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Hale SJM, Lux CA, Willoughby JE, Koefoed A, Broderick D, Biswas K, Kim R, Mackenzie BW, Douglas RG. A methodological pipeline for the preclinical evaluation of novel topical agents for the treatment of CRS. Int Forum Allergy Rhinol 2024. [PMID: 39010849 DOI: 10.1002/alr.23418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 07/02/2024] [Accepted: 07/08/2024] [Indexed: 07/17/2024]
Abstract
KEY POINTS Novel topical therapeutics require extensive pre-clinical testing to assess efficacy and safety. Antibiofilm or immunosuppressant agents can utilize ex vivo models to measure ciliotoxicity. Agents that are found to be effective and non-toxic ex vivo warrant further investigation in vivo.
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Affiliation(s)
- Samuel J M Hale
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christian A Lux
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - James E Willoughby
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Arne Koefoed
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - David Broderick
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kristi Biswas
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Raymond Kim
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Brett Wagner Mackenzie
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Richard G Douglas
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Matsumura E, Nohara K, Fukatsu H, Tanaka N, Fujii N, Sakai T. Effects of Thickening Agents on the Mucociliary Transport Function: Comparison by the Type of Thickening Agents and the Viscosity of Thickened Water. Dysphagia 2024:10.1007/s00455-024-10704-3. [PMID: 38777870 DOI: 10.1007/s00455-024-10704-3] [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: 11/07/2023] [Accepted: 03/26/2024] [Indexed: 05/25/2024]
Abstract
Thickening agents effectively prevent liquid aspiration, but their impact on the ease of discharging aspirated liquids from the trachea remains unclear due to alterations in the physical properties of liquids. This study clarifies the effects of thickening agents, comprising various raw materials, on mucociliary transport function, focusing on the viscosities of thickened waters. The subjects were 23 healthy adults. Five types of saccharin solution were prepared: a solution without a thickening agent, a starch-based nectar-like solution, a starch-based honey-like solution, a xanthan-gum-based nectar-like solution, and a xanthan-gum-based honey-like solution. Using these five types of saccharin solutions randomly, each subject underwent five trials of the saccharine dye test to evaluate the mucociliary transport function of the respiratory tract. The saccharin time was defined as the time from the placement of the saccharin solution on the nasal vestibule of the subject to when the subject reported that they became aware of the sweetness. The saccharin transit times for all samples of thickened water were longer compared to those of water without a thickening agent (p < 0.01). A comparison between thickened water samples with different viscosities showed that the saccharin transit time was longer when thickened water samples with high viscosity were prepared using the same thickening agent (p < 0.01). This suggests that while thickening reduces aspiration, the use of thickening agents may increase the difficulty in discharging aspirated fluids from the trachea.
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Affiliation(s)
- Erika Matsumura
- Division for Oral-Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
- Department of Oral-Facial Disorders, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kanji Nohara
- Department of Oral-Facial Disorders, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Hikari Fukatsu
- Department of Oral-Facial Disorders, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
- Fukatsu Dental Clinic, Mie, Japan
| | - Nobukazu Tanaka
- Division for Oral-Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
| | - Nami Fujii
- Division for Oral-Facial Disorders, Osaka University Dental Hospital, Osaka, Japan
| | - Takayoshi Sakai
- Department of Oral-Facial Disorders, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
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Weiland T, Gellner V, Pondorfer P, Hortobagyi D, Maitz E, Kiss P, Borenich A, Reininghaus EZ, Thurnher D, Tomazic PV. Endoscopic trans-sphenoidal pituitary surgery does not impact postoperative nasal quality of life. Eur Arch Otorhinolaryngol 2024; 281:245-256. [PMID: 37650929 PMCID: PMC10764578 DOI: 10.1007/s00405-023-08203-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE The aim of this prospective longitudinal study was to assess both subjective quality of life using questionnaires and objective examination of nasal function with regard to olfaction, nasal air flow and mucociliary clearance in patients after minimally invasive, turbinate-preserving endoscopic transnasal trans-sphenoidal pituitary surgery. METHODS Patients undergoing endoscopic transnasal pituitary surgery were recruited prospectively and examined during three study visits, preoperatively and 3 and 6 months postoperatively. We examined nasal function using sniffin' sticks test, rhinomanometry, saccharin transit time test, and endoscopic and radiological scores. In addition, the influence on subjective quality of life and mental health was recorded using the Sinonasal-Outcome-Test-20 (SNOT-20) and the Hospital-Anxiety-and-Depression-Scale (HADS). RESULTS 20 patients undergoing endoscopic pituitary tumor resections were included. No significant changes in olfaction or mucociliary clearance were noted. Nasal air flow showed a tendency to increase in the postoperative course lacking significance. Both the endoscopy and the radiological scores showed a significant deterioration, especially after 3 months, with a trend towards improvement over time. However, neither the SNOT-20 nor the HADS showed significant changes compared to baseline. CONCLUSIONS Our concept of minimally invasive endoscopic tumor resections on the pituitary gland with preservation of nasal turbinates shows low morbidity for the patient. Despite objectifiable surgery-associated changes in the nose, nasal physiology in terms of smell, airflow and mucociliary clearance can be preserved and the subjective quality of life of our patients remains stable.
