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1.
Artículo en Chino | MEDLINE | ID: mdl-34628831

RESUMEN

Objective:To analyze the effects of different dosages of oral glucocorticoids on short-term recovery and recurrence in patients with eosinophilic chronic rhinosinusitis with nasal polyps(ECRSwNP). Methods:150 patients with ECRSwNP who underwent functional endoscopic sinus surgery for the first time after the failure of maximum drug therapy were recruited. They were randomly divided into group A, B and C, and their baseline demographic and clinical characteristics were recorded. Group A, B and C were treated with 30 mg, 45 mg and 60 mg oral prednisone tablets once a day separately for 14 consecutive days. Patients in the three groups were regularly followed up at 1, 3 and 6 months after surgery. Visual analogue score (VAS), 20 item Sino-Nasal Outcome Test (SNOT-20) and Lund-Kennedy endoscopic score (LKS) were completed. The subjective and objective scores and the recurrence of polys 6 months after surgery were compared, and the related factors were analyzed. Results:There were 49 patients in group A, 44 patients in group B and 45 patients in group C in this study. The age of the three groups was significant difference (0.021), but no significant difference was found in other demographic characteristics such as sex, smoking and so on, and the baseline subjective and objective scores of diseases between three groups(P>0.05). The VAS, SNOT-20 and LKS score in group B and C was significantly lower than that in group A at 1 month after surgery, but there was no significant difference between group B and C. The LKS score in group C was significantly lower than that in group A and B at 3 months after surgery, but there was no significant difference between group A and group B. There was no significant difference in subjective and objective scores as well as disease recurrence among three groups at 6 months after surgery. However, the recurrence rate of patients with asthma was significantly higher than that in patients without asthma in three groups (62.50% vs 4.88%, 55.56% vs 5.71%, 66.67% vs 7.69% respectively). Conclusion:Postoperative oral glucocorticoids therapy at moderate or higher dosage can improve the subjective and objective scores of ECRSwNP patients 1 month after surgery, but increasing the dosage did not increase its benefit. Different dosages of oral glucocorticoids had no significant effect on the subjective scores at 3 months, the subjective and objective scores as well as the recurrence of polyps at 6 months after surgery. Asthma is an important factor affecting the recurrence of polyps at 6 months after surgery in patients with ECRSwNP.


Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , Glucocorticoides , Humanos , Pólipos Nasales/tratamiento farmacológico , Recurrencia , Rinitis/tratamiento farmacológico , Sinusitis/tratamiento farmacológico
2.
Artículo en Chino | MEDLINE | ID: mdl-34628809

RESUMEN

Objective:To investigate the changes of serum B cell activating factor(BAFF) levels in chronic rhinosinusitis with nasal polyps(CRSwNP) patients and its predictive value in phenotypes. Methods:Forty healthy volunteers(control group) and 77 patients with CRSwNP were recruited in the present study, all CRSwNP patients were divided into eosinophilic(neCRSwNP group, n=40) and non-eosinophilic(eCRSwNP group, n=37) according to the degree of eosinophil infiltration in postoperative histological sections. Serum samples were collected from all subjects, and serum BAFF levels were detected by ELISA, and the relationships between BAFF levels and clinical variables were evaluated. The predictive value of serum BAFF in distinguishing eCRSwNP was evaluated by receiver operating curve(ROC) and Logistic regression. Results:BAFF concentrations in the serum of CRSwNP patients were(1.2±0.4) ng/mL, which were higher than control group([0.8±0.3]ng/mL). In addition, serum BAFF levels in eCRSwNP group were (1.3±0.5) ng/mL, which were higher than neCRSwNP group([1.1±0.2]ng/mL), and both groups were higher than control groupt(P<0.05). The elevated serum BAFF levels in CRSwNP patients were positively correlated with the tissue eosinophil percentage(r=0.629, P<0.001) and counts(r=0.563, P<0.001), peripheral blood eosinophil percentage(r=0.411, P=0.002) and counts(r=0.501, P<0.001), and serum total IgE(r=0.178, P=0.021). Multivariate Logistic regression showed that serum BAFF level was an independent factor associated with CRSwNP phenotypes(OR=3.652, P=0.001). ROC analysis suggested that serum BAFF exhibited a good predictive value for eCRSwNP(AUC=0.885). Conclusion:Serum BAFF levels were increased in CRSwNP patients and associated with the degree of systemic and polyp eosinophilic inflammation. Preoperative evaluation of serum BAFF level maybe clinically meaningful for distinguishing CRSwNP phenotypes.


Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , Linfocitos B , Humanos , Pólipos Nasales/diagnóstico , Fenotipo , Rinitis/diagnóstico , Sinusitis/diagnóstico
3.
Artículo en Chino | MEDLINE | ID: mdl-34628815

RESUMEN

Objective:To explore the pathological type, clinical features and their relationship with prognosis of chronic rhinosinusitis(CRS). Methods:A retrospective study of 135 patients with CRS who underwent surgical treatment in the Affiliated Jiangning Hospital of Nanjing Medical University from January 2017 to December 2018. Review the pathological slices retrospectively and divide the CRS into 4 types, eosinophilic type(eCRS), lymphocyte or(and) plasma cell type, neutrophil type and mixed type, the latter three are collectively referred to as "non-eosinophil type(non-eCRS)". Follow-up was conducted between January and February 2021 to analyze the distribution, clinical features, and differences in prognosis of the different endotypes. Results:①Among the 135 CRS patients, 42 cases(31.1%) were eCRS and 93 cases(68.9%) were non-eCRS(76 cases[56.3%] of lymphocyte or plasma cell type, 4 cases[3.0%] of neutrophil type and 13 cases[9.6%] of mixed type). The difference in composition ratio between the groups was statistically significant(n=135, P<0.001). ②The absolute value and percentage of preoperative peripheral blood eosinophils(EOS) in eCRS patients were higher than those of non-eCRS patients, and the difference was statistically significant(n=125, P(absolute value)=0.030, P(percentage)=0.033). The results of receiver operating characteristic curve showed that both absolute value and percentage have predictive value, and cut-off value was 0.325×109/L(absolute value) or 2.750%(percentage). There was no statistically significant difference in preoperative peripheral blood procalcitonin among the groups(n=69, P=0.647). ③The ratio(E/M value) of the bilateral ethmoid sinus scores and bilateral maxillary sinus scores of the preoperative paranasal sinus CT in eCRS patients was 2.03±1.23, while the non-eCRS patients was 1.47±0.96, and the difference was statistically significant(n=112, P=0.009). ④In total, 101 cases were effectively followed up, including 34 cases of eCRS(7 cases[20.6%] of control, 18 cases[52.9%] of partial control), 9 cases[26.5%] of non-control and 67 cases of non-eCRS(32 cases[47.8%] of control, 26 cases[38.8%] were partially controlled, 9 cases[13.4%] were not controlled), and the efficacy of the non-eCRS group was significantly better than that of the eCRS group(χ²=7.499, P=0.024). Conclusion:When the absolute value of EOS in the preoperative blood examination is greater than 0.325×109/L or the percentage is greater than 2.750%, eCRS can be predicted, but the accuracy is low. CT of patients with eCRS is mostly characterized by inflammation of the ethmoid sinus and usually E/M>2. The efficacy of eCRS group is worse than that of the non-eCRS group 2-4 years after surgery.


Asunto(s)
Patología Clínica , Rinitis , Sinusitis , Humanos , Pronóstico , Estudios Retrospectivos
4.
Vestn Otorinolaringol ; 86(4): 50-53, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34499448

RESUMEN

The authors examined and operated on 64 patients with a diagnosis of cystic peritoneal cyst, with various concomitant diseases of the nose and SNP, in order to identify the peculiarities of the histological structure of cysts of percussion. In 18 patients, concomitant disease was allergic rhinitis, in patients with a violation of the aerodynamics of the nasal cavity, 14 patients with recurrent bacterial sinusitis. According to the histological structure, characteristic features of the structure of maxillary sinus cysts were revealed in various diseases of the nose and paranasal sinuses. Based on the histological structure of the maxillary sinus cysts, 3 types of the structure of cysts characteristic of a certain pathology were identified.


