Science.gov

Sample records for daily azelastine nasal

  1. Effectiveness of twice daily azelastine nasal spray in patients with seasonal allergic rhinitis

    PubMed Central

    Horak, Friedrich

    2008-01-01

    Azelastine nasal spray (Allergodil®, Lastin®, Afluon®; Meda AB, Stockholm, Sweden) is a fast-acting, efficacious and well-tolerated H1-receptor antagonist for the treatment of rhinitis. In addition it also has mast-cell stabilizing and anti-inflammatory properties, reducing the concentration of leukotrienes, kinins and platelet activating factor in vitro and in vivo, as well as inflammatory cell migration in rhinitis patients. Well-controlled studies in patients with seasonal allergic rhinitis (SAR), perennial rhinitis (PR) or vasomotor rhinitis (VMR) confirm that azelastine nasal spray has a rapid onset of action, and improves nasal symptoms associated with rhinitis such as nasal congestion and post-nasal drip. Azelastine nasal spray is effective at the lower dose of 1 spray as well at a dose of 2 sprays per nostril twice daily, but with an improved tolerability profile compared to the 2-spray per nostril twice daily regimen. Compared with intranasal corticosteroids, azelastine nasal spray has a faster onset of action and a better safety profile, showing at least comparable efficacy with fluticasone propionate (Flonase®; GSK, USA), and a superior efficacy to mometasone furoate (Nasonex®; Schering Plough, USA). In combination with fluticasone propionate, azelastine nasal spray exhibits greater efficacy than either agent used alone, and this combination may provide benefit for patients with difficult to treat seasonal allergic rhinitis. In addition, azelastine nasal spray can be used on an as-needed basis without compromising clinical efficacy. Compared with oral antihistamines, azelastine nasal spray also demonstrates superior efficacy and a more rapid onset of action, and is effective even in patients who did not respond to previous oral antihistamine therapy. Unlike most oral antihistamines, azelastine nasal spray is effective in alleviating nasal congestion, a particularly bothersome symptom for rhinitis sufferers. Azelastine nasal spray is well tolerated

  2. Efficacy and safety of azelastine 0.15% nasal spray administered once daily in subjects with seasonal allergic rhinitis.

    PubMed

    van Bavel, Julius; Howland, William C; Amar, N J; Wheeler, William; Sacks, Harry

    2009-01-01

    Azelastine nasal spray is commercially available as a 0.1% w/v solution and is recommended for twice-daily dosing. Increasing the azelastine concentration to 0.15% may be effective with once-daily dosing without increasing the incidence of adverse events. This study evaluated the efficacy and safety of azelastine 0.15% nasal spray at a dosage of 2 sprays/nostril once daily. This randomized, double-blind, placebo-controlled study was conducted in subjects with moderate-to-severe seasonal allergic rhinitis (SAR) during the 2007/2008 Texas Mountain Cedar season. In total, 536 subjects were randomized to 2 sprays/nostril once daily (A.M.) of azelastine 0.15% or placebo. The primary efficacy variable was change from baseline in a 12-hour reflective Total Nasal Symptom Score (TNSS), consisting of nasal congestion, runny nose, itchy nose, and sneezing. The key secondary variable was change from baseline in 24-hour instantaneous TNSS, which determines the duration of action and effective dosing interval. After 2 weeks, the mean improvement in 12-hour reflective TNSS and percentage improvement in 12-hour reflective TNSS were significant (p < 0.001) with azelastine 0.15% (19%) compared with placebo (10%). The improvement in 24-hour instantaneous TNSS also was significant (p < 0.001) for azelastine 0.15% compared with placebo, supporting efficacy with once-daily dosing. All individual TNSS symptoms were significantly (p < 0.01) improved with azelastine 0.15% compared with placebo. With the exception of bitter taste (4.5%) and nasal discomfort (4.5%), adverse events with azelastine 0.15% were reported with an incidence similar to placebo. Azelastine 0.15% nasal spray was effective and well tolerated in subjects with SAR with once-daily dosing.

  3. Efficacy and safety of azelastine 0.15% nasal spray administered once daily in patients with allergy to Texas mountain cedar pollen.

    PubMed

    Howland, William C; Amar, Niran J; Wheeler, William; Sacks, Harry

    2011-01-01

    A previous study with azelastine nasal spray in patients with seasonal allergic rhinitis (SAR) demonstrated that increasing the azelastine concentration from 0.1% to 0.15% allowed for once-daily dosing without increasing the incidence of adverse effects. This study evaluated the efficacy of azelastine 0.15% nasal spray administered once daily for treating symptoms of SAR. In this 14-day, randomized, double-blind, placebo-controlled study, patients with moderate-to-severe SAR were randomized to azelastine 0.15% (n = 251) or placebo (n = 255), both at a dosage of 2 sprays/nostril once daily. The primary efficacy variable was change from baseline in the 12-hour reflective Total Nasal Symptom Score (TNSS). Key secondary variables were change from baseline in 24-hour instantaneous TNSS, to establish the dosing interval, and change from baseline in the Total Ocular Symptom Score (TOSS). The mean improvement (3.57) and percentage improvement (19.3%) in 12-hour reflective TNSS was significant (p < 0.012) with azelastine 0.15% compared to placebo (2.14 and 11.4%, respectively). The mean improvement in 24-hour instantaneous TNSS was also significant (p < 0.001) for azelastine 0.15% compared to placebo, indicating efficacy with once-daily dosing. The overall improvement and percentage improvement in TOSS was significant (p ≤ 0.012) with azelastine 0.15% (2.21 and 16.7%, respectively) compared to placebo (1.28 and 6.0%, respectively). The overall score for the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was significantly (p < 0.001) improved from baseline in the azelastine group compared with the placebo group. Nasal discomfort (3.6%) and bitter taste (2.4%) were the most common adverse events. There were no reports of somnolence with azelastine. Azelastine 0.15% was effective and well tolerated with once-daily dosing. Azelastine 0.15% nasal spray significantly improved a complex of eye symptoms compared to placebo. Copyright © 2011 American Rhinologic Society

  4. Efficacy and safety of azelastine 0.15% nasal spray and azelastine 0.10% nasal spray in patients with seasonal allergic rhinitis.

    PubMed

    Shah, Shailen; Berger, William; Lumry, William; La Force, Craig; Wheeler, William; Sacks, Harry

    2009-01-01

    Azelastine is a second-generation antihistamine approved for treatment of allergic rhinitis. This randomized, double-blind, placebo- and active-controlled, parallel-group clinical trial evaluated the efficacy and safety of azelastine 0.15% and azelastine 0.10% nasal spray at a dosage of 2 sprays/nostril twice daily in patients with moderate-to-severe seasonal allergic rhinitis (SAR). In total, 526 patients were randomized 1:1:1 to treatment with 2 sprays/nostril twice daily of azelastine 0.15%, azelastine 0.10%, or placebo. The primary efficacy variable was change from baseline in 12-hour reflective Total Nasal Symptom Score (TNSS; A.M. and P.M. combined), consisting of nasal congestion, rhinorrhea, itchy nose, and sneezing. After 2 weeks, the mean improvement and percentage improvement in the 12-hour reflective TNSS were significant (p < 0.001) with azelastine 0.15% and azelastine 0.10% compared with placebo. In a retrospective analysis, there was a statistical difference (p = 0.047) in the mean improvement versus placebo in the 12-hour reflective TNSS with azelastine 0.15% compared with azelastine 0.10%. Onset of action with azelastine 0.15% was within 30 minutes. Bitter taste was the most common adverse event with both azelastine 0.15% and azelastine 0.10% (8.4% and 9.4% of patients, respectively). Somnolence was reported by 1.7% of patients treated with azelastine 0.15%, 0.6% of patients treated with azelastine 0.10%, and 0.6% of patients treated with placebo. Azelastine 0.15% nasal spray at 2 sprays/nostril twice daily significantly improved the nasal symptoms associated with SAR with an onset of action within 30 minutes and was well tolerated.

  5. Azelastine Nasal Spray

    MedlinePlus

    ... and replace with the pump unit. Prime the delivery system (pump unit) with four sprays or until a fine mist appears. If 3 days or more have elapsed since your last use of the nasal spray, reprime the pump with two sprays or until a fine mist appears.

  6. Double-blind, placebo-controlled study of azelastine and fluticasone in a single nasal spray delivery device.

    PubMed

    Hampel, Frank C; Ratner, Paul H; Van Bavel, Julius; Amar, N J; Daftary, Pramila; Wheeler, William; Sacks, Harry

    2010-08-01

    A proof-of-concept study suggested that combination therapy with commercial azelastine hydrochloride nasal spray and fluticasone propionate nasal spray significantly improved nasal symptoms of seasonal allergic rhinitis compared with either agent alone. To compare an azelastine-fluticasone combination nasal spray administered in a single-delivery device with a commercially available azelastine nasal spray and fluticasone nasal spray. This 14-day, multicenter, randomized, double-blind study was conducted during the Texas mountain cedar season. After a 5-day placebo lead-in, 610 patients with moderate-to-severe nasal symptoms were randomized to treatment with (1) azelastine nasal spray, (2) fluticasone nasal spray, (3) combination azelastine and fluticasone nasal spray, or (4) placebo nasal spray. All treatments were given as 1 spray per nostril twice daily. The primary efficacy variable was the change from baseline in the total nasal symptom score (TNSS), consisting of nasal congestion, runny nose, itchy nose, and sneezing. All 3 active groups were statistically superior (P azelastine-fluticasone, 20.4% with fluticasone, 16.4% with azelastine, and 11.2% with placebo. All 3 treatments were well tolerated. The combination azelastine-fluticasone nasal spray provided statistically significant improvement in the TNSS and additive clinical benefit compared with either agent alone in patients with moderate-to-severe seasonal allergic rhinitis. clinicaltrials.gov Identifier: NCT00660517. Copyright 2010 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Effectiveness of azelastine nasal spray in the treatment of adenoidal hyper-trophy in children

    PubMed Central

    Berkiten, G; Kumral, TL; Çakır, O; Yıldırım, G; Salturk, Z; Uyar, Y; Atar, Y

    2014-01-01

    Aim: To evaluate the effects of topical azelastine treatment on symptoms related to adenoid hypertrophy and the size of adenoid tissue in children. Material and Methods: In total, 60 children who were found to have adenoid hypertrophy were included. A questionnaire on nasal symptoms, nasal endoscopy and skin prick tests was administered to all patients. All patients had complaints of chronic nasal obstruction symptoms and nasal endoscopy showed > 75% choanal obstruction, attributable to adenoid pads. The adenoid/nasopharyngeal areas were calculated. All of the patients underwent azelastine nasal spray therapy (1 spray per nostril, twice daily; 0.28 mg/dose) for 30 days. After 1 month, all children were reassessed. The efficacy of therapy, symptoms, adenoid / nasopharynx ratio, and obstruction ratio, obtained by endoscopy, were compared. Results: Azelastine treatment was well tolerated by all patients. After the first treatment period, the severity of symptoms, endoscopic grade, and adenoid size decreased in all of the 60 patients. There were significant improvements in total subjective symptoms (nasal obstruction, rhinorrhea, cough, snoring, and obstructive sleep apnea) post-treatment. Conclusions: Azelastine nasal spray may be useful in decreasing adenoid pad size and the severity of symptoms related to adenoidal hypertrophy. Hippokratia 2014; 18 (4): 340-345. PMID:26052201

  8. Effect of topical nasal azelastine on the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.

    PubMed

    Golden, S; Teets, S J; Lehman, E B; Mauger, E A; Chinchilli, V; Berlin, J M; Kakumanu, S; Lucus, T; Craig, T J

    2000-07-01

    Recent data suggested that daytime somnolence in patients with allergic rhinitis was secondary to disrupted sleep caused by nasal congestion. Medications, which decreased congestion, would be expected to improve sleep and daytime somnolence. Previously, we demonstrated that nasal steroids improved all three symptoms. The effect of topical nasal antihistamines on these symptoms has yet to be studied. The objective of this 8-week, double-blind, placebo-controlled study was to determine whether topical nasal azelastine was effective at decreasing congestion, daytime somnolence, and improving sleep. We recruited 24 subjects with perennial allergic rhinitis and randomized them in a double-blinded, crossover fashion, to receive placebo or azelastine two sprays BID, using Balaam's design. Questionnaires, daily diary, and Epworth Sleepiness Scale were used as tools. The last 2 weeks of each 4-week treatment period were summarized, scored, and compared by PROC MIXED in SAS. The analysis of the Rhinitis Severity Score showed significant improvement only of rhinorrhea in the azelastine group (P = .03). The symptom severity of nasal congestion and daytime somnolence was not significantly different between placebo and azelastine. Subjects considered azelastine effective at improving their sleep (P = .04), but daytime somnolence (P = .06) and congestion (P = .09) were not statistically improved. Azelastine is effective in reducing rhinorrhea and improving sleep quality. We were unable to demonstrate that azelastine can significantly reduce the severity of congestion or daytime somnolence.

  9. Double-blind, placebo-controlled trial of reformulated azelastine nasal spray in patients with seasonal allergic rhinitis.

    PubMed

    Bernstein, Jonathan A; Prenner, Bruce; Ferguson, Berrylin J; Portnoy, Jay; Wheeler, William J; Sacks, Harry J

    2009-01-01

    Azelastine nasal spray is a topical antihistamine with a distinctive taste that may be objectionable to some patients. The primary objectives of this clinical trial were (1) to determine if a reformulated azelastine nasal spray (Astepro) with sucralose as a taste-masking agent provides comparable efficacy to the original formulation (Astelin) and (2) to evaluate dose-response relationships between groups. Eight hundred thirty-five patients with seasonal allergic rhinitis were randomized to six treatment groups: (1) original azelastine nasal spray, 1 spray/nostril b.i.d.; (2) reformulated azelastine, 1 spray/nostril b.i.d.; (3) placebo, 1 spray/ nostril b.i.d.; (4) original azelastine nasal spray, 2 sprays/nostril b.i.d., (5) reformulated, 2 sprays/nostril b.i.d.; and (6) placebo, 2 sprays/nostril b.i.d. The primary efficacy variable was the change from baseline to day 14 in total nasal symptom score (TNSS) consisting of runny nose, sneezing, itchy nose, and nasal congestion. Original azelastine nasal spray and the reformulated spray produced comparable improvements in the TNSS at both dosages. There was a dose-related difference in TNSS comparing the 1- and 2-spray dosages. The percentage changes from baseline in the TNSS in the 2-sprays/nostril dosage groups were 27.9% (p<0.001) with the reformulated nasal spray, 23.5% (p<0.01) with the original formulation, and 15.4% with placebo. The incidence of bitter taste was 7% with the reformulated spray and 8% with the original at the 2-sprays/nostril dosage. The results of this study showed efficacy both with original azelastine nasal spray and with the reformulated nasal spray and a clear dose-response difference between the 1- and 2-spray dosages.

  10. Effect of budesonide and azelastine on histamine signaling regulation in human nasal epithelial cells.

    PubMed

    Liu, Shao-Cheng; Lin, Chun-Shu; Chen, Shyi-Gen; Chu, Yueng-Hsiang; Lee, Fei-Peng; Lu, Hsuan-Hsuan; Wang, Hsing-Won

    2017-02-01

    Both glucocorticoids and H1-antihistamines are widely used on patients with airway diseases. However, their direct effects on airway epithelial cells are not fully explored. Therefore, we use the primary culture of human nasal epithelial cells (HNEpC) to delineate in vitro mucosal responses to above two drugs. HNEpC cells were cultured with/without budesonide and azelastine. The growth rate at each group was recorded and measured as population double time (PDT). The histamine1-receptor (H1R), muscarinic1-receptor (M1R) and M3R were measured using immunocytochemistry and western blotting after 7-days treatment. Then, we used histamine and methacholine to stimulate the mucus secretion from HNEpC and observed the MUC5AC expression in culture supernatants. Concentration-dependent treatment-induced inhibition of HNEpC growth rate was observed. Cells incubated with azelastine proliferated significantly slower than that with budesonide and the combined use of those drugs led to significant PDT prolong. The immunocytochemistry showed the H1R, M1R and M3R were obviously located in the cell membrane without apparent difference after treatment. However, western blotting showed that budesonide can significantly up-regulate the H1R, M1R and M3R level while azelastine had opposite effects. Histamine and methacholine stimulated MUC5AC secretion was greater in cells treated with budesonide but was lesser in those treated with azelastine, as compared to controls. Our data suggest that both budesonide and azelastine can significantly inhibit HNEpC proliferation, and therefore, be helpful in against airway remodeling. Long-term use of budesonide might amplify histamine signaling and result in airway hyperreactivity to stimulants by enhancing H1R, M1R and M3R expression while azelastine can oppose this effect. Therefore, combined use of those two drugs in patients with chronic inflammatory airway diseases may be an ideal option.

  11. [Investigation of the efficacy and tolerability of azelastine nasal spray versus ebastine tablets in patients with seasonal allergic rhinitis].

    PubMed

    Antépara, I; Jaúregui, I; Basomba, A; Cadahia, A; Feo, F; García, J J; Gonzalo, M A; Luna, I; Rubio, M; Vázquez, M

    1998-01-01

    The efficacy and safety of the nasally administered histamine H1 receptor blocking drug Azelastine was investigated in an open, multicenter, randomized comparative trial with Ebastine in seasonal allergic rhinitis. 110 patients in two parallel groups were treated for 14 days and efficacy was assessed by the physician using a rating scale measuring 10 nasal and ocular symptoms of seasonal rhinitis (0 = absent, 1 = mild, 2 = moderate, 3 = severe). Tolerability was measured on the basis of reported adverse events. Both treatment groups had dramatic reductions in the physician's total symptom score following treatment (p < 0.0005). There was no significant difference between the two groups. Changes in individual rhinitis symptoms showed no differences between the two groups. During treatment, 19 patients had at least one adverse event, 13 in Azelastine group and 6 in Ebastine group; all were mild. The most frequent adverse events reported were somnolence (4 cases in Ebastine group) and a bitter taste (4 patients in the Azelastine group). In conclusion, the results of the study on 110 patients suggest that both Azelastine and Ebastine are effective treatments of the symptoms of seasonal allergic rhinitis. Both drugs were well tolerated.

  12. Azelastine and budesonide (nasal sprays): Effect of combination therapy monitored by acoustic rhinometry and clinical symptom score in the treatment of allergic rhinitis

    PubMed Central

    Fabbri, Natalia Zanellato; Abib-Jr, Eduardo

    2014-01-01

    The aim of this study was to objectively evaluate the effects of intranasal therapy with azelastine (AZE), budesonide (BUD), and combined AZE plus BUD (AZE/BUD) using a nasal provocation test (NPT) and acoustic rhinometry in patients with allergic rhinitis. A randomized, single-blind, crossover study with three treatment sequences was used. Thirty patients with persistent AR received the three treatments using a nasal spray twice daily for 30 days and were evaluated by an NPT with histamine before and after each period of treatment. The treatment comparison, assessed by the nasal responsiveness to histamine, was monitored based on subjective (symptom score) and objective parameters (acoustic rhinometry). The minimal cross-area 2 (MCA2) was measured by acoustic rhinometry at 1, 4, 8, and 12 minutes after NPT for each histamine concentration administered (0.5, 1, 2, 4, and 6 mg/mL) up to at least a 20% reduction in the MCA2 from baseline (NPT20). The subjects were scored regarding nasal response encompassing histamine dose and time after histamine administration that caused nasal obstruction (NPT20 score) to assess the treatments' effects. Combination therapy produced a significant increase in baseline MCA2, viz., the improvement of nasal patency (p = 0.005). The symptoms score was significantly decreased after treatment with AZE (p = 0.03), BUD (p < 0.0001), and AZE/BUD (p < 0.0001), compared with pretreatment. The NPT20 score was significantly higher (p = 0.0009) after AZE/BUD, compared with AZE and BUD on their own. Thus, AZE therapy combined with BUD might provide more therapeutic benefits than the isolated drugs for improving nasal patency. PMID:24988550

  13. Treatment of Allergic Rhinitis with Ectoine Containing Nasal Spray and Eye Drops in Comparison with Azelastine Containing Nasal Spray and Eye Drops or with Cromoglycic Acid Containing Nasal Spray

    PubMed Central

    Werkhäuser, Nina; Sonnemann, Uwe

    2014-01-01

    Objectives. Allergic rhinitis is a common disease with increasing prevalence and high impact on economic burden and comorbidities. As treatment with pharmacological drugs is not always satisfactory due to side effects and incomplete efficacy, alternative treatment strategies are needed. Ectoine is an osmolyte with membrane stabilizing and inflammation reducing capacities. Nasal spray and eye drops containing ectoine are promising new treatment regimens for allergic rhinitis sufferers. Design and Methods. The current two noninterventional trials evaluated the efficacy and safety of ectoine containing nasal spray and eye drops for treating allergic rhinitis in comparison with either azelastine or cromoglycic acid containing products. Nasal and ocular symptom developments as well as judgment of tolerability and efficacy were assessed both by investigators and patients over a time period of one to two weeks. Results. Both trials confirmed that ectoine containing products reduced nasal and ocular symptoms in allergic rhinitis patients. Results clearly demonstrated good safety profiles of the ectoine products comparable to those of azelastine and even better to those of cromoglycate products. Conclusion. Ectoine containing nasal spray and eye drops are interesting new treatment strategies for sufferers of allergic rhinitis, combining both good efficacy and absence of side effects. PMID:24982680

  14. Treatment of allergic rhinitis with ectoine containing nasal spray and eye drops in comparison with azelastine containing nasal spray and eye drops or with cromoglycic Acid containing nasal spray.

    PubMed

    Werkhäuser, Nina; Bilstein, Andreas; Sonnemann, Uwe

    2014-01-01

    Objectives. Allergic rhinitis is a common disease with increasing prevalence and high impact on economic burden and comorbidities. As treatment with pharmacological drugs is not always satisfactory due to side effects and incomplete efficacy, alternative treatment strategies are needed. Ectoine is an osmolyte with membrane stabilizing and inflammation reducing capacities. Nasal spray and eye drops containing ectoine are promising new treatment regimens for allergic rhinitis sufferers. Design and Methods. The current two noninterventional trials evaluated the efficacy and safety of ectoine containing nasal spray and eye drops for treating allergic rhinitis in comparison with either azelastine or cromoglycic acid containing products. Nasal and ocular symptom developments as well as judgment of tolerability and efficacy were assessed both by investigators and patients over a time period of one to two weeks. Results. Both trials confirmed that ectoine containing products reduced nasal and ocular symptoms in allergic rhinitis patients. Results clearly demonstrated good safety profiles of the ectoine products comparable to those of azelastine and even better to those of cromoglycate products. Conclusion. Ectoine containing nasal spray and eye drops are interesting new treatment strategies for sufferers of allergic rhinitis, combining both good efficacy and absence of side effects.

  15. Two-week comparison study of olopatadine hydrochloride nasal spray 0.6% versus azelastine hydrochloride nasal spray 0.1% in patients with vasomotor rhinitis.

    PubMed

    Lieberman, Phil; Meltzer, Eli O; LaForce, Craig F; Darter, Amy L; Tort, Maria J

    2011-01-01

    Olopatadine hydrochloride nasal spray 0.6% (OLO) and azelastine nasal spray 137 micrograms (AZE) are effective in treating allergic rhinitis and AZE is indicated for nonallergic vasomotor rhinitis (VMR). This study evaluates the relative safety and efficacy of OLO and AZE in patients with VMR. This randomized, double-blind, parallel-group, multicenter study compared OLO (an investigational use) with AZE over 14 days in patients (n = 129) ≥12 years of age with chronic VMR. Efficacy included the severity of nasal symptom scores. Safety included adverse events (AEs) and nasal examinations. Patient perceptions of treatment satisfaction and changes in allergy condition were determined using the Treatment Satisfaction Questionnaire for Medication and Patient Global Assessment scores. In the OLO and AZE groups, reflective scores for individual nasal symptoms (nasal congestion, rhinorrhea, postnasal drip, and sneezing) and total nasal VMR symptom scores decreased significantly from baseline to day 14 (p < 0.05). No significant between-group differences were observed (p > 0.05). No serious AEs were reported in either group. Overall, 22 and 20 AEs were reported in the OLO and AZE groups, respectively. The most common AE was taste disturbance, reported by three (5.3%) and six (10.3%) patients in the OLO and AZE groups, respectively. Patients in both groups reported similar treatment satisfaction scores and a majority of patients in both groups perceived an overall improvement in their rhinitis condition. OLO has a similar efficacy and safety profile to AZE for the management of VMR in patients ≥12 years of age.

  16. Bioavailability and disposition of azelastine and fluticasone propionate when delivered by MP29-02, a novel aqueous nasal spray

    PubMed Central

    Derendorf, Hartmut; Munzel, Ullrich; Petzold, Ursula; Maus, Joachim; Mascher, Hermann; Hermann, Robert; Bousquet, Jean

    2012-01-01

    AIM(S) To determine azelastine hydrochloride (AZE) and fluticasone propionate (FP) bioavailabilities of the novel nasal spray combination product MP 29-02, compared with MP29-02-based products containing only AZE (MP29-02-AZE-mono), FP (MP29-02-FP-mono), marketed AZE and FP single entity products (Astelin® and FP Boehringer-Ingelheim; FP-BI). METHODS Two randomized, three period, six sequence, three treatment crossover studies were conducted in healthy subjects. Study 1 administered 200 µg FP as MP29-02, MP29-02-FP-mono or FP-BI. Study 2 administered 548 µg AZE as MP29-02, MP29-02-AZE-mono or Astelin®. Each dose consisted of two sprays/nostril. Serum FP and plasma AZE were followed over 24 (FP) and 120 h (AZE) and quantified by LC-MS/MS. Peak (Cmax) and total exposures AUC(0,tlast) were compared between the treatments by anova. RESULTS Study 1: Average FP Cmax was very low with all products (≤10 pg ml−1). FP AUC(0,tlast) point estimates (90% CIs) for MP29-02 : MP29-02-FP-mono and MP29-02 : FP-BI ratios (%) were 93.6 (83.6, 104.7) and 161.1 (137.1, 189.3). Corresponding ratios for Cmax were 91.0 (82.5, 100.4) and 157.4 (132.5, 187.1). Study 2: AZE AUC(0,tlast) point estimates (90% CIs) for MP29-02 : MP29-02-AZE-mono and MP29-02 : Astelin® ratios (%) were 98.8 (91.0, 107.4) and 105.5 (95.6, 116.4). Corresponding outcomes for Cmax were 102.7 (92.1, 114.4) and 107.3 (92.6, 124.3). CONCLUSIONS No interactions of AZE and FP were found with the MP29-02 formulation. Azelastine bioavailability was similar for MP29-02 and Astelin®. Maximum and total FP exposure was higher for MP29-02-based products compared with FP-BI. FP concentrations were generally very low with all investigational products and did not suggest clinically meaningful differences concerning systemic safety. PMID:22356350

  17. Comparative study of sensory attributes of two antihistamine nasal sprays: olopatadine 0.6% and azelastine 0.1%.

    PubMed

    Meltzer, Eli O; Garadi, Rekha; Laforce, Craig; Chadwick, Stephen J; Berger, William E; Gross, Gary; Edwards, Michael R; Crenshaw, Krista; Wall, G Michael

    2008-01-01

    Allergic rhinitis is a chronic, allergen-induced inflammatory reaction. Patients often differentiate intranasal treatments based on sensory attributes. The purpose of this study was to evaluate the sensory attributes of olopatadine HCl nasal spray 0.6% (OLO) relative to azelastine HCl nasal spray 0.1% (AZE). This was a multicenter, double-blind, randomized, crossover comparison of OLO versus AZE in adult, symptomatic patients with at least a 2-year history of allergic rhinitis. Patients received each of the treatments separately with a washout between exposures, evaluated their sensory perceptions immediately after and 45 minutes postdosing with each treatment, and evaluated their perceptions of the two medications after administering both therapies. The mean age of the 110 patients was 42.4 years; 67% were women. OLO was superior to AZE in overall aftertaste (60.6% versus 30.3%; p = 0.0005), patient preference (62.4% versus 33.9%; p = 0.0001), and likelihood of extended use (60.9% versus 34.5%; p = 0.0004). OLO was superior to AZE in perceptions of immediate taste (1.9 U versus 3.2 U, respectively; p < 0.0001). Perceptions of additional attributes after administration of both treatments were significant and favored OLO (p < or = 0.0036 for all variables). In these assessments, respectively, 54.1 and 32.1% of patients favored the taste and smell of OLO compared with 27.5 and 11.9% who favored AZE. Both treatments were well tolerated. The sensory attributes of OLO are superior to AZE in terms of immediate taste postdosing, overall aftertaste, overall patient preference, and likelihood of use. This outcome could lead to greater patient compliance and improved treatment effect.

  18. Azelastine eye drops in the treatment of perennial allergic conjunctivitis.

    PubMed

    Nazarov, Ozod; Petzold, Ursula; Haase, Hans; Nguyen, Duc Tung; Ellers-Lenz, Barbara; Hermann, Robert

    2003-01-01

    Azelastine (CAS 58581-89-8) is a selective H1-receptor antagonist that inhibits histamine release and interferes with activation of other mediators of allergic inflammation. The present double-blind study aimed to evaluate azelastine eye drops (Allergodil) in patients with perennial allergic conjunctivitis compared to placebo. A total of 116 patients with an ocular symptoms score for itching and conjunctival redness > or = 3 (0-6 scale) were randomized to twice-daily 0.05% azelastine eye drops treatment (n = 58) or placebo. Patients maintained daily logs and were clinically evaluated after 7, 21 and 42 days of treatment. Azelastine significantly improved itching and conjunctival redness versus placebo (p < 0.001). Tolerability was rated good or better by 97% of patients with only bitter taste and application site reaction notable adverse experiences. On Day 7, ocular symptoms score improved by 1.5 +/- 0.9 (versus 0.5 +/- 0.8 placebo) with score improvement > or = 2 in 55% with azelastine (versus 14% placebo). Itching and redness further improved at Day 42 (score improvement > or = 2 in 95% with azelastine versus 33% placebo) and completely resolved for 47% azelastine patients (versus 10% placebo). Daily patient logs confirmed the clinically assessed scores. Topical azelastine progressively improved itching and conjunctival redness in patients with moderate to severe perennial allergic conjunctivitis. Continued improvement with prolonged use is consistent with mechanisms other than H1-receptor blockade, such as possible down regulation of adhesion molecule receptors.

  19. Azelastine and olopatadine in the treatment of allergic rhinitis.

    PubMed

    Kaliner, Michael A

    2009-11-01

    To review the literature supporting current recommendations for nasal antihistamines as first-line therapy for allergic rhinitis. Published articles in the peer-reviewed medical literature. Clinical trials focusing on the efficacy, safety, and recommended uses of the currently approved nasal antihistamines in the United States: azelastine nasal spray, 0.1%, and olopatadine nasal spray, 0.6%. Azelastine nasal spray, 0.1%, and olopatadine nasal spray, 0.6%, have rapid onsets of action, are well tolerated, and have clinical efficacy for treating allergic rhinitis that is equal or superior to oral second-generation antihistamines. Both also have a clinically significant effect on nasal congestion. Azelastine is also approved for nonallergic rhinitis. Although older data suggest that intranasal steroids have greater clinical efficacy than nasal antihistamines, more recent comparisons in patients with mild to moderate disease have shown equal or noninferior efficacy. In addition, in contrast to oral antihistamines or leukotriene antagonists, the combination of a nasal antihistamine and intranasal steroid may provide additive benefits for treating patients with more severe disease. The data support current recommendations for nasal antihistamines as first-line therapy for allergic rhinitis. Future studies should address possible as needed use, the use of premixed antihistamine-steroid combinations, and the treatment of mixed rhinitis.

  20. Pharmacokinetic interactions between Japanese traditional medicine (kampo) and modern medicine (III). Effect of Sho-seiryu-to on the pharmacokinetics of azelastine hydrochloride in rats.

    PubMed

    Makino, Toshiaki; Inagaki, Takahiro; Komatsu, Ken-Ichi; Kano, Yoshihiro

    2004-05-01

    Sho-seiryu-to (SST) is widely used herbal formula in Japanese traditional medicine (kampo) to treat allergic diseases. Since Japanese physicians frequently prescribe this formula combined with azelastine hydrochloride, one of anti-histamine and anti-allergic medicines, we evaluated the pharmacokinetic interactions between SST and azelastine hydrochloride in rats to obtain the drug information for the prevention from disadvantage or adverse effects by their combined therapy. Oral administration of SST did not influence the plasma concentration profile of azelastine after its intravaneous injection, suggesting that SST would not change the activities of metabolic enzymes such as cytochrome P450s. However, maximum concentration (C(max)) of azelastine after oral administration of azelastine hydrochloride was significantly reduced and mean residence time (MRT) was significantly lengthened when SST was orally administered at 20 times amount of human daily dosage. There was not significant difference in the area under the plasma concentration-time curve (AUC), suggesting that SST might delay the absorption of azelastine without affecting the extent of bioavailability. Since this delay was independent of ephedrine that is a main constituent of SST and that a suppressor for gastric transit, SST might form unsoluble complex with azelastine to reduce its absorption. At the double of human daily dose, SST did not made the absorption of azelastine delay. The possibility that SST reduce the absorption of azelastine hydrochloride could not be denied completely, however, it is suggested that SST would not cause pharmacokinetic interaction with azelastine hydrochloride clinically.

  1. Azelastine hydrochloride, a dual-acting anti-inflammatory ophthalmic solution, for treatment of allergic conjunctivitis

    PubMed Central

    Williams, Patricia B; Crandall, Elizabeth; Sheppard, John D

    2010-01-01

    Over 50% of patients who seek treatment for allergies present with ocular symptoms. Our current ability to control ocular allergic symptoms is greater than ever before. Newer dual-acting topical eyedrops attack multiple facets of the allergic cascade. Azelastine has antihistaminic effects providing immediate relief, mast cell stabilization providing early-phase intervention, and inhibition of expression and activation of anti-inflammatory mediators which characterize the late phase of the immune reaction. The ophthalmic eyedrop formulation is approved for treatment of allergic conjunctivitis in adults and children aged over 3 years. In clinical trials comparing azelastine with other dual-acting eyedrops, such as levocabastine and olopatadine, azelastine was reported to be slightly less efficacious and to sting briefly upon administration. Even so, many patients experienced the full benefit of symptom relief, and preferred azelastine. As a broad-spectrum drug, azelastine offers many desirable properties for management of ocular allergies. Because it can often produce maximal effect with just twice-daily dosing, azelastine is a particularly good choice for the allergic population in whom minimizing exposure to topical products and preservatives is a key concern. PMID:20856595

  2. A study of the clinical efficacy of azelastine in patients with extrinsic asthma, and its effect on airway responsiveness.

    PubMed Central

    Gould, C A; Ollier, S; Aurich, R; Davies, R J

    1988-01-01

    1. The effect of 4.4 mg azelastine administered orally on airway responsiveness, skin prick testing, daily peak expiratory flow rates and symptoms of asthma was compared with placebo in a 7 week double-blind, parallel group study of 24 patients with extrinsic asthma. The study was in two parts: a 2 week assessment period, during which all patients received placebo tablets but recorded daily peak flow rates (PEFRs) and symptoms, preceding the 7 week double-blind comparison. 2. Azelastine, 4.4 mg, significantly decreased airway responsiveness to histamine compared with placebo both after a single dose (P less than 0.001), and following 7 weeks continuous treatment (P less than 0.02). Airway responsiveness to methacholine was not altered by administration of azelastine compared with placebo. 3. Skin prick test weal diameters to both allergen and histamine were significantly reduced after both a single dose and following 7 weeks continuous therapy treatment with azelastine. 4. There was a significant improvement in both the mean of the morning and the evening peak flow rates recorded during the last week compared with the first week of the study in the group receiving 4.4 mg of azelastine twice daily compared with placebo. Scores for wheeze were significantly reduced during the final 3 weeks of the study in patients receiving azelastine compared both with those receiving placebo and with the first week of the study (P less than 0.05, P less than 0.01). Consumption of inhaled bronchodilators fell significantly during the study in the group receiving azelastine therapy (P less than 0.05); no such fall occurred in the placebo treated patients. 5. A bitter metallic taste was reported by 58% of patients who received azelastine therapy. PMID:2905153

  3. Management of allergic conjunctivitis: an evaluation of the perceived comfort and therapeutic efficacy of olopatadine 0.2% and azelastine 0.05% from two prospective studies

    PubMed Central

    Epstein, Arthur B; Van Hoven, Peter T; Kaufman, Alan; Carr, Warner W

    2009-01-01

    Purpose: Results from 2 patient-reported outcome studies of allergic conjunctivitis sufferers who used olopatadine 0.2% and azelastine 0.05% are analyzed. Methods: The PACE (Pataday Allergic Conjunctivitis Evaluation) multi-center, prospective, open-label study examined patient perceptions of olopatadine 0.2% once daily (qd) and previous twice daily (bid) allergic conjunctivitis medications via questionnaire in allergic conjunctivitis sufferers who had previously used bid medication and then initiated olopatadine. A second conjunctival antigen challenge (CAC) study evaluated comfort of 4 allergic conjunctivitis medications. Results: Forty-nine patients from the PACE study (N = 125) with prior azelastine use were examined. Significantly more patients rated themselves “very satisfied” with current olopatadine use compared with past azelastine use on drop comfort (p < 0.0001), speed of relief (p = 0.0004), and overall satisfaction (70% vs 16%, p < 0.0001). Significantly more patients reported olopatadine “very effective” against swelling compared with azelastine (47% vs 8%, p = 0.0404). In the CAC study (N = 36), data from olopatadine (n = 8), azelastine (n = 9) and placebo (N = 36) groups were reported. Olopatadine was rated significantly more comfortable than azelastine upon instillation (p = 0.0223), at 30 seconds (p = 0.0479), and at 1 minute after instillation (p = 0.0240). Conclusion: In the reported studies, olopatadine 0.2% qd was more comfortable than azelastine 0.05% and preferred by patients with allergic conjunctivitis by a ratio of 4:1. PMID:19668586

  4. [Azelastine in the treatment of allergic conjunctivitis].

    PubMed

    Vakhabova, N T; Bakhritdinova, F A

    2001-01-01

    The efficiency of azelastin (eye drops) in allergic conjunctivitis was evaluated. Ophthalmological, specific allergological, bacteriological, and cytological studies were carried out in 3 groups of patients. Group 1 was treated with claritin (orally), group 2 with azelastin (eye drops), and group 3 with both. The treatment was effective in all 3 groups. Regression of the clinical symptoms started earlier in groups 2 and 3 and was observed throughout the entire period of observation.

  5. Comparison of azelastine eye drops with levocabastine eye drops in the treatment of seasonal allergic conjunctivitis.

    PubMed

    Giede, C; Metzenauer, P; Petzold, U; Ellers-Lenz, B

    2000-01-01

    A randomised, multicentre parallel group study was undertaken to compare the efficacy and safety of 0.05% azelastine eye drops (101 patients) in an open manner with 0.05% levocabastine eye drops (103 patients) and in a double-blind manner with placebo (103 patients) during a 14-day treatment period involving patients with seasonal allergic conjunctivitis. The three main eye symptoms, scored on a four-point scale, were itching, lacrimation and conjunctival redness; the primary efficacy variable was the responder rate on day 3. Responders were patients whose sum score of the three main eye symptoms decreased by at least three points from a baseline score of at least six points. In addition to these main symptoms, five other symptoms were recorded on days 0, 3, 7 and 14, and patients kept daily diaries of the three main eye symptoms and swollen eyelids. The responder rate after 3 days of treatment was 69% in patients treated with azelastine, 59% in patients treated with levocabastine and 51% in the placebo group. Only the difference in responder rates between azelastine and placebo eye drops was statistically significant (p = 0.02). The improvements in other ocular symptoms and entries in the patients' diaries closely reflected the changes reported by the investigators. No serious adverse events occurred throughout the study. Nine patients (three in the azelastine, five in the levocabastine and one in the placebo group) terminated the study prematurely due to poor tolerability. Adverse drug reactions, mainly a mild, transient irritation and a bitter or unpleasant taste, were reported in 37% of patients receiving azelastine eye drops, 31% of patients receiving levocabastine and 9% of placebo patients. Overall tolerability was assessed as very good or good in 86% of azelastine- and levocabastine-treated patients, and in 95% of the patients receiving placebo. The results of this study indicate that azelastine possesses a tolerability profile at least comparable to that

  6. Azelastine eye-drops in seasonal allergic conjunctivitis or rhinoconjunctivitis. A double-blind, randomized, placebo-controlled study.

    PubMed

    Giede-Tuch, C; Westhoff, M; Zarth, A

    1998-09-01

    This study was carried out to assess the efficacy of 0.025% and 0.05% azelastine eye-drops in patients with seasonal allergic conjunctivitis of > or = 1 year's duration. A total of 151 patients received 0.025% or 0.05% azelastine eye-drops or placebo b.i.d. for 14 days according to a double-blind, randomized, placebo-controlled, parallel-dosing design; 129 patients completed the study as planned. The three target symptoms, scored on 4-point scales, were itching, lacrimation, and redness of the eyes; responders were patients whose symptom sum score decreased by > or = 3 from a baseline score of > or = 6 by day 3. Mean scores of these and five other symptoms were recorded also on days 7 and 14, and patients kept daily diaries of the three main symptoms and swollen eyelids. Responder rates were 73% for 0.025% (P=0.115 vs placebo) and 82% for 0.05% azelastine eye-drops (P=0.011 vs placebo) and 56% for placebo. The time courses of the mean (investigators' and patients') scores for the three main symptoms reflected the dose-dependent effect of azelastine eye-drops. One patient each from the two azelastine groups and three from the placebo group withdrew because of inefficacy. Adverse drug reactions were reported by 14 and 24 patients receiving 0.025% and 0.05% azelastine eye-drops, respectively, and by eight placebo patients. These reactions were mainly slight application site reactions and taste perversion (bitter or unpleasant taste). Azelastine eye-drops are effective and well tolerated at a dose of 0.05% for the treatment of seasonal allergic conjunctivitis.

  7. Long-term, randomized safety study of MP29-02 (a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate in an advanced delivery system) in subjects with chronic rhinitis.

    PubMed

    Berger, William E; Shah, Shailen; Lieberman, Phil; Hadley, James; Price, David; Munzel, Ullrich; Bhatia, Sanjay

    2014-01-01

    MP29-02 is a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate (FP) in an advanced delivery system for the treatment of seasonal allergic rhinitis. The objective of this study was to evaluate the long-term safety of MP29-02 in subjects with chronic allergic (perennial) or nonallergic (vasomotor) rhinitis. This was a 1-year, randomized, open-label, active-controlled, parallel-group study in subjects with chronic allergic or nonallergic rhinitis. A total of 612 subjects were randomized in a 2:1 ratio to (1) MP29-02, one spray per nostril twice daily (total daily doses of azelastine hydrochloride and FP were 548 mcg and 200 mcg, respectively); or (2) FP, 2 sprays per nostril once daily (total daily dose 200 mcg). Safety and tolerability assessments were made at months 1, 3, 6, 9, and 12. The incidence of treatment-related adverse events was low with both MP29-02 (9.4%) and FP (11.1%), with no evidence of late-occurring adverse events. Nasal examinations showed no evidence of nasal mucosal ulcerations or septal perforations with MP29-02, and the overall incidence of adverse findings was reduced as the study progressed. There were no unusual or unexpected ocular examination findings and no clinically important laboratory findings or clinically important differences between groups in fasting AM serum cortisol levels after 12 months of treatment. MP29-02 was well tolerated. There were no safety findings that would preclude the long-term use of MP29-02 in the treatment of allergic rhinitis. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Dose-dependent protection by azelastine eye drops against pollen-induced allergic conjunctivitis. A double-blind, placebo-controlled study.

    PubMed

    Horak, F; Berger, U E; Menapace, R; Toth, J; Stübner, P U; Marks, B

    1998-04-01

    The efficacy and tolerability of azelastine (CAS 58581-89-8) eye drops at three different doses (0.025%, 0.05% and 0.1%) were investigated in a double-blind, randomized, placebo-controlled, crossover study in 24 subjects with a history of allergic conjunctivitis/rhinoconjunctivitis, who were challenged, out of season, by airbone allergen in the "Vienna Challenge Chamber" (VCC). Subjects received a single dose of azelastine eye drops 60 min before the start of a 4 h challenge in the VCC. Additional local challenge, mimicking a gust of wind, was administered 15 min before the end of the session. Each of the 4 study days was separated by a 2 week washout period. Azelastine eye drops showed a dose-dependent inhibition of the development of itching of the eyes. The effect was most pronounced 15 min after the additional local challenge. A maximal effect was achieved at a dose of 0.05%. Similar effects were observed on lacrimation. Azelastine eye drops also dose-dependently inhibited the degree of conjunctival redness, measured by digital imaging, and tended to reduce the low incidence of chemosis observed. Ranking of the results of all symptoms for each treatment group confirmed the optimal effect at a dose of 0.05%. Azelastine eye drops had no effect on nasal and bronchial symptoms or on measurements of airways function (FEV1). No adverse effects of the treatments were reported. The data support the use of 0.05% azelastine eye drops in the treatment of allergic conjunctivitis/rhinoconjunctivitis.

  9. Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice.

    PubMed

    Ottaviano, G; Fokkens, W J

    2016-02-01

    Objective measures can be used to assist the clinician to diagnose and treat nasal obstruction and also to quantify nasal obstruction in research. Objective measurements of nasal obstruction are as important as objective measurements of lung function. peak nasal inspiratory flow (PNIF), acoustic rhinometry (AR) and rhinomanometry (RM), with their specific peculiarity, assess different aspects of nasal obstruction. From the studies available in the literature, it seems that these methods roughly correlate with each other and that all of them can be alternatively utilized very well in research as well as in clinical practice. This review describes the various methods that can be used to measure nasal patency, airflow and resistance, mainly peak nasal inspiratory flow, rhinomanometry and acoustic rhinometry. PNIF has been demonstrated to be reproducible and as good an indication of objective nasal patency as formal rhinomanometry and has the advantage to be cheap, simple and suitable for serial measurements and for home use even in the paediatric population. PNIF normative data are available for children, adults and elderly subjects, and the availability of unilateral PNIF normal values allows evaluation of nasal sides separately. Just as in the lower airways, objective and subjective evaluation gives different information that together optimizes the diagnosis and the treatment of our patients. We argue that PNIF should be used regularly in every outpatient clinic that treats patients with nasal obstruction. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Double-blind, randomised, placebo-controlled study of two concentrations of azelastine eye drops in seasonal allergic conjunctivitis or rhinoconjunctivitis.

    PubMed

    Lenhard, G; Mivsek-Music, E; Perrin-Fayolle, M; Obtulowicz, K; Secchi, A

    1997-01-01

    This double-blind, randomised, placebo-controlled study was carried out to assess the efficacy and safety of 0.025% and 0.05% azelastine eye drops twice daily administered for 14 days to patients with seasonal allergic conjunctivitis or rhinoconjunctivitis. A total of 278 patients were recruited and 226 patients were evaluable for per protocol analysis. The target parameter was the response rate. Four eye symptoms, including the main symptom (itching) were recorded by patients in diaries and eight symptoms were assessed by physicians before and after seven and 14 days of treatment. Severity of symptoms was measured on a four-point scale. The response rates for itching (improvement of at least one score point within the first three days) according to patient assessment were 43% for placebo, 52% for 0.025% and 56% for 0.05% azelastine (NS). However, a more objective assessment of the three main eye symptoms by physicians showed a concentration-dependent improvement in response rate compared with placebo (a decrease of > or = 3 points from a baseline total score of > or = 6), which reached statistical significance for 0.05% azelastine on Day 7 (p < 0.002). In the evaluable patient population, the scores of the three main eye symptoms as well as of all eight recorded eye symptoms, as assessed by the physician, were significantly (p < 0.05) lower in the 0.05% azelastine eye drops group in comparison with the placebo group at Day 7. Inefficacy was the cause of withdrawal in five and three patients on 0.025% and 0.05% azelastine, respectively, and in six patients on placebo. Adverse drug effects, mainly a mild, transient irritation and a bitter or unpleasant taste, were reported by 14% (0.025%), 20% (0.05%) and 15% (placebo) of the patients. No serious side-effects occurred. Azelastine eye drops are effective and well tolerated at a concentration of 0.05% for the treatment of seasonal allergic conjunctivitis.

  11. Daily nasal spray of hPTH(1-34) for 3 months increases bone mass in osteoporotic subjects: a pilot study.

    PubMed

    Matsumoto, T; Shiraki, M; Hagino, H; Iinuma, H; Nakamura, T

    2006-10-01

    Although intermittent parathyroid hormone (PTH) injection can lead to strong anabolic effects on bone, daily subcutaneous injection is a disadvantage for patient acceptance. We have developed a nasal spray formula of parathyroid peptide [hPTH(1-34)] with peak serum hPTH(1-34) concentrations by nasal spray of 1,000 microg similar to those by subcutaneous injections of 20 microg hPTH(1-34). To determine the clinical efficacy and safety of nasal hPTH(1-34) spray, a randomized, open-labeled clinical trial was conducted in subjects with osteoporosis. Ninety osteoporotic subjects age 52-84 years (mean 66.5 years) were randomly assigned to receive either 250 microg (PTH250, n=31), 500 microg (PTH500, n=30), or 1,000 microg (PTH1000, n=29) of daily nasal hPTH(1-34) spray for 3 months. All received daily supplements of 300 mg calcium and 200 IU vitamin D(3). Daily nasal hPTH(1-34) spray for 3 months increased lumbar bone mineral density (L-BMD) in a dose-dependent manner, and the PTH1000 group showed a 2.4% increase in L-BMD from baseline. Only the 1,000-microg dose produced consistent and statistically significant changes in markers of bone turnover; after 3 months, median serum type I procollagen N-propeptide (PINP) and osteocalcin increased 14.8% and 19.4% from baseline, while urinary type I collagen N-telopeptide (NTX) decreased 16.4%. Seven subjects developed transient hypercalcemia at 3 h after nasal hPTH(1-34) spray, but none of the subjects developed sustained hypercalcemia. These observations demonstrate that nasal hPTH(1-34) spray is safe and well tolerated and can rapidly increase L-BMD. The results warrant further studies to examine its long-term efficacy on bone mass and fractures.

  12. Effects of smell loss on daily life and adopted coping strategies in patients with nasal polyposis with asthma.

    PubMed

    Nordin, Steven; Blomqvist, Ebba Hedén; Olsson, Petter; Stjärne, Pär; Ehnhage, Anders

    2011-08-01

    Results from prior studies of quality of life (QoL) in heterogeneous patient groups (regarding disorder type and etiology) with olfactory disorders may be useful also for understanding QoL in homogeneous patient groups. Diagnosis and treatment of smell loss should be given high priority in polyposis with asthma, and coping strategies can be suggested to these patients. To investigate the effects of smell loss on daily life and coping strategies in patients with smell loss without dysosmia and with nasal polyposis with asthma as the only primary etiology, and to compare these results with those from a prior study of a patient group with heterogeneous olfactory disorders and etiology. Fifty patients with smell loss and with nasal polyposis and asthma responded to questions about consequences of smell loss, QoL, psychological well-being and distress, and coping strategies. Negative consequences of smell loss, associated risks, and diminished food enjoyment were commonly reported, and various aspects of QoL were rated as being deteriorated. Psychological well-being was found to be poorer than normal, and use of both problem- and emotion-focused strategies was common. The results from this homogeneous patient group are very similar to those previously obtained from a heterogeneous group.

  13. Evaluation of olopatadine hydrochloride nasal spray, 0.6%, used in combination with an intranasal corticosteroid in seasonal allergic rhinitis.

    PubMed

    LaForce, Craig F; Carr, Warner; Tilles, Stephen A; Chipps, Bradley E; Storms, William; Meltzer, Eli O; Edwards, Michael

    2010-01-01

    The combination of intranasal antihistamines and intranasal corticosteroids results in superior relief of seasonal allergic rhinitis (SAR) symptoms compared with monotherapy. This study was designed to evaluate the safety and efficacy of olopatadine hydrochloride nasal spray, 0.6% (OLO), administered in combination with fluticasone nasal spray, 50 micrograms (FNS), relative to azelastine nasal spray, 0.1% (AZE), administered in combination with FNS in the treatment of SAR. This was a multicenter, double-blind, randomized, parallel-group comparison of OLO + FNS versus AZE + FNS administered for 14 days to patients > or =12 years of age with histories of SAR. Efficacy assessments recorded by patients in a daily diary included nasal symptom scores. Safety was evaluated based on adverse events (AEs). Pretreatment values for reflective total nasal symptoms scores (rTNSS) were similar for both treatment groups. The mean (SD) 2-week average rTNSS was 4.28 (2.63) for OLO + FNS and 4.15 (2.63) for AZE + FNS; these scores were not statistically different between treatment groups. No significant differences (p > 0.05) between OLO + FNS and AZE + FNS were observed for the average 2-week percent changes from baseline in rTNSS or in the individual nasal symptoms (nasal congestion, rhinorrhea, itchy nose, and sneezing). Compared with baseline, both groups had statistically significant improvement in rTNSS (p < 0.05). No serious AEs were reported in either group during the study period. Overall, 19 AEs were reported in the OLO + FNS group and 29 AEs were reported in the AZE + FNS group. OLO, when administered adjunctively with FNS, is effective, safe, and well-tolerated in patients with SAR.

  14. Evaluation of olopatadine hydrochloride nasal spray, 0.6%, used in combination with an intranasal corticosteroid in seasonal allergic rhinitis.

    PubMed

    LaForce, Craig F; Carr, Warner; Tilles, Stephen A; Chipps, Bradley E; Storms, William; Meltzer, Eli O; Edwards, Michael

    2010-04-01

    The combination of intranasal antihistamines and intranasal corticosteroids results in superior relief of seasonal allergic rhinitis (SAR) symptoms compared with monotherapy. This study was designed to evaluate the safety and efficacy of olopatadine hydrochloride nasal spray, 0.6% (OLO), administered in combination with fluticasone nasal spray, 50 micrograms (FNS), relative to azelastine nasal spray, 0.1% (AZE), administered in combination with FNS in the treatment of SAR. This was a multicenter, double-blind, randomized, parallel-group comparison of OLO + FNS versus AZE + FNS administered for 14 days to patients ≥12 years of age with histories of SAR. Efficacy assessments recorded by patients in a daily diary included nasal symptom scores. Safety was evaluated based on adverse events (AEs). Pretreatment values for reflective total nasal symptoms scores (rTNSS) were similar for both treatment groups. The mean (SD) 2-week average rTNSS was 4.28 (2.63) for OLO + FNS and 4.15 (2.63) for AZE + FNS; these scores were not statistically different between treatment groups. No significant differences (p > 0.05) between OLO + FNS and AZE + FNS were observed for the average 2-week percent changes from baseline in rTNSS or in the individual nasal symptoms (nasal congestion, rhinorrhea, itchy nose, and sneezing). Compared with baseline, both groups had statistically significant improvement in rTNSS (p < 0.05). No serious AEs were reported in either group during the study period. Overall, 19 AEs were reported in the OLO + FNS group and 29 AEs were reported in the AZE + FNS group. OLO, when administered adjunctively with FNS, is effective, safe, and well-tolerated in patients with SAR.

  15. Azelastine eye drops reduce conjunctival hyperresponsiveness to hyperosmolar glucose challenge in children with asymptomatic mite conjunctivitis.

    PubMed

    Ciprandi, G; Catrullo, A; Tosca, M; Cerqueti, P; Mondino, C; Passalacqua, G; Canonica, G W

    1999-01-01

    Mite allergy is characterized by a continuous allergen exposure. Persistent inflammation is therefore always detectable; and during symptomless periods as well. It has been reported that mite allergic patients also present a nonspecific hyperreactivity to different stimuli, including hyperosmolar solution. Since azelastine was previously demonstrated to be able to reduce allergic inflammation, the aim of the study was to investigate the effects of the drug on nonspecific conjunctival hyperreactivity in mite-allergic patients. Twenty children with mite allergy were studied. A hyperosmolar conjunctival challenge was performed before and after azelastine eye drops or placebo treatment for a period of 2 weeks. It was found that patients treated with azelastine eye drops showed a significant reduction in nonspecific conjunctival hyperreactivity compared to the placebo group (p = 0.018). It was concluded that azelastine eye drops are able to reduce the nonspecific hyperreactivity present in subjects with mite allergy.

  16. Nasal Anatomy

    MedlinePlus

    ... Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure Statement CONDITIONS Adult ... Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure Statement Printer Friendly ...

  17. Azelastine eye drops in the treatment of seasonal allergic conjunctivitis or rhinoconjunctivitis in young children.

    PubMed

    Sabbah, A; Marzetto, M

    1998-01-01

    In a randomised, multicentre study, the effect of azelastine eye drops (n = 51 patients) was compared in a double-blind manner with placebo eye drops (n = 30 patients) and in an open manner with levocabastine eye drops (n = 32 patients) during a 14-day treatment period involving 113 children (aged 4 to 12 years) suffering from seasonal allergic conjunctivitis/rhinoconjunctivitis. The primary variable was the response rate defined as the number of patients showing an improvement after three days of treatment of at least three score points, from a minimum baseline score of six, in the main ocular symptoms of itching, conjunctival redness and lacrimation (each assessed on a four-point scale). Patients discontinuing due to inefficacy were regarded as non-responders. The mean response rate in the azelastine eye drops group (74%) was significantly higher (p < 0.01) than that in the placebo group (39%) and comparable with that in the levocabastine group. The response rates assessed by the patients in their diaries were very similar. Significant differences (p < 0.01) for azelastine compared with placebo were observed on days 3 and 14 in the mean sum scores for the three main symptoms and for a total of eight eye symptoms. The overall assessment of efficacy confirmed the superiority of both active treatments compared with placebo. Adverse drug reactions were reported in 23% of placebo-, 35% of azelastine- and 38% of levocabastine-treated patients. These were mainly local irritant effects. Overall tolerability was assessed as very good or good in 80%, 84% and 91% of placebo-, azelastine- and levocabastine-treated patients, respectively. Azelastine eye drops are effective and well-tolerated in children with seasonal allergic conjunctivitis.

  18. Effect of azelastine on sulphur dioxide induced impairment of ciliary motility in airway epithelium.

    PubMed Central

    Tamaoki, J; Chiyotani, A; Sakai, N; Takeyama, K; Konno, K

    1993-01-01

    OBJECTIVE--The effect of azelastine on airway mucociliary transport function was studied by measuring ciliary motility of human bronchial epithelium in vitro with a photoelectric method. METHOD--Bronchial epithelial cells were obtained by fibreoptic bronchoscopy, mounted in a Rose chamber, and perfused with Krebs-Henseleit solution. The preparations were placed on a microscope stage equipped with an illuminator, and the variations of light intensity caused by ciliary beating were detected by a photometer. RESULTS--The addition of azelastine to the perfusate increased ciliary beat frequency (CBF) in a dose dependent manner without ciliary discoordination. The mean (SE) maximal increase from the baseline value and the concentration required to produce a half maximal effect were 27.0 (4.2)% and 9.2 x 10(-6) mol/l, respectively. Exposure of the cells to the perfusate containing 3 ppm sulphur dioxide rapidly decreased CBF by 59.2 (5.0)%, and was accompanied by a reduction in intracellular cyclic AMP levels from 38.1 (4.3) to 10.1 (2.4) pmol/mg protein. This effect was prevented by pretreatment of cells with azelastine in a dose dependent manner. CONCLUSIONS--Azelastine not only stimulates ciliary motility of airway epithelium and hence mucociliary transport function, but may also protect against sulphur dioxide induced ciliary dysfunction, probably by inhibiting intracellular cyclic AMP loss. PMID:8322244

  19. Nasal polyps

    MedlinePlus

    ... get rid of nasal polyps. Nasal steroid sprays shrink polyps. They help clear blocked nasal passages and ... is stopped. Corticosteroid pills or liquid may also shrink polyps, and can reduce swelling and nasal congestion. ...

  20. A Pilot Study Investigating Clinical Responses and Biological Pathways of Azelastine/Fluticasone in Nonallergic Vasomotor Rhinitis before and after Cold Dry Air Provocation.

    PubMed

    Singh, Umesh; Bernstein, Jonathan A; Lorentz, Holly; Sadoway, Tara; Nelson, Victoria; Patel, Piyush; Salapatek, Anne Marie

    2017-01-01

    Nonallergic vasomotor rhinitis (NAVMR) has been considered a diagnosis by exclusion due to unknown mechanisms or lack of diagnostic biomarkers. To determine clinical responses and biological pathways in NAVMR subjects challenged to cold dry air (CDA) in an environmental exposure chamber (EEC) pre- and posttreatment with azelastine/fluticasone (AzeFlu), 30 NAVMR subjects, prescreened for CDA-induced symptoms (approx. 14°C, <15% relative humidity, ×1 h) were randomized to treatment with AzeFlu (n = 20) or placebo (n = 10) for 2 weeks. Total nasal symptoms scores, minimum cross-sectional area, cough, and conjunctival redness were recorded at visit 1 (pretreatment) and visit 2 (posttreatment) before, during, and after CDA challenge. At both visits, nasal lavage fluid (NLF) and nasal scrapings (NS) were collected pre- and post-CDA challenge. Substance P, neurokinin-A, and calcitonin gene-related peptide concentrations in NLF were analyzed pre- and postchallenge at each visit. Their relationship with CDA-induced symptoms was determined by statistical analysis. MicroRNA sequencing from NS determined differentially expressed miRNA between the treatment groups post-CDA challenge at each visit. The minimum cross-sectional area (p < 0.05), cough count (p < 0.05), and substance P (p < 0.01) improved posttreatment with AzeFlu versus placebo. Gene targets for differentially expressed miRNAs at visit 1 were enriched for biological pathways regulating epithelial ciliogenesis and cell integrity that were modified in the AzeFlu-treated group versus placebo posttreatment. This study demonstrated the feasibility of an EEC model to investigate CDA-induced clinical responses and pathobiology in NAVMR subjects pre- and posttreatment with AzeFlu. NAVMR disease mechanisms for other nonallergic triggers can be investigated similarly. © 2017 S. Karger AG, Basel.

  1. Validated sensitive spectrofluorimetric method for determination of antihistaminic drug azelastine HCl in pure form and in pharmaceutical dosage forms: application to stability study.

    PubMed

    El-Masry, Amal A; Hammouda, Mohammed E A; El-Wasseef, Dalia R; El-Ashry, Saadia M

    2017-03-01

    A highly sensitive, simple and rapid spectrofluorimetric method was developed for the determination of azelastine HCl (AZL) in either its pure state or pharmaceutical dosage form. The proposed method was based on measuring the native fluorescence of the studied drug in 0.2 M H2 SO4 at λem  = 364 nm after excitation at λex  = 275 nm. Different experimental parameters were studied and optimized carefully to obtain the highest fluorescence intensity. The proposed method showed a linear dependence of the fluorescence intensity on drug concentration over a concentration range of 10-250 ng/mL, with a limit of detection of 1.52 ng/mL and limit of quantitation of 4.61 ng/mL. Moreover, the method was successfully applied to pharmaceutical preparations, with percent recovery values (± SD) of 99.96 (± 0.4) and 100.1 (± 0.52) for nasal spray and eye drops, respectively. The results were in good agreement with those obtained by the comparison method, as revealed by Student's t-test and the variance ratio F-test. The method was extended to study the stability of AZL under stress conditions, where the drug was exposed to neutral, acidic, alkaline, oxidative and photolytic degradation according to International Conference on Harmonization (ICH) guidelines. Copyright © 2016 John Wiley & Sons, Ltd.

  2. Nasal Cancer

    MedlinePlus

    ... the way to your throat as you breathe. Cancer of the nasal cavity and paranasal sinuses is ... be like those of infections. Doctors diagnose nasal cancer with imaging tests, lighted tube-like instruments that ...

  3. Azelastine is more potent than olopatadine n inhibiting interleukin-6 and tryptase release from human umbilical cord blood-derived cultured mast cells.

    PubMed

    Kempuraj, Duraisamy; Huang, Man; Kandere, Kristiana; Boucher, William; Letourneau, Richard; Jeudy, Sheila; Fitzgerald, Kim; Spear, Kathleen; Athanasiou, Achilles; Theoharides, Theoharis C

    2002-05-01

    Mast cells are involved in early- and late-phase reactions by releasing vasoactive molecules, proteases, and cytokines. Certain histamine-1 receptor antagonists and other antiallergic drugs seem to inhibit the release of mediators from rat and human mast cells. Azelastine and olopatadine are antiallergic agents present in the ophthalmic solutions azelastine hydrochloride (Optivar, Asta Medica/Muro Pharmaceuticals, Tewksbury, MA), and olopatadine hydrochloride (Patanol, Alcon Laboratories, Fort Worth, TX), respectively. We investigated the effect of these drugs on interleukin-6 (IL-6), tryptase, and histamine release from cultured human mast cells (CHMCs). CHMCs were grown from human umbilical cord blood-derived CD34+ cells in the presence of stem cell factor and IL-6 for 14 to 16 weeks. Sensitized CHMCs were pretreated with various concentrations of azelastine or olopatadine for 5 minutes. CHMCs were then challenged with anti-immunoglobulin E, and the released mediators were quantitated. The greatest inhibition of mediator release was seen with 24 microM azelastine; this level of inhibition was matched with the use of 133 microM olopatadine. At this concentration, these drugs inhibited IL-6 release by 83% and 74%, tryptase release by 55% and 79%, and histamine release by 41% and 45%, respectively. Activated CHMCs were characterized by numerous filopodia that were inhibited by both drugs as shown by electron microscopy. These results indicate that azelastine and olopatadine can inhibit CHMCs activation and release of IL-6, tryptase, and histamine. On an equimolar basis, azelastine was a more potent inhibitor than olopatadine.

  4. A review of the clinical efficacy and safety of MP-AzeFlu, a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate, in clinical studies conducted during different allergy seasons in the US

    PubMed Central

    Prenner, Bruce M

    2016-01-01

    A novel intranasal formulation of azelastine HCl (AZE, an antihistamine) and fluticasone propionate (FP, a corticosteroid) in a single spray (MP-AzeFlu [Dymista®]) was studied in four randomized, double-blind, placebo-controlled trials of patients with seasonal allergic rhinitis conducted in the US. Study sites were distributed so that all major US geographic regions and the prevalent pollens within these regions were represented. Spring and summer studies included patients aged 12 years and older with allergy to grass and tree pollens. Fall studies enrolled patients with allergy to weeds, in particular ragweed. In addition, a study was conducted during the winter months in patients with allergy to mountain cedar pollen in TX, USA. Regardless of allergy season or prevalent pollen, MP-AzeFlu improved nasal symptoms of allergic rhinitis (AR) to a significantly greater degree than AZE or FP, two treatments that currently are recommended as the first-line AR therapy. MP-AzeFlu improved all individual AR symptoms and was significantly better than FP and AZE for nasal congestion relief, which is generally accepted as the most bothersome symptom for AR patients. The onset of action was within 30 minutes. MP-AzeFlu also provided clinically important improvement in the overall Rhinoconjunctivitis Quality of Life Questionnaire score and significantly improved ocular symptoms of rhinitis compared to placebo. Favorable characteristics of the MP-AzeFlu formulation as well as superior clinical efficacy make it an ideal intranasal therapy for AR. PMID:27468241

  5. Nasal polyposis

    PubMed Central

    Brown, Gerald A.

    1969-01-01

    A review of 313 cases of nasal polyposis indicates that there is a high incidence of recurrence in this disease. Other nasal pathology affects a significant number of these patients. Simple surgical removal of the polypi by a transnasal route is the common mode of treatment. PMID:4187956

  6. Strong humming for one hour daily to terminate chronic rhinosinusitis in four days: a case report and hypothesis for action by stimulation of endogenous nasal nitric oxide production.

    PubMed

    Eby, George A

    2006-01-01

    Rhinosinusitis is an inflammation or infection of the nose and air pockets (sinuses) above, below and between the eyes which connect with the back of the nose through tiny openings (ostia). Rhinosinusitis can be caused by bacteria, viruses, fungi (molds) and possibly by allergies. Chronic rhinosinusitis (CRS) is an immune disorder caused by fungi. The immune response produced by eosinophils causes the fungi to be attacked, which leads to damage of the sinus membranes, resulting in full-blown rhinosinusitis symptoms. Gaseous nitric oxide (NO) is naturally released in the human respiratory tract. The major part of NO found in exhaled air originates in the nasal airways, although significant production of NO also takes place in the paranasal sinuses. Proper ventilation is essential for maintenance of sinus integrity, and blockage of the ostium is a central event in pathogenesis of sinusitis. Concentrations of NO in the healthy sinuses are high. Nasal NO is known to be increased 15- to 20-fold by humming compared with quiet exhalation. NO is known to be broadly antifungal, antiviral and antibacterial. This case report shows that a subject hummed strongly at a low pitch ( approximately 130 Hz) for 1h (18 hums per minute) at bedtime the first night, and hummed 60-120 times 4 times a day for the following 4 days as treatment for severe CRS. The humming technique was described as being one that maximally increased intranasal vibrations, but less than that required to produce dizziness. The morning after the first 1-h humming session, the subject awoke with a clear nose and found himself breathing easily through his nose for the first time in over 1 month. During the following 4 days, CRS symptoms slightly reoccurred, but with much less intensity each day. By humming 60-120 times four times per day (with a session at bedtime), CRS symptoms were essentially eliminated in 4 days. Coincidentally, the subject's cardiac arrhythmias (PACs) were greatly lessened. It is

  7. Azelastine Ophthalmic

    MedlinePlus

    ... than prescribed by your doctor.To instill the eye drops, follow these steps: Wash your hands thoroughly with ... dropper tip against your eye or anything else; eye drops and droppers must be kept clean. While tilting ...

  8. Desmopressin Nasal

    MedlinePlus

    ... stop some types of bleeding in people with hemophilia (condition in which the blood does not clot ... When desmopressin nasal (Stimate®) is used to treat hemophilia and von Willebrand's disease, 1 to 2 spray(s) ...

  9. Simultaneous determination of Fluticasone propionate and Azelastine hydrochloride in the presence of pharmaceutical dosage form additives.

    PubMed

    Merey, Hanan A; El-Mosallamy, Sally S; Hassan, Nagiba Y; El-Zeany, Badr A

    2016-05-05

    Fluticasone propionate (FLU) and Azelastine hydrochloride (AZE) are co-formulated with phenylethyl alcohol (PEA) and Benzalkonium chloride (BENZ) (as preservatives) in pharmaceutical dosage form for treatment of seasonal allergies. Different spectrophotometric methods were used for the simultaneous determination of cited drugs in the dosage form. Direct spectrophotometric method was used for determining of AZE, while Derivative of double divisor of ratio spectra (DD-RS), Ratio subtraction coupled with ratio difference method (RS-RD) and Mean centering of the ratio spectra (MCR) are used for the determination of FLU. The linearity of the proposed methods was investigated in the range of 5.00-40.00 and 5.00-80.00μg/mL for FLU and AZE, respectively. The specificity of the developed methods was investigated by analyzing laboratory prepared mixtures containing different ratios of cited drugs in addition to PEA and their pharmaceutical dosage form. The validity of the proposed methods was assessed using the standard addition technique. The obtained results were statistically compared with those obtained by official or the reported method for FLU or AZE, respectively showing no significant difference with respect to accuracy and precision at p=0.05. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. Simultaneous determination of Fluticasone propionate and Azelastine hydrochloride in the presence of pharmaceutical dosage form additives

    NASA Astrophysics Data System (ADS)

    Merey, Hanan A.; El-Mosallamy, Sally S.; Hassan, Nagiba Y.; El-Zeany, Badr A.