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Affiliation(s)
- Thomas Weiland
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria.
| | - Verena Gellner
- Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - Prisca Pondorfer
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - David Hortobagyi
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Emanuel Maitz
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Peter Kiss
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Andrea Borenich
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Eva Z Reininghaus
- Department for Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Dietmar Thurnher
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Peter Valentin Tomazic
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
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Hale SJM, Lux CA, Kim R, Biswas K, Tucker S, Friedland P, Mackenzie BW, Douglas RG. In vitro Nasodine Can be an Effective Antibiofilm Agent for Biofilms that May Cause CRS. Laryngoscope 2023; 133:2490-2495. [PMID: 36644968 DOI: 10.1002/lary.30558] [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] [Received: 10/10/2022] [Revised: 12/11/2022] [Accepted: 12/17/2022] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Bacterial biofilms on the sinonasal mucosa, especially biofilms of Staphylococcus aureus, are associated with greater severity and recalcitrance of chronic rhinosinusitis (CRS). There are few, if any, antibiofilm agents suitable for sinonasal application available for the management of this problem. Nasodine® Nasal Spray (Nasodine) is a 0.5% povidone-iodine-based formulation that has been developed for sinonasal application. We investigated the antibiofilm efficacy of Nasodine to determine whether it may be a candidate for the treatment of biofilm-associated CRS. METHODS Biofilms of S. aureus ATCC 6538 were grown in vitro using the Centers for Disease Control biofilm reactor. Intact biofilms were treated by immersion in 0.9% saline (control), half concentration Nasodine, or full concentration Nasodine for between 5 min and 6 h. Further biofilm cells were dispersed into suspension then treated for between 30 s and 5 min. Surviving bacteria were then enumerated by culture and counting colonies, and the log10 reduction in viable bacteria was compared with control. RESULTS Nasodine demonstrated time and concentration-dependent bacterial killing against intact biofilm. Statistically significant reductions in viable bacteria from intact biofilms were seen with exposures as brief as 5 min. Nasodine consistently eradicated dispersed biofilm within 1 min. CONCLUSION Nasodine is highly active against biofilms of S. aureus ATCC 6538 in vitro. Biofilm killing is impeded by the presence of the intact biofilm structure. LAY SUMMARY In chronic rhinosinusitis (CRS), bacterial communities called biofilms are associated with more severe inflammation. An iodine-based nasal spray called Nasodine almost completely eradicates bacterial biofilms after 6 h of exposure. Nasodine may be useful for treating CRS. Laryngoscope, 133:2490-2495, 2023.
