Allergy & Rhinology最新文献

{"title":"Long-term follow-up of a patient with malignant transformation of inverted papilloma into sinonasal undifferentiated carcinoma.","authors":"Carolyn A Orgain,&nbsp;Terry Y Shibuya,&nbsp;Lester D Thompson,&nbsp;David B Keschner,&nbsp;Rohit Garg,&nbsp;Jivianne T Lee","doi":"10.2500/ar.2017.8.0209","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0209","url":null,"abstract":"<p><strong>Introduction: </strong>Inverted papillomas (IP) are benign sinonasal neoplasms, which account for 0.5-4% of all nasal tumors. IPs have been known to transform into squamous cell carcinoma in 5-15% of cases. Rarely, transformations to other malignancies have been reported. Here we report a unique case of malignant transformation of an IP into sinonasal undifferentiated carcinoma (SNUC).</p><p><strong>Methods: </strong>A case report with a literature review; institutional review board exempted. The clinical presentation, radiographic features, surgical intervention, histopathologic analysis, treatment, and outcome of the case were examined.</p><p><strong>Results: </strong>A 62-year-old man presented with a 3-month history of nasal airway obstruction, rhinorrhea, and postnasal drip refractory to medical therapy. He had a long history of exposure to fumes, chemicals, dusts, and solvents as a professional painter as well as a 45 pack-year history of smoking and alcohol abuse. The patient was ultimately found to have a left ethmoidal IP with a focus of malignant transformation into SNUC. Endoscopic resection was performed, followed by concurrent chemoradiation and adjuvant chemotherapy. After surgery, he had no evidence of recurrent disease after 9 years of follow-up.</p><p><strong>Conclusions: </strong>IP is known to transform into squamous cell carcinoma. Here we report a rare case of malignant transformation into SNUC, a much more uncommon and aggressive lesion. Although traditionally associated with a poorer prognosis, the positive outcome for SNUC observed in this patient may potentially be attributed to early detection and timely therapeutic intervention.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"173-177"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546356","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":"Oral immunotherapy in children with IgE-mediated hen's egg allergy: Follow-ups at 2.5 and 7 years.","authors":"Paolo Meglio,&nbsp;Paolo Gianni Giampietro,&nbsp;Rossella Carello,&nbsp;Elena Galli","doi":"10.2500/ar.2017.8.0211","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0211","url":null,"abstract":"<p><strong>Background: </strong>The present report was a follow-up investigation at 2.5- and 7-year intervals of a previous study of 20 children with moderate-to-severe immunoglobulin E (IgE) mediated hen's egg (HE) allergy who received oral immunotherapy (OIT) with raw HE. The study design of the previous study divided the 20 subjects into two groups of 10 each: (1) group 1, the OIT group (OIT-G), and, (2) group 2, an age-matched control group (C-G). In that study, 8 of 10 of the children in the OIT-G were successfully desensitized, one child was partially desensitized, and desensitization failed in one child. The aims of the present study were to evaluate the long-term effectiveness and safety profile of OIT with raw HE, and to assess the course and prognostic value of skin-prick tests (SPT) and serum-specific HE-IgEs in this study population.</p><p><strong>Methods: </strong>Of the 20 children who were recalled, 2 dropped out, which left 18 to be evaluated. Information on their HE intake was recorded, and SPTs with HE allergen extracts and with raw and hard-boiled HE were performed. Ovomucoid- and ovalbumin-specific IgE levels were also measured.</p><p><strong>Results: </strong>At the first (2.5-year) and second (7-year) follow-ups, 87.5% of the children in the OIT-G who tolerated raw HE were still tolerant, whereas the children in the C-G were significantly less tolerant. Overall, cutaneous sensitivity to HE significantly decreased after the 6-month desensitization period and at both follow-ups with regard to the OIT-G but not with regard to the C-G. A significant reduction in serum ovomucoid- and ovalbumin-specific IgE levels was seen in both the OIT-G and the C-G.</p><p><strong>Conclusion: </strong>Clinical raw HE tolerance induced by OIT persists over time. Negativization of SPTs could be considered a more reliable prognostic indicator of clinical tolerance to raw HE than the reduction in specific-HE IgE levels. Raw-HE OIT would seem to be a promising method to treat HE allergy.