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Zyryanov SK, Strok AB. [Problems of polypragmasia and drug interaction in the treatment of uncomplicated acute rhinosinusitis]. Vestn Otorinolaringol 2024; 89:71-81. [PMID: 38805467 DOI: 10.17116/otorino20248902171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
This publication discusses polypragmasia and drug interactions in the treatment of uncomplicated acute rhinosinusitis in children and adults. Treatment of rhinosinusitis on an outpatient basis in multimorbid patients may be accompanied by multiple prescriptions, which increases the risk of drug interactions. The article reflects the most significant inappropriate combinations of both medicines and biologically active additives, herbal preparations. The advantages of using drugs with proven effectiveness, in particular intranasal glucocorticosteroids, are considered.
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Affiliation(s)
- S K Zyryanov
- Patrice Lumumba Peoples' Friendship University of Russia, Moscow, Russia
- City Clinical Hospital No. 24, Moscow, Russia
| | - A B Strok
- Patrice Lumumba Peoples' Friendship University of Russia, Moscow, Russia
- Russian Children's Clinical Hospital of the Pirogov Russian National Research Medical University, Moscow, Russia
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Krishniya P, Rajpurohit P, Sharma VK, Aseri Y, Verma PC. A Prospective Correlation Study Between Computerized Tomography of Paranasal Sinuses and Nasal Endoscopy Findings in Patients of Chronic Rhinosinusitis Undergoing Functional Endoscopic Sinus Surgery. Indian J Otolaryngol Head Neck Surg 2022; 74:4706-4712. [PMID: 36742912 PMCID: PMC9895699 DOI: 10.1007/s12070-021-03030-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023] Open
Abstract
In order to diagnose chronic rhinosinusitis (CRS), diagnostic nasal endoscopy (DNE) and computed tomography (CT) scan both are important investigations. But both have their pros and cons, some findings are seen better in DNE and others in CT. Our study aims to correlate DNE and CT findings. 50 patients with CRS were included in this observational prospective study done at tertiary care hospital. Preoperative each patient underwent DNE and got CT scan followed by scoring using Lund Kennedy and Lund Mackay grading respectively. Functional Endoscopic Sinus Surgery (FESS) was performed and intraoperative findings were correlated with CT scan for each of them. The sensitivity of endoscopy was 93.18% and the specificity was 83.33%. Positive predictive value of DNE was 97.62% and negative predictive value was 62.50%. Most of the endoscopy positive patients of CRS were CT positive. Also, the sensitivity of CT PNS was highest for all groups of sinus disease while specificity was high for posterior group of sinuses (81.82%) and frontal sinus (89.19%). Both DNE and CT scan should be used for planning the management of CRS. DNE tells better about middle meatal secretions, condition of mucosa, polyps. But in situations where due to anatomical variation DNE is difficult, CT scan helps us. CT identifies the extent of disease, the anatomical variants and vital relations of PNS. Overdiagnosis through CT is checked by DNE.
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Affiliation(s)
- Pratibha Krishniya
- Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Ajmer, India
| | - Pragya Rajpurohit
- Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Ajmer, India
| | - Vikrant Kumar Sharma
- Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Ajmer, India
| | - Yogesh Aseri
- Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Ajmer, India
| | - P. C. Verma
- Department of Otorhinolaryngology and Head and Neck Surgery, Jawahar Lal Nehru Medical College, Ajmer, India
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Askari M, Khezri M, Zoghi G. Introducing a Novel Combination Therapy with Macrolides for the Treatment of Chronic Rhinosinusitis: A Randomized Controlled Trial. IRANIAN JOURNAL OF MEDICAL SCIENCES 2022; 47:533-540. [PMID: 36380971 PMCID: PMC9652494 DOI: 10.30476/ijms.2021.91813.2303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/25/2021] [Accepted: 11/21/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND Macrolides have shown beneficial effects in the treatment of chronic rhinosinusitis (CRS). This study aimed to compare the effect of azithromycin and clarithromycin in combination with conventional therapies for the treatment of CRS. METHODS This single-blind randomized controlled trial was conducted during 2018-2019 at the Otorhinolaryngology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran. Out of 102 selected patients, 90 were included in the analysis. Patients were selected through convenience sampling and randomly assigned to two equal groups. In addition to conventional therapies (nasal irrigation, betamethasone injection, oxymetazoline and fluticasone spray, guaifenesin syrup, and steam inhalation), the patients in the clarithromycin group received clarithromycin 500 mg tablets twice daily for four weeks. The other group received azithromycin 500 mg tablets daily for four weeks. Patients' symptoms were evaluated pre- and post-intervention, and the Lund-Mackay (LM) scoring system was used for the staging of CRS based on computed tomography scan findings. Data were analyzed using SPSS software, and P<0.05 was considered statistically significant. RESULTS Patients in both groups were comparable in terms of age and sex. Complete resolution of symptoms was significantly higher in the azithromycin group than the clarithromycin group (71.1% vs. 24.4%, P<0.001). Baseline LM scores did not differ significantly between the groups (P=0.120). However, post-intervention, LM scores reduced considerably in both groups, but the change was significantly higher in the azithromycin group (P<0.001). CONCLUSION In combination with conventional therapies for CRS in adults, a four-week course of treatment with azithromycin is more effective than clarithromycin.Trial Registration Number: IRCT20201209049661N1.
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Affiliation(s)
- Mehdi Askari
- Department of Otorhinolaryngology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mehrdad Khezri
- Department of Radiology, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ghazal Zoghi
- Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Hao Z, Gu H, Li W. The Efficacy of Functional Endoscopic Sinus Surgery Combined With Triamcinolone Acetonide Aqueous Nasal Spray for the Treatment of Chronic Rhinosinusitis. Front Surg 2022; 9:855618. [PMID: 35711705 PMCID: PMC9197098 DOI: 10.3389/fsurg.2022.855618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022] Open
Abstract
Objective We aimed to investigate the efficacy of functional endoscopic sinus surgery (FESS) combined with triamcinolone acetonide aqueous nasal spray (TAA AQ) for the treatment of chronic rhinosinusitis. Methods From December 2019 to June 2021, 109 patients with chronic rhinosinusitis were classified into a control group (n = 50) and an experimental group (n = 59) according to the method of treatment. Subjects in the control group were treated with FESS while those in the experimental group were treated with FESS + TAA AQ. We then compared clinical indices, total effective rate, and the clinical symptoms of patients between the two groups. The pre- and postoperative serum levels of inflammatory cytokines were also determined. Before and 12 months after surgery, we analyzed the recovery of the nasal mucosa, olfactory function, and mucociliary transport rate of each patient. Postoperative complications were observed and recorded and the quality-of-life 12 months after surgery was ascertained. Results Clinical indices and total effective rate were higher in the experimental group. After treatment, the VAS score and serum levels of inflammatory cytokines in the two groups both decreased, although the experimental group had lower VAS scores and inflammatory cytokine levels. Six months after treatment, olfactory function, and the recovery of nasal mucosa were improved, MTR had increased, and the total incidence of complications had reduced in the experimental group when compared with the control group. No significant difference was found between the two groups in terms of quality-of-life (P > 0.05). Conclusion The combination of FESS and TAA AQ exerted a certain therapeutic effect on chronic rhinosinusitis.
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Wang X, Zhu X, Peng L, Zhao Y. Identification of lncRNA Biomarkers and LINC01198 Promotes Progression of Chronic Rhinosinusitis with Nasal Polyps through Sponge miR-6776-5p. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9469207. [PMID: 35572732 PMCID: PMC9106458 DOI: 10.1155/2022/9469207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/06/2022] [Accepted: 01/18/2022] [Indexed: 11/17/2022]
Abstract
Background Chronic sinusitis (CRS) was a chronic inflammation that originated in the nasal mucosa and affected the health of most people around the world. Chronic rhinosinusitis with nasal polyps (CRSwNP) was one kind of chronic sinusitis. Emerging research had suggested that long noncoding RNAs (lncRNAs) played vital parts in inflammatories and inflammation development. Methods We acquired GEO data to analyze the differential expression between the miRNA, immune genes, TF, and lncRNA data in CRSWNP and the corresponding control tissues. Bioinformatic analysis by coexpression of endogenous RNA network and competitive way enrichment, analysis, and forecasting functions of these noncoding RNA. The different pathway expressions in CRSwNP patients were confirmed using GSVA to analyze the differentially expressed immune genes and TF data sets in CRSwNP patients. The differential immune gene and transcription factor data set in CRSwNP perform functional notes and protein-protein interaction (PPI) network structure. We predicted the potential genes and RNAs related to CRSWNP by constructing a ceRNA network. In addition, we also used 19 hub immune genes to predict the potential drugs of CRSWNP. lncRNA biomarkers in CRSwNP were identified by lncRNAs LASSO regression. The CIBERSORT algorithm was used to contrast the divergence in immune infiltrations between CRSwNP and usual inferior turbinate organizations in 22 immunocyte subgroups. Results We identified a total of 48 miRNAs, 304 lncRNAs, 92 TFs, and 525 immune genes as CRSwNP-specific RNAs. GO and KEGG pathways both analyzed differentially expressed immune genes and transcription factor data sets. We predicted the potential genes GNG7, TUSC8, LINC01198, and has-miR-6776-5p by constructing ceRNA and PPI networks. At the same time, we found that the above genes were involved in two important pathways: chemokine signal path and PI3K/AKT signal path. In addition, we predicted 5 small molecule drugs to treat CRSwNP by analyzing 19 central immune genes, namely, danazol, ikarugamycin, semustine, cefamandole, and molindone. Finally, we identified 5 biomarkers in CRSwNP, namely, LINC01198, LINC01094, LINC01798, LINC01829, and LINC01320. Conclusions We had identified CRSwNP-related miRNAs, lncRNAs, TFs, and immune genes, which may be making use of latent therapeutic target for CRSwNP. At the same time, we identified 5 lncRNA biomarkers in CRSwNP. The results of this study showed that LINC01198 promoted the progression of CRSwNPs through spongy miR-6776-5p. Our studies provide a new way for further analyses of the pathogenesis of CRSwNP.
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Affiliation(s)
- Xueping Wang
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China 410000
| | - Xiaoyuan Zhu
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China 410000
| | - Li Peng
- Department of Obstetrics and Gynecology, The First People's Hospital of Nanyang, Nanyang, Henan, China 473000
| | - Yulin Zhao
- Department of Otolaryngology Head and Neck Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China 410000
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Zhou F, Zhang T, Jin Y, Ma Y, Xian Z, Zeng M, Yu G. Developments and Emerging Trends in the Global Treatment of Chronic Rhinosinusitis From 2001 to 2020: A Systematic Bibliometric Analysis. Front Surg 2022; 9:851923. [PMID: 35465432 PMCID: PMC9021416 DOI: 10.3389/fsurg.2022.851923] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/28/2022] [Indexed: 11/21/2022] Open
Abstract
Background Research on the treatment of chronic rhinosinusitis (CRS) has increased in recent decades. We undertook a bibliometric and visualization analysis of studies on CRS treatment to track research trends and highlight current research “hotspots”. Methods Original publications related to CRS treatment were obtained from the Science Citation Index-Expanded (SCI-E) and Social Sciences Citation Index (SSCI) databases in the Web of Science Core Collection (WoSCC) of Clarivate Analytics between 2001 and 2020. The country/region, institution, author, journal, references, and keywords involved in this topic were extracted using CiteSpace and VOSviewer to identify and analyze the research focus and trends in this field. Results In the previous two decades (especially after 2015), the number of publications on CRS treatment has grown markedly. With regard to publications and access to collaborative networks, the leading country was the USA. High-frequency keywords were “CRS,” “endoscopic sinus surgery,” “sinusitis,” “nasal polyps,” “asthma,” “rhinosinusitis,” “management,” “diagnosis,” “outcomes,” and “quality of life.” Inspection of keyword bursts suggested that “clinical practice guideline,” “adult CRS,” “innate lymphoid cell,” “recurrence,” and “mepolizumab” are the emerging research hotspots. The timeline view of the cluster map revealed that biologic agents have become an up-and-coming “hot topic” in CRS treatment in recent years. Conclusion Academic understanding of CRS treatment has improved markedly over the past 20 years. We study analyzed the papers objectively, methodically, and comprehensively, and identified hotspots and prospective trends in the field of CRS treatment. These results will aid rhinologists in gaining greater insight into CRS treatment strategies and identifying the changing dynamics of CRS research.
