Anthropometric study of the caucasian nose in the city of Curitiba: relevance of population evaluation

Introduction

Norms and patterns of nasal esthetics are essential for an adequate preoperative evaluation and surgical programming. The esthetic nasal patterns used are a blend of artistic beauty ideals and tracings in models and celebrities. Because they do not consider population measures, they vary according to the period, and allow a discrepancy between the surgeon's preference and the patient's real desire for rhinoplasty. Not all populations wish to obtain an esthetic result according to these values, but prefer a natural result, that is, one with some of the nasal characteristics of the population to which they belong to. The Brazilian population lacks population studies to evaluate its nose measurements.

Outcomes of external septorhinoplasty in a Turkish male population

Introduction

The first and one of the most important steps in facial plastic surgery is accurate preoperative facial analysis and recording of data that may help the surgeon to check the outcomes of his/her techniques, promoting a surgeon's professional development.

Lateral pharyngeal flap with a double pedicle for repair of unilateral velopharyngeal insufficiency

ObjectivesConventional pharyngeal flap surgery, which closes the median portion of the velopharynx, has been performed for dysarthria patients with velopharyngeal insufficiency (VPI). However, for VPI due to unilateral pharyngeal paralysis, median closing disrupts pharyngeal contraction of the unaffected side and allows pharyngeal pressure to escape through the nose at the lateral portion of the affected side during speech and swallowing. The purpose of this study was to evaluate the effectiveness of lateral pharyngeal flap (LPF) surgery for unilateral VPI.MethodsSeven patients with unilateral VPI (five males and two females with an average age of 54 years) underwent LPF surgery combined with other transoral surgeries for dysphagia. The LPF surgical technique was as follows: after the laterocaudal-based pedicle flap of the soft palate and cranial-based pedicle flap of the posterior pharyngeal wall on the affected side were transorally elevated, each mucosal pedicle flap was sutured together. Functional oral intake scale (FOIS) scores and swallowing pressure before and after surgery were compared.ResultsUnilateral velopharyngeal closure preserved nasal breathing after LPF surgery in all patients. Rhinolalia aperta improved postoperatively in all patients except one. The mean FOIS scores were 2.3 preoperatively and 3.7, 5.3, and 5.9 at 2 weeks, 1 month, and 6 months postoperatively, respectively. The mean pressures significantly increased at the velopharynx (from 49 ± 30 mmHg to 92 ± 45 mmHg) and oropharynx (from 48 ± 18 mmHg to 66 ± 15 mmHg) six months after the surgery.ConclusionLPF surgery leaving the unaffected side intact can be an effective surgical procedure for patients with unilateral VPI.     

Characterization of spontaneous otoacoustic emissions in full-term newborns

ObjectiveTo analyze the characteristics of spontaneous otoacoustic emissions (SOAEs) in full-term newborns.MethodsA total of 236 ears from 147 randomly selected full-term Chinese neonates (82 females and 65 males), who had passed the initial newborn hearing screening, were assessed for SOAEs using the Capella OAE equipment (Madsen, Denmark). The test was performed in a sound booth.Results(1) The overall prevalence of SOAE was 56.77% of the ears. The prevalence of SOAEs was significantly higher in females (69.23%) than in males (41.51%, p < 0.01), as well as in the right ears (64.17%) than in the left ears (49.14%, p < 0.05). (2) The overall mean level of SOAE was 11.78 ± 8.36 dB SPL, with no significant differences between males (11.73 ± 8.25 dB SPL) and females (11.81 ± 8.43 dB SPL) or between the left (11.97 ± 8.56 dB SPL) and the right ears (11.65 ± 8.22 dB SPL). (3) The 25th and 75th percentiles of SOAE frequencies were 2.31 and 4.36 kHz in females and 1.93 and 3.94 kHz in males, which were statistically significantly different (p < 0.01). In contrast, the SOAE frequency was not significantly different between ears (2.22–4.18 kHz in the left ears and 2.17–4.14 kHz in right ears). (4) The overall mean number of SOAEs was 3.70 ± 2.75, with no significant differences in females (3.62 ± 2.70) and males (3.86 ± 2.87) or in right (3.70 ± 2.55) and left ears (3.70 ± 3.02).ConclusionsThe prevalence rate of SOAE is significantly higher in females than in males and in the right ears than in the left ears in Chinese newborns. The frequencies of the SOAEs in newborns appeared to be higher than those reported in normal-hearing adults in the literature.     

