Paranasal Sinuses In Patients Research Articles

Clinical and microbiological peculiarities of nose pathology and paranasal sinuses in patients with non-hospital pneumonia.

This article presents the results of a comprehensive otorhinolaryngological and microbiological study of diseases of the nose and paranasal sinuses in patients with community-acquired pneumonia. These diseases are closely interconnected, since the upper and lower respiratory tract are a single whole, have structures and functions and mechanisms for the development of pathological conditions. The etiopathogenesis of bacterial inflammatory diseases of the upper and lower respiratory tract is based on the violation of the integrity of epithelial cells under the influence of respiratory viruses. Under the influence of the general toxic effect of the virus, phagocytosis is inhibited, immunological protection is disrupted, as a result, favorable conditions are created for microbial colonization in the nasopharynx and the further spread of infections to the paranasal sinuses and lower respiratory tract. As a result of a clinical and microbiological study, it was revealed that in community-acquired pneumonia, inflammatory diseases of the nose and paranasal sinuses such as acute and chronic rhinosinusitis, allergic and vasomotor rhinitis, curvature of the nasal septum were often encountered. To determine the nature of the microbial landsURTe of the upper and lower respiratory tract, a comparative microbiological analysis was performed from the nose and sputum. Analyzes showed that there was no significant difference in pathogenic microflora between the upper and lower respiratory tract. The main pathogen in both diseases was Streptococcus pneumoniae. Correspondence of the pathogenic microflora of the nasal cavity and lower respiratory tract when rhinosinusitis is detected in patients with community-acquired pneumonia confirms the pathogenetic relationship of inflammatory processes in these organs, as well as the need for parallel diagnosis, treatment, prevention.

Peculiarities of the chemical composition of fungal bodies of the paranasal sinuses

Introduction: The significance of fungal microflora in the development of chronic rhinosinusitis tends to increase. The purpose of the study: We had studied the chemical composition of fungal bodies of odontogenic and nonodontogenic origin to determine the relationship between fungal sinusitis and previous endodontic treatment. Methods and materials: The 7 samples of the most common dental endodontic materials and 32 fungal ball removed from the paranasal sinuses in patients were examined by electron microscopy and masspectrometry: 22 of them were from the maxillary sinus in persons with a probable odontogenic cause of the disease (group 1), and 10 with the exception of odontogenic factor – 5 from the maxillary sinus - group 2 and 5 - from the sphenoid - group 3). The resultsand disscusion: In areas with high radiation density of fungal balls, its level in group 1 was 1173.6 ± 257.9 HU, groups 2 and 3 - 283.2 ± 21.8 HU and 262.6 ± 3 HU, and the radiation density from the samples with base it’s level in all groups did not differ among them and was from 50.1 to 55.0 HU. It was found that in all samples dental materials there was a content of Zn with a mass fraction from 0.71 ± 0.42% to 85.51 ± 0.05%. When analyzing the structure of fragments of fungal balls from areas with a base level of radiation density in patients of all three groups, its homogeneity and absence of crystalline inclusions were noted. In contrast, in fragments of fungal ball from areas of high radiation density there where a significant number of crystals in individuals with established odontogenic factor (group 1) and their absence in the material of groups 2 and 3. In the composition of samples of fungal balls from areas with high radiation density, it was found that in group №1 in 10 samples (45.45%) showed a significant content of Zinc (average mass fraction - 23.71 ± 4.45%), and Calcium was found in 40.9% of the samples at the level of 3.8 ± 1.33%. The chemical composition of areas of fungal bodies with high radiation density in individuals with excluded odontogenic factor (group 2 and group 3) was similar and was characterized by the presence of high level of Calcium from areas with increased radiation density of 24.38 ± 6.22%, and 22.04 ± 5,72%, while the background (group 2 - 1.26 ± 0.33%, group 3 –0.90 ± 0.34%). Zinc and other chemical elements - markers of dental materials in groups 2 and 3 were not detected. Conclusions: All dental materials we examined contain Zn and chemical elements are not characteristic of tissues of biological origin (Ba, Zr, W, Co and Ti), the content of which may cause increased radiological density of the tissue of the fungal ball. Elevated Zn and Ca content was detected in 45.45% and 40.9% of samples of fungal ball of odontogenic origin, and in almost all samples of fungal ball of neodontogenic origin, regardless of the location of the sinus (maxillary or sphenoidal), Ca was detected, which allows to predict the absorption of these chemicals. elements from the tissues surrounding the fungal body, as the main mechanism of their accumulation in concentrations that cause the formation of areas of high radiation density.

