Allergy & Rhinology最新文献

{"title":"Combined Endoscopic and External Resection of an Inverted Papilloma of the Lacrimal Sac: A Case Report and Review of the Literature","authors":"Kalla A. Gervasio, Phoebe L Mellen, R. S. Boparai, R. Soares, J. Fastenberg, Mark B. Chaskes, Michael P. Rabinowitz, Mindy R. Rabinowitz","doi":"10.1177/2152656719876254","DOIUrl":"https://doi.org/10.1177/2152656719876254","url":null,"abstract":"Background Inverted papillomas (IPs) are benign, locally aggressive neoplasms with a high recurrence rate that most commonly arise from the lateral nasal wall. Rarely, IP can originate from the lacrimal sac and/or nasolacrimal duct (NLD) system. A 58-year-old man presented with chronic epiphora and an enlarging mass inferior to his left medial canthal tendon (MCT) for 2 years. Objective The patients’ clinical presentation and surgical management are described. A literature review on IP of the lacrimal sac and NLD system was conducted. Methods Case report. Results We present a case of an IP that arose primarily from the lacrimal sac and grew below the MCT rather than extending above it. This is one of few published case reports detailing the use of a combined endoscopic and external approach for the resection of an IP of the lacrimal sac. Conclusion Combined endoscopic and external resection is a viable approach for complete removal of extensive IP of the lacrimal sac and NLD system. IP arising from the lacrimal sac may grow below the MCT or extend above it as previously reported.","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719876254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45975438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult and Pediatric Lateral Lamella Cribriform Plate Height: In Need for a Comparative Study","authors":"Gilbert Sakandar, J. Haron, A. Mohamad, I. Mohamad, R. Ramli","doi":"10.1177/2152656719874775","DOIUrl":"https://doi.org/10.1177/2152656719874775","url":null,"abstract":"Surgery for sinuses has evolved with the advancement of instruments and modification in techniques. Endoscopes have expanded the surgical roles for lesions in the nose and para-nasal sinuses with reduced rate of complications and cosmetic side effects. Nevertheless sinus surgery in pediatrics patients has its own challenges. Pre-operative imaging is of paramount important especially when embarking on skull base procedures. The differences between adult and pediatric anatomy need to be further studied.","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719874775","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46563669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure Pressures of Dural Repairs in a Porcine Ex Vivo Model: Novel Use of Titanium Clips Versus Tissue Glue","authors":"K. Chorath, Mason R Krysinski, L. Bunegin, Jacob S Majors, E. Weitzel, K. McMains, Philip G. Chen","doi":"10.1177/2152656719879677","DOIUrl":"https://doi.org/10.1177/2152656719879677","url":null,"abstract":"Objective Endoscopic skull base surgery is advancing, and it is important to have reliable methods to repair the resulting defect. The objective of this study was to determine the failure pressures of 2 commonly used methods to repair large dural defects: collagen matrix underlay with fibrin glue and collagen matrix underlay with polyethylene glue, as well as a novel repair method: fascia lata with nonpenetrating titanium vascular clips. Methods The failure pressure of the 3 dural repairs was determined in a closed testing apparatus. Defects in porcine dura were created and collagen matrix grafts were used as an underlay followed by either fibrin glue (FG/CMG) or polyethylene glycol glue (PEG/CMG). A third condition using a segment of fascia lata was positioned flush with the edges of the dural defect and secured with titanium clips (TC/FL). Saline was infused to simulate increasing intracranial pressure (ICP) applied to the undersurface of the grafts until the repairs failed. Results The mean failure pressure of the PEG/CMG repair was 34.506 ± 14.822 cm H2O, FG/CMG was 12.413 ± 5.114 cm H2O, and TC/FL was 8.330 ± 3.483 cm H2O. There were statistically significant differences in mean failure pressures among the 3 repair methods. Conclusion In this ex vivo model comparing skull base repairs’ ability to withstand cerebrospinal fluid leak, the repairs that utilized PEG/CMG tolerated the greatest amount of pressure and was the only repair that exceeded normal physiologic ICP’s. Repair methods utilizing glues generally tolerated higher pressures compared to the novel repair using clips alone.","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656719879677","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47680963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in the Nasal Inflammatory Response to <i>Cynodon dactylon</i> From Rural and Urban Areas in Patients With Allergic Rhinitis.","authors":"Jorge Sánchez,&nbsp;Andres Sánchez,&nbsp;Jorge Sánchez","doi":"10.1177/2152656718815870","DOIUrl":"https://doi.org/10.1177/2152656718815870","url":null,"abstract":"<p><strong>Background: </strong>Epidemiological and experimental studies suggest that air pollution has a negative impact on human health and modifies the environment. However, the clinical implications of changes in environmental allergens secondary to air pollution have been little studied.