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1.
Sci Rep ; 14(1): 8470, 2024 04 11.
Artículo en Inglés | MEDLINE | ID: mdl-38605046

RESUMEN

The nasal microbiota is a key contributor to animal health, and characterizing the nasal microbiota composition is an important step towards elucidating the role of its different members. Efforts to characterize the nasal microbiota composition of domestic pigs and other farm animals frequently report the presence of bacteria that are typically found in the gut, including many anaerobes from the Bacteroidales and Clostridiales orders. However, the in vivo role of these gut-microbiota associated taxa is currently unclear. Here, we tackled this issue by examining the prevalence, origin, and activity of these taxa in the nasal microbiota of piglets. First, analysis of the nasal microbiota of farm piglets sampled in this study, as well as various publicly available data sets, revealed that gut-microbiota associated taxa indeed constitute a substantial fraction of the pig nasal microbiota that is highly variable across individual animals. Second, comparison of herd-matched nasal and rectal samples at amplicon sequencing variant (ASV) level showed that these taxa are largely shared in the nasal and rectal microbiota, suggesting a common origin driven presumably by the transfer of fecal matter. Third, surgical sampling of the inner nasal tract showed that gut-microbiota associated taxa are found throughout the nasal cavity, indicating that these taxa do not stem from contaminations introduced during sampling with conventional nasal swabs. Finally, analysis of cDNA from the 16S rRNA gene in these nasal samples indicated that gut-microbiota associated taxa are indeed active in the pig nasal cavity. This study shows that gut-microbiota associated taxa are not only present, but also active, in the nasal cavity of domestic pigs, and paves the way for future efforts to elucidate the function of these taxa within the nasal microbiota.


Asunto(s)
Microbiota , Cavidad Nasal , Porcinos , Animales , Cavidad Nasal/microbiología , ARN Ribosómico 16S/genética , ARN Ribosómico 16S/análisis , Nariz/microbiología , Microbiota/genética , Sus scrofa/genética
2.
Neurosurg Focus ; 56(4): E10, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38560943

RESUMEN

OBJECTIVE: Minimally invasive endoscopic endonasal multiport approaches create additional visualization angles to treat skull base pathologies. The sublabial contralateral transmaxillary (CTM) approach and superior eyelid lateral transorbital approach, frequently used nowadays, have been referred to as the "third port" when used alongside the endoscopic endonasal approach (EEA). The endoscopic precaruncular contralateral medial transorbital (cMTO) corridor, on the other hand, is an underrecognized but unique port that has been used to repair CSF rhinorrhea originating from the lateral sphenoid sinus recess. However, no anatomical feasibility studies or clinical experience exists to assess its benefits and demonstrate its potential role in multiport endoscopic access to the other contralateral skull base areas. In this study, the authors explored the application and potential utility of multiport EEA combined with the endoscopic cMTO approach (EEA/cMTO) to three target areas of the contralateral skull base: lateral recess of sphenoid sinus (LRSS), petrous apex (PA) and petroclival region, and retrocarotid clinoidocavernous space (CCS). METHODS: Ten cadaveric specimens (20 sides) were dissected bilaterally under stereotactic navigation guidance to access contralateral LRSS via EEA/cMTO. The PA and petroclival region and retrocarotid CCS were exposed via EEA alone, EEA/cMTO, and EEA combined with the sublabial CTM approach (EEA/CTM). Qualitative and quantitative assessments, including working distance and visualization angle to the PA, were recorded. Clinical application of EEA/cMTO is demonstrated in a lateral sphenoid sinus CSF leak repair. RESULTS: During the qualitative assessment, multiport EEA/cMTO provides superior visualization from a high vantage point and better instrument maneuverability than multiport EEA/CTM for the PA and retrocarotid CCS, while maintaining a similar lateral trajectory. The cMTO approach has significantly shorter working distances to all three target areas compared with the CTM approach and EEA. The mean distances to the LRSS, PA, and retrocarotid CCS were 50.69 ± 4.28 mm (p < 0.05), 67.11 ± 5.05 mm (p < 0.001), and 50.32 ± 3.6 mm (p < 0.001), respectively. The mean visualization angles to the PA obtained by multiport EEA/cMTO and EEA/CTM were 28.4° ± 3.27° and 24.42° ± 5.02° (p < 0.005), respectively. CONCLUSIONS: Multiport EEA/cMTO to the contralateral LRSS offers the advantage of preserving the pterygopalatine fossa contents and the vidian nerve, which are frequently sacrificed during a transpterygoid approach. This approach also offers superior visualization and better instrument maneuverability compared with EEA/CTM for targeting the petroclival region and retrocarotid CCS.


