Nasal Cavity Research Articles

Exploring the impact of adenoid obstruction on the human nasal airflow through parallel computational fluid dynamics

AbstractAdenoid obstruction is a prevalent condition that can significantly alter nasal airflow patterns, leading to various respiratory symptoms. This study aims to explore the influence of adenoid obstruction on human nasal airflow using computational fluid dynamics (CFD) simulations. We developed a realistic nasal cavity model to simulate both steady‐state inhalation and transient breathing cycles, accounting for various levels of obstruction. The three‐dimensional, incompressible Navier‐Stokes equations were discretized employing a stabilized finite element method on unstructured meshes, along with an implicit second‐order backward differentiation formula. The numerical solution was obtained using a Newton‐Krylov‐Schwarz algorithm‐based parallel solver. Our findings indicate that obstruction of the adenoid cross‐sectional area below 50% minimally affects nasal airflow, whereas noticeable changes occurred as obstructions exceeded the 50% threshold. Complete blockage was observed at levels greater than 70%, and inhalation difficulties could arise even at the 50% obstruction mark during stimulation or extreme inhalation scenarios. These results substantiate the clinical guidelines that advocate a 50% obstruction ratio as the demarcation between conservative treatment and surgery. Furthermore, this study offers valuable insights into the intricate relationship between the adenoid obstruction and nasal airflow, potentially enhancing clinical decision‐making in the diagnosis and treatment of nasal obstruction.

Navigating Challenges: Case Series of Congenital Nasal Pyriform Aperture Stenosis

Congenital nasal pyriform aperture stenosis (CNPAS) is characterized by a narrowing of the pyriform orifice attributed to excessive growth of the nasal process of the maxilla, resulting in blockage of the nasal passage. Early intervention is crucial as newborns are obligate nasal breathers during the first few months, which may result in respiratory distress in patients with CNPAS. This report reviewed the presentation and management of the CNPAS in a single tertiary paediatric otorhinolaryngology centre. We reported a case series with three term neonates that presented with respiratory distress and noisy breathing at birth. All of them required intubation and were unable to introduce suction catheter size 6Fr via the nostrils. Conservative management, including the use of nasal decongestants and humidification, was tried but failed. The sublabial approach was used for surgical correction in all patients. The pyriform aperture is enlarged with a bone drill and the placement of a nasopharyngeal airway (NPA) into both nostrils, which acts as a stent. The stent is left in place for a total of two to three weeks for all three patients to ensure the patency of the surgical area. All the patients were able to be extubated following surgery and discharged home without oxygen support.

Design of experiment (DoE) of mucoadhesive valproic acid-loaded nanostructured lipid carriers (NLC) for potential nose-to-brain application

Epilepsy is a highly prevalent neurological disease and valproic acid (VPA) is used as a first-line chronic treatment. However, this drug has poor oral bioavailability, which requires the administration of high doses, resulting in adverse effects. Alternative routes of VPA administration have therefore been investigated, such as the nose-to-brain route, which allows the drug to be transported directly from the nasal cavity to the brain. Here, the use of nanostructured lipid carriers (NLC) to encapsulate drugs administered in the nasal cavity has proved advantageous. The aim of this work was to optimise a mucoadhesive formulation of VPA-loaded NLC for intranasal administration to improve the treatment of epilepsy. The Design of Experiment (DoE) was used to optimise the formulation, starting with component optimisation using Mixture Design (MD), followed by optimisation of the manufacturing process parameters using Central Composite Design (CCD).The optimised VPA-loaded NLC had a particle size of 76.1 ± 2.8 nm, a polydispersity index of 0.190 ± 0.027, a zeta potential of 28.1 ± 2.0 mV and an encapsulation efficiency of 85.4 ± 0.8%. The in vitro release study showed VPA release from the NLC of 50 % after 6 h and 100 % after 24 h. The in vitro biocompatibility experiments in various cell lines have shown that the optimised VPA-loaded NLC formulation is safe up to 75 µg/mL, in neuronal (SH-SY5Y), nasal (RPMI 2650) and hepatic (HepG2) cells. Finally, the interaction of the optimised VPA-loaded NLC formulation with nasal mucus was investigated and mucoadhesive properties were observed. The results of this study suggest that the use of intranasal VPA-loaded NLC may be a promising alternative to promote VPA targeting to the brain, thereby improving bioavailability and minimising adverse effects.