</p><p><strong>Objectives: </strong>To explore if the growth conditions of the <i>Cynodon dactylon</i> (rural vs urban area) modify the inflammatory response among patients with allergic rhinitis.<b>Methodology:</b> Two extracts were prepared for diagnostic test with Cyn d proteins obtained from rural and urban environment. Skin prick test (SPT), nasal challenge test (NCT), and eosinophil count in nasal mucus were performed in 3 groups: healthy subjects without rhinitis, rhinitis with (+) Cyn d, and rhinitis with (-) Cyn d.</p><p><strong>Results: </strong>There was a 97% concordance in the positive and negative results of the SPT with the 2 extracts. However, Cyn d-urban extract generated larger wheals (<i>P</i> = .03) and a higher number of patients with rhinitis presented a positive NCT to this extract (n = 7 vs 14, <i>P</i> = .04). Patients with positive NCT had a significant increase in eosinophils in mucus, but there was no difference between the extracts. The healthy controls did not react to the extracts tested in the skin or nasal test.</p><p><strong>Conclusion: </strong>The findings suggest that the growth conditions in urban area of <i>Cynodon dactylon</i> can generate changes in the protein extract and have clinical implications in patients with allergic rhinitis.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718815870"},"PeriodicalIF":2.2,"publicationDate":"2018-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718815870","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36839358","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":"Not All Rashes Are Allergic: Keratoderma Blennorrhagicum-Like Rash Masquerading as Contact Dermatitis.","authors":"Maxwell Y Li,&nbsp;Jason Kolfenbach,&nbsp;Alan Schocket","doi":"10.1177/2152656718811566","DOIUrl":"https://doi.org/10.1177/2152656718811566","url":null,"abstract":"A 56-year-old Caucasian man was referred to the allergy clinic for evaluation of palmoplantar dermatitis. The patient’s rash developed one year prior to presentation. He described erythema, pruritus, and hyperkeratosis of the involved skin with the eventual development of deep fissuring. He had a history of onychomycosis of his toenails but no history of fungal skin rash. He was exposed to solvents, mineral spirits, and gasoline through his occupation in home renovation and wearing neither nitrile nor cotton gloves alleviated his symptoms. Prior evaluations were carried out by primary care and dermatology. He had been treated with topical emollients, topical steroids (including potent agents such as clobetasol) for suspected atopic dermatitis, and topical antifungal agents as well (although KOH prep was negative). All prior treatments failed to resolve his severe palmoplantar rash. His medical history included hypertension, obesity, fatty liver disease, uveitis, bilateral total hip arthroplasty, and a history of childhood allergic rhinitis for which he underwent allergen immunotherapy and was quiescent at the time of evaluation. The physical examination was significant for moderately erythematous, hyperkeratotic, well-defined plaques on the palmoplantar surfaces of the hands and feet without dorsal involvement. Fissuring was seen at the fingertips and the plantar surface of the feet (Figure 1(A) to (D)) without associated pustulosis. There were no obvious nail pitting, oil spots, nor onycholysis, and scalp examination was normal. External examination of the eyes and oral examination were both normal. No appreciable synovitis was documented on peripheral joint examination, but the patient appeared “stiff” with ambulation as well as when stepping down from the examination table. Patch testing result revealed a weak positive reaction to gold sodium thiosulfate and an irritant reaction to thimerosal. Common sensitizers of allergic contact dermatitis in the construction worker were evaluated. The patient did not have reactions to potassium dichromate found in cements, biocides such as isothiazolinones, rubber chemical, and metal allergens (ie, chrome, thiurams, carbamates, mercaptobenzothiazole) accounting for foot dermatitis from work boot materials, and epoxy resin. These results, along with the patient’s history, led to decreased suspicion for either contact or atopic dermatitis. Given the patient’s history of uveitis (which upon review of the chart was recurrent and associated with HLA-B27 positivity), the hyperkeratotic and plaque-like appearance of his lesions, and the concern for possible axial spine disease based on examination, formal radiographs were