Association between facial nerve second genu angle and facial canal dehiscence in patients with cholesteatoma: evaluation with temporal multidetector computed tomography and surgical findings

IntroductionOtitis media, mastoiditis or the pressure effect of tumorous lesions such as cholesteatoma can be the cause of facial canal dehiscence and facial nerve paralysis. The most common segment involved in dehiscence is the tympanic segment and the second most common is the lateral aspect of the facial canal in the oval window area.ObjectiveTo determine the prevalence of the facial canal dehiscence and the relationship between the angle at the second genu of the facial nerve and facial canal dehiscence.MethodsWe evaluated the surgical findings in 113 patients who underwent surgery for cholesteatoma. Facial canal dehiscence was detected in 62 of the 113 patients. Patients were divided into two groups: Group 1, with dehiscence of the facial canal and Group 2, without dehiscence of the facial canal.ResultsThe mean angles at the second genu of the facial nerve in Groups 1 and 2 were 117.8° ± 9.63° and 114° ± 9.9°, respectively. There was a statistically significant difference between the mean angles at the second genu for the two groups (p = 0.04).ConclusionIn patients with dehiscence of the facial canal, the angle at the second genu was found to be wider than those without dehiscence.     

Effects of oral isotretinoin therapy on the nasal cavities

IntroductionIsotretinoin (13 cis-retinoic acid) is the most effective treatment for acne vulgaris and is the only treatment option that can provide either remission or a permanent cure.ObjectiveThe aim of this study was to use both subjective and objective methods to assess the nasal complaints of patients with severe acne who received oral isotretinoin therapy.MethodsFifty-four subjects were enrolled in the study. All the subjects were assessed with subjective (NOSE and VAS questionnaires) and objective (rhinomanometry and saccharine) tests to determine the severity of their nasal complaints.ResultsThe mean severity scores (min: 0; max: 100) for nasal dryness/crusting and epistaxis were 0.47 ± 1.48 (0–5); 0.35 ± 1.30 (0–5) at admission, 3.57 ± 4.45 (0–10); 2.26 ± 4.71 (0–20) at the first month, and 4.28 ± 6 (0–20); 2.26 ± 4.71 (0–20) at the third month of the treatment respectively. Total nasal resistance of 0.195 ± 0.079 (0.12–0.56) Pa/cm³/s at admission, 0.21 ± 0.084 (0.12–0.54) Pa/cm³/s at the first month, and 0.216 ± 0.081 (0.14–0.54) Pa/cm³/s at the third month.ConclusionOral isotretinoin therapy can cause the complaint of nasal obstruction. In addition, nasal complaints, such as dryness/crusting and epistaxis, significantly increase in patients during the therapy schedule.     

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 systolic pulmonary artery pressure and the E/e’ ratio decrease after septoplasty in patients with grade 2 and 3 pure nasal septal deviation

IntroductionNasal septal deviation may contribute to a wide range of symptoms including nasal obstruction, headache, increased secretion, crusting, mucosal damage, and loss of taste and smell. Excessive increase in the respiratory resistance, as seen in nasal septal deviation, results in reduced lung ventilation, thereby potentially leading to hypoxia, hypercapnia, pulmonary vasoconstriction. The deformities in the nasal cavity can be associated with major respiratory and circulatory system diseases.ObjectiveTo investigate cardiovascular effects of septoplasty by comparing pre- and postoperative transthoracic echocardiography findings in nasal septal deviation patients undergoing septoplasty.MethodsThe prospective study included 35 patients with moderate and severe nasal septal deviation (mean age, 23.91 ± 7.01) who underwent septoplasty. The Turkish version of the nasal obstruction symptom evaluation, NOSE questionnaire, was administered to each participant both pre- and postoperatively in order to assess their views on the severity of nasal septal deviation, the effect of nasal obstruction, and the effectiveness of surgical outcomes. A comprehensive transthoracic echocardiography examination was performed both preoperatively and at three months postoperatively for each patient and the findings were compared among patients.ResultsMean preoperative NOSE score was 17.34 ± 1.62 and the mean postoperative score was 2.62 ± 1.68 (p = 0.00). Mean preoperative systolic pulmonary artery pressure value was 22.34 ± 4.31 mmHg and postoperative value was 18.90 ± 3.77 mmHg (p = 0.00). Mean E/e’ ratio was 5.33 ± 1.00 preoperatively and was 5.01 ± 0.90 postoperatively (p = 0.01). The NOSE scores, systolic pulmonary artery pressure values, and the E/e’ ratios decreased significantly after septoplasty (p < 0.05 for all), whereas no significant difference was found in other transthoracic echocardiography parameters (p > 0.05).ConclusionThe decrease in NOSE scores following septoplasty indicated that the satisfaction levels of the patients were increased. Upper airway obstruction secondary to nasal septal deviation may be a cardiovascular risk factor and may affect transthoracic echocardiography measurements. Moreover, the significant decrease in the systolic pulmonary artery pressure value and E/e’s ratio following septoplasty indicated that negative echocardiographic findings may be prevented by this surgery.     

