bluuebunny/crossref_metadata_2025_split huggingface dataset:
Radiological Sinonasal Findings in Adults with Cystic Fibrosis
Authors: Orlandi Richard R. , Wiggins Richard H. 
Published: February 2010

Background Care of cystic fibrosis (CF) patients has extended the expected survival far into adulthood. The morphological changes of adult CF patients’ paranasal sinuses have not been thoroughly addressed. Methods A retrospective review was performed of computed tomography imaging of adult CF patients at an academic medical center. Developmental changes, bone sclerosis, mucoceles, and degree of inflammation (using a modified Lund-Mackay scoring system) were assessed. Results Forty-five patients were included in the study. The majority of frontal and sphenoid sinuses were either aplastic or hypoplastic. Maxillary hypoplasia was less commonly seen. Seven patients had mucoceles. Sclerosis of the sinuses was a common finding, affecting 84.4% of patients. Inflammation of the sinuses was also common, with a median modified Lund-Mackay score of 15.0 (out of a median 20 possible). Conclusion Poor development of the sinuses seen in pediatric CF patients persists into adulthood. Inflammation of the sinuses is a common finding. Bone sclerosis, likely caused by chronic inflammation, affects a large majority of these patients.
Frontal Sinus Inverted Papilloma: Surgical Strategy Based on the Site of Attachment
Authors: Yoon Bit-Na , Batra Pete S. , Citardi Martin J. , Roh Hwan-Jung 
Published: February 2010

Background The surgical management of inverted papilloma (IP) involving the frontal sinus (FS) remains a challenge given the narrow confines of the frontal recess and the close proximity to critical structures. The objective of this study was to elucidate a surgical strategy for management of frontal sinus IP based on the site of attachment. Methods A retrospective chart review was performed on 18 patients with FS IP treated at the Pusan National University Hospital and the Cleveland Clinic Foundation between 1998 and 2008. Results The mean age was 53.8 years with a male/female ratio of 13:5. The sites of tumor attachment included the medial wall (MW; six cases), posterior wall (PW; five cases), diffuse (all walls involved; five cases), intersinus septal cell (three cases), lateral wall (two cases), and anterior wall (two cases). IP involvement was unifocal in 10 cases and multifocal in 8 cases. Unifocal IP attached to the MW or PW was managed strictly by endoscopic frontal sinusotomy (EFS) in five of six cases (83%). Multifocal IP required endoscopic modified Lothrop (EML) and/or open approaches (endoscopic frontal trephination [EFT], four, osteoplastic flap [OPF], one) in seven of eight cases (88%). One additional patient with bilateral anterior table involvement required OPF. Four (22%) patients developed recurrences. Two were managed by EML, one was managed by EFS, and one was managed by EFT and EFS. Two patients developed cerebrospinal fluid leaks that were managed endoscopically without untoward effects. All patients were free of disease at the time of last evaluation with a mean follow-up of 36.6 months. Conclusion Frontal sinus IP with MW or PW involvement can generally be managed by standard EFS. Tumors with multifocal involvement often require EML, along with adjunct EFT in selected cases. OPF can be avoided as the primary surgical approach in most patients with sinonasal papilloma of FS.
Effect of Coblation Polypectomy on Estimated Blood Loss in Endoscopic Sinus Surgery
Authors: Eloy Jean Anderson , Walker Thomas J. , Casiano Roy R. , Ruiz Jose W. 
Published: February 2010