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Affiliation(s)
- Fangwei Zhou
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Tian Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Ying Jin
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Yifei Ma
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Zhipeng Xian
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Mengting Zeng
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China
| | - Guodong Yu
- Department of Clinical Medicine, Guizhou Medical University, Guiyang, China
- Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China
- *Correspondence: Guodong Yu
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Chegini Z, Didehdar M, Khoshbayan A, Karami J, Yousefimashouf M, Shariati A. The role of Staphylococcus aureus enterotoxin B in chronic rhinosinusitis with nasal polyposis. Cell Commun Signal 2022; 20:29. [PMID: 35264183 PMCID: PMC8905720 DOI: 10.1186/s12964-022-00839-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/05/2022] [Indexed: 02/05/2023] Open
Abstract
CRS with nasal polyps (CRSwNP) is a multifactorial disease, and various etiological factors like bacterial superantigens are known to develop this disease. Recent studies reported that Staphylococcus aureus nasal colonization was detected in 67% of the patients with CRSwNP. Moreover, it was reported that specific IgE against S. aureus enterotoxins are discovered in almost half of the nasal tissue homogenates from nasal polyps. Thus, investigations have highlighted the role of staphylococcal enterotoxins, especially enterotoxin B (SEB), in pathogenesis of CRSwNP. The destruction of mucosal integrity was reported as a main SEB-related pathogenic mechanisms in CRSwNP. SEB activates Toll Like Receptor 2 and triggers the production of pro-inflammatory cytokines; furthermore, it induces reactive oxygen species and endoplasmic reticulum stress-induced inflammation that may cause epithelial cell integrity disruption and enhance their permeability. SEB-induced Type 2/Th2 pathway results in degranulation of eosinophils, cationic proteins production, and localized eosinophilic inflammation. Furthermore, SEB may be involved in the expression of RORC and HIF-1α in Tregs and by maintaining the inflammation in sinonasal mucosa that could have a main role in the pathogenesis of nasal polyposis. Different in vitro findings were confirmed in animal studies; however, in vivo analysis of SEB-induced nasal polyps and CRS remains unfulfilled due to the lack of appropriate animal models. Finally, after elucidating different aspects of SEB pathogenesis in CRSwNP, therapeutic agents have been tested in recent studies with some encouraging results. The purpose of this article is to summarize the most important findings regarding SEB-induced CRS and nasal polyposis. Video Abstract
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Affiliation(s)
- Zahra Chegini
- Department of Microbiology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, Iran
| | - Amin Khoshbayan
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Jafar Karami
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran.,Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran
| | - Milad Yousefimashouf
- Department of Medical Laboratory Sciences, Faculty of Paramedical, Borujerd Branch, Islamic Azad University, Borujerd, Iran
| | - Aref Shariati
- Molecular and Medicine Research Center, Khomein University of Medical Sciences, Khomein, Iran. .,Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran.
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Bridwell RE, Gillis SC, Davis GW, Inman BL, Long B. Facial Natural Killer/T-Cell Lymphoma: A Deadly Sinusitis Mimic. Cureus 2022; 14:e22095. [PMID: 35295351 PMCID: PMC8917820 DOI: 10.7759/cureus.22095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/15/2022] Open
Abstract
Sinusitis and pre-septal cellulitis are common emergency department (ED) conditions, though rare and lethal mimics can present in a similar manner. We present a case of natural killer (NK)/T-cell lymphoma mimicking sinusitis and pre-septal cellulitis. Diagnosis of this condition may include imaging modalities such as CT and MRI, though definitive diagnosis requires tissue biopsy. Therapeutic interventions involve chemotherapy and radiation, with little role for surgical debridement. Complications in treatment can occur including hemophagocytic lymphohistiocytosis. Despite standard treatments, mortality remains high for cases of facial lymphoma.
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Al-Ahmad M, Alsaleh S, Al-Reefy H, Al Abduwani J, Nasr I, Al Abri R, Alamadi AMH, Fraihat AA, Alterki A, Abuzakouk M, Marglani O, Rand HA. Expert Opinion on Biological Treatment of Chronic Rhinosinusitis with Nasal Polyps in the Gulf Region. J Asthma Allergy 2022; 15:1-12. [PMID: 35018101 PMCID: PMC8742580 DOI: 10.2147/jaa.s321017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/01/2021] [Indexed: 02/05/2023] Open
Abstract
Chronic rhinosinusitis (CRS) is defined as the inflammation of nose and paranasal sinuses, affecting the patients' quality of life and productivity. Chronic rhinosinusitis with nasal polyps (CRSwNP) is a principal clinical entity confirmed by the existence of chronic sinonasal inflammation and is characterized by anterior or posterior rhinorrhea, nasal congestion, hyposmia and/or facial pressure or facial pain. Several epidemiologic studies have revealed wide variations in the incidence of CRS among regions globally ranging from 4.6% to 12%. The Gulf countries are also witnessing an unprecedented burden of CRSwNP. According to the current clinical guidelines, glucocorticosteroids and antibiotics are the principal pharmacotherapeutic approaches. Endoscopic sinus surgery is recommended for those who have failed maximal pharmacotherapy. Recently, biologics are considered as an alternative best approach due to the complications associated with medical therapy and surgery. However, precise data on the clinical position of biologic agents in the management of CRSwNP in the Gulf region is not available. The present review article addresses the current diagnostic and management approaches for CRSwNP and also emphasizes the role of emerging biologics in the current treatment strategies for CRSwNP in the Gulf region. Further, a consensus protocol was convened to rationalize the guideline recommendations, strategize the best practices with biologics, and develop clinical practice guidelines for all primary-care specialists in the Gulf region. The consensus-based report will be a useful reference tool for primary-care physicians in primary-healthcare settings, regarding the appropriate time for the initiation of biological treatment in the Gulf region.
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Affiliation(s)
| | - Saad Alsaleh
- Rhinology and Endoscopic Skull Base Surgery Division, Otolaryngology – Head and Neck Surgery Department, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | | | | | | | - Abdulmohsen Alterki
- Department Otolaryngology, Head and Neck Surgery, Zain and Al Sabah Hospitals, Medical Department, Dasman Diabetes Institute, Kuwait, State of Kuwait
| | | | - Osama Marglani
- Umm Al Qura University, Makkah and KFSH&RC, Jeddah, Saudi Arabia
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Bianco MR, Ralli M, Modica DM, Amata M, Poma S, Mattina G, Allegra E. The Role of Probiotics in Chronic Rhinosinusitis Treatment: An Update of the Current Literature. Healthcare (Basel) 2021; 9:healthcare9121715. [PMID: 34946441 PMCID: PMC8701913 DOI: 10.3390/healthcare9121715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/25/2021] [Accepted: 12/10/2021] [Indexed: 12/14/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is a significant health problem. It affects 5–12% of the general population. The causes that underlie the onset of CRS are not yet well known. However, many factors may contribute to its onset, such as environmental factors and the host’s general condition. Medical treatment mainly uses local corticosteroids, nasal irrigation, and antibiotics. In recent years, a new therapeutic approach that employs the use of probiotics emerged. Probiotics have been extensively studied as a therapy for dysbiosis and inflammatory pathologies of various parts of the body. We aimed to examine the studies in vivo and in vitro and clinicals reports in the existing literature to update probiotics’ role in rhinosinusitis chronic medical treatment.
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Affiliation(s)
- Maria Rita Bianco
- Otolaryngology-Department of Health Science, University of Catanzaro, 88100 Catanzaro, Italy;
- Correspondence: ; Tel.: +39-0961-3647130; Fax: +39-0961-3647131
| | - Massimo Ralli
- Department of Sense Organs, Sapienza University of Rome, 00185 Rome, Italy;
| | - Domenico Michele Modica
- Otolaryngology Unit-“Villa Sofia”-Cervello Hospital, 90146 Palermo, Italy; (D.M.M.); (S.P.); (G.M.)
| | - Marta Amata
- Department of Biomedicine and Internal and Specialistic Medicine (DIBIMIS), University of Palermo, 90133 Palermo, Italy;
| | - Salvatore Poma
- Otolaryngology Unit-“Villa Sofia”-Cervello Hospital, 90146 Palermo, Italy; (D.M.M.); (S.P.); (G.M.)
| | - Gianfranco Mattina
- Otolaryngology Unit-“Villa Sofia”-Cervello Hospital, 90146 Palermo, Italy; (D.M.M.); (S.P.); (G.M.)
| | - Eugenia Allegra
- Otolaryngology-Department of Health Science, University of Catanzaro, 88100 Catanzaro, Italy;
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Nemati S, Masroorchehr M, Elahi H, Kamalinejad M, Ebrahimi SM, Akbari M. Effects of Nigella sativa Extract on Chronic Rhinosinusitis: A Randomized Double Blind Study. Indian J Otolaryngol Head Neck Surg 2021; 73:455-460. [PMID: 34722227 DOI: 10.1007/s12070-020-02296-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 11/24/2020] [Indexed: 11/25/2022] Open
Abstract
Chronic rhinosinusitis (CRS) causes long-term discomfort for patients, and due to the frequent relapses and dissatisfaction with current treatments, CRS patients pay more attention to herbal-traditional remedies nowadays. Nigella sativa seed has a special place in Traditional Persian medicine because of its therapeutic and clinical applications. Therefore, we decided to evaluate the effect of N. sativa seed extract on clinical symptoms of CRS patients. In a double-blind controlled clinical trial on CRS patients referred to otolaryngology clinics of Firoozgar and Amiralmomenin hospitals, all the patients used nasal drops of the N. sativa (drug) or sesame oil extract (placebo), and standard SNOT-22 questionnaire completed on days 0 and 28th of study. Data collected and statistical analysis performed by SPSS software. Level of significance was considered as P < 0.05. Out of 53 subjects (33 male and 20 female), 27 were assigned in the drug group and 26 in the placebo group. The mean SNOT-22 score on the 28th day was 19.08 ± 13.21 in the drug group, and in the placebo group, the mean was 37.15 ± 21.47 (P = 0.001). N. sativa extract was particularly effective in improving the feeling of pain, pressure or fullness, numbness and congestion in the nose, and reduction of bad breath. The results of our study indicated that the N. sativa seed nasal drop significantly improved the symptoms of CRS-especially, four major and one minor symptoms- and improved the quality of life of the patients.
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Affiliation(s)
- Shadman Nemati
- Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Sciences, 17 Shahrivar Ave, Rasht, Guilan 4139637459 Iran
| | | | - Homayoon Elahi
- Department of Pharmacognosy, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Kamalinejad
- Department of Pharmacognosy, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Seyedeh Matin Ebrahimi
- Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Sciences, 17 Shahrivar Ave, Rasht, Guilan 4139637459 Iran
| | - Maryam Akbari
- Department of Otolaryngology and Head and Neck Surgery, Otorhinolaryngology Research Center, School of Medicine, Amiralmomenin Hospital, Guilan University of Medical Sciences, 17 Shahrivar Ave, Rasht, Guilan 4139637459 Iran
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Baba Caliaperoumal VB, Gs D, Velayutham P, Krishnaswami B, Rama Krishnan KK, Savery N. Correlation of Clinical Symptoms With Nasal Endoscopy and Radiological Findings in the Diagnosis of Chronic Rhinosinusitis: A Prospective Observational Study. Cureus 2021; 13:e16575. [PMID: 34434675 PMCID: PMC8380294 DOI: 10.7759/cureus.16575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction: In the diagnosis of chronic rhinosinusitis (CRS), computed tomography (CT) of the nose and paranasal sinuses (PNS) remains the gold standard investigation. Though the diagnostic nasal endoscopy (DNE) is an equally effective and easily available investigation for diagnosis of CRS, its reliability and clinical significance to that of patient’s symptoms have to be proven. Objective: The purpose of this study is to determine the correlations between the symptom severity score, radiological score, and the endoscopic score in the diagnosis of CRS. Methods: This prospective observational study included 70 patients with CRS. It was conducted in a tertiary care institute from January 2019 to June 2020. All patients were subjected to DNE and CT nose and PNS. Symptom score was assessed using Visual Analogue Scale (VAS) score of 0-10. DNE and CT scores were calculated using the Lund-Kennedy endoscopic scoring system and the Lund-Mackay CT scoring system, respectively. The correlation between these scores were done using Pearson’s correlation coefficient (p-value). Results: The mean and standard deviation of the symptom score by VAS was 7 ± 1.7; the Lund-Kennedy score was 7.6 ± 2.3, and the Lund-Mackay score was 14.3 ± 6.5, respectively. The symptom score had moderate correlation with the Lund-Kennedy Score (r = 0.643, p < 0.001) and high degree of correlation with the Lund-Mackay Score (r = 0.835, p < 0.001). The Lund-Kennedy score had a positive correlation with The Lund-Mackay score. Conclusion: DNE can be utilized as an early diagnostic tool in the clinical evaluation of CRS and is equally effective as CT in diagnosing the same. At the same time, a CT scan can be done in patients with positive symptoms and can be reserved as a second-level investigation for those patients with negative endoscopic findings but who become symptomatic on follow-up.
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Affiliation(s)
| | - Dharanya Gs
- Ear Nose Throat, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, IND
| | - Prabu Velayutham
- Ear Nose Throat, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, IND
| | | | | | - Nishanth Savery
- Ear Nose Throat, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, IND
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13
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Lucas SK, Feddema E, Boyer HC, Hunter RC. Diversity of cystic fibrosis chronic rhinosinusitis microbiota correlates with different pathogen dominance. J Cyst Fibros 2021; 20:678-681. [PMID: 33931358 PMCID: PMC8403624 DOI: 10.1016/j.jcf.2021.03.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 02/27/2021] [Accepted: 03/30/2021] [Indexed: 09/30/2022]
Abstract
Chronic rhinosinusitis (CRS) affects nearly all individuals with cystic fibrosis (CF) and is thought to serve as a reservoir for microbiota that subsequently colonize the lung. To better understand the microbial ecology of CRS, we generated a 16S rRNA gene sequencing profile of sinus mucus from CF-CRS patients. We show that CF-CRS sinuses harbor bacterial diversity not entirely captured by clinical culture. Culture data consistently identified the dominant organism in most patients, though lower abundance bacteria were not always identified. We also demonstrate that bacterial communities dominated by Staphylococcus spp. were significantly more diverse compared to those dominated by Pseudomonas spp. Diversity was not significantly associated with clinical factors or patient age, however, younger subjects yielded a much wider range of bacterial diversity. These data mirror bacterial community dynamics in the lung and provide additional insight into the role of sinus microbiota in chronic airway disease progression.
