Sinusitis In Patients Research Articles

The subsequent risk of retinal vein occlusion disease after sinusitis diagnosis: a nationwide population-based study

Retinal vein occlusion (RVO) is a common retinal vascular disease that causes visual impairment. However, there is limited evidence regarding the relationship between sinusitis and risk of RVO. This study investigated the association between sinusitis and the subsequent risk of RVO disease. A retrospective cohort study was conducted and patients with sinusitis or RVO were selected from the National Health Insurance Research Database (NHIRD) of Taiwan. In this population-based study, we identified a total of 131,532 sinusitis patients, who were matched with 263,064 non-sinusitis individuals based on sex and age. The Cox proportional hazard regression was applied to demonstrate the adjusted hazard ratio (aHR) with 95% confidence interval (CI) of main outcomes. Our results showed that the crude hazard ratio (cHR) for the risk of RVO was 1.35 (95% CI: 1.20–1.52) in the sinusitis cohort compared with the non-sinusitis cohort. After adjustment for demographics and comorbidities in the multivariable cox regression, the adjusted hazard ratio (aHR) was 1.28 (95% CI: 1.13–1.44). Moreover, statistically significant differences were observed in the 14-year cumulative incidence of RVO (p < 0.0001), central RVO (p = 0.0002), and branch RVO (p = 0.0004) between the sinusitis and non-sinusitis cohorts. In conclusion, our study revealed that patients with sinusitis were at higher risk of being diagnosed with RVO.

Symptomatic aseptic sinusitis induced by immune checkpoint inhibitors for metastatic melanoma treatment.

Immune-mediated sinusitis is poorly described and may easily go undiagnosed. We conducted a retrospective, multicenter, national study focusing on symptomatic immune-mediated sinusitis in patients receiving immune checkpoint inhibitors (ICIs) for melanoma treatment. Twelve patients were included (50% women, median age 58 years). Overall, the paraclinical assessment, the inefficacy of antibiotic/antihistaminic treatment, the improvement of symptoms on immunosuppressants and/or after ICI discontinuation, and the presence of multiple concomitant immune-related adverse-events, suggested a noninfectious etiology. Recognizing this toxicity is imperative for limitation of diagnostic wandering and appropriate treatment. However, additional epidemiological studies are needed to assess its prevalence as a potential immune-related adverse-event, and its prognostic value in patients treated with ICIs.

Evaluation of Serum Levels of Vitamin D3 and IgE in Patients with Chronic and Allergic Sinusitis: A Cross-sectional Study.

Chronic rhinosinusitis is known as a common problem with inflammatory and allergic causes. Several factors are associated with developing chronic rhinosinusitis, including immunoglobulin E (IgE) production and vitamin D deficiency. In this study, we investigated the role of IgE and Vitamin D deficiency and differences between patients with chronic, allergic sinusitis and controls. A total of 90 subjects were included in 3 groups (n=30) in this cross-sectional, correlational descriptive study. The subjects were divided into three groups, including control (healthy subjects), chronic sinusitis patients, and allergy patients. A checklist was used to collect the necessary data, including age, gender, and body mass index (BMI). To evaluate serum levels of vitamin D3 and IgE, ELISA kits were used. The mean vitamin D was 22 g/ml. Fifty-four participants (60%) out of all included people had insufficient vitamin D, 13% had a deficiency, and the high deficiency and insufficiency were in the group of allergic sinusitis. Our results indicated that gender (female) was significantly associated with vitamin D deficiency (p =0.01). Thirty-nine participants (43.3%) out of all studied subjects had high IgE, and the highest level of abnormality of IgE was in the allergic sinusitis group. Furthermore, it was found that gender and IgE were not significantly related. However, IgE was significantly associated with vitamin D deficiency in the allergic sinusitis group. Our findings highlighted that most of the patients with chronic and allergic sinusitis had insufficient vitamin D. A possible association was also found between low vitamin D and IgE levels and the prevalence of allergic sinusitis. This study showed that patients with allergic sinusitis may be more vulnerable to lower serum levels of vitamin D. Therefore, vitamin D supplementation as an adjunctive therapy may be considered in these patients.