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Affiliation(s)
- Samuel J M Hale
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christian A Lux
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Raymond Kim
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Kristi Biswas
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Peter Friedland
- Firebrick Pharma, Melbourne, Australia
- School of Medicine, University of Western Australia, Perth, Australia
| | - Brett Wagner Mackenzie
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Richard G Douglas
- Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Pezato R, David AG, Boggi AC, Melo B, Rosalino CMV, Rodriguez AP, Thamboo A, Voegels RL. Upper Airway Mucociliary Clearance is Impaired in Dyspneic COVID-19 Patients. Indian J Otolaryngol Head Neck Surg 2023:1-5. [PMID: 36714224 PMCID: PMC9867881 DOI: 10.1007/s12070-022-03426-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 12/15/2022] [Indexed: 01/20/2023] Open
Abstract
Covid-19 is transmitted mainly by respiratory droplets and as the upper airway mucosa is the first innate immune barrier, it is crucial to understand the effects of SARS-CoV-2 on this system. In the current study, we aimed to evaluate the nasal mucociliary clearance in patients with SARS-CoV-2 infection and their symptom development. Observational cross-sectional study. The nasal mucociliary clearance (NMC) time was evaluated by the saccharin test and the results were compared between patients with SARS-CoV-2 infection (group 1) and controls (group 2, asymptomatic patients with a negative polymerase chain reaction test). We also compared the NMC time for each specific symptom suffered by participants in group 1 with the NMC time of the control group as well as with the patients in group 1 who were asymptomatic. There was a significant increase in NMC time in group 1 with dyspnea when compared to the control group (p = 0.032) and also when compared to patients who were infected were not dyspneic (p = 0.04). There were no differences in the clearance times when considering other symptoms. COVID-19 patients with dyspnea present with altered nasal mucociliary clearance.
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Affiliation(s)
- Rogério Pezato
- Departament of Ophathalmology and Otorhinolaryngology, University of Sao Paulo, Av. Prof. Lineu Prestes, 2565 - Butantã, São Paulo, SP 05508-000 Brazil ,Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada ,Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Andrea Goldwasser David
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada ,Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Alexandre Coelho Boggi
- Department of Otorhinolaryngology and Head and Neck Surgery, Universidade Federal de São Paulo, São Paulo, Brazil ,Escola Superior de Bombeiros – Polícia Militar de São Paulo, Rod. Pref. Luiz Salomão Chamma, 3300 - Parque Industrial, Franco da Rocha, SP 07857-050 Brazil
| | - Bruna Melo
- Fundação Oswaldo Cruz, Av. Brasil, 4365 - Manguinhos, Rio de Janeiro, RJ 21040-900 Brazil
| | | | | | - Andrew Thamboo
- Centre of Heart Lung Innovation, University of British Columbia, Vancouver, BC Canada
| | - Richard Louis Voegels
- Departament of Ophathalmology and Otorhinolaryngology, University of Sao Paulo, Av. Prof. Lineu Prestes, 2565 - Butantã, São Paulo, SP 05508-000 Brazil
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Sailer MM, Köllmer M, Masson B, Fais F, Hohenfeld IP, Herbig ME, Koitschev AK, Becker S. Nasal residence time and rheological properties of a new bentonite-based thixotropic gel emulsion nasal spray - AM-301. Drug Dev Ind Pharm 2023; 49:103-114. [PMID: 36852769 DOI: 10.1080/03639045.2023.2183724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE The present work provides characterization of rheological properties of a new bentonite-based thixotropic gel emulsion nasal spray (AM-301), its nasal residence time, distribution, safety and tolerability. SIGNIFICANCE The nasal epithelium is a portal of entry for allergens and primary infection by airborne pathogens. Non-pharmacological interventions, which enhance physical and biological barriers, protect against allergens and pathogens without drug-related side effects. AM-301 has shown promising efficacy and safety in the nasal epithelium against viruses (in vitro) and pollen (clinical). METHODS Technical part (i) spray characterization was performed with a validated droplet size distribution method; evaluation of the rheological properties of the formulation was performed by a validated amplitude sweep method and a validated oscillation, rotation, oscillation; Clinical part (ii) nasal and oropharyngeal endoscopy were used to provide a semi-quantitative evaluation of distribution and residence time of fluorescein-labelled AM-301 in the nose and oropharynx of healthy volunteers; (iii) tolerability and safety. RESULTS (i) The non-Newtonian rheological properties of the formulation allow AM-301 to be sprayed and then to revert to a gel to prevent run-off from the nasal cavity; (ii) the formulation remains on the inferior turbinate, septum and oropharynx of volunteers for up to 210 min and on the middle turbinate for up to 60 min; two nasal sprays provide no substantial benefit over a single application with regards to coverage or retention; (iii) the spray is well tolerated. CONCLUSIONS Single dose spray delivery of AM-301 provides extended coverage of the nasal mucosa up to the inferior turbinates.
