BMC Ear, Nose and Throat Disorders最新文献

{"title":"Isolation and antimicrobial drug susceptibility pattern of bacterial pathogens from pediatric patients with otitis media in selected health institutions, Addis Ababa, Ethiopia: a prospective cross-sectional study.","authors":"Tewodros Tesfa Hailegiyorgis,&nbsp;Wondemagegn Demsiss Sarhie,&nbsp;Hailemariam Mekonnen Workie","doi":"10.1186/s12901-018-0056-1","DOIUrl":"https://doi.org/10.1186/s12901-018-0056-1","url":null,"abstract":"<p><strong>Background: </strong>Otitis media is inflammation of the middle ear and tympanic membrane, which often occurs after an acute upper respiratory tract infection. It is the most common episode of infection in children and the second most important cause of hearing loss affecting 1.23 billion people, thus ranked fifth global burden of disease with a higher incidence in sub-Saharan Africa. Thus, the aim of this study was to determine the isolation rate of bacterial pathogens from pediatric patients with otitis media.</p><p><strong>Methodology: </strong>Institutional based cross-sectional study was conducted from January 2013-June 2014 in Addis Ababa among 210 pediatrics patients. Demographic, clinical and associated factors data was obtained in face to face interview with guardians/parents by 5 trained nurse data collectors using structured questionnaire. Middle ear drainage swab was collected following all aseptic procedures and transported to the microbiology laboratory. Culture and Antimicrobial sensitivity test were performed according to the standards. The data quality was assured by questionnaire translation, retranslation and pretesting. Reference strains were used as a positive and negative control for biochemical tests, and culture results were cross checked. Data was checked for completeness, consistency and then entered into Epi Info v3.5.1 and analyzed by SPSS v20. Data interpretation was made using graphs, tables, and result statements.</p><p><strong>Result: </strong>A total of 196 middle ear drainage swab samples were analyzed from pediatric patients and of those 95 (48.5%) samples were positive for pathogenic organisms. The major isolate was <i>S. aureus</i> (15.8%) followed by <i>P. aeruginosa</i> (10.9%), Viridians streptococcus (9.9%), <i>S. pneumoniae</i> (8.9%) and <i>S. pyogenes</i> (7.9%). Upper respiratory tract infection history and living in the rural area have shown significant association with the isolation of pathogenic organism, (<i>p-value = 0.035)</i> and (<i>p-value = 0.003)</i> respectively. Most of the isolates show a high level of resistance to Trimethoprim-Sulfamethoxazole, Penicillin G, Ampicillin, Amoxicillin, and Chloramphenicol.</p><p><strong>Conclusion: </strong><i>S. aureus</i> and <i>P. aeruginosa</i> are the most common pathogens that contribute to otitis media as well most of the isolates show a high level of resistance to commonly used drugs to treat otitis media. Therefore, culture and susceptibility testes have paramount importance for the better management of otitis media and drug-resistant infections.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-018-0056-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36178028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency of mitochondrial m.1555A > G mutation in Syrian patients with non-syndromic hearing impairment.","authors":"Hazem Kaheel, Andreas Breß, Mohamed A Hassan, Aftab Ali Shah, Mutaz Amin, Yousuf H Y Bakhit, Marlies Kniper","doi":"10.1186/s12901-018-0055-2","DOIUrl":"10.1186/s12901-018-0055-2","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial maternally inherited hearing impairment (HI) appears to be increasing in frequency. The incidence of mitochondrial defects causing HI is estimated to be between 6 and 33% of all hearing deficiencies. Mitochondrial m.1555A > G mutation is the first mtDNA mutation associated with non-syndromic sensorineural deafness and also with aminoglycoside induced HI. Its prevalence varied geographically between different populations.</p><p><strong>Methods: </strong>We carried out PCR, restriction enzyme based screening, and sequencing of 337 subjects (including 132 patients diagnosed clinically with hereditary deafness) from 54 families from Syria for m.1555A > G mitochondrial mutation.</p><p><strong>Results: </strong>Mitochondrial m.1555A > G mutation was detected in one of fifty-four families (1.85%), six out of the 132 (4.5%) of all patients with NSHI and one propositus of the 205 individuals with normal hearing (0.48%).</p><p><strong>Conclusion: </strong>This is the first study to report prelingual deafness causative gene mutations identified by sequencing technology in Syrian families. It is obvious from the results that the testing for the m.1555A > G mutation is useful for diagnosis of hearing loss in Syrian patients and should also be considered prior to treatment with aminoglycosides in predisposed individuals.