Nasal Entrance Research Articles

Acoustic rhinometry を用いた鼻腔断面積・鼻腔容積の経時的変化の測定と検討

Periodic fluctuations in the size of the normal nasal mucosa were evaluated and analyzed by acoustic rhinometry.Seven healthy volunteers (males 4, females 3, average age 29 years, range 24 to 35 years) without any nasal lesions served as the subjects of this study. An acoustic rhinometry (GM Co.) was used, and each subject remained quiet in a sitting position for 5 hours. Nasal cross-sectional area was evaluated every 15 minites in a quiet, air-conditioned room.Periodic fluctuations in cross-sectional area were observed in 6 of the subjects, and the average cycle was 2.2hrs.. No significant difference was seen between the genders. The anterior and posterior area of the nasal cavity were highly correlated (r: 0.94), demonstrating simultaneous swelling and shrinkage of the nasal mucosa. The minimal cross-sectional area was set equal to 100% as a baseline, and fluctuation on one side of the nose was 66-139%, and fluctuaion on both sides was 80-121%.Fluctuation in volume from the nasal entrance to a depth of 7cm was 69-143% on one side and 82-117% on both sides. Fluctuation tended to be less on both sides, but the sum of values on one side did not show any constant areas, as suggested by rhinomanometry.This normal fluctuation of 70-140% in cross-sectional area and volume must be taken into consideration when applying acoustic rhinometry in clinical settings. All evaluations should be repeated at different times.

レミカットの鼻アレルギー鼻閉に対する効果

Emedastine difumarate is a new anti-allergic agent which has been reported to be highly effective for allergy-induced nasal obstructionWe evaluated the efficacy of the agent (Remicut® 2mg, 2 capsules/day) taken for more than 2 weeks by 10 patients (7 males and 3 females aged 34.2±8.7 years) with perennial nasal allergy. We used a 100mm linear visual analogue scale (VAS) in the subjective measurement of the nasal sensation of airflow. Objective measurement was done with acoustic rhinometry, a newly developed technic which provides an accurate estimate of the cross-sectional area of the nasal cavity in relation to the distance from the nasal entrance and, by integration, the nasal cavity volume. For the statistical study the paired t test was used.1) The mean±standard error (SE) of the VAS score was 28.0±7.9 before medication, 27.1±8.5 at one week, 25.3±7.6 at two weeks and 31.6±6.9 one week after the end of medication. There were no significant differences.2) The mean±SE of the right+left minimum cross-sectional area of the nose was a) 0.68±0.10cm2 before medication, b) 0.75±0.10cm2 at one week, c) 0.79±0.10cm2 at two weeks and d) 0.75±0.10cm2 one week after the end of medication. The difference between a) and b) c) is significant (p<0.005).3) The mean±SE of the right+left nasal cavity volume was a) 13.8±1.4cm3 before medication, b) 15.9±1.3cm3 at one week, c) 16.2±1.2cm3 at two weeks and d) 13.8±1.1cm3 one week after the end of medication. The difference between a) and b) c) is significant (p<0.01).The present acoustic study shows that emedastine difumarate reduces allergy-induced nasal obstruction. However, the subjective sensation of nasal airflow was not significantly improved as shown by the VAS study.

Das Trichoadenom Nikolowski: ein seltener Tumor im HNO-Gebiet

A case of trichoadenoma Nikolowski in a 74-year-old woman is reported. The tumour invaded the upper lip, the base of the columella and the left nasal entrance. The tumour was cured by surgery and plastic reconstruction of the defect. This benign lesion of the hair follicles is rare and therefore often misdiagnosed as basal cell carcinoma or seborrheic keratosis. Examination of tumour cells by DNA-flow cytophotometry showed a normal diploid DNA-content of the tumour cells.

An Anatomic Study of Retrobulbar Needle Path Length

One hundred twenty human orbits were measured to determine orbital depth and the position of orbital structures in relation to the length of needles used for retrobulbar anesthesia. The distance from the inferior temporal orbital rim to the nasal entrance of the optic foramen ranged from 42 to 54 mm. Taking into account the size of the optic nerve, the common 38-mm (1.5-in) retrobulbar needle could perforate the optic nerve where it is fixed in front of the foramen in over 11% of the population. The authors recommend that needles be placed less than 31 mm (1.25 in) behind the orbital rim for both retro- and peribulbar anesthesia.

Diffusional deposition of ultrafine aerosols in a human nasal cast

This report describes an experimental study of aerosol deposition in a human nasal cast. A clear polyester resin cast of the upper airways of a normal human adult was used. This life-sized model included nasal hairs, the nasal airways, oral cavity, nasopharynx, larynx and entrance to the trachea. For nasal air flow rates, the measured pressure drop in the cast was similar to the in vivo measurements reported in the literature. Thus, the cast appeared to be a good representation of the nasal airways of living humans. The total deposition was measured in the cast for monodisperse NaCl aerosols between 0.2 and 0.0046 μm at flow rates between 4 and 50 l min −1 of inspiratory flow. The deposition efficiency increased with decreasing particle size and flow rate, indicating that diffusion was the dominant mechanism for deposition. At 20 1 min −1 flow (comparable to that for normal breating at rest), inspiratory deposition efficiencies were 16 and 40% for 0.01 and 0.005 μm particles, respectively. A theoretical equation relating the deposition efficiency to the flow rate and diffusion coefficient was derived based on a turbulent diffusion process. The agreement achieved between the theoretical and measured deposition indicated that the turbulent diffusion was the dominant mechanism of deposition in the nasal cast. This information will be incorporated into future models of respiratory tract dosimetry.

Repair of postintubational lesions of the cartilaginous nose in infants--sometimes a surgical problem.

Among the complications of prolonged nasotracheal intubation in infants the possibility of pressure necrosis of the cartilaginous nose due to inadequate fixation or improper size of the tube is rarely mentioned. Three cases with postintubational alar defects and another child with a severe stenosis of the nasal entrance are reported. In the latter case a multi-staged reconstructive rhinoplasty had to be done in order to restore nasal breathing. While describing our surgical procedures the multiple difficulties and hazards of reconstructive rhinoplasty in early childhood are discussed.

Theoretical principles and technique of functional closure of the lip and nasal aperture

Since many approaches to the closure of the cleft lip have not satisfied the hopes placed into them, the author has gone back to the principles stated by Veau (1938). His anatomical findings are presented. They form the basis of his technique of functional closure of the lip and nasal aperture: Careful dissection of all muscles involved, anatomical repositioning of all structures of the lip and the nasal entrance, and wide subperiosteal dissection. Careful reconstruction of a normal anatomical situation leads not only to better appearance and good mobility of the area concerned, but also to an enhanced growth of the underlying bony structures. Primary osteoplasty has been used, but does not seem to be necessary. The early results of this technique are very satisfying, however, later re-evaluation has to be made.

Human drowning: Phylogenetic origin

Because most animals are able to survive much longer when in water than most humans and apes, it is likely that at some time during human phylogeny the-innate-ability to swim like animals has been lost. Paleontology and comparative zoology provide indications for selective pressures and adaptations explaining this phenomenon. Among these are (a) buoyancy having become reduced slightly due to a smaller lung air/body weight ratio, less air trapped in the body covering hairs and reduction in gastrointestinal gas, (b) the caudally directed nasal entrance cranially to which there is the heavy neurocranium, (c) the low position of the laryngeal entrance, (d) the ineffective propulsion by the human innate crawling and walking movements, and (e) the well developed cerebrum being present cranially to the airway entrance, being sensitive for anoxia and hypothermia, and causing behaviour adding to drowning risks.