Nasal Pathology Research Articles

Comparative Study between Nasal Endoscopic Findings and Nose and Paranasal Sinus Computerized Tomography in diagnosis of Nose and Paranasal Sinuses Diseases

Background: Nasal obstruction is common in otorhinolaryngology outpatient visitors. The diagnosis of such compliant is by history, clinical examination and diagnostic procedures. Nasal endoscopy and computerized tomography scan are common diagnostic investigations. Nasal obstruction is either anterior or posterior (nasal septal deviations, hypertrophied turbinate pathological cyst, polyps, mass etc), or postnasal obstruction (hypertrophied turbinate, adenoid hypertrophy, nasopharyngeal cyst or nasopharyngeal tumors).
 Aim of study: Prospective study to compare endoscopic finding and computerized tomography of nose, paranasal sinuses and postnasal space as diagnostic methods for nasal obstruction and other nose, paranasal sinuses and post nasal space diseases.
 Subjects and methods: 80 patients with nasal obstruction between the age of 12-60 years old.All patient were examined by nasal endoscopy (rigid or flexible) under local anaesthesia (10 % xylocaine spray and cotton wicks soaked with ephidren 0.5 % and xylocaine 2 % ) and nose, paranasal sinuses and post nasal space C.T. scan,weather without contrast or with it, bone window or soft tissue according to the lesion. 
 Results: Both nasal endoscopy and C.T. scan were an important tools for diagnosis of nasal diseases and complementary to each other.
 Conclusion: Endoscopic examination of the nose gives a real view of nasal structures, postnasal space, any mass or polyps present.Computerized tomography is an accurate diagnostic method of the Nose, paranasal sinuses and post nasal spaces anatomical variations or pathologies.

Correlation between severity of diabetes mellitus, polyneuropathy and nasal mucociliary clearance

Objective: To examine the relationship between the severity of polyneuropathy and nasal mucociliary clearance times in patients with polyneuropathy and investigate how the presence and severity of electrophysiological polyneuropathy might affect mucociliary clearance in patients with diabetes mellitus.
 Material and Methods: This prospective cross-sectional study was carried out in the Neurol-ogy and Ear, Nose and Throat (ENT) clinics in a tertiary hospital. The study included three groups of patients with 20 participants in each group (Group 1, patients with diabetic poly-neuropathy; Group 2, patients with non-diabetic polyneuropathy; and Group 3, diabetes melli-tus patients with a normal nerve conduction study) Nasal saccharin test was performed on all patients.
 Results: There was a statistically significant difference in the duration of nasal mucociliary clearance among the groups (p= 0.001). There was a positive, statistically significant (p = 0.007) correlation between the nasal mucociliary clearance duration and the severity of poly-neuropathy. The nasal mucociliary clearance duration increased with the severity of polyneuropathy.
 Conclusion: Patients with diabetes mellitus are a special group, and preventable problems should be taken into consideration when examining nasal pathologies. It should be kept in mind that nasal mucociliary clearance dysfunction can be both a cause and a result in management of diabetes mellitus patients, and thus it should be evaluated carefully.

Assessing the Clinical Value of Performing CT Scan before Rhinoplasty Surgery.

Introduction The endonasal mucosal or anatomic pathologies could lead to poor functional results and dissatisfaction after rhinoplasty. Although computed tomography (CT) scan has become an integral part of the diagnostic paradigm for patients with pathologies of the paranasal sinuses, the use of CT scan for preoperative evaluation of patients seeking rhinoplasty is up for debate. Our aim in this study was to compare the efficacy of CT scan in diagnosing nasal pathologies with other evaluating tools in patients undergoing rhinoplasty. Design In this randomized controlled trial study, 74 consecutive patients seeking cosmetic rhinoplasty referred to otorhinolaryngology clinic were randomly assigned into three groups based on the perioperative evaluation method: the CT group, the nasal endoscopy group, and the control group (anterior rhinoscopy only). Surgical planning was made according to perioperative findings, and the identified endonasal pathologies were corrected during the surgery. The functional and aesthetic outcomes of the rhinoplasty were assessed by Nasal Obstruction Symptom Evaluation (NOSE), Rhinoplasty Outcome Evaluation (ROE), and the Visual Analogue Scale (VAS) tools before surgery and at 12-month follow-up. Results All outcome measures improved significantly in either group toward one year after rhinoplasty (all with p value <0.05). Subjects in the CT group demonstrated greater improvement in the NOSE, VAS, and ROE compared to other two groups (NOSE: p value = 0.17; VAS: p value = 0.024; ROE: p value = 0.042). Conclusions According to our study, perioperative CT is associated with greater patients' satisfaction and quality of life after rhinoplasty compared to either nasal endoscopy or anterior rhinoscopy. A preoperative CT scan may improve the outcomes of rhinoplasty.

