bluuebunny/crossref_metadata_2025_split huggingface dataset:
Angiofibroma Arising from the Uncinate
Authors: Kamal Sally M. , Strong Edward Bradley 
Published: September 2011

Objective1) Report the case of a nasal angiofibroma that presented in an unusual location in an adult patient. 2) Review the available literature on nasal angiofibroma, with a focus on atypical presentations.MethodAn adult male presented with left‐sided nasal obstruction. Examination revealed a polypoid mass obscuring the middle meatus. Intraoperatively, the mass appeared to originate from the uncinate process. Minimal bleeding was encountered. Pathology revealed nasal angiofibroma. Three months postoperatively, he is free of disease.ResultsThis represents a rare presentation of nasal angiofibroma, which is a primarily nasopharyngeal lesion seen in adolescent males. Review of the literature confirmed this. The most common atypical locations were the middle and inferior turbinates. No cases of angiofibroma arising from the uncinate process were previously reported. Angiofibroma is a highly vascular tumor, frequently requiring preoperative embolization. In this case, however, we did not embolize preoperatively and did not encounter significant bleeding. Endoscopic technique is becoming more common for excision of nasal angiofibromas. We were able to completely excise the tumor using an endoscopic approach.ConclusionNasal angiofibroma is a rare tumor presenting predominately as a nasopharyngeal lesion in adolescent males. Uncommonly, this tumor presents in adults or in varying locations within the nose. Angiofibroma should be included in the differential diagnosis of atypical nasal masses. These patients require close follow‐up given the propensity for recurrence.
Atypical Skull Base Osteomyelitis in an Immunocompetent Patient
Authors: Haffey Timothy Michael , Woodard Troy D. 
Published: September 2011

Objective1) Present an abnormal case presentation of an already rare and deadly disease process. 2) Critically review/summarize the literature as it pertained to this case. 3) Increase awareness of a diagnostically challenging reversible deadly disease process. 4) Review current treatment options/recommendations for atypical SBO.MethodThis is an unusual case of atypical skull base osteomyelitis in an immunocompetent patient diagnosed in 2010 at the Cleveland Clinic Foundation (CCF). A literature review for “atypical” and “central skull base osteomyelitis” was performed using PubMed.ResultsAs with other published cases of atypical skull base osteomyelitis, this patient was an elderly male, had no preceding infective source, and presented initially with headache that progressed to multiple lower cranial neuropathies (CN 8, 9, 10, 12). However, our patient is unique because he was not diabetic and had no immunodeficiencies. His work‐up initially centered on ruling out a primary headache disorder, temporal arteritis, and oncologic pathology. Biopsy, culture, and an indium tagged WBC scan were pivotal in proving an infectious etiology. Prolonged IV antibiotics were vital in clearing the infection.ConclusionSkull base osteomyelitis should be considered even in immunocompetent patients presenting with headache and cranial neuropathies. When possible, culture, biopsy, and indium‐tagged‐WBC scan should be performed to help distinguish an infectious process over malignancy, and guide antibiotic therapy. Early diagnosis and treatment is imperative in managing this life‐threatening disease.
Biofilm Disruption: Combined Modality Treatment Using Hydrodynamic Therapy and Laser
Authors: Kanotra Sohit P. , James Garth , Kizhner Victor Z. , Krespi Yosef P. , Myntti Matthew F. 
Published: September 2011

ObjectiveBiofilms have been increasingly implicated as an underlying factor in refractory chronic rhinosinusitis (CRS). This study researches the efficacy of a combination of hydrodynamic therapy and laser in disrupting bacterial biofilms.MethodIsolates of Staphylococcus aureus and Pseudomonas aeruginosa were cultured and divided into 3 groups. Group 1 was the control group, Group 2 was treated with saline delivered with hydrodynamic force, and Group 3 was treated with both hydrodynamic force and a near infrared diode laser.ResultsFor both the bacterial species, the use of laser augmented the reduction of Colony Forming Units obtained with hydrodynamic shearing, with an additional reduction in CFUs counts ranging from 0.94‐2.18 logs and 0.68‐1.15 logs for P Aeroginosa and S Aureus respectively. The overall log reduction obtained by combined modality treatment ranged from 4.57‐5.06 for P Aeroginosa and 3.55‐3.67 for S Aureus; both of these were statistically significant (P <. 005).ConclusionA combination of hydrodynamic therapy and laser produces superior results in disrupting biofilm in in vitro models, and further studies of this combined modality treatment are warranted in living tissues and animal models.
Chitosan Membrane for Nasal Packing
Authors: Hernandez Maria I. M. , Ojeda Alejandro G. , Lopez‐Dellamry Toral Fernando A. , Estrada Joaquin G. , Jimenez Jose C. V. , Plascencia Miguel R. O. , Marcias‐Reyes Hector 
Published: September 2011

