bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of Bacterial Biofilms on Frontal Recess Stents in Patients with Chronic Rhinosinusitis
Authors: Perloff Joel R. , Palmer James N. 
Published: August 2018

Background Bacterial biofilms have been documented on middle ear mucosa, tonsils, and cholesteatoma. We hypothesize that bacterial biofilms are present in mucosa of patients with chronic sinusitis. We believe that frontal sinus stents may serve as a reservoir for biofilms. Experiment We studied silicone frontal sinus stents removed from six patients 1 to 4 weeks after FESS with scanning electron microscopy (SEM). Results We identified evidence of bacterial biofilms on the frontal recess stents in six of six patients under SEM. Five of these patients had sinus cultures positive for Staphylococcus aureus. Bacterial biofilms were identified by evidence of glycocalyx, water channels, and three-dimensional structure. These images were similar to other images of known biofilms. Conclusions This is evidence of the possible presence of bacterial biofilms on frontal sinus stents in patients with chronic sinusitis. Further study into the role of bacterial biofilms in perpetuating chronic sinusitis is warranted.
Overcorrected Septum as a Complication of Septoplasty
Authors: Lee Bong-Jae , Chung Yoo-Sam , Ju Jang Yong 
Published: August 2018

Background After septoplasty, the rhinologic surgeon often encounters an unexpected deviation of the septum toward the side contralateral to the initial deflection, a phenomenon which we would call an overcorrection. Methods To investigate the incidence of overcorrected septum, we assessed the incidence of overcorrection in different age groups by reviewing medical records. Results Of 1124 patients, 22 (2.0%) showed occurrence of overcorrection after septoplasty. The incidence of overcorrection was 7.3% (16/218) in subjects aged 10 to 19, 1.7% (5/294) in their twenties, 0.4% (1/250) in their thirties, and 0% in the older ages. Conclusion The results of this study indicate that the risk of overcorrection following septoplasty is particularly higher in the younger patient group.
Ethnic and Gender Differences in Bone Erosion in Allergic Fungal Sinusitis
Authors: Wise Sarah K. , Venkatraman Giridhar , Wise Justin C. , DelGaudio John M. 
Published: August 2018

Background Erosion of the bony sinus walls in allergic fungal sinusitis (AFS) is an established phenomenon. Reports of the incidence of bone erosion in AFS vary widely, and definitions of bone erosion lack uniformity. Differences in bone erosion among ethnic and gender groups have not been examined previously in the literature. Methods At our institution we reviewed 47 cases of AFS for ethnic and gender differences in presentation and presence of bone erosion. Results Caucasians presented at a mean 12 years later than African-Americans (p = 0.002); however, this difference was largely carried by Caucasian females. African-Americans presented with a greater incidence of bone erosion than Caucasians (p = 0.028). In addition, there are statistically significant differences in the individual paranasal sinuses affected by bone erosion in AFS. Conclusions We examine the potential implications of ethnic and gender differences in presentation and bone erosion in AFS.
Enlargement of the Bone Component in Different Parts of Compensatorily Hypertrophied Inferior Turbinate
Authors: Uzun Lokman , Savranlar Ahmet , Beder Levent Bekir , Ugur Mehmet Birol , Cinar Fikret , Ozdemir Huseyin , Gundogdu Sadi 
Published: August 2018

Background To evaluate the unilateral compensatorily hypertrophied inferior turbinate (CHIT) by computed tomography (CT) and determine the enlargement of the bone component in different parts of the CHIT. Methods Patients were studied in three groups: those with a straight or nearly straight septum (n = 143), with mild deviation (n = 42), and with moderate to severe deviation (n = 99). The cross sectional area (CSA) of the inferior turbinate (IT) bone and the whole turbinate were measured at anterior, middle, and posterior thirds of the IT in coronal sections. The ratio of CSA of the IT bone on two sides of the septum (interturbinate ratio) and the ratio of the CSA of the overall turbinate to the IT bone (intraturbinate ratio) were calculated. Results The interturbinate ratio of the bony turbinate CSA for the severe deviation group was significantly higher compared with other groups in anterior and middle segments (p < 0.0001). The intraturbinate ratio was highest in the posterior segment and lowest in the middle segments in compensatorily hypertrophied sides for all groups (p < 0.001). Conclusion Skeletal enlargement is prominent in anterior and middle thirds of CHIT in patients with pronounced septal deviation.
Evidence of Bacterial Biofilms in a Rabbit Model of Sinusitis
Authors: Perloff Joel R. , Palmer James N. 
Published: August 2018

