Sinonasal Inflammatory Disease Research Articles

Association Between Frequency of Away-From-Home Meals and Prevalence of Inflammatory Sinonasal Diseases: A Population-Based Cross-Sectional Study

At the beginning of the COVID-19 pandemic, people had to stay at home due to quarantine, and the food delivery industry grew significantly. Concerns have been raised regarding the popularity of away-from-home (AFH) meals and their impact on health. In this study, we evaluated the association between the frequency of AFH meals and the prevalence of allergic rhinitis (AR) and chronic rhinosinusitis (CRS). In this cross-sectional study, the Korean National Health and Nutrition Examination Survey was reviewed from 2010 to 2019. The frequency of AFH meals was assessed as how often the respondents ate AFH meals in an average week. Those who ate AFH meals less than once per week were designated as group 1, one to four times as group 2, and five times or more as group 3. The diagnoses of AR and CRS were evaluated, and symptoms, endoscopic findings, and serum immunoglobulin E (IgE) levels were assessed. Logistic regression analyses were performed. A total of 48,515 participants were eligible. In multivariate logistic regression analysis for AR, when compared to group 1, the odds ratios (ORs) for AR in participants of group 2 (OR = 1.226, 95% confidence interval [CI] = 1.136–1.324) and group 3 (OR = 1.227, 95% CI = 1.126–1.337) were significantly higher (p < 0.0001). For CRS, group 2 (OR = 1.139, 95% CI = 1.029–1.260) and group 3 (OR = 1.210, 95% CI = 1.078–1.358) showed a significantly higher risk than group 1 (p = 0.0044). Individuals who consume AFH meals frequently might suffer less from AR or CRS if they change their dietary habits and prepare meals more often at home.

Resident memory B cells are enriched in chronic rhinosinusitis with nasal polyps

BackgroundChronic rhinosinusitis with nasal polyps (CRSwNPs) is a chronic nasal and sinonasal inflammatory disease. Recently, resident memory B cells (BRMs) have been identified in the lungs, although not in the sinonasal mucosa. ObjectiveTo characterize memory B cell phenotypes with regards to patients with CRSwNPs and to identify BRMs in both normal sinonosal mucosa and CRSwNPs. MethodsCD19+ B cells were isolated from patients with CRSwNPs and analyzed using flow cytometry and immunohistochemistry. ResultsAlthough BRMs were found in the normal sinonasal mucosa, their numbers and frequencies tended to be limited. These findings were confirmed based on immunohistochemical analyses indicating an upregulation of CD69/CD45RB in tissue sections from CRSwNPs, although not in normal sinonasal mucosa. Accordingly, BRMs were established to be enriched in the nasal polyps isolated from patients with CRSwNPs. ConclusionOur findings in this study reveal that BRMs can be detected in normal sinonasal mucosa, although are significantly enriched in nasal polyps derived from patients with CRSwNP. These findings can contribute to gaining a more comprehensive understanding of the immune reactions associated with CRSwNP and facilitate the identification of potential therapeutic targets, such as anti-B cell therapy.

Computed Tomography Signs of Sinonasal Inflammation in Patients with Acute Dacryocystitis.

Nasal and paranasal sinus abnormalities may be related to nasolacrimal duct obstructive disease but are strongly debated. Data of acute disease stage are lacking. The purpose of this study was to determine if there are correlations between radiologic signs of sinus inflammation and acute dacryocystitis (AD). This cross-sectional controlled study was conducted at Wenzhou, Zhejiang Province, China from February 2021 to November 2023. Forty-four consecutive patients with AD and 50 consecutive patients with orbital tumors (the control group), who completed preoperative computed tomography scans, were enrolled to evaluate the extent of their inflammatory sinonasal disease by the modified Lund-Mackay score system. The inflammation signs of the paranasal sinuses (total mean sinus scores, 95% CI [0.00, 2.00]; P < 0.001), namely the anterior ethmoid sinus(95% CI [0.00, 1.00]; P < 0.001), the posterior ethmoid sinus(95% CI [0.00, 0.00]; P = 0.003), the frontal sinus (95% CI [0.00, 0.00]; P = 0.02), and the ostiomeatal complex (P < 0.001) were more extensive in patients with AD when compared with the controls. The disease course was negatively correlated with the anterior ethmoid (P = 0.03) and frontal scores (P = 0.01). The symptom of eyelid swelling was positively correlated with the anterior ethmoid (P = 0.03), ostiomeatal complex (P = 0.004), and total sinus scores (P = 0.005). Inflammatory sinus disease was found to be more frequent in patients with AD, which was gradually alleviated with the prolongation of the disease course. The mutual spread of inflammation particularly in the acute course may play an important role in lacrimal duct obstructive disease.

