A nasal chemosensation-dependent critical window for somatosensory development.

Nasal chemosensation is considered the evolutionarily oldest mammalian sense and, together with somatosensation, is crucial for neonatal well-being before auditory and visual pathways start engaging the brain. Using anatomical and functional approaches in mice, we reveal that odor-driven activity propagates to a large part of the cortex during the first postnatal week and enhances whisker-evoked activation of primary whisker somatosensory cortex (wS1). This effect disappears in adult animals, in line with the loss of excitatory connectivity from olfactory cortex to wS1. By performing neonatal odor deprivation, followed by electrophysiological and behavioral work in adult animals, we identify a key transient regulation of nasal chemosensory information necessary for the development of wS1 sensory-driven dynamics and somatosensation. Our work uncovers a cross-modal critical window for nasal chemosensation-dependent somatosensory functional maturation.

Beyond skeletal studies: A computational analysis of nasal airway function in climate adaptation.

OBJECTIVES: Ecogeographic variation in human nasal anatomy has historically been analyzed on skeletal morphology and interpreted in the context of climatic adaptations to respiratory air-conditioning. Only a few studies have analyzed nasal soft tissue morphology, actively involved in air-conditioning physiology. MATERIALS AND METHODS: We used in vivo computer tomographic scans of (N = 146) adult individuals from Cambodia, Chile, Russia, and Spain. We conducted (N = 438) airflow simulations during inspiration using computational fluid dynamics to analyze the air-conditioning capacities of the nasal soft tissue in the inflow, functional, and outflow tract, under three different environmental conditions: cold-dry; hot-dry; and hot-humid. We performed statistical comparisons between populations and sexes. RESULTS: Subjects from hot-humid regions showed significantly lower air-conditioning capacities than subjects from colder regions in all the three conditions, specifically within the isthmus region in the inflow tract, and the anterior part of the internal functional tract. Posterior to the functional tract, no differences were detected. No differences between sexes were found in any of the tracts and under any of the conditions. DISCUSSION: Our statistical analyses support models of climatic adaptations of anterior nasal soft tissue morphology that fit with, and complement, previous research on dry skulls. However, our results challenge a morpho-functional model that attributes air-conditioning capacities exclusively to the functional tract located within the nasal cavity. Instead, our findings support studies that have suggested that both, the external nose and the intra-facial soft tissue airways contribute to efficiently warming and humidifying air during inspiration. This supports functional interpretations in modern midfacial variation and evolution.

Overview of Nasal Airway and Nasal Breathing Evaluation.

Several methods are available for evaluating nasal breathing and nasal airflow, as this evaluation may be made from several different perspectives.Physiologic methods for nasal airway evaluation directly measure nasal airflow or nasal airway resistance, while anatomical methods measure nasal airway dimensions. Subjective methods evaluate nasal breathing through several validated patient-reported scales assessing nasal breathing. Computational fluid dynamics evaluates nasal airflow through the analysis of several physics' variables of the nasal airway.Being familiar to these methods is of utmost importance for the nasal surgeon to be able to understand data provided by the different methods and to be able to choose the combination of evaluation methods that will provide the information most relevant to each clinical situation.

Nasal Breathing Assessment Using Computational Fluid Dynamics: An Update from the Rhinologic Perspective.

An objective assessment of nasal breathing is currently insufficiently achievable. The application of computational fluid dynamics for this purpose is increasingly gaining attention. However, the suggested specific frameworks can differ considerably. To the best of our knowledge, there is not yet a widely accepted clinical usage of computational fluid dynamics. In this article, selected aspects are addressed that might be crucial for future development and possible implementation of computational fluid dynamics in rhinology.

Nasopharyngeal lymphatic plexus is a hub for cerebrospinal fluid drainage.