Background Bacterial biofilms have been documented on middle ear mucosa, tonsils, and cholesteatoma. In addition, we have described previously bacterial biofilms on frontal recess stents placed during surgery for chronic sinusitis. We hypothesize that bacterial biofilms are present on the mucosa of animals with sinuses experimentally infected with Pseudomonas aeruginosa. Methods We instilled Pseudomonas aeruginosa at log phase growth into the right maxillary sinus in 22 New Zealand white rabbits and harvested specimens 1–20 days later. We then examined the tissues with scanning electron microscopy (SEM) and light microscopy. Mucosa from the middle turbinate on the contralateral side was used as a control. Results We identified evidence of bacterial biofilms on the mucosa of all 22 animals under SEM. Twenty-one of 22 animals had sinus cultures positive for Pseudomonas. Bacterial biofilms were identified by evidence of glycocalyx, water channels, and three-dimensional structure. These images were similar to other images of known biofilms. Conclusion This is evidence of the presence of bacterial biofilms in an animal model of sinusitis. This model may serve as a means to study the efficacy and safety of pharmacologic and surgical treatments on the disruption and elimination of bacterial biofilms. Additional study into the role of bacterial biofilms in perpetuating chronic sinusitis is warranted.
Expression, Localization, and Significance of Vascular Permeability/Vascular Endothelial Growth Factor in Nasal Polyps
Authors: Gosepath Jan , Brieger Juergen , Lehr Hans Anton , Mann Wolf J. 
Published: August 2018

Background The exact etiologic mechanisms leading to the formation of nasal polyps have remained largely obscure. A key phenomenon of this specific type of chronic inflammatory disease in nasal respiratory mucosa is remarkable edema. Vascular permeability/vascular endothelial growth factor (VPF/VEGF) plays an important role in inducing angiogenesis and modulating capillary permeability. Objective To study the expression and localization of VPF/VEGF as a putative key factor in nasal polyp development. Methods Specimens of nasal polyps (n = 12) were harvested during endonasal sinus surgery in patients with polypous chronic rhinosinusitis. Specimens of healthy nasal respiratory mucosa (n = 12) served as controls and were obtained from inferior turbinates of patients undergoing surgery for nasal obstruction without signs and symptoms of inflammatory disease. Frozen sections were immunohistochemically stained for VPF/VEGF and quantitatively analyzed, using computer-based image analysis. Results The expression of VPF/VEGF in specimens of nasal polyps was significantly stronger than in specimens of healthy nasal mucosa of controls. VPF/VEGF in polypous tissue was mainly localized in vascular endothelial cells, in basal membranes and perivascular spaces, and in epithelial cells. Conclusion The markedly increased expression in nasal polyps as opposed to healthy nasal mucosa suggests that VPF/VEGF may play a significant role in both the formation of nasal polyps and in the induction of heavy tissue edema. This finding is discussed with respect to the differential expression of cyclooxygenase (COX) isoenzymes-1 and -2 (COX-1 and COX-2) in nasal polyps.
An Assessment for the Presence of Bacterial Contamination of Venturi Principle Atomizers in a Clinical Setting
Authors: Rizzi Mark , Batra Pete S. , Hall Geraldine , Citardi Martin J. , Lanza Donald C. 
Published: August 2018

Background Venturi principle atomizers have been criticized for potential contamination and disease transmission when used for nasal application. A recent laboratory study reported a high rate of contamination of these atomizers after their tips were immersed and sprayed into a broth containing Staphylococcus aureus. The objective of this study was to determine whether the Venturi-type atomizers used regularly at a busy referral center for sinonasal disorders were contaminated with bacteria. Methods Fifteen Venturi-type atomizers containing 2% lidocaine (four bottles), 4% lidocaine (three bottles), or 0.05% oxymetazoline (eight bottles) were sprayed onto blood agar plates. All atomizer bottles had been in routine use in a tertiary rhinology clinic for 1 month. The contents within each bottle's reservoir also were cultured. Thus, the total sample size was 30 plates. Then, the plates were incubated at 35°C for 48 hours and then at room temperature for 72 hours. Results Three of our 30 plates grew one colony each of Gram-positive bacilli, Gram-positive cocci, and Staphylococcus species. Conclusion The rare growth of any bacteria seen in our samples could as likely represent contamination during processing and handling of the plates as contamination of the atomizers themselves. Thus, Venturi-type atomizers may not have a high potential contamination risk, which has been suggested by previous reports.
Presence of Fungus in Sinus Cultures of Cystic Fibrosis Patients
Authors: Wise Sarah K. , Kingdom Todd T. , McKean Lawrence , DelGaudio John M. , Venkatraman Giridhar 
Published: August 2018