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Affiliation(s)
- Martin M Sailer
- Department of Otorhinolaryngology, Head and Neck Surgery, St. Trudpert SILOAH Medical Center Pforzheim, Pforzheim, Germany
| | | | | | | | | | | | - Assen K Koitschev
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University Tübingen, Germany, Tübingen, Germany
| | - Sven Becker
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center of Eberhard-Karls University Tübingen, Germany, Tübingen, Germany
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Toro MDC, Ortiz E, Marson FAL, Pinheiro LM, Toro AADC, Ribeiro JD, Sakano E. Cross-sectional evaluation of the saccharin transit time test for primary ciliary dyskinesia: did we discard this tool too soon? SAO PAULO MED J 2023; 141:e2022508. [PMID: 37194765 DOI: 10.1590/1516-3180.2022.0508.r2.13032023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 03/13/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) is a rare and heterogeneous disease that is difficult to diagnose and requires complex and expensive diagnostic tools. The saccharin transit time test is a simple and inexpensive tool that may assist in screening patients with PCD. OBJECTIVES This study aimed to compare changes in the electron microscopy findings with clinical variables and saccharin tests in individuals diagnosed with clinical PCD (cPCD) and a control group. DESIGN AND SETTING An observational cross-sectional study was conducted in an otorhinolaryngology outpatient clinic from August 2012 to April 2021. METHOD Patients with cPCD underwent clinical screening questionnaires, nasal endoscopy, the saccharin transit time test, and nasal biopsy for transmission electron microscopy. RESULTS Thirty-four patients with cPCD were evaluated. The most prevalent clinical comorbidities in the cPCD group were recurrent pneumonia, bronchiectasis, and chronic rhinosinusitis. Electron microscopy confirmed the clinical diagnosis of PCD in 16 of the 34 (47.1%) patients. CONCLUSION The saccharin test could assist in screening patients with PCD due to its association with clinical alterations related to PCD.
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Affiliation(s)
- Mariana Dalbo Contrera Toro
- MD, MSc. PhD Student, Department of Otolaryngology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Erica Ortiz
- MD, PhD. Physician, Department of Otolaryngology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Fernando Augusto Lima Marson
- MD, PhD. Physician, Department of Pediatrics, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil; Researcher, Laboratory of Medical Genetics and Genome Medicine, Department of Medical Genetics, Faculty of Medical Sciences, UNICAMP, Campinas (SP), Brazil; Professor, Laboratory of Human and Medical Genetics, Universidade São Francisco, Bragança Paulista (SP), Brazil
| | - Laíza Mohana Pinheiro
- MD. Physician, Department of Otolaryngology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Adyléia Aparecida Dalbo Contrera Toro
- MD, PhD. Adjunct Professor, Department of Pediatrics, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - José Dirceu Ribeiro
- MD, PhD. Pediatric Pulmonologist and Full Professor, Department of Pediatrics, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
| | - Eulália Sakano
- MD, PhD. Adjunct Professor, Department of Otolaryngology, Faculty of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil
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Austero RM, Gelera JE. Evaluation of Nasal Mucociliary Clearance Using Saccharin Test Versus Charcoal Test Among Filipinos in a Tertiary Government Hospital. Cureus 2022; 14:e22065. [PMID: 35295368 PMCID: PMC8916846 DOI: 10.7759/cureus.22065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Nasal mucociliary clearance is mainly measured using the saccharin test because it is inexpensive, readily available, and non-toxic. However, in the local setting, the authors had difficulty procuring saccharin, and this prompted the authors to look for an alternative. Upon an expansive review of the literature, the authors came to know about the use of charcoal that has the same properties as saccharin plus it is inert and easily traceable. The objectives of this study were to (1) establish the normal nasal mucociliary clearance time (MCT) using the saccharin test (ST) and charcoal test (CT) among Filipinos, (2) determine if CT can be used to determine nasal mucociliary clearance and (3) determine if the age, sex, land of dwelling, and comorbidities can prolong MCT. Methods: This is a cross-sectional study involving 50 subjects. ST and CT were performed by placing a particle of sodium saccharine and 10μg of charcoal on the medial surface and at least 1 cm behind the head of the inferior turbinate. All STs were done on the right nostril while CTs were done on the left. A 0- to 20-minute MCT was considered normal while MCT of more than 30 minutes was considered prolonged clearance. Lastly, a transit time of more than 60 minutes was considered a failed mucociliary clearance test. Results: The mean mucociliary transit time for the saccharin group was 14.48 minutes while for the charcoal group was 14.78 minutes (p=0.531). When grouped into subcategories, CT results showed a higher mucociliary clearance mean time among males, provincial residents, and those without comorbidities while ST had a higher mean mucociliary clearance time among females, Metro Manila residents, and those with comorbidities. All were noted to be not statistically significant. Conclusion: This study showed that CT is comparable with ST. Also, it can be used as an alternative to ST because the tester directly observes the charcoal transit in the oropharynx while ST relies on the patient's perception of taste that could result in false results.
