Anterior Part Of Inferior Turbinate Research Articles

Inferior Turbinate Swing Technique: A Novel Surgical Route to Approach Maxillary Sinus Area Pathology.

The inferior turbinate is an important structure for maintenance of adequate physiologic function within the nasal cavity. However, it hampers access to lesions involving maxillary sinus areas, including postoperative mucocele or benign tumor, and acts as an inferior limit to widening the natural ostium of a maxillary sinus. Here, we introduce a novel technique, interior turbinate swing, to facilitate entry to the inferior meatus or maxillary sinus while maintaining integrity of the inferior turbinate. In this technique, the anterior part of inferior turbinate is cut with sharp scissors, rotated posteriorly, and held in the nasopharynx. The inferior turbinate swing technique was employed in 38 subjects, and no patients exhibited recurrence of the causative disease without complication. Therefore, we may conclude that the inferior turbinate swing technique is a simple, effective, and safe treatment option for the management of postoperative mucocele, maxillary sinusitis with narrow inlet, or benign tumors.

Comparison of Nasal Mucociliary Function before and after Septorhinoplasty Surgery Using Saccharin Test.

Background:This study was carried out to compare mucociliary function (MCF) of nasal cavity before and after septorhinoplasty surgery by saccharin test.Materials and Methods:This study was carried out on 70 patients who needed septorhinoplasty surgery in Kashani and Alzahra Hospital during 2013–2014 to measure MCF. Saccharin test was performed on the patients before surgery and on three more intervals 1 day, 1 week, and on month after ward and the readings were recorded. Saccharin test is performed by placing saccharin granules on the anterior part of inferior turbinate and the time the patient feels the sweet taste is recorded the normal range is below 30 min.Results:Mean of test for each time interval was obtained and comparison of measurements was made reading were mean of saccharin test before surgery (7.74 ± 1.65 min) the day after surgery (7.75 ± 1.7 min), on week after surgery (15.04 ± 3.4), and 1 month after surgery (8.49 ± 2.08 min). The readings before surgery did not have statistically significant difference with the readings 1 day after surgery P = 0.99, but comparison of test results at other time intervals were significant (P < 0.001). A relative increase in saccharin test time was seen in a period of 1 month after surgery the rise was more noticeable in the 1st week compared to 1 month after surgery.Conclusion:This study in the period after septorhinoplasty surgery MCF undergoes slight impairment that gradually progresses to normal values during 1 month after surgery.

Deposition of intranasal glucocorticoids--preliminary study.

Intranasal glucocorticoids are the treatment of choice in the therapy of rhinitis. The differences in efficiency of particular medications proven by therapeutic index may result from differences in composition of particular formulations as well as from diverse deposition in nasal cavities. Intranasal formulations of glucocorticoids differ in volume of a single dose in addition to variety in density, viscosity and dispenser nozzle structure. The aim of this report was to analyze the deposition of most often used intranasal glucocorticoids in the nasal cavity and assessment of the usefulness of a nose model from a 3D printer reflecting anatomical features of a concrete patient. Three newest and most often used in Poland intranasal glucocorticoids were chosen to analysis; mometasone furoate (MF), fluticasone propionate (FP) and fluticasone furoate (FF). Droplet size distribution obtained from the tested formulations was determined by use of a laser aerosol spectrometer Spraytec (Malvern Instruments, UK). The model of the nasal cavity was obtained using a 3D printer. The printout was based upon a tridimensional reconstruction of nasal cavity created on the basis of digital processing of computed tomography of paranasal sinuses. The deposition of examined medications was established by a method of visualization combined with image analysis using commercial substance which colored itself intensively under the influence of water being the dominant ingredient of all tested preparations. On the basis of obtained results regions of dominating deposition of droplets of intranasal medication on the wall and septum of the nasal cavity were compared. Droplet size of aerosol of tested intranasal medications typically lies within the range of 25-150 µm. All tested medications deposited mainly on the anterior part of inferior turbinate. FP preparation deposited also on the anterior part of the middle nasal turbinate, marginally embracing a fragment of the central part of this turbinate as well together with deposition in the middle and superior nasal meatus reaching the region of nasal ceiling and olfactory field. MF preparation deposited on the anterior part of the inferior turbinate and central part of this turbinate alike. The area of mucous membrane of lateral wall of nasal cavity on which MF deposited was similar to the area achieved after the application of FP preparation but much greater than in the case of FF preparation. FF drug deposition concentrates only on the anterior part of the inferior turbinate. Despite directing the drug to the lateral wall of the nasal cavity a great proportion of examined preparations deposit also on the nasal septum. The practical application of tridimensional representation (3D printout) of actual geometry of nasal cavity to establish the deposition of inGKS was proven. Droplet size and the geometry of the aerosol cloud introduced into the nostril determine the significant deposition of medication droplets in the anterior part of the nasal cavity. Both physical properties of the drug as well as spraying system applied influence spatial distribution of the drug. The interaction of the air flow with the layer of deposited fluid plays a major role in the deposition of the drug in the nasal cavity, therefore it is so important that the drug does not drain by gravity but remains at the site of deposition which may be reinforced by thixotropic properties of the preparation.

Nasal passage patency in patients with allergic rhinitis measured by acoustic rhinometry: nasal responses after allergen and histamine provocation

We investigated nasal passage patency after allergen and histamine provocation in patients with allergic rhinitis by acoustic rhinometry. In total, 75 outpatients with allergic rhinitis were studied. The threshold of nasal hypersensitivity to histamine was measured by the 10 μl instillation of serial 10-fold dilution in the ipsilateral nasal cavity. Nasal provocation testing to specific antigen was applied to the anterior part of inferior turbinate in bilateral sides in sitting position. Measurement of nasal patency by acoustic rhinometry was repeated three times in each nasal cavity. The minimal cross-sectional area and total volume of nasal cavity were measured in an individual subject. The minimal cross-sectional area and total volume in the histamine challenged-side significantly decreased on the 10 −2, 10 −1, 10 −0 of end point, and up to 30 min after challenge with the threshold dose, but not in the unchallenged side. This means acoustic reflection technique is sensitive at least 100-fold in comparison with classical method like findings by anterior rhinoscopy and symptom scores. Nasal passage patency after bilateral allergen provocation showed predominant in the unilateral side, suggesting the cross over-reflex effects.It was concluded that acoustic rhinometry is one of the highly quantitative and sensitive method which can observe the change of nasal congestion.