bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acoustic Rhinometry and Rhinomanometry in the Preoperative Screening of Septal Surgery Patients
Authors: Pirilä Tapio , Tikanto Jukka 
Published: February 2010

Background The preoperative assessment of septal surgery patients with acoustic rhinometry (AR) or rhinomanometry (RMM) is still a controversial subject. This study was designed to apply AR and RMM in preoperative screening of septal surgery patients. Methods The gold standard is postoperative satisfaction expressed by patients as “very high,” “high,” “moderate,” or “low” subjective total benefit from the operation to the nasal obstruction 1 year after surgery. One hundred fifty-seven consecutive patients presenting for septal surgery because of an obstructing septum deviation in anterior rhinoscopy, sufficient pre- and postoperative data were available in 110 patients. Anterior rhinoscopy, AR, and RMM were performed before and 1 year after surgery. Results The preoperative AR and RMM had a statistically significant impact (p < 0.01) in predicting the postoperative satisfaction. The best single preoperative parameter for predicting postoperative satisfaction was the postdecongestion overall minimum cross-sectional area on the deviation side in AR; the estimated optimal cutoff value was 0.40 cm2. The most predictive preoperative RMM parameter was the postdecongestion intercavital flow ratio (the flow on the deviation side divided by the flow on the wide side); the estimated optimal cutoff value was 1:2. For both parameters the sensitivity/specificity for the cutoff values was around 65/60% in finding patients with high or very high postoperative satisfaction. For anterior rhinoscopy the optimal cutoff was a deviation between severe and moderate with sensitivity/specificity around 55/55%. Conclusion In patients with a very severe deviation, anterior rhinoscopy was sufficient for preoperative screening but in milder deviations AR and RMM significantly predicted postoperative success.
Nasoseptal Flap Reconstruction of High Flow Intraoperative Cerebral Spinal Fluid Leaks during Endoscopic Skull Base Surgery
Authors: Zanation Adam M. , Carrau Ricardo L. , Snyderman Carl H. , Germanwala Anand V. , Gardner Paul A. , Prevedello Daniel M. , Kassam Amin B. 
Published: February 2010

Background Over the past 10 years, significant anatomic, technical, and instrumentation advances have facilitated the exposure and resection of intradural lesions via a fully endoscopic expanded endonasal approach (EEA). The vascularized nasoseptal flap (based on the posterior nasoseptal artery) has become our primary endoscopic reconstructive technique. The goals of this study are to prospectively evaluate the nasoseptal flap and high-risk cerebral spinal fluid (CSF) leak variables. Methods Prospective evaluation was performed of EEA patients with intraoperative high-flow leaks (either a cistern or ventricle open to nasal cavity during tumor dissection) who underwent nasoseptal flap reconstruction. Results Seventy consecutive nasoseptal flaps for high-flow intraoperative leaks were evaluated prospectively by the primary author. Twelve risk factors were then graded at the time of the operations and correlated to CSF leak outcomes. The overall postoperative CSF leak rate was 5.7% (4/70). All four postoperative leaks were successfully managed with endoscopic repair and CSF diversion. A multivariate analysis of all 12 risk factors is detailed. Pediatric patients, large dural defects, and radiation therapy were noted to be factors in reconstructive failure. One flap death occurred in a patient with prior surgery and proton therapy, this leak was managed with a temporoparietal flap and endonasal repair. Conclusion The nasoseptal flap is an excellent anterior skull base reconstructive technique. Patients with high-flow intraoperative CSF leaks had a 94% successful reconstruction rate. Patients with skull base proton radiation therapy are at higher risk for flap failure and preparation for nonradiated tissue reconstruction should be discussed with the patient.
Acupuncture for Nasal Congestion: A Prospective, Randomized, Double-Blind, Placebo-Controlled Clinical Pilot Study
Authors: Sertel Serkan , Bergmann Zazie , Ratzlaff Kerstin , Baumann Ingo , Greten Henry Johannes , Plinkert Peter Karl 
Published: February 2010