A study of factors affecting the success rate of type-1 tympanoplasty

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic otitis media (COM) (tubo-tympanic) is a common ear pathology for which tympanoplasty is done. Factors that affect the success rate of tympanoplasty can be patient related (age, gender, socio-economic status), disease related (duration and severity of symptoms) or technique related (equipment and surgical approaches). This study was undertaken to know the factors affecting success rate of type-1 tympanoplasty at our institute.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This was a prospective observational study conducted at ENT Department of Gujarat Adani Institute of Medical Sciences, Bhuj, from October 2017 to July 2019. All patients between 20 and 60 years of age with inactive mucosal COM operated for type-1 tympanoplasty were included in the study. Pre-operative, intra-operative and post-operative details were recorded as per the pre validated proforma and evaluated using Chi-square and paired t-test.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;100 patients were included in our study. Females were more commonly affected (61%) than males (39%). In 78% of patients one ear was affected (left 40%, right 38%). Ear discharge was the most common symptom (99%). Maximum patients (55%) had a moderate perforation. The perforation was central in all cases. Microscopic surgery was done in 79% of patients. Post aural approach (Wilde’s incision) was the most common approach used (70%). The most common graft material used was temporalis fascia (96%). In 61% of patients graft was kept by underlay technique.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In our study, the success rate of tympanoplasty was significantly more when duration of discharge was less, microscope was used for surgery and post aural approach was used. Success rate was less when there was history of any previous nasal pathology. Other factors, like age, gender, socio-economic class, occupation, side of involvement of ear, size and site of perforation and grafting techniques, did not affect the success rate of tympanoplasty.&lt;/p&gt;

Characterization and Outcome of Patients Presented with Unilateral Nasal Disease to ENT unit at Hillah, Iraq

Background: A common finding during daily otolaryngological practice is a patient with unilateral nasalsymptoms, nasal polyp or mass. The causes behind most cases of unilateral nasal disorder are inflammatoryin nature and responds well to medical intervention and rarely there is need for surgical management. Thepossibility of neoplastic nature is high when there is unilateral nasal complaint or pathology as neoplasticconditions during their early stages may mimic inflammatory pathologies.Aim of the Study: The aim of the current study was to highlight the causes of unilateral nasal disease, theirmost frequent mode of presentation, management strategies and outcome in a sample of Iraqi patients.Patients and Method: The current prospective study included 96 patients, 42 males and 54 females, withsigns and symptoms suggestive of unilateral nasal disease. The study was carried out at Hillah GeneralTeaching Hospital, Babel province, mid-Euphrates region of Iraq and the work with this study has extendedfrom January 2014 to August 2019. All enrolled patients were subjected to routine ENT examination andoffice flexible endoscopy. Patients were managed by functional endoscopic sinus surgery for purpose ofexcisional or incisional biopsy.Results: The current study included 96 patients with a mean age of 49.09± 7.43 years and an age range of 39 to67 years. There were 42 males and 54 females. The results of complete evaluation have shown the followingpathologies at the end of the study: nasal polyposis (31, 32.3%), chronic rhinosinusitis without polyp (16,16.7%), antrochoanal polyp (14, 14.6%), inverted papilloma (11, 11.5%), frontoethmoidal mucocele (7,7.3%), concha bullosa (4, 4.2%), squamous cell carcinoma (3, 3.1%), rhinolith (2, 2.1%), fibrous dysplasia(2, 2.1%), adenocarcinoma (2, 2.1%), malignant melanoma (1, 1.0%), cavernous hemangioma (1, 1.0%),pyocele in concha bullosa (1, 1.0%) and non Hodgkin’s (1, 1.0%). Therefore, in the current study, nasalpolyposis was the commonest cause of unilateral sinonasal disease followed by chronic rhinosinusitiswithout polyp, antrochoanal polyp and inverted papilloma. The rate of malignant neoplasms was low.Conclusion: Differentiating the neoplastic nature form non-neoplastic nature of unilateral nasal pathologyis the most critical management step and in the current study, nasal polyposis was the commonest causeof unilateral sinonasal disease followed by chronic rhinosinusitis without polyp, antrochoanal polyp andinverted papilloma. The rate of neoplastic malignant conditions was low.

