Presence Of Sinusitis Research Articles

Management of Oro-Antral Communication: A Systemic Review of Diagnostic and Therapeutic Strategies.

Aim: This study aims to evaluate the management of oro-antral communications (OAC) and fistulas (OAF), focusing on treatment strategies based on defect size, epithelialization, and the presence of sinus infections, while exploring both traditional and emerging techniques. Materials and Methods: The systematic review was conducted following the PRISMA guidelines and registered on PROSPERO (CDR ID 623251). Using targeted keywords, articles in English published within the last 10 years were analyzed from databases such as PubMed, WoS and Scopus, selecting only clinical studies on human patients. After thorough screening, 20 publications were included in the qualitative analysis, among 734 initially identified. Results: Small OACs (<5 mm) were managed conservatively with hemostatic materials, while larger defects (>5 mm) required surgical closure, with the Bichat flap proving highly effective for large defects. Innovative treatments using autologous bone grafts and PRF showed promise in supporting tissue regeneration. In cases with sinusitis, the combination of FESS and intra-oral closure techniques resulted in high success rates for infection resolution and defect closure. Conclusions: Treatment outcomes for OAC and OAF are highly dependent on the size of the defect and the presence of sinusitis. Multidisciplinary collaboration, along with timely surgical intervention and adherence to medical therapies, is essential for successful management. Emerging techniques and minimally invasive procedures continue to improve patient outcomes, offering hope for more effective and sustainable solutions in complex cases.

Exploring the impact of tobacco consumption on the respiratory health of two Dutch skeletal populations (1300–1829 CE)

ABSTRACT This study explored the influence of tobacco consumption on the respiratory health of two historical Dutch populations (1300–1829 CE). We conducted a macroscopic examination of 235 skeletons for which tobacco consumption status was known, focusing on the presence of sinusitis, ear infection, and pulmonary inflammation. Our goal was to investigate the correlation between respiratory diseases and tobacco consumption. Despite all conditions being prevalent in the total sample (sinusitis: 50.2%, ear infection: 23.2%, pulmonary inflammation: 14.1%), almost no significant correlation was found between disease and tobacco consumption. Our findings suggest that additional factors, such as exposure to second-hand smoke and unsanitary living/working environments, may have also impacted respiratory health. However, our interpretations are difficult to confirm due to the limitations of macroscopic analysis in determining tobacco consumption status. Future research should consider employing biomolecular techniques and expand beyond respiratory diseases to enhance our understanding of historical health implications of tobacco use.

Microbiology and Epidemiology of Orbital Cellulitis in Pediatric and Young Adult Patients.

Using data from the large and geographically diverse Military Health System (MHS) beneficiary population, we aimed to characterize and update the epidemiology and microbiology of pediatric orbital cellulitis given previous data are limited to small, single-center studies. Following institutional review board approval, we performed a retrospective analysis using the Military Health System admissions, microbiology, and pharmacy data between June 2009 and September 2019. Patients less than 22 years of age with radiological confirmation of orbital cellulitis were included. Demographic data, presence of sinusitis, advanced imaging reports, blood and wound culture results with antibiotic susceptibilities, and antibiotic prescriptions were collected. Descriptive statistics were used to summarize demographic characteristics. Imaging findings were grouped by Chandler's stage (CS), an imaging-based measure of the progressive severity of orbital involvement. A Cochran-Armitage trend test was used to evaluate the relationship between CS and likelihood of positive confirmatory culture. There was a male predominance (66.9%) and 55.5% of subjects had comorbid sinusitis. Of the 130 subjects included, 33.8% had one or more positive cultures, 30.8% had a positive wound culture, and 4.6% had a positive blood culture. The most identified organism was coagulase-negative staphylococci (23.3%), followed by Staphylococcus aureus (18.9%), Streptococcus intermedius (17.8%), and strict anaerobes as a group (13.3%). Gram-negative organisms were rare. Twenty-five percent of S. aureus were methicillin-resistant. Clindamycin resistance was identified in 9% of all S. aureus, 50% of coagulase-negative staphylococci, and 25% of S. intermedius. Clindamycin plus ceftriaxone was the most prescribed empiric antibiotic regimen (36.2%). Likelihood of a positive culture significantly increased with advancing CS. Orbital cellulitis occurs most frequently in males with sinusitis. Likelihood of positive wound culture is increased with a more advanced CS. Staphylococcus and Streptococcus spp. and anaerobes are the most identified pathogens in orbital cellulitis, while gram-negative organisms are rare. Empiric antibiotic selection should include an anti-methicillin-resistant S. aureus agent combined with a broad-spectrum beta-lactam and anaerobic coverage.