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Affiliation(s)
- Sarah K Lucas
- Department of Microbiology & Immunology, University of Minnesota, USA.
| | - Erin Feddema
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, USA.
| | - Holly C Boyer
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, USA.
| | - Ryan C Hunter
- Department of Microbiology & Immunology, University of Minnesota, USA.
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14
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Agarwal A, Spath D, Sherris DA, Kita H, Ponikau JU. Therapeutic Antibodies for Nasal Polyposis Treatment: Where Are We Headed? Clin Rev Allergy Immunol 2021; 59:141-149. [PMID: 31073812 DOI: 10.1007/s12016-019-08734-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This review article aims to outline what is known in the pathophysiology of chronic rhinosinusitis with nasal polyposis (CRSwNP) and describe the mechanism of the biologic agents being investigated for this disease. Chronic rhinosinusitis with nasal polyposis is an inflammatory disease of the nasal and paranasal mucosa, which causes symptoms of nasal obstruction, hyposmia, and rhinorrhea. Conventional therapy for CRSwNP includes intranasal corticosteroids (INCS) and polypectomy, but INCS offer only modest benefits, and recurrence after surgery is common. Therefore, effective pharmacologic therapies for CRSwNP are being actively sought. Monoclonal antibodies have been successful in other chronic diseases involving eosinophilic inflammation, such as chronic urticaria and asthma. Thus, researchers have begun expanding their scope and investigating the efficacy of these drugs in the treatment of nasal polyposis. The monoclonal antibodies under investigation (omalizumab (anti IgE), dupilumab (anti IL-4/IL-13), and reslizumab and mepolizumab (both anti IL-5), benralizumab (anti IL-5Rα), and etokimab (anti IL-33)) target key players in the pathophysiology of nasal polyposis (NP). Dupilumab has just completed phase III trials for CRSwNP with positive results, while omalizumab, mepolizumab, and benralizumab are currently in phase III trials for this indication. At this time, while there are no FDA-approved biologics for use in NP, research has highlighted the contributions of IL-4, IL-5, IL-13, and IgE as disease mediators in the pathogenesis of NP. The current FDA-approved treatment of intranasal steroids does not provide significant relief for many patients; therefore, these phase III trials of monoclonal antibodies bring hope for an exciting new treatment option.
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Affiliation(s)
- Aarti Agarwal
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, Gromo Institute and Sinus Center, University at Buffalo, The State University of New York, 1237 Delaware Avenue, Buffalo, NY, 14209, USA
| | - Derek Spath
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, Gromo Institute and Sinus Center, University at Buffalo, The State University of New York, 1237 Delaware Avenue, Buffalo, NY, 14209, USA
| | - David A Sherris
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, Gromo Institute and Sinus Center, University at Buffalo, The State University of New York, 1237 Delaware Avenue, Buffalo, NY, 14209, USA
| | - Hirohito Kita
- Department of Medicine, Division of Allergic Disease, Mayo College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Jens U Ponikau
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical Sciences, Gromo Institute and Sinus Center, University at Buffalo, The State University of New York, 1237 Delaware Avenue, Buffalo, NY, 14209, USA.
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15
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Didehdar M, Khoshbayan A, Vesal S, Darban-Sarokhalil D, Razavi S, Chegini Z, Shariati A. An overview of possible pathogenesis mechanisms of Alternaria alternata in chronic rhinosinusitis and nasal polyposis. Microb Pathog 2021; 155:104905. [PMID: 33930423 DOI: 10.1016/j.micpath.2021.104905] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 01/23/2023]
Abstract
Chronic Rhinosinusitis (CRS) is a multifactorial disease, and different etiologies like metabolism and immunity disorders, bacterial superantigens, biofilms, and fungal allergens are known to develop this disease, especially the CRS with nasal polyps. Alternaria alternata (Alternaria) is one of the most prevalent airborne fungal species in the nasal discharge, which might have vigorous immunologic activities in nasal epithelial cells and play an essential role in the pathogenesis of CRS. Moreover, the interaction between this fungus and the innate and adaptive immune systems leads to the development of chronic inflammation. This inflammation may consequently instigate the CRS and nasal polyposis. The attenuation of surfactant protein synthesis or intracellular reserves and mucus hypersecretion could prevent the clearance of Alternaria from sinuses and may be correlated with colonization and re-infection of airborne fungi. Furthermore, higher expression of cathelicidin, thymic stromal lymphopoietin, toll-like receptors, and T helper 2-dominant immune responses can result in an IgE-mediated pathway activation and eosinophils degranulation. Moreover, higher local Alternaria-specific IgE was shown to be correlated with eosinophilic cationic proteins and might relate to nasal polyps. However, the role of genetic and environmental factors affecting CRS and nasal polyposis is not well studied. Likewise, further animal and clinical studies are required to better understand the role of Alternaria in CRS disease. The current article reviews the recent findings around the Alternaria-induced CRS and nasal polyposis.
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Affiliation(s)
- Mojtaba Didehdar
- Department of Medical Parasitology and Mycology, Arak University of Medical Sciences, Arak, Iran
| | - Amin Khoshbayan
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Soheil Vesal
- Department of Molecular Genetics, Faculty of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - Davood Darban-Sarokhalil
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Shabnam Razavi
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran; Microbial Biotechnology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Chegini
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Aref Shariati
- Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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16
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Ayodele SO, Afolabi OA, Segun-Busari S, Omokanye HK, Alabi BS, Ologe FE. Clinical evaluation and nasoendoscopic scores of patients with chronic rhinosinusitis in Ilorin, Nigeria. Pan Afr Med J 2021; 38:396. [PMID: 34381540 PMCID: PMC8325466 DOI: 10.11604/pamj.2021.38.396.26115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 04/12/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction chronic rhinosinusitis (CRS) is characterised by inflammation of the mucosal lining of the nose and paranasal sinuses for at least 12 weeks duration. Other than the diagnostic criteria that is based on clinical features; nasoendoscopy and/or computerized tomographic scan have been included in the diagnosis. This study seeks to outline the clinical evaluation and nasoendoscopic assessment of CRS patients. Methods a hospital-based analytical study carried out on 154 participants. Clinical assessment and nasoendoscopy were performed and scored according to the discharge, inflammation and polyps/oedema (DIP) scale. Statistical analysis was carried out and results were presented in charts and tables. Results of the 154 participants, 71 (46.1%) were males and 83 (53.9%) females with a male to female ratio of 1: 1.7. Nasal discharge and blockage were the commonest symptoms. Nasoendoscopy had higher yield in the examination of intranasal polyps (NPs) over anterior rhinoscopy. The prevalence of NPs was 26.6%. The result of DIP nasoendoscopic findings revealed more participants with moderate scores. There was a significant statistical difference between the presence of NPs on nasoendoscopy and DIP score. Conclusion nasoendoscopy is an important aspect in the diagnosis and evaluation of patients with CRS. It provides a better visualization of NPs; therefore, it should be made routine in the clinical assessment and treatment of patients with CRS. The nasal endoscopic scoring of CRS should be considered as a common practice in clinical setting as well.
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Affiliation(s)
- Samuel Oluyomi Ayodele
- Department of Ear, Nose and Throat, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | - Segun Segun-Busari
- Department of Ear, Nose and Throat, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | | | - Biodun Sulyman Alabi
- Department of Ear, Nose and Throat, University of Ilorin Teaching Hospital, Ilorin, Nigeria
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17
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Choi SY, Jeon SY, Rim HS, Kim SW, Min JY. Nasal Septal Deviation and Incidental Paranasal Sinus Opacification: A Role of Computed Tomography. JOURNAL OF RHINOLOGY 2021. [DOI: 10.18787/jr.2020.00334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background and Objectives: The purpose of this study was to investigate the prevalence of incidental paranasal sinus (PNS) opacification in nasal septal deviation (NSD) using computed tomography (CT) and to identify contributing factors.Subjects and Method: We analyzed 216 patients who underwent septoplasty for the correction of NSD and who underwent preoperative PNS CT. We assessed the prevalence of incidental PNS opacification in these patients and determined the type of NSD according to Mladina classification. We also evaluated whether the direction of NSD affected the presence of PNS opacification on CT, and whether the presence of PNS opacification was associated with other rhinologic symptoms.Results: Of 216 patients with NSD, 86 showed opacified PNS on CT. According to Mladina classification, NSD patients were classified as type I (24.1%), type II (36.1%), type III (20.8%), type IV (5.6%), type V (9.7%), type VI (2.3%), or type VII (1.4%). Patients with type II NSD showed a significantly higher incidence of PNS opacification compared with other types of NSD (p=0.001). However, the direction of NSD did not significantly influence the presence of incidental PNS opacification. Furthermore, regardless of the presence of PNS opacification, there was no significant difference in rhinologic symptoms such as olfactory dysfunction, among others.Conclusion: We found that incidental PNS opacification on CT was common in NSD patients, especially in patients with type II NSD. Thus, we suggest that CT evaluation of patients with NSD may be helpful for assessing comorbid PNS pathologies as well as objectively identifying nasal septal deformities.
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18
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Kim JH, Choi J, Jang SS, Wrobel BB, Ference EH. Smell and Taste Impairment in a Nationwide Sample of US Adults With Chronic Rhinosinusitis Symptoms. OTO Open 2021; 5:2473974X20986756. [PMID: 33598596 PMCID: PMC7863166 DOI: 10.1177/2473974x20986756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/12/2020] [Indexed: 11/15/2022] Open
Abstract
Objective To estimate the prevalence of objectively confirmed olfactory and gustatory dysfunction in US adults reporting chronic rhinosinusitis (CRS) symptoms in a nationally representative database. Study Design Cross-sectional epidemiologic analysis. Setting Data were analyzed from the smell and taste component of the 2013-2014 NHANES data set (National Health and Nutrition Examination Survey). Methods Individuals reporting the presence of ≥2 cardinal CRS symptoms (nasal blockage, sinus pain, discolored mucus, and dysosmia) were identified as patients with a potential diagnosis of CRS. Associations were examined between the presence of CRS symptoms and both self-reported and objectively measured smell and taste. Results One-third (33%) of adults who have ≥2 CRS symptoms report subjective olfactory impairment, though only 18% of these adults have quantifiable olfactory dysfunction on objective testing. Of these adults, 27% report subjective taste impairment, but just 17% have quantifiable gustatory dysfunction on objective testing. The presence of ≥2 CRS symptoms was not significantly associated with objective olfactory or gustatory dysfunction, although the individual symptoms of subjective dysosmia and discolored mucus were associated with objectively confirmed olfactory dysfunction. Conclusion The prevalence of objective olfactory and gustatory dysfunction was higher among adults reporting the presence of ≥2 CRS symptoms, but the differences were not statistically significant. Specific sinonasal symptoms, including discolored mucus and subjective smell dysfunction, were significantly associated with objective smell impairment.
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Affiliation(s)
- James H Kim
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Janet Choi
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Sophie S Jang
- Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
| | - Bozena B Wrobel
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Elisabeth H Ference
- Caruso Department of Otolaryngology-Head and Neck Surgery, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
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19
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Bin LR, Filho LI, Yamashita AL, de Souza Pinto GN, Mendes RA, Ramos AL, Dos Santos Previdelli IT, Iwaki LCV. How does bimaxillary orthognathic surgery change dimensions of maxillary sinuses and pharyngeal airway space? Angle Orthod 2021; 90:715-722. [PMID: 33378484 DOI: 10.2319/120919-782.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) after bimaxillary orthognathic surgery using cone-beam computed tomography (CBCT). MATERIALS AND METHODS The CBCT scans of 48 patients were divided into two groups: group 1: maxillary advancement and mandibular setback (n = 24); group 2: maxillomandibular advancement (n = 24). The CBCTs were acquired 1 to 2 months preoperatively and 6 to 8 months postoperatively. A kappa test was used to determine intra- and interexaminer agreement. Area, volume, and linear measurements of MSs and PASs obtained before and after surgery were compared using a mixed model (P < .05). RESULTS All variables of the MS showed significant postsurgical reductions in both groups, except the MS length, which showed a significant increase in group 2. Volume and minimum axial area of PAS showed statistically significant postsurgical increases in both groups (P < .05). CONCLUSIONS Despite the reduction in the MS and the increase in the PAS, results indicated that the airway was not negatively affected after maxillomandibular advancement and maxillary advancement with mandibular setback.
