Allergy & Rhinology最新文献

{"title":"Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature.","authors":"Carly A Clark,&nbsp;Cameron P Worden,&nbsp;Brian D Thorp,&nbsp;Charles S Ebert,&nbsp;Adam M Zanation,&nbsp;Brent A Senior,&nbsp;Steven M Johnson,&nbsp;Wade G McClain,&nbsp;Adam J Kimple","doi":"10.1177/2152656720918874","DOIUrl":"https://doi.org/10.1177/2152656720918874","url":null,"abstract":"<p><strong>Background: </strong>Extramedullary hematopoiesis (EMH) occurs in patients with hematologic disorders, but rarely within the paranasal sinuses. We report a case of EMH in a 17-year-old male with sickle cell disease (SCD) who presented with occipital pain and sinusitis. A computed tomography (CT) scan demonstrated heterogeneous opacification of the right maxillary sinus concerning for allergic fungal sinusitis or a fungal ball with bony erosion. He was taken to the operating room for endoscopic biopsy and a limited endoscopic sinus surgery. Grossly, his maxillary sinus was filled with spiculated osseous tissue. Final pathology demonstrated active hematopoietic bone marrow filling the sinus.</p><p><strong>Methods: </strong>We present a case report and literature review of sinonasal EMH.</p><p><strong>Results: </strong>We identified 14 articles with 15 patients. EMH was typically associated with SCD or beta thalassemia. The average age of presentation was 30. There was a male sex predilection with a ratio of 11:15. The most common presenting symptom was a headache and nasal obstruction (33% for both). The most common finding on CT was a soft tissue expansile mass (73%). The most commonly affected location was the maxillary sinus (60%).</p><p><strong>Conclusions: </strong>This case report serves as a reminder to consider EMH as an uncommon cause of sinus opacification, particularly in patients with SCD or beta thalassemia. The expansion of hematopoietic tissue may be identified as a sinus mass on CT. By recognizing the potential manifestations of chronic anemia, an accurate and timely diagnosis can be made.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720918874","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37897163","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":"Epithelial-Myoepithelial Carcinoma of the Lacrimal Sac and Literature Review of the Lacrimal System.","authors":"Dhruv Sharma,&nbsp;Ashley Neiweem,&nbsp;Kyle Davis,&nbsp;Mark Prendes,&nbsp;Rao Chundury,&nbsp;Elisa Illing","doi":"10.1177/2152656720920600","DOIUrl":"https://doi.org/10.1177/2152656720920600","url":null,"abstract":"<p><strong>Background: </strong>Epithelial-myoepithelial carcinomas make up less than 0.1% of head and neck malignancies and are regarded as rare, low-grade malignant neoplasms of the salivary gland. They are thought to arise from intercalated ducts with histopathology showing a classic biphasic morphology of an outer layer of myoepithelial cells and inner layer of epithelial cells. These tumors most commonly occur in the parotid gland; however, rare cases have also been described in the nasal cavity, nasopharynx, subglottis, base of tongue, and the lacrimal gland.</p><p><strong>Objective: </strong>To describe the clinical presentation, surgical management, and histopathology of the first reported case of lacrimal sac epithelial-myoepithelial carcinoma. To conduct a literature review of this malignancy, which is present in the lacrimal system.</p><p><strong>Methods: </strong>Case report (n = 1) and literature review.</p><p><strong>Results: </strong>We report a case of a 72-year-old man presenting with epiphora and a lacrimal sac mass with intranasal extension on imaging and nasal endoscopy. A combined endoscopic endonasal and open approach provided successful definitive treatment for final pathologic diagnosis of epithelial-myoepithelial carcinoma of the lacrimal sac, with orbital reconstruction and lacrimal stenting providing good cosmetic and functional results.</p><p><strong>Conclusions: </strong>After PubMed database search for any case series or reports of lacrimal system epithelial-myoepithelial carcinomas, we believe this is the first documented case originating from the lacrimal sac. Although the histopathology of this tumor is distinct, unusual location and clinical presentation may pose significant diagnostic difficulties.