Nasal Obstruction Research Articles

Effects of Topical Polymyxin Neomycin Hydrocortison in Patients with Non-Allergic Rhinitis, a Randomized Clinical Trial

Background: Bacterial infection is involved in the pathogenesis of inflammatory non-allergic rhinitis(NAR), and a broad-spectrum antibiotic should reduce the severity of the disease by eliminating themucosal biofilm. The purpose of this study is to assess the efficacy of a topical mixture of polymyxin,neomycin, and hydrocortisone in patients with NAR. Methods: This double-blind phase 3 randomized clinical trial was conducted on 90 patients with non- allergic rhinitis (NAR) in Mashhad, Iran. The subjects experienced symptoms for more than two weeks, and the pretrial course of topical corticosteroids was ineffective. Patients were randomly assigned to treatment groups receiving polymyxin NH, hydrocortisone, or saline. The drug was administered as nasal drops three times daily for a treatment course of two weeks, and the containers were identical. The primary outcome was nasal obstruction. Results: The pretrial comparison showed no significant difference between groups in terms of clinical findings. However, after the trial, nasal obstruction, as the primary outcome, significantly decreased from 20 subjects (66%) to 7 subjects (23%) in the Polymyxin NH group, along with other secondary outcomes, including palatal itching (56% to 23%), sneezing (76% to 40%), mucosal inflammation (100% to 75%), post-nasal drip (PND) (96% to 63%), and concha swelling (96% to 73%). In the other groups, sneezing was the only significant improvement observed in the saline group. Cytology of nasal discharge showed a reduction in nasal neutrophil counts in the Polymyxin NH group (68±16.7% to 46±27.6%) compared to the hydrocortisone and saline-treated groups. Conclusion: Topical intranasal polymyxin NH is effective in treating patients with non-allergic rhinitis.

Depression in patients with chronic otolaryngology symptoms - A vicious cycle.

Depression is a common comorbidity among individuals with otolaryngologic disorders, particularly those with longstanding conditions. This study aims at analysing the sociodemographic profile of depressive disorders in patients with chronic otolaryngology symptoms or conditions, and the correlation with PHQ-9 score. A cross-sectional study was conducted on a hundred patients presenting to the outpatient department with chronic otolaryngology symptoms or conditions. They were requested to fill in the PHQ-9 questionnaire, containing questions based on the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) for major depressive disorder (MDD). Median age was 39, male: female ratio was 1.17. Nasal obstruction (29%), ear discharge (25%), and headache (17%) were the common presenting complaints. Mean and median PHQ-9 scores were 5.03 and 4 respectively. Seven patients (7%) had MDD, while eleven (11%) had other depressive disorder; 9% of cases were found to have no significant otolaryngologic problem despite presenting with symptoms, two of which were found to have depressive disorder. Thirty-five (35%) and thirty-six (36%) patients had minimal and mild depressive symptoms respectively, while one (1%) had severe depressive symptoms. Statistical significance was noted for the duration of symptoms (p-value 0.005); high statistical significance was found for occupation and otolaryngology diagnosis (p-value < 0.001 each). PHQ-9 score showed statistical significance in comparison with gender and duration of symptoms (p-value 0.046 and 0.005 respectively). Correlation of severity of depressive disorder revealed statistical significance with gender (p-value 0.049) and high statistical significance with duration of symptoms (p-value < 0.001). Chronic otolaryngology conditions are associated with significant morbidity, attributable to longstanding disturbing symptoms and prolonged treatment protocols, leading to depression. Nevertheless, depression in chronic otolaryngology disorders may aggravate or overlap the clinical symptoms or may go undetected. Hence it may be worthwhile to evaluate for depressive disorders in chronic patients presenting to otolaryngology.

