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O Cohen, M Adi, Y Shapira-Galitz, D Halperin, M Warman
BACKGROUND: The prevalence of sinuses' anatomic variations in the healthy pediatric population has not been studied. The study describes the prevalence of known anatomic variations with regard to gender and age in this population. METHODS: A single academic institute observational cohort study. A total of 200 head CT scans were reviewed, subdivided into five equal age subgroups (0-4.99; 5-7.99; 8-10.99; 11-13.99; 14-17 years), with an equal male to female ratio...
February 19, 2019: Rhinology
F Droege, C Lueb, K Thangavelu, B A Stuck, S Lang, U Geisthoff
STATEMENT OF PROBLEM: Hereditary hemorrhagic telangiectasia (HHT) is characterized by recurrent epistaxis that can lead to a feeling of losing control. We assessed potential benefits and side effects of different nasal packings used by patients themselves. METHOD OF STUDY: An online-questionnaire in English and German was used to analyze nasal self-packings. RESULTS: 588 of the 915 respondents suffered from HHT with most of them having moderate or severe epistaxis...
February 10, 2019: Rhinology
Z Farzal, A G Del Signore, A M Zanation, C S Ebert, D Frank-Ito, J S Kimbell, B A Senior
BACKGROUND: Nasal septal perforations (NSPs) often cause bleeding, crusting, obstruction, and/or whistling. The objective was to analyze the impact of anterior NSP size and shape on nasal physiology using computational fluid dynamics (CFD). METHODS: A 3-dimensional model of the nasal cavity was constructed from a radiologically normal CT scan using imaging software. Anterior NSPs (ovoid (ONSP): 0.5, 1, 2, and 3 cm long anterior-to-posteriorly and round (RNSP, 0...
January 29, 2019: Rhinology
R Moreno-Luna, J Gonzalez-Garcia, J M Maza-Solano, E Molina-Fernandez, C D Pinheiro-Neto, A Del Cuvillo Bernal, C Langdon, S Sanchez-Gomez
BACKGROUND: We report a novel surgical technique based on an endonasal free mucosal graft (mucoplasty) for improving clinical results and local healing in chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: Patients diagnosed with bilateral CRSwNP scheduled for endoscopic sinus surgery were included. They underwent complete removal of anterior and posterior ethmoid cells, in addition to bilateral type III frontal sinusotomy. An endoscopic mucoplasty was performed in the left nasal cavity, whereas the right nasal cavity served as control...
January 28, 2019: Rhinology
D E Page, J Rimmer, M Keane, S Manikappa, D Butzbach, C Giddings
BACKGROUND: In order to perform endoscopic sinus surgery (ESS) safely and efficiently, preparation of the nasal mucosa with vasoconstrictor agents is crucial to minimise bleeding. There is no single best method, although traditionally cocaine has been the agent of choice. However, there have been concerns over the potential for systemic side effects when applied topically. With this concern in mind, there exists limited contemporary research looking at cocaine absorption in the context of ESS...
January 10, 2019: Rhinology
Nishchay Mehta, Kara Stevens, Matthew E Smith, Richard J Williams, Matthew Ellis, John C Hardman, Claire Hopkins
BACKGROUND: There is a paucity of high-quality evidence relating to the management of epistaxis severe enough to require admission to a hospital. Previous studies of interventions for epistaxis have suffered from small sample sizes. They lacked the power to allow analysis of the effect of an intervention on epistaxis control that is independent of the condition severity or additional interventions given. OBJECTIVE: To determine the effect of specialist treatments on the successful management of severe epistaxis METHODOLOGY: Secondary analysis of data collected from a national multi-centre audit of patients with epistaxis over 30 days in 2016...
January 5, 2019: Rhinology
M Hoggard, M Zoing, K Biswas, M W Taylor, R G Douglas
BACKGROUND: While bacterial associations with chronic rhinosinusitis (CRS) are increasingly well described, fewer studies have examined the fungal component of the sinonasal microbiota. Here we present a study of the sinonasal mycobiota in a cohort of 144 patients (106 patients with CRS and 38 controls). METHODOLOGY: Fungal communities were characterised by analysis of mucosal swab samples of the left and right middle meatuses via ITS2 marker amplicon sequencing on the Illumina MiSeq platform...