Effectiveness of probiotic therapy in chronic purulent maxillary sinusitis in patients with type 1 diabetes mellitus

Effectiveness of probiotic therapy in chronic purulent maxillary sinusitis in patients with type 1 diabetes mellitus

Dupilumab Improves Facial Pain and Reduces Rescue Treatments in Patients with CRSwNP and Recalcitrant Frontal Sinusitis.

Recalcitrant frontal sinusitis in patients with chronic rhinosinusitis and nasal polyps (CRSwNP) has a negative impact on their quality of life due to frontal pain and a high risk of sinus occlusion, thus necessitating antibiotics, systemic corticosteroids, and multiple surgeries. The aim of this study was to assess the efficacy of dupilumab in reducing frontal pain and the need for rescue treatments for recalcitrant frontal sinusitis in patients with CRSwNP. We enrolled a cohort of 10 patients with severe uncontrolled CRSwNP and concomitant recurrent frontal sinusitis associated with severe facial pain measured by MIDAS score who were treated with dupilumab 300 mg every 2 weeks and followed for at least 12 months. The mean MIDAS score decreased from 45.6 ± 10.7 at baseline to 1.3 ± 2.3 at 6 months (p < 0.05). VAS craniofacial pain decreased from 7.3 ± 1.6 at baseline to 1.2 ± 1.5 at 6 months (p < 0.05). No patient needed oral corticosteroids during treatment with dupilumab (p < 0.05), and the use of analgesics decreased from 9.6 ± 3.1 NSAID pills/week in the last 2 months at baseline to 0.6 ± 1.3 at 1 year of follow-up (p < 0.05). Our results demonstrated that use of subcutaneous dupilumab can improve symptom control, including recurrent severe cranio-facial pain, and reduce the need for rescue medical treatments (systemic steroids and NSAID) in patients with severe uncontrolled CRSwNP and concomitant recurrent frontal sinusitis.

A longitudinal study of subjective olfactory function post-operatively in chronic rhinosinusitis patients with asthma and analysis of influencing factors

Objective:To evaluate the subjective olfactory function in chronic sinusitis（CRS）patients with asthma after nasal endoscopic surgery and associated factors that may affect olfactory function. Methods：The study included 90 CRS patients with asthma from January 2008 to December 2020，and all of them underwent endoscopic sinus surgery（ESS）. VAS score of olfactory function before and after surgery were collected，and the data at baseline，3 months，6 months，1 year，3 years，5 years，8 years and 10 years after surgery were compared. Factors affecting olfactory function were analyzed in a generalized mixed linear model，which including age，surgical procedure，allergic rhinitis and so on.Results： The olfactory VAS scores were significantly lower at 3 months，6 months，1 year，3 years，and 5 years postoperatively compared with baseline，and the difference was statistically significant（P<0.05）.Olfactory VAS scores at 8 and 10 years postoperatively were not statistically different from baseline（P>0.05）.Age（≥60 years），aspirin intolerance syndrome，Lund-Kennedy score，modified sinus CT olfactory cleft score，and follow-up time were risk factors, and radical sinus surgery is a protective factor.Conclusion：Subjective olfactory scores in CRS patients with asthma after ESS remain relatively stable for 5 years postoperatively.Prior history of surgery did not affect postoperative subjective olfactory scores. Age，aspirin intolerance syndrome, Lund-Kennedy score，modified sinus CT olfactory cleft score, follow-up time，and surgical approach were strongly associated with subjective olfactory scores in CRS patients with asthma，and radical surgery had a protective effect on olfaction.

Prevalence of Chronic Rhino Sinusitis in Patients with Concha Bullosa.