Endoscopic Sinus Surgery in the Management of Inflammatory Sinonasal Disease

Background: Inflammation of the nose and paranasal sinus is a clinical problem frequently encountered in the practice of otolaryngology in our country. Endoscopic sinus surgery is a minimally invasive technique for the evaluation and treatment of inflammatory sinonasal disease. Endoscopic sinus surgery is used to restore sinus ventilation and normal function of sinuses.Objectives: To see the outcome of endoscopic sinus surgery associated with inflammatory sinonasal diseases.Materials and Methods: It is a prospective observational study carried out in ENT &amp;Head Neck Surgery of Shaheed Suhrawardy Medical College Hospital Dhaka from April 2016 to September 2016.Fifty(50) patients were enrolled in this study. Data was collected by Structural Questionnaire.Result: The majority of patients were 21-30years age group. The mean age group was 35.32 years, Male: male-to-female ratio was 1.3:1. The Majority of cases were antrochoanal polyps followed by an ethmoidal polyp, chronic maxillary sinusitis, and fungal rhinosinusitis. The majority of patients came with nasal obstruction and nasal discharge. Polyp was found in the majority of cases. A major complication was found in hemorrhage. Symptomatic improvement was found following endoscopic sinus surgery. KYAMC Journal Volume: 14, No: 04, January 2024: 226-233.

THE CONTENT OF CYTOKINES REGULATING INFLAMMATION IN NASAL FLUSHING IN CHRONIC RHINOSINUSITIS IN ELDERLY AND SENILE PERSONS

ABSTRACT&#x0D; BACKGROUND. Chronic rhinosinusitis is a heterogeneous sinonasal inflammatory disease with constant symptoms and recurrent exacerbations, which affects about 10% of the world's population. Age-related changes in the nasal mucosa (involutive immunodeficiency, atrophic changes, etc.) can affect the course of the inflammatory process, which, in turn, should be borne in mind when planning therapeutic interventions.&#x0D; AIMS - to study the features of local production of IL-4, IL-6, IL-8, IL-10 in elderly and senile persons with chronic rhinosinusitis.&#x0D; MATERIALS AND METHODS. The study included patients aged 45 to 90 years with a confirmed diagnosis of "chronic rhinosinusitis" in the acute stage, who gave written informed consent to the study. The exclusion criteria were: age up to 45 years; allergic rhinitis; primary immunodeficiency; smoking; oncological disease of any organ system; chronic polypous rhinosinusitis; acute (exacerbation of chronic) diseases of other localization; vaccination; use of immunotropic drugs for 3 months before the start of the study. The scope of the laboratory examination included determination of the concentration of cytokines IL-4, IL-6, IL-8, IL-10 in nasal secretions by enzyme immunoassay.&#x0D; RESULTS. The analysis of the determined values showed that the maximum level of IL-4 was determined in younger persons with rhonic rhinosinusitis 45-59 years old compared with older persons. In our study, the maximum content of IL-6 occurred in a group of patients aged 75-90 years, while the cytokine level significantly exceeded IL-6 in a group of healthy age-related patients, which indicates a more pronounced inflammatory reaction in patients of the oldest group with chronic rhinosinusitis. Cytokine levels above 600 pg/ml were found mainly in patients with chronic rhinosinusitis. Patients of group 4 had high IL-10 values and their values went beyond the range of the comparison groups.&#x0D; CONCLUSION. The maximum level of macrophage-monocytic cytokines (IL-6 and IL-8) and anti-inflammatory IL-10 is determined in nasal flushing in patients with chronic rhinosinusitis aged 75-90 years, the highest detectable values of IL-4 are characteristic of patients aged 45-59 years.