New Ringer's lactate gel formulation on nasal comfort and humidification

IntroductionThe use of saline irrigation for nasal washes is a well established procedure in the treatment of sinonasal inflammation and infection. In addition to saline solutions, Ringer's lactate is also an efficient option for nasal washes and humidification.ObjectiveTo assess the comfort, humidification and tolerance regarding stinging sensation, provided by sodium chloride nasal gel at the concentrations of 4.5 mg/g and 6.0 mg/g through questionnaires answered by the patients.MethodsA total of 60 patients, 56 females, aged between 22 and 66 years old (mean age of 47) and 4 males, aged between 36 and 66 years (mean age of 49), were included in the study for a period of 17 days (±2 days) treatment. The patients were monitored by a general practitioner throughout the study period. They were instructed to apply each product in both nostrils twice a day during a 7-day period (±2 days). The patients were evaluated prior to the use of the first product at visit 0 (V0), after 7 days of treatment (±2 days) at visit 1 (V1), after 3 days of product discontinuation at visit 2 (V2) and after 7 days (±2 days) of treatment with the second product, in visit 3 (V3).ResultsA significant difference (5% significance) was observed regarding comfort and stinging sensation between the two different concentrations; comfort was higher and stinging was lower with the 6.0 mg/g concentration gel. No difference in humidification was observed between the two treatments.ConclusionRinger's lactate at the concentration of 6.0 mg/g was superior to that at 4.5 mg/g for parameters comfort and stinging sensation. No statistical difference was observed between the two products regarding nasal humidification.     

Is the C-reactive protein/albumin ratio a prognostic and predictive factor in sudden hearing loss?

IntroductionSudden hearing loss is a significant otologic emergency. Previous studies have revealed a coexistence of sudden hearing loss with chronic inflammation. The predictive importance of C-reactive protein/albumin values as a prognostic factor has been shown in various inflammatory and tumoral conditions.ObjectivesThe aim of this study was to determine whether the C-reactive protein/albumin ratio in sudden hearing loss can be used for prognostic purposes and whether there is a relationship between the neutrophil/lymphocyte ratio and the C-reactive protein/albumin ratio.MethodsA retrospective examination was made of 40 patients diagnosed with idiopathic sudden hearing loss and a control group of 45 healthy subjects. The pure tone averages of all the patients were determined on first presentation and repeated at 3 months after the treatment. The patients were separated into 2 groups according to the response to treatment. The neutrophil/lynphocyte ratio and the C-reactive protein/albumin ratios were calculated from the laboratory tests.ResultsThe patients included 16 females and 24 males with a mean age of 44.1 ± 14.2 years and the control group was composed of 23 females and 22 males with a mean age of 42.2 ± 13.8 years. The mean C-reactive protein/albumin ratio was 0.95 ± 0.47 in the patient group and 0.74 ± 0.13 in the control group. The difference was statistically significant (p = 0.009). The mean C-reactive protein/albumin ratio was 0.79 ± 0.12 in the response to treatment group and 1.27 ± 0.72 in the non-response group, with no significant difference determined between the groups (p = 0.418). The mean neutrophil/lymphocyte ratio was 3.52 ± 3.00 in the response to treatment group and 4.90 ± 4.60 in the non-response group, with no statistically significant difference determined between the groups (p = 0.261).ConclusionC-reactive/albumin ratio was significantly higher in patients with sudden hearing loss than in the control group. Although C-reactive protein/albumin ratio was found to be lower in sudden hearing loss patients who responded to treatment compared to those who did not, the difference between two groups was not statistically significant.     