    2016-05-01

    Fluticasone propionate (FLU) and Azelastine hydrochloride (AZE) are co-formulated with phenylethyl alcohol (PEA) and Benzalkonium chloride (BENZ) (as preservatives) in pharmaceutical dosage form for treatment of seasonal allergies. Different spectrophotometric methods were used for the simultaneous determination of cited drugs in the dosage form. Direct spectrophotometric method was used for determining of AZE, while Derivative of double divisor of ratio spectra (DD-RS), Ratio subtraction coupled with ratio difference method (RS-RD) and Mean centering of the ratio spectra (MCR) are used for the determination of FLU. The linearity of the proposed methods was investigated in the range of 5.00-40.00 and 5.00-80.00 μg/mL for FLU and AZE, respectively. The specificity of the developed methods was investigated by analyzing laboratory prepared mixtures containing different ratios of cited drugs in addition to PEA and their pharmaceutical dosage form. The validity of the proposed methods was assessed using the standard addition technique. The obtained results were statistically compared with those obtained by official or the reported method for FLU or AZE, respectively showing no significant difference with respect to accuracy and precision at p = 0.05.

  11. Evaluation of the efficacy of olopatadine hydrochloride 0.1% ophthalmic solution and azelastine hydrochloride 0.05% ophthalmic solution in the conjunctival allergen challenge model.

    PubMed

    Spangler, D L; Bensch, G; Berdy, G J

    2001-08-01

    Olopatadine hydrochloride 0.1% ophthalmic solution and azelastine hydrochlofide 0.05% ophthalmic solution are 2 topical antiallergic agents indicated for the treatment of itching of the eye associated with allergic conjunctivitis. Olopatadine has recently received US Food and Drug Administration (FDA) approval for an expanded indication for the treatment of signs and symptoms of allergic conjunctivitis, including itching, tearing, eyelid swelling, redness, and chemosis. The purpose of this study was to compare the efficacy of olopatadine hydrochloride versus azelastine hydrochloride and placebo (artificial tears) in the conjunctival allergen challenge (CAC) model. This was a prospective, randomized, double-masked, contralaterally controlled, multicenter, allergen-challenge study. Itching was chosen as the primary efficacy variable since it is the only FDA-approved indication these 2 agents have in common. Subjects with a history of allergic conjunctivitis who responded to the CAC at screening visits 1 and 2 were randomized to 1 of 3 treatment groups: olopatadine in 1 eye and azelastine in the other eye; olopatadine in 1 eye and placebo in the other eye; or azelastine in 1 eye and placebo in the other eye. At the assessment visit (visit 3), subjects received masked study medication according to the randomization scheme. After 5 minutes, subjects were bilaterally challenged with the allergen concentration that had elicited a positive conjunctival allergic response at visits 1 and 2. Immediately after challenge, subjects gave itching assessments (scale, 0 = no itching to 4 = severe itching) every 30 seconds for a total period of 20 minutes. Mean itching scores for all eyes were compared by treatment. Mean itching scores at each time point were compared between treatments using 2 sample t tests. Of the 180 subjects screened, 111 responded to the CAC at visits 1 and 2 and completed the study; 65% (72/111) of patients were female, 87% (97/111) were white, and 49% (54

  12. Video-rhino-hygrometer: a new method for evaluation of nasal breathing after nasal surgery.

    PubMed

    Casale, Manuele; Pappacena, Marco; Setola, Roberto; Soda, Paolo; Cusimano, Valerio; Vitali, Massimiliano; Mladina, Ranko; Salvinelli, Fabrizio

    2010-01-01

    Nasal obstruction is one of the most frequent symptoms in the ear, nose, and throat (ENT) setting. It can be evaluated either subjectively or objectively. In a subjective way, a visual analog scale (VAS) and the Sino-Nasal Outcome Test 20 (SNOT 20) can rapidly quantify the degree of obstruction, whereas the most commonly used objective methods are nasal endoscopy and active anterior rhinomanometry (AAR). It is still a matter of controversy to what extent the sense of nasal obstruction is associated with objective measures for nasal space and airflow. The aim of the study was to evaluate nasal breathing before and after functional nasal surgery by video-rhino-hygrometer (VRH) comparing the results with widely accepted methods. Twenty patient candidates for septoplasty and inferior turbinate reduction were included in the study. SNOT-20, VAS, nasal endoscopy, and AAR were analyzed and compared with VRH values. Before surgery VRH showed variability of nasal respiratory flow between individuals and between nostrils. After surgery we had an increase (p < 0.05) of airflow in both nostrils. VRH data were found to be correlated with VAS and SNOT-20 values (p < 0.05) both pre- and postoperatively. Despite the statistically significant correlation of AAR with SNOT-20 and VAS, no statistically significant correlation between AAR and VRH was found. VRH provides an immediate, easy, and noninvasive assessment of nasal respiration. For these reasons it can be used, in association with rhinoscopic data and other instrumental tests, to evaluate nasal breathing in daily ENT practice.

  13. Nasal ventilation.

    PubMed Central

    Simonds, A. K.

    1998-01-01

    Nasal intermittent positive pressure ventilation is likely to have an increasing role in the management of acute ventilatory failure, weaning, and chronic ventilatory problems. Further improvements in ventilator and mask design will be seen. Appropriate application is likely to reduce both mortality and admissions to intensive care, while domiciliary use can improve life expectancy and/or quality of life in chronic ventilatory disorders. As with any new technique, enthusiasm should not outweigh clear outcome information, and possible new indications should always be subject to careful assessment. Images Figure 2 PMID:9799887

  14. Fabrication of a provisional nasal prosthesis.

    PubMed

    Rosen, Evan B; Golden, Marjorie; Huryn, Joseph M

    2014-11-01

    A technique for making a provisional nasal prosthesis for interim use after the ablation of a midface tumor is described. The technique is especially useful for the re-creation of a nasal form in an expedient and cost-effective manner. A preoperative definitive cast, or moulage, of the patient that includes a nasal form is used to fabricate a vacuum form of the midface. The vacuum form is evaluated on the patient, the extension is adjusted, and an external adhesive knit liner is applied to give the appearance of a contoured nasal bandage. The provisional nasal prosthesis is attached with medical adhesive tape and removed daily by the patient. The prosthesis is easily replaced during the course of treatment and has been found to be functional and esthetically acceptable to those patients receiving care from the Dental Service at Memorial Sloan Kettering Cancer Center.

  15. Nasalance, nasality, voice, and articulation after uvulopalatopharyngoplasty.

    PubMed

    Van Lierde, Kristiane M; Van Borsel, John; Moerman, Mieke; Van Cauwenberge, Paul

    2002-05-01

    The main purpose of the study was to determine the impact of uvulopalatopharyngoplasty (UPPP) on nasalance and nasality. It was hypothesized that nasalance would change from the presurgical to the postsurgical condition because the surgical protocol involves removal of palatal tissue. An additional objective of the study was to provide objective and subjective data about changes in voice and articulation after UPPP. Because the surgical procedure of UPPP does not involve laryngeal tissue, it was hypothesized that the voice characteristics remain relatively stable. Because of removal of effective velar length, articulation problems of the uvular /R/ can occur in the Dutch language. Prospective study in which 26 men were studied before (1 week before UPPP) and after (3 weeks after UPPP) surgery. The Nasometer was used to obtain nasalance scores. The mirror-fogging test, a perceptual evaluation of each subject's readings, and the Gutzmann and the Bzoch hypernasality tests were used for the assessment of nasality. For the assessment of articulation, a phonetic analysis was performed. Voice assessment included a perceptual rating of the voice and a determination of fundamental frequency. No significant differences were found between the conditions before and after surgery regarding nasalance (except for the vowel /i/), nasality, and voice. Regarding articulation, only 1 patient showed a derhotacized /R/. The findings of the study indicate that UPPP does not have an impact on nasality, voice, and articulation. Regarding nasalance, no significant nasalance change occurred after UPPP, except for the high vowel /i/.

  16. Simultaneous enantioselective separation of azelastine and three of its metabolites for the investigation of the enantiomeric metabolism in rats. I. Liquid chromatography-ionspray tandem mass spectrometry and electrokinetic capillary chromatography.

    PubMed

    Heinemann, Ute; Blaschke, Gottfried; Knebel, Norbert

    2003-08-15

    Enantioselective separation methods and the enantioselective determination of the anti-allergic drug azelastine and of three of its main phase I metabolites in a biological matrix underwent chromatographic and electrophoretic investigations. An enantioselective assay of a coupling of HPLC using a beta-cyclodextrin chiral stationary phase to ionspray tandem mass spectrometry is presented. Additionally, this assay is compared to another enantioselective assay using electrokinetic capillary chromatography with beta-cyclodextrin and carboxymethyl-beta-cyclodextrin in polyacrylamide-coated capillaries. For capillary electrophoresis (CE) the importance of polyacrylamide coating for the validation of this separation method is highlighted. Extracted rat plasma samples of enantioselective metabolism studies were measured by both validated assays. Differences in the pharmacokinetics and pharmacodynamics were evaluated for the main substance azelastine and its main metabolite demethylazelastine. So, a first hint about the enantioselectivity of biotransformation of azelastine in rats was seen after oral application of either enantiomer or the racemate to rats.

  17. Deprojecting the nasal profile.

    PubMed

    Papel, I D; Mabrie, D C

    1999-02-01

    The nose is the most prominent aesthetic feature of the facial profile. Nasal length, tip rotation, and tip projection are integral aspects in analysis of the nasal profile. In most rhinoplasties the surgeon has the difficult task of increasing or maintaining tip projection of an underprojected or normally projected nasal tip. Less commonly, the rhinoplastic surgeon is presented with an overprojected nasal tip, and efforts are focused on deprojecting the nasal profile. In this article, the authors present a discussion of the overprojected tip, elucidating strategies of analysis, etiologies, and management of the nasal profile and give clinical examples.

  18. Nasal Injuries in Sports.

    PubMed

    Marston, Alexander P; O'Brien, Erin K; Hamilton, Grant S

    2017-04-01

    Nasal trauma is a common consequence of athletic competition. The nasal bones are the most commonly fractured facial bone and are particularly at risk during sports participation. Acute management of trauma to the nose includes thorough evaluation of all injuries and may require immediate management for repair of facial lacerations, epistaxis control, or septal hematoma drainage. Nasal fractures can often be addressed with closed reduction techniques; however, in the setting of complex nasal trauma, an open approach may be indicated. Using appropriate treatment techniques, posttraumatic nasal sequelae can be minimized; most patients report satisfactory long-term nasal form and function.

  19. Effects of olopatadine hydrochloride nasal spray 0.6% in the treatment of seasonal allergic rhinitis: a phase III, multicenter, randomized, double-blind, active- and placebo-controlled study in adolescents and adults.

    PubMed

    Shah, Shailen R; Nayak, Anjuli; Ratner, Paul; Roland, Peter; Michael Wall, G

    2009-01-01

    Seasonal allergic rhinitis (SAR) is an allergen-induced inflammatory reaction that occurs during periods of high pollen count. Current treatments for SAR include allergen avoidance, systemic antihistamines, and steroidal and nonsteroidal intranasal sprays. Olopatadine is a selective antihistamine and an inhibitor of proinflammatory mediators from human mast cells. An intranasal formulation of olopatadine has been developed for the treatment of SAR. The aim of this study was to compare the efficacy and tolerability of olopatadine hydrochloride nasal spray 0.6% (OLO) relative to azelastine hydrochloride nasal spray 0.1% (AZE) and an inactive vehicle in the treatment of SAR. This Phase III, multicenter, randomized, double-blind, active- and placebo-controlled, parallel-group study was conducted at 21 centers across the United States. Eligible patients were aged > or =12 years and had a history of SAR and verified allergy to a prevalent local allergen. After a run-in period during which inactive vehicle was administered, patients were randomly assigned to OLO, AZE (active control), or inactive vehicle (identical to OLO; placebo control), 2 sprays in each nostril BID for 16 days. The timing of enrollment was correlated with the start of the allergy season at each site. Symptoms were recorded twice daily in an electronic diary. Efficacy assessments included changes in mean daily reflective total nasal symptom scores (TNSS). Tolerability was evaluated based on adverse events (AEs) and nasal, physical, and cardiovascular parameters. A total of 544 patients were randomized. The mean age was 36 years (range, 12-77 years); men and boys represented 32.2% of the population; and the patients were predominantly white (75.4%). The mean reductions from baseline in reflective TNSS were 26.8%, 29.9%, and 18.4% with OLO, AZE, and inactive vehicle, respectively (P = 0.003 OLO vs inactive vehicle; 95% CI, -2.5% to 8.7% OLO vs AZE [non-inferiority]). The most commonly reported treatment

  20. Beclomethasone Nasal Spray

    MedlinePlus

    ... the lining of the nose) after nasal polyp removal surgery. Beclomethasone nasal spray should not be used ... room temperature and away from excess heat and moisture (not in the bathroom).Unneeded medications should be ...

  1. Triamcinolone Nasal Spray

    MedlinePlus

    ... itchy nose and itchy, watery eyes caused by hay fever or other allergies. Triamcinolone nasal spray should not ... germs.Triamcinolone nasal spray controls the symptoms of hay fever and allergies but does not cure these conditions. ...

  2. Azelastine hydrochloride (Azeptin) inhibits peplomycin (PLM)-induced pulmonary fibrosis by contradicting the up-regulation of signal transduction.

    PubMed

    Yoneda, K; Yamamoto, T; Ueta, E; Osaki, T

    1997-10-01

    Inhibition of peplomycin (PLM)-induced pulmonary fibrosis by azelastine hydrochloride (Azeptin) was examined using ICR mice, and the effects of both drugs on signal transduction were investigated. Microscopically, Azeptin (a total of 56 mg/kg for 28 days) suppressed pulmonary fibrosis in mice which received an i.p. injection of a total of 60 or 75 mg/kg PLM. In parallel with the microscopic findings, smaller amounts of collagen were synthesized in the lungs of Azeptin-injected mice. PLM enhanced the expression of interleukin-1 beta- and transforming growth factor-beta-mRNA in lungs. In contrast, Azeptin suppressed the expression. Compatible with these in vivo results, Azeptin and PLM contradictively regulated protein tyrosine phosphorylation and c-myc mRNA expression in human gingival and mouse pulmonary fibroblasts. In addition, NF-kappa B was activated by fibroblast treatment with 5 micrograms/ml PLM for 1 h, but intranuclear NF-kappa B was decreased by cell treatment with 10(-5) M Azeptin. From these results, it is concluded that Azeptin inhibits PLM-induced pulmonary fibrosis by antagonizing the up-regulation of signal transduction.

  3. Nasal Harmony in Aguaruna.

    ERIC Educational Resources Information Center

    Moon, Gui-Sun

    A discussion of the nasal harmony of Aguaruna, a language of the Jivaroan family in South America, approaches the subject from the viewpoint of generative phonology. This theory of phonology proposes an underlying nasal consonant, later deleted, that accounts for vowel nasalization. Complex rules that suppose a complex system of vowel and…

  4. Nasal Harmony in Aguaruna.

    ERIC Educational Resources Information Center

    Moon, Gui-Sun

    A discussion of the nasal harmony of Aguaruna, a language of the Jivaroan family in South America, approaches the subject from the viewpoint of generative phonology. This theory of phonology proposes an underlying nasal consonant, later deleted, that accounts for vowel nasalization. Complex rules that suppose a complex system of vowel and…

  5. Nasal septal hematoma.

    PubMed

    Ginsburg, C M

    1998-04-01

    Nasal septal hematoma is a rare but potentially serious complication of nasal trauma. Proper management consists of early recognition, prompt surgical evacuation of the hematoma, and antimicrobial therapy if a secondary nasal septal abscess is suspected. Clindamycin is recommended as initial therapy until the results of cultures and susceptibility studies are available.

  6. Nasal computed tomography.

    PubMed

    Kuehn, Ned F

    2006-05-01

    Chronic nasal disease is often a challenge to diagnose. Computed tomography greatly enhances the ability to diagnose chronic nasal disease in dogs and cats. Nasal computed tomography provides detailed information regarding the extent of disease, accurate discrimination of neoplastic versus nonneoplastic diseases, and identification of areas of the nose to examine rhinoscopically and suspicious regions to target for biopsy.

  7. [Nasal fractures in adults].

    PubMed

    Sjöstedt, Sannia; Larsen, Christian Grønhøj; Bilde, Anders; von Buchwald, Christian

    2016-03-07

    The risk of complications warrants treatment of most dislocated nasal fractures. Other injuries including other facial fractures and septal haematoma must be treated if present at the initial presentation. The usual treatment for a simple nasal fracture is closed reduction in local anaesthesia after five to seven days. Complicated cases require open reduction in general anaesthesia. Later revision of the deviated nose may become necessary in patients suffering from complications such as persistent nasal stenosis and/or deformity.

  8. External Nasal Neuralgia: A Neuropathic Pain Within the Territory of the External Nasal Nerve.

    PubMed

    García-Moreno, Héctor; Aledo-Serrano, Ángel; Gimeno-Hernández, Jesús; Cuadrado, María-Luz

    2015-10-01

    Nasal pain is a challenging diagnosis and very little has been reported in the neurological literature. The nose is a sophisticated structure regarding its innervation, which is supplied by the first and second divisions of the trigeminal nerve. Painful cranial neuropathies are an important group in the differential diagnosis, although they have been described only scarcely. Here, we report a case that can conform a non-traumatic external nasal nerve neuralgia. A 76-year-old woman was referred to our office due to pain in her left nose. She was suffering from daily excruciating attacks, which were strictly limited to the territory supplied by her left external nasal nerve (left ala nasi and apex nasi). She denied previous traumatisms and the ancillary tests did not yield any underlying pathology. An anesthetic blockade of her left external nasal nerve achieved a marked reduction of the number of episodes as well as their intensity. External nasal neuralgia seems a specific neuralgia causing nasal pain. Anesthetic blockades of the external nasal nerve may be a valid treatment for this condition. © 2015 American Headache Society.

  9. The supernumerary nasal tooth.

    PubMed

    Kirmeier, R; Truschnegg, A; Payer, M; Malyk, J; Daghighi, S; Jakse, N

    2009-11-01

    Teeth exceeding the normal dental complement that have erupted into the nasal cavity are a rare pathological entity. This case report describes a female patient with recurrent complaints and fetid discharge from the left nasal cavity. The suspected clinical diagnosis of a supernumerary nasal tooth was confirmed by computed tomography. After endoscopic removal, the tooth was examined using X-ray microtomography and thin-section preparations; these findings are presented for the first time. A literature search identified 25 supernumerary nasal teeth in 23 patients.

  10. Measuring Nasal Obstruction.

    PubMed

    Keeler, Jarrod; Most, Sam P

    2016-08-01

    The nose and the nasal airway is highly complex with intricate 3-dimensional anatomy, with multiple functions in respiration and filtration of the respired air. Nasal airway obstruction (NAO) is a complex problem with no clearly defined "gold-standard" in measurement. There are 3 tools for the measurement of NAO: patient-derived measurements, physician-observed measurements, and objective measurements. We continue to work towards finding a link between subjective and objective nasal obstruction. The field of evaluation and surgical treatment for NAO has grown tremendously in the past 4-5 decades and will continue to grow as we learn more about the pathophysiology and treatment of nasal obstruction.

  11. Toxicology of the nasal passages

    SciTech Connect

    Barrow, C.S.

    1986-01-01

    Contents of this work include: Comparative Anatomy and Function of the Nasal Passages; Light Microscopic Examination of the Rat Nasal Passages: Preparation and Morphologic Features; Histopathology of Acute and Subacute Nasal Toxicity; Pathology of Chronic Nasal Toxic Responses Including Cancer; Responses of the Nasal Mucociliary Apparatus to Airborne Irritants; Effects of Chemical Exposure on Olfaction in Humans, Possible Consequences of Cytochrome P-450-Dependent Monooxygenases in Nasal Tissues.

  12. Nasality in Taiwanese

    ERIC Educational Resources Information Center

    Pan, Ho-hsien

    2004-01-01

    This study used perceptual and articulatory data to investigate a language specific phonemic inventory, and allophonic rules for homorganic initial voiced stops versus homorganic nasal stops, and oral versus nasal vowels in Taiwanese. Four experiments were conducted: concept formation, gating, and two airflow studies. Results of a first nasal…

  13. Nasality in Taiwanese

    ERIC Educational Resources Information Center

    Pan, Ho-hsien

    2004-01-01

    This study used perceptual and articulatory data to investigate a language specific phonemic inventory, and allophonic rules for homorganic initial voiced stops versus homorganic nasal stops, and oral versus nasal vowels in Taiwanese. Four experiments were conducted: concept formation, gating, and two airflow studies. Results of a first nasal…

  14. Lining in nasal reconstruction.

    PubMed

    Haack, Sebastian; Fischer, Helmut; Gubisch, Wolfgang

    2014-06-01

    Restoring nasal lining is one of the essential parts during reconstruction of full-thickness defects of the nose. Without a sufficient nasal lining the whole reconstruction will fail. Nasal lining has to sufficiently cover the shaping subsurface framework. But in addition, lining must not compromise or even block nasal ventilation. This article demonstrates different possibilities of lining reconstruction. The use of composite grafts for small rim defects is described. The limits and technical components for application of skin grafts are discussed. Then the advantages and limitations of endonasal, perinasal, and hingeover flaps are demonstrated. Strategies to restore lining with one or two forehead flaps are presented. Finally, the possibilities and technical aspects to reconstruct nasal lining with a forearm flap are demonstrated. Technical details are explained by intraoperative pictures. Clinical cases are shown to illustrate the different approaches and should help to understand the process of decision making. It is concluded that although the lining cannot be seen after reconstruction of the cover it remains one of the key components for nasal reconstruction. When dealing with full-thickness nasal defects, there is no way to avoid learning how to restore nasal lining.

  15. Nasal dermoid sinus cyst.

    PubMed

    Cauchois, R; Laccourreye, O; Bremond, D; Testud, R; Küffer, R; Monteil, J P

    1994-08-01

    Nasal dermoid sinus cyst is one of the diagnoses of midline nasal masses in children. This retrospective study analyzes the various theories regarding the origin of this congenital abnormality, the differential diagnosis, and the value of magnetic resonance imaging, as well as the various surgical options available.

  16. [Nasal allergenic provocation test].

    PubMed

    Becerril Angeles, M H; Pérez López, A; Azuara Pliego, E

    2000-01-01

    This is a method to evaluate both specific sensitivity to allergens in the nasal mucosa, IgE-mediated hypersensitivity, and antiinflammatory and antiallergic drugs efficacy, whose objectives are for research in diagnosis and treatment. The method is based in allergen extracts delivery in the nasal mucosa and the post-challenge measurement of rhinitis symptoms, vasoactive mediators release quantification and nasal obstruction degree evaluated by rhinomanometry. Nasal allergen challenge is a procedure of diagnostic and therapeutic evaluation usefulness, that must be performed in selected patients, in adequate facilities, by experts physicians, with standardised allergen dosages, in an specific nasal area, with objective measurements (rhinomanometry, mediators and secretions of the allergic response) and symptoms scoring that allow get reliable results in patients with allergic rhinitis under study.

  17. Nanoparticles for nasal vaccination.

    PubMed

    Csaba, Noemi; Garcia-Fuentes, Marcos; Alonso, Maria Jose

    2009-02-27

    The great interest in mucosal vaccine delivery arises from the fact that mucosal surfaces represent the major site of entry for many pathogens. Among other mucosal sites, nasal delivery is especially attractive for immunization, as the nasal epithelium is characterized by relatively high permeability, low enzymatic activity and by the presence of an important number of immunocompetent cells. In addition to these advantageous characteristics, the nasal route could offer simplified and more cost-effective protocols for vaccination with improved patient compliance. The use of nanocarriers provides a suitable way for the nasal delivery of antigenic molecules. Besides improved protection and facilitated transport of the antigen, nanoparticulate delivery systems could also provide more effective antigen recognition by immune cells. These represent key factors in the optimal processing and presentation of the antigen, and therefore in the subsequent development of a suitable immune response. In this sense, the design of optimized vaccine nanocarriers offers a promising way for nasal mucosal vaccination.

  18. Efficacy of mometasone furoate nasal spray for nasal symptoms, quality of life, rhinitis-disturbed sleep, and nasal nitric oxide in patients with perennial allergic rhinitis.

    PubMed

    Yamada, Takechiyo; Yamamoto, Hideyuki; Kubo, Seita; Sakashita, Masafumi; Tokunaga, Takahiro; Susuki, Dai; Narita, Norihiko; Ogi, Kazuhiro; Kanno, Masafumi; Yamashita, Shinji; Terasawa, Yuko; Kayano, Yuichiro; Masada, Mikio; Fujieda, Shigeharu

    2012-01-01

    Intranasal corticosteroid therapy has exhibited effectiveness for improving nasal symptoms and quality of life (QOL) scores associated with seasonal allergic rhinitis. We prospectively investigated the efficacy of mometasone furoate nasal spray (MFNS) for improving the total nasal symptom score, QOL score, and sleep quality in subjects with perennial allergic rhinitis (PAR). Nasal airway conditions were also objectively assessed by measuring nasal nitric oxide (NO). Fifty-seven patients with PAR were randomized to MFNS or placebo for a 14-day, double-blind, crossover study. The subjects recorded their symptoms on nasal symptom forms and a visual analog scale. QOL and sleep quality were surveyed in accordance with the Japanese version of the Rhinoconjunctivitis Quality of Life Questionnaire (JRQLQ) and the Japanese version of the Epworth Sleepiness Scale. Nasal NO was measured during a single exhalation using a chemiluminescence analyzer. MFNS treatment achieved significant reductions versus placebo for total nasal symptoms (p < 0.001). There were significant decreases of the usual daily activity domain (p < 0.005), outdoor activities (p < 0.01), social function (p < 0.05), and the overall QOL score (p < 0.05) of JRQLQ with MFNS therapy versus placebo. A significant reduction of the sleepiness scale was also observed in the MFNS group with high sleep disturbance (p < 0.01). A significant decrease of nasal NO was found in the MFNS group (p < 0.01), especially among patients with severe nasal symptoms (p < 0.005). This prospective study indicated that MFNS therapy significantly improves nasal symptoms, QOL, sleep quality, and upper airway condition in Japanese subjects with PAR.

  19. Similarity and Enhancement: Nasality from Moroccan Arabic Pharyngeals and Nasals

    ERIC Educational Resources Information Center

    Zellou, Georgia Eve

    2012-01-01

    Experimental studies of the articulation, acoustics, and perception of nasal and pharyngeal consonants and adjacent vowels were conducted to investigate nasality in Moroccan Arabic (MA). The status of nasality in MA is described as coarticulatorily complex, where two phoneme types (pharyngeal segments and nasal segments) yield similar…

  20. Comparison of Nasal Acceleration and Nasalance across Vowels

    ERIC Educational Resources Information Center

    Thorp, Elias B.; Virnik, Boris T.; Stepp, Cara E.

    2013-01-01

    Purpose: The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Method: Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using…

  1. Similarity and Enhancement: Nasality from Moroccan Arabic Pharyngeals and Nasals

    ERIC Educational Resources Information Center

    Zellou, Georgia Eve

    2012-01-01

    Experimental studies of the articulation, acoustics, and perception of nasal and pharyngeal consonants and adjacent vowels were conducted to investigate nasality in Moroccan Arabic (MA). The status of nasality in MA is described as coarticulatorily complex, where two phoneme types (pharyngeal segments and nasal segments) yield similar…

  2. Comparison of Nasal Acceleration and Nasalance across Vowels

    ERIC Educational Resources Information Center

    Thorp, Elias B.; Virnik, Boris T.; Stepp, Cara E.

    2013-01-01

    Purpose: The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Method: Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using…

  3. Nasal septal trauma in children.

    PubMed

    Olsen, K D; Carpenter, R J; Kern, E B

    1979-07-01

    If the septal component of a nasal injury is adequately managed, usually the entire nasal injury will be well managed. Major or minor nasal trauma can cause cartilage fracture, deviation, dislocation, hematoma, or abscess formation, and the various associated sequelae, some of them life-threatening. A negative x-ray report should never be used as a substitute for a complete intranasal examination in any child with nasal trauma. Any nasal abnormality should be referred for immediate evaluation and treatment.

  4. Nasal corticosteroid sprays

    MedlinePlus

    ... best for decreasing symptoms during that season. Several brands of nasal corticosteroid sprays are available. They all ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  5. Budesonide Nasal Spray

    MedlinePlus

    ... by an allergy to pollen, mold, dust, or pets). Budesonide nasal spray should not be used to ... disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, ...

  6. Cyanocobalamin Nasal Gel

    MedlinePlus

    ... B12 can cause anemia (condition in which the red blood cells do not bring enough oxygen to the organs) ... be treated with vitamin B12 injections. After the red blood cells have returned to normal, cyanocobalamin nasal gel can ...

  7. Nasal fracture (image)

    MedlinePlus

    A nasal fracture is a break in the bone over the ridge of the nose. It usually results from a blunt ... and is one of the most common facial fracture. Symptoms of a broken nose include pain, blood ...

  8. Chapter 6: Nasal polyps.

    PubMed

    Settipane, Russell A; Peters, Anju T; Chiu, Alexander G

    2013-01-01

    Nasal polyps occur in 1-4% of the population, usually occurring in the setting of an underlying local or systemic disease. The most common associated condition is chronic rhinosinusitis (CRS). A high prevalence of nasal polyps is also seen in allergic fungal rhinosinusitis, aspirin-exacerbated respiratory disease, Churg-Strauss syndrome, and cystic fibrosis. In the setting of CRS, nasal polyps are not likely to be cured by either medical or surgical therapy; however, control is generally attainable. The best medical evidence supports the use of intranasal corticosteroids for maintenance therapy and short courses of oral corticosteroids for exacerbations. The evidence for short- and long-term antibiotics is much less robust. For patients with symptomatic nasal polyposis nonresponsive to medical therapies, functional endoscopic sinus surgery provides an adjunctive therapeutic option.

  9. Nasal packing and stenting

    PubMed Central

    Weber, Rainer K.

    2011-01-01

    Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue. PMID:22073095

  10. Saline nasal washes

    MedlinePlus

    ... Be sure you only use distilled, boiled, or filtered water. While rare, some tap water may contain small ... pot or nasal bulb with distilled, boiled, or filtered water after every use and let it dry. Use ...

  11. [Smokers develop a nasal obstruction in supine position].

    PubMed

    Gudziol, H; Krause, J; Stadeler, M; Guntinas-Lichius, O

    2011-07-01

    We found in a previous study a healthy non-smoker nose does not develop obstruction lying in supine position . We examined whether a designated smoker nose behaves consistently. 39 healthy young smokers participated. The daily consumption was Ø 21 cigarettes. 9 test positions have been realized. Acoustic rhinometry was used for the estimation of nasal volumes and the nasal minimum cross-sectional areas as parameters for nasal respiration. Additionally, blood pressure and heart rate were measured to control the cardiovascular behavior. The total nasal volume decreased significantly lying down. Only one third of the volunteers noticed this obstruction. Going upstairs all measured parameters increased. 2 min later all rhinometric parameters, the diastolic blood pressure and heart rate had reached its baseline level. Systolic blood pressure took about 4 min. A cigarette smoke-induced nasal obstruction can be demonstrated during supine position using the acoustic rhinometry. One third of smokers noted a deterioration of nasal breathing. During stairs climbing the sympathic tone is increasing followed by nasal decongestion, raised blood pressure and heart rate. If smokers complaint of nasal obstruction in lying position - whether alert or during sleep - it is advisable to lift the bed-head. In medium term a therapy of chronic rhinitis with topical corticosteroids, in longer term a smoking cessation is recommended. © Georg Thieme Verlag KG Stuttgart · New York.

  12. Pathophysiology of nasal congestion

    PubMed Central

    Naclerio, Robert M; Bachert, Claus; Baraniuk, James N

    2010-01-01

    Nasal congestion is a common symptom in rhinitis (both allergic and nonallergic), rhinosinusitis and nasal polyposis. Congestion can also be caused by physical obstruction of nasal passages and/or modulation of sensory perception. Mucosal inflammation underlies many of the specific and interrelated factors that contribute to nasal congestion, as well as other symptoms of both allergic rhinitis and rhinosinusitis. A wide range of biologically active agents (eg, histamine, tumor necrosis factor-α, interleukins, cell adhesion molecules) and cell types contribute to inflammation, which can manifest as venous engorgement, increased nasal secretions and tissue swelling/edema, ultimately leading to impaired airflow and the sensation of nasal congestion. Inflammation-induced changes in the properties of sensory afferents (eg, expression of peptides and receptors) that innervate the nose can also contribute to altered sensory perception, which may result in a subjective feeling of congestion. Increased understanding of the mechanisms underlying inflammation can facilitate improved treatment selection and the development of new therapies for congestion. PMID:20463823

  13. Titanium Mesh Nasal Repair without Nasal Lining.

    PubMed

    Zenga, Joseph; Kao, Katherine; Chen, Collin; Gross, Jennifer; Hahn, Samuel; Chi, John J; Branham, Gregory H

    2017-02-01

    The objective of this study was to describe outcomes for patients who underwent titanium mesh reconstruction of full-thickness nasal defects without internal lining repair. This is a retrospective cohort study. Patients with through-and-through nasal defects were identified at a single academic institution between 2008 and 2016. Nasal reconstruction was performed with either titanium mesh and external skin reconstruction without repair of the intranasal lining or traditional three-layer closure. Five patients underwent titanium mesh reconstruction and 11 underwent traditional three-layer repair. Median follow-up was 11 months (range, 2-66 months). The only significant difference between groups was older age in patients undergoing titanium reconstruction (mean, 81 vs. 63 years; difference of 18; 95% confidence interval [CI], 4-32 years). Defect extent including overall size and structures removed was similar between groups (p > 0.05). Paramedian forehead flap was the most common external reconstruction in both groups (100% for titanium mesh and 73% for three-layer closure). Time under anesthesia was significantly shorter for titanium mesh reconstruction (median, 119 vs. 314 minutes; difference of 195; 95% CI, 45-237). Estimated blood loss and length of hospital stay were similar between groups (p > 0.05). Complication rates were substantial although not significantly different, 40 and 36% in titanium and three-layer reconstruction, respectively (p > 0.05). All patients with complications after titanium reconstruction had prior or postoperative radiotherapy. Titanium mesh reconstruction of through-and-through nasal defects can successfully be performed without reconstruction of the intranasal lining, significantly decreasing operative times. This reconstructive technique may not be suitable for patients who undergo radiotherapy.

  14. Testosterone nasal gel (Natesto) for hypogonadism.

    PubMed

    2015-05-11

    In one study, Natesto nasal gel administered intranasally 3 times daily was effective in raising low serum testosterone levels into the normal range in patients with hypogonadism. Whether patients will find this method of administration more acceptable than an intramuscular injection every 2-4 weeks or once-daily application to the skin remains to be determined. Based on the lack of convincing evidence of benefit in older men and concerns about its safety, the FDA has warned against using testosterone to treat hypogonadism due solely to aging.

  15. Assessment of the performance of nasal pillows at high CPAP pressures.

    PubMed

    Zhu, Xueling; Wimms, Alison J; Benjafield, Adam V

    2013-09-15

    Compliance with CPAP therapy remains an issue despite its effectiveness. Mask selection is likely to affect a patients experience with CPAP, and multiple mask options are currently available. Nasal pillows have less contact with the face compared to nasal masks and may benefit patients by minimizing side effects; however, they are infrequently used at high CPAP pressures. The aim of this study was to examine the performance of nasal pillows at pressures ≥ 12 cm H2O compared with nasal masks. Twenty-one subjects were recruited. Participants were randomized to Swift FX nasal pillows and their current nasal mask for 7 consecutive nights each in a prospective crossover trial. Objective device data and subjective feedback were collected. There were no differences in objective device data of nasal pillows vs. nasal masks: Daily Usage 7.4 ± 1.4 vs. 7.2 ± 1.4 (h/night); 95(th)%ile Leak 28.6 ± 13.5 vs. 27.9 ± 17.9 (L/min); AHI 1.9 ± 1.3 vs. 1.7 ± 1.1, respectively (all p-values > 0.05). There were no differences between the nasal pillows and nasal masks for subjective ratings of comfort, seal, red marks, side effects such as jetting and dry nose/mouth, and overall performance (all p-values > 0.05). The nasal pillows were rated to be less obtrusive and claustrophobic (both p-values < 0.01), but less stable (p = 0.04). Overall preference was 50% nasal pillows, 45% nasal masks; 5% found no difference. Nasal pillows are as efficacious as nasal masks at CPAP pressures ≥ 12 cm H2O and are a suitable option for patients requiring high CPAP pressures. NIH Clinical Trials Registry. http://clinicaltrials.gov. Nasal Pillows at High CPAP Pressure. Identifier: NCT01690923.

  16. Chondrosarcoma of the nasal septum

    PubMed Central

    Bahgat, Mohammed; Bahgat, Yassin; Bahgat, Ahmed; Elwany, Yasmine

    2012-01-01

    Chondrosarcoma of the nasal septum is a rare malignancy. When it occurs, early diagnosis is difficult because patients generally present with common, non-specific sinonasal complaints. This is the report of a 62-year-old woman who presented with a 1-month history of nasal obstruction, headache and anosmia. Nasal endoscopy showed a nasal mass obstructing both nasal cavities not separable from the septum. A wedge biopsy of the nasal mass was taken. Histopathology was suggestive of chondrosarcoma. The tumour was removed by an endoscopic approach. The clinical presentation, diagnosis and treatment of this case as well as a review of the literature are discussed. PMID:22669930

  17. Infarcted angiomatous nasal polyps.

    PubMed

    Sheahan, Patrick; Crotty, Paul L; Hamilton, Sam; Colreavy, Michael; McShane, Donald

    2005-03-01

    Angiomatous nasal polyps are a rarely reported subtype of inflammatory sinonasal polyps that are characterized by extensive vascular proliferation and ectasia. Compromise of their vascular supply may occasionally lead to infarction, resulting in clinical, radiological and pathological features that simulate a neoplastic process. In the present paper, the salient characteristics of this unusual entity are described. The clinical, radiological and pathological features of two patients with infarcted angiomatous nasal polyps are presented. Grossly, the polyps had an unusual inhomogenous appearance and texture and were associated with a foul odor. CT findings included bony expansion and destruction. MRI findings included markedly inhomogenous contrast enhancement on T1-weighted images. Histopathologically, both cases showed abundant vascular ectasia, with widespread intraluminal thrombosis and necrosis. Recanalization and reparative changes were also present. Angiomatous nasal polyps are poorly documented in the literature. Although entirely benign, they may simulate neoplastic processes, thus awareness of their existence is of considerable importance.

  18. Nasal spray flu vaccine (image)

    MedlinePlus

    The flu vaccine can also be administered as a nasal spray instead of the usual injection method. It can be ... the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not ...

  19. Nasalance in Cochlear Implantees

    PubMed Central

    Sreedevi, N; Lepcha, Anjali; Mathew, John

    2015-01-01

    Objectives Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing. Methods Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated. Results Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers. Conclusion The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees. PMID:26330912

  20. Nasal reconstruction after epithelioma.

    PubMed

    Rodríguez-Camps, S

    2001-01-01

    In this paper we present our procedure for the treatment, histopathological diagnosis, and resection of skin cancer in the nasal pyramid and its subsequent reconstruction. Because we are dealing with the most important anatomical feature of the face our goal is an aesthetic reconstruction [2,4] according to the anatomical subunits criterion of Burget [3]. First, a histopathological diagnosis is made to determine the nature of the tumor. Then, we proceed with the resection according to the Mohs Micrographic Surgery [1,5,7]. Then we begin with the first step of the nasal reconstruction.

  1. Large rhinolith causing nasal obstruction

    PubMed Central

    Dincer Kose, Onur; Kose, Taha Emre; Erdem, Mehmet Ali; Cankaya, Abdulkadir Burak

    2015-01-01

    Rhinoliths are calcified masses located in the nasal cavity and may cause symptoms such as nasal obstruction, fetid odour and facial pain. They are usually diagnosed incidentally on radiographic examinations or depending on the symptoms. In this paper we report a 27-year-old Caucasian woman with a calcified mass in the right nasal cavity causing nasal obstruction, anosmia and facial pain. The calcified mass was removed by endonasal approach. PMID:25759270

  2. Nasalance Norms in Greek Adults

    ERIC Educational Resources Information Center

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni

    2011-01-01

    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal…

  3. Nasalance Norms in Greek Adults

    ERIC Educational Resources Information Center

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni

    2011-01-01

    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal…

  4. Lysosomal exoglycosidases in nasal polyps.

    PubMed

    Chojnowska, Sylwia; Minarowska, Alina; Knaś, Małgorzata; Niemcunowicz-Janica, Anna; Kołodziejczyk, Paweł; Zalewska-Szajda, Beata; Kępka, Alina; Minarowski, Łukasz; Waszkiewicz, Napoleon; Zwierz, Krzysztof; Szajda, Sławomir Dariusz

    2013-01-01

    Nasal polyps are smooth outgrowths assuming a shape of grapes, formed from the nasal mucosa, limiting air flow by projecting into a lumen of a nasal cavity. Up to now the surgical resection is the best method of their treatment, but etiology and pathogenesis of the nasal polyps is not yet fully established. The aim of the study was the assessment of the selected lysosomal exoglycosidases activity in the nasal polyps. In this study the activity of β-galactosidase, α-mannosidase and α-fucosidase was determined in the tissue of the nasal polyps obtained from 40 patients (10F, 30M) and control tissues derived from mucosa of lower nasal conchas obtained during mucotomy from 20 patients (10F, 10M). We observed significant lower values of GAL, FUC and tendency to decrease of MAN and GLU concentration in nasal polyps (P) in comparison to control healthy nasal mucosa (C). In nasal polyp tissue (P) no differences of GAL, MAN and FUC specific activity in comparison to control mucosa (C) were found. Our research supports bioelectrical theory of the nasal polyps pathogenesis and directs attention at research on glycoconjugates and glycosidases of the nasal mucosa extracellular matrix. Copyright © 2013 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

  5. Cosmetic and Functional Nasal Deformities

    MedlinePlus

    ... nasal complaints. Nasal deformity can be categorized as “cosmetic” or “functional.” Cosmetic deformity of the nose results in a less ... taste , nose bleeds and/or recurrent sinusitis . A cosmetic or functional nasal deformity may occur secondary to ...

  6. Nasal obstruction and human communication.

    PubMed

    Malinoff, R; Moreno, C

    1989-04-01

    Nasal obstruction may cause a variety of communication disorders, particularly in children. The effects of nasal obstruction on hearing, speech, language, and voice are examined. Methods for assessing the effects of nasal obstruction are delineated, and recommendations for therapeutic interventions are described.

  7. Comparison of nasal acceleration and nasalance across vowels.

    PubMed

    Thorp, Elias B; Virnik, Boris T; Stepp, Cara E

    2013-10-01

    The purpose of this study was to determine the performance of normalized nasal acceleration (NNA) relative to nasalance as estimates of nasalized versus nonnasalized vowel and sentence productions. Participants were 18 healthy speakers of American English. NNA was measured using a custom sensor, and nasalance was measured using the KayPentax Nasometer II. Speech stimuli consisted of CVC syllables with the vowels (//, /æ/, /i/, /u/) and sentences loaded with high front, high back, low front, and low back vowels in both nasal and nonnasal contexts. NNA showed a small but significant effect of the vowel produced during syllable stimuli but no significant effect of vowel loading during sentence stimuli. Nasalance was significantly affected by the vowel being produced during both syllables and sentences with large effect sizes. Both NNA and nasalance were highly sensitive and specific to nasalization. NNA was less affected by vowel than nasalance. Discrimination of nasal versus nonnasal stimuli using NNA and nasalance was comparable, suggesting potential for use of NNA for biofeedback applications. Future work to improve calibration of NNA is needed to lower intersubject variability.

  8. Routine nasal packing follwoing nasal surgery-Is it necessary?

    PubMed

    Basha, S I; Gupta, D; Kaluskar, S K

    2005-01-01

    The practice of routine nasal packing after nasal surgery is usually customary and not evidence based. Post operative complications, while uncoumon, are sometimes pack related. A retrospective analysis of 110 patients who underwent a variety of nasal operations was performed to determine the incidence of complications when nasal packs were not routinely inserted 9 cases (8.2%) [6 out of these were revision surgeries] needed nasal packing for haemostasis at the end of surgery. 4 cases (3.6%) required to be packed in the immediate post operative period. One patient who required nasal packing developed a unilateral adhesion. No patient developed septal hematoma. The need for routine nasal packing is not supported. Packing should be indicated where there continuous bleeding at.

  9. Management of nasal hemangiomas.

    PubMed

    Hochman, Marcelo; Mascareno, Alfredo

    2005-01-01

    Infantile hemangiomas commonly involve the nose. Because of the nose's prominence as an aesthetically and functionally sensitive area, management of these lesions has important implications. The available options including medical therapy, lasers, and surgery are reviewed with recommendations specific to nasal tip and lobule lesions based on the senior author's (M.H.) experience.

  10. Oxymetazoline Nasal Spray

    MedlinePlus

    ... Rinse the tip of the dispenser with hot water or wipe it clean after you use it.Follow the directions for using the nasal spray that appear on the package label. If you are using a product that comes in a pump dispenser, press down on the rim several times ...

  11. Cromolyn Sodium Nasal Solution

    MedlinePlus

    Cromolyn comes as a solution to use with a special nasal applicator. It usually is inhaled three to six times a day to prevent allergy ... first time, read the instructions provided with the solution. Ask your doctor, pharmacist, or respiratory therapist to ...

  12. Nasalance norms in Greek adults.

    PubMed

    Okalidou, Areti; Karathanasi, Asimina; Grigoraki, Eleni

    2011-08-01

    The purposes of this study were to derive nasalance norms for monolingual Greek speakers, to examine nasalance scores as a function of gender and to draw cross-linguistic comparisons based on normative data. Participants read aloud a corpus of linguistic material, consisting of (1) a nasal text, an oral text and a balanced text; (2) a set of nasal sentences and four sets of oral sentences and (3) repetitions of each of 12 syllable types (8 oral and 4 nasal). The last two sets of material corpus were based on an adaptation of the Simplified Nasometric Assessment Procedures Test (SNAP test) test ( MacKay and Kummer, 1994 ) in Greek, called the G-SNAP test. Eighty monolingual healthy young adult speakers of Greek, 40 males (mean age = 21 years) and 40 females (mean age = 20.5 years), with normal hearing and speech characteristics and unremarkable history were included in the study. The Nasometer (model 6200-3) was used to derive nasalance scores. Mean normative nasalance for spoken Greek was 25.50%, based on the G-oronasal text (with 8.6% nasals). Nasalance scores did not differ significantly with respect to gender. Finally, spoken Greek consistently yielded lower nasalance scores than other languages examined in past work. The aforementioned normative data on nasalance of young adult speakers of Greek are valid across gender and have direct clinical utility as they provide valuable reference information for the diagnosis and management of Greek adults with resonance disorders caused by velar dysfunction.

  13. Does rhinoplasty improve nasal breathing?

    PubMed

    Xavier, Rui

    2010-08-01

    Rhinoplasty is a surgical procedure that aims to improve nasal aesthetics and nasal breathing. The aesthetic improvement of the nose is usually judged subjectively by the patient and the surgeon, but the degree of improvement of nasal obstruction is difficult to assess by clinical examination only. The measurement of peak nasal inspiratory flow (PNIF) is a reliable tool that has been shown to correlate with other objective methods of assessing nasal breathing and with patients' symptoms of nasal obstruction. Twenty-three consecutive patients undergoing rhinoplasty have been evaluated by measurement of PNIF before and after surgery. All but three patients had an increase in PNIF after surgery. The mean preoperative PNIF was 86.5 L/min and the mean postoperative PNIF was 123.0 L/min ( P < 0.001). Not surprisingly, the greatest improvement in PNIF was achieved when bilateral spreader grafts were used. This study suggests that rhinoplasty does improve nasal breathing. (c) Thieme Medical Publishers

  14. Hydrocolloid dressing in preventing nasal trauma secondary to nasal continuous positive airway pressure in preterm infants

    PubMed Central

    Xie, Li- hua

    2014-01-01

    BACKGROUND: Continuous positive airway pressure (CPAP) with nasal devices (nCPAP) is widely used in the respiratory management of newborns. The present study aimed to compare the incidence of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) protected with or without hydrocolloid dressing in preterm infants. METHODS: This prospective controlled study was performed in the neonatal intensive care unit (NICU) of the Children’s Hospital of Hunan Province from March 1, 2010 to June 31, 2010. A total of 65 infants, 46 males and 19 females, were recruited in this study. Their average gestational age was 32.6 weeks (range 28–37 weeks). The infants were randomly divided into clinical trial group (group A, n=33) and control group (group B, n=32). Paraffin oil was smeared around the nostrils before inserting prongs in group B; the infants in group A were covered on the infant’s nostrils surface with hydrocolloid dressing (hydrocolloid dressing, 1.8 mm thick, 90029T, 3M Company, Minnesota, USA) with a size of 2–3 cm cutting two holes adapted to the nose and nostrils. The nostrils of those infants were inspected daily during nCPAP support until they were weaned off nCPAP. RESULTS: Nine infants (2 in group A and 7 in group B) developed nasal injury during nCPAP support. The Chi-square test revealed that there was a statistically significant difference (P=0.01) in the incidence of nasal injury between groups A and B. CONCLUSION: The study demonstrated that hydrocolloid dressing significantly decreased the incidence and the severity of nasal injury. PMID:25225588

  15. Hydrocolloid dressing in preventing nasal trauma secondary to nasal continuous positive airway pressure in preterm infants.

    PubMed

    Xie, Li-Hua

    2014-01-01

    Continuous positive airway pressure (CPAP) with nasal devices (nCPAP) is widely used in the respiratory management of newborns. The present study aimed to compare the incidence of nasal trauma secondary to nasal continuous positive airway pressure (nCPAP) protected with or without hydrocolloid dressing in preterm infants. This prospective controlled study was performed in the neonatal intensive care unit (NICU) of the Children's Hospital of Hunan Province from March 1, 2010 to June 31, 2010. A total of 65 infants, 46 males and 19 females, were recruited in this study. Their average gestational age was 32.6 weeks (range 28-37 weeks). The infants were randomly divided into clinical trial group (group A, n=33) and control group (group B, n=32). Paraffin oil was smeared around the nostrils before inserting prongs in group B; the infants in group A were covered on the infant's nostrils surface with hydrocolloid dressing (hydrocolloid dressing, 1.8 mm thick, 90029T, 3M Company, Minnesota, USA) with a size of 2-3 cm cutting two holes adapted to the nose and nostrils. The nostrils of those infants were inspected daily during nCPAP support until they were weaned off nCPAP. Nine infants (2 in group A and 7 in group B) developed nasal injury during nCPAP support. The Chi-square test revealed that there was a statistically significant difference (P=0.01) in the incidence of nasal injury between groups A and B. The study demonstrated that hydrocolloid dressing significantly decreased the incidence and the severity of nasal injury.

  16. Nasal symptoms and clinical findings in adult patients treated for unilateral cleft lip and palate.

    PubMed

    Morén, Staffan; Mani, Maria; Lundberg, Kristina; Holmström, Mats

    2013-10-01

    The aim of the study was to investigate self-experienced nasal symptoms among adults treated for UCLP and the association to clinical findings, and to evaluate whether palate closure in one-stage or two-stages affected the symptoms or clinical findings. All people with UCLP born between 1960-1987, treated at Uppsala University Hospital, were considered for participation in this cross-sectional population study with long-term follow-up. Eighty-three patients (76% participation rate) participated, a mean of 37 years after the first operation. Fifty-two patients were treated with one-stage palate closure and 31 with two-stage palate closure. An age-matched group of 67 non-cleft controls completed the same study protocol, which included a questionnaire regarding nasal symptoms, nasal inspection, anterior rhinoscopy, and nasal endoscopy. Patients reported a higher frequency of nasal symptoms compared with the control group, e.g., nasal obstruction (81% compared with 60%) and mouth breathing (20% compared with 5%). Patients also rated their nasal symptoms as having a more negative impact on their daily life and physical activities than controls. Nasal examination revealed higher frequencies of nasal deformities among patients. No positive correlation was found between nasal symptoms and severity of findings at nasal examination. No differences were identified between patients treated with one-stage and two-stage palate closure regarding symptoms or nasal findings. Adult patients treated for UCLP suffer from more nasal symptoms than controls. However, symptoms are not associated with findings at clinical nasal examination or method of palate closure.

  17. In vitro suppression of lymphocyte activation in patients with seasonal allergic rhinitis and pollen-related asthma by cetirizine or azelastine in combination with ginkgolide B or astaxanthin.

    PubMed

    Mahmoud, Fadia F; Haines, D; Al-Awadhi, R; Arifhodzic, N; Abal, A; Azeamouzi, C; Al-Sharah, S; Tosaki, A

    2012-06-01

    Novel strategies are evaluated for management of allergic rhinitis and asthma in patients co-afflicted with both disorders. It is hypothesized that the platelet activating factor receptor antagonist ginkgolide B (GB) and the carotenoid antioxidant astaxanthin (ASX) interact with antihistamines cetirizine dihydrochloride (CTZ) and azelastine (AZE) to potentiate their ability to downregulate potentially pathological immune activation. Peripheral blood mononuclear cells from asthmatics and healthy subjects, cultured 24 hours with 50 μg/ml phytohemaglutinin (PHA) or PHA plus each drug are analyzed by flow cytometry for expression of CD25+ or HLA-DR+ by CD3+ (T cells). Results are reported as stimulation indices for CD3+CD25+ (SICD3+CD25+) and CD3+HLA-DR+ (SICD3+HLADR+) cells in cultures treated with PHA alone, versus cultures treated with both PHA and drugs. Optimal suppression of activated cells was observed in cultures stimulated with ASX 10-6 M + CTZ 10-6 M (SICD3+CD25+, p = 0.016; SICD3+HLADR, p = 0.012); ASX 10-6 M + AZE 10-6 M (SICD3+CD25+, p = 0.012; SICD3+HLADR, p = 0.015); GB 10-6 M + CTZ 10-6 M (SICD3+CD25+, p = 0.024, SICD3+HLADR+, p = 0.019). Results demonstrate improved activity of antihistamines by 2 phytochemicals, suggesting dosing strategies for animal trials of ASX- or GB-augmented formulations for seasonal allergic rhinitis and asthma.

  18. [Differential proteins analysis among human nasal inverted papilloma and nasal polyposis and normal nasal mucosa].

    PubMed

    Meng, Qing-shu; Jin, Sheng; Zhang, Qiu-hang; Zhang, Man

    2010-04-01

    Proteomics-based approach was applied to analyze and compare the difference of proteins among human nasal inverted papilloma (NIP), nasal polyposis and normal nasal mucosa, in order to screen different proteins as marker. The total proteins of NIP, nasal polyposis and normal nasal mucosa were separated by two-dimensional gel electrophoresis (2-DE). Protein image obtained by using the gel of Calibrated GS-800 Densitometer system, and determined different protein spots. Six differential proteins between NIP and nasal polyp tissue were identified, which were galectin-1, Manganese-superoxide dismutase, galectin-7, trichostatin A, prohibitin and transferring. All of them were increased in NIP. Six differential proteins were possibly involved in NIP, which provided a new way for discriminating NIP from nasal polyposis. The data would be good for the establishment of NIP protein 2-DE map.

  19. Collagen V nasal tolerance in experimental model of systemic sclerosis.

    PubMed

    Velosa, Ana Paula Pereira; Teodoro, Walcy Rosolia; de Oliveira, Cristiane Carla; Dos Santos Filho, Antonio; Moutinho, Rodnei Francisco; Santos, Angela Gomes; Vendramini, Margarete Borges Galhardo; Bueno, Cleonice; Parra, Edwin Roger; Capelozzi, Vera Luiza; Yoshinari, Natalino Hajime

    2007-07-01

    Our aim was to study skin remodeling and autoantibody production in an experimental model of scleroderma (SSc), following nasal tolerance with human type V collagen (Col V). Female New Zealand rabbits (n = 12) were immunized with two doses of 1 mg/ml of Col V in complete Freund's adjuvant and additional two boosters in incomplete Freund's adjuvant to induce SSc. After 150 days, half of these immunized rabbits were submitted to type V collagen-induced tolerance receiving a daily nasal administration of 25 mug of Col V. Control animals (n = 6) were only submitted to type V collagen-induced tolerance. Serial skin biopsies were performed on days 0, 150 and 210, and stained with H&E, Masson's trichrome and Picrosirius for morphological and morphometric analysis. Types I, III and V collagen were identified by immunofluorescence. The animals' serum samples were collected to determine anti types I, III, IV and V collagen and antinuclear antibodies (ANA). Skin biopsies from immunized animals confirmed SSc morphology as previously described, such as progressive decrease of papillary dermis, appendages atrophy, increased type I, III and V collagen deposition. Rabbits with Col V-induced nasal tolerance showed reduction of skin involvement, with significant decrease of collagen amount. Humoral immune response did not change with nasal tolerance. Collagen V nasal tolerance promotes regression of skin remodeling process in an experimental model of SSc. We suggest that nasal tolerance with type V collagen can be a promising therapeutic option to treat scleroderma patients.

  20. Impact of airflow communication between nasal cavities on nasal ventilation.

    PubMed

    Zhou, Bing; Huang, Qian; Cui, Shunjiu; Liu, Yingxi; Han, Demin

    2013-01-01

    To investigate the impact of airflow communication between bilateral nostril sides on nasal ventilation. In addition, we try to validate the efficacy of the Draf III procedure from the aerodynamics perspective. One health model and two disease models were constructed. These included 2 patients with nasal septum perforation and 1 patient who received the Draf III procedure. With the computational fluid dynamics method, indices such as airflow velocity and wall shear stress in the nasal cavity were detected and compared among the 3 subjects. The main pathway for airflow in the nasal cavity is the common meatus. Little airflow exchange occurred in the patient who underwent the Draf III procedure, and the wall shear stress around the communication site was as low as in the adjacent areas. However, when airflow communication occurred in the lower part of the nasal cavity, the airflow velocity and wall shear stress were obviously altered, and the ventilation function of the nasal cavity was impaired. Airflow communication in the upper part of the nasal cavity has little impact on nasal ventilation. Nonetheless, airflow communication occurring in the lower part of the nasal cavity disturbs the overall airflow distribution and a repair procedure is necessary. © 2013 S. Karger AG, Basel.

  1. Some acoustic features of nasal and nasalized vowels: a target for vowel nasalization.

    PubMed

    Feng, G; Castelli, E

    1996-06-01

    In order to characterize acoustic properties of nasal and nasalized vowels, these sounds will be considered as a dynamic trend from an oral configuration toward an [n]-like configuration. The latter can be viewed as a target for vowel nasalization. This target corresponds to the pharyngonasal tract and it can be modeled, with some simplifications, by a single tract without any parallel paths. Thus the first two resonance frequencies (at about 300 and 1000 Hz) characterize this target well. A series of measurements has been carried out in order to describe the acoustic characteristics of the target. Measured transfer functions confirm the resonator nature of the low-frequency peak. The introduction of such a target allows the conception of the nasal vowels as a trend beginning with a simple configuration, which is terminated in the same manner, so allowing the complex nasal phenomena to be bounded. A complete study of pole-zero evolutions for the nasalization of the 11 French vowels is presented. It allows the proposition of a common strategy for the nasalization of all vowels, so a true nasal vowel can be placed in this nasalization frame. The measured transfer functions for several French nasal vowels are also given.

  2. Nasal airflow during respiratory cycle.

    PubMed

    Chung, Seung-Kyu; Son, Young Rak; Shin, Seok Jae; Kim, Sung-Kyun

    2006-01-01

    Knowledge on the airflow patterns in the nasal cavity is essential to understanding the function of the nasal cavity. This study has attempted to observe the breath cycle of nasal airflow during respiration at rest. We constructed a nasal cavity model by rapid prototyping using 1.25-mm-thick CT data and devised a piston pump driven by a cam, to simulate respiration at rest. The airflow was evaluated with particle image velocimetry and visualized in coronal reconstructed images. During the inspiration, a maximal velocity was observed at the valve area and the main stream occurred in the middle and superior airways. During the expiration, main stream was noted in the middle airway and was slow compared with the flow during inspiration. Vortexes were observed between inspiration and expiration. This result widens our knowledge of nasal airflow and this technique will allow a more physiological understanding of nasal operations.

  3. Objective monitoring of nasal patency and nasal physiology in rhinitis.

    PubMed

    Nathan, Robert A; Eccles, Ron; Howarth, Peter H; Steinsvåg, Sverre K; Togias, Alkis

    2005-03-01

    Nasal obstruction can be monitored objectively by measurement of nasal airflow, as evaluated by nasal peak flow, or as airways resistance/conductance as evaluated by rhinomanometry. Peak flow can be measured during inspiration or expiration. Of these measurements, nasal inspiratory peak flow is the best validated technique for home monitoring in clinical trials. The equipment is portable, relatively inexpensive, and simple to use. One disadvantage, however, is that nasal inspiratory peak flow is influenced by lower airway as well as upper airway function. Rhinomanometry is a more sensitive technique that is specific for nasal measurements. The equipment, however, requires an operator, is more expensive, and is not portable. Thus, it is applicable only for clinic visit measures in clinical trials. Measurements require patient cooperation and coordination, and not all can achieve repeatable results. Thus, this objective measure is best suited to laboratory challenge studies involving smaller numbers of selected volunteers. A nonphysiological measure of nasal patency is acoustic rhinometry. This sonic echo technique measures internal nasal luminal volume and the minimum cross-sectional area. The derivation of these measures from the reflected sound waves requires complex mathematical transformation and makes several theoretical assumptions. Despite this, however, such measures correlate well with the nasal physiological measures, and the nasal volume measures have been shown to relate well to results obtained by imaging techniques such as computed tomography scanning or magnetic resonance imaging. Like rhinomanometry, acoustic rhinometry is not suitable for home monitoring and can be applied only to clinic visit measures or for laboratory nasal challenge monitoring. It has advantages in being easy to use, in requiring little patient cooperation, and in providing repeatable results. In addition to nasal obstruction, allergic rhinitis is recognized to be associated with

  4. Comparison between Perceptual Assessments of Nasality and Nasalance Scores

    ERIC Educational Resources Information Center

    Brunnegard, Karin; Lohmander, Anette; van Doorn, Jan

    2012-01-01

    Background: There are different reports of the usefulness of the Nasometer[TM] as a complement to listening, often as correlation calculations between listening and nasalance measurements. Differences between findings have been attributed to listener experience and types of speech stimuli. Aims: To compare nasalance scores from the Nasometer with…

  5. Nasal septum injury in preterm infants using nasal prongs 1

    PubMed Central

    Bonfim, Suely de Fátima Santos Freire; de Vasconcelos, Maria Gorete Lucena; de Sousa, Nayara Francisca Cabral; da Silva, Daiana Vieira Câmara; Leal, Luciana Pedrosa

    2014-01-01

    OBJECTIVE: to assess the incidence and risk factors associated with nasal septum injury in premature infants using reused and new nasal prongs. METHOD: the study was a cohort from an open therapeutic intervention. The sample included 70 infants with a gestational age inferior to 37 weeks, who used nasal prongs and were hospitalized at the neonatal service of a hospital in Recife-PE, in the Northeast of Brazil. The data were collected in patient files through the assessment of the application of the device and of the nasal septum. Multinomial Logistic Regression and Survival analyses were applied. RESULTS: the incidence of nasal injury corresponded to 62.9%. In the multiple analysis, only the length of the infant's treatment was a determinant factor for the occurrence and severity of the injuries. CONCLUSION: the type of nasal prong does not serve as a risk factor for the nasal injury. The high incidence of nasal injury indicates the need to adapt the nursing care with emphasis on prevention. PMID:25493679

  6. Comparison between Perceptual Assessments of Nasality and Nasalance Scores

    ERIC Educational Resources Information Center

    Brunnegard, Karin; Lohmander, Anette; van Doorn, Jan

    2012-01-01

    Background: There are different reports of the usefulness of the Nasometer[TM] as a complement to listening, often as correlation calculations between listening and nasalance measurements. Differences between findings have been attributed to listener experience and types of speech stimuli. Aims: To compare nasalance scores from the Nasometer with…

  7. Objective Measure of Nasal Air Emission Using Nasal Accelerometry.

    PubMed

    Cler, Meredith J; Lien, Yu-An S; Braden, Maia N; Mittelman, Talia; Downing, Kerri; Stepp, Cara E

    2016-10-01

    This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and nasal accelerometer signals were collected during the production of /pɑpɑpɑpɑ/ speech utterances by 25 children with and without cleft palate. Fourteen inexperienced raters listened to the microphone signals from the pediatric speakers and rated the samples for the severity of NAE using direct magnitude estimation. Mean listener ratings were compared to a novel quantitative measurement of NAE derived from the nasal acceleration signals. Correlation between the nasal acceleration energy measure and the measured nasal airflow was high (r = .87). Correlation between the measure and auditory-perceptual ratings was moderate (r = .49). The measure presented here is quantitative and noninvasive, and the required hardware is inexpensive ($150). Future studies will include speakers with a wider range of NAE severity and etiology, including cleft palate, hearing impairment, or dysarthria. Further development will also involve validation of the measure against airflow measures across subjects.

  8. Objective Measure of Nasal Air Emission Using Nasal Accelerometry

    PubMed Central

    Cler, Meredith J.; Lien, Yu-An S.; Braden, Maia N.; Mittelman, Talia; Downing, Kerri

    2016-01-01

    Purpose This article describes the development and initial validation of an objective measure of nasal air emission (NAE) using nasal accelerometry. Method Nasal acceleration and nasal airflow signals were simultaneously recorded while an expert speech language pathologist modeled NAEs at a variety of severity levels. In addition, microphone and nasal accelerometer signals were collected during the production of /pɑpɑpɑpɑ/ speech utterances by 25 children with and without cleft palate. Fourteen inexperienced raters listened to the microphone signals from the pediatric speakers and rated the samples for the severity of NAE using direct magnitude estimation. Mean listener ratings were compared to a novel quantitative measurement of NAE derived from the nasal acceleration signals. Results Correlation between the nasal acceleration energy measure and the measured nasal airflow was high (r = .87). Correlation between the measure and auditory-perceptual ratings was moderate (r = .49). Conclusion The measure presented here is quantitative and noninvasive, and the required hardware is inexpensive ($150). Future studies will include speakers with a wider range of NAE severity and etiology, including cleft palate, hearing impairment, or dysarthria. Further development will also involve validation of the measure against airflow measures across subjects. PMID:27618145

  9. Visual exploration of nasal airflow.

    PubMed

    Zachow, Stefan; Muigg, Philipp; Hildebrandt, Thomas; Doleisch, Helmut; Hege, Hans-Christian

    2009-01-01

    Rhinologists are often faced with the challenge of assessing nasal breathing from a functional point of view to derive effective therapeutic interventions. While the complex nasal anatomy can be revealed by visual inspection and medical imaging, only vague information is available regarding the nasal airflow itself: Rhinomanometry delivers rather unspecific integral information on the pressure gradient as well as on total flow and nasal flow resistance. In this article we demonstrate how the understanding of physiological nasal breathing can be improved by simulating and visually analyzing nasal airflow, based on an anatomically correct model of the upper human respiratory tract. In particular we demonstrate how various Information Visualization (InfoVis) techniques, such as a highly scalable implementation of parallel coordinates, time series visualizations, as well as unstructured grid multi-volume rendering, all integrated within a multiple linked views framework, can be utilized to gain a deeper understanding of nasal breathing. Evaluation is accomplished by visual exploration of spatio-temporal airflow characteristics that include not only information on flow features but also on accompanying quantities such as temperature and humidity. To our knowledge, this is the first in-depth visual exploration of the physiological function of the nose over several simulated breathing cycles under consideration of a complete model of the nasal airways, realistic boundary conditions, and all physically relevant time-varying quantities.

  10. Same Noses, Different Nasalance Scores: Data from Normal Subjects and Cleft Palate Speakers for Three Systems for Nasalance Analysis

    ERIC Educational Resources Information Center

    Bressmann, Tim; Klaiman, Paula; Fischbach, Simone

    2006-01-01

    Nasalance scores from the Nasometer, the NasalView and the OroNasal System were compared. The data was collected from 50 normal participants and 19 hypernasal patients with cleft palate. The Nasometer had the lowest nasalance scores for the non-nasal Zoo Passage and that the OroNasal System had the lowest nasalance scores for the Nasal Sentences.…

  11. Reduced need for surgery in severe nasal polyposis with mepolizumab: Randomized trial.

    PubMed

    Bachert, Claus; Sousa, Ana R; Lund, Valerie J; Scadding, Glenis K; Gevaert, Philippe; Nasser, Shuaib; Durham, Stephen R; Cornet, Marjolein E; Kariyawasam, Harsha H; Gilbert, Jane; Austin, Daren; Maxwell, Aoife C; Marshall, Richard P; Fokkens, Wytske J

    2017-07-04

    Patients with eosinophilic nasal polyposis frequently require surgery, and recurrence rates are high. We sought to assess the efficacy and safety of mepolizumab versus placebo for severe bilateral nasal polyposis. This randomized, double-blind, placebo-controlled trial recruited patients aged 18 to 70 years with recurrent nasal polyposis requiring surgery. Patients received 750 mg of intravenous mepolizumab or placebo every 4 weeks for a total of 6 doses in addition to daily topical corticosteroid treatment. The primary end point was the number of patients no longer requiring surgery at Week 25 based on a composite end point of endoscopic nasal polyp score and nasal polyposis severity visual analog scale (VAS) score. Secondary end points included change in nasal polyposis severity VAS score, endoscopic nasal polyp score, improvement in individual VAS symptoms (rhinorrhea, mucus in throat, nasal blockage, and sense of smell), patient-reported outcomes, and safety. One hundred five patients received mepolizumab (n = 54) or placebo (n = 51). A significantly greater proportion of patients in the mepolizumab group compared with the placebo group no longer required surgery at Week 25 (16 [30%] vs 5 [10%], respectively; P = .006). There was a significant improvement in nasal polyposis severity VAS score, endoscopic nasal polyp score, all individual VAS symptom scores, and Sino-Nasal Outcome Test patient-reported outcome score in the mepolizumab compared with placebo groups. Mepolizumab's safety profile was comparable with that of placebo. In patients with recurrent nasal polyposis receiving topical corticosteroids who required surgery, mepolizumab treatment led to a greater reduction in the need for surgery and a greater improvement in symptoms than placebo. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Assessment of the Performance of Nasal Pillows at High CPAP Pressures

    PubMed Central

    Zhu, Xueling; Wimms, Alison J.; Benjafield, Adam V.