Potential of bioregulatory therapy in the treatment of patients with rhinitis medicamentosa

Chronic rhinitis is a common condition characterized by inflammation of the mucous membrane of the nose. It can lead to troublesome symptoms like itching, runny nose, nasal congestion, sneezing and irritation. Rhinitis can significantly lower the quality of life, have a detrimental effect on productivity and negatively affect social communications. Therefore, it is important to diagnose and treat this disease in due time. There are two main types of rhinitis: allergic rhinitis and non-allergic rhinitis. Non-allergic rhinitis refers to patients who have nasal symptoms, but skin tests do not show any allergic reactions. In this case, additional tests are necessary before making an accurate diagnosis. In turn, several subgroups of non-allergic rhinitis can be distinguished according to the causes and mechanisms of its development. The article discusses the features of the treatment of rhinitis medicamentosa. The use of different drugs can cause nasal symptoms, including nasal congestion. Rhinitis medicamentosa can be divided into two subgroups: rhinitis caused by adverse effects of systemic drugs and rhinitis due to overuse of antioedemic nasal therapy. Topically active vasoconstrictors are used to relieve nasal congestion caused by various reasons. However, the long-term use of such drugs can lead to the development of rhinitis medicamentosa and other adverse reactions. There are several hypotheses as to why rhinitis medicamentosa occurs. They include activation of beta-adrenergic receptors, the decreased production of presynaptic endogenous norepinephrine, and the development of tachyphylaxis. The overuse of topical nasal decongestants can bring on vicious cycle: the more frequently the patients use the drugs, the more likely thery are to get increased adverse effects. It is important to understand the potential risks and limitations of using topical nasal decongestants. If symptoms of nasal congestion or other adverse effects develop, it is necessary to consult a doctor to adjust the treatment.

Vertical Sectioning of the Cartilaginous Vault for Rhinoplasty: Technique and Assessment.

To describe and assess the vertical sectioning technique for mid vault dissection in patients undergoing primary and secondary rhinoplasty. A retrospective review of 208 patients undergoing primary or revision rhinoplasty utilizing the vertical sectioning technique. The Nasal Obstruction Symptom Evaluation (NOSE) scale was administered to patients pre- and post-operatively. A detailed description of the technique is presented. Mean follow up was 8.59 ± 7.30 months. Spreader grafts were used in 185 patients (89%), upper lateral cartilage autospreader flaps were utilized in 16 patients (7.7%), and both spreader grafts and autospreader flaps were used in 7 patients (3.4%). Ten primary rhinoplasty patients (4.8%) and 3 revision rhinoplasty patients (4.5%) complained of functional nasal obstruction post-operatively. At time of last follow-up, there was a significant improvement in mean NOSE scores for patients receiving spreader grafts (71.2 ± 21.4-21.5 ± 2.8, P < .001), autospreader flaps (69.2 ± 25.9-17.2 ± 21.5, P < .001), and both (57.9 ± 35.0-26.1 ± 20.2, P = .03). The vertical sectioning technique respects the anatomic, functional, and esthetic relationship of the middle vault, while maximizing cartilage preservation.

A Repair Technique for Internal Nasal Valve Collapse Using Lateral Nasal Suspension Sutures

One of the most common reasons a patient would see an otolaryngologist is for nasal obstruction. This article provides an overview of the physical principles related to nasal airflow as well as the critical role that the internal nasal valve plays in regulating airflow resistance. Common treatment options for internal nasal valve obstruction are discussed as well as an in-depth tutorial on an alternate lateral nasal suspension suture technique for internal nasal valve collapse.

