Clinical Research Directory

Clinicoradiological Correlation Between Long Standing Untreated Adenoids and Nasal Septum Deviation in Adolescents

The adenoids, also known as pharyngeal tonsils, are the peripheral immune organs of the human body and are located at the junction of the nasopharyngeal parietal and posterior walls. The adenoids represent the first defense portal of the respiratory tract and the earliest site of exposure to various antigens by inhalation or ingestion This can result in adenoid hypertrophy (AH) due to repeated stimulation by various antigens and their own inflammation (1) . AH is the chronic enlargement of the adenoids usually accompanied by recurrent infections. Adenoids which are enlarged are capable of becoming practically the ping pong ball sized and wholly obstruct airflow in the course of nasal cavities (2) . AH is commonly encountered in children and is a well-recognized cause of nasal obstruction. Typically, the tissue undergoes involution during adolescence, and its persistence into adulthood is considered unusual. However, AH in adolescents is thought to be a persistence of untreated AH of childhood (3) In such cases, persistent adenoid hypertrophy may continue to cause chronic nasal obstruction and prolonged mouth breathing. Mouth breathing alters the normal functional balance between the tongue, lips, and buccal muscles, which may contribute to narrowing of the maxillary arch and development of a high-arched palate during childhood growth. If adenoid hypertrophy and nasal obstruction remain untreated, these functional and structural changes may persist into adolescence (4) . As the hard palate forms the floor of the nasal cavity, a high-arched palate and associated maxillary changes may alter the shape and available space of the nasal cavity. Such anatomical changes may * may influence the configuration of the nasal septum, particularly during the growing years, 2 providing a possible structural link between long-standing adenoid hypertrophy and septal deviation (5) Despite the recognized effects of chronic adenoid obstruction on nasal breathing and craniofacial development, evidence specifically addressing whether long-standing untreated AH is associated with septal deviation remains limited. so, this study aims to investigate the clinicoradiological correlation between long-standing untreated AH and nasal septal deviation in adolescent

Effect of Controlled Hypotension on GFAP and Cognition in Rhinoplasty

This prospective observational study aims to evaluate the neurological safety of controlled hypotension (Mean Arterial Pressure 50-65 mmHg) during elective rhinoplasty. The investigators will assess whether this standard intraoperative hypotensive strategy causes cellular stress by measuring serum Glial Fibrillary Acidic Protein (GFAP) levels and early postoperative cognitive changes using the Montreal Cognitive Assessment (MoCA) test.

Anesthesia Type and Postoperative Sleep Quality in Septoplasty

This prospective observational study aims to evaluate the association between routinely applied anesthesia techniques and postoperative sleep quality in adult patients undergoing septoplasty. Patients will receive either total intravenous anesthesia or inhalational anesthesia according to standard clinical practice, without any intervention by the investigators. Postoperative sleep quality will be assessed using the Richards-Campbell Sleep Questionnaire on postoperative days 7 and 15. Secondary outcomes include postoperative pain intensity, opioid consumption, and postoperative nausea and vomiting.

Disarticulation Septoplasty Versus Classical Way

The objective of this study is to determine which of the two techniques (disarticulation septoplasty versus open surgery) offers the best functional results for correcting symptomatic deviations of the nasal septum. More specifically it's about: * Compare the improvement in respiratory symptoms between the two techniques * Analyze and compare complication rates between the two techniques * Evaluate patient satisfaction with aesthetic results (including columella deviation)