Quality of life assessment in patients treated with nasal corticotherapy for allergic rhinitis: A cohort study

IntroductionAllergic rhinitis (AR) is a chronic nasal pathology induced by an inflammation of the mucous membranes due to a dependent IgE reaction following allergenic exposure. The main symptoms are rhinorrhea, nasal itching, nasal obstruction and sneezing bursts. It highly affects the patient quality of life (QoL) in many levels making it a public health issue.The aim of this study is to assess the QoL of patients with AR as well as the level of its improvement after nasal corticotherapy. Materials and methodsFrom June 2019 to February 2020, a prospective study was carried out based on the use of the validated Arabic version of the RQLQ (Rhinoconjunctivitis Quality of Life Questionnaire) on a cohort of AR patients to measure their QoL before and after three months of treatment by “Budesonide”. ResultsA total of 70 patients participated in the study with an average age of 39.54 years with a sex ratio of 0.60. Their total RQLQ score was up to 4.28, improved to 2.35 after treatment. Also, a statistically significant improvement in sub-scores was also observed (p < 0.001): activities (from 4.43 to 2.29), nasal symptoms (from 5.00 to 2.80), eye symptoms (from 3.38 to 1.80), practical problems (from 4.29 to 2.18), general problems (from 4.63 to 2.78) and emotional state (from 4.28 to 2.43). ConclusionThe RQLQ is a reliable tool to evaluate the QoL in AR patients, stating the negative influence of AR on patients daily life and the effectiveness of nasal corticosteroid treatment.

Posterior Cephalic Soft Triangle of the Nose: Surgical Implications.

The posterior cephalic soft triangle is formed between the posterior cephalic border of the lower lateral cartilage, posterior caudal border of the upper lateral cartilage, and the caudal edge of the nasal bone. PCST is an important component of the external nasal valve which provides resistance against dynamic collapse. The objective of this study was to describe the anatomy of the PCST and to demonstrate its anatomic variations, dynamic interplays, and surgical implications. A retrospective review was conducted of 310 primary and 42 secondary cases who underwent extended open approach rhinoplasty by the first author. The structures that create the PCST of the nose were preserved unless resection/displacement of them was absolutely necessary. Whenever an external nasal valve pathology was found, it was corrected with one or combination of the following maneuvers: triangular PCST onlay graft, caudal bone outfracture, alar rim graft, lateral crural strut graft. Twenty-four non-consecutive cases were identified in which PCST was intraoperatively confirmed to be weak or deformed. The most common pathology in the PCST was overresection of the posterior segments of the LLC during primary surgery (54.1%), followed by en bloc medialization of the PCST (33.3%). Triangular onlay grafting of the PCST was the most common corrective surgical intervention (83.3%), followed by corrective lateralization of caudal edge of nasal bone (29.1%). External valve function has been restored in 21 (87.5%) cases. PCST of the nose is an important anatomic landmark which has esthetic and functional significance in rhinoplasty. This 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 .

Surgical correction of nasal cavity pathology in children with allergic rhinitis: quality of life

Introduction . Allergic rhinitis is one of the most common diseases. It is difficult to recognize concomitant pathology of allergic rhinitis on time, this fact reduces the effectiveness of therapy and affects the patient’s quality of life. Objective . To assess the quality of life and effectiveness of surgical treatment of children with various diseases of the ENT organs in combination with allergic rhinitis. Children characteristics and research methods . The intervention group included 169 children with allergic rhinitis and concomitant pathology of ENT organs aged from 6 to 17 years, the average age (median, upper and lower quartiles) 12 [9,0; 14,0] years. All patients underwent endoscopic endonasal surgical treatment. Quality of life was assessed using the questionnaire before and in 1 month after surgical treatment. The effectiveness of treatment was based on the changes in the quality of life in points (6 points — the maximum decrease in the quality of life; 0 points — no decrease in the quality of life). Results. Initially the average quality of life was 4 [3; 5] points. In a month after surgery this indicator decreased to 2 [1; 2] points, i.e. we observed a significant decrease in the quality of life (p=0,0000001). The percentage change in the quality of life indicator was 60 [50; 67], which was significantly higher than in the control group (41 children) (p=0,0000001). The authors revealed a significant positive correlation between the level of total IgE (R=0,4; p=0,0000001), the concentration of specific IgE (R=0,5; p=0,0000001) and a decrease in the quality of life before surgery, as well as a negative correlation between the level of total IgE and the degree of change in quality of life (R= -0,2; p=0,02). Conclusion. The combination of allergic rhinitis with non-allergic pathology of ENT organs is an indication for surgical treatment. The concentration of total IgE and specific IgE, along with questionnaires is an additional criterion for assessing the quality of life. At the same time, patients with high concentrations of total IgE are likely to have insufficient effectiveness of surgical treatment.

