Chronic Nasal Sinusitis Research Articles

Chronic sinusitis diagnosis and treatment

The growing popularity and use of endoscopic surgery in the field of otolaryngology prompts an attempt to organize knowledge about possible methods of surgery in the nasal cavity and paranasal sinuses. Chronic sinusitis is an inflammatory process involving the mucous membrane of the paranasal sinuses, lasting more than 12 weeks. The system of fissures in the lateral wall of the nasal cavity is an ostiomal ductal complex, the obstruction of which is the direct cause of chronic inflammation of the paranasal sinuses. FESS is a modern method in which access to the paranasal sinuses is obtained through the nasal cavity. The aim of the procedure is to widen, above all, too narrow sections of the middle meatus and the orifice-ductal complex. Compared to traditional methods, it is less invasive, allows you to regain the proper function of the maxillary sinus and, moreover, allows you to correct a deviated nasal septum, remove or reduce overgrown turbinates during one operation using the same access. Although traditional methods of surgery are still used in some groups of patients, modern minimally invasive endoscopic surgery strongly limits their use and becomes the method of first choice. Method: The literature was reviewed using the Pub med search engine and Google scholar using the words: Chronic nasal sinusitis, reasons of chronic nasal sinusitis, FESS, acute nasal sinusitis, nasal sinusitis radiology.

The seventh nationwide surveillance of six otorhinolaryngological infectious diseases and the antimicrobial susceptibility patterns of the isolated pathogens in Japan

The Japanese Three Academic Societies Joint Antimicrobial Susceptibility Surveillance Committee conducted a nationwide surveillance on six otorhinolaryngological diseases and investigated the antimicrobial susceptibility patterns and isolation rates of the causative pathogens. The surveillance program was conducted in the otorhinolaryngological departments of 12 universities, and 36 affiliated hospitals and clinics. Patients with acute otitis media (children under six years old), chronic otitis media, acute nasal sinusitis, chronic nasal sinusitis, acute tonsillitis, and peritonsillar abscess (over 20 years old) between December 2015 and June 2017 were investigated. The collected swab or incision samples were cultivated for microbial identification, and the antimicrobial susceptibility of the detected bacteria was measured at the Kitasato University Research Center for Infections and Antimicrobials. The surveillance focused on three gram-positive bacteria (Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus), three gram-negative bacteria (Haemophilus influenzae, Moraxella catarrhalis, and Pseudomonas aeruginosa), and three anaerobic bacteria (anaerobic gram-positive cocci, Prevotella spp., Porphyromonas spp., and Fusobacterium spp.). Bacterial susceptibility to 40 antimicrobial agents was investigated. We were unable to completely mitigate the rise in the occurrence of resistant bacteria, such as methicillin-resistant S. aureus, penicillin-resistant S. pneumoniae, penicillin-intermediate resistant S. pneumoniae, beta-lactamase non-producing ampicillin-resistant H. influenzae, and beta-lactamase producing ampicillin-resistant H. influenzae. We suggest promoting the proper usage of antimicrobial agents to prevent the spread of these bacteria. We also suggested that immunization with pneumococcal vaccines is useful for decreasing the occurrence of otorhinolaryngological infectious diseases caused by pneumococci.

Regulation of KDM2B and Brg1 on Inflammatory Response of Nasal Mucosa in CRSwNP.

Chronic nasal sinusitis with nasal polyps (CRSwNP) is a reversible nasal mucosal remodeling disease caused by persistent inflammation and structural changes in chronic nasal mucosa. Although there have been many studies on the inflammation of the nasal mucosa epithelium, the mechanism remains unclear. Our study found that H3K4me3 histone demethylase KDM2B (also known as JHDM1B) and transcriptional regulator Brg1 (also called SNF2-β or Smarca4) were significantly decreased in nasal mucosa of CRSwNP patients, and they were positively correlated. Brg1 and KDM2B co-localize in the epithelial cells of nasal mucosa. We used poly(I:C)-treated nasal mucosal epithelial cells (HNECs) to find that the expression of KDM2B and Brg1 was also decreased, and the main expression position transferred from the nucleus to the nuclear membrane. We used small interfering RNA to knock down the expression of KDM2B and Brg1 in nasal epithelial cells. It was interesting to find that the decreased expression of KDM2B and Brg1 produced similar effects to that of poly(I:C)-treated cells, which could promote inflammatory response of nasal mucosal epithelial cells. And Brg1 appears to play a role in KDM2B regulating gene promoters of IL-6 and TNF-α inflammatory. This study shows that KDM2B and Brg1 may have an inhibitory effect on the development of CRSwNP nasal mucosal epithelial inflammation. This study will provide a new perspective for gene targeting therapy of CRSwNPs.