Evaluation of Different Approaches for Sinus Membrane Perforation Repair During Sinus Elevation: A Systematic Review and Meta-analysis.

To evaluate the impact of different approaches to sinus membrane perforation (SMP) repair on bone formation, postoperative complications, and implant loss risk. Electronic searches on PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases were conducted for publications up to February 2021. All included articles reported SMPs submitted for repair. The proportion of implant loss in repaired SMP sites was calculated using a random-effects model meta-analysis. A total of 130 studies reporting SMP repair protocols were included in the systematic review, with 20 selected for meta-analysis. A total of 1,972 sinuses that were perforated and repaired during sinus elevation using different approaches were included in the qualitative analysis. The resorbable collagen membrane was the most commonly reported treatment. The presence of sinusitis was the most frequently described complication. Regarding bone parameters, the majority of studies described no differences between perforated and repaired sinuses and intact membranes. No difference in the implant loss proportion was observed between sites with repaired SMP compared to undetected SMP. The proportion of implant loss in repaired sinuses membrane sites (independent of the material or implant placement time) was 4% (95% CI: 2.0 to 8.0). In meta-regression analysis, no association was observed between the SMP size and implant loss proportion (P = .86). The materials and techniques indicated for SMP management seem to securely seal the maxillary sinus, without a negative effect on the ultimate survival of the implants placed in the affected sinuses.

Association between sinusitis and incident rheumatic diseases: a population-based study

ObjectivesTo determine whether antecedent sinusitis is associated with incident rheumatic disease.MethodsThis population-based case–control study included all individuals meeting classification criteria for rheumatic diseases between 1995 and 2014. We matched three...

EVALUATION OF THE OLFACTORY FOSSA WITH COMPUTED TOMOGRAPHY FOR ENDOSCOPIC SURGERY

OBJECTIVE: The aim of this case-control study is to assess the olfactory fossa (OF) anatomy in computed tomography (CT) images of patients with clinical and radiological diagnoses of sinusitis as well as those of patients of a control group. MATERIAL AND METHODS: 100 patients without sinusitis and 100 patients with a clinical and radiological diagnosis of chronic sinusitis who were referred for CT scans were included. The OF types were recorded according to the Keros classification. Medial ethmoid roof point (MERP) height, cribriform plate (CP) height and width, OF depth and width, and angle of lateral lamella-cribriform plate (ALLCP) were also measured. RESULTS: The mean depth of OF was 5.9 mm and 6.1 mm on the right and left sides, respectively. The most common type was type 2 on the right (51%) and left (45.5%) sides. The mean height of the MERP was 27.9 mm in both the right and left sides. The mean height of CP was 22.0 mm and 21.8 mm on the right and left sides, respectively. The mean width of the OF was 4.1 mm and 3.4 mm on the right and left sides, respectively. The mean width of CP was 2.8 mm and 2.4 mm on the right and left sides, respectively.The mean right and left ALLCP were 77.6° and 79.1°, respectively. No significant difference was found between the parameters in the case and control groups. CONCLUSIONS: According to the results, the presence of sinusitis has no effect on the anatomy of the OF. However, preoperative evaluation of the OF anatomy is very important in minimizing complications that may occur during functional endoscopic sinus surgery (FESS).

