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Biomedical subjects

S Elwany

Publications and source records attributed to S Elwany.

At least 19 recordsLinked to original sources
PubMed2001

Treatment of rhinitis medicamentosa with fluticasone propionate--an experimental study.

The efficacy of fluticasone propionate aqueous nasal spray (0.05% w/w) in the treatment of rhinitis medicamentosa has been studied in an animal model (guinea pig). Rhinitis medicamentosa was induced through the instillation of 0.05% naphthazoline nitrate (Privine) for 8 weeks. Fluticasone propionate nasal spray was then administered to the animals for 2 weeks. The spray successfully cleared the interstitial edema which is the pathologic hallmark of rhinitis medicamentosa. The study suggests that fluticasone propionate nasal spray can be beneficial in the treatment of patients with rhinitis medicamentosa.

Administration, Intranasal↗
PubMed2001

Endoscopic carbon dioxide laser turbinoplasty.

In the present work we describe the management of hypertrophied inferior turbinates using CO(2) laser in the UniPulse mode. The laser beam is delivered through the nasal probe delivery system, and the procedure is performed using the 0 degrees endoscope. The UniPulse mode allowed fine-tuned, char-free tissue ablation, and the nasal probes allowed delivery of laser energy to the posterior parts of the inferior turbinates. The procedure was performed on 149 patients. The one-year post-operative follow-up period revealed good functional results in 131 patients (88 per cent). The minimal nasal cross sectional area increased significantly from 0.52 cm(2) to 0.81 cm(2). The average decongestive effect, on the other hand, decreased from 0.26 cm(2) to 0.07 cm(2) indicating significant laser-induced fibrosis. The operation can be performed as an out-patient procedure with little or no morbidity.

Adolescent↗
PubMed1999

Endoscopic anatomy of the sphenoid sinus.

The anatomy of the sphenoid sinus, as it relates to endoscopic sinus surgery, was studied in 93 cadaver heads (186 sphenoid sinuses) using endoscopic dissections as well as sagittal sections. The relationship of the sphenoid sinuses to the carotid artery, optic nerve, floor of sella turcica, as well as other important structures, were verified and discussed. The recesses of the sinus as well as its ostium and accessory septa and crests were described and their clinical importance was discussed. Pertinent measurements were included wherever appropriate.

Dissection↗
PubMed1999

Laser surgery for allergic rhinitis: the effect on seromucinous glands.

Ten patients with perennial allergic rhinitis were subjected to CO2 laser turbinectomy. Tiny (1 mm3) biopsy specimens were taken at the time of surgery and 1 month thereafter. The biopsy specimens were processed for transmission electron microscopy. Also, the activity of succinic dehydrogenase and cholinesterase enzymes was measured. The study showed that laser turbinectomy was followed by reduction in the number and activity of the glandular acini in the laser-treated areas. This reduction is ascribed to the local destructive effect of laser energy on the glandular acini and on the surrounding cholinergic nerve fibers. The enzymatic activity of the cholinergic nerve fibers themselves, however, did not diminish, indicating that laser surgery has no inhibitory effect on the local allergic reaction.

Adult↗
PubMed1998

The effect of endoscopic sinus surgery on mucociliary clearance in patients with chronic sinusitis.

The saccharin test was used to measure mucociliary clearance in 50 patients with symptoms of chronic sinusitis. Samples of the nasal mucosa were also examined under transmission electron microscopy before and after functional endoscopic sinus surgery (FESS). Before surgery, the mean saccharin clearance (ST) was 37.0 +/- 15.7 min, with nasal mucosa exhibiting ciliary loss as well as other ultrastructural changes. Three months after surgery, the mean ST had improved to 20.3 +/- 7.5 min and significant regeneration of cilia was observed. It was therefore concluded that FESS had successfully corrected mucociliary dysfunction in these patients.

Adolescent↗
PubMed1997

Carbon dioxide laser turbinectomy. An electron microscopic study.

Ten patients with chronic non-allergic rhinitis and presenting mainly with nasal obstruction due to hypertrophied inferior turbinates were subjected to laser turbinectomy using CO2. Tiny biopsies were taken, at the time of surgery as well as one month later, and were processed for transmission electron microscopy. The ultrastructural observations included: early epithelial loss which was followed by prompt regeneration of healthy epithelium, decreased number and activity of the seromucinous glands, fibrosis of the connective tissue stroma, as well as diminished number and congestion of the cavernous blood spaces. These observations were discussed in view of the excellent clinical response of the patients.