Effect of e-cigarettes on nasal epithelial cell growth, Ki67 expression, and pro-inflammatory cytokine secretion.

Upon use, e-cigarette aerosol comes in contact with various mucosal tissues, including the nasal epithelium, which may lead to nasal pathologies. We therefore assessed the effect of e-cigarettes on nasal epithelial cell and tissue behaviours. Human primary nasal epithelial cells and engineered 3D nasal mucosa tissues were exposed or not to either e-cigarette aerosol or standard cigarette smoke. We then evaluated cell viability and lactate dehydrogenase (LDH) activity. With the tissues analysed tissue structure, the expression of Ki67 proliferating marker, and the secretion of pro-inflammatory cytokines by the engineered nasal mucosa. The nasal epithelial cells exposed to e-cigarettes displayed a larger cell size and a faint nucleus following exposure to e-cigarettes. This is supported by the increased levels of LDH activity following exposure to e-cigarettes, compared to that observed in the control. Tissues exposed to e-cigarette aerosol displayed a structural deregulation, with more large-sized cells, fewer Ki67-positive cells, and a reduced proliferation rate, compared to that observed in the non-exposed tissues. Cytokine measurements showed high levels of IL-6, IL-8, TNFα, and MCP-1, demonstrating that e-cigarettes activated pro-inflammatory cytokine responses. E-cigarette aerosol showed adverse effects on nasal epithelial cells and nasal engineered mucosa tissue. These findings indicate that e-cigarettes could be a threat to nasal tissues and may impair the innate immune function of nasal epithelial cells.

Otorhinolaryngologic Evaluation of Brick Kiln Workers: ENT Findings of Brick Kiln Workers.

Brick kiln workers were evaluated in the field using otorhinolaryngologic and head and neck surgery (ENT) assessments. One-hundred and twenty laborers were assessed. The subjects were divided into three categories according to the work area: before the brick kiln, in the brick kiln, and after the brick kiln. Two evaluations were made, a questionnaire and an ENT examination. If structural changes were observed during the examination, the complication was deemed structural. Seventeen laborers who completed the questionnaire did not participate in the examination. A total of 103 laborers participated in the study: 29 before the brick kiln, 63 in the brick kiln, and 11 after the brick kiln. While general otologic complications were observed in 26 (25.2%) laborers, structural otologic complications were observed in 2 (1.9%). While general nasal complications were observed in 70 (68.0%) laborers, structural nasal complications were observed in 27 (26.2%). Although the general otologic and structural nasal complication rates were higher in the brick kiln group, the general, structural otologic, and nasal complication rates did not reach statistical significance among groups (p>0.05). Both the general and structural nasal complication rates were significantly higher in laborers who had worked for more than 10years and did not wear a mask (p < 0.01). We detected prominent nasal pathologies in brick kiln workers in our ENT-based study. These pathologies were much more common in laborers who had worked for over 10years and did not wear a mask.

The impact of ivacaftor on sinonasal pathology in S1251N-mediated cystic fibrosis patients.