Features of management of patients with seasonal allergic rhinitis

Introduction. Seasonal allergic rhinitis continues to be one of the most common chronic diseases, affecting up to 24% of the adult population of the Russian Federation.Aim. To evaluate the effectiveness of the drug mometasone furoate (Nozefrin Allergy) in patients with seasonal allergic rhinitis in outpatient practice.Materials and methods. The study was conducted in a group of 42 patients aged 18 to 73 years (average age 39.0 ± 15.5 years) diagnosed with seasonal allergic rhinitis. All patients received monotherapy with Nozefrin Allergy, 2 injections (50 mcg of mometasone furoate each) into each nostril once a day for 30 days. The effectiveness of the treatment was determined on the 7th, 14th, 30th day of treatment and on the 60th day.Results and discussion. During the use of the drug Nozefrin Allergy, by the 7th day there was a significant decrease in complaints of impaired smell by 3.6 times, sneezing by 2.4 times, discharge from the nasal cavity decreased by 2.3 times, and nasal congestion by 2.3 times. 2.1 times. After 14 days, nasal congestion disappeared in 64.3%, nasal discharge and itching in the nasal cavity were absent in 69.0% and 88.1% of patients. According to the SST-12 test, already by the 7th day of using the drug Nozefrin Allergy, there was an increase in the average total score to 10.1 ± 1.9 points, which corresponds to normosmia. At days 14, 30, and 60, the mean total SST-12 score remained stable at 10.6 ± 0.9 points, 10.9 ± 1.1 points, and 11.1 ± 0.5 points, respectively. The dynamics of respiratory function at the end of the course of treatment was characterized by an improvementin the total volumetric flow to 783.4 ± 162.7 cm3/s and a decrease in nasal resistance to 0.2 ± 0.1 cPa/ml. The total rTNSS scale score by the 7th day decreased to 9.1 ± 0.4 points, the severity of the assessed complaints was moderate.Conclusion. The data obtained indicate the effectiveness of using the drug Nozefrin Allergy in patients with seasonal allergic rhinitis in outpatient clinical practice.

Comparison of different nasal septal areas between patients with and without nasal obstruction.

Comparison of different nasal septal areas between patients with and without nasal obstruction.

Knowledge Gaps Regarding Allergic Rhinitis among the Patients Visiting Community Pharmacies of Lahore, Pakistan

Introduction: Allergic rhinitis is a varied disorder characterized by symptoms such as sneezing, nasal blockage, nasal itching, and a runny nose. This study assessed the knowledge of patients about Allergic rhinitis and to identify knowledge gaps in patient’s understanding along with the factors that may impact knowledge regarding the disease. Methods: A cross-sectional observational study design was implemented to collect data from patients visiting community pharmacies of Lahore on a structured questionnaire (self-developed) containing 12 items related to knowledge. The questionnaire was distributed to physician diagnosed Allergic rhinitis patients. The questionnaire with closed-ended questions was completed by 240 participants of both genders as sampled through random sampling procedure. The study spanned over a period of eight months. Results: Among 240 respondents, 81.3% were students and majority were female (58.3%). It revealed that only 33.3% of respondents demonstrated adequate knowledge about Allergic rhinitis, while 66.7% demonstrated inadequate knowledge. Among demographic variables, female respondents presented better knowledge compared to the male population. Moreover, education status was positively associated with knowledge of respondents. Low education status of study subjects was observed to be the reason for knowledge gap among respondents. The p-values&lt;0.05 were considered statistically significant. Conclusion: This study highlights a significant gap in respondent’s knowledge, emphasizing the need for targeted education and intervention. Low literacy rate was the major factor negatively associated with respondents’ knowledge of Allergic rhinitis. Improved knowledge is crucial to promoting good practices and achieving desired outcomes. Educational interventions and seminars should be conducted at public health sectors to enhance awareness in the general population.

Olfactory neuroblastoma

Originating from the olfactory neuroepithelium, olfactory neuroblastoma is a rare malignant tumor of the nasal cavity that typically affects adults between the ages of 35 and 70. Clinical presentation predominantly consists of nonspecific symptoms such as nasal obstruction, nasal drainage or epistaxis, thus illustrating the need for a thorough diagnostic workup. In addition to a complete head and neck examination, rigid nasal endoscopy, biopsy and imaging are necessary to establish a definitive diagnosis as well as plan for treatment. Computed tomography (CT) and magnetic resonance imaging (MRI) are the primary imaging modalities utilized to assess for bony invasion and soft tissue involvement, respectively. Hyams grading system provides a histologic assessment of disease severity while various staging systems correlate severity of disease to anatomic location/progression. Treatment relies on both surgical intervention and radiation. In addition, ongoing research trials are investigating therapeutic targets. Given the risk of recurrence, extended post-treatment surveillance remains necessary.

