Treatment Of Nasal Obstruction Research Articles

Hyaluronic Acid in Facial Rehabilitation—A Narrative Review

Background: Hyaluronic acid fillers (HAF) are a versatile tool in esthetic medicine. They also have a potential for medical indications including facial rehabilitation. Materials and methods: We performed a literature search on PUBMED and Google Scholar until December 2022. Clinical trials, clinical studies, review articles, systematic reviews, meta-analyses, case series, and case reports were considered for review. Keywords “facial rehabilitation”, “acne scars”, “traumatic scars”, “oral restoration”, “facial lipoatrophy”, “facial asymmetry”, “periocular correction”, “nasal obstruction”, “ear lobe restoration”, “morphea”, AND “hyaluronic acid filler” were used to select articles. Results: We prepared a narrative review on the use of HAF for correction of facial asymmetry and asymmetric lips, improvement of different types of scars, improvement of the jaw line, improvement of ear lobes, periocular and oral restoration, and the treatment of nasal obstruction and morphea en coub de sabre. The amount of HA used in these indications is often less than 1 mL. The bolus technique, fanning, and dual-plane injections can be utilized for treatment. Duration of clinical effects depends upon the anatomical region and is usually maintained between 2 months and 2 years. Adverse events are often mild and temporary. Vascular occlusion is a severe adverse event, but it has not been reported yet for these medical indications. Repeated injections are recommended to obtain a longer-lasting improvement. In cases of morphea, only stable and non-inflammatory plaques should be treated. The advantage of HAF compared to permanent and semipermanent fillers is the availability of hyaluronidase for rapid removal of filler material and to revise overcorrection. Conclusions: HAF play an auxiliary role in facial rehabilitation. Knowledge of filler qualities, anatomy, and underlying diagnoses is important for their safe application. More prospective controlled trials are necessary to improve evidence.

The independent role of nasal obstruction in resistant hypertension for uncontrolled hypertensive patients with obstructive sleep apnea.

To determine the independent predictive role of nasal obstruction in resistant hypertension (RH) in uncontrolled hypertensive patients with obstructive sleep apnea (OSA). This prospective cohort study comprised of 236 OSA patients with uncontrolled blood pressure (BP) using 1 or 2 classes of antihypertensive drugs visiting Sleep Medicine Center from April 2021 to March 2022. Information on demographic characteristics, comorbidities, BP control and classes of antihypertensive medication, sleep-related symptoms, Nasal Obstruction Symptom Evaluation (NOSE) Scale and sleep parameters was collected. RH incidence according to the BP control and classes of antihypertensive drugs data during the 5month follow-up was collected. After 5month follow-up, 217 participants were included for final data analysis. Ninety-five subjects had nocturnal nasal obstruction with a higher proportion of RH (36.8% vs. 17.2%, p = 0.001) compared to those without nocturnal nasal obstruction. After adjustment for demographic characteristics, sleep-related symptoms and OSA severity, multinomial logistic regression models showed that nocturnal nasal obstruction (all ORs > 2.5, p < 0.05) or NOSE ≥ 8 (all ORs > 4.5, p < 0.05) was independently associated with a higher odds of RH. Nasal obstruction treatment improved NOSE score significantly, but did not reduce the incidence of RH significantly. Effective nasal obstruction treatment was associated with antihypertensive drugs reduction (OR 4.43; 95% CI 1.20-16.27). Nasal obstruction is an independent predictor of RH in uncontrolled hypertensive patients with OSA. In addition to the treatment of OSA, assessment and treatment of nasal obstruction should be considered in the management of uncontrolled hypertensive patients with OSA.