Asunto(s)
Quistes , Enfermedades de los Senos Paranasales , Senos Paranasales , Sinusitis , Quistes/diagnóstico , Humanos , Seno Maxilar/diagnóstico por imagen , Cavidad Nasal , Enfermedades de los Senos Paranasales/diagnóstico , Enfermedades de los Senos Paranasales/etiología
5.
Vestn Otorinolaringol ; 86(4): 59-66, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34499450

RESUMEN

Cystic fibrosis (cystic fibrosis) is an important medical and social problem. The main clinical manifestations that determine the prognosis and outcome of this disease are changes in the respiratory and digestive systems. In recent years, there has been an understanding of the importance of assessing pathological changes in the nasal cavity and paranasal sinuses in patients with cystic fibrosis. RESEARCH OBJECTIVES: Assess the efficacy of topical antibacterial therapy in adult cystic fibrosis patients after surgery on nasal cavity structures and paranasal sinuses. MATERIAL AND METHODS: In the clinic for ear, nose and throat diseases at Sechenov University, 46 adult patients with cystic fibrosis and chronic rhinosinusitis were observed; all patients underwent extended endoscopic polysinusotomy. According to clinical studies, Isofra nasal spray is highly effective and safe in the treatment of patients with infectious diseases of the nasal cavity, nasopharynx and paranasal sinuses. FINDINGS: The use of Isofra nasal spray (the active ingredient is framycetin sulfate) in our clinic in patients with cystic fibrosis against the background of basic therapy (inhalation with bronchodilators and mucolytics, intranasal topical steroids), had a positive effect on the microbial landscape in the nasal cavity in patients with cystic fibrosis in the postoperative period and allowed to reduce the need for the appointment of systemic antibacterial drugs.


Asunto(s)
Fibrosis Quística , Pólipos Nasales , Rinitis , Sinusitis , Adulto , Antibacterianos/uso terapéutico , Enfermedad Crónica , Fibrosis Quística/tratamiento farmacológico , Humanos , Pólipos Nasales/tratamiento farmacológico , Rinitis/diagnóstico , Rinitis/tratamiento farmacológico , Sinusitis/diagnóstico , Sinusitis/tratamiento farmacológico
6.
Vestn Otorinolaringol ; 86(4): 73-78, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34499452

RESUMEN

Cystic fibrosis is genetic multisystem disorder with a predominant lesion of the respiratory tract. The duration and quality of life of these patients depends on the state of respiratory function. Progressive lung dysfunction is still the leading cause of mortality patients with cystic fibrosis. End-stage lung diseases in patients with cystic fibrosis, lung transplantation is a viable method of treatment. It has the ability to prolong life of these patients. Survival in cystic fibrosis has steadily increased medical treatment and post-transplant. Chronic rhinosinusitis (with nasal polys and without) impacts almost all cystic fibrosis patients, leading to significant reductions in quality of life. Chronic rhinosinusitis with nasal polyps is prevalent in the cystic fibrosis patients, and it is often a recalcitrant infection with multidrug resistant organisms. Medical therapies such as nasal irrigations, nasal steroids, and antibiotics are critical for managing symptoms, but functional endoscopic sinus surgery is necessary for refractory cases. The unified airway hypothesis suggests that sanitation bacterial infection in the upper airway can also decrease bacterial burden in the lungs. The article presents a clinical case of successful endoscopic sinus surgery in a 15-year-old patient with chronic rhinosinusitis with nasal polyps and cystic fibrosis after lung transplantation. The intervention was performed under General anesthesia and controlled hypotension. Bilateral antrostomy, ethmoidectomy and Draf IIb frontal sinusotomy were performed by endoscopic endonasal approach. There were no intra - and post-operative rhinosurgical or lung complications. The follow-up period was 18 months. At present, there is no relapse of chronic polypous rhinosinusitis, and there are no indications for revision intervention.