Study of Spectrum of Cavernous Sinus Syndrome in Tertiary Care Centre

ABSTRACT Introduction: Cavernous sinus syndrome (CSS) is a condition with varied etiology. It is characterized by ophthalmoplegia, facial sensory loss, and Horner’s syndrome. The objective of this study was to determine the clinical and radiological presentations and to identify the factors that could help in the identification of etiology. Methods: We prospectively observed all the patients presenting with CSS from October 2019 to September 2021 at a tertiary care hospital. Patients with coronavirus disease 2019 (COVID-19)-associated mucormycosis were excluded. All of these patients underwent detailed clinical examination, hematological, radiological, and specialized investigations based on clinical suspicion. Clinical presentations, imaging characteristics, etiology, and clinical outcomes were analyzed. 45 patients were included in our study. Results: The mean age was 44.6 ± 10.8 years with a female preponderance. The most common presentation was diplopia which was seen in all patients. The commonest cranial nerve involved was the abducens (75.9%). Infections (12 (26.6%)) constituted the commonest cause of CSS, followed by neoplastic involvement in 11 (24.4%), Tolosa–Hunt syndrome in 9 (20%) and vascular involvement in 8 (17.7%) patients. Other inflammatory causes were seen in 5 (11%) patients. Diabetes was positively associated with fungal infections. The presence of bruit was strongly associated with vascular etiology. The presence of sinusitis with bony erosions was strongly associated with fungal infections. Evidence of dilated superior ophthalmic vein with early filling in the angiographic phase was associated with carotid-cavernous fistulas. Conclusions: CSS has variable etiology and radiological presentation. The presence of rapid progressive ophthalmoplegia with underlying diabetes with imaging evidence of sinusitis and bony erosions mandates a high degree of suspicion of fungal infections and empirical antifungal therapy needs to be considered for better outcomes.

Seasonal variations, acute rhinosinusitis and orbital infections in children

BackgroundOrbital infections in children are commonly secondary to acute bacterial rhinosinusitis (ABRS). It is unclear whether seasonal variations can predispose to these complications mirroring acute rhinosinusitis incidence. ObjectiveTo determine the incidence of ABRS as a cause of orbital infections and whether seasonality is a risk factor. MethodsA retrospective review of all children who presented to West Virginia University children's hospital between 2012 and 2022 were reviewed. All children with CT evidence of orbital infection were included. Date of occurrence, age, gender, and presence of sinusitis were reviewed. Children with orbital infection secondary to tumors, trauma, or surgery were excluded. Results118 patients were identified with mean age of 7.3 years with 65 (55.1 %) males. 66 (55.9 %) children had concomitant sinusitis on CT scan, and the distribution of orbital complications per season showed 37 (31.4 %) cases occurred in the winter season, followed by 42 (35.6 %) cases in spring, 24 (20.3 %) cases in summer, and 15 (12.7 %) in fall. Children with orbital infections during winter & spring had sinusitis in 62 % of children vs. 33 % in other seasons (P = 0.02). Preseptal cellulitis was present in 79 (67 %) children, 39 (33 %) children with orbital cellulitis, and 40 (33.9 %) children with abscesses. 77.6 % children were treated with IV antibiotics and 94 % with oral antibiotics, and 14 (11.9 %) with systemic steroids. Only 18 (15.3 %) children required surgery. ConclusionsThere seems to be a seasonal predisposition for orbital complications mainly in the winter and spring seasons. Rhinosinusitis was present in 55.6 % of children presenting with orbital infections. Level of evidence4.

Olfactory dysfunction in Japanese children with moderate-to-severe allergic rhinitis

ObjectiveDetailed quantitative studies on olfaction remain inadequate in patients with paediatric allergic rhinitis (AR). This study examined olfactory dysfunction in children with AR. MethodsFrom July 2016 to November 2018, children aged 6–9 years were recruited and grouped as AR (n = 30) or without AR (control group, n = 10). Odour identification was evaluated by the Universal Sniff (U-Sniff) test and the Open Essence (OE). The results were compared between the AR and control groups. Intranasal mucosa findings, nasal smear eosinophil counts, blood eosinophil counts, total immunoglobulin E (IgE) levels, Japanese cedar-specific IgE and Dermatophagoides pteronyssinus-specific IgE were evaluated in all participants. Additionally, the presence of sinusitis and adenoid hypertrophy in patients with AR was also evaluated by sinus X-ray examinations. ResultsThe median U-Sniff test scores were not significantly different between the AR and control groups (9.0 vs. 10.0, respectively; p = 0.107). The OE score was significantly lower in the AR group than in the control group (4.0 vs. 8.0; p = 0.007, respectively), especially in the moderate-to-severe AR group versus the control group (4.0 vs. 8.0; p = 0.004). Furthermore, in the OE, the correct answer rates for ‘wood’, ‘cooking gas’ and ‘sweaty socks’ were significantly lower in the AR group than in the control group. ConclusionsPaediatric AR patients can reduce olfactory identification ability, and the degree may be associated with the severity of AR in nasal mucosal findings. Furthermore, olfactory dysfunction may slow down the response to ‘emergency situations’, such as gas leak.