Cerebrospinal fluid (CSF) in the subarachnoid space around the brain has long been known to drain through the lymphatics to cervical lymph nodes1-17, but the connections and regulation have been challenging to identify. Here, using fluorescent CSF tracers in Prox1-GFP lymphatic reporter mice18, we found that the nasopharyngeal lymphatic plexus is a major hub for CSF outflow to deep cervical lymph nodes. This plexus had unusual valves and short lymphangions but no smooth-muscle coverage, whereas downstream deep cervical lymphatics had typical semilunar valves, long lymphangions and smooth muscle coverage that transported CSF to the deep cervical lymph nodes. α-Adrenergic and nitric oxide signalling in the smooth muscle cells regulated CSF drainage through the transport properties of deep cervical lymphatics. During ageing, the nasopharyngeal lymphatic plexus atrophied, but deep cervical lymphatics were not similarly altered, and CSF outflow could still be increased by adrenergic or nitric oxide signalling. Single-cell analysis of gene expression in lymphatic endothelial cells of the nasopharyngeal plexus of aged mice revealed increased type I interferon signalling and other inflammatory cytokines. The importance of evidence for the nasopharyngeal lymphatic plexus functioning as a CSF outflow hub is highlighted by its regression during ageing. Yet, the ageing-resistant pharmacological activation of deep cervical lymphatic transport towards lymph nodes can still increase CSF outflow, offering an approach for augmenting CSF clearance in age-related neurological conditions in which greater efflux would be beneficial.

Peak Nasal Inspiratory Flow (PNIF) for Nasal Breathing Evaluation.

Measuring nasal airflow and nasal breathing has been a major goal of rhinology. Many objective methods for measuring nasal airflow or nasal airway resistance or dimensions provide valuable data but are time-consuming and require expensive equipment and trained technicians, thus making these methods less practical for clinical practice. Peak nasal inspiratory flow (PNIF) measurement is fast, unexpensive, noninvasive, and able to provide an objective evaluation of nasal airflow in real-time. Unilateral PNIF measurements allow separated evaluation of each side of the nasal airway and may prove particularly useful when clinical assessment detects significant asymmetry between both nasal cavities.PNIF measurements are most useful for assessing changes in nasal airflow achieved by any form of therapy, including surgical treatment of the nasal airway. These measurements generally correlate with other objective methods for nasal airway evaluation, but not unequivocally with patient-reported evaluation of nasal breathing. Nevertheless, as low PNIF values prevent the sensation of a suitable nasal breathing, PNIF measurement may also prove useful to optimize the decision of how to best address patients with complaints of nasal airway obstruction.

Reliability of maximal respiratory nasal pressure tests in healthy young adults.

INTRODUCTION: Sniff nasal inspiratory (SNIP) and expiratory pressure (SNEP) may complement the assessment of respiratory muscle strength. Thus, specifying their reliability is relevant to improving the clinical consistency of both tests. OBJECTIVE: To assess the reliability of SNIP and SNEP in healthy young adults. METHODS: This cross-sectional study included self-reported healthy aged 18 to 29 years. SNIP was performed using a plug to occlude one nostril, while SNEP was conducted using a facemask. Participants performed 20 SNIP and SNEP maneuvers with 30-second intervals in between. The intraclass correlation coefficient (ICC), standard error of measurement (SEM), and minimum detectable change (MDC) assessed the reliability of SNIP and SNEP. Analyses were conducted between the highest peak pressure and the first reproducible maneuver in men and women. RESULTS: The total sample comprised 32 participants: 16 men and 16 women. The ICC, SEM, and MDC for SNIP maneuvers were 0.994 (95%CI 0.988 to 0.997), 1.820 cmH2O, and 5.043 cmH2O, respectively. For SNEP, these parameters were 0.950 (95%CI 0.897 to 0.976), 6.03 cmH2O, and 16.716 cmH2O. The SNIP and SNEP in men showed ICC of 0.992 (95%CI 0.977 to 0.997) and 0.877 (95%CI 0.648 to 0.957), SEM of 2.07 and 7.66 cmH2O, and MDC of 5.74 and 21.23 cmH2O. In women, SNIP and SNEP presented ICC of 0.992 (95%CI 0.977 to 0.997) and 0.957 (95%CI 0.878 to 0.985), SEM of 1.15 and 6.11 cmH2O, and MDC of 3.19 and 16.95 cmH2O. Also, 60% of the highest SNIPs occurred among the 11th and 20th maneuvers in men and women. In men, 55% of the highest SNEPs occurred among the 11th and 20th maneuvers; this value was 50% in women. CONCLUSION: SNIP and SNEP showed excellent reliability. The reliability of SNIP and SNEP in men was good and excellent, respectively, whereas both tests had excellent reliability in women. Also, women reached the highest peak pressure faster than men in both tests.