    2013-01-01

    Study Objectives: Compliance with CPAP therapy remains an issue despite its effectiveness. Mask selection is likely to affect a patients experience with CPAP, and multiple mask options are currently available. Nasal pillows have less contact with the face compared to nasal masks and may benefit patients by minimizing side effects; however, they are infrequently used at high CPAP pressures. The aim of this study was to examine the performance of nasal pillows at pressures ≥ 12 cm H2O compared with nasal masks. Methods: Twenty-one subjects were recruited. Participants were randomized to Swift FX nasal pillows and their current nasal mask for 7 consecutive nights each in a prospective crossover trial. Objective device data and subjective feedback were collected. Results: There were no differences in objective device data of nasal pillows vs. nasal masks: Daily Usage 7.4 ± 1.4 vs 7.2 ± 1.4 (h/night); 95th%ile Leak 28.6 ± 13.5 vs 27.9 ± 17.9 (L/min); AHI 1.9 ± 1.3 vs 1.7 ± 1.1, respectively (all p-values > 0.05). There were no differences between the nasal pillows and nasal masks for subjective ratings of comfort, seal, red marks, side effects such as jetting and dry nose/mouth, and overall performance (all p-values > 0.05). The nasal pillows were rated to be less obtrusive and claustrophobic (both p-values < 0.01), but less stable (p = 0.04). Overall preference was 50% nasal pillows, 45% nasal masks; 5% found no difference. Conclusion: Nasal pillows are as efficacious as nasal masks at CPAP pressures ≥ 12 cm H2O and are a suitable option for patients requiring high CPAP pressures. Clinical Trial Registration: NIH Clinical Trials Registry. http://clinicaltrials.gov. Title: Nasal Pillows at High CPAP Pressure. Identifier: NCT01690923. Citation: Zhu X; Wimms AJ; Benjafield AV. Assessment of the performance of nasal pillows at high CPAP pressures. J Clin Sleep Med 2013;9(9):873-877. PMID:23997699

  13. Correlation between nasal airflow characteristics and clinical relevance of nasal septal deviation to nasal airway obstruction.

    PubMed

    Kim, Sung Kyun; Heo, Go Eun; Seo, Anna; Na, Yang; Chung, Seung-Kyu

    2014-02-01

    Since the imbalance of the nasal cavities due to nasal septal deviation (NSD) is a commonly observed anatomic variation in healthy adults, clinicians must often decide whether or not it is clinically relevant to the symptoms of nasal airway obstruction (NAO). Main reason for this is a lack of data correlating the symptoms of NAO with objective findings. The aim of our study is to find the correlation between fluid dynamic parameters and the anatomy of nasal cavity with NSD by numerical simulation. We generated 6 computational models of nasal cavities with NSD were created from computed tomographic images: 3 symptomatic patients with NAO and 3 asymptomatic patients. Computational fluid dynamics (CFD) was used to simulate steady inspiratory airflows in each nasal cavity model and compare the fluid dynamic properties of each. In the symptomatic cases, the pressure drop from the naris to the end of the septum was larger, and more uneven flow partitioning was observed. Local maximum velocity and wall shear stress were higher in the symptomatic group than in the asymptomatic group. The symptoms of NAO seem to be related more to the nasal resistance from the naris to the end of the septum than to the total nasal resistance from naris to nasopharynx. Factors correlated with NAO by CFD can be used as elements in patient-specific objective diagnostic tools for NAO in the presence of NSD. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. Effects of Nasal Corticosteroids on Boosts of Systemic Allergen-Specific IgE Production Induced by Nasal Allergen Exposure

    PubMed Central

    Egger, Cornelia; Lupinek, Christian; Ristl, Robin; Lemell, Patrick; Horak, Friedrich; Zieglmayer, Petra; Spitzauer, Susanne; Valenta, Rudolf; Niederberger, Verena

    2015-01-01

    Background Allergen exposure via the respiratory tract and in particular via the nasal mucosa boosts systemic allergen-specific IgE production. Intranasal corticosteroids (INCS) represent a first line treatment of allergic rhinitis but their effects on this boost of allergen-specific IgE production are unclear. Aim Here we aimed to determine in a double-blind, placebo-controlled study whether therapeutic doses of an INCS preparation, i.e., nasal fluticasone propionate, have effects on boosts of allergen-specific IgE following nasal allergen exposure. Methods Subjects (n = 48) suffering from grass and birch pollen allergy were treated with daily fluticasone propionate or placebo nasal spray for four weeks. After two weeks of treatment, subjects underwent nasal provocation with either birch pollen allergen Bet v 1 or grass pollen allergen Phl p 5. Bet v 1 and Phl p 5-specific IgE, IgG1–4, IgM and IgA levels were measured in serum samples obtained at the time of provocation and one, two, four, six and eight weeks thereafter. Results Nasal allergen provocation induced a median increase to 141.1% of serum IgE levels to allergens used for provocation but not to control allergens 4 weeks after provocation. There were no significant differences regarding the boosts of allergen-specific IgE between INCS- and placebo-treated subjects. Conclusion In conclusion, the application of fluticasone propionate had no significant effects on the boosts of systemic allergen-specific IgE production following nasal allergen exposure. Trial Registration http://clinicaltrials.gov/ NCT00755066 PMID:25705889

  15. Pathogenesis of nasal polyposis

    PubMed Central

    Hulse, K. E.; Stevens, W. W.; Tan, B. K.; Schleimer, R. P.

    2015-01-01

    Summary Chronic rhinosinusitis with nasal polyps (CRSwNP) is a complex inflammatory condition that affects a large proportion of the population world-wide and is associated with high cost of management and significant morbidity. Yet, there is a lack of population-based epidemiologic studies using current definitions of CRSwNP, and the mechanisms that drive pathogenesis in this disease remain unclear. In this review, we summarize the current evidence for the plethora of factors that likely contribute to CRSwNP pathogenesis. Defects in the innate function of the airway epithelial barrier, including diminished expression of antimicrobial products and loss of barrier integrity, combined with colonization by fungi and bacteria likely play a critical role in the development of chronic inflammation in CRSwNP. This chronic inflammation is characterized by elevated expression of many key inflammatory cytokines and chemokines, including IL-5, thymic stromal lymphopoietin and CCL11, that help to initiate and perpetuate this chronic inflammatory response. Together, these factors likely combine to drive the influx of a variety of immune cells, including eosinophils, mast cells, group 2 innate lymphoid cells and lymphocytes, which participate in the chronic inflammatory response within the nasal polyps. Importantly, however, future studies are needed to demonstrate the necessity and sufficiency of these potential drivers of disease in CRSwNP. In addition to the development of new tools and models to aid mechanistic studies, the field of CRSwNP research also needs the type of robust epidemiologic data that has served the asthma community so well. Given the high prevalence, costs and morbidity, there is a great need for continued research into CRS that could facilitate the development of novel therapeutic strategies to improve treatment for patients who suffer from this disease. PMID:25482020

  16. Post-Nasal Drip

    MedlinePlus

    ... three hours before bedtime, and eliminating alcohol and caffeine from the daily diet. Antacids such as Maalox®, ... to thin out secretions. Drinking more water, eliminating caffeine, and avoiding diuretics (medications that increase urination) will ...

  17. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A nasal... nasal airflow. The device decreases airway resistance and increases nasal airflow. The external...

  18. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A nasal... nasal airflow. The device decreases airway resistance and increases nasal airflow. The external...

  19. The Relationship between Nasalance and Nasality in Children with Cleft Palate.

    ERIC Educational Resources Information Center

    Watterson, Thomas; And Others

    1993-01-01

    This study correlated measures of nasalance computed by the Nasometer with listener judgments of nasality of speech passages spoken by 25 children with craniofacial disorders. Results showed a significant correlation between nasalance and nasality only when nasal consonants were not included in the passage spoken. (Author/DB)

  20. Easy removal of nasal magnets.

    PubMed

    Starke, Lori

    2005-09-01

    This article uses a case report and discussion to demonstrate the removal of magnets which have become lodged in the nasal cavity as a result of using magnet-backed earrings to decorate the alae. If bi-alar decoration is used, removal of nasal magnets can present more of a challenge than other nasal foreign bodies. This is because of their attraction to each other through the septum and because of the edema that can form around the magnets. This case discusses that removal of magnets lodged in the nares can be easily achieved with minimal trauma, by the use of a household pocket magnet.

  1. Efficacy of nasal irrigation in the treatment of acute sinusitis in atopic children.

    PubMed

    Wang, Yun-Hu; Ku, Min-Sho; Sun, Hai-Lun; Lue, Ko-Huang

    2014-02-01

    Nasal irrigation has been used as adjunctive therapy for sinonasal disease but is under-researched in children. The study aim was to evaluate the effectiveness of nasal irrigation with normal saline in the management of acute sinusitis in atopic children. We enrolled 60 atopic children with acute sinusitis, of whom 29 received nasal irrigation with normal saline and 31 did not receive nasal irrigation. All participants underwent a nasal peak expiratory flow rate (nPEFR) test, a nasal smear examination, and radiography (Water's projection) and were requested to complete a Pediatric Rhinoconjunctivitis Quality-of-Life Questionnaire (PRQLQ) during the baseline visit. All participants were requested to record symptoms in a daily diary and were followed up at 1-week intervals. A physical examination, nasal smear, and nPEFR were performed at each visit, and all daily diaries were collected. At the final visit (after 3 weeks), the symptom diaries were reviewed and participants were requested to complete the PRQLQ again. nPEFR, radiography, and a nasal smear were also repeated. There were significant improvements in mean PRQLQ and nPEFR values (p < 0.05) for the irrigation compared to the non-irrigation group. There was no significant difference in radiographic findings between the groups (p > 0.05). The irrigation group recorded significant improvements in eye congestion, rhinorrhea, nasal itching, sneezing, and cough symptoms compared with the non-irrigation group. Nasal irrigation is an effective adjunctive treatment for acute sinusitis in atopic children. Copyright © 2012. Published by Elsevier B.V.

  2. [The influence of nasal flow aerodynamics on the nasal physiology].

    PubMed

    Betlejewski, Stanisław; Betlejewski, Andrzej

    2008-01-01

    The ability of the human nose to warm and humidify the respiratory air is important to maintaining the internal environment of the lungs, since ambient air is conditioned to nearly alveolar conditions (body temperature and fully saturated with water vapour) upon reaching the nasopharynx. Because of very short time of the inspiratory phase duration, as well as expiratory phase, only the rich vascularization of the nasal mucosa and specific organization of the submucosal vessels are not able to assure such effective physiological activity. Therefore the type of airflow during the respiration is essential to understanding the functional possibilities of the nasal mucosa. Most studies have investigated the airflow only in steady-flow conditions, where the laminar flow was observed. Anatomically accurate physical models of real nasal cavities and particle image velocimetry allow evaluation of the entire flow field in the nasal cavity. In these investigations a partially turbulent flow was observed even at low air velocities in most part of the nasal cavity. From a physiological perspective, a turbulent flow would seem sensible, since it enhances contact between air and the mucosal layer. By doing so, the nasal physiological functions - humidification, cleaning and warming are optimized.

  3. Bilateral nasal bone osteophytosis associated with short-term oral isotretinoin therapy for cystic acne vulgaris.

    PubMed

    Novick, N L; Lawson, W; Schwartz, I S

    1984-10-01

    Bilateral 2.5 and 3.0 mm nasal bone osteophytes developed five weeks following the initiation of oral isotretinoin therapy (50 mg daily) for severe cystic acne vulgaris in a healthy 30-year-old white woman who had undergone uneventful rhinoplasty 12 years earlier. Histologically mature bone fragments were removed at surgery. Vitamin A and its analogs have been reported to cause hyperostosis of the vertebrae and long bones, but no known reports link them to nasal bone changes. Clinically significant nasal bone osteophytosis may be another adverse reaction to oral isotretinoin therapy.

  4. The nose and nasal vault.

    PubMed

    Vogelzang, P J; Babbel, R W; Harnsberger, H R

    1991-12-01

    In this article we have reviewed the anatomy of the nose and nasal vault, with emphasis on specific features that are imaged with the SSCT. Important areas of the lateral wall anatomy include the OMU and SER, areas that are key to understanding the obstructive patterns of inflammatory sinonasal disease. Lesions that result in these specific obstructive patterns include anatomic variants and other focal pathological lesions, such as polyps. Other types of sinonasal inflammatory disease include sinonasal polyposis and granulomatous and fungal disease. Congenital lesions of the nose may be understood through a knowledge of the relevant developmental anatomy. These lesions include nasal dermoids and epidermoids, cephaloceles, gliomas, and choanal atresia. Important benign masses include antrochoanal polyps, inverting papillomas, angiomatous polyps, JNAs, and osteomas. Benign nasal masses have characteristic features that distinguish them from malignant lesions. Malignant nasal tumors, such as SSCa, esthesioneuroblastoma, and others, are characterized by their more aggressive and destructive behavior.

  5. Complications of Nasal Bone Fractures.

    PubMed

    Hwang, Kun; Yeom, Seung Han; Hwang, Suk Hyun

    2017-05-01

    The aim of this study was to perform a systematic review of the treatment of nasal bone fractures. The search terms ("nasal bone fracture" AND complication) and ("nasal bone fracture" AND [anosmia OR olfaction OR olfactory nerve OR smell]) and (anosmia AND ["nasal preparation" OR "nasal antiseptics"]) were used to search PubMed and SCOPUS. Of the 500 titles, 40 full papers were reviewed. One paper was excluded, and 3 mined papers were added. Ultimately, 12 papers were analyzed. The overall deformity rate was 10.4% ± 4.8%. No significant differences were found between patients who underwent closed reduction (14.7% ± 7.3%) and those who underwent open reduction (9.4% ± 4.4%), between those who underwent local anesthesia (5.8% ± 4.5%), and those who underwent general anesthesia (8.8% ± 3.8%), or between those who received timely treatment (5.7%) and those whose treatment was delayed (9.0%). Septal deviation occurred in 10.0% of patients as a sequela of nasal bone fracture. The nasal obstruction rate was 10.5% ± 5.3%. Fewer patients of nasal obstruction occurred in the open reduction patients (6.9% ± 4.4%) than in the closed reduction patients (15.2%). One patient of epiphora and 1 patient of diplopia were reportedAmong the 77 patients with nasal bone fractures, 29 (37.7% ± 11.3%) complained of olfactory disturbances. No significant associations were found between the type of fracture and the presence of olfactory disturbances. It is recommended for providers to explain to patients that approximately one-tenth of nasal bone fractures exhibit deformity, septal deviation, or nasal obstruction after surgery. Surgeons should take considerable care to avoid the olfactory mucosa during reduction surgery.

  6. Complications of Nasal Bone Fractures.

    PubMed

    Hwang, Kun; Yeom, Seung Han; Hwang, Suk Hyun

    2017-01-27

    The aim of this study was to perform a systematic review of the treatment of nasal bone fractures. The search terms ("nasal bone fracture" AND complication) and ("nasal bone fracture" AND [anosmia OR olfaction OR olfactory nerve OR smell]) and (anosmia AND ["nasal preparation" OR "nasal antiseptics"]) were used to search PubMed and SCOPUS. Of the 500 titles, 40 full papers were reviewed. One paper was excluded, and 3 mined papers were added. Ultimately, 12 papers were analyzed. The overall deformity rate was 10.4% ± 4.8%. No significant differences were found between patients who underwent closed reduction (14.7% ± 7.3%) and those who underwent open reduction (9.4% ± 4.4%), between those who underwent local anesthesia (5.8% ± 4.5%), and those who underwent general anesthesia (8.8% ± 3.8%), or between those who received timely treatment (5.7%) and those whose treatment was delayed (9.0%). Septal deviation occurred in 10.0% of patients as a sequela of nasal bone fracture. The nasal obstruction rate was 10.5% ± 5.3%. Fewer patients of nasal obstruction occurred in the open reduction patients (6.9% ± 4.4%) than in the closed reduction patients (15.2%). One patient of epiphora and 1 patient of diplopia were reportedAmong the 77 patients with nasal bone fractures, 29 (37.7% ± 11.3%) complained of olfactory disturbances. No significant associations were found between the type of fracture and the presence of olfactory disturbances. It is recommended for providers to explain to patients that approximately one-tenth of nasal bone fractures exhibit deformity, septal deviation, or nasal obstruction after surgery. Surgeons should take considerable care to avoid the olfactory mucosa during reduction surgery.

  7. Cleft Nasal Deformity and Rhinoplasty

    PubMed Central

    Kaufman, Yoav; Buchanan, Edward P.; Wolfswinkel, Erik M.; Weathers, William M.; Stal, Samuel

    2012-01-01

    The cleft nasal deformity is a complex challenge in plastic surgery involving the skin, cartilage, mucosa, and skeletal platform. Ever since Blair and Brown first described the intricacies of the cleft pathology in 1931, the appropriate approach has been extensively debated in the literature with respect to timing, technique, and extent of surgical intervention. In this article, the authors review the literature and summarize the various modalities for achieving a successful rhinoplasty in the patient with a cleft nasal deformity. PMID:24179452

  8. Angioleiomyoma of the Nasal Cavity

    PubMed Central

    Arruda, Milena Moreira; Monteiro, Daniela Yasbek; Fernandes, Atilio Maximino; Menegatti, Vanessa; Thomazzi, Emerson; Hubner, Ricardo Arthur; Lima, Luiz Guilherme Cernaglia Aureliano de

    2014-01-01

    Introduction Vascular leiomyoma of the nasal cavity is an extremely rare tumor that represents less than 1% of all vascular leiomyomas. It is more prevalent in women between the fourth and sixth decades, reaching primarily the inferior nasal turbinates. Objectives Reporting and assisting the systematization of more accurate diagnostic methods in clinical and complementary investigation of vascular leiomyoma in the nasal cavity. Resumed Report We present the case of a 49-year-old woman diagnosed with vascular leiomyoma in the nasal cavity, which manifested mainly with nasal obstruction. During investigation, computer tomography was not diagnostic, the cytologic study was not conclusive, and according to the biopsy, it was a squamous papilloma. Conclusion We suggest that the technical difficulty in obtaining an adequate amount of material for preoperative biopsy, associated with the topography of the lesion in the vestibular nasal region, may have contributed to changing the postoperative diagnosis. Thus, pathologic study of the surgical fragment is the more accurate method for diagnosis. PMID:25992133

  9. Oxytocin nasal spray in fibromyalgic patients.

    PubMed

    Mameli, S; Pisanu, G M; Sardo, S; Marchi, A; Pili, A; Carboni, M; Minerba, L; Trincas, G; Carta, M G; Melis, M R; Agabio, R

    2014-08-01

    Fibromyalgia is a pain disorder associated with frequent comorbid mood, anxiety, and sleep disorders. Despite the frequent use of a complex, poly-drug pharmacotherapy, treatment for fibromyalgia is of limited efficacy. Oxytocin has been reported to reduce the severity of pain, anxiety, and depression, and improve the quality of sleep, suggesting that it may be useful to treat fibromyalgia. To evaluate this hypothesis, 14 women affected by fibromyalgia and comorbid disorders, assuming a complex pharmacotherapy, were enrolled in a double-blind, crossover, randomized trial to receive oxytocin and placebo nasal spray daily for 3 weeks for each treatment. Order of treatment (placebo-oxytocin or oxytocin-placebo) was randomly assigned. Patients were visited once a week. At each visit, the following instruments were administered: an adverse drug reaction record card, Visual Analog Scale of Pain Intensity, Spielberger State Anxiety Inventory, Zung Self-rating Depression Scale, and SF-12. Women self-registered painkiller assumption, pain severity, and quality of sleep in a diary. Unlikely, oxytocin nasal spray (80 IU a day) did not induce positive therapeutic effects but resulted to be safe, devoid of toxicity, and easy to handle.

  10. Nasal Reconstruction and Repair of Secondary Nasal Deformities Following Treatment of Nasal Hemangiomas.

    PubMed

    Lu, Xiaona; Fan, Fei; Wang, Huan; You, Jianjun

    2017-03-01

    Secondary nasal deformities and retardation of development due to treatment of nasal hemangioma during infancy are a challenge when it comes to nasal reconstruction. In order to evaluate nasal repair and reconstruction in these patients, the authors compared the ease and outcomes of using expanded forehead, nasolabial sulcus, and medial upper arm tube flaps. According to the deformities and patients' wishes, flaps were selected; using autogeneic rib cartilage, auricle cartilage, or silica gel as a scaffold or without framework; the inner lining were made by the residual scar tissue or the distal end of transferred flap. The esthetical and functional scores were recorded by the Nasal Appearance and Function Evaluation Questionnaire score to evaluate the effectiveness of the methods. From January 2010 to December 2015, 34 patients were included. Postoperative follow-up went for 12 to 36 months. The expanded forehead flap was used in 28 patients, the nasolabial sulcus flap in 5 patients, and the medial upper arm tube flap in 1 patient. Regarding framework, 20 patients used rib cartilage, 8 patients used auricle cartilage, 1 patient used silicone, and 5 patients did not use any framework. All patients reported the increasing nasal appearance and function evaluation. Repair of secondary nasal defects following treatment of hemangiomas in infants and young children using an expanded frontal flap and autogenous cartilage framework is a reliable method with great long-term esthetic results. The nasolabial sulcus flap is a relatively simple method, especially for patients with a unilateral nasal alar defect. Supporting structure is needed and appropriate overcorrection is necessary.

  11. Effects of Preoperative Clarithromycin Administration in Patients with Nasal Polyposis

    PubMed Central

    Perić, A; Baletić, N; Milojević, M; Sotirović, J; Živić, L; Perić, AV; Vojvodić, D

    2014-01-01

    ABSTRACT Objective: In recent years, various investigators have shown considerable interest in the use of macrolide antibiotics for treatment of chronic rhinosinusitis and nasal polyposis. The aim of this study was to evaluate the clinical effects of preoperative long-term, low-dose clarithromycin administration in patients with nasal polyposis. Methods: Eighty nasal polyp patients (42 non-atopic and 38 atopic) were included in this prospective, non-placebo controlled investigation and randomized equally to either the combined clarithromycin-surgical or surgical group. Forty patients received 500 mg of clarithromycin daily for eight weeks, and, after evaluation, they were treated by functional endoscopic sinus surgery (FESS). The other 40 patients were treated only surgically. The nasal symptom scores and endoscopic scores after macrolide treatment/surgical treatment, and after six and 12 months of follow-up were evaluated. Results: After clarithromycin therapy, we found improvement in symptom scores in 25/40, and improvement in endoscopic scores in 19/40 patients. We found no significant difference in nasal symptom score between allergic and non-allergic patients regarding the outcome to macrolide (p = 0.352) or surgical treatment (p = 0.396). When we compared differences between endoscopic scores at the time points of 12 months and six months postoperatively (ESt12 minus ESt6), we found statistically lower differences in the clarithromycin-surgery group than in the surgery group (p = 0.006). Conclusion: Preoperative clarithromycin administration postponed nasal polyp relapse after FESS. Allergies have no influence on the clinical efficacy of clarithromycin therapy and on the efficacy of FESS. PMID:25867579

  12. Bilateral cleft lip nasal deformity

    PubMed Central

    Singh, Arun Kumar; Nandini, R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM) too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it's management both at the time of cleft lip repair and also secondarily

  13. Evaluation of polyvinylidene fluoride nasal sensor to assess deviated nasal septum in comparision with peak nasal inspiratory flow measurements.

    PubMed

    Manjunatha, Roopa G; Rajanna, K; Mahapatra, D Roy; Prakash, Surya

    2014-01-01

    Deviated nasal septum (DNS) is one of the major causes of nasal obstruction. Polyvinylidene fluoride (PVDF) nasal sensor is the new technique developed to assess the nasal obstruction caused by DNS. This study evaluates the PVDF nasal sensor measurements in comparison with PEAK nasal inspiratory flow (PNIF) measurements and visual analog scale (VAS) of nasal obstruction. Because of piezoelectric property, two PVDF nasal sensors provide output voltage signals corresponding to the right and left nostril when they are subjected to nasal airflow. The peak-to-peak amplitude of the voltage signal corresponding to nasal airflow was analyzed to assess the nasal obstruction. PVDF nasal sensor and PNIF were performed on 30 healthy subjects and 30 DNS patients. Receiver operating characteristic was used to analyze the DNS of these two methods. Measurements of PVDF nasal sensor strongly correlated with findings of PNIF (r = 0.67; p < 0.01) in DNS patients. A significant difference (p < 0.001) was observed between PVDF nasal sensor measurements and PNIF measurements of the DNS and the control group. A cutoff between normal and pathological of 0.51 Vp-p for PVDF nasal sensor and 120 L/min for PNIF was calculated. No significant difference in terms of sensitivity of PVDF nasal sensor and PNIF (89.7% versus 82.6%) and specificity (80.5% versus 78.8%) was calculated. The result shows that PVDF measurements closely agree with PNIF findings. Developed PVDF nasal sensor is an objective method that is simple, inexpensive, fast, and portable for determining DNS in clinical practice.

  14. Nasal and cutaneous aspergillosis in a goat.

    PubMed

    do Carmo, P M S; Portela, R A; de Oliveira-Filho, J C; Dantas, A F M; Simões, S V D; Garino, F; Riet-Correa, F

    2014-01-01

    Nasal and cutaneous aspergillosis is reported in an adult goat. The clinical signs were severe respiratory distress due to partial nasal obstruction, bilateral mucopurulent nasal discharge, skin nodules on the ears and dorsal nasal region and focal depigmentation of the ventral commissure of the right nostril. At necropsy examination, sagittal sectioning of the head revealed a yellow irregular mass extending from the nasal vestibule to the frontal portion of the nasal cavity. Microscopically, there was pyogranulomatous rhinitis and dermatitis, with numerous intralesional periodic acid-Schiff-positive fungal hyphae morphologically suggestive of Aspergillus spp. Aspergillus niger was isolated by microbiological examination.

  15. Influence of nasal structure on the distribution of airflow in nasal cavity.

    PubMed

    Yu, Shen; Liu, Yingxi; Sun, Xiuzhen; Li, Shouju

    2008-06-01

    Numerical simulation of the nasal cavity is essential in order to understand the relationship between nasal structure and airflow characteristics. Since the structure of the nasal cavity varies significantly, the relationship between nasal structure and airflow characteristics will be investigated by numerical simulation of airflow in twenty-four nasal models in this paper. Twenty-four three-dimensional models of the nasal cavity structure have been reconstructed on the basis of Computed Tomography medical images collected from twenty-four healthy volunteers. Modification of the turbinate has been applied to one of these models in order to simulate an operation. The results from this variant model have been compared with the original model. The numerical simulation for the airflow in the nasal cavity was performed by the finite element method. Pressure drop and the airflow distribution in nasal models are presented quantitatively in flow field. Main airflow will pass through the common nasal meatus. The nasal airway resistance in the region of nasal valve and nasal vestibule (flow limiting structure) accounts for 52.6%-78.3% of total nasal airway resistance. The numerical results show that differences in patients' nasal cavity structure may lead to different airflow distributions. Changes of nasal structure lead to variation of airflow in both sides of the nasal cavity as well as airflow redistribution in each side of the nasal cavity.

  16. Investigation on the nasal airflow characteristics of anterior nasal cavity stenosis.

    PubMed

    Wang, T; Chen, D; Wang, P H; Chen, J; Deng, J

    2016-08-01

    We used a computational fluid dynamics (CFD) model to study the inspiratory airflow profiles of patients with anterior nasal cavity stenosis who underwent curative surgery, by comparing pre- and postoperative airflow characteristics. Twenty patients with severe anterior nasal cavity stenosis, including one case of bilateral stenosis, underwent computed tomography (CT) scans for CFD modelling. The pre- and postoperative airflow characteristics of the nasal cavity were simulated and analyzed. The narrowest area of the nasal cavity in all 20 patients was located within the nasal valve area, and the mean cross-sectional area increased from 0.39 cm2 preoperative to 0.78 cm2 postoperative (P<0.01). Meanwhile, the mean airflow velocity in the nasal valve area decreased from 6.19 m/s to 2.88 m/s (P<0.01). Surgical restoration of the nasal symmetry in the bilateral nasal cavity reduced nasal resistance in the narrow sides from 0.24 Pa.s/mL to 0.11 Pa.s/mL (P<0.01). Numerical simulation of the nasal cavity in patients with anterior nasal cavity stenosis revealed structural changes and the resultant patterns of nasal airflow. Surgery achieved balanced bilateral nasal ventilation and decreased nasal resistance in the narrow region of the nasal cavity. The correction of nasal valve stenosis is not only indispensable for reducing nasal resistance, but also the key to obtain satisfactory curative effect.

  17. Investigation on the nasal airflow characteristics of anterior nasal cavity stenosis

    PubMed Central

    Wang, T.; Chen, D.; Wang, P.H.; Chen, J.; Deng, J.

    2016-01-01

    We used a computational fluid dynamics (CFD) model to study the inspiratory airflow profiles of patients with anterior nasal cavity stenosis who underwent curative surgery, by comparing pre- and postoperative airflow characteristics. Twenty patients with severe anterior nasal cavity stenosis, including one case of bilateral stenosis, underwent computed tomography (CT) scans for CFD modelling. The pre- and postoperative airflow characteristics of the nasal cavity were simulated and analyzed. The narrowest area of the nasal cavity in all 20 patients was located within the nasal valve area, and the mean cross-sectional area increased from 0.39 cm2 preoperative to 0.78 cm2 postoperative (P<0.01). Meanwhile, the mean airflow velocity in the nasal valve area decreased from 6.19 m/s to 2.88 m/s (P<0.01). Surgical restoration of the nasal symmetry in the bilateral nasal cavity reduced nasal resistance in the narrow sides from 0.24 Pa.s/mL to 0.11 Pa.s/mL (P<0.01). Numerical simulation of the nasal cavity in patients with anterior nasal cavity stenosis revealed structural changes and the resultant patterns of nasal airflow. Surgery achieved balanced bilateral nasal ventilation and decreased nasal resistance in the narrow region of the nasal cavity. The correction of nasal valve stenosis is not only indispensable for reducing nasal resistance, but also the key to obtain satisfactory curative effect. PMID:27533764

  18. Nasal bone clip: a novel approach to nasal bone fixation.

    PubMed

    Kosaka, Masaaki; Sai, Kenshin; Shiratake, Yasuhisa; Ohjimi, Hiroyuki

    2010-03-01

    Nasal bone fracture is a common injury, but its repair can be unexpectedly difficult. To date, intranasal gauze packing has been used to support the nasal bone in position and to maintain contact between the mucosa of the septum and the cartilage. This gauze packing, however, has a tendency to shift, resulting in an inflammatory response characterized by a foul odor until removal, which detracts from the comfort of the patient. We developed a novel device, the nasal bone clip (NBC), which provides a satisfactory nasal airway and improved comfort. A 1.2-mm Kirschner wire and a small piece of hydrocolloid wound dressing are used. The single wire is bent into a double-curved shape, after which each of the 2 tips is curled with pliers. The end of the wire in the nasal passage is covered with a piece of wound dressing to protect the mucosa. After reduction, the external portion of the wire is inserted on the surface of the splint. The NBC was applied in 14 cases: 12 instances of fresh fractures and 2 of old fractures; there were 8 men and 6 women; their mean age was 19.9 years. Complications were not observed; moreover, no patients exhibited problems during the treatment. The advantages of the NBC are that all materials are available in the operating room or outpatient department, it is low cost, it is readily installable and detachable, it affords superior support for gauze packing, it provides effective external splinting with intranasal support, it never disturbs the nasal airway, and it offers comfort.

  19. Powered Endoscopic Nasal Septal Surgery.

    PubMed

    Sousa, Aderito de; Iniciarte, Livia; Levine, Howard

    2005-01-01

    While nasal endoscopy is typically used for diagnosis and sinus surgery, endoscopy can be combined with powered instrumentation to perform nasal septal surgery. Powered Endoscopic Nasal Septum Surgery (PENSS) is an easy, effective and quick alternative to traditional headlight approaches to septoplasty. PENSS limits the dissection to the area of the deviation and markedly reduces the extent of subperichondrial dissection. This is particularly valuable in patients who have undergone prior septal cartilage resection. PENSS was used in 2,730 patients over 8 years. Surgical indications and technique are discussed. These patients had either isolated nasal septal deformities associated with other rhinologic pathology (sinusitis, adenoid hypertrophy polyps and external nasal deformity). PENSS was utilized with video assistance to allow an enhanced view of the endoscopic operative field. These patients were operated upon in an outpatient surgical suite and were seen for a post-operative video endoscopic evaluation at 5, 10, 15 and 20 days after surgery. The patients who had associated functional endoscopic sinus surgery were evaluated as needed until 6 weeks after surgery. There were no delayed complications. Endoscopic resection of septal spurs, deformities and deviations can be performed safely alone or in combination with endoscopic sinus surgery with minimal additional morbidity.

  20. Clinical application of nasal nitric oxide measurement in pediatric airway diseases.

    PubMed

    Manna, Angelo; Montella, Silvia; Maniscalco, Mauro; Maglione, Marco; Santamaria, Francesca

    2015-01-01

    Nitric oxide plays an important role in several physiological and pathophysiological processes in the respiratory tract. Different ways to measure nasal nitric oxide levels in children are currently available. The possibility of obtaining nasal nitric oxide measurement from relatively young children, combined with the availability of portable devices that can be used even in the office setting, opens new perspectives for nasal nitric oxide analysis in the pediatric daily practice. This review presents a synopsis about the current clinical applications of nasal nitric oxide measurement in the pediatric clinical practice. A total of 3,775 articles on the topic were identified, of which 883 duplicates were removed, and 2,803 were excluded based on review of titles and abstracts. Eighty-nine full text articles were assessed for eligibility and 32 additional articles were obtained from the reference lists of the retrieved studies. Since very low nasal nitric oxide levels are found in the majority of patients with primary ciliary dyskinesia, most publications support a central role for nasal nitric oxide to screen the disease, and indicate that it is a very helpful first-line tool in the real-life work-up in all age groups. Decreased nasal nitric oxide concentration is also typical of cystic fibrosis, even though nasal nitric oxide is not as low as in primary ciliary dyskinesia. In other upper airway disorders such as allergic rhinitis, rhinosinusitis, nasal polyposis, and adenoidal hypertrophy, clinical utility of nasal nitric oxide is still critically questioned and remains to be established. Since nNO determination is flow dependent, a general consensus from the major investigators in this area is highly desirable so that future studies will be performed with the same flow rate. A shared nNO methodology will enable to overcome the challenges that lie ahead in incorporating nNO measurement into the mainstream clinical setting of pediatric airway diseases. © 2014 Wiley

  1. Effects of Nasal Port Area on Perception of Nasality and Measures of Nasalance Based on Computational Modeling

    PubMed Central

    Bunton, Kate

    2015-01-01

    Objective The purpose of this study was to extend previously published modeling work examining the relation between nasal port opening, measures of nasalance, and perceptual ratings of nasality by experienced listeners for three simulated English corner vowels, /i/, /u/, and /ɑ/. Design Samples were generated using a computational model that allowed for exact control of nasal port size and direct measures of nasalance. Perceptual ratings were obtained using a paired stimulus presentation. Participants Four experienced listeners. Main Outcome Measures Nasalance and perceptual ratings of nasality. Results Findings indicate that perceptual ratings of nasality and nasalance increased for samples generated with nasal port areas up to and including 0.16 cm2 but plateaued in samples generated with larger nasal port areas. No vowel differences were noted for perceptual ratings. Conclusions This work extends previously published work by including nasal port areas representative of those reported in the literature for clinical populations, however, continued work using samples with varied phonetic context, and varying suprasegmental and temporal characteristics are needed. PMID:24437587

  2. Tuberculous granuloma in haemangiomatous nasal polyp.

    PubMed

    S, Bal M; S, Kanwal; P, Ritu

    2003-03-01

    Tuberculosis of upper respiratory tract is quite infrequent especially the nasal involvement. Isolated cases have been reported by certain authors. A ease of nasal tubercolosis is being presented for its rare site and its association with haemangioma.

  3. [Nasal septum cyst of odontogenic origin].

    PubMed

    Calvo Boizas, E; Sancipriano Hernández, J A; Diego Pérez, C; Rodríguez Gutiérrez, A; Martínez-Alegría López, J; Gómez Toranzo, F

    1997-10-01

    Cysts in the nasal septum are unusual, and the presence of a dental cyst is even rarer. A cyst of dental origin was produced by dental root fracture in the nasal septum. The differential diagnosis and management are discussed.

  4. Matizaciones ortologicas: La nasalizacion (Orthoepic Variations: Nasalization)

    ERIC Educational Resources Information Center

    Prado, Eduardo

    1975-01-01

    This paper discusses the slight nasalization occurring in Spanish to the vowels preceding "n" or "m" when placed before a "b" or "p" between two nasal consonants, in word-initial position or in elision. (Text is in Spanish.) (CHK)

  5. Nasal trauma: Primary reconstruction with open rhinoplasty

    PubMed Central

    Konstantinidis, I; Malliari, H; Metaxas, S

    2011-01-01

    Due to the prominent location of the nose, the most common facial traumas are nasal injuries. Although nasal traumas usually require staged intervention at a later period of time, in selected cases, primary reconstruction can be effective. A 20-year-old man who was referred from the emergency department with nasal trauma is presented. He reported a fall after feeling unsteady, which caused a direct nasal injury. Clinical examination revealed septal fracture with obstruction of the left nasal cavity and deformity of the nasal pyramid (inverted V deformity). The patient also had a complete dissection of the columella skin. Epistaxis was self-limited, and an open rhinoplasty procedure was decided because the trauma occurred 1 h before admission and there was no significant edema. Surgical intervention included septal reconstruction combined with restoration of the nasal pyramid and columella. One month later, the patient had patent nasal airways, and he was satisfied with the aesthetic result. PMID:22942663

  6. Nasal mucociliary clearance after radiation therapy.

    PubMed

    Stringer, S P; Stiles, W; Slattery, W H; Krumerman, J; Parsons, J T; Mendenhall, W M; Cassisi, N J

    1995-04-01

    Irradiation has been demonstrated to cause decreased mucociliary clearance in animal models. We sought to verify this effect clinically by using the saccharin transport test to evaluate nasal mucociliary clearance in 9 patients previously treated with radiation therapy to the nasal cavity. The patients also completed a questionnaire examining the prevalence of nasal symptoms before and after radiation therapy. Patients who received radiation therapy had no clearance of saccharin from the nasal cavity at a minimum of 20 minutes. The controls had a median clearance time of 5 minutes. The patients noted a higher prevalence of nasal congestion, drainage, and facial pain after radiation therapy. This study demonstrates that radiation therapy to the nasal cavity causes a decrease in nasal mucociliary clearance. This alteration should be considered when selecting therapy for malignancies in the nasal area.

  7. The Effect of Propolis in Healing Injured Nasal Mucosa: An Experimental Study

    PubMed Central

    El-Anwar, Mohammad Waheed; Abdelmonem, Said; Abdelsameea, Ahmed A.; AlShawadfy, Mohamed; El-Kashishy, Kamal

    2016-01-01

    Introduction  Mechanical trauma to the nasal mucosa increases the risk of synechia formation, especially after chronic rhinosinusitis and nasal surgeries. Objective  This study was carried to assess the effect of propolis administration in healing injured nasal mucosa in rats. Methods  We randomly divided eighteen rats into three equal experimental groups: (1) non-treated group; (2) gum tragacanth (suspending agent for propolis) treated group; and (3) propolis treated group. The non-treated group received no treatment for 15 days. The second group received gum tragacanth administration (5 ml/kg, orally) once daily for 15 days. The third group received propolis suspension orally at a dose of 100 mg/kg once daily for 15 days. At the beginning of this study, we induced unilateral mechanical nasal trauma on the right nasal mucosa of all rats in the three groups using a brushing technique. A pathologist stained tissue samples using hematoxylin and examined eosin by using a light microscope. Results  The severity of inflammation was milder with the absence of ulcerations in the propolis treated group compared with the non-treated and gum tragacanth groups. Goblet cell and ciliated cell loss was substantially lower in patients treated with propolis compared with groups without treatment and those treated with gum tragacanth. Conclusion  Propolis decreased inflammation and enhanced healing of wounds of the nasal mucosa in rats. PMID:27413403

  8. The Efficacy of Nasal Steroids in Treatment of Otitis Media with Effusion: A Comparative Study

    PubMed Central

    El-Anwar, Mohammad Waheed; Nofal, Ahmad Abdel-Fattah; Khazbak, Alaa Omar; Sayed, Ahmad Ebrahim El; Hassan, Mohammad Ramadan

    2015-01-01

    Introduction Otitis media with effusion (OME) continues to be an important pediatric clinical problem, and more studies are needed to decide the proper treatment for it. Objective To assess the efficacy of nasal steroids in the management of OME by comparing its results with that of oral steroid and that of nasal saline spray as placebo. Methods This study was carried on 60 patients with OME who were divided into three groups: in group 1, 20 patients received mometasone furoate spray, one puff in each nostril daily, for 3 months; in group 2, 20 patients received oral prednisolone, 5 mg three times per day for the first 3 weeks; in group 3, 20 patients received nasal saline spray, one puff in each nostril daily for 3 months. Results A highly significant difference between systemic or topical (nasal spray) steroid therapy and saline nasal spray was detected (p < 0.001), and the difference between systemic and topical steroid was nonsignificant (p > 0.05). Conclusion Nasal steroid spray can be used as an effective treatment for OME, giving a significant result similar to systemic steroid. Further studies are needed to investigate its use for longer duration and in recurrent cases. PMID:26491474

  9. Aspiration of Nasopore nasal packing.

    PubMed

    Smith, Jonathan; Reddy, Ekambar

    2017-10-04

    We present a case of postoperative Nasopore aspiration in an otherwise fit and well 11-year-old. An endoscopic adenoidectomy had been performed without incident and Nasopore packing placed into each nasal cavity. Immediately after extubation, there was marked hypoxia, tachypnoea and high clinical suspicion of pack aspiration. The patient returned to theatre for emergency rigid bronchoscopy and retrieval of nasal packing. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Nasal pemphigoid: a diagnostic dilemma.

    PubMed

    Rourke, Thomas; Pankhania, Miran; Hettige, Roland; Draper, Mark R

    2012-06-29

    Cicatricial pemphigoid is a chronic, systemic, immunobullous disorder affecting mucous membranes. Nasal manifestations of cicatricial pemphigoid are less common than in the rest of the upper aero-digestive tract, and may prove difficult to diagnose and manage effectively. We report one such case presenting with isolated nasal symptoms, in which diagnosis, treatment and ongoing management of the underlying cause was particularly challenging. A literature review was performed to ascertain the incidence of cicatricial pemphigoid and to establish the best evidence-based investigation and treatment.

  11. Quilting sutures for nasal septum.

    PubMed

    Hari, C; Marnane, C; Wormald, P J

    2008-05-01

    Suturing of the nasal septum after septal surgery is a commonly performed procedure designed to prevent complications such as septal haematoma and bleeding. It is also useful for closing any inadvertent tears of the septal mucosa and providing additional support for the cartilage pieces retained in septoplasty. In addition, the suture can be placed through the middle turbinates, stabilising them during the healing process. Placing knots for interrupted sutures in the posterior and middle part of the nasal septum can be technically difficult. We describe a continuous suturing technique for approximating the mucosal flaps following septal surgery.

  12. Tolerability and effects on quality of life of liposomal nasal spray treatment compared to nasal ointment containing dexpanthenol or isotonic NaCl spray in patients with rhinitis sicca.

    PubMed

    Hahn, C; Böhm, M; Allekotte, S; Mösges, R

    2013-09-01

    This study aimed to investigate symptom reduction via the liposomal nasal spray LipoNasal (LN) in patients with rhinitis sicca. Tolerability and the impact on quality of life were also examined. The same parameters were established in parallel for treatment approaches with Bepanthen (BP) nasal ointment containing dexpanthenol and the Rhinomer (RH) nasal spray containing NaCl. This prospective, controlled, open-label observation study was a multicenter trial. 92 patients with rhinitis sicca were allocated to three arms according to their symptoms: LN: n = 33; BP: n = 32 and RH: n = 27. The study comprised three visits at an interval of 14 days. Efficacy was examined by the Rhinitis Sicca Symptom Score (RSSS) documented daily and at the visits based on an endoscopic evaluation. The nasal spray sensory scale was used to investigate the tolerability. Quality of life (QoL) was measured by means of the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the "Short Form 12" of the "Impact on Health-Related Quality of Life (HRQL)" questionnaire on general quality of life. Nasal symptoms improved significantly (p = 0.001) under all three treatment approaches, reflected by the reduction in the RSSS and the Endoscopy Sum Score. A comparison of the three groups showed that no therapy was significantly superior to any of the others (p = 0.410). The tolerability of all treatments was good. Concerning the nasal moisturization, LipoNasal was evaluated better than Bepanthen and Rhinomer. Quality of life improved in all groups, but not significantly. The results show good efficacy and tolerability of the liposomal nasal spray compared to generally recognized treatments of rhinitis sicca with dexpanthenol nasal ointment and NaCl nasal spray. LipoNasal therefore constitutes a good treatment for patients suffering from dry nose.

  13. Nasal septal cyst--a case report.

    PubMed

    Chiang, C H; Juan, K H; Kuo, W R; Tai, C F; Wu, J R

    1996-04-01

    The usual complications of submucous resection of the nasal septum (SMR) are septal hematoma, infection, hemorrhage, septal perforation, and nasal deformity. We present a case of nasal septal cyst which may be a rare complication of SMR. Entrapment of free nasal mucosal remnants or inward folding of incised septal mucosa is thought to be the cause. The patient underwent deroofment of the left cystic wall by lateral rhinotomy. There was no recurrence after one year.

  14. Characterizing human nasal airflow physiologic variables by nasal index.

    PubMed

    Patki, Aniruddha; Frank-Ito, Dennis O

    2016-10-01

    Although variations in nasal index (NI) have been reported to represent adaptation to climatic conditions, assessments of NI with airflow variables have not been rigorously investigated. This study uses computational fluid dynamics modeling to investigate the relationship between NI and airflow variables in 16 subjects with normal nasal anatomy. Airflow simulations were conducted under constant inspiratory pressure. Nasal resistance (NR) against NI showed weak association from nostrils to anterior inferior turbinate (R(2)=0.26) and nostril to choanae (R(2)=0.12). NI accounted for 38% and 41% of the respective variation in wall shear stress (WSS) and heat flux (HF) at the nasal vestibule, and 52% and 49% of variability in WSS and HF across the entire nose. HF and WSS had strong correlation with NI<80, and weakly correlated with NI>80; these differences in HF and WSS for NI<80 and NI>80 were not statistically significant. Results suggest strong relationship between NI and both WSS and HF but not NR, particularly in subjects with NI<80. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Extramedullary plasmacytoma of the nasal sinus cavities.

    PubMed

    Lomeo, Paul E; McDonald, John E; Finneman, Judith; Shoreline

    2007-01-01

    This is case report of extramedullary plasmacytoma occurring in the nasal cavity. These are unusual tumors especially in the nasal area. Patients present mainly with nasal symptoms on the same side of the tumors. The treatment consists of surgery resection, or, radiation, or both. There is a fifty percent survival rate in five years.

  16. Does post septoplasty nasal packing reduce complications?

    PubMed

    Naghibzadeh, Bijan; Peyvandi, Ali Asghar; Naghibzadeh, Ghazal

    2011-01-01

    The main issues in nasal surgery are to stabilize the nose in the good position after surgery and preserve the cartilages and bones in the favorable situation and reduce the risk of deviation recurrence. Also it is necessary to avoid the synechia formation, nasal valve narrowing, hematoma and bleeding. Due to the above mentioned problems and in order to solve and minimize them nasal packing, nasal splint and nasal mold have been advised. Patients for whom the nasal packing used may faced to some problems like naso-pulmonary reflex, intractable pain, sleep disorder, post operation infection and very dangerous complication like toxic shock syndrome. We have two groups of patients and three surgeons (one of the surgeons used post operative nasal packing in his patients and the two others surgeons did not).Complications and morbidities were compared in these two groups. Comparing the two groups showed that the rate of complication and morbidities between these two groups were same and the differences were not valuable, except the pain and discomfort post operatively and at the time of its removal. Nasal packing has several risks for the patients while its effects are not studied. Septoplasty can be safely performed without postoperative nasal packing. Nasal packing had no main findings that compensated its usage. Septal suture is one of the procedures that can be used as alternative method to nasal packing. Therefore the nasal packing after septoplasty should be reserved for the patients with increased risk of bleeding.

  17. Nasal intubation: A comprehensive review

    PubMed Central

    Chauhan, Varun; Acharya, Gaurav

    2016-01-01

    Nasal intubation technique was first described in 1902 by Kuhn. The others pioneering the nasal intubation techniques were Macewen, Rosenberg, Meltzer and Auer, and Elsberg. It is the most common method used for giving anesthesia in oral surgeries as it provides a good field for surgeons to operate. The anatomy behind nasal intubation is necessary to know as it gives an idea about the pathway of the endotracheal tube and complications encountered during nasotracheal intubation. Various techniques can be used to intubate the patient by nasal route and all of them have their own associated complications which are discussed in this article. Various complications may arise while doing nasotracheal intubation but a thorough knowledge of the anatomy and physics behind the procedure can help reduce such complications and manage appropriately. It is important for an anesthesiologist to be well versed with the basics of nasotracheal intubation and advances in the techniques. A thorough knowledge of the anatomy and the advent of newer devices have abolished the negative effect of blindness of the procedure. PMID:27994382

  18. Chronic Rhinosinusitis with Nasal Polyps

    PubMed Central

    Stevens, Whitney W.; Schleimer, Robert P.; Kern, Robert C.

    2016-01-01

    Chronic rhinosinusitis with nasal polyps (CRSwNP) is an important clinical entity diagnosed by the presence of both subjective and objective evidence of chronic sinonasal inflammation. Symptoms include anterior or posterior rhinorrhea, nasal congestion, hyposmia and/or facial pressure or pain that last for greater than 12 weeks duration. Nasal polyps are inflammatory lesions that project into the nasal airway, are typically bilateral, and originate from the ethmoid sinus. Males are more likely to be affected than females but no specific genetic or environmental factors have been strongly linked to the development of this disorder to date. CRSwNP is frequently associated with asthma and allergic rhinitis but the cellular and molecular mechanisms that contribute to the clinical symptoms are not fully understood. Defects in the sinonasal epithelial cell barrier, increased exposure to pathogenic and colonized bacteria, and dysregulation of the host immune system are all thought to play prominent roles in disease pathogenesis. Additional studies are needed to further explore the clinical and pathophysiological features of CRSwNP so that biomarkers can be identified and novel advances can be made to improve the treatment and management of this disease. PMID:27393770

  19. Early nasal injury resulting from the use of nasal prongs in preterm infants with very low birth weight: a pilot study

    PubMed Central

    Ota, Nathalie Tiemi; Davidson, Josy; Guinsburg, Ruth

    2013-01-01

    Objective To analyze the incidence of early-onset nasal injury in infants with very low birth weight and indication for noninvasive ventilation via nasal prongs. Methods A prospective case series of infants with gestational age <37 weeks, weight <1.500 g and postnatal age <29 days. The patients were evaluated three times daily from the installation of nasal prongs to the 3rd day of use. The patients' clinical conditions and the device's characteristics and its application were analyzed. The initial analysis was descriptive, indicating the prevalence of nasal injury and factors associated with it. Categorical data were analyzed using the chi-squared test or Fisher's exact test, and numerical data were analyzed using the t-test or the Mann-Whitney test. Results Eighteen infants were included; 12 (with a gestational age of 29.8±3.1 weeks, birth weight of 1.070±194 g and a Score for Neonatal Acute Physiology - Perinatal Extension (SNAPPE) of 15.4±17.5) developed nasal injuries (injury group), and 6 (with a gestational age of 28.0±1.9 weeks, weight of 1.003±317 g and SNAPPE of 26.2±7.5) showed no nasal injury (uninjured group). The injury group subjects were more often male (75% versus 17%), and their injuries appeared after an average of 18 hours, predominantly during the night (75%). Conclusion The incidence of nasal injury in preterm infants who experienced noninvasive ventilation via nasal prongs was high, and a study of associated factors may be planned based on this pilot. PMID:24213089

  20. Pediatric nasal fractures: evaluation and management.

    PubMed

    Desrosiers, Arthur E; Thaller, Seth R

    2011-07-01

    Nasal fractures have been reported as 1 of the 3 most commonly encountered pediatric facial bone fractures. The most common causes of nasal fractures in this age group are auto accidents (40%), sports injuries (25%), intended injuries (15%), and home injuries (10%). Nasal fractures are usually treated with closed reduction (Higuera S, Lee EI, Stal S. Nasal trauma and the deviated nose. Plast Reconstr Surg 2007;120:64S-75S). This results in a significant incidence of posttraumatic deformities, often requiring secondary surgical treatment. For this reason, it is paramount to pay careful attention to the underlying structural nasal anatomy during the initial diagnosis and management.

  1. Relationship between the degree and direction of nasal septum deviation and nasal bone morphology.

    PubMed

    Serifoglu, Ismail; Oz, İbrahim İlker; Damar, Murat; Buyukuysal, Mustafa Cagtay; Tosun, Alptekin; Tokgöz, Özlem

    2017-02-28

    Nasal septal deviation may affect nasal bone growth and facial morphology. Knowledge of nasal morphologic parameters may plays an important role in planning successful rhinoplasty and septoplasty operation. The aim of our study was to evaluate the relationship between the direction and degree of nasal septal deviation with nasal bone morphology, along with factors such as age and gender. Maxillofacial computed tomography (CT) of 250 patients with nasal septal deviation was analyzed retrospectively in this study. We excluded patients with factors that could affect their nasal bone morphology, and a total of 203 patients (111 males, 92 females; mean age, 36.23 years; age range, 18-79 years) were evaluated. The nasal deviation angle was measured on coronal CT images as the angle between the most deviated point of the septum, and the midline nasal morphology was determined by measuring nasal length, internasal angle and lateral and intermediate nasal thickness on both sides. The deviation of nasal septum has been detected as to the right in 107 patients (52.7%) and to the left in 96 patients (47.3%). Lateral and intermediate nasal bone thickness and nasal bone length were significantly greater on the ipsilateral deviation side (Table 3). No significant correlation was found between the variation of the nasal deviation angle and nasal bone morphology (Table 4). There were significant differences between the sexes for all investigated parameters except for the nasal deviation angle (p = 0.660). We found that the only internasal angle increases with aging (p = 0.002). The study shows that the direction of nasal septal deviation may be a factor that affects nasal bone morphology.

  2. Cosmetic rhinoseptoplasty in acute nasal bone fracture.

    PubMed

    Kim, Ji Heui; Lee, Jung Woo; Park, Chan Hum

    2013-08-01

    Traditionally, rhinoseptoplasty for nasal bone fracture is only considered after an unsatisfactory outcome from initial closed reduction. However, better surgical outcomes may be achieved if rhinoseptoplasty is performed at the same time as the nasal bone fracture reduction. This study investigated the surgical outcomes of patients who underwent rhinoseptoplasty concomitantly with nasal bone fracture reduction according to their computed tomography image-based nasal bone fracture classifications. Case series with chart review. Academic tertiary care medical center. Fifty-six patients who underwent rhinoseptoplasty concomitantly with nasal bone fracture reduction were enrolled in this study. Nasal bone fractures were classified into 6 types by computed tomography scans. Two independent facial plastic surgeons evaluated the outcomes 6 months postoperatively using a visual analog scale. The nasal tip projection and rotation were measured using the pre- and postoperative profile views. The satisfaction scores of type I, IIo, and IIIo fractures without septal fracture were significantly higher than those of type II, III, and IV fractures with septal fractures. Among the patients, 82.1% underwent lower vault surgery. The nasal tip projection and rotation were increased after surgery in patients without septal fractures, whereas the tip rotation was elevated but the projection was unchanged postoperatively in patients with septal fractures. Rhinoseptoplasty for acute nasal bone fractures can be performed at the same time as nasal bone fracture reduction. However, nasal bone fracture with septal fracture should be managed carefully.

  3. A simple nasal anemometer for clinical purposes.

    PubMed

    Hutters, B; Brøndsted, K

    1992-01-01

    There is a need for clinical methods which give more direct information about the behaviour of the velopharyngeal mechanism in natural speech than do the examination methods normally applied to patients suffering from velopharyngeal insufficiency. One possibility is the recording of nasal airflow in order to detect nasal emission of air. The purpose of the present study is to examine the qualities and the characteristics of a simple and cheap nasal anemometer. As this type of flowmeter is considered less reliable than most other flowmeters, its limitations must be clearly understood and accounted for in drawing conclusions. Therefore, nasal airflow in speech obtained with this flowmeter is discussed in relation to nasal airflow obtained by the more reliable pneumotachograph and in relation to nasal airflow data found in the literature. The tests made here suggest that, at least for the type of speech material and measurements used in the present study, reliable nasal airflow data can be obtained by the anemometer.

  4. The effect of an adhesive external nasal dilator strip on the inspiratory nasal airflow.

    PubMed

    Seren, Erdal

    2010-01-01

    We studied the affect of an adhesive external nasal dilator strip (ENDS) on the inspiratory nasal airflow. A prospective study was performed. Twenty-two healthy volunteers were enrolled in the study. All volunteers analyzed the inspiratory nasal sound samples before and while wearing a commercially available ENDS. This nasal sound analysis includes the spectral analysis and average sound intensities in low frequency (Lf), medium frequency (Mf), and high frequency (Hf). In the sound analyses, an increase was found in sound intensity at Hf when the nasal strips were not worn whereas a decrease was found in sound intensity at Hf when the nasal strips were on. Changes in the nasal geometry of the anterior part of the nose by wearing nasal strips affects the pattern of nasal airflow and transforms it into a laminar pattern.

  5. Clinical evaluation of a novel internal nasal dilation stent for the improvement of nasal breathing.

    PubMed

    Brandt, Michael G; Moore, Corey C; Doyle, Philip C

    2008-05-01

    This study assessed rhinometric improvement in nasal airflow, perceived comfort, and the utility of nasal dilation devices for individuals with nasal obstruction treated with an external nasal dilator (END) or a novel internal nasal dilation stent (INDS). Prospective, randomized, crossover trial. Individuals with symptoms of nasal obstruction. Twenty-three participants underwent rhinometry and a trial with a novel INDS and a validated END. Devices were used in a randomized, crossover fashion. Nasal airflow, maximum use, continuous use, comfort, and challenge with these devices were assessed. The END and INDS showed greater nasal airflow from baseline, with the INDS being significantly better than the END. The INDS was used significantly more than the END, and demonstrated significantly greater comfort and less associated challenge. The novel INDS showed 3.4 times improved nasal airflow from baseline, was used maximally and continuously longer than a validated END, and was judged to be significantly more tolerable.

  6. The Effect of Nasal Obstruction after Different Nasal Surgeries Using Acoustic Rhinometry and Nasal Obstruction Symptom Evaluation Scale

    PubMed Central

    Kahraman, Erkan; Cil, Yakup; Incesulu, Armagan

    2016-01-01

    BACKGROUND The efficiency of nasal surgeries can be determined by objective or subjective methods. We have assessed the effect of nasal obstruction after different nasal surgeries using Acoustic Rhinometry (AR) and Nasal Obstruction Symptom Evaluation (NOSE) Scale. METHODS Between May 2011 and May 2012, 40 young adult patients and 10 healthy volunteers as control group who referred to Otorhinolaryngology Clinic in Eskisehir Military Hospital due to nasal obstruction were enrolled. Depending on operation, patients were divided into four equal groups. Group 1: Septoplasty, Group 2: Septoplasty with sprader graft, Group 3: Septorinoplasty and Group 4: Septorhinoplasty with spreader graft. The patients completed NOSE scale, 1 week before and 1 month after the surgery and AR measurements. RESULTS There were a significant improvement in mean NOSE scores of patients and statistical difference was found between pre and post-operational values for each group. There was a statistically significant change of the mean minimal cross section areas (MCA) of the deviated side of nasal passages measured by AR between pre and postoperative period. CONCLUSION In patients with nasal obstruction, functional nasal surgeries which were performed after appropriate medical examination and with right operation methods had a positive impact on quality of life and patient satisfaction. We observed that nasal findings were correlated with NOSE scores and MCA values. So, we suggest that NOSE scale and AR to be used for evaluation of the efficiency of functional nasal surgeries. PMID:27853686

  7. Cytological assessment of the epithelial cells of the nasal mucous membrane after local fluticasone therapy.

    PubMed

    Trybus, E; Krol, T; Obarzanowski, T; Trybus, W; Kopacz-Bednarska, A; Obarzanowski, M

    2015-02-01

    The majority of cytological studies concern the influence of glucocorticosteroids on cells involved in creating and sustaining inflammation, such as eosinophils or neutrophils. Much less attention is devoted to epithelial cells. It should also be noticed that glucocorticosteroid drugs administered nasally for local action can significantly change the cytological image of the nasal mucous membrane. Therefore, the purpose of this research was to cytologically assess the influence of topical fluticasone therapy on the nasal mucous membrane cells, with special attention for the changes in the morphology of epithelial cells. The research samples were taken from patients with symptoms of chronic rhinitis and suspected allergies. The research was a two-step process. In the first step, a smear was taken from the surface of the nasal mucous membrane of the above-mentioned patients before the start of therapy and the obtained cytological image was compared with a control image of the nasal mucous of healthy people. Step two involved the cytology of the same patients after 4 weeks of fluticasone therapy, applied as a nasal aerosol in two doses of 50 μg to each nostril once per day, in the combined daily dose of 200 μg (for adults and children aged 12 or more). Children aged between 4 and 12 were given a single dose of 50 μg to each nostril once per day, in a daily dose of 100 μg. Based on smears stained according to the Papanicolaou and Pappenheim method, a qualitative and quantitative analysis of changes in the mucous membrane of nasal cells was performed. The cytological assessment of nasal mucous membrane stains of patients with chronic rhinitis before fluticasone treatment enabled a diagnosis of chronic infectious rhinitis, compared through the presence of numerous neutrophils and bacteria. The studied samples did not show significant changes in the morphology of epithelial cells, only a few cells with mild vacuolation changes of the cytoplasm were found. The use of

  8. The clinical value of peak nasal inspiratory flow, peak oral inspiratory flow, and the nasal patency index.

    PubMed

    Tsounis, Michael; Swart, Karin M A; Georgalas, Christos; Markou, Konstantinos; Menger, Dirk J

    2014-12-01

    The aim of this study was to ascertain the most reliable objective measurement for the assessment of nasal patency by investigating the relationship between peak nasal inspiratory flow, peak oral inspiratory flow, and the nasal patency index in relation to the patient's subjective perception regarding nasal obstruction. Prospective cohort study. This study included 131 volunteers of both genders, aged 18 years or older, with or without nasal symptoms, who were able to give informed consent, completed the study protocol, and could speak and write Dutch fluently. Peak nasal inspiratory flow and peak oral inspiratory flow were performed and nasal patency index was computed. The results were evaluated and compared with the subjective perception of nasal passage, using the validated Nasal Obstruction Symptom Evaluation scale and visual analog scale for nasal passage. Our study showed that peak nasal inspiratory flow, nasal patency index and nasal patency visual analog scale correlate with the Nasal Obstruction Symptom Evaluation scale in contrast to peak oral inspiratory flow. Peak nasal inspiratory flow and nasal patency index also showed significant association with the Nasal Obstruction Symptom Evaluation scale after adjustment for confounders. Peak nasal inspiratory flow is the most reliable method for the assessment of nasal patency. It is quick, inexpensive, and easy to perform, and correlates significantly with the subjective feeling of nasal obstruction. There is no clinical need to measure peak oral inspiratory flow or to calculate the nasal patency index in the evaluation of nasal patency. 4 © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  9. Safety and efficacy of olopatadine hydrochloride nasal spray for the treatment of seasonal allergic rhinitis to mountain cedar.

    PubMed

    Ratner, Paul H; Hampel, Frank C; Amar, Niran J; van Bavel, Julius H; Mohar, Dale; Marple, Bradley F; Roland, Peter S; Wall, G Michael; Brubaker, Michael J; Drake, Margaret; Turner, Darell; Silver, Lewis H

    2005-11-01

    A nasal spray containing the antiallergy agent olopatadine hydrochloride is being developed for the treatment of seasonal allergic rhinitis (SAR) to mountain cedar. To evaluate the safety and efficacy of 2 concentrations of olopatadine nasal spray vs placebo nasal spray in patients with SAR to mountain cedar. This was a multicenter, randomized, double-blind, placebo-controlled study. After a 3- to 21-day placebo run-in, 677 patients aged 12 to 81 years were randomized to receive 0.4% or 0.6% olopatadine or placebo, 2 sprays per nostril twice daily for 2 weeks. Patients evaluated morning and evening reflective and instantaneous nasal symptoms (sneezing, stuffy nose, runny nose, and itchy nose, which compose the total nasal symptom score [TNSS]) and ocular symptoms. Olopatadine spray (0.4% and 0.6%) was statistically significantly superior to placebo for percentage change from baseline in overall reflective and instantaneous TNSSs. Also, 0.6% olopatadine was statistically significantly superior to placebo for reducing the reflective and instantaneous assessments of sneezing, runny nose, itchy nose, stuffy nose, itchy eyes, and watery eyes. Olopatadine spray exhibited a safety profile comparable with that of placebo. Olopatadine nasal spray (0.4% and 0.6%) provided statistically significant improvements in allergic rhinitis symptoms compared with placebo regarding TNSSs and individual symptoms, including congestion, itchy and runny nose, sneezing, and itchy and watery eyes, in patients with SAR to mountain cedar. Olopatadine nasal spray administered twice daily was safe and well tolerated in adolescents and adults.

  10. Smart Polymers in Nasal Drug Delivery

    PubMed Central

    Chonkar, Ankita; Nayak, Usha; Udupa, N.

    2015-01-01

    Nasal drug delivery has now been recognized as a promising route for drug delivery due to its capability of transporting a drug to systemic circulation and central nervous system. Though nasal mucosa offers improved bioavailability and quick onset of action of the drug, main disadvantage associated with nasal drug delivery is mucocilliary clearance due to which drug particles get cleared from the nose before complete absorption through nasal mucosa. Therefore, mucoadhesive polymeric approach can be successfully used to enhance the retention of the drug on nasal mucosal surface. Here, some of the aspects of the stimuli responsive polymers have been discussed which possess liquid state at the room temperature and in response to nasal temperature, pH and ions present in mucous, can undergo in situ gelation in nasal cavity. In this review, several temperature responsive, pH responsive and ion responsive polymers used in nasal delivery, their gelling mechanisms have been discussed. Smart polymers not only able to enhance the retention of the drug in nasal cavity but also provide controlled release, ease of administration, enhanced permeation of the drug and protection of the drug from mucosal enzymes. Thus smart polymeric approach can be effectively used for nasal delivery of peptide drugs, central nervous system dugs and hormones. PMID:26664051

  11. Hemoglobin Promotes Staphylococcus aureus Nasal Colonization

    PubMed Central

    Schwartz, Kelly; Hernandez, Margarita; Boles, Blaise R.

    2011-01-01

    Staphylococcus aureus nasal colonization is an important risk factor for community and nosocomial infection. Despite the importance of S. aureus to human health, molecular mechanisms and host factors influencing nasal colonization are not well understood. To identify host factors contributing to nasal colonization, we collected human nasal secretions and analyzed their ability to promote S. aureus surface colonization. Some individuals produced secretions possessing the ability to significantly promote S. aureus surface colonization. Nasal secretions pretreated with protease no longer promoted S. aureus surface colonization, suggesting the involvement of protein factors. The major protein components of secretions were identified and subsequent analysis revealed that hemoglobin possessed the ability to promote S. aureus surface colonization. Immunoprecipitation of hemoglobin from nasal secretions resulted in reduced S. aureus surface colonization. Furthermore, exogenously added hemoglobin significantly decreased the inoculum necessary for nasal colonization in a rodent model. Finally, we found that hemoglobin prevented expression of the agr quorum sensing system and that aberrant constitutive expression of the agr effector molecule, RNAIII, resulted in reduced nasal colonization of S. aureus. Collectively our results suggest that the presence of hemoglobin in nasal secretions contributes to S. aureus nasal colonization. PMID:21750673

  12. Contrastive and contextual vowel nasalization in Ottawa

    NASA Astrophysics Data System (ADS)

    Klopfenstein, Marie

    2005-09-01

    Ottawa is a Central Algonquian language that possesses the recent innovation of contrastive vowel nasalization. Most phonetic studies done to date on contrastive vowel nasalization have investigated Indo-European languages; therefore, a study of Ottawa could prove to be a valuable addition to the literature. To this end, a percentage of nasalization (nasal airflow/oral + nasal airflow) was measured during target vowels produced by native Ottawa speakers using a Nasometer 6200-3. Nasalized vowels in the target word set were either contrastively or contextually nasalized: candidates for contextual nasalization were either regressive or perserverative in word-initial and word-final syllables. Subjects were asked to read words containing target vowels in a carrier sentence. Mean, minimum, and maximum nasalance were obtained for each target vowel across its full duration. Target vowels were compared across context (regressive or perseverative and word-initial or word-final). In addition, contexts were compared to determine whether a significant difference existed between contrastive and contextual nasalization. Results for Ottawa will be compared with results for vowels in similar contexts in other languages including Hindi, Breton, Bengali, and French.

  13. Nasal septal haematoma in Nigeria.

    PubMed

    Chukuezi, A B

    1992-05-01

    A prospective study of 46 consecutive patients with nasal septal haematoma admitted at the General Hospital, Owerri, Nigeria over a five year period is presented. The disease was commoner in males than females. The majority of the cases (65.6 per cent) were of unknown cause and were therefore grouped as spontaneous haematoma while 30.4 per cent were due to trauma. Trauma was more common in patients below the age of 15 years while spontaneous haematoma was common in patients above that age. All the patients with septal haematoma represented 0.2 per cent of total attendances to the ENT clinic over the period. Most of the patients presented with severe and threatening symptoms necessitating intense aggressive management. All the patients were managed by surgical incision and drainage, four had marked nasal abnormalities. Three patients died from a brain abscess as a complication of infected haematoma.

  14. Nasal gel and olfactory cleft.

    PubMed

    Herranz González-Botas, Jesús; Padín Seara, Anselmo

    2012-01-01

    To evaluate whether a nasal gel, administrated using a radial-hole inhaler, reaches the olfactory cleft and if a different administration method influences distribution. Sixteen healthy volunteers underwent a nasal endoscopy at 1 and 7minutes after the administration of a intranasal gel, with a different method in each fossa. No dye deposition was identified at the olfactory cleft, middle turbinate or middle meatus. In all cases the gel was identified at the nasal vestibule. On the right side, the second most frequent dye identification area was the inferior turbinate, with a rate of 87% at the first minute and 75% at 7 minutes. It was followed by the septum (75 and 62%) and the inferior meatus (6.2 and 12.5%). On the left side, the second most frequent stained area was the septum (18.7 and 13.5%), followed by the inferior meatus (6.5 and 65%). No inferior turbinate staining was found in the left side. There was a significant difference in the deposition rate at the septum (P<.01) and inferior turbinate (P<.001), when both administration methods were compared. No nasal gel, administrated using a radial-hole inhaler, was found at the olfactory cleft, middle turbinate or middle meatus. Gel distribution was located at the anterior and inferior portion of the nose, independent of the administration method used. Significantly different gel distribution rates were found at the septum and inferior turbinate when the 2 administration methods were compared. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  15. Nasal airway responses to nasal continuous positive airway pressure breathing: An in-vivo pilot study.

    PubMed

    White, David E; Bartley, Jim; Shakeel, Muhammad; Nates, Roy J; Hankin, Robin K S

    2016-06-14

    The nasal cycle, through variation in nasal airflow partitioning, allows the upper airway to accommodate the contrasting demands of air conditioning and removal of entrapped air contaminants. The purpose of this study was to investigate the influence of nasal continuous positive airway pressure (nCPAP) breathing has on both nasal airflow partitioning and nasal geometry. Using a custom-made nasal mask, twenty healthy participants had the airflow in each naris measured during normal nasal breathing followed by nCPAP breathing. Eight participants also underwent magnetic resonance imaging (MRI) of the nasal region during spontaneous nasal breathing, and then nCPAP breathing over a range of air pressures. During nCPAP breathing, a simultaneous reduction in airflow through the patent airway together with a corresponding increase in airway flow within the congested nasal airway were observed in sixteen of the twenty participants. Nasal airflow resistance is inversely proportional to airway cross-sectional area. MRI data analysis during nCPAP breathing confirmed airway cross-sectional area reduced along the patent airway while the congested airway experienced an increase in this parameter. During awake breathing, nCPAP disturbs the normal inter-nasal airflow partitioning. This could partially explain the adverse nasal drying symptoms frequently reported by many users of this therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Antibiotic surgical prophylaxis increases nasal carriage of antibiotic-resistant staphylococci.

