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Zheng C, Cui X, Zhang L, Wang L, Jiang L, Yan X, Jiang Y, Yu L. The nasal and systemic inflammatory responses in early phase of acute radiation rhinosinusitis: A pilot study. Int Forum Allergy Rhinol 2024; 14:1115-1118. [PMID: 38197519 DOI: 10.1002/alr.23317] [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: 11/07/2023] [Revised: 11/29/2023] [Accepted: 12/26/2023] [Indexed: 01/11/2024]
Abstract
KEY POINTS Disease severity in acute radiation rhinosinusitis (ARRS) peaks after radiation therapy. ARRS is mainly local inflammation, manifested by increased pro-inflammatory cytokines. Intranasal corticosteroids are effective anti-inflammatory drugs in the treatment of ARRS.
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Affiliation(s)
- Chunge Zheng
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xin Cui
- Department of Otolaryngology, Head and Neck Surgery, Qingdao Women and Children' Hospital, Qingdao, China
| | - Li Zhang
- Department of Otolaryngology, Head and Neck Surgery, Qingdao Women and Children' Hospital, Qingdao, China
| | - Lin Wang
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Liwei Jiang
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Xudong Yan
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Yan Jiang
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Longgang Yu
- Department of Otolaryngology, Head and Neck Surgery, The Affiliated Hospital of Qingdao University, Qingdao, China
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Guo C, Pan L, Chen L, Xie J, Liang Z, Huang Y, He L. Investigating the epidemiological relevance of secretory otitis media and neighboring organ diseases through an Internet search. PeerJ 2024; 12:e16981. [PMID: 38464759 PMCID: PMC10921933 DOI: 10.7717/peerj.16981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/29/2024] [Indexed: 03/12/2024] Open
Abstract
Background This study examined the epidemiological correlations between secretory otitis media (SOM) and diseases of neighboring organs. We measured changes in disease incidences during the 2020 COVID-19 pandemic using Internet big data spanning from 2011 to 2021. Methods This study used the Baidu Index (BI) to determine the search volume for the terms "secretory otitis media (SOM)", "tonsillitis", "pharyngolaryngitis", "adenoid hypertrophy (AH)", "nasopharyngeal carcinoma (NPC)", "nasal septum deviation (NSD)", "rhinosinusitis", "allergic rhinitis (AR)", and "gastroesophageal reflux disease (GERD)" in Mandarin from January 2011 to December 2021. The correlations between these terms were analyzed using Spearman's correlation coefficients. The results were compared search data from 2019 and 2021 to assess the effects of isolation on SOM in 2020. Results The seasonal variations trends of SOM and other diseases coincided well (P < 0.05), except for AR. During the 11-year timeframe, the monthly searches for rhinosinusitis, NSD, tonsillitis, pharyngolaryngitis, and NPC were statistically correlated with SOM (R = 0.825, 0.594, 0.650, 0.636, 0.664, respectively; P < 0.05). No correlation was found between SOM and AR, SOM and AH, or SOM and GERD (R = - 0.028, R = 0.259, R = 0.014, respectively, P > 0.05). The total search volumes for SOM, rhinosinusitis, NPC, and AH decreased in 2020 compared to 2019. Discussion SOM exhibited a discernible epidemiological connection with rhinosinusitis, nasal septal deviation (NSD), tonsillitis, pharyngolaryngitis, and nasopharyngeal carcinoma (NPC). A decrease in public gatherings was observed to effectively reduce the incidences of SOM. This underscores the pivotal role of social measures in influencing the prevalence of SOM and emphasizes the intricate interplay between SOM and various associated health factors, with implications for public health strategies.
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Affiliation(s)
- Cheng Guo
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong Province, China
| | - Linlin Pan
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong Province, China
| | - Ling Chen
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong Province, China
| | - Jinghua Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong Province, China
| | - Zhuozheng Liang
- Intensive Care Unit, The First People’s Hospital of Foshan, Foshan, Guangdong Province, China
| | - Yongjin Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong Province, China
| | - Long He
- Department of Otorhinolaryngology Head and Neck Surgery, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong Province, China
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Bao X, Wang Y, Li B, Peng L, Ouyang B, Ng CL, Zhuo Y, Wang Q, Li C, Li J. Clinical and dosimetric predictors of radiation-induced rhinosinusitis following VMAT for nasopharyngeal carcinoma: A retrospective study. Heliyon 2024; 10:e23554. [PMID: 38187301 PMCID: PMC10770446 DOI: 10.1016/j.heliyon.2023.e23554] [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: 07/17/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
Background We aimed to investigate the clinical and dosimetric factors associated with radiation-induced rhinosinusitis, and further elucidate the optimal dose-volume constraints for nasopharyngeal cancer patients who underwent volumetric-modulated arc therapy (VMAT). Methods A retrospective review of 196 nasopharyngeal carcinoma (NPC) patients who underwent definitive VMAT between August 2018 and May 2021 was conducted. Both clinical and dose-volume histogram (DVH) data of NPC patients without rhinosinusitis at baseline were selected for analysis. Results The cumulative incidence of post-RT rhinosinusitis at the 3-, 6-, 9-, and 12-months, and >1 year were 29.6 %, 41.3 %, 42.9 %, and 45.4 %, and 47.4 %, respectively. Nasal irrigation was negatively associated with post-RT rhinosinusitis (p < 0.001). Higher cumulative incidences of maxillary and ethmoid sinusitis were associated with V70 > 1.16 % and >1.00 %, respectively (p = 0.027 and p = 0.002). Sphenoid sinusitis was more frequent when Dmax(maxillary sinus) exceeded 69.2Gy (p = 0.005). Conclusions Regular nasal irrigation may reduce the development of rhinosinusitis. Dose-volume constraints of V70 and Dmax to the maxillary sinus are suggested for VMAT planning. Patients exceeding these thresholds should be closely monitored and potentially offered preventative interventions within 3-6 months post-RT.
