Turbinate Research Articles

Sensitive and Accurate Quantification of Enterovirus-D68 (EV-D68) Viral Loads Using Droplet Digital PCR (ddPCR).

Enterovirus-D68 (EV-D68) is a reemerging virus that has been associated with numerous outbreaks in children in the past 10 years. Most assays examining viral infection kinetics have relied on the use of quantitative RT-PCR (qRT-PCR) assays as an assay of choice. Though valuable, there are inherent limitations that introduce variability, thereby reducing its value when comparing results across the field. Unlike the qRT-PCR assay that uses a standard curve to determine the copy number of viral RNA, the droplet digital PCR assay (ddPCR) directly quantifies the absolute number of copies within a given sample, which in turn makes the assay highly sensitive and accurate. Here, we have developed an EV-D68-specific ddPCR assay that effectively quantifies EV-D68 RNA copies in both cells and supernatants within a dynamic range of 6.7 × 10-3 copies/μL to 1.2 × 104 copies/μL of the sample. The assay was highly specific for a broad range of EV-D68 isolates (Fermon, US/MO/14-18947, US/MO/14-18949, US/KY/14-18953, USA/2018-23088, USA/2020-23336 and EV-D68-infected human nasal turbinate samples from the 2022 outbreak) without cross-reactivity to other viruses such as Enterovirus-A71 (EV-A71), Human Parechovirus (HPeV)-1 and -2, Coxsackievirus (CV)-B1, Human Coronavirus (HCoV)-NL63, SARS-CoV-2, Influenza-A and B, Rhinovirus, and Respiratory Syncytial Virus (RSV)-A2, which are known to cause infection in children. The assay was able to readily quantify EV-D68 in infected cells and supernatants along with nasal turbinate samples collected from children during the 2022 outbreak. Our results suggest that the assay can be readily translated to accurately quantify viral loads in tissues and body fluids such as plasma and lung or nasal aspirates.

Ronapreve (REGN-CoV; casirivimab and imdevimab) reduces the viral burden and alters the pulmonary response to the SARS-CoV-2 Delta variant (B.1.617.2) in K18-hACE2 mice using an experimental design reflective of a treatment use case.

With some exceptions, global policymakers have recommended against the use of existing monoclonal antibodies in COVID-19 due to loss of neutralization of newer variants. The purpose of this study was to investigate the impact of Ronapreve on compartmental viral replication using paradigms for susceptible and insusceptible variants. Virological efficacy and impact on pathogenicity was assessed in K18-hACE2 mice inoculated with either the Delta or BA.1 Omicron variants. Ronapreve reduced sub-genomic viral RNA levels in lung and nasal turbinate, 4 and 6 days post-infection, for the Delta variant but not the Omicron variant. It also blocked brain infection, which is seen with high frequency in K18-hACE2 mice after Delta variant infection. At day 6, the inflammatory response to lung infection with the Delta variant was altered to a multifocal granulomatous inflammation in which the virus appeared to be confined. The current study provides evidence of an altered tissue response to SARS-CoV-2 after treatment with a monoclonal antibody combination that retains neutralization activity. These data demonstrate that experimental designs that reflect treatment use cases are achievable in animal models for monoclonal antibodies. Extreme caution should be taken when interpreting prophylactic experimental designs that may not be representative of treatment.IMPORTANCEFollowing the emergence of the SARS-CoV-2 Omicron variant, the WHO recommended against the use of Ronapreve in its COVID-19 treatment guidelines due to a lack of efficacy based on current pharmacokinetic-pharmacodynamic understanding. However, the continued use of Ronapreve, specifically in vulnerable patients, was advocated by some based on in vitro neutralization data. Here, the virological efficacy of Ronapreve was demonstrated in both the lung and brain compartments using Delta as a paradigm for a susceptible variant. Conversely, a lack of virological efficacy was demonstrated for the Omicron variant. Comparable concentrations of both monoclonal antibodies were observed in the plasma of Delta- and Omicron-infected mice. This study made use of a reliable murine model for SARS-CoV-2 infection, an experimental design reflective of treatment, and demonstrated the utility of this approach when assessing the effectiveness of monoclonal antibodies.