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Rajan N, Choudhury B, Prakash D, Soni K, Kaushal D, Shakrawal N, Nair NP, Goyal A. Does Prolonged Use of N95 Masks Affect Nasal Mucociliary Clearance? A Single Group Pre-Post Study. Ann Otol Rhinol Laryngol 2021; 131:730-736. [PMID: 34459285 DOI: 10.1177/00034894211041821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE It has been shown that prolonged use of face masks results in physiological changes in the nasal cavity. The objective of this study was to examine the effect of prolonged use of face masks on nasal mucociliary clearance (NMC). METHODS A single group pre-post study was conducted to determine the effects of prolonged use of N95 face mask (≥4 hours) on the NMC rates in health care workers. Saccharin transit time (STT) was used to measure the NMC. STT before and after using an N95 mask for at least 4 hours was measured for all participants in controlled conditions of temperature and humidity. RESULTS Forty-eight volunteers (20 female and 28 male) completed the study after the enrollment of 57 volunteers. The mean STT before mask use was 580.27 ± 193.93 seconds (95% CI; 523.95-636.58 seconds) and after mask use was 667.47 ± 237.42 seconds (95% CI; 598.53-736.42 seconds). There was significant prolongation of the NMC after prolonged use of N95 mask on performing the paired t-test (P = .002). The mean prolongation was 87.20 ± 184.97 seconds with an actual effect size of 0.40. Ambient temperature and humidity were not significantly different at the two test instances. CONCLUSION Use of the N95 face masks for 4 hours results in prolongation of the nasal mucociliary clearance as measured by STT. Susceptibility to any respiratory infection may be increased following doffing of the personal protective equipment, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) itself.
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Affiliation(s)
- Nikhil Rajan
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Bikram Choudhury
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Dipika Prakash
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Kapil Soni
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Darwin Kaushal
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bilaspur, Himachal Pradesh, India
| | - Neha Shakrawal
- Department of Otorhinolaryngology, Dr. Sampurnanand Medical College, Jodhpur, Rajasthan, India
| | - Nithin Prakasan Nair
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Amit Goyal
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Çoban Büyükbayraktar Z, Doruk C, Doğan M, Ertaş G. Effects of rapid maxillary expansion or alternating rapid maxillary expansion and constriction on nasal mucociliary clearance : A randomized clinical trial. J Orofac Orthop 2021; 83:395-402. [PMID: 34191034 DOI: 10.1007/s00056-021-00316-z] [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: 12/12/2020] [Accepted: 05/06/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE This parallel trial aimed to evaluate the changes in nasal mucociliary clearance (MCC) after a rapid maxillary expansion (RME) protocol or an alternating rapid maxillary expansion and constriction (Alt-RAMEC) protocol in orthodontic patients. METHODS This trial included 36 patients with a mean age of 14.38 years, with a narrow maxillary arch, bilateral posterior crossbite, no narrowing of the mandibular arch, no previous orthodontic treatment, and no nasal or systemic disease. Patients were randomly distributed into two groups (n = 18 each)-one group was treated with the RME protocol and the other group was treated with the Alt-RAMEC protocol. MCC was evaluated using the saccharine transit time (STT) test, which was measured for each individual before expansion (T0), after expansion (T1), and after a 4-month retention phase (T2). The study was single blinded, and blinding was applied only to the outcome assessor. The primary objective was to evaluate the effect of the Alt-RAMEC and RME protocols on MCC. The secondary objective was to determine the relationship between age, sex, and MCC. The χ 2 test and independent samples t‑test were used to evaluate the data. RESULTS The STT decreased after expansion and retention in the RME group. In the Alt-RAMEC group, the STT decreased after expansion and slightly increased after retention. When the RME and Alt-RAMEC groups were compared, the STT showed a significant difference after expansion and retention (p < 0.05). No significant relationship was observed between age and sex and STT (p > 0.05). CONCLUSION This study demonstrated that the Alt-RAMEC protocol improved MCC and had a positive effect on nasal physiology by increasing the nasal volume more than that achieved by RME.