This study aims to investigate the prevalence of chronic rhino sinusitis in patients with concha bullosa, a common anatomical variation characterised by pneumatization of the middle turbinates. Chronic rhino sinusitis is an inflammatory disorder of the paranasal sinuses and the linings of the nasal passages that lasts for 12weeks or longer. The incidence of chronic rhino sinusitis was assessed among patients with diagnosed concha bullosa, focusing on the presence of symptoms, and severity. There seems to be a strong relationship between concha bullosa and the development of chronic rhino sinusitis To screen the patients of concha bullosa for chronic rhino sinusitis. To find out of the percentage of chronic rhino sinusitis in patients with concha bullosa. To determine the sinuses affected and their respective sides. This is a retrospective study to investigate the incidence of chronic rhino sinusitis in patients diagnosed with concha bullosa. The study was conducted at Vydehi institute of medical science and research centre, Whitefield, Bangalore and the data from 01/02/23 to 01/09/23 were analyzed. Medical records of patients with diagnosed concha bullosa were identified through electronic medical records and imaging databases (CT scan paranasal sinuses). Inclusion criteria consisted of patients with a confirmed diagnosis of concha bullosa based on radiological imaging (CT scans) and clinical assessment.Exclusion criteria: patients with previous sinus surgeries and malignancy. The study's methods focused on retrospectively assessing the incidence of chronic rhino sinusitis in patients diagnosed with concha bullosa. In the above study it is concluded that concha bullosa plays major role in development of chronic rhino sinusitis. Thus after confirming the presence of concha bullosa practitioner should keep in mind the possibility of development of chronic rhino sinusitis.

Relationship of the accessory maxillary ostium to mucosal thickening and maxillary sinus cysts: a 3D segmentation study

ObjectivesWe aimed to investigate the relationship between the presence of the accessory maxillary ostium (AMO) with mucosal thickening (MT) and maxillary sinus cysts (MSCs). Study DesignThis single-center retrospective study included patients who underwent paranasal sinus CT between November 2022 and February 2023. We excluded patients with natural maxillary ostium (NMO) occlusion. Two radiologists evaluated the presence of AMOs, MT, and MSCs in CT images and measured their dimensions using a 3D volumetric analysis program. ResultsWe included 125 patients (mean age: 36.47± 16.0 years; male/female: 67/58). In total, 65 patients (52%) had single or multiple AMOs. No significant relationship was found between the presence of an AMO and the presence of MT on either side (P ≥ 0.306). There was a statistically significant difference between the presence of an AMO and MSC on the right side (P = 0.002), but not on the left side (P = 0.477). The diameter of the AMO and the distance from the AMO to the maxillary floor were not correlated with mucosal thickness or MSC volume, but the distance from the AMO to the sinus floor had a small positive correlation with total maxillary sinus volume. ConclusionThe presence of an AMO and its increased diameter may not contribute to ipsilateral maxillary sinusitis in patients whose unilateral or bilateral NMOs are not occluded.

A Case-Control Analysis of Risk Factors Associated With Allergic Fungal Sinusitis Patients

A Case-Control Analysis of Risk Factors Associated With Allergic Fungal Sinusitis Patients

C-reactive Protein Kinetics During In-Patient Treatment of COVID-19-Associated Rhino-Orbito-Cerebral Mucormycosis: A Retrospective Cohort Study in a Tertiary Hospital in Central India.

COVID-associated rhino-orbito-cerebral Mucormycosis (CA-ROCM), henceforth referred to as Covid-Associated Mucormycosis (CAM), is a serious and fatal condition unless treated promptly and completely. The main treatment of the CAM is complete surgical debridement and administration of systemic antifungals. The first line antifungal recommended for CAM is Amphotericin-B. Since Amphotericin-B has systemic side effects mainly on the renal system, a timely decision to start and end Amphotericin-B therapy is very essential. Besides the Computed Tomography (CT) scan, serum levels of C-reactive protein (CRP) levels are a good indicator of CAM-associated inflammation levels in the patient's body. By monitoring the CRP levels, we can titrate amphotericin treatment to cause minimal harm to the kidneys.Our study was done to analyze the kinetics of C-reactive protein in patients of CAM admitted in a tertiary-care hospital and compare it with the CRP levels in COVID-associated non-Mucormycosis Sinusitis patients. Aim and objective To study the kinetics of serum C-reactive protein (CRP) levels among patients undergoing in-patient care for COVID-associated rhino-orbito-cerebral mucormycosis and compare with serum CRPlevels in COVID-19 patients suffering from sinusitis without rhino-orbito-cerebral mucormycosis. Materials and methods This was a retrospective cohort study. The source of data was post-COVID sinusitis patients who were admitted during 2nd wave of COVID-19 in India in our hospital whose medical records were accessed by the Medical Records Department. The subjects were recruited into the two study groups namely the Mucormycosis group and the non-Mucormycosis group based on the histopathological report of the nasal biopsy specimen. The medical records of each member of the two groups were studied for the levels of serum C-reactive protein measured at the time of admission and every 5(+1) days thereafter till the time of discharge. The kinetics of serum C-reactive protein levels, which is a marker of inflammation is studied in each of the two groups and compared using statistical methods. Results There was a significant difference between Mucormycosis and Non-Mucormycosis groups in CRP-level kinetics. However, there was no significant trend of decrease or increase over time in Mucormycosis as well as non-Mucormycosis cases. Conclusion CRP is an important biomarker in assessing the septic response to COVID-associated rhino-orbito-cerebral mucormycosis. Detection of raised CRP levels helps in prompt early initiation of anti-fungal treatment. Also, monitoring the levels of serum CRP will guide in deciding the time to stop the antifungals at an appropriate time. CRP monitoring is commonly available and affordable. Hence, we recommend CRP monitoring of in-patients of CAM.