January 5, 2019: Rhinology
Andrzej Bozek, Wojciech Scierski, Beata Ignasiak, Jerzy Jarzab, Maciej Misiolek
BACKGROUND: Local allergic rhinitis (LAR) is found in some patients with typical symptoms but who have negative skin prick tests and negative IgE to aeroallergens while presenting with positive nasal provocation tests for proper allergens. Little information about the clinical characteristics and prevalence of LAR has been published. The aim of this study was to determine the prevalence and characteristics of LAR in patients with symptoms of chronic rhinitis. METHODS: In total, 680 patients out of 3400 pre-screened subjects with chronic rhinitis who were at least 5 years old were included from 17 sites in Poland in the study protocol...
December 17, 2018: Rhinology
Marjolein E Cornet, Katriina Kostamo, Albert B Rinia, Aeilko H Zwinderman, Danielle van Egmond, Esther J J de Groot, Wytske J Fokkens, Cornelis M van Drunen
BACKGROUND: Airway epithelial cells have a well-accepted role in the regulation of local inflammatory processes in allergic and innate defence responses. However, their role the pathophysiology of chronic rhinosinusitis with nasal polyps (CRSwNP) is unclear. The objective was to investigate whether potential differences in the mRNA expression profile of nasal epithelia from healthy individuals and from CRSwNP patients would shed new light on disease mechanisms. METHODS: Primary epithelial cells from nasal polyps of 24 affected individuals and from middle turbinates of 9 healthy controls were obtained using magnetic beat assisted isolation and were used for expression profiling using the Human Genome U133 Plus 2...
December 1, 2018: Rhinology
Kimia G Ganjaei, Zachary M Soler, Elliott D Mappus, Mitchell L Worley, Nicholas R Rowan, Guilherme J M Garcia, Lois J Matthews, Judy R Dubno, Mark A Eckert, Rodney J Schlosser
BACKGROUND: With an aging population, it is important to understand age-related anatomic changes in the nasal cavity and cribriform plate (CP) that may have clinical implications. METHODOLOGY: Computed tomography (CT) scans obtained for non-rhinologic conditions were divided into a young cohort (N=35, 18-34 years old) and an older adult cohort (N=32, 80-99 years old). Intranasal airspace volumes and bony anatomy of the CP were manually segmented using OsiriX software...
December 1, 2018: Rhinology
Sophia C Poletti, Jacqueline Hausold, Andreas Herrmann, Martin Witt, Thomas Hummel
BACKGROUND: Topographical differences in trigeminal receptor distribution of the nasal cavity has been investigated so far indirectly using various agonists to stimulate receptors in different locations. However, polymodal activation of trigeminal receptors poses difficulties in such investigation. The aim of our study was to examine the distribution of trigeminal receptor mRNA expression using quantitative PCR. METHODOLOGY: A prospective study was performed in 18 healthy volunteers...
November 29, 2018: Rhinology
Wanrawee Thaitrakool, Narittee Sukswai, Somboon Keelawat, Supinda Chusakul, Jesada Kanjanaumporn, Songklot Aeumjaturapat, Kornkiat Snidvongs
BACKGROUND: This study aims to compare histopathology of nasal polyp and ethmoid mucosa for diagnosing eosinophilic mucin rhinosinusitis (EMRS). METHODOLOGY: Patients with chronic rhinosinusitis with polyps (CRSwNP) were enrolled. Using eosinophilic mucin as a reference, histopathology of polyp apex, polyp pedicle and ethmoid mucosa was compared for density of tissue eosinophil and sensitivity for diagnosing EMRS. Associations with asthma were assessed for each site...
February 1, 2019: Rhinology
W J Fokkens
In recent years non-allergic rhinitis has received a lot of interest; in particular the different phenotypes, endotypes, the impact on quality of life and the potential role of IgE in local allergic rhinitis (LAR). The prevalence of LAR reported in the literature has been extremely variable (0-100%); Hamizan’s review in this issue explains many of these discrepancies. The overall prevalence of IgE in nasal secretion was found to be 10.2 (7.4-13.4) %. However, where there is history of an identifiable aeroallergen which triggered nasal symptoms or seasonality of symptoms, the prevalence is 19...