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20
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Shih LC, Hsieh HH, Tsay GJ, Lee IT, Tsou YA, Lin CL, Shen TC, Bau DT, Tai CJ, Lin CD, Tsai MH. Chronic rhinosinusitis and premorbid autoimmune diseases: a population-based case-control study. Sci Rep 2020; 10:18635. [PMID: 33122743 PMCID: PMC7596473 DOI: 10.1038/s41598-020-75815-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/30/2020] [Indexed: 12/12/2022] Open
Abstract
Evidence shows that chronic rhinosinusitis (CRS) is associated with prior presence of autoimmune diseases; however, large-scale population-based studies in the literature are limited. We conducted a population-based case–control study investigating the association between CRS and premorbid autoimmune diseases by using the National Health Insurance Research Database in Taiwan. The CRS group included adult patients newly diagnosed with CRS between 2001 and 2013. The date of diagnosis was defined as the index date. The comparison group included individuals without CRS, with 1:4 frequency matching for gender, age, and index year. Premorbid diseases were forward traced to 1996. Univariate and multivariate logistic regression was performed to estimate odds ratios (ORs) and 95% confidence intervals. The CRS group consisted of 30,611 patients, and the comparison group consisted of 122,444 individuals. Patients with CRS had a higher significant association with premorbid autoimmune diseases (adjusted OR 1.39 [1.28–1.50]). Specifically, patients with CRS had a higher significant association with ankylosing spondylitis, polymyositis, psoriasis, rheumatoid arthritis, sicca syndrome, and systemic lupus erythematosus (adjusted OR 1.49 [1.34–1.67], 3.47 [1.12–10.8], 1.22 [1.04–1.43], 1.60 [1.31–1.96], 2.10 [1.63–2.72], and 1.69 [1.26–2.25]). In subgroup analysis, CRS with and without nasal polyps demonstrated a significant association with premorbid autoimmune diseases (adjusted OR 1.34 [1.14–1.58] and 1.50 [1.38–1.62]). In addition, CRS with fungal and non-fungal infections also demonstrated a significant association with premorbid autoimmune diseases (adjusted OR 2.02 [1.72–2.49] and 1.39 [1.28–1.51]). In conclusion, a significant association between CRS and premorbid autoimmune diseases has been identified. These underlying mechanisms need further investigation.
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Affiliation(s)
- Liang-Chun Shih
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, 40447, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 40447, Taiwan.,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Hua-Hsin Hsieh
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Gregory J Tsay
- Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Ivan T Lee
- Division of Allergy, Immunology, and Rheumatology, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Yung-An Tsou
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, 40447, Taiwan.,School of Medicine, China Medical University, Taichung, 40447, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Te-Chun Shen
- Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, 40447, Taiwan. .,School of Medicine, China Medical University, Taichung, 40447, Taiwan. .,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, China Medical University Hospital, No. 2, Yude Rode, Taichung, 40447, Taiwan.
| | - Da-Tian Bau
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 40447, Taiwan.,Terry Fox Cancer Research Laboratory, Department of Medical Research, China Medical University Hospital, Taichung, 40447, Taiwan
| | - Chih-Jaan Tai
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, 40447, Taiwan.,School of Medicine, China Medical University, Taichung, 40447, Taiwan
| | - Chia-Der Lin
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, 40447, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 40447, Taiwan.,School of Medicine, China Medical University, Taichung, 40447, Taiwan
| | - Ming-Hsui Tsai
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, 40447, Taiwan.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 40447, Taiwan.,School of Medicine, China Medical University, Taichung, 40447, Taiwan
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21
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Shin CH, Byun J, Lee K, Kim B, Noh YK, Tran NL, Park K, Kim SH, Kim TH, Oh SJ. Exosomal miRNA-19a and miRNA-614 Induced by Air Pollutants Promote Proinflammatory M1 Macrophage Polarization via Regulation of RORα Expression in Human Respiratory Mucosal Microenvironment. THE JOURNAL OF IMMUNOLOGY 2020; 205:3179-3190. [PMID: 33115854 DOI: 10.4049/jimmunol.2000456] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 09/23/2020] [Indexed: 12/12/2022]
Abstract
Air pollution exposure leads to various inflammatory diseases in the human respiratory system. Chronic rhinosinusitis is an inflammatory disease caused by viruses, bacteria, or air pollutants. However, the underlying molecular mechanisms through which air particulate matter (PM) causes inflammation and disease remain unclear. In this article, we report that the induction of exosomal microRNAs (miRNAs) from human nasal epithelial cells upon airborne PM exposure promotes proinflammatory M1 macrophage polarization via downregulated RORα expression. Exposure of human nasal epithelial cells to PM results in inflammation-related miRNA expression, and more miRNA is secreted through exosomes delivered to macrophages. Among these, miRNA-19a and miRNA-614 directly bind to the 3'-untranslated region of RORα mRNA and downregulate RORα expression, which leads to inflammation due to inflammatory cytokine upregulation and induces macrophages to a proinflammatory M1-like state. Finally, we showed enhanced expression of miRNA-19a and miRNA-614 but reduced RORα expression in a chronic rhinosinusitis patient tissue compared with the normal. Altogether, our results suggest that PM-induced exosomal miRNAs might play a crucial role in the proinflammatory mucosal microenvironment and macrophage polarization through the regulation of RORα expression.
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Affiliation(s)
- Cheol-Hee Shin
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea
| | - Junhyoung Byun
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 136-701, South Korea
| | - Kijeong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 136-701, South Korea
| | - Byoungjae Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 136-701, South Korea
| | - Yong Kwan Noh
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea.,Division of Bio-Medical Science and Technology, Korea University of Science and Technology, Seoul 02792, South Korea; and.,Department of Biotechnology, Korea University, Seoul 136-701, South Korea
| | - Na Ly Tran
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea.,Division of Bio-Medical Science and Technology, Korea University of Science and Technology, Seoul 02792, South Korea; and
| | - Kwideok Park
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea.,Division of Bio-Medical Science and Technology, Korea University of Science and Technology, Seoul 02792, South Korea; and
| | - Sang-Heon Kim
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea.,Division of Bio-Medical Science and Technology, Korea University of Science and Technology, Seoul 02792, South Korea; and
| | - Tae Hoon Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul 136-701, South Korea
| | - Seung Ja Oh
- Center for Biomaterials, Biomedical Research Institute, Korea Institute of Science and Technology, Seoul 02792, Republic of Korea;
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22
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Thunberg U, Saber A, Söderquist B, Hugosson S. Long-Term Clinical Follow-Up of Patients With Chronic Rhinosinusitis. Ann Otol Rhinol Laryngol 2020; 130:504-512. [PMID: 33000628 PMCID: PMC8044630 DOI: 10.1177/0003489420962822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: This study comprised a long-term follow-up of a cohort of patients with chronic rhinosinusitis (CRS) regarding clinical features and symptomatology. Methods: Data from 42 patients with CRS were available from a previous study. Forty of these patients were alive and were contacted for inclusion after approximately 10 years. Patients completed a questionnaire about disease and symptoms, and underwent a clinical examination. Results: Thirty-four patients (85%) responded and could be included and evaluated. For the participants in this follow-up study median length of time between initial inclusion (C1) and follow-up (C2) was 11 years (range: 8-15). In some patients the CRS shifted phenotype over time, from CRS with nasal polyposis to CRS without nasal polyposis or vice versa. The median total visual analogue score for combined sinonasal symptoms for all patients was statistically significantly reduced at follow-up. For individual patients, scores for nasal congestion, nasal discharge, facial pressure, and hyposmia were also statistically significantly reduced. The most frequently reported symptom-relieving treatments were nasal steroids and saline rinsing of the nose. Self-reported general quality of life was statistically significantly improved at C2 compared to C1. Conclusion: At long-term follow-up, symptoms were generally reduced and patients reported an improved quality of life. Patients can be given hope for eventual symptom relief. CRS is a chronic condition that seems to harbor the ability to alter its phenotype after several years. Topical corticosteroids and saline rinsing of the nose should be emphasized, since patients consider these treatments to be of high value.
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Affiliation(s)
- Ulrica Thunberg
- Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden.,Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Amanj Saber
- Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden.,Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Bo Söderquist
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden.,Department of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden
| | - Svante Hugosson
- Department of Otorhinolaryngology, Örebro University Hospital, Örebro, Sweden.,Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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23
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Cho DY, Skinner D, Hunter RC, Weeks C, Lim DJ, Thompson H, Walz CR, Zhang S, Grayson JW, Swords WE, Rowe SM, Woodworth BA. Contribution of Short Chain Fatty Acids to the Growth of Pseudomonas aeruginosa in Rhinosinusitis. Front Cell Infect Microbiol 2020; 10:412. [PMID: 32850504 PMCID: PMC7431473 DOI: 10.3389/fcimb.2020.00412] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/06/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Chronic rhinosinusitis (CRS) is characterized by complex bacterial infections with persistent inflammation. Based on our rabbit model of sinusitis, blockage of sinus ostia generated a shift in microbiota to a predominance of mucin degrading microbes (MDM) with acute inflammation at 2 weeks. This was followed by conversion to chronic sinus inflammation at 3 months with a robust increase in pathogenic bacteria (e.g., Pseudomonas). MDMs are known to produce acid metabolites [short chain fatty acids (SCFA)] that have the potential to stimulate pathogen growth by offering a carbon source to non-fermenting sinus pathogens (e.g., Pseudomonas). The objective of this study is to evaluate the concentrations of SCFA within the mucus and its contribution to the growth of P. aeruginosa. Methods: Healthy and sinusitis mucus from the rabbit model were collected and co-cultured with the PAO1 strain of P. aeruginosa for 72 h and colony forming units (CFUs) were determined with the targeted quantification of three SCFAs (acetate, propionate, butyrate). Quantification of SCFAs in healthy and sinusitis mucus from patients with P. aeruginosa was also performed via high performance liquid chromatography. Results: To provide evidence of fermentative activity, SCFAs were quantified within the mucus samples from rabbits with and without sinusitis. Acetate concentrations were significantly greater in sinusitis mucus compared to controls (4.13 ± 0.53 vs. 1.94 ± 0.44 mM, p < 0.01). After 72 h of co-culturing mucus samples with PAO1 in the presence of mucin medium, the blue-green pigment characteristic of Pseudomonas was observed throughout tubes containing sinusitis mucus. CFUs were higher in cultures containing mucus samples from sinusitis (8.4 × 109 ± 4.8 × 107) compared to control (1.4 × 109 ± 2.0 × 107) or no mucus (1.5 × 109 ± 2.1 × 107) (p < 0.0001). To provide evidence of fermentative activity in human CRS with P. aeruginosa, the presence of SCFAs in human mucus was analyzed and all SCFAs were significantly higher in CRS with P. aeruginosa compared to controls (p < 0.05). Conclusion: Given that SCFAs are solely derived from bacterial fermentation, our evidence suggests a critical role for mucin-degrading bacteria in generating carbon-source nutrients for pathogens. MDM may contribute to the development of recalcitrant CRS by degrading mucins, thus providing nutrients for potential pathogens like P. aeruginosa.
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Affiliation(s)
- Do-Yeon Cho
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States.,Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL, United States.,Division of Otolaryngology, Department of Surgery, Veteran Affairs Medical Center, Birmingham, AL, United States
| | - Daniel Skinner
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ryan C Hunter
- Department of Microbiology and Immunology, University of Minnesota, Minneapolis, MN, United States
| | - Christopher Weeks
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dong Jin Lim
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Harrison Thompson
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Christopher R Walz
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Shaoyan Zhang
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Jessica W Grayson
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States
| | - William E Swords
- Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL, United States.,Department of Medicine and Microbiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Steven M Rowe
- Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL, United States.,Department of Medicine, Pediatrics, Cell Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Bradford A Woodworth
- Department of Otolaryngology Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL, United States.,Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL, United States
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24
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Rabago D, Kille T, Mundt M, Obasi C. Results of a RCT assessing saline and xylitol nasal irrigation for CRS and fatigue in Gulf War illness. Laryngoscope Investig Otolaryngol 2020; 5:613-620. [PMID: 32864432 PMCID: PMC7444787 DOI: 10.1002/lio2.425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the efficacy of saline nasal irrigation (S-NI) and xylitol nasal irrigation (X-NI) for chronic rhinosinusitis in participants with Gulf War illness (GWI). METHODS This 26 week, 3-arm (1:1:1) randomized controlled trial examined veterans meeting criteria for GWI with moderate-to-severe chronic rhinosinusitis and fatigue symptoms. All participants received standard of care for chronic rhinosinusitis (CRS); additionally, S-NI or X-NI participants added twice-daily NI using 2% saline or 5% xylitol solutions. Outcomes included disease-specific quality of life (primary; sino-nasal outcome test [SNOT-20]; 0-100 points), overall quality of life (Short-Form 36), and fatigue (Multidimensional Fatigue Index). Outcome assessors were blind to allocation group. Intention-to-treat analysis used repeated measures modeling; statistical significance was evaluated at the two-sided α level of .05. RESULTS Randomization (N = 40) produced three similar groups regarding sex (male, 80%), age (53.8 ± 7.8 years), duration (19.8 ± 7.7 years), and illness severity (48.5 ± 12.7 SNOT-20 points). Age- and gender-adjusted between-group comparison showed that X-NI participants, compared with control, reported improved SNOT-20 scores at 8 weeks (13.5 points, 95% confidence interval [CI] -27.9 to 0.9) and at 26 weeks (15.4 points, 95% CI -30.1 to -0.6). S-NI participants improved by 13.4 points (95% CI -28.8, 2.1) at 26 weeks compared with control.The improvement in both NI groups approached minimal clinical important difference compared to control for the SNOT-20 in the general population. Secondary outcomes were not different between groups. Satisfaction in both irrigation groups was high. CONCLUSIONS This randomized controlled trial suggests that NI with saline or xylitol improves chronic sinus symptoms among participants with GWI with improvement scores similar to those in the general population. LEVEL OF EVIDENCE 1b, individual randomized controlled trial.