Elexacaftor/tezacaftor/ivacaftor improves nasal nitric oxide in patients with cystic fibrosis

BackgroundIn health, nitric oxide (NO) shows high concentrations in the upper airways, while nasal NO (nNO) is significantly lower in patients with sinonasal inflammation, such as people with cystic fibrosis (PwCF). In PwCF treated with elexacaftor/tezacaftor/ivacaftor (ETI; PwCF-ETI), clinical improvement of sinonasal symptoms and inflammation was observed. We therefore hypothesised that ETI may increase nNO in PwCF. Methods25 PwCF-ETI underwent nNO measurement at baseline and after 3 to 24 months of ETI treatment. NNO was measured using velum closure (VC) techniques in cooperative patients and tidal breathing (TB) for all patients. As controls, 7 CF patients not eligible for ETI (PwCF-non ETI) and 32 healthy controls (HC) were also repeatedly investigated. ResultsIn PwCF-ETI, sinonasal symptoms, lung function parameters and sweat chloride levels improved from baseline to follow-up whereas there was no change in PwCF-non ETI and HC. NNO increased from a median (IQR) value at baseline to follow-up from 348.2 (274.4) ppb to 779.6 (364.7) ppb for VC (P < 0.001) and from 198.2 (107.0) ppb to 408.3 (236.1) ppb for TB (P < 0.001). At follow-up, PwCF-ETI reached nNO values in the normal range. In PwCF-non ETI as well as HC, nNO did not change between baseline and follow-up. ConclusionsIn PwCF-ETI, the nNO values significantly increased after several months of ETI treatment in comparison to baseline and reached values in the normal range. This suggests that nNO is a potential non-invasive biomarker to examine sinonasal inflammatory disease in PwCF and supports the observation of clinical improvement in these patients.

Nasal sprays: commonly used medications that are often misunderstood.

Sinonasal inflammatory disease is very common and all clinicians who care for these patients should understand the topical treatment options available. This article reviews the utility and application of steroidal, saline, decongestant, antihistamine and anticholinergic preparations for the treatment of sinonasal disease, with a particular focus on evidence-based guidelines for use in both specialist and non-specialist healthcare settings.

Platelet-rich Plasma in Management of Anosmia (Single Versus Double Injections).

Anosmia is a common problem with a significant impact on quality of life and increased mortality. People with anosmia may not be able to fully taste foods and may lose interest in eating. This can lead to weight loss or malnutrition. Anosmia can also lead to depression because it may impair one's ability to smell or taste pleasurable foods. Platelet-rich plasma (PRP) is an autologous biologic product with anti-inflammatory and neuroprotective effects. This prospective study evaluated the role of PRP on olfactory neuroregeneration in patients with anosmia and compare the results of single and double injections. 54 patients were included in the study who had olfactory loss greater than 6months in duration, no evidence of sinonasal inflammatory disease, and no improvement with olfactory training and topical steroids. 27 patients received a single intranasal injection of PRP into the mucosa of the olfactory cleft and 27 patients received a double injections with 3weeks interval between them. The Q-Sticks Test was administered at the beginning of the study and at 1 and 3months. All patients reported a subjective improvement of their smell shortly after injection but then stabilized. At 3-month post-treatment, 16 patients improved significantly after single injection and 19 patients improved significantly after double injections. There were no adverse outcomes from intranasal PRP injections. PRP appears safe for use in the treatment of olfactory loss, and preliminary data suggest possible efficacy, especially for those with persistent loss. Further studies will help determine optimal frequency and duration of use.

Increased CYR61 expression activates CCND1/c-Myc pathway to promote nasal epithelial cells proliferation in chronic rhinosinusitis with nasal polyps

PurposeChronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) is a chronic sinonasal inflammatory disease characterized histologically by hyperplastic nasal epithelium and epithelial cells proliferation. Cysteine-rich angiogenic inducer 61 (CYR61) acts as a positive regulator of cell cycle process. Cyclin D1 (CCND1) and c-Myc play key roles in the processes of cell cycle and cell growth. The purpose of our research was to explore the expression and roles of CYR61, CCND1 and c-Myc in CRSwNP. MethodsFeaturePlot and vlnPlot functions embedded in the seurat package (version 4.1.1) of R software (version 4.2.0) were applied to explore the cellular distribution of CYR61, CCND1 and c-Myc in the single-cell RNA sequencing (scRNA-seq) dataset of nasal tissue samples. CYR61, CCND1 and c-Myc immunolabeling and mRNA levels in nasal tissue samples were assessed by immunohistochemistry and real-time PCR. Co-localization of CYR61, CCND1 and c-Myc with basal epithelial cell marker P63 was assayed using double-label immunofluorescence staining. Furthermore, we collected and cultured human nasal epithelial cells (HNEC) to assess the regulation and role of CYR61 in vitro study. ResultsCYR61, CCND1 and c-Myc were primarily expressed by nasal epithelial cells. Significant upregulation of CYR61, CCND1 and c-Myc positive cells and increased levels of CYR61, CCND1 and c-Myc mRNA were found in nasal polyps in comparison to control samples. Of note, CYR61 mRNA and protein levels were altered by SEB, LPS, IFN-γ, IL-13, IL-17A and TGF-β1 in HNEC. In addition, CYR61 intervention could increase CCND1 and c-Myc mRNA and protein levels to promote HNEC proliferation, and siRNA against ITGA2 (si-ITGA2) could reverse CYR61 induced upregulation of CCND1 and c-Myc mRNA and protein levels in HNEC and cell proliferation of HNEC. ConclusionsCYR61, CCND1 and c-Myc were primarily expressed by epithelial cells in nasal mucosa. CYR61, CCND1 and c-Myc expression levels were increased in CRSwNP compared with controls. CYR61 could interact with ITGA2 to enhance HNEC proliferation via upregulating CCND1 and c-Myc levels in the HNEC, leading to hyperplastic nasal epithelium in CRSwNP.

Anatomical evaluation of sphenoid sinus, foramen rotundum, and vidian canal for ventrolateral skull base surgery: A radiological study

Introduction: We aimed to evaluate the pneumatization of the sphenoid sinus (SS) and configuration of the vidian canal (VC) and foramen rotundum (FR). Materials and Methods: This study was performed on a total of 259 coronal and sagittal computed tomography (CTs) scans that we divided into rhinosinusitis (RS), nasal septum deviation (NSD), nasal polyposis (NP), and control (C) groups. We performed various morphometric measurements on CTs and evaluated the SS pneumatization and the position and protrusion of the FR and VC. Results: The mean age was found to be 42.42 ± 1.28 and 44.06 ± 1.45 in 149 males and 110 females, respectively. Significant differences were found among all morphometric measurements in the right and left side measurements and between genders except for the distance between VC and FR on both sides. The rotundum angle and bilateral VC distance values were found to be high in the NP and NSD groups. There was a difference in the distribution of categorical data between patient groups. We found prevalence of the FR and VC Type I as 3.3% and 13.3%, Type II as 35.5% and 43.65%; Type III as 61.2% and 43.05%, respectively. The position of FR was medial in 45.15%, online in 35.95%, and lateral in 18.9% of cases and SS pneumatization with lateral recess in 41.6%, tangent in 16.7%, and less pneumatized in 41.7% of cases in total. Discussion and Conclusion: Our findings show that the configuration of the structures, which are important anatomical landmarks for ventrolateral skull base surgery, changes in patients with anatomical variations and inflammatory sinonasal diseases.

Allergic fungal rhinosinusitis presented as a unilateral nasal mass: A first case report from Thailand and literature review

Allergic fungal rhinosinusitis (AFRS) is a relatively new inflammatory sinonasal disease. Prevalence of the disease is reported to be highly different across Asia. A 23-year-old Thai male came to our hospital with left-sided nasal obstruction. Endoscopic examination found a mass originated from the left sphenoethmoidal recess. Incisional biopsy result of the mass indicated an inflammatory process and high level of serum specific IgE to several aeroallergens was found. Based on the biopsy results and other investigations, the diagnosis of AFRS was made and the patient was treated successfully with endoscopic sinus surgery and postoperative systemic/topical steroids. While AFRS is quite common in some regions, the disease is rarely encountered in Thailand and can be presented as a unilateral lesion, mimicking a tumor mass, which could lead to an incorrect diagnosis and inappropriate treatment. Even though AFRS is rarely reported in our country, it still can be found and might be recognized falsely as a neoplastic process. High level of awareness of the disease features could help to minimize inappropriate disease management.

Efficacy and toxicity of Anatolian propolis on healthy nasal epithelial cells.