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Affiliation(s)
| | - Cenk Doruk
- Department of Orthodontics, Sivas Cumhuriyet University School of Dentistry, Sivas, Turkey
| | - Mansur Doğan
- Department of Otorhinolaryngology, Sivas Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
| | - Gökcan Ertaş
- Department of Orthodontics, Sivas Cumhuriyet University School of Dentistry, Sivas, Turkey
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Alekseenko S, Karpischenko S, Artyushkin S, Barashkova S, Anikin I. Ciliary function and sinonasal mucosal cytology in pediatric patients with chronic rhinosinusitis during a year after functional endoscopic sinus surgery. Rhinology 2021; 59:319-327. [PMID: 33904535 DOI: 10.4193/rhin20.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The objective of the study is evaluation of ciliary function and mucosal cytology after endoscopic sinus surgery in children with chronic rhinosinusitis (CRS). METHODOLOGY A total of 132 children with CRS who underwent endoscopic sinus surgery, as well as 15 healthy controls were involved in the study. In this follow-up study patients were examined preoperatively, as well as 3, 6, 9, and 12 months after endoscopic sinus surgery. Assessment of ciliary function and sinonasal mucosal cytology was performed using high-speed videomicroscopy. Lund-Kennedy, Lund-Mackay, and sinonasal outcome test 20 (SNOT20) scores were also evaluated. RESULTS Total SNOT-20, Lund-Mackay, and Lund-Kennedy values significantly decreased after sinus surgery. In contrast, ciliary function and mucosal cytology only tended to improve after 6 months. 9 months after surgery the number of ciliated cells, ciliary beat frequency, cell viability, and ciliary length were significantly higher than preoperatively. The most significant improvement of ciliary function and cell height was observed 12 months after operation, whereas epithelial dystrophy and neutrophil infiltration were significantly reduced. CONCLUSIONS Substantial improvement was observed only in a year after surgery, whereas 0 to 3 months after the surgery ciliary function was severely impaired thus predisposing to recurrent sinusitis or other complications.
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Affiliation(s)
- S Alekseenko
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia; K.A. Raukhfus Childrens City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia
| | - S Karpischenko
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; K.A. Raukhfus Childrens City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia; First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - S Artyushkin
- I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia
| | - S Barashkova
- K.A. Raukhfus Childrens City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia; National Center of morphological diagnostic, St. Petersburg, Russia
| | - I Anikin
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia; K.A. Raukhfus Childrens City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia
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Alekseenko S, Karpischenko S, Barashkova S. Comparative Analysis of Mucociliary Clearance and Mucosal Morphology Using High-Speed Videomicroscopy in Children With Acute and Chronic Rhinosinusitis. Am J Rhinol Allergy 2021; 35:656-663. [PMID: 33467866 DOI: 10.1177/1945892420988804] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE evaluation of mucociliary clearance and mucosal morphology using high-speed videomicroscopy, and their association with markers of disease severity in children with acute (ARS) and chronic rhinosinusitis (CRS). METHODS A total of 67 children aged from 6 to 17 years including 15 healthy children, 20 pediatric patients with acute rhinosinusitis, and 32 cases with chronic rhinosinusitis were enrolled in the present study. SNOT20, Lund-Kennedy, and Lund-Mackay scores were also evaluated. RESULTS Children with rhinosinusitis were characterized by significantly lower number of cells with motile cilia, ciliary beat frequency, cilia length, and cell viability, as well as ciliary beat asynchrony, epithelia dystrophy and reduced epithelial cell height, being more severe in ARS group. Neutrophil infiltration of sinonasal mucosa was more profound in children with ARS, whereas the number of lymphocytes was significantly reduced. Markers of ciliary function were characterized by a significant correlation with epithelia dystrophia and neutrophil infiltration. Discriminant analysis demonstrated significant group separation based on the parameters of mucociliary clearance and mucosal morphology. In regression models mucociliary function was also associated with SNOT20, Lund-Kennedy, and Lund-Mackay scores. CONCLUSION The results of the present study demonstrate significant alteration of mucociliary clearance and mucosal morphology and its association with sinonasal inflammation and disease severity in patients with rhinosinusitis. Given a tight association between altered mucociliary clearance and severity of the disease, modulation of inflammation and ciliary function both in acute and chronic rhinosinusitis may be considered as the potential tool in therapeutic and surgical management of the disease.