Odor modality is transmitted to cortical brain regions from the olfactory bulb.

Odor perception is the impetus for important animal behaviors with two predominate modes of processing: odors pass through the front of the nose (orthonasal) while inhaling and sniffing, or through the rear (retronasal) during exhalation and while eating. Despite the importance of olfaction for an animal's well-being and that ortho and retro naturally occur, it is unknown how the modality (ortho vs. retro) is even transmitted to cortical brain regions, which could significantly affect how odors are processed and perceived. Using multielectrode array recordings in tracheotomized anesthetized rats, which decouples ortho-retro modality from breathing, we show that mitral cells in rat olfactory bulb can reliably and directly transmit orthonasal versus retronasal modality with ethyl butyrate, a common food odor. Drug manipulations affecting synaptic inhibition via GABAA lead to worse decoding of ortho versus retro, independent of whether overall inhibition increases or decreases, suggesting that the olfactory bulb circuit may naturally favor encoding this important aspect of odors. Detailed data analysis paired with a firing rate model that captures population trends in spiking statistics shows how this circuit can encode odor modality. We have not only demonstrated that ortho/retro information is encoded to downstream brain regions but also used modeling to demonstrate a plausible mechanism for this encoding; due to synaptic adaptation, it is the slower time course of the retronasal stimulation that causes retronasal responses to be stronger and less sensitive to inhibitory drug manipulations than orthonasal responses.NEW & NOTEWORTHY Whether ortho (sniffing odors) versus retro (exhalation and eating) is encoded from the olfactory bulb to other brain areas is not completely known. Using multielectrode array recordings in anesthetized rats, we show that the olfactory bulb transmits this information downstream via spikes. Altering inhibition degrades ortho/retro information on average. We use theory and computation to explain our results, which should have implications on cortical processing considering that only food odors occur retronasally.

Dedicated odor-taste stimulation design for fMRI flavor studies.

BACKGROUND: Flavor is a mental representation that results from the brain's integration of at least odor and taste, and fMRI can highlight brain-related areas. However, delivering stimuli during fMRI can be challenging especially when administrating liquid stimuli in supine position. It remains unclear how and when odorants are released in the nose and how to improve odorant release. NEW METHOD: We used a proton transfer reaction mass spectrometer (PTR-MS) to monitor the in vivo release of odorants via the retronasal pathway during retronasal odor-taste stimulation in a supine position. We tested techniques to improve odorant release, including avoiding or delaying swallowing and velum open training (VOT). RESULTS: Odorant release was observed during retronasal stimulation, before swallowing, and in a supine position. VOT did not improve odorant release. Odorant release during stimulation had a latency more optimal for fitting with BOLD timing than after swallowing. COMPARISON WITH EXISTING METHOD(S): Previous in vivo measurements of odorant release under fMRI-like conditions showed that odorant release occurred only after swallowing. On the contrary, a second study found that aroma release could occur before swallowing, but participants were sitting. CONCLUSION: Our method shows optimal odorant release during the stimulation phase, meeting the criteria for high-quality brain imaging of flavor processing without swallowing-related motion artifacts. These findings provide an important advancement in understanding the mechanisms underlying flavor processing in the brain.

Effects of Nasalization on Vocal Tract Response Curve.