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720920600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37878480","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":"Post Autologous Bone Marrow Transplant Associated With a Resultant Mixed Polyclonal/Monoclonal Hyper-IgG3.","authors":"Lauren Fill,&nbsp;Marija Rowane,&nbsp;Kelsey Graven,&nbsp;Neha Sanan,&nbsp;Shan Shan Wu,&nbsp;Robert W Hostoffer","doi":"10.1177/2152656720915701","DOIUrl":"https://doi.org/10.1177/2152656720915701","url":null,"abstract":"<p><p>There have been few studies illustrating the post immunological phenotype of patients receiving autologous bone marrow transplant (ABMT) for the treatment of diffuse large B-cell lymphoma. High-dose chemotherapy and autologous bone marrow transplantation have been shown to be the only potential curative treatment modalities for B-cell lymphoma. Autologous bone marrow transplantation, although widely utilized in patients with non-Hodgkin lymphoma recurrence, does have an association with immunologic side effects, although serologic changes where rarely reported unless accompanied by recurrent infections. We report the first case of a 62-year-old female patient who experienced recurrent infections, namely, sinusitis and pneumonia, after receiving an ABMT with subsequent hyper-IgG3 phenotype.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720915701","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37831090","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 Microbiome of the Nose-Friend or Foe?","authors":"Sofia Dimitri-Pinheiro,&nbsp;Raquel Soares,&nbsp;Pedro Barata","doi":"10.1177/2152656720911605","DOIUrl":"https://doi.org/10.1177/2152656720911605","url":null,"abstract":"<p><p>Recently, multiple studies regarding the human microbiota and its role on the development of disease have emerged. Current research suggests that the nasal cavity is a major reservoir for opportunistic pathogens, which can then spread to other sections of the respiratory tract and be involved in the development of conditions such as allergic rhinitis, chronic rhinosinusitis, asthma, pneumonia, and otitis media. However, our knowledge of how nasal microbiota changes originate nasopharyngeal and respiratory conditions is still incipient. Herein, we describe how the nasal microbiome in healthy individuals varies with age and explore the effect of nasal microbiota changes in a range of infectious and immunological conditions. We also describe the potential health benefits of human microbiota modulation through probiotic use, both in disease prevention and as adjuvant therapy. Current research suggests that patients with different chronic rhinosinusitis phenotypes possess distinct nasal microbiota profiles, which influence immune response and may be used in the future as biomarkers of disease progression. Probiotic intervention may also have a promising role in the prevention and adjunctive treatment of acute respiratory tract infections and allergic rhinitis, respectively. However, further studies are needed to define the role of probiotics in the chronic rhinosinusitis.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720911605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37765973","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":"Effect of Biospray Dressings on Eosinophil Infiltration in the Nasal Mucosa and Serum IgE Levels After Nasal Provocation in Experimental Allergic Rhinitis.","authors":"Shan Huang,&nbsp;Geping Wu,&nbsp;Xiaodan Gu,&nbsp;Hongyan Zhu,&nbsp;Xingkai Ma,&nbsp;Yifang Yuan,&nbsp;Yan Lv,&nbsp;Di Li,&nbsp;Ling Zhang","doi":"10.1177/2152656720902142","DOIUrl":"https://doi.org/10.1177/2152656720902142","url":null,"abstract":"Purpose To investigate the effect of biospray dressing on the extent of eosinophil infiltration in the nasal mucosa and the level of serum IgE in experimental allergic rhinitis with nasal provocation. Method Twenty-four BALB/c mice were randomly divided into the normal control group, allergic rhinitis (AR) group, dexamethasone (DEX) treatment group, and biospray dressing (BD) group. The mice in the latter 3 groups were prepared for animal models of AR according to standard protocols. Mice in the BD group were administered a nasal spray before the nasal provocation, and those in the DEX group were administered an intraperitoneal injection of DEX. The nasal mucosa and serum were collected from each group. Nasal mucosa eosinophil infiltration was evaluated using hematoxylin and eosin staining, and enzyme-linked immunosorbent assay (ELISA) was performed to analyze the serum IgE expression. Results Eosinophil infiltration (AR vs BD P = .009) in the nasal mucosa and serum IgE expression (AR vs BD P = .001) were significantly lower in the BD group than in the AR group. There were no significant differences in the extent of eosinophil infiltration in the nasal mucosa or serum IgE expression between the BD and DEX groups. Conclusion Biospray dressings can significantly reduce allergen provocation in the nasal cavity and have a protective effect on the nasal mucosa. They can be used for the prevention and treatment of AR.","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720902142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37762914","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":"Low Baseline Pneumococcal Antibody Titers Predict Specific Antibody Deficiency, Increased Upper Respiratory Infections, and Allergy Sensitization.","authors":"Charles H Song,&nbsp;Dennys Estevez,&nbsp;Diana Chernikova,&nbsp;Francesca Hernandez,&nbsp;Rie Sakai-Bizmark,&nbsp;Richard Stiehm","doi":"10.1177/2152656719900338","DOIUrl":"https://doi.org/10.1177/2152656719900338","url":null,"abstract":"<p><strong>Background: </strong>Inadequate titers of pneumococcal antibody (PA) are commonly present among patients with recurrent respiratory infections.