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"157-169"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546354","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":"Barosinusitis: Comprehensive review and proposed new classification system.","authors":"Reza Vaezeafshar,&nbsp;Alkis J Psaltis,&nbsp;Vidya K Rao,&nbsp;David Zarabanda,&nbsp;Zara M Patel,&nbsp;Jayakar V Nayak","doi":"10.2500/ar.2017.8.0221","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0221","url":null,"abstract":"<p><strong>Background: </strong>Barosinusitis, or sinus barotrauma, may arise from changes in ambient pressure that are not compensated by force equalization mechanisms within the paranasal sinuses. Barosinusitis is most commonly seen with barometric changes during flight or diving. Understanding and better classifying the pathophysiology, clinical presentation, and management of barosinusitis are essential to improve patient care.</p><p><strong>Objectives: </strong>To perform a comprehensive review of the available literature regarding sinus barotrauma.</p><p><strong>Methods: </strong>A comprehensive literature search that used the terms \"barosinusitis,\" \"sinus barotrauma,\" and \"aerosinusitis\" was conducted, and all identified titles were reviewed for relevance to the upper airway and paranasal sinuses. All case reports, series, and review articles that were identified from this search were included. Selected cases of sinus barotrauma from our institution were included to illustrate classic signs and symptoms.</p><p><strong>Results: </strong>Fifty-one articles were identified as specifically relevant to, or referencing, barosinusitis and were incorporated into this review. The majority of articles focused on barosinusitis in the context of a single specific etiology rather than independent of etiology. From analysis of all the publications combined with clinical experience, we proposed that barosinusitis seemed to fall within three distinct subtypes: (1) acute, isolated barosinusitis; (2) recurrent acute barosinusitis; and (3) chronic barosinusitis. We introduced this terminology and suggested independent treatment recommendations for each subtype.</p><p><strong>Conclusion: </strong>Barosinusitis is a common but potentially overlooked condition that is primed by shifts in the ambient pressure within the paranasal sinuses. The pathophysiology of barosinusitis has disparate causes, which likely contribute to its misdiagnosis and underdiagnosis. Available literature compelled our proposed modifications to existing classification schemes, which may allow for improved awareness and management strategies for barosinusitis.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"109-117"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35641324","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":"Prenatal maternal depression related to allergic rhinoconjunctivitis in the first 5 years of life in children of the EDEN mother-child cohort study.","authors":"Cailiang Zhou,&nbsp;Gladys Ibanez,&nbsp;Vincent Miramont,&nbsp;Magali Steinecker,&nbsp;Nour Baiz,&nbsp;Soutrik Banerjee,&nbsp;Jocelyne Just,&nbsp;Isabella Annesi-Maesano,&nbsp;Julie Chastang","doi":"10.2500/ar.2017.8.0213","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0213","url":null,"abstract":"<p><p>Backgroud: Evidence about the relationship between prenatal maternal depression and the development of childhood asthma and allergies in early life is scarce. We aimed to examine this relationship by using data set of EDEN mother-child cohort study. A total of 1139 children were followed-up until the age of 5 years.</p><p><strong>Methods: </strong>Prenatal maternal depression was self-reported by using the Centre for Epidemiological Studies-Depression scale (CES-D) questionnaire and was classified into binary variable (maternal depression [CES-D score of ≥16] and no maternal depression [CES-D score of <16]). Asthma and allergies in the first 5 years were assessed by using the questionnaire of the International Study of Asthma and Allergies in Childhood (ISAAC). Adjusted odds ratio (aOR) was estimated for the relationship between prenatal maternal depression and early life asthma and allergies by marginal models through the method of generalized estimating equation (GEE) when adjusting for the confounders.</p><p><strong>Results: </strong>In our study population, 13.67 % of the mothers had clinical significant depression (the total scores for CES-D ≥16) during pregnancy. For children ages 5 years, the prevalence of wheezing, physician-diagnosed asthma, physician-diagnosed eczema and allergic rhinoconjunctivitis were 46.78, 20.99, 29.17, and 22.54%, respectively. Prenatal maternal depression was associated with ever allergic rhinoconjunctivitis (aOR 1.87 [95% confidence interval {CI}, 1.33-2.62]). No significant relationships were found between prenatal maternal depression and wheezing, physician-diagnosed asthma and physician-diagnosed eczema (aOR 1.12 [95% CI, 0.91-1.39], aOR 1.23 [95% CI, 0.81-1.85] and aOR 1.17 [95% CI, 0.86-1.61], respecitvely).</p><p><strong>Conclusion: </strong>Prenatal maternal depression was related to ever allergic rhinoconjunctivitis in the first 5 years of life in children of EDEN mother-child cohort study.