Early clinical outcomes of ınferior turbinate radiofrequency and lateralization combined with septoplasty

IntroductionMechanical obstruction is the most common form of nasal obstruction. Among the types of mechanical obstructions, septum deviation and inferior turbinate hypertrophy are the most prevalent.ObjectiveThis study evaluated the early clinical outcomes of inferior turbinate radiofrequency and inferior turbinate lateralization combined with septoplasty in the treatment of nasal obstruction symptoms.MethodsThe research retrospectively evaluated data from 33 patients (24 male, nine female) undergoing septoplasty and inferior turbinate radiofrequency (RF group) and 32 patients (24 male, eight female) treated with septoplasty and inferior turbinate lateralization (LAT group), who were admitted, with complaints of nasal obstruction, to the University of Health Sciences, Department of Otorhinolaryngology, between January 1, 2017 and January 1, 2018. The patients’ preoperative and 6-month postoperative symptoms were evaluated via the Nasal Obstruction Symptom Evaluation, the NOSE scale.ResultsThe mean preoperative NOSE scores were 10.3 ± 4.2 in the RF group and 10.9 ± 4.9 in the LAT group, and the mean six-month postoperative scores were 1.09 ± 1.3 in the RF group and 1.2 ± 1.3 in the LAT group. There was no significant difference in NOSE scores between the two groups (p > 0.05).ConclusionThe data obtained in this study show that both methods result in similar outcomes in terms of relieving nasal obstruction symptoms in patients requiring inferior turbinate intervention. Therefore, the researchers believe that, in each case, the intervention method should be selected at the discretion of the patient and surgeon(s).     

Evaluation of choroidal thickness measurements in patients with marked nasal septal deviation

IntroductionChronic upper airway obstruction due to marked nasal septal deviation may cause chronic hypoxia. It may change the balance of the sympathetic-parasympathetic system and may affect blood flow in the choroid.ObjectiveTo assess choroidal thickness measurements of patients with marked nasal septal deviation.MethodsThe patients who had nasal obstruction symptoms diagnosed with marked nasal septal deviation by anterior rhinoscopy and nasal endoscopy and scheduled for septoplasty were included in the study. The control group consisted of age, sex and body mass index-matched healthy individuals. The choroidal measurements at the central fovea and 1000 μm away from the fovea in the nasal and temporal regions were performed using enhanced depth imaging optical coherence tomography.ResultsIn the study group, 52 eyes of 26 patients with a mean age of 26.34 ± 8.14 years were examined. In the control group, 52 eyes of 28 healthy individuals with a mean age of 26.69 ± 7.84 years were examined. There was no statistically significant difference in terms of choroidal thickness measurements between the groups (p > 0.05).ConclusionOur results suggest that marked nasal septal deviation may not lead to significant hypoxia and sympathetic activation, resulting in deterioration of the choroidal blood flow and consequent choroidal thickening.     

The styloid process and the formation of sigmoid sinus diverticulum: is there a link?

IntroductionSigmoid sinus diverticulum has been considered the most common cause of pulsatile tinnitus; the mechanism underlying sigmoid sinus diverticulum formation is unclear. To the best of our knowledge, no previous studies have assessed whether the formation of sigmoid sinus diverticulum is related to compression of the internal jugular vein by the styloid process.ObjectiveTo discuss the relationship between the styloid process and the formation of sigmoid sinus diverticulum.MethodsThe medical records of nine patients diagnosed with venous pulsatile tinnitus caused by sigmoid sinus diverticulum were reviewed between April 2009 and May 2019. All patients underwent high-resolution computed tomography of the temporal bones, computed tomography venogram of the head and neck, magnetic resonance venography, and brain magnetic resonance imaging. The length and medial angulation of the styloid process were measured, and compression of the internal jugular vein was recorded.ResultsThe study population consisted of nine female right-sided pulsatile tinnitus patients with a mean age of 53.8 ± 4.6 years. The mean lengths of the styloid process were 3.9 ± 0.6 cm on the right side and 4.1 ± 0.7 cm on the left side. The mean medial angulation of the styloid process was significantly smaller on the right side than the left side (65.3° ± 1.2° vs. 67.8° ± 1.7°, p < 0.05). In addition, computed tomography venogram of the head and neck demonstrated the left internal jugular vein was compressed by the styloid process in eight of the nine patients.ConclusionThe formation of sigmoid sinus diverticulum with venous pulsatile tinnitus may be related to compression of the contralateral internal jugular vein by the styloid process. However, accumulation of data in additional cases is required to verify this suggestion.     