Background We conducted a pilot study comparing estimated blood loss (EBL) using coblation-assisted endoscopic sinus surgery (CAESS) where coblation is used to debulk nasal polyps before microdebridement with a traditional microdebrider technique in chronic rhinosinusitis (CRS) patients with sinonasal polyps undergoing endoscopic sinus surgery (ESS). Methods A retrospective analysis was performed at a tertiary care center on patients with nasal polyposis undergoing ESS between January 2008 and July 2008. The University of Miami CT staging system was used preoperatively to evaluate the extent of sinonasal disease. The duration of surgery, blood loss per minute, total EBL, and demographic data were collected. Results Twenty-one patients underwent nasal polypectomy/ESS using CAESS and 16 patients underwent nasal polypectomy/ESS using microdebridement. The two groups had comparable University of Miami CT staging scores (p > 0.05). The average EBL was 307.1 ± 169.8 mL using coblation compared with 627.8 ± 424.2 mL using microdebridement (p < 0.05). The average duration of surgery using coblation was 116.2 ± 41.7 minutes, compared with 125.3 ± 48.4 minutes using microdebridement (p > 0.05). The average blood loss per minute was 2.8 ±1.7 mL in the coblation group compared with 4.8 ± 2.1 mL in the microdebridement group (p < 0.05). Subgroup analyses showed a significant decrease in average EBL and EBL/minute to be only significant for revision cases (p < 0.05) and not for primary cases (p > 0.05). Conclusion Coblation-assisted nasal polypectomy/ESS is associated with a statistically significant lower EBL and blood loss per minute when compared with traditional microdebridement technique. Coblation represents a new device that can reduce blood loss in patients with nasal polyposis undergoing traditional revision ESS. Further prospective randomized trials are needed to validate these findings.
[6]-Gingerol Suppresses Interleukin-1β-Induced MUC5AC Gene Expression in Human Airway Epithelial Cells
Authors: Kim Jeong Hong , Chang Jung Hyun , Yoon Joo-Heon , Kwon Soon Ho , Bae Jung Ho , Kim Kyung-Su 
Published: February 2010

Background [6]-Gingerol is a major active component of ginger and a natural polyphenol compound. The present study investigated whether [6]-gingerol suppresses interleukin (IL)-1beta-induced MUC5AC gene expression in human airway epithelial cells and, if so, examined whether the suppression of MUC5AC gene expression is mediated via the mitogen-activated protein kinase (MAPK) signal transduction pathway. Methods MUC5AC mRNA and protein were measured using reverse transcription-polymerase chain reaction (PCR), real-time PCR, and Western blot analysis in cultured NCI-H292 human airway epithelial cells. Extracellular signal-regulated kinase (ERK) and p38 MAPK protein levels were analyzed by Western blot. Results Expression of MUC5AC mRNA increased in NCI-H292 cells upon treatment with 10 ng/mL of IL-1beta for 24 hours. When the cells were pretreated with 10 microM of [6]-gingerol, expression of IL-1 beta -induced MUC5AC mRNA and protein was significantly suppressed. Suppression of IL-1 beta-induced MUC5AC mRNA was also observed in cells pretreated with ERK- or p38 MAPK-specific inhibitors, suggesting that [6]-gingerol-mediated suppression of IL-1 beta -induced MUC5AC mRNA operated via the ERK- and p38 MAPK-dependent pathways. Conclusions [6]-Gingerol suppresses IL-1beta -induced MUC5AC gene expression in human airway epithelial cells via the ERK- and p38 MAPK-dependent pathways; therefore, [6]-gingerol may be considered a possible anti-hypersecretory agent.
Clinical Correlation between Irrigation Bottle Contamination and Clinical Outcomes in Post-Functional Endoscopic Sinus Surgery Patients
Authors: Welch Kevin C. , Cohen Michael B. , Doghramji Laurie L. , Cohen Noam A. , Chandra Rakesh K. , Palmer James N. , Chiu Alexander G. 
Published: February 2010

Background Sinonasal irrigation after endoscopic sinus surgery (ESS) is a common practice, but the role irrigation bottles play in iatrogenic contamination of the operated sinuses is unknown. Therefore, we investigated whether irrigation bottles used postoperatively become contaminated and have any potential association with immediate postsurgical infection and outcomes. Methods Patients irrigated twice daily after ESS. Bottle cleaning was performed as recommended by the manufacturer. New bottles were distributed at the time of the operation and at each postoperative visit. During postoperative weeks 1, 2, and 4, bottles were cultured. Medical charts were reviewed for the presence of postsurgical infection and changes in management. Results Twenty post-ESS patients were enrolled and examined at weeks 1, 2, and 4. A total of 51 bottles were collected and cultured. Overall, 15 of 51 (29%) bottles demonstrated bacterial growth when cultured. During the first two collection periods, 10 of 40 (25%) bottles demonstrated bacterial growth when cultured; however, five of 11 (45%) bottles collected at the last postoperative visit demonstrated bacterial growth when cultured. During the study, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae were frequently recovered during the collection periods. Other organisms isolated included Escherichia coli and Enterobacter spp. Although positive bottle cultures were more common at weeks 2 and 4, no postoperative infections occurred. Conclusions Irrigation bottles used postoperatively have a measurable incidence of contamination. Contamination rate increases when bottles are used for longer than 1 week, but this does not appear to result in postsurgical infection.
Effect of Intraoperative Injection of 0.25% Bupivacaine with 1:200,000 Epinephrine on Intraoperative Blood Loss in FESS
Authors: Javer Amin R. , Gheriani Heitham , Mechor Brad , Flamer David , Genoway Krista , Yunker Warren K. 
Published: February 2010