Background Nasal congestion is one of the most common complaints dealt with in otorhinolaryngology. Side effects of decongestants are frequently seen in patients with chronic nasal congestion. This leads to an increasing demand of alternative treatments such as acupuncture. Future studies on acupuncture should aim at objectifying effects by both physical measuring and double blinding. Therefore, we were interested in whether these effects can potentially be measured as increase in nasal airflow (NAF) in ventus (“wind”) disease of traditional Chinese medicine (TCM). Methods Twenty-four patients with a history of nasal congestion due to hypertrophic inferior turbinates or chronic sinusitis without polyposis were additionally diagnosed according to the Heidelberg model of TCM. They were asked to score the severity of their nasal congestion on a visual analog scale (VAS). The acupuncturist was blinded according to the Heidelberg blinding assay. NAF was measured by using active anterior rhinomanometry (ARM). Specific verum acupoints according to the Chinese medical diagnosis were tested against nonspecific control acupoints. VAS and NAF were scored and measured before and 15 and 30 minutes after acupuncture. Results Control acupuncture showed a significant improvement in VAS and a deterioration of NAF. Verum acupuncture showed highly significant improvements in VAS and NAF. In addition, verum acupuncture improved NAF and VAS significantly over time. Conclusion Our control and verum acupoints fulfill the condition of a control and verum treatment, respectively. Measuring NAF by RRM and scoring VAS are possible and reflect acupuncture effects in vivo.
Proton Secretion in Freshly Excised Sinonasal Mucosa from Asthma and Sinusitis Patients
Authors: Cho Do-Yeon , Hajighasemi Mohammad , Hwang Peter H. , Illek Beate , Fischer Horst 
Published: February 2010

Background Proton (H+) secretion and the HVCN1 H+ channel are part of the innate host defense mechanism of the airways. The objective of this study was to determine H+ secretion in asthmatic and nonasthmatic patients with chronic rhinosinusitis (CRS) in freshly excised human sinonasal tissue. Methods Nasal or sinus mucosa from subjects with three different conditions (normal, CRS, and CRS with asthma) was harvested during sinus surgery. The equilibrium pH and the rate of H+ secretion were measured in an Ussing chamber using the pH-stat titration technique. Results Nasal epithelia isolated from subjects with CRS and asthma had a mucosal equilibrium pH = 6.95 (n = 5), which was significantly lower than in normal subjects (7.35 ± 0.21; n = 5) or from subjects with CRS without asthma (7.33 ± 0.15 In = 5). Nasal epithelia from CRS with asthma (n = 5) secreted H+ at a rate of 135 ± 46 nmol·min–1·cm–2. This rate was significantly higher compared with normal (73 ± 39 nmol·min–1·cm–2; n = 8) or CRS without asthma (51 ± 28 nmol·min–1·cm–2; n = 7). Mucosal addition of the HVCN1 blocker ZnCl2 blocked H+ secretion by 70% in normal, 53% in CRS without asthma, and by 51% in CRS with asthma. In contrast, measures in sinus tissues were unaffected by the disease condition. Conclusion Freshly excised human nasal and sinus epithelia secrete acid. Nasal (but not sinus) tissues from asthmatic CRS patients showed lower mucosal pH values and higher rates of H+ secretion than CRS and normal subjects. The increased acid secretion might contribute to epithelial injury in CRS patients with asthma.
The Role of Columellar Struts to Gain and Maintain Tip Projection and Rotation: A Randomized Blinded Trial
Authors: Sadeghi Mohammad , Saedi Babak , Sazegar Amir Arvin , Amiri Mandana 
Published: February 2010

Background Rhinoplasty is one of the most challenging esthetic surgeries. The ability to achieve precise and predictable changes in the shape and position of the nasal tip is still among one of the demanding areas of rhinoplasty. Columellar strut is one of many techniques to ensure an adequate nasal tip projection and rotation; however, there is little evidence to support long-term efficacy of this technique. Methods In a clinical trial, 93 patients who were rhinoplasty candidates were studied prospectively. They were randomly divided into two groups according to the use of columellar strut. The outcome measures were gaining and maintaining tip projection and rotation in the long term. Standardized photographs before and 3, 6, and 12 months after surgery were the measurements to compare the results between two groups. Results The mean age was 23.3 ± 4.8 years. In 47 cases, surgery was performed using columellar strut and in 45 cases this method was not used. Preoperatively, nasolabial angle and tip projection were not significantly different between the two groups. In addition, postoperatively, the mean of nasolabial angel and tip projection were not significantly different in the two groups 3, 6, and 12 months after surgery. The decreasing of these parameters was not significantly different during follow-up in the two groups. Conclusion It seems that columellar strut is not an essential technique to enhance and maintain tip projection and/or rotation in rhinoplasty. Using good techniques in qualified hands give the best results in the long term even without columellar strut.
In Vivo Effects of Citric Acid/Zwitterionic Surfactant Cleansing Solution on Rabbit Sinus Mucosa
Authors: Tamashiro Edwin , Banks Caroline A. , Chen Bei , Gudis David A. , Dogrhamji Laurel , Myntti Matthew , Medina Jennifer , Chiu Alexander G. , Cohen Noam A. 
Published: February 2010