Effeciny of CO2 laser in treatment of nasal obstration due to inferfer turninate hypertrohy in Kirkuk province

Introduction: Nasal obstruction secondary to Inferior turbinate hypertrophy (ITH) may be a slight irritation to some people but to others it is considerable distress and affects the value of life to a great extent. The aim of study is to assessment of outcome of CO2 laser application to anterior end of inferior turbinate in treatment of nasal obstruction, and assessment of effect of CO2 laser on mucosa of inferior turbinate. Method: Cross sectional comparative study of 46 patients with nasal obstruction due to inferior turbinate hypertrophy. After select of patient according to inclusion and exclusion criteria, complete explanation of the procedure and its sequel with informed, procedure done in Kirkuk general hospital with lemmer CO2 laser with local anesthesia apply to nasal cavity, by using proper size laser probe laser apply to anterior 1/3 of inferior turbinate for 30-90 seconds, nasal pack apple for 2 -3 hours then removed, with re-packing if there is bleeding, daily follow up of patient for 1st week then 1 month and 6-month post operatively done. Results: Cross sectional comparative study of 46 patients, mean age (37 ± 14) years old, 14 (30%) of them are females and 32 (70%).

Office based inferior turbinate coblation treatment: a randomized controlled trial on effectiveness and tolerability of medicinal honey

Background: When conservative treatment for nasal obstruction fails, surgery is often applied. Inferior Turbinate Hypertrophy (ITH) is a common cause of nasal obstruction, which can be treated by means of radiofrequency coblation. This technique can be administered under local anesthesia (office based coblation; OBC) and if expedient combined with a lateralization (out-fracture) of the inferior turbinate (IT). Ointment based on medical grade honey, is known to have wound healing characteristics. Methodology: Single center, single blinded randomized controlled trial. Fifty-five subjects received bilateral OBC of the IT. Subjects were randomized to postoperative care with either nasal saline irrigations (NSI) or NSI combined with ointment based on honey (NSI+STB). Subjects weekly reported subjectively overall nasal burden, -crusting, -pain, loss of smell by means of VAS-scores and nasal obstruction by means of the NL-NOSE scale. Results: No significant differences between the NSI and NSI+STB groups, though the latter showed less pain. Concerning the study group as a whole, mean nasal burden score and nasal obstruction significantly decreased from 63.4 to 16.0 and 65.3 to 22.0, respectively. Nasal crusting, -pain, and loss of smell largely resolved 3-4 weeks postoperatively and were only mild. Concomitant lateralization showed a tendency to quicker resolution of the nasal obstruction. Conclusions: OBC is a safe, well tolerated and effective treatment for nasal obstruction caused by ITH. Concerning multiple end-points, we found no evidence of a beneficial effect of ointment based on honey as addition to NSI in postoperative care, except a clear tendency in less crusting and pain.

The septal tubercle: the state of the problem

The septal tubercle is considered to be a thickened area of the nasal septum, which is located above the lower nasal concha and in front of the middle nasal concha. Taking into account its histological structure and location in the distal segment of the internal nasal valve, it is located and structured for secretory function and vasoactive regulation of the respiratory air flow. These histologically rich tissues with glandular elements are well adapted to the possible dryness that occurs under the influence of intense air flow during breathing, and the existence of a certain number of venous sinusoids of the blood confirms the connection with part of the extensive vascular tissues in the nasal cavity. It is believed that the tubercle of the nasal septum is more pronounced in patients with chronic inflammation of the sinonasal region, for example, with chronic allergic rhinitis or chronic rhinosinusitis. There is currently no consensus on the issue of surgery of the nasal septum body. Due to the lack of consensus among practitioners, many surgeons do not routinely perform operations on this structure and consider the surgical intervention too aggressive, and the effect on nasal obstruction is insignificant. However, according to the presented studies, the results of surgical reduction of soft tissues of the enlarged septal tubercle in the treatment of nasal obstruction using radiofrequency ablation, coblation or microdebrider seem promising, which requires additional study of this issue during long-term follow-up.