Mucormycosis of the bones of the facial skull, nasal cavity and par anasal sinuses in patients with COVID19

Abstract Currently, the relevance of the issues of diagnosis and treatment of invasive fungal diseases has increased significantly due to the pandemic of a new coronavirus infection COVID-19 and the massive use of corticosteroids for the treatment. The key success factors in the outcome of invasive fungal diseases are early diagnosis and treatment, including the applying of an adequate systemic antifungal therapy and surgical treatment. Extensive areas of mycotic lesions of the facial bones and paranasal sinuses are lifethreatening conditions due to anatomical proximity to brain structures and a high risk of dissemination of I invasive fungal diseases with a fatal outcome. The objective of this work was to study the risk factors, possible pathogenesis, diagnosis and treatment strategy of invasive fungal diseases of the orofacial region in convalescents of COVID-19. We present case-series data on six patients in the clinics of maxillofacial surgery and otorhinolaryngology of the Pavlov First Saint Petersburg State Medical University over the period of 2021–2022. Predisposing factors, clinical and radiological symptoms, features of diagnosis, therapy and surgical strategy were analyzed. The presented observations confirm the relevance and danger of complications after a COVID-19 in the form of the development of invasive fungal diseases with damage to the maxillofacial region caused by mucormycetes and Aspergillus spp., as well as importance of early diagnosis and treatment.

Структурная перестройка слизистой оболочки полости носа и околоносовых пазух у больных с полипозным риносинуситом по данным цитологического и гистологического исследования

Aim: to study the morphological patterns of polypous tissue according to cytology and histology. Pateints and methods: 78 patients with a confirmed diagnosis of polypoid rhinosinusitis (PRS) were selected for the study, including 50 men and 28 women aged 25 to 74 years. The material for cytology was scraped from the surface of nasal cavity and paranasal sinus (PNS) polyps, as well as touch smears from the cut surface of removed polyps, and the material for histology was pieces of removed polypous tissue. Results: in the course of the study, the following comparative analysis of the obtained results was made: a) with polyps with a fibrous component in touch smears, there are expressed signs of chronic inflammation along with signs of respiratory epithelial cells proliferation; b) edematous and myxoid polyps are commonly combined with an allergic condition; c) analysis of cytomorphological signs of the respiratory epithelium of the nasal cavity and PNS in PRS indicates a structural alteration of the mucous membrane in this disease. The epithelial proliferation is associated with the activation of stroma components — fibroblasts and leukocytes. At the light-optical level, the characteristics of compensatory and adaptive changes that contribute to the morphofunctional cell unity preservation of the mucous membrane that counteract the pathological process are revealed. Conclusions: according to the method of sampling material for cytology, the most informative are touch smears from the cut surface of the removed polyp, which help to identify more morphological patterns of the polypous tissue. The analysis of cytomorphological features of the respiratory epithelium of the nasal cavity and PNS in PRS indicates the remodeling of the mucous membrane in this disease. The epithelial proliferation is associated with the activation of stroma components — fibroblasts and leukocytes. At the light-optical level, the characteristics of compensatory and adaptive changes that contribute to the morphofunctional cell unity preservation of the mucous membrane that counteract the pathological process are revealed. The obtained results will help to understand the mechanisms of structural and functional alteration in the nasal mucosa and PNS in PRS. KEYWORDS: polypoid rhinosinusitis, cytology, histology, paranasal sinuses, smears, fibroblasts, eosinophils, leukocytes, respiratory epithelium. FOR CITATION: Zakharova N.M., Shabalova I.P., Egorov V.I. et al. Structural reconstruction of the nasal mucosa and paranasal sinuses in patients with polypous rhinosinusitis according to cytological and histological studies. Russian Medical Inquiry. 2021;5(7): 479–485 (in Russ.). DOI: 10.32364/2587-6821-2021-5-7-479-485.