Background This study was designed to compare differences in intraoperative blood loss, mean arterial blood pressure (MABP), and duration of surgery when 0.25% bupivacaine with 1:200000 epinephrine is injected, preoperatively, versus normal saline (NS), during functional endoscopic sinus surgery (FESS). Methods A prospective, double-blind randomized placebo-controlled study was performed. Part I involved 46 patients who were infiltrated with 0.25% bupivacaine with 1:200000 epinephrine on one side of the nose and sterile NS on the other (control). Part II involved 30 patients infiltrated with 0.25% bupivacaine with 1:200000 epinephrine bilaterally and 30 patients with NS bilaterally (control). Patient demographics, preoperative MABP, intraoperative MABP, duration of surgery, and total estimated blood loss (EBL) were recorded for each side (part I) and case (part II). Results For part I, there were 46 patients (mean age, 49 years), 24 women and 22 men. MABP was 72 mmHg for each side (p = 0.97). Preoperative MABP was 93 mmHg. Duration of surgery was 48 minutes for epinephrine side and 45 minutes for control (p = 0.17). Total EBL was 185 mL for the epinephrine side and 197 mL for control (p = 0.53). For part II, there were 60 patients (mean age, 56 years), 28 women and 32 men. The MABP was 77 mmHg for the epinephrine group and 72 mmHg for control (p = 0.048). Preoperative MABP was 100 mmHg for the epinephrine group and 97 mmHg for control (p = 0.37). Duration of surgery was 2.25 hours for the epinephrine group and 2.08 hours for control (p = 0.17). Total EBL was 589 mL for the epinephrine group and 538 mL for control (p = 0.64). Conclusion There was no significant reduction in intraoperative blood loss during FESS when local anesthetic containing epinephrine was used compared with infiltration with NS. More importantly, part II shows a significantly higher MABP associated with infiltration of epinephrine. Parts I and II did not show a significant difference in preoperative MABP or duration of surgery.
Rhinoplasty to Correct Nasal Deformities in Postseptoplasty Patients
Authors: Yeo Nam-Kyung , Jang Yong Ju 
Published: February 2010

Background Although not so common, septoplasty carries the risk of inducing nasal deformity such as saddle nose and deviated nose. Surgical correction for those deformities is a formidable task to deal with, because the septal cartilage framework was already weakened due to previous procedure. This study was designed to examine various causes and effective techniques of rhinoplasty for correction of nasal deformities after septoplasty. Methods Subjects comprised 19 patients who developed nasal deformities after septoplasty. Pre- and postoperative photographs were analyzed by two rhinoplastic surgeons. Anthropometric measurements of the external nose before and after surgery were made using frontal and lateral photographs to objectively evaluate outcomes. Results Intraoperative analysis showed that 5 patients had weak L-struts and 13 patients had displaced caudal septa. Septum was reconstructed using costal cartilage in 13 cases. Spreader grafting was performed in 13 patients and caudal septal extension grafts were performed in 10 patients. All but 1 patient had successful functional and esthetic outcomes. In the saddle nose group, all parameters except nasolabial angle were significantly improved. In the deviated nose group, curved deviated angles were completely corrected, whereas the linear deviated angle was not. Conclusion Loss of caudal septal support appears to be a major reason for nasal deformity after septoplasty. The best surgical approach for septal cartilage framework reconstruction appears to involve the use of bilateral spreader or septal extension grafts using costal cartilage.
Cartilage Outgrowth in Fibrin Scaffolds
Authors: Sage August , Chang Angela A. , Schumacher Barbara L. , Sah Robert L. , Watson Deborah 
Published: February 2010