    PubMed

    McMurray, Claire L; Hardy, Katherine J; Verlander, Neville Q; Hawkey, Peter M

    2015-12-01

    Staphylococci are a significant cause of hospital-acquired infection. Nasal carriage of Staphylococcus aureus is an important risk factor for infection in surgical patients and coagulase-negative staphylococci (CNS) are a major cause of prosthetic joint infections. The impact that antibiotic surgical prophylaxis has on the nasal carriage of staphylococci has not been studied. Daily nasal swabs were taken from 63 patients who received antibiotic surgical prophylaxis and 16 patients who received no antibiotics. Total aerobic bacterial count, S. aureus and CNS were enumerated by culture from nasal swabs. Representative isolates were typed by staphylococcal interspersed repeat units (SIRU) typing and PFGE, and MICs to nine antibiotics were determined. After antibiotic administration, there was a reduction in S. aureus counts (median - 2.3 log(10)c.f.u. ml(- 1)) in 64.0 % of S. aureus carriers, compared with only a 0.89 log(10)c.f.u. ml(- 1) reduction in 75.0 % of S. aureus carriers who did not receive antibiotics. A greater increase in the nasal carriage rate of meticillin-resistant CNS was observed after antibiotic surgical prophylaxis compared with hospitalization alone, with increases of 16.4 and 4.6 %, respectively. Antibiotic-resistant S. epidermidis carriage rate increased by 16.6 % after antibiotic administration compared with 7.5 % with hospitalization alone. Antibiotic surgical prophylaxis impacts the nasal carriage of both S. aureus and CNS.

  17. REDUCTION OF PREOPERATIVE CONJUNCTIVAL BACTERIAL FLORA WITH THE USE OF MUPIROCIN NASAL OINTMENT

    PubMed Central

    Alexandrou, Terry J.; Hariprasad, Seenu M.; Benevento, Joseph; Rubin, Michael P.; Saidel, Michael; Ksiazek, Susan; Thompson, Kenneth; Boonlayangoor, Sue; Mieler, William F.

    2006-01-01

    Purpose To determine whether the use of mupirocin ointment for preoperative eradication of nasal bacterial carriage was effective in reducing conjunctival bacterial flora. Methods Prospective, double-arm, blinded clinical trial of 37 eyes of 37 patients undergoing intraocular surgery (cataract extraction or pars plana vitrectomy) randomized to either control or mupirocin treatment groups. Treated patients received mupirocin nasal ointment twice daily for 5 days prior to surgery. Nasal cultures were obtained in all patients. All patients received a standard 5% povidone-iodine preparation before the surgical procedure, and conjunctival cultures were obtained in all patients before and after the povidone-iodine preparation. Results All 37 patient nasal swabs were positive for bacterial growth (cultures were obtained prior to the use of mupirocin ointment in the treatment group). One of 15 eyes (6.7%) in the treatment group had positive conjunctival cultures prior to povidone-iodine preparation, compared with nine of 22 eyes (41%) in the control group (P < .05). Even after povidone-iodine preparation, eight of 22 eyes (36%) in the control group demonstrated persistent positive cultures, whereas one (6.7%) of the treatment eyes exhibited growth (P < .05). Conclusions Prophylactic use of mupirocin nasal ointment resulted in significant reduction of conjunctival flora with or without preoperative topical 5% povidone-iodine preparation. The use of mupirocin nasal ointment prior to intraocular surgery or intravitreal injections is a novel method for reducing conjunctival contamination rates, which theoretically should reduce the incidence of endophthalmitis. PMID:17471340

  18. Unilateral nasal resistance and asymmetrical body pressure.

    PubMed

    Haight, J S; Cole, P

    1986-08-01

    Lateral recumbency causes ipsilateral nasal congestion and contralateral decongestion. Nasal resistances were measured before, during and after the application of pressure either regionally or by lateral recumbency. In some experiments an attempt was made to block the response by local anesthetic injection, splinting the nasal vestibules, or topical decongestants. In others an electric blanket was employed as a stimulus instead of pressure. It was concluded that the nasal resistance changes during lateral recumbency are due to pressure receptors in the pelvic and pectoral girdles, and thorax. These adapt slowly. They are probably situated in the intercostal spaces, parietal pleura, or sterno-costal joints. Their centripetal fibers probably travel in the intercostal nerves, and their efferents in the cervical sympathetic outflow to the nasal erectile tissue. Lateral recumbency of 12 minutes' duration induces changes in nasal resistance which persist after the pressure asymmetry has been terminated. This may be due to temporal summation.

  19. Nasal reconstruction using porous polyethylene implants.

    PubMed

    Romo, T; Sclafani, A P; Jacono, A A

    2000-01-01

    Nasal reconstruction presents a significant challenge to the facial plastic surgeon. The dual goals of reconstruction are restoration of the desired aesthetic nasal contour and an improved nasal airway. Autologous cartilage and bone are considered optimal grafting material, but their supply is often limited and harvesting entails additional morbidity. Many synthetic materials have been introduced in nasal reconstruction, but high infection and extrusion rates limited their use. Porous high density polyethylene implants present an alternative to autologous material as they allow for fibrovascular ingrowth, leading to stability of the implant and decreased rates of infection. Herein we describe the use of porous high density polyethylene implants for reconstruction of the platyrrhine nose and in revision rhinoplasty. The use of preformed nasal-dorsal tip and alar batten implants are described, as well as the use of columellar strut and premaxillary plumper implants. We believe that porous high density polyethylene implants provide a safe, desirable alternative in functional and aesthetic nasal reconstruction.

  20. Post Septorhinoplasty Custom-Made Unilateral Nasal Stent for Nasal Cleft Deformity

    PubMed Central

    Rathee, Manu; Bhoria, Mohaneesh; Boora, Priyanka

    2015-01-01

    Context: Nasal cleft deformity is a complicated problem. Utilization of nasal stent in post septorhinoplastyaims at establishing and maintaining airway patency, tissue position, and reduces tissue contracture after surgery. Case Report: A 16-year-old female patient presented with history of surgical reconstruction of congenital cleft lip and cleft palate with secondary septorhinoplasty of nasal cleft deformity. Patient was referred for nasal stent 1 week after septorhinoplasty. This case report provides a novel technique for fabrication of esthetic nasal stent after postseptorhinoplasty for secondary cleft nose deformity correction. Conclusion: This case report presents a simple, convenient technique for nasal stent fabrication for prevention of restenosis for cleft nose deformity post secondary septorhinoplasty. Provision of nasal stent allows breathing, maintains esthetics, comfort, nasal patency, and contour with minimal discomfort. PMID:25789253

  1. Clinical evaluation of 368 patients with nasal rosacea: subtype classification and grading of nasal rosacea.

    PubMed

    Lee, Woo Jin; Jung, Joon Min; Won, Kwang Hee; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Moon, Kee Chan; Lee, Mi Woo

    2015-01-01

    The clinical features of nasal rosacea have not been described in detail. To describe the clinical features of nasal rosacea. 599 patients were classified into those with rosacea in both the nasal and extra-nasal areas (group A), localized nasal rosacea (group B) and rosacea without nasal involvement (group C). The mixed subtype was more common in group A (n = 337) than in group C (n = 231). The severity score was higher in group A than in group C. Erythematotelangiectatic rosacea was the most common subtype in group B (n = 31) and was more common in group B than in group A. Rosacea mainly affected the lower half of the nose in group B, but affected the entire nose in group A. Nasal involvement may be an index of severe rosacea. Localized nasal rosacea is a separate spectrum with different clinical features. © 2015 S. Karger AG, Basel.

  2. Air flow in the human nasal cavity

    NASA Astrophysics Data System (ADS)

    Fomin, V. M.; Vetlutsky, V. N.; Ganimedov, V. L.; Muchnaya, M. I.; Shepelenko, V. N.; Melnikov, M. N.; Savina, A. A.

    2010-03-01

    A mathematical model of the air flow in the human nasal cavity is developed under the assumption of a turbulent viscous air flow. The shape of the nasal cavity is modeled with the use of the Gambit graphical software system and tomography data. A numerical solution is obtained by using the Fluent commercial software system. Calculations are performed for various variants of construction of the human nasal cavity.

  3. Nasal sequelae of Treacher Collins syndrome.

    PubMed

    Plomp, Raul G; Mathijssen, Irene M J; Moolenburgh, Sanne E; van Montfort, Kees A G M; van der Meulen, Jacques J N M; Poublon, René M L

    2015-06-01

    This study aimed to determine external and endonasal deformity, and satisfaction with nasal functioning and appearance, in Treacher Collins syndrome. A cross-sectional cohort study was conducted. Eleven adult patients with Treacher Collins syndrome were compared with 151 controls in terms of satisfaction with nasal functioning and appearance by means of the Nasal Appearance and Function Evaluation Questionnaire. In all patients with Treacher Collins syndrome, external nasal deformities were scored on standardized digital photographs of the nose as rated independently by three experienced physicians. Endonasal deformity was determined by standardized nasal endoscopy. The patients were relatively satisfied with the various esthetic nasal subunits. The most significant functional problems were snoring (P = 0.001) and quality of phonation (P = 0.003). The main external nasal deformities were the dorsal hump (73%), external deviation (≤55%), the bifid or bulbous nasal tip (55%), and columellar septal luxation (55%). In 82% of the patients, a septal deviation was found, often associated with spurs. Satisfaction with esthetics of the nose was fair, but these patients suffer from the functional problems of snoring and impaired quality of phonation. A structured nasal ENT physical examination with nasal endoscopy might determine aspects requiring more attention during treatment. Septorhinoplasty can be performed at an adult age if there is a considerable esthetic wish of the patient and/or nasal obstruction combined with septal deviation. Attention should be paid to dorsal hump reduction, correction of the deviated external osseous framework, septoplasty, and correction of the nasal tip shape. 2b. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Noninterventional Open-Label Trial Investigating the Efficacy and Safety of Ectoine Containing Nasal Spray in Comparison with Beclomethasone Nasal Spray in Patients with Allergic Rhinitis

    PubMed Central

    Sonnemann, Uwe; Möller, Marcus

    2014-01-01

    Objectives. The current study aimed to compare the efficacy and safety of a classical anti-inflammatory beclomethasone nasal spray in comparison to a physic-chemical stabilizing ectoine containing nasal spray in the treatment of allergic rhinitis. Design and Methods. This was a noninterventional, open-label, observational trial investigating the effects of beclomethasone or ectoine nasal spray on nasal symptoms and quality of life. Over a period of 14 days, patients were asked to daily document their symptoms. Efficacy and tolerability were assessed by both physicians and patients. Results. Both treatments resulted in a significant decrease of TNSS values. An equivalence test could not confirm the noninferiority of ectoine treatment in comparison with beclomethasone treatment. Although clear symptom reduction was achieved with the ectoine products, the efficacy judgment showed possible advantages for the beclomethasone group. Importantly, tolerability results were comparably good in both groups, and a very low number of adverse events supported this observation. Both treatments resulted in a clear improvement in the quality of life as assessed by a questionnaire answered at the beginning and at the end of the trial. Conclusion. Taken together, it was shown that allergic rhinitis can be safely and successfully treated with beclomethasone and also efficacy and safety were shown for ectoine nasal spray. PMID:24976831

  5. Noninterventional open-label trial investigating the efficacy and safety of ectoine containing nasal spray in comparison with beclomethasone nasal spray in patients with allergic rhinitis.

    PubMed

    Sonnemann, Uwe; Möller, Marcus; Bilstein, Andreas

    2014-01-01

    Objectives. The current study aimed to compare the efficacy and safety of a classical anti-inflammatory beclomethasone nasal spray in comparison to a physic-chemical stabilizing ectoine containing nasal spray in the treatment of allergic rhinitis. Design and Methods. This was a noninterventional, open-label, observational trial investigating the effects of beclomethasone or ectoine nasal spray on nasal symptoms and quality of life. Over a period of 14 days, patients were asked to daily document their symptoms. Efficacy and tolerability were assessed by both physicians and patients. Results. Both treatments resulted in a significant decrease of TNSS values. An equivalence test could not confirm the noninferiority of ectoine treatment in comparison with beclomethasone treatment. Although clear symptom reduction was achieved with the ectoine products, the efficacy judgment showed possible advantages for the beclomethasone group. Importantly, tolerability results were comparably good in both groups, and a very low number of adverse events supported this observation. Both treatments resulted in a clear improvement in the quality of life as assessed by a questionnaire answered at the beginning and at the end of the trial. Conclusion. Taken together, it was shown that allergic rhinitis can be safely and successfully treated with beclomethasone and also efficacy and safety were shown for ectoine nasal spray.

  6. Nasal dorsal augmentation with silicone implants.

    PubMed

    Erlich, Mark A; Parhiscar, Afshin

    2003-11-01

    Silicone rubber has been used safely and effectively for facial augmentation for nearly 5 decades in eastern Asia. We have used silicone rubber nasal implants in primary ethnic rhinoplasty and have found consistent and long-lasting results with low complication rates. Silicone dorsal nasal augmentation in primary rhinoplasty avoids donor site morbidity and implant resorption as seen with autogenous implants. Silicone nasal implants have a low extrusion and infection rate. In the appropriate patient with proper placement, silicone nasal implant is nearly the ideal implant material.

  7. Reconstruction of Small Soft Tissue Nasal Defects

    PubMed Central

    Wolfswinkel, Erik M.; Weathers, William M.; Cheng, David; Thornton, James F.

    2013-01-01

    Nasal defect repair has been one of the more challenging areas of reconstructive surgery due to the lack of uniform nasal skin thickness and complex contours. Currently, algorithms for medium to large nasal soft tissue defects have been well defined by various authors. Small defects, arbitrarily defined as 1 cm or less, still present significant challenges. In this article, the authors examine the options available to repair small soft tissue nasal defects and the appropriate situations in which each method is best suited. PMID:24872751

  8. Nasal Myiasis in Hinduism and Contemporary Otorhinolaryngology.

    PubMed

    Bosmia, Anand N; Zimmermann, Terence M; Griessenauer, Christoph J; Shane Tubbs, R; Rosenthal, Eben L

    2017-08-01

    Various case reports on nasal myiasis written during the 1990s and 2000s state that nasal myiasis, which is known as peenash among South Asian natives, is a form of divine punishment in Hindu mythology, but do not provide citations from Hindu scriptures that would suggest this interpretation. This paper aims to discuss the phenomenon of peenash in a historical context by examining medical literature written during the nineteenth and early twentieth centuries, to identify Hindu texts contributing to the belief of some Hindus that nasal myiasis is a form of divine punishment, and to provide an overview of contemporary treatment for and management of nasal myiasis.

  9. A computational analysis of nasal vestibule morphologic variabilities on nasal function.

    PubMed

    Ramprasad, Vaibhav H; Frank-Ito, Dennis O

    2016-02-08

    Although advances in computational modeling have led to increased understanding of nasal airflow, not much is known about the effects of normal sinonasal anatomic variabilities on nasal function. In this study, three distinct variations in the human nasal vestibule airspace that have not been previously described were identified. Computational fluid dynamics modeling of nasal airflow profile in each identified variation of nasal vestibule phenotype was conducted to assess the role of these phenotypes on nasal physiology. Three-dimensional reconstructions of the nasal geometry in sixteen subjects with normal radiographic sinonasal images were created and each respective unilateral nasal cavity was classified as Notched, Standard, or Elongated phenotype based nasal vestibule morphology. Steady state, laminar and incompressible flow simulations were performed in the nasal geometries under physiological, pressure-driven conditions with constant inspiratory pressure. Results showed that at localized regions of the unilateral nasal cavity, average resistance was significantly different among nasal vestibule phenotypes. However, global comparison from nostril to choana showed that average resistance was not significantly different across phenotypes; suggesting that with normal anatomic variations, the nose has a natural compensatory mechanism that modulates localized airflow in order to achieve a desired amount of global airflow. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Perception of Better Nasal Patency Correlates with Increased Mucosal Cooling after Surgery for Nasal Obstruction

    NASA Astrophysics Data System (ADS)

    Garcia, Guilherme; Sullivan, Corbin; Frank-Ito, Dennis; Kimbell, Julia; Rhee, John

    2014-11-01

    Nasal airway obstruction (NAO) is a common health problem with 340,000 patients undergoing surgery annually in the United States. Traditionally, otolaryngologists have focused on airspace cross-sectional areas and nasal resistance to airflow as objective measures of nasal patency, but neither of these variables correlated consistently with patients' symptoms. Given that the sensation of nasal airflow is also associated with mucosal cooling (i.e., heat loss) during inspiration, we investigated the correlation between the sensation of nasal obstruction and mucosal cooling in 10 patients before and after NAO surgery. Three-dimensional models of the nasal anatomy were created based on pre- and post-surgery computed tomography scans. Computational fluid dynamics (CFD) simulations were conducted to quantify nasal resistance and mucosal cooling. Patient-reported symptoms were measured by a visual analog scale and the Nasal Obstruction Symptom Evaluation (NOSE), a disease-specific quality of life questionnaire. Our results revealed that the subjective sensation of nasal obstruction correlated with both nasal resistance and heat loss, but the strongest correlation was between the NOSE score and the nasal surface area where heat flux exceeds 50 W /m2 . In conclusion, a significant post-operative increase in mucosal cooling correlates well with patients' perception of better nasal patency after NAO surgery.

  11. [Clinical analysis of nasal resistance and pulmonary function testing in patients with chronic nasal-sinusitis and nasal polyps].

    PubMed

    Liao, Hua; Shen, Ying; Wang, Pengjun

    2015-05-01

    To study the pulmonary function and nasal resistance characteristics of patients with chronic nose-sinusitis and nasal polyps (CRSwNP), to explore the evaluation role of nasal resistance in nasal ventilation function and the effect of endoscopic sinus surgery on pulmonary function in patients with CRSwNP. Fifty CRSwNP patients that met the study criteria were selected . The patients were performed endoscopic surgeries according to Messerklinger surgical procedures under general anesthesia. Extent of surgery was based on preoperative CT showing the range of the lesion of disease and endoscopic findings. Perioperative treatments contained intranasal corticosteroids, cephalosporin or penicillin antibiotics, nasal irrigation and other treatments. Main outcome measures included visual analog scale (VAS), endoscopic Lind-Kennedy scores, nasal resistence, pulmonary function in patientsone week before and after surgery, three months and six months after surgery. Pulmonary function includes forced expiratory volume in one second (FEV1), forced vital capacity FEV1/FVC and peak expiratory flow (PEF). The study found that there were significantly positive correlations among VAS score, Lund-Kennedy score and nasal resistance (P < 0.05) in CRSwNP patients, but there is a significantly negative correlation between VAS score, Lund-Kennedy score, nasal resistance and pulmonary function indexes of FEV1, FVC and PEF (P < 0.05). The VAS score, Lund-Kennedy score and nasal resistance values of CRSwNP patients were decreased significantly after comprehensive treatments with nasal endoscopic operation as the major one, the difference was statistically different (P < 0.05). And the pulmonary function indexs (FEV1, FVC, PEF) were significantly increased after surgery in CRSwNP patients. The nasal resistance can objectively and reliably reflect the degree of nasal congestion and the recovery of nasal function in CRSwNP patients after endoscopic sinus surgery. The detection method of nasal

  12. Neurilemmoma of lateral nasal wall.

    PubMed

    Bharti, Jyotsna Naresh; Gautam, Parul; Arora, Prerna

    2015-01-01

    Neurilemmoma is a benign tumour of nerve sheath origin that can arise from myelinated nerve. The Head and neck is the most frequent site involved and other sites are scalp, face, oral cavity, pharynx, larynx, trachea and ear. Neurilemmoma usually occur as solitary lesions and in association with NF type 2. Malignant transformation is very rare. We report a case of 18 year old male presented with complaint of nasal obstruction and swelling in right side of nose. We discuss the clinical presentation, histologic features, and therapeutic options for such a rare benign lesion.

  13. Numbered nasal discs for waterfowl

    USGS Publications Warehouse

    Bartonek, J.C.; Dane, C.W.

    1964-01-01

    Numbered nasal discs were successfully used in studies requiring large numbers of individually marked waterfowl. The procedure for constructing these discs is outlined. Blue-winged teal (Anas discors) with 5/8-inch discs, and canvasback (Aythya valisineria) and redhead (A. americana) with 3/4-inch discs can be individually identified up to 50 and 80 yards, respectively, with a gunstock-mounted, 20-power spotting scope. The particular value of these markers is their durability, the number of combinations possible, and the apparent absence of behavioral or mortality influence among such species as the blue-winged teal.

  14. Tumours of the nasal cavity*

    PubMed Central

    Stünzi, H.; Hauser, B.

    1976-01-01

    Tumours of the nasal cavity are rare in domestic animals, most cases occurring in the dog. Epithelial tumours are the most common type in carnivores (dogs and cats). In general, the same types of tumour occur in domestic animals as occur in man. There was no significant predisposition for breed in dogs, but in both dogs and cats far more males than females were affected. Metastases occurred only rarely. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 9Fig. 10Fig. 11Fig. 12Fig. 5Fig. 6Fig. 7Fig. 8 PMID:1086156

  15. Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction

    PubMed Central

    Kimbell, J.S.; Frank, D.O.; Laud, Purushottam; Garcia, G.J.M.; Rhee, J.S.

    2014-01-01

    Surgeries to correct nasal airway obstruction (NAO) often have less than desirable outcomes, partly due to the absence of an objective tool to select the most appropriate surgical approach for each patient. Computational fluid dynamics (CFD) models can be used to investigate nasal airflow, but variables need to be identified that can detect surgical changes and correlate with patient symptoms. CFD models were constructed from pre- and post-surgery computed tomography scans for 10 NAO patients showing no evidence of nasal cycling. Steady-state inspiratory airflow, nasal resistance, wall shear stress, and heat flux were computed for the main nasal cavity from nostrils to posterior nasal septum both bilaterally and unilaterally. Paired t-tests indicated that all CFD variables were significantly changed by surgery when calculated on the most obstructed side, and that airflow, nasal resistance, and heat flux were significantly changed bilaterally as well. Moderate linear correlations with patient-reported symptoms were found for airflow, heat flux, unilateral allocation of airflow, and unilateral nasal resistance as a fraction of bilateral nasal resistance when calculated on the most obstructed nasal side, suggesting that these variables may be useful for evaluating the efficacy of nasal surgery objectively. Similarity in the strengths of these correlations suggests that patient-reported symptoms may represent a constellation of effects and that these variables should be tracked concurrently during future virtual surgery planning. PMID:24063885

  16. Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction.

    PubMed

    Kimbell, J S; Frank, D O; Laud, Purushottam; Garcia, G J M; Rhee, J S

    2013-10-18

    Surgeries to correct nasal airway obstruction (NAO) often have less than desirable outcomes, partly due to the absence of an objective tool to select the most appropriate surgical approach for each patient. Computational fluid dynamics (CFD) models can be used to investigate nasal airflow, but variables need to be identified that can detect surgical changes and correlate with patient symptoms. CFD models were constructed from pre- and post-surgery computed tomography scans for 10 NAO patients showing no evidence of nasal cycling. Steady-state inspiratory airflow, nasal resistance, wall shear stress, and heat flux were computed for the main nasal cavity from nostrils to posterior nasal septum both bilaterally and unilaterally. Paired t-tests indicated that all CFD variables were significantly changed by surgery when calculated on the most obstructed side, and that airflow, nasal resistance, and heat flux were significantly changed bilaterally as well. Moderate linear correlations with patient-reported symptoms were found for airflow, heat flux, unilateral allocation of airflow, and unilateral nasal resistance as a fraction of bilateral nasal resistance when calculated on the most obstructed nasal side, suggesting that these variables may be useful for evaluating the efficacy of nasal surgery objectively. Similarity in the strengths of these correlations suggests that patient-reported symptoms may represent a constellation of effects and that these variables should be tracked concurrently during future virtual surgery planning.

  17. Transnasal microsurgical ethmoidectomy in nasal polyposis.

    PubMed

    Bagatella, F; Mazzoni, A

    1980-03-01

    A technique of microsurgical ethmoidectomy by a nasal route was devised for and applied to the treatment of nasal polyposis. A description of the operative procedure and the results in 30 cases with a 3-5 years of follow-up are reported.

  18. Nasal allergen challenge and mediators release.

    PubMed

    Carlos, A G; Carlos, M L; Ferreira, M B; Santos, A S; Santos, M C; Pedro, E

    1997-11-01

    Nasal allergen challenges, despite not reproducing exactly natural allergen exposure, are a very useful method to understand the complex cellular kinetics and cellular interactions that occur in allergic rhinitis. Cell-specific soluble mediator measurements can give useful diagnostic information. In this paper we present data concerning eosinophil cationic protein (ECP) and tryptase measurements after nasal allergen challenge.

  19. Respiratory mode, nasal patency and palatine dimensions.

    PubMed

    Trevisan, Maria Elaine; Bellinaso, José Humberto; Pacheco, Andrielle de Bitencourt; Augé, Luciana Barros; Silva, Ana Maria Toniolo da; Corrêa, Eliane Castilhos Rodrigues

    2015-01-01

    To investigate the influence of breathing mode and nasal patency in the dimensions of the hard palate by comparing mouth breathing (MB) and nasal breathing (NB) adults. Seventy-seven individuals, distributed into the MB group (n=38) and the NB group (n=39), of both genders and aged between 18 and 30 years old, took part in the study. The respiratory mode diagnosis was based on anamnesis, physical characteristics, and otorhinolaryngological examination. The volunteers were evaluated in terms of nasal patency, with a peak nasal inspiratory flow (PNIF) meter, and obstruction symptoms, by a Nasal Obstruction Symptom Evaluation (NOSE) scale, and had their transversal and vertical hard palate dimensions measured with a digital caliper in plaster models. Comparing both groups, the MB group presented significantly higher values in the NOSE scale, lower values in the PNIF, lower values in the transversal distance of the palate in the intercanine region, and significantly higher values in the vertical distance in the regions of the first and second premolars and molars. There was a negative correlation between PNIF and NOSE, and a positive correlation between PNIF and transversal distance of the palate in the region of the first premolars. MB adults presented reduced nasal patency and a higher degree of nasal obstruction symptoms. The hard palate was morphologically narrower and deeper in adults with the MB mode compared to the NB mode. Moreover, it was concluded that the smaller the nasal patency, the greater the obstruction symptoms and the narrower the hard palate.

  20. Nasal Airway Resistance: Its Measurement and Regulation.

    ERIC Educational Resources Information Center

    Hamilton, Lyle H.

    1979-01-01

    Reviews studies of regulation of nasal airway resistance (Rn). Describes methods of calculating Rn by measuring pressure-flow relationship. Data are presented on improved methods for measuring Rn and effects for expiratory and inspiratory Rn after topical application of phenylephrine nasal decongestant spray. (Author/SA)

  1. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nasal dilator. 874.3900 Section 874.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A...

  2. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nasal dilator. 874.3900 Section 874.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A...

  3. 21 CFR 874.3900 - Nasal dilator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nasal dilator. 874.3900 Section 874.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3900 Nasal dilator. (a) Identification. A...

  4. Chronic Rhinosinusitis without Nasal Polyps

    PubMed Central

    Cho, Seong H; Kim, Dae Woo; Gevaert, Philippe

    2016-01-01

    Chronic rhinosinusitis without nasal polyps (CRSsNP) is more prevalent than chronic rhinosinusitis with nasal polyps (CRSwNP). Certain diseases predispose to whereas others are associated with CRSsNP. Predisposing diseases include allergic and non-allergic upper and lower airway diseases, epithelial cell disorders, immunodeficiencies, autoimmune diseases, and some infectious diseases. Additionally, environmental and host factors, examples of which include smoking, a higher incidence of abnormal biofilms, and innate immune defects play a role in the pathogenesis of this disease. CRSsNP is characterized by histologic abnormalities, including basement membrane thickening (fibrosis) and goblet cell hyperplasia. Neutrophils and several chemokines, TGF-β and CXCL-8, play a role in CRSsNP remodeling. However, there are conflicting data about CRSsNP endotypes, e.g., whether it is characterized by neutrophilia or eosinophilia or both. In spite of advancements and the understanding of the pathogenesis of this disease, additional study is necessary to better comprehend its underlying mechanisms, endotypes, and evidence based treatment strategies. PMID:27393771

  5. Assessment of nasalance and nasality in patients with a repaired cleft palate.

    PubMed

    Sinko, Klaus; Gruber, Maike; Jagsch, Reinhold; Roesner, Imme; Baumann, Arnulf; Wutzl, Arno; Denk-Linnert, Doris-Maria

    2017-03-15

    In patients with a repaired cleft palate, nasality is typically diagnosed by speech language pathologists. In addition, there are various instruments to objectively diagnose nasalance. To explore the potential of nasalance measurements after cleft palate repair by NasalView(®), we correlated perceptual nasality and instrumentally measured nasalance of eight speech items and determined the relationship between sensitivity and specificity of the nasalance measures by receiver-operating characteristics (ROC) analyses and AUC (area under the curve) computation for each single test item and specific item groups. We recruited patients with a primarily repaired cleft palate receiving speech therapy during follow-up. During a single day visit, perceptive and instrumental assessments were obtained in 36 patients and analyzed. The individual perceptual nasality was assigned to one of four categories; the corresponding instrumental nasalance measures for the eight specific speech items were expressed on a metric scale (1-100). With reference to the perceptual diagnoses, we observed 3 nasal and one oral test item with high sensitivity. However, the specificity of the nasality indicating measures was rather low. The four best speech items with the highest sensitivity provided scores ranging from 96.43 to 100%, while the averaged sensitivity of all eight items was below 90%. We conclude that perceptive evaluation of nasality remains state of the art. For clinical follow-up, instrumental nasalance assessment can objectively document subtle changes by analysis of four speech items only. Further studies are warranted to determine the applicability of instrumental nasalance measures in the clinical routine, using discriminative items only.

  6. Nasal foreign body removal in children.

    PubMed

    Kiger, James R; Brenkert, Timothy E; Losek, Joseph D

    2008-11-01

    Nasal foreign bodies in children are often managed in the pediatric emergency department. The child is usually between 2 and 4 years old, and the foreign body is most commonly a plastic toy or bead. Nasal foreign bodies are removed by a number of techniques. Positive-pressure expulsion is accomplished by orally applied pressure via a parent's mouth or an Ambu bag or by nasally applied pressure via a catheter or an oxygen source. The object can be washed out with nasally applied saline. Direct mechanical extraction is possible with a variety of tools, including forceps, hooks, or balloon-tipped catheters. Each method carries its own risks and benefits. Serious complications of nasal foreign bodies include posterior dislodgement and aspiration, trauma caused by the object itself or removal attempts, infection, and choanal stenosis. Magnets and button batteries require emergent removal as they carry the risk of septal perforation or necrosis, which may develop within a relatively short time.

  7. [Nasal foreign body in infants].

    PubMed

    Claudet, I; Salanne, S; Debuisson, C; Maréchal, C; Rekhroukh, H; Grouteau, E

    2009-09-01

    Provide a descriptive analysis of children admitted to a tertiary care pediatric emergency department (PED) for a nasal foreign body (NFB) and describe the current knowledge and management of such accidents. A retrospective study was conducted from January 2003 to May 2008, including all patients aged less than 15 years admitted for a NFB. The data collected were age, sex, geographic origin, time and day of admission, duration in PED, duration of NFB insertion, nostril location, symptoms and clinical signs, prehospital extraction attempts, facial x-ray, extraction mode, referral to an ENT specialist, progression, and complications. For statistical analysis, the data were entered in Microsoft Excel spreadsheets. The data were analyzed with StatView 5.1 (SAS Institute) and EpiInfo 6.04fr (VF, ENSP Epiconcept). In the descriptive analysis, the data are presented as mean values with standard deviation, median with extreme values or with 95% confidence intervals where appropriate, unless otherwise indicated. To compare qualitative variables, a chi(2) test (Mantel-Haenszel) was used and the two-tailed Fisher exact test if the expected value was 5 or less. Statistical significance was set at p<0.05. A total of 388 patients were included (393 NFB). The annual mean number of cases was 68. The annual distribution showed a higher number in January, March, April, and October following Christmas, Easter and Halloween celebrations, totaling 40% of all NFB admissions. The sex-ratio was 0.95. Children aged less than 4 years accounted for 71% of the studied population. The mean age was 3.5+/-1.6 years (range, 1.4-13 years). The majority of accidents occurred at home (95%). The length of time spent in the PED was 78+/-57 min. The NFB duration of insertion was unknown in one-quarter of cases, present for less than 4 h in 65% of cases. No symptoms were described in most cases (88%). When symptoms were described, bleeding, pain or nasal discomfort, and foul nasal odor were the

  8. Functional nasal morphology of chimaerid fishes.

    PubMed

    Howard, Lauren E; Holmes, William M; Ferrando, Sara; Maclaine, James S; Kelsh, Robert N; Ramsey, Andrew; Abel, Richard L; Cox, Jonathan P L

    2013-09-01

    Holocephalans (chimaeras) are a group of marine fishes comprising three families: the Callorhinchidae (callorhinchid fishes), the Rhinochimaeridae (rhinochimaerid fishes) and the Chimaeridae (chimaerid fishes). We have used X-ray microcomputed tomography and magnetic resonance imaging to characterise in detail the nasal anatomy of three species of chimaerid fishes: Chimaera monstrosa, C. phantasma and Hydrolagus colliei. We have shown that the nasal chamber of these three species is linked to the external environment by an incurrent channel and to the oral cavity by an excurrent channel via an oral groove. A protrusion of variable morphology is present on the medial wall of the incurrent channel in all three species, but is absent in members of the two other holocephalan families that we inspected. A third nasal channel, the lateral channel, functionally connects the incurrent nostril to the oral cavity, by-passing the nasal chamber. From anatomical reconstructions, we have proposed a model for the circulation of water, and therefore the transport of odorant, in the chimaerid nasal region. In this model, water could flow through the nasal region via the nasal chamber or the lateral channel. In either case, the direction of flow could be reversed. Circulation through the entire nasal region is likely to be driven primarily by the respiratory pump. We have identified several anatomical features that may segregate, distribute, facilitate and regulate flow in the nasal region and have considered the consequences of flow reversal. The non-sensory cilia lining the olfactory sensory channels appear to be mucus-propelling, suggesting that these cilia have a common protective role in cartilaginous fishes (sharks, rays and chimaeras). The nasal region of chimaerid fishes shows at least two adaptations to a benthic lifestyle, and suggests good olfactory sensitivity, with secondary folding enhancing the hypothetical flat sensory surface area by up to 70%.

  9. Nasal Drug Delivery in Traditional Persian Medicine

    PubMed Central

    Zarshenas, Mohammad Mehdi; Zargaran, Arman; Müller, Johannes; Mohagheghzadeh, Abdolali

    2013-01-01

    Background Over one hundred different pharmaceutical dosage forms have been recorded in literatures of Traditional Persian Medicine among which nasal forms are considerable. Objectives This study designed to derive the most often applied nasal dosage forms together with those brief clinical administrations. Materials and Methods In the current study remaining pharmaceutical manuscripts of Persia during 9th to 18th century AD have been studied and different dosage forms related to nasal application of herbal medicines and their therapeutic effects were derived. Results By searching through pharmaceutical manuscripts of medieval Persia, different nasal dosage forms involving eleven types related to three main groups are found. These types could be derived from powder, solution or liquid and gaseous forms. Gaseous form were classified into fumigation (Bakhoor), vapor bath (Enkebab), inhalation (Lakhlakheh), aroma agents (Ghalieh) and olfaction or smell (Shomoom). Nasal solutions were as drops (Ghatoor), nasal snuffing drops (Saoot) and liquid snuff formulations (Noshoogh). Powders were as nasal insufflation or snorting agents (Nofookh) and errhine or sternutator medicine (Otoos). Nasal forms were not applied only for local purposes. Rather systemic disorders and specially CNS complications were said to be a target for these dosage forms. Discussion While this novel type of drug delivery is known as a suitable substitute for oral and parenteral administration, it was well accepted and extensively mentioned in Persian medical and pharmaceutical manuscripts and other traditional systems of medicine as well. Accordingly, medieval pharmaceutical standpoints on nasal dosage forms could still be an interesting subject of study. Therefore, the current work can briefly show the pharmaceutical knowledge on nasal formulations in medieval Persia and clarify a part of history of traditional Persian pharmacy. PMID:24624204

  10. Nasal deposition in infants and children.

    PubMed

    Zhou, Yue; Guo, Mindy; Xi, Jinxiang; Irshad, Hammad; Cheng, Yung-Sung

    2014-04-01

    The variability of particle deposition in infant and child nasal airways is significant due to the airway geometry and breathing rate. Estimation of particle deposition in the nasal airway of this age group is necessary, especially for inhalation drug delivery application. Previous studies on nasal aerosol deposition were focused mostly on adult. A few empirical equations were also developed to calculate nasal deposition in different age groups of children. However, those studies have their limitations. The aim of this study is to find a simple way to calculate the nasal aerosol deposition in all age groups. An in vitro test of micrometer particle deposition in nasal airways for three different ages of infants and children is conducted. An adult nasal replica is also studied as a comparison. Monodisperse oleic acid aerosols ranging in size between 2 and 28 μm are delivered into the replica at the rest condition. This size range covers the deposition efficiency up to around 100%. This study also compares results from our previous deposition tests with a 5-year-old replica. Nasal deposition of micrometer aerosols in small children and infants is higher than that in adults under equivalent breathing conditions, e.g., sitting awake in this study. Combining the data set of infants, children, and adults, we found the deposition in the nasal airway strongly depends on the particle size and pressure drop. The particle deposition can be calculated based on a single empirical equation in all age groups. The intersubject variability within the same age group was not addressed in this study. An empirical equation for all age groups is developed. From this equation, particle deposition efficiency in the nasal airway can best be estimated with input data of particle size and pressure drop of the airway.

  11. The Relation Between Body Mass Index and Nasal Airflow.

    PubMed

    Demir, Mehmet Gökhan; Ylmaz, Hüseyin Baki

    2015-06-01

    Nasal obstruction and complaints are common attendance causes in otorhinolaryngology clinics. Obese patients are especially more vulnerable for these complaints. There is not enough data about nasal resistance and weight. One hundred ten patients who had no nasal complaint and nasal pathology were investigated by peak nasal inspiratory flow meter, nasal symptom evaluation scale (NOSE), and visual analog scale (VAS) calculation. According to the statistical analyses among the BMI groups, there is no significant difference detected. Peak nasal inspiratory flow values highly correlated with height. Height correlated with VAS and weight correlated with NOSE scores. VAS score highly correlated with NOSE score. Also, there is a negative statistically significant correlation between BMI and nasal congestion index. All these data show that there is no relation between BMI and nasal resistance, and although the nasal congestion cycle is preserved in all BMI groups, nasal congestion index is decreased when the weight is raised.

  12. Safety and efficacy of olopatadine hydrochloride nasal spray for the treatment of seasonal allergic rhinitis.

    PubMed

    Meltzer, Eli O; Hampel, Frank C; Ratner, Paul H; Bernstein, David I; Larsen, Lawrence V; Berger, William E; Finn, Albert F; Marple, Bradley F; Roland, Peter S; Wall, G Michael; Brubaker, Michael J; Dimas, Carolyn; Potts, Susan L; Silver, Lewis H; Barnes, J Rod

    2005-12-01

    A nasal spray containing the antiallergy agent olopatadine hydrochloride is being developed for the treatment of seasonal allergic rhinitis (SAR). To evaluate the safety and efficacy of 2 concentrations of olopatadine nasal spray vs placebo in patients with SAR. This was a multicenter, randomized, double-blind, placebo-controlled study. After a 3- to 21-day placebo run-in, 565 patients aged 12 to 80 years were randomized to receive 0.4% or 0.6% olopatadine or placebo, 2 sprays per nostril twice daily for 2 weeks. Patients evaluated morning and evening reflective and instantaneous nasal symptoms (sneezing, stuffy nose, runny nose, and itchy nose, which compose the total nasal symptom score [TNSS]) and ocular symptoms and completed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Olopatadine spray (0.4% and 0.6%) was significantly superior to placebo for percentage change from baseline in overall reflective (P = .004 and P < .001, respectively) and instantaneous (P = .02 and P = .003, respectively) TNSSs. Also, 0.6% olopatadine was significantly superior to placebo for reducing the reflective and instantaneous assessments of sneezing, runny and itchy nose, and itchy eyes; the instantaneous assessments of watery eyes; and the overall and all 7 domain scores of the RQLQ (P < .05). Olopatadine spray exhibited a safety profile comparable with that of placebo. Olopatadine nasal spray (0.4% and 0.6%) provided statistically significant improvements in allergic rhinitis symptoms compared with placebo regarding TNSSs (reflective and instantaneous) and in quality-of-life variables in patients with SAR. Olopatadine nasal spray administered twice daily was safe and well tolerated in adolescents and adults.

  13. Nasal cytology in southwest metropolitan Mexico City inhabitants: a pilot intervention study.

    PubMed Central

    Calderon-Garcidueñas, L; Roy-Ocotla, G

    1993-01-01

    Southwest metropolitan Mexico City (SWMMC) inhabitants have been exposed several hours per day for the last 6 years to photochemical smog, ozone being the most important oxidant pollutant. Subjects exposed to the SWMMC atmosphere develop several histopathological changes in their nasal mucosa: dysplasia is the most significant, affecting 78.72% of adult individuals within 60 or more days of residence in SWMMC. This study was originally designed to explore whether chemical intervention could modify nasal dysplasia, as determined by nasal cytology, in a defined adult population. In a placebo-controlled, randomized, double-blind trial, 177 healthy male subjects were divided into 5 groups to whom 5000 IU of vitamin A, 100 IU of vitamin E, a combination of vitamins A and E (5000 IU + 100 IU), 16 mg of beta-carotene, or placebo were administered daily for 4 months. Sixteen clinical and cytological variables were monitored. No effect on dysplasia was seen at the end of the 4-month trial; however, an apparent reversibility as well as progression of the dysplastic nasal lesions and high correlation coefficients between dysplasia and nasal cytology of polymorphonuclear leukocytes (PMNs; 0.85), squamous metaplasia (SM; 0.50), and nasal mucosa atrophy (NMA; 0.41) were found. A mathematical theoretical nasal dysplasia (tD) predictor equation for SWMMC adult male inhabitants is proposed (tD = 0.85 delta PMNs + 0.50 delta SM + 0.41 delta NMA + 0.98), in which PMNs are the best single dysplasia predictor, and all variables are independent.(ABSTRACT TRUNCATED AT 250 WORDS) Images p138-a Figure 1. Figure 2. Figure 3. Figure 4. PMID:8354200

  14. Nasal cytology in southwest metropolitan Mexico City inhabitants: A pilot intervention study

    SciTech Connect

    Calderon-Garciduenas, L.; Roy-Ocotla, G. )

    1993-06-01

    Southwest metropolitan Mexico City (SWMMC) inhabitants have been exposed several hours per day for the last 6 years to photochemical smog, ozone being the most important oxidant pollutant. Subjects exposed to the SWMMC atmosphere develop several histopathological changes in their nasal mucosa: dysplasia is the most significant, affecting 78.72% of adult individuals within 60 or more days of residence in SWMMC. This study was originally designed to explore whether chemical intervention could modify nasal dysplasia, as determined by nasal cytology, in a defined adult population. In a placebo-controlled, randomized, double-blind trial, 177 healthy male subjects were divided into 5 groups to whom 5000 IU of vitamin A, 100 IU of vitamin E, a combination of vitamins A and E (5000 IU + 100 IU), 16 mg of beta-carotene, or placebo were administered daily for 4 months. Sixteen clinical and cytological variables were monitored. No effect on dysplasia was seen at the end of the 4-month trial; however, an apparent reversibility as well as progression of the dysplastic nasal lesions and high correlation coefficients between dysplasia and nasal cytology of polymorphonuclear leukocytes (PMNs; 0.85), squamous metaplasia (SM; 0.50), and nasal mucosa atrophy (NMA; 0.41) were found. A mathematical theoretical nasal dysplasia (tD) predictor equation for SWMMC adult male inhabitants is proposed (tD = 0.85 delta PMNs + 0.50 delta SM + 0.41 delta NMA + 0.98), in which PMNs are the best single dysplasia predictor, and all variables are independent.

  15. Increase of axial and appendicular trabecular and cortical bone density in established osteoporosis with intermittent nasal salmon calcitonin therapy.

    PubMed

    Peichl, P; Rintelen, B; Kumpan, W; Bröll, H

    1999-02-01

    The aim of this study was to examine the effect of intranasal administration of salmon calcitonin to a group of 24 postmenopausal women with severe, established osteoporosis (t score < -2.5 SD) and more than one vertebral fracture. The patients were treated with 200 IU of nasal salmon calcitonin daily for 2 months with a subsequent pause of 2 months (3 cycles) and 500 mg calcium daily over a total of 12 months in an open randomized study. The patients were compared with an age matched control group of 18 women of a similar clinical status who were treated with calcium and vitamin D only. In the nasal calcitonin treatment group an increase in the trabecular axial bone density of 2.8% was achieved, as well as increase in trabecular appendicular (forearm) bone density of 1.6%, together with a cortical bone density increase of 1.8% axial and 1% appendicular. Initially, elevated values of urinary deoxypyridinoline were found in 12 women in the nasal calcitonin treatment group; these levels returned to normal under salmon calcitonin nasal therapy and documented the inhibition of increased osteoclastic activity. Cyclic intermittent calcitonin nasal therapy led to a general increase in trabecular and cortical axial and appendicular bone density, marked alleviation of the subjective sensation of pain, and a reduction in the daily dose of accompanying nonsteroidal anti-inflammatory drugs by 50%.

  16. [Exhaled and nasal nitric oxide in patients with Japanese cedar pollinosis and effects of nasal steroids].

    PubMed

    Miyazaki, Y

    1999-12-01

    Nitric oxide (NO) is produced by the action of NO synthase (NOS) using L-arginine as a substrate in various cells and found in air exhaled by humans. Previous studies suggest that almost all exhaled NO is derived from the upper airways and increases in patients with untreated asthma and allergic rhinitis. Exhaled NO is inhibited by treatment with inhalation of steroids that may be caused by inhibition of inducible nitric oxide synthase (iNOS). The purpose of this study is to determine whether exhaled and nasal NO increases in patients with Japanese cedar pollinosis compared with nonallergic healthy subjects, and whether it is affected by treatment with nasal steroids. Furthermore, we investigated its relation to nasal function and allergic rhinitis. 10 patients with Japanese cedar pollinosis and 5 healthy normal subjects were tested. All subjects had no history of respiratory infection for at least 2 weeks and did not smoke. Exhaled NO was collected in a sampling bag from oral and nasal breathing, and nasal NO was sampled directly from the nasal cavity. Both were measured by a chemiluminescence NO analyzer, ML9841, at a detection limit of 1 part per billion (ppb). Subjects used nasal steroids for 2 weeks and were measured similarly afterwards. NO concentrations in nasal air and air exhaled from the nose in patients with Japanese cedar pollinosis (277.9 +/- 59.5 ppb, 34.4 +/- 3.9 ppb, n = 10) were higher than the normal subjects (153.3 +/- 30.6 ppb, 19.9 +/- 3.4 ppb, n = 5) (p < 0.05). NO exhaled from the mouth was not significantly different between patients (20.5 +/- 4.9 ppb) and normal subjects (23.7 +/- 2.6 ppb). In patients with Japanese cedar pollinosis, the concentration of nasal NO and nasal exhaled NO were significantly decreased after treatment with nasal steroids (144.0 +/- 21.0 ppb, 26.1 +/- 3.0 ppb) (p < 0.01, p < 0.05), but there was no change in oral exhaled NO (17.2 +/- 3.3 ppb). In normal subjects, oral (22.5 +/- 5.3 ppb), nasal exhaled NO (19

  17. [Dacryolithiasis: diagnosis using nasal endoscopy].

    PubMed

    Piaton, J-M; Keller, P; Sahel, J-A; Nguyen, R; Quesnot, S

    2003-09-01

    The purpose of this study was to assess the value of two new clinical findings for the diagnosis of dacryolithiasis discovered with nasal endoscopy: anatomical abnormalities of the Hasner valve (HV) and mucopurulent discharge visible at this valve. The value of these findings is compared with other clinical and radiological signs of dacryolithiasis. A hypothesis is developed as to the responsibility of the HV in the formation of dacryolithiasis. This study was prospective and based on 797 operations performed for epiphora: 647 endonasal dacryocystorhinostomies and 150 meatotomies of the HV, with systematic preoperative nasal videoendoscopy. Ninety dacryocystographies (DCGs) and 129 lacrimal computed tomographies (LCT) were preoperatively performed. Dacryoliths were found in 55 of 797 patients (6.9%). The HV could be examined in 48 patients in the lithiasis group and in 687 patients in the control group. Mucopurulent discharge was observed in 22 patients with lithiasis (45.8%) and in 40 patients (5.8%) (p<10(-6)) of the control group. Anatomical abnormalities of the HV were found in 40 patients with dacryolithiasis (83.3%) as compared to 82 patients ing the control group (11.4%) (p<10(-6)). In 13 patients, the VH was very small (<2 mm), in 12 patients it was very long (>15 mm), and in 15 patients both abnormalities were observed. Other clinical signs were young age (mean, 48.2 years vs 59.1% in the control group) (p<0.05), a history of acute noninfectious dacryocystic retention (38.2% vs 9.5%) (p<10(-5)), partial obstruction of the lacrimal pathway (LP) (61.8% vs 30.5%) (p<10(-5)). The 28 LCTs that were performed in subjects who had lithiasis made it possible to diagnose 19 cases of dacryolithiasis and confirmed abnormalities of the HV causing narrowing of the LP in 20. Dacryolithiasis is frequent and often misdiagnosed. When dacryolithiasis is suspected, a nasal videoendoscopic exam must be done to seek HV abnormalities and mucopurulent discharge at this valve

  18. Perception of better nasal patency correlates with increased mucosal cooling after surgery for nasal obstruction.

    PubMed

    Sullivan, Corbin D; Garcia, Guilherme J M; Frank-Ito, Dennis O; Kimbell, Julia S; Rhee, John S

    2014-01-01

    To (1) quantify mucosal cooling (ie, heat loss) spatially in the nasal passages of nasal airway obstruction (NAO) patients before and after surgery using computational fluid dynamics (CFD) and (2) correlate mucosal cooling with patient-reported symptoms, as measured by the Nasal Obstruction Symptom Evaluation (NOSE) and a visual analog scale (VAS) for sensation of nasal airflow. Prospective. Academic tertiary medical center. Computed tomography (CT) scans and NOSE and VAS surveys were obtained from 10 patients before and after surgery to relieve NAO. Three-dimensional models of each patient's nasal anatomy were used to run steady-state CFD simulations of airflow and heat transfer during inspiration. Heat loss across the nasal vestibule and the entire nasal cavity, as well as the surface area of mucosa exposed to heat fluxes >50 W/m(2), were compared pre- and postoperatively. After surgery, heat loss increased significantly on the preoperative most obstructed side (P < .0002). A larger surface area of nasal mucosa was exposed to heat fluxes >50 W/m(2) after surgery. The best correlation between patient-reported and CFD measures of nasal patency was obtained for NOSE against surface area in which heat fluxes were >50 W/m(2) (Pearson r = -0.76). A significant postoperative increase in mucosal cooling correlates well with patients' perception of better nasal patency after NAO surgery. Computational fluid dynamics-derived heat fluxes may prove to be a valuable predictor of success in NAO surgery.

  19. Expression and distribution of epithelial sodium channel in nasal polyp and nasal mucosa.

    PubMed

    Jiang, Yiming; Xu, Ji; Chen, Yanqing; Shi, Jiali; Zhang, Chun; Li, Jiping

    2015-11-01

    To evaluate the expression and location of epithelial sodium channels (ENaCs) in human nasal polyp and normal nasal mucosa, and to characterize the relevance of ENaCs to the development of NPs. Nasal polyp tissue from 17 patients and nasal mucosa from ten patients were obtained through endoscopic sinus surgery. The mRNA concentrations of ENaC-α, β, and γ were detected by real-time polymerase chain reaction. The expression of ENaC-α was detected using western blot and immunofluorescence techniques. The distribution of ENaC-α in mucosal tissue was observed using a laser scanning confocal microscope. The transcriptional expression of three subunits of ENaC was in the following order: α > β > γ, in both groups. The transcriptional expression of α, β, and γ subunits of ENaC was elevated in nasal polyp compared to nasal mucosa (p < 0.01). ENaC-α expression was higher in nasal polyp than in nasal mucosa (p < 0.05). Immunofluorescent staining indicated that ENaC-α protein was distributed in the epithelial cell apical membrane. The expression of ENaC is upregulated in human nasal polyp, which might in turn facilitate the formation and development of nasal polyp.

  20. Effects of Ginkgo biloba on exhaled nasal nitric oxide during normobaric hypoxia in humans.

    PubMed

    Jowers, Casey; Shih, Richard; James, Jim; Deloughery, Thomas G; Holden, William E

    2004-01-01

    Ginkgo biloba, an extract of the ginkgo tree, may prevent or lessen symptoms of acute mountain sickness in humans. The mechanism of this effect is poorly understood. One hypothesis is that ginkgo alters nitric oxide (NO) metabolism, possibly by scavenging NO or altering nitric oxide synthase expression and thereby lessening the vasodilatory effects of NO. To date, an effect of Ginkgo biloba on NO metabolism has not been demonstrated in humans. We measured exhaled nasal NO output in humans (n = 9) during normoxia and then during acute normobaric hypoxia (goal oxyhemoglobin saturation 75% to 85%) before and after administration of a standardized extract of Ginkgo biloba (120 mg twice daily for 5 days). Oxygen saturation, heart rate, and minute ventilation were similar before and after Ginkgo biloba administration. Exhaled nasal NO output was increased during normoxia following ginkgo (p < 0.02) and reduced during normobaric hypoxia both before (p < 0.02) and following (p < 0.003) ginkgo. Exhaled nasal NO output during normobaric hypoxia was lowest following ginkgo (p < 0.003). We conclude that Ginkgo biloba increases exhaled nasal NO output during normoxia and enhances reduced exhaled nasal NO output during normobaric hypoxia. Our results suggest that Ginkgo biloba may act to reduce AMS through an effect on NO metabolism.

  1. Adjuncts to Improve Nasal Reconstruction Results.

    PubMed

    Gordon, Shayna Lee; Hurst, Eva A

    2017-02-01

    The final cosmetic appearance of nasal reconstruction scars is of paramount importance to both the patient and surgeon. Ideal postreconstruction nasal scars are flat and indistinguishable from surrounding skin. Unfortunately, even with meticulous surgical execution, nasal scars can occasionally be suboptimal. Abnormal fibroblast response can lead to hypertrophic nasal scars, and excessive angiogenesis may lead to telangiectasias or an erythematous scar. Imperfect surgical closure or poor postoperative management can lead to surgical outcomes with step-offs, depressions, suture marks, or dyspigmentation. Aesthetically unacceptable nasal scars can cause pruritus, tenderness, pain, sleep disturbance, and anxiety and depression in postsurgical patients. Fortunately, there are several minimally invasive or noninvasive techniques that allow for enhancement and improvement of cosmetic results with minimal risk and associated downtime. This article provides an overview of adjuncts to improve nasal reconstruction with a focus on techniques to be used in the postoperative period. Armed with an understanding of relevant available therapies, skillful surgeons may drastically improve the final cosmesis and outcome of nasal reconstruction scars.

  2. The effect of vowels on nasalance scores.

    PubMed

    Lewis, K E; Watterson, T; Quint, T

    2000-11-01

    Nasalance scores were compared for nine different speech stimuli with vowel content controlled. The nine speech stimuli included four vowels spoken in isolation and five sentences. The four vowels were /i/, /u/, /ae/, and /a/. Four of the five sentences were loaded with High Front, High Back, Low Front, or Low Back vowels, and the fifth sentence contained a mixture of vowel types. Academic and clinical craniofacial center. The subjects were 19 children with velopharyngeal dysfunction (VPD) and 19 children without history of communication disorder. The main outcome measures were the nasalance scores associated with the nine different speech stimuli for two groups of subjects. For the VPD group, analysis of variance procedures revealed that nasalance scores for high-vowel sentences and the mixed-vowel sentence were significantly higher than the nasalance scores for the two low-vowel sentences. This pattern was the same for the non-VPD group except for the High Back/Low Back contrast, which was not significant. In both groups, nasalance scores for sustained vowels were significantly higher for the High Front vowel /i/ than for any other vowel, and nasalance was significantly higher for the High Back vowel /u/ than for either of the Low vowels /ae/ or /a/. There was no significant difference between Low vowels. Nasalance scores may be affected by the vowel content of the speech stimulus. This should be taken into consideration on a clinical basis and for research purposes.

  3. Nonneoplastic nasal lesions in rats and mice.

    PubMed Central

    Monticello, T M; Morgan, K T; Uraih, L

    1990-01-01

    Rodents are commonly used for inhalation toxicology studies, but until recently the nasal passages have often been overlooked or only superficially examined. The rodent nose is a complex organ in which toxicant-induced lesions may vary, depending on the test compound. A working knowledge of rodent nasal anatomy and histology is essential for the proper evaluation of these responses. Lack of a systematic approach for examining rodent nasal tissue has led to a paucity of information regarding nonneoplastic lesions in the rodent nose. Therefore, slides from the National Toxicology Program (NTP) and the Chemical Industry Institute of Toxicology (CIIT) were examined, and the literature was reviewed to assemble the spectrum of nonneoplastic rodent nasal pathology. Presented are lesions associated with the various types of epithelia lining the rodent nasal cavity plus lesions involving accessory nasal structures. Even though there are anatomic and physiologic differences between the rodent and human nose, both rats and mice provide valuable animal models for the study of nasal epithelial toxicity, following administration of chemical compounds. Images PLATE 1. PLATE 2. PLATE 3. PLATE 4. PLATE 5. PLATE 6. PLATE 7. PLATE 8. PLATE 9. PLATE 10. PLATE 11. PLATE 12. PLATE 13. PLATE 14. PLATE 15. PLATE 16. PLATE 17. PLATE 18. PLATE 19. PLATE 20. PLATE 21. PLATE 22. PLATE 23. PLATE 24. PLATE 25. PLATE 26. PLATE 27. PLATE 28. PLATE 29. PLATE 30. PLATE 31. PLATE 32. PLATE 33. PLATE 34. PLATE 35. PLATE 36. PLATE 37. PLATE 38. PMID:2200665

  4. Polypoidal Lesions in the Nasal Cavity

    PubMed Central

    Kumari M.K., Kalpana; K.C., Mahadeva

    2013-01-01

    Introduction: Nasal polyps are polypoidal masses arising from mucous membranes of nose and paranasal sinuses. They are overgrowths of the mucosa that frequently accompany allergic rhinitis. They are freely movable and nontender. Aims and Objectives: The purpose of this study was to study the histopathologic spectrum of polypoidal lesions of the nasal cavity. Materials and Methods: The study comprised of 100 consecutive cases of polypoidal lesions in the nasal cavity, received in the department of pathology. The age and sex of the patients were recorded. The tissues were routinely processed for histopathologic sections and stained with haematoxylin and eosin stains. Special stains like Periodic acid Schiff (PAS) was done wherever applicable. The cases were classified into neoplastic and nonneoplastic lesions. The neoplastic lesions were further classified according to WHO classification on histopathologic examination. Results: Analysis of 100 polypoidal lesions in the nose and paranasal sinuses with clinical diagnosis of nasal polyps, revealed 66 cases were nonneoplastic and 34 were neoplastic;17 (50%)were benign and 17(50%) were malignant. True nasal polyps both inflammatory and allergic together comprised 44 cases of the 100 polypoidal lesions in the nasal cavity. Angiofibroma and inverted papilloma were the most frequent benign tumour accounting for 12/17(0.7%). The most common malignant tumour was anaplastic carcinoma 7/17(0.4%). Nonneoplastic and benign tumours were common in younger age groups whereas malignant tumours were most common in older males. Conclusion: The majority of polypoidal lesions in the nasal cavity are nonneoplastic. PMID:23905098

  5. Phenotype and function of nasal dendritic cells

    PubMed Central

    Lee, Haekyung; Ruane, Darren; Law, Kenneth; Ho, Yan; Garg, Aakash; Rahman, Adeeb; Esterházy, Daria; Cheong, Cheolho; Goljo, Erden; Sikora, Andrew G.; Mucida, Daniel; Chen, Benjamin; Govindraj, Satish; Breton, Gaëlle; Mehandru, Saurabh

    2015-01-01

    Intranasal vaccination generates immunity across local, regional and distant sites. However, nasal dendritic cells (DC), pivotal for the induction of intranasal vaccine- induced immune responses, have not been studied in detail. Here, using a variety of parameters, we define nasal DCs in mice and humans. Distinct subsets of “classical” DCs, dependent on the transcription factor zbtb46 were identified in the murine nose. The murine nasal DCs were FLT3 ligand-responsive and displayed unique phenotypic and functional characteristics including the ability to present antigen, induce an allogeneic T cell response and migrate in response to LPS or live bacterial pathogens. Importantly, in a cohort of human volunteers, BDCA-1+ DCs were observed to be the dominant nasal DC population at steady state. During chronic inflammation, the frequency of both BDCA-1+ and BDCA-3hi DCs was reduced in the nasal tissue, associating the loss of these immune sentinels with chronic nasal inflammation. The present study is the first detailed description of the phenotypic, ontogenetic and functional properties of nasal DCs and will inform the design of preventative immunization strategies as well as therapeutic modalities against chronic rhinosinusitis. PMID:25669151

  6. Disorders of the nasal valve area

    PubMed Central

    Bloching, Marc Boris

    2008-01-01

    The nasal valve area is not a singular structure, but a complex three-dimensional construct consisting of several morphological structures. From the physiologic point of view, it is the place of maximum nasal flow resistance (“flow limiting segment”). Therefore, according to Poiseuille’s law, even minor constrictions of this area result in a clinically relevant impairment of nasal breathing for the patient. This narrow passage, also called “ostium internum nasi”, is formed by the mobile lateral nasal wall, the anterior septum with the swell body, the head of the inferior turbinate and the osseous piriform aperture. Within the framework of aetiology, static and dynamic disorders of the nasal valve area have to be distinguished since they result in different therapeutic measures. In the context of diagnosis, the exploration of the case history for assessing the patient’s extent of suffering and the clinical examination are very important. In addition to the presentation of the basics of disorders of the nasal valves, this paper focuses on the treatment of dynamic disorders that mainly constitute the more important therapeutic issue. In this context, we distinguish between stabilisation techniques through grafts or implants and stabilising suture techniques. Following a thorough analysis, the correction of static nasal valve disorders requires various plastic-reconstructive measures using transposition grafting and skin or composite grafts. PMID:22073083

  7. Canine and feline nasal neoplasia.

    PubMed

    Malinowski, Christine

    2006-05-01

    Dogs and cats of our society have outgrown their status as merely pets and are now considered our close companions and even family members. This shift in their roles has led to pet owners seeking improved preventative medicine for their four-legged friends. Subsequently, dogs and cats are living longer lives than ever before and developing more old-age-related diseases. One of the most devastating diseases of older animals is cancer. Once a veterinarian has detected cancer in a pet, pet owners seek advice on their next course of action. This article is intended to provide concise information regarding the diagnosis and treatment of intranasal tumors of the dog and cat. This article outlines the forms of nasal tumors that are the most common, the recommended imaging and biopsy techniques to diagnose the tumor, and the most appropriate treatments of them.

  8. Effect of nasal salmon calcitonin on bone remodeling and bone mass in postmenopausal osteoporosis.

    PubMed

    Thamsborg, G; Jensen, J E; Kollerup, G; Hauge, E M; Melsen, F; Sorensen, O H

    1996-02-01

    The effect of nasal salmon calcitonin (SCT) on bone has been investigated by densitometry, biochemical markers of bone turnover, and histomorphometry. 62 women (mean age 65 years) who had experienced Colles' fracture after menopause were randomized to receive either nasal salmon calcitonin (SCT) 200 IU or nasal placebo daily for 24 months. All received a daily supplement of 0.5 g calcium. There was a significant increase above baseline in the bone mineral density of the lumbar spine in the SCT group (2.5%; 95% confidence interval 0.9--4.2%) and in the placebo group (1.7%; 95% confidence interval 0.3--3.1%) after 24 months, but the difference between the groups was not significant (0.8%; 95% confidence interval -1.2-3.0%). Serum levels of osteocalcin decreased significantly below baseline in the SCT group, whereas they were unchanged in the placebo group. At months 12 and 24, serum levels of osteocalcin were significantly lower in the SCT group than in the placebo group (p < 0.03). Urinary levels of deoxypyridinoline/creatinine decreased significantly below baseline in the SCT group, whereas only a transient decrease was observed in the placebo group. The differences between the groups were, however, not significant. The erosion depth was significantly lower in the SCT group than in the placebo group after 12 months (median [interquartile range]; 46.9 mu m [10.4] vs. 50.5 mu m [10.7]; p = 0.03), whereas bone volume and activation frequency did not differ between the groups. This study indicates that nasal SCT in a dose of 200 IU daily induces only a minor inhibition of bone resorption and therefore produces only a minor increase in bone mass. Furthermore, it seems that nasal SCT in a dose of 200 IU does not interfere with the recruitment of new bone multicellular units, but preferably decreases ongoing osteoclastic bone resorption.

  9. 21 CFR 874.5550 - Powered nasal irrigator.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5550 Powered nasal irrigator. (a) Identification. A powered nasal irrigator is an AC-powered device intended to wash the nasal cavity by means of a... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered nasal irrigator. 874.5550 Section...

  10. 21 CFR 874.5550 - Powered nasal irrigator.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5550 Powered nasal irrigator. (a) Identification. A powered nasal irrigator is an AC-powered device intended to wash the nasal cavity by means of a... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Powered nasal irrigator. 874.5550 Section...

  11. Daily exercise routines

    NASA Technical Reports Server (NTRS)

    Anderson, Patrick L.; Amoroso, Michael T.

    1990-01-01

    Viewgraphs on daily exercise routines are presented. Topics covered include: daily exercise and periodic stress testings; exercise equipment; physiological monitors; exercise protocols; physiological levels; equipment control; control systems; and fuzzy logic control.

  12. Microsurgery in nasal polyposis transnasal ethmoidectomy.

    PubMed

    Bagatella, F; Mazzoni, A

    1986-01-01

    Transnasal ethmoidectomy is a current treatment in selected cases of nasal polyposis, and with its complicated anatomy offers a proper opportunity for microsurgery. Ten years' experience of microsurgical ethmoidectomy in 155 patients with nasal polyposis is reported. The surgical anatomy of the ethmoid sinus is reviewed with attention to the requirements of the microsurgical approach, and the operative procedure is described. The microsurgical approach is discussed both as a part of the treatment of nasal polyposis and as a new development in rhinologic surgery. Advantages of the technique are the objective safety against risks of the ethmoid area and enhanced sense of security for the surgeon.

  13. Pharmacology of Nasal Medications: An Update

    PubMed Central

    Martin, G. F.

    1988-01-01

    The author of this article reviews the pharmacology of nasal medication, focusing on the indications and side-effects. The newer group of non-sedating antihistamines proves to be a useful supplement to disodium cromoglycate and the traditional antihistamines in the treatment of allergic rhinitis. The topical steroids (flunisolide and beclomethasone dipropionate) did not produce a significant incidence of adrenal suppression, mucosal atrophy, or nasal candidiasis. The anticholinergic ipatropium bromide shows promise in the treatment of rhinorrhea. The author also reviews the use of decongestants and emollients and remarks on the factors that affect patient compliance when nasal medications are prescribed. PMID:20469495

  14. Evaluation and Reduction of Nasal Trauma

    PubMed Central

    Kelley, Brian P.; Downey, Cara R.; Stal, Samuel

    2010-01-01

    Nasal trauma plays a large and important role in the field of craniofacial trauma. The resulting aesthetic, structural, and functional sequelae associated with these injuries necessitate a thorough understanding of the topic. This includes an appreciation for the unique anatomic features of the region, the important aspects of the initial history and examination, nasal injury classification, and subsequent treatment timing and options. While a large body of literature has accumulated on the topic, the purpose of this article is to focus on both clinically relevant information and pearls of management. Additionally, age-specific concerns, secondary procedures, and nasal fracture grafting, will be addressed as well. PMID:22550458

  15. [Integrated approach to nasal defects reconstruction].

    PubMed

    Verbo, E V; Gorkush, K N

    2016-01-01

    The aim of the study was to define and solve main problems in nasal defects reconstruction procedures planning. Fifty-two patients with nasal defects treated in Central Research Institute of Dentistry and Maxillofacial Surgery in 2010-2015 were included in the study. In 28 cases the defects were reconstructed by means of paramedial forehead flap. The authors highlight typical procedure pitfalls mainly associated with the planning stage. The study results prove paramedical forehead flap to be the most useful tool for subtotal and total nasal defects reconstruction but meticulous procedure planning is a must for success.

  16. Dynamic Changes in Heart Rate Variability and Nasal Airflow Resistance during Nasal Allergen Provocation Test.

    PubMed

    Seppänen, Tiina M; Alho, Olli-Pekka; Seppänen, Tapio

    2016-01-01

    Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS.

  17. Dynamic Changes in Heart Rate Variability and Nasal Airflow Resistance during Nasal Allergen Provocation Test

    PubMed Central

    Seppänen, Tiina M.; Alho, Olli-Pekka; Seppänen, Tapio

    2016-01-01

    Allergic rhinitis is a major chronic respiratory disease and an immunoneuronal disorder. We aimed at providing further knowledge on the function of the neural system in nasal allergic reaction. Here, a method to assess simultaneously the nasal airflow resistance and the underlying function of autonomic nervous system (ANS) is presented and used during the nasal provocation of allergic and nonallergic subjects. Continuous nasal airflow resistance and spectral heart rate variability parameters show in detail the timing and intensity differences in subjects' reactions. After the provocation, the nasal airflow resistance of allergic subjects showed a positive trend, whereas LF/HF (Low Frequency/High Frequency) ratio and LF power showed a negative trend. This could imply a gradual sympathetic withdrawal in allergic subjects after the allergen provocation. The groups differed significantly by these physiological descriptors. The proposed method opens entirely new opportunities to research accurately concomitant changes in nasal breathing function and ANS. PMID:27196870

  18. Nasal mass removal in the koala (Phascolarctos cinereus).

    PubMed

    Bercier, Marjorie; Wynne, Janna; Klause, Stephen; Stadler, Cynthia K; Gorow, April; Pye, Geoffrey W

    2012-12-01

    Nasal masses in the koala (Phascolarctos cinereus) are not uncommon and can be challenging to diagnose and treat. Differential diagnoses for nasal masses in the koala are cryptococcal granulomas, nasal polyps, nasal adenocarcinoma, and osteochondromatosis. This report describes successful surgical approaches for two adult koalas with nasal masses and includes photodocumentation and description of the anatomy of the koala nasal passages from the postmortem transverse sectioning of a normal koala head. Surgical removal of the nasal masses in these koalas resulted in a rapid resolution of clinical signs.

