bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sinonasal Osteocartilaginous Necrosis in Cocaine Abusers: Experience in 25 Patients
Authors: Trimarchi Matteo , Nicolai Piero , Lombardi Davide , Facchetti Fabio , Morassi Maria Laura , Maroldi Roberto , Gregorini Gina , Specks Ulrich 
Published: August 2018

Background Cocaine-induced lesions may cause extensive destruction of the osteocartilaginous structures of the nose, sinuses, and palate that mimics the clinical picture of other diseases. Methods From January 1991 to September 2001 25 patients with cocaine-induced midline destructive lesions were observed at the Department of Otorhinolaryngology of the University of Brescia. The diagnosis was based on physical and endoscopic evaluation, routine blood and urine analysis, radiological findings, and repeated biopsies of the nasal mucosa. Serum was analyzed by the antineutrophilic cytoplasmic antibody (ANCA) test using indirect immunofluorescence and by enzyme-linked immunosorbent assay for antibodies against proteinase 3 and myeloperoxidase. Results Septal perforation was present in all 25 patients, 16 of which (68%) also had partial destruction of the inferior turbinate. Hard palate reabsorption was observed in only six patients (24%); in two of these patients, the lesion also extended to the soft palate. Fourteen patients (56%) were positive by the immunofluorescence test (nine patients had a P-ANCA and five patients a C-ANCA pattern). Four patients (16%) with the P-ANCA pattern and all patients with the C-ANCA pattern also tested positive for anti–proteinase 3 antibodies. Conclusion Any sinonasal inflammation involving the midline that persists or remains refractory to treatment may be the first manifestation of potentially lethal drug addiction. Cocaine abuse should be considered in the differential diagnosis of destructive lesions of the nasal cavity even in the presence of a positive ANCA test.
Long-Term Follow-Up of Patients with Microscopic Endonasal Dacryocystorhinostomy
Authors: Dietrich Christoph , Mewes Torsten , Kühnemund Matthias , Hashemi Basir , Mann Wolf J. , Amedee Ronald G. 
Published: August 2018

Background Stenosis of the nasolacrimal drainage system is a relatively frequent complication of acute or chronic inflammation, trauma, tumor, or congenital malformation. Symptoms include epiphora, intermittent purulent secretion, and swelling of the nasolacrimal sac. The principle of dacryocystorhinostomy (DCR) is to create an artificial opening of the lacrimal sac into the nasal cavity. This can be done via an external as well as an endonasal route. Methods In this retrospective study, we examined 74 microscopic endonasal DCRs, which were performed on 70 patients between 1990 and 2000. All of the 74 DCR operations had no major complications intraoperatively. Results Sixty DCR procedures (81.1%) were successful after a mean follow-up time of 3.18 years. This success rate is lower than those rates reported in the literature for the external approach, which range between 85 and 99%, although follow-up times were shorter in most of these studies. Conclusions Advantages of the endonasal approach such as saving the medial palpebral ligament, the lacrimal pump mechanism, and the horizontal apparatus are obvious. If necessary, additional management of sinus, septal, and conchal disease can be performed simultaneously. Our results reveal that the microscopic endonasal approach is a safe and reliable procedure in the management of postsaccular or saccular nasolacrimal duct obstruction and is an alternative to the traditional external route.
Endoscopic Anatomy of the Sphenopalatine and Posterior Nasal Arteries: Implications for the Endoscopic Management of Epistaxis
Authors: Schwartzbauer Heather R. , Shete Mona , Tami Thomas A. 
Published: August 2018