ObjectiveSynthesize chitosan membranes for nasal packing. This is the first part of a clinical trial (preliminary results).MethodWe made a 3% chitosan in 2% acetic acid solution. After mixing, filtration, and sonication, it was placed in a Petri plate (0.21g/cm2), frizzed at −5°C (24‐hours), and lyophilized (in ultra vacuum and temperatures less than −45°C) until complete drying. Chitosan polymer membrane was stabilized with NaOH 1mM w/v solution.ResultsWe obtained a membrane with neutral pH. It is placed in sterile distillated water in glass containers. After that, it is placed in a neutral solution of sodium hypochlorite for the sterilization. This solution does not affect the stability of the polymer. We proceed to use it as nasal packing in the clinical trial we are working on.ConclusionThe chitosan membrane is stable, is not harmful for nasal mucosa, and can be used as nasal packing. This is the preliminary result of a clinical trial.
Effects of Mometasone Furoate Nasal Spray on Patients with Seasonal Grass Pollinosis
Authors: Ota Nobuo , Suzuki Yusuke , Aoyagi Masaru 
Published: September 2011

ObjectiveSeasonal grass pollinosis has recently become a major problem because many people suffer from this allergy. In this study, we evaluate the clinical effects of mometasone for seasonal grass pollinosis, the changes of chemical mediators in nasal lavage fluid, and their correlation with the clinical response.MethodTwenty patients were treated with mometasone from May to August 2009. To assess the clinical response, we focused on the changes of symptoms shown by the allergy diary of each patient. We also investigated the correlation of ECP, VEGF, and eotaxin levels in nasal lavage fluid with the severity of symptoms.ResultsThere was a significant reduction of the symptom score, medication score, and symptom medication score after administration of mometasone, and also ECP, VEGF, and eotaxin levels showed significant reduction in nasal lavage fluid. We found a significant correlation with VEGF and nasal symptoms.ConclusionThese results may allow us to speculate that mometasone furoate nasal spray is effective for the treatment of patients with seasonal grass pollinosis and also useful to improve QOL of these patients.
Endoscopic Marsupialization of Congenital Nasolacrimal Duct Cysts
Authors: Dogan Ersoy , Yaman Aylin , Berk Ayse T. , Ecevit Mustafa Cenk , Yuksel Nesibe G. , Sutay Semih 
Published: September 2011

ObjectiveProvide information on the clinical characteristics and management of an uncommon congenital nasolacrimal duct anomaly with intranasal cysts.MethodThree cases of intranasal nasolacrimal duct cysts are presented with a brief literature review. Patients were presented from 2007 to 2010. Diagnosis was made by clinical observation and endoscopic examination with a search for a cyst in the inferior meatus. The intranasal cysts were successfully treated with nasal endoscopic marsupialization.ResultsWe report 3 cases of congenital nasolacrimal duct anomaly with intranasal extension presenting as intranasal cystic masses. The first case is a 60 days old child presented with bilateral intranasal cystic masses that caused nasal obstruction and respiratory distress. The second case is a 1‐year‐old child presented with congenital dacryocystocele and coexisting ipsilateral intranasal cyst explored by nasal endoscopy. The last case is a 6 days old newborn presented with respiratory distress and found to have bilateral choanal atresia and left side intranasal cyst. All 3 cases were treated with nasal endoscopic marsupialization. All children with intranasal cysts were cured.ConclusionBecause the extension of nasolacrimal cysts into the nose may lead to respiratory distress and difficulty in feeding, nasal examination must be performed to exclude coexistence of nasolacrimal cysts. Endoscopic marsupialization is a safe and curative treatment. Both ophthalmologist and otorhinolaryngologist should be involved in the diagnosis and management.
Endoscopic Medial Maxillectomy for Infected Dental Implants
Authors: Hahn Samuel , Palmer James , Adappa Nithin D. 
Published: September 2011