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Affiliation(s)
- David Rabago
- Department of Family and Community MedicinePennsylvania State UniversityHersheyPennsylvaniaUSA
| | - Tony Kille
- Department of Surgery, Division of OtolaryngologyUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Marlon Mundt
- Department of Family MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Chidi Obasi
- Department of Family MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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25
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Lu H, Liu Z, Hu L, Feng X, Hu L, Gu Y, Li H, Li H, Wang D. Are objective 'findings' the same as subjective 'severity'? A study of the relationship between computed tomography findings and subjective severity in preoperative CRSwNP patients. Exp Ther Med 2020; 20:2985-2992. [PMID: 32855664 PMCID: PMC7444383 DOI: 10.3892/etm.2020.9032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/22/2020] [Indexed: 01/20/2023] Open
Abstract
In pre-surgical patients with chronic rhinosinusitis with nasal polyps (CRSwNPs), positive findings on computed tomography (CT) scans and an exacerbation of symptoms are two possible factors that indicate surgery. However, the relationship between these factors remains unclear. Confirmed CRSwNP patients ready for sinus surgery were consecutively enrolled. The Sino-Nasal Outcome Test 22 (SNOT-22) and visual analog scale (VAS) scoring were completed by these patients, and scores were subjected to factor analysis using a principal component analysis (PCA) to evaluate subjective symptom components related to CRS. Patient CT scores, measured by the Lund-Mackay score (LMS), together with their demographics, medical treatment, and atopy status, were collected and analyzed. A total of 288 patients who met the criteria for CRSwNP and underwent CT scanning prior to surgery in the Eye, Ear, Nose, and Throat Hospital of Fudan University were enrolled. Five components were identified from the PCA of the SNOT-22 results and VAS scores related to subjective symptoms. More severe ‘nasal’ symptoms (P=0.03; 95% CI, 0.092-1.824), loss of smell and taste (P<0.001; 95% CI, 0.961-1.767) and lower facial pain (P=0.001; 95% CI 1.811 to -0.475), derived from the SNOT-22, were significantly associated with total CT score. For the VAS PCA components, less severe ‘ocular’ symptoms (P=0.004; 95% CI -1.852 to -0.352), a reduced ‘pain’ component (P<0.001; 95% CI -2.133 to -0.715), a higher ‘nasal’ symptom component (P<0.001; 95% CI 0.752-2.257) and, again, loss of smell and taste (P<0.001; 95% CI 0.437-0.811) showed an association with total CT score. ‘Allergy-associated symptoms’ in both the SNOT-22 and VAS scores and ‘loss of smell or taste’ and ‘hyposmia’ were significantly more severe in patients with ethmoid sinus/maxillary sinus (E/M) ratios of >2.59 compared with patients with E/M ratios <2.59. Loss of smell and taste alone was correlated with the LMS in patients with highly positive CT scores. The present study demonstrated associations between several subjective symptoms and objective severity in preoperative CRSwNP patients. Nasal symptoms, including olfaction loss, were correlated positively with CT scores, while ocular- and pain-related symptoms showed an opposite pattern. However, this relationship was not confirmed in patients with highly positive CT scores. A subset analysis confirmed, in terms of symptoms, the value of the E/M ratio for indicating eosinophilic chronic rhinosinusitis.
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Affiliation(s)
- Hanyu Lu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Zhuofu Liu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Li Hu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Xian Feng
- Department of Clinical Laboratory, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Li Hu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Yurong Gu
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Houyong Li
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Huabin Li
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
| | - Dehui Wang
- Department of Otorhinolaryngology, Eye, Ear, Nose and Throat Hospital of Fudan University, Shanghai 200031, P.R. China
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26
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Gianella P, Roncone S, Ala U, Bottero E, Cagnasso F, Cagnotti G, Bellino C. Upper digestive tract abnormalities in dogs with chronic idiopathic lymphoplasmacytic rhinitis. J Vet Intern Med 2020; 34:1845-1852. [PMID: 32618401 PMCID: PMC7517503 DOI: 10.1111/jvim.15827] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Chronic idiopathic lymphoplasmacytic rhinitis (CILPR) is a common inflammatory disorder of unknown etiology affecting the nasal cavity of dogs. The diagnosis is made by exclusion of other causes of nasal disease and specific therapeutic protocols are lacking. In human medicine, a relationship between CILPR and gastrointestinal clinical signs has been postulated, and remission of respiratory signs after clinical trials with medications for gastrointestinal disorders has been observed. OBJECTIVES To describe history, clinical presentation, endoscopic and histopathologic concurrent respiratory and digestive tract abnormalities, and to evaluate improvement of respiratory signs after treatment for gastrointestinal signs. ANIMALS Twenty-five dogs with CILPR. METHODS Prospective study. For inclusion, following information had to be available: respiratory and digestive clinical signs, airway and digestive tract endoscopic abnormalities, histologic evaluation of respiratory and gastrointestinal tract biopsy specimens, and clinical response to different treatment strategies. RESULTS Twenty-two dogs had endoscopic gastrointestinal lesions, whereas 13 dogs had concurrent gastrointestinal signs. Most esophageal and duodenal endoscopic abnormalities were classified as moderate or severe. Respiratory and gastrointestinal tract histologic evaluation identified mostly chronic inflammation. Remission or marked improvement of respiratory signs was observed in the majority of dogs treated only for gastrointestinal signs up to 12 months after endoscopy. No significant associations between treatments and follow-up information were found. CONCLUSION AND CLINICAL IMPORTANCE Nasal and upper digestive tract abnormalities coexist in some dogs with CILPR. Lack of standardized therapeutic protocols suggests caution when interpreting improvement in nasal clinical signs. Additional studies are needed to explore the possibility of a cause-effect relationship between the 2 processes.
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Affiliation(s)
- Paola Gianella
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Silvia Roncone
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Ugo Ala
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | | | - Federica Cagnasso
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Giulia Cagnotti
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Claudio Bellino
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
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27
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Basu S, Holbrook LT, Kudlaty K, Fasanmade O, Wu J, Burke A, Langworthy BW, Farzal Z, Mamdani M, Bennett WD, Fine JP, Senior BA, Zanation AM, Ebert CS, Kimple AJ, Thorp BD, Frank-Ito DO, Garcia GJM, Kimbell JS. Numerical evaluation of spray position for improved nasal drug delivery. Sci Rep 2020; 10:10568. [PMID: 32601278 PMCID: PMC7324389 DOI: 10.1038/s41598-020-66716-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/26/2020] [Indexed: 11/23/2022] Open
Abstract
Topical intra-nasal sprays are amongst the most commonly prescribed therapeutic options for sinonasal diseases in humans. However, inconsistency and ambiguity in instructions show a lack of definitive knowledge on best spray use techniques. In this study, we have identified a new usage strategy for nasal sprays available over-the-counter, that registers an average 8-fold improvement in topical delivery of drugs at diseased sites, when compared to prevalent spray techniques. The protocol involves re-orienting the spray axis to harness inertial motion of particulates and has been developed using computational fluid dynamics simulations of respiratory airflow and droplet transport in medical imaging-based digital models. Simulated dose in representative models is validated through in vitro spray measurements in 3D-printed anatomic replicas using the gamma scintigraphy technique. This work breaks new ground in proposing an alternative user-friendly strategy that can significantly enhance topical delivery inside human nose. While these findings can eventually translate into personalized spray usage instructions and hence merit a change in nasal standard-of-care, this study also demonstrates how relatively simple engineering analysis tools can revolutionize everyday healthcare. Finally, with respiratory mucosa as the initial coronavirus infection site, our findings are relevant to intra-nasal vaccines that are in-development, to mitigate the COVID-19 pandemic.
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Affiliation(s)
- Saikat Basu
- Department of Mechanical Engineering, South Dakota State University, Brookings, SD, 57007, United States.
| | - Landon T Holbrook
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Kathryn Kudlaty
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Olulade Fasanmade
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Jihong Wu
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Alyssa Burke
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Benjamin W Langworthy
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Zainab Farzal
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Mohammed Mamdani
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - William D Bennett
- Center for Environmental Medicine, Asthma and Lung Biology, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Jason P Fine
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Brent A Senior
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Adam M Zanation
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Charles S Ebert
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Adam J Kimple
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Brian D Thorp
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
| | - Dennis O Frank-Ito
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, 27708, United States
| | - Guilherme J M Garcia
- Joint Department of Biomedical Engineering, Medical College of Wisconsin and Marquette University, Milwaukee, WI, 53226, United States
| | - Julia S Kimbell
- Department of Otolaryngology/Head and Neck Surgery, School of Medicine - University of North Carolina, Chapel Hill, NC, 27599, United States
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28
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Far J, Abdel-Haq M, Gruber M, Abu Ammar A. Developing Biodegradable Nanoparticles Loaded with Mometasone Furoate for Potential Nasal Drug Delivery. ACS OMEGA 2020; 5:7432-7439. [PMID: 32280885 PMCID: PMC7144157 DOI: 10.1021/acsomega.0c00111] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/16/2020] [Indexed: 05/30/2023]
Abstract
Intranasal drug administration is considered a routine in the treatment of many nasal conditions including chronic rhinosinusitis (CRS), which is a common disease involving long-term inflammation of the nasal mucosa. Topical nasal steroid treatment is safe and easy to use and plays a basic role in both nonsurgical and surgical treatments for CRS. Intranasal steroid therapy for various time intervals is commonly used before and after endoscopic CRS nasal surgeries to reduce inflammation and edema and to improve mucosal healing. The medication is currently administered via conventional nasal sprays; therefore, there is an incentive to develop more efficient drug delivery systems for the controlled release of topical steroids into the sinonasal cavities over a prolonged period of time. In this study, poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with mometasone furoate (MF) were generated using the nanoprecipitation method and characterized physicochemically and morphologically. MF NPs exhibited adequate physicochemical properties and high drug encapsulation efficiency and loading content. MF exhibited sustained release from NPs over 7 days in vitro with an initial burst release; various mathematical models were applied to determine the kinetics of drug release. Having demonstrated the ability to load MF in PLGA-NPs using the nanoprecipitation method for the first time, these NPs urge the need for additional investigations to demonstrate their therapeutic potential in nasal delivery applications.
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Affiliation(s)
- Jumana Far
- Department
of Pharmaceutical Engineering, Azrieli College
of Engineering Jerusalem, Jerusalem 9103501, Israel
| | - Muhammad Abdel-Haq
- Department
of Pharmaceutical Engineering, Azrieli College
of Engineering Jerusalem, Jerusalem 9103501, Israel
| | - Maayan Gruber
- Department
of Otolaryngology−Head and Neck Surgery, Galilee Medical Center, Nahariya 2210001, Israel
- Faculty
of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel
| | - Aiman Abu Ammar
- Department
of Pharmaceutical Engineering, Azrieli College
of Engineering Jerusalem, Jerusalem 9103501, Israel
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29
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Elkalla RAL, Nossier AAH, Millar AL, El-Sheikh MM, El Behairy RAA, Mogahed HGH. Intraoral Dual Wavelength Laser Diode Therapy for Chronic Maxillary Sinusitis. Laser Ther 2020; 29:35-40. [PMID: 32904078 DOI: 10.5978/islsm.20-or-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 04/18/2020] [Indexed: 12/21/2022]
Abstract
Background Chronic sinusitis is one of the most common chronic diseases involving different age groups. The different etiological factors and difficult diagnostic procedures contribute to misdiagnosis and chronicity of sinusitis. There is no standard treatment for sinusitis. Long term use of corticosteroids and antibiotics may lead to numerous adverse side effects. Laser therapy has been suggested as a non-invasive treatment for sinusitis. It has anti-inflammatory and antibacterial effects. When considering maxillary sinusitis, discharge tends to collect in the sinus base due to its anatomy and altered physiology. To improve penetration of laser into the maxillary sinus, intraoral laser at the vestibule depth of the maxilla may be more effective. Material and Subject Thirty-four patients with chronic maxillary sinusitis were assigned into two groups. All were assessed before and after treatment. Group A received laser radiation plus standard medical treatment and group B received medical treatment only. The treatment plan was performed in 12 sessions using a Diode laser with a wavelength of 810 nm and 980nm. The SNOT-22 questionnaire and Computed Tomography were used to evaluate patients. A p-value < 0.05 was considered statistically significant. Results Both groups showed a significant improvement in symptoms following treatment (p < .001), however, the laser therapy group demonstrated greater improvements for all variables in response to treatment as compared to the traditional treatment group (p < .001). Conclusions Using high intensity intra-oral laser therapy with medical treatment is more effective than using medical treatment only for treatment of chronic maxillary sinusitis.