EFFECT OF SEPTUM DEVIATION ON OSTEOMEATAL COMPLEX DISTANCES

Objective: It is known that deviation of the septum plays an etiological role in the obstructions formed in the osteomeatal complex. In this study, it was aimed to evaluate the effect of the degree of deviation of the nasal septum on the distances between the bone structures forming the osteomeatal complex. Method: The research universe was obtained by retrospectively scanning 1200 computed tomography (CT) images of January 2018-December 2019 in the PACS archive of the Department of Radiology of Sivas Cumhuriyet Faculty of Medicine Hospital. A total of 453 individuals, 228 females and 225 males (18-82 years old) meeting the criteria for inclusion in the study were included. Septal deviation angle was measured. Individuals were grouped according to the degree of septal deviation. Osteomeatal complex spaces (OMC) were evaluated according to the degree of septal deviation. In the study, the distance between OMC spaces was also investigated in the presence of sinusitis. Results: In the septum, the distance between lamina papyricea and middle nasal concha (LP-MNC) at medium and high grades was found to be large in the opposite direction of the deviation. The distance between the lamina papyricea and uncinate process [ethmoidal infundibulum (LP-UP)] was small on the right side in low-grade deviation to the right. When the distance between uncinate process and middle nasal concha (UP-MNC) and the distance between LP-UP was compared, it was found to be smaller in the direction of deviation in individuals with middle deviation to the left (p < 0.05). While the right osteometal complex spaces were found to be smaller than the control group, the distance between UP-MNC from the left osteomeatal spaces made a difference with the control group. Conclusions: Degrees and type of septal deviation were effective in narrowing the osteomeatal complex spaces. It was determined that OMC distances did not change with the presence of sinusitis. It is thought that it may be useful to evaluate the degree of septal deviation in obstruction of osteomeatal complex spaces and mucosal changes in the paranasal region.

Effect of Endoscopic Sinus Surgery on Eustachian Tube Function in Adult Sinusitis Patients: A Prospective Case-Control Study.

The eustachian tube (E-tube) function is known to be related with sinusitis; however, the effect of endoscopic sinus surgery (ESS) on E-tube function is not clearly documented. This study aimed to prospectively evaluate the function of the E-tube by using both subjective and objective tests in adult chronic sinusitis patients undergoing ESS, and to compare with those of the patients without sinusitis. Thirty adult patients who underwent ESS for treatment of chronic sinusitis and another thirty patients without sinusitis who underwent other nasal surgeries (septoplasty, rhinoplasty, or closed reduction) were evaluated and compared for E-tube function before and after three months of their surgeries. The E-tube function tests included the seven-item eustachian tube dysfunction questionnaire (ETDQ-7), Valsalva test, and inflation-deflation test that were compared preoperatively and postoperatively in both groups. Compared with the group without sinusitis, the ESS group showed significant improvement of E-tube function after surgery in the ETDQ-7 (p = 0.002), right Valsalva test (p = 0.015), right deflation test (p = 0.005), and left deflation test (p = 0.006). A binary logistic regression analysis revealed that ESS significantly improved E-tube function in the right Valsalva test in a univariate (p = 0.021) and multivariate analysis (p = 0.008), and E-tube function in the left deflation test in a univariate (p = 0.021) and multivariate analysis (p = 0.039). These findings indicate that E-tube function is significantly improved after ESS in adult sinusitis patients, and that the presence of sinusitis and implementation of ESS should be considered (if sinusitis is present) in managing patients with ear diseases that are affected by E-tube function.

Association between sinusitis and relapse and changes in the myeloperoxidase-antineutrophil cytoplasmic antibody in microscopic polyangiitis.