  19. Mouth leak with nasal continuous positive airway pressure increases nasal airway resistance.

    PubMed

    Richards, G N; Cistulli, P A; Ungar, R G; Berthon-Jones, M; Sullivan, C E

    1996-07-01

    Nasal congestion, dry nose and throat, and sore throat affect approximately 40% of patients using nasal continuous positive airway pressure (CPAP). The mechanisms causing nasal symptoms are unclear, but mouth leaks causing high unidirectional nasal airflow may be important. We conducted a study to investigate the effects of mouth leak and the influence of humidification on nasal resistance in normal subjects. Nasal resistance was measured with posterior rhinomanometry in six normal subjects who deliberately produced a mouth leak for 10 min while using nasal CPAP. Nasal resistance was measured regularly for 20 min after the challenge. A series of tests were performed using air at differing temperatures and humidities. There was no change in nasal resistance when subjects breathed through their noses while on CPAP, but a mouth leak caused a large increase in resistance (at a flow of 0.5 L/s) from a baseline mean of 2.21 cm H2O/L/s to a maximum mean of 7.52 cm H2O/L/s at 1 min after the challenge. Use of a cold passover humidifier caused little change in the response (maximum mean: 8.27 cm H2O/L/s), but a hot water bath humidifier greatly attenuated the magnitude (maximum mean: 4.02 cm H2O/L/s) and duration of the response. Mouth leak with nasal CPAP leads to high unidirectional nasal airflow, which causes a large increase in nasal resistance. This response can be largely prevented by fully humidifying the inspired air.

  20. Evaluation of nasal IgA secretion in normal subjects by nasal spray and aspiration.

    PubMed

    Fujimoto, Chisa; Kido, Hiroshi; Sawabuchi, Takako; Mizuno, Dai; Hayama, Masaki; Yanagawa, Hiroaki; Takeda, Noriaki

    2009-06-01

    Nasal washing (NW) is a popular method for collecting human nasal lavage fluid. However, for NW the subject must be trained, and the method is unsuitable for field studies on untrained subjects. To overcome this problem, we have developed an easy and painless method, a nasal spray and aspiration (NSA) method. This method is different from NW in that the nasal cavity is misted over with saline, and the nasal lavage fluid is aspirated from the nostrils through a silicon tube. First, nasal lavage fluid was obtained twice by NSA with an interval of a week between lavages to evaluate intraindividual variability, and the IgA and protein levels in the nasal lavage fluid were measured by enzyme-linked immunosorbent assay and bicinchoninic acid assay, respectively. Next, the IgA value determined by NSA was compared with that by NW in another 12 normal subjects 2 days after NSA. In 10 normal subjects, mean volume of saline sprayed into the nose was 0.46+/-0.15 ml (mean+/-S.D.). Mean volume of aspirated nasal lavage fluid containing both sprayed saline and nasal secretion was 0.44+/-0.37 ml. The mean IgA level/mg protein in the nasal lavage fluid determined by NSA was 112+/-18 microg/mg protein at the first and 99+/-20 at the second times of measurement, being highly reproducible. The mean value by NSA was 114+/-19 microg/mg protein, being almost the same as that by NW of 99+/-27. These findings suggest that the IgA level/mg protein in nasal lavage fluid determined by NSA instead of NW might be useful for assessing the variability of nasal IgA secretion.

  1. Liposomal Nasal Spray versus Guideline-Recommended Steroid Nasal Spray in Patients with Chronic Rhinosinusitis: A Comparison of Tolerability and Quality of Life

    PubMed Central

    Eitenmüller, Anna; Böhm, Myriam; Glowania, Andreas; Pfaar, Oliver; Mösges, Ralph; Klimek, Ludger

    2014-01-01

    Objective. To investigate the tolerability and impact on quality of life of liposomal nasal spray compared to guideline-recommended steroid-based therapy in patients with chronic rhinosinusitis. Symptom reduction and use of antisymptomatic medication were also examined. Methods. In this monocenter, prospective, controlled, open, and noninterventional study, 60 patients with chronic rhinosinusitis were treated with liposomal nasal spray and 30 patients received steroid-based therapy. The study comprised five visits occurring at intervals of two to four weeks. Efficacy was determined according to the sinusitis symptom score documented daily. The polyp score was recorded at the initial and final visits. Tolerability was determined through the Nasal Spray Evaluation Questionnaire, and quality of life was ascertained with the SNOT-20 Score. Results. Both treatments achieved a significant reduction of sinusitis symptoms (P < 0.05) and also rhinoscopic improvement (P < 0.05). The majority of patients assessed the treatments as “good” or “very good,” and the quality of life improved significantly (P < 0.05). There was no significant difference in symptom reduction, QoL, and endoscopic exams between both treatments. Conclusion. The treatment of chronic rhinosinusitis with liposomal nasal spray results in a similar, significant reduction of symptoms and significant improvement in quality of life as guideline-recommended treatment and is therefore a comparable alternative. PMID:24963305

  2. [Disturbances of nasal aerodynamics in patients with the curved nasal septum and the rationale for its surgical correction].

    PubMed

    Tulebaev, R K; Mustafin, A A; Zholdybaeva, Z T

    2011-01-01

    Serious disturbances of nasal aerodynamics contribute to the development of diseases of the broncho-pulmonary apparatus. The early recognition of ventilation problems in patients with the curved nasal septum is paramount for the efficacious prevention and treatment of respiratory complications. The authors describe principles of rhinosurgical correction of affected nasal aerodynamics in patients with the curved nasal septum.

  3. Influence of cooling face masks on nasal air conditioning and nasal geometry.

    PubMed

    Lindemann, J; Hoffmann, T; Koehl, A; Walz, E M; Sommer, F

    2017-06-01

    Nasal geometries and temperature of the nasal mucosa are the primary factors affecting nasal air conditioning. Data on intranasal air conditioning after provoking the trigeminal nerve with a cold stimulus simulating the effects of an arctic condition is still missing. The objective was to investigate the influence of skin cooling face masks on nasal air conditioning, mucosal temperature and nasal geometry. Standardized in vivo measurements of intranasal air temperature, humidity and mucosal temperature were performed in 55 healthy subjects at defined detection sites before and after wearing a cooling face mask. Measurements of skin temperature, rhinomanometry and acoustic rhinometry were accomplished. After wearing the face mask the facial skin temperature was significantly reduced. Intranasal air temperature did not change. Absolute humidity and mucosal temperature increased significantly. The acoustic rhinometric results showed a significant increase of the volumes and the cross-sectional areas. There was no change in nasal airflow. Nasal mucosal temperature, humidity of inhaled air, and volume of the anterior nose increased after application of a cold face mask. The response is mediated by the trigeminal nerve. Increased mucosal temperatures as well as changes in nasal geometries seem to guarantee sufficient steady intranasal nasal air conditioning.

  4. Perceiving nasal patency through mucosal cooling rather than air temperature or nasal resistance.

    PubMed

    Zhao, Kai; Blacker, Kara; Luo, Yuehao; Bryant, Bruce; Jiang, Jianbo

    2011-01-01

    Adequate perception of nasal airflow (i.e., nasal patency) is an important consideration for patients with nasal sinus diseases. The perception of a lack of nasal patency becomes the primary symptom that drives these patients to seek medical treatment. However, clinical assessment of nasal patency remains a challenge because we lack objective measurements that correlate well with what patients perceive. The current study examined factors that may influence perceived patency, including air temperature, humidity, mucosal cooling, nasal resistance, and trigeminal sensitivity. Forty-four healthy subjects rated nasal patency while sampling air from three facial exposure boxes that were ventilated with untreated room air, cold air, and dry air, respectively. In all conditions, air temperature and relative humidity inside each box were recorded with sensors connected to a computer. Nasal resistance and minimum airway cross-sectional area (MCA) were measured using rhinomanometry and acoustic rhinometry, respectively. General trigeminal sensitivity was assessed through lateralization thresholds to butanol. No significant correlation was found between perceived patency and nasal resistance or MCA. In contrast, air temperature, humidity, and butanol threshold combined significantly contributed to the ratings of patency, with mucosal cooling (heat loss) being the most heavily weighted predictor. Air humidity significantly influences perceived patency, suggesting that mucosal cooling rather than air temperature alone provides the trigeminal sensation that results in perception of patency. The dynamic cooling between the airstream and the mucosal wall may be quantified experimentally or computationally and could potentially lead to a new clinical evaluation tool.

  5. Perceiving Nasal Patency through Mucosal Cooling Rather than Air Temperature or Nasal Resistance

    PubMed Central

    Zhao, Kai; Blacker, Kara; Luo, Yuehao; Bryant, Bruce; Jiang, Jianbo

    2011-01-01

    Adequate perception of nasal airflow (i.e., nasal patency) is an important consideration for patients with nasal sinus diseases. The perception of a lack of nasal patency becomes the primary symptom that drives these patients to seek medical treatment. However, clinical assessment of nasal patency remains a challenge because we lack objective measurements that correlate well with what patients perceive.The current study examined factors that may influence perceived patency, including air temperature, humidity, mucosal cooling, nasal resistance, and trigeminal sensitivity. Forty-four healthy subjects rated nasal patency while sampling air from three facial exposure boxes that were ventilated with untreated room air, cold air, and dry air, respectively. In all conditions, air temperature and relative humidity inside each box were recorded with sensors connected to a computer. Nasal resistance and minimum airway cross-sectional area (MCA) were measured using rhinomanometry and acoustic rhinometry, respectively. General trigeminal sensitivity was assessed through lateralization thresholds to butanol. No significant correlation was found between perceived patency and nasal resistance or MCA. In contrast, air temperature, humidity, and butanol threshold combined significantly contributed to the ratings of patency, with mucosal cooling (heat loss) being the most heavily weighted predictor. Air humidity significantly influences perceived patency, suggesting that mucosal cooling rather than air temperature alone provides the trigeminal sensation that results in perception of patency. The dynamic cooling between the airstream and the mucosal wall may be quantified experimentally or computationally and could potentially lead to a new clinical evaluation tool. PMID:22022361

  6. [Nasal septum cartilage-silica gel complex for repairing nasal deformities of unilateral cleft lip].

    PubMed

    Li, Qingwei; Sheng, Zunqi; Tang, Shengjian; Yang, Biaobing; Yu, Xiaohua

    2009-07-01

    To evaluate the operative methods and therapeutic effects of nasal septum cartilage-silica gel complex for two-stage repair of nasal deformities of unilateral cleft lip. From June 2001 to June 2007, 38 cases of secondary nasal deformity and septum deviation of cleft lip were treated with transplanting nasal septum cartilage-silica gel complex. Among of them, there were 21 males and 17 females, aging 14-23 years with an average of 17.6 years. All cases were with nasal deformities of unilateral cleft lip, including 21 cases of complete cleft lip and 17 cases of incomplete cleft lip. The locations were left side in 26 cases and right side in 12 cases. Nasal deformities were columella nasi deflexion, flattened nasal tip, pteleorrhine and alanasi collapse. The patients received 1-4 times operations, and the interval of two operations was 3-10 years (mean 5.5 years). According to nasal deformity, the nasal septum cartilage of 1.8 cm x 1.2 cm was cut, and transplanted into the nose point phantom surface forming "the shield" to extend nose column and to raise the tip of the nose. At the same time the nasal tip fat-connective tissue flap graft with fat knot was given. After fixation, the nasal alar cartilage and soft tissues were reduced to normal position. Primary healing of the incisions was achieved in all cases. The nasal deformity was corrected. The postoperative follow-up period was 12-18 months with an average of 15.6 months. All the patients of regional cartilage scars had no complication. The figure of nose was slinky, the height of apex of nose and the shape of nose was natural, the apex of nose, nasal ala, nostrils and nasal columella were satisfactory [(the results were satisfactory in 30 cases (78.9%), general in 8 cases (21.1%)]. The nose department overall esthetics shape was improved in all the patients, no complications of the phantom sliding, shifting and exposure, hemorrhage and infection occurred. The nasal septum cartilage-silica gel complex to repair

  7. A model of airflow in the nasal cavities: Implications for nasal air conditioning and epistaxis.

    PubMed

    Bailie, Neil; Hanna, Brendan; Watterson, John; Gallagher, Geraldine

    2009-01-01

    A friction force is generated when moving air contacts the nasal walls, referred to as wall shear stress. This interaction facilitates heat and mass transfer between the mucosa and air, i.e., air-conditioning. The objective of this research was to study the distribution of wall shear stress within the nasal cavity to identify areas that contribute significantly to air-conditioning within the nasal cavity. Three-dimensional computational models of the nasal airways of five healthy subjects (three male and two female subjects) were constructed from nasal CT scans. Numerical simulations of nasal airflow were conducted using the commercial computational fluid dynamics code Fluent 6 (Ansys, Inc., Canonsburg, PA). Wall shear stress was derived from the numerical simulation. Air-conditioning was simulated to confirm the relationship with wall shear stress. Nasal airflow simulations predicted high wall shear stress along the anterior aspect of the inferior turbinate, the anteroinferior aspect of the middle turbinate, and within Little's area. The airflow simulations indicate that the inferior and middle turbinates and Little's area on the anterior nasal septum contribute significantly to nasal air-conditioning. The concentration of wall shear stress within Little's area indicates a desiccating and potentially traumatic effect of inhaled air that may explain the predilection for spontaneous epistaxis at this site.

  8. [Does nasal decontamination reduce the incidence of infections after cardiac surgery?].

    PubMed

    Jabbour, Hisham; Madi-Jebara, Samia; Jabbour, Khalil; Yazigi, Alexandre; Haddad, Fadia; Hayek, Gemma; Yazbeck, Patricia; Antakly, Marie-Claire

    2010-01-01

    Mupirocin applied to the anterior nares four times daily usually eliminates Staphylococcus aureus, including methicillin resistant, within 48 hours. Prophylactic intranasal mupirocin is safe, inexpensive and effective in reducing the overall sternal wound infection after open-heart surgery. This study was designed to determine whether decreasing nasal bacterial colonization by applying mupirocin intra nasally decreases mediastinal, sternal, pulmonary and cutaneous infections after open-heart surgery. After institutional approval and informed consent, 392 patients were included in a randomized, prospective study. Nasal cultures were taken for all patients before surgery. Patients were divided in two groups: Group I (n = 190) receiving mupirocin in the anterior nares 4 times daily for 48 hours before surgery; Group II (n = 202) was the control group. Patients were followed for a month after surgery. All mediastinal, sternal, pulmonary and cutaneous infections were documented and treated with appropriate antibiotics. A Student test for quantitative data and a chi2 test for qualitative data were used for statistical analysis. p < or = 0.05 was considered significant. The two groups had the same demographic characteristics and risk factors. Nasal carriage of Staphylococcus was 36.2% in the two groups. Neither mediastinitis nor sternitis were noticed in any of the two groups. There was no statistical difference between the groups according to the frequency of the cutaneous infections (Group I: 19/190 - Group II: 13/202) and pneumonia (Group I: 7/190 - Group II: 13/202). In patients who had nasal carriage of Staphylococcus, nasal decontamination has not shown a statistical difference of cutaneous infections of the lower limbs nor pneumonia. Although nasal decontamination reduced the incidence of sternal wound infection (Gr I 0/190 - Gr II 4/202 ; p = 0.017). Staphylococcus aureus, in the control group, induced more cutaneous infections (30.8% vs 11.7% ; p = 0.048). The

  9. Penetration of oxytetracycline into the nasal secretions and relationship between nasal secretions and plasma oxytetracycline concentrations after oral and intramuscular administration in healthy pigs.

    PubMed

    Bimazubute, M; Cambier, C; Baert, K; Vanbelle, S; Chiap, P; Gustin, P

    2011-04-01

    The penetration of oxytetracycline (OTC) in plasma and nasal secretions of healthy pigs was evaluated during the first study, in response to oral dose of 20 mg of OTC per kg of body weight (bwt) per day as a 400 mg/kg feed medication (n = 5) and to intramuscular (i.m.)-administered formulations at 10 mg/kg bwt (n = 5), 20 mg/kg bwt (n = 5), 40 mg/kg bwt (n = 5). Concentrations of OTC in plasma and nasal secretions were determined by a validated ultra-high performance liquid chromatography associated to tandem mass spectrometry method (UPLC/MS/MS). The objectives were to select the efficacy treatment and to evaluate the possibility to predict nasal secretions concentrations from those determined in plasma. The animals were housed together in each experiment. In each group, the treatment was administered once daily during 6 consecutive days, and nasal secretions and plasma were collected after 4 and 24 h at day 2 and day 6. For oral administration, only one medicated feed was prepared and distributed to all the animals together and was consumed in approximately 1 h. To meet recommendations of efficacy for OTC in nasal secretions, only the i.m. of 40 mg/kg bwt associated to an inter-dosing interval of 24 h provides and maintains concentrations in nasal secretions ≥1 μg/mL, appropriate to the MIC 50 and 90 of Pasteurella multocida and Bordetella bronchiseptica, respectively, the main pathological strains in nasal secretions. It has been demonstrated that, using a generalized linear mixed model (GLMM), OTC in the nasal secretions (μg/mL) can be predicted taking into account the OTC concentrations in plasma (μg/mL), according to the following equation: OTC(nasal secretions)  = 0.28 OTC(plasma) -1.49. In a second study, the pharmacokinetic behaviour of OTC in plasma and nasal secretions of healthy pigs was investigated, after single-dose i.m. of 40 mg/kg bwt of the drug. Blood samples and nasal secretions were collected at

  10. Effectiveness and satisfaction with zolmitriptan 5 mg nasal spray for treatment of migraine in real-life practice: results of a postmarketing surveillance study.

    PubMed

    Diener, Hans-Christoph; Evers, Stefan

    2007-01-01

    Addressing the needs of migraineurs by actively seeking patient feedback on disease-related disability and treatment satisfaction may lead to improved management and treatment outcomes. Patient feedback can be collected in postmarketing surveillance (PMS) studies. The objective of this PMS study was to evaluate the efficacy and tolerability of zolmitriptan 5 mg nasal spray in the acute treatment of migraine attacks. Patients received zolmitriptan 5 mg nasal spray to treat migraine attacks of any severity and were followed up after a maximum of 4 months. Patients evaluated the efficacy and tolerability of zolmitriptan nasal spray, and were asked whether they wished to continue using zolmitriptan nasal spray and their preference compared with previous treatments. Physicians also assessed the efficacy and tolerability of zolmitriptan nasal spray. A total of 1838 patients (84.8% females) participated in the study. Within 30 minutes of administration of zolmitriptan nasal spray, 85.0% of patients reported improvements in headache pain, with 25.1% reporting an improvement within 10 minutes. At 1 hour post-dose, 57.9% of patients were pain free and 61.7% were able to resume usual daily activities. Most patients (72.9%) rated zolmitriptan nasal spray as 'better' than previous therapy. The majority (88.8%) expressed a wish to continue using zolmitriptan nasal spray. Physicians evaluated the efficacy of zolmitriptan nasal spray as 'excellent' or 'good' in 89.4% of patients. Tolerability was evaluated as 'excellent' or 'good' in 91.6% of patients. Zolmitriptan 5 mg nasal spray provides favourable efficacy and tolerability in the acute treatment of migraine attacks. Most patients assessed zolmitriptan nasal spray as 'better' than previous treatment, with nearly all wishing to continue using it.

  11. Unilateral nasal pain with migraine features.

    PubMed

    Alvarez, Mónica; Montojo, Teresa; de la Casa, Beatriz; Vela, Lydia; Pareja, Juan A

    2013-09-01

    Migraine attacks exclusively felt in the face are very rare, the pain involving the territories supplied by the second and third branches of the trigeminal nerve. Two patients suffering from heminasal pain attacks accompanied with typical migrainous features and responsive to oral or intranasal triptans - but not to intranasal lidocaine or oxymetazoline. In one patient, the attacks could be precipitated upon slight touching on the tip of the nose, in the other attacks were preceded by the nasal sensation typically heralding sneezing. Migraine pain mostly develops within the innervation territory of the first branch of the trigeminal nerve, which includes the nose. Therefore, episodes of unilateral nasal pain with migrainous features could be considered a migraine with unusual topography (nasal migraine). Painful nasal attacks occasionally preceded by stimulation of trigeminal afferents in the nose, could be conceived of as migraine-tic syndrome.

  12. Primary nasal tuberculosis: a case report.

    PubMed

    Nayar, Ravi C; Al Kaabi, Juma; Ghorpade, Kanchanmala

    2004-03-01

    During the past 2 decades, tuberculosis--both pulmonary and extrapulmonary--has re-emerged as a major health problem worldwide. Nasal tuberculosis--either primary or secondary to pulmonary tuberculosis or facial lupus--is rare, but it should be considered in the differential diagnosis of nasal granulomas. We describe a case of primary nasal tuberculosis in an adult male who presented with a polypoid lesion in one nasal cavity. The diagnosis was based on histopathology and the patient's successful response to antituberculous drug treatment. Given the rising incidence of tuberculosis, it is prudent that otolaryngologists remain cognizant of this infection as a potential cause of unusual lesions in the head and neck.

  13. Development of the cetacean nasal skull.

    PubMed

    Klima, M

    1999-01-01

    The adaptation of cetaceans to aquatic life habits is reflected, in their nasal region, in three marked changes from the original relations found in land mammals. These changes include (1) the loss of the sense of smell, (2) translocation of the nostrils from the tip of the rostrum to the vertex of the head, and (3) elongation of the anterior head to form a rostrum protruding far towards anterior. The morphogenetic processes taking place during embryogenesis of the nasal skull play a decisive part in the development of all these changes. The lateral parts of the embryonic nasal capsule, encompassing the nasal passages, change their position from horizontal to vertical. At the same time, the structures of the original nasal floor (the solum nasi) are shifted in front of the nasal passages towards the rostrum. The structures of the original nasal roof (the tectum nasi) and of the nasal side wall (the paries nasi) are translocated behind the nasal passages towards the neurocranium. The medial nasal septum (the septum nasi) mostly loses its connection to the nasal passages and is produced into a point protruding far towards anterior. The transformed embryonic nasal skull of the Cetacea can be divided into three sections: 1. The median structures. These include the cartilaginous structures, viz., the rostrum nasi, the septum interorbitale and the spina mesethmoidalis, which are accompanied by the dermal bones, the vomer and the praemaxillare. In adult cetaceans the rostrum nasi is mostly preserved as a robust cartilage of the skull, which may possibly serve as a sound transmitting structure of the sonar system, or it may be responsible for the sensing of water streams and vibrations. 2. The posterior side wall structures. These include the following cartilaginous structures that are mostly heavily reduced or mutually fused: the cupula nasi anterior, the tectum nasi, the lamina cribrosa, the paries nasi, the commissura orbitonasalis, the cupula nasi posterior, the

  14. Anterior rhinomanometry in nasal allergen challenges.

    PubMed

    Ferreira, M B; Carlos, A G

    1998-11-01

    Even simple and relatively safe provocation procedures like nasal allergen challenges, should aim to allow detection of positivity with the less possible discomfort to the patient. The objective of this work was to evaluate if the use of rhinomanometric measurements during nasal provocation procedures could allow a decrease in the total administered allergen dose, causing less symptoms to the patients but without increasing the number of false-negatives, comparatively to clinical scores or nasal peak-flow measurements. Our results showed that performing rhinomanometric measurements during nasal HDM challenge procedures can lead in many patients to a reduction in the total dose of allergen administered during the challenge, without loss of sensitivity or specificity. This allergen dose reduction translates in less time consumed during the provocation and less patients' discomfort.

  15. Effect of bilastine upon nasal obstruction.

    PubMed

    Dávila, I; Sastre, J; Mullol, J; Montoro, J; Jáuregui, I; Ferrer, M; del Cuvillo, A; Bartra, J; Valero, A

    2011-01-01

    H1 antihistamines constitute one of the main references for the treatment of allergic rhinitis. Classically, these drugs have been considered effective in controlling sneezing, rhinorrhea and itching, though they have not been regarded as particularly effective in application to nasal obstruction. The most recent studies, involving second-generation H1 antihistamines (desloratadine, fexofenadine, levocetirizine, rupatadine), have shown these drugs to offer effects upon nasal obstruction significantly superior to those of placebo. The present review examines the effect of bilastine, a new, potent and highly specific H1 antihistamine without sedative effects or cardiac toxicity, upon nasal obstruction. The analysis of the data from the different clinical trials indicates that in patients with allergic rhinitis, the effect of bilastine upon nasal obstruction is superior to that of placebo and similar to that of other second-generation H1 antihistamines, manifesting within 24 hours after the start of treatment.

  16. Nasal Chondromesenchymal Hamartoma in a Child

    SciTech Connect

    Finitsis, Stefanos; Giavroglou, Constantinos; Potsi, Stamatia; Constantinidis, Ioannis; Mpaltatzidis, Angelos; Rachovitsas, Dimitrios; Tzioufa, Valentini

    2009-05-15

    Nasal chondromesenchymal hamartoma (NCMH) is a benign tumor that was described in 1998. The occurrence of this lesion in the nasal cavity of infants and children is especially rare, with only 21 cases reported in the international literature. We report a 12-month-old boy with respiratory distress due to nasal obstruction. Computed tomographic scan and magnetic resonance imaging examination demonstrated a soft-tissue mass obstructing the left nasal cavity. Digital subtraction angiography and preoperative superselective embolization with microparticles were also performed. The tumor was completely resected surgically. Histopathology and immunohistochemical analyses of the tumor disclosed a NCMH. The imaging characteristics of the tumor are described and the radiology literature is reviewed.

  17. Nasal toxicity of cocaine: a hypercoagulable effect?

    PubMed Central

    Patel, R.; Shah, R.; Baredes, S.; Spillert, C. R.; Lazaro, E. J.

    2000-01-01

    Nasal insufflation of cocaine injures the nasal mucosa and can perforate the septum. Cocaine-induced vasoconstriction resulting in ischemia is one of the methods that may be responsible for this damage. We are determining whether cocaine also produces a hypercoagulable state that may compound factors which have been previously established to cause damage to the nasal mucosa and septum. This study uses Modified Recalcification Time (MRT), a test developed in our laboratory that has the ability to measure the overall coagulation process. Our study revealed no connection between cocaine and enhanced platelet function or monocyte-released tissue factor. The coagulation process was unaffected by the addition of the drug, so we conclude that cocaine does not cause a hypercoagulable state and cannot assist in the explanation regarding the ischemic changes of the nasal septum. PMID:10800286

  18. Fogarty catheter removal of nasal foreign bodies.

    PubMed

    Fox, J R

    1980-01-01

    The removal, without incident, of 14 nasal foreign bodies is described. None of the bodies was amenable to anterior instrumental extraction, and all were removed using a small-diameter Fogarty catheter.

  19. Nasal inflammation and its response to local glucocorticoid regular treatment in patients with persistent non-allergic rhinitis: a pilot study.

    PubMed

    Poletti, Donatella; Iannini, Valeria; Casolari, Paolo; Contoli, Marco; Papi, Alberto; Kirkham, Paul; Hansel, Trevor T; Chung, Kian Fan; Barnes, Peter J; Pastore, Antonio; Pelucchi, Stefano; Adcock, Ian M; Caramori, Gaetano

    2016-01-01

    The pathogenesis of non-allergic rhinitis (NAR) is still largely unknown. Furthermore, it is unclear whether there is a correlation between the effect of nasal glucocorticoids on nasal inflammation and on nasal symptoms and quality of life. In this pilot study we recruited 12 healthy subjects and 24 patients with recently diagnosed persistent NAR [12 untreated and 12 under regular treatment with nasal fluticasone furoate (two sprays of 27.5 μg each in each nostril once daily, total daily dose = 110 μg) for at least 20 days]. Each subject filled a mini rhinoconjunctivitis quality of life questionnaire (mini RQLQ). Nasal scrapings were obtained from each subject and used to prepare slides for Diff-Quik and immunocytochemical staining for inflammatory and epithelial cells count, MUC5AC expression and the general pro-inflammatory transcription factor nuclear factor kB (NF-kB) activation. The nasal score of the mini RQLQ, the number of nasal inflammatory cells (neutrophils, eosinophils) and the number of goblet cells are significantly higher in untreated patients with persistent NAR compared with control subjects and treated NAR patients. The percentage of MUC5AC+ nasal epithelial cells is significantly increased in untreated patients with persistent NAR compared with the control subjects (41.8 ± 6.4 vs 22.3 ± 4.8, respectively; p = 0.0403) without significant differences between control subjects and patients with persistent NAR on regular fluticasone furoate treatment (33.9 ± 5.0 %; p = 0.0604) nor between the 2 groups of persistent NAR subjects (p = 0.3260). The number of cytosolic and/or nuclear p65+ nasal epithelial and inflammatory cells was not significantly different between the three groups. Patients with persistent untreated NAR, compared with normal control subjects and patients with persistent NAR under regular treatment with nasal fluticasone furoate by at least 20 days, have more nasal symptoms, worst quality of life

  20. Estimates of nasal airflow at the nasal cycle mid-point improve the correlation between objective and subjective measures of nasal patency.

    PubMed

    Gaberino, Courtney; Rhee, John S; Garcia, Guilherme J M

    2017-04-01

    The nasal cycle represents a significant challenge when comparing pre- and post-surgery objective measures of nasal airflow. Computational fluid dynamics (CFD) simulations of nasal airflow were conducted in 12 nasal airway obstruction patients showing significant nasal cycling between pre- and post-surgery computed tomography scans. To correct for the nasal cycle, mid-cycle models were created virtually. Subjective scores of nasal patency were obtained via the Nasal Obstruction Symptom Evaluation (NOSE) and unilateral visual analog scale (VAS). The correlation between objective and subjective measures of nasal patency increased after correcting for the nasal cycle. In contrast to biophysical variables in individual patients, cohort averages were not significantly affected by the nasal cycle correction. The ability to correct for the confounding effect of the nasal cycle is a key element that future virtual surgery planning software for nasal airway obstruction will need to account for when using anatomic models based on single instantaneous imaging. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Open safety pin in the nasal cavity.

    PubMed

    Sen, I; Sikder, B; Sinha, R; Paul, R

    2004-04-01

    Foreign bodies in the nasal cavity are common-day occurrences in Otolaryngologic practice. But an open safety pin in nose with it' s sharp end directed towards roof is a rare incidence, and available literature is silent about this presentation; it is probably, the first of it' s kind being reported. Two cases of safety pins inside the nasal cavity, one open and the other closed, have been presented here with a brief review of literature.

  2. Nasal manifestations in chromium industry workers.

    PubMed

    Aiyer, R G; Kumar, Gaurav

    2003-04-01

    People working in mines, plating factories, cement industries are mainly exposed to chrome substances, IIexavalent chromium has been implicated for its toxic effect on the nasal mucosa. Hereby we present a rare study of 28 patients who attended out patient department of Otorhinolaryngology at SSG Hospital, Baroda from a nearby chromium industry. This study aims to present various nasal manifestations of toxic effects of prolonged chromium exposure.

  3. Ecogeographic variation in human nasal passages.

    PubMed

    Yokley, Todd R

    2009-01-01

    Theoretically, individuals whose ancestors evolved in cold and/or dry climates should have greater nasal mucosal surface area relative to air volume of the nasal passages than individuals whose ancestors evolved in warm, humid climates. A high surface-area-to-volume (SA/V) ratio allows relatively more air to come in contact with the mucosa and facilitates more efficient heat and moisture exchange during inspiration and expiration, which would be adaptive in a cold, dry environment. Conversely, a low SA/V ratio is not as efficient at recapturing heat and moisture during expiration and allows for better heat dissipation, which would be adaptive in a warm, humid environment. To test this hypothesis, cross-sectional measurements of the nasal passages that reflect surface area and volume were collected from a sample of CT scans of patients of European and African ancestry. Results indicate that individuals of European descent do have higher SA/V ratios than individuals of African descent, but only when decongested. Otherwise, the two groups show little difference. This pattern of variation may be due to selection for different SA/V configurations during times of physical exertion, which has been shown to elicit decongestion. Relationships between linear measurements of the skeletal nasal aperture and cavity and cross-sectional dimensions were also examined. Contrary to predictions, the nasal index, the ratio of nasal breadth to nasal height, is not strongly correlated with internal dimensions. However, differences between the nasal indices of the two groups are highly significant. These results may be indicative of different adaptive solutions to the same problem.

  4. Numerical simulation and nasal air-conditioning

    PubMed Central

    Keck, Tilman; Lindemann, Jörg

    2011-01-01

    Heating and humidification of the respiratory air are the main functions of the nasal airways in addition to cleansing and olfaction. Optimal nasal air conditioning is mandatory for an ideal pulmonary gas exchange in order to avoid desiccation and adhesion of the alveolar capillary bed. The complex three-dimensional anatomical structure of the nose makes it impossible to perform detailed in vivo studies on intranasal heating and humidification within the entire nasal airways applying various technical set-ups. The main problem of in vivo temperature and humidity measurements is a poor spatial and time resolution. Therefore, in vivo measurements are feasible only to a restricted extent, solely providing single temperature values as the complete nose is not entirely accessible. Therefore, data on the overall performance of the nose are only based on one single measurement within each nasal segment. In vivo measurements within the entire nose are not feasible. These serious technical issues concerning in vivo measurements led to a large number of numerical simulation projects in the last few years providing novel information about the complex functions of the nasal airways. In general, numerical simulations merely calculate predictions in a computational model, e.g. a realistic nose model, depending on the setting of the boundary conditions. Therefore, numerical simulations achieve only approximations of a possible real situation. The aim of this review is the synopsis of the technical expertise on the field of in vivo nasal air conditioning, the novel information of numerical simulations and the current state of knowledge on the influence of nasal and sinus surgery on nasal air conditioning. PMID:22073112

  5. Numerical simulation and nasal air-conditioning.

    PubMed

    Keck, Tilman; Lindemann, Jörg

    2010-01-01

    Heating and humidification of the respiratory air are the main functions of the nasal airways in addition to cleansing and olfaction. Optimal nasal air conditioning is mandatory for an ideal pulmonary gas exchange in order to avoid desiccation and adhesion of the alveolar capillary bed. The complex three-dimensional anatomical structure of the nose makes it impossible to perform detailed in vivo studies on intranasal heating and humidification within the entire nasal airways applying various technical set-ups. The main problem of in vivo temperature and humidity measurements is a poor spatial and time resolution. Therefore, in vivo measurements are feasible only to a restricted extent, solely providing single temperature values as the complete nose is not entirely accessible. Therefore, data on the overall performance of the nose are only based on one single measurement within each nasal segment. In vivo measurements within the entire nose are not feasible. These serious technical issues concerning in vivo measurements led to a large number of numerical simulation projects in the last few years providing novel information about the complex functions of the nasal airways. In general, numerical simulations merely calculate predictions in a computational model, e.g. a realistic nose model, depending on the setting of the boundary conditions. Therefore, numerical simulations achieve only approximations of a possible real situation. The aim of this review is the synopsis of the technical expertise on the field of in vivo nasal air conditioning, the novel information of numerical simulations and the current state of knowledge on the influence of nasal and sinus surgery on nasal air conditioning.

  6. Hybrid mesh for nasal airflow studies.

    PubMed

    Zubair, Mohammed; Abdullah, Mohammed Zulkifly; Ahmad, Kamarul Arifin

    2013-01-01

    The accuracy of the numerical result is closely related to mesh density as well as its distribution. Mesh plays a very significant role in the outcome of numerical simulation. Many nasal airflow studies have employed unstructured mesh and more recently hybrid mesh scheme has been utilized considering the complexity of anatomical architecture. The objective of this study is to compare the results of hybrid mesh with unstructured mesh and study its effect on the flow parameters inside the nasal cavity. A three-dimensional nasal cavity model is reconstructed based on computed tomographic images of a healthy Malaysian adult nose. Navier-Stokes equation for steady airflow is solved numerically to examine inspiratory nasal flow. The pressure drop obtained using the unstructured computational grid is about 22.6 Pa for a flow rate of 20 L/min, whereas the hybrid mesh resulted in 17.8 Pa for the same flow rate. The maximum velocity obtained at the nasal valve using unstructured grid is 4.18 m/s and that with hybrid mesh is around 4.76 m/s. Hybrid mesh reported lower grid convergence index (GCI) than the unstructured mesh. Significant differences between unstructured mesh and hybrid mesh are determined highlighting the usefulness of hybrid mesh for nasal airflow studies.

  7. Sino-nasal mucosal malignant melanoma.

    PubMed

    Karim, Muneeb Uddin; Khan, Khursheed; Ali, Nasir; Ikram, Mubasher

    2015-04-29

    A 49-year-old man with a history of left nasal discharge and nasal cavity blockage for 5 months was diagnosed with sino-nasal mucosal malignant melanoma on nasal biopsy. On CT scan, the tumour involved the nasal cavity, left maxillary sinus, ethmoid sinus and medial left orbit. The tumour was grossly excised and adjuvant radiation therapy was offered. The patient was planned for an Intensity Modulated Radiotherapy technique to keep tolerance doses of organs at risk within normal limits and at same time deliver the intended dose of radiation to the tumour site, using 66 Gy in 33 fractions. Owing to the anatomical complexity of the sino-nasal region, precision radiotherapy (RT) is mandatory to optimally irradiate the tumour area while sparing critical surrounding normal structures from late toxicity of RT. Established dose constraints for at-risk organs can only be accomplished through this novel technique of RT. However, despite advances in techniques, current treatment modalities have not significantly made an impact on survival of these patients. 2015 BMJ Publishing Group Ltd.

  8. Hybrid Mesh for Nasal Airflow Studies

    PubMed Central

    Zubair, Mohammed; Abdullah, Mohammed Zulkifly; Ahmad, Kamarul Arifin

    2013-01-01

    The accuracy of the numerical result is closely related to mesh density as well as its distribution. Mesh plays a very significant role in the outcome of numerical simulation. Many nasal airflow studies have employed unstructured mesh and more recently hybrid mesh scheme has been utilized considering the complexity of anatomical architecture. The objective of this study is to compare the results of hybrid mesh with unstructured mesh and study its effect on the flow parameters inside the nasal cavity. A three-dimensional nasal cavity model is reconstructed based on computed tomographic images of a healthy Malaysian adult nose. Navier-Stokes equation for steady airflow is solved numerically to examine inspiratory nasal flow. The pressure drop obtained using the unstructured computational grid is about 22.6 Pa for a flow rate of 20 L/min, whereas the hybrid mesh resulted in 17.8 Pa for the same flow rate. The maximum velocity obtained at the nasal valve using unstructured grid is 4.18 m/s and that with hybrid mesh is around 4.76 m/s. Hybrid mesh reported lower grid convergence index (GCI) than the unstructured mesh. Significant differences between unstructured mesh and hybrid mesh are determined highlighting the usefulness of hybrid mesh for nasal airflow studies. PMID:23983811

  9. Metabolism of dopamine by the nasal mucosa.

    PubMed

    Chemuturi, Nagendra V; Donovan, Maureen D

    2006-11-01

    The nasal route of administration offers several advantages over oral and intravenous administration, including the ability to avoid hepatic first pass metabolism. Dopamine deficiency has been associated with several neurological disorders; it has been shown to have good systemic bioavailability and significant uptake into the CNS following intranasal administration. The purpose of these studies was to investigate the limiting role of mucosal metabolism of dopamine during nasal absorption. In vitro transport and initial rate studies were carried out using nasal mucosal explants to study dopamine permeability and metabolism. Dihydroxyphenylacetic acid (DOPAC) was the only metabolite detected. Monoamine oxidase (MAO), the enzyme responsible for DOPAC formation, was localized to the submucosal region of the nasal explants. The amount of DOPAC formed during the transport studies was less than 0.5% of the initial amount of dopamine placed into the system. Iproniazid, an MAO inhibitor, blocked DOPAC formation but had no effect on dopamine transport. The limited extent of dopamine metabolism compared to its mucosal transport demonstrates that nasal dopamine transport is not significantly reduced by mucosal metabolism and suggests that the nasal route may be promising for the efficient delivery of dopamine to the CNS.

  10. Nasal Dorsum Reconstruction With Alloplastic Material.

    PubMed

    Scopelliti, Domenico; Amodeo, Giulia

    2016-10-01

    The secondary nasal surgery represents a challenging surgical procedure. The difficulties in fact are several: the surgeon must make an effort to achieve the functional and aesthetic consequences of the previous surgical procedure, has to correct the aesthetic and functional imperfections, and has to work on a fibrotic and altered framework.The goal of the secondary nasal surgery is then to restore the normal nasal proportions correcting any functional inability unresolved by the previous surgery or determined by it.The aim of our study is to present our experience in dorsum reconstruction using Medpor. It became necessary as a result of previous surgery procedures responsible for an important sagittal projection deficiency.In the past the autologous grafts were used to restore the correct anatomical relationships.With the improvement in the surgical procedure, the alloplastic implants become of a wider use. Among these, Medpor represents the first choice because of its own intrinsic characteristics.Between 2004 and 2014, 18 patients underwent nasal dorsum reconstruction procedure using Medpor. Medpor was used to reconstruct the nasal dorsum and to augment the columella, supporting the nasal tip.The 18 patients treated by Medpor reported an aesthetic and functional improvement.Medpor represents a safe method in the secondary rhinoplasty to restore the nose anatomy and functionality and to achieve good aesthetic results.

  11. RANS and LES simulations of the airflow through nasal cavities

    NASA Astrophysics Data System (ADS)

    Lamberti, Giacomo

    2015-11-01

    The prediction of detailed flow patterns in nasal cavities using computational fluid dynamics (CFD) can provide essential information on the potential relationship between patient-specific geometrical characteristics and health problems. The long-term goal of the OpenNOSE project is to develop a reliable open-source computational tool based on the OpenFOAM CFD toolbox that can assist surgeons in their daily practice. The objective of this study was to investigate the effect of the turbulence model and boundary conditions on simulations of the airflow in nasal cavities. The geometry, including paranasal sinuses, was reconstructed from a carefully selected CT scan, and RANS and LES simulations were carried out for steady inspiration and expiration. At a flow rate near 20 l/min, the flow is laminar in most of the domain. During the inspiration phase, turbulence develops in nasopharynx and oropharynx regions; during the expiration phase, another vortical region is observed down the nostrils. A comparison between different boundary conditions suggests the use of a total pressure condition, or alternatively a uniform velocity, at the inlet and outlet. In future work the same geometry will be used for setting up a laboratory experiment, intended to cross-validate the numerical results.

  12. [Model of nasal cavity and paranasal sinuses created for studying the dynamics of the nasal airflow].

    PubMed

    Jiang, Guang-Li; Xu, Geng

    2008-09-01

    To create a model from an adult cadaver's nasal cavity and verify whether it can be used to study the airflow dynamics in the nasal cavity and paranasal sinuses. (1) The model was made by the material of transparent resin and Bengal gelatin according to a nasal cast of a cadaver. (2) The model was check by Acoustic Rhino-meter, CT scan and nasal endoscope, then compared with the normal. (3) To observe the smoke flow in the model and record it by a digital camera It was succeeded in creating a model of the nasal cavity and paranasal sinus. The model was good at simulation and transparency. The structure of the model, the cross-sectional areas of the nasal passage and the CT scan results of the model were similar to the normal. The airflows in the model could be recorded by a digital camera. It showed that there were two types of airflows in the nose. The majority of airflows were found in the common and middle nasal meatus, the little part of the airflows passed through the upper of the nose like a parabola. There was an increasing proportion of airflows in the olfactory region when elevated the airflow rates. A relatively large vortex formed in the upper part of the nose, just behind the nasal valve, and another one was in the pharynx nasals. (1) The transparent resin and Bengal gelatin are suitable for making the model of the nose. The model can be used to study the airflows dynamics of the nasal cavity and paranasal sinuses. (2) The majority of inspired airflows go straightly to the pharynx nasals through the combined middle and inferior airways, a little part of inspired airflows through the olfactory region like a parabola. (3) The inspired airflows first arrived at the front position of the middle and inferior turbinate. The airflows can go into the maxillary sinus, a vortex can be see in the maxillary sinus during breath.

  13. Assessments of nasal bone fracture effects on nasal airflow: A computational fluid dynamics study.

    PubMed

    Chen, Xiao Bing; Lee, Heow Pueh; Chong, Vincent Fook Hin; Wang, De Yun

    2011-01-01

    The aim of this study was to evaluate effects of nasal bone fractures on nasal aerodynamic flow patterns using computational fluid dynamics (CFD) simulations. A three-dimensional model of nasal cavity with a nasal bone fracture was constructed from computerized tomography (CT) scans of a patient with use of software Mimics 13.0 (The Materilize Group, Leuven, Belgium). CFD simulations were performed using Fluent 6.3 (ANSYS, Inc., Canonsburg, PA) with a turbulent flow model. Numerical results were presented with velocity, streamline, and pressure contour distributions in left and right nasal cavities and were compared with those of a healthy one. Possible outcomes on functional performances or patencies of the nose were also examined and discussed. For the nose with a nasal bone fracture, distributions of velocity contours showed there was more airflow in the right nasal cavity than in the left one, especially for inspiration status. In the left cavity, the airflow was redirected irregularly and there were also more circulations with larger sizes, higher pressure jumps, and greater wall shear stresses. Flow partitioning in the right and left cavities was noticeable with a larger nasal resistance compared with the healthy one. When the inspirational flow rate was increased, pressure jump from the nostril to the nasopharynx increased faster. The aerodynamic flow was redistributed greatly for the nose with a nasal bone fracture compared with the healthy one, which might affect local normal nasal functions. Such physical assessments of nasal airflow based on a model from the patients' CT scans may help clinicians determine the best treatment in advance.

  14. Therapeutic equivalence of triamcinolone acetonide hydrofluoroalkane and chlorofluorocarbon nasal inhalers in patients with seasonal allergic rhinitis.

    PubMed

    Schenkel, Eric; Newman, Kenneth B

    2013-01-01

    Triamcinolone acetonide (TAA) has been reformulated as an hydrofluoroalkane (HFA) aerosol for intranasal use in patients with seasonal allergic rhinitis (SAR). This study compared the TAA HFA formulation with the previously available chlorofluorocarbon (CFC) nasal inhaler in a dose-ranging study. This was a double-blind, parallel-group, multicenter study in 780 adults with SAR. Patients had a history of fall seasonal rhinitis and positive skin tests to ragweed. After meeting minimum symptom requirements during the run-in phase, patients were randomized to one of eight groups: TAA CFC or HFA at 14, 110, or 440 micrograms once daily or matching placebo. Treatment was continued for two weeks and patient completed a daily diary for reflective and instantaneous rating of nasal and ocular allergy symptoms. All active treatment groups were statistically superior to placebo with respect to the primary outcome variable, total nasal symptoms. Furthermore, the TAA HFA and TAA CFC formulations were statistically comparable over the dose range. Within each formulation, there was a significant mean reduction from baseline in the symptoms of rhinitis that increased with increasing dose. Ocular symptoms were also reduced with both formulations. Both preparations were well tolerated without any safety concerns. In conclusion, a new formulation of TAA with a HFA propellant was found to be effective in the treatment of SAR and comparable with the previously available TAA CFC formulation. There was a dose response to TAA, with doses as low as 7 micrograms per nostril once daily producing statistically significant improvement in rhinitis symptoms.

  15. Efficacy and safety of fixed-dose loratadine/montelukast in seasonal allergic rhinitis: effects on nasal congestion.

    PubMed

    Prenner, Bruce; Anolik, Robert; Danzig, Melvyn; Yao, Ruji

    2009-01-01

    A need exists for safe, effective therapy for the relief of the symptoms of allergic rhinitis (AR) that also consistently relieves nasal congestion, the most common and bothersome symptom. This study was performed to assess efficacy and safety of a once-daily tablet containing 10 mg of loratadine, an antihistamine, and 10 mg of montelukast, a leukotriene antagonist (SCH 445761) versus placebo and pseudoephedrine (PSE; 240 mg once-daily formulation; active comparator). In a multicenter, parallel-group, double-blind, double-dummy, randomized study, 1095 subjects with documented history of seasonal AR and positive skin-prick test to a prevailing aeroallergen were treated for 15 days with fixed-dose combination loratadine/montelukast (L/M), PSE, or placebo. After randomization, subjects rated severity of nasal congestion and measured peak nasal inspiratory flow (PNIF) rate in the morning and evening. The change in quality of life from baseline was also assessed. L/M and PSE were significantly more effective than placebo in alleviating nighttime and daytime nasal congestion and improving PNIF rate, an objective measure of nasal obstruction. There were no significant differences between L/M and PSE for any efficacy analysis including improvement in the quality of life. Subjects treated with L/M experienced a similar incidence of total adverse events versus placebo and a lower incidence of total adverse events (including dizziness, insomnia, jitteriness, nausea, and dry mouth) versus PSE. Nasal decongestant activity of L/M was significantly higher than that of placebo and similar to that of PSE in symptomatic AR subjects. L/M showed a safety profile similar to placebo and was better tolerated than PSE. Thus, L/M offers a safe and efficacious alternative to PSE for the treatment of nasal congestion associated with AR.

  16. Efficacy of a carrageenan nasal spray in patients with common cold: a randomized controlled trial.

    PubMed

    Ludwig, Martin; Enzenhofer, Elisabeth; Schneider, Sven; Rauch, Margit; Bodenteich, Angelika; Neumann, Kurt; Prieschl-Grassauer, Eva; Grassauer, Andreas; Lion, Thomas; Mueller, Christian A

    2013-11-13

    The common cold is the most widespread viral infection in humans. Iota-carrageenan has previously shown antiviral effectiveness against cold viruses in clinical trials. This study investigated the efficacy of a carrageenan-containing nasal spray on the duration of the common cold and nasal fluid viral load in adult patients. In a randomized, double-blind, placebo-controlled trial, 211 patients suffering from early symptoms of the common cold were treated for seven days. Application was performed three times daily with either a carrageenan-supplemented nasal spray or saline solution as placebo with an overall observation period of 21 days. The primary endpoint was the duration of disease defined as the time until the last day with symptoms followed by all other days in the study period without symptoms. During the study, but prior unblinding, the definition of disease duration was adapted from the original protocol that defines disease duration as the time period of symptoms followed by 48 hours without symptoms. In patients showing a laboratory-confirmed cold virus infection and adherence to the protocol, alleviation of symptoms was 2.1 days faster in the carrageenan group in comparison to placebo (p = 0.037). The primary endpoint that had been prespecified but was changed before unblinding was not met. Viral titers in nasal fluids showed a significantly greater decrease in carrageenan patients in the intention-to-treat population (p = 0.024) and in the per protocol population (p = 0.018) between days 1 and 3/4. In adults with common cold virus infections, direct local administration of carrageenan with nasal sprays reduced the duration of cold symptoms. A significant reduction of viral load in the nasal wash fluids of patients confirmed similar findings from earlier trials in children and adults. Current Controlled Trials ISRCTN80148028.

  17. Efficacy of a Carrageenan nasal spray in patients with common cold: a randomized controlled trial

    PubMed Central

    2013-01-01

    Background The common cold is the most widespread viral infection in humans. Iota-carrageenan has previously shown antiviral effectiveness against cold viruses in clinical trials. This study investigated the efficacy of a carrageenan-containing nasal spray on the duration of the common cold and nasal fluid viral load in adult patients. Methods In a randomized, double-blind, placebo-controlled trial, 211 patients suffering from early symptoms of the common cold were treated for seven days. Application was performed three times daily with either a carrageenan-supplemented nasal spray or saline solution as placebo with an overall observation period of 21 days. The primary endpoint was the duration of disease defined as the time until the last day with symptoms followed by all other days in the study period without symptoms. During the study, but prior unblinding, the definition of disease duration was adapted from the original protocol that defines disease duration as the time period of symptoms followed by 48 hours without symptoms. Results In patients showing a laboratory-confirmed cold virus infection and adherence to the protocol, alleviation of symptoms was 2.1 days faster in the carrageenan group in comparison to placebo (p = 0.037). The primary endpoint that had been prespecified but was changed before unblinding was not met. Viral titers in nasal fluids showed a significantly greater decrease in carrageenan patients in the intention-to-treat population (p = 0.024) and in the per protocol population (p = 0.018) between days 1 and 3/4. Conclusions In adults with common cold virus infections, direct local administration of carrageenan with nasal sprays reduced the duration of cold symptoms. A significant reduction of viral load in the nasal wash fluids of patients confirmed similar findings from earlier trials in children and adults. Trial registration Current Controlled Trials ISRCTN80148028 PMID:24219370

  18. MRO SOW Daily Script

    NASA Technical Reports Server (NTRS)

    Fisher, Forest E.; Khanampornpan, Teerapat; Gladden, Roy E.

    2008-01-01

    The MRO SOW daily script (wherein "MRO" signifies "Mars Reconnaissance Orbiter" and "SOW" signifies "sequence systems engineer of the week") is a computer program that automates portions of the MRO daily SOW procedure, which includes checking file-system sizes and automated sequence processor (ASP) log files. The MRO SOW daily script effects clear reporting of (1) the status of, and requirements imposed on, the file system and (2) the ASP log files.

  19. Correlations of nasal responses to leukotriene D4 and histamine nasal provocation with quality of life in allergic rhinitis

    PubMed Central

    Zhu, Zheng; Xie, Yanqing; Guan, Weijie; Gao, Yi; Xia, Shu; Shi, Xu

    2016-01-01

    Background The symptoms of allergic rhinitis (AR) greatly affect the quality of life (QoL) in the patients with AR. The correlations of nasal response to leukotriene D4 (LTD4) and histamine nasal provocation with health related QoL in AR are not clear. Objective To evaluate the correlations of nasal response to LTD4 and histamine nasal challenge with QoL in AR. Methods Patients randomly underwent LTD4 and histamine nasal challenge tests, completed the rhinoconjunctivitis quality of life questionnaire (RQoLQ), and rating the symptom severity score (total symptom score 4, TSS4) in the previous week. The correlations between nasal challenge tests induced nasal responses and QoL in RQoLQ were analyzed. Results A total of 25 eligible AR patients enrolled and finished both LTD4 and histamine nasal challenge and completed the questionnaire of RQoLQ. Histamine nasal challenge induced sneezing, increased nasal resistant were correlated with most of the dimensions (general, practical, nasal, eye problems, and quality of sleep, p < 0.05), while LTD4 nasal challenge induced sneeze, increased nasal resistant only correlated with nasal and ocular problems. On the contrary, the severity of the sneeze assessed by TSS4, was not correlated with QoL, while the severity of rhinorrhea, congestion, and nasal pruritus were correlated with nasal and practical problems, and nasal congestion was also correlated with ocular problems (r = 0.60, p = 0.01). Conclusion LTD4 and histamine nasal challenge induced nasal responses were correlated with different clinical symptoms severity and QoL, which can be used as a good diagnosis and evaluation methods for the management of AR. PMID:27803885

  20. Nasal obstruction and smell impairment in nasal polyp disease: correlation between objective and subjective parameters.

    PubMed

    Hox, V; Bobic, S; Callebaux, I; Jorissen, M; Hellings, P W

    2010-12-01

    Chronic rhinosinusitis with nasal polyposis (NP) represents an invalidating disorder that causes mainly nasal blockage and loss of smell. The aim of this study is to investigate correlations between individual subjective and objective parameters of stable NP disease. 65 NP patients scored their sinonasal symptoms on a visual analogue scale (VAS) and questionnaires (SNOT-22 and SF-36). Peak nasal inspiratory flow (PNIF) measurement, Sniffinatm Sticks (SS) smell test, blood analysis for eosinophilia, total IgE and culture for Staphylococcus aureus (SA) were performed. VAS scores for nasal blockage correlated with the SNOT-22 and SF-36 scores, which was not observed for VAS of other symptoms. VAS scores for nasal blockage correlated well with PNIF values as well as VAS scores for smell dysfunction and SS results (both p<0.001). NP size correlated with VAS scores for nasal blockage (p<0.01) but not with VAS for other symptoms. NP size showed an inverse correlation with PNIF and SS scores (both p<0.05). Blood eosinophilia correlated with subjective smell reduction (p<0.05). The presence of SA or total IgE levels were not associated with symptoms of NP disease. PNIF and SS are good tools to evaluate symptoms of nasal obstruction and smell reduction in NP disease. Nasal blockage is the only symptom that correlates well with NP size and SNOT-22 scores, whereas smell reduction correlates with blood eosinophilia.

  1. Visualization and Quantification of Nasal and Olfactory Deposition in a Sectional Adult Nasal Airway Cast.

    PubMed

    Xi, Jinxiang; Yuan, Jiayao Eddie; Zhang, Yu; Nevorski, Dannielle; Wang, Zhaoxuan; Zhou, Yue

    2016-06-01

    To compare drug deposition in the nose and olfactory region with different nasal devices and administration techniques. A Sar-Gel based colorimetry method will be developed to quantify local deposition rates. A sectional nasal airway cast was developed based on an MRI-based nasal airway model to visualize deposition patterns and measure regional dosages. Four nasal spray pumps and four nebulizers were tested with both standard and point-release administration techniques. Delivered dosages were measured using a high-precision scale. The colorimetry correlation for deposited mass was developed via image processing in Matlab and its performance was evaluated through comparison to experimental measurements. Results show that the majority of nasal spray droplets deposited in the anterior nose while only a small fraction (less than 4.6%) reached the olfactory region. For all nebulizers considered, more droplets went beyond the nasal valve, leading to distinct deposition patterns as a function of both the nebulizer type (droplet size and initial speed) and inhalation flow rate. With the point-release administration, up to 9.0% (±1.9%) of administered drugs were delivered to the olfactory region and 15.7 (±2.4%) to the upper nose using Pari Sinus. Standard nasal devices are inadequate to deliver clinically significant olfactory dosages without excess drug losses in other nasal epitheliums. The Sar-Gel based colorimetry method appears to provide a simple and practical approach to visualize and quantify regional deposition.

  2. Septal suturing following nasal septoplasty, a valid alternative for nasal packing?

    PubMed

    Lemmens, W; Lemkens, P

    2001-01-01

    Septal suturing following nasal septoplasty, a valid alternative for nasal packing? After septal surgery most surgeons still routinely perform nasal packing since this is generally recommended. The aims of packing are numerous: haemostasis, prevention of haematoma, increase septal flap apposition, closure of dead space and prevention of displacement of the replaced cartilage. However, nasal packing is not an innocuous procedure and may lead to cardiovascular changes, continued bleeding, nasal injury, hypoxia, foreign body reaction or infection. The major disadvantage of nasal packing is patient discomfort--usually necessitating hospital stay--and the need to administer antibiotics. Therefore alternatives were sought. Sessions, Lee and Vukovic conceived and reported in the eighties forms of continuous septal suturing, but are not widely used. A similar technique of septal suturing after nasal septoplasty without nasal packing was used in 226 consecutive surgical procedures and reviewed retrospectively. Complications like postoperative episodes of bleeding, infections, septal haematomas, septal perforations or synechia were not noted. On one patient a recurrence of the septal deviation occurred. Patients reported almost no discomfort. Moreover, the septal surgery procedure could be carried out on a day-surgery basis. Readmission of a patient was never necessary. Based on these observations the septal suturing technique is a valid alternative to intranasal packing following septal surgery.

  3. [A case of nasal tip necrosis after hyaluronic acid injection].

    PubMed

    Honart, J-F; Duron, J-B; Mazouz Dorval, S; Rausky, J; Revol, M

    2013-12-01

    Hyaluronic acid (HA) is the most used dermal filler. Some complications associated with its use have been described, but most of them are rare and benign. We report an exceptional case of skin necrosis of the tip of the nose, in a 22-year-old patient, after HA injection. The initial appearance may occurred subsequent aesthetic sequels. After necrotic tissue excision, patient was followed in rapid succession. Daily local care has led to wound healing, without any important sequel. This rare complication reminds us that HA injections are not without risk, despite their apparent simplicity of use. Moreover, the case presented confirms the potential healing of the nasal tip, allowing treatment with wound healing, rather than other early invasive procedure.

  4. Safety analysis of long-term budesonide nasal irrigations in patients with chronic rhinosinusitis post endoscopic sinus surgery.

    PubMed

    Soudry, Ethan; Wang, Jane; Vaezeafshar, Reza; Katznelson, Laurence; Hwang, Peter H

    2016-06-01

    Although the safety of topical nasal steroids is well established for nasal spray forms, data regarding the safety of steroid irrigations is limited. We studied the effect of long-term budesonide nasal irrigations (>6 months) on hypothalamic-pituitary-adrenal axis (HPAA) function and intraocular pressure (IOP) in patients post-endoscopic sinus surgery. This was retrospective case series. Adrenal function was assessed by using the high-dose cosyntropin stimulation test. A total of 48 patients were assessed, with a mean duration of budesonide irrigations of 22 months. Stimulated cortisol levels were abnormally low in 11 patients (23%). None reported to have symptoms of adrenal suppression. Three of 4 patients who repeated the study being off budesonide for at least 1 month returned to near normal levels. Logistic regression analysis revealed that concomitant use of both nasal steroid sprays and pulmonary steroid inhalers was significantly associated with HPAA suppression (p = 0.024). Patients with low stimulated cortisol levels were able to continue budesonide irrigations under the supervision of an endocrinologist without frank clinical manifestations of adrenal insufficiency. IOP was within normal limits in all patients. Long-term use of budesonide nasal irrigations is generally safe, but asymptomatic HPAA suppression may occur in selected patients. Concomitant use of both nasal steroid sprays and pulmonary steroid inhalers while using daily budesonide nasal irrigations is associated with an increased risk. Rhinologists should be alerted to the potential risks of long-term use of budesonide nasal irrigations, and monitoring for HPAA suppression may be warranted in patients receiving long-term budesonide irrigation therapy. © 2016 ARS-AAOA, LLC.

  5. Effect of Deviated Nasal Septum Type on Nasal Mucociliary Clearance, Olfactory Function, Quality of Life, and Efficiency of Nasal Surgery.

    PubMed

    Berkiten, Güler; Kumral, Tolgar Lütfi; Saltürk, Ziya; Atar, Yavuz; Yildirim, Güven; Uyar, Yavuz; Aydoğdu, Imran; Arslanoğlu, Ahmet

    2016-07-01

    The aim of this study was to analyze the influence of deviated nasal septum (DNS) type on nasal mucociliary clearance, quality of life (QoL), olfactory function, and efficiency of nasal surgery (septoplasty with or without inferior turbinate reduction and partial middle turbinectomy). Fifty patients (20 females and 30 males) with septal deviation were included in the study and were divided into 6 groups according to deviation type after examination by nasal endoscopy and paranasal computed tomography. The saccharin clearance test to evaluate the nasal mucociliary clearance time, Connecticut Chemosensory Clinical Research Center smell test for olfactory function, and sinonasal outcome test-22 (SNOT-22) for patient satisfaction were applied preoperatively and postoperatively at the sixth week after surgery. Nasal mucociliary clearance, smell, and SNOT-22 scores were measured before surgery and at the sixth week following surgery. No significant difference was found in olfactory and SNOT-22 scores for any of the DNS types (both convex and concave sides) (P > 0.05). In addition, there was no difference in the saccharin clearance time (SCT) of the concave and convex sides (P > 0.05). According to the DNS type, the mean SCT of the convex sides showed no difference, but that of the concave sides showed a difference in types 3, 4, 5, and 6. These types had a prolonged SCT (P < 0.05). Olfactory scores revealed no difference postoperatively in types 5 and 6 but were decreased significantly in types 1 to 4 (P < 0.05). There was no significant difference in the healing of both the mucociliary clearance (MCC) and olfactory functions. SNOT-22 results showed a significant decrease in type 3. All DNS types disturb the QoL regarding nasal MCC and olfaction functions. MCC values, olfactory function, and QoL scores are similar among the DNS types. Both sides of the DNS types affect the MCC scores symmetrically. Septal surgery improves olfaction function and QoL at the

  6. Nasal glioma or nasal glial heterotopia? Morphological, immunohistochemical and ultrastructural study of two cases.

    PubMed

    Cerdá-Nicolás, M; Sanchez Fernandez de Sevilla, C; Lopez-Ginés, C; Peydro-Olaya, A; Llombart-Bosch, A

    2002-01-01

    The term nasal glioma has been used to describe a congenital benign tumor of the nasal region containing neural tissue. The nature of these lesions remains open to controversy, because of the different locations of the heterotopic neural tissue involved, the deficient development of the bony structures and the persistence or not of the structural relations with the central nervous system. More recent terms define these lesions as ectopic nervous tissue. A clinical, morphological, ultrastructural and immunohistochemical study is made of two cases of nasal glioma, one associated with agenesis of the corpus callosum. In this case, the mother had been treated with clomiphene. In such cases, morphological and immunohistochemical findings support that "nasal glioma" remain valid as a descriptive term defining a congenital benign tumor composed of heterotopic neural tissue within the nasal region and covered by skin, that may recur following incomplete surgical resection.

  7. Response of nasal airway and heart rate variability to controlled nasal breathing.

    PubMed

    Fan, W-H; Ko, J-H; Lee, M-J; Xu, G; Lee, Guo-She

    2011-04-01

    To investigate the responses of nasal airway and autonomic nervous system (ANS) under controlled nasal breathings. Ten healthy volunteers, aged between 21 and 37 years, were enrolled. The participants breathed either through bilateral nostrils (BNB) or unilaterally through the left nostril (UNB) at 0.25 Hz for 5 min. The electrocardiography was simultaneously recorded and the ANS activities were evaluated using heart rate variability analysis. Nasal airway resistance and related factors were measured by rhinomanometry. The results showed that the mean heartbeat interval during UNB was significantly greater than during BNB. The sympathetic modulation decreased significantly during UNB. The correlations between nasal airway resistance and mean heartbeat interval were significant for both UNB and BNB. The increase of heartbeat intervals during UNB was associated with the decrease of cardiac sympathetic activities. The changes of ANS activities and nasal airway resistance during UNB are similar to the changes caused by a prolonged lying.

  8. Effect of silicon gel sheeting in nasal injury associated with nasal CPAP in preterm infants.

    PubMed

    Günlemez, Ayla; Isken, Tonguç; Gökalp, Ayse S; Türker, Gülcan; Arisoy, Engin A

    2010-03-01

    We conducted this study to investigate the efficacy of the silicon gel application on the nares in prevention of nasal injury in preterm infants ventilated with nasal continuous positive airway pressure (NCPAP). Patients (n=179) were randomized into two groups: Group 1 (n=87) had no silicon gel applied to nares, and in Group 2 (n=92), the silicon gel sheeting was used on the surface of nares during ventilation with NCPAP. Nasal injury developed in 13 (14.9%) neonates in Group 1 and 4 (4.3%) newborns in Group 2 (OR:3.43; 95% CI: 1.1-10.1; P<0.05). The incidence of columella necrosis was also significantly higher in the Group 1 (OR: 6.34; 95% CI: 0.78-51.6; P<0.05). We conclude that the silicon gel application may reduce the incidence and the severity of nasal injury in preterm infants on nasal CPAP.

  9. Aesthetic and functional outcome following nasal reconstruction.

    PubMed

    Mureau, Marc A M; Moolenburgh, Sanne E; Levendag, Peter C; Hofer, Stefan O P

    2007-10-01

    Few reports on outcome of aesthetic nasal reconstruction exist. Therefore, subjective and objective aesthetic and functional outcome following nasal reconstruction was assessed. Outcome was assessed in 38 consecutive patients treated for subtotal nasal defects using standardized semistructured interviews. Standardized physical examination forms and photographs were used. In six patients, one aesthetic subunit was involved; in 14, two; and in 18, three or more. Defects were classified as skin only (13 percent), skin/cartilage (21 percent), and full thickness (66 percent). Some defects (32 percent) involved adjacent aesthetic units. Inner lining was reconstructed with local mucosa or turnover skin flaps. Support was provided with regional cartilage grafts and/or composite septal flaps. Skin defects were reconstructed with forehead, nasolabial, cheek advancement, Abbé, facial artery perforator, or free radial forearm flaps. Nasal reconstructions required 116 procedures. Thirty-three patients participated in the follow-up study. Mucosal crusting was noted in 36 percent, passage difficulties in 31 percent, and worse olfaction in 16 percent. Phonation was unchanged. Eighty-one percent were very satisfied with nasal function. Flap color match was moderate to good in 97 percent; hair growth occurred in 61 percent. At critical inspection, a thicker flap (58 percent), smaller ostium nasi (77 percent), thicker alar rim (86 percent), and minor alar rim retraction (46 percent) were noted. Seventy-nine percent were very satisfied with total nasal appearance. Although objective functional and aesthetic outcome following nasal reconstruction sometimes shows impairment compared with the normal situation, it gives high subjective patient satisfaction with function and aesthetics.

  10. Triclosan promotes Staphylococcus aureus nasal colonization.

    PubMed

    Syed, Adnan K; Ghosh, Sudeshna; Love, Nancy G; Boles, Blaise R

    2014-04-08

    The biocide triclosan is used in many personal care products, including toothpastes, soaps, clothing, and medical equipment. Consequently, it is present as a contaminant in the environment and has been detected in some human fluids, including serum, urine, and milk. Staphylococcus aureus is an opportunistic pathogen that colonizes the noses and throats of approximately 30% of the population. Colonization with S. aureus is known to be a risk factor for several types of infection. Here we demonstrate that triclosan is commonly found in the nasal secretions of healthy adults and the presence of triclosan trends positively with nasal colonization by S. aureus. We demonstrate that triclosan can promote the binding of S. aureus to host proteins such as collagen, fibronectin, and keratin, as well as inanimate surfaces such as plastic and glass. Lastly, triclosan-exposed rats are more susceptible to nasal colonization with S. aureus. These data reveal a novel factor that influences the ability of S. aureus to bind surfaces and alters S. aureus nasal colonization. IMPORTANCE Triclosan has been used as a biocide for over 40 years, but the broader effects that it has on the human microbiome have not been investigated. We demonstrate that triclosan is present in nasal secretions of a large portion of a test population and its presence correlates with Staphylococcus aureus nasal colonization. Triclosan also promotes the binding of S. aureus to human proteins and increases the susceptibility of rats to nasal colonization by S. aureus. These findings are significant because S. aureus colonization is a known risk factor for the development of several types of infections. Our data demonstrate the unintended consequences of unregulated triclosan use and contribute to the growing body of research demonstrating inadvertent effects of triclosan on the environment and human health.

  11. Perception of better nasal patency correlates with increases in mucosal cooling after surgery for nasal obstruction

    PubMed Central

    Sullivan, Corbin D.; Garcia, Guilherme J. M.; Frank, Dennis O.; Kimbell, Julia S.; Rhee, John S.

    2014-01-01

    Objectives 1. Quantify mucosal cooling (i.e., heat loss) spatially in the nasal passages of nasal airway obstruction (NAO) patients before and after surgery using computational fluid dynamics (CFD). 2. Correlate mucosal cooling with patient-reported symptoms, as measured by the Nasal Obstruction Symptom Evaluation (NOSE) and a visual analog scale (VAS) for sensation of nasal airflow. Study Design Prospective Setting Academic tertiary medical center. Subjects and Methods Computed tomography (CT) scans and NOSE and VAS surveys were obtained from 10 patients before and after surgery to relieve NAO. Three-dimensional models of each patient’s nasal anatomy were used to run steady-state CFD simulations of airflow and heat transfer during inspiration. Heat loss across the nasal vestibule and the entire nasal cavity, and the surface area of mucosa exposed to heat fluxes > 50 W/m2 were compared pre- and post-operatively. Results After surgery, heat loss increased significantly on the pre-operative most obstructed side (p values < 0.0002). A larger surface area of nasal mucosa was exposed to heat fluxes > 50 W/m2 after surgery. The best correlation between patient-reported and CFD measures of nasal patency was obtained for NOSE against surface area in which heat fluxes > 50 W/m2 (Pearson r = −0.76). Conclusion A significant post-operative increase in mucosal cooling correlates well with patients’ perception of better nasal patency after NAO surgery. CFD-derived heat fluxes may prove to be a valuable predictor of success in NAO surgery. PMID:24154749

  12. Non-traumatic nasal septal abscess in an immunocompetent patient.

    PubMed

    Salam, Badar; Camilleri, Andrew

    2009-12-01

    Nasal septal abscess is an uncommon condition. Most commonly it is secondary to nasal trauma, which leads to haematoma, and subsequent abscess formation. There are other less common causes like sinusitis, dental infections and furunculosis. Non-traumatic nasal septal abscess has also been reported in immunocompromised individuals. We report a case of non-traumatic, spontaneous nasal septal abscess, in a healthy immunocompetent patient with no evidence of sinusitis or other localized infections. Using Medline and Google.co.uk search applications, there has been one previous report of such a condition. We stress the importance of excluding nasal septal abscess in patients presenting with nasal obstruction especially with signs of toxaemia.