Evaluation of the Effects of Orthopedic Treatment on the Dentofacial Structure and Upper Airway of Subjects with Skeletal Class III Malocclusion.

The present study aimed to evaluate the effect of rapid maxillary expansion (RME) and face mask treatment on the upper airway in patients with maxillary retrusion in two dimensions using digital cephalograms and volumetric evaluation using acoustic rhinometric measurements. A total of 22 individuals with a concave profile and skeletal and dental Class III malocclusion during growth and development with a mean age of 9.9±1.38 years were included in the study. A bonded RME appliance and a petit face mask were adapted for the patients. Before treatment (T0) and after maxillary protraction (T1), lateral cephalometric films and acoustic rhinometric recordings were obtained. The dependent sample t-test was used for statistical evaluation. Cephalometric analysis revealed forward movement of the maxilla and backward downward rotation of the mandible. A significant increase was observed in the nasopharyngeal and oropharyngeal regions of the upper airway. Three-dimensional evaluation of the upper airway by acoustic rhinometry revealed only an increase in the volumes of the left nasal cavity after decongestant administration. A statistically significant increase in acoustic rhinometric measurements in nasal valves. When the correlation of the cephalometric findings of the nasopharyngeal region with the acoustic rhinometry findings was examined, no statistically significant relationship was found. As a result of this study, we observed an increase in the cephalometric measurements of the nasopharyngeal and oropharyngeal areas. A significant increase was observed in the minimal cross-sectional area measured by acoustic rhinometry.

Comprehensive clinical implementation, workflow, and FMEA of bespoke silicone bolus cast from 3D printed molds using open-source resources.

Bolus materials have been used for decades in radiotherapy. Most frequently, these materials are utilized to bring dose closer to the skin surface to cover superficial targets optimally. While cavity filling, such as nasal cavities, is desirable, traditional commercial bolus is lacking, requiring other solutions. Recently, investigators have worked on utilizing 3D printing technology, including commercially available solutions, which can overcome some challenges with traditional bolus. To utilize failure modes and effects analysis (FMEA) to successfully implement a comprehensive 3D printed bolus solution to replace commercial bolus in our clinic using a series of open-source (or free) software products. 3D printed molds for bespoke bolus were created by exporting the DICOM structures of the bolus designed in the treatment planning system and manipulated to create a multipart mold for 3D printing. A silicone (Ecoflex 00-30) mixture is poured into the mold and cured to form the bolus. Molds for sheet bolus of five thicknesses were also created. A comprehensive FMEA was performed to guide workflow adjustments and QA steps. The process map identified 39 and 30 distinct steps for the bespoke and flat sheet bolus workflows, respectively. The corresponding FMEA highlighted 119 and 86 failure modes, with 69 shared between the processes. Misunderstanding of plan intent was a potential cause for most of the highest-scoring failure modes, indicating that physics and dosimetry involvement early in the process is paramount. FMEA informed the design and implementation of QA steps to guarantee a safe and high-quality comprehensive implementation of silicone bolus from 3D printed molds. This approach allows for greater adaptability not afforded by traditional bolus, as well as potential dissemination to other clinics due to the open-source nature of the workflow.

Cross-Sectional Study of Nasal Cavity, Nasal Septum and Paranasal Sinus Anatomy in Children

Cross-Sectional Study of Nasal Cavity, Nasal Septum and Paranasal Sinus Anatomy in Children

Intranasal Linguatula serrata (tongue worm) in canids and vulpids can be detected using computed tomography.