The study of the rational use of antibiotics after nasal surgery

Objective:To study whether the antibiotics should be used in the patients with or without chronic nasal sinusitis after the nasal surgery,and how to rationally use it.Method：Study design:prospective stratified randomized controlled study.Patients with sinusitis were divided into three groups.A group was without antibiotics,B group was with standard antibiotics using ,and C group was with prolonged antibiotics using.Patients without sinusitis were divided into D group without antibiotics,E group with standard antibiotics using,and F group with prolonged antibiotics using. Observe the postoperative infection rate in each group and compare them.Result：The infection rates were 3.53%,2.67%,0.00% in A,B and C group, and there was no significant differences between three groups. The infection rates were 1.22%,0.00%,1.39% in D,E and F group,and there was no significant differences between them.Conclusion： There was no influence in patients with or without using antibiotics,standard or prolonged using antibiotics after nasal surgery. Recommend not to use antibiotics after nasal surgery,and appropriately use antibioctics within 48 hours.Prolonged using is not recommended.

Nasal sinus tuberculosis misdiagnosed as chronic nasal sinusitis in 2 cases

Nasal sinus tuberculosis misdiagnosed as chronic nasal sinusitis in 2 cases

Effect of outpatient nursing intervention in patients with chronic rhinosinusitis

Objective To investigate the effect of outpatient nursing intervention in patients with chronic rhinosinusitis (CRS) on the aspects of clinical efficacy, quality of life and nursing satisfaction after medical therapy. Methods The clinical efficacy according to the judgment standard for clinical effect was valued. Medical outcome study short-form 36-items health survey (SF-36) was used to assess the quality of life of the subjects. Satisfaction Questionnaire was used to evaluate the satisfaction scale of patients. Eighty subjects with CRS were randomly divided into the control group (40 cases) and the trial group (40 cases). The trial group was given nursing intervention on basis of usual nursing. In three months after treatment, the data and statistics analysis was purely descriptive by SPSS 20.0. Results Clinical efficacy: in the group, nineteen subjects were cured, fourteen subjects were improved and inefficacy occurred in seven subjects. The effective rate was 77.5% (31/40). In the trial group, twenty-six subjects were cured, twelve subjects were improved and inefficacy occurred in two subjects. The effective rate was 95.0% (38/40). There were differences in general data between the two groups (χ2=5.165, P=0.023). Quality of life: the average score of the control group was 58.10±5.04, while the average score of the trial group was 72.22±5.63, the average score of quality of life in the trial group was significantly higher than that in the control group (t=3.08, P=0.025) . Nursing satisfaction: there were significant differences in nursing satisfaction between the control group and the trial group (u=-7.048, P=0.000). Conclusions Outpatient nursing intervention can improve the effect of patients with chronic nasal sinusitis after medical therapy, improve the quality of life and improve nursing satisfaction. Key words: Quality of life; Sinusitis; Outpatient nursing intervention; Nursing satisfaction

Bilateral Sinonasal Lymphoma in the Absence of a Solitary Lesion: Case Report and Review of the Literature

Objective: Primary sinus lymphoma is rare, accounting for about 0.2 to 5% of extra nodal lymphomas. Lymphomas are the second most common malignancy in the head and neck after squamous cell carcinoma. Methods: Case report Results: We present the case of a 50-year-old African American female with an atypical presentation of sinonasal lymphoma. She had chronic nasal congestion and sinusitis for one-year duration. Computed tomography was significant for scattered mucosal thickening bilaterally in all paranasal sinuses; however, no discrete mass lesion was identified. She underwent functional endoscopic sinus surgery, and pathology was positive for diffuse large B-cell lymphoma. The multidisciplinary tumor conference recommended R-CHOP with intrathecal therapy. She deferred further treatment and was symptom-free without evidence of recurrent disease at 10 months post-surgery. Conclusion: This case of bilateral sinonasal lymphoma with no mass lesion serves as a reminder to maintain a high index of suspicion for non-typical sinus pathology that may masquerade as chronic sinusitis.