Effect of Tezepelumab on Sino-Nasal Outcome Test (SNOT)-22 Domain and Symptom-Specific Scores in Patients with Severe, Uncontrolled Asthma and a History of Chronic Rhinosinusitis with Nasal Polyps.

Tezepelumab blocks the activity of thymic stromal lymphopoietin, an epithelial cytokine implicated in the pathogenesis of asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). In a previous analysis, tezepelumab improved asthma and rhinosinusitis symptoms compared with placebo in patients with severe, uncontrolled asthma and a history of CRSwNP in the 2years before randomization in the NAVIGATOR study. This post hoc analysis of patients with a CRSwNP diagnosis at any time before randomization in NAVIGATOR enabled domain and symptom-specific analyses of Sino-Nasal Outcome Test (SNOT)-22 outcomes. Patients (aged 12-80years) with severe, uncontrolled asthma were randomized to tezepelumab 210mg or placebo subcutaneously every 4weeks for 52weeks. SNOT-22 total, domain, and item scores were assessed in patients with a history of CRSwNP. Annualized asthma exacerbation rate (primary efficacy outcome), pre-bronchodilator forced expiratory volume in 1s, and Asthma Control Questionnaire-6, Asthma Quality of Life Questionnaire (standardized) for patients 12years and older, and Asthma Symptom Diary scores were also assessed in patients with and without a history of CRSwNP. Of 1059 patients with severe asthma, 165 (15.6%) had a history of CRSwNP. Tezepelumab treatment resulted in sustained improvements versus placebo in SNOT-22 total score throughout the 52-week study period [least-squares mean difference (95% confidence interval) - 11.08 (- 17.80, - 4.35)]. Tezepelumab improved all five SNOT-22 domain scores (sleep, nasal, function, ear/facial, and emotion) and the five SNOT-22 item scores of most clinical interest (decreased sense of smell/taste, nasal blockage, reduced productivity, waking up tired, and cough). Tezepelumab improved asthma-related clinical outcomes in patients with and without a history of CRSwNP. In patients with severe, uncontrolled asthma and a history of CRSwNP, tezepelumab improved rhinosinusitis symptoms across multiple domains, as well as asthma exacerbations, lung function, asthma control, and health-related quality of life. NCT03347279 ( https://classic. gov/ct2/show/NCT03347279 ).

Intranasal acupuncture for allergic rhinitis: A systematic review and meta-analysis.

To evaluate the efficacy of intranasal acupuncture as a treatment for allergic rhinitis (AR) through a comprehensive review. Comprehensive searches were performed in both Chinese (CNKI, VIP, CBM, and Wanfang) and English databases (PubMed, Embase, Cochrane Library, and Web of Science) to gather randomized controlled trials available from the inception of the database until August 2024. The primary outcomes considered were the effectiveness rate, visual analog scale score, total nasal symptom scores, total nonnasal symptom scores, Rhinoconjunctivitis Quality-of-Life Questionnaire score, adverse effects, and follow-up observations. The quality of each study was assessed using the Cochrane Collaboration risk of bias tool, and data analysis was conducted using RevMan 5.4 software. This study incorporated 14 articles involving a total of 1009 patients. The meta-analysis revealed that patients with AR who underwent intranasal acupuncture experienced more significant improvements compared to the control group. Notably, the treatment considerably improved both nasal and nonnasal symptoms, along with the patients' quality of life. Moreover, during the follow-up, it was noted that intranasal acupuncture patients had a lower recurrence rate compared to the control group, indicating better long-term effects in alleviating symptoms like nasal congestion, runny nose, and sneezing. Nonetheless, there was no marked improvement of nasal itching. It's noteworthy that some adverse effects were reported, but all were mild. The findings suggest that intranasal acupuncture serves as an effective intervention for AR, particularly in alleviating both nasal and nonnasal symptoms and enhancing quality of life. However, these positive outcomes should be approached with caution, and further high-quality and extensive studies to substantiate these results are warranted.

