This study established three kainic acid-induced epileptic models via intraperitoneal, intranasal, and intravenous injections, comparing their behavioral and pathological differences to inform model selection in epilepsy research. A total of 108 male C57BL/6J mice were randomized into six groups (intraperitoneal/intranasal/intravenous + kainic acid or PBS). Acute seizure severity (Racine scale), latency to stage IV-V seizures, status epilepticus duration, hippocampal neuronal degeneration (hematoxylin and eosin staining), apoptosis [terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)], and glial activation (immunofluorescence for glial fibrillary acid protein/ionized calcium-binding adapter molecule 1) were assessed. The intravenous + kainic acid group showed the lowest mortality (10.0%) and highest success rate (96.3%), with shorter latency to severe seizures, longer status epilepticus duration, and milder Racine scores (P < 0.05). It also exhibited greater neuronal loss, morphological abnormalities, TUNEL-positive cells in CA3/dentate gyrus, and stronger glial activation. The intranasal + kainic acid group only showed increased dentate gyrus apoptosis. The intravenous + kainic acid model exhibited low mortality, reduced dosage requirements, and inducible localized pathological damage, rendering it suitable for investigating localized neuronal injury. The intraperitoneal method, though simple with higher mortality, is preferable for systemic seizure models. The noninvasive intranasal approach is promising for trauma-sensitive research.

Background: Intranasal drug delivery system has several advantages, but evidence associated with their use in patients is limited. This study evaluated the effectiveness of a novel drug delivery system for procedural sedation in adults undergoing endoscopic procedures at a tertiary care Indian centre.Methodology: A prospective, comparative study was conducted at Sir H.N. Reliance Foundation Hospital &amp; Research Centre (HNRFHRC) in Mumbai (India), including all adult patients posted for gastrointestinal endoscopy between July 2023 and June 2024. Enrolled patients were randomized to receive pre-operative medications by standard protocol (group 1) or intranasally (group 2). The intranasal approach involved attaching the cannula and nozzle of a standard lignocaine nasal spray to a syringe using a 20G needle. All patients were monitored using pulse oximetry, continuous electrocardiography, and noninvasive blood pressure measurements. Standardized assessment tools were used to evaluate the system: Amsterdam Preoperative Anxiety and Information Scale (APAIS), functional mobility scale (FMS), visual analogue scale (VAS) for pain, Observer’s Assessment of Alertness and Sedation (OAA/S), and 24-hour postoperative anxiety score (PAS).Results: Of the 319 patients enrolled (166 control, 153 test), age, gender, and anthropometric characteristics were comparable (p &gt; 0.05). Hemodynamic parameters and oxygen saturation were similar across groups (p &gt; 0.05). The mean APAIS was significantly lower in the test group (p &lt; 0.05), while OAA/S was comparable (p &gt; 0.05). More patients in the test group had a VAS score of zero (92.16% vs. 69.88%, p &lt; 0.05). Higher proportions in the control group had an FMS score of 2 or 3 (7.23% vs. 0%, p &lt; 0.05) and PAS &gt;18 (5.42% vs. 0%, p &lt; 0.05). These findings demonstrate that the intranasal system reduces anxiety and pain and represents a conceptual advance, showing that a simple, low-cost modification can enhance peri-procedural comfort without compromising safety.Conclusion: The novel intranasal drug delivery system improved pre-operative anxiety, immediate pain control, alertness, and postoperative anxiety. Further studies are warranted.

Drug delivery strategies for paediatric diffuse midline gliomas.

Supernumerary intranasal teeth are rare, and few cases of supernumerary intranasal floating teeth have been reported in the English literature. Here, we report a case of a supernumerary intranasal floating tooth in a middle childhood boy. CT revealed a floating tooth-like structure on the right nasal floor with no bone contact. We made a clinical diagnosis of a supernumerary intranasal floating tooth, which was endoscopically removed via an intranasal approach. CT was used to confirm the position of the tooth and select the surgical approach for its removal. Finally, we meticulously conducted a literature review of previous cases of supernumerary intranasal teeth, hoping to provide guidance to clinicians for the correct diagnosis and choice of treatment modality.