ImportanceSinonasal symptoms in patients suffering from cystic fibrosis can negatively influence the quality of life and sinuses can be a niche for pathogens causing infection and inflammation leading to a decrease of lung function. Ivacaftor, a potentiator of the Cystic Fibrosis Transmembrane Conductance Regulator protein, has shown improvement in pulmonary function in cystic fibrosis patients with different forms of class III gating mutations. However, the effects of ivacaftor on sinonasal pathology have hardly been studied.ObjectiveTo determine the impact of ivacaftor therapy on sinonasal pathology in patients with cystic fibrosis with an S1251N mutation.DesignProspective observational mono-center cohort study, between June 2015 and December 2016.SettingA tertiary referral center in Utrecht, The Netherlands.ParticipantsEight patients with cystic fibrosis with an S1251N mutation, treated with the potentiator ivacaftor were investigated.ExposuresIvacaftor (Kalydeco, VX-770) therapy. Computed tomography imaging of paranasal sinuses. Nasal nitric oxide concentration measurements and nasal endoscopy.Main outcomes and measuresPrimary outcome is opacification of paranasal sinuses examined with computed tomography scan analysis and scaled by the modified Lund-Mackay score before and one year after treatment. Secondary outcomes are nasal nitric oxide concentration levels, sinonasal symptoms and nasal endoscopic findings before and approximately two months and in some cases one year after treatment.ResultsComputed tomography scan analysis showed a significant decrease in opacification of the majority of paranasal sinuses comparing the opacification score per paranasal sinus before and after one year of treatment with ivacaftor. Median nasal nitric oxide levels significantly improved from 220.00 (IQR:136.00–341.18) to 462.84 (IQR:233.17–636.25) (p = 0.017) parts per billion. Likewise, the majority of sinonasal symptoms and nasal endoscopic pathology decreased or resolved at two months after the use of ivacaftor.Conclusion and relevanceIvacaftor appears to improve sinonasal outcome parameters and thereby sinonasal health in patients with cystic fibrosis with an S1251N mutation.

The Nasal Cavity Mass with Oropharyngeal Extension Causing Progressive Dysphagia.

Although dysphagia and lump sensation in the throat caused by intranasal benign tumors with oropharyngeal extension is a rare condition, we suggest that clinicians should thoroughly examine the presence of nasal pathologies using various endoscopes for the differential diagnosis.

Unilateral sinonasal disease regarding clinical, radiological and pathological features

Background and objective: Patient with unilateral nasal pathology is common in clinical practice. A careful history followed by complete otolaryngology examination is mandatory and diagnostic nasal endoscopy by either flexible or by using endoscope. This study aimed to assess patients presented with the unilateral sinonasal disease, regarding clinical features, CT scan findings, and histopathological results. Methods: A prospective study was completed on 90 patients with unilateral sinonasal disease. The study was conducted at the Otolaryngology Department, Rizgary Teaching Hospital, Erbil city, Iraq, from February 2017 to July 2018. Regarding the pathological result, patients were categorized into two main groups of inflammatory and neoplastic. A biopsy was taken for histopathological confirmation from the patients with nasal mass either under local or under general anesthesia. The patients had been assessed clinically and radiologically. Results: Chronic rhinosinusitis was found to be the commonest cause of unilateral sinonasal disease followed by antrochoanal Polyp, benign tumor, fungal sinusitis and then malignant tumor in that order. Male gender and right side were predominant. The purulent nasal discharge was the commonest symptom under inflammatory conditions, while nasal bleeding, dental and orbital complained were the main symptoms in neoplastic diseases. Calcifications were noted on CT scan, mainly in patients with fungal sinusitis. Bony erosion and destruction were detected in the malignant tumor. Conclusion: Chronic rhinosinusitis was the most common cause of unilateral nasal and paranasal disease. Comprehensive evaluations of patient age, presenting symptoms, naso- endoscopic examination, and CT finding help in the diagnosis of unilateral sinus disease. However, histopathological confirmation remains the gold standard for final diagnosis.

Effect of nasal obstruction surgery on eustachian tube function and middle ear ventilation

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The purpose of this study was to assess the effect of surgery for nasal obstruction in improving Eustachian tube function and middle ear ventilation.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This prospective study involved 60 patients with different nasal pathologies causing nasal obstruction along with complaints of ear fullness. In required cases the nasal pathologies were surgically managed. Pre and postoperative impedance audiometric evaluation and nasal endoscopy were done to assess the eustachian tube function, changes the value of middle ear pressure and ear fullness sensation at 1 month and at 3 months after surgery. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Preoperatively, 56 (93.3%) patients had sensation of ear fullness, postoperatively at 1 month and at 3 months after nasal surgery only 20 (33.3%) patient and 18 (30%) respectively, has sensation of ear fullness, with significant improvement (p&amp;lt;0.05). Preoperatively, 74 (61.6%) ears were type A tympanogram, 50 ears of them had poor eustachian tube function and 24 ears had good Eustachian tube function. 42 (35%) ears were type C, 4 (3.3%) ear were type B tympanogram, all of them had poor eustachian tube function. The postoperative results of eustachian tube function test and tympanometric value were significantly better than preoperative results (p&amp;lt;0.05).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; We find out that nasal obstruction has a definite relationship with eustachian tube function. Surgery for nasal obstruction has a favourable effect on the middle ear pressure and eustachian tube function. Corrective surgery for nasal obstruction should be considered at least 1 month before undertaking the middle ear surgery to improve middle ear ventilation.&lt;/p&gt;