Background Sinonasal pathology is nearly universal in the cystic fibrosis (CF) population. The bacteriology of sinus cultures from CF patients and the implications of sinus bacterial pathogens in this group have been studied; however, sinus fungal isolates from CF patients have not been examined in the literature. Methods We reviewed 30 consecutive CF patients undergoing endoscopic sinus surgery at our institution for the presence of fungal isolates obtained from the sinuses at the time of surgery. Results Thirty-three percent of fungal cultures were positive in this sample; in addition, two patients were newly diagnosed with allergic fungal sinusitis. Conclusion We examine the possible implications of positive fungal sinus cultures in the CF population.
Long-Term Rhinoflowmetry: A New Method for Functional Rhinologic Diagnostics
Authors: Grützenmacher Stefan , Lang Christian , Mlynski Robert , Mlynski Barbara , Mlynski Gunter 
Published: August 2018

Background With current functional diagnostic tools in rhinology (rhinomanometry, rhinoresistometry, and acoustic rhinometry) long-term assessment of nasal function is difficult to acquire. Usually, only the situation at the time of examination is evaluated. Therefore, temporary nasal complaints of the nasal cycle are difficult to assess. It was the aim of this work to create a diagnostic tool to measure nasal flow over a long time period under physiological and everyday life conditions. We term the method long-term rhinoflowmetry (LRFM). Methods A portable device recording nasal airflow over a time period up to 72 hours was developed. Kinetic pressure fluctuations during respiration as a measure for the flow were registered over time and relative airflow was calculated. A summary of diagnostic results is given in six exemplary patients. Results Classic nasal cycles could be recorded in detail with durations ranging from 90 minutes to 10 hours. The manifestation of nighttime nasal obstruction as well as a case of paradoxical nasal obstruction were objectified. LRFM enables the assessment of time, duration, and extent of temporary nasal obstruction. Conclusion LRFM enables an assessment of temporary nasal obstruction as well as physiological and pathological fluctuations in the nasal cycle. Especially in cases in which traditional rhinological diagnostic tools are unsatisfying, the enhanced diagnostic quality of LRFM appears to be a promising supplement to the currently available rhinological monitoring methods.
Morphology and Distribution of Nasal Telangiectasia in HHT-Patients with Epistaxis
Authors: Folz Benedikt J. , Wollstein Ana Cerra , Lippert Burkard M. , Werner Jochen A. 
Published: August 2018

Background Epistaxis in hereditary hemorrhagic telangiectasia (HHT; Rendu-Osler-Weber syndrome) is a frequent symptom that may be caused by a multitude of different genetic and epigenetic phenomena. This investigation analyzes the distribution of nasal telangiectasia in 21 patients with HHT. Methods The patients were examined for endonasal telangiectasia by videoendoscopy with rigid endoscopes; in addition, the anterior portion of the nose was examined under the operating microscope. The endonasal findings were recorded on videotape and then evaluated in the media laboratory. Results Morphology of the nasal telangiectasia showed wide variations: the vessels were shaped like spots, loops, or spiders or they clustered and resembled raspberries. Gender did not have an influence on the phenotype of telangiectasia, whereas advancing age correlated with a higher density of telangiectasia. Patients with an intact nasal septum exhibited the bulk of telangiectasia in the anterior nasal cavity but also on the middle turbinates, the floor of the nose, and within the valve area. Patients with septal perforations displayed the majority of telangiectasia around the edge of the perforations, on the floor of the nose, and on the turbinates. Scattered telangiectasia also could be found in the profound parts of the nasal cavity and in the nasopharynx, especially in patients with septal perforations. Conclusion The shapes of endonasal telangiectasia in HHT patients are very heterogeneous; predilection sites could first of all be found within the anterior portion of the nose. Morphology and distribution of endonasal telangiectasia change as a result of therapeutic interventions, development of septal perforations, and with advancing age. Therefore, repeat endoscopies are recommended to assess the actual stage of the disease before epistaxis therapy.
The SF-36 Health Status Questionnaire in Assessing Patients with Epistaxis Secondary to Hereditary Hemorrhagic Telangiectasia
Authors: Lennox Penelope A. , Hitchings Anne E. , Lund Valerie J. , Howard David J. 
Published: August 2018