ObjectiveAssess the efficacy of the sandwich graft technique from the concha of auricle or the rest of nasal septum of 2-mm thickness of cartilage with both layers of its perichondrium in the treatment of moderate perforations of the nasal septum (diameter: 1 to 2 cm).BackgroundNasal septal perforations (NSPs) are bilateral mucosal deformities accompanied by cartilage or defect in the bone. The only permanent solution for NSP is the surgical repair of the defect.MethodsThirteen instances with moderate nasal septal perforations (1 to 2 cm in diameter) which were managed using an endoscope-assisted intranasal approach as well as the sandwich technique from April 2022 to April 2024 were enrolled in the study. Following up lasted for 3 months.ResultsIn 13 instances, the sandwich technique was implemented. Twelve cases were entirely cured (92.3%). A matter is partially closed.ConclusionsFixing moderate nasal septal perforation (1 to 2 cm) with an endoscopic sandwich graft is a straightforward procedure with an elevated probability of achievement.

ObjectiveMedium- and large-sized iatrogenic nasal septal perforations are difficult to repair. Many techniques using local flaps with or without interposition grafts are used to repair septum perforation. The aim of this study was to describe our surgical technique for repairing iatrogenic nasal septal perforations with medium sized (1–2 cm) and large sized (> 2 cm).MethodsWe retrospectively reviewed 15 patients with medium- and large-sized iatrogenic nasal septal perforations treated with a sandwich technique (temporoparietal fascia and polycaprolactone nasal sheet as an interposition graft) by an endoscope-assisted intranasal approach at the Kastamonu Training and Research Hospital from September 2021 to September 2024. Clinical follow-up periods were between 3 and 28 months in duration (mean 12 months).ResultsFifteen patients, nine men and six women, were operated on using this technique. A mean follow-up time is 12 months. Complete closure was achieved in 13 of 15 patients (86.6%). No complications were also occurred in either the early or late postoperative periods.ConclusionAn endoscopic sandwich technique that uses a temporalis fascia polycaprolactone nasal sheet combined as an interpositioning graft to repair iatrogenic nasal septal perforations is described. The transnasal endoscopic sandwich technique for repairing of medium-sized and large-sized iatrogenic nasal septal perforations has a high success rate and is relatively easy to perform.Level of Evidence IVThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Over the past century, frontal sinus surgery has undergone substantial transformation, with advances in imaging, optics, and instrumentation contributing to current treatment paradigms. This review article is devoted to the evolution of surgical methods for treating frontal sinus diseases, demonstrates the complexity of surgical access, anatomical features, and the high rate of postoperative complications in this area. The historical development of frontal sinus surgery is outlined, from ancient trepanation practices, first thoroughly described in the 18th century, to modern minimally invasive endoscopic techniques. Particular attention is given to the transition from radical external approaches, such as the Ogston–Luc procedure, radical ablation, and complete sinus obliteration, to more conservative procedures aimed at preserving anatomical integrity and frontal sinus function. The review includes an analysis of early surgical milestones by Ogston, Kuhnt, Riedel-Schenke, and Killian, and examines the evolution of external frontoethmoidectomies known as Lynch–Howarth procedures. The limitations of these techniques, including high restenosis rates, scarring, and cosmetic deformities, are discussed, along with the development of various modifications intended to improve drainage and reduce postoperative complications. The article also addresses the challenges of intranasal approaches, such as limited visualization and the risk of intracranial complications. Advances in osteoplastic techniques are reviewed, noting their high efficacy alongside technical difficulty and risks such as cerebrospinal fluid leak and neuralgia. Despite the rise of endoscopic methods, external approaches remain relevant for certain specialists due to the unique anatomy of the frontal sinus, limited surgical experience, or complex disease course, either as stand-alone options or part of combined strategies. The review demonstrates that optimizing surgical treatment of the frontal sinus remains a relevant challenge, requiring continuous refinement of techniques and an individualized approach to each patient.