Редкие причины назальной обструкции

Nasal obstruction can be influenced by numerous anatomical and physiological factors. For rhinosurgeons, it is important to know about the existence of such muscular and vascular components of the internal nasal valve (INV) region as the nasal septal swell body (NSB) and the nasal vestibular body (NVB) that – like other components of the INV – can take part in the development of the nasal obstruction. The body of the nasal septum is a glandular structure consisting of seromucous glands and venous sinusoids. It is associated with the area of the internal nasal valve and provides additional resistance to nasal airflow. The nasal vestibular body is an unstable dynamic vascular structure of the internal nasal valve, which is located on the inferolateral border of the area of the internal nasal valve, immediately in front of the head of inferior turbinate. There is currently no consensus regarding the surgery of these muscular and vascular components of the internal nasal valve for the treatment of nasal obstruction. However, the studies described in this review may indicate the effectiveness of surgical reduction of NSB and NVB. At the same time, other anatomical causes of nasal obstruction, such as hypertrophy of the inferior turbinate or deformation of the nasal septum, may interfere with the analysis of the described structures of the INV region, which may compromise the results of standard surgical interventions for nasal obstruction.

Our Septoplasty Results: Evaluation with the Nose Scale.

The aim of this study was to evaluate the effectiveness of septoplasty and septoplasty + bilateral radio frequency ablation of inferior turbinate (b-RFAIT) according to the type of operation, age groups, gender of patients, and the duration of control period by using Nasal Obstruction Symptom Evaluation (NOSE) Scale. Prospective observational study was undertaken in the otolaryngology department of a training hospital. Using the NOSE scale, the study prospectively compared the results of septoplasty only and septoplasty with b-RFAIT in the treatment of nasal obstruction caused by the combination of septal deviation and turbinate hypertrophy. Patients were divided into 2 groups. The first group had only septoplasty and the second group had septoplasty with b-RFAIT. General and local anesthesia were applied in both groups. To review clinical success, all patients were controlled at the 1st week, 1st month, and 3rd month. One hundred seventy-eight adult patients (male/female: 127/51) with chronic nasal obstruction complaint were enrolled in this prospective study. Our data demonstrated significant improvement from baseline after 24 months for the NOSE scores in both the septoplasty and septoplasty + b-RFAIT groups. No statistical difference was noted in the amount of postoperative improvement between the 2 treatment groups ( P = 0.306). No significant difference was observed between general and local anesthesia with respect to patients' preop and postop mean scores ( P > 0.05). There was a significant difference between the age of patients' postoperative mean ( P < 0.001). There were 4 postoperative means with respect to control time. There was an 82.29% decrease in the complaints of patients at 0 to 6 months, 80.51% decrease at 7 to 12 months, 76.1% decrease at 13 to 18 months, and 59.67% decrease at 19 to 24 months. Only the last group had a significant difference regarding mean change in scores ( P < 0.001). This study shows that septoplasty + bilateral turbinate radiofrequency should be applied to patients who suffer from septum deviation with concha hypertrophy. Postoperative NOSE scale shows that the success of operation does not depend on the gender of patients and operation types (general or local anesthesia). We conclude that younger patients (18-40 age) who have obstruction with septal deviation and septum deviation with concha hypertrophy benefit more from operation than older patients do.