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Affiliation(s)
- Svetlana Alekseenko
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia.,I.I. Mechnikov North-Western State Medical University, St. Petersburg, Russia.,K.A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia
| | - Sergey Karpischenko
- Saint-Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia.,K.A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia.,First Pavlov State Medical University of Saint Petersburg, St. Petersburg, Russia
| | - Svetlana Barashkova
- K.A. Rauhfus Children's City Multidisciplinary Clinical Center for High Medical Technologies, St. Petersburg, Russia.,National Center of morphological diagnostic, St. Petersburg, Russia
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Emma R, Caponnetto P, Cibella F, Caruso M, Conte G, Benfatto F, Ferlito S, Gulino A, Polosa R. Short and Long Term Repeatability of Saccharin Transit Time in Current, Former, and Never Smokers. Front Physiol 2020; 11:1109. [PMID: 33071804 PMCID: PMC7537769 DOI: 10.3389/fphys.2020.01109] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 08/11/2020] [Indexed: 11/24/2022] Open
Abstract
Smoking progressively damages the efficiency of mucociliary clearance (MCC) defense mechanisms, thus contributing to increased susceptibility to respiratory infections. Prolonged mucociliary clearance transit time (MCCTT) caused by chronic smoking has been investigated by saccharin test, but little data is available about its short- and long-term reproducibility. Moreover, it is not known if MCC impairment can be reversed when stopping smoking. Objective of the study is to investigate and compare short (3 days) and long term (30 days) repeatability of baseline saccharin transit time (STT) among current, former, and never smokers. STT results were analyzed in 39 current, 40 former, and 40 never smokers. Significant (p < 0.0001) short-term and long-term repeatability of STT were observed in current (R squared = 0.398 and 0.672, for short- and long-term, respectively) and former smokers (R squared = 0.714 and 0.595, for short- and long-term, respectively). Significant differences in MCCTT were observed among the three study groups (p < 0.0001); the median (IQR) MCCTT being 13.15 (10.24–17.25), 7.26 (6.18–9.17), and 7.24 (5.73–8.73) minutes for current, former and never smokers, respectively. Comparison between current smokers and former smokers was significantly different (p < 0.0001). There was no significant difference between former and never smokers. The Saccharin test was well tolerated by all participants. We have shown for the first time high level repeatability in both current and former smokers. Moreover, MCC impairment can be completely reversed, former smokers exhibiting similar STT as never smokers. Measurement of STT is a sensitive biomarker of physiological effect for the detection of early respiratory health changes and may be useful for clinical research.
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Affiliation(s)
- Rosalia Emma
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Pasquale Caponnetto
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Fabio Cibella
- National Research Council, Institute of Biomedicine and Molecular Immunology, Palermo, Italy
| | - Massimo Caruso
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Gianluca Conte
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy
| | - Francesca Benfatto
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy
| | - Salvatore Ferlito
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F., Ingrassia", University of Catania, Catania, Italy
| | - Alessandro Gulino
- Department of Medical, Surgical Sciences and Advanced Technologies "G.F., Ingrassia", University of Catania, Catania, Italy
| | - Riccardo Polosa
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy.,Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.,Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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Shusterman D. A simplified technique for evaluating nasal mucociliary clearance via saccharin transit time. Int Forum Allergy Rhinol 2020; 10:572-574. [PMID: 32052924 DOI: 10.1002/alr.22528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/23/2019] [Accepted: 01/03/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Dennis Shusterman
- Division of Occupational and Environmental Medicine, University of California, San Francisco, CA
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