Preparation and placement of cartilage island graft in tympanoplasty

IntroductionCartilage graft tympanoplasty has a better success rate in the treatment of chronic otitis media if regularly prepared and placed.ObjectiveTo prepare cartilage island material and evaluate its effect on the success rate of tympanoplasty.MethodsThe medical records of 87 patients (48 males and 39 females; mean age, 27.3 ± 11.2 years; range, 14–43 years) with chronic otitis media without cholesteatoma who underwent intact canal-wall-up tympanoplasty and revision surgery between December of 2007 and October of 2011 were retrospectively evaluated. Surgery was performed under general anesthesia via a retroauricular approach.ResultsThe overall success rate of this technique was 93% in terms of perforation closure. No graft lateralization or displacement into the middle ear occurred. The overall average preoperative air bone gap was 37.27 ± 12.35 dB, and the postoperative air bone gap was 27.58 ± 9.84 dB. The mean postoperative follow-up period was 15.3 months (range: 7–21 months).ConclusionIf cartilage graft is properly prepared and placed, cartilage graft tympanoplasty appears to provide better success rates and hearing results.     

Mometasone furoate intranasal spray is effective in reducing symptoms and adenoid size in children and adolescents with adenoid hypertrophy

IntroductionThe use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation.Material and methodA prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients’ aged 7–11-years old used 1 spray in each nostril once daily, while patients aged 12–17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12).ResultsA total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms’ score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms’ score (p < 0.001). AH significantly reduced in size from week 0 (2.89 ± .87) to week 12 (1.88 ± .83) (p < 0.001).ConclusionMF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered.     

Is there a correlation between nasal septum deviation and maxillary transversal deficiency? A retrospective study on prepubertal subjects

IntroductionDeviated nasal septum may cause a reduction of the nasal airflow, thus, during the craniofacial development, a reduced nasal airflow could originate a chronic mouth-breathing pattern, related with moderate to severe maxillary constriction. The aim of this retrospective study is to analyze the correlation between maxillary transverse deficiency and nasal septum deviation.MethodsFrontal cephalograms were performed on 66 posterior–anterior radiographs of subjects (34M, 32F; mean age 9.95 ± 2.50 years) with maxillary transverse deficiency and on a control group of 31 posterior–anterior radiographs of subjects (13M, 18F; 9.29 ± 2.08 years). Angular parameters of the nasal cavities were recorded and compared between the two groups using a Student's t-test.ResultsGenerally all the parameters are very similar between the two groups except for the ASY angle that differs for about the 27%; anyway the Student's t-test showed no statistically significant differences between the two groups (mostly p > 0.20).ConclusionsThis study failed to show an association between transverse maxillary deficiencies and nasal septum deviations. Moreover, no significant differences were found between the mean nasal cavities dimensions in subjects with transverse maxillary deficiency and the control group.     

Cervical vestibular evoked myogenic potentials in children

IntroductionCervical vestibular evoked myogenic potential is a test used in neurotological examination. It verifies the integrity of vestibular function through a muscular response evoked by an acoustic stimulation which activates the saccular macula. Normal standards in adults have been established, however, there are few published data on the normal responses in children.ObjectiveTo establish normal standards for vestibular myogenic responses in children without neurotological complaints.MethodsThis study's design is a cohort with cross-sectional analysis. The sample consisted of 30 subjects, 15 females (50%) and 15 males (50%).ResultsThe age of the subjects ranged between 8 and 13 years, with a mean of 10.2 (± 1.7). P1 peak showed an average latency of 17.26 (± 1.78) ms and a mean amplitude of 49.34 (± 23.07) μV, and the N2 peak showed an average latency of 24.78 (± 2.18) ms and mean amplitude of 66.23 (± 36.18) μV. P1–N2 mean amplitude was 115.6 (± 55.7) μV. There were no statistically significant differences when comparing by gender or by laterality.ConclusionWe established normal values of cervical myogenic vestibular responses in children between 8 and 13 years without neurotological complaints.     

Changes in substance P levels of inferior turbinate in patients with mucosal contact headache

