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10,11 The patients in our study were treated according to this guideline. In the year 2011, a sinus X-ray bepotastine was still commonly taken before sending the patient to HUH for consultation. Technique of antral irrigation Local anesthesia is introduced to the inferior meatus with a cotton-tipped applicator soaked in local anesthetic or with a mixture of lidocaine hydrochloride and prilocaine hydrochloride (EMLA cream, Astra-Zeneca) instilled with a suction needle and a syringe. Maxillary sinus puncture is performed with a straight needle (circumference: 1.3�C2 mm, length: 12 cm) under the inferior turbinate. The stylet is removed and a 100 mL syringe is connected to the needle with a prefilled silicon tube and a connector. Irrigation is performed with warm (38��C) physiological saline solution with the patient sitting in a forward leaning position. The patients were informed about the study at the end of their visit. If the patient was willing to participate, he/she Olaparib price completed an informed consent form and filled in a questionnaire before leaving the clinic or at home on the same day. The questionnaires were handed to the nurses or returned by prepaid mail in a closed envelope. The treating physician did not see their answers. The physicians completed their part of the questionnaire at the end of the patients�� visit. The researchers opened and analyzed the data after all the patients had returned the questionnaires. The patients�� questionnaire included questions about previous experiences of antral irrigation, learn more as well as current symptoms both before and immediately after the procedure. The patients evaluated the severity of facial pain and nasal obstruction on a 10 cm visual analog scale (VAS). VAS values >0 to 3 were graded as mild, >3 to 7 as moderate, and >7 as severe.12 The same scale was also used in determining the severity of pain caused by antral irrigation. The patients compared the current procedure with their previous experiences. Additionally, they evaluated using VAS their sensation of other common medical procedures, such as having a blood sample taken or dental restoration. The physicians�� questionnaire inquired about their degree and level of experience, way of application, and choice of local anesthetics, as well as the doctors�� impression about the discomfort caused by the irrigation to the patients. We also asked whether the physician experienced any anxiety when performing the procedure. The study was approved by the Operative Ethics Committee of the Helsinki and Uusimaa Hospital District. This study has been conducted according to the Declaration of Helsinki. A professional statistician performed the statistical analysis. The Mann�CWhitney U-test was used to compare two independent samples and the Kruskall�CWallis analysis of variance was used for comparison of several independent samples.

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