Nasal Symptoms Research Articles

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.

Therapeutic Effectiveness SNOT 22-based interdose interval adjustment of dupilumab for CRSwNP.

This study aims to evaluate whether Sino-nasal Outcome Test (SNOT-22)-based interdose interval adjustment of dupilumab demonstrates enduring efficacy and patient satisfaction in chronic rhinosinusitis with nasal polyps (CRSwNP). A retrospective analysis was conducted using planned data collection from 44 patients who received dupilumab and had been followed up for more than 6 months, targeting individuals with CRSwNP based on the EPOS 2020 Criteria. Patients were treated with add-on dupilumab by adjusting the interdose interval based on SNOT-22, which was tapered when subjects with >40 SNOT-22 at pretreatment evaluation were controlled at the level of ≤20 SNOT-22; when subjects with ≤40 SNOT-22 at pretreatment evaluation were controlled at the level of ≥50% improvement. SNOT-22, nasal polyp scores (NPS), and a subjective satisfaction questionnaire modified from the Treatment Satisfaction Questionnaire for Medication (TSQM v.1.4) were assessed at each visit. The SNOT-22-based interdose interval adjustment of dupilumab showed sustained improvement in patients' subjective symptoms, satisfaction, and NPS. Mean scores (S.D) of SNOT-22 improved from 46.04 (22.30) to 14.72 (13.66) at 6 months (p=0.000); NPS improved from 3.20 (2.24) to 1.72 (1.46) at 6 months (p=0.000). Satisfaction scores (0-5) were well maintained above 3.5 points for up to 6 months(p=0.166). There was also a significant correlation between the improvement in the nasal symptom domain of SNOT-22 scores and higher satisfaction scores. Adjusting dupilumab intervals based on SNOT-22 from the start leads to sustained efficacy and patient satisfaction in Korean CRSwNP. This will be of great clinical help in determining the optimal dupilumab interval.

Evaluation of nasal mucociliary clearance in patients with psoriasis.

Psoriasis is an autoimmune pathology characterized by chronic inflammation with known multiorgan involvement. In the literature, there are few studies investigating the effects of psoriasis on upper respiratory tract mucosa. Our aim in our study was to investigate the possible effect of psoriasis disease severity and duration on nasal mucosa. A study group was formed from patients with psoriasis and disease duration, Psoriasis Area Severity Index (PASI) and Nasal Obstruction Symptom Evaluation (NOSE) scores of these patients were recorded. Demographic data were noted in all participants with the participation of control group patients, saccharin test was performed to evaluate the nasal mucosa and nasal mucociliary clearance (NMC) times were measured. Psoriasis patients with pathology that may cause nasal obstruction were excluded from the study. A total of 59 people (30 patients and 29 controls) aged 20-65 years were included in the study. There was no difference in age and gender distribution between the two groups. No statistically significant difference in the NMC time between two groups. In the patients group, a correlation was observed between the NMC time to the NOSE test, but no correlation was observed between the NMC time to the duration of the disease and the PASI score. In our study, no difference was observed in NMC time between the two groups and according to the duration or severity of the disease. In addition, NOSE score of patients was also relatively low. No significant impact of psoriasis on nasal functions was found.

Ameliorative Potency of Iridoid Glucoside Compound Catalpol on Inhibiting NF-κB-mediated Inflammation in Allergic Rhinitis-induced Mice