IntroductionMucosal contact headache is a referred pain that arises from contact between the nasal septum and the lateral nasal wall. Evidence supports the role of substance P in a contact headache such that release of substance P from sensory nerve endings causes inflammation and allergy.ObjectivesThis study aimed to determine possible differences in substance P levels in inferior turbinate hypertrophy creating a contact headache.Methods28 patients who had contact headaches (study group) and 16 volunteers with no complaints were included in the study. Substance P levels in the inferior turbinate tissue samples were quantified using a commercially available substance P EIA kit.ResultsIn the study group average substance P levels were 2.65 ± 0.27 pg/mg tissue (range: 0.61–5.44) and in the control group it was 1.77 ± 0.27 pg/mg tissue (range: 0.11–4.35). The difference was statistically significant between the two groups (p = 0.0215). Average preoperative headache group visual analog scale scores was 5.93 ± 0.38 (2–9) and the turbinate volume was 6.56 ± 0.35 cm³ (3.50–10.30). The control group turbinate volume was 4.71 ± 0.39 cm³ (2.50–7.70). We found a correlation between the visual analog scale scores and substance P levels such that substance P levels were higher in visual analog scale scores above 5 (p = 0.001).ConclusionThis study demonstrates the relationship between intranasal contact headaches and increased mucosal substance P levels. We also found that there is no correlation with substance P levels and volume of the inferior turbinate.     

Possible effects of low testosterone levels on olfactory function in males

IntroductionFunctions attributed to androgens have increased, ranging from the role in hypothalamic–pituitary–gonadal axis and reproductive behaviors to modulation of cognition, mood and some other functions. Sex differences and changes in circulating sex hormones affect human sensory function. In the literature, authors reported this kind of influence for olfaction predominantly in females.ObjectiveTo investigate the effects of low testosterone levels on olfactory functions in males, in this prospective clinical study.MethodsMale patients diagnosed with prostate cancer were included. Thirty-nine patients with prostate cancer whose testosterone levels were lower than 50 ng/dL due to castration, were the study group. Thirty-one patients with prostate cancer who were not castrated with testosterone levels higher than 50 ng/dL were selected as the control group. Acoustic rhinometry and peak nasal inspiratory flow tests were performed for all participants; and for evaluation of olfactory function, both groups completed the Connecticut chemosensory clinical research center olfactory test.ResultsThe mean ages of the patients and controls were 69.6 ± 7.2 (57–89) and 66.3 ± 5.8 (50–78) years, respectively (p = 0.039). There was a significant difference between groups in terms of testosterone levels (p < 0.0001). The multivariate logistic regression revealed testosterone level as the only predictive factor determining the difference between the groups. In terms of olfactory parameters, all scores were lower in the emasculated group (butanol threshold test p = 0.019, identification p = 0.059, and Connecticut center score p = 0.029) There was a significant correlation between testosterone levels and olfactory parameters (p = 0.023; p = 0.025 for identification and Connecticut center scores, respectively).ConclusionLow testosterone levels in males have negative effects on olfactory functions. Further molecular research is required to understand the connection between testosterone and olfaction.     

Role of VPAC1 and VPAC2 receptors in the etiology of pregnancy rhinitis: an experimental study in rats

IntroductionPregnancy rhinitis is a common sex hormone-related otorhinolaryngological disorder. There are some epidemiological and physiological studies on pregnancy rhinitis, but histopathological and biomolecular changes have not been studied thoroughly.ObjectivesThe receptors VPAC1 and VPAC2 are known for their roles in allergic rhinitis. On the other hand, activation of subclinical allergy has been suggested in the pathophysiology of pregnancy rhinitis. Therefore, we aimed to compare the physiological and gestational pattern of VPAC1 and VPAC2 expression in rat nasal mucosa.MethodsTwenty adult Wister albino female rats were enrolled into the study. Two groups constituted as 10 control (group A) and 10 pregnant (group B) rats. They were fed ad libitum and sheltered at room temperature (22°±2 °C). The rats were sacrificed at the 20th day of gestation by intraperitoneal injection of 400 mg/kg Na-pentobarbitone. Then, 10 ? 15 mL of blood was taken, and samples were reserved for the detection of serum estradiol and progesterone levels by ELISA test. The nasal septum was resected and divided in half for immunohistochemical analyses and real time polymerase chain reaction testing of VPAC1 and VPAC2.ResultsVPAC1 and VPAC2 were found to be in all layers of septal specimens, but the immunostaining of surface epithelium was more distinct in specimens of both groups. We demonstrated higher overall staining intensity in the pregnant group. PCR revealed significant increase in expression of VPAC1 (p = 0.023) and VPAC2 (p = 0.021) in pregnant group when compared with control group. In addition, we demonstrated upregulatory effect of estradiol and progesterone on the vasoactive intestinal peptide receptor expression.ConclusionsGestational up-regulation of nasal VPAC1 and VPAC2 was shown both by PCR and immunohistochemical analysis. These findings support the hypothesis that PR is caused by the activation of subclinical allergy that is present before pregnancy.