Linguatula serrata ("tongue worm") is a zoonotic intranasal parasite found globally in wild dogs, free-ranging dogs, some domestic dogs, and vulpids. Since there are no sensitive tests currently available, infections are underdiagnosed. This is a pilot observational prospective study aimed at determining whether nasal linguatulosis can be diagnosed using CT. The secondary aims were to evaluate radiography, rhinoscopy, and nasal egg swabs as methods in the diagnosis of tongue worms. Fifty-four wild canids and three vulpids euthanased by gunshot were sourced from pest-control officers. Cadaver heads were subjected to helical CT examination, nasal-swabbed for tongue worm eggs, and necropsied. Radiographs and rhinoscopy were performed on cadavers suspected to be infected based on preliminary CT examination. Tongue worms were retrieved at necropsy in 25 dogs and one fox. CT findings in animals with no nasal cavity ballistic damage were reviewed in six infected dogs and one infected fox. Adult female tongue worms were identified in 4 of 6 dogs and 1 of 1 fox as long, tubular, slightly heterogeneously attenuating structures in the mid to caudal nasal cavities. They were not clearly visible in CT scans when surrounded by nasal fluid, and small parasites (male and immature females) were not discernible. Radiographic findings were mild and nonspecific. One tongue worm was detected in 1 of 12 dogs examined rhinoscopically. Tongue worm eggs were found in swabs from 7 of 25 dogs. While small tongue worms could not be detected with CT, CT proved to be a useful diagnostic method for visualizing adult female tongue worms.

Body image discontentment among head and neck cancer patients in Visakhapatnam district: An empirical study

Head and neck cancers, which comprise tumours of the oral cavity, throat, nasal cavity, and thyroid, pose substantial physical and psychological issues. These tumours frequently require harsh therapies such as surgery, radiation therapy, and chemotherapy, which can result in apparent changes in appearance and physical function. As a result, patients are frequently subjected to body image distress, low self-esteem, and overall unhealthy psychological well-being. This study aims to investigate head and neck cancer patients' self-perceptions and body image problems, with an emphasis on feelings of self-consciousness, physical attractiveness, and general body dissatisfaction amongst head and neck cancer out patients undergoing treatment in HCG cancer hospital in Visakhapatnam. This study was conducted on 50 head and neck cancer outpatients undergoing treatment at an oncology centre Healthcare Global Enterprises ltd (HCG) hospital Visakhapatnam during the period of (May 2023 to June 2023) who were willing to participate in the study and were 20 years of age and above. An interview schedule was prepared by the researcher and administered to the patients comprising section A (questions pertaining to the demographic and clinical details of the patient), section B (modified 6 item Body Image Scale). Majority of the patients were male (62%) while female constituted 38% with the majority aged between 20- 39 years (61%) and the most common cancer being that of oral cavity (58%). The findings reveal a sizable proportion of respondents reporting feeling self-conscious and less physically attractive as a result of their sickness or treatment. Many individuals are dissatisfied with their appearance and overall body image, with a significant percentage reporting that these issues interfere with their social relationships and sense of wholeness. These findings highlight the need of addressing psychological and emotional support in the treatment and care of head and neck cancer patients. Integrating mental health and body image counselling into cancer treatment programmes has the potential to greatly improve patients' overall well-being and quality of life.

Feeding and Nutritional Key Features of Crisponi/Cold-Induced Sweating Syndrome.

Feeding difficulties are constantly present in patients with Crisponi/cold-induced sweating syndrome type 1 (CS/CISS1). The aim of our study was to describe their prevalence and evolution from birth to adult age. We performed an observational study at the Department of Life Sciences and Public Health, Rome. Fourteen patients were included in this study (six M; mean age: 18 years; SD: 10.62 years; median age: 15 years; age range: 6-44 years); six were adults (43%). Data on oral motor abilities from birth were collected. Meal duration, presence of swallowing reflex, dysphagia symptoms, difficulty chewing, and drooling management were assessed. At birth, all patients needed enteral feeding. Introduction of solid food was postponed beyond the age of 18 months in 43% of patients. During childhood and adolescence, mealtime was characterized by increased duration (43%) accompanied by fatigue during chewing (43%), food spillage from the nasal cavities (21%), sialorrhea (86%), and poor/reduced appetite (57%). A mature rotatory chewing skill was never achieved. This report expands the phenotype description of CS/CISS1 and also improves the overall management and prevention of complications in this ultra-rare disease.

Respiratory system: Highly exposed yet under-reported organ in pyrethrin and pyrethroid toxicity.