The maxillary sinus via aprelacrimal approach as agateway to the retromaxillary space and orbital floor

Endonasal surgery has emerged as the standard procedure for the majority of nasal and paranasal sinus pathologies. However, some pathological changes beyond the maxillary sinus seem to be out of the instrumental range and are addressed by open approaches. The prelacrimal approach to the maxillary sinus published by Zhou and coworkers has stimulated arapid development of various procedures in this field. In the current work, the possibilities of the prelacrimal approach are illustrated by means of three clinical cases. The prelacrimal approach enables isolated fractures of the orbital floor to be reconstructed without the risk of lower eyelid complications. Meningo- or encephaloceles in the far lateral aspects of the sphenoid sinus are comparatively well reached via endonasal, transantral, and transpterygoid approaches. Until recently, tumors beyond the maxillary sinus were the domain of open surgery, particularly when they extended laterally of the maxillary sinus. The technique of choice was either aCaldwell-Luc or amidfacial degloving approach. Many of these operations can now be performed via the endonasal prelacrimal approach, with lower morbidity and more rapid postoperative healing. The approach described herein is equal if not superior to the traditional approaches in terms of overview and accessibility.

Does laryngopharyngeal reflux disease impair nasal mucociliary transport? A case control prospective study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Laryngopharyngeal reflux disease (LPRD) is the retrograde reflux of gastro duodenal contents above the level of upper oesophageal sphincter into larynx and pharynx. LPRD can lead to upper respiratory pathology by direct contact of nasal and nasopharyngeal mucosa with the regurgitated gastric acid. Refluxate can damage the cilia, thereby prolonging the mucociliary clearance time (MCT) and consequently affecting the innate defence mechanism of upper airway. Our objective was to analyse the relationship between MCT and LPRD in patients without any nasal pathology.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was a prospective case control study, with 45 patients each in the study and reference group. Study group included patients with symptoms of LPRD who fulfilled the reflux symptom index (RSI) score of more than 13 points. The reference group included subjects without LPRD, with RSI less than 13. In both groups, conditions causing impaired MCT like allergic rhinitis, sinusitis, rhinitis and history of smoking were excluded. Chronic sinusitis cases were excluded in both groups using sino-nasal outcome test -22 scoring system. Nasal MCT was measured in all these participants using the Saccharin test. Duration more than 20 minutes was taken as prolonged mucociliary clearance time. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; MCT was prolonged in 62% of subjects (28 out of 45) in the study group whereas, in the reference population MCT was normal.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; LPRD is a contributing factor for impaired nasal mucociliary transport.&lt;/p&gt;

Effects of Trio and Pair Breeding of Mice on Environmental Parameters and Nasal Pathology and Their Implications for Cage Change Frequency.

According to the Guide, cage change frequencies must be considered when cage density requirements are exceeded. We monitored ammonia, carbon dioxide, cage wetness, health status, and breeding parameters of trio and pair breeding cages containing CD1 mice in ventilated and static microisolation caging (4 cages per condition) daily for approximately 6 wk. Minimum cage change frequencies for each condition were determined on the basis of performance data. At 3 d after cage change, static trio and pair cages had average ammonia levels of 74 and 38 ppm. Ventilated cages remained below the 25ppm threshold reported to be potentially deleterious for mice until at least day 7 after cage change. By 7 d after cage change, ammonia levels had risen to an average of 100 ppm and 64 ppm in static trio and pair cages and to 34 ppm and 20 ppm in ventilated trio and pair cages, respectively. Ammonia levels in ventilated cages continued to rise slowly through day 14 after cage change. CO₂ levels exceeded 5000 ppm in all groups at 2 d after cage change. Pair breeders in ventilated cages took the longest-10 to 14 d-to reach cage wetness threshold scores. On day 7, pups in trio static cages were noted to have decreased and squinted eyes, whereas in ventilated cages containing trios and pairs, these clinical signs were rare to absent. Histologically, there was an increasing incidence and severity of nasal lesions in weanlings with increasing housing density and decreasing ventilation, consistent with nasal epithelial toxicity. Given these parameters, we concluded that under the current husbandry conditions, it may be necessary to change breeders in static cages more frequently than every 7 d. Additional studies are necessary to evaluate the effects of more frequent cage changes on reproductive parameters, given that cage changing is stressful for mice and affects breeding results.