Previous studies have evaluated the risk factors for relapse of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and the biomarkers of AAV for predicting relapse. However, little is known about the association between the presence of sinusitis and relapse and changes in the ANCA levels in AAV. This single-center, retrospective cohort study included 104 consecutive patients who were newly diagnosed with myeloperoxidase (MPO)-ANCA-positive microscopic polyangiitis (MPA) between 2006 and 2018 and were treated at the Aichi Medical University Hospital in Japan. The relationships between sinusitis and relapse of vasculitis and elevated MPO-ANCA levels were assessed using multivariate Cox proportional hazards models that were adjusted for clinically relevant factors. During the entire follow-up period (median, 24 months; interquartile range, 7–54 months), 93 (89.4%) patients achieved remission. After achieving remission, 38 (40.9%) patients experienced at least one relapse (13 [65.0%] in the sinusitis group; 25 [34.3%] in the non-sinusitis group). Sinusitis was identified as a significant predictor of relapse (adjusted hazard ratio: 2.41, 95% confidence interval [CI]: 1.19–4.88; P = 0.015). Furthermore, sinusitis was more likely to be associated with elevated MPO-ANCA levels (adjusted hazard ratio: 2.59, 95% CI: 1.14–5.92; P = 0.024). In conclusion, sinusitis was associated with a higher risk of relapse and elevated MPO-ANCA levels in MPA patients, suggesting that careful management may be required to reduce the risk of relapse in patients with sinusitis. Further studies are needed to elucidate the optimal treatment strategy for these patients.

Relationship between Increased Intracranial Pressure and Mastoid Effusion.

ObjectiveThis study aimed to assess the relationship between increased intracranial pressure (ICP) and mastoid effusions (ME). MethodsBetween January 2015 and October 2018, patients who underwent intracranial surgery and had ICP monitoring catheters placed were enrolled. ICP was recorded hourly for at least 3 days. ME was determined by the emergence of opacification in mastoid air cells on follow-up brain imaging. C-reactive protein (CRP) levels, presence of endotracheal tube (ETT) and nasogastric tube (NGT), duration of intensive care unit (ICU) stay, duration of mechanical ventilator application, diagnosis, surgical modalities, and presence of sinusitis were recorded. Each factor’s effect on the occurrence of ME was analyzed by binary logistic regression analyses. To analyze the independent effects of ICP as a predictor of ME a multivariable logistic regression analysis was performed. ResultsTotal of 61 (53%) out of 115 patients had ME. Among the patients who had unilateral brain lesions, 94% of subject (43/50) revealed the ipsilateral development of ME. ME developed at a mean of 11.1±6.2 days. The variables including mean ICP, peak ICP, age, trauma, CRP, ICU stays, application of mechanical ventilators and presence of ETT and NGT showed statistically significant difference between ME groups and non-ME groups in univariate analysis. Sex and the occurrence of sinusitis did not differ between two groups. Adding the ICP variables significantly improved the prediction of ME in multivariable logistic regression analysis. ConclusionWhile multiple factors affect ME, this study demonstrates that ICP and ME are probably related. Further studies are needed to determine the mechanistic relationship between ICP and middle ear pressure.

Assessment of clinical and computed tomographic findings for association with the outcome of intraoral cheek tooth extraction in horses and ponies.

To describe clinical and CT findings for horses and ponies undergoing intraoral cheek tooth extraction and assess potential associations between these features and outcome of the procedure. 74 horses and 7 ponies. Medical records were searched to identify horses and ponies that underwent CT and intraoral extraction of ≥ 1 cheek tooth with standing sedation. Signalment and clinical variables were recorded, and CT scans were reviewed. Anatomic location and measurements of affected teeth; abnormalities of the periodontium, pulp, infundibula, roots, and tooth shape; fracture presence and type; presence of sinusitis; and affected sinus cavities were assessed by a surgeon and a radiologist. Intraoral extraction outcome was recorded as successful (complete removal of the tooth in 1 intraoral extraction procedure) or unsuccessful. Univariable and multivariable logistic regression analyses were performed to assess associations between clinical or CT findings and outcome. 89 cheek teeth (80 maxillary and 9 mandibular) were included in the analyses. Sixty of 89 (67%) cheek teeth were extracted successfully (56/80 [70%] maxillary and 4/9 [44%] mandibular cheek teeth). Only presence of a simple fracture (vs no fracture) was associated with outcome on multivariable regression analysis; odds of successful intraoral extraction were significantly lower when this feature was present. Most extractions of cheek teeth in the study sample were successful, and results may be useful for practitioners in refining cheek tooth extraction plans for horses and ponies. Further studies are required to assess whether specific CT findings can be used to predict the outcome of intraoral extraction in equids.

Treatment of pediatric extra-axial sinogenic infection: case series and literature review.