A Double Intranasal Approach to Treat Cholesteatoma of the Maxillary Sinus: A Report of Two Cases and a Literature Review

Photobiomodulation (PBM) therapy on the brain employs red to near-infrared (NIR) light to treat various neurological and psychological disorders. The mechanism involves the activation of cytochrome c oxidase in the mitochondrial respiratory chain, thereby enhancing ATP synthesis. Additionally, light absorption by ion channels triggers the release of calcium ions, instigating the activation of transcription factors and subsequent gene expression. This cascade of events not only augments neuronal metabolic capacity but also orchestrates anti-oxidant, anti-inflammatory, and anti-apoptotic responses, fostering neurogenesis and synaptogenesis. It shows promise for treating conditions like dementia, stroke, brain trauma, Parkinson's disease, and depression, even enhancing cognitive functions in healthy individuals and eliciting growing interest within the medical community. However, delivering sufficient light to the brain through transcranial approaches poses a significant challenge due to its limited penetration into tissue, prompting an exploration of alternative delivery methods such as intracranial and intranasal approaches. This comprehensive review aims to explore the mechanisms through which PBM exerts its effects on the brain and provide a summary of notable preclinical investigations and clinical trials conducted on various brain disorders, highlighting PBM's potential as a therapeutic modality capable of effectively impeding disease progression within the organism-a task often elusive with conventional pharmacological interventions.

Supernumerary Tooth Extraction with Intranasal Approach: A Case Report

Objective: To observe the functional and esthetic results of endoscope-assisted septo-rhinoplasty via intranasal approach. Methods: The clinical data of 12 patients with septal deviation and nasal deformity in the University of Hong Kong-Shenzhen Hospital from June 2021 to June 2022 were analyzed, including 8 males and 4 females, aging 28 to 58 years. All patients were operated under general anesthesia. The septal deviation was corrected by hemitransfixion incision, combined with intercartilaginous incision and other intranasal or extranasal incisions to perform osteotomy, hump resection and saddle nose correction. Patient satisfaction with postoperative functional and aesthetic improvements was assessed through Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and Visual Analogue Scale (VAS).SPSS 25 software was used for statistical analysis. Results: The correction of nasal septum deviation was satisfactory in all 12 patients. Nasal obstruction was relieved, with NOSE score and VAS score of nasal ventilation decreased [(21.67±10.30) vs (70.83±14.12), (1.83±1.03) vs (8.33±0.89), t value was 9.49 and 16.30, respectively, both P<0.05]. The nasal appearance of 10 patients with crooked nose deformity was improved, with ROE score and VAS score of nasal appearance increased [(21.30±2.31) vs (8.10±3.31), (8.90±0.99) vs (3.80±1.62), t value was -11.85 and -9.33, respectively, both P<0.05];The nasal vestibule morphology of 2 patients with abnormal nasal vestibule was improved. During the follow-up of 12 to 24 months, no postoperative complication such as nasal septum perforation, nasal cavity adhesion or nasal dorsal collapse occurred in all patients. Conclusion: Endoscope-assisted septo-rhinoplasty via intranasal approach can resolve both functional and esthetic problems at the same time, improving outcomes while reducing surgical trauma.