Adult↗
PubMed1997

Topical levocabastine for the treatment of perennial allergic rhinitis.

The ultrastructure of the nasal mucosa following the use of intranasal levocabastine was studied in 20 patients suffering from perennial allergic rhinitis. The patients received twice daily 0.05 per cent levocabastine spray with a treatment duration of four weeks. At the end of the treatment period regression of the allergic process was evidenced by progressive reappearance of normal cilia and microvilli on the columnar cells, decrease of intercellular oedema and cytoplasmic vacuoles, increased number of mucous acinar cells, gradual decrease of vascular congestion, as well as diminished oedema fluid formation. The drug, however, had no effect on mast cell degranulation nor on eosinophilic infiltration. Normalization of the ultrastructural features correlated well with clinical improvement. Considering the results of the present study, levocabastine nasal spray appears to be an effective treatment for perennial allergic rhinitis and can be used with, or as an alternative to, other anti-allergic medications.

Administration, Intranasal↗
PubMed1996

Obstruction of the nasal valve.

Obstruction of the nasal valve is an important cause of chronic nasal obstruction in adults. In a series of 500 patients, obstruction at the level of the nasal valve was diagnosed in 65 of them (13 per cent). The obstruction was unilateral in 57 patients (88 per cent). Forty-seven patients (72 per cent) had history of previous nasal surgery of accidental trauma. Causes of obstruction of the nasal valve included high septal deviations, a weak or deformed upper lateral cartilage, adhesions, and alar collapse. All patients underwent corrective nasal surgery and the surgical procedures were tailored according to the existing pathology. Post-operatively, the mean nasal patency score increased from 2.9 to 8.6, the mean nasal airflow increased from 579.5 to 727 cm/sec (at 150 Pa), and the mean nasal resistance decreased from 0.31 to 0.23 Pa/cm3 sec-1.

Adolescent↗
PubMed1996

Endoscopic control of posterior epistaxis.

Control of bleeding vessels by suction cautery under endoscopic vision was used on 38 patients suffering from posterior epistaxis. Twelve patients also required the insertion of nasal tampons at the end of the cautery procedure. Eight patients, six of them hypertensive, had recurrent epistaxis post-operatively. Five patients needed further cautery in order to control the bleeding. Three patients required temporary balloon tamponade, and a single patient had internal maxillary ligation. Temporary palatal numbness in three patients was the only post-operative complication. Otherwise, the technique has the potential advantages of simplicity, safety, effectiveness and simplified post-operative care.

Cautery↗
PubMed1993

Pathology of the eustachian tube in otitis media: an electron microscopic study.

The ultrastructure of the mucosa of the eustachian tube was studied in four temporal bones showing tympanosclerosis, cholesteatoma, otitic meningitis and a grafted tympanic membrane (tympanoplasty). The mucosa of tube was abnormal in the four cases confirming the relationship between the state of the eustachian tube and the inflammatory process in the middle ear. The observed abnormalities included: ciliary loss, abnormal ciliary morphology and motility, oedema of the microvilli, hyperplasia of the goblet cells and the seromucinous acini, desquamation of the non-ciliated cells and appearance of mast cells in the lamina propria of the tube. Ciliary changes were the most frequent abnormalities and the morphological changes, in general, were fewest in the case of healed tympanoplasty. The pathophysiology of the morphological changes was discussed and correlated with the disease in the middle ear.

Adolescent↗
PubMed1990

Inferior turbinectomy: comparison of four techniques.

As yet, there is not totally satisfactory means for treating hypertrophied turbinates and the proper management of turbinate dysfunction remains in question. In the present series, four of the widely practiced surgical procedures for the reduction of the size of the inferior turbinates were evaluated and compared. In all cases turbinectomy was performed as an isolated procedure. Eighty patients with chronic non-allergic rhinitis and hypertrophied inferior turbinates were selected, randomly divided into four groups, and followed up post-operatively for one year. Study of the results indicated that the beneficial effect of the operation is mainly mechanical by reduction of the resistance to nasal airflow. The post-operative improvement in smell acuity correlated positively with the increased patency of the nasal airway. None of the procedures had a deleterious effect on olfactory acuity. In contrast, the operation failed to enhance the mucociliary clearance rate or significantly decrease nasal drainage. Partial inferior turbinectomy and laser turbinectomy improved nasal breathing in 77 per cent of patients, and enhanced olfactory acuity in 78 per cent of patients who had pre-operative hyposmia. The results of turbinoplasty and cryoturbinectomy were less favourable. The surgical technique, advantages, and drawbacks of each of these procedures are discussed.

