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Background and objective Chronic rhinosinusitis (CRS) is an inflammatory condition affecting the nasal mucosa, and it causes olfactory dysfunction (OD) in up to 78.2% of patients. Corticosteroids are the mainstay of treatment to shrink nasal polyposis, reduce inflammation, and improve olfactory function. While many delivery methods for topical nasal corticosteroids exist, there is scarce data on the efficacy of the various medication delivery methods to the olfactory cleft (OC). In light of this, this study aimed to compare the following delivery methods to the OC: conventional nasal spray (NS), nasal drops in the Kaiteki position (KP), and exhalation delivery system (EDS). Methods We evaluated 16 sinonasal cavities from eight cadaver specimens in this study. Each sinonasal cavity was administered fluorescein dye solution via NS, KP, and EDS. Following administration, nasal endoscopy was employed to capture staining patterns in the OC. OC staining was rated with scores ranging from 0 (no staining) to 3 (heavy staining) after each administration of dye solution. Mean OC staining ratings were calculated and compared using the Kruskal-Wallis rank sum test and the Wilcoxon signed-rank test. Results The mean OC staining score for the different delivery methods was as follows - NS: 1.095 ± 1.008, EDS: 0.670 ± 0.674, and KP: 2.038 ± 1.097. Nasal drops in the KP had a significantly higher staining score compared to NS (p=0.041) and EDS (p=0.003). However, there was no significant difference in staining scores between NS and EDS. Conclusions Nasal drops in the KP are more effective at reaching the OC than NS or EDS and should be considered as a first-line modality for administering topical medications when treating OD.
RESUMEN
Objectives: To analyze the association between neurocognitive performance and age-related hearing loss in the right and left ear, individually. Design: Subjects included 5277 participants (≥50 years) from the general Hispanic population who underwent audiometric testing in a US multicentered epidemiologic study. Linear regression was performed to assess the cross-sectional association between cognitive performance (Digit Symbol Substitution Test [DSST], Word Frequency Test, Spanish-English Verbal Learning Test [SEVLT] 3 Trials, SEVLT Recall, and Six-Item Screener) and hearing in each ear (4-frequency pure-tone average), adjusting for age, sex, education, cardiovascular disease, and hearing aid use. Results: Mean age was 58.4 ± 6.2 years; 3254 (61.7%) were women. Mean pure-tone averages were 20.2 ± 11.7 dB (right ear) and 20.2 ± 12.3 dB (left ear). Multivariable regression demonstrated significant associations between all cognitive tests and hearing loss in both ears. Conclusions: Worsening hearing loss in the right and left ear was associated with decreased performance across all tests. No laterality in the association was demonstrated.