Immunogenicity and Protective Efficacy of a Single Intranasal Dose Vectored Vaccine Based on Sendai Virus (Moscow Strain) against SARS-CoV-2 Variant of Concern.

The mouse paramyxovirus Sendai, which is capable of limited replication in human bronchial epithelial cells without causing disease, is well suited for the development of vector-based intranasal vaccines against respiratory infections, including SARS-CoV-2. Using the Moscow strain of the Sendai virus, we developed a vaccine construct, Sen-Sdelta(M), which expresses the full-length spike (S) protein of the SARS-CoV-2 delta variant. A single intranasal delivery of Sen-Sdelta(M) to Syrian hamsters and BALB/c mice induced high titers of virus-neutralizing antibodies specific to the SARS-CoV-2 delta variant. A significant T-cell response, as determined by IFN-γ ELISpot and ICS methods, was also demonstrated in the mouse model. Mice and hamsters vaccinated with Sen-Sdelta(M) were well protected against SARS-CoV-2 challenge. The viral load in the lungs and nasal turbinates, measured by RT-qPCR and TCID50 assay, decreased dramatically in vaccinated groups. The most prominent effect was revealed in a highly sensitive hamster model, where no tissue samples contained detectable levels of infectious SARS-CoV-2. These results indicate that Sen-Sdelta(M) is a promising candidate as a single-dose intranasal vaccine against SARS-CoV-2, including variants of concern.

Palatal dysgenesis in a feline causing complete obstruction of the nasopharynx: A case report.

The nasopharyngeal disease is common in felines. Nasopharyngeal stenosis is uncommonly a congenital problem, with most cases being secondary to other diseases. An 8-month-old male neutered domestic shorthair presented with a chief complaint of chronic nasal congestion, open-mouth breathing, and discharge. CT was performed, and palatal dysgenesis resulting in complete nasopharyngeal obstruction, secondary nasopharyngitis, and rostral nasal turbinate lysis were found. This was confirmed by an endoscopic evaluation of the nasopharynx region, which demonstrated a lack of connection between the nasopharynx and oropharynx. This is the first CT report documenting congenital palate dysgenesis resulting in complete obstruction of the nasopharynx.

Histopathological and Immunohistochemical Studies of a Spontaneous Case of Pulmonary Adenomatosis in an Adult Ram: A Case Report

Aim: The present study aimed to describe histopathological findings and immunohistochemical expression of proliferating cell nuclear antigen (PCNA) in a spontaneous case of pulmonary adenomatosis in an adult ram. Case Presentation: A carcass of an adult ram was presented for necropsy in the Post-mortem Hall of the Department of Veterinary Pathology, College of Veterinary Sciences of the Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar with a history of respiratory distress. A detailed necropsy was performed. The tracheal mucosa showed mild congestion. The lungs were pale and firm in consistency. On histopathological examination, nasal turbinate and trachea both showed the vascular changes along with mild infiltration of mononuclear cells. The sections of lungs revealed pulmonary adenocarcinoma characterized by the presence of cuboidal to low columnar epithelial cells forming acinar or papillary-like structures in the parenchyma and surrounded by the normal alveoli. Areas of necrosis along with infiltration of mononuclear cells were also evident. An Immunohistochemical study of the lung sections revealed mild to moderate immunopositive reactivity for the PCNA in the nuclei of neoplastic cells of adenocarcinoma. It indicated the proliferative activity of neoplastic cells. Conclusion: Based on histopathological examination, the present case was diagnosed as pulmonary adenomatosis. PCNA expression indicated the presence of actively proliferating neoplastic cells.

A Comparative Study of Outcomes of Submucosal Diathermy Versus Inferior Turbinoplasty in Patients With Deviated Nasal Septum With Inferior Turbinate Hypertrophy.