Nasal decongestants in the treatment of nasal obstruction

Nasal congestion is one of the most common symptoms of common colds and rhinitis, due to an inflammatory reaction, vasodilation, increased nasal blood flow and vascular permeability. Nasal obstruction is often a multifactorial problem, in addition to infectious causes, it can be caused by a combination of anatomical aberrations, swelling of the nasal mucosa and enlargement of the turbinates. Anatomical and structural problems, such as nasal septum deviation and nasal valve collapse, are usually treated surgically. Drug therapy of nasal obstruction is aimed at reducing edema and inflammation of the nasal mucosa. Pharmacotherapy of nasal obstruction is aimed at reducing inflammation and/or swelling of the mucous membrane. Decongestants are widely prescribed to relieve symptoms. The drugs used have different mechanisms of action and include systemic and topical drugs. This article discusses decongestants as a treatment for nasal obstruction. When applied topically, the drugs of this group act directly on the α2 and α1-adrenergic receptors of the nasal cavity, causing vasoconstriction, a decrease in the volume of the nasal conch, an increase in nasal patency, and relieving the symptoms of obstruction. The existing risk of developing side effects, both systemic and local, is reduced with atopic exposure and proper dosing of the drug used. Preferably, the use of drugs with low bioavailability. The suppression of the ciliated epithelium can be caused not only by the pathological process, but also by the composition of drugs. The value is given to the acidity of the buffer system. The optimal pH value of intranasal agents is about 6 (neutral range). The combination with anticholinesterase substances reduces the production of pathological discharge. The use of multi-component medicines allows you to restore nasal breathing and suppress excessive nasal secretion. One of the effective and safe drugs of topical action is Xylometazoline, as a monocomponent agent or in combination with ipratropium bromide.

Выбор топического деконгестанта для симптоматической терапии назальной обструкции

Выбор топического деконгестанта для симптоматической терапии назальной обструкции

Outcome comparison of submucous resection versus combined submucous diathermy and outfracture for treatment of inferior turbinate hypertrophy.

The aim of this study was to compare the outcome of submucous resection and combined submucous diathermy with outfracture technique in treatment of nasal obstruction caused by inferior turbinate hypertrophy. This study is a prospective randomized clinical trial involving 90 patients with hypertrophied inferior turbinate not responding to medical treatment. All patients were selected with equal or near equal mucosal and bony turbinate components using computed tomography (CT) and then randomly allocated into two groups; group A (n = 45): underwent submucous resection in both sides and group B (n = 45): underwent combined submucous diathermy and outfracture in both sides. Subjective (NOSE score) and objective (4-grades endoscopic classification system and PNIF evaluation) measures of nasal airflow were done preoperatively and postoperatively. Subjective assessment using NOSE scale proved that both techniques were effective in relieving nasal obstruction as it improved in both groups postoperatively compared to the preoperative data. However, resection technique was better than diathermy technique with a statistically significant difference (p < 0.05), while objective assessment of nasal obstruction showed better results in resection group than diathermy group, but with no statistically significant difference. Both techniques are effective in relief of nasal obstruction due to inferior turbinate hypertrophy. However, submucous resection showed marked improvement compared to diathermy technique especially at long-term follow-up.

Caudal Septal Deviation: New Classification and Management Strategy.

To propose a classification of anatomical variation of the caudal septal deviation and propose strategy for the management of caudal septal deviation by septo-rhinoplasty and to evaluate the efficacy of treatment of different types of caudal septal deviation in terms of aesthetic and functional outcome. The study is a retrospective review of 124 cases with significant anterior caudal deviation causing aesthetic and or functional problems, treated by septo-rhinoplasty within a 5year period from December 2014 to December 2019, with a minimum follow up of 6months. Visual analogue scale, photographic evaluation and subjective assessment were used for postoperative outcomes. Significant improvement in the treatment of nasal obstruction was achieved, with mean visual analogue scale score of 7.83 preoperatively to 3.56 postoperatively, Subjective assessment showed marked satisfaction in 96 patients, moderate satisfaction in 21 and no improvement in seven patients of total 124 patients. The rate of revision was (4%). A novel classification of anterior caudal septal deviation is proposed with surgical technique directed for individual deformity and we have achieved very good results.

Improvement in Snoring-Related Quality-of-Life Outcomes After Functional Nasal Surgery.