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"132-138"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546351","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 study of a possible correlation between serum levels of interleukin 17 and clinical severity in patients with allergic rhinitis.","authors":"Mai Aly Gharib Aly,&nbsp;Mohamed Tawfik El Tabbakh,&nbsp;Waheed Fawzy Heissam,&nbsp;Said Hamed Abbadi","doi":"10.2500/ar.2017.8.0207","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0207","url":null,"abstract":"<p><strong>Introduction: </strong>Allergic rhinitis (AR) is one of the most common allergic diseases, which affects ∼20% of the world's population. T-helper (Th) type 2 cells produce interleukin (IL) 4 and IL-13, and mediate allergic responses, and these cytokines have been extensively studied as key players in the atopic airway diseases. However, the involvement of Th17 cells and IL-17 in AR has not been clearly examined.</p><p><strong>Aim: </strong>To reevaluate AR clinical severity with serum IL-17, whether IL-17 affects the disease alone or in contribution with the atopic predisposition.</p><p><strong>Patients and methods: </strong>During an 18-month period, 39 individuals were divided into three groups: A, (13 control), B (13 with mild-to-moderate AR), and C (13 with severe AR). Both group B and group C patients (26) were subjected to clinical examination and allergy skin testing, and to measurement of both total serum immunoglobulin E (IgE) and IL-17 levels. Eleven patients with AR then were exposed to 6 months of cluster immunotherapy, whereas the rest of the patients were not exposed.</p><p><strong>Results: </strong>Revealed a significant elevation of serum IL-17 levels with an associated increase in serum IgE in the patients with AR compared with controls and revealed that the serum levels of both total serum IgE and IL-17 decreased significantly after cluster immunotherapy.</p><p><strong>Conclusion: </strong>These preliminary results added new data about the use of injective immunotherapy as well as reported on the use of sublingual immunotherapy.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"126-131"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0207","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35641326","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":"Characterization of T-cell subpopulations in patients with chronic rhinosinusitis with nasal polyposis.","authors":"Pascal Ickrath,&nbsp;Norbert Kleinsasser,&nbsp;Xin Ding,&nbsp;Christian Ginzkey,&nbsp;Niklas Beyersdorf,&nbsp;Rudolf Hagen,&nbsp;Thomas Kerkau,&nbsp;Stephan Hackenberg","doi":"10.2500/ar.2017.8.0214","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0214","url":null,"abstract":"<p><strong>Background: </strong>There is an ongoing discussion concerning the potential origins of chronic rhinosinusitis with nasal polyposis (CRSwNP).</p><p><strong>Objective: </strong>The aim of this study was to quantify subpopulations of T cells in peripheral blood and nasal polyps in CRSwNP to examine their influence on the etiology of this disease.</p><p><strong>Methods: </strong>Tissue and blood samples were collected from 11 patients who underwent nasal sinus surgery, and these samples were analyzed by multicolor flow cytometry.</p><p><strong>Results: </strong>There was a significantly lower frequency of CD4+ T-helper (Th) cells and a significantly higher frequency of CD8+ T cells among lymphocytes isolated from nasal polyps compared with peripheral blood mononuclear cells (PBMC). In both T-cell subpopulations, a shift mainly from naive T cells among peripheral blood lymphocytes toward an effector memory and terminally differentiated subtype predominance in nasal polyps was observed. Among CD4+ T cells, the frequencies of cluster of differentiation (CD) 45RA- Forkhead-Box-Protein P3high (FoxP3high) cytotoxic T-lymphocyte-associated Protein 4high (CTLA-4high) activated regulatory T (Treg) cells, and CD45RA- Forkhead-Box-Protein P3low (FoxP3low) memory T cells were significantly increased in nasal polyps compared with PBMC.</p><p><strong>Conclusion: </strong>In this study, we presented a detailed characterization of CD4+ and CD8+ T-cell subpopulations in patients with CRSwNP. CD8+ T cells were more prominent in nasal polyps than in CD4+ T cells. Both nasal CD8+ T cells and CD4+ T cells predominantly had an effector memory phenotype. Among CD4+ T cells, activated Treg cells were increased in nasal polyps compared with PBMC. The data point toward a local regulation of T-cell composition within the microenvironment of nasal polyps, which might be further exploited in the future to develop novel immunotherapeutic strategies.