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36257293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sinonasal adenoid cystic carcinoma-role of on-site FNAC: a case report.","authors":"Santosh Tummidi, Kanchan Kothari, Roshni Patil, Shruti S Singhal, Vyoma Shah","doi":"10.1186/s12901-018-0053-4","DOIUrl":"10.1186/s12901-018-0053-4","url":null,"abstract":"<p><strong>Background: </strong>Adenoid cystic carcinoma (ACC), a rare tumor of epithelial cell origin, commonly arises from the major salivary glands. Uncommonly it may be found outside the salivary glands and it's especially rare in the nasal cavity.</p><p><strong>Case presentation: </strong>A 71-year female had complaints of swelling at the base of nose, Fine needle aspiration (FNA) from the swelling revealed features of adenoid cystic carcinoma; cell block & IHC for CD-117 was positive.</p><p><strong>Conclusions: </strong>Sino-nasal ACC (SNACC) continues to pose diagnostic and therapeutic challenges to clinicians. Due to its rarity & vague presentation, early diagnosis requires a high index of suspicion. FNA can be used as an invaluable diagnostic tool in the evaluation of these lesions. Since it's incidence in sinonasal region is rare; our attempt to report this case will heighten the physician's awareness of this disease, helping further treatment.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5941585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36099265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of transcutaneous neuromuscular electrical stimulation on laryngeal vestibule closure timing in swallowing.","authors":"Christopher R Watts,&nbsp;Matthew J Dumican","doi":"10.1186/s12901-018-0054-3","DOIUrl":"https://doi.org/10.1186/s12901-018-0054-3","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to investigate the effect of transcutaneous neuromuscular electrical stimulation (NMES) on the timing of laryngeal vestibule closure during the pharyngeal stage of swallowing in healthy adults. The theoretical framework proposed that NMES applied to these muscles would present a perturbation to laryngeal vestibular closure reaction time (the amount of time for the laryngeal vestibule to close once the swallowing reflex has been triggered) by providing an antagonistic force to the direction of vestibule closure.</p><p><strong>Methods: </strong>Nine healthy adults (2 males, 7 females) received ten consecutive stimulations applied to the submandibular hyolaryngeal muscles while performing dry swallows. Laryngeal vestibule closure reaction time (LVCrt) and the laryngeal vestibule closure duration (LVCd) were measured from videoflouroscopic images pre-stimulation and post-stimulation.</p><p><strong>Results: </strong>Results indicated a significant effect of stimulation on LVCrt but not LVCd. LVCrt was significantly reduced (timing was faster) during swallows immediately after stimulation compared to pre-stimulation.</p><p><strong>Conclusions: </strong>Findings from this study support the supposition that laryngeal muscles respond to perturbations via adaptation learning, which might be used for rehabilitation of neuromuscular swallowing impairment. This pilot study supports the need for further research.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-018-0054-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36099264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment, outcomes, and demographics in sinonasal sarcoma: a systematic review of the literature.","authors":"Mitchell R Gore","doi":"10.1186/s12901-018-0052-5","DOIUrl":"https://doi.org/10.1186/s12901-018-0052-5","url":null,"abstract":"<p><strong>Background: </strong>Sarcomas comprise a diverse group of soft tissue mesenchymal malignancies. The sinuses and nasal region are a relatively rare site of sarcomas.</p><p><strong>Methods: </strong>Retrospective review of the literature on sinonasal sarcomas from 1987-2017. Data were analyzed for demographics, treatment type, stage, and histopathologic type. Kaplan-Meier analysis was used to assess and compare survival.</p><p><strong>Results: </strong>A total of 198 cases of sinonasal sarcoma were identified and analyzed. The median age at diagnosis was 39 years. Overall 5-, 10-, and 20-year survival was 61.3%, 58.9%, and 49.1%, respectively, and disease-free 5-, 10-, and 20-year survival was 53.2%, 49.1%, and 38.3%, respectively. Lymph node metastasis was present at diagnosis in 3.0% of cases, and distant metastasis was present in 3.5% of cases. On univariate analysis T stage, overall stage, treatment type, histopathologic subtype, and presence of distant metastasis significantly affected survival. On multivariate analysis overall stage alone significantly predicted overall survival. Open vs. endoscopic surgery, total radiation dose, and presence of neck metastasis did not significantly affect survival. Combined modality treatment was associated with higher survival rates than single modality therapy.