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Affiliation(s)
- Xiaomin Bao
- Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
| | - Yan Wang
- Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat‐sen University, Guangdong, Guangzhou, China
| | - Bin Li
- Clinical Trials Unit, The First Affiliated Hospital, Sun Yat‐sen University, Guangdong, Guangzhou, China
| | - Liang Peng
- Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
| | - Bin Ouyang
- Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat‐sen University, Guangdong, Guangzhou, China
| | - Chew Lip Ng
- Department of Otolaryngology-Head and Neck Surgery, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Yongshi Zhuo
- Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
| | - Qiumin Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
| | - Chunwei Li
- Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
| | - Jian Li
- Department of Otorhinolaryngology, The First Affiliated Hospital of Sun Yat-sen University, Guangdong, Guangzhou, China
- Guangxi Hospital Division of The First Affiliated Hospital, Sun Yat-sen University, Guangxi, Nanning, China
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Zheng W, Yan T, Liu D, Chen G, Wen Y, Rao X, Wang Y, Zheng H, Yang J, Peng H. Clinical evaluation of radiation-induced sinusitis by MRI-based scoring system in nasopharyngeal carcinoma patients. Radiat Oncol 2023; 18:153. [PMID: 37723540 PMCID: PMC10508027 DOI: 10.1186/s13014-023-02331-3] [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: 04/06/2023] [Accepted: 08/08/2023] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVE To explore the application of magnetic resonance imaging (MRI) in the evaluation of radiation-induced sinusitis (RIS), MRI-based scoring system was used to evaluate the development regularity, characteristics and influencing factors of RIS in nasopharyngeal carcinoma (NPC) patients. PATIENTS AND METHODS A retrospective analysis was performed by collecting the clinical and MRI data of 346 NPC patients to analyze the characteristics and prognosis of RIS. The predictive model was constructed according to the influencing factors of RIS. RESULTS (1) In the 2-year follow-up after radiotherapy (RT), there was significant change in L-M score in both groups of NPC patients (sinusitis before RT group: p = 0.000 vs. non-sinusitis before RT group: p = 0.000). After 6 months of RT, the L-M scores of the two groups tended to plateau (sinusitis before RT group: p = 0.311 vs. non-sinusitis before RT group: p = 0.469). (2) The prevalence of sinusitis in two groups of NPC patients (without or with sinusitis before RT) was 83% vs. 93%, 91% vs. 99%, 94% vs. 98% at 1, 6 and 24 months after RT, respectively. (3) In the patients without sinusitis before RT, the incidence of sinusitis in maxillary and anterior/posterior ethmoid, sphenoid and frontal sinuses was 87.1%, 90.0%/87.1%, 49.5%, 11.8% respectively, 1 month after RT. (4) A regression model was established according to the univariate and multivariate analysis of the factors related to RIS (smoking history: p = 0.000, time after RT: p = 0.008 and TNM staging: p = 0.040). CONCLUSION (1) RIS is a common complication in NPC patients after RT. This disorder progressed within 6 months after RT, stabilized and persisted within 6 months to 2 years. There is a high incidence of maxillary sinus and ethmoid sinus inflammation in NPC patients after RT. (2) Smoking history, time after RT and TNM staging were significant independent risk factors for RIS. (3) The intervention of the risk factors in the model may prevent or reduce the occurrence of RIS in NPC patients.
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Affiliation(s)
- Wenya Zheng
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Tao Yan
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
- Department of Cardiology, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
| | - Dongjiao Liu
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
| | - Geng Chen
- Department of Medical Imaging, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
| | - Yingjuan Wen
- Department of Radiation Oncology, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
| | - Xiuli Rao
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
| | - Yizhe Wang
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Huijuan Zheng
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Jiahong Yang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China
| | - Hua Peng
- Department of Otolaryngology, Head and Neck Surgery, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, China.
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
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Sinonasal Side Effects of Chemotherapy and/or Radiation Therapy for Head and Neck Cancer: A Literature Review. Cancers (Basel) 2022; 14:cancers14092324. [PMID: 35565453 PMCID: PMC9105089 DOI: 10.3390/cancers14092324] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 04/29/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Radiotherapy and chemotherapy represent important treatment modalities for head and neck cancer. Rhinosinusitis and smell alterations are common side effects in the sinonasal region. This review will summarize and analyze our current knowledge of the sinonasal side effects of chemotherapy and/or radiation therapy for head and neck cancer (HNC), with a specific focus on mucosal and olfactory disorders. A review of the English literature was performed using several databases (PubMed, Embase, Cochrane, Scopus). Fifty-six articles were included in qualitative synthesis: 28 assessed mucosal disorders (rhinitis or rhinosinusitis), 26 evaluated olfactory alterations, and 2 articles addressed both topics. The incidence and severity of olfactory dysfunction and chronic rhinosinusitis were highest at the end of radiotherapy and at three months after treatment and decreased gradually over time. Smell acuity deterioration and chronic rhinosinusitis seemed to be related to radiation dose on olfactory area and nasal cavities, but different degrees of recovery were observed. In conclusion, it is important to establish the severity of chronic rhinosinusitis and olfactory dysfunction in order to find strategies to support patients and improve their quality of life.