ObjectiveChronic maxillary sinusitis of dental origin (CMSDO) is a known complication of osseointegrated dental implants. Treatment of CMSDO currently involves antibiotics, steroids, and nasal irrigation. When medical management has failed, standard of care is removal of the dental implant. We propose performing endoscopic medical maxillectomy (EMM) as an alternative therapy.MethodSingle center retrospective chart review on five patients with recalcitrant maxillary sinusitis secondary to dental implants into the maxillary sinus that were subsequently treated with EMM. Review included preoperative symptoms and SNOT‐20 scores, medical treatment, computed tomography findings, intraoperative findings, postoperative medical management, postoperative symptoms, and SNOT‐20 scores.ResultsAll 5 patients underwent endoscopic medial maxillectomy, postoperative culture‐directed antimicrobial therapy, oral steroids, and nasal irrigation. The patients were followed postoperatively from a period of 3 months to 2 years. All 5 patients demonstrated complete resolution of symptoms of chronic sinusitis and did not require removal of the osseointegrated dental implants.ConclusionEndoscopic medial maxillectomy provides a safe treatment option for CMSDO due to osseointegrated dental implants that have failed maximal medical therapy. Based on our series, we propose EMM as a viable alternative for those patients who have traditionally required implant removal as definitive therapy.
A Novel Technique in Repair of Moderate‐sized Nasal Septal Perforations
Authors: Raol Nikhila , Olson Krista L 
Published: September 2011

Objective1) Describe a novel technique which has been successful in closure of moderate‐sized nasal septal perforations. 2) Review the current literature on various techniques that have been previously described for closure of nasal septal perforations.MethodRetrospective review of a successful technique used at our institution for closure of septal perforations over a 5‐year span (2006‐2010) at a facial plastic surgery practice. Charts were reviewed to find patient characteristics, symptoms, etiologies of perforation, and outcomes, including patient satisfaction and rate of recurrent perforation.ResultsOver the past 5 years at our institution, 12 patients were identified with nasal septal perforations, which were closed using bilateral mucosal advancement flaps: one inferiorly‐based flap advanced from the floor of the nose and another superiorly‐based flap advanced from the lateral nasal wall and upper lateral cartilage. The size of the perforations ranged from 0.6 cm to 1.6 cm. The majority of patients had excellent outcomes with resolution of symptoms and a low rate of recurrence.ConclusionNasal septal perforations have been approached traditionally with 2 superiorly based or 2 inferiorly based flaps. We present a technique with a combination of both flaps for closure of a moderate‐size perforation. This decreases the risk of recurrence of the perforation, flap necrosis, and development of a new perforation.
Audit of Flexible Nasoendoscope Decontamination: Clinical Efficacy and Cost Effectiveness
Authors: Phua Chu Qin , Mahalingappa Yogesh , Karagama Yakubu 
Published: September 2011

ObjectiveThere are various methods available for flexible nasoendoscope decontamination. Department of Health, United Kingdom, advocates the use of an automated washer, as it has the advantage of reducing errors resulting from variability of human practice. We aim to compare the efficacy and cost effectiveness of chlorine dioxide wipes versus the automated washer.MethodThe tip of a flexible nasoendoscope is immersed into a Staphylococcus epidermidis culture, with bacteriological swabs taken from the tip before immersion and after the process of decontamination with either chlorine dioxide wipes or automated wash. Bacteriological swabs are then checked for growth of STE. Cost calculation is performed.ResultsPostdecontamination, samples from chlorine dioxide wipes showed 2% (1 out of 50 swabs) growth of STE as opposed to 28% (14/50) from the automated wash. P =. 00. On a 10‐year cost calculation, the automated wash had a lower cost.ConclusionFrom the study, wipes are more efficacious in decontamination compared with the washer. However, the automated washer costs less. Further studies should also be performed on real patients to check the significance of improper decontamination and the actual risk of disease transmission.
House Dust Mite Nonspecifically Induces Fluid Secretion from Nasal Glands
Authors: Cho Hyung‐Ju , Lee Hyun Jae , Kim Chang‐Hoon , Choi Jae Young , Yoon Joo‐Heon , Kim Kyubo 
Published: September 2011