BACKGROUND: Earlier studies have shown that nasalization affects the radiated spectrum by modifying the vocal tract transfer function in a complex manner. METHODS: Here we study this phenomenon by measuring sine-sweep response of 3-D models of the vowels /u, a, ᴂ, i/, derived from volumetric MR imaging, coupled by means of tubes of different lengths and diameters to a 3-D model of a nasal tract. RESULTS: The coupling introduced a dip into the vocal tract transfer function. The dip frequency was close to the main resonance of the nasal tract, a result in agreement with the Fujimura & Lindqvist in vivo sweep tone measurements [Fujimura & Lindqvist, 1972]. With increasing size of the coupling tube the depth of the dip increased and the first formant peak either changed in frequency or was split by the dip. Only marginal effects were observed of the paranasal sinuses. For certain coupling tube sizes, the spectrum balance was changed, boosting the formant peaks in the 2 - 4 kHz range. CONCLUSION: A velopharyngeal opening introduces a dip in the transfer function at the main resonance of the nasal tract. Its depth increases with the area of the opening and its frequency rises in some vowels.

Clinical Observation of the Effect of Nasal Breathing on Nonanalgesic and Sedative Gastroscopy.

This study aimed to investigate the safety, tolerance, and comfort of the subjects in gastroscopy by observing and comparing the effect of gastroscopy under two different breathing modes: nasal breathing and nasal inspiration and oral expiration. A total of 60 subjects who underwent routine gastroscopy in the hospital from January 2021 to June 2021 were selected as the research subjects. According to the willingness of the subjects, they were divided into a nasal breathing group and a nasal inspiration and oral expiration group. The differences in vital signs, adverse reactions, and visual analog scale (VAS) scores were compared between the two groups. There were no significant differences in mean arterial pressure, heart rate, and blood oxygen saturation between the two groups before, during, and after the examination (P > 0.05). The nasal breathing group had fewer adverse reactions such as nausea, cough, belching, and restlessness than the nasal inspiration and oral expiration group, and the difference was statistically significant (P < 0.01). VAS score of the nasal breathing group was lower than that of the nasal inspiration and oral expiration group, and the difference was statistically significant (P < 0.01). Subjects are more tolerant to nasal breathing mode, which causes fewer adverse reactions, less pain, and more comfort and is more worthy to be popularized in primary hospitals.

Skin wrinkles and folds enable asymmetric stretch in the elephant trunk.

The elephant's trunk is multifunctional: It must be flexible to wrap around vegetation, but tough to knock down trees and resist attack. How can one appendage satisfy both constraints? In this combined experimental and theoretical study, we challenged African elephants to reach far-away objects with only horizontal extensions of their trunk. Surprisingly, the trunk does not extend uniformly, but instead exhibits a dorsal "joint" that stretches 15% more than the corresponding ventral section. Using material testing with the skin of a deceased elephant, we show that the asymmetry is due in part to patterns of the skin. The dorsal skin is folded and 15% more pliable than the wrinkled ventral skin. Skin folds protect the dorsal section and stretch to facilitate downward wrapping, the most common gripping style when picking up items. The elephant's skin is also sufficiently stiff to influence its mechanics: At the joint, the skin requires 13 times more energy to stretch than the corresponding length of muscle. The use of wrinkles and folds to modulate stiffness may provide a valuable concept for both biology and soft robotics.

Importance of the numerical schemes in the CFD of the human nose.

Computational fluid dynamics of the air flow in the human nasal cavities, starting from patient-specific Computer Tomography (CT) scans, is an important tool for diagnostics and surgery planning. However, a complete and systematic assessment of the influence of the main modelling assumptions is still lacking. In designing such simulations, choosing the discretization scheme, which is the main subject of the present work, is an often overlooked decision of primary importance. We use a comparison framework to quantify the effects of the major design choices. The reconstructed airways of a healthy, representative adult patient are used to set up a computational study where such effects are systematically measured. It is found that the choice of the numerical scheme is the most important aspect, although all varied parameters impact the solution noticeably. For a physiologically meaningful flow rate, changes of the global pressure drop up to more than 50% are observed; locally, velocity differences can become extremely significant. Our results call for an improved standard in the description of this type of numerical studies, where way too often the order of accuracy of the numerical scheme is not mentioned.

Otogenic Pneumocephalus After Tegmen Bone Reconstruction: A Case Report.