Pyrethrin and pyrethroid are a relatively new class of pesticides with potent insecticidal properties. Pyrethrins are naturally occurring pesticides obtained from the Chrysanthemum cinerariaefolium flower, while pyrethroids are their synthetic derivatives. They are widely used as the insecticides of choice in agriculture, veterinary medicine, public health programs, and household activities. Pyrethrin, being a broad-spectrum insecticide kills a wide range of pests, while pyrethroids last longer in the environment owing to low susceptibility to sunlight, and greater stability and efficacy than parent molecules. Humans can be exposed through inhalation, ingestion, and dermal routes. Indoor usage of an insecticide poses a serious risk to human health, especially to women, children, and stay-at-home people. Although pyrethrin and pyrethroid are generally considered safe, sustained skin or inhalation exposure or direct contact with open wounds results in higher toxicity to mammals. There is a paucity of data on the impact of pyrethrin and pyrethroid on overall pulmonary health. The respiratory system, from the nose, nasal passages, airways, and bronchi to the pulmonary alveoli, is vulnerable to environmental contaminants such as pesticides because of its anatomical location as well as being a highly blood profused organ. Under and over-functioning of the respiratory system triggers diverse pathologies such as serious infections, allergies, asthma, metastatic malignancies, and auto-immune conditions. While the association between workplace-related pesticide exposures and respiratory diseases and symptoms is well documented, it is important to understand the adverse health impact of pyrethrin and pyrethroid on the general population for awareness and also for better regulation and implementation of the law.

Impact of Intra-Phenotypic Nasal Vestibular Variation on Local Airflow Dynamics.

Many individuals with healthy normal nasal anatomy and function exhibit a prominent notch indentation at the junction of the ala and sidewall, specifically around the anterior-superior region of the unilateral nasal vestibule up to the internal nasal valve. This study evaluates the influence of various sizes of notched indentations at the anterior nasal airway on local airflow pattern. A retrospective study involving 25 healthy individuals, each exhibiting at least one unilateral notched indentation (40 total airways). Each individual's notched indentation was quantified after subject-specific three-dimensional nasal airway reconstruction from radiographic images. Computational fluid dynamics modeling was used to simulate nasal inspiratory airflow in each nasal airway at 15 L/min. Localized airflow distributions passing through the inferior, middle, and superior regions were calculated at 15 cross sections. Notched indentation size ranged 1.75-86.84 mm2 (average = 22.37 mm2). At the anterior airway, notched size significantly correlated with inferior airflow volume (R = 0.32, p = 0.04) but not in the middle (R = 0.21, p = 0.20) or superior (R = 0.06, p = 0.70) regions, whereas middle and superior regional resistance values were significantly correlated with notched size (middle: R = 0.54, p < 0.001; superior: R = 0.41, p = 0.009). Medially, resistance at the middle region significantly correlated with notched size (R = 0.56, p < 0.001). At the posterior airway, airflow distributions through the inferior, middle, and superior regions demonstrated weak correlation with notched size (inferior: R = 0.24, p = 0.14, middle: R = 0.24, p = 0.13; superior:R = 0.03, p = 0.83), whereas resistance was significantly correlated in the middle and inferior regions (middle: R = 0.56, p < 0.001;inferior: R = 0.43, p = 0.006). Anterior nasal airway notched indentation size had significantly stronger influence on localized airflow volume through the anterior-inferior airway than other regions of the nasal passage. N/A Laryngoscope, 2024.

Two draft genome assemblies of Staphylococcus aureus strains isolated from a cheek swab of a healthy female participant.

Staphylococcus aureus is an opportunistic pathogen often commensal within the nasal and oral cavities. Here we present the genomes of S. aureus O139-S and O139-NS, both isolated from the cheek swab of a healthy female participant. While found in the same sample, the two strains displayed distinct colony morphologies.

Analytical Methodologies to Detect N-Nitrosamine Impurities in Active Pharmaceutical Ingredients, Drug Products and Other Matrices.