Demographic characteristics and risk factors for invasive fungal sinusitis in the context of COVID-19: A systematic review and meta-analysis

ObjectivesTo identify the demographic characteristics and potential risk factors of invasive fungal sinusitis (IFS) patients with Coronavirus Disease in 2019 (COVID-19). MethodsWeb of Science, Embase, the Cochrane Library, and PubMed were searched from database inception to August 2023 using the combination of medical searching heading terms “invasive fungal sinusitis” and “COVID-19” and their free words. The research protocol was registered on PROSPERO (CRD42023467175). ResultsA total of 53 studies were included. The mean age of IFS patients with COVID-19 was 53.72 (95% credible interval [CI]: 51.08, 56.36), with 66% males (95% CI: 0.62, 0.70), and 81% diabetes (95% CI: 0.77, 0.86). The mean time from COVID-19 diagnosis to IFS onset was 19.09 days (95% CI: 16.96, 21.22). The percentage of patients with COVID-19 PCR positivity was 33% (95% CI: 0.21, 0.45). Overall, 71% of patients receiving steroid therapy during COVID-19 infection (95% CI: 0.63, 0.78). The odds ratio of diabetes mellitus, steroid administration, and COVID-19 PCR positivity were 6.09, 2.21, and 1.82, respectively. COVID-19 infection did not affect the IFS stage. ConclusionIFS patients with COVID-19 had an average age of 53.72 years and were predominantly males, with a mean interval of 19.09 days from COVID-19 diagnosis to IFS onset. Diabetes, steroid administration, and COVID-19 PCR positivity were risk factors.

Risk Factors for Isolated Sphenoid Sinusitis after Endoscopic Endonasal Transsphenoidal Pituitary Surgery.

(1) Background: Transsphenoidal pituitary surgery can be conducted via microscopic or endoscopic approaches, and there has been a growing preference for the latter in recent years. However, the occurrence of rare complications such as postoperative sinusitis remains inadequately documented in the existing literature. (2) Methods: To address this gap, we conducted a comprehensive retrospective analysis of medical records spanning from 2018 to 2023, focusing on patients who underwent transsphenoidal surgery for pituitary neuroendocrine tumors (formerly called pituitary adenoma). Our study encompassed detailed evaluations of pituitary function and MRI imaging pre- and postsurgery, supplemented by transnasal endoscopic follow-up assessments at the otolaryngology outpatient department. Risk factors for sinusitis were compared using univariate and multivariate logistic regression analyses. (3) Results: Out of the 203 patients included in our analysis, a subset of 17 individuals developed isolated sphenoid sinusitis within three months postoperation. Further scrutiny of the data revealed significant associations between certain factors and the occurrence of postoperative sphenoid sinusitis. Specifically, the classification of the primary tumor emerged as a notable risk factor, with patients exhibiting nonfunctioning pituitary neuroendocrine tumors with 3.71 times the odds of developing sinusitis compared to other tumor types. Additionally, postoperative cortisol levels demonstrated a significant inverse relationship, with lower cortisol levels correlating with an increased risk of sphenoid sinusitis postsurgery. (4) Conclusions: In conclusion, our findings underscore the importance of considering tumor classification and postoperative cortisol levels as potential predictors of postoperative sinusitis in patients undergoing transsphenoidal endoscopic pituitary surgery. These insights offer valuable guidance for clinicians in identifying at-risk individuals and implementing tailored preventive and management strategies to mitigate the occurrence and impact of sinusitis complications in this patient population.

