bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of Computer-Aided Surgery Registration Methods for Endoscopic Sinus Surgery
Authors: Hardy Stuart M. , Melroy Christopher , White David R. , Dubin Marc , Senior Brent 
Published: August 2018

Background Stereotactic computer-aided surgery has provided the surgeon with a means to navigate more safely through diseased or surgically altered sinus anatomy. Accurate registration is vital to successful image-guided surgery. This study compared the accuracy and performance of three registration methods: fiducial, anatomic landmarks, and surface registration. Methods Ten fixed cadaveric heads underwent endoscopic computed tomography scan followed by middle meatal antrostomy and sphenoidotomy. Each registration method was performed, and the time required and mean registration error were recorded. Five anatomic sites were then identified and compared with the preoperative computed tomography images. The true distances between the known anatomic sites and the crosshair locations on the images were measured. Results Statistically significant differences were noted for mean registration error and time for registration. The mean ± SEM time for registration for the fiducial, surface, and landmark methods were 5 minutes 24 seconds ± 27 seconds, 1 minute 1 second ± 5 seconds, and 11 minutes 46 seconds ± 45 seconds, respectively. The mean ± SEM registration error for the fiducial, surface, and landmark methods were 0.48 ± 0.21 mm, 1.05 ± 0.06 mm, and 3.1 ± 0.25 mm, respectively. When the true accuracy of the three registration methods were compared, no significant difference was found between fiducial and surface registration. However, fiducial registration was significantly more accurate than landmark registration at all points. When compared with landmark registration, surface registration was statistically more accurate at all anatomic sites except for the sella turcica and optic nerve. Conclusion When the true accuracies of these methods were compared infixed cadaveric specimens, fiducial and surface registration were statistically similar but were found to be significantly more accurate than landmark registration. Furthermore, when time of registration, accuracy, and ease of use were considered, surface registration was found superior.
Risk Factors for Wheezing in Primary School Children in Bursa, Turkey
Authors: Alper Züleyha , Sapan Nihat , Ercan İlker , Canıtez Yakup , Bilgel Nazan 
Published: August 2018

Background Wheezing is the most common symptom of childhood respiratory tract illnesses. It is important not only for its associated acute morbidity, but also for the fact that early childhood wheezing confers a high risk for asthma. Epidemiological studies from various countries show that 10–15% of children <1 year of age and 25% of children <5 years of age have wheezing-associated respiratory tract illness, and one-third of these children develop asthma later in life. Methods In this retrospective study, we evaluated the association between a history of wheezing and prenatal, postnatal, familial, and environmental risk factors in 858 7-year-old children, randomly selected from seven primary schools in Bursa, Turkey, by means of an easy-to-understand questionnaire form. Among these children, 12.4% had a history of early transient wheezing, 7.1% had persistent wheezing, and 7.7% had late onset wheezing; 72.8% had no wheezing symptoms and 33.3% of children who experienced wheezing during the first 3 years of life had physician-diagnosed asthma. Results Notable risk factors associated with wheezing were as follows: male gender, lower socioeconomic status, premature birth, maternal smoking during pregnancy, bottle-feeding before 2 months of age, dampness and mold at home, hospitalization due to any respiratory illness in infancy, history of croup between 6 months and 5 years of age, frequent upper respiratory infections during the first 3 years of life, allergic eczema in the child, and any allergic disease in the mother or siblings. Conclusion This study shows that the high rates of reported wheezing in the 858 primary school children in Bursa are clearly attributable to important risk factors that have long been recognized and discussed by researchers worldwide, and this suggests that all efforts at primary prevention may be insufficient.
Endoscopic Treatment of Benign Tumors of the Nose and Paranasal Sinuses: A Report of 33 Cases
Authors: Sciarretta Vittorio , Pasquini Ernesto , Frank Giorgio , Modugno Giovanni Carlo , Cantaroni Cosetta , Mazzatenta Diego , Farneti Giovanni 
Published: August 2018