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"139-147"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0214","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546352","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 multicenter, prospective, noninterventional study in a Norwegian cohort of patients with moderate-to-severe allergic rhinitis treated with MP-AzeFlu.","authors":"Ralph Dollner,&nbsp;Petter Lorentz Larsen,&nbsp;Sinan Dheyauldeen,&nbsp;Sverre Steinsvåg","doi":"10.2500/ar.2017.8.0216","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0216","url":null,"abstract":"<p><strong>Background: </strong>Allergic Rhinitis and its Impact on Asthma guidelines recently recommended a treatment strategy for allergic rhinitis (AR) based on disease control rather than symptom severity by using a visual analog scale (VAS) to categorize control.</p><p><strong>Objectives: </strong>To evaluate the effectiveness of MP-AzeFlu (Dymista®) by using this VAS in routine clinical practice in Norway. MP-AzeFlu comprises a novel formulation that contains azelastine hydrochloride, fluticasone propionate and excipients delivered in a single spray.</p><p><strong>Methods: </strong>This multicenter, prospective, noninterventional study enrolled patients (n = 160) with moderate-to-severe AR and acute symptoms who were eligible to receive treatment with MP-AzeFlu according to its summary of product characteristics. Patients assessed symptom severity by using a VAS from 0 (not at all bothersome) to 100 mm (very bothersome) in the morning before MP-AzeFlu use on days 0, 1, 3, 7, and after ∼14 days. On day 3, the patients assessed their level of disease control as well controlled, partly controlled, or uncontrolled. The proportion of Norwegian patients who achieved defined VAS score cutoffs for \"well-controlled\" and \"partly controlled\" AR were also calculated.</p><p><strong>Results: </strong>MP-AzeFlu reduced the mean ± standard deviation VAS score from 68.1 ± 16.4 mm at baseline to 37.4 ± 25.9 mm on the last day, a reduction of 30.8 ± 27.2 mm. The results were consistent, irrespective of disease severity, phenotype (i.e., seasonal AR [SAR], perennial AR [PAR], SAR plus PAR, unknown) or age (i.e., 12-17, 18-65, and >65 years). Of the patients (with recorded data), 88.1% considered their symptoms to be partly or well controlled at day 3; and 19.5, 32.0, 50.0, and 61.0% of the patients achieved a ≤38 mm well-controlled VAS score cutoff on days 1, 3, 7, and the last day, respectively.</p><p><strong>Conclusions: </strong>MP-AzeFlu provided rapid sustained symptom control in a routine clinical practice in Norway, which provided support for its effectiveness for the treatment of AR in real life.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"148-156"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0216","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546353","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":"Multiple doses of icatibant used during pregnancy.","authors":"Lauren W Kaminsky,&nbsp;Theodore Kelbel,&nbsp;Fay Ansary,&nbsp;Timothy Craig","doi":"10.2500/ar.2017.8.0210","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0210","url":null,"abstract":"<p><strong>Background: </strong>Hereditary angioedema (HAE) is a life-long disease that often manifests by puberty. Treatment of attacks is essential to improve quality of life and to decrease morbidity and mortality. During pregnancy, treatment is limited because multiple treatment options, including icatibant, are not approved for use during pregnancy.</p><p><strong>Objective: </strong>We report the outcomes of three pregnancies during which icatibant was used by a patient with HAE with normal C1-inhibitor for treatment of attacks. We also reviewed the literature for reports of icatibant use during pregnancy for outcomes and adverse events.</p><p><strong>Methods: </strong>We report on a patient who treated herself with icatibant during three separate pregnancies. Postpartum follow-up verified the health of the mother and children. We also performed a complete literature search of medical literature data bases on icatibant use during pregnancy.</p><p><strong>Results: </strong>The patient in our report administered multiple doses of icatibant during three pregnancies. The child born from the first pregnancy and the child from the third pregnancy were born at term and without congenital anomalies. The child from the second pregnancy was 1-month preterm. All three children were developmentally normal. The literature search identified two case reports and one abstract of limited icatibant use without adverse events during pregnancy in patients with HAE. These pregnancies resulted in the births of healthy infants.</p><p><strong>Conclusion: </strong>From a search of the literature, three cases of icatibant use during pregnancy resulted in healthy infants. In addition, we report that from icatibant use in three separate pregnancies, one infant was born prematurely, but there were no birth defects. From follow-up, the children continued meeting developmental milestones. This report adds to the acquisition of knowledge for drug adverse events during postmarketing surveillance for icatibant use during pregnancy.