Introduction Nasal obstruction due to deviated nasal septum (DNS) and inferior turbinate hypertrophy (ITH) is a common problem necessitating surgical intervention. Submucosal diathermy (SMD) and inferior turbinoplasty (IT) are two commonly performed procedures aimed at improving nasal patency. Methods A prospective comparative study was conducted on 56 patients with DNS and inferior turbinate hypertrophy, divided into SMD and inferior turbinoplasty groups. Preoperative and postoperative assessments included symptom assessment using the 22-itemSinonasalOutcomeTest(SNOT-22) questionnaire. Results Both procedures led to significant improvements in nasal symptoms and quality of life. Inferior turbinoplasty showed slightly better outcomes in symptom improvement compared to submucosal diathermy. Conclusions Inferior turbinoplasty appears to offer slightly better outcomes in improving nasal symptoms compared to SMD in patients with DNS and inferior turbinate hypertrophy. However, both procedures are effective and safe options for surgical management. Individualized treatment decisions should consider patient preferences and surgeon expertise.

A Label-Efficient Framework for Automated Sinonasal CT Segmentation in Image-Guided Surgery.

Segmentation, the partitioning of patient imaging into multiple, labeled segments, has several potential clinical benefits but when performed manually is tedious and resource intensive. Automated deep learning (DL)-based segmentation methods can streamline the process. The objective of this study was to evaluate a label-efficient DL pipeline that requires only a small number of annotated scans for semantic segmentation of sinonasal structures in CT scans. Retrospective cohort study. Academic institution. Forty CT scans were used in this study including 16 scans in which the nasal septum (NS), inferior turbinate (IT), maxillary sinus (MS), and optic nerve (ON) were manually annotated using an open-source software. A label-efficient DL framework was used to train jointly on a few manually labeled scans and the remaining unlabeled scans. Quantitative analysis was then performed to obtain the number of annotated scans needed to achieve submillimeter average surface distances (ASDs). Our findings reveal that merely four labeled scans are necessary to achieve median submillimeter ASDs for large sinonasal structures-NS (0.96 mm), IT (0.74 mm), and MS (0.43 mm), whereas eight scans are required for smaller structures-ON (0.80 mm). We have evaluated a label-efficient pipeline for segmentation of sinonasal structures. Empirical results demonstrate that automated DL methods can achieve submillimeter accuracy using a small number of labeled CT scans. Our pipeline has the potential to improve pre-operative planning workflows, robotic- and image-guidance navigation systems, computer-assisted diagnosis, and the construction of statistical shape models to quantify population variations. N/A.

Prosedur Pemeriksaan Dacryocystografi Pada Kasus Dacryosistitis Kronis Di Instalasi Radiologi RSUP. Dr.Wahidin Sudirohusodo Makassar

Dacryocystography examination is the examination of the radiologist to show the nasolacrimal duct by using a positive contrast medium. The purpose of this examination is to describe the system of tear duct blockage and the level of blockage. This research method is descriptive with aproachcase study conducted in RSUP. Dr. WahidinSudirohusodo Makassar on Juni 2019. The inspection technique is done by using the projection Antero Posterior (AP), which contrast material is inserted throught the tear duct in the lacrimal punctum which empties into the concha nasalis inferior. From the result of the examination has been done, it can be concluded that the contrast as much as 1 cc inserted throught the superior lacrimal punctum, contrast restrained and spilled out. Contrast as much as 1 cc inserted throught the inferior lacrimal punctum, the contrast seems to fill out the inferior palpebra area. From the research, lacrimal duct obstruction impression superior and inferior.

Treatment of primary nasal tuberculosis with anti-tumor necrosis factor immunotherapy: A case report

BACKGROUND Primary nasal tuberculosis (TB) is a rare form of extrapulmonary TB, particularly in patients receiving anti-tumor necrosis factor (TNF) immunotherapy. As a result, its diagnosis remains challenging. CASE SUMMARY A 58-year-old male patient presented to the ear, nose, and throat department with right-sided nasal obstruction and bloody discharge for 1 month. He was diagnosed with psoriatic arthritis and received anti-TNF immunotherapy for 3 years prior to presentation. Biopsy findings revealed chronic granulomatous inflammation and a few acid-fast bacilli, suggestive of primary nasal TB. He was referred to our TB management department for treatment with oral anti-TB agents. After 9 months, the nasal lesions had disappeared. No recurrence was noted during follow-up. CONCLUSION The diagnosis of primary nasal TB should be considered in patients receiving TNF antagonists who exhibit thickening and crusting of the nasal septum mucosa or inferior turbinate, particularly when pathological findings suggest granulomatous inflammation.