Background The endoscopic approach can be used successfully for the treatment of benign tumors such as fibroosseous and vascular lesions, pleomorphic adenoma, glioma, meningioma, and schwannoma. Methods Thirty-three patients diagnosed with benign tumors of the nasal cavity and paranasal sinuses and treated using an endoscopic approach were reviewed retrospectively. The endoscopic approach was simple in 28 cases and associated with an external approach in 5 cases (because of an intracranial extension of the tumor in four patients and its location at the level of the anterior wall of the frontal sinus in the last case). Results The resection of the lesions was complete in 32 patients and subtotal in one case. The mean follow-up was 28 months and only two recurrences (6%) were observed in the juvenile angiofibroma group and in the case of the fibrous dysplasia associated to aneurysmal bone cyst, respectively, 20 and 24 months postoperatively. Conclusion In selected cases, endoscopic surgery can be considered an effective treatment for the resection of benign tumors involving the sinonasal tract.
Endoscopically Guided Aerobic Cultures in Postsurgical Patients with Chronic Rhinosinusitis
Authors: Coffey Charles S. , Sonnenburg Robert E. , Melroy Christopher T. , Dubin Marc G. , Senior Brent A. 
Published: August 2018

Background There is considerable amount of debate in the literature regarding the microbial flora of normal, acutely infected, and chronically infected paranasal sinuses. Few studies have specifically looked at the microbial flora of healthy and infected sinus cavities after functional endoscopic sinus surgery. Methods One hundred thirty-four cultures were studied. All cultures were obtained using a standard technique. The nasal cavities were decongested and anesthetized, and nasal endoscopy was performed. When purulent secretions were identified, specimens of purulent secretions were obtained for incubation. Sensitivities were tested according to microorganisms identified. Empiric therapy generally consisted of a fluoroquinolone, amoxicillin/clavulanate, or a later-generation cephalosporin, and adjustment in individual instances when appropriate. Results Twelve cultures showed no growth, 86 grew a single microorganism, and 35 grew two or more microorganisms for a total of 151 microorganisms identified. The most common microorganisms were Staphylococcus aureus, coagulase-negative staphylococci, and Pseudomonas aeruginosa. Other organisms that were cultured <5% of the time included Streptococcus pneumoniae, Haemophilus influenza, Moraxella catarrhalis, Serratia liquefaciens, Stenotrophomonas (Xanthomonas) maltophilia, alcaligenes, Fusobacterium, Escherichia coli, diphtheroids, Acinetobacter species, Klebsiella species, skin flora, and mixed Gram-negative and Gram-positives. Conclusion Endoscopically guided aerobic cultures in postsurgical patients with acute exacerbations of chronic rhinosinusitis most commonly grew S. aureus, coagulase-negative staphylococci, and pseudomonal species. These cultures altered antibiotic treatment management decisions in a significant number of cases regardless of patients’ clinical characteristics or history of previous culture.
Analysis of Methods to assess Frontal Sinus Extent in Osteoplastic Flap Surgery: Transillumination versus 6-ft Caldwell versus Image Guidance
Authors: Melroy Christopher T. , Dubin Marc G. , Hardy Stuart M. , Senior Brent A. 
Published: August 2018

Background The aim of this study was to compare three common methods (transillumination, plain radiographs, and computerized tomography [CT] image guidance) for estimating the position and extent of pneumatization of the frontal sinus in osteoplastic flap surgery. Methods Axial CT scans and 6-ft Caldwell radiographs were performed on 10 cadaver heads. For each head, soft tissue overlying the frontal bone was raised and the anticipated position and extent of the frontal sinus at four points was marked using three common methods. The silhouette of the frontal sinus from the Caldwell plain radiograph was excised and placed in position. Four points at the periphery also were made using information obtained from a passive optically guided image-guided surgery device, and transillumination via a frontal trephination also was used to estimate sinus extent. The true sinus size was measured at each point and compared with experimental values. Results The use of CT image guidance generated the least difference between measured and actual values (mean = 1.91 mm; SEM = 0.29); this method was found statistically superior to Caldwell (p = 0.040) and transillumination (p = 0.007). Image guidance did not overestimate the size of the sinus (0/36) and was quicker than the Caldwell approach (8.5 versus 11.5 minutes). There was no learning curve appreciated with image guidance. Conclusion Accurate and precise estimation of the position and extent of the frontal sinus is crucial when performing osteoplastic flap surgery. Use of CT image guidance was statistically superior to Caldwell and transillumination methods and proved to be safe, reproducible, economic, and easy to learn.
Low Temperature Decreased Tension in Isolated Hypertrophic Human Nasal Mucosa
Authors: Chu Yueng-Hsiang , Wu Chin-Chen , Kao Chuan-Hsiang , Wang Hsing-Won 
Published: August 2018