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Jiang RS, Liang KL. Effect of hypochlorous acid nasal spray as an adjuvant therapy after functional endoscopic sinus surgery. Am J Otolaryngol 2022; 43:103264. [PMID: 34653953 DOI: 10.1016/j.amjoto.2021.103264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/14/2021] [Accepted: 09/09/2021] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To evaluate the efficacy of hypochlorous acid (HOCl) nasal spray as an adjuvant therapy after functional endoscopic sinus surgery (FESS). MATERIAL AND METHODS Patients with chronic rhinosinusitis who had received FESS for treatment were recruited and assigned to one of two groups at random at one month post-surgery. In the HOCl group, patients received 0.02% HOCl nasal spray three times a day for two months. In the control group, normal saline (NS) nasal irrigation was given. Before FESS and before and after nasal spray or irrigation, patients completed the Taiwanese version of the 22-item Sino-Nasal Outcome Test (TWSNOT-22). In addition, patients received endoscopic examination, acoustic rhinometry, smell test, saccharine transit test, and bacterial cultures obtained from their middle meatus. RESULTS Seventy-eight patients completed the study. Among them, 41 received HOCl nasal spray, and 37 received NS irrigation. Endoscopic score significantly decreased after 2-month HOCl nasal spray (p = 0.036). TWSNOT-22 score also decreased, although insignificantly (p = 0.285). In contrast, TWSNOT-22 score significantly decreased after NS nasal irrigation (p = 0.017), but endoscopic score did not significantly decrease (p = 0.142). CONCLUSIONS Our results showed that HOCl nasal spray had a similar effect to that of NS nasal irrigation in post-FESS care. It can be an alternative of NS nasal irrigation for its convenient application.
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Xiao Y, Peng S, Tang Y, Xie H, Huang M, Wang J, Gong X, Li J. Retrospective Analysis of a Modified Irrigation Method for Nasopharyngeal Carcinoma Patients With Post-Radiation Nasopharyngeal Necrosis. Front Oncol 2021; 11:663132. [PMID: 34026642 PMCID: PMC8139247 DOI: 10.3389/fonc.2021.663132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 04/01/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose Post-radiation nasopharyngeal necrosis (PRNN) is one of the most serious late effects of nasopharyngeal carcinoma (NPC) after radiotherapy. Standard conservative treatments are not always effective, and this study sought to investigate the feasibility of modified nasopharyngeal irrigation in the treatment of PRNN. Methods Between September 2011 and September 2018, 113 NPC patients with pathologically or radiologically diagnosed PRNN were analyzed retrospectively. All patients received the traditional conservative treatments of debridement of the necrotic tissues guided by an endoscope and systematic antibiotic therapy partly guided by culture results. The patients were divided into two groups according to the irrigation method used: traditional and modified groups. Modified irrigation used an irrigation device made by our hospital, guided by endoscopy, while the patients in the traditional irrigation group used a nasopharyngeal irrigation pot to wash the nasopharynx by themselves each day. Results Survival was affected by ICA (internal carotid artery) exposure, necrosis grade, and re-irradiation, but only ICA exposure and re-irradiation were found to be independent prognostic factors. The modified irrigation had a significantly more positive effect on the recovery rates of patients with mild- and moderate-grade PRNN than did traditional irrigation. The 2-year overall survival (OS) of the 113 patients was 68.4%. The modified irrigation was associated with better OS in the mild- and moderate-grade groups, in the one-course radiotherapy group, and in the low-risk group (according to the 2017 system). Conclusions More intense modified irrigation under the physicians control may be an effective treatment for PRNN, especially mild- and moderate-grade, one-course radiotherapy, or low-risk PRNN.