Background Chronic rhinosinusitis that is refractory to medical or surgical intervention may involve a particularly resistant form of infection known as a bacterial biofilm that is recalcitrant to antibiotics secondary to physical barrier characteristics. Recently, a novel sinus cleansing solution, citric acid/zwitterionic surfactant (CAZS) was shown to be extremely effective in disrupting biofilms in vitro. The purpose of this study was to determine the effects of CAZS on sinonasal epithelium in vivo compared with normal saline. Methods Indwelling catheters were placed into the right maxillary sinus of New Zealand white rabbits. CAZS solution or normal saline (10 mL) was instilled at a rate of 20 mL/minute into the sinus followed by aspiration. Rabbits were killed 1, 3, and 6 days after treatment. Mucosa from both maxillary sinuses was harvested and evaluated for physiological activity (ciliary beating) as well as morphological integrity of the epithelium by scanning electron microscopy. Results One day after treatment, beating cilia was evident with morphological analysis shown intact epithelium with 80–85% denudation of cilia compared with saline. Three days after treatment, ciliary activity was again noted with morphological evidence of persistent denuded cilia. By day 6 after treatment, the epithelium had regenerated cilia over the apical surface. Throughout the recovery period beating cilia was evident in CAZS-treated sinuses. Conclusion This study shows that although CAZS acutely denudes respiratory cilia, the remaining cilia are active. Additionally, the epithelial barrier appears intact with active ciliogenesis, and reciliation of the mucosal surface occurring 6 days after treatment.
Laser-Induced Microbial Reduction in Acute Bacterial Rhinosinusitis
Authors: Krespi Yosef P. , Kizhner Victor , Kara Cuneyt O. 
Published: February 2010

Background This study was designed to assess laser-induced manipulation on bacterial load and host in an animal model of acute bacterial rhinosinusitis (ABRS). An animal study using 12 rabbits followed an elaborated efficient in vitro model. ABRS was created by packing the nose with a sponge soaked in solution containing pathogenic microorganisms. Eight infected animals were randomly allocated to two separate groups, each being exposed to different laser therapies. Two healthy animals served as treatment controls, and one animal without ABRS and treatment was observed. Methods ABRS was confirmed histologically, radiologically, and bacteriologically. Two days after bacterial inoculation, packing was removed and nasal passages were treated by laser irradiation. Two laser modalities were tested. A near infrared (NIR) 940-nm diode laser with diffuser fiber tip was used in four rabbits. A photosensitizer (methylene blue 0.01 or 0.05%) and 635-nm laser combination was used in the second cohort. Nasal cultures were obtained before and after the laser treatments. Animals were killed 5–10 days after laser treatment and bacteriological/histological results were analyzed. Results An average 2 log reduction in bacterial colony counts was achieved with both laser methods compared with control. Histological studies showed tissue integrity preservation without significant damage to nasal mucosa. Conclusion Significant bacterial reduction was achieved with both NIR laser and photograph activated therapies in an animal study of ABRS. This pilot study shows an innovative method of bacterial killing without host tissue damaging and may have potential future clinical application.
Chinook Wind Barosinusitis: An Anatomic Evaluation
Authors: Rudmik Luke , Muzychuk Adam , Paolucci Elizabeth Oddone , Mechor Brad 
Published: February 2010

Background Chinook, or föhn, is a weather phenomenon characterized by a rapid influx of warm, high-pressured winds into a specific location. Pressure changes associated with chinook winds induce facial pain similar to acute sinusitis. The purpose of this study was to determine the relationship between sinonasal anatomy and chinook headaches. Methods Retrospective computed tomography (CT) sinonasal anatomy analysis of 38 patients with chinook headaches and 27 controls (no chinook headaches). The chinook headache status was blinded from the CT reviewer. Forty-one sinonasal anatomy variants, Lund-Mackay status, and sinus size (cm3) were recorded. Results There were three statistically significant sinonasal anatomy differences between patients with and without chinook headaches. The presence of a concha bullosa and sphenoethmoidal cell (Onodi cell) appeared to predispose to chinook headaches (p = 0.004). Chinook headache patients had larger maxillary sinus size (right, p = 0.015, and left, p = 0.002). The Lund-Mackay score was higher in the control patients (p = 0.003) indicating that chronic sinusitis does not play a role in chinook headaches. Conclusion Chinook winds are a common source of facial pain and pressure. This is the first study to show that sinonasal anatomic variations may be a predisposing factor. Anatomic variants may induce facial pain by blocking the natural sinus ostia, thus preventing adequate pressure equilibrium.
An Evidence-Based Review of Endoscopic Frontal Sinus Surgery
Authors: Silverman Joshua B. , Prasittivatechakool Kajohnkiat , Busaba Nicolas Y. 
Published: February 2010

