Rhinology online最新文献

{"title":"3D CT stereoscopic imaging: an improved anatomical understanding of the anterior ethmoid sinus and frontal sinus drainage pathway","authors":"S. Zinreich, F. Kuhn, N. London, D. Kennedy, M. Solaiyappan, W. Hosemann","doi":"10.4193/rhin20.061","DOIUrl":"https://doi.org/10.4193/rhin20.061","url":null,"abstract":"OBJECTIVE: The objective of this presentation is to display a series of new anatomical concepts and terms regarding the frontal si- nus, its drainage pathway and cells vs. spaces of the anterior ethmoid, based on Three-Dimensional Computer X-ray Tomography Stereoscopic Imaging (3DCTSI) and contrast these concepts to those reported in the current literature. METHODS: Given the new anatomic observations provided by 3DCTSI, and the widespread anatomic variations a small sample was initially selected to describe our observations. Six exemplary cases according to the “Classification of Fronto-Ethmoidal cells” by Kuhn, Bent et al., Lee et al., expanded by Wormald et al., and adopted by Ramakrishnan et al., Huang et al., and Void et al. (1-7) were chosen to illustrate our detailed anatomic observations. Additional observations and data of prevalence identified in a larger series will follow. RESULTS and CONCLUSION: Conceptually, the anterior ethmoid “cells” are in essence “spaces” with openings that communicate with the middle meatus and/or the ethmoidal infundibulum. The frontal sinus and frontal recess are a united and continuous three-dimensional, irregularly shaped space, the Frontal Sinus/Recess Space (FSRS). The uncinate process has two segments: the Ethmoidal Uncinate Process (EUP), which encompasses the Infundibular Space of the EUP (IS-EUP), currently known as the Agger Nasi cell; and the Turbinal Uncinate Process (TUP), which borders the Turbinal Infundibulum (TI) medially. The superior attach- ment of the EUP will be detailed in each of the six cases (Table 2). The middle meatus and infundibular passages are the drainage pathways from the frontal sinus and maxillary sinus to the nasal cavity.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48062327","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":"Early and noninvasive diagnosis using serological antigen biomarkers in chronic invasive fungal rhinosinusitis","authors":"A. Oba, S. Ito, H. Okada, T. Anzai, K. Kikuchi, K. Ikeda","doi":"10.4193/rhinol/20.041","DOIUrl":"https://doi.org/10.4193/rhinol/20.041","url":null,"abstract":"Background: Chronic invasive form of fungal rhinosinusitis (FRS) is characterized by the invasion of fungal organisms into the sinonasal mucosa in the background of diabetes mellitus and corticosteroid treatment. Although the histopathology has traditionally been used to make a proven diagnosis of invasive fungal infections, the dependence on tissue samples and the slow turnaround time hamper the early confirmation of such infections. Methodology: This is a retrospective case series conducted over 6 years. All patients with a chronic course and immunosuppressive background of FRS diagnosed by radiologic imaging and treated with endoscopic sinus surgery were eligible for inclusion. Data were collected through medical records, including basic characteristics, symptoms and signs, imaging findings, laboratory investigations, pathology, treatment, and outcomes. Results: Fifteen patients with chronic course and immunosuppressive background of FRS diagnosed by radiologic imaging were identified. High values of 1,3-b-D-glucan (BDG) assay were recognized in 5 patients, whereas the other 10 patients with negative findings in the BDG assay showed sinus mycetomas. All the 5 patients showing significant elevations of serum BDG showed positive findings in the polymerase chain reaction (PCR), but only 2 patients were positive in the histopathology. The findings of the BDG assay were consistent with those of the PCR method, which was superior in sensitivity to the histopathology. Conclusion: We first applied BDG assay as a diagnostic tool for chronic invasive FRS. The BDG assay may be useful to distinguish chronic invasive FRS, including its early stage, from noninvasive mycetoma, contributing to timely treatment.