Background The purpose of this study was to evaluate the effect of low temperature on basal tension in isolated hypertrophic human nasal mucosa with or without α1-agonist stimulation. Methods A tissue bath for isolated nasal mucosa was used. Tension in strips of human turbinate mucosa that were untreated and treated with an α1-adrenoreceptor agonist, methoxamine (10 μM), was recorded continuously in a stepwise manner in temperatures that varied from 37 to 10°C. Results The changes of tension in the human nasal mucosa were found to be temperature-dependent in both untreated and treated tissues, with tension decreasing to 48.6% at 10°C in comparison with 100% at 37°C in the untreated group, the presence of methoxamine (10 μM) had minimal effect. Conclusion Low temperature induced a rapid and reproducible relaxation in isolated hypertrophic human nasal mucosa that was not affected by the presence of the α1-agonist methoxamine (10 μM).
Nasal Polyposis: Role of Allergy on Therapeutic Response of Eosinophil- and Noneosinophil-Dominated Inflammation
Authors: Kirtsreesakul Virat , Atchariyasathian Viraporn 
Published: August 2018

Background It is considered that allergy, at least in some cases, is associated with nasal polyps and affects recurrence rate. Our purpose was to determine the effects of aeroallergen hypersensitization on therapeutic response of eosinophil- and noneosinophil-dominated inflammation. Methods Sixty-eight patients were enrolled. Histopathological investigation and a skin-prick test were done and categorized as eosinophil-dominated inflammation with positive (ESPT+) or negative skin test (ESPT-) and nonesoinophil-dominated inflammation with positive (NESPT+) or negative skin test (NESPT-). Patients were treated over 6 weeks with budesonide nasal spray, 400 μg/day. At 0, 3, and 6 weeks after treatment, nasal symptoms, polyp size, nasal and oral peak expiratory flow (PEF) index and overall assessment within and between groups were evaluated and compared. Results At 3 and 6 weeks after treatment, the ESPT- group showed the most, and the NESPT+ group showed the least therapeutic improvement. In comparing between the positive and negative skin tests in each histopathology, the positive skin tests tended to have less improvement than the negative skin tests in all variables. The differences increased over time and reached statistical significance at 6 weeks in the PEF index and overall assessment of eosinophil-dominated inflammation (p = 0.004 and 0.033, respectively) and in sneezing score, postnasal drip score, and overall assessment of noneosinophil-dominated inflammation (p = 0.019, 0.035, and 0.013, respectively). Conclusion Nonallergic eosinophilic polyps had the best and allergic noneosinophilic polyps had the worst therapeutic response. Within each histopathology, allergic nasal polyps had less therapeutic response than nonallergic nasal polyps. This augmented effect could be caused by concomitant allergic inflammation.
Computed Tomography Scans in the Evaluation of Patients with Olfactory Dysfunction
Authors: Mueller Christian , Temmel Andreas F.P. , Toth Josef , Quint Christian , Herneth Andreas , Hummel Thomas 
Published: August 2018