Effect analysis of three different therapy of chronic nasal-sinusitis after radiotherapy of nasopharyngeal carcinoma

Effect analysis of three different therapy of chronic nasal-sinusitis after radiotherapy of nasopharyngeal carcinoma

Nationwide surveillance of 6 otorhinolaryngological infectious diseases and antimicrobial susceptibility pattern in the isolated pathogens in Japan.

The Japanese Three Academic Societies Joint Antimicrobial Susceptibility Surveillance Committee has conducted a nationwide surveillance on antimicrobial susceptibility patterns and rates of isolation in 6 otolaryngological diseases. The surveillance program was conducted in the otorhinolaryngological departments of 29 universities, and their 26 affiliated hospitals. Patients suffering from acute otitis media, chronic otitis media, acute nasal sinusitis, chronic nasal sinusitis, acute tonsillitis, and peritonsillar abscess between January 2011 and June 2012 were investigated. The collected swab or incision samples were cultivated for microbial identification, and the drug susceptibility of detected bacteria was measured at the Kitasato University Research Center for Infections and Antimicrobials. The surveillance focused on three gram-positive bacteria (Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus), three gram-negative bacteria (Haemophilus influenzae, Moraxella Catarrhalis, and Pseudomonas aeruginosa), and three anaerobic bacteria (Peptostreptococcus spp., Prevotella spp., and Fusobacterium spp.). Bacterial susceptibility to 39 antimicrobial drugs was investigated. We compared bacterial isolation ratio of each disease in this surveillance from those of past 4 times surveillance which we performed formerly, and we also compared percentage of main drug resistant strains from those of past 4 times surveillance. The age composition between this time and former surveillances was not statistically significant by student-t test. We were unable to completely resolve the rise in resistant bacteria, such as methicillin-resistant S. aureus, penicillin-resistant S. pneumoniae, penicillin-intermediate resistant S. pneumoniae, beta-lactamase non-producing ampicillin-resistant H. influenzae, beta-lactamase producing ampicillin-resistant H. influenzae, and beta-lactamase producing amoxicillin clavulanic acid-resistant H. influenzae. We suggest promoting the proper usage of antimicrobial drugs in order to avoid the spread of these bacteria.

慢性鼻窦炎鼻息肉鼻内镜手术治疗临床分析

目的：分析鼻内镜手术治疗慢性鼻窦炎鼻息肉的手术技巧，评价临床疗效。方法：回顾性分析鼻内镜手术治疗慢性鼻窦炎鼻息肉410例的临床资料，评估疗效与并发症。结果：通过术后的随访，本组患者中达到治愈标准的320例，显效标准的82例，总有效率为98.0%，无重大手术并发症发生。结论：鼻内镜下手术治疗慢性鼻窦炎鼻息肉具有视野清晰、范围准确、切除组织彻底等特点，对保证手术质量和防止并发症有着重要的意义。 Objective: To analyze the operation technique and the clinical treating effect of endoscopic sinus surgery for the chronic nasal sinusitis patients combined with nasal polyp. Methods: To make the retrospective analysis for the 410 cases chronic nasal sinusitis patients combined with nasal polyp that underwent the nasal endoscopy operation through the clinical data and hold the analysis of the treating effect and complication. Results: For the follow-up process, 320 cases reach the full-recovered standard, 82 reach the obvious-improvement standard, the total efficiency was 98.0% and without the occurrence of the serious complication. Conclusions: Compared with the traditional operation method, the nasal endoscopy operation has obvious advantages such as “clear visual field”, “accurate operating scope”, “thoroughly resection” and of high significance to guarantee the quality and decrease the occurrence of the complication as far as the nasal endoscopy operation.