</p><p><strong>Conclusions: </strong>Sinonasal sarcoma is a relatively rare malignancy. Lower T and overall stage, lack of distant metastasis, and multimodality therapy were associated with improved survival. Certain histopathologic subtypes were associated with poorer survival.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-018-0052-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35949723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of tonsillectomy in the Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis syndrome; a literature review.","authors":"Jostein Førsvoll,&nbsp;Knut Øymar","doi":"10.1186/s12901-017-0049-5","DOIUrl":"https://doi.org/10.1186/s12901-017-0049-5","url":null,"abstract":"<p><strong>Background: </strong>Tonsillectomy (TE) or adenotonsillectomy (ATE) may have a beneficial effect on the clinical course in children with the Periodic Fever, Aphthous stomatitis, Pharyngitis and cervical Adenitis (PFAPA) syndrome. However, an immunological reason for this effect remains unknown. This literature review summarizes the current knowledge of the effect of TE or ATE in the PFAPA syndrome.</p><p><strong>Methods: </strong>A search of PubMed, Medline, EMBASE and Cochrane was conducted for papers written in English dated from 1 January 1987 to 31 December 2016. The search included all studies reporting outcomes after TE or ATE from children aged 0 to 18 years with PFAPA.</p><p><strong>Results: </strong>Two randomized controlled trials reported significantly faster resolution of febrile episodes after TE or ATE in children with PFAPA compared to controls (non-surgery groups). We identified 28 case series including 555 children with PFAPA. The diagnosis was set prospectively before surgery in 440 children and retrospectively after surgery in 115 of the children. TE or ATE had a curative effect in 509 of the 555 children with PFAPA (92%), but few studies were of high quality.</p><p><strong>Conclusion: </strong>TE or ATE may have a curative effect on children with PFAPA, but the evidence is of moderate quality. Further high-quality randomized controlled studies are still needed.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-017-0049-5","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35866104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of symptoms and quality of life before and after nasal septoplasty and radiofrequency therapy of the inferior turbinate.","authors":"Ann Helen Nilsen,&nbsp;Anne-Sofie Helvik,&nbsp;Wenche Moe Thorstensen,&nbsp;Vegard Bugten","doi":"10.1186/s12901-017-0050-z","DOIUrl":"https://doi.org/10.1186/s12901-017-0050-z","url":null,"abstract":"<p><strong>Background: </strong>The primary goal of this study is to compare pre- and postoperative symptoms and health related quality of life (HQOL) in 57 patients who underwent septoplasty (group-1), 56 patients who underwent septoplasty combined with radiofrequency therapy of inferior turbinates (RFIT) (group-2) and 58 patients who underwent RFIT alone (group-3). The secondary goal is to investigate if the change in symptoms and HQOL differed between these three patient groups after surgery.</p><p><strong>Methods: </strong>All patients reported symptoms on a visual analogue scale (VAS) and HQOL on Sino-Nasal-Outcome-Test-20 (SNOT-20) and Short-Form-Health-Survey-36 (SF-36) before and 6 months after surgery. The pre- and postoperative scores and improvement were compared within and between the three patient groups.</p><p><strong>Results: </strong>Preoperatively the three patient groups had a fairly similar symptom burden and HQOL, except for group-1 which reported more symptoms of oral breathing than group-3 <i>(p < 0.01)</i> and group-3 which reported more problems in the ear/facial--subset of SNOT-20 and in the general-mental-health-domain of SF-36 than group-1 <i>(p < 0.01)</i>.Postoperatively all patient groups reported improved symptom scores of nasal obstruction, nasal discharge, snoring, oral breathing and reduced general health <i>(p < 0.01),</i> and better HQOL <i>(p < 0.05).</i> Patients in group-2 had less symptoms of nasal obstruction than group-3 <i>(p < 0.05)</i>. Postoperative symptom score for nasal obstruction was 29.1 (SD67.6) in group-1, 27.5 (SD22.5) in group-2 and 37.2 (SD24.8) in group-3. Revision cases reported more nasal obstruction postoperatively; 41.3 (SD27) than non revision cases; 28.6 (SD24) <i>(p < 0.01).