Background The necessity of computed tomography (CT) scans of the olfactory cleft and the sinuses in patients presenting with olfactory dysfunction is a matter of debate. This study aimed to investigate the significance of CT scans for the diagnosis of olfactory loss and for therapeutic decisions. Methods This retrospective study included 137 consecutive patients presenting with the main complaint of olfactory loss. Standardized history; ear, nose, and throat examination; and olfactory tests were administered. In addition, a CT scan of the nasal sinuses was obtained. The assumed diagnosis (sinonasal disease [SND] or non-SND) was compared with the diagnosis when additionally considering results from the CT scan. Results CT scans suggested SND in 7/101 patients without clinical evidence of its presence. In 12/36 patients with suspected SND-related olfactory loss, no signs of SND were detected in CT scans. Conclusion CT scans are useful to diagnose conductive/inflammatory olfactory loss in patients suspected of non-SND, which may then justify a course with systemic steroids. Alternatively, considering low costs and rare side effects of a short course with steroids in selected patients, CT scans appear to be of clinical significance only when surgical treatment is contemplated or where the use of systemic corticosteroids is not possible.
Expression and Distribution of Aquaporin-1 in Nasal Polyps: Does it have any Significance in Edema Formation?
Authors: Altuntaş Ali , Yılmaz Mustafa Deniz , Aktepe Fatma , Kahveci Orhan Kemal , Derekoy Sefa , Dilek Hüsniye , Serteser Mustafa 
Published: August 2018

Background The aim of this study was to investigate the expression of Aquaporin 1 (AQP1) and AQP4 in polyp tissue. Methods Nasal polyps were obtained from 34 patients with nasal polyposis during endoscopic sinus surgery. Bullous middle turbinates with normal-appearing mucosa of 10 patients were used as controls. Expression of AQP1 and AQP4 water channels were determined by immunohistochemical methods. Results AQP1 has been found to be expressed in fibroblasts located in polyp tissue, especially in the subepithelial area, periphery of seromucous glands, and endothelial cells of venules. Conclusion We have established a high expression of AQP1 water channels in nasal polyp tissue and have suggested two mechanisms to explain this finding. Increased AQP1 expression may be a cause or a consequence of edema formation. Thus, additional studies are needed to elucidate the true mechanism underlying this relationship.
Acoustic Rhinometry Predicts Tolerance of Nasal Continuous Positive Airway Pressure: A Pilot Study
Authors: Morris Luc G. , Setlur Jennifer , Burschtin Omar E. , Steward David L. , Jacobs Joseph B. , Lee Kelvin C. 
Published: August 2018

Background Nasal continuous positive airway pressure (nCPAP) is usually the first-line intervention for obstructive sleep apnea, but up to 50% of patients are unable to tolerate therapy because of discomfort–-usually nasal complaints. No factors have been definitively correlated with nCPAP tolerance, although nasal cross-sectional area has been correlated with the level of CPAP pressure, and nasal surgery improves nCPAP compliance. This study examined the relationship between nasal cross-sectional area and nCPAP tolerance. Methods We performed acoustic rhinometry on 34 obstructive sleep apnea patients at the time of the initial sleep study. Patients titrated to nCPAP were interviewed 18 months after starting therapy to determine CPAP tolerance. Demographic, polysomnographic, and nasal cross-sectional area data were compared between CPAP-tolerant and -intolerant patients. Results Between 13 tolerant and 12 intolerant patients, there were no significant differences in age, gender, body mass index, CPAP level, respiratory disturbance index, or subjective nasal obstruction. Cross-sectional area at the inferior turbinate differed significantly between the two groups (p = 0.03). This remained significant after multivariate analysis for possibly confounding variables. A cross-sectional area cutoff of 0.6 cm2 at the head of the inferior turbinate carried a sensitivity of 75% and specificity of 77% for CPAP intolerance in this patient group. Conclusion Nasal airway obstruction correlated with CPAP tolerance, supporting an important role for the nose in CPAP, and providing a physiological basis for improved CPAP compliance after nasal surgery. Objective nasal evaluation, but not the subjective report of nasal obstruction, may be helpful in the management of these patients.
Th2 Immunological Inflammation in Allergic Fungal Sinusitis, Nonallergic Eosinophilic Fungal Sinusitis, and Chronic Rhinosinusitis
Authors: Carney A. Simon , Tan Lor-Wai , Adams Damian , Varelias Antiopi , Ooi Eng Hooi , Wormald Peter-John 
Published: August 2018

