bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mucocele Rate after Endoscopic Skull Base Reconstruction Using Vascularized Pedicled Flaps
Authors: Bleier Benjamin S. , Wang Eric W. , Vandergrift W. Alex , Schlosser Rodney J. 
Published: May 2011

Background Postoperative cerebrospinal fluid leak is a significant risk after endoscopic skull base surgery. Recently, novel reconstructive techniques using vascularized pedicled mucosal flaps have been applied to decrease this potential risk. Complete mucosal extirpation in the wound bed is not always feasible and the impact of insetting the flap over intact underlying mucosa is not clear. The purpose of this study was to determine the rate of mucocele formation after nasoseptal flap reconstruction without mucosal stripping. Methods This is an Institutional Review Board–approved, retrospective study consisting of 28 patients undergoing skull base reconstruction using a pedicled nasoseptal flap between 2008 and 2010 at a tertiary care hospital. In all cases the sinus or skull base mucosa surrounding the defect was left intact. Patients were followed postoperatively by endoscopy and/or imaging for evidence of mucocele formation in the reconstructive bed. Results The total rate of mucocele formation was 3.6% (1 of 28, noted on postoperative day 46). The mean follow-up time was 243 ± 174 days (range, 46–585 days). Eleven patients were followed for over 1 year. All flaps remained viable and well vascularized. Conclusion The pedicled nasoseptal flap is an effective means of reconstruction after endoscopic skull base surgery. Avoidance of extensive stripping of the surrounding mucosa does not result in a significant rate of postoperative mucocele formation in the short term. Long-term follow-up is still indicated.
Endoscopic Surgery for Acquired Choanal Atresia after Radiotherapy for Nasopharyngeal Carcinoma
Authors: Liu Xiang , Huang Xiaoming , Sun Wei , Zeng Liang , Han Ping 
Published: May 2011

Background This study was designed to investigate the role of endoscopic surgery for acquired choanal atresia after radiotherapy for nasopharyngeal carcinoma. Methods Twenty-two patients with bilateral or unilateral acquired choanal atresia received transnasal endoscopic surgery with the aid of a powered microdebrider to open atresia choana and received endoscopic sinus surgery simultaneously if they had sinusitis. Merocel epistaxis packing was used to pack the nasal airway for 3 days postoperatively. All of the patients underwent endoscopy regularly for follow-up. Results Sixteen patients with acquired bilateral choanal atresia and 6 with unilateral choanal atresia were included in this study. The median age was 46 years old (range, 33–65 years). Twenty-one patients had sinusitis. Sixteen patients with bilateral choanal atresia and 4 patients with unilateral atresia had bilateral sinusitis. One patient with unilateral atresia had ipsilateral sinusitis. The mean follow-up period was 35 months (range, 12–72 months) after surgery. Twenty patients were symptom-free after a single operation; nasal obstruction, rhinorrhea, and xerostomia improved significantly for these patients. Two patients had unilateral restenosis that required revision surgery, and both were subsequently free from further restenosis. No complications occurred. Conclusion Acquired posterior choanal atresia after radiotherapy can be successfully treated with transnasal endoscopic resection assisted by a powered instrument without stenting.
The Nose as a Target Organ in the Diagnosis of Severe Aspirin-exacerbated Respiratory Disease
Authors: González-Pérez Ruperto , Poza-Guedes Paloma , Vives-Conesa Ramón 
Published: May 2011

Background The nasal provocation test (NPT) with lysine aspirin is a useful tool in the diagnosis of aspirin-exacerbated respiratory disease (AERD), previously reffered to as Samter's disease. The aim of the present study focuses on methodological interventions to show the usefulness of the NPT with lysine aspirin in differentiating AERD patients from aspirin-tolerant asthma (ATA) patients to improve the diagnostic efficacy and minimize the risk for adverse reactions compared with the gold standard. Methods Thirty AERD patients comprised the active study group while the control group consisted of 25 ATA patients. A combination of objective nasal aerodynamic response (i.e., nasal inspiratory flow and nasal inspiratory resistance) was evaluated by active anterior rhinomanometry and the subjective clinical nasal and extranasal symptoms (including forced expiratory volume) were monitored throughout the challenge. Results Fifty-five NPTs were successfully completed: sensitivity, 87%; specificity, 100%; positive predictive value, 100%; negative predictive value, 86%; global efficacy, 92.72%. No severe adverse reactions were recorded. Conclusion The present NPT with lysine aspirin proved to be a safe, efficient, and a timesaving method in the diagnosis of patients with AERD, even in those with severe rhinitis–rhinosinusitis and/or recurrent nasal polyposis.
A Controlled Laboratory and Clinical Evaluation of a Three-dimensional Endoscope for Endonasal Sinus and Skull Base Surgery
Authors: Shah Rupali N. , Leight W. Derek , Patel Mihir R. , Surowitz Joshua B. , Wong Yu-Tung , Wheless Stephen A. , Germanwala Anand V. , Zanation Adam M. 
Published: May 2011