Deep Learning-Based Multi-Class Segmentation of the Paranasal Sinuses of Sinusitis Patients Based on Computed Tomographic Images.

Accurate paranasal sinus segmentation is essential for reducing surgical complications through surgical guidance systems. This study introduces a multiclass Convolutional Neural Network (CNN) segmentation model by comparing four 3D U-Net variations-normal, residual, dense, and residual-dense. Data normalization and training were conducted on a 40-patient test set (20 normal, 20 abnormal) using 5-fold cross-validation. The normal 3D U-Net demonstrated superior performance with an F1 score of 84.29% on the normal test set and 79.32% on the abnormal set, exhibiting higher true positive rates for the sphenoid and maxillary sinus in both sets. Despite effective segmentation in clear sinuses, limitations were observed in mucosal inflammation. Nevertheless, the algorithm's enhanced segmentation of abnormal sinuses suggests potential clinical applications, with ongoing refinements expected for broader utility.

Occurrence of acute otitis and sinusitis in patients hospitalized for influenza.

Acute otitis and sinusitis are common complications in patients with influenza and are responsible for increased hospitalization rates. A five-year retrospective study (2018-2023) was conducted including all patients hospitalized for influenza (etiologic diagnosis by RT-PCR) to identify the incidence and characteristics of cases complicated with otitis and/or sinusitis. Cases associated with other viral co-infections were excluded from the analysis. We identified a cumulative rate of 20.6% (324 cases) of acute otitis (AO) and acute sinusitis (AS) among patients with influenza. Of these, 62.3% had AO, 28.1% AS, and 9.6% concomitant AO and AS. Cases of AO were predominant in the pediatric population (97.0%), while cases of AS were more common in adults (56.1%). Influenza A viruses were identified in 67.2% of patients. The infection with influenza B viruses increased the risk of acute congestive otitis media 2.1-fold (p=0.020), and influenza A viruses increased the risk of acute maxillary sinusitis 2.7-fold (p=0.029). Late presentation to the hospital, with a median of 4 days from the onset of influenza symptoms, was identified as a factor in the occurrence of AO and AS. The risk of AO and AS is increased in patients with influenza, especially in the pediatric population and in late hospital presentations. These findings highlight the importance of proper monitoring and management of patients with influenza to prevent the development of complications, as well as the need to better understand the mechanisms whereby influenza viruses contribute to these secondary conditions.

Luteolin Inhibits Lipopolysaccharide-Induced Inflammation and Epithelial–Mesenchymal Transition in Human Nasal Epithelial Cells

Chronic sinusitis is a persistent inflammatory condition needing better treatment options with fewer side effects to reduce recurrence. Luteolin, a flavonoid found in various plants, exhibits anti-inflammatory and anti-allergic properties. This study explores luteolin’s impact on chronic sinusitis. We isolated human nasal epithelial cells from sinusitis patients and used lipopolysaccharide-induced cells as a model. High-mobility group box 1 protein was notably elevated in these patients. Our findings suggest that luteolin can suppress the expression of inflammatory cytokines induced by lipopolysaccharide in these cells. Additionally, luteolin was able to inhibit the epithelial–mesenchymal transition in the treated cells. This inhibitory effect on high-mobility group box 1 expression led to reduced inflammation and transition processes. Overall, luteolin could potentially be an effective treatment for chronic sinusitis, minimizing inflammation and cellular transition in nasal epithelial cells.

The Variants of Frontal Recess and Its Effect in the Development and Prevalence of Frontal Sinusitis in Patients in a Tertiary Care Hospital: A Retrospective Observational Study.