Background Noninvasive fungal sinusitis is a heterogenous group of conditions including allergic fungal sinusitis (AFS) and nonallergic eosinophilic fungal sinusitis (NEFS). Th2-mediated cascades have been postulated to be the major inflammatory response in patients with AFS although other mechanisms also may be involved. The detailed mucosal Th2 cytological status of NEFS still has not been studied in great depth. Methods Using a meticulous patient selection algorithm over a 2-year period, infundibular mucosal tissue from patients with AFS, NEFS, chronic rhinosinusitis (CRS), and normal controls was studied (n = 59). Immunohistochemistry for mast cells, eosinophils, and immunoglobulin E (IgE) cells was performed and cell counts per unit area were measured. Results Mast cell, eosinophil, and IgE+ cell numbers were significantly raised in patients with AFS, NEFS, and CRS when compared with controls. There was no significant difference between cell numbers in patients with AFS and NEFS. Conclusion Patients with AFS exhibit a classic Th2 inflammatory response in nasal mucosal tissue with NEFS and CRS patients showing evidence of a similar Th2 cascade, including the presence of IgE+ cells.
In Vivo Optical Coherence Tomography of the Nasal Mucosa
Authors: Mahmood Usama , Ridgway James , Jackson Ryan , Guo Shuguang , Su Jianping , Armstrong William , Shibuya Terry , Crumley Roger , Chen Zhongping , Wong Brian 
Published: August 2018

Background Optical coherence tomography (OCT) is an emerging imaging modality that uses light to produce in vivo high-resolution cross-sectional images (7 μm) of tissues to depths of up to 3 mm. OCT is analogous to ultrasound, but relies on interferometry and low-coherence optical sources to produce images of tissue structure at the histological level. Methods In this study, OCT was used to image the mucosa overlying structures in the nasal cavity to obtain information regarding normative in vivo tissue microstructure. An OCT system using a Michaelson interferometer and a 1.3-μm broadband light source was incorporated into a fiber-optic imaging device that was inserted into the nasal cavity. Cross-sectional tomographic images of the anterior and posterior nasal septum, turbinates, and vestibule were acquired in 44 patients in either the office or the operating room during surgical endoscopy. Results OCT images of the nasal mucosa identified the distinct boundaries between the epithelium, lamina propria, and underlying bone/cartilaginous tissue. Within the lamina propria, features consistent with glands, ducts, and blood vessels were clearly identified. In patients who underwent decongestant therapy, before and after images showed distinct morphological changes in the mucosa. The thickness of the epithelium was tabulated, as well. Conclusion This study establishes the potential of using OCT to produce high-resolution images of the nasal mucosa. As an in vivo tissue microstructural imaging modality, OCT may be valuable in studying the impact of allergic and infectious disease on the nasal mucosa and monitoring its response to pharmacologic therapy.
Signals through CD40 Play a Critical Role in the Pathophysiology of Schistosoma Mansoni Egg Antigen–Induced Allergic Rhinitis in Mice
Authors: Hattori Hisashi , Okano Mitsuhiro , Kariya Shin , Nishizaki Kazunori , Satoskar Abhay R. 
Published: August 2018

Background Interaction between CD40 and CD40L is thought to regulate immune responses in several allergic diseases. However, little is known about its in vivo role in the pathophysiology of allergic rhinitis. We sought to determine whether the lack of signals through CD40 affects the pathophysiology of allergic rhinitis using a murine model. Methods Wild type (WT) and CD40-deficient BALB/c (CD40-/-) mice were sensitized intranasally to Schistosoma mansoni egg antigen (SEA). After repeated sensitization, histamine responsiveness, serum antibody titer including immunoglobulin E (IgE), nasal eosinophilia, and cytokine production by nasal mononuclear cells were determined in each group. Results Intranasal sensitization with SEA in WT mice elicited a strong Th2 response including SEA-specific IgE production, nasal eosinophilia, and interleukin (IL)-4, and IL-5 production by nasal mononuclear cells after antigen challenge. Production of SEA-specific IgE and IgG1 was abolished in SEA-sensitized CD40-/- mice. These mice showed impaired nasal eosinophilia and displayed markedly reduced histamine-induced nasal hyperresponsiveness as compared with WT mice. Furthermore, reduced production of IL-4 and IL-5 by nasal mononuclear cells was seen in CD40-/- mice. Conclusion These results show that signals through CD40 play a critical role in not only IgE production but also pathophysiology of allergic rhinitis such as nasal hyperresponsiveness and nasal eosinophilia.