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Affiliation(s)
- Reham ALaa Elkalla
- Assistant Lecturer of Physical Therapy for Surgery, School of Physical Therapy, Badr University in Cairo, Egypt
| | | | - Audrey Lynn Millar
- Professor and Chair of Physical Therapy Department, School of Health Science, Winston Salem State University, United States of America
| | - Mohamed Mahmoud El-Sheikh
- Assistant Professor of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Helwan University, Egypt
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30
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Yadav SPS, Singh K, Gulia JS, Hooda A. Swing door technique for uncinectomy versus standard technique: a comparative study. Singapore Med J 2019; 62:92-95. [PMID: 31820008 DOI: 10.11622/smedj.2019165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Uncinectomy can be performed using various methods. The aim of the present study was to compare the results and complications of uncinectomy and middle meatus antrostomy using the standard and swing door techniques during functional endoscopic sinus surgery. METHODS In a prospective controlled study, 60 patients (aged 18-50 years) suffering from chronic maxillary sinusitis underwent functional endoscopic sinus surgery from January 2007 to December 2008 at a tertiary care centre. The patients were randomly divided into two groups of 30: Group A underwent uncinectomy using the standard technique, while Group B underwent uncinectomy using the swing door technique. RESULTS Group B showed more improvement in symptoms, with a mean visual analogue scale score of 80.58 ± 14.34 compared to 78.50 ± 16.63 in Group A. Both groups had no major complications. At the end of Week 2, minor complications were observed in 8 (26.7%) of the patients from Group A and 2 (6.7%) from Group B. By the sixth week, the minor complication rate was 1 (3.3%) and 0 (0%) in Group A and Group B, respectively. When compared statistically during the second week using chi-square test, the difference in the minor complication rate was found to be statistically significant (p < 0.05, χ2 = 4.81), with lower incidence of complications in Group B. CONCLUSION The swing door technique for uncinectomy produces good postoperative results, with fewer complications, as compared to the standard technique.
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Affiliation(s)
- Samar Pal Singh Yadav
- Department of Otolaryngology, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Kuljeet Singh
- Department of Otolaryngology, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Joginder Singh Gulia
- Department of Otolaryngology, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Anita Hooda
- Department of Oral Anatomy, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
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31
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Lim DJ, Skinner D, Mclemore J, Rivers N, Elder JB, Allen M, Koch C, West J, Zhang S, Thompson HM, McCormick JP, Grayson JW, Cho DY, Woodworth BA. In-vitro evaluation of a ciprofloxacin and azithromycin sinus stent for Pseudomonas aeruginosa biofilms. Int Forum Allergy Rhinol 2019; 10:121-127. [PMID: 31692289 DOI: 10.1002/alr.22475] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 10/04/2019] [Accepted: 10/16/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a chronic inflammatory disease characterized by persistent inflammation and bacterial infection. Ciprofloxacin and azithromycin are commonly prescribed antibiotics for CRS, but the ability to provide targeted release in the sinuses could mitigate side effects and improve drug concentrations at the infected site. This study was aimed to evaluate the efficacy of the novel ciprofloxacin-azithromycin sinus stent (CASS) in vitro. METHODS The CASS was created by coating ciprofloxacin (hydrophilic, inner layer) and azithromycin (hydrophobic, outer layer) onto a biodegradable poly-l-lactic acid (PLLA) stent. In-vitro evaluation included: (1) assessment of drug-coating stability within the stent using scanning electron microscopy (SEM); (2) determination of ciprofloxacin and azithromycin release kinetics; and (3) assessment of anti-biofilm activities against Pseudomonas aeruginosa. RESULTS The ciprofloxacin nanoparticle suspension in the inner layer was confirmed by zeta potential. Both ciprofloxacin (60 µg) and azithromycin (3 mg) were uniformly coated on the surface of the PLLA stents. The CASS showed ciprofloxacin/azithromycin sustained release patterns, with 80.55 ± 11.61% of ciprofloxacin and 93.85 ± 6.9% of azithromycin released by 28 days. The CASS also significantly reduced P aeruginosa biofilm mass compared with bare stents and controls (relative optical density units at 590-nm optical density: CASS, 0.037 ± 0.006; bare stent, 0.911 ± 0.015; control, 1.000 ± 0.000; p < 0.001; n = 3). CONCLUSION The CASS maintains a uniform coating and sustained delivery of ciprofloxacin and azithromycin, providing anti-biofilm activities against P aeruginosa. Further studies evaluating the efficacy of CASS in a preclinical model are planned.
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Affiliation(s)
- Dong-Jin Lim
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Daniel Skinner
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - John Mclemore
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Nick Rivers
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Jeffrey Brent Elder
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Mark Allen
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Connor Koch
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - John West
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Shaoyan Zhang
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Harrison M Thompson
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Justin P McCormick
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Jessica W Grayson
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Do-Yeon Cho
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL.,Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL
| | - Bradford A Woodworth
- Department of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, Birmingham, AL.,Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Birmingham, AL
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Taghiloo H, Halimi Z. The frequencies of different types of nasal septum deviation and their effect on increasing the thickness of maxillary sinus mucosa. J Dent Res Dent Clin Dent Prospects 2019; 13:208-214. [PMID: 31857867 PMCID: PMC6904919 DOI: 10.15171/joddd.2019.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/19/2019] [Indexed: 11/15/2022] Open
Abstract
Background. Diseases of the paranasal sinuses are very prevalent in East Azerbaijan Province, Iran, which is attributed to various reasons, including environmental and anatomical factors. This study investigated the prevalence of anatomical variations of nasal septum deviation and evaluated the effect of this factor on increasing the mucosal thickness of the sinuses. Methods. The samples included all the patients referred to Tabriz Faculty of Dentistry, and the frequency of nasal septum deviation in the sample population was evaluated. The samples were re-examined to select the samples with a thickened mucosa of the maxillary sinus. The results were reported using descriptive statistical methods. Results. Deviation of the nasal septum was seen in 75% of the cases. The results showed that 31.76 % of males and 56.67% of females had an increased maxillary sinus mucosa thickness. Conclusion. There was a significant relationship between nasal septum deviation and thickening of the maxillary sinus mucosa.
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Affiliation(s)
- Hamid Taghiloo
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zohreh Halimi
- Department of Pediatric Dentistry, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Szaleniec J, Gibała A, Pobiega M, Parasion S, Składzień J, Stręk P, Gosiewski T, Szaleniec M. Exacerbations of Chronic Rhinosinusitis-Microbiology and Perspectives of Phage Therapy. Antibiotics (Basel) 2019; 8:antibiotics8040175. [PMID: 31590369 PMCID: PMC6963383 DOI: 10.3390/antibiotics8040175] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 11/16/2022] Open
Abstract
The chronically inflamed mucosa in patients with chronic rhinosinusitis (CRS) can additionally be infected by bacteria, which results in an acute exacerbation of the disease (AECRS). Currently, AECRS is universally treated with antibiotics following the guidelines for acute bacterial rhinosinusitis (ABRS), as our understanding of its microbiology is insufficient to establish specific treatment recommendations. Unfortunately, antibiotics frequently fail to control the symptoms of AECRS due to biofilm formation, disruption of the natural microbiota, and arising antibiotic resistance. These issues can potentially be addressed by phage therapy. In this study, the endoscopically-guided cultures were postoperatively obtained from 50 patients in order to explore the microbiology of AECRS, evaluate options for antibiotic treatment, and, most importantly, assess a possibility of efficient phage therapy. Staphylococcus aureus and coagulase-negative staphylococci were the most frequently isolated bacteria, followed by Haemophilus influenzae, Pseudomonas aeruginosa, and Enterobacteriaceae. Alarmingly, mechanisms of antibiotic resistance were detected in the isolates from 46% of the patients. Bacteria not sensitive to amoxicillin were carried by 28% of the patients. The lowest rates of resistance were noted for fluoroquinolones and aminoglycosides. Fortunately, 60% of the patients carried bacterial strains that were sensitive to bacteriophages from the Biophage Pharma collection and 81% of the antibiotic-resistant strains turned out to be sensitive to bacteriophages. The results showed that microbiology of AECRS is distinct from ABRS and amoxicillin should not be the antibiotic of first choice. Currently available bacteriophages could be used instead of antibiotics or as an adjunct to antibiotics in the majority of patients with AECRS.
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Affiliation(s)
- Joanna Szaleniec
- Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland.
| | - Agnieszka Gibała
- Jerzy Haber Institute of Catalysis and Surface Chemistry Polish Academy of Sciences, Niezapominajek 8, 30-239 Krakow, Poland.
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Garncarska 11, 31-115 Krakow, Poland.
| | - Monika Pobiega
- Biophage Pharma S.A., Mogilska 40, 31-546 Krakow, Poland.
| | | | - Jacek Składzień
- Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland.
| | - Paweł Stręk
- Department of Otolaryngology, Faculty of Medicine, Jagiellonian University Medical College, Sniadeckich 2, 31-531 Krakow, Poland.
| | - Tomasz Gosiewski
- Chair of Microbiology, Department of Molecular Medical Microbiology Unit, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18, 31-121 Krakow, Poland.
| | - Maciej Szaleniec
- Jerzy Haber Institute of Catalysis and Surface Chemistry Polish Academy of Sciences, Niezapominajek 8, 30-239 Krakow, Poland.
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Li L, Feng J, Zhang D, Yong J, Wang Y, Yao J, Huang R. Differential expression of miR-4492 and IL-10 is involved in chronic rhinosinusitis with nasal polyps. Exp Ther Med 2019; 18:3968-3976. [PMID: 31611936 PMCID: PMC6781800 DOI: 10.3892/etm.2019.8022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 07/05/2019] [Indexed: 12/22/2022] Open
Abstract
Chronic rhinosinusitis (CRS) is one of the most common types of respiratory disease and affects a large proportion of the population worldwide. The clinical differences between CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP) facilitate studies on the development of polyps. In the present study, next-generation sequencing was performed to identify differentially expressed microRNAs (miRNAs/miRs) in CRSwNP vs. CRSsNP tissues and subsequently validated the expression of selected genes using reverse transcription-quantitative polymerase chain reaction analysis. In total, 6 miRNAs were identified to be downregulated in the CRSwNP samples compared with those in the CRSsNP samples. The predicted targets of these miRNAs were determined to be enriched in a number of signaling pathways, including the ErbB, Ras, cyclic adenosine monophosphate and Janus kinase (Jak)/signal transducer and activator of transcription (STAT) pathways. The expression of miR-4492 and that if its targets predicted by a bioinformatics analysis, tumor necrosis factor α (TNF-α) and interleukin (IL)-10, was validated in 96 clinical specimens. miR-4492 was downregulated and IL-10 was upregulated in CRSwNP vs. CRSsNP tissues, and an inverse correlation between miR-4492 and IL-10 was determined in CRS tissues; however no difference was identified in the expression of TNF-α between the different groups. The present results indicate that the miR-4492/IL-10 interaction in the Jak/STAT signaling pathway may be one of the key mechanisms in CRSwNP.
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Affiliation(s)
- Linge Li
- Department of Otorhinolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Juan Feng
- Department of Otorhinolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Dinghao Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Jun Yong
- Department of Otorhinolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Yan Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, P.R. China
| | - Jianfeng Yao
- Reproductive Medicine Center, Quanzhou Maternal and Child Health Hospital, Fujian Medical University, Quanzhou, Fujian 362000, P.R. China
| | - Rongfu Huang
- Clinical Laboratory, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, Fujian 362000, P.R. China
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Martyn L, Sethia R, Chon R, Novotny L, Goodman SD, Elmaraghy C, Bakaletz LO. Antibodies against the DNABII protein integration host factor (IHF) inhibit sinus implant biofilms. Laryngoscope 2019; 130:1364-1371. [PMID: 31314141 DOI: 10.1002/lary.28188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/24/2019] [Accepted: 06/27/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Chronic rhinosinusitis is a common, costly condition often treated with endoscopic sinus surgery and intraoperative placement of intranasal sinus implant materials. Whereas these materials aid in postoperative healing, they also support bacterial biofilm formation and thus contribute to negative outcomes. This study examined pretreatment of sinus implant materials with antibody against an essential bacterial biofilm structural component, the DNABII family of DNA-binding proteins, as a strategy to prevent biofilm formation. METHODS Sinus implant materials were equilibrated in immunoglobulin G (IgG)-enriched antiserum against the DNABII protein integration host factor (IHF), individually or in combination with amoxicillin-clavulanate prior to inoculation with nontypeable Haemophilus influenzae (NTHI), a predominant pathogen of chronic rhinosinusitis. After 16 hours, the bacterial burden was quantitated and compared to pretreatment with saline, IgG-enriched naive serum, or amoxicillin-clavulanate alone. RESULTS NTHI readily formed biofilms on all three materials in vitro. However, pretreatment of each material with IgG-enriched anti-IHF resulted in a significant decrease in bacterial burden compared to controls (P ≤ 0.05). Moreover, a significant and synergistic outcome was achieved with a cocktail of anti-IHF plus amoxicillin-clavulanate (P ≤ 0.05) with complete inhibition of NTHI biofilm formation on all three materials. CONCLUSIONS Biofilm formation was well supported in vitro on three sinus implant materials that vary in composition and resorption characteristics; however, pretreatment of each with DNABII protein targeted antibodies in combination with a previously ineffective antibiotic was highly effective to prevent the formation NTHI biofilms. These data demonstrate the potential for clinical utility of pretreatment of sinus implant and additional surgical materials with anti-DNABII antibodies. LEVEL OF EVIDENCE NA Laryngoscope, 130:1364-1371, 2020.