</i>The HQOL after surgery was about the same in all three patient groups, but we found that patients with comorbidities as sleep apnea and asthma reported worse HQOL than other patients <i>(p < 0.01).</i></p><p><strong>Conclusion: </strong>Surgical treatment of nasal obstruction led to less symptoms and better HQOL for all three patient groups. Comparing the postoperative scores between the patient groups we find that all groups reached the same level of HQOL. Regarding symptoms, the patients who underwent septoplasty combined with RFIT reported postoperatively less nasal obstruction than patients who underwent RFIT alone which may indicate that a combined procedure of septoplasty and RFIT is better than RFIT alone to treat nasal obstruction. Furthermore, revision cases, patients with sleep apnea and asthma patients seem to have poorer outcome after surgery than other patients. Both disease specific and general QOL instruments add valuable information for identifying factors influencing outcome.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-017-0050-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35814452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generic quality of life in persons with hearing loss: a systematic literature review.","authors":"Øyvind Nordvik,&nbsp;Peder O Laugen Heggdal,&nbsp;Jonas Brännström,&nbsp;Flemming Vassbotn,&nbsp;Anne Kari Aarstad,&nbsp;Hans Jørgen Aarstad","doi":"10.1186/s12901-018-0051-6","DOIUrl":"https://doi.org/10.1186/s12901-018-0051-6","url":null,"abstract":"<p><strong>Background: </strong>To the best of our knowledge, no empirically based consensus has been reached as to if, and to what extent, persons with hearing loss (HL) have reduced generic Quality of life (QoL). There seems to be limited knowledge regarding to what extent a hearing aid (HA) would improve QoL. The main aim of the present study was to review studies about the relationship between HL and QoL. A supporting aim was to study the association between distress and HL.</p><p><strong>Methods: </strong>Literature databases (Cinahl, Pub Med and Web of Science) were searched to identify relevant journal articles published in the period from January 2000 to March 17, 2016. We performed a primary search pertaining to the relationship between HL, HA and QoL (search number one) followed by a supporting search pertaining to the relationship between distress/mood/anxiety and HL (search number two). After checking for duplications and screening the titles of the papers, we read the abstracts of the remaining papers. The most relevant papers were read thoroughly, leaving us with the journal articles that met the inclusion criteria.</p><p><strong>Results: </strong>Twenty journal articles were included in the present review: 13 were found in the primary search (HL and QoL), and seven in the supporting search (HL and distress). The literature yields equivocal findings regarding the association between generic QoL and HL. A strong association between distress and HL was shown, where distressed persons tend to have a lowered generic QoL. It is suggested that QoL is lowered among HL patients. Some studies suggest an increased generic QoL following the use of HA, especially during the first few months after initiation of treatment. Other studies suggest that HA use is one of several possible factors that contribute to improve generic QoL.</p><p><strong>Conclusions: </strong>The majority of the studies suggest that HL is associated with reduced generic QoL. Using hearing aids seem to improve general QoL at follow-up within the first year. HL is a risk factor for distress. Further research is needed to explore the relationship between HL and generic QoL, in addition to the importance of influencing variables on this relationship.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-018-0051-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35780688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and validity study of Sino-nasal outcome test 22 (Thai version) in chronic rhinosinusitis.","authors":"Jate Lumyongsatien, Waralak Yangsakul, Chaweewan Bunnag, Claire Hopkins, Pongsakorn Tantilipikorn","doi":"10.1186/s12901-017-0047-7","DOIUrl":"10.1186/s12901-017-0047-7","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is one of common health conditions that affects patients' health-related quality of life. Our purpose is to assess the reliability and validity of Thai-version of Sino-Nasal Outcome Test 22 in chronic rhinosinusitis.