ObjectiveInvestigate the effects of the house dust mite (HDM) on fluid secretion in submucosal glands in nasal tissue and to compare its effects in control and diseased groups. In addition, we looked to see if PAR2 was involved in the HDM‐induced fluid response.MethodInferior nasal turbinate tissue was harvested from 26 patients with either allergic rhinitis (with HDM‐specific IgE) and/or chronic rhinosinusitis, and eight controls. We used a microscope attached to a camera to quantify mucus bubbles secreted from individual submucosal glands in response to HDM extract and PAR2‐AP (activating peptide).ResultsHDM stimulated fluid secretion, and the diseased group showed a higher secretion rate than did the controls. Interestingly, there was no significant difference between the three diseased groups, and CRS patients without HDM‐specific IgE were also stimulated by HDM. The nonspecific response induced by HDM was hypothesized to be through PAR2. The expression of PAR2 was predominant on the basolateral side of gland acini. HDM‐induced secretion rates positively correlated with PAR2‐AP‐induced secretion rates. Carbachol responses and gland density were not different among the three groups.ConclusionThese findings suggest that HDM induces an IgE‐independent nonspecific response from nasal submucosal glands, generating fluid secretion in allergic or infective nasal tissue, and PAR2 is at least partially involved in this process.
Bitter Taste Receptor Gene in Patients with Taste Disorders
Authors: Hirai Ryoji , Ikeda Minoru 
Published: September 2011

ObjectiveExamine changes in the expression of taste receptor genes in patients who had loss of taste and those who had phantogeusia.MethodThe subjects of this study consisted of 51 patients with loss of bitter taste and 43 patients with phantogeusia. The control group consisted of 24 subjects. We took specimens by scraping their foliate papillae. T2R family and TAS2R family gene expression was detected using RT‐PCR and electrophoresis.ResultsThe patients with loss of bitter taste showed a significant decrease in the frequency of expression of taste receptor genes T2R8 (P =. 002), 10 (P =. 001), 13 (P =. 003), 16 (pTAS2R40 (p48 (P =. 007) compared with the control group. The frequency of gene expression of TAS2R42 (P =. 008) and T2R3 (P =. 033) were significantly increased in patients with phantogeusia.ConclusionExpression of some genes was decreased in patients with loss of taste, while expression of other genes was increased in patients with phantogeusia. It was suggested that conflicting changes in taste receptor gene expression were involved in the pathogenesis of the loss of taste and phantogeusia.
Identification of Chronic Rhinosinusitis Phenotypes
Authors: Nakayama Tsuguhisa , Asaka Daiya , Okushi Tetsushi , Moriyama Hiroshi , Otori Nobuyoshi , Yoshikawa Mamoru , Matsuwaki Yoshinori 
Published: September 2011

ObjectiveThe pathogenesis of chronic rhinosinusitis is still unclear. A variety of factors are thought to be involved in the pathogenesis of chronic paranasal sinusitis. We sought to identify the phenotypes of chronic paranasal sinusitis patients by means of a cluster analysis.MethodWe conducted a retrospective analysis of prospectively collected data from April 2007 to March 2008 in a multicenter study involving 5 hospitals.ResultsThe cluster analysis yielded 6 phenotypes: Cluster 1(n = 102), low blood and tissue eosinophil counts; Cluster 2 (n = 118), slightly increased blood and tissue eosinophil counts, but higher CT polyp score than in Cluster 1; Cluster 3 (n = 84), moderately elevated IgE level and high blood eosinophil counts, but mild increase in tissue eosinophil counts, and common aspirin‐tolerant asthma as comorbidity; Cluster 4 (n = 69), extremely high tissue eosinophil counts, but mild blood eosinophil increase; Cluster 5 (n = 20), hyperimmunoglobulinemia E and specific IgE antibodies to fungi and house dust mites; Cluster 6 (n = 6), all aspirin‐intolerant.ConclusionChronic rhinosinusitis was classified into 6 phenotypes according to the eosinophil, IgE, asthma, and nasal polyp findings. The pathogenesis of chronic paranasal sinusitis needs to be further investigated by including cases of recurrent disease.
Local Anesthetic Nasal Polypectomy: The Patient Perspective
Authors: Green Richard , Blackmore Kate , Hogg Richard , Kara Naveed 
Published: September 2011