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Affiliation(s)
- Yun Xiao
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China.,NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China.,Faculty of Medicine, Nanchang University, Nanchang, China
| | - Shiyi Peng
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China
| | - Yiqiang Tang
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China
| | - Honghui Xie
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China
| | - Min Huang
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China
| | - Jing Wang
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China
| | - Xiaochang Gong
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China
| | - Jingao Li
- Department of Radiation Oncology, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China.,NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital of Nanchang University, Nanchang, China.,Faculty of Medicine, Nanchang University, Nanchang, China
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Swathi PS, Raghavendra BR, Saoji AA. Health and therapeutic benefits of Shatkarma: A narrative review of scientific studies. J Ayurveda Integr Med 2021; 12:206-212. [PMID: 33454186 PMCID: PMC8039332 DOI: 10.1016/j.jaim.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 10/20/2020] [Accepted: 11/24/2020] [Indexed: 12/17/2022] Open
Abstract
Shatkarma, also known as Shatkriya are a set of six yogic cleansing techniques described in the Hatha Yoga texts. Several health benefits of these procedures are indicated in the traditional texts of Yoga. However, there is no comprehensive literature about the scientific evidence on Shatkriya. Hence, we searched in PubMed, PubMed Central and Google Scholar databases to review relevant articles in English. The search yielded a total 723 references, published from 1976 to April 2020. Based on the inclusion and exclusion criteria, 37 articles were included in this review. We found scientific studies on four out of six cleansing techniques. The limited evidence on Shatkriya suggests positive effects on various physiological and clinical domains. The practice of dhauti was found to enhance respiratory functions and was useful in digestive disorders. Nasal cleansing, neti was particularly found beneficial in managing the rhinosinusitis in age groups ranging from children to adults. Although trataka practice was found to enhance cognition and bring a state of relaxation, but there was no evidence supporting its role in eye disorders. Kapalabhati practice appears to have a beneficial role in the activation of sympathetic nervous system, enhance cognition, and improve overall metabolism. Further large-scale clinical trials with robust designs are warranted to evaluate the effects of Shatkriya in health and disease.
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Affiliation(s)
- P S Swathi
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bengaluru, 560019, India.
| | - B R Raghavendra
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bengaluru, 560019, India
| | - Apar Avinash Saoji
- Division of Yoga and Life Sciences, Swami Vivekananda Yoga Anusandhana Samsthana (S-VYASA), 19, Eknath Bhavan, Gavipuram Circle, KG Nagar, Bengaluru, 560019, India
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Yin G, Tu B, Ye L. Correlation of intensity-modulated radiation therapy at a specific radiation dose with the prognosis of nasal mucous damage after radiotherapy. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2020; 59:245-255. [PMID: 32030481 DOI: 10.1007/s00411-020-00830-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
Objective of the present study was to investigate the tolerant radiation dose of nasal mucosa by observing and analyzing patients who received intensity-modulated radiation therapy (IMRT). Patients with nasopharyngeal carcinoma (N = 66) were selected for this study. The modified saccharin assay, endoscopy test, magnetic resonance imaging, and sino-nasal outcome test-20 (SNOT-20) survey were performed for the patients before and at 0 (T0), 3 (T1), 6 (T2), and 12 (T3) months after radiotherapy. The threshold doses of IMRT before radiotherapy and at T0, T1, T2, and T3 were determined as, respectively, 37 Gy, 37 Gy, 39 Gy, and 37 Gy for the saccharin test; 38 Gy, 37 Gy, 40 Gy, and 38 Gy for the endoscopy test; and 39 Gy, 37 Gy, 39 Gy, and 39 Gy for the nasal-related symptom scoring test. The modified saccharin assay, endoscopy test, and SNOT-20 survey revealed that a low dose (< threshold dose) of IMRT was associated with higher mucocilia transport rate (MRT), better endoscopy test score, and improved SNOT-20 score. The patients who received IMRT at a dose less than the threshold had the least damaged nasal mucosa morphology, and functional impairment scores were highest at T1 of IMRT. We conclude that nasal mucosa showed the most serious damage within 3 months after IMRT. If the radiation dose can be controlled within the threshold, the nasal mucosa can recover in the following few months, but recovery will be difficult otherwise.
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Affiliation(s)
- Gendi Yin
- Department of Otolaryngology and Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Bo Tu
- Department of Otolaryngology and Head and Neck Surgery, The First Affiliated Hospital of Ji Nan University, Guangzhou, 510632, Guangdong, China
| | - Ling Ye
- Department of Oncology, The First Affiliated Hospital of Ji Nan University, No. 613 Huang Pu Road west, Guangzhou, 510632, Guangdong, China.
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Meera S, Vandana Rani M, Sreedhar C, Robin DT. A review on the therapeutic effects of NetiKriya with special reference to JalaNeti. J Ayurveda Integr Med 2019; 11:185-189. [PMID: 30616871 PMCID: PMC7329727 DOI: 10.1016/j.jaim.2018.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 06/05/2018] [Accepted: 06/08/2018] [Indexed: 12/05/2022] Open
Abstract
Neti kriya is an integral part of shatkarmas/the six cleansing techniques that form the most important aspect of hatha yoga. Neti helps in preventing and managing upper respiratory tract diseases. An attempt is being made to collate and review articles that highlight the therapeutic effects of neti kriya. Databases like PubMed (January 1980–April 2016), Scopus and Ayush Portal were searched. We used keywords like jala neti, neti kriya, neti combined with terms such as yoga, sinusitis, rhinitis, common cold, vision, snoring, nasopharyngeal carcinoma and mental health for the search. As only a few results were obtained, we reviewed relevant studies with saline nasal irrigation. Evidence emerging from this review suggests that neti offers manifold benefits and relief from the antibiotic grip. Most studies support the role of neti in treating sinusitis, rhinosinusitis, allergic conditions and in improving vision. Jala neti has a significant role in improving the presence of mind and intelligence. We identified that it can be applied in mitigating post irradiation rhinosinusitis in nasopharyngeal carcinoma. However, randomized control trials must be conducted to substantiate the therapeutic efficacy of this simple cost-effective, non-pharmacological mode of treatment.