  13. Same noses, different nasalance scores: data from normal subjects and cleft palate speakers for three systems for nasalance analysis.

    PubMed

    Bressmann, Tim; Klaiman, Paula; Fischbach, Simone

    2006-01-01

    Nasalance scores from the Nasometer, the NasalView and the OroNasal System were compared. The data was collected from 50 normal participants and 19 hypernasal patients with cleft palate. The Nasometer had the lowest nasalance scores for the non-nasal Zoo Passage and that the OroNasal System had the lowest nasalance scores for the Nasal Sentences. The nasalance distance was largest for the Nasometer and smallest for the OroNasal System. When the calculation was based on nasalance magnitudes, results for sensitivity ranged from 57.9% to 81.8% and results for specificity ranged from 62.0% to 76.0%. When the calculation was based on nasalance distances, results for sensitivity ranged from 84.2% to 100.0% and results for specificity ranged from 82.0% to 100.0%. Results suggest that nasalance scores from the three systems are not interchangeable. Diagnostic efficacy improved when the calculations were based on nasalance distances rather than magnitudes, but further research is warranted to corroborate these findings.

  14. Revision of the overresected nasal tip complex.

    PubMed

    Davis, Richard E

    2012-08-01

    Tip deformities resulting from previous nasal surgery range from mild to profound. For the mild deformity, morbidity is low and successful correction is usually achieved with a modest and targeted surgical adjustment. However, for the profound deformity, overt cosmetic deformities and corresponding functional impairment are the byproducts of severe derangements in skeletal architecture. Hence, for the severely damaged nasal tip, a complex surgical revision in which the decimated nasal tip framework is reconstructed with autologous cartilage grafts is essential. However, rebuilding the decimated nasal tip is a challenging and risky procedure that is best left to the seasoned rhinoplasty specialist. Careful assessment of the previously operated tissues, combined with an accurate cosmetic analysis, must be juxtaposed with the patient's cosmetic desires to derive an individualized and effective treatment plan. Atraumatic soft tissue technique, combined with a strategic yet balanced and judicious application of graft material, often culminate in satisfactory surgical outcomes. Proper assessment, technical skill, and sound clinical judgment are all critical ingredients in successful restoration of the surgically compromise nasal tip. Copyright © 2012 by Thieme Medical Publishers, Inc.

  15. Nasal commensal Staphylococcus epidermidis counteracts influenza virus

    PubMed Central

    Chen, Hui-Wen; Liu, Pei-Feng; Liu, Yu-Tsueng; Kuo, Sherwin; Zhang, Xing-Quan; Schooley, Robert T.; Rohde, Holger; Gallo, Richard L.; Huang, Chun-Ming

    2016-01-01

    Several microbes, including Staphylococcus epidermidis (S. epidermidis), a Gram-positive bacterium, live inside the human nasal cavity as commensals. The role of these nasal commensals in host innate immunity is largely unknown, although bacterial interference in the nasal microbiome may promote ecological competition between commensal bacteria and pathogenic species. We demonstrate here that S. epidermidis culture supernatants significantly suppressed the infectivity of various influenza viruses. Using high-performance liquid chromatography together with mass spectrometry, we identified a giant extracellular matrix-binding protein (Embp) as the major component involved in the anti-influenza effect of S. epidermidis. This anti-influenza activity was abrogated when Embp was mutated, confirming that Embp is essential for S. epidermidis activity against viral infection. We also showed that both S. epidermidis bacterial particles and Embp can directly bind to influenza virus. Furthermore, the injection of a recombinant Embp fragment containing a fibronectin-binding domain into embryonated eggs increased the survival rate of virus-infected chicken embryos. For an in vivo challenge study, prior Embp intranasal inoculation in chickens suppressed the viral titres and induced the expression of antiviral cytokines in the nasal tissues. These results suggest that S. epidermidis in the nasal cavity may serve as a defence mechanism against influenza virus infection. PMID:27306590

  16. Nasal Involvement in Obstructive Sleep Apnea Syndrome

    PubMed Central

    Michels, Daniel de Sousa; Rodrigues, Amanda da Mota Silveira; Nakanishi, Márcio; Sampaio, André Luiz Lopes; Venosa, Alessandra Ramos

    2014-01-01

    Numerous studies have reported an association between nasal obstruction and obstructive sleep apnea syndrome (OSAS), but the precise nature of this relationship remains to be clarified. This paper aimed to summarize data and theories on the role of the nose in the pathophysiology of sleep apnea as well as to discuss the benefits of surgical and medical nasal treatments. A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in OSAS. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex, and the role of nitric oxide (NO). Pharmacological treatment presents some beneficial effects on the frequency of respiratory events and sleep architecture. Nonetheless, objective data assessing snoring and daytime sleepiness are still necessary. Nasal surgery can improve the quality of life and snoring in a select group of patients with mild OSAS and septal deviation but is not an effective treatment for OSA as such. Despite the conflicting results in the literature, it is important that patients who are not perfectly adapted to CPAP are evaluated in detail, in order to identify whether there are obstructive factors that could be surgically corrected. PMID:25548569

  17. Nasonasal reflexes, the nasal cycle, and sneeze.

    PubMed

    Baraniuk, James N; Kim, Dennis

    2007-05-01

    The nasal mucosa is a complex tissue that interacts with its environment and effects local and systemic changes. Receptors in the nose receive signals from stimuli, and respond locally through afferent, nociceptive, type C neurons to elicit nasonasal reflex responses mediated via cholinergic neurons. This efferent limb leads to responses in the nose (eg, rhinorrhea, glandular hyperplasia, hypersecretion with mucosal swelling). Anticholinergic agents appear useful against this limb for symptomatic relief of a "runny nose." Chronic exposure to allergens can lead to hyperresponsiveness of the nasal mucosa. As a result, receptors upregulate specific ion channels to increase the sensitivity and potency of their reflex response. Nasal stimuli also affect distant parts of the body. Nerves in the sinus mucosa cause vasodilation; the lacrimal glands can be stimulated by nasal afferent triggers. Even the cardiopulmonary system can be affected via the trigeminal chemosensory system, where sensed irritants can lead to changes in tidal volume, respiratory rate, and blink frequency. The sneeze is an airway defense mechanism that removes irritants from the nasal epithelial surface. It is generally benign, but can lead to problems in certain circumstances. The afferent pathway involves histamine-mediated depolarization of H1 receptor-bearing type C trigeminal neurons and a complex coordination of reactions to effect a response.

  18. Corrective Septorhinoplasty in Acute Nasal Bone Fractures.

    PubMed

    Kim, Jisung; Jung, Hahn Jin; Shim, Woo Sub

    2017-06-13

    Closed reduction is generally recommended for acute nasal bone fractures, and rhinoplasty is considered in cases with an unsatisfactory outcome. However, concomitant rhinoplasty with fracture reduction might achieve better surgical outcomes. This study investigated the surgical techniques and outcomes in patients who underwent rhinoplasty and fracture reduction concomitantly, during the acute stage of nasal bone fracture. Forty-five patients who underwent concomitant rhinoplasty and fracture reduction were enrolled. Nasal bone fractures were classified into 3 major types (type I, simple fracture; type II, fracture line that mimics nasal osteotomy; and type III, comminuted fracture) based on computed tomography images and preoperative facial images. Two independent otolaryngology-head and neck surgeons evaluated the surgical outcomes and telephone based survey were made to evaluate patients satisfaction. Among 45 patients, there were 39 males and 6 females. Type I was the commonest type of fracture with 18 patients (40%), while the most frequently used surgical technique for corrective surgery was dorsal augmentation with 44 patients (97.8%). The mean visual analogue scale satisfaction score of the surgeons and patients were 7.62 and 8, respectively, with no significant differences between fracture types. Concomitant rhinoplasty with fracture reduction can be performed for acute nasal bone fracture patients, and it might lead to better aesthetic outcomes.

  19. Nasal commensal Staphylococcus epidermidis counteracts influenza virus.

    PubMed

    Chen, Hui-Wen; Liu, Pei-Feng; Liu, Yu-Tsueng; Kuo, Sherwin; Zhang, Xing-Quan; Schooley, Robert T; Rohde, Holger; Gallo, Richard L; Huang, Chun-Ming

    2016-06-16

    Several microbes, including Staphylococcus epidermidis (S. epidermidis), a Gram-positive bacterium, live inside the human nasal cavity as commensals. The role of these nasal commensals in host innate immunity is largely unknown, although bacterial interference in the nasal microbiome may promote ecological competition between commensal bacteria and pathogenic species. We demonstrate here that S. epidermidis culture supernatants significantly suppressed the infectivity of various influenza viruses. Using high-performance liquid chromatography together with mass spectrometry, we identified a giant extracellular matrix-binding protein (Embp) as the major component involved in the anti-influenza effect of S. epidermidis. This anti-influenza activity was abrogated when Embp was mutated, confirming that Embp is essential for S. epidermidis activity against viral infection. We also showed that both S. epidermidis bacterial particles and Embp can directly bind to influenza virus. Furthermore, the injection of a recombinant Embp fragment containing a fibronectin-binding domain into embryonated eggs increased the survival rate of virus-infected chicken embryos. For an in vivo challenge study, prior Embp intranasal inoculation in chickens suppressed the viral titres and induced the expression of antiviral cytokines in the nasal tissues. These results suggest that S. epidermidis in the nasal cavity may serve as a defence mechanism against influenza virus infection.

  20. [Effect of the external nasal dilator breathe right and nasal cycle influence].

    PubMed

    Yoshinami, Hiroyoshi; Takegoshi, Hideki; Kikuchi, Shigeru; Iinuma, Toshitaka

    2005-11-01

    The external nasal dilator Breathe Right is a nonprescription disposable mechanical device worn over the bridge of the nose that supports the outer walls of the nasal vestibule to increase cross-sectional nasal valve area and enhance air flow through the nose. When worn, the device applies a gentle outward pull to the outside walls of the nasal vestibule that helps prevent collapse of the lateral walls of the nasal vestibule. The device appears similar to an adhesive bandage with two polyester springs attached lengthwise to the nonadhesive side of the backing material. The form of the external nose varies significantly between racial groups and some comment is possible about the form of the nasal valve, i.e., Caucasian noses are leptorrhine, Negroid noses platyrrhine, and Oriental noses intermediate. A question exists about whether Breathe Right is as effective in Japanese as in Caucasians against nasal obstruction. We measured the effect by acoustic rhinometry in 35 healthy subjects. We measured 2 cross-sectional areas-the I-notch and C-notch-and 3 nasal volumes-V(0-1), from 0 to 1 cm corresponding to the I-notch, V(1-3), from 1 to 3cm corresponding to the C notch, and V (3-6), from 3 to 6cm. We studied the influence of the nasal cycle on the effect of Breathe Right in the nasal cavity. We evaluated subjects in a stable sitting position before applying Breathe Right, after using 5 minutes, and in a free interval of 25 minutes following. The experiment was repeated 10 times. We found that Breathe Right increases the nasal volume especially in V(1-3) and the cross-sectional area especially in the C-notch. Interestingly, the change in the C-notch decreased gradually with time. One possible mechanism may be the change in compliance between the skin under the Breathe Right and the nasal mucous membrane. The nasal cycle did not significantly influence the effect of Breathe Right.

  1. What's New in Nasal Cavity and Paranasal Sinus Cancer Research and Treatment?

    MedlinePlus

    ... About Nasal Cavity and Paranasal Sinus Cancer What’s New in Nasal Cavity and Paranasal Sinus Cancer Research ... About Nasal Cavity and Paranasal Sinus Cancers? What’s New in Nasal Cavity and Paranasal Sinus Cancer Research ...

  2. Expression of survivin and enhanced polypogenesis in nasal polyps.

    PubMed

    Qiu, Zhe-Fu; Han, De-Min; Zhang, Luo; Zhang, Wei; Fan, Er-Zhong; Cui, Shun-Jiu; Huang, Qian; Wang, Xiang-Dong

    2008-01-01

    The pathogenesis of nasal polyps still is not clear. This disease is believed to be inflammation related. Previous research has indicated that apoptosis in inflammatory cells is an important factor in the resolution of inflammation. Survivin is regarded as a novel member of the group of inhibitors of apoptosis proteins. It is overexpressed in a number of tumor types. The objective of this study was to investigate the expression of the survivin gene in human nasal polyps. We investigated the expression of survivin in nasal polyps of adult patients with chronic rhinosinusitis. Specimens of nasal polyps were harvested during endonasal sinus surgery (n=22), and the normal mucosa surrounding the nasal polyp tissues or inferior turbinate tissues served as control (n=7). Immunohistochemical staining, reverse transcription polymerase chain reaction (RT-PCR), and Western blotting were performed for detecting the expression of survivin in the nasal polyps. This study has clearly shown that immunoreactivity of survivin significantly increased in the nasal polyp compared with nasal mucosa specimens surrounding nasal polyps (p<0.001). The higher expression of survivin Western blotting and RT-PCR also was observed in the nasal polyp but not in normal nasal mucosa. With a markedly increased expression of survivin in nasal polyps at both the mRNA and the protein levels, we believe the elevated expression of survivin might play an important role of development in nasal polyps.

  3. Facial Artery Musculomucosal (FAMM) flap for nasal lining in reconstruction of large full thickness lateral nasal defects.

    PubMed

    Rahpeyma, Amin; Khajehahmadi, Saeedeh

    2015-12-01

    Obviously, restoring the nasal lining is a great challenge in the reconstruction of nasal defects. Full thickness nasal defects usually require special flaps for reconstructing the nasal lining. Intranasal mucosal flaps, hinge over flaps, perinasal second flaps, folded or second forehead flaps and finally free flaps are examples that can be used for this purpose. Moreover, the case presented in this article expresses a new role for the superiorly based Facial Artery Musculomucosal (FAMM) flap in this topic. Furthermore, mucosal island variant of this flap is presented to reduce the tension on this flap while restoring the nasal lining in large full thickness nasal defect.

  4. Staphylococcus aureus nasal colonization in a nursing home: eradication with mupirocin.

    PubMed

    Cederna, J E; Terpenning, M S; Ensberg, M; Bradley, S F; Kauffman, C A

    1990-01-01

    Recent reports have emphasized an increase in both infection and colonization with methicillin-resistant Staphylococcus aureus (MRSA) in institutionalized older patients. We studied whether or not local treatment with mupirocin ointment could eliminate nasal colonization with S aureus. A total of 102 patients in a Veterans Administration nursing home were screened for S aureus nasal colonization. Thirty-nine patients (38.2%) were colonized, 18 with methicillin-sensitive Saureus (MSSA) and 21 with MRSA. Almost half of all colonized patients were in the most dependent functional category and there was a significant association of MRSA colonization, but not MSSA colonization, with poor functional status. Colonized patients were treated with mupirocin ointment applied to the anterior nares twice daily for seven days. After treatment, MSSA persisted in only two patients and MRSA in only one patient; thus, nasal colonization was eliminated in 91.4% of colonized patients. At one month and two months follow-up, 11 patients became transiently recolonized and three became persistently recolonized with S aureus. Mupirocin was well tolerated with no side effects noted. Mupirocin ointment may be useful in controlling nasal colonization with S aureus in the nursing home setting.

  5. Assessment of Patients Who Underwent Nasal Reconstruction After Non-Melanoma Skin Cancer Excision.

    PubMed

    Uzun, Hakan; Bitik, Ozan; Kamburoğlu, Haldun Onuralp; Dadaci, Mehmet; Çaliş, Mert; Öcal, Engin

    2015-06-01

    Basal and squamous cell carcinomas are the most common malignant cutaneous lesions affecting the nose. With the rising incidence of skin cancers, plastic surgeons increasingly face nasal reconstruction challenges. Although multiple options exist, optimal results are obtained when "like is used to repair like". We aimed to introduce a simple algorithm for the reconstruction of nasal defects with local flaps, realizing that there is always more than one option for reconstruction. We retrospectively reviewed 163 patients who underwent nasal reconstruction after excision of non-melanoma skin cancer between March 2011 and April 2014. We analyzed the location of the defects and correlated them with the techniques used to reconstruct them. There were 66 males and 97 females (age, 21-98 years). Basal cell carcinoma was diagnosed in 121 patients and squamous cell carcinoma in 42. After tumor excision, all the defects were immediately closed by either primary closure or local flap options such as Limberg, Miter, glabellar, bilobed, nasolabial, V-Y advancement, and forehead flaps. Obtaining tumor-free borders and a pleasing aesthetic result are major concerns in nasal reconstruction. Defect reconstruction and cosmesis are as important as rapid recovery and quick return to normal daily activities, and these should be considered before performing any procedure, particularly in elderly patients.

  6. Humming greatly increases nasal nitric oxide.

    PubMed

    Weitzberg, Eddie; Lundberg, Jon O N

    2002-07-15

    The paranasal sinuses are major producers of nitric oxide (NO). We hypothesized that oscillating airflow produced by humming would enhance sinus ventilation and thereby increase nasal NO levels. Ten healthy subjects took part in the study. Nasal NO was measured with a chemiluminescence technique during humming and quiet single-breath exhalations at a fixed flow rate. NO increased 15-fold during humming compared with quiet exhalation. In a two-compartment model of the nose and sinus, oscillating airflow caused a dramatic increase in gas exchange between the cavities. Obstruction of the sinus ostium is a central event in the pathogenesis of sinusitis. Nasal NO measurements during humming may be a useful noninvasive test of sinus NO production and ostial patency. In addition, any therapeutic effects of the improved sinus ventilation caused by humming should be investigated.

  7. Nasal lift-nasal valve lift and nasal tip lift-preliminary results of a new technique using noninvasive self-retaining unidirectional nasal suspension with threads.

    PubMed

    Saban, Yves; Javier, De Benito; Massa, Michela

    2014-12-01

    In the context of nasal obstruction treatment, an alternative, no invasive technique is described. It consists in the suspension of the nasal valve or in the association of the suspension of the valve and rotation of the tip, through the placement of one or two absorbable threads, already known in aesthetic medicine. This technique allows to open the nasal valve and to correct the moderate closure of the nasolabial angle obtaining an immediate benefit of breathing. Functional improvement has been evaluated at regular intervals, that is, 1, 3, 6, and 12 months and then provided for every 6 months, through the use of a visual scale of 0/10 to 10/10. In our experience, the technique allows to obtain satisfactory results, avoiding more invasive techniques and postoperative recovery days.

  8. [Nasal mucosa in patients with diabetes mellitus].

    PubMed

    Müller, Maciej; Betlejewski, Stanisław

    2003-01-01

    Diabetes mellitus is the most common endocrinologic disease all over the world. 150 million people suffer from this disease, in Poland about 2 million. The disease on the basis of the onset and pathophysiology may be divided into type I and type II. Pathophysiologic changes include diabetic microangiopathy, macroangiopathy and neuropathy. The most common presentations in head and neck are otitis externa, hypoacusis, vertigo, disequilibrium, xerostomia, dysphagia, fungal and recurrent infections. The changes in nasal mucosa are not very well known. Only few papers concerned the problem. The main complaints of patients regarding the nose are xeromycteria, hyposmia and various degree of decreased patency of the nose. Chronic atrophic rhinitis, septal perforation, ulceration of nasal mucosa, alar necrosis, symptoms of staphylococcal or fungal infection can be found during otolaryngologic examination. The treatment in this group of patients should consist of systemic therapy of diabetes mellitus and on the other hand focal therapy with the use of a solution to moisten the nasal mucosa.

  9. [Complications and sequelae after nasal trauma].

    PubMed

    Calderón, R; Miralles, G; Rodríguez Urcelay, P; Berenguer, B; González Meli, B; Enríquez de Salamanca, J; Cervera, J

    2007-04-01

    Septal haematoma after nasal trauma is a complication that can lead to septal abscess if unrecognized or early intervention is not performed. It can cause compression and thereby necrosis that evolve to a septal abscess in which cultures reveal saprophyte bacteria. Cartilage necrosis and destruction can produce impaired breathing and aesthetic deformities with collapse of the dorsum and the tip of the nose. We present a 10 year old masculine infant, that suffered a nasal fracture with a septal haematoma that remained undiagnosed. The patient developed a septal abscess that required drainage and resulted in nasal sequelae with collapse of dorsum and cranial displacement of tip and columella. Functional and aesthetic reconstruction was performed using rib cartilage grafts. No complications occurred. Functional and aesthetic improvement was observed. Result after 2 months of follow-up is considered favourable.

  10. Comparison of functional results after ethmoidectomy and nasalization for diffuse and severe nasal polyposis.

    PubMed

    Jankowski, R; Pigret, D; Decroocq, F

    1997-07-01

    Taking advantage of a natural experimental situation, we compared, retrospectively, functional results after nasalization and ethmoidectomy for diffuse nasal polyposis. Nasalization was a radical ethmoidectomy systematically removing all the bony lamellae and mucosa within the labyrinth, with large antrostomy, sphenoidotomy, frontotomy, and middle turbinectomy (Surgeon 1, 39 consecutive patients operated on between March and September 1991). Ethmoidectomy was a less systematic procedure, that was adapted to the extent of the pathology (Surgeon 2, 37 consecutive patients, operated on between October 1991 and November 1994). In May 1994, a third physician mailed a questionnaire simultaneously to all patients including 10-point visual analog scales 34/39 patients in the nasalization group (age: 28-71 years: 20 asthmatics; follow-up: 32-36 months), and 29/37 patients in the ethmoidectomy group (age: 26-65 years: 9 asthmatics: follow-up: 18-31 months) participated in the study. The overall nasal improvement was 8.8 +/- 0.2 (mean +/- SEM) after nasalization and 5.9 +/- 0.6 after ethmoidectomy (p = 0.0001). Olfaction improvement was similar in both groups 6 months after surgery, remained at the same level 36 months after nasalization (6.9 +/- 0.7), but decreased to 4.2 +/- 1 points 24 months after ethmoidectomy (p = 0.02). Asthma improvement remained significantly better after nasalization (p = 0.05), and the need for systemic steroids was also lower (p = 0.03). Results of this study suggest that when dealing with nasal polyposis, the more radical the surgery, the better the functional results.

  11. Measuring and Characterizing the Human Nasal Cycle

    PubMed Central

    Kahana-Zweig, Roni; Geva-Sagiv, Maya; Weissbrod, Aharon; Secundo, Lavi; Soroker, Nachum; Sobel, Noam

    2016-01-01

    Nasal airflow is greater in one nostril than in the other because of transient asymmetric nasal passage obstruction by erectile tissue. The extent of obstruction alternates across nostrils with periodicity referred to as the nasal cycle. The nasal cycle is related to autonomic arousal and is indicative of asymmetry in brain function. Moreover, alterations in nasal cycle periodicity have been linked to various diseases. There is therefore need for a tool allowing continuous accurate measurement and recording of airflow in each nostril separately. Here we provide detailed instructions for constructing such a tool at minimal cost and effort. We demonstrate application of the tool in 33 right-handed healthy subjects, and derive several statistical measures for nasal cycle characterization. Using these measures applied to 24-hour recordings we observed that: 1: subjects spent slightly longer in left over right nostril dominance (left = 2.63 ± 0.89 hours, right = 2.17 ± 0.89 hours, t(32) = 2.07, p < 0.05), 2: cycle duration was shorter in wake than in sleep (wake = 2.02 ± 1.7 hours, sleep = 4.5 ± 1.7 hours, (t(30) = 5.73, p < 0.0001). 3: slower breathing was associated with a more powerful cycle (the extent of difference across nostrils) (r = 0.4, p < 0.0001), and 4: the cycle was influenced by body posture such that lying on one side was associated with greater flow in the contralateral nostril (p < 0.002). Finally, we provide evidence for an airflow cycle in each nostril alone. These results provide characterization of an easily obtained measure that may have diagnostic implications for neurological disease and cognitive state. PMID:27711189

  12. Measuring and Characterizing the Human Nasal Cycle.

    PubMed

    Kahana-Zweig, Roni; Geva-Sagiv, Maya; Weissbrod, Aharon; Secundo, Lavi; Soroker, Nachum; Sobel, Noam

    2016-01-01

    Nasal airflow is greater in one nostril than in the other because of transient asymmetric nasal passage obstruction by erectile tissue. The extent of obstruction alternates across nostrils with periodicity referred to as the nasal cycle. The nasal cycle is related to autonomic arousal and is indicative of asymmetry in brain function. Moreover, alterations in nasal cycle periodicity have been linked to various diseases. There is therefore need for a tool allowing continuous accurate measurement and recording of airflow in each nostril separately. Here we provide detailed instructions for constructing such a tool at minimal cost and effort. We demonstrate application of the tool in 33 right-handed healthy subjects, and derive several statistical measures for nasal cycle characterization. Using these measures applied to 24-hour recordings we observed that: 1: subjects spent slightly longer in left over right nostril dominance (left = 2.63 ± 0.89 hours, right = 2.17 ± 0.89 hours, t(32) = 2.07, p < 0.05), 2: cycle duration was shorter in wake than in sleep (wake = 2.02 ± 1.7 hours, sleep = 4.5 ± 1.7 hours, (t(30) = 5.73, p < 0.0001). 3: slower breathing was associated with a more powerful cycle (the extent of difference across nostrils) (r = 0.4, p < 0.0001), and 4: the cycle was influenced by body posture such that lying on one side was associated with greater flow in the contralateral nostril (p < 0.002). Finally, we provide evidence for an airflow cycle in each nostril alone. These results provide characterization of an easily obtained measure that may have diagnostic implications for neurological disease and cognitive state.

  13. Desloratadine for the Relief of Nasal and Non-nasal Allergy Symptoms: An Observational Study.

    PubMed

    Aberer, Werner

    2009-06-01

    INTRODUCTION: The rates of allergic rhinitis, allergic asthma, and atopic eczema range from 6% to 16% globally. Second-generation antihistamines have been shown to be safe and effective for the treatment of symptoms of allergic disease. This study investigated the efficacy and safety of desloratadine, a nonsedating second-generation antihistamine, in the treatment of common allergy symptoms. METHODS: In this open-label, uncontrolled, non-randomized, observational study, subjects (N = 973) with allergy symptoms were given desloratadine 5 mg daily for 3 weeks. Nasal, ocular, and dermal symptom severity was rated as asymptomatic, mild, moderate, or severe; changes in the percentage of subjects in each severity category were assessed. Overall efficacy and tolerability of desloratadine treatment were evaluated separately by physicians and subjects. RESULTS: Allergic rhinitis was the most frequent diagnosis, occurring in 59.0% of subjects. Approximately 40% of subjects had received previous treatment with other antihistamines, systemic/topical glucocorticosteroids, or beta-sympathicomimetics. Slightly more than half of subjects received concomitant medication during the study; 263 (53.0%) of those used intranasal steroids. A significant reduction in severity scores was observed in all symptom subgroups (P < 0.001). Desloratadine efficacy was judged to be excellent or good by 90.2% of physicians and 88.6% of subjects; 82.5% of investigators and 80.9% of subjects considered it more effective than previous therapy. The tolerability of desloratadine was rated excellent or good by 97.0% of both groups. Thirty-one subjects (3.2%) experienced adverse events. CONCLUSIONS: In an open-label, uncontrolled, non-randomized, observational study allergy symptoms improved significantly in subjects treated with desloratadine.

  14. Bilateral Nasoalveolar Cyst Causing Nasal Obstruction

    PubMed Central

    Yildizoglu, Uzeyir; Polat, Bahtiyar; Durmaz, Abdullah

    2016-01-01

    Nasoalveolar cysts, which originate from epithelial remnants of nasolacrimal duct, are nonodontogenic soft tissue lesions of the upper jaw. These cysts are thought to be developmental and are presented with fullness in the upper lip and nose, swelling on the palate, and sometimes nasal obstruction. Because of cosmetic problems, they are often diagnosed at an early stage. These lesions are mostly revealed unilaterally but also can be seen on both sides. In this case report, a patient who complained of nasal obstruction and then diagnosed with bilateral nasoalveolar cysts and treated by sublabial excision is presented and clinical features and treatment approaches are discussed with the review of literature. PMID:27980871

  15. A grading system for nasal dorsal deformities.

    PubMed

    Kienstra, Matthew A; Gassner, Holger G; Sherris, David A; Kern, Eugene B

    2003-01-01

    There is no uniform grading system for nasal dorsal deformities currently in general use among surgeons who perform rhinoplasty. Given the popularity of this procedure among both the general public and surgeons, it is time that there was a uniform system describing dorsal deformities. Such a system has value in the education of students of rhinology and cosmetic nasal surgery. We have developed one such system, and applied it to 100 cases. In all cases it accurately describes the major pathological conditions of the dorsum, if present, as noted on physical examination. We have found application of this system to be facile.

  16. Nasalance scores for normal Korean-speaking adults and children.

    PubMed

    Park, Mikyong; Baek, William S; Lee, Eunkyung; Koh, Kyung S; Kim, Baek-Kyu; Baek, Rongmin

    2014-02-01

    There are numerous nasometric studies to date, including normative nasalance scores for various languages as well as nasometric differences in age, gender, race and region except the Korean language. In this regard, we sought to establish normative nasalance scores for Koreans. We created speech samples based on the everyday use of phonemes in the Korean language which were syntactically simple for children. In addition, we analysed nasometric features based on age and gender and confirmed test-retest reliability. The study included 108 children (54 girls and 54 boys, aged 7-11 years) and 108 adults (54 women and 54 men, aged 18-29 years) with normal articulation, resonance, voice and hearing. Nasometer II 6400 was used to measure the nasalance scores. The subjects read or repeated three speech stimuli, each consisting of 33, 36 and 24 syllables: (1) an oral passage devoid of nasal consonants, (2) an oro-nasal passage and (3) nasal sentences. For each stimulus, mean nasalance scores were obtained and gender or age dependence was analysed, using two-way analyses of variance. The mean nasalance scores for the oral passage, oro-nasal passage and nasal sentences were 11.69% (standard deviation (SD) 3.68), 34.04% (SD 4.88) and 63.72% (SD 6.07), respectively. Female speakers exhibited significantly higher nasalance scores than male speakers on the oro-nasal passage (p = 0.000) and nasal sentences (p = 0.004). Children exhibited significantly higher nasalance scores than adults on nasal sentences (p = 0.000). The nasalance scores in children and females were a little higher. Korean normative data will provide reference information in the evaluation and treatment of resonance problems. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Tips for Daily Living

    MedlinePlus

    ... Tips and Gadgets for Daily Activities Dressing Tips Shopping Tips Modifying the Bathroom Driving After Stroke Medication ... and resources. Find a group in your area . Online Support If there is not a support group ...

  18. NORMAL NASAL GENE EXPRESSION LEVELS USING CDNA ARRAY TECHNOLOGY

    EPA Science Inventory

    Normal Nasal Gene Expression Levels Using cDNA Array Technology.

    The nasal epithelium is a target site for chemically-induced toxicity and carcinogenicity. To detect and analyze genetic events which contribute to nasal tumor development, we first defined the gene expressi...

  19. Underlying Phoneme Velar Nasal with Lip Rounding in Hueyapan Nahuatl

    ERIC Educational Resources Information Center

    Campbell, R. Joe

    1976-01-01

    Reasons are given for the idea that Hueyapan (Morelos) Nahuatl has an underlying velar nasal with lip rounding phoneme which never has the surface reflex of a rounded velar nasal allophone, but occurs phonetically as a velar nasal allophone or a labial dental voiced allophone or disappears. (SCC)

  20. Hypoxia depresses nitric oxide output in the human nasal airways.

    PubMed

    Haight, J S; Qian, W; Daya, H; Chalmers, P; Zamel, N

    2000-03-01

    The role of oxygen in the nasal air on nasal nitric oxide (NO) output was studied in 13 adult volunteers. Nasal NO was measured while air containing oxygen (0%-100% in nitrogen) was aspirated through the nasal airway before and after the topical application of xylometazoline. The mean nasal NO output of the untreated nose was 507.8 +/- 161.9 nL/min (mean +/- SD) when 21% oxygen was aspirated through the nasal cavities in series and remained unaltered by 100% O2 (P = .79). Below 10% oxygen the reduction in nasal NO output correlated positively and significantly with the decrease in oxygen concentration (r2 = 0.14). NO output was 245.2 +/- 153.4 nL/min at 0% oxygen, a significant decline from 21% oxygen (P < .0001). Nasal vasoconstriction induced by xylometazoline and alterations in the blood oxygen content by a maximal breath-holding or breathing 100% oxygen did not alter nasal NO in hypoxia (P = .41). Nasal NO output is markedly depressed in hypoxia and is oxygen dependent at concentrations of less than 10%. Approximately 50% of nasally generated NO is produced from oxygen in nasal air or regulated by it.

  1. NORMAL NASAL GENE EXPRESSION LEVELS USING CDNA ARRAY TECHNOLOGY

    EPA Science Inventory

    Normal Nasal Gene Expression Levels Using cDNA Array Technology.

    The nasal epithelium is a target site for chemically-induced toxicity and carcinogenicity. To detect and analyze genetic events which contribute to nasal tumor development, we first defined the gene expressi...

  2. 21 CFR 868.5350 - Nasal oxygen catheter.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  3. 21 CFR 868.5350 - Nasal oxygen catheter.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  4. 21 CFR 868.5340 - Nasal oxygen cannula.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasal oxygen cannula. 868.5340 Section 868.5340...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5340 Nasal oxygen cannula. (a) Identification. A nasal oxygen cannula is a two-pronged device used to administer oxygen to a patient...

  5. 21 CFR 868.5350 - Nasal oxygen catheter.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  6. 21 CFR 868.5340 - Nasal oxygen cannula.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Nasal oxygen cannula. 868.5340 Section 868.5340...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5340 Nasal oxygen cannula. (a) Identification. A nasal oxygen cannula is a two-pronged device used to administer oxygen to a patient...

  7. 21 CFR 868.5340 - Nasal oxygen cannula.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Nasal oxygen cannula. 868.5340 Section 868.5340...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5340 Nasal oxygen cannula. (a) Identification. A nasal oxygen cannula is a two-pronged device used to administer oxygen to a patient...

  8. 21 CFR 868.5340 - Nasal oxygen cannula.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Nasal oxygen cannula. 868.5340 Section 868.5340...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5340 Nasal oxygen cannula. (a) Identification. A nasal oxygen cannula is a two-pronged device used to administer oxygen to a patient...

  9. 21 CFR 868.5340 - Nasal oxygen cannula.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nasal oxygen cannula. 868.5340 Section 868.5340...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5340 Nasal oxygen cannula. (a) Identification. A nasal oxygen cannula is a two-pronged device used to administer oxygen to a patient...

  10. 21 CFR 868.5350 - Nasal oxygen catheter.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  11. 21 CFR 868.5350 - Nasal oxygen catheter.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Nasal oxygen catheter. 868.5350 Section 868.5350...) MEDICAL DEVICES ANESTHESIOLOGY DEVICES Therapeutic Devices § 868.5350 Nasal oxygen catheter. (a) Identification. A nasal oxygen catheter is a device intended to be inserted through a patient's nostril...

  12. 21 CFR 874.5800 - External nasal splint.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a) Identification. An external nasal splint is a rigid or partially rigid device intended for use externally for... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External nasal splint. 874.5800 Section...

  13. 21 CFR 874.5800 - External nasal splint.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint. (a) Identification. An external nasal splint is a rigid or partially rigid device intended for use externally for... 21 Food and Drugs 8 2011-04-01 2011-04-01 false External nasal splint. 874.5800 Section...

  14. Older individuals have increased oro-nasal breathing during sleep.

    PubMed

    Madronio, M R; Di Somma, E; Stavrinou, R; Kirkness, J P; Goldfinch, E; Wheatley, J R; Amis, T C

    2004-07-01

    Breathing route during sleep has been studied very little, however, it has potential importance in the pathophysiology of sleep disordered breathing. Using overnight polysomnography, with separate nasal and oral thermocouple probes, data were obtained from 41 subjects (snorers and nonsnorers; 25 male and 16 female; aged 20-66 yrs). Awake, upright, inspiratory nasal resistance (Rn) was measured using posterior rhinomanometry. Each 30-s sleep epoch (not affected by apnoeas/hypopnoeas) was scored for presence of nasal and/or oral breathing. Overnight, seven subjects breathed nasally, one subject oro-nasally and the remainder switched between nasal and oro-nasal breathing. Oral-only breathing rarely occurred. Nasal breathing epochs were 55.79 (69.78) per cent of total sleep epochs (%TSE; median (interquartile range)), a value not significantly different to that for oro-nasal (TSE: 44.21 (68.66)%). Oro-nasal breathing was not related to snoring, sleep stage, posture, body mass index, height, weight, Rn (2.19 (1.77) cm H2O x L(-1) x sec(-1)) or sex, but was positively associated with age. Subjects > or = 40 yrs were approximately six times more likely than younger subjects to spend >50% of sleep epochs utilising oro-nasal breathing. Ageing is associated with an increasing occurrence of oro-nasal breathing during sleep.

  15. Extradural frontal abscess complicating nasal septal abscess in a child.

    PubMed

    Thomson, C J; Berkowitz, R G

    1998-10-02

    Nasal septal abscess (NSA) is an uncommon sequel to minor nasal trauma. Abscess extension beyond the nasal cavity is rarely documented. A case of a 10-year-old boy who presented with a NSA associated with a large extradural frontal abscess is presented and indications for CT scanning in the workup of pediatric patients with NSA is discussed.

  16. Underlying Phoneme Velar Nasal with Lip Rounding in Hueyapan Nahuatl

    ERIC Educational Resources Information Center

    Campbell, R. Joe

    1976-01-01

    Reasons are given for the idea that Hueyapan (Morelos) Nahuatl has an underlying velar nasal with lip rounding phoneme which never has the surface reflex of a rounded velar nasal allophone, but occurs phonetically as a velar nasal allophone or a labial dental voiced allophone or disappears. (SCC)

  17. Nasal bots...a fascinating world!

    PubMed

    Angulo-Valadez, Carlos E; Scholl, Philip J; Cepeda-Palacios, Ramón; Jacquiet, Philippe; Dorchies, Philippe

    2010-11-24

    Larvae causing obligatory myiasis are numerous and they may affect cutaneous and subcutaneous tissues, wounds, nasopharyngeal cavities (nasal bots), internal organs and the digestive tract (bots) of domestic and wild animals and humans as well. Nasal bots belong to the Family Oestridae, Subfamily Oestrinae, which includes several important genera: Oestrus, Kirkioestrus, and Gedoelstia infecting Artiodactyla (except Cervidae) in Africa and Eurasia, Cephenemyia and Pharyngomyia infecting Cervidae, Rhinoestrus infecting horses, Cephalopina infecting camels, Pharyngobolus infecting African elephants, and Tracheomyia infecting Australian kangaroos. Nasal bots are widespread in Mediterranean and tropical areas and in affected animals they induce sneezing and nasal discharge which may become caked with dust making breathing very difficult. The aforementioned species of larvae are host-specific but sometimes the may be deposited in human eyes inducing a painful opthalmomyiasis of short duration. The first fascinating trait of these parasites is the very efficient morphological and biological adaptations to parasitism they show either as larvae or as adults, in order to facilitate their survival and search for a suitable host. Nasal bots have reached different degrees of complexity in their life cycles. Indeed, while for some species (e.g., Oestrus ovis, Rhinoestrus usbekistanicus) larvae are injected by flies directly into nostrils and develop in the sinuses before being ejected for external pupation, some other species migrate from eyes to blood before returning to nasal cavities either through the ethmoid bone (Gedoelstia hässleri) or via lungs and bronchi (Gedoelstia cristata). Moreover, larvae are very well-adapted to their environment being able to undergo through hypobiosis either inside or outside the host, according to the climatic environmental conditions and seasonality. The second fascinating trait of nasal bots is related to host behavioural and immune

  18. Nasal ventilation is more effective than combined oral-nasal ventilation during induction of general anesthesia in adult subjects.

    PubMed

    Liang, Yafen; Kimball, William R; Kacmarek, Robert M; Zapol, Warren M; Jiang, Yandong

    2008-06-01

    The authors hypothesized that nasal mask ventilation may be more effective than combined oral-nasal mask ventilation during induction of general anesthesia. They tested this hypothesis by comparing the volume of carbon dioxide removed per breath with nasal versus combined oral-nasal mask ventilation in nonparalyzed, apneic, adult subjects during induction of general anesthesia. Fifteen adult subjects receiving general anesthesia were ventilated first with a combined oral-nasal mask and then with only a nasal mask. The patient's head was maintained in a neutral position, without head extension or lower jaw thrust. Respiratory parameters were recorded simultaneously from both the nasal and oral masks regardless of ventilation approach. The volume of carbon dioxide removed per breath during nasal mask ventilation (median, 5.0 ml; interquartile range, 3.4-8.8 ml) was significantly larger than that during combined oral-nasal mask ventilation (median, 0.0 ml; interquartile range, 0.0-0.4 ml; P = 0.001); even the peak inspiratory airway pressure during nasal ventilation (16.7 +/- 2.7 cm H2O) was lower than that during combined oral-nasal ventilation (24.5 +/- 4.7 cm H2O; P = 0.002). The expiratory tidal volume during nasal ventilation (259.8 +/- 134.2 ml) was also larger than that during combined oral-nasal ventilation (98.9 +/- 103.4 ml; P = 0.003). Nasal mask ventilation was more effective than combined oral-nasal mask ventilation in apneic, nonparalyzed, adult subjects during induction of general anesthesia. The authors suggest that nasal mask ventilation, rather than full facemask ventilation, be considered during induction of anesthesia.

  19. Ocular and nasal allergy symptom burden in America: the Allergies, Immunotherapy, and RhinoconjunctivitiS (AIRS) surveys.

    PubMed

    Bielory, Leonard; Skoner, David P; Blaiss, Michael S; Leatherman, Bryan; Dykewicz, Mark S; Smith, Nancy; Ortiz, Gabriel; Hadley, James A; Walstein, Nicole; Craig, Timothy J; Allen-Ramey, Felicia

    2014-01-01

    Previous nationwide surveys of allergies in the United States have focused on nasal symptoms, but ocular symptoms are also relevant. This study determines the effects of ocular and nasal allergies on patients' lives. Telephone surveys of randomly selected U.S. households (the patient survey) and health care providers (provider survey) were conducted in the United States in 2012. Study participants were 2765 people ≥5 years of age who had ever been diagnosed with nasal or ocular allergies and 500 health care providers in seven specialties. Respondents to the patient survey reported a bimodal seasonal distribution of allergy symptoms, with peaks in March to May and September. Nasal congestion was the most common of the symptoms rated as "extremely bothersome" (39% of respondents), followed by red, itchy eyes (34%; p = 0.84 for difference in extreme bothersomeness of nasal and ocular symptoms). Twenty-nine percent of respondents reported that their or their child's daily life was impacted "a lot" when allergy symptoms were at their worst. Workers rated their mean productivity at 29% lower when allergy symptoms were at their worst (p < 0.001 compared with no symptoms). Providers reported that itchy eyes was the symptom causing most patients to seek medical treatment by pediatricians (73%), ophthalmologist/optometrists (72%), and nurse practitioners or physician assistants (62%), whereas nasal congestion was the symptom causing most patients to seek treatment from otolaryngologists (85%), allergist/immunologists (79%), and family medicine practitioners (64%). Ocular and nasal allergy symptoms substantially affected patients' lives and were comparable in their impact.

  20. Two-piece nasal septum prosthesis for a large nasal septum perforation: a clinical report.

    PubMed

    Sashi Purna, C R; Annapurna, P D; Ahmed, Syed Basheer; Vurla, Samyuktha; Nalla, Sandeep; Abhishek, S M

    2013-02-01

    Nasal septum perforation presents with the symptoms of epistaxis and crusting. Obturation of the defect will decrease the symptoms and increase patient comfort. Prosthetic closure is more predictable and thus the treatment of choice in larger defects. This article describes a procedure for construction of a magnet-retained, heat-processed acrylic nasal septum prosthesis. The two-piece nasal septum prosthesis was processed and joined together in situ by magnets. Each piece of the septum prosthesis conforms to the remaining medial wall of each nostril and forms the missing half of the nasal septum. The prosthesis not only alleviates symptoms, but also provides structural support to the saddle-shaped nose and improves esthetics.

  1. Effects of topical phenytoin on nasal wound healing after mechanical trauma: An experimental study.

    PubMed

    Şimşek, Gökçe; Ciftci, Osman; Karadag, Neşe; Karatas, Erkan; Kizilay, Ahmet

    2014-12-01

    Impaired postoperative wound healing is the second most common morbidity after synechia formation in endoscopic sinus surgery. The aim of this experimental study was to investigate the potential effects of topical phenytoin on wound healing after nasal mucosal trauma in rats. An experimental study at the Inonu University Faculty of Medicine. Twenty-four rats were randomized into three groups: 1) phenytoin group (n = 8), 2) control group (n = 8), and 3) vehicle group (n = 8). After damaging the right nasal cavity, in the phenytoin group, 1% topical phenytoin cream was applied for 7 days. The rats in the control group did not receive any treatment. The vehicle group was treated with daily topical cold cream for 1 week. The rats were sacrificed at the end, and the nasal cavities were excised. Tissue edema and inflammatory cell infiltration were compared among the groups. Additionally, proliferating cell nuclear antigen (PCNA) and cluster of differentiation 31 (CD31) immunoexpression levels were evaluated. Furthermore, in biochemical analysis, the tissue levels of vascular endothelial growth factor and (EGF) of the groups were investigated. In the phenytoin group, tissue edema and inflammatory cell infiltration were significantly decreased, and PCNA and CD31 immunoexpression levels were more prominent (P < .001) and the tissue EGF levels were significantly higher (P < .01). Topical phenytoin treatment may alter the nasal wound healing after mechanical trauma. The potential beneficial effects of topical phenytoin on nasal mucosa should be investigated by further experimental and human trials. NA. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Staphylococcal species heterogeneity in the nasal microbiome following antibiotic prophylaxis revealed by tuf gene deep sequencing.

    PubMed

    McMurray, Claire L; Hardy, Katherine J; Calus, Szymon T; Loman, Nicholas J; Hawkey, Peter M

    2016-12-02

    Staphylococci are a major constituent of the nasal microbiome and a frequent cause of hospital-acquired infection. Antibiotic surgical prophylaxis is administered prior to surgery to reduce a patient's risk of postoperative infection. The impact of surgical prophylaxis on the nasal staphylococcal microbiome is largely unknown. Here, we report the species present in the nasal staphylococcal microbiome and the impact of surgical prophylaxis revealed by a novel culture independent technique. Daily nasal samples from 18 hospitalised patients, six of whom received no antibiotics and 12 of whom received antibiotic surgical prophylaxis (flucloxacillin and gentamicin or teicoplanin +/- gentamicin), were analysed by tuf gene fragment amplicon sequencing. On admission to hospital, the species diversity of the nasal staphylococcal microbiome varied from patient to patient ranging from 4 to 10 species. Administration of surgical prophylaxis did not substantially alter the diversity of the staphylococcal species present in the nose; however, surgical prophylaxis did impact on the relative abundance of the staphylococcal species present. The dominant staphylococcal species present in all patients on admission was Staphylococcus epidermidis, and antibiotic administration resulted in an increase in species relative abundance. Following surgical prophylaxis, a reduction in the abundance of Staphylococcus aureus was observed in carriers, but not a complete eradication. Utilising the tuf gene fragment has enabled a detailed study of the staphylococcal microbiome in the nose and highlights that although there is no change in the heterogeneity of species present, there are changes in abundance. The sensitivity of the methodology has revealed that the abundance of S. aureus is reduced to a low level by surgical prophylaxis and therefore reduces the potential risk of infection following surgery but also highlights that S. aureus does persist.

  3. Nasal reconstruction with articulated irradiated rib cartilage

    SciTech Connect

    Murakami, C.S.; Cook, T.A.; Guida, R.A. )

    1991-03-01

    Nasal structural reconstruction is a formidable task in cases where there is loss of support to both the nasal dorsum and tip. A multitude of surgical approaches and materials have been used for the correction of the saddle-nose deformity with varying degrees of success. Articulated irradiated rib cartilage inserted through an external rhinoplasty approach was used to reconstruct nasal deformities in 18 patients over a 6-year period. Simultaneous use of a midline forehead flap to reconstruct the overlying soft tissue was required in four cases. Follow-up ranged from 1 to 6 years (mean, 2.8 years). Results were rewarding in most cases with marked improvement in nasal support and airway. Revision and/or replacement secondary to trauma or warping of the graft was required in four cases. None of the patients exhibited infection, extrusion, or noticeable resorption. A description of the surgical technique, review of all the cases, and recommendation for continued use of this graft material are discussed.

  4. How to Use Nasal Pump Sprays

    MedlinePlus

    Using Nasal Pump SpraysBlow your nose gently before using the spray. Prime the pump bottle by spraying it into the air a ... Breathe in quickly while squeezing down on the pump bottle one time. Repeat in other nostril. Do ...

  5. [A project to improve nasal ice packs].

    PubMed

    Chen, Mei-Chuan; Lin, Ting-Yu; Huang, Kai-Ning; Shih, Whei-Mei; Chen, Hsiu-Chen; Tsai, Mei-Chu

    2008-06-01

    Nasal problems are a commonly encountered diseases in the ENT (ear, nose, and throat) specialty. People with nasal problems usually seek medical therapy. When the problem cannot resolved by medical therapy then surgery becomes an option. According to statistics of the ENT unit where author served in 2006, 255 patients underwent nasal surgery. Swelling and pain are the most common discomfort symptoms for patients after nasal surgery. After data collection, it was found that only 16.7% of patients were willing to use ice packs, because they attached poorly (100%), were difficult to secure (100%), and were inconvenient to use (83.3%). After seeking an alternative ice pack replacement, the group decided to use a latex glove filled with 50 gm crushed ice and water in its index and middle fingers, tied with shoe laces and tied to the ears. The project involved three periods: preparation, execution, and evaluation. The results showed that 96.7% of patients were willing to use the new ice pack. The satisfaction rate for use of the new ice pack was 96.7%. The results of this project might improve patients' quality of care, as well as cost reduction.

  6. Nasalance Changes Following Various Endonasal Surgeries

    PubMed Central

    Amer, Hazem Saeed; Elaassar, Ahmed Shaker; Anany, Ahmad Mohammad; Quriba, Amal Saeed

    2017-01-01

    Introduction There is change in nasalance post endonasal surgery which is not permanent. Objectives The objective of this study is to evaluate the long-term nasalance changes following different types of endonasal surgeries. Methods We included in this study patients who underwent sinonasal surgery at the Otorhinolaryngology Department in Zagazig University Hospitals from February 2015 until March 2016. We divided the patients into two groups according to the surgeries they underwent: Group (A) was the FESS group and group (B), the septoturbinoplasty group. We checked nasalance using a nasometer before and after the sinonasal surgery. Results Nasalance increased at one month after the operation in both groups. However, it returned to nearly original levels within three months postoperatively. Conclusion FESS, septoplasty, and turbinate surgery may lead to hypernasal speech. This hypernasal speech can be a result of change in the shape and diameter of the resonating vocal tract. Hypernasal speech in these circumstances may be a temporary finding that can decrease with time. Surgeons should inform their patients about the possibility of hypernasality after such types of surgery, especially if they are professional voice users. PMID:28382115

  7. Triclosan Promotes Staphylococcus aureus Nasal Colonization

    PubMed Central

    Syed, Adnan K.; Ghosh, Sudeshna; Love, Nancy G.; Boles, Blaise R.

    2014-01-01

    ABSTRACT The biocide triclosan is used in many personal care products, including toothpastes, soaps, clothing, and medical equipment. Consequently, it is present as a contaminant in the environment and has been detected in some human fluids, including serum, urine, and milk. Staphylococcus aureus is an opportunistic pathogen that colonizes the noses and throats of approximately 30% of the population. Colonization with S. aureus is known to be a risk factor for several types of infection. Here we demonstrate that triclosan is commonly found in the nasal secretions of healthy adults and the presence of triclosan trends positively with nasal colonization by S. aureus. We demonstrate that triclosan can promote the binding of S. aureus to host proteins such as collagen, fibronectin, and keratin, as well as inanimate surfaces such as plastic and glass. Lastly, triclosan-exposed rats are more susceptible to nasal colonization with S. aureus. These data reveal a novel factor that influences the ability of S. aureus to bind surfaces and alters S. aureus nasal colonization. PMID:24713325

  8. An Unusual Case of a Nasal Foreign Body in a Cat with Chronic Nasal Discharge.

    PubMed

    Bellei, Emma; Pisoni, Luciano; Joechler, Monika; Pietra, Marco

    2015-01-01

    This report describes a cat infected with the feline infectious virus and a 1 yr history of unilateral mucopurulent nasal discharge. Intraoral radiography and endoscopic examination revealed the presence of a large fragment of tooth root in the right nasal cavity. The cat had previously undergone maxillary canine tooth (104) extraction. The root was successfully removed by an endoscopic-assisted procedure, and follow-up examination 1 yr later documented complete disappearance of the respiratory signs.

  9. Sensory properties of selected terpenes. Thresholds for odor, nasal pungency, nasal localization, and eye irritation.

    PubMed

    Cometto-Muñiz, J E; Cain, W S; Abraham, M H; Kumarsingh, R

    1998-11-30

    We tested four normosmics and four anosmics in detection thresholds for six terpenes commonly found indoors: cumene, p-cymene, delta-3-carene, linalool, 1,8-cineole and geraniol. Normosmics provided odor thresholds and anosmics provided nasal pungency thresholds. All subjects provided nasal localization (i.e., right/left nostril) and eye irritation thresholds. Each type of threshold was measured eight times per subject-stimulus combination. Stimuli were presented from squeeze bottles in a two-alternative forced-choice procedure via an ascending method of limits. Odor thresholds ranged between 0.1 and 1.0 parts per million (ppm, by volume). Nasal pungency thresholds lay about three orders of magnitude above odor thresholds. Nasal localization and eye irritation thresholds did not differ between normosmics and anosmics, and fell close to nasal pungency thresholds. Olfactory thresholds could be obtained for all stimuli in all repetitions using the criterion of five correct choices in a row. Trigeminal thresholds (i.e., pungency, localization and eye irritation) could be obtained on all repetitions only for some terpenes using that same criterion. Carene and cineol produced nasal pungency and eye irritation on all repetitions. None of the terpenes could be localized on all repetitions, but cineol was localized a higher percentage of instances than were the other stimuli. At the other extreme, geraniol failed to evoke any of the three trigeminal responses in most instances. Overall, the results indicate that the three trigeminal thresholds produce a uniform view of the potency of these terpenes, with nasal pungency and eye irritation being slightly more sensitive than nasal localization. Furthermore, application of a previously derived linear solvation energy relationship to the results reinforced the view that physicochemical properties can predict the chemesthetic impact of volatile organic compounds.

  10. Nasalance and nasality in children with cochlear implants and children with hearing aids.

    PubMed

    Baudonck, N; Van Lierde, K; D'haeseleer, E; Dhooge, I

    2015-04-01

    In prelingually deaf children, many speech production aspects including resonance, are known to be problematic. This study aimed to investigate nasality and nasalance in two groups of prelingually hearing impaired children, namely deaf children with a cochlear implant (CI) and moderate-to-severely hearing impaired hearing aid (HA) users. The results of both groups are compared with the results of normal hearing children. Besides, the impact of the degree of hearing loss was determined. 36 CI children (mean age: 9;0y), 25 HA children (mean age: 9;1y) and 26 NH children (mean age: 9;3y) were assessed using objective assessment techniques and perceptual evaluations in order to investigate the nasal resonance of the three groups. Ten HA children had thresholds above 70dB (range: 91dB-105dB) and fifteen below 70dB (range: 58dB-68dB). The Nasometer was used for registration of the nasalance values and nasality was perceptually evaluated by two experienced speech therapists using a nominal rating scale (consensus evaluation). For nasal stimuli, both CI children and HA children showed lower nasalance values in comparison with NH children. The opposite was observed for the oral stimuli. In both hearing impaired groups, cul-de-sac-resonance was observed on a significantly larger scale than in the NH group, and the HA children were judged to be significantly more hypernasal in comparison with NH children. Despite the fact that a substantial number of the CI and HA children demonstrate normal (nasal) resonance quality, this aspect of speech production is still at risk for hearing impaired children. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Nasal septum giant pyogenic granuloma after a long lasting nasal intubation: case report.

    PubMed

    Neves-Pinto, Roberto M; Carvalho, Adolpho; Araujo, Elizabeth; Alberto, Carlos; Basilio-De-Oliveira; De Carvalho, Gustavo Adolpho

    2005-03-01

    The authors present a case of Pyogenic Granuloma (PG) arising from the nasal septum in the posterior nasal cavity of a patient male sex, caucasian, 32 years old, with a previous history of cranioencephalic trauma, several neurosurgeries for different subsequent neurological problems and the use of a nasogastric tube for feeding (nasal intubation) during 30 days. He underwent surgery in St. Vincent de Paul Hospital (Rio de Janeiro) on May 18, 1993, for the tumor removal and straightening of the nasal septum. Under endoscopic guidance the complete excision of the tumor mass was perfectly done thanks to the excellent exposure of the lesion, provided by the enlarged telescopic view, and the wide access afforded by the septum straighttening plus the cartilaginous septum mobilization through the maxilla-premaxilla approach of Cottle, allied to the lateralization and volume reduction of the right inferior nasal concha, simultaneously performed, thus making lateral rhinotomy or "degloving" unnecessary. The patient is until now (2004) completely free of the lesion operated on. This is the first report in the literature of such a lesion associated to nasal intubation as the triggering agent.

  12. Congenital Nasal Pyriform Aperture Stenosis: First Case Report in Oman

    PubMed Central

    Al Abri, Rashid; Javad, Hashim; Kumar, Sudesh; Bharga, Deepa; Koul, RL; Al Futaisi, Amna; Sankla, Dilip

    2008-01-01

    Congenital nasal pyriform aperture stenosis (CNPAS) is a recently defined clinical entity that causes airway obstruction in the neonate as a result of narrowing of the nasal pyriform aperture. The pyriform aperture is the narrowest, most anterior portion of the nasal airway, and a slight decrease in its cross sectional area will significantly increase the nasal airway resistance. This entity should be kept in the differential diagnosis of any neonate or infant with signs and symptoms of upper air way obstruction. The CNPAS presents with symptoms of nasal airway obstruction, which are often characterized by episodic apnea and cyclic cynosis. PMID:22359713

  13. Congenital nasal pyriform aperture stenosis: first case report in oman.

    PubMed

    Al Abri, Rashid; Javad, Hashim; Kumar, Sudesh; Bharga, Deepa; Koul, Rl; Al Futaisi, Amna; Sankla, Dilip

    2008-07-01

    Congenital nasal pyriform aperture stenosis (CNPAS) is a recently defined clinical entity that causes airway obstruction in the neonate as a result of narrowing of the nasal pyriform aperture. The pyriform aperture is the narrowest, most anterior portion of the nasal airway, and a slight decrease in its cross sectional area will significantly increase the nasal airway resistance. This entity should be kept in the differential diagnosis of any neonate or infant with signs and symptoms of upper air way obstruction. The CNPAS presents with symptoms of nasal airway obstruction, which are often characterized by episodic apnea and cyclic cynosis.

  14. New CFD tools to evaluate nasal airflow.

    PubMed

    Burgos, M A; Sanmiguel-Rojas, E; Del Pino, C; Sevilla-García, M A; Esteban-Ortega, F

    2017-08-01

    Computational fluid dynamics (CFD) is a mathematical tool to analyse airflow. As currently CFD is not a usual tool for rhinologists, a group of engineers in collaboration with experts in Rhinology have developed a very intuitive CFD software. The program MECOMLAND(®) only required snapshots from the patient's cross-sectional (tomographic) images, being the output those results originated by CFD, such as airflow distributions, velocity profiles, pressure, temperature, or wall shear stress. This is useful complementary information to cover diagnosis, prognosis, or follow-up of nasal pathologies based on quantitative magnitudes linked to airflow. In addition, the user-friendly environment NOSELAND(®) helps the medical assessment significantly in the post-processing phase with dynamic reports using a 3D endoscopic view. Specialists in Rhinology have been asked for a more intuitive, simple, powerful CFD software to offer more quality and precision in their work to evaluate the nasal airflow. We present MECOMLAND(®) and NOSELAND(®) which have all the expected characteristics to fulfil this demand and offer a proper assessment with the maximum of quality plus safety for the patient. These programs represent a non-invasive, low-cost (as the CT scan is already performed in every patient) alternative for the functional study of the difficult rhinologic case. To validate the software, we studied two groups of patients from the Ear Nose Throat clinic, a first group with normal noses and a second group presenting septal deviations. Wall shear stresses are lower in the cases of normal noses in comparison with those for septal deviation. Besides, velocity field distributions, pressure drop between nasopharynx and the ambient, and flow rates in each nostril were different among the nasal cavities in the two groups. These software modules open up a promising future to simulate the nasal airflow behaviour in virtual surgery intervention scenarios under different pressure or

  15. A comparison of fluticasone propionate nasal spray and cetirizine in ragweed fall seasonal allergic rhinitis.

    PubMed

    Ford, Linda B; Matz, Jonathan; Hankinson, Todd; Prillaman, Barbara; Georges, George

    2015-01-01

    Intranasal corticosteroids are generally considered the most effective medication class for controlling allergic rhinitis. Previous comparative studies with oral antihistamines have been only partially informative due to a variety of variables encountered during their execution. To compare fluticasone propionate nasal spray (FPNS) with the second-generation antihistamine cetirizine (oral tablet) and with placebo in a head-to-head study in a 2-week treatment study during fall ragweed season. A total of 978 subjects were screened for this study. Six hundred and eighty-two subjects were randomized into the study (170 subjects, FPNS 200 mcg once daily; 170, cetirizine 10 mg once daily; 171, FPNS placebo; 171, cetirizine placebo) and comprised the intent-to-treat population. A 1-week placebo run-in was followed by a 2-week active treatment period during which time a total nasal symptom score (TNSS), total ocular symptom score, and the Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire were collected. The primary efficacy end point was the mean change from baseline over the entire treatment period in A.M. reflective TNSS. The TNSS was the sum of the four individual nasal congestion, nasal itching, rhinorrhea, and sneezing scores, in which each symptom was scored on a scale of 0 to 3. Both FPNS and cetirizine improved the primary end point when compared with placebo during the active treatment period. Although there was a trend that favored FPNS with regard to the primary and secondary end points, there was not a statistical difference between the two treatments. FPNS and cetirizine were equally effective in treating fall seasonal allergic rhinitis during a 2-week head-to-head treatment investigation. Clinical trial NCT01916226, www.clinicaltrials.gov.

  16. The physiological mechanism for sensing nasal airflow: a literature review.

    PubMed

    Sozansky, Jeanie; Houser, Steven M

    2014-10-01

    Nasal obstruction is a common otolaryngologic complaint, yet the mechanism of sensing airflow is not commonly understood. The objective of this work was to review current knowledge on the physiological mechanism for sensing nasal airflow. Current literature pertaining to nasal sensation to airflow was retrieved using PubMed and Google Scholar searches. The primary physiological mechanism that produces the sensation of ample nasal airflow is activation of trigeminal cool thermoreceptors, specifically transient receptor potential melastatin family member 8 (TRPM8), by nasal mucosal cooling. The dynamic change in temperature is ultimately sensed. Nasal mucosal cooling is a result of conductive heat loss, driven by temperature gradient, and evaporative heat loss, driven by humidity gradient. The perception of ample nasal airflow is dependent on the overall nasal surface area stimulated by mucosal cooling, which is mainly governed by air flow patterns. Cool thermoreceptors in the nasal mucosa are connected to the respiratory centers and consequently can alter respiration patterns. Mechanoreceptors do not seem to play a role in sensing nasal airflow. Computational fluid dynamics (CFD) modeling could be a valuable objective tool in evaluating patients with nasal congestion. Understanding the physiological mechanism of how the nose senses airflow can aid in diagnosing the cause behind patient symptoms, which allows physicians to provide better treatment options for patients. © 2014 ARS-AAOA, LLC.

  17. The effects of prosodic boundaries on nasality in Taiwan Min.

    PubMed

    Pan, Ho-hsien

    2007-06-01

    This study explores the effects of prosodic boundaries on nasality at intonational phrase, word, and syllable boundaries. The subjects were recorded saying phrases that contained a syllable-final nasal consonant followed by a syllable-initial stop. The timing, duration, and magnitude of the nasal airflows measured were used to determine the extent of nasality across boundaries. Nasal amplitudes were found to vary in a speaker-dependent manner among boundary types. However, the patterns of nasal contours and temporal aspects of the airflow parameters consistently varied with boundary type across all the speakers. In general, the duration of nasal airflow and nasal plateau were the longest at the intonational phrase boundary, followed by word boundary and then syllable boundary. In addition to the hierarchical influence of boundary strength, there were unique phonetic markings associated with individual boundaries. In particular, two nasal rises interrupted by nasal inhalation occurred only across an intonation phrase boundary. Also, unexpectedly, a word boundary was marked by the longest postboundary vowel, whereas a syllable boundary was marked with the shortest nasal duration. The results here support the hierarchical effect of boundary on both domain-edge strengthening and cross-boundary coarticulation.

  18. [A case of neurinoma of the nasal septum].

    PubMed

    Sakamoto, Kikuo; Gondo, Kyujiro; Tomita, Kazuhide; Kasuya, Takao

    2003-05-01

    Neurinoma grows in the modulated nerve with Schwann cells, and is observed for all positions of the body. It is comparatively rare for neurinoma to grow in the nasal cavity and paranasal sinuses, however. We report a case of neurinoma of the nasal septum. A 24-year-old man seen for nasal obstruction was found in anterior rhinoscopy to have a tumor of the bilateral nasal cavity. Computed tomography (CT) showed a soft tissue density mass in the anterior part of the nasal cavity. Because we suspected neurinoma from biopsy, we resected the tumor by Denker's operation under general anesthesia. We found that it originated from the nasal septum. Histopathological findings of the tumor indicated an Antoni A type neurinoma. After surgery, cartilago costalis was transplanted the plastic surgery to correct the defect in the nasal septum. The post operative course was good and no signs of recurrence were seen. This is the 19th case found in the literature.

  19. Dialectal and gender differences in nasalance for a Mandarin population.

    PubMed

    Kim, Ha-Kyung; Yu, Xiao-meng; Cao, Yan-jing; Liu, Xiao-ming; Huang, Zhao-Ming

    2016-01-01

    The purpose of this study was to determine whether there are dialectal and gender related differences in nasalance of main Mandarin vowels and three sentences in 400 Chinese normal adults. The mean nasalance score difference for dialect and gender was significant (p < .001) in all speech materials. For different dialects, the average nasalance scores show that Chongqing > Beijing > Shanghai > Guangzhou for the nasal sentence, oro-nasal sentence, /a/, /i/ and /u/. In addition, the average nasalance scores of females were higher than those of males for all speech materials in all dialects. The clinical significance of this study can be helpful in making nasalance clinical decisions for Chinese people with cleft palate, hearing disorders and dysarthria with resonance disorders. It also shows the theoretical and socio-cultural features for linguists considering dialects and gender.

  20. Inhalation of diethylamine--acute nasal effects and subjective response

    SciTech Connect

    Lundqvist, G.R.; Yamagiwa, M.; Pedersen, O.F.; Nielsen, G.D. )

    1992-03-01

    Adult volunteers were exposed to 25 ppm (75 mg/m3) diethylamine in a climate chamber for 15 min in order to study the acute nasal reactions to an exposure equivalent to the present threshold limit value-short-term exposure limit. Changes in nasal volume and nasal resistance were measured by acoustic rhinometry and by rhinomanometry. Acute change in nasal volume, usually seen as acute nasal mucosa response to thermal stimuli, was not observed, nor was an acute change in nasal airway resistance. In a subsequent experiment, the aim was to measure acute sensory effects. Exposure to a concentration increasing from 0 to 12 ppm took place for 60 min, equal to an average concentration of 10 ppm (30 mg/m3). A moderate to strong olfactory response and distinct nasal and eye irritation were observed. In spite of considerable individual variation, the results were in agreement with sensory effect estimates obtained from animal studies.

  1. Correlation between subjective and objective nasal breathing assessments in examinees with nasal septum deformities.

    PubMed

    Savović, Slobodan; Smajić, Miroslav; Molnar, Slavko; Jovancević, Ljiljana; Buljcik-Cupić, Maja; Kljajić, Vladimir; Pilija, Vladimir

    2013-04-01

    Nasal obstruction is one of the most frequent disorders because of which patients see their Ear, Nose and Throath (ENT) doctors. Impaired nose breath ing is a subjective symptom and it often does not coincide with clinical nose findings and functional tests of breath ing function. Therefore, the aim of this study was to es tablish if there is an accordance between a subjective nose breathing assessment and objective methods (rhinoma nometry and acoustic rhinometry) in assessing nose breathing function in patients with diverse nasal septum deformity degrees, as well as to establish an accordance between these two objective methods. This study involved the total of 90 examinees divided into three groups. The group I consisted of examinees with nasal septum deformities less than 10 degrees. The group II consisted of examinees with nasal septum deformities ranged from 10 degrees to 15 degrees. The group III involved examinees with nasal septum deformities over 15 degrees. Each examinee had subjec tively graded his/her nasal breathing on the side of the nose septum deformity from 0 to 10, and afterwards the whole noses. Rhinomanometry and acoustic rhinometry were done on the side of the nasal septum deformities and after that on the other side of the nose using the Interacoustics SRE 2000 device. In the groups II and III there was a positive correlation between a subjective nose breathing assessment and rhinomanometric values both on the side of the nasal septum deformities and the nose as a whole, (p < 0.05), and no correlation between these traits in the group I (p > 0.05). In none of the exam ined groups correlation was found between a subjective nose breathing assessment and rhinometric values, both minimum cross-sectional area (MCA) and volume (VOL), both on the side of the nasal septum deformities and the nose as a whole (p > 0.05). There was no correlation found between rhinomanometric and rhinometric MCA and VOL values in either on the sides of nasal septum

  2. Nasal nitric oxide in infants before and after extubation.

    PubMed

    Chang, Chun-Cheng; Lien, Shao-Hung; Liu, Tao-Yuan; Hua, Yi-Ming; Lee, Chuen-Ming; Yuh, Yeong-Seng

    2008-11-01

    The endogenous production of nitric oxide (NO) in the upper airways is known to be high, but reports of the exact level vary, especially in newborn infants. Currently there is still no standard methodology for nasal NO measurements in neonates. In this study, we compared the levels of NO from the nasal cavity, and from the lower respiratory tracts in intubated infants together with the differences in nasal NO before and after extubation. A total of 35 intubated infants were enrolled in the study. The sampling was conducted with a fast-response chemoluminescence analyzer using the on-line tidal breathing techniques. The levels of NO in the nasal cavity were sampled using two different methods, namely nasal catheterization (Group 1), and nasal occlusion (Group 2). In both groups, the NO levels in the nasal cavity were found to be significantly higher than in the lower airway (P < 0.001). After extubation, the concentration of nasal NO in Group 1 was found to be significantly lower than before extubation (P < 0.05). There was no difference found between the levels of nasal NO in Group 2 before and after extubation (P = 0.95). Generally speaking, the concentrations of nasal NO in Group 2 were significantly higher than in Group 1 after extubation (P < 0.05). For the sample that used nasal occlusion, the nasal NO levels were more stable before and after extubation and the concentration was not affected by the breathing pattern or crying. The infants were more comfortable as well. We therefore conclude that nasal occlusion is a better method for measuring the levels of nasal NO in infants and neonates. (c) 2008 Wiley-Liss, Inc.