Delayed Onset Perinasal Mucocele Cyst in a Patient With Remote History of Orofacial Cleft Repair.

Nasoalveolar cysts are rare, nonodontogenic cysts with a subtle course that can lead to nasal deformity and, uncommonly, nasal airway obstruction. Herein the authors present the case of a 28-year-old male who presented with a recurrent left-sided nasoalveolar cyst. Upon presentation, this cyst had formed a significant alar defect and was obstructing the left nasal airway. Although nasoalveolar cysts have been well-described in literature, the patient represents an atypical case in that nasoalveolar cysts most commonly occur in females and in patients aged 40 to 60 years old. The patient's history of extensive facial reconstruction for cleft palate and lip is also anomalous and suggests an inclusion cyst rather than a cyst of typical epithelial origin. The complex course of this cyst and the history of this patient, which led to treatment with a subdermal dissection, septoplasty and turbinate reduction, and alar defect correction make this case of particular note.

Biphenotypic Sinonasal Sarcoma: Literature Review of a Peculiar Pathological Entity—The Neurosurgical Point of View

Background: Biphenotypic sinonasal sarcoma (BSNS) is a low-grade tumor of the sinonasal tract with frequent extension to the orbit and skull base. Due to its rare incidence and recent histopathological and molecular characterization, little data are available in regard to its natural history, treatment and surveillance protocol. Methods: A comprehensive literature review in Embase online electronic databases on BSNS was made. The analyzed factors included the patients’ sex and age, presenting symptoms and signs, anatomical origin and pattern of growth of the tumor, immunohistochemical and molecular features, time to treatment, type of treatment, surgical approach, extent of resection, peri- and post-operative complications, adjuvant therapies, clinical outcome, recurrence and overall survival rates. Results: This literature review involved 34 studies for an overall series of 149 cases of BSNS. The female (66.9%) and middle-aged populations (median 54.88 years old) were mainly affected. The most frequent clinical onset was nasal obstruction (81%), followed by facial discomfort (44%), epistaxis (15.5%) and ocular impairment (14.3%). Ethmoid sinus (67.8%) and nasal cavity (45.4%) were the most common anatomical site of tumor origin, while an extension to the orbit and skull base was registered in 28.7% and 24.5% of cases. Surgery was the main treatment, especially in the form of endoscopic endonasal approach (56.9%), and allowed for gross total resection in 79% of cases. The recurrence rate was 26.2%; three cases of tumor-related death were reported. Median follow-up was 4.6 years. Conclusions: Biphenotypic sinonasal sarcoma is a rare and unique tumoral entity in terms of biological and clinical behavior. Based on the current knowledge, surgery plays the leading role in treatment, accounting for gross total tumor resection in most cases, allowing for clinical symptom and sign resolution and presenting a low rate of perioperative complications. The type of approach and the aim of surgery should be assessed case by case according to patient and pathology features and the surgeon’s experience, as well as the aim of the treatment. Further studies including large surgical series and with long follow-up are required to define prognostic factors and guidelines of treatment for this peculiar pathological entity.

The first report of rhinosinusitis by Rhizopus delemar in a patient with severe COVID-19 in Iran: a case report

BackgroundMucormycosis is a severe and fatal fungal infection in patients with coronavirus disease 2019 caused by Mucorales. Here we present a case of a 63-year-old man with coronavirus disease 2019 infection, along with rhinosinusitis mucormycosis caused by Rhizopus delemar.Case presentationA 63-year-old Iranian man suffering from a coronavirus disease 2019 infection with symptoms of cough, shortness of breath, and generalized body pain. On the basis of the clinical manifestations, such as headache, a history of black nasal discharge, nasal hypoesthesia, facial swelling, numbness, nasal obstruction, presence of necrotic lesions on the nasal passages on physical examination, and abnormal computed tomography scans of paranasal sinuses, the patient underwent surgical debridement. Direct microscopy of specimens obtained from the paranasal sinuses, and subsequent isolation and identification, revealed a rhinosinusitis mucormycosis caused by R. delemar. Despite therapeutic measures, such as sinus debridement surgery and antifungal therapy with amphotericin B injection (50 mg/day), the patient died after 35 days of hospitalization.ConclusionIn this report, we present the first documented case of human infection with R. delemar in a patient with coronavirus disease 2019 infection, who also exhibited rhinosinusitis mucormycosis. R. delemar appears to be an emerging agent of rhinosinusitis mucormycosis in this region. Furthermore, prompt diagnosis and the exploration of alternative antifungal treatments, beyond amphotericin B, may be crucial for effectively managing patients with R. delemar infections.