According to medical literature, the frontal recess' intricate physical structure resembles an inverted funnel. The anatomical structure is not distant from the frontal ostium. Surgery requires a good understanding of the frontal recess architecture because of the intricate anatomy of this relatively small area. The pathophysiological characteristics of frontal sinusitis and the process of sinus ventilation through the sinus ostium have been linked, according to medical literature. Medical studies show that one of the most important factors affecting the amount of drainage in the frontal sinuses is the size of the frontal sinus ostium. Inflammation brought on by frontal recess cells can frequently affect the airflow in the frontal sinuses. The drainage channel of the frontal sinus is stated as narrowing in the current investigation as an observed phenomenon. The aim of this study was to examine the frontal recess changes and how they might affect the emergence of frontal sinusitis. The classification of frontal recesses according to their various categories was the study's principal finding. The investigation of the causal elements that resulted in the development of frontal sinusitis was the study's secondary goal. In a hospital setting, a cohort of 200 patients with sinonasal disorders underwent a retrospective observational research. Over the course of a year, from July 2021 to June 2022, the study participants had evaluations at a tertiary care center. 200 CT PNS images of individuals who fit certain inclusion and exclusion criteria were examined in this study. Using the chi-square test, the study looked into the relationships between several risk factors, including age, gender, and the type of frontal recess. The presence of frontal sinusitis served as the main outcome indicator. This study included a total of 200 participants with a mean age was 43.38years (± 10.69). There was 146 (73%) male and 54 (27%) female were in the study. Type I frontal recess in 50 (25%), type II in 82 (41%), type III in 24 (12%) and type IV in 18 (9%) patients. The association of age (P = 0.141) and gender (P = 0.345) with frontal sinusitis was not significant. The statistical association between type of frontal recess and frontal sinusitis was statistically not significant. The association between age and the type of frontal recess was found to be statistically significant by Fischer's exact test with P value of 0.012 (< 0.05), whereas gender was not associated with the type of frontal recess by the same test. It is difficult to overstate the significance of the terms frontal recess, frontal sinusitis, and sinus ostium in this particular medical context. This article was a retrospective observational study that investigates the connection between frontal sinusitis and changes in the frontal recess in patients receiving care at tertiary medical facilities.

Effect of correction of refractive error and threshold estimation in ocular headache patients in a tertiary eye care center

Purpose: Headache is one of the most common symptoms in patients with refractive error. Our study aimed to find the effect of refractive error correction and estimate the threshold of refractive error in patients with ocular headaches in a tertiary eye care center. Methods: We enrolled patients who came with complaints of headaches. It was a prospective, interventional study. All the patients underwent comprehensive ocular examination that included a detailed headache history, objective and subjective refraction, cycloplegic refraction, Humphrey visual fields test (30-2), cover test, and dilated fundus examination. We excluded uveitis, glaucoma, optic atrophy, papilledema, sinusitis, migraine, dental cavities, and neuropathy patients. We prescribed glasses after the post-mydriatic test. We surveyed via phone call regarding the compliance of spectacle wear and relief of headaches. Results: Out of the 98 enrolled patients, 67 were female and 31 were male in the age group of 16 to 35. The patients had simple astigmatism (57.14%), simple myopia (15.30%), simple myopic astigmatism (23.46%), and hyperopia (9.18%). The threshold value of dioptric power was −1.25 D, −1.00 D, −0.75 DS/−0.75 DC, and +1.00 D for simple astigmatism, simple myopia, simple myopic astigmatism, and hyperopia, respectively. 86.73% recovered with glasses. Simple astigmatism had the highest recovery rate. Headaches frequently occurred in the frontal (44.89%), followed by temporal (32.65%), parietal (16.32%), occipital, and parietal (11.22%). Conclusion: Lower degrees of refractive error caused the headache. We reported the threshold values of the refractive error that caused the ocular headache. Correcting the refractive error relieved the headache

Evaluation of ear, nose, and throat-screening in liver transplantation candidates: A retrospective cohort study.

Patients with end-stage liver disease can be treated with a liver transplantation (LT). Before listing, candidates are subjected to a screening procedure according to the EASL Clinical Practice Guidelines for LT. In our hospital, this includes an ear, nose, and throat (ENT) examination, directed towards the identification of (asymptomatic) infections and head and neck malignancies. We retrospectively reviewed all ENT screening examinations in LT candidates from 2007 to 2022. The screening consisted of a visit to the ENT outpatient clinic combined with sinus radiography. ENT screening was performed in 1099 patients. Sixty-one cases were identified, either diagnosed with an infection (n = 58, almost exclusively sinusitis) or a neoplasm (n = 3, of which two malignancies). With binary logistic regression, we could not identify significant risk factors for diagnosing sinusitis. 711 patients underwent LT. After LT, two patients developed a novel malignancy of the head and neck area, while 14 patients were diagnosed with sinusitis, two of the latter already showed opacification on sinus radiography during screening. Despite immunosuppressive drugs, no complicated sinusitis was observed. Sinusitis or a neoplasm was diagnosed in almost 6% in a large cohort of LT candidates. Although almost a third of sinusitis patients were not treated accordingly, we did not observe any complicated sinusitis after LT. A more conservative approach to sinusitis may therefore be justified in LT candidates, especially in asymptomatic cases. At our institution, we aim to refer only those patients with specific ENT complaints .