Importance: Sleep-disordered breathing (SDB) represents a spectrum of sleep-related disorders associated with significant medical comorbidities. Nasal airway surgery has been shown to improve SDB but no large-scale studies exist that describe the long-term impact of surgery on patient perception of snoring and nasal obstruction. Objective: To characterize longitudinal snoring symptoms and nasal obstruction after functional nasal surgery for patients with SDB, stratified by history of snoring or obstructive sleep apnea (OSA). Design, Setting, and Participants: In this prospective cohort study, patients undergoing nasal surgery between 2013 and 2017 at a tertiary academic center were surveyed using Snoring Outcome Survey (SOS) and Nasal Obstruction Symptom Evaluation (NOSE) questionnaires through 24 months postoperatively. Patient demographics, history of snoring, diagnosis of OSA, and prior nasal surgeries were analyzed. A total of 625 patients were recruited with 325 females (52.0%) and mean age of 36.3 years (SD 15.6), with 74.9% patients reported snoring (n = 468) and 10.7% patients (n = 67) with OSA. Patients undergoing dual functional and cosmetic septorhinoplasty with or without turbinate surgery were included. Those undergoing concomitant sinus surgery were excluded. Intervention: Functional nasal surgery. Main Outcomes and Measures: SOS and NOSE scores were collected at 2, 4, 6, 12, and 24 months postoperatively. Results: Patients undergoing nasal surgery had statistically and clinically significant improvement in NOSE score at 24 months (mean improvement 29.0 points, p < 0.0001). Patients with snoring history also had significant improvement in SOS score through 24 months (mean improvement 10.7 points, p < 0.0001). Nonsnorers demonstrated no significant change. OSA patients achieved clinically significant improvement in SOS scores through 24 months (mean improvement 31.9; p > 0.05, minimum clinically important difference = 7.6 points). Conclusions and Relevance: Nasal surgery improves long-term nasal obstruction as measured by NOSE score and, for those with comorbid snoring and OSA, can lead to a sustained improvement in snoring-related quality of life (QOL) based on SOS score. Nonsnorers did not have a significant change in snoring symptoms. SOS can be used as a practical and effective instrument to measure snoring-related QOL outcomes after nasal airway surgery. Future studies using objective measures of snoring are needed to quantify the physiologic change in snoring after treatment of nasal obstruction. Level of Evidence: 2c.

Does surgical treatment of nasal airway obstruction improve sexual functions?

To investigate the effects of surgical treatment for nasal obstruction on sexual functions, regardless of the condition causing the nasal obstruction. Of 238 patients identified with nasal obstruction, 57 complained of erectile dysfunction and were included in the analysis. Patients underwent septoplasty, functional endoscopic sinus surgery, concha bullosa excision or radiofrequency ablation of the inferior turbinates, depending on their obstruction-causing disease. Pre- and post-operative evaluation of perceived nasal obstruction was performed using the Nasal Obstruction Symptom Evaluation questionnaire. Pre- and post-operative assessment of sexual functions was performed using the International Index of Erectile Function. Mean post-operative scores for erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall sexual satisfaction were significantly higher compared to the pre-operative scores (p = 0.022, p = 0.036, p = 0.033, p = 0.016 and p = 0.029, respectively). Surgical treatment of nasal obstruction by septoplasty, endoscopic sinus surgery, concha bullosa excision or radiofrequency can significantly improve sexual performance.

The mechanism and treatment of nasal obstruction in allergic rhinitis

SummaryNasal obstruction is one of the main symptoms of allergic rhinitis（AR） as well as one of the most common complains in the otolaryngology department. Among the many causes of nasal congestion, such as inflammation and anatomy, the most common clinical cause is the nasal mucosal inflammatory response that caused by AR. The nasal congestion caused by AR can induce nighttime sleep disturbance and mental-psychological burden. Nasal congestion has a greater impact on children, which can directly affect growth and development due to affecting nighttime sleep, and may even affect maxillofacial development, which should be paid special attention by physicians. According to the particularity of AR nasal congestion, this review summarizes how to carry out clinical consultation, select specialist examination and objective examination methods, and develop the optimal treatment strategy.

