The Annals of otology, rhinology & laryngology. Supplement最新文献_第2页

Sinonasal mucociliary clearance in health and disease. 鼻粘膜纤毛清除在健康和疾病中的作用。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s904

Noam A Cohen

{"title":"Sinonasal mucociliary clearance in health and disease.","authors":"Noam A Cohen","doi":"10.1177/00034894061150s904","DOIUrl":"https://doi.org/10.1177/00034894061150s904","url":null,"abstract":"Although much has been elucidated in the past 170 years concerning the precise mechanism of ciliary function in the healthy or diseased human respiratory system, significant questions remain. The first description of ciliary action is credited to Sharpey in 1835. However, the importance of mucosal function was not apparent until Hilding's investigations of the postsurgical canine sinus demonstrated scar formation and disruption of mucociliary clearance. Subsequently, several techniques for mucosal coverage of exposed bone, most notably by Sewall and Boyden, were reported. The underlying physiology explaining the importance of the mucosa and the concept of mucosal preservation became apparent with the description of the sinonasal mucociliary flow patterns by Messerklinger; and thus the restoration of natural sinus physiology, ie, mucociliary clearance, became the goal of both medical and surgical treatment of sinonasal inflammatory disease. Clearance of benign and pathological substances in the mucus is governed by the propulsive force of the beating cilia and the physical characteristics of the overlying mucus. The respiratory cilia continually beat in a coordinated fashion, and in times of stress (eg, exercise, infection, or fever) ciliary beat frequency increases to accelerate mucus clearance. Thus, upper airway ciliary motility is under dynamic modulation. Multiple investigations incontrovertibly demonstrate a marked decrease in sinonasal mucociliary clearance in patients with chronic rhinosinusitis. Possible explanations for this finding are 1) a reduced basal ciliary beat frequency, 2) an alteration of the viscoelastic properties of airway secretions, and/or 3) a blunted dynamic response of sinonasal cilia to environmental stimuli. Studies of the first two explanations yield conflicting results, and to date, the third possibility remains uninvestigated. A review of the current understanding of the cellular regulation of respiratory ciliary activity and its contribution to chronic rhinosinusitis is presented.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"20-6"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s904","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308153","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}

引用次数: 139

Fungus and chronic rhinosinusitis: from bench to clinical understanding. 真菌与慢性鼻窦炎:从实验到临床的认识。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s905

Donald C Lanza, Hun-Jong Dhong, Pongsakorn Tantilipikorn, Jirayu Tanabodee, Douglas M Nadel, David W Kennedy

{"title":"Fungus and chronic rhinosinusitis: from bench to clinical understanding.","authors":"Donald C Lanza, Hun-Jong Dhong, Pongsakorn Tantilipikorn, Jirayu Tanabodee, Douglas M Nadel, David W Kennedy","doi":"10.1177/00034894061150s905","DOIUrl":"https://doi.org/10.1177/00034894061150s905","url":null,"abstract":"Although fungus-related sinusitis has been described for at least 2 centuries, a more detailed pathologic description of the problem as it relates to eosinophilic disease was not detailed until 1983, when \"allergic fungal sinusitis\" was described histopathologically. Until then, most fungal sinus disease was perceived to occur in immunosuppressed diabetic patients with invasive fungus. It is now acknowledged that depending upon the immune status of the host, fungus-related sinus disease can take several forms. Interest in this subject matter was intensified in 1999, when it was suggested that fungi might be an important cause of most cases of chronic rhinosinusitis. This hypothesis remains controversial, and there is mounting evidence to support the multifactorial nature of chronic rhinosinusitis, which may include fungus. In fact, etiologic factors for all forms of fungus-related sinus disease are still poorly understood. The prevalence of the disease and the dominant fungal pathogen appear to vary in different geographic regions and probably are related to individual host conditions. Immunoglobulin E-mediated allergic reactions to mold appear to be associated with disease in some patients, but not in all. Although antifungal therapy is known to be lifesaving for invasive disease, its role in extramucosal disease is less well defined. Preliminary trials suggest that some systemic and topical antifungal agents are of clinical benefit in extramucosal disease. Since sinus fungi are rarely invasive in immunocompetent individuals, it is not clear whether the effects of the antifungal treatments are a result of the antifungal action itself, or due to additional properties these drugs possess. This review summarizes the available data and presents some of our clinical and experimental findings as to the role of fungus in chronic rhinosinusitis.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"27-34"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308154","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}

引用次数: 48

Bacterial biofilms in chronic rhinosinusitis. 慢性鼻窦炎的细菌生物膜。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s906