Background Fibrin glue has been a favorable hydrogel in cartilage tissue engineering, but implantation of chondrocyte-fibrin suspensions have resulted in volume loss. In this study, human septal cartilage chips were seeded onto a fibrin scaffold, and cellular proliferation and production of cartilaginous extracellular matrix (ECM) were evaluated. Methods Human septal cartilage was diced into cartilage chips and encased with and without fibrin glue. Four conditions were initially tested for DNA content and glycosaminoglycan (GAG) production: (1) control medium in tissue culture, (2) control medium with fibrin glue, (3) collagenase-supplemented medium in tissue culture, and (4) collagenase-supplemented medium seeded in fibrin glue. Cartilage chips cultured in collagenase-treated medium were then seeded onto either cell culture plates, suspended in alginate, or mixed with fibrin. Cellular proliferation, GAG production, and histochemistry were evaluated. Results Fibrin preparations increased cellular proliferation and DNA content. GAG levels were highest in collagenase-treated samples encased in fibrin. Cartilage chips treated with collagenase showed increased cellular proliferation in the fibrin preparations compared with preparations without fibrin. GAG increased with the addition of fibrin when compared with explant. Histochemistry revealed increased GAG accumulation in the regions between the cartilage chips with the addition of fibrin. Conclusion Adding fibrin glue to collagenase-treated cartilage chips results in increased proliferation and maintains ECM production and, therefore, may facilitate generation of cartilaginous tissue for use in reconstructive surgery.
Comparison between Three-Dimensional and Triplanar Computed Tomography Imaging of the Frontal Recess
Authors: Isaacs Seth J. , Goyal Parul 
Published: February 2010

Background Despite advances in endoscopic surgical techniques, management of frontal sinus disease remains challenging. Much of this is related to the complex nature of frontal recess anatomy. A thorough understanding of frontal recess anatomy is paramount for the safety and success of frontal sinus surgery. Three-dimensional (3D) computed tomography (CT) may allow surgeons to obtain a more complete preoperative assessment of frontal recess anatomy. The purpose of this study was to determine if reconstructed 3D CT images as an adjunct to conventional triplanar imaging provide additional information regarding the frontal recess anatomy. Methods A prospective study was performed. Two otolaryngologists reviewed the CT scans of 25 patients referred for routine paranasal sinus disease. The findings from review of the triplanar CT images were compared with the findings from review of the 3D reconstructions. Each study was assessed for (1) frontoethmoidal cells, (2) agger nasi cell, (3) subrabullar and frontal bullar cells, (4) intersinus septal cell, (5) superior uncinate process attachment site, and (6) and frontal sinus outflow tract. The examiners rated the usefulness of each study to identify each of the aforementioned anatomic subsites using a modified 5-point Likert scale. Results Intersinus septal cells, supraorbital ethmoid cells, and the anterior–posterior dimension of the frontal sinus outflow tract were better defined on the reconstructed 3D CT images. Conclusion Three-dimensional CT is a useful adjunct to the conventional triplanar studies for the evaluation of frontal sinus and recess anatomy. This technique can define certain anatomic variants more effectively than 2D multiplanar reconstructed images.
Dynamic Nasal Infrared Thermography in Patients with Nasal Septal Perforations
Authors: Lindemann Joerg , Wiesmiller Kerstin , Keck Tilman , Kastl Konrad 
Published: February 2010