Background Over time, the prevalence of allergic rhinitis (AR) has surged due to various risk factors, notably attributed to global urbanization, rendering heightened levels of pollutants, including traffic-related emissions and particulate matter. About 25% of the global children population and 40% of the adult population were reported with AR. Even though AR is recognized as a systemic inflammatory disease, it often results in diverse other comorbidities, such as dermatitis, sinusitis, conjunctivitis, and otitis, requiring extensive and expensive treatment. Purpose We assessed the effectiveness of iridoid glucoside catalpol against AR in a mouse model. Catalpol is recommended in traditional Chinese medicine to treat diverse acute and chronic diseases. Methods AR was induced in mice with an ovalbumin-sensitized AR model and treated with 10 and 20 mg of catalpol. Nasal severity scoring was performed to confirm the AR induction in mice. Allergic mediators immunoglobulin E (IgE) and histamine were quantified in the serum to assess the anti-allergic response of catalpol. In nasal lavage fluid (NALF), the inflammatory mediators IgE Ab, prostaglandin D2, leukotriene C4, eosinophil cationic protein (ECP), and pro-inflammatory cytokines were measured to analyze the anti-inflammatory potency of catalpol. The binding capacity of nuclear factor-kappa B (NF-κB) to DNA was evaluated to assess the catalpol inhibitory potency against NF-κB-mediated inflammation in AR mice. To confirm the ameliorative potency of catalpol in AR mice, a histopathological analysis of nasal mucosa was performed. Results Catalpol treatment significantly decreased the nasal symptoms and reduced the allergic mediators in the serum of experimental animals. It effectively inhibited the synthesis of inflammatory mediators, ECP, and pro-inflammatory cytokines in the NALF, and also suppressed the NF-κB DNA-binding activity in AR mice. The decrease in ciliary loss, goblet cells, eosinophil infiltration, and vascular congestion observed with our nasal mucosa histopathological analysis confirmed the ameliorative potency of catalpol. Conclusion Our findings have proven catalpol inhibits NF-κB-mediated inflammatory response in AR mice. With further analysis, a potent natural compound, catalpol, can be formulated as a drug to treat AR.

Efficacy and safety of azelastine hydrochloride and fluticasone propionate nasal spray in treating allergic rhinitis: a randomized controlled trial

Background: MP-AzeFlu (Dymista; Meda Pharma GmbH & Co., KG), a formulation combining azelastine hydrochloride and fluticasone propionate in a single spray, is superior to fluticasone propionate alone in relieving symptoms and improving the quality of life of patients with allergic rhinitis. Objectives: In this study, we evaluated whether the effect of AzeFlu, a generic drug manufactured from China, is equivalent to that of MP-AzeFlu. Methods: In total, 679 patients were recruited for a multicentre, randomized, double-blind, original drug-controlled, and parallel-group clinical trial. Overall, 339 and 340 patients were administered with AzeFlu and MP-AzeFlu, respectively. Efficacy was assessed by changes in the reflective total nasal symptom score, the area under the curve of reflective total nasal symptom score changes over time, changes from baseline in individual nasal symptom scores, and the Rhinoconjunctivitis Quality of Life Questionnaire. In addition, a safety evaluation was simultaneously performed. Results: AzeFlu and MP-AzeFlu reduced the reflective total nasal symptom score from baseline (AzeFlu −6.7 [standard deviation, 2.59]; MP-AzeFlu −6.7 [standard deviation, 2.76]; P = 0.905) and improved nasal symptoms and quality of life (AzeFlu −62.3 [standard deviation, 33.59]; MP-AzeFlu −64.7 [standard deviation, 33.73]; P = 0.394) in patients with allergic rhinitis. Significant differences were not observed between groups. Conclusion: AzeFlu showed effects equivalent to those of MP-AzeFlu in this clinical trial and may benefit Chinese patients with allergic rhinitis. Registration number: CTR20190189 (chinadrugtrials.org.cn/index.html)

A co-created citizen science project on the short term effects of outdoor residential woodsmoke on the respiratory health of adults in the Netherlands