Analyze the clinical presentation, microbiology, outcomes, and medical and surgical treatment strategies of intracranial extension of sinogenic infection in pediatric patients. A retrospective, single-center study of patients < 18 years of age, presenting with intracranial extension of bacterial sinogenic infections requiring surgical intervention over a 5-year period, was conducted. Electronic medical records were reviewed for age, sex, primary symptoms, duration of symptoms, presence of sinusitis at initial presentation, microorganisms isolated, mode of surgery, timing of surgery, length of stay, and neurologic sequelae. Seventeen patients were identified; mean age was 10 years with 82.3% male predominance. Average duration of illness prior to presentation was 9.8 days, with 64.7% of patients displaying disease progression while on oral antibiotics prior to presentation. Sinusitis and intracranial extension were present in all patients upon admission. Simultaneous endoscopic endonasal drainage and craniotomy were performed on 70.5% of the patients, with the remaining 29.5% undergoing endonasal drainage only. Of the patients who underwent simultaneous endoscopic endonasal drainage and craniotomy, 17.6% required repeat craniotomy and 5.8% required repeat sinus surgery. The most commonly isolated organisms were S. intermedius (52.9%), S. anginosus (23.5%), and S. pyogenes (17.6%). All patients were treated postoperatively antibiotic on average 4-6 weeks. Frequently occurring long-lasting complications included seizures (29.4%) and focal motor deficits (17.6%); learning disability, anxiety disorders, impaired cognition, and sensory deficits occurred less frequently. In the case of intracranial extension of bacterial sinogenic infection, early identification and surgical treatment are crucial to avoid neurological sequelae.

Post-radiation sinusitis is associated with recurrence in nasopharyngeal carcinoma patients treated with intensity-modulated radiation therapy

BackgroundThis study investigated the impact of post-radiation sinusitis on the prognosis of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiation therapy (IMRT).MethodsTwo hundred and thirty patients with non-metastatic NPC were analyzed in terms of freedom from local failure (FFLF), freedom from distant failure (FFDF), overall survival (OS), and disease-free survival (DFS). For each patient, the status of the sinus mucosa was flexibly assessed by documenting mucosal changes as indicated by differences between images obtained before radiotherapy and more than 6 months post-radiation.ResultsWith a median follow-up of 39.7 months (8 to 81 months), 19 (8.26%) patients relapsed locally, 13 (5.65%) patients failed in the neck, and 26 (11.3%) patients developed distant metastases. The presence of sinusitis noted in images post-radiation was a significant predictor for DFS (p = 0.001), FFLF (p = 0.004), and FFDF (p = 0.015), in addition to having high negative predictive value for local relapse (97.5%).ConclusionsThis is the first study to investigate the prognostic value of post-radiation sinusitis in NPC patients treated with IMRT. Post-radiation sinusitis was found to be a significant predictor for DFS, FFLF, and FFDF, and was also found to have high negative predictive value for local recurrence (97.5%). It may thus be used as an additional tool for clinicians to determine the possibility of recurrence.

Additional role of bronchial mucosal biopsy for ciliary structural abnormality in diagnosis of primary ciliary dyskinesia.

Transmission electron microscopy (TEM) is one of diagnostic tests for primary ciliary dyskinesia (PCD). The mucosal samples obtained for cilia examination are generally procured from the nasal turbinate, but these specimens often yield inadequate results. The bronchial mucosa is recognized as an alternative sample, but no study has examined the additional utility of bronchial mucosa compared with nasal mucosa in the diagnosis of PCD. The medical records of 96 patients who underwent TEM for suspected PCD between April 1997 and June 2017 were reviewed. Patients were divided into three groups based on the site of mucosal biopsy: nasal biopsy (NB) group with nasal mucosal biopsy only; bronchial biopsy (BB) group with bronchial mucosal biopsy only; and nasal and bronchial biopsy (NBB) group with a combination of nasal and bronchial mucosal biopsies. The rate of PCD diagnosis was 28.8% (17/59) in the NB group, 41.2% (7/17) in the BB group, and 60.0% (12/20) in the NBB group. The yield of PCD diagnosis significantly increased in the NBB group compared with the NB group (P=0.012). In the NBB group, 25.0% (5/20) of patients were diagnosed with PCD by nasal mucosal biopsy, and 35.0% (7/20) of patients were additionally diagnosed by bronchial mucosal biopsy. The presence of sinusitis or bronchiectasis was not associated with prediction of PCD diagnosis from nasal or bronchial mucosal biopsy. The combination of nasal and bronchial mucosal biopsy for TEM showed higher yields of PCD diagnosis than nasal mucosal biopsy alone.