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Affiliation(s)
- S Meera
- Department of Swasthavritta (Social and Preventive Medicine), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, Kerala 690525, India
| | - M Vandana Rani
- Department of Swasthavritta (Social and Preventive Medicine), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, Kerala 690525, India
| | - Cijith Sreedhar
- Department of Swasthavritta (Social and Preventive Medicine), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, Kerala 690525, India
| | - Delvin T Robin
- Department of Swasthavritta (Social and Preventive Medicine), Amrita School of Ayurveda, Amritapuri, Amrita Vishwa Vidyapeetham, Kerala 690525, India.
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Di R, Li G. Use of a Smartphone Medical App Improves Complications and Quality of Life in Patients with Nasopharyngeal Carcinoma Who Underwent Radiotherapy and Chemotherapy. Med Sci Monit 2018; 24:6151-6156. [PMID: 30178780 PMCID: PMC6134889 DOI: 10.12659/msm.908146] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background We explored the intervention effect of a smartphone medical app on complications and quality of life of patients with nasopharyngeal carcinoma who underwent radiotherapy and chemotherapy. Material/Methods We divided 132 patients with nasopharyngeal carcinoma who received radiotherapy and chemotherapy for the first time, in accordance with the random number table method, into a control group (67 patients) and an intervention group (65 patients). Patients in control group were discharged with standard care and patients in the intervention group used a smartphone medical app after discharge. Data on adverse effects of radiotherapy and chemotherapy, complications, and quality of life were collected and analyzed. Results There was no difference between the complications of radiotherapy and chemotherapy and quality of life between the 2 groups at discharge (P>0.05). The incidence of oral mucositis, xerostomia, mouth-opening difficulties, and nasal congestion in the intervention group was significantly lower than in the control group at 6 months after discharge and quality of life was significantly higher than in the control group (P<0.05). Conclusions Reasonable use of this smartphone app can improve the exercise compliance of discharged patients with nasopharyngeal carcinoma who underwent radiotherapy and chemotherapy, reduce the adverse reactions and complications of radiotherapy and chemotherapy, and improve quality of life and satisfaction of patients after discharge.
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Affiliation(s)
- Ruiqing Di
- Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
| | - Guowen Li
- Department of Radiotherapy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China (mainland)
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Antibacterial Effect of Hypochlorous Acid Solution on Nasal Discharge from Patients with Chronic Rhinosinusitis. Int J Otolaryngol 2018; 2018:8568694. [PMID: 29681944 PMCID: PMC5848054 DOI: 10.1155/2018/8568694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 01/31/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose The antibacterial effect of hypochlorous acid (HOCl) solution on nasal secretion of patients with chronic rhinosinusitis (CRS) was investigated. Materials and Methods Five swab specimens were collected from the middle meatus of CRS patients. The first one was placed directly in a Thanswab tube while all of the others were placed randomly into 4 glass tubes containing either HOCl solution, normal saline (NS), 75% alcohol, or povidone-iodine (PVPI) solution for one minute in the first part and for 5 minutes in the second part of the study before transfer to a Thanswab tube. Results Bacteria were cultured from 27 of 50 specimens when they were put directly in a Thanswab tube and from 26 after soaking in HOCl solution, 27 in NS, 13 in 75% alcohol, and 25 in PVPI solution for one minute. In the second part of the study, bacteria were cultured from 14 of 32 specimens when they were put directly in a Thanswab tube and from 14 after soaking in HOCl solution, 13 in NS, 3 in 75% alcohol, and 11 in PVPI solution for 5 minutes. Conclusions This study showed that HOCL solution did not exert an antibacterial effect on nasal secretion from CRS patients within 5 minutes.
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Ayoub N, Walgama E, Thamboo A, Nayak JV, Hwang PH. Efficacy of endoscopic sinus surgery for chronic rhinosinusitis following primary radiotherapy and concurrent chemotherapy for nasopharyngeal carcinoma. Int Forum Allergy Rhinol 2017; 7:1045-1051. [DOI: 10.1002/alr.22002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 05/22/2017] [Accepted: 07/26/2017] [Indexed: 01/24/2023]
Affiliation(s)
- Noel Ayoub
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery; Stanford University School of Medicine; Stanford CA
| | - Evan Walgama
- Division of Otolaryngology, Department of General Surgery; Cedars Sinai Medical Center; Los Angeles CA
| | - Andrew Thamboo
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery; Stanford University School of Medicine; Stanford CA
| | - Jayakar V. Nayak
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery; Stanford University School of Medicine; Stanford CA
| | - Peter H. Hwang
- Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery; Stanford University School of Medicine; Stanford CA
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Nasal Irrigation as Treatment in Sinonasal Symptoms Relief: A Review of Its Efficacy and Clinical Applications. Indian J Otolaryngol Head Neck Surg 2017; 71:1718-1726. [PMID: 31763232 DOI: 10.1007/s12070-017-1070-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 01/09/2017] [Indexed: 10/20/2022] Open
Abstract
Nasal irrigations have been used for centuries without any scientific data to determine its efficacy. Despite their widespread use, much confusion exist about the mechanism of action, preparation, indications and therapeutic advantage of nasal irrigations. Anecdotal evidence and poorly controlled studies add to the confusion. Recent evidence provides strong scientific justification of the benefits and advantages of using nasal irrigations in sinonasal symptoms relief. The present review of the evidence based literature highlights its efficacy and clinical applications.