Background and aimWoodsmoke from household fireplaces contributes significantly to outdoor air pollution in the Netherlands. The current understanding of the respiratory health effects of exposure to smoke from residential wood burning is limited. This study investigated the association between short-term changes in outdoor woodsmoke exposure and lung function, respiratory symptoms, and medication use in adults in the Netherlands.MethodsThis study was co-created with citizen scientists and other relevant stakeholders. A panel study was conducted with repeated observations in 46 adults between February and May 2021 in four Dutch towns. Participants recorded their symptoms and medication use in daily diaries, and conducted morning and evening home spirometry measurements. Woodsmoke exposure was characterized by measuring levoglucosan (most specific marker for woodsmoke exposure), black/brown carbon, fine and ultrafine particulate matter at central monitoring sites. Individual woodsmoke perception (smell) was recorded in daily diaries. Linear and logistic regression models were used to investigate the association between respiratory health and woodsmoke exposure. Models were adjusted for time-varying confounders and accounted for repeated observations within participants.ResultsConsistent positive associations were found between levoglucosan and shortness of breath (SOB) during rest and extra respiratory medication use. Odds ratios for current day exposure to levoglucosan were 1.12 (95% CI: 0.97, 1.30) for SOB during rest and 1.19 (95% CI: 1.07, 1.33) for extra medication use, expressed per interquartile range of levoglucosan concentrations (69.16 ng/m3). Positive non-significant associations were found between levoglucosan and nasal symptoms, cough and waking up with SOB. No consistent association was found between levoglucosan and lung function. Associations found between woodsmoke markers, SOB during rest and extra medication use remained after the inclusion of PM2.5 and UFP in two-pollutant models.ConclusionsAdults experienced more SOB during rest, nasal symptoms and used more medication to treat respiratory symptoms on days with higher levels of outdoor woodsmoke concentrations.

Designing a Nasal Lining-Framework Complex for Reconstructing Total Nasal Defects.

To validate the feasibility of an innovative nasal lining-framework complex (NLFC) for reconstructing total nasal defects. Retrospective cohort study. This NLFC is composed of forearm flap and support framework. Twenty-four patients were followed up for a minimum of 17 months in 5 centers. Patients' medical history data were retrospectively analyzed. Visual Analog Scale (VAS) of surgeons and patients was used to evaluate the aesthetic effects and self-satisfaction. The Nasal Obstruction Symptom Evaluation (NOSE) questionnaire and Rhinoplasty Outcome Evaluation (ROE) questionnaire were used for functional assessment. Reconstruction surgeries were all successfully completed. The flaps healed well in all patients, and there were no signs of ischemic necrosis. The healing time of the wound was 10 to 14 days, except for 1 case with infection. The nasal lining was reconstructed and no significant contracture was observed. The average VAS of surgeons was 4.29 ± 0.69 (range 3-5). The mean VAS score of patients was 3.75 ± 0.79 (range 2-5). There was a significant positive correlation between patients' and surgeons' VAS scores (P = .007, r = .5355). The results of the NOSE questionnaire showed that all patients had no obvious ventilation restriction, and only 3 patients mildly felt that the nasal inspirations were slightly insufficient during exercise or exertion. The mean ROE of the patients was 21 ± 1.96 (range 18-25). This NLFC is suitable for total nasal reconstruction, which can provide effective support to prevent flap collapse and retraction and ensure good nasal ventilation. Level IV, therapeutic study.

Sinonasal Phosphaturic Mesenchymal Tumors Without Any Nasal Symptoms: A Case Report and Literature Review.

We present a case of phosphaturic mesenchymal tumor (PMT) in the left ethmoid without any nasal symptoms in a 63-year-old woman. Initially diagnosed with postmenopausal osteoporosis, 2-year history of hypophosphatemia and a significantly higher uptake of Fluorine-18 (18F)-AlF-NOTA-octreotide (18F-OC) in the left ethmoid sinus, provided crucial information for accurate diagnosis. We presented a case with chart review and conducted review of the literature. The patient endured 1-year history of weakness and bone pain but without any nasal symptoms before a tissue diagnosis was eventually reached. It is a challenging diagnosis to make-patients present with non-specific clinical symptoms and the culprit neoplasm is often tiny in size and difficult to detect. It emphasizes the importance of thorough patient history-taking and the whole-body functional imaging. Sinonasal PMTs are rare, and because of this most otolaryngologists are unfamiliar with its clinical presentation. This case highlights the importance of early diagnosis to enable prompt intervention and reduce the burden of associated symptoms.