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Affiliation(s)
- Lauren Martyn
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A
| | - Rishabh Sethia
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.,The Ohio State University College of Medicine, Columbus, Ohio, U.S.A
| | - Rachel Chon
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A
| | - Laura Novotny
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A
| | - Steven D Goodman
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.,The Ohio State University College of Medicine, Columbus, Ohio, U.S.A
| | - Charles Elmaraghy
- Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, U.S.A.,The Ohio State University College of Medicine, Columbus, Ohio, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
| | - Lauren O Bakaletz
- Center for Microbial Pathogenesis, Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, U.S.A.,The Ohio State University College of Medicine, Columbus, Ohio, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, U.S.A
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Wickenheisser VA, Zywot EM, Rabjohns EM, Lee HH, Lawrence DS, Tarrant TK. Laser Light Therapy in Inflammatory, Musculoskeletal, and Autoimmune Disease. Curr Allergy Asthma Rep 2019; 19:37. [PMID: 31267251 DOI: 10.1007/s11882-019-0869-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE OF REVIEW The goal of this review is to summarize the field to date and to discuss strengths and limitations of low-level laser (light) therapy (LLLT) for the future investigation as a treatment of inflammatory disease. RECENT FINDINGS LLLT is a promising therapeutic, particularly for those diseases of skin and joints because they are most accessible to treatment. Indeed, the known mechanisms of LLLT support its use for anti-inflammatory purposes, as well as stimulation of tissue growth and repair. Although the standard of care for the majority of inflammatory diseases is immunosuppressive agents such as corticosteroids with undesirable toxicities, LLLT offers a unique approach by being non-invasive and incurring minimal side effects. It is also relatively inexpensive and accessible and even has the possibility to be patient directed at home. There is evidence that LLLT is able to modulate the immune system at the skin and joint, and it has been shown to be efficacious in humans by affecting bacterial colonization as it may pertain to chronic rhinosinusitis. However, there is variability in the methods of laser application as well as a lack of evidence for laser type, dose-ranging studies, and wavelength selection that create barriers to the implementation of LLLT without further more rigorous and standardized study. The heterogeneity makes it difficult to draw strong conclusions about the efficacy of LLLT and its mechanisms.
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Affiliation(s)
| | - Emilia Marta Zywot
- Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, USA
| | - Emily Mary Rabjohns
- Duke Department of Medicine, Division of Rheumatology and Immunology, DUMC 3874, 200 Trent Dr., Durham, NC, 27710, USA
| | - Hyun Ho Lee
- Duke Department of Medicine, Division of Rheumatology and Immunology, DUMC 3874, 200 Trent Dr., Durham, NC, 27710, USA
| | - David S Lawrence
- Division of Chemical Biology and Medicinal Chemistry, UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, USA
- Department of Chemistry, University of North Carolina, Chapel Hill, USA
- Department of Pharmacology, School of Medicine, University of North Carolina, Chapel Hill, USA
| | - Teresa Kathleen Tarrant
- Duke School of Medicine, Durham, NC, USA.
- Duke Department of Medicine, Division of Rheumatology and Immunology, DUMC 3874, 200 Trent Dr., Durham, NC, 27710, USA.
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Soudry E, Mace J, Smith TL, Hwang PH. Role of inferior turbinate reduction in the quality of life of patients undergoing endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol 2019; 9:926-933. [PMID: 31220413 DOI: 10.1002/alr.22356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/09/2019] [Accepted: 05/09/2019] [Indexed: 11/06/2022]
Abstract
BACKGROUND The impact on quality of life (QoL) of bilateral inferior turbinate reduction (BITR) performed in the setting of endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) has been a point of controversy. The aim of this study was to determine whether addition of BITR to ESS is associated with improved QoL when compared with ESS alone. METHODS This study presented findings a multi-institutional, retrospective analysis of a prospective open cohort of patients electing ESS for failed medical management of CRS. QoL parameters were compared between patients who underwent ESS alone vs those who underwent ESS with BITR. RESULTS A total of 571 patients with CRS who elected to undergo ESS were identified. Sixty-one of these patients also underwent concurrent BITR, whereas 510 patients underwent ESS without BITR. Mean length of follow-up was 15.1 months. Comparison between baseline and last postoperative QoL, olfaction, and endoscopic scores revealed significant improvement in both groups. Overall, BITR surgery was not significantly associated with clinically significant incremental improvement in QoL in either the polyp or non-polyp group. Nevertheless, statistically significant improvement was noted for the nasal congestion/blockage symptom in polyp patients (p = 0.006) and in primary surgery patients (p = 0.027) who underwent BITR. CONCLUSION BITR in the setting of ESS for CRS is not associated with significant incremental improvement in overall QoL vs ESS alone. However, BITR in polyp and primary surgery patients undergoing ESS appears to offer a significant incremental improvement in nasal congestion/blockage symptoms compared with ESS alone. Future studies are warranted to better corroborate these findings.
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Affiliation(s)
- Ethan Soudry
- Division of Endoscopic Sinus and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Jess Mace
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA
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Petersen SM, Jull GA, Learman KE. Self-reported sinus headaches are associated with neck pain and cervical musculoskeletal dysfunction: a preliminary observational case control study. J Man Manip Ther 2019; 27:245-252. [PMID: 30935330 PMCID: PMC7025697 DOI: 10.1080/10669817.2019.1572987] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives: Headaches can be associated with rhinosinusitis and may present a diagnostic challenge because of symptomatic overlap with other recurring headaches. Neck pain has received extensive attention in migraine, tension-type and cervicogenic headache but not as a comorbid feature of headache in those with rhinosinusitis. This study investigated the occurrence of neck pain and cervical musculoskeletal dysfunction in individuals with self-reported sinus headaches (SRSH). Methods: Participants with and without SRSH attended a single data collection session. Participants completed the Headache Impact Test (HIT)-6 and the Sino-Nasal Outcome Test (SNOT)-22. Cervical range of motion (ROM), segmental examination, muscle endurance and pressure-pain threshold (PPT) were measured . Results: Participants included 31 with SRSH (77.4% female; age 43.7 (9.9) years) and 30 without headache. Average symptom duration was 89.7 (±85.6) months. Mean SNOT-22 and HIT-6 scores were 36.2 (15.3) and 56.7 (7.1), respectively. In the SRSH group, 83.9% (n = 26) reported neck pain. There was a significant difference between groups for cervical sagittal (14.3° [5.3°, 23.3°], p = 0.002) and transverse plane ROM (21.5° [12.4°, 30.6°], p < 0.001), but no difference in frontal plane motion (p = 0.017). There were significant between groups difference in neck flexor endurance (19.5 s [10.1 s, 28.9 s], <0.001), segmental dysfunction O-C4 (p < 0.001) but not in PPT (p = 0.04). Discussion: Neck pain and cervical musculoskeletal dysfunction are common among persons with SRSH and may be a comorbid feature or contributing factor to headaches attributed to rhinosinusitis. Further research is needed to understand these associations.
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Affiliation(s)
- Shannon M Petersen
- a Physical Therapy Program, Des Moines University , Des Moines , IA , USA
| | - Gwendolen A Jull
- b Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane , Australia
| | - Kenneth E Learman
- c Department of Physical Therapy, Youngstown State University , Youngstown , OH , USA
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Denneny JC, Cyr DD, Witsell DL, Brereton J, Schulz K. A pathway to value-based care of chronic rhinosinusitis using a claims database. Laryngoscope Investig Otolaryngol 2019; 4:193-206. [PMID: 30828639 PMCID: PMC6383304 DOI: 10.1002/lio2.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/10/2018] [Accepted: 11/12/2018] [Indexed: 11/29/2022] Open
Abstract
Objective To construct a comprehensive picture of the typical chronic rhinosinusitis (CRS) patient in the United States including the demographics, comorbidities, and geographic prevalence. The study will also identify the diagnostic and treatment regimens, their cost, and pattern of use for both medically and surgically managed patients. Study Design Historical cohort study utilizing private and public payer databases. Methods Medical claims data from the Truven Health MarketScan Research Databases from the years 2010 to 2012 for patients with acute rhinosinusitis (ARS) and CRS 18 and older were analyzed. Results There were 54 million unique patients in the databases from 2010 to 2012. Approximately 8 million had at least one diagnosis of ARS and 298,337 had a diagnosis of CRS. Females represented 63.7% of patients with ARS and 59.4% with CRS. Medicare patients represented 6.7% of the ARS population and 10.2% of the CRS population. The mean cost of a CRS episode for those commercially insured was $1024 and $762 in Medicare. CRS patients underwent diagnostic procedures including diagnostic endoscopy (55.1%), cultures (23.6%), sinus CT scan (82.1%) and MRI (0.2%). Endoscopic sinus surgery (ESS) was performed on 14.4% of those patients with CRS. Change in frequency of medication use from the 6 months prior to ESS to the 6 months post‐ESS yielded a reduction in total costs of 34.2% or $3.9 M. The most commonly operated sinuses (with or without septoplasty on same day as ESS) were the maxillary (94%/76.1%); followed by ethmoid (82.1%/66.6%); frontal (38.8%/35.1%); and sphenoid (28.5%/28.1%). In total, 16.6% had one sinus operated on, 39.1% had two, 24.6% had three, and 18.7% had four sinuses operated on. Conclusions This data paints a much clearer understanding of the current medical and surgical management. This study confirms the previously described “value proposition” for the surgical management of those CRS patients refractory to medical management. Level of Evidence 4
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Affiliation(s)
- James C Denneny
- Department of Otolaryngology-Head and Neck Surgery Johns Hopkins School of Medicine Baltimore Maryland
| | - Derek D Cyr
- Duke Clinical Research Institute Durham, North Carolina
| | - David L Witsell
- Duke University Medical Center Division of Head & Neck Surgery and Communications Sciences Durham, North Carolina
| | - Jean Brereton
- American Academy of Otolaryngology-Head and Neck Surgery Alexandria, Virginia
| | - Kristine Schulz
- Duke University Medical Center Division of Head & Neck Surgery and Communications Sciences Durham, North Carolina
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Lopatin AS, Ivanchenko OA, Soshnikov SS, Mullol J. Cyclamen europaeum improves the effect of oral antibiotics on exacerbations and recurrences of chronic rhinosinusitis: a real-life observational study (CHRONOS). ACTA ACUST UNITED AC 2019; 38:115-123. [PMID: 29967550 DOI: 10.14639/0392-100x-1342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 01/15/2017] [Indexed: 11/23/2022]
Abstract
SUMMARY Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and paranasal sinuses affecting 11% of the European population. Cyclamen europaeum plant extract (CE) has demonstrated efficacy in treating acute rhinosinusitis, but its role in CRS exacerbations remains unknown. In this real-life, prospective, epidemiological, observational study, a total of 317 patients with exacerbations of CRS without nasal polyps (CRSsNP) of moderate severity were treated using three different options: oral antibiotics, CE extract nasal spray, or the combination of oral antibiotic with CE extract. The main outcomes were the effect of treatment on sinonasal symptoms and endoscopic appearance after 6 weeks of therapy, and the number of recurrences of CRS exacerbations after 6 months of follow-up. On the top of oral antibiotics, CE extract significantly improved sinonasal symptoms and endoscopic findings and caused a 4-fold reduction of CRS recurrences. When administered in monotherapy, CE extract was at least as effective as antibiotic in monotherapy on relief of both symptoms and reduction of CRS recurrences. In patients with CRS exacerbation of moderate severity, CE extract nasal spray in monotherapy or added to standard antibiotic treatment significantly reduces sinonasal symptoms and CRS recurrences compared to antibiotics in monotherapy.
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Affiliation(s)
- A S Lopatin
- Policlinic N. 1, Medical Department, Business Administration of the President of the Russian Federation, Moscow, Russia
| | - O A Ivanchenko
- Consultative and Diagnostic Policlinic N. 121, Moscow Healthcare Department, Moscow, Russia
| | - S S Soshnikov
- Department of Mathematical Modelling in Medicine, Central Research Institute for Public Health, Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic & Clinical and Experimental Respiratory Immunoallergy, IDIBAPS& CIBERES. Barcelona, Catalonia, Spain
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Marcus S, DelGaudio JM, Roland LT, Wise SK. Chronic Rhinosinusitis: Does Allergy Play a Role? Med Sci (Basel) 2019; 7:medsci7020030. [PMID: 30781703 PMCID: PMC6410311 DOI: 10.3390/medsci7020030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 02/02/2019] [Accepted: 02/12/2019] [Indexed: 12/12/2022] Open
Abstract
A few chronic rhinosinusitis (CRS) variants have demonstrated a strong association with environmental allergy, including allergic fungal rhinosinusitis (AFRS) and central compartment atopic disease (CCAD). However, the overall relationship between CRS and allergy remains poorly defined. The goal of this review is to evaluate the relationship between CRS and allergy with a focus on specific CRS variants.
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Affiliation(s)
- Sonya Marcus
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA 30308, USA.
| | - John M DelGaudio
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA 30308, USA.
| | - Lauren T Roland
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA 30308, USA.
| | - Sarah K Wise
- Department of Otolaryngology-Head and Neck Surgery, Emory University, Atlanta, GA 30308, USA.
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Sonone J, Nagpure PS, Puttewar M, Garg D. Changes in Maxillary Sinus Volume and It's Walls Thickness Due to Chronic Rhinosinusitis: A Prospective Study. Indian J Otolaryngol Head Neck Surg 2019; 71:2182-2185. [PMID: 31763317 DOI: 10.1007/s12070-019-01613-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 01/28/2019] [Indexed: 10/27/2022] Open
Abstract
This is a prospective observational cross sectional study comprising of 57 patients who were having symptoms of chronic rhinosinusitis which were evaluated with the help of computed tomography scan (coronal and axial sections) to measure the thickness of all walls of maxillary sinus and it's volume. Computed tomographic imaging of sinonasal region has become the gold standard in the evaluation of patients with chronic sinusitis. The maxillary sinus is pyramidal in shape with lateral wall of nose forming its base and its apex is directed towards zygomatic process. All three dimensions of the maxillary sinus were measured and the volume of each maxillary sinus was also calculated. Hyperostosis of maxillary sinus tended to increase maxillary sinus walls thickness which ultimately results into decrease in maxillary sinus volume in chronic rhinosinusitis patients.