Reinke's Edema and Risk Factors, A Case-Control Study.

Reinke's edema (RE) is a benign pathological non-inflammatory disorder of the vocal folds with a wide range of clinical manifestations. We aim to investigate the relationship between Reinke's edema and some common inhalant abuse. In this case-control study, subjective consisted of 23 patients with RE (the cases), and 50 patients with sinusitis (control) who underwent surgery in the Department of Otolaryngology, between 2015 and 2020. Demographic characteristics, history of some related disease, methods, and the duration of cigarette, and opium consumption were collected through the patients' files. The chi-square (χ²) test was run to analyze the differences in the categorical and, and the Independent Sample T-test was used to compare two sample means from unrelated groups. A significant level (p-value) was considered less than 0.05. The mean age was 54 ± 12 years, and 42 ± 11 years, respectively for Reinke's edema and sinusitis. More women had been recorded in the RE group, compared to men. Allergy, unprincipled use of voice and talkativeness, history of laryngeal surgery, and type of disease were correlated to RE (p < 0.05). Also, cigarette smoking was significantly correlated with Reinke's edema. The average number of cigarettes per day, the duration of smoking, and opium consumption were more frequent in RE (P < 0.05). 90% of the RE and 4% of sinusitis patients were opium consumers. There was a statistically significant difference in the methods of substance use in the two groups of cases and control (p < 0.0001). Among the different methods, the poker and stone method was the most common (69.6%), and the opium smoking pipe was the second most common method. This study also confirmed the hazardous effects of smoking and inhaling opiates in the formation of lesions of the pharynx and larynx. In particular, longer use of these substances will be associated with more serious side effects. Therefore, it seems that people who are addicted to opiates should undergo periodic visits and counseling to reduce and stop their use.

Surgical Correction of Nasal Obstruction and Its Effect on Eustachian Tube Dysfunction Symptoms.

To investigate how eustachian tube dysfunction symptoms change following surgical treatment of nonsinusitis-related nasal obstruction. Retrospective chart review. Single academic center. We assessed patients who underwent septoplasty, turbinate reduction, or both for nasal obstruction. Chronic sinusitis patients were excluded. Eustachian tube dysfunction (ETD) symptoms were studied using the Eustachian Tube Dysfunction Questionnaire (ETDQ-7), collected preoperatively and postoperatively (1 week, 1 month, 3 months, 6 months postop). Patients with preoperative ETDQ-7 > 14.5 were considered to have clinically significant symptoms. Sinonasal outcomes test scores were also assessed. Pre- and postoperative ETDQ-7 scores were compared using t test. Multivariate linear regression analysis identified factors associated with ETDQ-7 change. We analyzed 259 patients. Preoperatively, 37.5% of patients with nasal obstruction had clinically significant ETD symptoms. These patients exhibited significant improvement in ETDQ-7 at all postoperative timepoints from 23.3 ± 7.6 at baseline to 19.1 ± 9.1 at 1 week, 16.5 ± 8.0 at 1 month, 16.2 ± 7.8 at 3 months, and 16.7 ± 10.4 at 6 months (all P < .01). In patients without baseline ETD symptoms, (baseline ETDQ-7: 9.1 ± 2.3) ETDQ-7 scores did not change significantly at postoperative timepoints, except for an acute worsening at 1 week postoperatively (10.7 ± 5.1, P < .001). Regression analysis showed that higher preoperative ETDQ-7 score (β = -0.84, 95% confidence interval [CI]: -1.10 to -0.59) and postoperative antihistamine spray usage (β = -8.70, 95% CI: -14.20 to -3.20) were associated with ETDQ-7 improvement, while comorbid GERD (β = 7.50, 95% CI: 3.42-11.58) and asthma (β = 5.62, 95% CI: 0.80-10.45) were negatively associated with improvement. Surgical correction of nasal obstruction may improve ETD symptoms.