Background Refractory posterior epistaxis is a challenge for otolaryngologists. Most algorithms for managing this condition ultimately call for interrupting the arterial blood supply to the nasal mucosa. Traditionally, this was accomplished either by transantral arterial ligation or by arteriographic-guided embolization. More recently, the endonasal endoscopic approach has also been described. Because the primary blood supply to the posterior nasal cavity is derived from the terminal branches of the sphenopalatine and the posterior nasal arteries, we conducted this anatomic study to examine and describe the anatomic relationship of these two arteries as they exit the pterygopalatine fossa and enter the nasal cavity. Methods We performed endoscopic dissections of this anatomic region in nine fresh and one formalin-preserved cadaver specimens. A total of 19 sides were examined. Results In 3 of 19 specimens (16%), the sphenopalatine artery branched from the sphenopalatine artery within the sphenopalatine canal, allowing the two arteries to exit together. In 8 of the 19 specimens (42%), the sphenopalatine artery exited much more posteriorly, yet from within a shared posteriorly elongated sphenopalatine foramen. In the remaining eight specimens (42%), the sphenopalatine artery exited through a distinct foramen directly posterior to the larger sphenopalatine foramen. Conclusion Understanding this anatomic relationship is important in performing endoscopic arterial ligation. If the sphenopalatine artery is not specifically identified and ligated, an important component of the posterior nasal circulation will not be addressed adequately by this surgical approach.
Ventricular Tachycardia as an Electrocardiography Artifact during Functional Endoscopic Sinus Surgery
Authors: Gaiser Robert R. , Demetry Daphne J. , Schlosser Rodney 
Published: August 2018

Background Functional endoscopic sinus surgery is frequently performed during conscious sedation not provided by an anesthesiologist. Several monitors are used during conscious sedation, one of which is the electrocardiogram (EKG). Equipment used in the operating room may interfere with the EKG tracing. Methods A 30-year-old man underwent his fourth functional endoscopic sinus surgery during general anesthesia. For the procedure, a Xomed Straight Shot microdebrider was used. Results Because of stray electrical current, the use of the microdebrider caused the EKG waveform to resemble ventricular tachycardia. Conclusion This case alerts the clinician to this possible occurrence to prevent inappropriate therapeutics from being initiated.
Chronic Sinonasal Disease in Patients with Inflammatory Bowel Disease
Authors: Book David T. , Smith Timothy L. , Mcnamar Justin P. , Saeian Kia , Binion David G. , Toohill Robert J. 
Published: August 2018

Background The objective of this study was to explore the possible relationship between inflammatory bowel disease (IBD) and chronic sinonasal disease. Methods A cross-sectional study was undertaken of 241 patients with Crohn's disease (CD) or ulcerative colitis from a tertiary medical center IBD clinic. Patient demographic data and information regarding IBD diagnosis and management, sinonasal disease diagnosis and management, and complications related to these diagnoses were gathered by retrospective chart review and a standardized patient survey. Results One hundred sixty surveys (67%) were returned and analyzed. Overall, 48% of patients with IBD reported chronic sinonasal disease symptoms. Patients with CD had a higher prevalence of sinonasal disease than patients with ulcerative colitis (53% versus 32%; p < 0.02). The subgroup of CD patients with obstructive bowel complications had the highest prevalence of sinonasal disease (68% versus 27%; p = < 0.001), with 23% reporting chronic rhinosinusitis, 13% reporting chronic rhinitis, and an additional 32% reporting chronic nasal or sinus symptoms. Conclusion The prevalence of chronic sinonasal disease is elevated in patients with IBD, occurring in approximately one-half of patients followed at a tertiary IBD center. Patients with CD experiencing obstructive complications had significantly increased rates of sinonasal disease. The relationship between chronic sinonasal disease and obstructive CD is not defined, but several hypotheses are generated.
An Assessment of Concentrations of Soluble CD4 and CD8 Receptors in Serum before and after Surgical Treatment in Patients with Chronic Maxillary Sinusitis
Authors: Olszewski Jurek , Chudzik Wiesław , Wiśniewski Kazimierz , Miłonski Jarosław , Matyja Robert 
Published: August 2018

Background The aim of this study was to assess the concentrations of soluble CD4 (sCD4) and sCD8 receptors in serum of patients before and after surgical treatment of chronic maxillary sinusitis. Methods We examined 57 patients, aged 20–63 years (mean age, 41 ± 0.5 years), and divided them into four groups: group I, 14 patients with chronic maxillary sinusitis without allergy; group II, 15 patients with chronic maxillary sinusitis with allergy; group III, 16 patients with cyst of maxillary sinuses without allergy (control); and group IV, 12 patients with cyst of maxillary sinuses with allergy (control). The assay of sCD4 and sCD8 receptor concentrations was performed by means of enzyme-linked immunosorbent assay method. The concentrations of sCD4 and sCD8 receptors before and after 30 days of surgical treatment of maxillary sinuses were examined. Results In our studies the increase of concentration of sCD4 in groups I and II in comparison with the concentration in control groups were statistically significant. The differences between mean concentrations of sCD8 in groups I and II and in the control groups were not statistically significant. After surgical treatment of chronic maxillary sinusitis, a significant decrease in values of sCD4 and sCD8 in comparison with the results before surgical treatment suggest that the measurement of cell suppression product concentration can be used to assess the extirpation of the inflammatory process and the effectiveness of the operation method. Conclusion Changes in concentration of sCD4 and sCD8 manifest activation or suppression of cells with particular receptor expression.
Paranasal Sinus Mucosal Regeneration: The Effect of Topical Retinoic Acid
Authors: Maccabee Mendy S. , Trune Dennis R. , Hwang Peter H. 
Published: August 2018