Role of topical antibacterial therapy in patients with cystic fibrosis

Assess the efficacy of topical antibacterial therapy in adult cystic fibrosis patients after surgery on nasal cavity structures and paranasal sinuses. In the clinic for ear, nose and throat diseases at Sechenov University, 46 adult patients with cystic fibrosis and chronic rhinosinusitis were observed; all patients underwent extended endoscopic polysinusotomy. According to clinical studies, Isofra nasal spray is highly effective and safe in the treatment of patients with infectious diseases of the nasal cavity, nasopharynx and paranasal sinuses. The use of Isofra nasal spray (the active ingredient is framycetin sulfate) in our clinic in patients with cystic fibrosis against the background of basic therapy (inhalation with bronchodilators and mucolytics, intranasal topical steroids), had a positive effect on the microbial landscape in the nasal cavity in patients with cystic fibrosis in the postoperative period and allowed to reduce the need for the appointment of systemic antibacterial drugs.

Bacterial Flora of the Nose and Paranasal Sinuses Among Patients Over 65 Years Old with Chronic Rhinosinusitis Who Underwent Endoscopic Sinus Surgery.

PurposeChronic rhinosinusitis (CRS) is one of the most common chronic diseases in the geriatric population. However, CRS inflammatory mechanisms in older people have not been thoroughly investigated. Our work aimed to analyze the bacterial flora of the nose and paranasal sinuses in patients with CRS over 65 years of age, including comorbidities, previously performed endoscopic sinus surgery (ESS), presence or absence of polyps and the extent of the inflammatory process.Patients and MethodsThe study involved 529 patients between 18 and 84 years of age with chronic rhinosinusitis who underwent endoscopic sinus surgery. There were 101 patients separated over 65 years of age (M = 52, K = 49, mean age 69 ± 0.7 years). The control group consisted of 168 patients aged 18–40 years with CRS. The bacterial culture of material collected from the patients during ESS was analyzed.ResultsIn the group of patients over 65 years of age, more frequent occurrence of Proteus spp. and Pseudomonas aeruginosa was found in comparison to younger patients. In older patients with bronchial asthma, the occurrence of S. aureus, Escherichia coli, and Citrobacter spp. was more frequent than in control group. Multiple sinus surgical procedures in older patients were associated with the dominance of Staphylococcus aureus and Escherichia coli, which was not demonstrated in the control group. There were no statistically significant differences between the occurrence of bacterial strain and the presence of polyps, both in the group of patients over 65 years of age as well as in the control group.ConclusionThe bacterial flora of patients with CRS is different in older and younger patients. A different therapeutic approach should be considered in older patients with CRS, but this problem requires further studies.

Normal Anatomical Variants of the Paranasal Sinuses at Computed Tomography Scanning

Background: Recognition of PNS (Paranasal sinus) anatomic variants is particularly important in preoperative workup of patients with sinonasal pathology. CT (computed tomography) scanning can give exquisite details on sinus anatomy and pathology and is the main modality used to image the paranasal sinuses so the aim of the study isto evaluate certain anatomic variants of the paranasal sinuses in patients referred to the CT unit in Al-Immamain Al-Kadhymain Medical City. Patients and Method: We retrospectively analyzed the CT scans of the paranasal sinuses for patients referred to the CT unit in Al-Immamain Al-Kadhymain Medical City/Baghdad, Iraq for a period of 12 months . All the patients included in the study underwent standard CT scan of the PNS. Results: A net sample size of 188 was analyzed by the current study. Female: Male ration was (1.26:1).The incidence of septal deviation in the study sample was (51.06%) slightly more cases were deviated to the right (51.4%) than to the left (48.95%).Paradoxical middle turbinate’s were observed in(18.6%), middle turbinate aeration was observed in (58.5%) on the right and (53.1%) on the left. The incidence of variant air cells were as follows: Onodi (24.4%), Haller (11.1%), and Aggernasi (87.7%). Conclusion:The percent of most of the anatomical variants in our study sample was approximate to the percent published in the literature with the most common anatomic variants encountered being septal deviation followed by aerated middle turbinate’s whether unilateral or bilateral. The most frequent air cell was Aggernasi present in 87.7%.