Evaluation of nasal pathologies accompanying rhinoplasty cases at otorhinolaryngology and plastic, reconstructive, & aesthetic surgery clinics

Rhinoplasty is a frequently performed surgical procedure. Besides an aesthetically successful outcome, determination of additional nasal pathologies and making a simultaneous intervention on these are also essential for a successful functional outcome. This study aims to determine the rates of accompanying nasal pathologies in patients undergoing rhinoplasty and reveals whether any additional interventions were performed during operation. In this cross-sectional study, 496 Caucasian Turkish patients who underwent rhinoplasty at the Plastic, Reconstructive & Aesthetic Surgery and Otorhinolaryngology clinics of our research hospital between 2015 and 2018 were retrospectively examined. Among them, the results of 271 patients who had preoperative paranasal computerized tomography scans were evaluated. The mean age of the 271 patients was 28.8 years (Range: 17-55). Among them, 156 (57%) were female and 115 (42%) were male. The numbers of patients with septal deviation, inferior concha hypertrophy, unilateral/bilateral concha bullosa, nasal polyp, mucosal thickening, and retention cysts at the Otorhinolaryngology clinic were found to be 126 (82%), 77 (50%), 20 (13%), 10 (6.5%), 77 (50%), and 41 (27%), respectively, and these numbers were respectively 97 (82%), 60 (51%), 11 (9.3%), 2 (1.7%), 57 (48%), and 17 (14%) at the Plastic, Reconstructive & Aesthetic Surgery clinic. A statistically significant difference was found in terms of the presence of retention cysts between the clinics (95% CI -0.11% to 0.16%; P=.014; P<.005), and the presence of retention cysts was significantly higher at the Otorhinolaryngology clinic. A total of 18 (12%) patients were found to have additional surgical interventions. This study showed that additional nasal pathologies were frequently present in patients undergoing rhinoplasty operations. Hence, for a successful operation, it is essential to have Otorhinolaryngology consultation and detect accompanying pathologies in rhinoplasty cases which will be performed by Plastic, Reconstructive & Aesthetic Surgery specialists. 4.

Canine nasal septum deviation can be a normal variation and correlates with increasing skull indices.

Nasal septal deviation has been studied in relation to nasal pathology and mass effect in dogs. The purpose of this retrospective, cross-sectional study was to compare the prevalence of nasal septal deviation in dogs with rhinitis, neoplasia, and those without nasal pathology based on the facial index, skull index, and cranial index. Computed tomographic studies of the nasal cavities of dogs performed over a 5-year period were retrospectively reviewed. This study had 233 dogs meeting the inclusion criteria with 135 dogs with no nasal pathology, 63 dogs with nasal neoplasia, and 35 dogs with rhinitis. The prevalence of nasal septal deviation, the angle, maximum distance, and longitudinal extent of deviation were recorded, as well as measurements to calculate the facial index, cranial index, and skull index. The results showed no difference in the prevalence of nasal septal deviation between dogs with nasal pathology and those without. The mean longitudinal extent of deviation and maximum distance of deviation was statistically greater for those with neoplasia compared to those with rhinitis and without nasal pathology. The longitudinal extent of deviation was inversely proportional to the cranial index, facial index, and skull index. The angle of deviation was directly proportional to the facial index and skull index. In conclusion, nasal septal deviation is an anatomic variant in different breeds of dogs with no predilection based on nasal pathology. Nasal septal deviation should be interpreted cautiously in the assessment of canine nasal disease.

Benign Paroxysmal Positional Vertigo (BPPV) and microvasculitis: A comparative study between nasal cytology and pathology

Benign Paroxysmal Positional Vertigo (BPPV) and microvasculitis: A comparative study between nasal cytology and pathology