Background Paranasal sinus mucosa may suffer morphological and functional alterations as a result of surgical trauma. Mucosal stripping typically yields regenerated mucosa characterized by fibrosis, inflammatory infiltrate, and dysmorphic or absent cilia. The aim of this study was to determine the effect of topical retinoic acid (vitamin A) on regeneration of paranasal sinus mucosa. Methods Both maxillary sinuses of 12 New Zealand white rabbits were surgically opened and stripped of mucosa. Six rabbits received 0.01% topical retinoic acid gel treatment to the stripped left maxillary sinus (low concentration group). The remaining six rabbits received 0.025% topical retinoic acid gel to the stripped left maxillary sinus (high concentration group). The stripped right maxillary sinus of all 12 rabbits served as the operated, untreated control to reflect the normal healing process. Six other animals served as unoperated controls. The sinus mucosa was examined by light microscopy after 14 days. Results Untreated regenerated mucosa showed expected changes of submucosal gland loss, basal lamina and lamina propria fibrosis, cellular atypia, and loss of cilia. Topical retinoic acid treatment appeared to result in better mucosal regeneration marked by less cellular atypia and fibrosis. Although the regenerated mucosa was still grossly abnormal, the degree of ciliary loss and cellular derangement was reduced. The lower-concentration retinoic acid group had more favorable morphology than the higher-concentration retinoic acid group, and both were improved when compared with no treatment. Conclusions In a rabbit model, topical vitamin A in the form of retinoic acid gel appears to enhance regeneration of ciliated paranasal sinus mucosa. This preliminary study suggests that topical retinoids may have applicability in promoting sinus wound healing.
Comparison of Subject-Reported Allergy versus Skin Test Results in a Common Cold Trial
Authors: Krahnke Jason S. , Gentile Deborah A. , Cordoro Kelly M. , Angelini Betty L. , Cohen Sheldon A. , Doyle William J. , Skoner David P. 
Published: August 2018

Background Few studies have examined the relationship between subject-reported allergy and results of allergy skin testing in large unselected or unbiased cohorts. The objective of this study was to compare the results of self-reported allergy via verbal questioning with the results of allergy skin testing by the puncture method in 237 healthy adult subjects enrolled in a common cold study. Methods On enrollment, all subjects were verbally asked if they had a history of allergy and then underwent puncture skin testing to 19 relevant aeroallergens, as well as appropriate positive and negative controls. A skin test was considered positive if its wheal diameter was at least 3 mm larger than that obtained with the negative control. Results Forty-eight (20%) subjects reported a history of allergy and 124 (52%) subjects had at least one positive skin test response. A history of allergy was reported in 40 (32%) of the skin test-positive subjects and 8 (7%) of the skin test-negative subjects. At least one positive skin test response was found in 40 (83%) of those subjects reporting a history of allergy and 84 (44%) of those subjects denying a history of allergy. Conclusion These data indicate that there is a relatively poor correlation between self-reported history of allergy and skin test results in subjects enrolled in a common cold study. These results have implications in both clinical practice and research settings.
Coronal Computed Tomography Analysis of Frontal Cells
Authors: Meyer Tanya K. , Kocak Mehmet , Smith Michelle M. , Smith Timothy L. 
Published: August 2018