In our study we aimed to evaluate the effects of applying propolis topically to epithelial cells of the nasal cells, to discover whether this causes any toxic effect upon the cells. Samples of healthy human primary nasal epithelium harvested during septoplasty from volunteers were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilized when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epithelial cells were incubated with propolis (Bee&You) for 24 hours at 37°C. The MTT assay was then performed, and the cell morphology was examined by confocal microscopy. In addition, via wound healing assay, cellular proliferation was assessed by the artificial scratch method followed by light microscopy. MTT assay results showed that the primary nasal cells were not affected by the topical application of propolis for 24 hours. All of the applied doses not changed significantly the viability of the cells. The agent was not found to be cytotoxic to the primary nasal cells in the application time of 24 hours. Our confocal microscopy findings supported the MTT findings. According to the confocal images, control cells that were not treated with test agent were with compact morphology and undamaged fusiform cell shape and nucleus. In test group of nasal cells, Propolis was found not to be cytotoxic on the cellular morphology and not changed the cells. When evaluating the results from the wound healing assay, the clear area of scratch obtained at the start of incubation (0th) was closed totally with the proliferated primary nasal cells after incubation of 24 hours with propolis. These findings are supported by our MTT findings that imply to the slight induce of proliferation of the primary cells by Propolis. Topically applied propolis did not have a cytotoxic effect on nasal epithelium cells. Considering its antibacterial and antioxidant effects, it has been concluded that topical application in sinonasal inflammatory diseases (e.g., acute and chronic rhinosinusitis) may have an auxiliary effect in treatment. Moreover, there is a slight induce of proliferation of the primary cells by propolis which may help wound healing in septal surgeries and epistaxis.

Ghrelin Downregulates Lipopolysaccharide/ Leptin-Induced MUC5AC Expression in Human Nasal Epithelial Cells.

Obesity, which induces chronic low-grade systemic inflammation in the human body, is a known risk factor for various diseases. Recent studies have shown associations between various otorhinolaryngological diseases and obesity. In particular, inflammatory sinonasal diseases have been found to be strongly associated with obesity-related proinflammatory mediators. Many studies have been conducted to identify therapeutic agents for controlling obesity-related inflammatory airway diseases. Ghrelin, an endogenous peptide from the stomach, has anti-inflammatory and antioxidative effects in a wide range of tissues. However, the effect of ghrelin on the regulation of mucus secretion has not yet been studied in the human nasal mucosa. Therefore, we investigated the effects of ghrelin on lipopolysaccharide (LPS)/leptin-mediated MUC5AC expression and mechanisms involved in human nasal epithelial cells (HNEpCs). In HNEpCs, the effect and signaling pathways of ghrelin on LPS/leptin-induced MUC5AC expression were examined using reverse transcription polymerase chain reaction, real-time polymerase chain reaction, enzyme immunoassays, Western blotting, and immunofluorescence staining. Growth hormone secretagogue receptor 1a (GHSR1a) was expressed in the HNEpCs. Ghrelin downregulated LPS/leptin-induced MUC5AC expression, which was abolished by D-Lys-3-growth hormone-releasing peptide 6 (D-Lys-3-GHRP-6). Ghrelin significantly inhibited LPS/leptin-activated extracellular signal-regulated kinase 1/2 (ERK1/2) and p38 mitogen-activated protein kinases (MAPKs). These ghrelin-mediated changes in MAPK activation were abolished by D-Lys-3-GHRP-6. These. showed that ghrelin inhibits LPS/leptin-induced MUC5AC overexpression by modulating the ERK1/2 and p38 MAPK pathways in HNEpCs. These findings suggest that ghrelin is a potential therapeutic agent for treating obesity-related inflammatory sinonasal diseases.

Eosinophil-derived interferon-γ drives transmembrane protein 119-induced new bone formation in chronic rhinosinusitis with nasal polyps.