Asunto(s)
Fibrosis Quística , Trasplante de Pulmón , Pólipos Nasales , Rinitis , Sinusitis , Adolescente , Enfermedad Crónica , Fibrosis Quística/complicaciones , Fibrosis Quística/cirugía , Endoscopía , Humanos , Trasplante de Pulmón/efectos adversos , Calidad de Vida , Rinitis/complicaciones , Rinitis/diagnóstico , Sinusitis/complicaciones , Sinusitis/diagnóstico
7.
Vestn Otorinolaringol ; 86(4): 99-105, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-34499456

RESUMEN

Inflammation of the paranasal sinuses significantly reduces the quality of life of people and causes marked economic damage to society. The striking clinical picture of sinusitis has always forced doctors to study the disease, as evidenced by the first records of the anatomy and diseases of the paranasal sinuses by doctors in ancient Egypt more than 3.000 years BC. Sinusitis has been treated in different ways in different historical periods. Effective medication treatment appeared relatively recently and began to steadily replace the older instrumental methods, to which many people had a preconceived notion of invasiveness. However, many studies are showing the positive effect of active drainage methods and, moreover, there is data showing that the discomfort during such procedures is slightly higher than during dental treatment under local anesthesia. This article presents a review of the available scientific literature on the use of different treatments for bacterial rhinosinusitis at different historical stages, ranging from the first publications on puncture techniques to balloon dilatation and the modern approach to conservative treatment.


Asunto(s)
Senos Paranasales , Rinitis , Sinusitis , Enfermedad Crónica , Humanos , Calidad de Vida , Rinitis/diagnóstico , Rinitis/terapia , Sinusitis/diagnóstico , Sinusitis/terapia
8.
JNMA J Nepal Med Assoc ; 59(239): 703-705, 2021 Jul 30.
Artículo en Inglés | MEDLINE | ID: mdl-34508493

RESUMEN

With the surge of cases during the second wave of COVID-19 in Nepal, a number of mucormycosis coinfection cases have also come to our attention. We present a case of a 65-year-old female who was admitted to our emergency department with complaints of pain, swelling, and tingling sensation of the left side of the face along with blood-tinged nasal discharge for 20 days. She had been tested positive for COVID-19 a month back and managed with oxygen support and corticosteroids. Magnetic Resonance Imaging showed invasive fungal sinusitis, with the positive black turbinate sign and mild extension along with the dura mater of the left temporal lobe, and left cavernous sinus. She was diagnosed with rhinocerebral mucormycosis and managed with systemic antifungal therapy and insulin. As per the treatment modality, surgical debridement could not be done because the patient did not give consent.


Asunto(s)
COVID-19 , Mucormicosis , Sinusitis , Anciano , Antifúngicos/uso terapéutico , Femenino , Humanos , Mucormicosis/complicaciones , Mucormicosis/diagnóstico , Mucormicosis/terapia , Nepal , SARS-CoV-2
9.
Trials ; 22(1): 606, 2021 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-34496924

RESUMEN

BACKGROUND: Endoscopic sinus surgery (ESS) has been used for decades to treat recurrent acute rhinosinusitis episodes (RARS) in adults. RARS results in infectious symptoms, antibiotic courses, sick leaves, and impaired quality of life. Theoretically, the ESS procedure, through improving the drainage of the paranasal sinuses, decreases the symptoms and enhances the quality of life of the RARS patients. Whether this is true has not been reported in a randomized trial yet. METHODS: We conduct a single-center, non-blinded, randomized, 6-month, parallel group superiority clinical study including 80 adult participants referred to surgical treatment for RARS. The participants will either have ESS or conservative medical treatment (control group). The primary outcome will be the difference between the mean disease-specific Sinonasal Outcome Test 22 (quality of life questionnaire) change scores (from baseline to 6 months) of ESS and control group. DISCUSSION: This study will add significant new information to the effect and harms of ESS procedure in the treatment of adults with RARS. TRIAL REGISTRATION: ClinicalTrials.gov NCT04241016 . Registered on 17 January 2020.