Adult↗
PubMed1990

Tympanic neurectomy: its effects on the seromucinous glands of the middle ear of cats.

The effect of tympanic neurectomy on the seromucinous glands of the middle ear was evaluated experimentally in cats. The operation suppressed the secretory activity of the glands and induced their atrophy, and glandular suppression was still evident 1 year postoperatively. This work points to the possibility of employing tympanic neurectomy in the treatment of refractory cases of otitis media with effusion. The operation is easy to perform, and, theoretically, it should allow drainage of the effusion and inspection of the ossicles. However, neurectomy should be carried out as completely as possible in order to achieve optimum and long-lasting effects.

Animals↗
PubMed1989

Nasopharyngeal bacterial flora before and after adenoidectomy.

Fifty patients (23 males and 27 females), with chronically hypertrophied and infected adenoids were subjected to adenoidectomy. Pre- and post-operative nasopharyngeal swabs were taken to study bacterial colonization of the nasopharynx both quantitatively and qualitatively. Twenty healthy controls were included in this study. The swabs were cultured on MacConkey's and Columbia blood agar plates. The rate of isolation of potentially pathogenic microorganisms decreased markedly following operation, while normal inhabitant organisms showed notable increase in their numbers post-operatively to reach a near normal level. It is concluded from this work that adenoidectomy produces a physiological effect on the nasopharyngeal microflora by conversion of an abnormal flora to a nearly normal one.

Adenoidectomy↗
PubMed1988

Auditory brain stem responses (ABR) in patients with acute severe closed head injuries. The use of a grading system.

ABR were recorded in 68 cases suffering from severe acute closed head injuries. Abnormal recordings were observed in 60 per cent of patients, and the abnormalities ranged from prolongation of the interpeak latency intervals to complete absence of auditory brain stem activity. Based on the results obtained, a grading system was developed and correlated with the neurological outcome. It was concluded that ABR is a useful diagnostic and prognostic tool which can provide valuable information about the function of the brain stem in these patients. Inclusion of ABR studies in the head injury management protocol is strongly recommended.

Acute Disease↗
PubMed1988

Sensorineural hearing loss in sickle cell crisis.

The present investigation examines the effects of sickle cell crisis on peripheral auditory function and auditory brainstem response (ABR). The study includes 10 homozygous sickle cell anemia patients with documented sickle cell (SS) hemoglobin. Testing was performed during the crisis and 1 month after it subsided. Unilateral high frequency hearing loss was found in three patients but persisted in only one of them. Abnormal ABR tracings occurred in four patients but reversed to normal in one of them. The study suggests a trend toward increased incidence of sensorineural hearing loss (SNHL) and ABR changes as frequency and severity of crisis episodes increases. The relationship between SNHL and ABR is analyzed and discussed.

Adolescent↗
PubMed1987

The adenoidal-nasopharyngeal ratio (AN ratio). Its validity in selecting children for adenoidectomy.

The present study disclosed that the AN ratio measured on simple lateral skull radiographs reliably expressed the adenoidal size and patency of the nasopharyngeal airway, and correlated well with the clinical assessment score and the weight of adenoids removed at operation. The inter-observer agreement was satisfactory, and for practical purposes, a value of AN ratio greater than 0.73 may be considered indicative of pathological enlargement of the adenoids. Hopefully this study will facilitate more accurate detection of those children most likely to benefit for adenoidectomy.

Adenoidectomy↗
PubMed1987

Effect of nasotracheal intubation on nasal mucociliary clearance.

Forty patients were studied to investigate the effect of nasotracheal intubation on nasal mucociliary clearance measured with the radiopaque disc method under standard conditions. Postoperative mucociliary slowing on the intubated side was observed in 65% of patients. Difficult or prolonged intubation increased the incidence of mucociliary stasis. Age, sex, smoking history, tube size and the use of lubricants had no effect. Postoperative slowing of the clearance rate was most probably the result of mechanical trauma to the superficial epithelial layers, and recovery of function was reasonably rapid with conservative management.

Adolescent↗