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Effect of intranasal steroids on rhinosinusitis after radiotherapy for nasopharyngeal carcinoma: clinical study. The Journal of Laryngology & Otology 2016; 130:265-71. [PMID: 26740194 DOI: 10.1017/s0022215115003448] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Post-irradiation rhinosinusitis is one of the most common untoward side effects in patients with nasopharyngeal carcinoma. This study aimed to evaluate the effect of fluticasone propionate aqueous nasal spray on post-irradiation rhinosinusitis. METHODS Nasopharyngeal carcinoma patients who had undergone radiotherapy and subsequently developed chronic rhinosinusitis were randomised to receive either fluticasone propionate aqueous nasal spray 200 µg plus nasal irrigation or a single nasal irrigation, for six months. A questionnaire, nasal endoscopy and computed tomography were used to evaluate rhinosinusitis severity, at the beginning of treatment, and at three and six months after treatment. RESULTS The group who received fluticasone propionate aqueous nasal spray combined with irrigation had fewer nasal complaints (overall symptoms, blocked nose and headache were reduced), a better quality of life and less severe endoscopic findings than those who only received nasal irrigation at three and six months after treatment. CONCLUSION Nasal steroids are a safe and effective therapy for patients with post-irradiation rhinosinusitis.
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Factors influencing the incidence of sinusitis in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy. Eur Arch Otorhinolaryngol 2015; 271:3195-201. [PMID: 24659365 DOI: 10.1007/s00405-014-3004-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
The aim of the study was to investigate the incidence of sinusitis in nasopharyngeal carcinoma (NPC) patients before and after intensity-modulated radiation therapy (IMRT) and to analyze factors associated with the incidence of sinusitis following IMRT. We retrospectively analyzed 283 NPC patients who received IMRT in our hospital from March 2009 to May 2011. The diagnostic criteria for sinusitis are based on computed tomography (CT) or magnetic resonance imaging (MRI) findings. CT or MRI scans were performed before and after IMRT to evaluate the incidence of sinusitis. Factors influencing the incidence of sinusitis were analyzed by log-rank univariate and logistic multivariate analyses. Among the 283 NPC patients, 128 (45.2 %) suffered from sinusitis before radiotherapy. The incidence rates of sinusitis in patients with T1, T2, T3, and T4 NPC before radiotherapy were 22.6, 37.5, 46.8, and 61.3 %, respectively (χ 2 = 14.548, p = 0.002). Among the 155 NPC patients without sinusitis before radiotherapy, the incidence rates of sinusitis at the end of radiotherapy and at 1, 3, 6, 9, 12, and 18 months after radiotherapy were 32.9, 43.2, 61.3, 68.4, 73.5, 69.7, and 61.3 %, respectively (χ 2 = 86.461, p < 0.001). Univariate analysis showed that T stage, invasion of the nasal cavity, nasal irrigation, and radiation dose to the nasopharynx were associated with the incidence of sinusitis in NPC patients after IMRT (p = 0.003, 0.006, 0.002, and 0.020). Multivariate analysis showed that T stage, invasion of the nasal cavity, and nasal irrigation were influential factors for the incidence of sinusitis in NPC patients after IMRT (p = 0.002, 0.002, and 0.000). There was a higher incidence of sinusitis with higher T stage among NPC patients before radiotherapy, and the incidence of sinusitis in NPC patients after IMRT was high (45.2 %). The incidence of sinusitis increased rapidly within the first 3 months after IMRT, and the number of sinusitis cases peaked at 6-9 months after IMRT and showed a trend toward stabilization after 1 year. Advanced T stage, invasion of the nasal cavity, and nasal irrigation were positively associated with the incidence of sinusitis in NPC patients after IMRT.
