part of the rainy season,is normally lost as runoff thus causing high soil loss as well as moisture stress to crops. Two tillage studies were conducted first at plot scale (320 m2) during 1991-95 and second at small watershed scale (1.45 ha) during 2007-10,at ICRISAT research station,Hyderabad,India. These studies were conducted to find out whether the problem of excessive runoff and soil loss during the early part of the rainy season can be controlled by various inter-row tillage systems in addition to normal intercultivation by breaking the crust or seal and thereby improving infiltration and soil moisture and reducing runoff and soil loss. The observations on rainfall,runoff,soil moisture,soil loss,soil surface roughness and crop yields were collected from both the studies. Results from these studies have shown that inter-row tillage in addition to normal intercultivation is found effective in controlling early season runoff and soil loss and increasing crop yields. The additional tillage systems are found most effective during low and medium rainfall years and not so much during high rainfall years. The additional tillage with shoe cultivators,which creates rough soil surface (11 mm depression storage),is found most effective in increasing crop yields and reducing runoff and soil loss. The additional tillage with blade harrow which generates smooth soil surface is relatively less effective. In most rainfall conditions,the normal intercultivation with one additional tillage is found adequate for controlling early season runoff and improving soil moisture and crop yields.展开更多
Mucotomy is one of the most frequently applied surgical techniques for the management of inferior turbinate hyperplasia. Mucotomy guarantees patent airway, however, it might lead to the emergence of sicca syndrome. In...Mucotomy is one of the most frequently applied surgical techniques for the management of inferior turbinate hyperplasia. Mucotomy guarantees patent airway, however, it might lead to the emergence of sicca syndrome. In contrast, KTP (potassium titanyl phosphate) laser treatment spares the medial part of the inferior turbinate mucosa, contributing to maintenance of physiological nasal function. A retrospective comparative clinical study was performed to reveal the advantages and side-effects of both surgical methods in medium- and long-term in allergic rhinitis and non-allergic patients. Furthermore, we wished to determine the exact indications of the up-to-date laser treatment. Ninety-one of the 117 patients who underwent bilateral turbinate surgery during an 8-year period (2000-2007) responded to our questionnaire focusing on subjective postoperative changes. Patients were separated into 6 groups, based on the type of operation they underwent, the length of the follow-up and whether they suffered from allergies. The major complaint, nasal obstruction, improved in all 6 groups, which reached significance (p ? 0.05) in 4 groups. The most pronounced improvement was observed in the group of non-allergic patients with medium-term follow-up who underwent mucotomy. Nevertheless, a serious side- effect: crusting also increased significantly (p ? 0.05) in the latter group, while it was absent in allergic patients with medium-term follow-up, who underwent mucotomy. These results lead us to propose the following protocol for the treatment of inferior turbinate hyperplasia: 1) after unsuccessful conservative treatment, laser treatment is suggested for non-allergic patients;2) following unsuccessful conservative and even repeated laser treatment in the allergic group, mucotomy or turbinoplasty should be attempted.展开更多
文摘Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to the sella, it entails complications such as nasal bleeding, impaired olfactory function, atrophic rhinitis, synechiae, etc. No studies have yet reported potential morbidities such as empty nose syndrome (ENS), although patients have a relatively empty nasal cavity after surgery. Therefore, we sought to verify the percentage of patients who truly met the diagnostic criteria for ENS after endoscopic transnasal sellar surgery, determine the variation between pre- and postoperative scores in each Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) item, and further evaluate the symptoms that may affect the patients the most after surgery. Methods: Between March 2015 and January 2019, eventually 11 patients who underwent extended endoscopic transnasal sellar surgery in Shin Kong Wu Ho-Su Memorial Hospital, a tertiary referral medical center in Taipei, Taiwan, were enrolled. The patients completed the recently validated ENS6Q after surgery. Results: One patient met the objective diagnostic criteria for ENS (score ≥ 11 in ENS6Q). Significant differences were observed in the pre- and postoperative total ENS6Q scores. The pre- and postoperative scores of “nose feeling too open” and nasal crusting showed statistically significant differences. Further, compared with the other items, the postoperative score of nasal crusting increased most obviously, and it may be the most apparent operation-related symptom. Conclusion: This study is the first to report the possibility of developing ENS after endoscopic transnasal sellar surgery. Although the transnasal endoscopic approach is a safe and minimally invasive procedure for the treatment of sellar lesions, possible complications such as ENS should be considered.
文摘In the semi-arid tropics (SAT),33% areas are occupied by Alfisols and related soils. In SAT these soils have low structural stability and thereby tend to form seal and crusts at the surface. Due to this a large proportion of the rain that falls on Alfisols during the early part of the rainy season,is normally lost as runoff thus causing high soil loss as well as moisture stress to crops. Two tillage studies were conducted first at plot scale (320 m2) during 1991-95 and second at small watershed scale (1.45 ha) during 2007-10,at ICRISAT research station,Hyderabad,India. These studies were conducted to find out whether the problem of excessive runoff and soil loss during the early part of the rainy season can be controlled by various inter-row tillage systems in addition to normal intercultivation by breaking the crust or seal and thereby improving infiltration and soil moisture and reducing runoff and soil loss. The observations on rainfall,runoff,soil moisture,soil loss,soil surface roughness and crop yields were collected from both the studies. Results from these studies have shown that inter-row tillage in addition to normal intercultivation is found effective in controlling early season runoff and soil loss and increasing crop yields. The additional tillage systems are found most effective during low and medium rainfall years and not so much during high rainfall years. The additional tillage with shoe cultivators,which creates rough soil surface (11 mm depression storage),is found most effective in increasing crop yields and reducing runoff and soil loss. The additional tillage with blade harrow which generates smooth soil surface is relatively less effective. In most rainfall conditions,the normal intercultivation with one additional tillage is found adequate for controlling early season runoff and improving soil moisture and crop yields.
文摘Mucotomy is one of the most frequently applied surgical techniques for the management of inferior turbinate hyperplasia. Mucotomy guarantees patent airway, however, it might lead to the emergence of sicca syndrome. In contrast, KTP (potassium titanyl phosphate) laser treatment spares the medial part of the inferior turbinate mucosa, contributing to maintenance of physiological nasal function. A retrospective comparative clinical study was performed to reveal the advantages and side-effects of both surgical methods in medium- and long-term in allergic rhinitis and non-allergic patients. Furthermore, we wished to determine the exact indications of the up-to-date laser treatment. Ninety-one of the 117 patients who underwent bilateral turbinate surgery during an 8-year period (2000-2007) responded to our questionnaire focusing on subjective postoperative changes. Patients were separated into 6 groups, based on the type of operation they underwent, the length of the follow-up and whether they suffered from allergies. The major complaint, nasal obstruction, improved in all 6 groups, which reached significance (p ? 0.05) in 4 groups. The most pronounced improvement was observed in the group of non-allergic patients with medium-term follow-up who underwent mucotomy. Nevertheless, a serious side- effect: crusting also increased significantly (p ? 0.05) in the latter group, while it was absent in allergic patients with medium-term follow-up, who underwent mucotomy. These results lead us to propose the following protocol for the treatment of inferior turbinate hyperplasia: 1) after unsuccessful conservative treatment, laser treatment is suggested for non-allergic patients;2) following unsuccessful conservative and even repeated laser treatment in the allergic group, mucotomy or turbinoplasty should be attempted.