Asunto(s)
Endoscopía , Base del Cráneo , Humanos , Base del Cráneo/diagnóstico por imagen , Base del Cráneo/cirugía , Base del Cráneo/anatomía & histología , Nariz/cirugía , Hueso Petroso/cirugía , Hueso Esfenoides/cirugía , Cadáver
4.
J Med Virol ; 96(4): e29601, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38597375

RESUMEN

Coronavirus disease 2019 (COVID-19) associated mucormycosis (CAM) was reported predominantly from India during the second wave of COVID-19  and has a high mortality rate. The present study aims to understand the fungal community composition of the nasopharyngeal region of CAM-infected individuals and compare it with severe COVID-19 patients and healthy controls. The fungal community composition was decoded by analyzing the sequence homology of the internal transcribed spacer-2-(ITS-2) region of metagenomic DNA extracted from the upper respiratory samples. The alpha-diversity indices were found to be significantly altered in CAM patients (p < 0.05). Interestingly, a higher abundance of Candida africana, Candida haemuloni, Starmerella floris, and Starmerella lactiscondensi was observed exclusively in CAM patients. The interindividual changes in mycobiome composition were well supported by beta-diversity analysis (p < 0.05). The current study provides insights into the dysbiosis of the nasal mycobiome during CAM infection. In conclusion, our study shows that severe COVID-19 and CAM are associated with alteration in mycobiome as compared to healthy controls. However, the sequential alteration in the fungal flora which ultimately leads to the development of CAM needs to be addressed by future studies.


Asunto(s)
COVID-19 , Mucormicosis , Micobioma , Humanos , Mucormicosis/epidemiología , Nariz , India/epidemiología
5.
Sci Rep ; 14(1): 8571, 2024 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-38609436

RESUMEN

This study emphasizes the benefits of open-source software such as DeepLabCut (DLC) and R to automate, customize and enhance data analysis of motor behavior. We recorded 2 different spinocerebellar ataxia type 6 mouse models while performing the classic beamwalk test, tracked multiple body parts using the markerless pose-estimation software DLC and analyzed the tracked data using self-written scripts in the programming language R. The beamwalk analysis script (BAS) counts and classifies minor and major hindpaw slips with an 83% accuracy compared to manual scoring. Nose, belly and tail positions relative to the beam, as well as the angle at the tail base relative to the nose and tail tip were determined to characterize motor deficits in greater detail. Our results found distinct ataxic abnormalities such as an increase in major left hindpaw slips and a lower belly and tail position in both SCA6 ataxic mouse models compared to control mice at 18 months of age. Furthermore, a more detailed analysis of various body parts relative to the beam revealed an overall lower body position in the SCA684Q compared to the CT-longQ27PC mouse line at 18 months of age, indicating a more severe ataxic deficit in the SCA684Q group.


Asunto(s)
Ataxia , Ataxias Espinocerebelosas , Animales , Ratones , Ataxias Espinocerebelosas/genética , Análisis de Datos , Modelos Animales de Enfermedad , Nariz
6.
J Drugs Dermatol ; 23(4): 262-267, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-38564403

RESUMEN

BACKGROUND: Full thickness defects of the ala, soft triangle, and nasal tip involving the nasal lining have traditionally been repaired with the three-stage folded paramedian forehead flap (FPFF), with a cartilage graft for support. For similar defects, the authors utilize the two-stage FPFF without cartilaginous support which provides reproducible functional and aesthetic results.  Objective: To describe the authors’ experience with the two-stage FPFF, including outcomes, complications, and design modifications to enhance functional and aesthetic success.  Methods: An IRB-approved retrospective database review of FPFF was performed at two sites. Using postoperative photographs, outcomes were assessed by blinded non-investigator dermatologist raters using a modified observer scar assessment scale. RESULTS: Thirty-five patients were reconstructed using the two-stage FPFF without cartilage grafts. Subjective assessment of scar vascularity, pigment, relief, and thickness by 3 independent reviewers yielded an overall cosmesis score of 8.4±1.9 (out of 40). CONCLUSION: The two-stage FPFF without cartilage grafts is a reliable, cosmetically elegant repair that can provide optimal functional and aesthetic results for complex unilateral distal nose defects.J Drugs Dermatol. 2024;23(4): doi:10.36849/JDD.7358.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Rinoplastia/métodos , Colgajos Quirúrgicos , Estudios Retrospectivos , Frente/cirugía , Cicatriz/patología , Nariz/cirugía , Cartílago/trasplante , Neoplasias Nasales/cirugía , Neoplasias Nasales/patología
7.
PLoS One ; 19(4): e0301268, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38573928