Pneumocephalus is usually induced by trauma, infections, tumors of the skull base, and surgical interventions. Spontaneous pneumocephalus occurs due to a defect in the temporal bone with no obvious cause. Few cases have been reported with spontaneous otogenic pneumocephalus. However, delayed postoperative pneumocephalus is rarely reported in the literature. Here, we present a case of otogenic pneumocephalus through Eustachian tube (ET) preceded by nose blowing 10 days after surgical treatment of meningoencephalocele of the right middle ear (ME) cleft and reconstruction of tegmen and dural defects. Pneumocephalus was provoked by decreased intracranial pressure (ICP) secondary to placement of lumbar drain, which caused direct communication between unsutured dural defect and the defective posterior wall of external auditory canal skin. A revision surgery of combined transmastoid/middle cranial fossa approach was performed for intracranial decompression followed by appropriate closure by suturing the dura, obliterating the ET and ME.

Uniqueness of inspiratory airflow patterns in a realistic rat nasal cavity.

In this study, we present a detailed flow analysis using an anatomically accurate rat nasal cavity model, in which the anatomy and physiology of the nasal airway was thoroughly examined. Special efforts were given to the swirling flow structures in the nasal vestibule (anterior section of the nose, lined by squamous epithelium), fractional flow patterns in the olfactory (posterior superior section of the rat nose, lined by olfactory epithelium), and a designated method to precisely quantify flow apportionment in the olfactory region was developed. Results revealed distinct inspiratory flow patterns in the anterior vestibule region, where the accelerated airflow undergoes two sharp turns as traveling through the tortuous airway, making a route in a shape of 8. Besides this, exceptionally large flow apportionment was observed at the interface of the olfactory recess, which can be as much as 15 times greater than that in the human nose. The thorough understanding of the airflow dynamics in the rat nasal cavity is necessary to avoid potential misinterpretation of rat-derived inhalation toxicity results. Research findings are expected to play a fundamental role in developing unbiased rat to human interspecies data extrapolation schemes.

Exhaled and nasal NO measurement: NO in your breath doesn't imply a negative attitude!

Measurement of exhaled nitric oxide (NO) and nasal nitric oxide commenced in the 1990s shortly after the scientific world learned about the endogenous production of NO and its multiple roles in physiologic and pathologic processes. Exhaled NO is an established approved clinical test in asthma that can cast light on eosinophilic airway inflammation and the response to anti-inflammatory medications e.g., inhaled corticosteroids. Nasal NO which is extremely low in primary ciliary dyskinesia is an established screening test for this condition. This review is a high-level practical guide for those wishing to use exhaled and nasal NO for research and clinical application.

The accuracy of tactile assessment of canine nose temperature to identify rectal hyperthermia and hypothermia in dogs presenting on an emergency basis.

The goals of this study were to evaluate whether touch can identify a warm nose as opposed to a cold nose, to examine the correlation between thermographically measured nose temperatures and rectal temperatures, and to calculate the accuracy of tactile assessment of nose temperature in detecting rectal hyperthermia and hypothermia in dogs. A total of 100 dogs presenting to an emergency room was prospectively enrolled. Tactile nose assessment was carried out on triage. Noses were subjectively categorized as warm, cold, or intermediate (neither warm nor cold). Thermographic nose temperatures were recorded using a thermal imaging camera. Tactile assessment categorized noses as warm, intermediate, or cold (P < 0.01). There was no correlation between thermographically measured nose temperature and rectal temperature (r = 0.02). Tactile assessment of noses as warm had a sensitivity of 29.4% and a specificity of 79.5% for detecting rectal hyperthermia; calculated test accuracy was 71%. Tactile assessment of noses as cold had a sensitivity of 54.5% and a specificity of 62.9%; calculated test accuracy was 62%. It was concluded that nose temperatures do not correlate with rectal temperatures. Tactile assessment of nose temperature is inaccurate for identifying rectal hyperthermia or hypothermia.

