Nasopharyngeal carcinoma and nasal allergy: any correlation?

Although it has been observed that nasal allergy is rarely seen in patients who have nasopharyngeal carcinoma, to our knowledge, no actual study of such a lack of association has been previously reported. To fill this void, we conducted a pilot study to investigate any such inverse relationship. We conducted skin-prick allergen tests on 22 patients with newly diagnosed but not-yet-treated nasopharyngeal carcinoma. Combining these test results with findings on the history and clinical examination, we concluded that only one of the 22 cancer patients (4.5%) had allergic rhinitis. Our study also confirmed the validity of using findings on the history, clinical examination, and skin-prick testing as a reliable means of diagnosing allergic rhinitis.     

Olfactory function and nasal manifestations of Behçet's disease

ObjectiveTo investigate the effect of Behçet's disease on olfactory function, the nasal mucosa, and nasal symptoms.MethodsA total of 30 patients with Behçet's disease and 30 healthy individuals volunteered to enroll in the study. Any condition leading to olfactory dysfunction was a criterion for exclusion. Nasal endoscopy was carried out individually, and nasal symptoms were assessed. An olfactory function assessment test defined by the Connecticut Chemosensory Clinical Research Center (CCCRC) was carried out. n-Butanol odor threshold and odor identification tests were performed, and the CCCRC test score (0: worst score; 7: best score) was calculated. The relationship between nasal findings, nasal symptoms, and olfactory function was evaluated.ResultsThe mean age of each group was the late 1930s, and demographic differences were not significant. n-Butanol threshold test scores were 5.57 ± 1.0 and 6.47 ± 0.7 out of 7 for subjects with Behçet's disease and the healthy control group, respectively. Identification test scores were 4.93 ± 1.3 and 6.15 ± 0.8 out of 7 and the mean CCCRC scores were 5.25 ± 1.0 and 6.31 ± 0.6, respectively, with significant differences (p < 0.001). Some nasal symptoms were significantly more common in patients with nasal findings, but no correlation was found between nasal findings and olfactory function.ConclusionAlthough Behçet's disease has been shown to involve the nasal cavity, its effects on olfactory function are unknown. The significant difference in CCCRC scores suggests, for the first time, that olfactory dysfunction is associated with Behçet's disease. Nasal symptoms are associated with the presence of nasal lesions, but there is no correlation between nasal findings and olfactory function.     

The activity of N-acetyl-β-d-hexosaminidase A and B and β-glucuronidase in nasal polyps and hypertrophic nasal concha

Nasal polyps and hypertrophic lower nasal conchae are common disorders of nasal cavity. The majority of etiopathogenetic theories indicate inflammatory background of polyps and hypertrophic concha. N-acetyl-β-d-hexosaminidase and β-glucuronidase are lysosomal exoglycosidases revealing accelerated activity in inflammatory processes. Aim: The aim of the study was to evaluate the catabolism of glycoconjugates in nasal polyps and hypertrophic nasal concha basing on the activity of N-acetyl-β-d-hexosaminidase (HEX) and β-glucuronidase (GLU). Material and methods: Material consisted of nasal polyps taken from 40 patients during polypectomy in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and hypertrophic lower nasal conchae taken from 20 patients during mucotomy. The activity of HEX, HEX A, HEX B and GLU in supernatant of homogenates of nasal polyps and hypertrophic lower nasal concha tissues has been estimated using colorimetric method. Results: Statistically significant decrease has been observed in concentration of the activity (per 1 mg of tissue) of HEX (p < 0.05), HEX B (p < 0.001) and specific activity (per 1 mg of protein) of HEX B (p < 0.001) in nasal polyps tissue in comparison to hypertrophic lower nasal conchae tissue. Conclusions: Decrease in the activity and specific activity concentration of the majority of examined lysosomal exoglycosidases (increasing in inflammations) in comparison to hypertrophic lower nasal conchae suggests electrolytes disorders and questions the inflammatory background of nasal polyps.     

Progress on diagnosis and treatment of nasal valve dysfunction北大核心CSCD

鼻阀是调节鼻腔气流的关键部位,轻度的外鼻阀或内鼻阀解剖异常即有可能引起鼻腔通气障碍。鼻阀功能障碍的原因除了鼻中隔偏曲和下鼻甲肥大外,还包括一些可能引起外鼻形态改变的结构异常,如鼻翼塌陷、张力鼻、鼻尖下垂等,但这些问题常被耳鼻咽喉科医生所忽略。本篇文章旨在介绍鼻阀的结构,分析鼻阀功能障碍影响通气的原因,并探讨鼻阀功能障碍的诊断方法和恢复鼻通气的治疗方案。     

Peak nasal inspiratory and expiratory flow measurements--practical tools in primary care?