Correlation between Lund-Mackay computed tomography score and subjective symptoms in Chinese patients with nasal polyps.

The association between objective imaging findings and subjective symptoms remains undefined. To investigate the correlation between objective imaging findings and symptom severity in the overall chronic rhinosinusitis with nasal polyps (CRSwNP) population as well as its subendotypes according to the eosinophilic inflammation. Patients with CRSwNP undergoing endoscopic sinus surgery were included. All participants completed the Sino-Nasal Outcome Test (SNOT-22) questionnaire. The Lund-Mackay (LM) CT scores was also obtained. Spearman correlation analysis was performed to evaluate the correlation between CT scores and SNOT-22 scores. Forty-four non-eosinophilic CRSwNP(neCRSwNP) and 93 eosinophilic CRSwNP (eCRSwNP) patients were recruited. There was significant association between LM total score and nasal subdomain of SNOT-22 in the overall CRSwNP patients. The nasal symptom of SNOT-22 was significantly associated with maxillary, frontal, sphenoid, anterior drainage, and posterior drainage in all CRSwNP patients. In eCRSwNP and neCRSwNP patients, the sense of smell/taste was associated with sphenoid and posterior drainage. Thick nasal discharge was positively correlated with maxillary, frontal, and anterior drainage only in eCRSwNP patients. The high score of sphenoid and posterior drainage may suggest the occurrence of loss of sense of smell/taste, while high score of maxillary sinus may indicate suffering from thick nasal discharge in eCRSwNP patients.

Prospective long-term follow-up after grommet insertion: Hearing and functional health outcomes in children

ObjectivesTo assess hearing levels and functional health outcomes of children two years after routine grommet surgery with standard care follow-up (discharge to General Practitioner (GP) care or Ear Nose and Throat (ENT) clinic appointment at 4–8 weeks). MethodsProspective cohort study of 89 children (average age of 7.98 years) recalled for audiological assessment 2 years after grommet surgery in a large ENT outpatient service in South Auckland, New Zealand. Functional health was assessed using parent-reported responses to the OMQ20 questionnaire. Results46 (51.7 %) children had hearing loss in at least one ear with 28 (31.5 %) children having bilateral hearing loss. Māori children had statistically higher odds compared to non-Māori children (odds ratio 5.491, p = .003) to have bilateral hearing loss after controlling for age, household deprivation, gender, season, and mode of follow-up. Most parents reported concerns with their child's hearing, speech, attention-seeking behaviours, and nasal symptoms, but not ear problems. Bilateral hearing loss (p < .001) was found to significantly predict functional health status (total OMQ20 score). ConclusionsThe high prevalence of hearing loss and functional health concerns suggest that the standard follow-up care is not adequately managing children after routine grommet insertion. Māori children are disproportionately impacted, and post-grommet follow-up schedules must consider individualised approaches to address these inequities in outcomes.

Effect of Y-shaped Nasal Columella Made of Autologous Cartilage in Secondary Nasal Deformity after Cleft Lip Surgery.

