1
|
Tarmizi NE, Hamizan AW, Ng CS, Gendeh HS, Guan LS, Zahedi FD, Baki MM, Husain S. The Nasal Endoscopic Features of Postnasal Drip: A Cross Sectional Study. Int Arch Otorhinolaryngol 2024; 28:e95-e100. [PMID: 38322444 PMCID: PMC10843929 DOI: 10.1055/s-0043-1767799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/02/2023] [Indexed: 02/08/2024] Open
Abstract
Introduction Patients with chronic rhinitis suffer from postnasal drip (PND) but this symptom is not well addressed. Nasal endoscopy may aid in identifying PND. Well described endoscopic features of PND are presence of secretions in the posterior nasal cavity, diffuse erythema, and hemorrhagic spots in the nasopharynx, but these have not been formally studied. Objectives The present study aims to assess the association of nasal endoscopic features with PND among rhinitis patients. This will guide clinicians to interpret the nasal endoscopic findings appropriately. Methods Adults (≥ 18 years old) with chronic rhinitis were consecutively recruited at an Otorhinolaryngology outpatient clinic in a tertiary referral center. The patients were grouped into either "Rhinitis with PND" or "Rhinitis only." The endoscopic features of PND were scored as: Secretions in the posterior nasal cavity (yes/no), erythema in the nasopharynx (none, roof only, diffuse), hemorrhagic spots (yes/no), then were compared between groups. Results There were 98 patients included (age 32.32 ± 11.33 years old, 61.2% female, 61.2% PND). Presence of secretions in the posterior nasal cavity was associated with PND ("Rhinitis with PND" versus "Rhinitis only," 78.3 versus 55.3; p = 0.02; Odds ratio: 2.81; 95% confidence interval [CI]: 1.08-7.32). Diffuse erythema of the nasopharynx was more frequent in "rhinitis only" compared with those with PND (76.3 versus 53.3%; p = 0.02). Hemorrhagic spots were equally present in both groups (11.7 versus 18.4%; p = 0.35). Conclusion Presence of secretions in the posterior nasal cavity may indicate bothersome PND among patients with rhinitis. Diffuse erythema of the nasopharynx and hemorrhagic spots are a nonspecific sign of inflammation.
Collapse
Affiliation(s)
- Nur Eliana Tarmizi
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Aneeza Wan Hamizan
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Chong Sian Ng
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Hardip Singh Gendeh
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Lum Sai Guan
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Farah Dayana Zahedi
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Marina Mat Baki
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Salina Husain
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| |
Collapse
|
2
|
Bordoni B, Escher AR, Toccafondi A, Mapelli L, Banfi P. Obstructive Sleep Apnea and Role of the Diaphragm. Cureus 2022; 14:e29004. [PMID: 36159353 PMCID: PMC9495286 DOI: 10.7759/cureus.29004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2022] [Indexed: 11/07/2022] Open
Abstract
Obstructive sleep apnea (OSA) causes multiple local and systemic pathophysiological consequences, which lead to an increase in morbidity and mortality in patients suffering from this disorder. OSA presents with various nocturnal events of apnoeas or hypopneas and with sub-clinical airflow limitations during wakefulness. OSA involves a large percentage of the population, particularly men, but the estimate of OSA patients could be much broader than data from the literature. Most of the research carried out in the muscle field is to understand the causes of the presence of chronic nocturnal desaturation and focus on the genioglossus muscle and other muscles related to dilating the upper airways. Sparse research has been published regarding the diaphragm muscle, which is the main muscle structure to insufflate air into the airways. The article reviews the functional anatomy of the muscles used to open the upper respiratory tract and the non-physiological adaptation that follows in the presence of OSA, as well as the functional anatomy and pathological adaptive aspects of the diaphragm muscle. The intent of the text is to highlight the disparity of clinical interest between the dilator muscles and the diaphragm, trying to stimulate a broader approach to patient evaluation.
Collapse
|