SummarySinoscopy consists of direct visualisation of the paranasal sinuses and was first conceived for diagnostic purposes using a rigid endoscope through a skull trephination. Since then, the use and approaches to perform it have evolved thanks to current advancements in knowledge (sinus anatomy and pathology) and technology. The aim of this article is to review the techniques reported to perform traditional and minimally invasive sinoscopy and to review the current use of sinoscopy to treat paranasal sinus disease. The history of sinoscopy, as we know it today, is relatively recent, but its use among clinicians is not necessarily widespread despite the invasiveness of the traditional technique when compared to imaging techniques. This limitation could be bypassed using the newer intranasal or extranasal minimally invasive sinoscopic approaches. These techniques allowed sinoscopic visualisation through natural orifices or minimally invasively created openings. Despite the potential of these techniques, case selection is still crucial as visualisation can be limited in selected disorders (i.e. sinus cyst), some sinuses (i.e. rostral maxillary with intranasal approaches) and if haemorrhage or severe exudate accumulation is found. Nevertheless, sinoscopy offers a diagnostic rate superior to traditional imaging and it is an alternative diagnostic tool when advanced imaging techniques, such as CT, are not available. In recent years, sinoscopic treatment has been progressively replacing the use of sinusotomies to treat most sinus disorders. Sinoscopic treatment yields a high‐resolution rate while complications are kept low. Familiarisation with sinoscopic techniques and in‐depth anatomic sinus knowledge will likely make sinoscopy the gold standard technique to treat sinus disease in the near future.

Carotenoid containing cationic nanoparticles for effective therapy for suppressing oxidative stress: An intranasal approach

Extraction of high inverted mesiodentes via the labial, palatal and subperiostal intranasal approach：A clinical prospective study

The incidence of odontogenic cysts of the maxillary sinus varies from 0.7% in asymptomatic patients to 2.8% in patients with clinical signs of maxillary sinusitis. Intranasal and transoral approaches are used during the excision of odontogenic cysts. Aim of the study. Determining the main selection criteria for the optimal approach for the excision of the odontogenic cyst of the maxillary sinus. Patients and methods. 54 patients were included into the study; they were divided into groups based on the presence or absence of the natural junction obstruction and the odontogenic cyst features according to computed tomography data. During the study, intranasal, transoral approaches, or their combination was used. The efficacy of surgical interventions used and the local status of patients during the first week of the postoperative period were accounted for. Data from histological studies of intraoperative biopsy specimens were also analyzed. 6 months later, the follow-up examination and cone-beam computed tomography of paranasal sinuses were conducted. Results. Complete recovery was confirmed in 51 patients out of 54 based on follow-up cone beam tomography scans. 2 patients managed with the intranasal approach had an incomplete excision of the ossified cyst wall. Sinusitis relapse with significant osteitis was observed in one case after the combined approach for the ossified cyst. Conclusion. Main selection criteria for the approach in odontogenic cysts of the maxillary sinus include the condition of the natural junction, as well as features of the odontogenic cyst sac structure.

To assess the safety and efficacy of utilizing dural suturing as an adjunctive procedure for saddle floor reconstruction in patients undergoing endoscopic surgery in the sellar region. According to the PRISMA guidelines, we searched the literature on sellar floor reconstruction in endoscopic sellar surgery. Fixed- or random-effects meta-analysis was used to pool the rate of return to postoperative cerebrospinal fluid (poCSF) leakage, repair operations, postoperative hospitalization, complete resection, infection, lumbar drainage (LD), and operative duration. A total of six studies involving 723 participants were included in the current meta-analysis. The pooled results demonstrated that patients in the dural suturing group had a lower incidence of poCSF leakage [odds ratio (OR), 0.18; 95% confidence interval (CI), 0.07 - 0.44; p=0.0002] and repair operation [OR, 0.24; 95% CI, 0.07 - 0.78; p=0.02], as well as a shorter hospitalization period [standardized mean difference (SMD), -0.45; 95% CI, -0.62 - -0.28; p < 0.00001]. There was no significant difference between the two groups in terms of the complete resection [OR, 1.06; 95% CI, 0.62 - 1.80; p=0.84], postoperative infection [OR, 0.49; 95% CI, 0.21 - 1.15; p=0.10] and lumbar drainage (LD) [OR, 0.28; 95% CI, 0.06 - 1.23; p=0.09]. Additionally, the dural suturing group may require a longer operative duration [SMD, 0.29; 95% CI, 0.02 - 0.56; p=0.03]. The results suggest that dural suturing can be advantageous in reducing postoperative complications and shortening postoperative hospitalization following neuroendoscopic surgery in the sellar region without increasing the risk of infection.