Les objectifs de cette étude étaient d'évaluer si le toucher peut identifier un nez chaud par opposition à un nez froid, d'examiner la corrélation entre les températures nasales mesurées thermographiquement et les températures rectales, et de calculer la précision de l'évaluation tactile de la température nasale dans la détection de l'hyperthermie et l'hypothermie rectale chez le chien. Un total de 100 chiens se présentant aux urgences a été enrôlé de manière prospective. Une évaluation tactile du nez a été réalisée lors du triage. Les nez ont été classés subjectivement comme chaud, froid ou intermédiaire (ni chaud ni froid). Les températures thermographiques du nez ont été enregistrées à l'aide d'une caméra thermique. L'évaluation tactile a classé les nez comme chauds, intermédiaires ou froids (P < 0,01). Il n'y avait pas de corrélation entre la température nasale mesurée par thermographie et la température rectale (r = 0,02). L'évaluation tactile des nez chauds avait une sensibilité de 29,4 % et une spécificité de 79,5 % pour détecter l'hyperthermie rectale; la précision calculée du test était de 71 %. L'évaluation tactile des nez froids avait une sensibilité de 54,5 % et une spécificité de 62,9 %; la précision calculée du test était de 62 %. Il a été conclu que les températures nasales ne sont pas corrélées avec les températures rectales. L'évaluation tactile de la température du nez est imprécise pour identifier l'hyperthermie ou l'hypothermie rectale.(Traduit par les auteurs).

Influence of Prebiotic Fructans on Retronasal Aroma from Elderly Individuals.

This study investigates for the first time the role of fructans with prebiotic effects (oligofructose and inulin) on retronasal aroma among elderly individuals. The impact of oligofructose (20% w/w) on retronasal aroma release was investigated using proton transfer reaction-mass spectrometry (PTR-MS) after 73 elderly individuals consumed aqueous solutions aromatized with five aroma compounds (pentan-2-one, nonan-2-one, hexan-2,3-dione, octanal and linalool). The influence of oligofructose and inulin (10% w/w) on the perceived intensity (n = 26) of two aroma descriptors (butter and floral) was also studied together with the possibility of a dumping effect on aroma evaluation due to the sweetness provided by the fructans. The results showed that the presence of oligofructose produced a significant reduction in retronasal aroma release, which could be generally explained by the physicochemical properties of aroma compounds. The presence of prebiotic fructans did not significantly affect the perceived intensity of butter and floral notes, although a dumping effect for the butter descriptor in the presence of oligofructose was observed. To conclude, these findings suggest that although fructans can exert an impact on retronasal aroma, they can be used at precise concentrations to increase the prebiotic fibre content of food products without affecting the aroma profile of foods.

The nasocardiac reflex during nasoendoscopy: A commonly overlooked risk.

PURPOSE: The nasocardiac reflex is known but not well researched. We aimed to ascertain the electrocardiographic features of the reflex and to chronologically map the heart rhythm dynamics during nasoendoscopy. We also intended to identify variables that could potentially affect the occurrence of this reflex. MATERIAL AND METHODS: A prospective, quasi-experimental physiological study. Selected healthy subjects were observed electrocardiographically for 60 s continuously in three equal phases of 20 s each - baseline phase, nasoendoscopic phase, and recovery phase (post-nasoendoscopy). Heart rate fluctuations were charted, followed by identification of a positive nasocardiac reflex group of subjects and a negative group. Analyses against multiple variables were done. RESULTS: A total of 53 subjects were analysed. Heart rate during the baseline phase was 81.0 ± 9.9, nasoendoscopic phase was 72.7 ± 10.1, and recovery phase was 75.2 ± 9.6. Sixteen subjects (30.2%) had a positive nasocardiac reflex, and they remained in sinus rhythm with no occurrences of skipped beats, atrioventricular blocks or asystoles. One subject (1.9%) developed temporary ectopic premature ventricular contractions after nasoendoscopy. No variables were found affecting the incidence of a nasocardiac reflex in our study. CONCLUSIONS: The pattern of heart rate dynamics was consistent as heart rates drop rapidly upon endoscope insertion and recover in some measure after its withdrawal. Although all our subjects remained asymptomatic, clinicians should not overlook the risks of a severe nasocardiac reflex when performing nasoendoscopy. We recommend that electrical cardiac monitoring be part of the management of vasovagal responses during in-office endonasal procedures.