Establishment and characterization of an experimental mouse model of allergic rhinitis.

Allergic rhinitis (AR) is a common worldwide disease. Animal studies on AR were adopted in various investigations. However, animal studies simply aimed at establishing an animal model for AR have been seldom seen. The purpose of this study was to introduce an easy-to-establish experimental mouse model of AR. To develop a mouse model of AR, 38 Balb/c mice were randomly assigned to two groups. Mice in the study group were sensitized by intraperitoneal (IP) injection of ovalbumin (OVA) on day 1 and 6, followed by continuous inhalation (IH) of OVA solution for 1 week (day 8-14) using a newly designed inhalation box. The control group mice received sensitization of IP normal saline and IH sterilized distilled water instead of OVA. Before and after sensitization, the frequencies of nasal symptoms (sneezing, nasal rubbing) were recorded and the serum levels of total immunoglobulin E (IgE) were evaluated using ELISA. Finally, the murine nasal mucosal tissues were stained by Giemsa solution to estimate the degree of mast cell infiltration. After sensitization by IP and IH OVA, the study group showed significant phenotypic changes including increased sneezing and rubbing. Pathological and cytological findings also confirmed significant elevated serum total IgE titer and local mast cell infiltration in the study group statistically. We successfully developed a workable experimental animal model for AR that was more easily sensitized using our new-designed inhalation box, with less stress and more precisely to be observed.

Human papillomavirus infection and papillary squamous cell carcinoma in the head and neck region.

Papillary squamous cell carcinoma (PSCC) is a rare variant of SCC in the head and neck region. The role of human papillomavirus (HPV) infection in PSCC is still unclear. We retrospectively reviewed 11 PSCCs in our institute over a 21-year period and compared the HPV status of PSCCs with 26 squamous cell papillomas (SCPs). Polymerase chain reaction (PCR) amplification to detect HPV DNA and in situ hybridization (ISH) were performed to analyze the relationship between the papillary lesions and HPV infection. Immunohistochemical (IHC) staining for p16 protein expression was used to analyze the PSCC specimens. Nine of 11 (82 %), eight of 11 (73 %), and eight of 11 (73 %) PSCC samples were found to be HPV positive by PCR, ISH, and IHC staining for p16 protein expression, respectively. PSCC had a significantly higher rate of HPV infection than SCP by PCR (p = 0.002) and ISH (p = 0.001) analysis. This study presents different HPV status in two papillary neoplasms and may help to clarify the unique morphological and biological characteristics of head and neck PSCC.

Do cervical degenerative diseases associate with foreign body sensation of the pharynx?

Foreign body sensation of the pharynx is a common complaint in otolaryngologic practice. The definite cause of this symptom is seldom precisely diagnosed, leading to chronic pharyngitis. The purpose of the present study was to evaluate the relationship between lump in throat and cervical degenerative disease by their clinical symptoms and the associated image characteristics. All patients with or without the complaint of lump in throat who attended the otolaryngologic clinics of Chang Gung Memorial Hospital-Kaohsiung Medical Center from January 2009 to May 2010 were prospectively eligible for this study. A total of 225 patients who met the inclusion criteria were assigned to either the study group (150 patients with symptoms of lump in the throat) or the control group (75 individuals without symptoms). All patients received plain views of the cervical lateral neck. The study group underwent further diagnostic examinations, including esophagography to exclude other diseases. Symptom scores (range, 0-3) and imaging characteristics such as the number (total spurs) and location (C level) of cervical osteophytes, interspace narrowing, spondylolisthesis, and retrolisthesis were compared between the two groups. It was found that the study group had a significantly greater number of total spurs (P < 0.001), and C45, C56, and C67 were the predominant sites, with significant odds ratios of more than 2 at all these levels. Only C67 revealed a difference in interspace narrowing, and only C45 showed a difference in spondylolisthesis between groups. Hence, a high correlation was found between the lump-in-throat sensation and total number of spurs, especially at the levels of C45, C56, and C67. This result implied that cervical osteophytes might be associated with foreign body sensations of the pharynx.

Computer-assisted quantitative evaluation of obstructive sleep apnea using digitalized endoscopic imaging with Muller maneuver.