  3. Nasalance measures in German-speaking cleft patients.

    PubMed

    Swennen, Gwen R J; Grimaldi, Hannes; Upheber, Juliane; Kramer, Franz-Josef; Dempf, Rupert

    2004-01-01

    The purpose of this study was to evaluate nasalance measures in German-speaking patients with different types of repaired cleft lip and palate and to find out if significant nasalance gender differences exist in the different cleft groups. A total of 125 German-speaking cleft patients (74 male and 51 female) were included in this study: 18 patients with isolated unilateral cleft lip (UCL; mean age: 13.00 +/- 2.03 years), 66 patients with complete unilateral cleft lip and palate (UCLP; mean age: 14.80 +/- 3.45 years), 25 patients with isolated cleft palate (CP; mean age: 14.60 +/- 3.48 years), and 16 patients with complete bilateral cleft lip and palate (BCLP; mean age: 14.30 +/- 3.61 years). Nasalance data were collected and computed using the NasalView hardware/software system (Fa. Tiger Electronics, Seattle, WA). Speech stimuli according to a modified Heidelberg Rhinophonia Assessment Form (sustained vowels "a," "e," "i," "o," and "u"; oral and nasal sentences; and three oral-nasal reading passages) were used to obtain nasalance scores. Nasalance distance and ratio were also calculated for the oral and nasal sentences and for one of the oral-nasal reading passages. Unpaired t tests showed no significant gender nasalance differences in each cleft group. Analysis of variance showed no significant differences in mean nasalance distance and ratio. For the nasal sentence, a significant difference (P = 0.032) in mean nasalance scores was found between the UCL and UCLP groups.

  4. Toothbrushing: Do It Daily.

    ERIC Educational Resources Information Center

    Texas Child Care, 1993

    1993-01-01

    Offers a practical guide for promoting daily toothbrushing in young children. Discusses the importance of proper dental care, explains the causes of tooth decay, describes proper dental care for infants and young children, recommends materials and teaching methods, and discusses visits to the dentist and the benefits of fluoride for dental health.…

  5. Toothbrushing: Do It Daily.

    ERIC Educational Resources Information Center

    Texas Child Care, 1993

    1993-01-01

    Offers a practical guide for promoting daily toothbrushing in young children. Discusses the importance of proper dental care, explains the causes of tooth decay, describes proper dental care for infants and young children, recommends materials and teaching methods, and discusses visits to the dentist and the benefits of fluoride for dental health.…

  6. Effect of nitric oxide inhibition on nasal airway resistance after nasal allergen challenge in allergic rhinitis.

    PubMed

    Maniscalco, M; Sofia, M; Carratù, L; Higenbottam, T

    2001-05-01

    Nitric oxide has been detected by chemiluminescence in the lumen of nasal airway, which is increased in nasal breathing in patients with seasonal rhinitis during a chronic exposure. The purpose of this study was to determinate the effect of a NO-synthase inhibitor NGL-arginine methyl ester (L-NAME) on nasal airway resistance (NAR) in patients with seasonal allergic rhinitis after an acute challenge to the allergen. Nitric oxide levels in the nose were measured by the chemiluminescence method in nine non-atopic volunteers and in seven patients with seasonal rhinitis at rest and after an acute challenge with the allergen. NAR were measured by active anterior rhinomanometry. Basal nasal NO concentration in allergic rhinitis was 496.5 +/- 151.4 parts per billion (ppb). (n = 7) and it was not significantly different from levels found in the control group: 458.4 +/- 105.9 ppb (n = 9). The topical administration of L-NAME in allergic rhinitis reduced the NO concentration (338.6 +/- 99.3 ppb, P < 0.001; n = 7). In the rhinitic patients the challenge with the allergen did not modify the nasal NO levels (504.5 +/- 138.5 ppb). The application of the allergen after the pretreatment with placebo caused a significant increase in NAR (from 0.32 +/- 0.11 Pa s cm-3 to 1.01 +/- 0.12 Pa s cm-3, P < 0.001; n = 7). Pre-treatment with L-NAME did not prevent the increase in NAR induced by allergen challenge (from 0.36 +/- 0.15 Pa s cm-3 to 1.06 +/- 0.26 Pa s cm-3). The results indicate that nasal administration of a NOS inhibitor L-NAME, at doses capable of decreasing nasal NO levels, has no effect on NAR and it does not prevent the NAR increase induced by an acute challenge with allergen in subjects with seasonal rhinitis.

  7. Effects of mobile phone WeChat services improve adherence to corticosteroid nasal spray treatment for chronic rhinosinusitis after functional endoscopic sinus surgery: a 3-month follow-up study.

    PubMed

    Feng, Shaoyan; Liang, Zibin; Zhang, Rongkai; Liao, Wei; Chen, Yuan; Fan, Yunping; Li, Huabin

    2017-03-01

    The objective of the study is to investigate the impact of receiving daily WeChat services on one's cell phone on adherence to corticosteroid nasal spray treatment in chronic rhinosinusitis (CRS) patients after functional endoscopic sinus surgery (FESS). This study was a two-arm, randomized, follow-up investigation. Patients with chronic rhinosinusitis with/without nasal polyps following bilateral FESS were randomised to receive, or to not receive, daily WeChat service on their cell phone to take corticosteroid nasal spray treatment. A prescription of budesonide aqueous nasal spray 128 µg bid was given to all the subjects. Then they returned to the clinic after 30, 60, 90 days. The primary study outcome was adherence to nasal spray treatment, whereas secondary outcomes were change in endoscopic findings and SinoNasal Outcome Test-20 (SNOT-20). On the whole, there was a significant inter-group difference in the change of adherence rate (F = 90.88, p = 0.000). The WeChat group had much higher adherence rate than the control group during the follow-up. In terms of postoperative endoscopic scores and SNOT-20, except granulation score, no significant differences were observed between the two randomization groups. WeChat services are already after a short period of observation associated with improved adherence to corticosteroid nasal spray treatment in CRS patients after FESS.

  8. Biotransformation enzyme expression in the nasal epithelium of woodrats.

    PubMed

    Skopec, Michele M; Hale, Andrew; Torregrossa, Ann-Marie; Dearing, M Denise

    2013-01-01

    When herbivores come in contact with volatile plant secondary compounds (PSC) that enter the nasal passages the only barrier between the nasal cavity and the brain is the nasal epithelium and the biotransformation enzymes present there. The expression of two biotransformation enzymes Cytochrome P450 2B (CYP2B) and glutathione-S-transferase (GST) was investigated in the nasal epithelia and livers of three populations of woodrats. One population of Neotoma albigula was fed juniper that contains volatile terpenes. Juniper caused upregulation of CYP2B and GST in the nasal epithelium and the expression of CYP2B and GST in the nasal epithelium was correlated to liver expression, showing that the nasal epithelia responds to PSC and the response is similar to the liver. Two populations of Neotoma bryanti were fed creosote that contains less volatile phenolics. The creosote naive animals upregulated CYP2B in their nasal epithelia while the creosote experienced animals upregulated GST. There was no correlation between CYP2B and GST expression in the nasal epithelia and livers of either population. The response of the nasal epithelium to PSC seems to be an evolved response that is PSC and experience dependent. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Characterization of nasal cavity-associated lymphoid tissue in ducks.

    PubMed

    Kang, Haihong; Yan, Mengfei; Yu, Qinghua; Yang, Qian

    2014-05-01

    The nasal mucosa is involved in immune defense, as it is the first barrier for pathogens entering the body through the respiratory tract. The nasal cavity-associated lymphoid tissue (NALT), which is found in the mucosa of the nasal cavity, is considered to be the main mucosal immune inductive site in the upper respiratory tract. NALT has been found in humans and many mammals, which contributes to local and systemic immune responses after intranasal vaccination. However, there are very few data on NALT in avian species, especially waterfowl. For this study, histological sections of the nasal cavities of Cherry Valley ducks were used to examine the anatomical location and histological characteristics of NALT. The results showed that several lymphoid aggregates are present in the ventral wall of the nasal cavity near the choanal cleft, whereas several more lymphoid aggregates were located on both sides of the nasal septum. In addition, randomly distributed intraepithelial lymphocytes and isolated lymphoid follicles were observed in the regio respiratoria of the nasal cavity. There were also a few lymphoid aggregates located in the lamina propria of the regio vestibularis, which was covered with a stratified squamous epithelium. This study focused on the anatomic and histological characteristics of the nasal cavity of the duck and performed a systemic overview of NALT. This will be beneficial for further understanding of immune mechanisms after nasal vaccination and the development of effective nasal vaccines for waterfowls. Copyright © 2014 Wiley Periodicals, Inc.

  10. Patient experience with mupirocin or povidone-iodine nasal decolonization.

    PubMed

    Maslow, Jed; Hutzler, Lorraine; Cuff, Germaine; Rosenberg, Andrew; Phillips, Michael; Bosco, Joseph

    2014-06-01

    Led by the federal government, the payers of health care are enacting policies designed to base provider reimbursement on the quality of care they render. This study evaluated and compared patient experiences and satisfaction with nasal decolonization with either nasal povidone-iodine (PI) or nasal mupirocin ointment (MO). A total of 1903 patients were randomized to undergo preoperative nasal decolonization with either nasal MO or PI solution. All randomized patients were also given 2% chlorhexidine gluconate topical wipes. Patients were interviewed prior to discharge to assess adverse events and patient experience with their assigned preoperative antiseptic protocol. Of the 1903 randomized patients, 1679 (88.1%) were interviewed prior to discharge. Of patients receiving PI, 3.4% reported an unpleasant or very unpleasant experience, compared with 38.8% of those using nasal MO (P<.0001). Sixty-seven percent of patients using nasal MO believed it to be somewhat or very helpful in reducing surgical site infections, compared with 71% of patients receiving PI (P>.05). Being recruited as an active participant in surgical site infection prevention was a positive experience for 87.2% of MO patients and 86.3% of PI patients (P=.652). Those assigned to receive PI solution preoperatively reported significantly fewer adverse events than the nasal MO group (P<.01). Preoperative nasal decolonization with either nasal PI or MO was considered somewhat or very helpful by more than two-thirds of patients. Copyright 2014, SLACK Incorporated.

  11. Mathematical model for preoperative identification of obstructed nasal subsites.

    PubMed

    Gamerra, M; Cantone, E; Sorrentino, G; De Luca, R; Russo, M B; De Corso, E; Bossa, F; De Vivo, A; Iengo, M

    2017-05-22

    The planning of experimental studies for evaluation of nasal airflow is particularly challenging given the difficulty in obtaining objective measurements in vivo. Although standard rhinomanometry and acoustic rhinometry are the most widely used diagnostic tools for evaluation of nasal airflow, they provide only a global measurement of nasal dynamics, without temporal or spatial details. Furthermore, the numerical simulation of nasal airflow as computational fluid dynamics technology is not validated. Unfortunately, to date, there are no available diagnostic tools to objectively evaluate the geometry of the nasal cavities and to measure nasal resistance and the degree of nasal obstruction, which is of utmost importance for surgical planning. To overcame these limitations, we developed a mathematical model based on Bernoulli's equation, which allows clinicians to obtain, with the use of a particular direct digital manometry, pressure measurements over time to identify which nasal subsite is obstructed. To the best of our knowledge, this is the first study to identify two limiting curves, one below and one above an average representative curve, describing the time dependence of the gauge pressure inside a single nostril. These upper and lower curves enclosed an area into which the airflow pattern of healthy individuals falls. In our opinion, this model may be useful to study each nasal subsite and to objectively evaluate the geometry and resistances of the nasal cavities, particularly in preoperative planning and follow-up. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale.

  12. Oral appliance titration and nasal resistance in nonapneic subjects.

    PubMed

    Okawara, Yoko; Tsuiki, Satoru; Hiyama, Shigetoshi; Hashimoto, Koji; Ono, Takashi; Ohyama, Kimie

    2004-11-01

    Initial mandibular position might be a key factor leading to rapid therapeutic outcome in oral appliance therapy for patients with obstructive sleep apnea (OSA). The purpose of this study was to investigate the effects of an adjustable oral appliance on nasal resistance in 7 nonapneic patients. Upright and supine nasal resistance was measured for each subject with an adjustable oral appliance in place in 3 mandibular positions: most retruded (MAX0), maximum protrusion (MAX100), and 67% of MAX100 (MAX67). A significant decrease in upright and supine nasal resistance was observed between MAX0 and MAX67 (P < .01), and between MAX0 and MAX100 (P < .01), but not between MAX67 and MAX100. In addition, there was a positive correlation between the nasal resistance at MAX0 and the nasal resistance change from MAX0 to MAX67 (P < .01), indicating that when the mandible was advanced from MAX0 to MAX67, the more nasal resistance at MAX0, the greater the reduction in nasal resistance at MAX67. These findings suggest that MAX67 might be indicated as the initial mandibular position and that gradual anterior titration of mandibular position beyond MAX67 would give OSA patients rapid therapeutic effects by reducing the nasal resistance. Moreover, OSA patients with augmented nasal resistance at MAX0 might have a greater reduction in nasal resistance in response to MAX67 in oral appliance therapy.

  13. The role of nasal allergy in chronic secretory otitis media.

    PubMed

    Pelikan, Zdenek

    2007-11-01

    Chronic secretory otitis media (SOM) has multifactorial causes, and nasal allergy is suspected as one of these causative factors. To investigate the possible role of nasal allergy in SOM in adults and to determine the diagnostic value of nasal challenges with allergens (nasal provocation tests) combined with tympanometry for the diagnosis of this disorder. In 69 young adults with chronic or recurrent SOM, 173 nasal challenges with allergens were performed by anterior rhinomanometry combined with tympanometry (pure-tone air conduction tympanometry). In 42 control subjects with only allergic rhinitis and no history of middle ear disease, 42 nasal challenges with allergens were repeated and combined with tympanometry. The study design was a placebo-controlled comparison. Of the 69 patients, 54 developed 129 positive nasal responses of various types (P < .01), 117 of which were accompanied by significant changes in middle ear pressure (P < .01). No significant tympanometric changes (P > .10) were recorded during the 42 positive nasal responses in control subjects. These results may confirm the occurrence of chronic SOM in some adult patients and the possible involvement of nasal allergy in chronic SOM. The nasal challenges with allergen performed by rhinomanometry, combined with tympanometry, seem to be a valuable supplementary tool for the diagnosis of this disorder.

  14. Airflow patterns in a human nasal model

    SciTech Connect

    Hornung, D.E.; Leopold, D.A.; Youngentob, S.L.; Sheehe, P.R.; Gagne, G.M.; Thomas, F.D.; Mozell, M.M.

    1987-02-01

    Nasal airflow patterns were studied by using xenon 133 gas to image the course taken by air as it flowed through a plastic model of the human nasal cavity. The model was produced from the head of a human cadaver, and was anatomically correct. A needle catheter was used to infuse the radioactive xenon into a continuous flow of room air maintained through the model by a variable vacuum source connected to the nasopharynx. The radioactive gas was infused at one of five release sites in the nostril, and the distribution of the radioactivity was imaged in the sagittal plane with a scintillation camera. The data were organized to show the activity in six contiguous regions of the midnose. For each catheter, release site activity patterns were determined for three flow rates. The results of this experiment showed that both catheter position and flow rate had significant and reproducible effects on the distribution of radioactivity within the model.

  15. Button battery impaction in nasal cavity.

    PubMed Central

    Kim, K. K.; Kim, J. R.; Kim, J. Y.

    1999-01-01

    A button battery inserted in the nose of children is an unusual foreign body which is capable of causing extensive tissue damage, resulting from electrical and chemical burns. We report a case of button battery in the nose of a 4-year-old boy presenting with unilateral nasal discharge, and necrosis in the septum and turbinate of the right nasal cavity. Mercury level in concentrated urine was within normal limit. Microscopic examination disclosed extensive liquefaction necrosis with calcification and fibrosis. Numerous dark brown to black granules were noted in the elastic and collagen fibers and interstitium. Dark-field examination of the section revealed brilliantly refractile granules. Polarized microscopy failed to show the granules. Most brown pigments reacted to prussian blue. Tissue mercury analysis yielded a mercury content of 8.01 ppm. We report this case to emphasize the hazards of button battery impaction and to draw attention to the significance of the problem through histopathologic examination. PMID:10331570

  16. Saline Nasal Irrigation for Upper Respiratory Conditions

    PubMed Central

    2009-01-01

    Acute and chronic upper respiratory conditions are common and expensive disorders with enormous impact on patient quality of life and society at large. Saline nasal irrigation (SNI), a therapy with roots in Ayurvedic medicine that bathes the nasal mucosa with in spray or liquid saline, has been used as adjunctive care for upper respiratory conditions. In liquid form, SNI has been found to be effective adjunctive care by the Cochrane Collaboration for symptoms associated with chronic rhinosinusitis. Less conclusive clinical trial evidence supports its use in spray and liquid forms as adjunctive treatment for mild-to-moderate allergic rhinitis and acute upper respiratory infections. Consensus or expert opinion recommendations exist for SNI as a treatment for a variety of other conditions including rhinitis of pregnancy. SNI appears safe; side effects are minimal and transient. It can be recommended by clinicians to interested patients with a range of upper respiratory conditions in the context of patient education and printed instructional handouts. PMID:19904896

  17. Fundus imaging with a nasal endoscope.

    PubMed

    Shanmugam, P Mahesh; Ramanjulu, Rajesh; Mishra, K C Divyansh

    2015-01-01

    Wide field fundus imaging is needed to diagnose, treat, and follow-up patients with retinal pathology. This is more applicable for pediatric patients as repeated evaluation is a challenge. The presently available imaging machines though provide high definition images, but carry the obvious disadvantages of either being costly or bulky or sometimes both, which limits its usage only to large centers. We hereby report a technique of fundus imaging using a nasal endoscope coupled with viscoelastic. A regular nasal endoscope with viscoelastic coupling was placed on the cornea to image the fundus of infants under general anesthesia. Wide angle fundus images of various fundus pathologies in infants could be obtained easily with readily available instruments and without the much financial investment for the institutes.

  18. Fundus imaging with a nasal endoscope

    PubMed Central

    Shanmugam, P Mahesh; Ramanjulu, Rajesh; Mishra, KC Divyansh

    2015-01-01

    Wide field fundus imaging is needed to diagnose, treat, and follow-up patients with retinal pathology. This is more applicable for pediatric patients as repeated evaluation is a challenge. The presently available imaging machines though provide high definition images, but carry the obvious disadvantages of either being costly or bulky or sometimes both, which limits its usage only to large centers. We hereby report a technique of fundus imaging using a nasal endoscope coupled with viscoelastic. A regular nasal endoscope with viscoelastic coupling was placed on the cornea to image the fundus of infants under general anesthesia. Wide angle fundus images of various fundus pathologies in infants could be obtained easily with readily available instruments and without the much financial investment for the institutes. PMID:25686069

  19. Staining of nasal mucosa to examine remodelling.

    PubMed

    Ahmed, S K; Williams, J L; Drake-Lee, A; Egginton, S

    2009-02-01

    The process of embedding tissue in paraffin degrades many important molecules involved in respiratory epithelial remodelling. We therefore examined alternative methods. Inferior turbinate and nasal polyp biopsies were either placed in formalin or immediately snap-frozen in the operating theatre. Novel protocols for staining remodelling markers were compared with current methods. Our method, using a mixture of three lectins, stained a significantly greater proportion of samples, compared with using Ulex europeaus lectin alone (84 vs 62 per cent; p < 0.005). Comparison of different proliferation markers showed that Ki67 was more suitable than proliferating cell nuclear antigen for frozen sections. This study indicates that our robust, repeatable methods for examining whole mounts and for staining capillaries, cell proliferation and nuclei on the same section of nasal mucosa are superior to current methods. The use of fresh tissue that has not been paraffin-embedded would allow a greater suite of epitopes to be examined in the future.

  20. Simulating the nasal cycle with computational fluid dynamics

    PubMed Central

    Patel, Ruchin G.; Garcia, Guilherme J. M.; Frank-Ito, Dennis O.; Kimbell, Julia S.; Rhee, John S.

    2015-01-01

    Objectives (1) Develop a method to account for the confounding effect of the nasal cycle when comparing pre- and post-surgery objective measures of nasal patency. (2) Illustrate this method by reporting objective measures derived from computational fluid dynamics (CFD) models spanning the full range of mucosal engorgement associated with the nasal cycle in two subjects. Study Design Retrospective Setting Academic tertiary medical center. Subjects and Methods A cohort of 24 nasal airway obstruction patients was reviewed to select the two patients with the greatest reciprocal change in mucosal engorgement between pre- and post-surgery computed tomography (CT) scans. Three-dimensional anatomic models were created based on the pre- and post-operative CT scans. Nasal cycling models were also created by gradually changing the thickness of the inferior turbinate, middle turbinate, and septal swell body. CFD was used to simulate airflow and to calculate nasal resistance and average heat flux. Results Before accounting for the nasal cycle, Patient A appeared to have a paradoxical worsening nasal obstruction in the right cavity postoperatively. After accounting for the nasal cycle, Patient A had small improvements in objective measures postoperatively. The magnitude of the surgical effect also differed in Patient B after accounting for the nasal cycle. Conclusion By simulating the nasal cycle and comparing models in similar congestive states, surgical changes in nasal patency can be distinguished from physiological changes associated with the nasal cycle. This ability can lead to more precise comparisons of pre and post-surgery objective measures and potentially more accurate virtual surgery planning. PMID:25450411

  1. Nasal nitric oxide measurements before and after repeated humming maneuvers.

    PubMed

    Maniscalco, M; Sofia, M; Weitzberg, E; Carratu, L; Lundberg, J O N

    2003-12-01

    It has been recently shown that humming greatly increases nasal nitric oxide (NO). This is most likely owing to a rapid washout of sinus NO caused by the oscillating sound waves. During repeated humming manoeuvres nasal NO gradually decreases, likely because NO accumulated in the sinuses is washed out. We studied whether humming before measurements would affect nasally exhaled NO. NO output was measured by the chemiluminescence technique in orally and nasally exhaled air in 38 subjects: 18 healthy subjects (HS), 15 subjects with allergic rhinitis (AR) and five subjects with allergic nasal polyposis (AP). Each subject performed a NO measurement during quiet nasal exhalation either preceded by a period of silence/free speaking or immediately after five consecutive humming manoeuvres (posthumming). Mean nasal NO output (95% CI) after a period of silence/free speaking was 231 nL min-1 (178-284) in HS, 434 nL min-1 (347-522) in AR (P < 0.001) and 262 nL min-1 (163-361) in AP. Post-humming nasal NO output was 16% (5 to 50%) lower in HS and 14% (1 to 49%) lower in AR, while it remained unchanged in AP subjects. Intra-subject coefficient of variation of quiet nasal exhalation was 12% in HS, 13% in AR and 5% in AP. Post humming intraindividual coefficient of variation significantly decreased in both HS and AR, but it did not change in AP. Nasal NO levels measured immediately after repeated humming manoeuvres are consistently lower and more reproducible than nasal NO levels measured after a period of silence or free speaking. Repeated humming effectively empties the sinuses, thereby probably minimizing the normal contribution from the sinuses to nasal NO. This may be useful to better estimate NO output from the nasal cavity mucosa in health and disease.

  2. Simulating the nasal cycle with computational fluid dynamics.

    PubMed

    Patel, Ruchin G; Garcia, Guilherme J M; Frank-Ito, Dennis O; Kimbell, Julia S; Rhee, John S

    2015-02-01

    (1) To develop a method to account for the confounding effect of the nasal cycle when comparing preoperative and postoperative objective measures of nasal patency. (2) To illustrate this method by reporting objective measures derived from computational fluid dynamics (CFD) models spanning the full range of mucosal engorgement associated with the nasal cycle in 2 subjects. Retrospective. Academic tertiary medical center. A cohort of 24 patients with nasal airway obstruction was reviewed to select the 2 patients with the greatest reciprocal change in mucosal engorgement between preoperative and postoperative computed tomography (CT) scans. Three-dimensional anatomic models were created based on the preoperative and postoperative CT scans. Nasal cycling models were also created by gradually changing the thickness of the inferior turbinate, middle turbinate, and septal swell body. Moreover, CFD was used to simulate airflow and to calculate nasal resistance and the average heat flux. Before accounting for the nasal cycle, patient A appeared to have a paradoxical worsening nasal obstruction in the right cavity postoperatively. After accounting for the nasal cycle, patient A had small improvements in objective measures postoperatively. The magnitude of the surgical effect also differed in patient B after accounting for the nasal cycle. By simulating the nasal cycle and comparing models in similar congestive states, surgical changes in nasal patency can be distinguished from physiological changes associated with the nasal cycle. This ability can lead to more precise comparisons of preoperative and postoperative objective measures and potentially more accurate virtual surgery planning. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  3. The effect of maxillary multidirectional movement on nasal respiration.

    PubMed

    Ghoreishian, Mehdi; Gheisari, Rasoul

    2009-10-01

    Deformities of the maxilla may exist on all planes, and we treat these problems by mobilizing and repositioning the maxilla on all planes. Some authors have examined the effects of maxillary movement on the nasal airway. In clinical, practice, active anterior rhinomanometry is the most reliable and frequently used method to assess nasal respiratory function. The purpose of this study was to evaluate changes in nasal airflow and nasal airway resistance after maxillary movement performed by active anterior rhinomanometry. We studied 25 patients (18 female patients and 7 male patients; aged 16-30 years) in this clinical trial. Three days before surgery and 6 months after surgery, after a rest period of 30 minutes, active anterior rhinomanometry with a tube was performed at a fixed transnasal pressure of 150 Pa. The surgical treatment plan included bimaxillary surgery consisting of a 1-piece Le Fort I osteotomy combined with a bilateral sagittal split osteotomy. Mean and median total nasal airflow and nasal resistance rate were calculated before surgery and after surgery and compared by use of SPSS software (version 11.5; SPSS, Chicago, IL) and paired t test. An increase in nasal airflow (P = .009) and a decrease in nasal resistance (P = .022) were observed in the maxillary impaction and advancement group. In the maxillary impaction and setback group, there was a significant difference in nasal resistance changes (P = .027); however, postsurgical nasal airflow compared with presurgical values showed no statistically significant difference (P = .244). Impaction and advancement of the maxilla can improve nasal respiratory function, but maxillary impaction and setback reduce nasal respiratory function. Hence candidates for maxillary impaction and setback must be informed about decreased nasal respiratory function.

  4. Oral administration of diluted nasal desmopressin in managing neonatal central diabetes insipidus.

    PubMed

    Mavinkurve, Meenal; McGrath, Niamh; Johnston, Niall; Moloney, Sinead; Murphy, Nuala P; Hawkes, Colin P

    2017-05-23

    Neonatal central diabetes insipidus (NCDI) remains a therapeutic challenge, as extremely low doses of enteral desmopressin cannot be titrated with current preparations. The aim of this study was to describe the use of orally administered dilute desmopressin in NCDI. Nasal desmopressin (100 μg/mL) was diluted in 0.9% saline to 10 μg/mL. Infants were treated with 1-5 μg and doses were titrated to a twice-daily regimen. The feed volume was 150 mL/kg/day and titrated according to weight gain. Five infants aged 6-105 days were included. Stabilizing treatment doses ranged from 2 to 5 μg twice daily in neonates, and 12 μg twice daily in the older infant who was diagnosed at 105 days. Dilution of nasal desmopressin with saline facilitates safe administration and dose titration in NCDI. We recommend considering this therapeutic approach to NCDI, particularly in small infants or where alternative treatment regimens have been unsuccessful.

  5. Evaluation of the effect of nasal dorsal skin cooling on nasal mucosa by acoustic rhinometry.

    PubMed

    Ozturk, M; Mutlu, F; Kara, A; Derin, S; Topdag, M

    2014-12-01

    The use of cold nasal packs on the nose and nape of the neck is currently recommended for patients with epistaxis as this is thought to induce reflex nasal vasoconstriction, which decreases the bleeding. There have been a few investigations on the effect of cold compress application to the nose, but none of these focused specifically on nasal cooling of the skin of the nose. Acoustic rhinometry was performed to obtain baseline measurements. Nasal dorsal skin was then cooled with two ice packs that were held on the left and right side of the nose for a total of 10 minutes by the subjects. The rhinometry measurements were taken at the time of initial application (baseline), and after 5 and 10 minutes of ice pack application. Comparisons of the first and second minimal cross-sectional area values, and total nasal cavity volume measurements revealed no statistical differences. The results of this study indicate that one should be sceptical about the efficiency of cold compress application, which is frequently used in clinical practice in cases with epistaxis.

  6. Assessment of the effect of deviated nasal septum on the structure of nasal cavity.

    PubMed

    Wang, Junguo; Dou, Xin; Liu, Dingding; Song, Panpan; Qian, Xiaoyun; Wang, Shoulin; Gao, Xia

    2016-06-01

    The present study was aimed to investigate the effects of DNS on the structure of nasal cavity. The paranasal sinus coronal view CT of 108 patients with DNS and 129 hospitalized patients without DNS was retrospectively analyzed. The transverse diameter of nasal cavity (a), transverse diameter of nasal cavity and paranasal sinus (b), angle between maxillary and palatal bone, interalveolar distance, and maxillary rotation distance were measured. The ratio of a/b in experimental group was 0.367 ± 0.006 which was significantly (P = 0.0023) less than that in control group (0.391 ± 0.005). For the angle between maxillary and palatal bone, there was no significant difference found between DNS and control group for both right and left sides. The interalveolar distance was 40.75 mm in experimental group, and 38.8 mm in control (P = 0.0002). For the maxillary rotation distance, findings were considered as significant (P < 0.0001) in experimental group (11.25 mm) compared with control (10.1 mm). The present study demonstrates that long-term DNS affects the development of nasal cavity and paranasal sinus, as well as increases the interalveolar distance and maxillary rotation distance. These influences may be caused by the alteration of airflow inside the nasal cavities.

  7. Sulforaphane-rich broccoli sprout extract attenuates nasal allergic response to diesel exhaust particles.

    PubMed

    Heber, David; Li, Zhaoping; Garcia-Lloret, Maria; Wong, Angela M; Lee, Tsz Ying Amy; Thames, Gail; Krak, Michael; Zhang, Yanjun; Nel, Andre

    2014-01-01

    The generation of oxidative stress by ambient air pollution particles contributes to the development of allergic sensitization and asthma, as demonstrated by intranasal challenge with well-characterized diesel exhaust particle (DEP) suspensions in humans. This effect is due to the presence of redox active organic chemicals in DEP, and can be suppressed by antioxidants and inducers of phase II enzymes in animals. In this communication, we determined whether the administration of a standardized broccoli sprout extract (BSE), which contains a reproducible amount of the sulforaphane (SFN) precursor, glucoraphanin, could be used to suppress the nasal inflammatory response in human subjects challenged with 300 μg of an aqueous DEP suspension (equivalent to daily PM exposure levels on a Los Angeles freeway). SFN is capable of inducing an antioxidant and phase II response via activation of the nuclear transcription factor (erythroid-derived 2)-like 2 (Nrf2). Previous studies have shown that 70-90% SFN delivered by BSE is absorbed, metabolized, and excreted in humans. An initial intranasal challenge with DEP in 29 human subjects was used to characterize the magnitude of the inflammatory response. Following a 4 week washout, a BSE that delivers a reproducible and standardized dose of 100 μmol SFN in mango juice was administered daily for four days. The nasal DEP challenge was repeated and lavage fluid collected to perform white blood cell (WBC) counts. The average nasal WBC increased by 66% over the initial screening levels and by 85% over the control levels 24 hours after DEP exposure. However, total cell counts decreased by 54% when DEP challenge was preceded by daily BSE administration for 4 days (p < 0.001). Since the SFN dose in these studies is equivalent to the consumption of 100-200 g broccoli, our study demonstrates the potential preventive and therapeutic potential of broccoli or broccoli sprouts rich in glucoraphanin for reducing the impact of particulate

  8. Salmon calcitonin nasal spray treatment for postmenopausal women after hip fracture with total hip arthroplasty.

    PubMed

    Peichl, Peter; Marteau, Robert; Griesmacher, Andrea; Kumpan, Wofgang; Schedl, Rudolf; Prosquil, Eugen; Fasol, Paul; Bröll, Hans

    2005-01-01

    The increasing rate of hip fractures is giving rise to a number of socioeconomic problems for the aging community. In addition to being unable to resume their previous living habits, many patients fail to achieve full functional recovery after the fractures. Total hip arthroplasty (THA) is a successful operation for the majority of patients with all forms of hip fractures. Dislocation and aseptic loosening are the major reasons for revisions. An additional problem post-THA is the rate of heterotopic soft tissue calcification after total hip arthroplasty, resulting in severely impaired function, pain, and a reduced range of hip motion. In an open study, 37 women who had undergone cementless total hip arthroplasty after accidental hip fractures were treated twice daily with 200 IU salmon calcitonin nasal spray for 12 months. Simultaneously, the patients received one bag of 1000 mg calcium plus 880 IU vitamin D daily throughout the treatment period of 1 year. A parallel group of 38 women with a similar clinical status in terms of hip fractures and cementless total hip arthroplasty were treated with only one bag of 1000 mg calcium plus 880 IU vitamin D daily through the treatment period. The results of this 12-month clinical trial show that 200 IU salmon calcitonin nasal spray per day promotes general independence from foreign assistance, mobility, and fear of further falls in postmenopausal elderly women following THA. Treatment with a salmon calcitonin nasal spray reduces bone turnover serum markers, loss of further bone density, and pain. Additionally, calcitonin promoted the repair of hip fractures and, as a coincidence finding, was associated with a significantly reduced rate of refractures as well as periprosthetic ossifications.

  9. Staphylococcal nasal carriage of health care workers.

    PubMed

    Akhtar, Naeem

    2010-07-01

    To determine the frequency of staphylococcal nasal carriage of health care workers (HCWs) and antimicrobial susceptibility profile of the isolates for appropriate decolonization therapy. An observational study. The study was conducted at Holy Family Hospital, Rawalpindi, during the period from May 2007 to April 2008. Nasal swabs from anterior nares of HCWs were cultured and identified as Staphylococcus aureus, coagulasenegative staphylococci (CoNS), methicillin-resistant S. aureus (MRSA), methicillin-resistant CoNS (MRCoNS) by using standard methods. Antimicrobial susceptibility testing was performed on Muller Hinton Agar using disc diffusion method. Of the 468 HCWs, 213 (45.5%) participants were men and 255 (54.5%) were women. Eighty five (18.2%) were nasal carriers of S. aureus, 07 (1.5%) for MRSA, 343 (73.3%) for CoNS and 10 (2.1%) for MRCoNS. The highest carriage rate for S. aureus was in midwives (30%) followed by maintenance staff (28.6%), security guards (25%), technicians (23.5%), staff nurses (22.7%) and < 20% in house physicians and nursing students. Carriage rate in HCWs from different departments was: surgical ICU (40%), gynaecology (34.9%), delivery room (30%), gynaecology operation rooms (25%), medicine (22.7%) and < 20% in pediatrics and surgery. All isolates were susceptible to vancomycin, imipenem and levofloxacin and > 90% of S. aureus and CoNS were susceptible to amikacin, gentamicin and fluoroquinolones tested. Fluoroquinolones, preferably oral levofloxacin in combination with topical gentamicin ointment, in places like Pakistan where mupirocin is not routinely available, can be used for decolonization of nasal staphylococcal carriage.

  10. Targeted Lung Delivery of Nasally Administered Aerosols.

    PubMed

    Tian, Geng; Hindle, Michael; Longest, P Worth

    2014-01-01

    Using the nasal route to deliver pharmaceutical aerosols to the lungs has a number of advantages including co-administration during non-invasive ventilation. The objective of this study was to evaluate the growth and deposition characteristics of nasally administered aerosol throughout the conducting airways based on delivery with streamlined interfaces implementing two forms of controlled condensational growth technology. Characteristic conducting airways were considered including a nose-mouth-throat (NMT) geometry, complete upper tracheobronchial (TB) model through the third bifurcation (B3), and stochastic individual path (SIP) model to the terminal bronchioles (B15). Previously developed streamlined nasal cannula interfaces were used for the delivery of submicrometer particles using either enhanced condensational growth (ECG) or excipient enhanced growth (EEG) techniques. Computational fluid dynamics (CFD) simulations predicted aerosol transport, growth and deposition for a control (4.7 μm) and three submicrometer condensational aerosols with budesonide as a model insoluble drug. Depositional losses with condensational aerosols in the cannula and NMT were less than 5% of the initial dose, which represents an order-of-magnitude reduction compared to the control. The condensational growth techniques increased the TB dose by a factor of 1.1-2.6x, delivered at least 70% of the dose to the alveolar region, and produced final aerosol sizes ≥2.5 μm. Compared to multiple commercial orally inhaled products, the nose-to-lung delivery approach increased dose to the biologically important lower TB region by factors as large as 35x. In conclusion, nose-to-lung delivery with streamlined nasal cannulas and condensational aerosols was highly efficient and targeted deposition to the lower TB and alveolar regions.

  11. Targeted Lung Delivery of Nasally Administered Aerosols

    PubMed Central

    Tian, Geng; Hindle, Michael; Longest, P. Worth

    2014-01-01

    Using the nasal route to deliver pharmaceutical aerosols to the lungs has a number of advantages including co-administration during non-invasive ventilation. The objective of this study was to evaluate the growth and deposition characteristics of nasally administered aerosol throughout the conducting airways based on delivery with streamlined interfaces implementing two forms of controlled condensational growth technology. Characteristic conducting airways were considered including a nose-mouth-throat (NMT) geometry, complete upper tracheobronchial (TB) model through the third bifurcation (B3), and stochastic individual path (SIP) model to the terminal bronchioles (B15). Previously developed streamlined nasal cannula interfaces were used for the delivery of submicrometer particles using either enhanced condensational growth (ECG) or excipient enhanced growth (EEG) techniques. Computational fluid dynamics (CFD) simulations predicted aerosol transport, growth and deposition for a control (4.7 μm) and three submicrometer condensational aerosols with budesonide as a model insoluble drug. Depositional losses with condensational aerosols in the cannula and NMT were less than 5% of the initial dose, which represents an order-of-magnitude reduction compared to the control. The condensational growth techniques increased the TB dose by a factor of 1.1–2.6x, delivered at least 70% of the dose to the alveolar region, and produced final aerosol sizes ≥2.5 μm. Compared to multiple commercial orally inhaled products, the nose-to-lung delivery approach increased dose to the biologically important lower TB region by factors as large as 35x. In conclusion, nose-to-lung delivery with streamlined nasal cannulas and condensational aerosols was highly efficient and targeted deposition to the lower TB and alveolar regions. PMID:24932058

  12. Nasal high flow reduces dead space.

    PubMed

    Möller, Winfried; Feng, Sheng; Domanski, Ulrike; Franke, Karl-Josef; Celik, Gülnaz; Bartenstein, Peter; Becker, Sven; Meyer, Gabriele; Schmid, Otmar; Eickelberg, Oliver; Tatkov, Stanislav; Nilius, Georg

    2017-01-01

    Recent studies show that nasal high flow (NHF) therapy can support ventilation in patients with acute or chronic respiratory disorders. Clearance of dead space has been suggested as being the key mechanism of respiratory support with NHF therapy. The hypothesis of this study was that NHF in a dose-dependent manner can clear dead space of the upper airways from expired air and decrease rebreathing. The randomized crossover study involved 10 volunteers using scintigraphy with (81m)Krypton ((81m)Kr) gas during a breath-holding maneuver with closed mouth and in 3 nasally breathing tracheotomized patients by volumetric capnography and oximetry through sampling CO2 and O2 in the trachea and measuring the inspired volume with inductance plethysmography following NHF rates of 15, 30, and 45 l/min. The scintigraphy revealed a decrease in (81m)Kr gas clearance half-time with an increase of NHF in the nasal cavities [Pearson's correlation coefficient cc = -0.55, P < 0.01], the pharynx (cc = -0.41, P < 0.01), and the trachea (cc = -0.51, P < 0.01). Clearance rates in nasal cavities derived from time constants and MRI-measured volumes were 40.6 ± 12.3 (SD), 52.5 ± 17.7, and 72.9 ± 21.3 ml/s during NHF (15, 30, and 45 l/min, respectively). Measurement of inspired gases in the trachea showed an NHF-dependent decrease of inspired CO2 that correlated with an increase of inspired O2 (cc = -0.77, P < 0.05). NHF clears the upper airways of expired air, which reduces dead space by a decrease of rebreathing making ventilation more efficient. The dead space clearance is flow and time dependent, and it may extend below the soft palate.

  13. Nasal nitric oxide in unilateral sinus disease

    PubMed Central

    Fu, Chia-Hsiang; Tseng, Hsiao-Jung; Huang, Chi-Che; Chang, Po-Hung; Chen, Yi-Wei; Lee, Ta-Jen

    2017-01-01

    Unilateral sinus disease (USD) can sometimes be difficult to accurately diagnose before surgery. The application of nasal nitric oxide (nNO) for USD diagnosis and its surgical outcome in USD has not been reported in the literature. We prospectively enrolled sixty-six USD patients who underwent endoscopic sinus surgery for fungal rhinosinusitis (n = 19), chronic rhinosinusitis (CRS) without nasal polyps (n = 13), CRS with nasal polyps (n = 12) and sinonasal mass lesions (n = 22). nNO levels were measured preoperatively and at three and six months postoperatively. Correlations between nNO levels and potential clinical parameters, type of disease, disease severity, and disease-related quality of life (QOL) were assessed. Unlike bilateral CRS, in USD, nNO levels did not correlate with disease severity or postoperative QOL improvements. Except for fungus group, there were no differences in nNO levels between lesion and non-lesion sides in all the other groups. nNO levels on both sides were significantly elevated six months postoperatively in all groups. Fungal rhinosinusitis patients had the lowest preoperative nNO levels, and a cutoff of 239.3 ppb had the best sensitivity (79.0%) and specificity (87.2%) for preoperative diagnosis. While preoperative nNO levels cannot serve as an alternative marker for disease severity of USD, they were lower in fungal rhinosinusitis patients than in other USD patients and may be useful for more accurate diagnosis prior to surgery. PMID:28199369

  14. [Nasal cavity and paranasal sinus cancer].

    PubMed

    Peyraga, G; Lafond, C; Pointreau, Y; Giraud, P; Maingon, P

    2016-09-01

    The nasal cavity and parasinusal cancer are rare (10% of tumors of the head and neck) and are mainly represented by squamous cell carcinoma of the nasal cavity or the maxillary sinus and adenocarcinoma of the ethmoid sinus (occupational disease, wood dust). The most common clinical sign is nasal obstruction, but tumors can also manifest as rhinorrhea and/or epistaxis (usually unilateral signs). A magnetic resonance imaging of the facial structure is systematic for staging before treatment. The treatment consists of a first surgery if the patient is operable with a resectable tumor. If it is not the case, the treatment consists of radiotherapy (RT) associated with chemotherapy (CT) according to the initial data (T3/T4 or N+). After first surgery, RT is indicated (except T1N0 with complete resection) associated with a CT based on postoperative data (capsular effraction or incomplete resection). Lymph node irradiation is considered case by case, but is indicated in any nodal involvement. RT must be an intensity modulated RT (IMRT), static or dynamic, and must be imagery guided (IGRT). According to ICRU 83, doses to organs at risk and target volumes must be carried. Finally, after a post-treatment baseline imaging between 2 and 4 months, monitoring will be alternated with the ENT surgeon every 2 or 3 months for 2 years, then every 4 to 6 months for 5 years.

  15. Surgical Nasal Implants: Indications and Risks.

    PubMed

    Genther, Dane J; Papel, Ira D

    2016-10-01

    Rhinoplasty often requires the use of grafting material, and the goal of the specific graft dictates the ideal characteristics of the material to be used. An ideal material would be biologically inert, resistant to infection, noncarcinogenic, nondegradable, widely available, cost-effective, readily modifiable, and easily removable, have compatible biomechanical characteristics, retain physical properties over time, and not migrate. Unfortunately, no material currently in existence meets all of these criteria. In modern rhinoplasty, autologous grafts are the gold standard against which all other nasal implants are measured and offer the safest long-term results for most patients. They are easily manipulated, have inherent stability and biomechanical characteristics similar to the native nasal framework, and confer minimal risk of complications. Modern homologous and alloplastic materials have gained considerable support in recent years because they are readily available in endless quantity, do not require a second surgical site for harvest, and are generally considered safe if most circumstances, but they confer additional risk and have biomechanical characteristics different from that of the native nasal framework. To address some of these issues, we provide a contemporary review of autologous, homologous, and alloplastic materials commonly used in rhinoplasty surgery.

  16. Standardization of Malaysian adult female nasal cavity.

    PubMed

    Lee, Chih Fang; Abdullah, Mohd Zulkifly; Ahmad, Kamarul Arifin; Lutfi Shuaib, Ibrahim

    2013-01-01

    This research focuses on creating a standardized nasal cavity model of adult Malaysian females. The methodology implemented in this research is a new approach compared to other methods used by previous researchers. This study involves 26 females who represent the test subjects for this preliminary study. Computational fluid dynamic (CFD) analysis was carried out to better understand the characteristics of the standardized model and to compare it to the available standardized Caucasian model. This comparison includes cross-sectional areas for both half-models as well as velocity contours along the nasal cavities. The Malaysian female standardized model is larger in cross-sectional area compared to the standardized Caucasian model thus leading to lower average velocity magnitudes. The standardized model was further evaluated with four more Malaysian female test subjects based on its cross-sectional areas and average velocity magnitudes along the nasal cavities. This evaluation shows that the generated model represents an averaged and standardized model of adult Malaysian females.

  17. Standardization of Malaysian Adult Female Nasal Cavity

    PubMed Central

    Abdullah, Mohd. Zulkifly; Ahmad, Kamarul Arifin; Lutfi Shuaib, Ibrahim

    2013-01-01

    This research focuses on creating a standardized nasal cavity model of adult Malaysian females. The methodology implemented in this research is a new approach compared to other methods used by previous researchers. This study involves 26 females who represent the test subjects for this preliminary study. Computational fluid dynamic (CFD) analysis was carried out to better understand the characteristics of the standardized model and to compare it to the available standardized Caucasian model. This comparison includes cross-sectional areas for both half-models as well as velocity contours along the nasal cavities. The Malaysian female standardized model is larger in cross-sectional area compared to the standardized Caucasian model thus leading to lower average velocity magnitudes. The standardized model was further evaluated with four more Malaysian female test subjects based on its cross-sectional areas and average velocity magnitudes along the nasal cavities. This evaluation shows that the generated model represents an averaged and standardized model of adult Malaysian females. PMID:23840279

  18. Autologous Diced Cartilage in Nasal Septoplasty

    PubMed Central

    Sersar, Sameh Ibrahim; Yassin, Ibrahim; Eldin Aly, Mohammed Saad

    2016-01-01

    Diced rib cartilage is an acceptable option in severe nasal deformities. We present our preliminary experience in KAMC in nasal septoplasties using the autologous diced costal cartilage. This is a retrospective study of the 22 cases who needed the autologous diced costal cartilage in our centre in 4 years. All our patients needed autologous diced rib cartilages. Twelve were wrapped with temporalis fascia, eight needed rectus fascia and perichondrium was used in only 2 cases. The naso-frontal angle for the whole series decreased by a mean of 4.41° (p=0.008) for the group using the rectus fascia diced cartilage graft. From the aesthetic point of view, all cases were satisfied except 3 (13.6%); two in the group of diced cartilage temporalis fascia; group 1. From the functional breathing view, only 1 case was not satisfied. He was in group 1. Autologous rib cartilage was shown to be a good graft in nasal septoplasty especially if wrapped with rectus fascia. PMID:27853694

  19. Deformation of Nasal Septal Cartilage During Mastication

    PubMed Central

    Dayeh, Ayman A. Al; Rafferty, Katherine L.; Egbert, Mark; Herring, Susan W.

    2009-01-01

    The cartilaginous nasal septum plays a major role in structural integrity and growth of the face, but its internal location has made physiologic study difficult. By surgically implanting transducers in 10 miniature pigs (Sus scrofa), we recorded in vivo strains generated in the nasal septum during mastication and masseter stimulation. The goals were (1) to determine whether the cartilage should be considered as a vertical strut supporting the nasal cavity and preventing its collapse, or as a damper of stresses generated during mastication and (2) to shed light on the overall pattern of snout deformation during mastication. Strains were recorded simultaneously at the septo-ethmoid junction and nasofrontal suture during mastication. A third location in the anterior part of the cartilage was added during masseter stimulation and manipulation. Contraction of jaw closing muscles during mastication was accompanied by anteroposterior compressive strains (around −1,000 με) in the septo-ethmoid junction. Both the orientation and the magnitude of the strain suggest that the septum does not act as a vertical strut but may act in absorbing loads generated during mastication. The results from masseter stimulation and manipulation further suggest that the masticatory strain pattern arises from a combination of dorsal bending and/or shearing and anteroposterior compression of the snout. J. Morphol. PMID:19434723

  20. Characterization of postoperative changes in nasal airflow using a cadaveric computational fluid dynamics model: supporting the internal nasal valve.

    PubMed

    Shadfar, Scott; Shockley, William W; Fleischman, Gita M; Dugar, Anand R; McKinney, Kibwei A; Frank-Ito, Dennis O; Kimbell, Julia S

    2014-01-01

    Collapse or compromise of the internal nasal valve (INV) results in symptomatic nasal obstruction; thus, various surgical maneuvers are designed to support the INV. To determine the effect on nasal airflow after various surgical techniques focused at the level of the INV and lateral nasal sidewall. A fresh cadaver head was obtained and underwent suture and cartilage graft techniques directed at the level of the INV using an external approach. Preoperative and postoperative digital nasal models were created from the high-resolution, fine-cut, computed tomographic imaging after each intervention. Isolating the interventions to the level of the INV, we used computational fluid dynamic techniques to calculate nasal resistance, nasal airflow, and nasal airflow partitioning for each intervention. Suture and cartilage graft techniques. Nasal airflow, nasal resistance, and partitioning of airflow. Using the soft-tissue elevation model as baseline, computational fluid dynamic analysis predicted that most of the suture and cartilage graft techniques directed toward the nasal valve improved nasal airflow and partitioning while reducing nasal resistance. Specifically, medial and modified flare suture techniques alone improved nasal airflow by 16.9% and 15.1%, respectively. The combination of spreader grafts and modified flare suture improved nasal airflow by 13.2%, whereas spreader grafts alone only improved airflow by 5.9%. The largest improvements in bilateral nasal resistance were achieved using the medial and modified flare sutures, outperforming the combination of spreader grafts and modified flare suture. Techniques directed at supporting the INV have tremendous value in the treatment of nasal obstruction. The use of flare sutures alone can address dynamic valve collapse or upper lateral cartilage incompetence without gross disruption of the nasal architecture. Using computational fluid dynamic techniques, this study suggests that flare sutures alone may improve flow and

  1. Satratoxin-G from the black mold Stachybotrys chartarum induces rhinitis and apoptosis of olfactory sensory neurons in the nasal airways of rhesus monkeys.

    PubMed

    Carey, Stephan A; Plopper, Charles G; Hyde, Dallas M; Islam, Zahidul; Pestka, James J; Harkema, Jack R

    2012-08-01

    Satratoxin-G (SG) is a trichothecene mycotoxin of Stachybotrys chartarum, the black mold suggested to contribute etiologically to illnesses associated with water-damaged buildings. We have reported that intranasal exposure to SG evokes apoptosis of olfactory sensory neurons (OSNs) and acute inflammation in the nose and brain of laboratory mice. To further assess the potential human risk of nasal airway injury and neurotoxicity, we developed a model of SG exposure in monkeys, whose nasal airways more closely resemble those of humans. Adult, male rhesus macaques received a single intranasal instillation of 20 µg SG (high dose, n = 3), or 5 µg SG daily for four days (repeated low dose, n = 3) in one nasal passage, and saline vehicle in the contralateral nasal passage. Nasal tissues were examined using light and electron microscopy and morphometric analysis. SG induced acute rhinitis, atrophy of the olfactory epithelium (OE), and apoptosis of OSNs in both groups. High-dose and repeated low-dose SG elicited a 13% and 66% reduction in OSN volume density, and a 14-fold and 24-fold increase in apoptotic cells of the OE, respectively. This model provides new insight into the potential risk of nasal airway injury and neurotoxicity caused by exposure to water-damaged buildings.

  2. [Dexpanthenol nasal spray in comparison to dexpanthenol nasal ointment. A prospective, randomised, open, cross-over study to compare nasal mucociliary clearance].

    PubMed

    Verse, T; Klöcker, N; Riedel, F; Pirsig, W; Scheithauer, M O

    2004-07-01

    Recent technical developments in metered pump systems allow the production and use of preservative-free nasal products. The aim of the current study is to compare the tolerability of a preservative-free dexpanthenol (5%) nasal spray with that of the established dexpanthenol (5%) nasal ointment, also without preservatives. The main outcome measure was in vivo mucociliary clearance. Mucociliary clearance was assessed by saccharin migration time in 20 volunteers. Wash-out phases were 7 days and the spray or ointment was always applied 20 min before the saccharin test. The study was designed to test for non-inferiority. Saccharin migration time was slightly longer after ointment administration, however, these were not significantly different to nasal spray. The saccharin migration time showed a significant correlation with the age of the volunteers. The upper confidence limit of dexpanthenol nasal spray was markedly less than that of the ointment. Therefore, dexpanthenol nasal spray is at least equal to if not better than dexpanthenol nasal ointment. Due to its ease of administration, preservative-free dexpanthenol nasal spray offers a valuable therapeutic alternative.

  3. A new approach to the treatment of nasal bone fracture: radiologic classification of nasal bone fractures and its clinical application.

    PubMed

    Han, Daniel Seung Youl; Han, Yea Sik; Park, Jin Hyung

    2011-11-01

    A radiologic examination is required in the treatment of nasal bone fracture to determine the fracture condition. Thus, there is an increasing need for radiologic classification of nasal bone fractures that can be applied to clinical practice. Computed tomography was performed in 125 patients with nasal bone fractures to determine which axial view best showed the entire nasal view. The obtained axial view was then used as a reference for classification. The length from the top to the base of the nasal bone was divided into upper, middle, and lower levels, after which the fracture location was determined. If the fracture spanned the boundaries of these levels, it was classified as the total level. Subsequently, the fracture was subclassified based on the fracture direction and pattern and the concurrent fracture. Radiologic examination of patients with nasal bone fracture showed that nasal bone fracture was frequently found at the total, middle, upper, and lower levels, in that order. Nasal bone fractures at the upper level showed lower frequencies of complication and reoperation than the fractures at the other levels, whereas nasal bone fractures at the total level showed the highest frequencies of complication and reoperation. Radiologic classification can be useful for preoperative and postoperative evaluations of nasal bone fractures and can be helpful in understanding such fractures because it can efficiently predict the prognosis of a fracture. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  4. The Effect of Menstrual Cycle on Nasal Resonance Characteristics in Females

    ERIC Educational Resources Information Center

    Kumar, Suman; Basu, Shriya; Sinha, Anisha; Chatterjee, Indranil

    2012-01-01

    The purpose of this study was to analyze resonance characteristics (nasality and nasalance values) during the menstrual cycle. Previous studies indicate changes in voice quality and nasal mucosa due to temporary falling estrogen levels in human females during their menstrual cycle. The present study compared the nasality and "nasalance scores"…

  5. The Effect of Menstrual Cycle on Nasal Resonance Characteristics in Females

    ERIC Educational Resources Information Center

    Kumar, Suman; Basu, Shriya; Sinha, Anisha; Chatterjee, Indranil

    2012-01-01

    The purpose of this study was to analyze resonance characteristics (nasality and nasalance values) during the menstrual cycle. Previous studies indicate changes in voice quality and nasal mucosa due to temporary falling estrogen levels in human females during their menstrual cycle. The present study compared the nasality and "nasalance scores"…

  6. Objectivating nasality in healthy and velopharyngeal insufficient children with the Nasalance Acquisition System (NasalView). Defining minimal required speech tasks assessing normative values for Dutch language.

    PubMed

    Hogen Esch, Thijs T; Dejonckere, Philippe H

    2004-08-01

    (1) To define normative nasalance data for Dutch language with "the NasalView System", and obtain a reference for normality when nasality is evaluated in children. (2) To investigate the minimal number of required speech tasks for a reliable nasalance measurement. 55 children (30 normal and 25 velopharyngeal insufficient), aged between 4 and 11 were included. All children had to read or repeat two Dutch passages ((one with a normal amount of nasal consonants (normal passage) and one with none (nonnasal passage)). Further, one normal and one velopharyngeal insufficient subject read a passage in repetition to test the NasalViews reproducibility: (1) For both passages, group means (GM) and standard deviations (S.D.) were used to compute "pathological nasalance boundaries" [GM +/- (2 x S.D.)], in combination with the coefficient of variation (CV), sensitivity, specificity and positive predictive values. (2) With ANOVA all sentences within each passage were tested for significant differences in nasalance. (1) The pathological boundaries were 28.6-41.4% (GM: 35.0) and 21.4-34.7% (GM: 28.1), for the normal and nonnasal passage, respectively. For the normal passage a sensitivity of 96%, a specificity of 93% and a positive predictive value of 92% was computed. For the nonnasal passage these parameters were 96, 95 and 96%, respectively. Intra subject CVs of 3.6% (normal subject) and 1.5% (VI subject) showed good reproducibility of measurements. (2) Within the normal passage only the third sentence was significantly different in nasalance, compared to the entire passage (31.2% versus 35.0%). Within the nonnasal passage the second and fifth sentences were significantly different (23.8 and 24.8% versus 28.1%). However, the individual nonsignificantly different sentences showed a higher variation in nasalance compared to the entire passages. The NasalView System seems to be reliable and quantifies valid nasalance values when nasality is evaluated. Within both passages high

  7. Postrhinoplasty nasal cysts and the use of petroleum-based ointments and nasal packing.

    PubMed

    Liu, Edmund S; Kridel, Russell W H

    2003-07-01

    Nasal cysts are rare complications of rhinoplasty, and numerous theories exist regarding their cause. The term "paraffinoma" has been used to describe cyst formation observed after topical antibiotic ointment application with nasal packing in the immediate postoperative period. Such complications are rare but may occur because of the inherent properties of the agent used or a lack of meticulous technique (in the placement of incisions and nasal packing). Three cases of postrhinoplasty cysts with a variety of presentations, including incidental intraoperative findings, bilateral medial canthal masses, and a draining dorsal cyst, are described. Although such cysts are uncommon, techniques to prevent these unwanted sequelae should routinely be used, with the judicious application of non-petroleum-based topical antibiotic preparations.

  8. Nasal shedding of equine herpesvirus-1 from horses in an outbreak of equine herpes myeloencephalopathy in Western Canada.

    PubMed

    Burgess, B A; Tokateloff, N; Manning, S; Lohmann, K; Lunn, D P; Hussey, S B; Morley, P S

    2012-01-01

    There is little information on the duration of nasal shedding of EHV-1 from horses with naturally occurring equine herpesvirus myeloencephalopathy (EHM). To evaluate the duration of nasal shedding of EHV-1 in horses affected by EHM. One hundred and four horses naturally exposed to EHV-1, 20 of which had clinical signs of EHM. All horses on affected premises were monitored. Those horses developing EHM were sampled in a longitudinal outbreak investigation. Nasal swabs were collected daily from 16 of 20 horses affected by EHM. A qPCR was performed on 98 of 246 nasal swab samples to determine nasal shedding duration. Historical and clinical information was analyzed to evaluate potential risk factors for developing EHM and duration of shedding during this outbreak. The last day shedding was detected in any horse was Disease Day 9. EHV-1 was detected in two-thirds of horses tested on Disease Days 0-3. The amount of EHV-1 DNA found in nasal swabs varied markedly and was not associated with disease severity or age. The odds of developing EHM were greater for febrile horses (OR = 20.3; 95% CI 3.4-390.3; P = .01) as well as for horses attending the riding clinic (OR = 4.1; 95% CI 0.84-21.65; P = .08). Biosecurity measures should be implemented for a minimum of 14 days beyond the onset of clinical signs of EHM. Animal managers cannot rely on the severity of clinical signs to predict the duration of EHV-1 shedding. Copyright © 2012 by the American College of Veterinary Internal Medicine.

  9. Nasal high flow reduces dead space

    PubMed Central

    Feng, Sheng; Domanski, Ulrike; Franke, Karl-Josef; Celik, Gülnaz; Bartenstein, Peter; Becker, Sven; Meyer, Gabriele; Schmid, Otmar; Eickelberg, Oliver; Tatkov, Stanislav; Nilius, Georg

    2017-01-01

    Recent studies show that nasal high flow (NHF) therapy can support ventilation in patients with acute or chronic respiratory disorders. Clearance of dead space has been suggested as being the key mechanism of respiratory support with NHF therapy. The hypothesis of this study was that NHF in a dose-dependent manner can clear dead space of the upper airways from expired air and decrease rebreathing. The randomized crossover study involved 10 volunteers using scintigraphy with 81mKrypton (81mKr) gas during a breath-holding maneuver with closed mouth and in 3 nasally breathing tracheotomized patients by volumetric capnography and oximetry through sampling CO2 and O2 in the trachea and measuring the inspired volume with inductance plethysmography following NHF rates of 15, 30, and 45 l/min. The scintigraphy revealed a decrease in 81mKr gas clearance half-time with an increase of NHF in the nasal cavities [Pearson’s correlation coefficient cc = −0.55, P < 0.01], the pharynx (cc = −0.41, P < 0.01), and the trachea (cc = −0.51, P < 0.01). Clearance rates in nasal cavities derived from time constants and MRI-measured volumes were 40.6 ± 12.3 (SD), 52.5 ± 17.7, and 72.9 ± 21.3 ml/s during NHF (15, 30, and 45 l/min, respectively). Measurement of inspired gases in the trachea showed an NHF-dependent decrease of inspired CO2 that correlated with an increase of inspired O2 (cc = −0.77, P < 0.05). NHF clears the upper airways of expired air, which reduces dead space by a decrease of rebreathing making ventilation more efficient. The dead space clearance is flow and time dependent, and it may extend below the soft palate. NEW & NOTEWORTHY Clearance of expired air in upper airways by nasal high flow (NHF) can be extended below the soft palate and de facto causes a reduction of dead space. Using scintigraphy, the authors found a relationship between NHF, time, and clearance. Direct measurement of CO2 and O2 in the trachea confirmed a reduction of rebreathing, providing

  10. Nasal Nosocomial Myiasis Infection Caused by Chrysomya bezziana (Diptera: Calliphoridae) Following the Septicemia: A Case Report

    PubMed Central

    MIRCHERAGHI, Seyed Farzin; MIRCHERAGHI, Seyed Farzam; RAMEZANI AWAL RIABI, Hamed; PARSAPOUR, Arezoo

    2016-01-01

    A 74 yr old woman from Gonabad, southern part of Khorasan Razavi Province of Iran was admitted to a Hospital of Gonabad, because of respiratory distress, exertional dyspnea and fever. Close contact with domestic animals, history of chronic obstructive pulmonary disease (COPD), and completely resolved pulmonary tuberculosis (TB) in remote past, were notable parts of her past medical history. Due to clinical, paraclinical and radiographic findings and because of recent hospitalization, she was admitted to internal medicine ward with the diagnosis of health care associated pneumonia (HCAP). Despite the application of broad-spectrum antibiotics and appropriate supportive care, she had a poor response to the treatment. During the daily visit in Intensive Care Unit (ICU), numerous white larvae were detected in both nostrils. Further investigation of oropharynx and tracheal tube aspiration, showed no more larvae in mentioned parts. An hour later, nasal spontaneous bleeding occurred. Otorhinolaryngology consultation was performed and led to surgical procedure. In ENT examination, there were numerous larvae and massive clot formation in both inferior meatuses and distal nasal septum perforation. Thirty-seven extracted larvae were transferred to Medical Entomology lab by vial 70% ethanol and 5 live larvae for rearing. After precise investigation by aid of light microscopy, the larvae were identified as Chrysomya bezziana. Due to discovered 2nd larvae stage and duration of hospitalization, this infestation was identified as nasal myiasis. PMID:28096867

  11. Nasal airflow and brain activity: is there a link?

    PubMed

    Price, A; Eccles, R

    2016-09-01

    Over the past few decades, evidence has emerged suggesting that nasal airflow asymmetry and brain asymmetry are linked. The nose exhibits asymmetrical airflow, with the dominant airflow alternating from one nasal passage to the other over a period of hours. Some authors have suggested a correlation between cerebral hemisphere dominance and nostril dominance. Others have proposed an association between rhythmic fluctuations in nasal airflow and corresponding fluctuations in cerebral hemisphere activity. Based on ancient yoga breathing techniques, newer evidence suggests that altering nasal airflow can influence brain activity, with reports of improved cognitive function caused by unilateral forced nostril breathing. It seems that a nasal airflow stimulus may have an activating effect on the brain, as it has also been shown to trigger seizure activity in epileptic patients. This article explores these theories in detail, reviews the evidence, and presents new models linking nasal airflow and brain activity.

  12. Infective endocarditis of native valve after anterior nasal packing.

    PubMed

    Jayawardena, Suriya; Eisdorfer, Jacob; Indulkar, Shalaka; Zarkaria, Muhammad

    2006-01-01

    We present a case report of a patient who was previously treated for spontaneous epistaxis with a petroleum jelly gauze (0.5 in x 72 in) anterior nasal packing filled with an antibiotic ointment, along with prophylactic oral clindamycin. The patient presented with fever and hypotension 3 days after the nasal packing. Her blood cultures grew methicillin-resistant Staphylococcus aureus and the transesophageal echocardiography showed vegetation on the atrial surface of the posterior mitral valve leaflet, confirming the diagnosis of bacterial endocarditis attributable to nasal packing. Several case reports discuss toxic shock syndrome after nasal packing, but none describe endocarditis of the native heart valves subsequent to anterior nasal packing. Current guidelines on endocarditis prophylaxis produced by the American Heart Association, European Cardiac Society, and British Cardiac Society together with published evidence do not recommend endocarditis prophylaxis for patients with native heart valves undergoing anterior nasal packing.

  13. External nasal dilators: definition, background, and current uses

    PubMed Central

    Dinardi, Ricardo Reis; de Andrade, Cláudia Ribeiro; Ibiapina, Cássio da Cunha

    2014-01-01

    Our goal was to revise the literature about external nasal dilators (ENDs) as to their definition, history, and current uses. We reviewed journals in the PubMed and MEDLINE databases. The current uses hereby presented and discussed are physical exercise, nasal congestion and sleep, snoring, pregnancy, cancer, and healthy individuals. Numerous studies have shown that ENDs increase the cross-sectional area of the nasal valve, reducing nasal resistance and transnasal inspiratory pressure and stabilizing the lateral nasal vestibule, avoiding its collapse during final inspiration. These effects also facilitate breathing and are beneficial to patients with nasal obstruction. Furthermore, END use is simple, noninvasive, painless, affordable, and bears minimum risk to the user. Most studies have limited sample size and are mainly focused on physical exercise. In conclusion, ENDs seem useful, so further studies involving potential effects on the performance of physical tests and improvements in sleep quality are necessary, especially in children and teenagers. PMID:25419156

  14. [Nasal septal abscess complicating acute sinusitis in a child].

    PubMed

    Hassani, R; Aderdour, L; Maliki, O; Boumed, A; Elfakiri, M M; Bouchoua, F; Raji, A

    2011-01-01

    Nasal septal abscess is a rare complication of acute sinusitis in children. We report the case of a 9-year-old girl who presented at the emergency unit with a bilateral eyelid edema evolving over 2 days, associated with bilateral rhinorrhea and nasal obstruction. Clinical examination found a tumefied nasal septum and nasal obstruction. A computed tomography scan of the nose and paranasal sinuses showed pansinusitis with an abscess of the nasal septum. Treatment consisted in the evacuation of the abscess associated with a triple antibiotic therapy. Progression was favorable. Acute sinusitis is seldom complicated by an abscess of the nasal septum, and very few cases are reported in the literature. Early diagnosis and treatment can avoid complications, which engage not only the functional but also the vital prognosis.

  15. Osteocutaneous radial forearm free flap in subtotal nasal reconstruction

    PubMed Central

    Moore, Alexander Michael; Montgomery, Jenny; McMahon, Jeremy; Sheikh, Saghir

    2014-01-01

    A 66-year-old man presented with a large squamous cell carcinoma of the right nasal vestibule. He underwent partial rhinectomy and medial maxillectomy followed by staged reconstruction. Reconstruction of a full-thickness nasal defect requires repair of three distinct layers: the skin–soft tissue envelope, subsurface framework and intranasal lining. We report the first use in the UK of an osteocutaneous radial forearm free flap in the reconstruction of a subtotal nasal deficit. The skin of the radial forearm free flap was tubed to recreate the nasal lining and the radial bone reconstructed the dorsal contour of the nose. A full-thickness paramedian forehead flap supplied external coverage. The osteocutaneous radial forearm free flap and forehead flap is a viable option for large nasal defects requiring reconstruction of framework, nasal lining and external covering. PMID:25427933

  16. Management of the middle nasal third in revision rhinoplasty.

    PubMed

    Sykes, Jonathan M

    2008-08-01

    The middle nasal third is often the source of both aesthetic and functional problems with primary rhinoplasty. Weakness of the middle nasal vault can occur from overresection of the upper lateral cartilages or cartilaginous nasal septum, malposition of the upper lateral cartilages, or from secondary scarring from the primary rhinoplasty. These functional and aesthetic problems can be avoided by maintaining an adequate infrastructure to the middle nasal vault. If secondary problems occur in the middle nasal third, precise anatomic reconstruction can be performed in the form of cartilage grafting and/or suture reconstitution. This reconstruction requires an in-depth knowledge of the functional nasal anatomy and the ability to re-create the infrastructure so that it withstands the forces of scarring and wound contraction. This article outlines the anatomy of the middle third of the nose, the conditions that cause secondary middle-third problems, and the surgical management of these deformities.

  17. Change in nasal congestion index after treatment in patients with chronic rhinosinusitis with nasal polyposis

    PubMed Central

    Sahin-Onder, Serap; Oysu, Cagatay; Deveci, Ildem; Sahin, Samil; Aktas, Betul

    2016-01-01

    Background: The management of chronic rhinosinusitis with nasal polyposis (CRSwNP) involves both surgical and medical approaches, and remains a controversial subject. Objective: The objective of this prospective, randomized, controlled trial was to compare the medical and surgical treatments of CRSwNP in terms of their effect on the nasal congestion index (NCI). Methods: Forty-eight patients with CRSwNP were randomized either to medical or surgical therapy. Pretreatment and 3- and 6-month posttreatment assessments of the visual analog scale score, the 20-Item Sino-Nasal Outcome Test, saccharine clearance time, nasal endoscopy, and NCI measurement with acoustic rhinometry were performed. Forty-one subjects were included in the analysis. Results: Both the medical and surgical interventions for CRSwNP resulted in significant improvement in the visual analog scale score, 20-Item Sino-Nasal Outcome Test, saccharine clearance time, and nasal endoscopic examination scores. There was no difference between the two groups in terms of the percentage change from baseline for any of the parameters at the 6-month posttreatment assessment. NCI showed no significant difference from baseline. Similarly, no significant difference was found between the medical and surgical groups in terms of their effect on the NCI (p > 0.05). Conclusion: Because NCI does not correlate with standard subjective measures in outcomes for this group of patients, it cannot be used as an outcome measurement of treatment of subjects with CRSwNP. Results of this prospective randomized study did not find any additional benefit of surgical therapy over medical therapy in subjects with CRSwNP.