Background Described by Schaefer in 1916, frontal cells have been implicated as a cause of frontal recess obstruction. In this cross-sectional study, we determine the prevalence of frontal cells and other anatomic variants and examine their relationships. Methods Coronal computed tomography scans of the sinuses performed from January 2000 to June 2001 were evaluated for frontal cells, other anatomic variants, and sinus disease. Of 1009 scans evaluated, 768 scans were included for data collection. Frontal cells were classified. Results In this population, 20.4% of individuals had frontal cells (14.9% had type I, 3.1% had type II, 1.7% had type III, and 2.1% had type IV). The presence of frontal cells was positively associated with hyperpneumatization of the frontal sinus (p = 0.01) and negatively associated with hypopneumatization of the frontal sinus (p < 0.01). Individuals with frontal cells had an increased prevalence of concha bullosa compared with individuals without frontal cells (41.4% versus 24.1%, p < 0.01). The prevalence of frontal mucosal thickening was increased in individuals with type III and type IV cells compared with individuals without frontal cells (38.5 and 69.0% versus 17.1%, p = 0.04 and p < 0.01). Conclusion The prevalence of frontal cells among a population undergoing sinus computed tomography is 20.4%. Frontal cells are associated with other variants of sinonasal pneumatization and should be suspected when these variants are noted. The presence of frontal cells does not invariably lead to frontal sinusitis but may contribute to the mechanical obstruction of the frontal recess and should be appropriately addressed during the surgical management of frontal sinusitis.
Age-Related Olfactory Dysfunction: Cellular and Molecular Characterization in the Rat
Authors: Conley David B. , Robinson Alan M. , Shinners Michael J. , Kern Robert C. 
Published: August 2018

Background Olfactory receptor neurons (ORNs) undergo apoptosis at a baseline rate even in the absence of obvious disease. Although the precise triggers of the apoptotic cascade are unclear, ORNs are exposed directly to the external environment, making them susceptible to injury. As an adaptive mechanism, mammals have the ability to replace lost ORNs throughout adult life from neuronal precursors within the olfactory epithelium (OE). In humans, this process fails with age as the surface area of the OE and the number of ORNs decline, coupled with a loss of clinical olfactory function. The question addressed in this study is whether this age-related failure of olfactory sensation is a result of a decrease in neuronal proliferation or an increase in ORN cell death. Methods To begin to address this question the ribonuclease protection assay was used to assess expression of apoptosisrelated genes in rat OE as a function of age. Second, the terminal deoxynucleotide transferase end labeling assay was used to assess the percentage of ORNs undergoing apoptosis (apoptotic index) in three groups of animals: young (12 weeks), old (32 months), and bulbectomized rats. Bulbectomy is a standard model for ORN injury associated with a massive increase in ORN apoptosis and serves as a positive control. Results Ribonuclease protection assay data indicate an age-related increase in Bax, Bcl-xL, and procaspase-3 messenger RNA expression in aged compared with young rats. A similar but more pronounced increase in expression of these apoptotic-related genes is seen after bulbectomy. The terminal deoxynucleotide transferase end labeling assay also showed a statistically significant increase in the apoptotic index with both age and bulbectomy. Conclusion Taken together, the current results indicate that aging and injury induce parallel changes in OE. Furthermore, these findings support the hypothesis that age-related olfactory dysfunction is, at least in part, related to an increase in ORN cell death.
Effect of Asthma on Sinus Computed Tomography Grade and Symptom Scores in Patients Undergoing Revision Functional Endoscopic Sinus Surgery
Authors: Kountakis Stilianos E. , Bradley Dewayne T. 
Published: August 2018

Background The aim of this study was to determine the influence of asthma on sinus computed tomography (CT) grade, endoscopic appearance, and symptom scores in patients undergoing revision functional endoscopic sinus surgery (FESS). Methods Prospective data was collected of patients undergoing revision FESS at a tertiary medical center over a 2-year period. CT scans were graded as per the Lund and Mackay system. Patient symptom scores were recorded from the Sino-Nasal Outcome Test (SNOT 20) inventory and individual symptoms from the Rhinosinusitis Task Force major and minor symptom list were graded on a visual analog scale. Results Eighty patients underwent revision FESS and 20 of those patients had asthma. The average CT grade in asthmatic patients was 18.6 compared with 11.7 in patients who were nonasthmatic (p = 0.000006). The average SNOT 20 symptom score in patients with asthma was 49.6 and in nonasthmatic patients it was 44.9 (p = 0.238). Both asthmatic and nonasthmatic patients experienced a reduction in SNOT 20 symptom scores at 1 year with reductions of 70% (p = 0.0000)versus 72.6% (p = 0.0000), respectively. Conclusion Patients with asthma undergoing revision FESS had higher sinus CT grades compared with patients without asthma. Asthmatic and nonasthmatic patients had statistically significant reductions in symptoms scores after revision FESS. Asthmatic patients had similar symptomatic relief scores after revision FESS as compared with nonasthmatic patients.
The Impact of Ethanol and Tobacco Smoke on Intranasal Epithelium in the Rat
Authors: Vent Julia , Bartels Sande , Haynatzki Gleb , Gentry-Nielsen Martha J. , Leopold Donald A. , Hallworth Richard 
Published: August 2018