February 1, 2019: Rhinology
Y Huang, H Lou, C Wang, L Zhang
BACKGROUND: No diagnostic criteria have been available for nonallergic rhinitis (NAR) to this point in time. Nonspecific nasal hyperresponsiveness (NHR), which could be efficiently assessed by cold dry air (CDA) provocation, is an essential feature of NAR. Thus, this study’s purpose was to assess the diagnostic value of CDA provocation in discriminating patients with NAR from healthy individuals. METHODS: CDA provocation was performed among 13 healthy volunteers and 15 NAR patients...
February 1, 2019: Rhinology
Philippe F D Bowles, Satish Agrawal, Mahmoud A Salam
BACKGROUND: Prospective study investigating the incidence of concurrent Eustachian Tube dysfunction (ETD) in patients with CRS refractory to medical therapy, and the effect of Endoscopic Sinus Surgery (ESS) on ETD in this patient group. METHODS: Prospective study of 57 CRS patients. Outcome measures were SNOT-22 and ETDQ-7 questionnaires, tympanometry and Valsalva manoeuvre recorded pre-operatively and at 3 and 9 months post ESS. RESULTS: There was a moderate positive correlation between pre-operative ETDQ-7 and SNOT 22 scores (r equals 0...
February 1, 2019: Rhinology
Aneeza W Hamizan, Janet Rimmer, Salina Husain, Raquel Alvarado, Jessica Tatersall, William Sewell, Larry Kalish, Richard J Harvey
BACKGROUND: Allergen specific immunoglobulin can be present in the nasal mucosa of patients with non-allergic rhinitis (NAR). This condition is defined as local allergic rhinitis. However, the reported presence of nasal specific immunoglobulin E (nspIgE) among NAR is variable. The aim of this review was to summarize the studies which reported the presence of nspIgE among patients diagnosed as NAR. METHODS: Embase (1947- ) and Medline (1946-) were searched until 6th June 2017...
February 1, 2019: Rhinology
P W Hellings
Prevention of chronic rhinosinusitis remains a true societal challenge, as prevention of this highly prevalent non-communicable disease will significantly reduce socio-economic costs and improve the overall well-being of the large group of affected individuals. In alignment with the health priorities of national governments, prevention and cost-effective health care should be embraced by the Rhinologic community.
December 1, 2018: Rhinology
A Santamaria-Gadea, M Lopez-Chacon, C Langdon, L Van Gerven, M Valls-Mateus, M Bernal-Sprekelsen, I Alobid
BACKGROUND: The nasal floor and inferior meatus (NFIM) flap represents an available option for the reconstruction of a septal perforation (SP). This study explores the feasibility of repairing SPs using a modified simple and extended (including inferior turbinate) NFIM flap. METHODS: An anatomic study was achieved in fresh frozen cadaveric specimens to measure the area and lengths of NFIM flap. The repair of SP with simple and extended NIFM flaps was performed in some of these cadaveric specimens...
December 1, 2018: Rhinology
M Lundberg, A Haapaniemi, J Hagstrom, S Juteau, M Hernberg, A A Makitie, S I Vento
BACKGROUND: To describe a cohort of sinonasal mucosal melanoma (SNMM) patients, and to assess if choice of surgical approach (open versus endoscopic) has impact on survival. METHODOLOGY: Adequate data on clinical presentation, treatment, and recurrence pattern were available for 58 consecutive patients treated for SNMM at the Helsinki University Hospital (HUH) between 1983 and 2016. RESULTS: The 5-year disease-specific survival (DSS) was 27% and overall survival 25% for the whole cohort...
November 24, 2018: Rhinology
Gregory Reychler, Claire Domachowski, Anne-Claire Latiers, Francois Jamar, Philippe Rombaux
BACKGROUND: Treatment of chronic rhinosinusitis (CRS) aims to treat the underlying inflammation or infection. Although the optimal modality of administration remains controversial, inhalation route is usually preferred. The aim of this systematic review was to summarize the efficacy of intranasal corticoisteroids or antibiotics delivery by nebulization on symptoms, histology, endoscopy scores, nasal obstruction, clinical outcomes and quality of life in CRS. METHOD: This systematic review followed the PRISMA guidelines...
November 24, 2018: Rhinology
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