General practitioners diagnose and treat numerous patients with nasal problems but have no objective equipment to aid diagnosis. We studied the characteristics of peak nasal inspiratory (PNIF) and expiratory (PNEF) flows to explore their utility for primary care use. One hundred healthy volunteers, 50 men, 50 women, performed PNIF and PNEF measurements in standardised laboratory circumstances. Repeatability was tested for a subgroup of 20 women who performed two consecutive series of PNIF and PNEF at a 2-minute interval. Diurnal variability was tested with a subgroup of 10 men and 10 women who recorded PNIF and PNEF values at home every morning and evening for 7 days. Distribution of individual values for both PNIF and PNEF was wide and independent of subject's age, height, or gender. Repeatability was poor and diurnal variation substantial. PNIF and PNEF lack the properties of good clinical tests and thus cannot be recommended for primary care use.     

Are nasal steroids safe?

Nasal steroids have emerged as an integral part of rhinitis management. Most studies have shown no evidence of significant hypothalamic-pituitary-adrenal axis suppression from nasal steroid use, at least based on dynamic testing. Bone mineral density loss, glaucoma, and cataract formation are risks associated with systemic steroids, but reports with nasal steroid use are few. Growth retardation has been seen with some nasal steroids, but not others, based on stadiometric growth studies. Further studies are certainly needed to resolve this issue. Nasal steroids, in general, have an excellent safety record.     

Does rapid maxillary expansion increase nasopharyngeal space and improve nasal airway resistance?

Objective

To evaluate the effect of rapid maxillary expansion (RME) on the dimension of the nasopharyngeal space and its relation to nasal airway resistance.

Methods

Twenty-five school-age children (from 7 to 10 year-old) with mouth and/or mixed breathing, with mixed dentition and uni- or bilateral posterior crossbite involving the deciduous canines and the first permanent molars, were evaluated. RME was placed and remained during 90 days. Rhinomanometry and orthodontic documentation were performed at four different times, i.e., before (T₁), immediately after (T₂), 90 days (T₃) and 30 months (T₄) after RME.

Results

Differences in nasopharyngeal area and in nasal airway resistance were observed only 30 months after RME, and could be explained by facial growth, and not because of the orthodontic procedure.

Conclusion

RME does not influence on nasopharyngeal area or nasal airway resistance in long-term evaluation.     

Clinical and histopathological correlation of nasal polyps: are there any surprises?

Nasal polypectomy is a common operation. There is debate about whether all nasal polyps removed at operation should be sent for histopathological examination. To investigate this, a prospective study was performed to check the correlation of clinical and histopathological examination. Three hundred and forty-four nasal polypectomy specimens during the period from September 1997 to September 1999 were sent for histopathological diagnosis, with the clinical diagnosis documented on the pathology form. The clinical diagnosis was then correlated with the histological diagnosis. Three hundred and twenty-eight specimens were diagnosed as inflammatory polyps and 16 as tumours, of which seven were malignant. There was a good correlation between the clinical and histological findings in 340 cases. There was disagreement between the forms and reports in four cases. When the notes were consulted, three cases had forms that were incorrectly filled in. There was only one unsuspected case of inverted papilloma in a polyp specimen, which looked like a benign inflammatory polyp. This study indicates there is a 99.7% correlation between clinical and histopathological diagnosis.     

Clinical and histopathological correlation of nasal polyps: are there any surprises?

kale s .u ., mohite u ., rowlands d . & drake ‐lee a .b . (2001) Clin. Otolaryngol. 26, 321–323 Clinical and histopathological correlation of nasal polyps: are there any surprises? Nasal polypectomy is a common operation. There is debate about whether all nasal polyps removed at operation should be sent for histopathological examination. To investigate this, a prospective study was performed to check the correlation of clinical and histopathological examination. Three hundred and forty‐four nasal polypectomy specimens during the period from September 1997 to September 1999 were sent for histopathological diagnosis, with the clinical diagnosis documented on the pathology form. The clinical diagnosis was then correlated with the histological diagnosis. Three hundred and twenty‐eight specimens were diagnosed as inflammatory polyps and 16 as tumours, of which seven were malignant. There was a good correlation between the clinical and histological findings in 340 cases. There was disagreement between the forms and reports in four cases. When the notes were consulted, three cases had forms that were incorrectly filled in. There was only one unsuspected case of inverted papilloma in a polyp specimen, which looked like a benign inflammatory polyp. This study indicates there is a 99.7% correlation between clinical and histopathological diagnosis.     