Background This study assesses the ability of the short form 36 (SF-36), a validated health status survey, to measure the health of patients with epistaxis due to hereditary hemorrhagic telangiectasia (HHT). Methods Thirty-eight patients completed the SF-36 and symptom-specific questionnaires. They were asked to rate their epistaxis as severe, moderate, or mild. The SF-36 data are compared with a reference population and analyzed with respect to the subgroups. Results The scores for each dimension of health were significantly reduced (p < 0.05) when compared with the reference population for all dimensions except pain. When compared with the patients’ ratings of severity, a significant correlation was detected in five dimensions (p < 0.05). Conclusion The SF-36 reflects the reduced health status of patients with epistaxis due to HHT. Changes in the SF-36 score could be used as an outcome measure in assessing efficacy of treatment of this condition.
The Effect of Treatment for Epistaxis Secondary to Hereditary Hemorrhagic Telangiectasia
Authors: Hitchings Anne E. , Lennox Penelope A. , Lund Valerie J. , Howard David J. 
Published: August 2018

Background Epistaxis is the most common symptom in patients with hereditary hemorrhagic telangiectasia. Different treatment options have been described but with little reference to their effect on quality of life or disease severity. Methods This study prospectively investigated the effect of nasal closure, argon laser, and a combination of septodermoplasty and argon laser treatments on quality-of-life scores and disease severity ratings in a group of 29 patients with moderate to severe epistaxis referred to a tertiary referral center. Results The only group of patients who showed a significant improvement (p < 0.05) in quality of life were those who underwent nasal closure. In addition, the nasal closure patients were the only group in which there was a complete cessation of bleeding. Conclusion Nasal closure should be offered to patients with moderate to severe epistaxis secondary to hereditary hemorrhagic telangiectasia that has proved unresponsive to other treatment.
Economic Analysis of the Treatment of Posterior Epistaxis
Authors: Miller Timothy R. , Stevens Edwin S. , Orlandi Richard R. 
Published: August 2018

Background The aim of this study was to compare the economic impact of controlling posterior epistaxis by transnasal endoscopic sphenopalatine artery ligation (TESPAL) and endovascular embolization. Methods We conducted a retrospective chart review of patients undergoing treatment of posterior epistaxis by either TESPAL or embolization. International Classification of Diseases 9 code 784.7 (epistaxis) was the initial screen followed by common procedural terminology codes for TESPAL and angiography with embolization. The total charges and direct costs for TESPAL and endovascular embolization were determined. An unpaired Student's t-test was used to evaluate statistical significance. Results Analysis revealed 25 patients that met inclusion criteria. The mean total charge was $14,088 for embolization and $7561 for TESPAL. The differences were statistically significant (p < 0.00006). Costs, defined as reimbursement by third-party payers and direct payments, varied widely and their difference did not reach statistical significance in this sample. Conclusion Our data established no economic advantage for angiography and, in fact, show a trend toward this treatment being more expensive than TESPAL. TESPAL is a procedure that can be performed quickly and on an outpatient basis without the need for angiography equipment or expertise. Additionally, the procedure provides the advantage of a comprehensive endoscopic nasal evaluation for ruling out tumors or other intranasal lesions. With equal efficacy, at least equal costs and equal risk, and additional diagnostic advantages, TESPAL is a more rational treatment for posterior epistaxis.
Endoscopic Biopsy of Human Olfactory Epithelium as a Source of Progenitor Cells
Authors: Winstead Welby , Marshall Charles T. , Lu Cheng L. , Klueber Kathleen M. , Roisen Fred J. 
Published: August 2018