Detection of bacterial biofilms in different types of chronic otitis media

Biofilms are organized bacterial communities that may be homogeneous or heterogeneous. They play a significant role in the pathogenesis of chronic nasal sinusitis, chronic tonsillitis, cholesteatomas, and device-related infections. Despite this, few studies have been done that examine the presence of bacterial biofilms in tissues from patients with different types of COM or middle ear cholesteatomas. In the current study, we examined the presence of biofilms in surgical tissue specimens from humans with chronic ear infections using scanning electron microscopy (SEM). We hypothesize that bacterial biofilms present differently in patients with different types of chronic otitis media. Our results provide new insights regarding treatment of chronic otitis media. A prospective study was conducted in which middle ear tissues were obtained from 38 patients who underwent tympanoplasty and/or tympanomastoid surgery due to chronic ear infections. A total of 50 middle and mastoid tissue samples were processed for SEM analysis. In addition, 38 middle ear secretion specimens were obtained for routine bacterial culture analysis. Bacterial biofilms were present in 85 % (11 of 13) of patients with middle ear cholesteatoma, 92 % (12/13) of patients with chronic otitis suppurative media (CSOM), and 16 % of patients (2/12) with tympanic membrane perforation (TMP). Fungal biofilms were found in two cases of cholesteatoma. The positive coincidence rate between bacterial biofilms visualized by SEM and bacteria detected by culture was 82 %. Our findings suggest that bacterial biofilms are very common in CSOM and middle ear cholesteatomas. Positive bacterial cultures imply the presence of biofilm formation in CSOM and cholesteatomas. As such, our results provide new insights regarding treatment of chronic otitis media.

A case of an intraventricular inflammatory pseudotumor presumably caused by Epstein-Barr virus infection

Background Inflammatory pseudotumor primarily affecting the CNS is an extremely rare lesion with uncertain etiology in most cases. Case Description A 67-year-old man developed involuntary movement disorder of the left upper extremity. On MRI, a solid homogeneously-enhanced tumor was noted in the right lateral ventricle adjacent to the thalamus. He had histories of right thalamic hypertensive hemorrhage and recurrent chronic nasal sinusitis associated with an orbital mass lesion, presumably an IP. Partial removal of the tumor yielded a diagnosis of IP associated with EBV infection. Conclusion The simultaneous occurrence of multiple IPs was presumably because of an exaggerated immune process after EBV infection. Inflammatory pseudotumor should be considered in any case of intraventricular mass lesion.

A correlative study of NF-κB activity and cytokines expression in human chronic nasal sinusitis

A growing body of literature suggests that cytokines play an important part in the pathogenesis of chronic nasal sinusitis. However, the mechanism by which the expression of cytokines in chronic nasal sinusitis is upregulated has not been well documented. The present study investigated the role of nuclear factor-kappa B (NF-kappaB) activation in upregulating the expression of interleukin-5, -6 and -8 (IL-5, IL-6 and IL-8). We titrated the levels of IL-5, IL-6 and IL-8 in nasal mucosa in 52 cases of chronic nasal sinusitis and 12 normal subjects using enzyme-linked immunosorbent assay. According to whether allergic rhinitis was associated or not, we subdivided the patients into the AR group (with allergic rhinitis) and the NAR group (without allergic rhinitis). Semi-quantitative reverse transcription-polymerase chain reaction and immunohistochemical staining were used to evaluate expression and activation of NF-kappaB P50 and P65 subunits in nasal mucosa. The correlation between activities of P50 and P65 and cytokines expression was analysed. Our results showed that IL-5, IL-6 and IL-8 in both the AR and NAR groups were strikingly elevated in comparison with the control group (all p < 0.01 for AR group; p < 0.05, 0.05, 0.01, respectively, for NAR group); and they were even higher in the AR group than those in the NAR group (p < 0.01, 0.05, 0.01, respectively). P50 and P65 mRNA levels in both AR and NAR groups were markedly greater than those in the control group (all p < 0.01); and the AR group had further higher levels as compared with the NAR group (both p < 0.05). Immunohistochemical study revealed that nucleus-positive rates of P50 and P65 in both AR and NAR groups were significantly higher than those of the control group (all p < 0.01), and they were much greater in the AR group in comparison with the NAR group (all p < 0.01). Pearson correlation analysis demonstrated that P50 and P65 nucleus-positive rates were closely correlated with IL-6 and IL-8 levels, but not IL-5, with a correlation coefficient of 0.49 for P50 and IL-6, 0.54 for P50 and IL-8, 0.61 for P65 and IL-6, and 0.66 for P65 and IL-8 (all p < 0.01). In conclusion, upregulated expression and activation of NF-kappaB P50 and P65 might be one of the mechanisms for induction of IL-6 and IL-8 expression in chronic nasal sinusitis. Association of allergic rhinitis with chronic nasal sinusitis further enhanced NF-kappaB activity, and subsequently lead to even stronger expression of IL-6 and IL-8. IL-5 expression appeared to be independent of NF-kappaB pathway in chronic nasal sinusitis.