James Palmer

{"title":"Bacterial biofilms in chronic rhinosinusitis.","authors":"James Palmer","doi":"10.1177/00034894061150s906","DOIUrl":"https://doi.org/10.1177/00034894061150s906","url":null,"abstract":"Chronic sinusitis is a prevalent, debilitating condition, and a subpopulation of patients fails to respond to either medical or surgical intervention. Bacterial biofilms are 3-dimensional aggregates of bacteria that have special properties due to their group structure, including increased resistance to antibiotics in some forms. They have been shown to play a major role in many chronic infections, including cystic fibrosis, endocarditis, and otitis media. Evidence now suggests that they may play an important role in chronic sinusitis. Our laboratory has identified the presence of biofilms in sinonasal mucosa isolated from human patients and on stents removed after frontal sinus surgery. In addition, biofilms have been found on the sinus epithelium of rabbits infected with Pseudomonas aeruginosa, but not in rabbits infected with non-biofilm-forming P. aeruginosa mutants. This animal model can provide opportunities to address the functional significance of biofilm production in the sinus cavities. A further understanding of the role of bacterial biofilms may lead to the development of more appropriate therapies for the treatment and prevention of chronic sinusitis.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"35-9"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308155","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}

引用次数: 57

Evolution of medical management of chronic rhinosinusitis. 慢性鼻窦炎医疗管理的演变。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s909

Eugenia M Vining

{"title":"Evolution of medical management of chronic rhinosinusitis.","authors":"Eugenia M Vining","doi":"10.1177/00034894061150s909","DOIUrl":"https://doi.org/10.1177/00034894061150s909","url":null,"abstract":"Chronic rhinosinusitis (CRS) is a surprisingly common, poorly defined, and notoriously difficult-to-treat disease. It has a complex pathophysiology that often, but not always, involves nasal or paranasal sinus infection. Anatomic variations that predispose the sinuses to obstruction may play a role, but are unusual sole causes of chronic disease. Other possible causative factors include allergic or nonallergic inflammation, mucociliary dysfunction, aspirin intolerance (Samter's triad), immunodeficiency, and cystic fibrosis. Although a majority of patients achieve long-term relief from CRS after successful endoscopic sinus surgery, a significant proportion do not, and are likely to benefit from sustained postsurgical medical therapy. Medical therapy for CRS may include treatment with corticosteroids, antibiotics, antifungal agents, antihistamines, leukotriene modifiers, nasal decongestants, mucolytics, and nasal irrigations. The selection of appropriate medical therapy is based on endoscopic evaluation, sinus cultures, and symptoms. Computed tomography, the imaging standard for evaluation of the sinuses, provides information about the extent and distribution of mucosal disease beyond what is visible endoscopically. Because it fails to provide information on the origin of the mucosal changes, computed tomography provides limited information to guide medical therapy.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"54-60"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308158","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}

引用次数: 18

Surfactant and its role in chronic sinusitis. 表面活性剂及其在慢性鼻窦炎中的作用。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s907

Rodney J Schlosser

{"title":"Surfactant and its role in chronic sinusitis.","authors":"Rodney J Schlosser","doi":"10.1177/00034894061150s907","DOIUrl":"https://doi.org/10.1177/00034894061150s907","url":null,"abstract":"Although numerous studies have focused on the nature and defensive role of surfactant in the lower airways, relatively little is known about its role in the upper airways. Decreased levels of the main component of surfactant--phospholipids--have been implicated in atrophic rhinitis. The lamellar body arrangement of phospholipids has now been demonstrated in both normal and diseased sinus tissue, resulting in the implication that these structures may play a crucial role in mucociliary clearance against inhaled pathogens, as well as in the regulation of mucous viscosity. Furthermore, they may be secreted from sinonasal ciliated epithelium. Surfactant proteins (SPs) make up a relatively smaller proportion of surfactant, but appear to have an important role in innate immunity. Altered levels of SPs have been observed in a number of respiratory tract diseases. These SPs may prove to play a significant role in chronic sinusitis. Demonstrated expression of SP-A and SP-D in diseased and normal sinus tissue may mean that these SPs are excreted into the airway-lining fluid of the sinuses. Additionally, initial contact and interaction between pathogens and SP-A and SP-D may occur relatively early after inhalation and deposition into the mucus of the respiratory tract. These findings may lead to potential therapeutic options for difficult-to-treat sinus disease in the future.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"40-4"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308156","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}

引用次数: 19

Frontal sinus surgery: its evolution, present standard of care, and recommendations for current use. 额窦手术:其发展，目前的护理标准，以及对当前使用的建议。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s903