Impact of septoplasty on pulmonary function

Background: Deviated nasal septum (DNS) is the most common cause of upper airway obstruction, and septoplasty is the surgery of choice for its correction. There seems a relationship between upper airway and lower airway. Spirometry is the easily available method to analyze pulmonary function. Aims and Objectives: The aims and objectives of this study were to assess the changes in pulmonary function after surgical correction of DNS for nasal obstruction. Materials and Methods: A total of 50 patients with DNS with the complaints of nasal obstruction underwent septoplasty were selected. Pre- and post-surgery (after 1 month) spirometry was done on these patients, and the results were analyzed using various statistical tools for difference in spirometry findings depending on age group, gender, and duration of disease. Results: There was an improvement in pulmonary function indices 1 month after surgery, and it was both clinically and statistically significant. The improvement was more in younger age group as compared to middle age group, and it was more in nasal obstruction of shorter duration. There was no significant difference in improvement among males and females. Conclusion: There is a strong correlation between treatment for nasal obstruction and improvement in pulmonary function which is more significant for younger age groups and nasal obstruction of shorter duration.

Could Nasal Surgery Affect Multilevel Surgery Results for Obstructive Sleep Apnea?

To study the role of nasal surgery as a part of multilevel surgery for management of obstructive sleep apnea (OSA). All patients underwent multilevel surgery for relieving OSA symptoms and they were classified according to type of surgical intervention into: group A (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy, suspension (El-Ahl and El-Anwar) sutures and nasal surgery (inferior turbinate surgery). Group B (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy and suspension sutures. Pre and postoperative sleep study, Epworth sleepiness scale, snoring score were reported and compared. Apnea hypoapnea index (AHI) dropped significantly in both groups. The mean preoperative AHI was significantly less in patients who had no nasal obstruction (P = 0.0367), while the difference in postoperative values was nonsignificant (P = 0.7358).The mean Epworth sleepiness scale improved significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. The lowest oxygen saturation elevated significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. As regards snoring scores, they dropped significantly in both groups. The preoperative snoring score was reported to be significantly more in patients who had associated nasal obstruction (group A) (P = 0.0113). But after surgery the difference in postoperative values was nonsignificant (P = 0.1296). Treatment of nasal obstruction should be considered a crucial component in the comprehensive management plan for OSA patients as it has significant impact on the patients' AHI and snoring.

0558 Less Invasive Procedure for the Treatment of Nasal Obstruction: Impact on Daytime Drowsiness

0558 Less Invasive Procedure for the Treatment of Nasal Obstruction: Impact on Daytime Drowsiness

SEPTOPLASTY VERSUS SEPTOPLASTY WITH MINIMAL NASAL VALVE REPAIR

Background&#x0D; Nasal obstruction is a highly prevalent problem in that can negatively affect quality of life. One of the common causes of nasal obstructions a deviated septum. In the presence of such nasal obstruction, nasal septoplasty and Minimal Nasal Valve Surgery procedures can improve the nasal airway and nasal scale score. Septoplasty procedure alone use commonly to overcome this nasal obstruction.&#x0D; Objective&#x0D; To compare the effectiveness of combination of septoplasty with minimal nasal valve surgery versus the septoplasty alone in the treatment of nasal obstruction and improving the nasal scale score.&#x0D; Patients and Methods&#x0D; This is a comparative prospective study conducted at tertiary center and private hospital from Nov. 2014 to June 2016. The study included 60 patients suffering from nasal obstruction for more than 6 months. The patients were selected for the type of surgery randomly. Following rigid nasal endoscopy of the nose and valve area to exclude other pathologies, assessment of nasal obstruction 1 week before surgery was done according to Nasal Obstruction Symptoms Evaluation (NOSE) Scale. The patients were divided into two groups according to the type of surgery. Group A: Septoplasty with minimal nasal valve repair. Group B: Septoplasty alone.&#x0D; Results&#x0D; Significant improvement in the treatment of nasal obstruction was achieved in group A with mean Nasal scores of [14.43] preoperatively and [4.20] 3 months postoperatively.No significant difference in the nasal score in early post-operative time in both groups. P value found significant in both group regarding the improvement in the airway breathing and overcoming the nasal obstructions in mean of nasal score in both groups A and B in two main period. There was no significant difference between the two groups regarding local nasal pain by VAS , P value were non-significant. here was no significant differenc regarding the bleeding in both groups A and B after removal of the silastic intranasal splintafter oneweek. No significant difference regarding crustation in both Groups.&#x0D; Conclusion&#x0D; Both groups in this study had good outcome in treating nasal obstruction and nasal scale with the superiority of the group A in long term after 3 months.