Background Nasal obstruction is a typical symptom in patients with nasal septal perforations. Rhinomanometry and acoustic rhinometry are not reliable in these cases because the perforations generate incorrect results. Infrared thermography camera (ITC) systems allow contact-free intranasal recordings of the nasal surface temperature and the semiquantification of nasal airflow. The aim of this study was to perform contact-free temperature measurements of the nasal vestibular surface by application of ITC systems in patients with septal perforations to investigate the disturbed intranasal heat exchange and nasal airflow. Methods The surface temperature profiles within the nasal vestibules of healthy volunteers (n = 10) and patients with septal perforations (n = 3) were recorded with an ITC during several breathing cycles. Thermal images were taken (60/s) displaying the surface temperature in degrees centigrade corresponding to a color scale. Results The temperature recordings showed a disturbed intranasal heat exchange during inspiration and expiration in patients with septal perforations in comparison with healthy subjects. A reduced and irregular inspiratory cooling of the entire surface within the nasal vestibules visualizes a reduced and disturbed airflow volume. Conclusion The study was able to prove the feasibility of intranasal temperature recordings of the surface with an ITC system in patients with septal perforations. Contrary to rhinomanometry and acoustic rhinometry, thermography cameras can be applied to examine airflow in patients with septal perforations. The detected reduced cooling of the surface during inspiration might be a possible explanation for the patients' feelings of nasal obstruction.
Contemporary Assessment of the Disease Burden of Sinusitis
Authors: Bhattacharyya Neil 
Published: February 2010

Background The objective of this study was to determine the disease burden of sinusitis relative to other medical conditions. Methods The adult sample of the National Health Interview Survey for calendar years 1997 to 2006 was analyzed, extracting 1-year prevalence data for the disease conditions sinusitis, hay fever, peptic ulcer, acute, asthma, and chronic bronchitis. Disease burden data for emergency room visits, general and specialist visits, health care spending, and workdays lost were also extracted. The influence of each disease condition on disease burden variables was statistically determined. Comparisons among outcomes variables were conducted across disease conditions to determine their relative economic and health care impacts. Results Adult patients were studied (313,982; mean age, 45.2 years). The 1-year disease prevalences were: sinusitis (15.2%), hay fever (8.9%), ulcer (2.4%), acute asthma (3.8%), and chronic bronchitis (4.8%). Patients with sinusitis were significantly more likely to: visit the emergency room (22.7% versus 17.4%, p < 0.001), spend greater than $500/year on health care (55.8% versus 45.0%, p < 0.001), and see a medical specialist (33.6% versus 22.3%, p < 0.001), than those without sinusitis. Patients with sinusitis missed an average of 5.67 workdays per 12 months versus 3.74 workdays for those without (p < 0.001). The number of workdays lost with sinusitis was similar to that of acute asthma (5.79 workdays, p > 0.05), and health care spending with sinusitis was significantly greater than that of ulcer disease, acute asthma, and hay fever (p < 0.004). Conclusions Sinusitis imparts a significant disease burden both within and outside of the health care system that is comparable with or exceeds that of other conditions commonly thought to be more serious.
Nasal Air Conditioning in Relation to Acoustic Rhinometry Values
Authors: Lindemann Joerg , Tsakiropoulou Evangelia , Keck Tilman , Leiacker Richard , Wiesmiller Kerstin M. 
Published: February 2010

Background Changes of nasal dimensions can influence the air-conditioning capacity of the nose because of alterations of airflow patterns. The goal of this study was to evaluate the correlation between intranasal temperature and humidity values and nasal dimensions, assessed by means of acoustic rhinometry. Methods Eighty healthy volunteers (40 men and 40 women; median age, 51 years; range, 20–84 years) were enrolled in the study. In total, 160 nasal cavities were examined. All volunteers underwent a standardized acoustic rhinometry. Additionally, intranasal air temperature and humidity measurements at defined intranasal detection sites within the anterior nasal segment were performed. Results There was no statistically significant difference between the right and left side of the nose regarding air temperature, absolute humidity, and acoustic rhinometric values. A negative correlation was established between the rhinometric nasal volumes/minimal cross-sectional areas and air temperature and absolute humidity values at the three intranasal detection sites. Conclusion According to our results, nasal volumes and cross- sectional areas relevantly influence nasal air conditioning. A healthy nasal cavity with smaller volumes and cross-sectional areas seems to present a more effective air-conditioning function than a too “wide” open nose because of changes in airflow patterns. This observation should be considered as a limitation for overly extensive nasal surgery especially of the turbinates.