Background Endoscopic approaches to treat frontal sinus disease gained in popularity over the past 20 years with a plethora of published studies that emphasize the high success rate of such surgeries. This study was designed to determine the levels of clinical evidence in the otolaryngology literature that address the efficacy of endoscopic approaches in the management of frontal sinus disease including frontal sinusitis. Methods Twenty-three publications that reported the surgical outcomes of endoscopic approaches to treat frontal sinus disease were reviewed. Data were collected regarding the study design, operative technique, number of patients, duration of follow-up, diagnostic method, surgical success rate, and method(s) used to assess surgical outcome. Results The study designs were a retrospective case series without control (16 articles), prospective case series without control (3 articles), and retrospective case series with internal control (4 articles). Eighty-three percent of the published articles provide an evidence level of IV, while the remaining 17% provide an evidence level of III. The surgical technique was described as frontal sinusotomy (n = 4), frontal sinusotomy or frontal sinus drillout (n = 1), frontal sinus drillout alone (n = 1), endoscopic modified Lothrop procedure (n = 9), Draf types I, II, or III (n = 6); trans-septal frontal sinusotomy (n = 1); and frontal sinus rescue procedure (n = 1). The mean number of subjects was 44, and the average follow-up period was 23.6 months. Surgical success rate ranged from 50 to 100%. Conclusion Despite the number of reports in the literature that address the surgical outcome of endoscopic approaches for treatment of frontal sinus disease, the majority of these studies have a small population size, short follow-up period, and provide a low clinical evidence level.
Cigarette Smoke Extract Enhances Rhinovirus-Induced Toll-Like Receptor 3 Expression and Interleukin-8 Secretion in A549 Cells
Authors: Wang Jong Hwan , Kim Hyuk , Jang Yong Ju 
Published: February 2010

Background Using A549 alveolar epithelial type II–like cells, we investigated the effects of cigarette smoke on the expression of rhinovirus (RV)-induced Toll-like receptor (TLR) 3, interleukin (IL)-6, and IL-8 secretion and viral replication. Methods Cigarette smoke extract (CSE) was prepared by smoking two commercial cigarettes with filters (0.9-mg of nicotine and 8.5-mg of tar per cigarette). Cells were infected with RV serotype 16 (RV-16) and cultured for 2 days (RV group), pretreated with 1, 2.5, or 5% CSE for 1 day before RV infection, and culture with CSE for 2 days after infection (RV plus CSE group), or were cultured in medium for 3 days (control group), treated with 1, 2.5, or 5% CSE for 3 days (CSE group). Changes in TLR3, IL-6, and IL-8 mRNA expression were assayed by real-time polymerase chain reaction and TLR3 protein expression were assessed by flow cytometry; IL-6 and IL-8 secretions were measured by ELISA; and RV replication was assessed by viral culture. Results CSE increased RV-induced TLR3 expression and RV-induced IL-8 secretion at lower concentrations in A549 cells. On the contrary, CSE dose dependently inhibited RV-induced IL-6 secretions and had no effect on RV replications. Conclusion Our results suggest that cigarette smoke may potentiate viral common cold symptoms by enhancing IL-8 secretion at lower concentrations, but not by increasing viral replication.
Predictability of Quantification of Beta-Trace Protein for Diagnosis of Cerebrospinal Fluid Leak: Cutoff Determination in Nasal Fluids with Two Control Groups
Authors: Sampaio Marcelo Hamilton , de Barros-Mazon Silvia , Sakano Eulália , Chone Carlos Takahiro 
Published: February 2010