Since 2018, N-nitrosamine impurities have become a widespread concern in the global regulatory landscape of pharmaceutical products. This concern arises due to their potential for contamination, toxicity, carcinogenicity, and mutagenicity and their presence in many active pharmaceutical ingredients, drug products, and other matrices. N-Nitrosamine impurities in humans can lead to severe chemical toxicity effects. These include carcinogenic effects, metabolic disruptions, reproductive harm, liver diseases, obesity, DNA damage, cell death, chromosomal alterations, birth defects, and pregnancy loss. They are particularly known to cause cancer (tumors) in various organs and tissues such as the liver, lungs, nasal cavity, esophagus, pancreas, stomach, urinary bladder, colon, kidneys, and central nervous system. Additionally, N-nitrosamine impurities may contribute to the development of Alzheimer's and Parkinson's diseases and type-2 diabetes. Therefore, it is very important to control or avoid them by enhancing effective analytical methodologies using cutting-edge analytical techniques such as LC-MS, GC-MS, CE-MS, SFC, etc. Moreover, these analytical methods need to be sensitive and selective with suitable precision and accuracy, so that the actual amounts of N-nitrosamine impurities can be detected and quantified appropriately in drugs. Regulatory agencies such as the US FDA, EMA, ICH, WHO, etc. need to focus more on the hazards of N-nitrosamine impurities by providing guidance and regular updates to drug manufacturers and applicants. Similarly, drug manufacturers should be more vigilant to avoid nitrosating agents and secondary amines during the manufacturing processes. Numerous review articles have been published recently by various researchers, focusing on N-nitrosamine impurities found in previously notified products, including sartans, metformin, and ranitidine. These impurities have also been detected in a wide range of other products. Consequently, this review aims to concentrate on products recently reported to contain N-nitrosamine impurities. These products include rifampicin, champix, famotidine, nizatidine, atorvastatin, bumetanide, itraconazole, diovan, enalapril, propranolol, lisinopril, duloxetine, rivaroxaban, pioglitazones, glifizones, cilostazol, and sunitinib.

Case Report: A 5 Yea kan r Old Girl with Diphtheria

Background: Diphtheria is an acute infectious disease caused by Corynebacterium diphtheriae. It is characterized by the formation of pseudomembranes in the tonsils, pharynx, and/or nasal cavity, which can lead to severe complications such as airway obstruction, myocarditis, and paralysis of the palate muscles. Aims: This study aims to detail the clinical course and treatment of a pediatric diphtheria case, emphasizing the importance of early diagnosis and appropriate therapeutic interventions. Methods: The case of a 5-year-old girl presenting with a 3-day history of fever at K.R.M.T Wongsonegoro Hospital is described. Clinical evaluation, including history, physical examination, and supportive tests, led to a diagnosis of diphtheritic tonsillitis. Findings: The patient exhibited classic symptoms of diphtheria, including sore throat, fever, and the presence of a dirty, greyish-white pseudomembrane on the tonsils. The membrane extended to adjacent structures, causing a condition known as bullneck. The treatment protocol included the administration of diphtheria antitoxin (DAT), antibiotics, antipyretics, corticosteroids, and symptomatic management. Conclusion: Diphtheria remains a serious infectious disease requiring prompt diagnosis and treatment to prevent complications. The case highlights the importance of early intervention, continuous monitoring, and the evaluation of therapeutic efficacy to improve patient outcomes. Implications: This study underscores the necessity of vigilant clinical practices in managing diphtheria cases, particularly in pediatric patients, to reduce morbidity and mortality.

Visualization of the infratemporal fossa: enhancing anatomical learning through three-dimensional modeling.

The infratemporal fossa and pterygopalatine fossa are critical pathways for blood vessels and nerves leading to the orbit, nasal cavity, and oral cavity. Anatomical observation of these areas is challenging for learners due to their complex connections with surrounding structures and their deep location within the body. Since it is not easy to understand this area in three dimensions with only textbook images, there is a need to produce three-dimensional (3D) content. Most existing 3D data have reconstructed the digital imaging and communication in medicine files from computed tomography images with high accuracy; however, the surrounding structures often obstruct the view. For this reason, this project utilized Cinema4D (R18; Maxon) software to refine the modeled bones and to create 3D models of muscles, blood vessels, and nerves that accurately represent their anatomical shapes and pathways. To facilitate easier access for learners via PC, the content was converted into PDF format. This enables the educational materials to be more easily viewed and the main structures more clearly observed using a computer-based viewer.