RESUMEN

Nitric oxide (NO) is involved in a variety of biological functions including blood vessel dilation and neurotransmitter release. In animals, NO has been demonstrated to affect multiple behavioral outcomes, such as memory performance and arousal, whereas this link is less explored in humans. NO is created in the paranasal sinuses and studies show that humming releases paranasal NO to the nasal tract and that NO can then cross the blood brain barrier. Akin to animal models, we hypothesized that this NO may traverse into the brain and positively affect information processing. In contrast to our hypothesis, an articulatory suppression memory paradigm and a speeded detection task found deleterious effects of humming while performing the task. Likewise, we found no effect of humming on emotional processing of photos. In a fourth experiment, participants hummed before each trial in a speeded detection task, but we again found no effect on response time. In conclusion, either nasal NO does not travel to the brain, or NO in the brain does not have the expected impact on cognitive performance and emotional processing in humans. It remains possible that NO influences other cognitive processes not tested for here.


Asunto(s)
Óxido Nítrico , Senos Paranasales , Humanos , Nariz , Emociones , Cognición
8.
Facial Plast Surg Clin North Am ; 32(2): 211-219, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575279

RESUMEN

In this review, the paramedian forehead flap indications and uses are reviewed, specifically examining clinical situations where patient selection is important. In these settings, a preoperative discussion with a patient regarding surgical expectations and goals in the setting of their defect is paramount. The authors review the literature regarding the psychosocial aspects of major nasal reconstruction and review preoperative discussion points that are key to a well-informed patient and improved patient satisfaction through the nasal reconstructive process.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Colgajos Quirúrgicos , Frente/cirugía , Nariz/cirugía , Neoplasias Nasales/cirugía , Toma de Decisiones
9.
Facial Plast Surg Clin North Am ; 32(2): 221-227, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575280

RESUMEN

Defects over 2.0 to 2.5 cm may often require repair with a multistaged forehead flap. However, in some such defects, other options may be available. In this article, the author will review some of these options.


Asunto(s)
Rinoplastia , Colgajos Quirúrgicos , Humanos , Frente/cirugía , Nariz/cirugía
10.
Facial Plast Surg Clin North Am ; 32(2): 189-198, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575277

RESUMEN

Owing to the complex, multilayered anatomy of the nose in the central face, major nasal reconstruction can pose a significant challenge for reconstructive surgeons. It is the responsibility of reconstructive surgeons to have an understanding of the most common cutaneous malignancies and excisional techniques that may lead to complex nasal defects. The purpose of this article is to discuss these malignancies, excisional techniques, and impacts of radiation on tissue that has implications for reconstructive surgeons.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Neoplasias Cutáneas , Humanos , Colgajos Quirúrgicos , Nariz/cirugía , Nariz/anatomía & histología , Neoplasias Cutáneas/cirugía , Neoplasias Nasales/radioterapia , Neoplasias Nasales/cirugía , Cirugía de Mohs , Rinoplastia/métodos
11.
Facial Plast Surg Clin North Am ; 32(2): 239-246, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575282

RESUMEN

A successful nasal reconstruction relies heavily on a stable internal lining. Larger defects pose unique challenges for internal lining reconstruction as obtaining tissue of adequate size while maintaining airway patency is difficult. The prelamination technique uses a staged skin graft to the paramedian forehead flap prior to transfer. As such, a composite flap can be later transferred to reconstruct internal and external nasal defects concomitantly. This article reviews the current background, techniques, and clinical considerations in the use of the prelaminated forehead flap for nasal lining reconstruction in partial to total nasal defects.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Rinoplastia/métodos , Frente/cirugía , Neoplasias Nasales/cirugía , Nariz/cirugía , Colgajos Quirúrgicos
12.
Facial Plast Surg Clin North Am ; 32(2): 247-259, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575283

RESUMEN

Total nasal reconstruction is a complex challenge due to the need to establish new internal lining, internal structural support, and external skin covering that is both functional and esthetic. The medial femoral condyle corticoperiosteal free flap represents an innovative option for restoration internal structure and internal nasal lining. When used in conjunction with a paramedian forehead flap, acceptable results in both function and esthetics can be achieved.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Colgajos Quirúrgicos , Neoplasias Nasales/cirugía , Frente/cirugía , Rinoplastia/métodos , Nariz/cirugía
13.
Facial Plast Surg Clin North Am ; 32(2): 199-210, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575278

RESUMEN

This article reviews special considerations in complex nasal defects including treatment of adjacent subunit defects, timing of repair with radiation, reconstruction in patients with prior repairs or recurrent disease, and the role of prosthetics. The role of technological advances including virtual surgical planning, 3 dimensional printing, biocompatible materials, and tissue engineering is discussed.