Лечение больных хроническим риносинуситом в условиях санатория и меры профилактики

The objective of the research is to study of clinical and functional disorders of the nasal mucosa and paranasal sinuses of patients with chronic rhino sinusitis, as well as to make the choice of the optimal treatment method in a sanatorium using natural factors. A survey of 145 patients (94 men and 51 women) with chronic rhinosinusitis at the age of 18 to 65 years was conducted. Of these, male accounted for 64.8%, female – 35.2%. In patients with pathology of the paranasal sinuses, functional disorders of the nasal mucosa and paranasal sinuses were revealed. Particularly, violations of mucociliary clearance, acid-base balance of the nasal mucosa, and a decrease in nasal patency according to the data of active anterior rhinomanometry were defined. The use of natural factors as a treatment: inhalation of natural mineral water Maibalyk and mud applications on the paranasal sinus area significantly improved the course of way of chronic rhinosinusitis and led to normalization of the functional parameters of the nasal mucosa, in contrast to the comparison group (60 people). The comparison group did not use with Maibalyk natural water inhalations and mud applications from Lake Maybalyk, but used only ordinary alkaline inhalations.

Computed Tomographic Findings of Nasal and Paranasal Sinuses in Patients Scheduled for Rhinoplasty in Shahid Mostafa Khomeini Hospital during 2011-13

Objective: Rhinoplasty is done to improve the morphology of the nose whilst also restoring its physiological function. Currently it is possible to perform rhinoplasty and endoscopic sinus surgery simultaneously. The need has therefore arisen to evaluate anatomical variation within the nose and paranasal sinuses in symptom-free patients who are scheduled for rhinoplasty. Coronal computed tomography (CT) is the standard method used to evaluate the nose and paranasal sinuses. We aimed to evaluate the frequency of anatomical variation noted within the nose and paranasal sinuses on coronal CT in patients scheduled for rhinoplasty. Methods: This is a descriptive, cross-sectional, retrospective study of CT findings in 84 patients who underwent rhinoplasty at Mostafa Khomeini Hospital, Shahed University, Tehran between 2011-13. The CT findings were evaluated in three different predefined categories: nasal septal, nasal turbinate, and paranasal sinuses abnormalities. Results: The study involved 84 individuals, consisting of 26 men and 58 women. The most frequent findings in the nasal septum category were nasal septal deviation (69.04%) and nasal septal spur (33.33%), whereas concha bullosa (45.23%) and inferior turbinate hypertrophy were the most frequent abnormality in the nasal turbinates category. Mucosal thickening of the sinuses (45.23%) and partial opacification of the sinuses (21.42%) were the most common findings in the paranasal sinuses. Conclusion: The high frequency of anatomical variation, inflammatory and congenital abnormal findings in CT images of the paranasal sinuses in patients scheduled for rhinoplasty indicates that preoperative CT examination may be useful in avoiding multiple surgical operations and in reducing costs.

Some Features of Clinical Laboratory and Instrumental Research in Chronic Inflammatory Diseases of the Nose and Paranasal Sinuses in Patients with Myocarditis

The issues of diagnosis and adequate treatment of rhinosinusitis (RS) remain very relevant today, since this disease is one of the most widespread in the whole world. So, up to 15% of the adult population suffers from various forms of RS; in children this disease is even more common. Otorhinolaryngologists and primary care physicians face RS in their practice on a daily basis. It should be noted that in most European countries and in America, it is the general practitioner who plays the main role in the treatment of uncomplicated forms of the disease. It is important to note that both acute and chronic RS lead to a significant decrease in the quality of life index, comparable with data on cardiological diseases and obstructive pulmonary disease.