Asunto(s)
Senos Paranasales , Rinitis , Sinusitis , Adulto , Enfermedad Crónica , Endoscopía/efectos adversos , Humanos , Senos Paranasales/diagnóstico por imagen , Senos Paranasales/cirugía , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Rinitis/diagnóstico , Rinitis/cirugía , Sinusitis/diagnóstico por imagen , Sinusitis/cirugía , Resultado del Tratamiento
10.
Artículo en Chino | MEDLINE | ID: mdl-34521165

RESUMEN

Objective: To explore the correlation between eosinophils (Eos) and the incidence of chronic sinusitis with nasal polyps (CRSwNP) in Xinjiang region of China by comparing the proportion of inflammatory cells in the pathological tissues and peripheral blood. Methods: Retrospective analysis was performed on 582 patients with CRSwNP who underwent endoscopic nasal surgery in the First Affiliated Hospital of Xinjiang Medical University from January 2012 to March 2018, including 367 males and 215 females, aged (45.5±13.4) years (x¯±s). Patients were divided into groups according to demographic characteristics, recurrence and complication of allergic rhinitis (AR). Preoperative blood routine and postoperative pathological section data of nasal polyps were collected to compare the ratio of inflammatory cells in pathological tissue and the ratio of peripheral blood Eos in each group. The correlation between the proportion of inflammatory cells in the pathological tissue of nasal polyps and the recurrence of CRSwNP was analyzed, as well as the distribution of (eosCRSwNP) in Uygur and Han CRSwNP patients in Xinjiang region. Statistical analysis was performed by SPSS 19.0 software. Results: Compared with non-recurrent CRSwNP patients, the ratio of Eos in nasal polyp tissue and peripheral blood was increased significantly, (Z value was -3.142 and -2.344, respectively, both P<0.05). Compared with CRSwNP patients without AR, the ratio of Eos in nasal polyps and peripheral blood was also increased significantly in patients with AR (Z value was -6.664 and -4.520, respectively, both P<0.05). There was a positive correlation between tissue Eos and CRSwNP recurrence (r=0.130, P=0.002). The majority of CRSwNP patients were both eosCRSwNP in Uygur and Han ethnic groups. Conclusions: Eos is associated with the recurrence of CRSwNP in Xinjiang region, and eosCRSwNP is the dominant factor in both Uygur and Han patients.


Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , China/epidemiología , Eosinófilos , Femenino , Humanos , Masculino , Pólipos Nasales/complicaciones , Pólipos Nasales/epidemiología , Estudios Retrospectivos , Rinitis/complicaciones , Rinitis/epidemiología , Sinusitis/complicaciones , Sinusitis/epidemiología
11.
Artículo en Chino | MEDLINE | ID: mdl-34521170

RESUMEN

Objective: To analyze the clinical features of patients with odontogenic sinusitis (OS) treated by endoscopic sinus surgery (ESS). Methods: A retrospective investigation was carried out in our 27 (16 males and 11 females) cases with OS aged (49.74±14.42) years old. Subjects were hospitalized between January 2018 and November 2020 from Department of Otorhinolaryngology Head and Neck Surgery, Beijing Chaoyang Hospital. The medical history, symptoms, result of nasal endoscopy and paranasal sinus computed tomography (CT) were analyzed statistically by SPSS 19.0. Results: OS mainly occured on unilateral sinuses, with a duration of (8.56±11.79) months. Seventy point four percent (19/27) of the patients had a course within six-month, only 11% was over 12 months (3/27). Symptoms mostly showed as nasal obstruction (88.9%; 24/27), runny nose (81.5%; 22/27), nasal stinks (16/19) and postnasal drip (10/10). Sixty-three percent (17/27) of the OS patients had a dental history. Nasal endoscopic examination revealed a swelling of the ostiomeatal complex (77.8%; 21/27), medial wall interhal displacement of maxillary sinus (55.6%; 15/27), white emulsion-like purulent secretion in the middle meatus (70.4%; 19/27) and nasal polyps (59.3%; 16/27). Etiology of OS included implant-related problems (14.8%; 4/27) and periodontal disease (85.2%; 23/27). Conclusions: OS is usually unilateral sinusitis with a short history. Its clinical features show nasal stinks, white emulsion-like purulent secretion in the middle meatus and imaging findings of unilateral maxillary sinusitis with tooth-related lesions.