ObjectiveAssess patient satisfaction with endoscopic nasal polypectomy carried out under local anesthesia. Patient consultation allows us to review and amend practice and is a fundamental aspect of clinical governance, hence ensuring good medical practice.MethodA 16‐point questionnaire was sent to all patients who underwent the procedure over a 2‐year period. They were asked about previous operative history, quality of operative information given, level of pain and how well it was managed, effectiveness of procedure on their symptoms, and overall perception of the experience.ResultsOf 32 patients the response rate was 81%. Half of the patients had previously had nasal polypectomy under general anesthetic. Ninety‐four percent felt their pain was dealt with appropriately, and all patients were discharged uneventfully within 6 hours. Ninety‐two percent reported symptomatic improvement and were happy with the procedure. All but one of the patients preferred avoiding a general anesthetic, and 88% would happily have the procedure performed again under a local anesthetic.ConclusionWe demonstrate a high level of overall patient satisfaction with this procedure, and conclude that endoscopic nasal polypectomy can be safely and effectively carried out as a day‐case local anesthetic procedure. This is in keeping with the Department of Health proposals to maximize day‐surgery, and it also represents significant cost savings.
Suspension Sutures in Management of Nasal Valve Collapse
Authors: Zaman Azrina S. K. , Raghavan Ullas , Eng Chee‐Yean 
Published: September 2011

ObjectiveAssess the efficacy of ala suspension sutures in the management of nasal valve collapse causing nasal obstruction.MethodRetrospective study of patients with ala suspension sutures inserted for nasal valve collapse in Doncaster Royal Infirmary from January 2009 to December 2010. Subjective nasal congestion was measured using visual analogue scale (VAS 0‐10), and objective measurement using Peak inspiratory flow rate (PIFR) before and after the operation was performed.ResultsTwenty‐six patients with ala suspension sutures inserted were identified. Five patients who had concurrent procedures carried out on septum and turbinates were excluded. Twenty‐one patients were included in our study. Ninety percent of patients were satisfied with the surgery, supported by significant improvement in the VAS (0 ‐ 10) for nasal congestion and PIFR scores. The average VAS score improvement was 4.6 points, and PIFR increased by 23.3L/min. Of the 21 patients, 4 required revision procedures to achieve satisfactory outcome. Two out of these 4 developed neuralgia, which was controlled with Amitriptyline.ConclusionThe result of our study shows a significant improvement in patient symptoms following insertion of ala suspension suture for nasal valve collapse causing nasal obstruction. This is a short and well tolerated procedure with minimal side effects.
The Evaluation of Effects of Pseudoephedrine, Xylometazoline, and Budesonide on the Rat Nasal Mucosa
Authors: Basutcu Ibrahim Serhat , Gozeler Mustafa Sitki 
Published: September 2011

ObjectiveSystemic decongestants, topical decongestants, and topical corticosteroids have been used in treatment of upper respiratory tract diseases. We proposed to find out histopathological changes caused by these drugs in therapeutic dosages in rat nasal mucosa, so we tried to compare the effects of pseudoephedrine, xylometazoline, and budesonide.MethodThe rats in the first group took 80 microL of liquid pseudoephedrine for 15 days twice daily. 10 microL of xylometazoline was administered to rats in the second group for 10 days. 10 microL of budesonide was administered to the third group for 21 days.ResultsThe whole slides were evaluated histopathologically under 400X microscopic magnification. The evaluation parameters were mucosal edema level, the loss of ciliated epithelium, intraepithelial gland proliferation, vascular changes, and the changes in epithelial thickness. In any group, a significant mucosal edema was detected. In the second group (xylometazoline), ciliated epithelium loss and goblet cell proliferation were detected in posterior nasal slides. In the third group (budesonide), partial fibrosis was detected in some slides. In the first group (pseudoephedrine), statistically significant epithelial thinning was detected.ConclusionWe concluded that xylometazoline causes ciliary epithelium loss and goblet cell proliferation. This change probably is due to preservatives in this medication. The budesonide, the topical corticosteroid, caused no significant side effect, especially ciliated epithelium loss. We could not assess the effect of budesonide in inflammation.