難治性浸出性中耳炎とＣＡＭ少量長期投与

The Clinical efficacy of low dose clarithromycin (CAM) was evaluated in refractory OME patients (aged 10 to 20 years) with chronic nasal sinusitis and no sign of organic disorder of the eustachian tube.Twenty seven patients (35 ears) were divided into two groups. Group 1 (15 ears) received CAM in a dose of 200 mg/day for 3 months and group 2 patients (20 ears) were treated by ventilation tube insertion for more than 3 months.Within the 3-month follow-up period after CAM treatment, 11 of the 15 ears (73%) showed satisfactory healing with type A or C 1 tympanograms. On the other hand, only 35% of the OME ears treated with ventilation tubes showed improvement of the tympanogram after extrusion of the tubes.These results indicate that low dose CAM may be useful in the treatment of refractory OME with accompanying chronic nasal sinusitis.

Paraffinoma of lung: lipoid pneumonia. Report of two cases.

Paraffinoma of lung—localized lipoid pneumonia due to exogenous oil in the alveoli—must be remembered when considering unusual lung disorders, for this benign lesion can mimic lung cancer clinically, radiologically, during operation, and even on frozen section. Though usually caused by mineral oils taken as nose drops, sprays or laxatives, it can be caused by animal or vegetable oils. The lesion is essentially a macrophage response with phagocytosis of oil droplets. Symptoms can be minimal, simulating `virus pneumonia9, local, with shortness of breath, cough, sputum, haemoptysis, and chest pain, or general. The history of oil ingestion, the finding of lipophages or free lipoid in the sputum, may suggest the diagnosis. Two cases treated 10 years earlier by lobectomy, one as lung cancer and the other as tuberculosis, and proven histologically to be paraffinoma of lung are described. Both patients had used oily nasal drops for chronic nasal sinusitis. Today they remain well.

The Medical Therapy of Chronic Para Nasal Sinusitis

The Medical Therapy of Chronic Para Nasal Sinusitis

Chronic nasal sinusitis in children.

Chronic nasal sinusitis in children.

BACTERIAL FACTORS IN CHRONIC CATARRHAL CONJUNCTIVITIS

The etiology of chronic catarrhal conjunctivitis is not clearly defined. With no single causative factor in evidence, a variety of agents and conditions have been regarded as inciting or contributing causes. Among the more important of these are the following: (1) bacteria, principally Haemophilus lacunatus (the diplobacillus of Morax and Axenfeld) ; (2) viruses, such as those causing molluscum contagiosum and the common wart; (3) acne rosacea; (4) allergy; (5) streptotrichal concretions of the canaliculi; (6) trichiasis; (7) minute foreign bodies; (8) irritants, such as smoke; (9) refractive errors; (10) excessive secretion of the meibomian glands; (11) vitamin deficiency; (12) deficient lacrimal secretion, and (13) chronic nasal sinusitis. It is proposed in this series of studies to consider the bacterial factors in chronic catarrhal conjunctivitis and to endeavor to determine the relationship of each bacterium to the disease. The term chronic catarrhal conjunctivitis will be used to include all forms

Chronic Nasal Sinusitis and its Relation to Mental Disorder

As a presentation of the relation of sinusitis to the occurrence of mental disorder, this book is not convincing. If the author would only give us reliable control figures wemight listen, but until we know what proportion of patientsin general hospitals have sinusitis, as judged by the same standards, we shall not be convinced. We take serious objection to the statement that “Hysteria should be treated as amedical disease due to minute focal brain lesions, and not due solely to the imagination”. The prevalence of agglutinins to organisms of the typhoid-dysentery-foodpoisoning group amongst mental hospital admissions probably corresponds to their occurrence amongst the general population of a large city like Birmingham. The percentage in admissions from rural areas is very small.

Chronic Nasal Sinusitis and its Relation to General Medicine

Chronic Nasal Sinusitis and its Relation to General Medicine