Analgesic efficacy of ultrasound-guided bilateral sphenopalatine ganglion block as a sole analgesic in fess surgeries and reconstructive nasal surgeries

: Severe postoperative pain is the most common complaint following Functional endoscopic sinus surgeries (FESS) and reconstructive nasal surgeries. Sensory, autonomic nerves supplying paranasal sinuses, nasal cavity, and palate relay in sphenopalatine ganglion. Bilateral Sphenopalatine ganglion block can be an effective regional anaesthetic technique for post-operative analgesia. We conducted a study with ultrasound-guided bilateral sphenopalatine ganglion block as the sole analgesic compared to Fentanyl in patients undergoing FESS &amp; reconstructive nasal surgeries performed under general anaesthesia. The primary objective of our study was to assess the analgesic effect, quality, and duration of analgesia of ultrasound guided bilateral sphenopalatine ganglion block as a sole analgesic. In addition, the secondary aim was to further evaluate the adverse effects.With Institutional ethical committee approval and written informed consent, we conducted this study with two groups of 30 patients each. The surgical procedure was performed under general anaesthesia. At the end of the surgery and before the reversal of neuromuscular blockade, bilateral sphenopalatine plexus block was performed under ultrasound guidance in interventional Group (A) with a mixture of 0.25% Ropivacaine, Dexamethasone 4mg 7.5ml each side, whereas the control Group (B) received fentanyl 2ug/kg intraoperatively. Visual analogue scale (VAS) scores were evaluated soon after extubating (0hrs) and up to 48 hrs postoperatively in all patients.There was no significant difference in VAS scores at 0hrs, 2hrs between both groups. Interventional group(A) had statistically significant lower scores (P &amp;#60;0.00) 4hrs onwards till 48hrs than in control group(B). No adverse events were noted with minimal postoperative analgesic requirement in group(A) (P &amp;#60;0.000).: We conclude, that ultrasound-guided bilateral sphenopalatine block is a safe and effective procedure that provides sustained and superior quality of analgesia when compared to fentanyl

Orbital Involvement as an Initial Presentation of Sinonasal Neuroendocrine Carcinoma

Purpose: To present a case of sinonasal neuroendocrine cancer initially manifesting with orbital involvement.Case summary: A 63-year-old female patient visited a neuro-ophthalmologic clinic due to a 3-week history of decreased visual acuity (VA), color vision abnormalities, and swelling of the upper eyelid in right eye. Best-corrected VA (BCVA) in the right eye was 0.8. Clinical findings included a relative afferent pupillary defect, restricted eye movement in lateral, superior, and medial gaze, and exophthalmos in the right eye. Wide-field fundus photography and optical coherence tomography indicated swelling of right optic disc. Magnetic resonance imaging was performed revealing a mass invading nasal cavity, sinus, and right orbital apex, and compressing the medial rectus, inferior rectus, superior oblique, and optic nerve. An otolaryngological nasal biopsy was conducted and immunohistochemical staining showed positive results for Ki-67, NSE, p16, P-53, and CD56, leading to a diagnosis of small cell neuroendocrine carcinoma with an irreducible tumor stage. Prior to initiation of treatment (concurrent chemoradiotherapy, CCRT), there was rapid worsening of VA and eye movement in the right eye. CCRT commenced alongside high-dose steroid treatment. One month following treatment, the BCVA of the right eye improved and protrusion of the right eye resolved. Six months after starting CCRT, a contrast-enhanced orbital computed tomography scan showed no residual lesion. The BCVA of the right eye stabilized at 0.3 with complete recovery of color vision and eye movement.Conclusions: Neuroendocrine cancer should be considered as a possible diagnosis in cases of rapidly progressing compressive optic neuropathy.