Background Cerebrospinal fluid (CSF) leak of the anterior skull base is an abnormal communication between the subarachnoid space and the nasal cavity or the paranasal sinus. Its presence increases the incidence of complications, as meningitis, with risk of sequelae. The early and correct diagnosis of the CSF leaks is important to perform surgical treatment as soon as possible. The CSF detection in nasal fluids could be made through the beta2-transferrin (beta2Tr) immunoelectrophoretic test, an expensive and cumbersome immunologic test, not available to the majority of the Brazilian hospitals. Recently, the detection of beta-trace protein (betaTP) for identification of CSF leaks has been described. The literature suggests there may be similar sensitivity and specificity to tests of beta2Tr, because betaTP is also a specific brain protein and it is present in CSF in high concentrations. The majority of Brazilian hospitals have the nephelometric equipment for betaTP detection. This study was designed to determine threshold values for betaTP concentrations in nasal cavity secretions as a predictor of CFS leak. Methods Nasal secretions were collected from patients with suspicion of CSF leak and from healthy volunteers. Pure CSF samples were used. A nephelometric assay was used to determine the betaTP concentration in samples. Results Values between 0.244 and 0.496 mg/L were determined for the cutoff. Conclusion Beta-trace concentrations above 0.496 mg/L are highly suggestive of the presence of CSF in examined nasal secretion. Positive predictive value and negative predictive value were 100%. BetaTP nephelometric test can predict the side of the CSF leak.
Surgical Instrument Force Exerted during Endoscopic Sinus Surgery: Differences within the Ethmoid Sinus Complex
Authors: Ross Peter D. , Joice Paul , Nassif Ramez G. , White Paul S. 
Published: February 2010

Background Endoscopic sinus surgery (ESS) has been the most important technical advance in surgical rhinology in the last 25 years. The technique is now used beyond its initial sinus confines but knowledge of the forces required to perform ESS is limited. Greater understanding of these forces will lead to improved surgical training and safety. The aim of this study was to quantify the magnitude of the forces exerted during punch osteotomy of the bony lamella of the paranasal sinuses and surrounding bony structures during ESS. Methods Fifteen formalin-fixed cadaveric heads underwent simulated ESS. Peak axial forces were measured using a pair of modified Blakesley forceps. Measurements were recorded during osteotomy of the paranasal sinus complex, skull base, and crests of the optic nerve and internal carotid artery. Statistical comparison between the mean forces was performed. Results A mean force of 6.06 N was required to breach the lamellae of the ethmoid sinus complex. This was significantly less than the mean force required to breach the skull base, excluding the olfactory cleft (17.80 N; p < 0.0001), crests of the optic nerve (15.43 N; p < 0.001), and internal carotid artery (13.15 N; p < 0.001). There was no significant difference between the ethmoid lamella and the lamina papyracea (6.13; p = 0.67). Conclusions Significantly greater force was required to breach the skull base and other safety critical areas encountered in ESS, than the bony lamellae of the ethmoid sinus complex. Although this result is reassuring, in vivo studies are now required to validate this relationship in the operative patient.
A Pilot Study of a Traditional Chinese Version of the University of Pennsylvania Smell Identification Test for Application in Taiwan
Authors: Jiang Rong-San , Su Mao-Chang , Liang Kai-Li , Shiao Jiun-Yih , Wu Shang-Heng , Hsin Chung-Han 
Published: February 2010

Background The 40-item University of Pennsylvania Smell Identification Test (UPSIT) is the most widely used smell test in the world. Presently, culturally modified versions of this test are available in 12 languages. This study describes the first assessment of a prototype traditional Chinese version of the UPSIT (UPSIT-TC) for administration in Taiwan. The goals were to determine the efficacy of specific items for testing Taiwanese subjects and to establish normative adjustments to allow for the use of North American norms. Methods The American version of the UPSIT and the UPSIT-TC were administered to 40 healthy Taiwanese subjects on two test occasions separated from one another by 2 weeks. One subject was excluded because of invalid data. Results The mean UPSIT score was 28.3 (median, 28; SD, 3.8) for the first test administration and 28.5 (median, 28.0; SD, 4.4) for the second test administration. The mean UPSIT-TC score was 33.1 (median, 33.0; SD, 2.9) for the first administration and 32.8 (median, 33.0; SD, 3.6) for the second test administration. The UPSIT-TC scores were significantly higher than those of the UPSIT on both test occasions (p < 0.0001). Pearson correlations computed across the two test occasions were positive and statistically significant for both the UPSIT and the UPSIT-TC (respectively, r = 0.803 and 0.664; p < 0.0001). Conclusions In accord with the modifications, the scores on the prototype UPSIT-TC were significantly higher than those on the American UPSIT when administered to a Taiwanese sample. Both versions of the UPSIT were stable across repeated test sessions.