Due to the diversity and complexity of tissues involved in secondary nasal deformities following unilateral cleft lip, secondary nasal deformity correction surgeries are challenging and often yield unsatisfactory results, posing a difficult problem for plastic surgeons. Autologous cartilage, with its low sculpting difficulty, minimal absorption, and stable tissue compatibility, is considered the optimal material for reconstructing the columella, nasal tip, and alar. This study analyzed the clinical outcomes of using autologous cartilage to create a Y-shaped columella to correct secondary nasal deformities after cleft lip surgery. In this retrospective study, 75 patients with secondary nasal deformity after unilateral cleft lip surgery were treated from January 2018 to December 2023. Appropriate costal cartilage, auricular cartilage, and iliac crest cartilage were fashioned into Y-shaped stents and implanted into the nasal columella of the patients to strengthen the tip cartilage. The free alar cartilage was sutured and fixed with a Y-shaped bracket. The wound healing rate, subjective satisfaction evaluation, and complications were analyzed. The nasal appearance, nasal deformity classification, and objective indices of healthy and affected nasal sides, function, and quality of life were compared before and after the operation. All patients healed well during the first stage without related complications, and the average incision healing time was 5.16 ± 1.37 days. The scores of nasal tip position, nasal tip shape, nostril shape, nasal dorsum shape, and nasal floor shape at 6 months post-operation were significantly lower compared to pre-operation (p < 0.001). The grade of nasal deformity at 6 months post-operation was lower than the pre-operation (p < 0.001). Pre-operation, the nasal base and nasal width of the affected side were higher than those of the healthy side, while the nasal columellar and nostril height were lower (p < 0.001). At 6 months post-operation, the nasal base and nasal width decreased, and the nasal columellar and nostril height increased (p < 0.001), with no significant difference between the two sides (p > 0.05). The nasal obstruction symptom evaluation (NOSE) and Functional Rhinoplasty Outcome Inventory-17 (FROI-17) scores at 6 months post-operation were significantly lower than pre-operation, while the rhinoplasty outcome evaluation (ROE) score was higher (p < 0.001). The total patient satisfaction was 97.33% (73/75). Y-shaped nasal columella made of autologous cartilage can effectively correct secondary nasal deformity after cleft lip surgery, improve nasal alar collapse, lengthen nasal columella, elevate nasal end, enhance the quality of life, nasal appearance, and nasal ventilation function of patients, with high satisfaction and few complications.

Efficacy of Capsaicin for Non-allergic Rhinitis: An Updated Systematic Review and Meta-analysis.

Non-allergic rhinitis (NAR) is a prevalent condition with limited effective treatments. Capsaicin, an agonist of the transient receptor potential vanilloid subfamily 1 (TRPV1) receptor, has emerged as a potential therapeutic option for NAR by targeting heightened nasal reactivity. This systematic review and meta-analysis, conducted in accordance with PRISMA guidelines and registered on PROSPERO, evaluated the efficacy of capsaicin for NAR treatment. Nine studies with placebo-controlled group were included, with primary outcomes assessed as total nasal symptom scores (TNSS), visual analog scale (VAS) scores, and the proportion of therapeutic responders. Meta-analysis revealed significant improvements in TNSS and VAS scores, along with a higher proportion of therapeutic responders in patients receiving capsaicin treatment compared to placebo. While some studies demonstrated reductions in substance P levels and TRPV1 expression after capsaicin treatment, further investigation is warranted. This meta-analysis provides preliminary evidence suggesting that capsaicin treatment holds promise for alleviating symptoms in patients with NAR. However, the limited number of studies and methodological heterogeneity necessitate larger and more rigorously designed clinical trials with standardized methodologies and advanced diagnostic techniques to establish their definitive roles in clinical practice.

Dupilumab for refractory chronic rhinosinusitis in eosinophilic granulomatosis with polyangiitis.

Eosinophilic granulomatosis with polyangiitis (EGPA) is frequently associated with refractory chronic rhinosinusitis with nasal polyps (CRSwNP), despite current treatments. Dupilumab demonstrated efficacy in the treatment of severe and uncontrolled CRSwNP, with improvements in patient-reported outcome measures and in objective measurements. This study aims to evaluate efficacy and safety of dupilumab in refractory CRSwNP in EGPA patients. A prospective observational study was conducted on EGPA patients treated with dupilumab between 2021 and 2023. Patients in a phase of prolonged remission of vasculitis manifestations but still experiencing active CRSwNP were included. Clinical, biological, and rhinologic evaluations were performed, alongside with patient-reported outcomes measures (PROMs) and nasal cytology. Complete response was defined by Birmingham Vasculitis Activity Score (BVAS)=0 and prednisone dose ≤ 4 mg/day, while partial response by BVAS = 0 and prednisone dose >4 mg/day. Nine EGPA patients were included. After 3 months, 55.6% achieved complete response, increasing to 83.3% at 12 months. Nasal symptoms and patient-reported outcomes improved significantly, with sustained efficacy over 12 months. An improvement in quality of life was also observed, with a significant reduction of the AAV-PRO score. Nasal cytology revealed reductions in eosinophils and neutrophils counts. Adverse events occurred in 44.4%, including hypereosinophilia in 2 cases, which led to dupilumab discontinuation. Dupilumab is an effective treatment option for severe and refractory ENT manifestations in EGPA, as it improves symptoms, reduces inflammation, and leads to better a quality of life. However, careful patient selection and monitoring are necessary to minimize adverse events and optimize outcomes.