The acute effects of the PAP treatment on nasal mucosa in patients with OSAS

Abstract BACKGROUND. Obstructive sleep apnea syndrome (OSAS) is a common disease in developed countries. PAP (Positive Airway Pressure) therapy is the most commonly used treatment modality, particularly in moderate to severe OSAS patients. However, several side effects make PAP treatment challenging to tolerate. This study examined the acute effects of PAP treatment on nasal functions. MATERIAL AND METHODS. This study included 32 patients who were diagnosed with severe OSAS following a PSG test and started PAP treatment. Symptom analysis was carried out with the SNOT-20 questionnaire; nasal physiological analysis was carried out with rhinomanometry and acoustic rhinometry tests performed before and after PAP treatment for one night and for one month. A saccharin test was carried out to assess the nasal mucociliary clearance before and after the treatment. RESULTS. A statistically significant difference between nasal symptom scores (p=0.003) and sleep quality (p=0.006) was observed in SNOT-20 questionnaire results. Total nasal resistance was significantly increased after one night’s sleep with PAP and after a one-month treatment with PAP. It was found that there was a statistically significant relation between the total nasal resistance value and PAP pressure. CONCLUSION. This study shows that PAP treatment increases nasal congestion after one night of treatment and after one month of treatment with a cumulative effect. PAP therapy positively affects sleeping quality and life quality, while negatively affecting nasal functions in the acute period.

Morphology of Nasal Septal Deviation in Obstructive Sleep Apnea Patients and its Treatment Method.

Nasal septal deviation can cause nasal breathing issues, contribute to obstructive sleep apnea (OSA) development, and often hinders successful CPAP therapy. We hypothesized that although prevalent in the general population, nasal septal deviations differ structurally between OSA and non-OSA patients. This study evaluated nasal septal deviation morphology in OSA versus non-OSA patients using computed tomography (CT). We consecutively enrolled 128 adult patients undergoing septoplasty for nasal obstruction between April and September 2019. Seven with trauma/surgery history were excluded. Polysomnography was performed preoperatively for those with significant sleep complaints. Using identical preoperative sinus CTs routines, we measured anterior, superior, and posterior deviation angles, comparing OSA and non-OSA groups. We studied 121 septoplasty patients (37 females, 84 males, mean age 45.73 ± 1.29 years), with 34 OSA and 87 non-OSA. Anterior deviation angle was significantly greater in OSA (mean 9.1 ± 0.7°) versus non-OSA (mean 6.5 ± 0.5°) groups (p = 0.001). However, no significant superior or posterior deviation differences existed between groups (p = 0.266 and 0.231, respectively). Multiple logistic regression showed anterior deviation as the only significant independent OSA predictive factor. Among the nasal septal deviations, only the anterior deviation was associated with the presence of OSA. Thus, the selection of a surgical technique for anterior deviation is an important consideration in patients with OSA. 3 Laryngoscope, 2024.