Sphenoid sinus development in patients with acquired middle ear cholesteatoma

ObjectiveIn this study, we examine the relationship between developmental insufficiency of mastoid air cells and abnormal morphology of the paranasal sinuses in patients with chronic otitis media (COM) and acquired middle ear cholesteatoma (AMEC) using precise image assessment, in order to evaluate whether the anatomical features of paranasal sinuses has any impact on the pathogenesis in COM and AMEC. MethodsA total of 127 patients, including 45 COM patients and 82 AMEC patients, were enrolled for this study. The existence of nasal septal deviation, the existence of paranasal sinus opacification, the modified Lund–Mackay score, the diameters of the paranasal sinuses, the Vidic classification, mastoid development, and cranial size were assessed by CT examination. A further 76 adult patients who underwent high-resolution CT imaging of their skull bone for other diseases were enrolled as the control. ResultsThe AMEC group showed a significantly shorter sphenoid length (P < 0.01) and lower Vidic classification score (P < 0.01) compared to the control group in this study. In addition, we observed that patients with AMEC had less pneumatization of the mastoid air cells compared to the control individuals, and that the sphenoid length of the poor MC score group was significantly shorter than that of the good MC score group. ConclusionOur results suggested that the developmental deficiency in sphenoid length caused by long-standing pediatric rhinosinusitis might indicate the potential of chronic middle ear inflammation in childhood and impact the pneumatization of mastoid air cells. Therefore, chronic rhinosinusitis during the childhood and adolescence might play a role in the pathophysiology of AMEC.

Pengaruh Cuci Hidung dengan NaCl 0,9% Terhadap Ekspresi Gen IL-1Beta dan TNF-Alpha Mukosa Hidung Penderita Rinosinusitis Kronis di RSUP Dr M Djamil Padang

Chronic rhinosinusitis is an inflammatory disease of the nasal mucosa and paranasal sinuses which produces several proinflammatory cytokines including; IFN-γ, TGF-β1, IL-1β, IL-3, IL-6, IL-8, TNF-α, IL-5. The use of NaCl 0.9% nasal wash in chronic rhinosinusitis could reduce mucin secretion, decrease the production of postnasal drip, accelerate mucosal repair and reduce the symptoms of nasal obstruction. From above, researchers want to know the effect of NaCl 0.9% nasal wash of the levels of cytokines IL-1β and TNF-α in the mucosa of the nose and paranasal sinuses in patients with chronic rhinosinusitis. This research is an experimental study with the technique of pre and post test design to determine the effect of NaCl 0.9% nasal wash of the gene expression of IL-1β and TNF-α of nasal mucosa of patients with chronic rhinosinusitis. The amount of IL-1β gene copynumber before and after nasal wash is obtained 8.07 ± 0.95 and 8,20 ± 0.93 (p &gt;0.05). The amount of TNF-α gene copynumber before and after nasal wash was 8,83 ±3,83 and 6,72 ±2,55 (p &gt;0.05). IL-1β gene ratio starting and ending intervention in two groups was 52,51 ± 1.21 and 61,99 ± 1.13. TNF-α gene ratio starting and ending intervention in two groups was 9,63 ±2.21 and 334,4 ±1.31. In this study there was no significant reduction in the absolute expression (log copynumber) gene IL-1β and TNF-α of nasal mucosa after being given medical treatment with NaCl 0,9% nasal wash.

The Effect of Antileukotrienes on the Results of Postoperative Treatment of Paranasal Sinuses in Patients with Non-Steroidal Anti-Inflammatory Drug-Exacerbated Respiratory Disease

Background: Based on endoscopic examination, chronic rhinosinusitis (CRS) is divided into chronic inflammation with (CRSwNP) or without nasal polyps (CRSsNP). On the basis of the pathomechanism of inflammation, CRS is divided into endotypes. Eosinophilic CRSwNP with coexisting bronchial asthma and hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) is a real therapeutic challenge. Aim: Comparative analysis of the results of treatment of patients with CRSwNP, bronchial asthma, or hypersensitivity to NSAIDs (NSAID-exacerbated respiratory disease, NERD), using antileukotrienes (leukotriene receptor antagonists, LTRAs) or intranasal glucocorticoids or both drugs together after endoscopic sinus surgery (ESS). Material and Methods: 33 patients (11 male, 33%) with NERD divided into three groups treated with LTRAs or intranasal glucocorticoids or both drugs together were assessed in terms of general well-being, state of pathological changes, and olfactory disorders using the following tools: Sino-Nasal Outcome Test, Visual Analogue Scale, Brief Identification Smell Test, and Lund-Kennedy score before and at 12 months after surgery. CT assessments were made prior to surgery using the Lund-MacKay scale. Results: Comparable efficacy of treatment with nasal steroids and antileukotrienes was found after 12 months of observation of patients. Conclusions: The results suggest comparable efficacy of treatment with nasal steroids and antileukotrienes in patients with NERD after ESS. Treatment with montelukast and mometasone has not been shown to be superior to both drugs administered separately.