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46700866","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":"Nasal chondromesenchymal hamartomas in a cohort with pathogenic germline variation in <i>DICER1</i>.","authors":"Lauren M Vasta,&nbsp;Alison Nichols,&nbsp;Laura A Harney,&nbsp;Ana F Best,&nbsp;Ann G Carr,&nbsp;Anne K Harris,&nbsp;Markku Miettinen,&nbsp;Kris Ann P Schultz,&nbsp;Hung Jeffrey Kim,&nbsp;Douglas R Stewart","doi":"10.4193/rhinol/20.007","DOIUrl":"https://doi.org/10.4193/rhinol/20.007","url":null,"abstract":"<p><strong>Background: </strong>Nasal chondromesenchymal hamartomas are benign, rare nasal tumors associated with <i>DICER1</i> pathogenic germline variation. They can be locally destructive and recurrent if not completely resected.</p><p><strong>Methodology: </strong>In this single-center, case-control study, otorhinolaryngology evaluations and review of systems questionnaires of <i>DICER1</i>-carriers and controls enrolled in the <i>DICER1</i> Natural History Study at the National Cancer Institute were collected. Review of these medical records were analyzed to determine if <i>DICER</i>1-carriers experienced different sinonasal clinical manifestations compared to controls. Additionally, the number of diagnoses of nasal chondromesenchymal hamartoma cases in the NCI <i>DICER1</i> study was compared against the total person years of observation of <i>DICER1</i>-carriers in the study to determine the total number of cases per person-years of observation. Lastly, both the NCI <i>DICER1</i> study and the International Pleuropulmonary Blastoma/<i>DICER1</i> Registry were queried for unpublished cases of nasal chondromesenchymal hamartomas.</p><p><strong>Results: </strong>There were no clinical differences in sinonasal symptomatology between <i>DICER1</i>-carriers and control patients seen in the ENT clinic. We observed of two cases of nasal chondromesenchymal hamartoma in a total of 555 person-years of monitoring <i>DICER1</i>-carriers. We include six unpublished nasal chondromesenchymal hamartoma cases. When combined with a comprehensive literature review, 38% of nasal chondromesenchymal hamartoma cases had at least one additional <i>DICER1</i>-associated tumor and 24% of the NCMH were found in the ethmoid sinus, the most commonly involved paranasal sinus.</p><p><strong>Conclusions: </strong>We quantify the risk of developing nasal chondromesenchymal hamartomas in our cohort of 236 <i>DICER1</i>-carriers, report six unpublished cases, and provide an updated review of the literature.</p>","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"3 ","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8218780/pdf/nihms-1601990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39021594","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":"Intranasal Corticosteroids: Patient Administration Angles and Impact of Education.","authors":"Sara Treat,&nbsp;Charles S Ebert,&nbsp;Zainab Farzal,&nbsp;Saikat Basu,&nbsp;Adam M Zanation,&nbsp;Brian D Thorp,&nbsp;Julia S Kimbell,&nbsp;Brent A Senior,&nbsp;Adam J Kimple","doi":"10.4193/rhinol/20.070","DOIUrl":"https://doi.org/10.4193/rhinol/20.070","url":null,"abstract":"<p><strong>Introduction: </strong>Intranasal corticosteroids sprays (INCS) are first line treatment for allergic rhinitis and are frequently used for chronic rhinosinusitis. Improperly aiming INCS increases the risk of epistaxis and may decrease the efficacy of the medication. The goal of this study was to determine how patients position INCS for drug delivery and if verbal or written instructions improve their positioning.</p><p><strong>Methods: </strong>Patients in rhinology clinics were photographed while administering a generic spray bottle. The angle of the spray bottle relative to the patients' head and a fixed background was determined.</p><p><strong>Results: </strong>A total of 46 participants were included. The average spray angle for the right naris was 10.1° towards the septum and 67.2° below the Frankfurt Horizontal plane. The average spray angle for the left naris was 4.5° towards the septum and 62.2° below the Frankfurt horizontal plane. The angle of the spray bottle ranged from 50° toward the septum to 43° away from the septum. Only 8 patients aimed away from the septum for both nares. Patients who recalled receiving verbal and written instructions aimed the INCS bottle at the lateral wall and inferior turbinate in contrast to patients who only received one form of instruction or no instructions.</p><p><strong>Conclusions: </strong>Most patients (83%) incorrectly aim INCS when compared to current guidelines. There was statistically significant improvement in the positioning of patients who reported receiving both verbal and written instruction; however, this study highlights a greater need for patient education.