Asunto(s)
Sinusitis Maxilar , Sinusitis , Adulto , Enfermedad Crónica , Endoscopía , Femenino , Humanos , Masculino , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Sinusitis Maxilar/diagnóstico por imagen , Sinusitis Maxilar/cirugía , Persona de Mediana Edad , Estudios Retrospectivos
12.
BMJ Open ; 11(9): e047344, 2021 09 03.
Artículo en Inglés | MEDLINE | ID: mdl-34479933

RESUMEN

OBJECTIVES: To assess the efficacy and safety of omalizumab for chronic rhinosinusitis with nasal polyps (CRSwNP) and to identify evidence gaps that will guide future research on omalizumab for CRSwNP. DESIGN: Systematic review and meta-analysis. DATA SOURCES: A comprehensive search was performed in PubMed, Embase, Web of Science and the Cochrane Library on 13 October 2020. ELIGIBILITY CRITERIA: Randomised controlled trials (RCTs) comparing omalizumab with placebo, given for at least 16 weeks in adult patients with CRSwNP. DATA EXTRACTION AND SYNTHESIS: Two independent authors screened search results, extracted data and assessed studies using the Cochrane risk of bias tool. Data were pooled using the inverse-variance method and expressed as mean differences (MDs) with 95% CIs. Heterogeneity was assessed by the χ2 test and the I2 statistic. RESULTS: A total of four RCTs involving 303 participants were identified. When comparing omalizumab to placebo, there was a significant difference in Nasal Polyps Score (MD=-1.20; 95% CI -1.48 to -0.92), Nasal Congestion Score (MD=-0.67; 95% CI -0.86 to -0.48), Sino-Nasal Outcome Test-22 (MD=-15.62; 95% CI -19.79 to -11.45), Total Nasal Symptom Score (MD=-1.84; 95% CI -2.43 to -1.25) and reduced need for surgery (risk ratio (RR)=5.61; 95% CI 1.99 to 15.81). Furthermore, there was no difference in the risk of serious adverse events ((RR=1.40; 95% CI 0.29 to 6.80), adverse events (RR=0.83; 95% CI 0.60 to 1.15) and rescue systemic corticosteroid (RR=0.52; 95% CI 0.17 to 1.61). CONCLUSIONS: This was the first meta-analysis that identified omalizumab significantly improved endoscopic, clinical and patient-reported outcomes in adults with moderate to severe CRSwNP and it was safe and well tolerated. PROSPERO REGISTRATION NUMBER: CRD42020207639.


Asunto(s)
Pólipos Nasales , Sinusitis , Adulto , Enfermedad Crónica , Humanos , Pólipos Nasales/complicaciones , Pólipos Nasales/tratamiento farmacológico , Omalizumab/efectos adversos , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Sinusitis/complicaciones , Sinusitis/tratamiento farmacológico
13.
Folia Med Cracov ; 61(2): 117-127, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34510169

RESUMEN

Mucormycosis is an invasive fungal disease caused by saprophytic molds and is characterized by a fulminant course and high mortality. Reported increase of disease cases and more frequent mucormycosis superinfections in COVID-19 patients are of a serious concern. Head and neck area is the most typical location of mucormycosis and often the first symptoms are eminent in oral cavity, therefore a dentist may be the first healthcare practitioner to recognize signs of this dangerous and potentially fatal disease. Urgent diagnosis and implementation of appropriate treatment are essential for the patient's survival. The dentist's participation in postoperative care is necessary and due to the destructive nature of radical surgical treatment, prosthetic rehabilitation is required to improve the patient's function and quality of life. Furthermore the vigilance of dentists will also allow early recognition of frequent recurrences of this insidious infection.