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Gray ST, Sadow PM, Lin DT, Sedaghat AR. Endoscopic sinus surgery for chronic rhinosinusitis in patients previously treated for sinonasal malignancy. Laryngoscope 2015; 126:304-15. [PMID: 26309057 DOI: 10.1002/lary.25435] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2015] [Indexed: 02/03/2023]
Abstract
OBJECTIVES/HYPOTHESIS Patients with a history of sinonasal malignancy can develop chronic rhinosinusitis (CRS) as a consequence of their oncologic treatment. Some patients will fail medical management and require endoscopic sinus surgery (ESS). This study reviews the use of ESS in the management of CRS in patients previously treated for sinonasal malignancy. STUDY DESIGN Retrospective review. METHODS All patients with a history of sinonasal malignancy who developed CRS and underwent ESS were reviewed. Preoperative and postoperative imaging and symptoms were collected. Major complications (bleeding, orbital injury, and cerebrospinal fluid leak) and minor complications (adhesion formation) and postoperative healing were reviewed. RESULTS Eighteen patients were identified. All patients presented with symptoms of CRS and sinonasal crusting. Additionally, five patients presented with recurrent facial cellulitis, and six patients had mucoceles. No major complications were encountered. Postoperatively, all patients reported a subjective improvement in their sinonasal symptoms. Comparison of pre- and post-ESS imaging revealed a significant improvement in Lund-Mackay scores after ESS (P < 0.001) from 12.8 (range 5-22) to 7 (range). Despite symptomatic improvement, all patients continued to have nasal crusting. All patients who initially presented with recurrent facial cellulitis had no further episodes after ESS. None of the endoscopically drained mucoceles recurred. CONCLUSION For patients previously treated for sinonasal malignancy with refractory CRS, ESS appears to be a safe and effective treatment option. ESS in these patients results in subjective improvement in sinonasal symptoms as well as objective improvement in radiographic CRS disease burden, although sinonasal crusting will likely not resolve. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Stacey T Gray
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology
| | - Peter M Sadow
- Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Derrick T Lin
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology
| | - Ahmad R Sedaghat
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology
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Duan HG, Ji F, Zheng CQ, Wang CH, Li J. Human umbilical cord mesenchymal stem cells alleviate nasal mucosa radiation damage in a guinea pig model. J Cell Biochem 2015; 116:331-8. [PMID: 25209829 DOI: 10.1002/jcb.24975] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 09/05/2014] [Indexed: 01/01/2023]
Abstract
Nasal complications after radiotherapy severely affect the quality of life of nasopharyngeal carcinoma patients, and there is a compelling need to find novel therapies for nasal epithelial cell radiation damage. Therefore, we investigated the therapeutic effect of human umbilical cord mesenchymal stem cells (hUC-MSCs) in guinea pig model of nasal mucosa radiation damage and explored its therapeutic mechanism. Cultured hUC-MSCs were injected intravenously immediately after radiation in the nasal mucosa-radiation-damage guinea pig model. Migration of hUC-MSCs into the nasal mucosa and the potential for differentiation into nasal epithelial cells were evaluated by immunofluorescence. The therapeutic effects of hUC-MSCs were evaluated by mucus clearance time (MCT), degree of nasal mucosa edema, and the nasal mucosa cilia form and coverage ratio. Results indicate that the hUC-MSCs migrated to the nasal mucosa lamina propria and did not differentiate into nasal epithelial cells in this model. The MCT and degree of mucosal edema were improved at 1 week and 1 month after radiation, respectively, but no difference was found at 3 months and 6 months after radiation. The nasal mucosa cilia form and coverage ratio was not improved 6 months after radiation. Thus, hUC-MSCs can migrate to the nasal mucosa lamina propria and improve MCT and mucosa edema within a short time period, but these cells are unable to differentiate into nasal epithelial cells and improve nasal epithelial regeneration in the nasal mucosa radiation damage guinea pig model.
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Affiliation(s)
- Hong-Gang Duan
- Department of Otolaryngology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Chuang JMJ, Lin WC, Fang FM, Huang YJ, Ho JT, Lu CH. Bacterial brain abscess formation in post-irradiated patients: What is the possible pathogenesis? Clin Neurol Neurosurg 2015; 136:132-8. [PMID: 26099700 DOI: 10.1016/j.clineuro.2015.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 05/20/2015] [Accepted: 05/20/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Until recently, post-radiotherapy brain abscess was considered rare, but it has become an increasingly important aetiology. Discussions of the relationship between bacterial brain abscess and radiotherapy (RT) are rare in the literature. Our clinical study was conducted to analyse the role of RT in the pathogenesis of bacterial brain abscess. METHODS For our retrospective study, 146 patients with bacterial brain abscess were recruited. Ten patients with a history of RT before brain abscess formation were reviewed. RESULTS Eight of these patients underwent RT treatment for nasopharyngeal carcinoma, one for olfactory neuroblastoma, and another for nasal plasmacytoma. Three showed presence of temporal lobe radiation necrosis neighbouring abscess. Eight patients were shown to have the evidence of tumour invasion. Seven had evidence of nasal infection or otitis media. Statistically significant differences between the RT and non-RT patients were observed for radionecrosis, bone defects between the middle fossa/sphenoid sinus, and the presence of nasal infection/otitis media. The mortality rate was 30%. CONCLUSION This study shows possible pathogenesis of bacterial brain abscess formation in post-irradiated patients, which is complicated by both radiation effects and tumour effects. Skull base deficits (either from tumour erosion or osteonecrosis) and nasal/ear infection were significantly different in patients who received radiation vs. those who did not. Radiation-related temporal lobe necrosis was also a predisposing factor. Further study based on a proper patient cohort is warranted.
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Affiliation(s)
- Jimmy Ming-Jung Chuang
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wei-Che Lin
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Department of Radio-oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yu-Jie Huang
- Department of Radio-oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jih-Tsun Ho
- Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Cheng-Hsien Lu
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Biological Science, National Sun Yat-Sen University, Kaohsiung, Taiwan; Department of Neurology, Xiamen Chang Gung Memorial Hospital, Xiamen, Fujian, China.