</p>","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"3 ","pages":"160-166"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8276915/pdf/nihms-1675049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39184810","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":"Recurrent epistaxis: a diagnostic dilemma","authors":"S. Bhatia, V. Gupta, D. Sharma","doi":"10.4193/rhinol/19.008","DOIUrl":"https://doi.org/10.4193/rhinol/19.008","url":null,"abstract":"","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48992984","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":"Rhinoscleroma: report of 2 cases and literature review","authors":"M. Ndiaye, M. Diouf, C. Ndiaye, Abdou Sy, Malick, Ndiaye, A. Tall, E. Diom, I. Ndiaye, R. Diouf","doi":"10.4193/rhinol/19.032","DOIUrl":"https://doi.org/10.4193/rhinol/19.032","url":null,"abstract":"Background: Rhinoscleroma is a chronic and specific granulomatous infectious disease caused by enterobacteria of the family Klebsiella: \"Klebsiella rhinoscleromatis\"; it reaches the nasal cavities in 95% of cases. The objective of our study is to report the clinical, diagnostic and therapeutic aspects of our patients. Observations/Medical findings: The study took place at the ENT department of the Fann National University Hospital Center in Dakar, and it was based on two female subjects who are 26 and 60 years old, respectively. The medical examination of the subjects indicated a granulomatous lesion blocking the two nasal cavities. A biopsy performed on each patient revealed a rhinoscleroma. Both patients received doxycycline-based medical treatment with endoscopic endonasal surgery like \"Debulking.\" The patients all recovered nasal breathing after airway clearance. However, we noted a scar retraction of the nasal cavities in the first patient. Conclusions: As the disease recurs, rhinoscleroma is becoming more and more a cosmopolitan affection. The diagnosis is histological. Well-conducted medical treatment allows healing in early forms while surgery is complementary in advanced forms. The fear of a recurrence calls for an extended follow-up.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44609162","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":"A retrospective study of surgically treated subperiosteal orbital abscesses derived from acute bacterial ethmoid sinusitis","authors":"J. H. Therchilsen, A. A. Muhamad, A. T. Bilde, C. Buchwald","doi":"10.4193/rhinol/19.021","DOIUrl":"https://doi.org/10.4193/rhinol/19.021","url":null,"abstract":"Background: Subperiosteal abscesses (SPOA) are a complication of acute purulent sinusitis, and their optimal treatment regime is a controversial topic. Some otolaryngologists consider surgery to be mandatory in the treatment of subperiosteal abscesses others advocate that especially paediatric patients can be treated medically in some cases. The purpose of this study was to evaluate our current treatment guidelines for subperiosteal abscesses. Methodology: A retrospective study was undertaken from 2010 to 2016, including patients registered with the diagnosis of subperiosteal abscesses derived from acute sinusitis based on clinical diagnoses, and CTs or MRIs. All patients received treatment with IV-antibiotics and were booked for prompt surgery. The main outcome measures were CT-measurements and intraoperatively identified pus. Treatment included antibiotic choice, microbiology, and outcomes. Results: Thirty-one patients were included in the study having the diagnosis of sinusitis and SPOA. Per operatively, we found pus in the subperiosteal space in 21/31 patients and 17 of the patients with available contrast-enhanced CT scans. When patients were grouped based on radiographically confirmed abscesses or not per the preoperative MRI or CT, we found that the presumed abscess volume was 0.83 mL greater in the patients, who had an abscess confirmed during surgery. Two patients needed endoscopic re-operation. In addition, three patients had sequela at the last follow-up, two with minor subjective sequelae due to oedema most likely resolving themselves over time and one with memory and concentration difficulties due to intracranial","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48568395","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":"Endonasal endoscopic dacryocystorhinostomy