Clinical observation of mometasone furoate nasal spray combined with montelukast sodium in the treatment of adenoid hypertrophy in children

Objective:To study the clinical effect of mometasone furoate nasal spray combined with montelukast in the treatment of adenoid hypertrophy in children.Method:One hundred and thirty eight cases with adenoid hypertrophy were randomly divided into two groups, 69 cases in each group; the control group were treated with mometasone furoate nasal spray alone; the observation group were treated with mometasone furoate combined with oral montelukast. Adenoid nasopharynx ratio (A/N), and the proportion of overall recurrence after treatment of nasal obstruction were compared, also with snoring, mouth breathing rate, life quality score before and after treatment in the two groups, and finally compared the clinical total effective ratio.Result:Compared with before treatment, A/N of two groups of patients were significantly decreased, and the observation group decreased more significantly, the difference between the two groups was significant (P< 0.05); nasal obstruction, snoring, mouth breathing rate of observation group were significantly lower than the control group, and the recurrence rate also lower than the control group, the difference was statistically significant (P< 0.05). The quality of life scores, sleep disorder scores, physical status score and daily function score in the two groups were significantly decreased after treatment, and in observation group the three scores were decreased more significantly, the difference between the two groups was statistically significant (P< 0.05). The total efficiency of the observation group was 94.1%, which was statistically higher than the control group (79.4%, P< 0.05).Conclusion:The clinical efficacy of mometasone furoate nasal spray combined with montelukast in the treatment of adenoid hypertrophy in children is significant, which can effectively reduce the adenoid nasopharynx ratio, improve the symptoms of snoring, mouth breathing, nasal congestion, improve the quality of life of patients, and the effective ratio was higher than single drug treatment, which was worthy to apply on clinic.

Sinonasal Characteristics in Patients with Obstructive Sleep Apnea Compared to Healthy Controls.

Background. The difference in nasal obstruction between OSA patients and healthy individuals is not adequately documented. Our aim was to describe the sinonasal quality of life and nasal function in OSA patients and healthy controls using the sinonasal outcome test-20 (SNOT-20), nasal obstruction visual analog scale (NO-VAS), and peak nasal inspiratory flow (PNIF). Methodology and Principal. Ninety-three OSA patients and 92 controls were included in a case-control study from 2010 to 2015. Results. Mean SNOT-20 score in the OSA group was 1.69 (SD 0.84) compared to 0.55 (SD 0.69) in controls (p < 0.001, 95% CI [0.9, 1.4]). The mean NO-VAS score was 41.3 (SD 12.8) and 14.7 (SD 14.4) in the OSA group and controls, respectively, (p < 0.001, 95% CI [22.7, 30.6]). PNIF measured 105 litres/minute in the OSA group and 117 litres/minute in controls (p < 0.01, 95% CI [−21.8, −3.71]). There was a positive correlation between subjective nasal obstruction and change in PNIF after decongestion in the control group alone. Conclusions. OSA patients have a reduced sinonasal QoL and lower peak nasal inspiratory flow compared to controls. Treatment of nasal obstruction in OSA patients should be made a priority along with treatment of the ailment itself.