Do nasal polyps and inverted papilloma have similar disorders in cell cycle regulation?

BACKGROUND: The aim of this study was to determine the expression of cell cycle regulation genes in patients with inverted papilloma (IP) and compare this with expression in patients with nasal polyps (NPs). METHODS: Tissue from 18 patients with IP and 5 patients with NPs were stained by immunohistochemistry techniques for p53 and p27. Measurement of the gene expression was performed by three assessors, who we blinded with respect to the specimens. RESULTS: The mean score for p53 expression (3.33) was significantly higher in the IP group than the NP group (1.46). The mean difference between IP and NPs was 1.80 (CI, 1.15-2.46; p = 0.003). Additionally, we showed in a number of individuals variation in the p53 expression within the same specimen. There was no difference in the mean scores for p27, with the mean difference 0.79 (CI, 0.30-1.89; p = 0.147). CONCLUSION: Our study established a significantly increased expression of p53 in IP when compared with NPs. Additionally, there appear to be two different cell populations identified within the same specimens, which exhibited variation in their p53 expression.     

Can nasal endoscopy be used to predict residual symptoms after adenoidectomy for nasal obstruction?

Background: the efficacy of adenoidectomy in relieving nasal symptoms has been questioned. Although enlarged adenoids are often blamed for nasal obstruction, other causes can be missed if examination is not thorough. We suggest that endoscopy at the time of adenoidectomy may be useful to confirm large adenoids and exclude other causes, and the findings may help predict residual symptoms 2 years after adenoidectomy. Method: a prospective study of a consecutive series of children undergoing adenoidectomy for nasal obstruction was performed. All underwent endoscopy with a 4-mm rigid endoscope without decongestants under GA immediately prior to adenoidectomy. Two years later a postal symptom questionnaire was sent, with telephone follow up for non-responders. The findings on endoscopy were compared with residual symptoms at 2 years. Results: Forty-eight children aged 2-9 (mean 4) years were enrolled, 26 of them female. At 2 years follow up, data were available for 34 children (71%). Complete obstruction of the posterior choanae of the nose by adenoids was seen in 21 (62%). Additional findings (e.g. septal deviation, hypertrophic mucosa on the turbinates) were present in 22 (65%). Of them 9 (26%) had residual nasal symptoms. Of the children with less than occlusive adenoids, six (50%) out of 12 had residual symptoms, compared with three (14%) out of 21 with occlusive adenoids (chi(2)=4.91, P<0.05). Although residual symptoms were more common in those with additional findings on the original endoscopy (32 vs. 17%), this did not reach statistical significance. Conclusions: residual nasal symptoms are common when children are followed up in the medium term. The findings on endoscopy may predict the success of adenoidectomy in relieving the symptoms, and may help to guide further treatment.     

Expression of the cysteinyl leukotriene 1 receptor and glucocorticoid receptor-β in nasal polyps

The objective of this study was to analyze the expression of cysteinyl leukotriene 1 (CysLT1) receptor and glucocorticoid receptors (GRs) in nasal polyps, and to evaluate the relationship between the expression of CysLT1 receptors and that of GRs. Nasal polyps were taken from 32 patients of chronic rhinosinusitis with nasal polyposis. Samples of middle turbinate from seven healthy subjects were used as controls. Specimens were immunohistochemically stained for CysLT1 receptor, GR-α and GR-β receptor, and were quantified in the unit area of the tissues. Numbers of CysLT1 receptor-positive cells were much increased in nasal polyps than in middle turbinate (281 ± 67 vs. 157 ± 85 cells/mm², P = .01). There was no significant difference in the numbers of GR-α positive cells between nasal polyps and normal turbinate mucosa. GR-β positive cells were increased in nasal polyps as compared to normal turbinate mucosa (36 ± 8 vs. 19 ± 7 cells/mm², P = .03). A significant relationship was found between the expression of CysLT1 receptor and GR-β in nasal polyps (R = .525, P = .04), whereas there was no significant relationship between the expression of CysLT1 receptor and GR-α in nasal polyps. Our study shows that CysLT1 receptor expression predominates on GR-β over-expressed polyps. This may suggest the additional effect of CysLT1 receptor antagonist for the treatment of nasal polyposis resistant to steroid alone.     

Hyaluronan and alpha-atrial natriuretic polypeptide in human nasal polyps: contributing factors to oedema formation and polyp growth?