Effect of mite-specific subcutaneous immunotherapy on patients with allergic rhinitis

This study analyzed the effect of mite-specific subcutaneous immunotherapy (SCIT) on patients with allergic rhinitis (AR). We enrolled 98 AR patients visiting our hospital from April 2017 to April 2019 and grouped them in a random number table. The control group (n=49) received conventional treatment for three years. The SCIT used a standardized mite allergen injection for the experimental group (n=49) for three years. The study compared total nasal symptom score (TNSS), daily medication score (DMS), total combined score (TCS), visual analog scale (VAS) score, mini-rhinitis quality of life questionnaire (MiniRQLQ) score, and serum immunoglobulin E (sIgE) level before and after treatment. The overall response rate was higher in the experimental group than in the control group (59.18% vs. 30.61%, p&lt;0.05). After treatment, the experimental group had lower values for TCS and VAS score (p&lt;0.05); motion score; practical problems; nasal, ocular, and other symptoms (p&lt;0.05); and sIgE, Dermatophagoides pteronyssinus (Dp)-sIgE, and Dermatophagoides farinae (Df)-sIgE levels (p&lt;0.05) than the control group. The sIgE, Dp-sIgE, and Df-sIgE levels were lower in the effective group than in the ineffective group (p&lt;0.05). The areas under the ROC curves of IgE, Dp-sIgE, and Df-sIgE and their combination for predicting the therapeutic effect of mite-specific SCIT on AR were 0.839, 0.779, 0.814, and 0.903, respectively. Mite-specific SCIT relieved clinical symptoms and improved the quality of life of AR patients, probably by decreasing the IgE expression level.

A clinical study on the relationship between chronic rhinosinusitis and bronchial asthma.

To investigate the correlation between chronic rhinosinusitis (CRS) and bronchial asthma, focusing on the CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP), as well as their impact on lung function. A total of 141 patients diagnosed with chronic nasal-sinus inflammation were included in this study. Clinical data, including medical histories, nasal endoscopy scores, CT scores, symptom scores, and quality of life assessments, were collected. Among the patients with CRSsNP, 23.8% had concomitant bronchial asthma. The incidence of asthma was significantly associated with the severity of sinus involvement in CRSsNP patients (p = 0.049). Pulmonary function impairment was correlated with the severity of sinus inflammation in CRSsNP patients (p = 0.019). Quality of life was significantly affected in patients with concomitant asthma and CRSsNP or CRSwNP. Chronic rhinosinusitis, both with and without nasal polyps, is closely correlated with bronchial asthma. Pulmonary function impairment is associated with the extent of inflammatory lesions in CRSsNP. Although CRSwNP does not significantly affect pulmonary function, the treatment of sinus diseases can contribute to the control of asthma.

Modern Aspects of Closed and Open Rhinoplasty (Literature Review)