Background Investigations have shown the influence of ethanol and tobacco smoke on olfaction, epithelial metaplasia, and cancer formation in the head and neck. Analysis of ethanol and tobacco smoke-induced histopathological mucosal changes in the upper respiratory tract may provide important insight into the pathophysiology of secondary olfactory dysfunction. Methods Three groups of laboratory rats were experimentally exposed to either ethanol, tobacco smoke, or both, with a control group having no such exposure. Results Compared with controls, histopathological analysis of nasal mucosa in exposed rats revealed a decrease in the length of olfactory epithelium, especially in the rats exposed to both ethanol and tobacco smoke. Structural changes included loss of cilia and metaplasia. Conclusion The histological changes noted in rats after ethanol and tobacco smoke exposure, if relevant to human physiology, could explain the decreased olfactory ability seen in patients who use these products.
Nasal Cytology: Description of a Hyperchromatic Supranuclear Stria as a Possible Marker for the Anatomical and Functional Integrity of the Ciliated Cell
Authors: Gelardi Matteo , Cassano Pasquale , Cassano Michele , Fiorella Maria Luisa 
Published: August 2018

Background The aim of this study was to describe a particular intracellular hyperchromatic formation located over the nucleus of normal nasal ciliated cells. This finding, never described in literature, very rarely occurs in pathological conditions. Methods A nasal cytological test and mucociliary transport test were performed in a group of 24 subjects with rhinologic diseases and in a control group of 10 healthy subjects. Results The “hyperchromatic supranuclear stria” (SNS) was observed in a high percentage of normal cells (90.3%); SNS was present in very few pathological subjects (in only 6.26% of pathologic cells). Conclusion We interpreted SNS as a specific marker for the anatomic and functional integrity of the ciliated cell. Therefore, the absence of SNS is considered an abnormal finding in the nasal mucosa and therefore could be useful as a “prognostic sign” of the disorders themselves and as an indication of the “therapeutic efficacy” of pharmacologic treatments, both topical and systemic.
Minimally Invasive Treatment of the Nasal Inverted Papilloma
Authors: Llorente José L. , Deleyiannis Fred , Rodrigo Juan P. , Nuñez Faustino , Ablanedo Pilar , Melón Santiago , Suárez Carlos 
Published: August 2018

Background The purpose of this work is to evaluate our results in the treatment of the nasal inverted papillomas with an endoscopic approach using a retrospective case series. Methods Between 1993 and 2000 we treated 27 patients with nasal inverted papillomas. All patients underwent endoscopic nasal surgery under general anesthesia. None of the inverted papillomas extended outside of the paranasal sinuses. All tissue samples underwent polymerase chain reaction and hybridization in situ to detect genetic sequences of the human papilloma virus and Epstein Barr virus. Results The study population consisted of 16 men and 11 women with a median age of 52 years (range, 22–77 years). Ten patients (37%) had undergone a previous nasal surgery. The median follow-up was 5 years (range, 2–8 years). None of the patients presented with bilateral nasal involvement or a synchronous carcinoma. Seven patients underwent an additional surgical approach (two endoscopic approaches via a Caldwel-Luc approach, four sublabial approaches via a Caldwel-Luc approach, and one external ethmoidectomy). There were no surgical complications. Two patients (7%) had recurrent papilloma 4 and 6 years after surgery and again underwent endoscopic resection. The amplification both by polymerase chain reaction and hybridization in situ for human papilloma virus and Epstein Barr virus were negative in the specimens from all patients. Conclusions According to the literature and our own experience, we believe that the initial surgical management of primary and recurrent inverted papillomas limited to the nasal cavity and paranasal sinuses should be endoscopic sinus surgery.