The radiologic evaluation of adenoid hypertrophy and the presence of sinusitis in pediatric patients with chronic otitis media

Objective: The present study was conducted to evaluate whether adenoid hypertrophy and the presence of sinusitis were associated with pediatric chronic otitis media (COM) radiologically. Materials and Methods: The computed tomography scans of 71 pediatric patients (33 males and 28 females) ranging in age from 3 to 17 (mean 12 ± 3.9) years who had been admitted to our tertiary care hospital were retrospectively evaluated for adenoid size, nasopharyngeal (NP) airway opening, and the presence of sinusitis. Thirty-six pediatric patients who had been operated on COM were selected as Group 1, and 35 patients who had no middle ear disease were selected as Group 2. The radiological findings of the two groups were compared. Results: Adenoid size and NP airway opening measurements were not statistically different between the groups (P = 0.237 and P = 0.298), so as the NP narrowing by soft palate (P = 0.992). Furthermore, there was no statistically significant difference in the incidence of sinusitis between the groups (P = 0.464). Conclusion: Our results have shown that there was no significant difference of adenoid hypertrophy and the presence of sinusitis in pediatric COM patients and non-COM patients radiologically. For further information, prospective epidemiological trials with longer follow-up periods including pediatric patients are suggested.

Morganella morganii: associated sinusitis with orbital abscess in a diabetic patient

&lt;p class="abstract"&gt;&lt;em&gt;Morganella morganii&lt;/em&gt; is a gram negative pathogen and may cause lethal disease in patients with immunosuppressive disease. It is commonly found in long term urinary catheter used and immune system deficiency patients as nosocomial disease. &lt;em&gt;Morganella morganii&lt;/em&gt; was also involving skin, skeletal system and central nervous system. In this case we present sporadic &lt;em&gt;Morganella morganii&lt;/em&gt; infection on sinonasal region with the presence of sinusitis, orbital absess, preseptal cellulitis and lamina propasia defect on 58 year old female diabetic patient. Microbiological assessment from nasal tissue and sinus puss discharge were reported as &lt;em&gt;Morganella morganii&lt;/em&gt;. This is the first case of sinonasal &lt;em&gt;Morganella morganii&lt;/em&gt; infection with sinonasal, preseptal cellulitis and orbital absess with lamina papyracea bone destruction.&lt;/p&gt;

The Burden of Sinusitis in Hematologic Transplant Patients: A National Perspective.

To determine the impact of sinusitis on outcomes of hematologic transplant procedures. Retrospective analysis of a national hospital database. The National Inpatient Sample database for 2012 to 2013 was queried using International Classification of Diseases, Ninth Revision, Clinical Modification codes to identify patients undergoing hematologic transplants. Patients were divided based upon the presence or absence of a concomitant diagnosis of acute or chronic sinusitis. Patient demographics, clinical characteristics, discharge results, lengths of stay (LOS), and costs were compared between groups. There were 7,069 hematologic transplant cases identified, 2.7% of which had a diagnosis of sinusitis. Sinusitis patients had a longer LOS after transplant (24.9 ± 15.9 days vs. 19.1 ± 17.4 days, P < .001) and higher total hospital charges ($487,941 ± $447,532 vs. $322,300 ± $369,596, P < .001) than nonsinusitis patients. There was no difference in mortality between the two groups (P = .75). The 23 (12%) sinusitis patients who underwent sinus procedures had a longer LOS after transplant (34.8 ± 25 days vs. 23.5 ± 13.7 days, P = .001) and higher total hospital charges ($857,891 ± $718,456 vs. $437,293 ± $372,075, P < .001) than sinusitis patients without sinus procedures. Linear regression showed that sinusitis patients had excess LOS after transplant of 2.442 days and cost of $82,000.098. This study demonstrates that presence of sinusitis in patients undergoing hematologic transplant is associated with increased LOS and higher total hospital charges. Increased focus on diagnosis and if possible treatment of sinusitis prior to admission for transplantation may help reduce the impact of sinusitis after hematologic transplant. NA Laryngoscope, 128:2688-2692, 2018.