STUDI KEANEKARAGAMAN OLAH TUMBUHAN BERKHASIAT OBAT DI KELURAHAN PASAR TELUKDALAM KECAMATAN TELUKDALAM

Based on the research focus, it aims to study the diversity of plants with medicinal properties in Pasar Telukdalam Village, Telukdalam District. This research aims to find out what types of medicinal plants are used by the community in Pasar Telukdalam Pasar Telukdalam Village as well as their benefits and what diseases can be cured. This type of research is qualitative with a case study approach. This research data was analyzed using data reduction, verification and drawing conclusions. The results of this research are that the types of medicinal plants used by the community in Pasar Telukdalam Village are ginger, turmeric, bitter gourd and galangal. Diseases that can be cured by medicinal plants that are used by people in Telukdalam Market Village are the ability to soothe a dry throat, overcome flatulence, overcome high stomach acid and are very good for helping to overcome coughs, shortness of breath, due to asthma, helping to relieve breathing, helps overcome nasal congestion and relieves the effects of a throbbing head due to flu. Suggestions for the community, it is hoped that this research can provide information to the community in using medicinal plants in Pasar Telukdalam Village, Telukdalam District and for Nias Raya University, it is hoped that the results of this research can enrich and add sources of information for Nias Raya University students, especially in plant processing. medicinal properties.

A Prospective, Multicenter European Study on the Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms.

Objectives: The current study examined the effectiveness of Rhinapi, a hypertonic saline nasal spray with Anatolian propolis added, on allergic rhinitis (AR) symptoms in a European population. Methods: Four hundred and forty AR patients (251 males and 189 females) from various European centers were enrolled. Nasal examination, overall symptom scores, individual AR symptoms (nasal discharge, sneezing, nasal itching, and nasal obstruction), and quality of life (QoL) were assessed before and after 3 weeks of treatment with Rhinapi, the nasal spray made of hypertonic saline with Anatolian propolis added (Bee&You, Istanbul, Turkey). Results: Rhinapi nasal drop use was associated with a substantial decrease (P < .05) in AR symptom ratings, including nasal discharge, sneezing, nasal itching, and nasal obstruction. QoL scores showed a significant improvement (P < .05), and the spray also alleviated swelling and improved concha color (P < .05). Conclusion: Rhinapi, Anatolian propolis-added hypertonic saline nasal spray (Bee&You, Istanbul, Turkey), when used for 3 weeks, reduced AR symptom scores and improved QoL. Both the concha color and the edema were also enhanced.

Efficacy of Clarithromycin Combined with Fluticasone Propionate on Nasal Function, Nasal Mucociliary Transport Function, and Serum Inflammatory Markers in Chronic Rhinosinusitis Patients After Functional Endoscopic Sinus Surgery.

Objective: This study aims to assess the efficacy of clarithromycin (CAM) combined with fluticasone propionate (FP) in patients with chronic rhinosinusitis (CRS) after functional endoscopic sinus surgery (FESS), focusing on nasal function, nasal mucociliary transport (MCT) function, and serum inflammatory markers. Methods: The control group (n = 48) was treated with FESS alone, while the study group (n = 48) was treated with FESS plus CAM combined with FP. The clinical effects, symptom scores, nasal function, nasal MCT function, serum inflammatory marker levels, and the occurrence of adverse reactions were compared. Results: The total efficacy rate of the study group (95.83%) was significantly higher than that of the control group (83.33%). After treatment, the study group showed lower symptom scores for nasal congestion, runny nose, sneezing and dizziness, and headache compared to those in the control group. The study group also had lower nasal airway resistance, shorter distance from the minimal cross-sectional area to the nostril, and lower T&T olfactory scores. In contrast, their nasal cavity volume and minimal cross-sectional area were higher than those of the control group. Additionally, the nasal mucociliary clearance and MCT rates were higher in the study group. Serum levels of interleukin-6, interleukin-8, tumor necrosis factor-α, and procalcitonin were significantly lower in the study group compared to the control group (all P < .05). Conclusion: The use of CAM combined with FP in patients after FESS for CRS is effective, leading to the relief of clinical symptoms, improvement of nasal function, enhancement of MCT function, and reduction of inflammatory response, without increasing the incidence of adverse reactions.

A 25-year-old Man with Headache, Lacrimation, Conjunctival Injection, Rhinorrhea, and Nasal Congestion

A 25-year-old Man with Headache, Lacrimation, Conjunctival Injection, Rhinorrhea, and Nasal Congestion