Background One criticism of current video systems for endoscopic surgery is that two-dimensional (2D) images lack depth perception and may impair surgical dissection. To objectively measure the efficacy of 3D endoscopy, we designed a training model with specific tasks to show potential differences between 2D and 3D endoscopy. Its clinical value was then evaluated during endoscopic sinus and skull base surgical cases. Methods Fifteen subjects were grouped according to endoscopic experience: novices and nonnovices. A training model was constructed to include five tasks: incision manipulation; ring transfer; nerve hook; distance estimation, visual only; and distance estimation, visual and tactile. Each participant was assessed with both a standard 2D endoscope and a 3D endoscope. The clinical value of a 3D endoscope (Visionsense, Ltd., Petach Tikva, Israel) was then examined in four endoscopic sinus cases and four skull base cases. Results Of the subjects, six (40%) were novices. Overall, the errors committed during any one task were not significantly different between systems. Novices trended toward more success during the nerve hook task using the 3D system. With size cueing versus visualization alone, distance estimation was significantly more accurate. Novices tended to prefer the 3D system and experienced surgeons disliked the initial learning curve. Advantages were particularly noticed during skull base surgery; subjectively improved depth perception was beneficial during vascular dissection. Conclusion Three-dimensional endoscopy may improve depth perception and performance for novices. The 3D endoscope is a safe and feasible tool for endoscopic sinus and skull base surgery; it is promising for improving microneurosurgical dissection precision transnasally.
Effect of Dexamethasone on Wound Healing of the Septal Mucosa in the Rat
Authors: Khalmuratova Roza , Kim Dae Woo , Jeon Sea-Yuong 
Published: May 2011

Background Postoperative treatment after functional endoscopic sinus surgery (FESS) aims to modulate the wound healing process. Systemic or topically applied corticosteroids have been reported to be beneficial for improving nasal wound healing after FESS. However, few studies have investigated the effects of postoperative systemic steroids on nasal wound healing with regard to histological changes. The aim of this study was to evaluate the effect of systemic dexamethasone on nasal wound healing after mechanical injury in the rat. Methods A unilateral wound in the nasal cavity was induced using the brushing technique in 4-week-old, Sprague-Dawley rats (n = 70). Dexamethasone (0.15 mg/kg daily for 7 days) and normal saline were administered i.p. to the experimental and control groups (n = 35 for each) after the injury. The rats (n = 7 for each) were killed on days 2, 5,14, 28, and 42 after the injury. Histological changes in the nasal mucosa were examined and compared using hematoxylin and eosin and Masson's trichrome staining. Results The experimental group showed less subepithelial edema formation and epithelial disarray at the early phase of the wound healing period. There were statistically significant differences in the subepithelial thickness and epithelial thickness indices between the experimental and control groups (p < 0.05). Ciliary and goblet cell indices were lower in the experimental group, which means that ciliary and goblet cell regeneration may be delayed by dexamethasone (p < 0.05). There were no differences in the subepithelial fibrosis index between the two groups. Adhesion formation between the nasal septum and turbinate were found only in the control group. Conclusion Systemic dexamethasone after mucosal injury may lessen subepithelial edema, goblet cell hyperplasia, and adhesion formation; however, it may cause delayed mucosal ciliary regeneration.
Transdifferentiation of Clara Cell 10-kDa Protein Secreting Cells in Experimental Allergic Rhinitis
Authors: Cui Yong-Hua , Wang Yuan-Yuan , Liu Zheng 
Published: May 2011