Asunto(s)
Antifúngicos/uso terapéutico , COVID-19/complicaciones , Atención Odontológica , Mucormicosis/terapia , Enfermedades Orbitales/terapia , Procedimientos Quirúrgicos Otorrinolaringológicos , Rinitis/terapia , Sinusitis/terapia , Humanos , Mucormicosis/complicaciones , Mucormicosis/diagnóstico , Mucormicosis/rehabilitación , Enfermedades Orbitales/complicaciones , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/rehabilitación , Cuidados Posoperatorios , Prótesis e Implantes , Rinitis/complicaciones , Rinitis/diagnóstico , Rinitis/rehabilitación , SARS-CoV-2 , Sinusitis/complicaciones , Sinusitis/diagnóstico , Sinusitis/rehabilitación
14.
Rhinology ; 59(4): 387-392, 2021 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34333577

RESUMEN

BACKGROUND: At present, there is no consensus for optimal orbital infection management in invasive fungal rhinosinusitis patients. This is the first retrospective cohort study aimed to determine efficacy and side effects of the retrobulbar amphotericin B injection for orbital management in invasive fungal rhinosinusitis patients. METHODOLOGY: A retrospective chart review was conducted from 2005 to 2020. Thirty-six patients (forty-two orbits) diagnosed with invasive fungal rhinosinusitis with orbital invasion, treated with or without retrobulbar amphotericin B injection, were included in the study. RESULTS: There were a total of 36 patients in the study, 12 patients received retrobulbar amphotericin B injection and 24 did not. There was no significant difference in orbital exenteration and death between two groups. Visual acuity change at the 3rd month was significantly better in the exposure group. There was a significant difference in the overall clinical outcome at 3rd month and 12th month. There was no report of severe side effects in all patients. CONCLUSIONS: Retrobulbar amphotericin B injection showed significant efficacy in stabilizing or even improving visual acuity without any side effects. This procedure should be considered as adjunctive treatment.


Asunto(s)
Anfotericina B , Sinusitis , Anfotericina B/efectos adversos , Antifúngicos/efectos adversos , Humanos , Órbita , Estudios Retrospectivos , Sinusitis/tratamiento farmacológico
15.
Int J Mol Sci ; 22(16)2021 Aug 16.
Artículo en Inglés | MEDLINE | ID: mdl-34445474

RESUMEN

Otolaryngology (also known as ear, nose, and throat (ENT)) diseases can be significantly affected by the level of sex hormones, which indicates that sex differences affect the manifestation, pathophysiology, and outcomes of these diseases. Recently, increasing evidence has suggested that proinflammatory responses in ENT diseases are linked to the level of sex hormones. The sex hormone receptors are present on a wide variety of immune cells; therefore, it is evident that they play crucial roles in regulating the immune system and hence affect the disease progression of ENT diseases. In this review, we focus on how sex hormones, particularly estrogens, regulate ENT diseases, such as chronic rhinosinusitis, vocal fold polyps, thyroid cancer, Sjögren's syndrome, and head and neck cancers, from the perspectives of inflammatory responses and specialized proresolving mediator-driven resolution. This paper aims to clarify why considering sex differences in the field of basic and medical research on otolaryngology is a key component to successful therapy for both males and females in the future.