OBJECTIVE: To validate the technique of the Muller maneuver (MM) using videoendoscopy and to quantify the correlation between its clinical results and variables of polysomnography. STUDY DESIGN: Prospective, controlled study. METHODS: Videoendoscopy with MM was performed in 70 patients who were categorized into two groups, with 35 patients giving a history suggestive of snoring and 35 patients without such history. The snoring group underwent further examination with polysomnography. Cross-sectional areas at the retropalatal (RP) and retrolingual (RL) levels during quiet respiration (RP(0) or RL(0)) and the maximal effort of MM (RP(1) or RL(1)) were calculated with the digital measurement software "Image J." One hundred forty pairs of data were acquired. The collapsing ratio (CR) was defined as the difference of RP(0) (or RL(0)) between RP1 (or RL(1)) divided by RP(0) (or RL(0)) to compare the difference between the two phases. These results were compared with each other and correlated to the variables obtained from polysomnographic studies. RESULTS: There were significant differences in the CR of RP (CR(RP)), the CR of RL (CR(RL)), and body mass index (BMI) when comparing the two groups. In snoring patients, BMI was positively related to the respiratory disturbance index (RDI) and obstructive sleep apnea (OSA) staging but not to CR(RP) and CR(RL). CR(RP) had a significant positive relationship with RDI and OSA rather than CR(RL). CONCLUSION: MM with videoendoscopy can be a simple, cost-effective, quantitative, and even predictable technique. This method allows us to examine the dynamic upper airway for more precise preoperative planning.

Zinc in the treatment of idiopathic sudden sensorineural hearing loss.

OBJECTIVES/HYPOTHESIS: The objective of this study was to investigate whether zinc supplementation can enhance the recovery of idiopathic sudden sensorineural hearing loss (SSNHL). STUDY DESIGN: Prospective, randomized study. METHODS: The 66 SSNHL patients who participated in this study were randomly divided into two groups: 33 were given corticosteroid treatment (control group) and 33 were given oral zinc gluconate plus corticosteroid treatment (zinc group). Serum zinc levels were checked before treatment in both groups and after zinc supplementation in the zinc group. Hearing gain and percentage of recovery were analyzed and compared between the two groups. The correlation between the serum zinc level changes and hearing recovery was also analyzed. RESULTS: A significantly larger hearing gain, an increased percentage of recovery, and an increased rate of successful recovery were seen in the zinc group compared with the control group (all P < .05). There was a significant correlation between serum zinc level changes and posttreatment hearing thresholds by correlation analysis (P < .05), as well as between changes of serum zinc levels and percentage of recovery in the zinc group (P < .05). CONCLUSIONS: Zinc supplementation may enhance the hearing recovery of SSNHL patients. Its antioxidant and anti-inflammatory effects may help reduce the oxidative stress of the cochlea in SSNHL, implying a new direction in the treatment of this disease.

Multiple analyses of factors related to intraoperative blood loss and the role of reverse Trendelenburg position in endoscopic sinus surgery.

OBJECTIVE/HYPOTHESIS: To find out the factors related to the volume of intraoperative blood loss during endoscopic sinus surgery and to validate the role of reverse Trendelenburg position (RTP) in controlling blood loss. STUDY DESIGN: Prospective, controlled, single-blind study. METHODS: Endoscopic sinus surgeries for chronic rhinosinusitis with or without polyposis were performed in 60 patients, which were randomly categorized into two groups. The study group (RTP group) consisted of 30 patients laid on operation table with the RTP of 10 degrees during the whole surgery, and the control group with 30 patients completely laid supine. All operations were performed by the same operator (the first author) without using hemostatic agents during the operation. Intraoperative blood loss was estimated by total volume of blood loss, blood loss per minute, and surgical field scale. Multiple factors related to blood loss, such as computed tomography scores, operation time, mean arterial pressure, polyposis, fungal sinusitis, and anesthetic agents were compared. RESULTS: There existed significant differences in total blood loss, blood loss per minute, and surgical field between the RTP group and supine group. In multiple analyses within the two groups, presence of polyp, non-fungal sinusitis and use of microdebrider exhibited a significant higher blood loss rate in the RTP group. CONCLUSION: RTP may reduce intraoperative blood loss. Besides, fungal sinusitis and rhinosinusitis without polyposis may contribute to a lesser intraoperative blood loss.

Cholesterol granuloma of the maxillary sinus presenting as sinonasal polyp.

Cholesterol granuloma is usually found in chronic middle ear diseases. However, it rarely occurs in the sinonasal regions and only a few case reports can be found in the literature. The etiology of sinonasal cholesterol granuloma is not yet known, and the clinical manifestations are nonspecific. Most patients presented with nasal discharge. Our patient is the only reported case presenting with nasal obstruction and facial pain. Here we present a patient with cholesterol granuloma of the maxillary sinus with a nasal polyp, whose clinical, imaging, and histological characteristics were unique. The tumor was excised via the transnasal endoscopic sinus approach without recurrence after 3 years of follow-up.