The Analysis of Computed Tomography of Paranasal Sinuses in Nasal Septal Deviation.

Anatomic variations of paranasal sinuses are frequent among population that should be analyzed and interpreted accurately. The purpose of this study is to analyze anatomical variants and their relationships of paranasal sinuses in patients with nasal septal deviation undergoing septoplasty. A total number of 150 patients (74 males, 76 females) with nasal septal deviation undergoing septal surgery were included in this retrospective study. The authors analyzed the direction and the angle of the nasal septal deviation, variations of the nasal turbinates, ethmoidal air cells, paranasal sinus pneumatization, accessory pneumatization of the paranasal complex and sphenoid sinus-related structures and the Keros, optic nerve and Vidian canal classification, and relationships between these structures in the paranasal computed tomography of the patients. The incidence of concha bullosa, Onodi cell, and anterior clinoid pneumatization were higher in patients with nasal septal deviation when compared with current literature. Physicians and surgeons dealing with the nose and maxillofacial region should be able to analyze paranasal computed tomography by themselves and must be aware of these variations during performing septal and craniomaxillofacial surgery.

Anatomical variants of the paranasal sinuses in patients with mid-facial segment pain: Our experience of a cohort of twenty-three patients.

Anatomical variants of the paranasal sinuses in patients with mid-facial segment pain: Our experience of a cohort of twenty-three patients.

Prevalence of normal anatomical variations in the region of paranasal sinuses in patients with chronic rhinosinusitis

Background: Knowledge of the anatomical relationships and the anatomical variations in paranasal sinus region is critical for surgeons performing endoscopic sinus surgery. It helps surgeons to avoid the potential complications of sinus surgery and to improve success of management strategies. Objective: The objective of this study was to show how prevalent are the anatomic variations in the region of the paranasal sinuses and nasal cavity in patients with chronic rhinosinusitis. Materials and Methods: A cross-sectional study was conducted from January 2018 to July 2018 at Al-Hilla general teaching hospital. We collected data of 75 patients (who have met the clinical criteria of chronic rhinosinusitis) subjected to computed tomography (CT) of the paranasal sinuses. CT was performed using SIEMENS SOMATOM Definition AS and Philips machines. Direct coronal scans (1 mm in thickness) were made, from the anterior wall of the frontal sinus to the posterior wall of the sphenoid sinus with axial and sagittal reconstruction images. Results: Anatomical variations found in 69 patients of a total 75 patients with age range from 18 to 60 years with 92%. Among these, nasal septal deviation was the most common (seen in 54/75 patients = 72%) followed by the Agger nasi cells in 52 patients (69%), concha bullosa in 31 patients (41.3%), Haller cells in 28 patients (37%), and Onodi cells in 18 patients (24%). Conclusion: Sinonasal anatomical variations are common findings in patients with chronic rhinosinusitis. Providing information on these anatomical variations will improve the success of endoscopic sinus surgery.

Diagnosis and treatment of nasal and paranasal inverted papillomas - epidemiology and own experience.