  18. Complex odontoma of the nasal cavity: a case report.

    PubMed

    Soltan, Michelle; Kacker, Ashutosh

    2008-05-01

    We describe the case of a 76-year-old man who presented with symptoms of chronic nasal obstruction and recurrent sinusitis of many years' duration. The patient's history and radiographic findings established a diagnosis of a complex odontoma of the nasal cavity. The mass was surgically excised, and the diagnosis was confirmed by histopathology. The occurrence of an odontoma in the nasal cavity is extremely rare.

  19. Muscle-building therapy in treatment of nasal valve collapse.

    PubMed

    Vaiman, Michael; Eviatar, Ephraim; Segal, Samuel

    2004-09-01

    The purpose of this paper is to describe the outcome of muscle-building therapy for nasal muscles in cases of nasal valve stenosis or collapse. The present study was performed to investigate the best way to combine transcutaneous and intranasal surface electromyography (sEMG) biofeedback training of muscles involved in nasal valve function with a home exercise program and electric stimulation of nasal muscles. A randomized pilot study of 3 groups of patients (n1=12, n2=12, n3=10; total 34 patients) presenting with symptoms of obstructed nasal breathing was conducted. All selected patients demonstrated nasal valve stenosis with a positive Cottler maneuver and clinically evident nasal valve collapse. Follow-up ranged from 8 to 12 months. Treatment for Group 1 included transcutaneous and intranasal electric stimulation of nasal muscles only. Treatment for Group 2 included biofeedback training and home exercise program of specific nasal movements, and treatment for Group 3 included surface and intranasal EMG biofeedback assisted specific strategies for nasal muscle education, home exercises and electric stimulation. All patients in these groups exhibited subjective improvement. For Group 3, in 80% the improvement was proved objectively; for Group 2, in 75% the improvement was proved objectively; for Group 1, in 58,33% the improvement was proved objectively. We found no significant difference between the results in Groups 3 and 2 and poorer results in Group 1. Relieve of nasal valve stenosis and collapse can be achieved with a complex muscle-building therapy as described. It helps a significant cohort of patients with symptoms of obstructed nasal breathing to avoid surgical intervention. Electric stimulation of the muscles does not contribute significantly in achieving of good results.

  20. Application of new packing material in endoscopic nasal surgery

    PubMed Central

    Yin, Haiying; Han, Fei; Cui, Zhaoyang

    2015-01-01

    Objective: To show the efficacy and comfort of pneumatic bag packing after the endoscopic nasal surgery. Pneumatic bag packing may be recommendable in terms of comfort and efficacy after endoscopic nasal surgery. Significant findings: There were statistical significant differences between the pneumatic bag packing and the expansive sponge packing regarding subjective symptoms and objective findings after surgery. Conclusions: Pneumatic bag packing may be recommendable in terms of comfort and efficacy after endoscopic nasal surgery. PMID:25785173

  1. An unusual presentation of a nasal septal abscess.

    PubMed

    Cuddihy, P J; Srinivasan, V

    1998-08-01

    Nasal septal abscess is a rare complication of septal haematoma. Nasal obstruction and, less frequently, pain are the usual presenting features. We report a case of a nasal septal abscess in a 21-year-old female patient who developed a naso-oral fistula. To our knowledge this is the first report of such an unusual presentation of a septal abscess. The aetiology, pathogenesis and management of septal abscesses are discussed.

  2. Nasal and Oral Inspiration During Natural Speech Breathing

    PubMed Central

    Lester, Rosemary A.; Hoit, Jeannette D.

    2015-01-01

    Purpose The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Method Ten healthy adults, 18–45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations were categorized as a nasal only, oral only, simultaneous nasal and oral, or alternating nasal and oral inspiration. The method was validated using nasal airflow, oral airflow, audio, and video recordings for two participants. Results The predominant pattern was simultaneous nasal and oral inspirations for all speaking tasks. This pattern was not affected by the nature of the speaking task or by the phonetic context surrounding the inspiration. The validation procedure confirmed that nearly all inspirations during counting and paragraph reading were simultaneous nasal and oral inspirations; whereas for sentence reading, the predominant pattern was alternating nasal and oral inspirations across the three phonetic contexts. Conclusions Healthy adults inspire through both the nose and mouth during natural speech breathing. This pattern of inspiration is likely beneficial in reducing pathway resistance while preserving some of the benefits of nasal breathing. PMID:24129013

  3. Usefulness of ultrasonography in the treatment of nasal bone fractures.

    PubMed

    Park, Chan-Hum; Joung, Ho-Hoon; Lee, Jun-Ho; Hong, Seok Min

    2009-12-01

    Ultrasonography has recently been used in assessment and diagnosis of maxillofacial trauma because it is easy and quick to perform, inexpensive, portable, and noninvasive. The aim of this study was to estimate ultrasonography as an intraoperative repositioning control of nasal bone fractures. We studied 32 patients with suspected nasal bone fracture. We performed preoperative computed tomography (CT) for evaluation of the type and extent of nasal bone fractures. We also took external photographs for evaluation of external deviation of the nose and nasal deformity. During surgery, we performed real-time ultrasonography-guided closed reduction using a 10 MHz linear transducer. After 1 year, we performed postoperative evaluation with CT and external photography. We classified patients into three groups according to their CT score. Patients were 23 males and 9 females aged 8-39 years. Clinical symptoms were pain, nasal swelling, nasal bleeding, and localized depression at the trauma site. In almost all patients, postoperative external photographs showed a symmetrical nasal dorsum without external deformity, and postoperative CT showed stabilization of bony fragments and good alignment of the nasal bone. Postoperatively, the CT score was 3 (excellent) in 25 patients, 2 (good) in 5 patients, and 1 (fair) in 2 patients. We suggest that ultrasonography is very useful for evaluating intraoperative repositioning of nasal bone fractures.

  4. Surgical Pearl on Reconstructing Surgical Defects of the Nasal Tip

    PubMed Central

    César, Artur; Barros, Ana; Santos, Paulo; Azevedo, Filomena

    2016-01-01

    Repairing surgical defects of the nasal tip is challenging, mainly because of the lack of freely mobile skin available peripherally. The Peng flap is a one-stage cutaneous flap that circumvents this difficulty by recruiting skin from the nasal dorsum and sidewall regions. The design produces a tridimensional shape perfectly adapted to the configuration of the nasal tip and allows for an inconspicuous closure of the defect. We present three examples of full-thickness skin defects involving the nasal tip, reconstructed using a modified version of the Peng flap, and present the experience at our department with this surgical technique. PMID:27942370

  5. Saline nasal irrigation: Its role as an adjunct treatment.

    PubMed Central

    Papsin, Blake; McTavish, Alison

    2003-01-01

    OBJECTIVE: To review clinical evidence on the efficacy of saline nasal irrigation for treatment of sinonasal conditions and to explore its potential benefits. QUALITY OF EVIDENCE: Clinical trials, reviews, and treatment guidelines discussing nasal irrigation were obtained through a MEDLINE search from January 1980 to December 2001. Most trials were small and some were not controlled; evidence, therefore, is level II, or fair. MAIN MESSAGE: Flushing the nasal cavity with saline solution promotes mucociliary clearance by moisturizing the nasal cavity and by removing encrusted material. The procedure has been used safely for both adults and children, and has no documented serious adverse effects. Patients treated with nasal irrigation rely less on other medications and make fewer visits to physicians. Treatment guidelines in both Canada and the United States now advocate use of nasal irrigation for all causes of rhinosinusitis and for postoperative cleaning of the nasal cavity. CONCLUSION: Nasal irrigation is a simple, inexpensive treatment that relieves the symptoms of a variety of sinus and nasal conditions, reduces use of medical resources, and could help minimize antibiotic resistance. PMID:12619739

  6. Olopatadine nasal spray for the treatment of allergic rhinitis.

    PubMed

    Roland, Peter S; Marple, Bradley F; Wall, G Michael

    2010-03-01

    Olopatadine hydrochloride nasal spray (Patanase Nasal Spray, Alcon Laboratories, TX, USA) was approved by the US FDA in 2008, and is indicated for the relief of symptoms of seasonal allergic rhinitis (SAR), also referred to as allergic rhinosinusitis. Olopatadine is an antihistamine with selective H1-receptor antagonist activity. Clinical trials of olopatadine nasal spray have demonstrated safety and efficacy in the treatment of SAR patients. With an onset of action of 30 min, olopatadine nasal spray has also been shown to improve quality of life, ability to perform work and the conduct of usual activities in SAR patients.

  7. A survey of postoperative nasal packing among UK ENT surgeons.

    PubMed

    Repanos, Costa; McDonald, Stephen E; Sadr, Amir H

    2009-10-01

    Packing of the nasal cavity following routine nasal surgery is a common but controversial practice. We aimed to evaluate nasal packing practices among UK ENT consultants for common nasal operations. A questionnaire was sent to 648 consultant ENT surgeons regarding their packing practice in patients undergoing nasal surgery. Data were collected regarding rhinology subspecialty interest, number of nasal operations performed per year, likelihood of packing for six common nasal procedures, and types of pack used. In all, 282 (43.5%) replies were received. Fifty-four (78.3%) rhinologists claimed to perform >100 nasal operations per year versus 64 (31.8%) non-rhinologists (P < 0.005). For specific operations, there was a universal trend towards less routine packing (>70% frequency) in the rhinologist group (P < 0.005). Surgeons who specified a subspecialty interest in rhinology packed significantly less often than the non-rhinologists for common nasal operations. There was great variation in the type of pack favoured by different surgeons.

  8. Nasal and oral inspiration during natural speech breathing.

    PubMed

    Lester, Rosemary A; Hoit, Jeannette D

    2014-06-01

    The purpose of this study was to determine the typical pattern for inspiration during speech breathing in healthy adults, as well as the factors that might influence it. Ten healthy adults, 18–45 years of age, performed a variety of speaking tasks while nasal ram pressure, audio, and video recordings were obtained. Inspirations were categorized as nasal-only, oral-only, simultaneous nasal and oral, or alternating nasal and oral inspiration. The method was validated using nasal airflow, oral airflow, audio, and video recordings for 2 participants. The predominant pattern was simultaneous nasal and oral inspirations for all speaking tasks. This pattern was not affected either by the nature of the speaking task or by the phonetic context surrounding the inspiration. The validation procedure confirmed that nearly all inspirations during counting and paragraph reading were simultaneous nasal and oral inspirations, whereas for sentence reading, the predominant pattern was alternating nasal and oral inspirations across the 3 phonetic contexts. Healthy adults inspire through both the nose and mouth during natural speech breathing. This pattern of inspiration is likely beneficial in reducing pathway resistance while preserving some of the benefits of nasal breathing.

  9. Nasal air conditioning in relation to acoustic rhinometry values.

    PubMed

    Lindemann, Joerg; Tsakiropoulou, Evangelia; Keck, Tilman; Leiacker, Richard; Wiesmiller, Kerstin M

    2009-01-01

    Changes of nasal dimensions can influence the air-conditioning capacity of the nose because of alterations of airflow patterns. The goal of this study was to evaluate the correlation between intranasal temperature and humidity values and nasal dimensions, assessed by means of acoustic rhinometry. Eighty healthy volunteers (40 men and 40 women; median age, 51 years; range, 20-84 years) were enrolled in the study. In total, 160 nasal cavities were examined. All volunteers underwent a standardized acoustic rhinometry. Additionally, intranasal air temperature and humidity measurements at defined intranasal detection sites within the anterior nasal segment were performed. There was no statistically significant difference between the right and left side of the nose regarding air temperature, absolute humidity, and acoustic rhinometric values. A negative correlation was established between the rhinometric nasal volumes/minimal cross-sectional areas and air temperature and absolute humidity values at the three intranasal detection sites. According to our results, nasal volumes and cross- sectional areas relevantly influence nasal air conditioning. A healthy nasal cavity with smaller volumes and cross-sectional areas seems to present a more effective air-conditioning function than a too "wide" open nose because of changes in airflow patterns. This observation should be considered as a limitation for overly extensive nasal surgery especially of the turbinates.

  10. Nasal and paranasal involvement in primary Sjogren`s syndrome.

    PubMed

    Midilli, R; Gode, S; Oder, G; Kabasakal, Y; Karci, B

    2013-09-01

    The aim of this study is to investigate nasal and paranasal signs and symptoms of the primary Sjogren`s syndrome patients and compare them with healthy controls. Seventy-seven (7 M, 70 F) primary Sjogren`s syndrome patients and 77 healthy controls were included in the study. Anterior rhinoscopy, nasal endoscopy, 5 component smell discrimination test, nasal clearance analysis with saccharin test and electrorhinomanometer were performed. Nasal crusting was present in 31 and 24 individuals in patient and control groups, respectively. Sinusitis was present in 2 and 1 individuals in patient and control groups, respectively. Nasal polyposis was present in 7 and 1 individuals in patient and control groups, respectively. These differences were not statistically different. Although there were some findings in a few patients, nasal findings were insignificant and mild even in patients with severe oral or ocular findings. Rhinomanometry, nasal clearance determination or smell discrimination tests have very little value in the diagnosis or management of primary Sjogren`s syndrome. Nasal polyposis was higher in the patient group, though it did not reach a significant level. Nasal glandular involvement is mild and insignificant in primary Sjogren`s syndrome.

  11. Exhaled nitric oxide and nasal tryptase are associated with wheeze, rhinitis and nasal allergy in primary school children.

    PubMed

    De Prins, Sofie; Marcucci, Francesco; Sensi, Laura; Van de Mieroop, Els; Nelen, Vera; Nawrot, Tim S; Schoeters, Greet; Koppen, Gudrun

    2014-09-01

    Rhinitis and asthma are the most common respiratory diseases in children. We assessed whether airway inflammation markers were associated with nasal allergies and self-reported symptoms of wheeze and rhinitis in 130 children 6-12 year old in an epidemiological context. Independent of sex and age, the fraction of exhaled nitric oxide (FeNO) and nasal mast cell (MC) activation (tryptase ≥ 5 ng/mL) were positively associated with wheeze, rhinitis and with nasal allergy. Nasal eosinophil cationic protein (ECP) and exhaled breath condensate (EBC) markers (pH, 8-isoprostane, interleukin-1β) were not associated with symptoms or with nasal allergy. In conclusion, FeNO and nasal tryptase reflect allergic inflammation in the respiratory system.

  12. Inhibition of capsaicin-driven nasal hyper-reactivity by SB-705498, a TRPV1 antagonist

    PubMed Central

    Holland, Carlijn; Drunen, Cornelis Van; Denyer, Jane; Smart, Kevin; Segboer, Christine; Terreehorst, Ingrid; Newlands, Amy; Beerahee, Misba; Fokkens, Wytske; Tsitoura, Daphne C

    2014-01-01

    AIMS To assess the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of intranasal SB-705498, a selective TRPV1 antagonist. METHODS Two randomized, double-blind, placebo-controlled, clinical studies were performed: (i) an intranasal SB-705498 first time in human study to examine the safety and PK of five single escalating doses from 0.5 to 12 mg and of repeat dosing with 6 mg and 12 mg twice daily for 14 days and (ii) a PD efficacy study in subjects with non-allergic rhinitis (NAR) to evaluate the effect of 12 mg intranasal SB-705498 against nasal capsaicin challenge. RESULTS Single and repeat dosing with intranasal SB-705498 was safe and well tolerated. The overall frequency of adverse events was similar for SB-705498 and placebo and no dose-dependent increase was observed. Administration of SB-705498 resulted in less than dose proportional AUC(0,12 h) and Cmax, while repeat dosing from day 1 to day 14 led to its accumulation. SB-705498 receptor occupancy in nasal tissue was estimated to be high (>80%). Administration of 12 mg SB-705498 to patients with NAR induced a marked reduction in total symptom scores triggered by nasal capsaicin challenge. Inhibition of rhinorrhoea, nasal congestion and burning sensation was associated with 2-to 4-fold shift in capsaicin potency. CONCLUSIONS Intranasal SB-705498 has an appropriate safety and PK profile for development in humans and achieves clinically relevant attenuation of capsaicin-provoked rhinitis symptoms in patients with NAR. The potential impact intranasal SB-705498 may have in rhinitis treatment deserves further evaluation. PMID:23909699

  13. Nasal polyps and middle turbinates epithelial cells sensitivity to amphotericin B.

    PubMed

    Jornot, L; Rochat, T; Lacroix, J S

    2003-12-01

    Intranasal application of the antimycotic agent amphotericin B (AmphoB) has been proposed as an effective treatment of chronic rhinosinusitis (CRS) with polyps. AmphoB is a sterol-binding agent known to modify cell membrane structure. The cytotoxic effects of AmphoB were studied on primary human nasal epithelial cells in vitro. Human epithelial cells were isolated from nasal polyps and middle turbinates of patients suffering from CRS, and grown on collagen-coated polycarbonate filters with an air liquid-interface. After 15 days of culture, cells were exposed apically to 50 microM AmphoB during 4 h daily for 5 days. Some cells were treated during 4 weeks. The bioelectric properties of cells were then studied in Ussing chambers. Integrity of the cell monolayers was assessed by measurement of the transepithelial resistance (R) and immunofluorescent localization of the tight junction protein occludin. Disruption of the epithelial monolayer integrity was observed in all of the nasal polyps cell cultures, as demonstrated by a 60% drop in R. Immunofluorescence microscopy showed significant loss in cell number and disruption in the distribution of occludin. Turbinate cell cultures elicited no change in R and expression of occludin after AmphoB treatment. However, the transepithelial potential, the basal short-circuit current and the amiloride-sensitive current were reduced by 70%. AmphoB was cytotoxic for nasal polyp epithelial cells with disruption of the epithelium integrity and loss of tight junctions. In contrast, integrity of turbinate epithelial cells was conserved despite alterations in transepithelial ion transport. These observations may explain the beneficial effect of intranasal application of AmphoB on CRS observed in clinical trials.

  14. [Survey of sensory perception and patients' subjective assessment of the application of nasal sprays - the nasal-spray-sensoric-scale].

    PubMed

    Mösges, Ralph; Pasch, N; Sayar, A; Schmalz, P; Vent, J

    2009-09-01

    The Nasal Spray Evaluation Questionnaire is a standardized means to evaluate hedonicity of nasal sprays in the English speaking countries. To date, there is no such questionnaire for German speaking patients. The here presented study aimed at evaluating the translated questionnaire. Three nasal sprays were tested and the questionnaire was used to estimate sensory hedonicity. Finally, the questionnaire was improved and can now serve as a standardized means to measure nasal sensory perceptions. The questionnaire was literally translated from English to German. There were three groups of 60 patients each presenting with the sensation of a 'dry nose' to a secondary medical center with a board certified otolaryngologist. The ingredients of the three different nasal sprays varied only in one phytotherapeutic addition. The first evaluation of the nasal spray was conducted immediately after application of the nasal spray, and two minutes after application. A third and optional telephone survey was performed several days later after continuous use of the spray. The different evaluations of nasal sprays were already lined out after the first questionnaire. It could serve as a new, reliable and reproduceable tool for the evaluation of nasal sensory perceptions. The questionnaire served as an adequate tool to estimate hedonicity of nasal sprays. First results of the German version show, however, that it could facilitate the evaluation by restructuring the questionnaire. Continuously marking good grades with high points (maximum 100) and negative answers with low points (minimum 0 points) will unify and simplify the questionnaire. The translation of the Nasal Spray Evaluation Questionnaire into a German version can serve as a new standard tool for measuring nasal sensation. Georg Thieme Verlag KG Stuttgart * New York.

  15. Eosinophils and mast cells: a comparison of nasal mucosa histology and cytology to markers in nasal discharge in patients with chronic sino-nasal diseases.

    PubMed

    Gröger, Moritz; Bernt, Andreas; Wolf, Maria; Mack, Brigitte; Pfrogner, Elisabeth; Becker, Sven; Kramer, Matthias F

    2013-09-01

    Allergic rhinitis (AR), nasal polyps (NP) as well as chronic rhinosinusitis (CRS) are all known to be associated with eosinophilic infiltration and elevated numbers of mast cells (MC) within the mucosa. Both cell types and their markers eosinophilic cationic protein (ECP) and tryptase are utilized in the diagnosis and management of chronic sino-nasal diseases. Mucosal cytology samples were gathered by cytobrush, histological samples were obtained from the inferior turbinate. In both sample sets, the number of eosinophils and MC was determined. Their corresponding markers ECP and tryptase were quantified from nasal discharge. Patients were grouped with reference to their main diagnosis: AR (n = 34), NP (n = 25), CRS (n = 27) and controls (n = 34). Eosinophil counts from cytobrush and ECP levels were significantly elevated in NP compared to all other groups-31- and 13-fold over control, respectively. However, histologic review did not reveal any difference in eosinophil count among groups. Tryptase was significantly elevated threefold in AR versus CRS and controls. No correlation to cytological and histological MC counts could be found. ECP levels in nasal discharge as well as eosinophil counts can provide useful information with regard to the diagnosis. Likewise, tryptase concentrations can do. The presented data show that the measurement of markers in nasal discharge is superior in differentiating among diagnosis groups. Given that the collection of nasal secretions is more comfortable for patients than the more invasive techniques, we recommend first line ECP and tryptase testing performed on nasal secretions.

  16. Effect of natural seasonal pollen exposure and repeated nasal allergen provocations on elevation of exhaled nitric oxide.

    PubMed

    Bergmann-Hug, K; Wirth, R; Henseler, M; Helbling, A; Pichler, W J; Schnyder, B

    2009-11-01

    Exhaled nitric oxide (FENO) is a marker for allergic airway inflammation. We wondered whether in patients with intermittent allergic rhinitis only (i) natural pollen exposure and (ii) artificial pollen exposure by repeated nasal allergen provocations may lead to an elevation of FENO. In two prospective studies, we compared the FENO of nonatopic controls with the FENO of nonasthmatic individuals with mild intermittent rhinitis to tree and/or grass pollen. Study I: 13 atopic individuals and seven controls had measurements of FENO, blood eosinophils and eosinophilic cationic protein (ECP) before, during and after pollen season. Study II: 16 atopic individuals and 12 controls had nasal allergen provocations on four following days out of pollen season, with daily measurements of FENO before, 2 and 6 h after provocation, and determination of blood eosinophils, ECP and FEV1 at baseline, on days 5 and 10-12. Natural pollen exposure (study I) caused a significant elevation of FENO in allergic individuals. Nasal allergen provocations (study II) did not elicit a statistically significant rise neither of FENO nor of blood eosinophils between baseline and day 5. However, a subgroup of four individuals with a rise of blood eosinophils during nasal allergen provocations showed also a rise of FENO. We suppose that in allergic rhinitis a concomitant reaction of the bronchial system is dependent on a strong local inflammation leading to a generalized immune stimulation.

  17. Correlation between Subjective Nasal Patency and Intranasal Airflow Distribution.

    PubMed

    Casey, Kevin P; Borojeni, Azadeh A T; Koenig, Lisa J; Rhee, John S; Garcia, Guilherme J M

    2017-04-01

    Objectives (1) Analyze the relationship between intranasal airflow distribution and subjective nasal patency in healthy and nasal airway obstruction (NAO) cohorts using computational fluid dynamics (CFD). (2) Determine whether intranasal airflow distribution is an important objective measure of airflow sensation that should be considered in future NAO virtual surgery planning. Study Design Cross-sectional. Setting Academic tertiary medical center and academic dental clinic. Subjects and Methods Three-dimensional models of nasal anatomy were created based on computed tomography scans of 15 patients with NAO and 15 healthy subjects and used to run CFD simulations of nasal airflow and mucosal cooling. Subjective nasal patency was quantified with a visual analog scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE). Regional distribution of nasal airflow (inferior, middle, and superior) was quantified in coronal cross sections in the narrowest nasal cavity. The Pearson correlation coefficient was used to quantify the correlation between subjective scores and regional airflows. Results Healthy subjects had significantly higher middle airflow than patients with NAO. Subjective nasal patency had no correlation with inferior and superior airflows but a high correlation with middle airflow (| r| = 0.64 and | r| = 0.76 for VAS and NOSE, respectively). Anterior septal deviations tended to shift airflow inferiorly, reducing middle airflow and reducing mucosal cooling in some patients with NAO. Conclusion Reduced middle airflow correlates with the sensation of nasal obstruction, possibly due to a reduction in mucosal cooling in this region. Further research is needed to elucidate the role of intranasal airflow distribution in the sensation of nasal airflow.

  18. Airflow, gas deposition, and lesion distribution in the nasal passages

    SciTech Connect

    Morgan, K.T.; Monticello, T.M. )

    1990-04-01

    The nasal passages of laboratory animals and man are complex, and lesions induced in the delicate nasal lining by inhaled air pollutants vary considerably in location and nature. The distribution of nasal lesions is generally a consequence of regional deposition of the inhaled material, local tissue susceptibility, or a combination of these factors. Nasal uptake and regional deposition are are influenced by numerous factors including the physical and chemical properties of the inhaled material, such as water solubility and reactivity; airborne concentration and length of exposure; the presence of other air contaminants such as particulate matter; nasal metabolism, and blood and mucus flow. For certain highly water-soluble or reactive gases, nasal airflow patterns play a major role in determining lesion distribution. Studies of nasal airflow in rats and monkeys, using casting and molding techniques combined with a water-dye model, indicate that nasal airflow patterns are responsible for characteristic differences in the distribution of nasal lesions induced by formaldehyde in these species. Local tissue susceptibility is also a complex issue that may be a consequence of many factors, including physiologic and metabolic characteristics of the diverse cell populations that comprise each of the major epithelial types lining the airways. Identification of the principal factors that influence the distribution and nature of nasal lesions is important when attempting the difficult process of determining potential human risks using data derived from laboratory animals. Toxicologic pathologists can contribute to this process by carefully identifying the site and nature of nasal lesions induced by inhaled materials. 61 references.

  19. Nasal Floor Mucosa: New Donor Site for Mucous Membrane Grafts.

    PubMed

    Morgan, Payam V; Suh, Jeffrey D; Hwang, Catherine J

    2016-01-01

    Mucous membrane grafts are used for various indications in oculoplastics. The authors report the use of nasal floor mucosa as a new donor site for mucous membrane grafts. Following adequate anesthesia and vasoconstriction, the nasal floor is visualized with a 30° endoscope. Next, the interior turbinate is medialized, and the nasolacrimal duct is identified and preserved. Anterior, posterior, medial, and lateral incisions are made through the nasal mucosa to the nasal bone. The mucosa is dissected off the nasal bone with a periosteal elevator. Nasal saline irrigation is used postoperatively to aid healing. Histologic analysis of the harvested graft and mucosa from the inferior and middle turbinates were analyzed histologically for the number of mucin-producing cells per high power field and compared. Nasal floor mucosa provides ample tissue for grafting with little donor site morbidity. The surgery is technically easy to learn and perform. There is less risk for blood loss compared with harvesting tissue from the turbinates and less postoperative discomfort compared with buccal mucosal grafts. The grafts have been used in 9 different patients for a variety of ocular indications. Histologically, the nasal floor mucosa contains statistically more mucin-secreting cells than other nasal site, which can be helpful especially in cases of ocular surface disease. In 1 case, biopsy of the grafted tissue at postoperative year 2 showed survival of the respiratory mucin-secreting cells under histologic examination. Nasal floor mucosa should be considered a donor site when a mucous membrane graft is needed. The surgery is safe, easy to perform, and has less morbidity than either a nasal turbinate graft or a buccal mucosal graft.

  20. Airflow, gas deposition, and lesion distribution in the nasal passages.

    PubMed Central

    Morgan, K T; Monticello, T M

    1990-01-01

    The nasal passages of laboratory animals and man are complex, and lesions induced in the delicate nasal lining by inhaled air pollutants vary considerably in location and nature. The distribution of nasal lesions is generally a consequence of regional deposition of the inhaled material, local tissue susceptibility, or a combination of these factors. Nasal uptake and regional deposition are are influenced by numerous factors including the physical and chemical properties of the inhaled material, such as water solubility and reactivity; airborne concentration and length of exposure; the presence of other air contaminants such as particulate matter; nasal metabolism, and blood and mucus flow. For certain highly water-soluble or reactive gases, nasal airflow patterns play a major role in determining lesion distribution. Studies of nasal airflow in rats and monkeys, using casting and molding techniques combined with a water-dye model, indicate that nasal airflow patterns are responsible for characteristic differences in the distribution of nasal lesions induced by formaldehyde in these species. Local tissue susceptibility is also a complex issue that may be a consequence of many factors, including physiologic and metabolic characteristics of the diverse cell populations that comprise each of the major epithelial types lining the airways. Identification of the principal factors that influence the distribution and nature of nasal lesions is important when attempting the difficult process of determining potential human risks using data derived from laboratory animals. Toxicologic pathologists can contribute to this process by carefully identifying the site and nature of nasal lesions induced by inhaled materials. Images FIGURE 4. FIGURE 6. FIGURE 7. PMID:2200663

  1. Piezoelectric sensing: Evaluation for clinical investigation of deviated nasal septum

    PubMed Central

    Manjunatha, Roopa G.; Mahapatra, Roy D.; Dorasala, Srinivas

    2013-01-01

    Noninvasive objective evaluation of nasal airflow is one of the important clinical aspects. The developed polyvinylidene fluoride (PVDF) sensor enables measurement of airflow through each side of the nose using its piezoelectric property. This study was designed to evaluate the diagnostic capability of the PVDF sensor in assessing the deviated nasal septum (DNS). PVDF nasal sensor uses its piezoelectric property to measure the peak-to-peak amplitude (Vp-p) of nasal airflow in both of the nostrils: right nostril (RN) and left nostril (LN), separately and simultaneously. We have compared the results of PVDF nasal sensor, visual analog scale (VAS), and clinician scale for 34 DNS patients and 28 healthy controls. Additionally, the results were further analyzed by receiver operating characteristic curve and correlation between PVDF nasal sensor and VAS in detecting DNS. We found a significant difference in the peak-to-peak amplitude values of the test group and the control group. The correlation between the PVDF nasal sensor measurements and VAS (RN and LN combined) for test group was statistically significant (−0.807; p < 0.001). Sensitivity and specificity of the PVDF nasal sensor measurements in the detection of DNS (RN and LN combined) was 85.3 and 74.4%, respectively, with optimum cutoff value ≤0.34 Vp-p. The developed PVDF nasal sensor is noninvasive and requires less patient efforts. The sensitivity and specificity of the PVDF nasal sensor are reliable. According to our findings, we propose that the said PVDF nasal sensor can be used as a new diagnostic tool to evaluate the DNS in routine clinical practice. PMID:24498519

  2. Regional peak mucosal cooling predicts the perception of nasal patency.

    PubMed

    Zhao, Kai; Jiang, Jianbo; Blacker, Kara; Lyman, Brian; Dalton, Pamela; Cowart, Beverly J; Pribitkin, Edmund A

    2014-03-01

    Nasal obstruction is the principal symptom that drives patients with rhinosinus disease to seek medical treatment. However, patient perception of obstruction often bears little relationship to actual measured physical obstruction of airflow. This lack of an objective clinical tool hinders effective diagnosis and treatment. Previous work has suggested that the perception of nasal patency may involve nasal trigeminal activation by cool inspiratory airflow; we attempt to derive clinically relevant variables following this phenomenon. Prospective healthy cohort. Twenty-two healthy subjects rated unilateral nasal patency in controlled room air using a visual analog scale, followed by rhinomanometry, acoustic rhinometry, and butanol lateralization thresholds (BLTs). Each subject then immediately underwent a computed tomography scan, enabling the construction of a real-time computational fluid dynamics (CFD) nasal airway model, which was used to simulate nasal mucosa heat loss during steady resting breathing. Among all measured and computed variables, only CFD-simulated peak heat loss posterior to the nasal vestibule significantly correlated with patency ratings (r = -0.46, P < .01). Linear discriminant analysis predicted patency categories with 89% success rate, with BLT and rhinomanometric nasal resistance being two additional significant variables. As validation, CFD simulated nasal resistance significantly correlated with rhinomanometrically measured resistance (r = 0.41, P < .01). These results reveal that our noses are sensing patency via a mechanism involving localized peak nasal mucosal cooling. The analysis provides a strong rationale for combining the individualized CFD with other objective and neurologic measures to create a novel clinical tool to diagnose nasal obstruction and to predict and evaluate treatment outcomes. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Regional Peak Mucosal Cooling Predicts the Perception of Nasal Patency

    PubMed Central

    Zhao, Kai; Jiang, Jianbo; Blacker, Kara; Lyman, Brian; Dalton, Pamela; Cowart, Beverly; Pribitkin, Edmund

    2013-01-01

    Objective Nasal obstruction is the principal symptom that drives patients with rhinosinus disease to seek medical treatment. However, patient perception of obstruction often bears little relationship to actual measured physical obstruction of airflow. This lack of an objective clinical tool hinders effective diagnosis and treatment. Previous work has suggested that the perception of nasal patency may involve nasal trigeminal activation by cool inspiratory airflow; we attempt to derive clinically relevant variables following this phenomenon. Study design Prospective healthy cohort. Methods Twenty-two healthy subjects rated unilateral nasal patency in controlled room air using a visual analog scale, followed by rhinomanometry, acoustic rhinometry and butanol lateralization thresholds (BLT). Each subject then immediately underwent a CT scan, enabling the construction of a “real-time” computational fluid dynamics (CFD) nasal airway model, which was used to simulate nasal mucosa heat loss during steady resting breathing. Results Among all measured and computed variables, only CFD-simulated peak heat loss posterior to the nasal vestibule significantly correlated with patency ratings (r=−0.46, p<0.01). Linear discriminant analysis predicted patency categories with 89% success rate, with BLT and rhinomanometric nasal resistance being two additional significant variables. As validation, CFD simulated nasal resistance significantly correlated with rhinomanometrically measured resistance (r=0.41, p<0.01). Conclusion These results reveal that our noses are sensing patency via a mechanism involving localized peak nasal mucosal cooling. The analysis provides a strong rationale for combining the individualized CFD with other objective and neurological measures to create a novel clinical tool to diagnose nasal obstruction and to predict and evaluate treatment outcomes. PMID:23775640

  4. Finite Element Model and Validation of Nasal Tip Deformation.

    PubMed

    Manuel, Cyrus T; Harb, Rani; Badran, Alan; Ho, David; Wong, Brian J F

    2017-03-01

    Nasal tip mechanical stability is important for functional and cosmetic nasal airway surgery. Palpation of the nasal tip provides information on tip strength to the surgeon, though it is a purely subjective assessment. Providing a means to simulate nasal tip deformation with a validated model can offer a more objective approach in understanding the mechanics and nuances of the nasal tip support and eventual nasal mechanics as a whole. Herein we present validation of a finite element (FE) model of the nose using physical measurements recorded using an ABS plastic-silicone nasal phantom. Three-dimensional photogrammetry was used to capture the geometry of the phantom at rest and while under steady state load. The silicone used to make the phantom was mechanically tested and characterized using a linear elastic constitutive model. Surface point clouds of the silicone and FE model were compared for both the loaded and unloaded state. The average Hausdorff distance between actual measurements and FE simulations across the nose were 0.39 ± 1.04 mm and deviated up to 2 mm at the outermost boundaries of the model. FE simulation and measurements were in near complete agreement in the immediate vicinity of the nasal tip with millimeter accuracy. We have demonstrated validation of a two-component nasal FE model, which could be used to model more complex modes of deformation where direct measurement may be challenging. This is the first step in developing a nasal model to simulate nasal mechanics and ultimately the interaction between geometry and airflow.

  5. Nasal lavage levels of granulocyte-macrophage colony-stimulating factor and chronic nasal hypereosinophilia.

    PubMed

    De Corso, Eugenio; Baroni, Silvia; Lucidi, Daniela; Battista, Mariapina; Romanello, Matteo; Autilio, Chiara; Morelli, Renato; Di Nardo, Walter; Passali, Giulio Cesare; Sergi, Bruno; Bussu, Francesco; Fetoni, Anna Rita; Zuppi, Cecilia; Paludetti, Gaetano

    2015-06-01

    The aim of the present study was to measure levels of granulocyte-macrophage colony-stimulating factor (GM-CSF) in nasal lavage of patients affected by chronic eosinophilic sinonasal inflammation to clarify the relationship with eosinophilic tissue infiltration and clinical features. Between November 2012 and June 2013, we selected 70 patients with chronic eosinophilic inflammation (average age 41.8 years) who were classified into the following groups: persistent allergic rhinitis (group 1), noninfectious non-allergic rhinitis with eosinophilia syndrome (group 2) and chronic rhinosinusitis with polyps (group 3). Finally, we enrolled 20 healthy subjects as controls (group 4). All patients underwent symptoms score questionnaire based on a visual analogue scale, nasal endoscopy and/or computed tomography (CT) scan, and allergy testing. Nasal cytology by scraping of the mucosa and GM-CSF assays in nasal lavage were performed in all subjects. Detectable levels of GM-CSF were found in 34 of 70 (48.57%) patients, with an average concentration of 2.67 ± 0.8 pg/mL, whereas in controls only 1 of 20 individuals showed detectable GM-CSF levels. Eosinophil infiltration was significantly higher in patients with detectable GM-CSF compared to those with undetectable levels (49.4% vs 39.2%, respectively; p < 0.05). Furthermore, significant weakly-moderate correlation was found between GM-CSF levels and percentage of eosinophil infiltration in tissue (p < 0.05). Correlation between symptom scores and GM-CSF levels was significant only in group 2, which showed higher average concentrations of GM-CSF compared to groups 1 and 3 (2.9 pg/mL vs 1.6 pg/mL and 1.8 pg/mL, respectively; p < 0.05). Our data confirm that GM-CSF is more frequently detectable in nasal lavages of patients affected by chronic sinonasal eosinophilic inflammation than in controls. Statistical analyses revealed a significant weakly-moderate correlation between GM-CSF levels in nasal lavage of all patients and

  6. Mometasone furoate nasal spray: a systematic review.

    PubMed

    Passali, Desiderio; Spinosi, Maria Carla; Crisanti, Anna; Bellussi, Luisa Maria

    2016-01-01

    The inflammatory diseases of the nose, rhino-pharynx and paranasal sinuses (allergic and non allergic rhinitis, NARES; rhinosinusitis with/without nasal polyposis, adenoidal hypertrophy with/without middle ear involvement) clinically manifest themselves with symptoms and complications severely affecting quality of life and health care expenditure. Intranasal administration of corticosteroids, being fast, simple, and not requiring cooperation, is the preferred way to treat the patients, to optimize their quality of life, at the same time minimizing the risk of exacerbations and complications. Among the different topical steroids available on the market, we performed a comparative analysis in terms of effectiveness and safety between mometasone furoate (MF) and its main competitors. Searching through Pub Med and Google Scholar and using as entries "mometasone furoate", "rhinitis", "sinusitis", "asthma", "polyposis", "otitis media with effusion", and "adenoid hypertrophy" we found 344 articles, 300 of which met the eligibility criteria. Taking into account relevance and date of publication, a sample of 40 articles was considered for the review. MF effectiveness for treatment and/or prophylaxis of nasal symptoms in seasonal and perennial allergic rhinitis has been fully established with a level of evidence Ia. Even though it has not been assessed for MF in particular, topical steroids are the most appropriate treatment in mixed rhinitis and NARES. In acute rhinosinusitis (ARS) evidences support their use as mono-therapy or as adjuvant to antibiotics for reducing the recurrence rate, and decrease the usage of related prescriptions and medical consultations. In chronic rhinosinusitis (CRS) with Nasal polyposis, MF reduces polyps size, nasal congestion, improves quality of life and sense of smell and it is also effective in the treatment of daytime cough. The topical use of MF has great efficacy in the management of adenoidal hypertrophy and otitis media of atopic

  7. Nasal fat preservation in upper eyelid blepharoplasty.

    PubMed

    Massry, Guy G

    2011-01-01

    Traditional upper blepharoplasty is a subtractive form of surgery that involves the excision of variable amounts of skin, muscle, and fat from the eyelid. The goal of surgery is to improve field of vision and/or appearance. While surgical debulking of the eyelid may improve appearance early on, the volume loss inherent to this process (especially fat excision) can contribute to a hollowed appearance with an associated deep and sunken superior sulcus. This skeletonized look may be mitigated by repositioning a prominent nasal fat pad, if present, to the central upper eyelid. The charts of patients who underwent upper blepharoplasty with repositioning of the nasal fat pad (as described in this manuscript) to the central arcus marginalis of the superior orbital rim during surgery were reviewed. Patients with a history of previous eyelid surgery or trauma or who had concurrent ptosis or other eyelid malpositions were excluded from the study. Also excluded were patients who did not manifest prominent nasal fat pads at surgery. Postoperative interval follow up was consistent until 6 months after surgery and more sporadic thereafter, as patients more frequently missed appointments. Postoperative healing issues, patient complaints, complications, and subjective physician and patient satisfaction assessments were noted. Final results were gauged on each patient's final visit after surgery. Seventy-six patients were included in the study. Forty-eight patients (63%) were women, and 28 patients (37%) were men. The surgical procedure was uneventful in all patients. The average patient age was 66 years and the mean follow up was 11 months (range 6-22 months). There was one case of postoperative pseudo-Brown syndrome, which resolved with steroid injections. There were 2 cases of postoperative presumed mechanical ptosis, early in the series, lasting for 2 weeks, which in both cases responded to oral steroids. Subjectively, there was no new or worsening superior sulcus hollowness

  8. New daily persistent headache.

    PubMed

    Tyagi, Alok

    2012-08-01

    New daily persistent headache (NDPH) is a chronic headache developing in a person who does not have a past history of headaches. The headache begins acutely and reaches its peak within 3 days. It is important to exclude secondary causes, particularly headaches due to alterations in cerebrospinal fluid (CSF) pressure and volume. A significant proportion of NDPH sufferers may have intractable headaches that are refractory to treatment. The condition is best viewed as a syndrome rather than a diagnosis. The headache can mimic chronic migraine and chronic tension-type headache, and it is also important to exclude secondary causes, particularly headaches due to alterations in CSF pressure and volume. A large proportion of NDPH sufferers have migrainous features to their headache and should be managed with treatments used for treating migraine. A small group of NDPH sufferers may have intractable headaches that are refractory to treatment.

  9. Quarrelsomeness in daily life.

    PubMed

    Moskowitz, D S

    2010-02-01

    It is common in studies of interpersonal characteristics to examine personality variables as static predictors. Yet in recent years it has also become possible to examine personality and related interpersonal processes as they unfold over time in association with event specific cues. The present article reviews research that (1) identifies behaviors that reflect the occurrence of hostile-irritable-quarrelsome traits in daily life, (2) demonstrates both the stability and within-person variability of these behaviors over time, (3) documents event-level interpersonal cues that are systematically associated with within-person variation in quarrelsome behavior, and (4) describes how dispositional level agreeableness and irritability moderate the associations of event-level cues with quarrelsome behavior. The influence of the neurotransmitter serotonin on quarrelsome behavior is also considered. The studies indicate that quarrelsome individuals have reduced affective reactivity to engaging in quarrelsome behavior, increased behavioral reactivity to perceptions of quarrelsomeness in others, and greater responsiveness to change in serotonin levels.

  10. Using the maxillary-nasal angle to evaluate congenital nasal pyriform aperture stenosis.

    PubMed

    Sitapara, Jigar B; Mahida, Justin B; McEvoy, Timothy P; Elmaraghy, Charles A; Deans, Katherine J; Minneci, Peter C; Grischkan, Jonathan M

    2015-06-01

    Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of nasal airway obstruction in newborns. The decision to operate is made clinically. Although pyriform aperture width is used for diagnosing CNPAS, it does not fully characterize stenosis of the nasal cavity. To determine the utility of additional metrics for evaluating CNPAS. The medical records of 13 patients with CNPAS treated from 2007 through 2012 at a single tertiary pediatric facility were retrospectively examined. Data on patient demographic characteristics, known genetic abnormalities, and hospital courses were extracted. Computed tomographic images were evaluated for pyriform aperture width; maxillary-nasal angle (MNA), defined as the angle between the anterior maxilla and anterior-posterior nasal axis; and choanal width. Medical management and surgical management. Pyriform aperture width, MNA, and choanal width. Six of 13 patients underwent medical management, and 7 patients underwent surgical treatment. For patients who were managed medically as compared with those managed surgically, the evaluation revealed a larger pyriform aperture width (median [interquartile range {IQR}], 5.6 [5.4-6.1] vs 4.6 [4.5-4.7] mm; P = .03) and MNA (median [IQR], 70° [63°-73°] vs 59° [59°-64°]; P = .048) but no significant difference in choanal width (median [IQR], 11.0 [9.6-12.2] vs 11.9 [10.3-11.9] mm; P = .76). The MNA, when used in conjunction with pyriform aperture width, provides additional pertinent information to supplement clinical decision making in the evaluation of patients with CNPAS. These measurements may be helpful in identifying patients who should undergo surgical intervention, although additional studies would be required to allow predictive use of the MNA.

  11. Three-Dimensional Analysis of Nasal Symmetry Following Primary Correction of Unilateral Cleft Lip Nasal Deformity.

    PubMed

    Linden, Olivia E; Taylor, Helena O; Vasudavan, Sivabalan; Byrne, Margaret E; Deutsch, Curtis K; Mulliken, John B; Sullivan, Stephen R

    2016-07-21

      To evaluate nasal symmetry using three-dimensional photogrammetry following primary tip rhinoplasty with or without an internal splint in patients with unilateral complete cleft lip/palate.   We captured three-dimensional images of patients with unilateral complete cleft lip/palate who underwent nasolabial repair by rotation-advancement of the lip and primary tip rhinoplasty, either with or without an internal resorbable splint, and normal control subjects. We assessed nasal symmetry by identifying the plane of maximum symmetry and the root-mean-square deviation between native and reflected surfaces.   We imaged 38 controls and 38 subjects with repaired unilateral complete cleft lip/palate (20 with, 18 without an internal splint).   Nasal asymmetry root-mean-square deviation clustered between 0.19 and 0.50 mm (median = 0.24 ± 0.08 mm) for controls; whereas, those with repaired unilateral complete cleft lip/palate ranged from 0.4 to 1.5 mm (median = 0.75 ± 0.40 mm). Although root-mean-square deviation ranges overlapped, patients with repaired unilateral complete cleft lip/palate had significantly greater asymmetry than controls (P < .001). We found no difference in asymmetry between patients with or without an internal splint (P = .5).   Three-dimensional photogrammetry was used to successfully compare symmetry among different patient and control groups. Although "normal" nasal symmetry was attained in some patients following cleft lip/nasal repair, most had persistent asymmetry compared with normal controls. Placement of a resorbable internal splint did not improve symmetry in patients with unilateral complete cleft lip/palate.

  12. Self-reported vs measured compliance with nasal CPAP for obstructive sleep apnea.

    PubMed

    Rauscher, H; Formanek, D; Popp, W; Zwick, H

    1993-06-01

    To estimate reliability of self-reported compliance with nasal continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea (OSA), we studied 63 OSA patients aged 53.7 +/- 1.2 years (mean +/- SEM) with an apnea hypopnea index (AHI) of 50.8 +/- 2.9 and lowest sleep SaO2 of 65.6 +/- 2.3 percent receiving nasal CPAP for 539 +/- 44 days. During a follow-up polysomnography (PSG) on the pressure prescribed for home therapy (10.3 +/- 0.3 cm H2O), the hours of operation shown on the built-in time counter of the patients' devices were read to determine objective compliance by dividing the run time by the days since initiation of therapy. This parameter was compared with subjective compliance reported in a self-administered questionnaire. Mean measured use time was 4.9 +/- 0.3 h per night, whereas reported daily use time calculated from reported nights a week and hours a night was 6.1 +/- 0.3 h per night. As predominantly patients with poor compliance misestimated daily use time, we conclude that self-reports are unable to distinguish between compliant and noncompliant patients.

  13. Accuracy evaluation of a numerical simulation model of nasal airflow.

    PubMed

    Lu, Jiuxing; Han, Demin; Zhang, Luo

    2014-05-01

    Our numerical simulation model provides an accurate reflection of nasal airflow, and the results were validated by clinical measurements. To evaluate the accuracy of a numerical simulation model of nasal airflow. Ten volunteers with normal nasal cavities underwent CT, acoustic rhinometry, and rhinomanometry. CT data were uploaded into Mimics, ICEM-CFD, Fluent, and CFD-Post software for three-dimensional modeling, finite element grid division, transient calculations, and analysis, respectively. Velocity and pressure data of airflow were obtained during the normal respiratory cycle. The accuracy of the simulation was evaluated by two methods: acoustic rhinometry measurements were used to evaluate the accuracy of the anatomic model, and rhinomanometry measurements were used to evaluate the accuracy of the nasal resistance values obtained by numerical simulation. There were no significant differences between the values describing the model and the acoustic rhinometry measurements, the nasal resistance values obtained by numerical simulation. The airflow through the nasal cavity was mainly laminar. The maximum velocities were measured at the nasal valve, the amplitudes of all velocity curves at locations beyond the nasal valve were reduced. The amplitudes of the pressure curves increased from the front to the back of the airway.

  14. Towards Personalized Nasal Surgery Using Computational Fluid Dynamics

    PubMed Central

    Rhee, John S.; Pawar, Sachin S.; Garcia, Guilherme J.M.; Kimbell, Julia S.

    2013-01-01

    Objective To evaluate whether virtual surgery (VS) performed on 3D nasal airway models can predict post-surgical, biophysical parameters obtained by computational fluid dynamics (CFD). Methods Pre- and post- surgery CT scans of a patient undergoing septoplasty and right inferior turbinate reduction (ITR) were used to generate 3D models of the nasal airway. Prior to obtaining the post-surgery scan, the pre-surgery model was digitally altered to generate three VS models: 1) right ITR only, 2) septoplasty only, and 3) septoplasty with right ITR. The results of the VS CFD analyses were compared with post-surgical CFD outcome measures including nasal resistance, unilateral airflow allocation, and regional airflow distribution. Results Post-surgery CFD analysis and all VS models predicted similar reductions in overall nasal resistance, as well as more balanced airflow distribution between sides, primarily in the middle region, when compared with the pre-surgery state. In contrast, virtual ITR alone produced little change in either nasal resistance or regional airflow allocation. Conclusions We present an innovative approach for assessing functional outcomes of nasal surgery using CFD techniques. This preliminary study suggests that virtual nasal surgery has the potential to be a predictive tool that will enable surgeons to perform personalized nasal surgery using computer simulation techniques. Further investigation involving correlation of patient-reported measures with CFD outcome measures in multiple individuals is underway. PMID:21502467

  15. Nasal cytochrome P4502A: Identification in rats and humans

    SciTech Connect

    Thornton-Manning, J.R.; Hotchkiss, J.A.; Ding, Xinxin

    1995-12-01

    The nasal mucosa, the first tissue of contact for inhaled xenobiotics, possesses substantial enobiotic-metabolizing capacti. Enzymes of the nasal cavity may metabolize xenobiotics to innocuous, more water-soluble compounds that are eliminated from the body, or they may bioactivate them to toxic metabolites. These toxic metabolites may find to cellular macromolecules in the nasal cavity or be transported to other parts of the body where they may react. Nasal carcinogenesis in rodents often results from bioactivation of xenobiotics. The increased incidences of nasal tumors associated with certain occupations suggest that xenobiotic bioactivation may be important in human nasal cancer etiology, as well. The increasing popularity of the nose as a route of drug administration makes information concerning nasal drug metabolism and disposition vital to accomplish therapeutic goals. For these reasons, the study of xenobiotic-met abolizing capacity of the nasal cavity is an important area of health-related research. In the present study, we have confirmed the presence of CYP2A6 mRNA in human respiratory mucosa.

  16. Lgr5 regulates the regeneration of lesioned nasal respiratory epithelium.

    PubMed

    Zhang, Yan-Qiang; Li, Peng; Zhang, Feng-Qin; Sun, Shao-Jun; Cao, Yin-Guang

    2016-12-09

    Nasal respiratory epithelium is a ciliated pseudostratified columnar epithelium. The cellular components of nasal respiratory epithelium include ciliated cells, goblet cells, and basal cells. Until now, our knowledge in the development of nasal respiratory epithelium is still limited and the cellular mechanism of regeneration is still elusive. In this study, we found that adult stem cell marker leucine-rich repeat-containing G-protein coupled receptor 5 (Lgr5) is expressed in the mice nasal respiratory epithelium. Both immunostaining and lineage tracing analysis indicated Lgr5 positive cells in the nasal respiratory epithelium are proliferative stem/progenitor cells. Using the Rosa-Tdtomato and Rosa26-DTR mice, we elucidated that Lgr5(+) cells participate in the regeneration of lesioned nasal respiratory epithelium, and this group of cells is necessary in the process of epithelium recovery. Using the in vitro culture system, we observed the formation of spheres from Lgr5(+) cells and these spheres have the capacity to generate other types of cells. Above all, this study reported a group of previously unidentified progenitor/stem cells in nasal respiratory epithelium, unveiling the potential cellular mechanism in nasal respiratory epithelium regeneration.

  17. Dialectical Effects on Nasalance: A Multicenter, Cross-Continental Study

    ERIC Educational Resources Information Center

    Awan, Shaheen N.; Bressmann, Tim; Poburka, Bruce; Roy, Nelson; Sharp, Helen; Watts, Christopher

    2015-01-01

    Purpose: This study investigated nasalance in speakers from six different dialectal regions across North America using recent versions of the Nasometer. It was hypothesized that many of the sound changes observed in regional dialects of North American English would have a significant impact on measures of nasalance. Method: Samples of the Zoo…

  18. NASAL FILTERING OF FINE PARTICLES IN CHILDREN VS. ADULTS

    EPA Science Inventory

    Nasal efficiency for removing fine particles may be affected by developmental changes in nasal structure associated with age. In healthy Caucasian children (age 6-13, n=17) and adults (age 18-28, n=11) we measured the fractional deposition (DF) of fine particles (1 and 2um MMAD)...

  19. Polymorphisms in chronic rhinosinusitis with nasal polyps - a systematic review.

    PubMed

    Dinarte, Vanessa Ramos Pires; Santos, Anemari Ramos Dinarte Dos; Araújo, Luiza Ferreira de; Reis, Mariah Guieiro Alves Dos; Tamashiro, Edwin; Valera, Fabiana Cardoso Pereira; Silva Júnior, Wilson Araújo da; Anselmo-Lima, Wilma Terezinha

    2017-03-23

    Chronic rhinosinusitis with nasal polyps is a multifactorial disease with a complex pathophysiology involving multiple genetic and environmental factors. The purpose of this work review is to focus on the importance of genetic studies in chronic rhinosinusitis with nasal polyps besides the several barriers that exists for its understanding. A systematic review on studies of association between single nucleotide polymorphisms and chronic rhinosinusitis with nasal polyps based on a PubMed/Medline and Periódicos CAPES search of all articles published between January 2005 and January 2015 was made. The search was guided on studies containing the terms polymorphisms, rhinosinusitis, and polyps. Two studies found an association of MMP-9 and MMP-2 polymorphisms and chronic rhinosinusitis with nasal polyps, but not in patients with recurrent nasal polyps. Other studies found an association of nasal polyps with MMP-9 polymorphisms, but not with MMP-2 ones. There is evidence of an association of LTC4S, NOS2A, PTGDR, MET, COX-2, OSF-2, and LF polymorphisms and the risk of developing nasal polyps, especially when combined with chronic allergic rhinitis and asthma. Genetic studies on chronic rhinosinusitis with nasal polyps are promising and may offer insights into its pathophysiology, which is likely affected by multiple genetic factors. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  20. Chitosan in nasal delivery systems for therapeutic drugs.

    PubMed

    Casettari, Luca; Illum, Lisbeth

    2014-09-28

    There is an obvious need for efficient and safe nasal absorption enhancers for the development of therapeutically efficacious nasal products for small hydrophilic drugs, peptides, proteins, nucleic acids and polysaccharides, which do not easily cross mucosal membranes, including the nasal. Recent years have seen the development of a range of nasal absorption enhancer systems such as CriticalSorb (based on Solutol HS15) (Critical Pharmaceuticals Ltd), Chisys based on chitosan (Archimedes Pharma Ltd) and Intravail based on alkylsaccharides (Aegis Therapeutics Inc.), that is presently being tested in clinical trials for a range of drugs. So far, none of these absorption enhancers have been used in a marketed nasal product. The present review discusses the evaluation of chitosan and chitosan derivatives as nasal absorption enhancers, for a range of drugs and in a range of formulations such as solutions, gels and nanoparticles and finds that chitosan and its derivatives are able to efficiently improve the nasal bioavailability. The revirtew also questions whether chitosan nanoparticles for systemic drug delivery provide any real improvement over simpler chitosan formulations. Furthermore, the review also evaluates the use of chitosan formulations for the improvement of transport of drugs directly from the nasal cavity to the brain, based on its mucoadhesive characteristics and its ability to open tight junctions in the olfactory and respiratory epithelia. It is found that the use of chitosan nanoparticles greatly increases the transport of drugs from nose to brain over and above the effect of simpler chitosan formulations.

  1. Toward personalized nasal surgery using computational fluid dynamics.

    PubMed

    Rhee, John S; Pawar, Sachin S; Garcia, Guilherme J M; Kimbell, Julia S

    2011-01-01

    To evaluate whether virtual surgery performed on 3-dimensional (3D) nasal airway models can predict postsurgical, biophysical parameters obtained by computational fluid dynamics (CFD). Presurgery and postsurgery computed tomographic scans of a patient undergoing septoplasty and right inferior turbinate reduction (ITR) were used to generate 3D models of the nasal airway. Prior to obtaining the postsurgery scan, the presurgery model was digitally altered to generate 3 virtual surgery models: (1) right ITR only, (2) septoplasty only, and (3) septoplasty with right ITR. The results of the virtual surgery CFD analyses were compared with postsurgical CFD outcome measures including nasal resistance, unilateral airflow allocation, and regional airflow distribution. Postsurgery CFD analysis and all virtual surgery models predicted similar reductions in overall nasal resistance, as well as more balanced airflow distribution between sides, primarily in the middle region, when compared with the presurgery state. In contrast, virtual ITR alone produced little change in either nasal resistance or regional airflow allocation. We present an innovative approach for assessing functional outcomes of nasal surgery using CFD techniques. This preliminary study suggests that virtual nasal surgery has the potential to be a predictive tool that will enable surgeons to perform personalized nasal surgery using computer simulation techniques. Further investigation involving correlation of patient-reported measures with CFD outcome measures in multiple individuals is under way.

  2. International Consensus on Nasal Polyposis 2002-2004.

    PubMed

    Mladina, R; Clement, P; Lopatin, A; Mann, W; Passali, D

    2005-06-01

    Seventeen well-known experts in rhinosinusology from various countries tried to achieve consensus on the etiology, conservative approach and surgical approach to nasal polyposis. A Digi-Vote electronic system was used for an immediate computer analysis of expert answers to 23 questions related to the problem of nasal polyposis.

  3. Correlation between Objective and Subjective Assessment of Nasal Patency

    PubMed Central

    Mozzanica, Francesco; Gera, Roberto; Bulgheroni, Chiara; Ambrogi, Federico; Schindler, Antonio; Ottaviani, Francesco

    2016-01-01

    Introduction: This study was performed to evaluate the correlation between the objective and subjective sensation of nasal patency, assessed through a validated questionnaire, the Italian version of the NOSE scale, and the rhinomanometric results in a large cohort of patients complaining about nasal obstruction. Materials and Methods: Data was obtained from a total of 233 adult patients, (123 males, 110 females, with a mean age of 43.7 years) with a diagnosis of septal deviation and complaining about nasal obstruction. Anterior active rhinomanometry was used for objective assessment, while the I-NOSE scale and a visual analog scale (VAS) were used for subjective evaluation. Results: Positive correlations between I-NOSE scores and VAS and rhinomanometric results were found. The higher correlation was demonstrated between the HUNR (higher unilateral nasal resistance) parameter of rhinomanometry and the second item of the I-NOSE scale (Nasal blockage or obstruction). No significant correlation was found between the fourth item of the I-NOSE (Trouble sleeping) and the VAS score. The VAS score appeared mildly, but still significantly, correlated with the HUNR parameter of rhinomanometry. Conclusion: The correlation between the subjective sensation of nasal patency and the rhinomanometric data proved to be significant. No correlation between subjective sensation of trouble sleeping and rhinomanometric assessment was found. In counselling with patients complaining of nasal obstruction trouble in sleeping should not be considered as a symptom related to nasal obstruction. PMID:27738607

  4. Nasal air-conditioning after partial turbinectomy: myths versus facts.

    PubMed

    Tsakiropoulou, Evangelia; Vital, Victor; Constantinidis, Jannis; Kekes, George

    2015-01-01

    Turbinectomy, although a common procedure, is often accused of having a negative impact in all nasal functions. This study is the first in vivo study that evaluates objectively the effect of partial turbinectomy on nasal air-conditioning capacity. In total, 57 patients with prior partial inferior turbinectomy and 28 healthy controls were examined. Intranasal temperature and humidity values were measured at the level of the head of inferior and middle turbinate. Nasal patency was evaluated by means of acoustic rhinometry. The clinical assessment was completed with nasal endoscopy and the Nasal Obstruction Symptom Evaluation questionnaire for subjective evaluation of nasal patency. Significant changes of temperature were found in both detection sites with 13% reduced heating capacity of the air at the level of the inferior and 19% at the level of the middle turbinate, respectively. No similar results were found for humidity measurements. No correlations were found between air-conditioning values and acoustic rhinometry results for both study groups. Nasal endoscopy revealed normal healing in all patients. No major complications were reported by the patients. Their subjective ratings of nasal obstruction were similar to healthy controls. Partial turbinectomy seems to have a negative impact on intranasal air heating but not to humidification. This effect has no impact on clinical condition and subjective perception of surgical outcome.

  5. Dialectical Effects on Nasalance: A Multicenter, Cross-Continental Study

    ERIC Educational Resources Information Center

    Awan, Shaheen N.; Bressmann, Tim; Poburka, Bruce; Roy, Nelson; Sharp, Helen; Watts, Christopher

    2015-01-01

    Purpose: This study investigated nasalance in speakers from six different dialectal regions across North America using recent versions of the Nasometer. It was hypothesized that many of the sound changes observed in regional dialects of North American English would have a significant impact on measures of nasalance. Method: Samples of the Zoo…

  6. Nasal angiocentric lymphoma: an entity that should be remembered.

    PubMed

    Guerrero, M T; Cárdenas-Camarena, L; Rodríguez-Carrillo, J

    2001-02-01

    After four nasal aesthetic functional surgeries in a period of 18 months, a 46-year-old woman was evaluated who presented with moderate functional alteration, saddle-nose deformity, and total loss of the septal cartilage. Four months before presentation the patient sustained severe nasal trauma, resulting in depression of the nasal bridge without loss of function. Her problem was diagnosed initially as a consequence of an infected septal hematoma and loss of the septal cartilage. Based on this diagnosis, the patient was subjected, in an 18-month period, to four reconstructive surgeries by different specialists, without any improvement and with worsening of clinical presentation. During the authors' physical examination of the patient, she demonstrated marked nasal cutaneous retraction, atrophic nasal conchae with total loss of the septal cartilage, and a large loss of septal bone. Three nasal mucosa biopsies were acquired and the authors proceeded to carry out complete nasal reconstruction using external cranial table and rib cartilage. Histopathologically, a lesion was noted that was compatible with angiocentric lymphoma, for which treatment was administered according to this type of illness. The authors point out the importance of establishing an adequate diagnosis in the face of an apparently obvious clinical case, present cross-disciplinary treatment, and discuss the study protocol that should be used for this type of pathology. They present their reconstructive technique of the nasal structure using a combination of bone tissue and cartilage, the results, and the current state of the patient.

  7. Cosmetic Concerns Related to the Posttraumatic Nose without Nasal Obstruction.

    PubMed

    Farrior, Edward H; Eisler, Lindsay S

    2015-06-01

    Because of its prominent position on the facial skeleton, the nose is commonly injured. Though significant trauma can result in nasal obstruction, there is also considerable concern for potential cosmetic deformity. Repairing traumatic deformities is complex and can involve all aspects of the nose, including the bony and cartilaginous framework as well as the soft tissue envelope. Trauma can result in deflection, asymmetry, and deformity of the bony nasal dorsum, midvault, and nasal tip. Any serious nasal trauma places patients at risk for complications that may include nasal septal hematoma, septal perforation, and possible cerebral spinal fluid leak. Unrecognized or untreated septal hematomas can result in cartilaginous septal necrosis followed by saddle nose deformity. Though damage to structural scaffolding is often the cause of cosmetic deformity following nasal trauma, the nasal soft tissue envelope is also commonly affected. This can result in lacerations, avulsions, and traumatic tattooing. The following will discuss the evaluation, diagnosis, and management of these cosmetic concerns relating to nasal trauma.

  8. 21 CFR 874.5550 - Powered nasal irrigator.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Powered nasal irrigator. 874.5550 Section 874.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5550 Powered nasal irrigator....

  9. 21 CFR 874.5800 - External nasal splint.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint....

  10. 21 CFR 874.5550 - Powered nasal irrigator.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Powered nasal irrigator. 874.5550 Section 874.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5550 Powered nasal irrigator....

  11. 21 CFR 874.5800 - External nasal splint.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint....

  12. 21 CFR 874.5800 - External nasal splint.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false External nasal splint. 874.5800 Section 874.5800 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5800 External nasal splint....

  13. 21 CFR 874.5550 - Powered nasal irrigator.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Powered nasal irrigator. 874.5550 Section 874.5550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Therapeutic Devices § 874.5550 Powered nasal irrigator....

  14. [Use of Solcoseryl DAP after nasal septum surgery].

    PubMed

    Krzeski, A; Makowska, W

    1991-01-01

    Solcoseryl is a biological agent, which accelerates the healing tissue procedure. This influence was studied during the nasal septum surgery. In 25 patients the postoperational nasal plug was inserted with the Solcoseryl and in 10 (control) with the paraffin. The cytologic verifications were performed before and after the surgery. In the solcoseryl group the mucosa regeneration procedure was accelerated and the inflammation reduced.

  15. NASAL FILTERING OF FINE PARTICLES IN CHILDREN VS. ADULTS

    EPA Science Inventory

    Nasal efficiency for removing fine particles may be affected by developmental changes in nasal structure associated with age. In healthy Caucasian children (age 6-13, n=17) and adults (age 18-28, n=11) we measured the fractional deposition (DF) of fine particles (1 and 2um MMAD)...

  16. Epidemiology and differential diagnosis of nasal polyps

    PubMed Central

    Chaaban, Mohamad R.; Walsh, Erika M.

    2013-01-01

    Background: Chronic rhinosinusitis (CRS) is one of the most common chronic medical conditions, with a significant impact on patient quality of life. CRS is broadly classified into two groups: CRS with nasal polyposis (CRSwNP) and CRS without NP (CRSsNP). Clinically, the major subtypes of CRSwNP may be divided into eosinophilic chronic rhinosinusitis (e.g., allergic fungal rhinosinusitis and aspirin-exacerbated respiratory disease [AERD]) and nasal polyps associated with neutrophilic inflammation (e.g., cystic fibrosis [CF]). CF is characterized by mutation of the gene encoding the CF transmembrane conductance regulator. Functional endoscopic sinus surgery is usually required for most NP patients with increased frequency in patients with AERD. This study provides a review of the epidemiology and major classification of CRSwNP. Methods: A review was performed of the literature regarding different subtypes of CRSwNP. Results: Many definitions of CRSwNP exist and estimates of prevalence vary. Conclusion: CRSwNP is a clinical syndrome with a heterogeneous inflammatory profile. Of the subtypes associated with eosinophilic inflammation, AERD remains the most recalcitrant to medical and surgical therapeutic interventions. PMID:24274222

  17. Clinical Implications of Nasal Septal Deformities

    PubMed Central

    Mladina, Ranko; Skitarelić, Neven; Poje, Gorazd; Šubarić, Marin

    2015-01-01

    The first attempts to systematize septal distortions have been given by Cottle who defined four groups of septal deformities: subluxation, large spurs, caudal deflection and tension septum. Fortunately, the variations of the septal deformities show a certain order, thus enabling more precise classification. Mladina was the first to make user-friendly classification of septal deformities in six basic types. He also described the seventh type, named “Passali deformity”, which presents individually, but is always a well-defined combination between some of the previous six types. Mladina types of septal deformities (SD) are divided in two main groups: so called “vertical” deformities (types 1, 2, 3 and 4), and “horizontal” ones (types 5 and 6). This classification was immediately well accepted by rhinologists worldwide and started to be cited from the very beginning. Since then it has been continuously cited increasingly more often, thus making Mladina classification a gold standard whenever clinical researches on nasal septum are concerned. More than forty clinical studies based on this classification have been performed to date. It is extremely important to make a strict distinction between the types of SD since all of them play some specific role in the nasal and general physiology in man. PMID:26167337

  18. Clinical evaluation of 30 patients with localized nasal rosacea.

    PubMed

    Lee, Woo Jin; Lee, Ye Jin; Won, Chong Hyun; Chang, Sung Eun; Choi, Jee Ho; Lee, Mi Woo

    2016-02-01

    The clinical features of localized nasal rosacea have not been described in detail. This study was designed to analyze the subtypes and severity of localized nasal rosacea. Our present study included 30 patients with localized nasal rosacea. The erythematotelangiectatic subtype (13/30, 43.3%) was the most common type, followed by the phymatous subtype (9/30, 30%). The duration of rosacea was shorter and the severity of localized nasal rosacea was lower in the erythematotelangiectatic subtype cases compared with the patients with mixed or phymatous subtypes. Almost all of the papulopustular eruptions or phymatous lesions were associated with erythematotelangiectatic lesions. These findings suggest that the erythematotelangiectatic subtype may be considered the initial phase of localized nasal rosacea.

  19. Handedness, eyedness and nasal cycle in children with autism.

    PubMed

    Dane, Senol; Balci, Nese

    2007-06-01

    Autism is referred to as cerebral lateralization abnormality. In this study, the possible relationships among handedness, eyedness and nasal cycle in autism have been investigated. Thirty-seven children with autism and 20 controls were included in the study. The patient group included 27 boys and 10 girls who ranged in age from 5 to 20 years. For hand preference, hand used to write and throw a ball was accepted as dominant hand. For eye preference or dominance, eye used to look through keyhole of a door was accepted as dominant eye. Nasal dominance was assessed by a method of measuring the nasal airflow. The rates of left-handedness and left-eyedness were higher in children with autism compared to normal populations. A majority of children with autism had left nasal dominance. Autism and early language impairment may be associated with left handedness, eyedness and nasal dominance.

  20. [Numerical flow simulation : A new method for assessing nasal breathing].

    PubMed

    Hildebrandt, T; Osman, J; Goubergrits, L

    2016-08-01

    The current options for objective assessment of nasal breathing are limited. The maximum they can determine is the total nasal resistance. Possibilities to analyze the endonasal airstream are lacking. In contrast, numerical flow simulation is able to provide detailed information of the flow field within the nasal cavity. Thus, it has the potential to analyze the nasal airstream of an individual patient in a comprehensive manner and only a computed tomography (CT) scan of the paranasal sinuses is required. The clinical application is still limi