</p><p><strong>Objective: </strong>We sought to determine the effect of the degree of inadequacy in baseline PA titers on the subsequent polysaccharide vaccine response, the incidence of sinusitis, and allergic conditions.</p><p><strong>Methods: </strong>A total of 313 patients aged 6 to 70 years with symptoms of recurrent respiratory infections were classified by baseline-pPA (percentage of protective [≥1.3 µg/mL] PA serotypes/total tested serotypes) and postvaccination pPA (post-pPA): Group A (adequate baseline-pPA), Group B (inadequate baseline-pPA, adequate post-pPA, responders), and Group C (inadequate baseline-pPA, inadequate postpPA, nonresponders, specific antibody deficiency [SAD]). Immunity against <i>Streptococcus pneumoniae</i> was defined as adequate when the pPA was ≥70%. Each group and combined groups, Group AB (inadequate baseline-pPA), and Group BC (adequate post-pPA) were analyzed for demographics, history of sinusitis, recurrent sinusitis in the following year, allergic conditions, and association with inadequate individual serotype titers.</p><p><strong>Results: </strong>Over 80% of patients with respiratory symptoms had inadequate baseline-pPA. Baseline-pPA and SAD prevalence are inversely related (odds ratio = 2.02, 95% CI: 1.15-3.57, <i>P</i> = .01). Inadequate serotype 3 antibody titer is highly associated with SAD (odds ratio = 2.02, 96% CI: 1.61-5.45, <i>P</i> < .01). The groups with inadequate pPA (Group B and C, or BC) had significantly higher percentage of patients with chronic rhinosinusitis (<i>P</i> < .001), allergic sensitization, and allergic rhinitis (<i>P</i> < .05). Group A contained higher percentage of patients with recurrent upper airway infections (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Low baseline-pPA and low antibody titers to serotype 3 are highly associated with SAD, increased incidence of respiratory infections including CRS and allergic conditions.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719900338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37619882","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":"Atypical Presentation of Silent Sinus Syndrome: A Case Report and Literature Review.","authors":"Nanki Hura,&nbsp;Omar G Ahmed,&nbsp;Nicholas R Rowan","doi":"10.1177/2152656719899928","DOIUrl":"https://doi.org/10.1177/2152656719899928","url":null,"abstract":"<p><strong>Introduction: </strong>Silent sinus syndrome (SSS) is a condition characterized by ophthalmologic features, such as spontaneous enophthalmos and hypoglobus with ipsilateral maxillary sinus atelectasis and an otherwise asymptomatic presentation. SSS has been documented secondary to a number of external causes, including trauma or surgery, but has less commonly been described in the setting of a potential mass in the deep masticator space.</p><p><strong>Case presentation: </strong>A 56-year-old woman with a history of chronic headaches with normal prior sinonasal imaging presented with increasing right-sided facial pain and headaches that radiated to her occiput, subjective visual changes, sharp ear pain, and long-standing subjective diminished sense of smell. Physical examination was normal, while nasal endoscopy demonstrated lateral bowing of the medial maxillary wall on the right. Magnetic resonance imaging demonstrated a homogenous 2 × 2 × 2.4 cm T1- and T2-weighted, hyperintense mass lesion in the deep masticator space splaying the right medial and lateral pterygoid muscles concerning for a possible lipomatous lesion. Computed tomography revealed an atelectatic and opacified maxillary sinus with inward bowing of the posterior maxillary wall and increased orbital volume on that side. Endoscopic maxillary antrostomy was performed with biopsy of the retromaxillary space lesion and with near immediate resolution of the patient's symptoms. Histologic examination of the mass demonstrated mature adipose tissue with few aggregates of benign small vessels.</p><p><strong>Discussion: </strong>This is an unusual presentation of SSS, with an accompanying enlargement of the retromaxillary fat pad. We herein review our clinical experience with SSS and provide a literature review of the presentation, management, and perioperative considerations for SSS.