Background The adult central nervous system contains progenitor cells; however, invasive surgery is required for their harvest. Olfactory neuroepithelium (ONe) has attracted attention because it is extracranial and contains progenitor cells that account for its regenerative capacity. Olfactory progenitor cells have been cultured from postmortem ONe. Our aim was to determine if olfactory progenitors could be obtained via biopsy from patients in a feasible, effective, and safe manner. Methods Endoscopic biopsy was performed on individuals undergoing sinus surgery (n = 42). Olfactory function was assessed pre- and postoperatively. Specimens were cultured under conditions for olfactory progenitor cell development. Results Progenitor cells emerged in cultures from 50% of our patients. The superior turbinate, biopsied with cutting punch forceps, gave the highest yield. No adverse impact on olfaction or complications with the biopsy were observed. Conclusion Endoscopic biopsy of ONe for obtaining olfactory progenitor cells from living donors is feasible, effective, and safe.
Glycoconjugate Expression in Normal Human Inferior Turbinate Mucosa: A Lectin Histochemical Study
Authors: Berger Gilead , Kogan Tatiana , Skutelsky Ehud , Ophi Dov 
Published: August 2018

Background Further study on the composition and concentration of normal nasal mucosal glycoconjugates is needed. Methods A battery often lectins was used to stain six carbohydrates residing in the inferior turbinate mucosa of 21 healthy individuals. Results The concentrations of glycoconjugates of the glycocalyx exceeded that of epithelial goblet, ciliated, and basal cells, and also of mucous, serous, and mixed submucosal glands. Epithelial goblet cells and submucosal mucous glands contained relatively high concentrations of glycoconjugates, whereas in epithelial ciliated and basal cells, similar to serous and mixed submucosal glands, concentrations were scanty. The concentrations of N-acetylgalactosamine and galactose were higher in goblet cells than in mucous glands (p = 0.006, and p = 0.056, respectively). Differences in the concentrations of N-acetylglucosamine, fucose, mannose, and sialic acid were insignificant. Conclusions The findings provide a baseline for comparison of the composition and concentration of carbohydrates of the normal and pathologic inferior turbinate mucosa.
Microbiology of Sinus Puncture versus Middle Meatal Aspiration in Acute Bacterial Maxillary Sinusitis
Authors: Joniau Sander , Vlaminck Stephan , Van Landuyt Herman , Kuhweide Rudi , Dick Catherine 
Published: August 2018

Background Maxillary sinus puncture is considered the gold standard for diagnosing acute bacterial maxillary sinusitis (ABMS) and for identifying bacterial pathogens in antimicrobial trials of ABMS. However, sinus puncture and aspiration is an invasive, time-consuming procedure that is limited by discomfort to the patient and possible complications. Therefore, the diagnostic usefulness in clinical practice and patient enrollment in studies of ABMS is hindered and alternatives for maxillary sinus puncture are being investigated. Methods We designed a prospective clinical and microbiological outpatient study. Cultures obtained by endoscopically guided middle meatal aspiration were compared with those from sinus puncture and aspiration in 24 patients with ABMS. Results Considering puncture and aspiration as the gold standard, endoscopy cultures provided a sensitivity of 80%, specificity of 100%, positive predictive value of 100%, negative predictive value of 78.6%, and correlation of 88.5%. Conclusions In our study, endoscopic sampling compared favorably with sinus puncture and aspiration.
Increased Role of the Otolaryngologist in Endoscopic Pituitary Surgery: Endoscopic Hydroscopy of the Sella
Authors: Senior Brent A. , Dubin Marc G. , Sonnenburg Robert E. , Melroy Christopher T. , Ewend Matthew G. 
Published: August 2018

Background The aim of this study was to discuss the use of nasal irrigation and suction systems in endoscopic pituitary surgery to examine the sella and facilitate tumor removal. We describe a new technique of sellar exploration. Methods Following the endoscopic approach to the pituitary by the otolaryngology team, pituitary masses are resected. Then, the ClearESS nasal irrigation and suction system is used by the otolaryngology team to visualize the sella (“hydroscopy”). The combination of this ClearESS technology and angled endoscopes is used to scrutinize previously inaccessible areas of the tumor bed. Results Over 50 patients have undergone minimally invasive pituitary surgery via the endoscopic approach with postresection hydroscopy of the sella. The use of angled endoscopes in combination with the ClearESS technology greatly increased visualization of the sella, thereby facilitating complete tumor removal. There have been no complications associated with the use of hydroscopy. Conclusion The use of angled endoscopes in conjunction with hydroscopy increases visualization of the sella. The otolaryngologist plays a critical role in this examination with manipulation of the angled endoscopes. Therefore, the role of the otolaryngologist is extended beyond the approach to the pituitary.