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Affiliation(s)
- Jayant Sonone
- Department of ENT, MGIMS, Sevagram, Maharashtra India
| | - P S Nagpure
- Department of ENT, MGIMS, Sevagram, Maharashtra India
| | | | - Deepika Garg
- Department of ENT, MGIMS, Sevagram, Maharashtra India
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Kristoffersen ES, Stavem K, Lundqvist C, Russell MB. Impact of chronic headache on workdays, unemployment and disutility in the general population. J Epidemiol Community Health 2019; 73:360-367. [PMID: 30683804 DOI: 10.1136/jech-2018-211127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 12/04/2018] [Accepted: 12/12/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Data on the socioeconomic burden of chronic headache (≥15 days/last month or >180 days/year) is lacking. This study investigated the impact of chronic headache on sickness absence, unemployment and disutility in the general population in Norway. METHODS 30 000 persons aged 30-44 from the general population were screened for chronic headache by a screening questionnaire. The responder rate was 71%. The International Classification of Headache Disorders was used. We analysed the association of chronic headache with lost workdays, days with ≥50% reduced productivity, sick leave, unemployment and disutility, as assessed with the Short-Form Six-Dimension (SF-6D) in separate regression analyses. RESULTS Eighty-three per cent (427/516, 79% women) of the eligible participants completed the data on workdays and utility. They reported a mean of 9.7 (SD 24.8) workdays lost over the last 3 months, because of headache. The mean disutility score (1-SF-6D score) was 0.41. Thirty-three per cent were on long-term (>1 year) sick leave. The OR for being on sick leave was 1.9 (95% CI 1.1 to 3.2, p=0.017) for those with secondary compared with primary chronic headache. Similarly, the OR for increased number of workdays lost to headache was 3.5 (95% CI 1.8 to 6.5, p<0.001) and for unemployment 1.7 (95% CI 1.0 to 2.9, p=0.07), for those with secondary compared with primary chronic headache. Secondary chronic headache, high headache frequency and high psychological distress were significantly associated with higher disutility score. CONCLUSIONS The burden of chronic headache in the general population is substantial with high rates of lost workdays and disutility.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Head and Neck Research Group, Research Centre, Akershus Universitetssykehus HF, Lorenskog, Norway.,Department of General Practice, HELSAM, University of Oslo, Oslo, Norway.,Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Knut Stavem
- Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway.,Department of Pulmonary Medicine, Medical Division, Akershus University Hospital, Lorenskog, Norway.,HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway
| | - Christofer Lundqvist
- Head and Neck Research Group, Research Centre, Akershus Universitetssykehus HF, Lorenskog, Norway.,Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway.,HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway.,Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Michael Bjørn Russell
- Head and Neck Research Group, Research Centre, Akershus Universitetssykehus HF, Lorenskog, Norway.,Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Oslo, Norway
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Lin X, Shan X, Lin S, Shu B, Wang Y, Xiao W. Is Sensorineural Hearing Loss Related to Chronic Rhinosinusitis Caused by Outer Hair Cell Injury? Med Sci Monit 2019; 25:627-636. [PMID: 30666045 PMCID: PMC6350453 DOI: 10.12659/msm.912382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background Sensorineural hearing loss is caused by defects in the inner ear. In the present study, associations between chronic rhinosinusitis, outer hair cell injury, and sensorineural hearing loss were investigated. Material/Methods A total of 103 patients who met the inclusion criteria were recruited and allocated into a chronic rhinosinusitis group (n=82) and a simple deviated nasal septum group (n=21). Degree and type of hearing loss, including distortion product otoacoustic emissions, were used to assess the status of cochlear outer hair cells. Results The rate of hearing loss in the simple deviated nasal septum group was significantly lower than in the chronic rhinosinusitis group (4.76%, 1/21 vs. 24.39%, 20/82, P<0.05), among which 15 chronic rhinosinusitis patients (75%, 15/20) had hearing loss in the high frequency range. Acoustic stapedial reflexes were elicited in all patients of the 2 groups, while positive Metz was found in 3 chronic rhinosinusitis patients (15%, 3/20). The pass rate of distortion product otoacoustic emissions (DPOAEs) for chronic rhinosinusitis patients was significantly lower than in simple deviated nasal septum patients (88.10% vs. 70.73%, P<0.05). Moreover, the signal-to-noise ratio of DPOAE test results at 704 Hz, 3991 Hz, and 5649 Hz in the chronic rhinosinusitis group were significantly lower than in the simple deviated nasal septum group (P<0.05). Logistic regression analysis revealed a correlation between severity of chronic rhinosinusitis and sensorineural hearing loss (OR=1.39, P<0.05). Conclusions Outer hair cell injury and sensorineural hearing loss may have a common cause in chronic rhinosinusitis patients.
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Affiliation(s)
- Xi Lin
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Xin Shan
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Shaolian Lin
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Bo Shu
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Yingge Wang
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
| | - Wenhui Xiao
- Department of Otolaryngology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China (mainland)
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Douglas RG, Psaltis AJ, Rimmer J, Kuruvilla T, Cervin A, Kuang Y. Phase 1 clinical study to assess the safety of a novel drug delivery system providing long‐term topical steroid therapy for chronic rhinosinusitis. Int Forum Allergy Rhinol 2019; 9:378-387. [DOI: 10.1002/alr.22288] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 12/10/2018] [Accepted: 12/20/2018] [Indexed: 12/14/2022]
Affiliation(s)
| | - Alkis J. Psaltis
- Department of Otolaryngology Head and Neck SurgeryThe Queen Elizabeth Hospital Woodville South South Australia
| | - Joanne Rimmer
- Monash Health Melbourne Australia
- Department of SurgeryMonash University Melbourne Australia
| | - Tom Kuruvilla
- Otolaryngology–Head and Neck SurgerySpecialists at Forte 2 Christchurch New Zealand
| | - Anders Cervin
- University of Queensland Centre for Clinical ResearchRoyal Brisbane & Women's Hospital Campus Herston QLD Australia
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Lazim NM, Abdullah AM, Abdullah B, Ismail ZIM. Significance of Nasal Septum Angulation and Its Association with Rhinosinusitis Symptom Scores. Medeni Med J 2019; 34:333-339. [PMID: 32821458 PMCID: PMC7433723 DOI: 10.5222/mmj.2019.25986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 12/07/2019] [Indexed: 12/04/2022] Open
Abstract
Objective: The aim of the study was to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptom score and Visual Analog Score (VAS). Method: The study was performed as a cross sectional study conducted at two different centres in Malaysia. Ninety-eight patients who were diagnosed with rhinosinusitis and fulfilled the selection criteria were assessed as for the symptom score and VAS and the measurement of angulation of nasal septum was performed through a coronal view of CT paranasal sinuses in bone window setting at osteomeatal complex level. Results: The result obtained from one-way ANOVA test revealed a significant association between category of severity of septal angulation and the symptom score of rhinosinusitis (p=0.025). In addition, the result obtained from one-way ANOVA test also revealed a significant association between category of severity of septal angulation and the VAS of rhinosinusitis (p<0.05). Conclusion: Severity of nasal septum angulation may be significantly associated with severity of rhinosinusitis based on symptom score and VAS. These findings could be used in tailored management of patient with rhinosinusitis especially during functional endoscopic sinus surgery.
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Affiliation(s)
- Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Abdul Mokhti Abdullah
- Hospital Melaka, Jalan Mufti Haji Khalil, Department of Otorhinolaryngology-Head & Neck Surgery, Melaka, Malaysia
| | - Baharudin Abdullah
- Universiti Sains Malaysia, Health Campus, Department of Otorhinolaryngology-Head & Neck Surgery, Kelantan, Malaysia
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Kristoffersen ES, Lundqvist C, Russell MB. Illness perception in people with primary and secondary chronic headache in the general population. J Psychosom Res 2019; 116:83-92. [PMID: 30654999 DOI: 10.1016/j.jpsychores.2018.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 12/02/2018] [Accepted: 12/02/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic headache (headache ≥15 days/month) is a leading cause of disability. Illness perception, beliefs and cognitive models are likely central for patient understanding of their chronic pain condition and are associated with treatment outcome. However, these factors are insufficiently described in chronic headache. OBJECTIVE To describe illness perception, and to explore the effect of background variables and headache characteristics on illness perceptions in primary and secondary chronic headaches in the general population. METHODS 30,000 persons aged 3044 from the general population were screened for chronic headache by a mailed questionnaire. Those with self-reported chronic headache were interviewed by headache specialists. The questionnaire response rate was 71%, and the interview participation rate was 74%. The International Classification of Headache Disorders III was applied. Illness perception was assessed by the Revised Illness Perception Questionnaire (IPQ-R). The statistical approach was exploratory. RESULTS 405 of the 516 eligible participants (78%) completed the IPQ-R. Confirmatory factor analysis showed good internal validity in chronic headache. People believed their chronic headache to be long-lasting, with negative life consequences including emotional distress. Severe headache-related disability was associated with more perception of chronicity, more perceived consequences, emotional load and illness identity and less illness coherence. People with secondary chronic headache scored significantly higher on chronicity and life consequences, and had less personal control than those with primary chronic headache. CONCLUSION Chronic primary and secondary headache is associated with a high symptom burden and chronicity with large perceived negative consequences for daily living, suggesting multidisciplinary management may be necessary.
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Affiliation(s)
- Espen Saxhaug Kristoffersen
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Christofer Lundqvist
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway; HØKH, Research Centre, Akershus University Hospital, Lørenskog, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Michael Bjørn Russell
- Head and Neck Research Group, Research Centre, Akershus University Hospital, Lørenskog, Norway; Institute of Clinical Medicine, Campus Akershus University Hospital, University of Oslo, Nordbyhagen, Norway
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Akbari Dilmaghani N, Alani N, Fazeli S. A Randomized Clinical Trial of Elemental Zinc Add-on Therapy on Clinical Outcomes of Patients with Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP). IRANIAN JOURNAL OF PHARMACEUTICAL RESEARCH : IJPR 2019; 18:1595-1601. [PMID: 32641966 PMCID: PMC6934942 DOI: 10.22037/ijpr.2019.1100767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Recent studies suggest a relationship between zinc deficiency and inflammation. In the present study, we studied the effect of oral zinc supplementation on clinical improvement of chronic rhinosinusitis with nasal polyposis. In this single-blind randomized controlled trial, 44 patients with chronic rhinosinusitis with polyposis referring to ENT clinic of the Loghman Hakim hospital during 2013-2014 were randomly allocated in two groups. The treatment group (n = 28) was treated with a four-drug fixed-dose regimen (FD_FDR) consisting of oral dexamethasone (0.02 mg/kg), fluticasone nasal spray, fexophenadine 60 mg daily, montelukast 10 mg daily plus 220mg zinc sulfate capsules containing 55 mg elemental zinc, b.d., and the control group (n = 16) received the FD_FDR without supplemental zinc, for six weeks. After sixth week, two groups were compared regarding clinical outcomes based on theSNOT20 (Sinonasal outcome test) questionnaire, the general health questionnaire (SF12), the Lund-Mackay, and the Lund-Kennedy scoring systems. In the treatment group, serum zinc levels were significantly increased compared to those at the baseline (1.33 fold-increase; p = 0.0002). Within groups analysis revealed a significant reduction (p < 0.01) in LM and LK in both treatment (55% LM; 50% LK) and control groups (45% LM; 53% LK). Incontrast, between groups analysis revealed no significant differences in the LM and LK. The treatment group showed a mild superiority in general health improvement compared to that of the control group. Add-on therapy with supplemental zinc sulfate was not associated with significant improvement in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP). The advantage of zinc supplementation on the general health improvement of the patients with CRSwNP requires further assessments.
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Affiliation(s)
- Nader Akbari Dilmaghani
- Department of Otolaryngology, Head and Neck Surgery, Loghman Hakim Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nadereh Alani
- Department of Otolaryngology, Head and Neck Surgery, Loghman Hakim Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Sepideh Fazeli
- Department of Otolaryngology, Head and Neck Surgery, Loghman Hakim Educational Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Asar S, Abolnezhadian F, Saki N, Nikakhlagh S, Safavi E. The relative frequency of primary immunodeficiency diseases in pediatric patients with recurrent sinusitis and otitis media. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2018. [DOI: 10.29333/ejgm/102413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abdel-Moemin AR, Regenstein JM, Abdel-Rahman MK. New Food Products for Sensory-Compromised Situations. Compr Rev Food Sci Food Saf 2018; 17:1625-1639. [DOI: 10.1111/1541-4337.12399] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 09/09/2018] [Accepted: 09/10/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Aly R. Abdel-Moemin
- Dept. of Nutrition and Food Science, Faculty of Home Economics; Helwan Univ.; Cairo Egypt
| | | | - Manal K. Abdel-Rahman
- Dept. of Nutrition and Food Science, Faculty of Home Economics; Helwan Univ.; Cairo Egypt
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