Barcoded SARS-CoV-2 viruses define the impact of time and route of transmission on the transmission bottleneck in a Syrian hamster model.

The transmission bottleneck, defined as the number of viruses that transmit from one host to infect another, is an important determinant of the rate of virus evolution and the level of immunity required to protect against virus transmission. Despite its importance, SARS-CoV-2's transmission bottleneck remains poorly characterized, in part due to a lack of quantitative measurement tools. To address this, we adapted a SARS-CoV-2 reverse genetics system to generate a pool of >200 isogenic SARS-CoV-2 viruses harboring specific 6-nucleotide barcodes inserted in ORF10, a non-translated ORF. We directly inoculated donor Syrian hamsters intranasally with this barcoded virus pool and exposed a paired naïve contact hamster to each donor. Following exposure, the nasal turbinates, trachea, and lungs were collected, viral titers were measured, and the number of barcodes in each tissue were enumerated to quantify the transmission bottleneck. The duration and route (airborne, direct contact, and fomite) of exposure were varied to assess their impact on the transmission bottleneck. In airborne-exposed hamsters, the transmission bottleneck increased with longer exposure durations. We found that direct contact exposure produced the largest transmission bottleneck (average 27 BCs), followed by airborne exposure (average 16 BCs) then fomite exposure (average 8 BCs). Interestingly, we detected unique BCs in both the upper and lower respiratory tract of contact animals from all routes of exposure, suggesting that SARS-CoV-2 can directly infect hamster lungs. Altogether, these findings highlight the utility of barcoded viruses as tools to rigorously study virus transmission. In the future, barcoded SARS-CoV-2 will strengthen studies of immune factors that influence virus transmission.

Human parainfluenza virus 3 vaccine candidates attenuated by codon-pair deoptimization are immunogenic and protective in hamsters

Human parainfluenza virus type 3 (HPIV3) is a major pediatric respiratory pathogen lacking available vaccines or antiviral drugs. We generated live-attenuated HPIV3 vaccine candidates by codon-pair deoptimization (CPD). HPIV3 open reading frames (ORFs) encoding the nucleoprotein (N), phosphoprotein (P), matrix (M), fusion (F), hemagglutinin-neuraminidase (HN), and polymerase (L) were modified singly or in combination to generate 12 viruses designated Min-N, Min-P, Min-M, Min-FHN, Min-L, Min-NP, Min-NPM, Min-NPL, Min-PM, Min-PFHN, Min-MFHN, and Min-PMFHN. CPD of N or L severely reduced growth in vitro and was not further evaluated. CPD of P or M was associated with increased and decreased interferon (IFN) response in vitro, respectively, but had little effect on virus replication. In Vero cells, CPD of F and HN delayed virus replication, but final titers were comparable to wild-type (wt) HPIV3. In human lung epithelial A549 cells, CPD F and HN induced a stronger IFN response, viral titers were reduced 100-fold, and the expression of F and HN proteins was significantly reduced without affecting N or P or the relative packaging of proteins into virions. Following intranasal infection in hamsters, replication in the nasal turbinates and lungs tended to be the most reduced for viruses bearing CPD F and HN, with maximum reductions of approximately 10-fold. Despite decreased in vivo replication (and lower expression of CPD F and HN in vitro), all viruses induced titers of serum HPIV3-neutralizing antibodies similar to wt and provided complete protection against HPIV3 challenge. In summary, CPD of HPIV3 yielded promising vaccine candidates suitable for further development.

