Background: Respiratory distress syndrome (RDS) is a major cause of mortality among premature neonates. The present study was conducted to find out whether early NASAL CPAP therapy could eliminate the need for mechanical ventilation in premature neonates with RDS.Materials and methods: For this clinical trial, premature neonates with RDS during the first 6 hours following the delivery were assigned in either case or control group. Case group received early treatment with NASAL CPAP, however, standard treatments were applied for controls based on arterial blood gas analysis.Results: Totally, 25 cases and 22 controls with the mean gestational age of 31.3±2.6 weeks and weight of 1621±540 gr. Totally, 68% of controls versus 40.9% of cases died (p=0.06). However, 80% of controls and 36.4% of cases required mechanical ventilation (p=0.006) that lasted averagely 2.9±2.6 days for controls and 0.68±1.3 days for cases (p=0.0009). Surfactant was injected in 48% of controls and 9.1% of cases (p=0.009). Finally, pneumothorax occurrence, oxygen therapy, and duration of hospitalization in NICU did not significantly differ between groups.Conclusions: Early therapy with NASAL CPAP could eliminate the need for mechanical ventilation, and surfactant in premature neonates with RDS. Thus, application of NASAL CPAP in centers lack NICU and respirator is strongly suggested.

Introduction: Skin defect reconstruction following tumor resection, is a challenge for surgeons. Nose as a key point of aesthetics has a significant role in this scenario. One of the practical approaches is dorsal NASAL flap (Rintala) to cover lower 1/3 NASAL defects. The disadvantages of this method are limitation to reach lower areas, especially nose tip, flap ischemia and wound dehiscence. Case report: A 47 years old man with supratip BCC lesion underwent tumor resection and prepared for dorsal NASAL flap reconstructive surgery, in which dorsal hump resection caused relaxed flap transfer and ultimately more acceptable profile view. Conclusion: Advancement of the dorsal NASAL flap more distally can be achieved by dorsal hump reduction in selected patients, which makes patients more satisfied with their new NASAL form and appearance and reduces the risk of distal flap ischemia.

BACKGROUNDThe efficiency of NASAL surgeries can be determined by objective or subjective methods. We have assessed the effect of NASAL obstruction after different NASAL surgeries using Acoustic Rhinometry (AR) and NASAL Obstruction Symptom Evaluation (NOSE) Scale.METHODSBetween May 2011 and May 2012, 40 young adult patients and 10 healthy volunteers as control group who referred to Otorhinolaryngology Clinic in Eskisehir Military Hospital due to NASAL obstruction were enrolled. Depending on operation, patients were divided into four equal groups. Group 1: Septoplasty, Group 2: Septoplasty with sprader graft, Group 3: Septorinoplasty and Group 4: Septorhinoplasty with spreader graft. The patients completed NOSE scale, 1 week before and 1 month after the surgery and AR measurements.RESULTSThere were a significant improvement in mean NOSE scores of patients and statistical difference was found between pre and post-operational values for each group. There was a statistically significant change of the mean minimal cross section areas (MCA) of the deviated side of NASAL passages measured by AR between pre and postoperative period.CONCLUSIONIn patients with NASAL obstruction, functional NASAL surgeries which were performed after appropriate medical examination and with right operation methods had a positive impact on quality of life and patient satisfaction. We observed that NASAL findings were correlated with NOSE scores and MCA values. So, we suggest that NOSE scale and AR to be used for evaluation of the efficiency of functional NASAL surgeries.

NASAL bone fracture, more than other bone fractures, involves a medicolegal social problem. In a retrospective study on 166 cases of NASAL fractures 146 patients (123 male, 23 female) were included in the authors specialized practice, mainly in a clinic south of Tehran (Naziabad) during the decade 1981 to 1991. The most common causes of NASAL fracture were conflict (48.65%), falling from the second floor or the beds of a sanatorium, and vehicle accidents (10.13%), Traumatic causes lead to NASAL fracture. Football lead to NASAL fracture (9.45%). The most common age involved in NASAL fracture was the third decade, approximately 55.48% . Most patients referred to my clinic within the first week rather later (70.39%); 36.84% visited the clinic within the first two days.