Orbital Apex Syndrome Caused by Invasive Fungal Sinusitis due to Candida glabrata: A Case Report

Purpose: To report a case of orbital apex syndrome resulting from invasive fungal sinusitis attributed to the unusual &lt;i&gt;Candida glabrata&lt;/i&gt; species.Case summary: A 76-year-old patient presented with persistent left-sided orbital pain, headaches, and blurred vision for 3 weeks. The patient had a history of uncontrolled diabetes, chronic kidney failure, and angina, and was treated for a COVID-19 infection 1 month prior to admission. Contrast-enhanced computed tomography scans revealed extensive bilateral sinusitis affecting the left optic nerve. The patient underwent endoscopic sinus surgery, which included nasal cavity biopsy, conducted by an otorhinolaryngologist. Histopathological analysis using Gömöri methenamine silver stains identified &lt;i&gt;Candida&lt;/i&gt;. Cultures from sinus specimens later grew &lt;i&gt;Candida glabrata&lt;/i&gt;. Treatment involved daily IV amphotericin B followed by oral itraconazole. After 6 months, the patient fully recovered from fungal sinusitis but continued to experience negative light perception in the left eye and progressed to complete ophthalmoplegia, consistent with orbital apex syndrome.Conclusions: Reports of invasive fungal sinusitis caused by &lt;i&gt;Candida&lt;/i&gt; infections are rare globally. This report marks the first occurrence in this country. Effective management requires careful assessment and appropriate treatment tailored to the specific species, especially considering the risk of orbital extension of the inflammatory lesion.

Host-microbe interactions in the nasal cavity of dogs with chronic idiopathic rhinitis.

Chronic rhinitis (CR) is a frustrating clinical syndrome in dogs and our understanding of the disease pathogenesis in is limited. Increasingly, host-microbe interactions are considered key drives of clinical disease in sites of persistent mucosal inflammation such as the nasal and oral cavities. Therefore, we applied next generation sequencing tools to interrogate abnormalities present in the nose of dogs with CR and compared immune and microbiome profiles to those of healthy dogs. Host nasal cell transcriptomes were evaluated by RNA sequencing, while microbial communities were assessed by 16S rRNA sequencing. Correlation analysis was then used to identify significant interactions between nasal cell transcriptomes and the nasal microbiome and how these interactions were altered in animals with CR. Notably, we observed significant downregulation of multiple genes associated with ciliary function in dogs with CR, suggesting a previously undetected role for ciliary dysfunction in this syndrome. We also found significant upregulation of immune genes related to the TNF-α and interferon pathways. The nasal microbiome was also significantly altered in CR dogs, with overrepresentation of several potential pathobionts. Interactome analysis revealed significant correlations between bacteria in the genus Porphyromonas and the upregulated host inflammatory responses in dogs with CR, as well as defective ciliary function which was correlated with Streptococcus abundance. These findings provide new insights into host-microbe interactions in a canine model of CR and indicate the presence of potentially causal relationships between nasal pathobionts and the development of nasal inflammation and ciliary dysfunction.

The effect of adipose tissue-derived stromal vascular fraction/gel material on wound healing in a rat model of nasal mucosa injury

Background Stromal Vascular fraction/gel (SVF/gel) is prepared mechanically from autologous adipose tissue, and it is known for its regenerative and anti-inflammatory properties. Aims To assess histopathological effects of adipose tissue-derived SVF/gel and nasal steroids on nasal mucosal healing Material and Methods Forty-two Wistar Albino rats with right nasal mucosal injury were randomly divided into three groups: control (saline), Mometasone Furoate (MF), and SVF/gel. Control group (n = 14) received saline for 7 days, while MF group (n = 14) was administered MF to the right nasal cavity for 7 days. SVF/gel group (n = 14) was treated once with SVF/gel in the right nasal cavity. Histological analysis on days 14 and 28 post-injury focused on evaluating epithelial thickness, inflammation, disarray, subepithelial thickness, goblet cell count, subepithelial fibrosis, presence of ciliated cells, lacunae, adhesion, and neo-osteogenesis. Results When comparing the MF and SVF/gel groups, statistically significant differences were found on day 14 in indices of epithelial thickness, subepithelial thickness, goblet cells, subepithelial fibrosis, and ciliated cells. On day 28, SVF/gel group exhibited higher ciliated cell counts and lower subepithelial fibrosis values (p = .027; p = .016). Additionally, epithelial disarray, adhesions, lacunae, and neo-osteogenesis were not observed in the SVF/gel group. Conclusions and Significance SVF/gel accelerates re-epithelialization, reduces fibrosis and adhesions, and enhances cilia formation compared to nasal steroids. These findings suggest that SVF/gel is an autologous and cost-effective treatment for improving nasal mucosal healing post-injury.