Alexander G Chiu

{"title":"Frontal sinus surgery: its evolution, present standard of care, and recommendations for current use.","authors":"Alexander G Chiu","doi":"10.1177/00034894061150s903","DOIUrl":"https://doi.org/10.1177/00034894061150s903","url":null,"abstract":"From a historical perspective, frontal sinus surgery has evolved from radical, highly invasive, disfiguring approaches to function-preserving, minimally invasive, and non-disfiguring intranasal procedures. Most sinus surgeons would agree that a sound surgical procedure is one that relieves patients' symptoms and provides a safe sinus in which future intracranial and orbital complications will not occur. For the future, sinus surgeons are searching for the ideal procedure, ie, one that is minimally invasive, reversible, and ensures the patient a safe frontal sinus for the long term. The ideal surgery will also leave minimal morbidity, will leave no cosmetic defect, and will allow for easy postoperative surveillance. To achieve this new standard in frontal sinus surgery, continuous refinements are required in the medical management and understanding of the disease processes that undermine long-term surgical success. Further advancements in instrumentation and visualization techniques are also necessary to enhance surgical precision, spare mucosa, and prevent the scarring and neo-osteogenesis that may cause surgical failures. Perhaps the most important development may be in the selection criteria for appropriate candidates who will benefit most from frontal sinus surgery.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"13-9"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308152","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}

引用次数: 24

Technical innovations and the evolution of endoscopic sinus surgery. 内窥镜鼻窦手术的技术革新和发展。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s902

David W Kennedy

{"title":"Technical innovations and the evolution of endoscopic sinus surgery.","authors":"David W Kennedy","doi":"10.1177/00034894061150s902","DOIUrl":"https://doi.org/10.1177/00034894061150s902","url":null,"abstract":"Since the introduction of endoscopic sinus surgery, a number of significant technological advances, as well as an improved understanding of disease pathogenesis and management, have enabled major evolutions in surgical techniques. Modifications to surgical instruments, imaging, the development of the microdebrider, and other newer instrumentation have all contributed to the current level of patient success associated with endoscopic intranasal techniques. At the same time, it has become evident that anatomic variations are less important in the pathogenesis of chronic rhinosinusitis than was previously thought, and that ventilation alone is insufficient to resolve well-established disease. This paper reviews the changes that have occurred in endoscopic sinus surgery over the past 20 years since the techniques were first introduced into the United States, and the technologies that have enabled these changes and the development of extended endoscopic techniques. Continuing developments of interactive computer-guided surgery, endoscopic 3-dimensional imagery, robotics, and improved adjunctive therapies will further extend the role of endoscopic transnasal approaches to an expanded number of skull base and intracranial lesions.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"3-12"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26307692","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}

引用次数: 70

Progress in sinonasal imaging. 鼻鼻窦成像研究进展。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s910

S James Zinreich

{"title":"Progress in sinonasal imaging.","authors":"S James Zinreich","doi":"10.1177/00034894061150s910","DOIUrl":"https://doi.org/10.1177/00034894061150s910","url":null,"abstract":"Imaging of sinonasal structures has evolved from standard radiographs to the much more complicated and informative techniques used today. The plain radiograph was useful when the surgical techniques practiced were primarily aimed at the maxillary and frontal sinuses. With a better understanding of the mucociliary clearance of the nasal cavity and the paranasal sinuses, the surgical technique was shifted to the ethmoid sinuses and became more focal, thus needing a better understanding and display of the intricate morphology of the nasal cavity and paranasal sinuses. Polytomography was a step above plain radiographs and was first used in the display of the regional anatomy for the development of functional endoscopic sinus surgery. Polytomography was quickly replaced by computed tomography, as this imaging technique provides a much more detailed view of the sinonasal architecture than does polytomography. Magnetic resonance imaging has also shown usefulness in imaging this morphological area, as it provides better soft tissue resolution, but it does not allow good visualization of bony structures. Newer computer systems with software capable of reconstructing the digitized information into a 3-dimensional display further enhance our understanding of the regional morphology and afford an improved means of correlating the imaging and endoscopic information. Furthermore, stereotactic navigation systems allow surgeons the ability to visualize the endoscope-instrument tip position, as instruments are actively being used during surgery, on the computed tomographic and/or magnetic resonance images. There is a persistent trend toward reducing the size of the imaging equipment to render it more mobile (computed tomography) and adapt it for operating room use.","PeriodicalId":76600,"journal":{"name":"The Annals of otology, rhinology & laryngology. Supplement","volume":"196 ","pages":"61-5"},"PeriodicalIF":0.0,"publicationDate":"2006-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894061150s910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"26308159","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}

引用次数: 15

Transnasal endoscopy-assisted skull base surgery. 经鼻内窥镜辅助颅底手术。

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2006-09-01 DOI: 10.1177/00034894061150s908

Aldo M Stamm

引用次数: 31

Consensus statements on the BAHA system: where do we stand at present? 关于BAHA系统的共识声明:我们目前处于什么位置?

The Annals of otology, rhinology & laryngology. Supplement Pub Date : 2005-12-01 DOI: 10.1177/0003489405114s1201

Ad F M Snik, Emmanuel A M Mylanus, David W Proops, John F Wolfaardt, William E Hodgetts, Thomas Somers, John K Niparko, Jack J Wazen, Olivier Sterkers, Cor W R J Cremers, Anders Tjellström

引用次数: 287