Open and closed rhinoplasty are two primary approaches to nasal modification. According to the current literature, there is no consensus among plastic surgeons and otolaryngologists regarding the preferred method in terms of aesthetic outcomes, complications, and patient satisfaction. This review aims to analyze published scientific materials to determine whether open or closed rhinoplasty leads to more favorable patient outcomes. For this systematic review, we followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and conducted a literature search across four databases according to our search strategy. The articles were then imported into COVIDENCE, where they underwent primary screening and full-text review. A total of twenty studies were selected for this review after analyzing 243 articles. Among them, there were four case series, twelve retrospective cohort studies, one prospective cohort study, one case-control study, and two outcome studies. The analysis included three cosmetic studies, eight functional studies, and nine studies that addressed both cosmetic and functional components. Sixteen studies used both open and closed rhinoplasty techniques, while four focused exclusively on open rhinoplasty. Both methods demonstrated high satisfaction rates among patients and professionals, with no significant advantage found for either technique. Based on the available studies, we cannot conclude the superiority of either open or closed rhinoplasty in achieving better patient outcomes. Several studies indicated that both open and closed rhinoplasty resulted in comparable levels of patient satisfaction. To enhance the reliability and consistency of outcome reporting, authors should focus on using the Nasal Obstruction Symptom Evaluation (NOSE) scale and other standardized rhinoplasty outcome assessments.

Quality of life in disease-free survived patients with early-stage extranodal nasal-type NK/T-cell lymphoma after definitive intensity-modulated radiotherapy: a cross-sectional study of 310 cases

PurposeRadiotherapy is a critical treatment for early-stage extranodal nasal-type NK/T-cell lymphoma (ENKTL) and has yielded favorable survival outcomes. However, their postradiotherapy quality of life (QOL) has not been investigated. Here, we conducted a cross-sectional study to assess the QOL of ENKTL patients with disease-free survival after definitive radiotherapy and to identify factors associated with QOL and treatment optimization.MethodsThis cross-sectional study included 310 patients with stage I–II ENKTL of the upper aerodigestive tract (UADT) who had received simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) with a consistent design and achieved disease-free survival. The median postradiotherapy time was 47.2 months (range, 3.1–115.7). The EORTC QLQ-H&N35 questionnaire was used to assess symptom-related QOL, and nine additional items were added to incorporate nasal, optical, and aural-related symptoms. The scores indicate the severity of the symptoms.ResultsThe most common postradiotherapy symptoms among patients with ENKTL were nose problems (49.7%), dry mouth (44.8%), tooth problems (41.3%), sensory problems (32.6%), and less sexuality (25.8%). Tooth problems had the highest average score of 18.6, which is still acceptable. The severity of these symptoms decreased over time and reached a plateau in the second year after radiotherapy. Multivariable regression analysis showed that whole-neck irradiation was an independent predictive factor for xerostomia (P = 0.013, OR = 1.114), while age > 60 years was a predictive factor for lower sexuality (P < 0.001, OR = 1.32).ConclusionThe QOL of patients with early-stage ENKTL after radiotherapy was favorable, and most symptoms improved over time. Radiotherapy was correlated with specific symptoms, which may suggest a direction for further improvement in SIB-IMRT.

Short-term influence of Immufen™ on mild allergic rhinitis: a randomized, double-blind, placebo-controlled study.

Allergic rhinitis (AR) is an IgE-mediated reaction to inhaled allergens, and is a prominent health concern affecting approximately 400 million people worldwide. A comprehensive understanding of AR's pathophysiology is imperative for developing novel therapies, especially considering its frequent co-morbidity with asthma and conjunctivitis. The escalating prevalence of AR is correlated with increased urbanization and environmental pollutants, recognized as prominent contributing factors. Dysregulation in immune networks, Th1/Th2 cytokine imbalance, activation of mast cells and eosinophils are implicated in AR progression. Classic AR symptoms include nasal congestion, nasal itching, rhinorrhea, and sneezing which significantly impact the quality of life, social interactions, and workplace productivity. This randomized, double-blind, placebo-controlled, three-arm, three-sequence study was aimed to assess the efficacy of supplementation of a co-delivery form of turmeric extract with ashwagandha extract (CQAB) in comparison with a bioavailable curcumin (CGM) and placebo in alleviating AR symptoms and enhancing the quality of life in individuals with mild AR. Participants received either placebo, CGM, or CQAB twice/day for 28 days, and subjective measures were recorded at the baseline and at the end of study. CQAB supplementation demonstrated a significant (P < 0.05) improvement in Total Nasal Symptom Score (TNSS) compared to placebo and CGM. Furthermore, CQAB administration resulted in enhanced sleep quality (P < 0.05) as evaluated by the BIS questionnaire, heightened energy levels, and decreased fatigue and overall mood disturbance (POMS-SF) compared to both placebo and CGM. The results suggests that CQAB has the potential to be used as a dietary supplement in alleviating AR discomforts. https://ctri.nic.in/Clinicaltrials/login.php; Identifier CTRI/2021/01/030355.