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a chronic inflammatory sinonasal disease characterized by eosinophilic infiltration and new bone formation. These changes indicate the severity and prognosis of CRSwNP and may be closely linked to each other. We performed RNA sequencing to screen specific osteogenic molecules and validated transmembrane protein 119 (TMEM119) expression by quantitative polymerase chain reaction (qPCR) and immunohistochemistry analyses. TMEM119 knockdown was performed to observe the downregulation of bone mineralization. We validated the bone-forming activity of interferon-γ (IFN-γ) and its signaling pathways in cultured primary sinus bone cells. Cellular sources of IFN-γ were identified using immunohistochemistry and immunofluorescence analyses. Interleukin-4-eosinophil-IFN-γ axis and the effect of dupilumab were investigated in Eol-1 cells. We observed elevated IFN-γ levels and eosinophils in the nasal fluid and predominantly eosinophil-derived IFN-γ in the sinus mucosa of patients with CRSwNP. TMEM119 expression and bone-forming activities were increased in the osteitic and primary sinus bone cells of CRSwNP. IFN-γ treatment enhanced bone mineralization and TMEM119 expression via signal transducer and activator of transcription 1 (STAT1) signaling. Moreover, TMEM119 knockdown inhibited sinus bone cell mineralization and dupilumab attenuated IFN-γ secretion by IL4-stimulated Eol-1 cells. Eosinophil-derived IFN-γ promotes the bone-forming activities of sinus bone cells via the STAT1-TMEM119 signaling pathway. Interleukin-4-eosinophil-IFN-γ axis may be crucial for TMEM119-mediated new bone formation in CRSwNP.

Comparative and correlative study of computerized tomographic scan findings and intropearative findings in patients with inflammatory sinonasal diseases

Inflammatory sinonasal diseases (ISD) refer to a group of disorders characterized by inflammation of the mucosa of the PNS. Acute ISD are defined as sudden in onset and duration less than 3 weeks. Recurrent acute infections are defined as four or more attacks per year lasting greater than 7-10 days. Chronic is defined as duration of symptoms more than 12 weeks Materials and methods: The present prospective study was conducted in the department of ENT JSS medical college and hospital. The study was conducted from a period of Nov 2012 to June 2014. The study included a total of 50 patients with clinically proven inflammatory sinonasal diseases not responding to medical line of treatment. A complete detail about their signs and symptoms was also recorded in a tabulated form. Data was expressed as percentage of the total information and analysis was done using SPSS software. Results: CT is effective in demonstrating predisposing cause of Inflammatory Sinonasal diseases (eg. Anatomical variants) and provides guidance for therapeutic endoscopic instrumentation. CT with its excellent capability for displaying bone and soft tissue is the current diagnostic modality of choice for evaluation of osteomeatal complex.

Nasal Nitric Oxide as a Biomarker in the Diagnosis and Treatment of Sinonasal Inflammatory Diseases: A Review of the Literature.

To critically review the literature on nasal nitric oxide (nNO) and its current clinical and research applicability in the diagnosis and treatment of different sinonasal inflammatory diseases, including acute bacterial rhinosinusitis (ABRS), allergic rhinitis (AR), and chronic rhinosinusitis (CRS). A search of the PubMed database was conducted to include articles on nNO and sinonasal diseases from January 2003 to January 2020. All article titles and abstracts were reviewed to assess their relevance to nNO and ABRS, AR, or CRS. After selection of the manuscripts, full-text reviews were performed to synthesize current understandings of nNO and its applications to the various sinonasal inflammatory diseases. A total of 79 relevant studies from an initial 559 articles were identified using our focused search and review criteria. nNO has been consistently shown to be decreased in ABRS and CRS, especially in cases with nasal polyps. While AR is associated with elevations in nNO, nNO levels have also been found to be lower in AR cases with higher symptom severity. The obstruction of the paranasal sinuses is speculated to be an important variable in the relationship between nNO and the sinonasal diseases. Treatment of these diseases appears to affect nNO through the reduction of inflammatory disease burden and also mitigation of sinus obstruction. nNO has been of increasing interest to researchers and clinicians over the last decade. The most compelling data for nNO as a clinical tool involve CRS. nNO can be used as a marker of ostiomeatal complex patency. Variations in measurement techniques and technology continue to impede standardized interpretation and implementation of nNO as a biomarker for sinonasal inflammatory diseases.