Continued evolution of H10N3 influenza virus with adaptive mutations poses an increased threat to mammals

The H10 subtype avian influenza virus (AIV) poses an ongoing threat to both birds and humans. Notably, fatal human cases of H10N3 and H10N8 infections have drawn public attention. In 2022, we isolated two H10N3 viruses (A/chicken/Shandong/0101/2022 and A/chicken/Shandong/0603/2022) from diseased chickens in China. Genome analysis revealed that these viruses were genetically associated with human-origin H10N3 virus, with internal genes originating from local H9N2 viruses. Compared to the H10N8 virus (A/chicken/Jiangxi/102/2013), the H10N3 viruses exhibited enhanced thermostability, increased viral release from erythrocytes, and accumulation of hemagglutinin (HA) protein. Additionally, we evaluated the pathogenicity of both H10N3 and H10N8 viruses in mice. We found that viral titers could be detected in the lungs and nasal turbinates of mice infected with the two H10N3 viruses, whereas H10N8 virus titers were detectable in the lungs and brains of mice. Notably, the proportion of double HA Q222R and G228S mutations in H10N3 viruses has increased since 2019. However, the functional roles of the Q222R and G228S double mutations in the HA gene of H10N3 viruses remain unknown and warrant further investigation. Our study highlights the potential public health risk posed by the H10N3 virus. A spillover event of AIV to humans could be a foretaste of a looming pandemic. Therefore, it is imperative to continuously monitor the evolution of the H10N3 influenza virus to ensure targeted prevention and control measures against influenza outbreaks.

Sinonasal chondrosarcoma in a llama.

A 14-y-old intact female llama (Lama glama) was presented for evaluation of a right maxillary swelling of 3-mo duration. Clinically, the animal had mild nasal discharge, abnormal retropulsion of the right eye, and moderate gingival disease. An incisional biopsy of the maxillary mass revealed pleomorphic and mitotically active neoplastic spindle-to-stellate cells organized in haphazard lacunae embedded in abundant chondroid matrix. Given the poor prognosis, euthanasia was elected. Postmortem examination and sectioning of the head exposed a large solid, white, firm mass that vastly expanded the right infraorbital region, extending to the maxilla, effacing the right nasal conchae and ipsilateral zygomatic bone. Collectively, postmortem dissection, cytology, and histopathology of the primary mass supported a diagnosis of sinonasal chondrosarcoma. To our knowledge, this entity had not been reported previously in this species and should be considered a differential for facial deformities in New World camelids.

Tissue specific stem cell therapy for airway regeneration.

Secondary atrophic rhinitis (AR), a consequence of mucosal damage during nasal surgeries, significantly impairs patient quality of life. The lack of effective, lasting treatments underscores the need for alternative therapeutic strategies. A major impediment in advancing research is the scarcity of studies focused on secondary AR. Our study addresses this gap by developing an animal model that closely mirrors the histopathological changes observed in patients with secondary AR. These changes include squamous metaplasia, goblet cell hyperplasia, submucosal fibrosis, and glandular atrophy. Upon administering human nasal turbinate stem cells embedded in collagen type I hydrogel in these models, we observed ciliary regeneration. This finding suggests the potential therapeutic benefit of this approach. Our animal models not only emulate the clinical manifestations of secondary AR but also serve as valuable tools for evaluating the efficacy of cell-based biotechnological interventions.

Prevalence of nasopharyngeal myiasis in roe deer (Capreolus capreolus) from an area with high sympatry between wild and domestic ungulates in Central Spain

Infestation by the sheep bot fly Oestrus ovis was firstly reported in a single roe deer from Central Spain in 2022. For assessing the current situation of nasal myiases in this ungulate in this area, the nasopharyngeal cavities of 184 roe deer hunted in Central Spain between January-June 2023 were examined. All larvae were recovered and morphologically identified; in addition, species identification was molecularly confirmed in a subset of specimens. Forty-four roe deer (23.9%; CI 95 17.95–30.74) were positive for different Oestrinae larval stages. Twenty-six animals (14.1%; CI 95 9.44–20.02%) were infested by the roe deer nasal bot fly (Cephenemyia stimulator) with a mean intensity of 35.2 (SD 49.71) larvae/infested animal, and eighteen (9.8%; CI 95 5.90-15.02%) roe deer harboured the sheep bot fly (O. ovis), with a mean intensity of 2.0 (SD 1.33) larvae/infested animal. No mixed infestations by both Oestrinae were found in a single animal. All larval instars (L1, L2 and L3) of both species were identified. Most C. stimulator specimens were located at the nasal turbinates, and a small percentage (3.2%) at the pharynx; all O. ovis larvae were found at the nasal turbinates. Since O. ovis is highly prevalent in sheep and goat flocks from Central Spain, the high sympatry between roe deer and small ruminant populations in the studied area may have increased the risk of cross-infection. Moreover, the finding of mature L3 of O. ovis suggests that this species can complete its life cycle in roe deer. Therefore, monitoring bot flies in sheep and goat flocks as well as in sympatric wild ruminants is strongly recommended for achieving an optimum control of nasal myiases.

