Acoustic Rhinometry-Predictive Value in Septal and Turbinate Surgery

Endonasal Sinus Surgery Improves Mucociliary Transport in Severe Chronic Sinusitis

A total of 22 patients with extensive chronic sinusitis were examined before and 7.2 ± 1.1 months after microscopic endonasal sinus surgery. Pre- and postoperative nasal mucociliary transport was measured using a modified saccharine test and ciliary beat frequency of nasal respiratory cells using video interference contrast microscopy. In patients suffering from chronic sinusitis, nasal ciliary beat frequency was significantly lower (8.0 ± 1.8 Hz) than in normals (9.5 ± 1.7 Hz, p < 0.02). Following endonasal sinus surgery, ciliary beat frequency in patients with chronic sinusitis remained reduced (8.3 ± 1.2 Hz). Nasal mucociliary transport time was significantly (p < 0.05) longer (20…

Respiratory epithelium exposed to sulfur dioxide--functional and ultrastructural alterations.

The value of morphological investigations of airway mucosa should be compared to a functional method when estimating the toxicity of airborne pollutants. In 34 guinea pig tracheas, mucociliary activity was measured using a modified light beam reflex method before and following exposure to sulfur dioxide for 30 minutes in concentrations ranging between 7.5 and 37.5 mg/m3. Exposure to air served as a control. Simultaneously, specimens were taken for light and electron microscopy. Mucociliary activity decreased from 8.4 +/- 2.9 Hz (control exposure) to 4.0 +/- 2.9 Hz following exposure to 7.5 mg/m3, to 3.4 +/- 2.7 Hz at 15 mg/m3 sulfur dioxide, to 1.8 +/- 2.2 Hz at 22.5 mg/m3 sulfur dioxide, t…

Von Willebrand-Syndrom - Blutungsrisiko bei HNO-Eingriffen im Kindesalter

Von Willebrand's disease (vWD) is the most common inherited bleeding disorder. Typical clinical features such as bleeding after surgery or trauma might suggest the disease. We present a series of 24 patients with vWD treated between 1989 and 1992. Diagnosis was confirmed by a reduction in plasma factor VIII antigen concentration, reduction of ristocetin cofactor activity and reduced factor VIII activity. Seventeen of the patients underwent surgery (7 adenoidectomies, 8 tonsillectomies, 2 paranasal sinus operations) and received preoperative stimulation of von Willebrand factor (vWF) using DDAVP. This resulted in a rapid increase in plasma vWF concentration from an average of 56% before stim…

An experimental model for the exposure of human ciliated cells to sulfur dioxide at different concentrations

Mucociliary transport is an important nonimmunological defense mechanism of the respiratory tract. The aim of this study was to investigate the effect of sulfur dioxide (SO2) at different concentrations on ciliary beat frequency (CBF). Ciliated cells were obtained from 12 volunteers by nose brush. CBF was quantified using video-interference microscopy. The cells were placed on a polycarbonate membrane in contact with the surface of a reservoir filled with RPMI 1640 (bicarbonate buffered) or Ringer's (electrolyte) solution, allowing the cells to be supplied by capillarity. In an exposure chamber the cells were exposed for 30 min to SO2 2.5-12.5 ppm at 37 degrees C and 100% air humidity. SO2 …

Eosinophil Cationic Protein in Nasal Secretions and Blood Serum in Grass-Pollen Allergic Rhinitis

Concentration of the Eosinophil Cationic Protein (ECP) measured in different body fluids has been demonstrated to be a good marker of eosinophilic inflammation. In allergic asthma, ECP levels in both broncho-alveolar-lavage (BAL) fluid and serum can be used to monitor disease activity. In allergic rhinitis, the value of ECP determinations in serum and nasal secretions was not directly compared, so far. In the present study, ECP levels in blood serum (Se) and nasal secretions (NS) of grass pollen allergic and healthy individuals under pollen exposure were analyzed. Forty-three grass-pollen allergic subjects and 19 healthy volunteers were included. Grass-pollen counts were measured using Bur…

Objective measures of nasal function

Numerous techniques to objectively measure nasal function are available to the rhinologic surgeon. Rhinomanometry, acoustic rhinometry, laser Doppler flowmetry, saccharin transport time, determination of ciliary beat frequency, and olfactory and trigeminal event-related potentials are all techniques in current use. Rhinomanometry is the standard clinical tool used to indicate those patients complaining of nasal obstruction who are likely to benefit from septal and turbinate surgery. Acoustic rhinometry permits the precise localization of nasal stenoses and is the best predictor of a patient's postoperative satisfaction. It is, in addition, more sensitive than rhinomanometry in recording cha…

The influence of Ca2+ antagonists on the ciliary activity of the guinea pig trachea.

The ciliary activity of the guinea pig tracheal respiratory epithelium was measured using a photoelectric device. Fourteen animals were administered 75 mg diltiazem/kg body weight 2 days, 1 day and 4 h prior to the investigation. Thirteen animals served as controls. In the pretreated group, the mean ciliary stroke frequency (13.4 +/- 3.0 Hz) was significantly lower (P = 0.02) than in the control group (16.6 +/- 3.7 Hz). The application of aerosolized 0.3 mmol/l nifedipine solution on the tracheal preparations of the control animals also significantly reduced the stroke frequency (P = 0.02). The ciliary activity never dropped beyond a frequency of about 8 Hz. The most probable interpretation…

Modifications of a nerve integrity monitor useful in skull base surgery.