Introduction: The Nasolacrimal duct is the terminal part of the nasolacrimal apparatus or tear apparatus. The anatomy of lateral nasal wall is Important for planning the surgeries on lacrimal duct through intranasal approach. Objective: The current study was designed to review the anatomy of nasolacrimal duct in relation to the lateral nasal wall. Material and method: Thirty sagittal sections (14 right and 16 left side) of head and neck of formalin fixed adult cadavers of known sex, gender, ethnicity present in department of anatomy GMCH, Chandigarh were studied. The following parameters were made using a digital calliper and rounded off to the nearest millimetres. 1.Length of nasolacrimal duct (NLD Length) 2. Nearest distance from the nasolacrimal duct to maxillary sinus ostium (NLD - MSO) 3. Nearest distance from the NLD to the anterior nasal spine. (NLD- ANS)4. Nearest distance of the intranasal orifice of the NLD to the nasal floor (NLD- NF) 5. Nearest distance of the intranasal orifice of the NLD to the nasal roof. (NSD- NR) 6. Nearest distance of the intranasal orifice of the NLD to the anterior attachment of the Inferior concha. (NSD- AIT). Observations: In our study the average length of the NLD was 19.8±1.57mm. The intranasal orifice of the NLD was observed to be located on an average of 24.5±2.6mm from the anterior nasal spine, ranging from 5.5-2. 9mm.The average distance from the nasal roof was found to be 32.2±1.67mm and 16.08±1.71mm from nasal floor. In addition, the average distance from the anterior attachment of inferior nasal concha was found to be 14.82±2.37mm. In our study the NLD was an average of 4.08±0.67mm anterior to MSO at the level of the anterior attachment of the MT. On Comparing right and left side The NLD Was found to be slightly longer 22.7 in comparison of 22.2 mm on left side. The distance of NLD From MSO was also found to be larger on left side. The distances of NLD-ANS, NLD NR, NLD -AIT and NLD- NF were also longer on left side. Conclusion: We found that most of the parameters were closer to a study done by Ertugel while the NLD-NF distance was more in our specimen. Running title: nasolacrimal duct: morphometry, surgical importance KEY WORDS: Nasolacrimal duct, Maxillary sinus ostium, nasal floor, nasal roof, Anterior attachment of inferior concha.

Comparative evaluation of extrasinus versus intrasinus approach for zygomatic implant placement.

Th1 and Th17 mucosal immune responses elicited by nasally inoculation in mice with virulence factors of Mycoplasma hyopneumoniae

A flat or concave lower midface profile is generally considered less attractive. Paranasal augmentation is usually performed to move paranasal deficiency to relative convexity. Herein, we present a viable and simplified modality with diced expanded polytetrafluoroethylene to correct paranasal deficiency. Between February of 2020 and April of 2021, 19 patients underwent procedures to correct paranasal deficiency. Paranasal augmentation was performed with diced expanded polytetrafluoroethylene. All procedures were performed via intranasal approach. Preoperative and postoperative photographs were taken. Of these 19 patients (18 women and 1 man), deficiency of 18 patients were caused by congenital factors and 1 by cleft deformities. All but 1 procedures were carried out bilaterally. Procedures were performed in conjunction with additional operations mainly including rhinoplasty and minimally invasive midface lift. Age of patients ranged from 19 to 57 years, with a mean of 37 years. Follow-up time ranged from 8 to 22 months, with a mean of 12.6 months. All patients were satisfied with esthetic improvement and facial holistic profile. No severe complications and reoperation arisen in any of the patients. Temporary discomfort involved foreign body sensation in 1 case and numbness in 2 cases. The present technique provides a viable and simplified method to give the face a more balanced appearance and achieves esthetically superior results.