The aim of this study was to analyse the occurrence of inverted papillomas of the nose and paranasal sinuses in patients that underwent endoscopic sinus surgery in our department. Between 2006 and 2016, 3,574 patients underwent surgery due to paranasal sinus diseases. Patients were qualified for surgery based on medical history, computed tomography, and laboratory tests. Data were gathered from medical files, and they included age, sex, and histopathological diagnosis. Among 3,574 patients that underwent surgery due to chronic inflammatory changes, on histopathology, inverted papillomas were diagnosed in 80 patients, including 31 women (38.75%) and 49 men (61.25%). Most patients were aged 60-70 years (women, 12.5%; men, 15%) or 50-60 years (women, 5%; men, 21.25%). Between 2006 and 2016, the number of surgeries ranged from 264 (7.38%) in 2013 to 355 (9.93%) in 2016, and the number of inverted papillomas ranged from 4 in 2007 and 2015 (1.23%) to 12 in 2014 (3.87%). Over the last 4 years of the study period, the incidence of inverted papillomas increased. Among 3,574 patients operated on due to chronic inflammatory changes, on histopathology, inverted papillomas were diagnosed in 80 cases (2.23%); thus, all patients qualified for endoscopic surgery due to inflammatory or hypertrophic changes should undergo rhino-fiberoscopy. Recurrence of inverted papillomas was observed in 17.50%, typically in patients with nasal polyps that co-occurred with inverted papillomas. We regard rhino-fiberoscopy as the most valuable method for detecting tumour recurrence in patients after surgery for inverted papillomas.

Respiratory viral detection in the paranasal sinuses of patients with cystic fibrosis.

Pulmonary colonization with antibiotic-resistant organisms in patients with cystic fibrosis (CF) is often preceded by upper-airway infections. Although there is a well-described relationship between pulmonary respiratory viral infections and overall disease progression of CF, the pathogenicity of respiratory viral infections in the paranasal sinuses of patients with CF remains unknown. With recent advances in respiratory virus detection techniques, this study sought to detect the presence of respiratory viruses in the paranasal sinuses of patients with CF in comparison with healthy controls and to correlate the viral presence with clinical measures of sinonasal disease. This prospective individual cohort study compared 24 patients with CF with 14 healthy controls. Basic demographics, clinical measures of disease and respiratory viral screens (commercial multiplex) obtained directly from the paranasal sinuses were compared between the two groups. Respiratory viruses were detected in 33% of patients with CF (8/24) compared with 0% of the healthy controls (0/14) (p = 0.017). Respiratory viruses were only detected during the winter months, and the most commonly identified were influenza A and human rhinovirus strains. There was no statistical difference in the 22-Item Sino-Nasal Outcome Test (SNOT-22) scores (p = 0.93) or modified Lund-Kennedy scores (p = 0.74) between patients with CF with a positive viral test and those without a positive result. Respiratory viral detection is more commonly detected in the paranasal sinuses of patients with CF compared with healthy controls. Although respiratory viral presence did not correlate with a worse clinical severity of sinonasal disease, these findings may provide insight into the pathophysiology of CF and open new avenues for potential targeted therapy.

Observation of Anterior Ethmoidal Artery in Coronal CT Scans of Paranasal Sinuses in Patients Attending Katihar Medical College, Katihar

Observation of Anterior Ethmoidal Artery in Coronal CT Scans of Paranasal Sinuses in Patients Attending Katihar Medical College, Katihar

Association of anatomic variations with antrochoanal polyps in paranasal sinus computed tomography scan.

Background:This study was designed to determine the prevalence of concomitant anatomic variation of paranasal sinuses in patients with antrochoanal polyp (ACP).Materials and Methods:Among patients referred by their clinicians for standard computed tomography scan of paranasal sinuses septal deviation, concha bullosa, and retention cyst were evaluated in both patients with ACP as well as in a control group.Results:Of the 17 patients with ACP, fifteen patients (88.2%) had septal deviation and two patients (11.8%) had concha bullosa. None of the patients with ACP had retention cyst or hypertrophic turbinate. Of the 78 patients in control group, twenty-nine (37.2%) had septal deviation, six (7.7%) had concha bullosa, seven (8.9%) had retention cyst, and one (1.2%) had hypertrophic turbinate. Septal deviation in patients with ACP has higher incidence (P < 0.001).Conclusion:This study showed that septal deviation is an anatomic variation which is significantly concomitant with ACP. Larger studies are needed to show the role of other anatomic variations in patients with ACP.