Topical Anesthesia Versus Submucosal Injection for Radiofrequency Turbinoplasty: Same Benefit but without Patient's Pain. A Comparative Study.

This study aimed at comparing the anesthetic efficacy of lidocaine injection versus pledgets soaked in lidocaine and epinephrine during radiosurgery of inferior turbinates. The study prospectively enrolled 120 outbound patients, who were randomly assigned to group 1 -anaesthesia with tampon soaked in lidocaine and adrenaline- or group 2 -anesthesia with tampon followed by lidocaine and adrenaline injection. The following parameters were evaluated by a visual analogue scale 1h after surgery: pain, anxiety, chocking sensation and difficulty swallowing. Nasal obstruction, rhinorrhea, sneezing, headache and inferior turbinate size were evaluated preoperatively (T0), after 1 (T1), 2 (T2) and 3 months (T3) to surgery. The data collected were analyzed by statistic tests. Group 1 showed lesser pain than group 2 during the procedure (p < 0.01); no statistically significant differences were observed for anxiety, chocking sensation and difficulty swallowing. All patients, independently from the belonging group, significantly improved the nasal symptoms comparing T0 and T1 (p < 0.01), T2 (p < 0.01) and T3 (p < 0.01), without statistically significant differences among the groups. Radiofrequency turbinoplasty allowed to all patients to reduce the turbinates hypertrophy. Local anaesthesia with tampon allowed to obtain the same results the injective anaesthesia in term of surgical outcomes; the use of tampon allowed patients did not experience pain.

CXCL8 Knockout: A Key to Resisting Pasteurella multocida Toxin-Induced Cytotoxicity.

Pasteurella multocida, a zoonotic pathogen that produces a 146-kDa modular toxin (PMT), causes progressive atrophic rhinitis with severe turbinate bone degradation in pigs. However, its mechanism of cytotoxicity remains unclear. In this study, we expressed PMT, purified it in a prokaryotic expression system, and found that it killed PK15 cells. The host factor CXCL8 was significantly upregulated among the differentially expressed genes in a transcriptome sequencing analysis and qPCR verification. We constructed a CXCL8-knockout cell line with a CRISPR/Cas9 system and found that CXCL8 knockout significantly increased resistance to PMT-induced cell apoptosis. CXCL8 knockout impaired the cleavage efficiency of apoptosis-related proteins, including Caspase3, Caspase8, and PARP1, as demonstrated with Western blot. In conclusion, these findings establish that CXCL8 facilitates PMT-induced PK15 cell death, which involves apoptotic pathways; this observation documents that CXCL8 plays a key role in PMT-induced PK15 cell death.

A murine model of DC-SIGN humanization exhibits increased susceptibility against SARS-CoV-2

To generate a new murine model for virus, DC-SIGN gene in murine was humanized. In this study, we successfully generated a humanized C57BL/6N mouse model expressing human DC-SIGN (hDC-SIGN) using CRISPR/Cas9 technology, and evaluated its characters and susceptibility to virus. The humanized mice could survival as usual, and with normal physiological index just like the wild-type mice. Whereas, we found significant differences in the intestinal flora and metabolic profiles between wild-type mice and humanized mice. Following intranasal infection with SARS-CoV-2, hDC-SIGN mice exhibited significantly increased viral loads in the lungs and nasal turbinates, along with more severe lung damage. This phenomenon may be associated with differential lipid metabolism and Fcγ receptor-mediated phagocytosis in two mouse models. This study provides a useful tool for investigating the mechanisms of coronavirus infection and potential drug therapies against novel coronavirus.