Effect of sulfur dioxide on mucociliary activity and ciliary beat frequency in guinea pig trachea

The effects of 30 min exposure to sulfur dioxide on mucociliary activity (MCA) and ciliary beat frequency (CBF) were studied in 31 guinea pig tracheas. MCA was measured by recording the light reflected from ciliated mucous membranes using an infrared bar code reader. CBF of single ciliated cells obtained by brushing was measured with phase-contrast microscopy. Each tracheal sample was exposed to SO2 at concentrations ranging from 2.5 to 12.5 ppm, or to air for control purposes. MCA and CBF were measured before and immediately after gas exposure. A reduction in mean MCA of 63% (P = 0.0007) and statistically insignificant changes in CBF (P > 0.05) were recorded at concentrations of 2.5 PPM SO…

Autonomic regulation of nasal vessels during changes in body position

The effects of postural changes on nasal airflow and nasal capillary blood flow were investigated in 15 healthy volunteers. Measurements were performed following nasal application of saline solution (control), the alpha-1 receptor antagonist prazosin, the alpha-2 receptor antagonist yohimbine, and after application of both prazosin and yohimbine. Nasal airflow in the control experiments did not significantly differ in the upright (362 +/- 166 ml/s), dorsally recumbent (350 +/- 167 ml/s) and 70 degrees head down position (311 +/- 167 ml/s). Following application of prazosin, nasal airflow was reduced to 223 +/- 121 ml/s in the upright position. Prazosin treatment significantly reduced nasal …

Diltiazem for Prevention of Acoustical Trauma during Otologic Surgery

100 patients were tested in a prospective, randomized, double-blinded study to assess the perioperative efficacy of a calcium channel blocker (diltiazem) in preventing acoustical trauma during otologic surgery. The patients were randomly divided into a therapy group (diltiazem) and a control group (placebo). Bone conduction hearing thresholds were examined preoperatively and again 1 day and 3 months postoperatively. Frequency-dependent changes in postoperative bone conduction and the number of patients with various degrees of postoperative hearing loss in both groups were statistically analyzed. The results indicated only a small postoperative hearing loss after ear surgery in both groups. …

EAACI Position paper on the standardization of nasal allergen challenges.

DR. FARID, S.H. M.H. M. Kn. - FR FARID/0000-0003-0372-4963; Gevaert, Philippe/0000-0002-1629-8468; Hox, Valerie/0000-0003-2390-294X; Wagenman, Martin/0000-0002-9734-0241; Vent, Julia/0000-0001-5071-9580 WOS: 000438710600002 PubMed: 29377177 Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differ…

Increased in vitro cvsteinvl leukotriene release from blood leukocytes in patients with asthma, nasal polyps, and aspirin intolerance

In vitro cysteinyl leukotriene (cLT) release from blood leukocytes was measured in eight normal individuals (NI), nine patients with nasal polyps (NP) without aspirin intolerance, and eight patients with NP, asthma, and aspirin intolerance (AI). Blood leukocytes were prestimulated with interleukin-3 (IL-3) and incubated with acetylsalicylic acid (ASA) (10 and 100 micrograms/ml) together with C5a (10(-8) mol/l) for 18 h. cLT release (LTC4, LTD4 and LTE4) from blood leukocytes was measured with a competitive enzyme-linked immunoassay. Background cLT release was 259 +/- 66 pg/ml (mean +/- SEM) in the NI group, 185 +/- 33 pg/ml in the NP group, and 578 +/- 136 pg/ml in the AI group (P = 0.1). A…

Measurement of Pharyngeal Pressure in Patients using Nasal CPAP

In patients with obstructive sleep apnea syndrome (OSAS), nasal continuous positive airway pressure (nCPAP) prevents pharyngeal collapse by applying positive pressure transnasally. Currently there are not objective criteria to determine whether surgical improvement of nasal resistance is necessary in patients undergoing nCPAP treatment. In 16 patients with documented OSAS, inspiratory and expiratory pressures in the pharynx were measured during nCPAP with pressures ranging from 5 to 20 mbar. Identical studies were performed in 12 patients with severe nasal obstruction without OSAS and in eight normal patients. The results of each group were compared to the nasal resistance as measured by a…

Sinusitis in Thyroid Associated Ophthalmopathy

In 19 patients with thyroid associated ophthalmopathy undergoing orbital decompression, histologic examination of paranasal sinus mucosa revealed moderate to severe inflammatory alterations in all patients. Only 2/19 patients had a history of chronic sinusitis. In 4/19 patients, mucosal abnormalities of the paranasal sinuses were found on preoperative computed tomography CT scans. Postoperatively, 10/19 patients developed purulent sinusitis. It is suggested that patients suffering from thyroid associated ophthalmopathy have an increased incidence of histologically detectable inflammatory changes of paranasal sinus mucosa. Because of preexisting mucosal inflammation, these patients are pron…

Real-life assessment of chronic rhinosinusitis patients using mobile technology: the mySinusitisCoach project by EUFOREA

Abstract Background Chronic rhinosinusitis (CRS) is a chronic inflammatory disease associated with a substantial personal and socioeconomic burden. Monitoring of patient‐reported outcomes by mobile technology offers the possibility to better understand real‐life burden of CRS. Methods This study reports on the cross‐sectional evaluation of data of 626 users of mySinusitisCoach (mSC), a mobile application for CRS patients. Patient characteristics of mSC users were analysed as well as the level of disease control based on VAS global rhinosinusitis symptom score and adapted EPOS criteria. Results The mSC cohort represents a heterogeneous group of CRS patients with a diverse pattern of major sy…