</p><p><strong>Methods: </strong>Permission for translation of SNOT-22 from English language to Thai language was obtained from the developer. The translation process was done based on the international standard of translation method. A total of 80 subjects were recruited into the study and divided into two groups comprising of 50 patients with chronic rhinosinusitis and 30 healthy volunteers. Cronbach's α and Intraclass correlation coefficient were evaluated for its reliability. Validity test was evaluated against VAS score, SF-36 (Thai version) questionnaire and CT scan (based on Lund-Mackay score). Responsiveness was assessed between pre-operative and post-operative scores in 34 patients.</p><p><strong>Results: </strong>The Thai version of SNOT-22 showed good reliability according to high value of Cronbach's α coefficient (<i>r</i> = 0.929) and intraclass correlation coefficient (<i>r</i> = 0.935). It also showed good validity by its ability to differential the patients with chronic rhinosinusitis from normal (<i>p</i> < 0.001), and different severity of symptoms (<i>p</i> < 0.05). In addition, the SNOT-22 Thai version also showed good responsiveness when compared between pre-operative and post-operative scores (p < 0.001) and also well-performed in effect size calculation (1.37).</p><p><strong>Conclusion: </strong>We demonstrated that Thai -version of SNOT-22 has good reliability and validity, suitable for evaluation of chronic rhinosinusitis symptoms together with severity of the disease and response to treatment.</p><p><strong>Trial registration: </strong>Thai clinical trials registry TCTR20170320003. Date of registration 20/03/2017 (retrospectively registered).</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-017-0047-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35706521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of higher symptomatic airway load in patients with chronic rhinosinusitis.","authors":"Øystein Eskeland,&nbsp;Kjell Arild Danielsen,&nbsp;Fredrik Dahl,&nbsp;Katrin Fridrich,&nbsp;Vivian Cecilie Orszagh,&nbsp;Gregor Bachmann-Harildstad,&nbsp;Espen Burum-Auensen","doi":"10.1186/s12901-017-0048-6","DOIUrl":"https://doi.org/10.1186/s12901-017-0048-6","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis display a variety of different phenotypes. The symptoms of disease are characterised by various signs and symptoms such as nasal congestion, nasal discharge, pressure sensation in the face and reduced or complete loss of smell.In a patient population undergoing functional endoscopic sinonasal surgery (FESS) for chronic rhinosinusitis, we wanted to investigate the clinical features and explore if the presence of biofilm, nasal polyps or other disease characteristic could serve as predictor for the symptomatic load. A patient group undergoing septoplasty without disease of the sinuses was included as control.</p><p><strong>Methods: </strong>The Sinonasal outcome test (SNOT-20), EPOS visual analogue scale (VAS) and the Lund-Mackey CT score (LM CT score) were used to examine 23 patients with chronic rhinosinusitis without nasal polyps (CRSsNP), 30 patient with nasal polyps (CRSwNP) and 22 patients with septal deviation. Tissue samples were collected prospectively during surgery. The cohort has previously been examined for the presence of biofilm.</p><p><strong>Results: </strong>Patients with CRSsNP and CRSwNP had significantly higher degree of symptoms compared to the septoplasty group (SNOT-20 scores of 39.8, 43.6 and 29.9, respectively, <i>p</i> = 0.034). There were no significant differences in the total SNOT-20 or VAS symptoms scores between the CRSsNP and CRSwNP subgroups. However patients with nasal polyps showed significantly higher scores of symptoms related to sinonasal discomfort such as cough, runny nose and need to blow nose (<i>p</i> = 0.011, <i>p</i> = 0.046, <i>p</i> = 0.001 respectively). Patients with nasal polyps showed a significantly higher LM CT score compared to patients without polyps (12.06 versus 8.00, <i>p</i> = 0.001). The presence of biofilm did not impact the degree of symptoms.</p><p><strong>Conclusion: </strong>The presence of nasal polyp formations in CRS patients was associated with a higher symptomatic airway load as compared to patients without polyps. These findings suggest that nasal polyps could be an indicator of more substantial sinonasal disease. The presence of biofilm did not impact the degree of symptoms, however, as biofilm seem to be a common feature of chronic rhinosinusitis (89% in this cohort), it is more likely to be involved in the development of the CRS, rather than being a surrogate marker for increased symptomatic load.</p>","PeriodicalId":39843,"journal":{"name":"BMC Ear, Nose and Throat Disorders","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12901-017-0048-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35706522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}