Expression of serotonergic (5HT) receptors in patients with chronic rhinosinusitis with nasal polyposis and in normal nasal mucosa

Expression of serotonergic (5HT) receptors in patients with chronic rhinosinusitis with nasal polyposis and in normal nasal mucosa: a case-control study.Background Chronic rhinosinusitis with nasal polyposis is one of the challenging conditions regarding treatment and management. Many recent studies introduced new modalities for treatment like targeted immunomodulating drugs rather than antihistamines, local and systemic steroids, and endoscopic sinus surgery. Understanding the pathology behind the disease by studying its immunologic pathways and substances that take part in the inflammatory process can help in the introduction of new treatment options that can improve outcomes and decrease the costs of treatment.Objective The aim of our study is to demonstrate the presence of 5-HT receptors in nasal polyps and inferior turbinate mucosa in patients with chronic rhinosinusitis with nasal polyposis and then compare this expression of 5-HT receptors with inferior turbinate mucosa of the normal control group.Methods A case-control study was conducted on 80 patients. Specimens from nasal polypi and turbinate mucosa of patients with chronic rhinosinusitis (cases) and specimens from normal turbinate mucosa (controls) were stained with serotonin receptor Immunohistochemical staining by automated immunostainer in the pathology department laboratory in Ain Shams University Hospital with ratio 1:200–400 as recommended by the manufacturing company. Then, compared as regards stain distribution and intensity of mucosal lining, glands, and blood vessels.Results There was a significant difference between polyp cases and controls as regards lining epithelium and mucosal gland stain distribution and stain intensity. Also significant difference between the polyp cases and controls as regards blood vessel strain distribution. However, no significant difference was found as regards blood vessel stain intensity. There was a significant difference between turbinate cases and controls as regards lining epithelium stain distribution, and stain intensity. There was no significant difference between turbinate cases and controls as regards gland stain distribution. However, a significant difference was found between turbinate and controls as regards gland stain intensity. There was a significant difference between turbinate cases and controls as regards blood vessel stain distribution; however, no significant difference was present as regards stain intensity. There was no significant difference between polyp and turbinate cases as regards lining epithelium and blood vessel stain distribution and stain intensity. There was no significant difference between polyp and turbinate cases as regards gland stain distribution; however, a highly significant difference between polyp and turbinate cases as regards gland stain intensity.Conclusion Serotonin receptors are highly expressed in patients with chronic rhinosinusitis with nasal polyposis in both turbinate and polypoidal tissues which proves that serotonin has a strong role in the formation and growth of nasal polypi and allergic reactions. Hence serotonin modulating drugs can be studied as a new therapy for chronic rhinosinusitis with nasal polyposis.

Effects of decongestion on nasal cavity air conditioning efficiency: a CFD cohort study

Decongestion reduces blood flow in the nasal turbinates, enlarging the airway lumen. Although the enlarged airspace reduces the trans-nasal inspiratory pressure drop, symptoms of nasal obstruction may relate to nasal cavity air-conditioning. Thus, it is necessary to quantify the efficiency of nasal cavity conditioning of the inhaled air. This study quantifies both overall and regional nasal air-conditioning in a cohort of 10 healthy subjects using computational fluid dynamics simulations before and after nasal decongestion. The 3D virtual geometry model was segmented from magnetic resonance images (MRI). Each subject was under two MRI acquisitions before and after the decongestion condition. The effects of decongestion on nasal cavity air conditioning efficiency were modelled at two inspiratory flowrates: 15 and 30 L min−1 to represent restful and light exercise conditions. Results show inhaled air was both heated and humidified up to 90% of alveolar conditions at the posterior septum. The air-conditioning efficiency of the nasal cavity remained nearly constant between nostril and posterior septum but dropped significantly after posterior septum. In summary, nasal cavity decongestion not only reduces inhaled air added heat by 23% and added moisture content by 19%, but also reduces the air-conditioning efficiency by 35% on average.