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"178-181"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546357","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":"An ergonomic assessment of operating table and surgical stool heights for seated otolaryngology procedures.","authors":"Anam F Azimuddin,&nbsp;Erik K Weitzel,&nbsp;Kevin C McMains,&nbsp;Philip G Chen","doi":"10.2500/ar.2017.8.0215","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0215","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal injuries, such as neck and back pain, during a surgeon's career are common. However, studies on ergonomics are limited with regard to seated otolaryngologic procedures. Key elements of an ergonomic operating environment include the height of operating tables and surgical chairs. Surgeons benefit from proper support and positioning to prevent musculoskeletal injuries and reduce occupational risk.</p><p><strong>Objective: </strong>The purpose of this study was to evaluate operating table and surgical seat heights, and determine whether adjustments can be made for various surgeon physiques.</p><p><strong>Methods: </strong>Operating tables and surgical seat dimensions were measured at local hospitals, and the information was complemented by an online search of other models.</p><p><strong>Results: </strong>Five unique operating tables and five unique surgical stools were identified, both in the local hospital and in a search on the Internet. Of available tables, the greatest range was 63.5-124.5 cm, which reaches above the maximum suggested working height of 76.2 cm. The surgical stool with the widest range was adjustable from heights of 50.8-72.4 cm. This combination of operative table and surgical stool provided the greatest range of heights.</p><p><strong>Conclusion: </strong>Of the available tables and stools measured, the combination of surgical table with a range of 63.5-125.7 cm and surgical stool with a range of 50.8-72.4 cm provided the greatest versatility for diverse physician heights. In ergonomic terms, this combination may reduce physical fatigue and create a potentially safer working environment for seated surgeons.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"182-188"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0215","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546359","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":"Evaluation of a new and simple classification for endoscopic sinus surgery.","authors":"Kengo Kanai, Mitsuhiro Okano, Takenori Haruna, Takaya Higaki, Ryotaro Omichi, Sei-Ichiro Makihara, Munechika Tsumura, Shin Kariya, Yuji Hirata, Kazunori Nishizaki","doi":"10.2500/ar.2017.8.0208","DOIUrl":"10.2500/ar.2017.8.0208","url":null,"abstract":"<p><strong>Objective: </strong>In 2013, the Japanese Rhinologic Society proposed a simple classification for endoscopic sinus surgery (ESS). This classification consists of five procedures (type I, fenestration of the ostiomeatal complex, with uncinectomy and widening of the natural ostium; type II, single-sinus procedure, with manipulating the inside of the sinus; type III, polysinus procedure; type IV, pansinus procedure; type V, extended procedure beyond the sinus wall). The clinical relevance of this classification in chronic rhinosinusitis (CRS) and paranasal sinus cyst was evaluated.</p><p><strong>Study design: </strong>A retrospective validation study.</p><p><strong>Methods: </strong>A total of 122 patients (195 sinuses) who underwent ESS in Okayama University Hospital in 2012 were enrolled. The relationships between the ESS classification and the clinical course, including the operation time, bleeding amounts during surgery and postoperative changes of olfaction, the computed tomography (CT) score, and nasal airway resistance were analyzed.</p><p><strong>Results: </strong>A total of 195 ESS procedures were classified into type I (n = 3), type II (n = 17), type III (n = 91), type IV (n = 82), and type V (n = 2). The major phenotypes of type II, III, and IV ESS were paranasal sinus cyst (68%), CRS without nasal polyps (77%), and CRS with nasal polyps (55%), respectively, and the difference was significant. The degree of ESS based on this classification was positively and significantly correlated with the operation time and bleeding amounts. As a whole, olfaction, CT score, and nasal airway resistance were significantly improved after surgery. The degree of improvement was similar between type III and type IV ESS.</p><p><strong>Conclusion: </strong>This simple classification for ESS reflected the perioperative burden of the disease.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"118-125"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3b/7c/arhe118.PMC5662536.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35641325","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}