Asunto(s)
Neoplasias Nasales , Nariz , Humanos , Nariz/cirugía , Neoplasias Nasales/cirugía , Impresión Tridimensional
14.
Facial Plast Surg Clin North Am ; 32(2): 261-269, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575284

RESUMEN

When large defects of the nose are present, it is imperative to address all 3 layers: the external skin envelope, the osteocartilaginous support, and the inner mucosal lining. The middle structural framework is the primary factor in determining the overall shape of the nose, in addition to facilitating a functional and patent airway. As such, its reconstruction must be robust enough to provide lasting osteocartilaginous support while minimizing disfiguring bulk. The goal is replacement of missing tissue with grafts of similar strength, size, and shape. This article will review approaches to the reconstruction of structural support in large nasal defects.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Colgajos Quirúrgicos , Nariz/cirugía , Neoplasias Nasales/cirugía , Piel
15.
Facial Plast Surg Clin North Am ; 32(2): 271-279, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575285

RESUMEN

The forehead flap is a time-tested and robust resurfacing flap used for nasal reconstruction. Owing to its excellent color and texture match, acceptable donor site morbidity, and robust and independent blood supply that can support both structural and internal lining grafts, this flap remains the workhorse flap for resurfacing large nasal defects. Various nuances of this technique relating to defect and template preparation, flap design, flap elevation, flap inset, donor site closure, and pedicle division are discussed in this article. These nuances are the guiding principles for improved outcomes using a forehead flap for the reconstruction of large nasal defects.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Rinoplastia/métodos , Frente/cirugía , Nariz/cirugía , Colgajos Quirúrgicos/irrigación sanguínea , Neoplasias Nasales/cirugía
16.
Facial Plast Surg Clin North Am ; 32(2): 229-237, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575281

RESUMEN

The reliability of local intranasal flaps speaks to the robust vascularity of the nose, which these flaps are based on. The goals for lining replacement, as in any other area of head and neck reconstruction, is to use tissue that best matches the qualities of what is being replaced. The goal of this review is to describe the extent to which local tissues can be used and when to consider regional flaps when the extent of a local flap will not provide enough coverage.


Asunto(s)
Neoplasias Nasales , Rinoplastia , Humanos , Reproducibilidad de los Resultados , Nariz/cirugía , Colgajos Quirúrgicos , Neoplasias Nasales/cirugía
17.
Facial Plast Surg Clin North Am ; 32(2): 291-302, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575287

RESUMEN

Nasal reconstruction remains one of the most challenging surgeries for facial plastic and reconstructive surgeons. The addition of defects extending beyond the nose adds a layer of complexity to an already technically demanding surgery. This article will focus on the management of composite defects extending beyond the boundaries of the nose. Surgeons need to have a variety of techniques at their disposal. These complex defects often require multiple local flaps, multiple stages, and, in select cases, free tissue transfer.


Asunto(s)
Neoplasias Nasales , Procedimientos de Cirugía Plástica , Rinoplastia , Humanos , Nariz/cirugía , Colgajos Quirúrgicos , Cara/cirugía , Neoplasias Nasales/cirugía , Rinoplastia/métodos , Frente/cirugía
18.
Facial Plast Surg Clin North Am ; 32(2): 315-325, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38575289

RESUMEN

Soft tissue injuries to the midface (and nose) are common causes for seeking trauma care. As trauma patients, observing advanced trauma life support protocols is warranted given the risk of concomitant injuries. Here, options for optimizing tissue preservation, microvascular replantation, non-microvascular tissue replacement, and wound stabilization are discussed. Included in this discussion are data-driven predictors for successful replantation as well as technique descriptions with anatomic references to guide surgeons in choosing optimal donor vessels. In both partial and complete avulsion injuries, venous congestion is common. Several postoperative wound care protocols to maximize tissue perfusion and long-term viability are discussed.


Asunto(s)
Amputación Traumática , Traumatismos de los Tejidos Blandos , Humanos , Amputación Traumática/cirugía , Microcirugia/métodos , Reimplantación/métodos , Traumatismos de los Tejidos Blandos/cirugía , Nariz/cirugía , Nariz/lesiones
19.
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