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719899928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37582178","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":"Management of Orbital Masses: Outcomes of Endoscopic and Combined Approaches With No Orbital Reconstruction.","authors":"Ryan A Rimmer,&nbsp;Alexander E Graf,&nbsp;Judd H Fastenberg,&nbsp;Jurij Bilyk,&nbsp;Gurston G Nyquist,&nbsp;Marc R Rosen,&nbsp;Michael P Rabinowitz,&nbsp;Mindy R Rabinowitz","doi":"10.1177/2152656719899922","DOIUrl":"https://doi.org/10.1177/2152656719899922","url":null,"abstract":"Introduction The endoscopic endonasal approach to management of orbital pathology has expanded. Due to the rarity of these conditions, most reports in the literature consist of small case reports. We report a series from a single institution with a focus on outcomes. Methods A retrospective chart review was carried out between 2010 and 2018. Results Twenty-four patients were identified (average age 58 years, 15 males, 9 females). Average follow-up was 14.9 months. Most common etiologies included cavernous hemangioma (7), metastases (6), idiopathic orbital inflammatory syndrome (6), orbital hematoma/clot (2), and schwannoma (1). Most common presenting symptoms were decreased visual acuity (8), proptosis (8), diplopia (7), and incidental findings (2). All patients underwent endoscopic medial wall orbital decompressions. Sixteen involved a combined open approach by an ophthalmologist. Pathology was either biopsied (15), resected (6), or could not be identified (3). No intraoperative complications were noted. No patients underwent orbital reconstruction of the medial wall. Six patients developed postoperative sinusitis successfully managed with antibiotics. One patient developed epistaxis managed conservatively. In 5 patients, Sino-Nasal Outcome Test-22 scores increased immediately postop and then decreased, whereas scores only decreased in 6 patients. Six patients noted reduced proptosis. There were no new cases of diplopia or worsening visual acuity. Conclusions A combined endoscopic endonasal and external approach can be useful for managing orbital lesions. Patients tolerated the procedure well with improvement in ocular symptoms and minimal sinonasal complications. Reconstruction of the medial wall may not be warranted to prevent postoperative diplopia.","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719899922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37582179","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":"Role of Olfaction in Human Health: A Focus on Coronaviruses.","authors":"Rosario B Jaime-Lara,&nbsp;Valentina Parma,&nbsp;Carol H Yan,&nbsp;Farhoud Faraji,&nbsp;Paule V Joseph","doi":"10.1177/2152656720928245","DOIUrl":"https://doi.org/10.1177/2152656720928245","url":null,"abstract":"Author(s): Jaime-Lara, Rosario B; Parma, Valentina; Yan, Carol H; Faraji, Farhoud; Joseph, Paule V","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656720928245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10487380","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 Unilateral Nasal Mass With Generalized Seizures: Potential Diagnostic Pitfalls in Giant Pituitary Adenoma.","authors":"Rahimah Aini,&nbsp;Ida Sadja'ah Sachlin,&nbsp;Lai Chuang Chee,&nbsp;Baharudin Abdullah","doi":"10.1177/2152656719896580","DOIUrl":"https://doi.org/10.1177/2152656719896580","url":null,"abstract":"<p><p>Giant pituitary adenomas are clinically nonfunctioning adenomas, and the clinical presentation is usually secondary to compression of the neighboring structures. Visual impairment and visual field defect are the most common preoperative symptoms, followed by headache. Generalized seizures may occur in giant pituitary adenomas when there is involvement of frontal lobes or medial temporal lobes. We present a case of a unilateral nasal mass with generalized seizures in a 55-year-old woman without prior episode of seizure and any predisposing factors. Imaging showed a sinonasal tumor with intracranial extension and histopathological examination confirmed a corticotroph adenoma. On seeing a patient with a unilateral nasal mass extending down from the roof of nasal cavity, olfactory neuroblastoma, or meningo-encephalocoele readily comes to mind. To avoid misdiagnosis and delay in treatment, imaging and, if possible, a biopsy should be considered. Giant pituitary adenoma although not common should be thought of as one of the differential diagnosis.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2019-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719896580","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37508493","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}