Association between empty nose syndrome and laryngopharyngeal reflux disease: a preliminary cohort study.

To investigate the association between laryngopharyngeal reflux disease (LPRD) and Empty Nose Syndrome (ENS). Nasal and laryngopharyngeal reflux symptoms were investigated in patients with ENS. Symptoms were evaluated with reflux symptom score-12 (RSS-12), nasal obstruction symptom evaluation (NOSE), empty nose syndrome 6-item questionnaire (ENS6Q), empty nose syndrome index (ENSI), and sinonasal outcome tool-22 (SNOT-22). The anxiety and depression were assessed with the general anxiety disorder-7 (GAD-7), and patient health questionnaire-9 (PHQ-9). A study of association was conducted between demographics and patient-reported outcome questionnaires. Forty-one ENS patients were included (20 females (48.8%)). The control groups included 27 patients with rhinitis/rhinosinusitis and 36 asymptomatic individuals. The ENSI and ENS6Q detected ENS in 97.6% and 90.2% of cases, respectively. The mean scores of ENSI, ENS6Q, RSS-12, NOSE, and SNOT-22 were significantly higher in the ENS group compared to controls. The prevalence of suspected LPRD was 90.2% in the ENS group, which was significantly higher compared to controls. The prevalence of mild, moderate, moderately severe, and severe depression in ENS patients was 7.3% (n = 3), 4.9% (n = 2), 39.0% (n = 16), and 46.3% (n = 19), respectively. RSS-12 reported significant and high associations with the ENS6Q (rs=0.939; p = .001) and ENSI (rs=0.699; p = .001). LPRD symptoms and prevalence were significantly higher in ENS patients compared to controls. Future controlled studies are needed to investigate the prevalence of LPRD in ENS patients through objective approaches (impedance-pH monitoring, nasal digestive enzyme measurements).

Outcomes after Functional Nasal Surgery in Patients with Versus without Rhinitis Medicamentosa.

Topical nasal decongestants (TNDs) are used to reduce nasal soft tissue edema and obstruction. However, after frequent TND use, patients can develop rhinitis medicamentosa (RM) with rebound nasal edema and obstruction. Management of RM has centered largely on TND cessation ± intranasal corticosteroids. The purpose of this study was to compare nasal obstruction outcomes following nasal obstruction surgery in patients with versus without RM. A retrospective case-control study was conducted with adult patients who underwent bilateral inferior turbinate reduction (ITR) with or without septoplasty and nasal valve repair. Patients with versus without RM were assessed. RM was defined as at least daily TND use for ≥4 weeks. Preoperative and postoperative Nasal Obstruction Symptom Evaluation (NOSE) scores, and long-term TND cessation rates were collected. NOSE score changes were compared between patients with versus without RM. Of the 36 RM patients, mean age was 52.0 years, and 63.9% were male. Of 116 non-RM patients, mean age was 41.6 years, and 46.6% were male. Postoperative NOSE scores were collected at a mean 972.1 days postoperatively for RM patients, and 565.0 days for non-RM patients. Mean NOSE score reductions were - 9.8 for RM and - 8.6 for non-RM patients, both of which were significant (p < 0.0001). NOSE score reductions were not significantlybetween the two groups (p = 0.2438). Long-term TND cessation was maintained in 86.1% of RM patients. Patients with and without RM achieved similar long-term significant NOSE score reductions following nasal obstruction surgery, and 86.1% of RM patients maintained long-term TND cessation. Level 3 evidence Laryngoscope, 2024.