in the paediatric population","authors":"C. Moreira, I. Correia, I. Cunha, Herédio Sousa, E. Barros","doi":"10.4193/RHINOL/19.007","DOIUrl":"https://doi.org/10.4193/RHINOL/19.007","url":null,"abstract":"Background: Congenital nasolacrimal duct obstruction is frequent and paediatric endonasal endoscopic dacryocystorhinostomy (DCR) is increasingly used after conservative treatment failure. Methodology: Retrospective noncomparative case series study was conducted from January 2007 to August 2017. Patients under 18 years old with nasolacrimal system obstruction who underwent endoscopic DCR were studied. All children were referred to our otorhinolaryngology department in a tertiary referral paediatric hospital. Population characteristics, presentation symptoms, success rate and predictive factors for failure were analysed. Results: 30 children were identified. Ages varied from 2 to 13 years old. Simultaneous bilateral surgery was performed in 5/30 (16,7%) children. Silicone stents were used in 93% of interventions with a mean time to removal of 9,6 weeks. Persistent epiphora was found in 43% of children and recurrent dacryocystitis in 57%. Success rate for primary DCR was 83,3%. Revision surgery was performed in 16,7% of cases. Minor complications rate was 13,3%. The presence of concomitant chronic nasal infections pointed for surgery failure reaching statistical significant value (p=0.0456). Conclusions: Paediatric endonasal endoscopic DCR seems to be an effective, safe and minimally invasive technique for the treatment of mechanical nasolacrimal system obstruction.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42214090","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":"The agreement between self-reported physician-diagnosed and epidemiologic definition of chronic rhinosinusitis","authors":"A. Ostovar, W. Fokkens, S. Farrokhi","doi":"10.4193/RHINOL/19.006","DOIUrl":"https://doi.org/10.4193/RHINOL/19.006","url":null,"abstract":"Chronic rhinosinusitis (CRS) is a major public health problem with a high burden on the health system. The studies conducted based on the Global Allergy and Asthma European Network (GALEN) reported that the prevalence of CRS in Europe, USA, China and Brazil were 10.9%, 11.9%, 8% and 5.5%, respectively . For epidemiological studies, the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) defined CRS as an inflammation of the nose and the paranasal sinuses characterized by presence of two or more symptoms, one of which should be either nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior nasal drip): ± facial pain/pressure; ± reduction or loss of smell for more than 12 weeks during the last 12 months .","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47692467","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":"The Sino-Nasal Outcome Test-22: translation and validation in an Estonian population","authors":"M. Plaas, P. Kasenõmm","doi":"10.4193/RHINOL/19.016","DOIUrl":"https://doi.org/10.4193/RHINOL/19.016","url":null,"abstract":"Background: Background: The Sino-Nasal Outcome Test-22 (SNOT-22) is widely used to assess symptom severity and quality of life for chronic rhinosinusitis patients. No translated version of the tool is available for the study and care of Estonian patients. Thus, the present study aimed to a) translate the SNOT-22 to Estonian and b) validate its adaptation and application to Estonian patients. Methods: The SNOT-22 was translated to Estonian following standard procedures. Fifty CRS patients and 25 healthy controls were recruited after application of stringent inclusion and exclusion criteria. Thirty-seven patients provided responses at the re-test stage (14 days after first test). Internal consistency, test-retest stability and validity were evaluated using appropriate statistical tests. Results: The overall mean score was significantly higher in the CRS group relative to healthy volunteers, indicating strong test validity. Internal consistency was good for both the initial test and the re-test. Test-retest reproducibility was excellent showing robust response stability over time. Conclusions: The SNOT-22 was successfully translated to Estonian and well-received by a cohort of Estonian subjects. The validation reported here shows that it is a reliable outcome measure for the study of CRS in Estonia.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47122121","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}