Background The reasons for the down-regulated Clara cell 10-kDa protein (CC10) expression in allergic rhinitis (AR) are unclear and the airway remodeling in AR has received little attention. This study explores epithelium remodeling and the change of CC10 secreting cells in AR by using a murine model. Methods AR murine models were established by ovalbumin sensitization and challenge. In some mice, dexamethasone was given before each challenge. Histological changes of nasal mucosa were examined by means of hematoxylin and eosin and periodic acid-Schiff staining. CC10 and trefoil factor family (TFF) 1 expression were evaluated by immunohistochemistry. Results In AR mice, both in turbinate and in septal mucosa, total cell number and the number of basal cells did not change; however, the number of dome-shaped cells decreased and the number of ciliated and goblet cells increased in turbinate mucosa, and the number of ciliated cells decreased and the number of goblet cells increased in septal mucosa. In turbinate mucosa, the number of CC10+ cells (mainly dome-shaped cells) decreased whereas the number of TFF1+ cells (mainly ciliated cells) increased. In septal mucosa, the number of CC10+ and TFF1+ cells (mainly ciliated cells) decreased simultaneously. Intermediate phenotypic goblet cells could express CC10 and TFF1. CC10 and TFF1 could be localized in the same cells. Dexamethasone reversed the changes of epithelium significantly. Conclusion Allergen exposure leads to a possible transdifferentiation of CC10 secreting cells into TFF1 secreting cells and/or goblet cells in upper airways. Nasal turbinate and septal epithelium display different patterns of transdifferentiation.
Experiences with a New Surgical Technique for Closure of Large Perforations of the Nasal Septum in 55 Patients
Authors: Teymoortash Afshin , Hoch Stephan , Eivazi Behfar , Werner Jochen A. 
Published: May 2011

Background The surgical closure of nasal septal perforation is still an unsolved clinical problem. In this study the experiences with a novel surgical technique for closure of large perforations of the nasal septum are presented. Methods A total of 55 patients with symptomatic nasal septal perforation measuring 23 ± 3 mm (range, 11–38 mm) at the widest point were enrolled in the study. The closure of the nasal septal perforation was performed with a new and simple surgical technique using a nasal mucosal flap consisting of the defect-corresponding mucosa of the floor of the nose, inferior nasal meatus, and inferior turbinate. Results A symptomatic improvement of nasal symptoms was noted in all treated patients. In only 3 of 55 cases was the perforation closing incomplete. Conclusion Our experience with this flap shows its reliability and safety in repairing large nasal septal perforations, with many advantages compared with other techniques for septal perforation repair.
Three-dimensional Volumetric Measurements and Analysis of the Maxillary Sinus
Authors: Deeb Robert , Malani Preeti N. , Gil Baljinder , Jafari-Khouzani Kourosh , Soltanian-Zadeh Hamid , Patel Suresh , Zacharek Mark A. 
Published: May 2011

Background Multiple chronic rhinosinusitis (CRS) staging systems have been developed in an attempt to correlate symptoms with radiological imaging results. Currently, no perfect system exists. We sought to analyze the maxillary sinus (MS) using three-dimensional volumetric measurements and advanced high-resolution CT imaging. Methods We reviewed MS CT scans from 50 control subjects and 50 subjects with documented CRS involving at least one MS. The following measurements were recorded: (1) volume of MS free air, (2) MS mucosal thickening, and (3) MS lateral wall bony thickness. Average Hounsfield unit (HU) values for mucosal thickening among CRS subjects were also recorded. Values are expressed as mean ± SD and median. Values from the CRS patients were compared with healthy controls using Student's t-tests. Results Among controls (n = 50), volumes (mL) of right and left MS were 24.1 ± 9.7 and 24.7 ± 9.0, respectively. Among CRS patients (n = 50), the portion of mucosal disease to total sinus volume was 51.8% (right) and 50.7% (left). Mean bony thickness (mm) in controls was 0.98 ± 0.2 (right) and 1.0 ± 0.3 (left). CRS patients had significantly greater bony thickness 1.9 ± 0.8 (right) and 2.0 ± 0.9 (left; p = 0.0001). HU for diseased MS were 30.1 ± 18.7 (right) and 35.7 ± 22.1 (left). Conclusion Three-dimensional volumetric analysis combined with HU calculations and bony thickness measurements represents a new and unique way to evaluate CT scans in patients with CRS. Additional studies correlating symptoms with imaging findings as well as analysis of all paranasal sinuses is the next step toward a novel staging system.
Comparison of Outcomes of Simple Polypectomy plus Balloon Catheter Dilatation versus Functional Endoscopic Sinus Surgery in Nasal Polyposis: A Preliminary Study
Authors: Bozdemir Kazım , Kutluhan Ahmet , Çetin Hüseyin , Yalçiner Gökhan , Bilgen Akif Sinan 
Published: May 2011