obtained (Figure 2) and a referral to rheumatology was initiated. His rheumatologic evaluation confirmed decreased range of motion at the spine with an abnormal occiput to wall test of 8 cm, abnormal Schober’s test (10–12 cm increase with flexion and no reversal of lumbar lordosis), and decrease","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718811566"},"PeriodicalIF":2.2,"publicationDate":"2018-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718811566","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36768834","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":"Endoscopic Management of Lacrimal System Dysgenesis and Dacryocystoceles in Fraser Syndrome: A Case Report and Literature Review.","authors":"Megan E Falls,&nbsp;Michael P Rabinowitz,&nbsp;Jacqueline R Carrasco,&nbsp;Mindy R Rabinowitz","doi":"10.1177/2152656718804905","DOIUrl":"https://doi.org/10.1177/2152656718804905","url":null,"abstract":"<p><strong>Background: </strong>Fraser syndrome is an autosomal recessive disorder characterized primarily by syndactyly, cryptophthalmos, urinary tract anomalies, ambiguous genitalia, and laryngeal anomalies. A 28-year-old man with Fraser syndrome presented with cryptophthalmos, microphthalmia, lacrimal system dysgenesis, and chronic sinusitis.</p><p><strong>Objective: </strong>The patients' clinical condition and surgical treatment are described. A literature review was conducted, and articles relevant to the case are presented.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>To our knowledge, this is the first published case report of endonasal management of dacryocystoceles in a Fraser syndrome patient. The patient was treated via endoscopic endonasal marsupialization and drainage.</p><p><strong>Conclusion: </strong>Fraser syndrome patients may initially present to many different specialties as the spectrum of clinical manifestations is broad. Physicians treating these patients should take a collaborative approach to surgical and medical management.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718804905"},"PeriodicalIF":2.2,"publicationDate":"2018-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718804905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36621315","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":"Randomized Trials of Nasal Patency and Dermal Tolerability With External Nasal Dilators in Healthy Volunteers.","authors":"John Ward,&nbsp;Renee Ciesla,&nbsp;William Becker,&nbsp;Gilbert Marava Shanga","doi":"10.1177/2152656718796740","DOIUrl":"https://doi.org/10.1177/2152656718796740","url":null,"abstract":"<p><strong>Background: </strong>External nasal dilator strips are used as nonpharmacological therapy to reduce snoring and daytime sleepiness. In a product improvement initiative, a marketed strip (BRNS) and 2 prototype nasal strips were evaluated.</p><p><strong>Objective: </strong>To compare the nasal patency and multiple-use dermal tolerability of the BRNS and prototype nasal strips using both objective and subject-reported outcome measures.</p><p><strong>Methods: </strong>Two studies were conducted separately in healthy volunteers ≥18 years of age. A single-day nasal patency randomized crossover study assessed minimal cross-sectional area (MCA; second restriction) and nasal volume (using acoustic rhinometry); nasal inspiratory flow and resistance (using posterior rhinomanometry); and subject-reported evaluations of the BRNS compared with the butterfly strip and teardrop strip prototypes. A single-center, randomized, controlled, parallel-group, evaluator-blinded study assessed dermal tolerability of the BRNS and the butterfly strip over 7 consecutive nights of use, using the Dermal Response Scale (DRS) and subject-reported comfort and ease of removal.</p><p><strong>Results: </strong>In the Patency study (N = 50), all 3 strips demonstrated significant improvement from baseline in MCA, nasal volume, and nasal flow parameters (resistance and peak flow). The prototype strips demonstrated significantly more improvement in nasal volume than the BRNS, and the butterfly strip showed significantly more improvement in MCA than the BRNS; all strips were similar with respect to nasal flow and subject-reported nasal breathing outcomes. In the Dermal Tolerability study (N = 82), all subjects scored 0 (no evidence of irritation) on the DRS at all 7 morning assessments; the BRNS was numerically, but not significantly, superior to the butterfly strip on subject-reported outcomes.</p><p><strong>Conclusion: </strong>The Patency study demonstrated significant improvement from baseline in nasal dimensions and flow for all 3 evaluated strips; between-strip differences were confined to nasal dimensions. Both the BRNS and butterfly strip were generally well tolerated, with no evidence of dermal response over 7 consecutive nights of use.<b>ClinicalTrials.gov identifiers:</b> NCT01105949 and NCT01495494.