OBJECTIVES: To identify and localize hyaluronan (HYA) and alpha-atrial natriuretic polypeptide (ANP) in human nasal polyps and to measure the HYA concentrations. MATERIAL AND METHODS: Twelve nasal polyps were collected during routine polypectomies and processed histochemically and biochemically to determine the occurrence of HYA. The distribution of ANP was investigated using an immunocytochemical method. RESULTS: HYA was unevenly distributed, being found abundantly in the surface epithelium and basement membrane and around fibres and vessels in the lamina propria. It was also present around seromucinous glands and in the secretion of cysts in the stroma. The HYA concentration was 1,000-fold higher than in serum. ANP was abundant in the apical part of ciliated surface epithelial cells and extracellularly in the basement membrane. In the stroma, ANP was confined to apical acinar cells of the seromucinous glands. CONCLUSIONS: Osmotically active HYA and numerous ANP-immunoreactive cells, active in fluid and/or ion transport functions, are present in human nasal polyps. These substances may well be involved in oedema formation and the successive growth of nasal polyps. The high concentrations of HYA in nasal polyps may be of clinical significance for the future development of a local enzyme treatment for nasal polyposis.     

Ventilation and appearance should be simultaneously considered during the diagnosis and surgery of nasal septum deviation北大核心CSCD

[No abstract available]     

Do topical nasal decongestants affect polyps?

CONCLUSIONS: The hypothesis that decongestants reduce the size of nasal polyps could not be verified. Decongestion is therefore recommended prior to nasal endoscopy, especially in polyp diagnosis, as it does not artificially change the size of the polyps. OBJECTIVE: The role of nasal decongestants in nasal stuffiness is well established and their action is well known. Decongestants are also used prior to nasal endoscopy to achieve a better view of the nasal cavity in order to diagnose polyps. The question is whether this decongestion invalidates the estimation of polyp size in clinical and scientific practice. The aim of this study was to evaluate possible effects of topical decongestants on polyp extension in patients with nasal polyposis. MATERIAL AND METHODS: The effect of the decongestants nafazoline and epinephrine on nasal polyp size was assessed by means of a double-blind, placebo-controlled randomized study. A sensitive endoscopic scoring system, lateral imaging, was used to assess the size and extension of the nasal polyps. RESULTS: No significant effect of decongestion on polyp size could be found for either treatment.     

Two unusual lesions in the nasal cavity of infants--a nasal chondromesenchymal hamartoma and an aneurysmal bone cyst like lesion. More closely related than we think?

Benign reparative lesions in the head and neck region in infants are rare and often difficult to classify on histology. Discussed herein are two rare lesions in infants occurring at identical locations in the nasal cavity with striking histologic similarity but different histologic labels. One was a case of nasal chondromesenchymal hamartoma (NCMH) occurring in a 1-year-old child and the other an aneurysmal bone cyst (ABC) like lesion affecting a 4-month infant. Both these lesions were locally destructive and had nearly similar clinical presentation. Both on immunohistochemistry showed myofibroblastic nature and had similar histology except that the ABC like lesion lacked the cartilage component of the former. In view of great similarity in the two lesions, it was thought that the second lesion might also represent a reparative, non-cartilage-containing counterpart of the former.     

Application of high‑density polyethylene implants in adult cleft lip and palate nasal deformity and dysfunction北大核心CSCD

Objective Through the use of high‑density polyethylene implants in adults with cleft lip and palate nasal deformities and abnormal functions, to evaluate the clinical effect of postoperative patients on improving nasal shape and symptoms. Methods A retrospective study of 12 patients with nasal deformities after cleft lip and palate surgery in the Shanghai Ninth People′s Hospital Affiliated to Shanghai JiaoTong University School of Medicine from January 2018 to January 2022 was completed, including 7 males and 5 females, with the age ranging from 18 to 29 years. All the patients underwent nasal deformity correction, and nasal septum correction was performed if necessary. High‑density polyethylene implants (MEDPOR/Su‑Por) were used intraoperatively. Follow‑up for at least 6 months was performed to measure the relevant appearance indicators and subjective Visual Analog Scale (VAS) scores, and to compare the clinical effects before and after surgery. SPSS 22.0 software was used for statistical analysis. Results Before and after surgery, the average VAS score of nasal obstruction decreased by (4.83±0.94) points; the average VAS score of appearance satisfaction increased by (3.92±1.08) points; the height of nasal columella was increased by (1.79±0.78)mm; the height of nasal tip was increased by (2.79±1.50)mm; the height of ipsilateral nostril was increased by (1.83±0.62)mm; the width of the ipsilateral nasal floor was reduced by (0.42±0.47)mm. All of above were statistically significant (all P<0.05). Conclusion High‑density polyethylene implants can effectively improve the shape and function of the nose in operations related to cleft lip and palate nasal deformity and abnormal functions, and are an ideal synthetic material. © 2023 Authors. All rights reserved.