Background The aim of this study was to compare the outcomes of functional endoscopic sinus surgery (FESS) and simple polypectomy plus balloon catheter dilatation (BCD) in nasal polyposis. Methods Ten patients (six male and four female subjects) with nasal polyposis who underwent surgical treatment were included in this research. BCD was performed on one side of each patient's paranasal sinuses (after nasal polypectomy by microdebrider) while standard FESS was performed on the other side. Preoperatively, all patients were treated with oral methylprednisolone, 1 mg/kg per day, for 5 days, which was reduced and stopped on the 14th day. Pre-and postoperative endoscopic and radiological findings were compared. Endonasal endoscopic examination results were classified according to MacKay classification. Paranasal sinus computed tomography findings were evaluated according to Lund-MacKay classification. Results Pre- and postmedical treatment results of the patients were not significantly different according to MacKay classification. There was no significant difference between the results of FESS and BCD during 12-month follow-up period according to Lund-MacKay and MacKay classifications. There was significant improvement in the results obtained 1 and 12 months after FESS and BCD, respectively. The improvement was also radiologically evident. Conclusion At 1 year postsurgery, polypectomy plus BCD is as effective as FESS. Longer-term studies are necessary to validate this technique.
Repeated Intranasal Instillation with Staphylococcal Enterotoxin B Induces Nasal Allergic Inflammation in Guinea Pigs
Authors: Tang Xinye , Sun Rong , Hong Suling , Hu Guohua , Yang Yang 
Published: May 2011

Background Staphylococcal enterotoxins (SEs) appear to play a role in the pathogenesis of allergic disease. However, no animal models have been reported to show nasal allergic inflammation by repeated inhalation with staphylococcal enterotoxin B (SEB) in the absence of adjuvant. This study was designed to determine whether intranasal instillation of guinea pigs with SEB results in nasal allergic inflammation. Methods Guinea pigs were intranasally instilled with 40 μL of 4-μg SEB once every 4 days 11 times. For the control group, guinea pigs were prepared with saline instead of SEB. Sneezing and nasal scratching frequency were evaluated after each intranasal instillation. The production of antigen-specific antibodies including IgE, nasal eosinophilia, and cytokines in the nasal cavity lavage fluid (NCLF) were measured after the 11th intranasal immunization. Results In the model group, symptoms of sneezing and nasal scratching were induced at the 8th to 11th challenges. Intranasal immunization with SEB elicited a local nasal mucosa inflammatory response characterized by apparent eosinophil infiltration. In the NCLF, the expression of IL-4 but not interferon-gamma was increased after challenges. The serum levels of total and SEB-specific IgE and IgG1 were higher in model groups in comparison with the control groups (p < 0.01). Conclusion These results indicate that repeated intranasal instillation with SEB leads to Th2 immune response, allergic nasal inflammation, and increased antigen-specific IgE production that are characteristic of allergic rhinitis (AR). The model in this study could be valuable in analyzing the pathogenesis of AR infected with Staphylococcus aureus.
Postoperative Care with Chinese Herbal Medicine or Amoxicillin after Functional Endoscopic Sinus Surgery: A Randomized, Double-blind, Placebo-controlled Study
Authors: Liang Kai-Li , Su Yi-Chang , Tsai Chen-Chen , Lin Jui-Shan , Jiang Rong-San , Su Mao-Chang 
Published: May 2011

Background A number of herbal preparations have been reported being used as adjunctive treatment of patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS). This study was designed to examine the efficacy of Chinese herbal medicine (CHM) in the postoperative care of post-FESS patients. Methods Patients with CRS who underwent FESS were prospectively enrolled in the study. Before surgery, they were evaluated by various methods, including the Chinese version of the Rhinosinusitis Outcome Measure (CRSOM-31), nasal endoscopy, acoustic rhinometry, and computed tomography (CT). After surgery, they were randomized to take CHM (Tsang-Erh-San extract granules and Houttuynia extract powder) for 8 weeks, amoxicillin for 4 weeks, or placebo. They were revaluated by CRSOM-31, nasal endoscopy, and acoustic rhinometry at 8 weeks and by CT at 12 weeks after surgery. Results Ninety-seven patients (33 in the CHM group, 34 in the amoxicillin group, and 30 in the placebo group) completed the study. In the CHM group, CRSOM-31 and endoscopic scores significantly decreased, and the second minimal cross-sectional area of the nasal cavity measured by acoustic rhinometry significantly increased after treatment. In the amoxicillin and placebo groups, CRSOM-31, endoscopic, and CT scores significantly decreased after treatment. However, there were no significant differences in subjective and objective treatment outcomes among three groups of patients. Conclusion Our results showed there was no significant benefit of using CHMs (Tsang-Erh-San extract granules and Houttuynia extract powder) or oral amoxicillin in post-FESS care of CRS patients. Additional investigation is necessary for post-FESS care.
Prevalence and Risk Factors of Chronic Rhinosinusitis in Korea
Authors: Kim Yoo Suk , Kim Na Hyun , Seong Sang Yeob , Kim Kyung Rok , Lee Gi-Bong , Kim Kyung-Su 
Published: May 2011