Association between Concentration of Air Pollutants and Prevalence of Inflammatory Sinonasal Diseases: A Nationwide Cross-sectional Study

Air pollution is a serious health concern and affects inflammatory sinonasal diseases such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS). Clarifying the relationship between air pollutants and upper respiratory diseases could help the patients. To evaluate the association between the concentration of air pollutants and the prevalence of AR and CRS among South Koreans. In this cross-sectional study, nationwide data were reviewed for participants of the Korean National Health and Nutrition Examination Survey (KNHANES) 2008 to 2012. Participants were surveyed with health questionnaires, examined with endoscopies by otolaryngologists, and tested with serum immunoglobulin E levels. The concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), and particulate matter with aerodynamic diameters ≤10 µm (PM10) were measured in 16 areas of South Korea. Air pollutant concentrations of geographic districts were matched to each participant's residence. Logistic regression analysis was performed. Among 27 863 eligible adults, 3359 and 1606 participants had AR or CRS, respectively. In multivariable logistic regression analysis for AR, PM10 showed statistically significant results (odds ratio [OR] = 1.145, 95% confidence interval [CI] = 1.042-1.258). No air pollutants showed statistically significant differences in the prevalence of CRS. In AR, PM10 (OR = 1.458, 95% CI = 1.201-1.770) was associated with endoscopic findings of watery rhinorrhea, whereas SO2 (OR = 1.202, 95% CI = 1.100-1.313) was associated with pale mucosa. The prevalence of AR was significantly associated with PM10 concentration. In patients with AR, endoscopic findings of watery rhinorrhea were associated with PM10. However, CRS was not associated with the air pollutant concentrations. Lower concentration of PM10 might help managing the clinical symptoms in patients of AR.

Identifying Olfactory Phenotypes to Differentiate Between COVID-19 Olfactory Dysfunction and Sinonasal Inflammatory Disease.

The objective of this study was to identify specific olfactory phenotypes-patterns of olfactory performance-across distinct cohorts with or without olfactory dysfunction (OD). Adult patients underwent testing via a novel olfactory testing methodology in 1 of 4 groups based on health status: sinonasal inflammatory condition (chronic rhinosinusitis or allergic rhinitis), ≥4 weeks of self-reported OD after resolved COVID-19 infection, Alzheimer's disease, and healthy control. Participants' scores for each scent were normalized on a scale of 0 to 1 relative to their worst and best scores. Agglomerative hierarchal cluster analysis was performed on normalized data for the COVID-19 and sinonasal cohorts. Resulting clusters from the penultimate merger revealed a sensitivity of 81% and specificity of 63% for the detection of patients with COVID-19. These results support that there are olfactory phenotypes that may discriminate COVID-19 OD from sinonasal inflammatory disease. These phenotypes will likely become increasingly leveraged in the workup and treatment of patients with OD.

Imaging After Sinonasal Surgery

Posttreatment imaging evaluation of sinuses encompasses a wide gamut of procedures, ranging from endoscopic procedures for sinonasal inflammatory diseases to markedly radical surgeries for malignant neoplasms (with or without reconstructions), as well as providing access for surgeries involving the anterior and central skull base. Advances in both techniques and devices have expanded the use of endoscopic approaches in managing both benign and malignant lesions, in addition to being the primary surgical method for treating all medically refractive sinonasal inflammatory disorders. Familiarity with the complex anatomy in the sinonasal region and knowledge of the various procedures is indispensable in interpreting these imaging studies.

A review of the revisions and complications management procedure in sinus surgery

One of the most standard and least invasive surgical procedures that could be applied mostly for the treatment of inflammation of the paranasal sinuses is endonasal endoscopic sinus surgery. The main objective of this study is to assess the available strategies for avoiding, diagnosis and also dealing with various kinds of potential complications of sinus disorders as well as the symptoms which specify the need for revision endoscopic sinus surgery mainly for the treatment of chronic rhinosinusitis. Based on the objectives of this study, the studies were categorized within four main groups; sinus disorders, diagnosis, management, and treatment. In this regard, wide research has been done in various scientific databases of PubMed, EMBASE, Europe PMC, HubMed, MEDLINE, Scientific Information Database (SID) and Google Scholar. From a total of 315 founded records, the final number of 91 records were reviewed. The rate of complication associated with endoscopic sinus surgery is not much and the improvement of surgical technology and experience could decrease its side effects. Performing immediate extensive surgery among patients who have inflammatory sinonasal disease could modify long-term consequences. Applying endoscopic sinus surgery could yield the most appropriate positive outcomes. For achieving the most suitable surgical consequences, the surgeon should be adequately qualified in diagnosis and facing with any possible complications during the operation in addition to cases with complex and revision problems.