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718796740"},"PeriodicalIF":2.2,"publicationDate":"2018-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718796740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36573931","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 <i>Nigella sativa</i> Nasal Spray on the Treatment of Chronic Rhinosinusitis Without a Nasal Polyp.","authors":"Ahmad Rezaeian,&nbsp;Sanaz Amoushahi Khouzani","doi":"10.1177/2152656718800059","DOIUrl":"https://doi.org/10.1177/2152656718800059","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is a common inflammatory disease of nasal and paranasal sinuses, with many treatment methods available for the management of this disease. Recently, herbal medicines have shown a significant impact on inflammatory diseases such as CRS, and one of these herbal medicines is <i>Nigella sativa</i>. Therefore, the current study aimed to evaluate the effectiveness of <i>N. sativa</i> in patients with CRS without nasal polyp (CRSsNP).</p><p><strong>Methods: </strong>In this randomized clinical trial, 65 patients with mild to moderate CRSsNP were enrolled based on the inclusion criteria. Patients were divided randomly into 2 parallel groups: intervention and placebo groups. Patients in the intervention group received 2 puffs/day of <i>N. sativa</i> nasal spray (1 g/day of <i>N. sativa</i>) and in the placebo group received 2 puffs/day of sodium chloride spray 0.65%.</p><p><strong>Results: </strong>Thirty-one patients (19 men and 12 women) in the intervention group and 34 in the placebo group (18 men and 16 women) were evaluated. Lund-McKay, Lund Kennedy, and Sino-Nasal Outcome Test-22 scores were assessed for both groups after 8 weeks of treatments. These scores decreased significantly in both groups. However, these scores were significantly lower in the intervention group compared with the placebo group (<i>P</i> < .0001, for all).</p><p><strong>Conclusion: </strong>The use of <i>N. sativa</i> nasal spray has symptom reliever effect with no adverse effects in patients with CRSsNP.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718800059"},"PeriodicalIF":2.2,"publicationDate":"2018-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718800059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36614320","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":"Pediatric Meningoencephaloceles Endoscopic Endonasal Repair: Our Experience.","authors":"Hetal K Marfatia,&nbsp;Kartik A Parelkar,&nbsp;Adhara Chakraborty,&nbsp;Shampa Mishra","doi":"10.1177/2152656718802408","DOIUrl":"https://doi.org/10.1177/2152656718802408","url":null,"abstract":"<p><strong>Background: </strong>Pediatric patients presenting with a nasal mass is uncommon and a high index of suspicion for it to be a meningoencephalocele is essential. Majority of these are congenital and require early intervention owing to the risk of meningitis. Surgery in these cases is very challenging because of the risk of anesthesia and limited space.</p><p><strong>Objective: </strong>This study aimed to describe our technique and experience in managing pediatric meningoencephaloceles.</p><p><strong>Methods: </strong>A retrospective study of 19 pediatric patients (age ranging from 40-day-old infants to 11.5-year-old children) was conducted at our tertiary care center from January 2012 to February 2017. Patients presenting with an intranasal meningoencephalocele were treated by endoscopic approach, using otological microinstruments. After detailed imaging and clinical evaluation, a tailored repair, using fat/fascia/cartilage, a multilayer closure, was carried out in all cases.</p><p><strong>Results: </strong>All patients had a successful repair and recovery, except for one death following an episode of convulsion. There was a minor circumferential narrowing of the nasal vestibule and synechia formation in 2 of our cases.</p><p><strong>Conclusion: </strong>Transnasal endoscopic repair of meningoencephalocele is minimally invasive. It avoids permanent anosmia and is cosmetic. A combination of miniaturized instruments and a 4-mm 0° nasal endoscope gives excellent visual field and an adequate working space. Owing to the larger defects in congenital meningoencephaloceles, a multilayer repair provides excellent outcomes.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718802408"},"PeriodicalIF":2.2,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718802408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36600035","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":"Erratum.","authors":"","doi":"10.1177/2152656718806726","DOIUrl":"https://doi.org/10.1177/2152656718806726","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/2152656718783630.].</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718806726"},"PeriodicalIF":2.2,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718806726","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36600036","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}