Background Chronic rhinosinusitis (CRS) is one of the most common inflammatory diseases with multiple etiologies. Despite its high prevalence, risk factors influencing its prevalence have not been thoroughly revealed. Therefore, we investigated the prevalence and risk factors of CRS in Korea. Methods The 4098 subjects that participated in the Korea National Health and Nutrition Examination Survey were included in the study. Risk factors were categorized into sociodemographic and personal medical factors. Univariate and multivariate analyses were performed to identify significant risk factors of CRS. In addition, population attributable risks of the significant factors were calculated to estimate the effect on the population level. Results The prevalence of CRS in Korea was 6.95%. Among sociodemographic factors, male sex, old age, and heavy stress were significantly related with CRS. Influenza vaccination, septal deviation, and persistent allergic rhinitis were significant personal medical risk factors of CRS. Among these risk factors, persistent/moderate to severe allergic rhinitis was proven to be the most significant risk factor for CRS at the population level. Conclusion Although the prevalence and risk factors vary according to time, place, and diagnostic criteria, periodic epidemiological study on CRS is necessary to reduce socioeconomic expenditure and establish an improved national health care policy.
Effects of Microelectrical Current on Migration of Nasal Fibroblasts
Authors: Choi Hyuk , Cho Jung-Sun , Park Il Ho , Yoon Hu Geun , Lee Heung-Man 
Published: May 2011

Background Migration of fibroblasts is critical in wound healing. The question of how wounded electric fields guide migration of nasal fibroblasts remains to be elucidated. This study was designed to determine morphology, directedness, and migration rate of nasal fibroblasts during microcurrent application, which is simulated by an endogenous electric field at the vicinity of the wound. Methods Nasal fibroblasts were exposed to a microelectric field at 50, 100, and 250 mV/mm for 3 hours at 37°C. In this experiment, the field polarity was reversed for an additional 3 hours. During in vitro testing, the cells were incubated in a newly developed miniature, microcurrent generating chamber system, with 5% CO2, at 37°C; the media was circulated by a pump system. A wound was created by scratching a cell-free area (∼150 μm wide) into a confluent monolayer. The average migration speed was calculated as the distance traveled by the cell divided by time. Results A microelectric field of 100 mV/mm or more induced significant cell migration in the direction of the cathode. Trajectory speeds at 50, 100, and 250 mV/mm were 9.8 ± 0.3, 11.8 ± 0.3, and 13.5 ± 0.9 μm/mm, respectively. A significant difference was observed between migratory rate of controls and that of 50 mV/mm (p < 0.05). Conclusion Microelectric fields appear to have a crucial role in control of nasal fibroblast activity in the process of wound healing.
Near-infrared Spectroscopy of Orbitofrontal Cortex during Odorant Stimulation
Authors: Kokan Norio , Sakai Nobuyuki , Doi Kiyoshi , Fujio Hisami , Hasegawa Shingo , Tanimoto Hitoshi , Nibu Ken-ichi 
Published: May 2011

Background For olfaction, several studies have reported near-infrared spectroscopy (NIRS) signal changes in the orbitofrontal cortex (OFC) during odor stimulation. However, the roles of human OFC in olfactory cognition are less well understood. This study was designed to better understand the roles of OFC for olfaction. Methods Hemodynamic responses for phenyl ethyl alcohol or citral in the OFCs were measured with NIRS. After the experiment, participants were asked to describe the characteristics of the odor and to rate odor intensity and hedonic valence. Results Statistical analysis of all participants’ data showed significant changes in the concentration of total hemoglobin in the left OFC during the trial (p = 0.04). The total hemoglobin signal increased significantly in the right OFC (p = 0.0008) of the participants who successfully identified the odorant stimulus. Conclusion Our findings showed that NIRS combined with a questionnaire is a useful method for studying the functional neuroanatomy of OFC in terms of olfaction.