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Post-irradiation otitis media, rhinosinusitis, and their interrelationship in nasopharyngeal carcinoma patients treated by IMRT. Eur Arch Otorhinolaryngol 2015; 273:471-7. [DOI: 10.1007/s00405-015-3518-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 01/18/2015] [Indexed: 10/24/2022]
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Xiang L, Fa-ya L, Ping H, Hua Z, Qiu-jian C, Xiao-yu J, Rui-Chen L, Xiao-Ming H. Management of radiation-induced early nasal adhesion after radiotherapy for nasopharyngeal carcinoma. Am J Rhinol Allergy 2013; 27:e82-4. [PMID: 23883797 DOI: 10.2500/ajra.2013.27.3915] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study investigates the conservative management of radiation-induced early nasal adhesion after radiotherapy for nasopharyngeal carcinoma (NPC). METHODS From June 2008 to June 2010, patients with bilateral or unilateral early nasal adhesion after radiotherapy for NPC were selected. All patients received endoscopic management and then nasal irrigation daily and nasal steroids spray for at least 3 months. All of the clinical data and follow-up endoscopy were analyzed. RESULTS There were 40 patients enrolled. The mean follow-up period was 19.6 months (range, 12-24 months) after procedure. Thirty-eight patients (95%) had patent nasal cavity during follow-up. Two patients (5%) had not received endoscopy regularly and developed severe fibrosis. For the whole group, nasal obstruction, rhinorrhea, hyposmia, and xerostomia all were improved from before management according to visual analog score (p < 0.05). CONCLUSION Therapeutic endoscopy in combination with nasal steroid sprays and nasal irrigation provides a convenient, simple, effective, and minimally invasive therapy to treat early radiation-induced nasal adhesion patients.
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Affiliation(s)
- Liu Xiang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People's Republic of China
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Comparison of otologic complications between intensity-modulated and two-dimensional radiotherapies in nasopharyngeal carcinoma patients. Otolaryngol Head Neck Surg 2010; 143:662-8. [DOI: 10.1016/j.otohns.2010.07.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 06/08/2010] [Accepted: 07/19/2010] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate the otologic complications in patients with nasopharyngeal carcinoma (NPC) who were treated by intensity-modulated radiotherapy (IMRT) and compared with those who were treated by two-dimensional radiotherapy (2DRT). STUDY DESIGN A historical cohort study was performed comprising NPC patients who underwent IMRT or 2DRT at Chung Shan Medical University Hospital. SETTING Chung Shan Medical University Hospital. SUBJECTS AND METHODS Twenty-six NPC patients treated by IMRT (group A) and 18 NPC patients treated by 2DRT (group B) were enrolled. All patients underwent otoscopy, audiometry, and a vestibular-evoked myogenic potential (VEMP) test at a mean interval of three years after irradiation. RESULTS Although groups A and B did not significantly differ in the occurrence rate of otitis media with effusion (OME), group B had a significantly greater occurrence rate of chronic otitis media than group A ( P < 0.05, χ2 test). The incidences of high-frequency sensorineural hearing loss were 46 percent in group A and 67 percent in group B, with no significant difference between the two. In terms of VEMPs, group A had a significantly lower abnormal rate (31%) than group B (61%; P < 0.05, χ2 test). In addition, a significant relationship existed between T stages and OME in NPC patients treated by IMRT ( P < 0.01, Fisher-Freeman-Halton test) but not by 2DRT. CONCLUSION The incidence of chronic otitis media and abnormal VEMPs in NPC patients treated by IMRT were significantly lower when compared with those treated by 2DRT, demonstrating the superiority of IMRT in decreasing unwanted otologic complications. However, occurrence of OME, which was related with advanced T stage, cannot be reduced by IMRT.
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Liang KL, Jiang RS, Lin JC, Chiu YJ, Shiao JY, Su MC, Hsin CH. Central nervous system infection in patients with postirradiated nasopharyngeal carcinoma: a case-controlled study. Am J Rhinol Allergy 2009; 23:417-21. [PMID: 19671259 DOI: 10.2500/ajra.2009.23.3336] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND It has been assumed that postirradiated nasopharyngeal carcinoma (NPC) patients are prone to central nervous system (CNS) infection. OBJECTIVE The purpose of this study was to better understand this clinical entity. METHODS From September 1989 to May 2006, we conducted a retrospective study of 18 postirradiated NPC patients with CNS infection including brain abscess, cavernous sinus thrombosis, epidural abscess, and meningitis in our institute. During the same period, 18 NPC patients without CNS infection who were matched for tumor stage, age, and gender with the study group were randomly selected from the cancer registry at our hospital and enrolled as the control group. All medical records of these patients were evaluated. RESULTS The local tumor relapse rate, nasopharyngeal radiotherapy dose, and skull base osteoradionecrosis were all significantly higher in patients with CNS infection (p = 0.003, 0.011, and 0.001, respectively). Although the incidences of otitis media and chronic rhinosinusitis were higher in patients with CNS infection, there were no significant differences between the two groups (p = 0.469 and 0.568, respectively). The in-hospital mortality was 61.1%, and the overall mortality of CNS infection was 83.3%. There was a significant difference in overall survival rate between the two groups (p = 0.001). CONCLUSIONS Postirradiated NPC patients with skull base osteoradionecrosis are prone to have CNS infection. CNS infection is an adverse prognostic factor in postirradiated NPC patients.
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Affiliation(s)
- Kai-Li Liang
- Department of Otolaryngology, Taichung Veterans General Hospital, Taichung, Taiwan.
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