Asunto(s)
Estrógenos/metabolismo , Neoplasias de Cabeza y Cuello/patología , Inflamación/patología , Rinitis/patología , Sinusitis/patología , Síndrome de Sjögren/patología , Neoplasias de la Tiroides/patología , Animales , Progresión de la Enfermedad , Neoplasias de Cabeza y Cuello/metabolismo , Humanos , Inflamación/metabolismo , Otolaringología , Rinitis/metabolismo , Factores Sexuales , Sinusitis/metabolismo , Síndrome de Sjögren/metabolismo , Neoplasias de la Tiroides/metabolismo
16.
Microb Pathog ; 159: 105125, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34371109

RESUMEN

The clinical diagnosis of Acute Invasive Fungal Rhinosinusitis (AIFRS) is technically difficult because it presents with non-exclusive and nonspecific clinical symptoms. Laboratory confirmation (usually via histopathologic techniques such as formalin-fixed paraffin-embedded (FFPE)) is necessary but it is time-consuming, despite the urgent need for timely diagnosis of AIFRS for effective management. This study aimed to investigate the sensitivity and specificity of the GMS frozen-section biopsy in the diagnosis of AIFRS and compare the same with that of different tissue staining methods to provide valid decision-grounds that may guide clinicians in prompt diagnosis of acute fungal invasive rhinosinusitis. A cross-sectional study was conducted in the Medical Mycology Laboratory, Faculty of Medicine, Iran University of Medical Sciences between 2018 and 2020 on 200 patients with suspected AIFRS referred to Baqiyatallah and Imam Khomeini Hospital, Tehran. All patients were subjected to diagnostic nasal endoscopy and computed tomography (CT) scan of paranasal sinuses. Magnetic resonance imaging (MRI) was done in cases of suspected intracranial extension. After screening by routine mycological examination, the diagnosis was confirmed using complementary molecular methods. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the frozen-section biopsy were also compared with FFPE. Of the 200 suspect patients, 47 cases (23.5%) met the criteria for AIFRS. Species of the genus Aspergillus were the predominant 27 (57.4%) followed by Mucorales species 10 (21.3%), and Fusarium spp 3 (6.4%). Also, 3 cases (6.4%) of co-infection due to Aspergillus/Rhizopus were reported. The accuracy, sensitivity, specificity, PPV, and NPV of frozen section assessments were 99.5%, 97.9%, 100%, 100% and 99.3%, respectively. For GMS frozen-section alone, sensitivity, specificity, NPV, and PPV was 100%. Overall, the calculated accuracy of FFPE was 98.5%, sensitivity was 94%, specificity was 100%, PPV was 100%, and NPV was 98.1%. Examination of the frozen-section biopsy is a highly predictive tool for a rapid and effective diagnosis of patients with suspected AIFRS. We observed that GMS frozen-section is a fast and reliable exam to confirm the diagnosis of fungal invasion, with good accuracy, sensitivity, and specificity compared to the gold-standard FFPE biopsy.


Asunto(s)
Secciones por Congelación , Sinusitis , Biopsia , Estudios Transversales , Humanos , Irán , Sensibilidad y Especificidad , Sinusitis/diagnóstico
17.
BMC Med Inform Decis Mak ; 21(1): 239, 2021 08 09.
Artículo en Inglés | MEDLINE | ID: mdl-34372852

RESUMEN

BACKGROUND: Rhinosinusitis is an inflammation of the sinonasal cavity which affects roughly one in seven people per year. Acute rhinosinusitis (ARS) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (30-50%), by a bacterial superinfection. Antibiotics, indicated only in rare cases according to EPOS guidelines, are nevertheless prescribed in more than 80% of ARS cases, which increases the resistant bacterial strains in the population. METHODS: We have designed a clinical decision support system (CDSS), RHINA, based on a web application created in HTML 5, using JavaScript, jQuery, CCS3 and PHP scripting language. The presented CDSS RHINA helps general physicians to decide whether or not to prescribe antibiotics in patients with rhinosinusitis. RESULTS: In a retrospective study of a total of 1465 patients with rhinosinusitis, the CDSS RHINA presented a 90.2% consistency with the diagnosis and treatment made by the ENT specialist. CONCLUSION: Patients assessed with the assistance of our CDSS RHINA would decrease the over-prescription of antibiotics, which in turn would help to reduce the bacterial resistance to the most commonly prescribed antibiotics.


Asunto(s)
Sistemas de Apoyo a Decisiones Clínicas , Rinitis , Sinusitis , Enfermedad Crónica , Humanos , Estudios Retrospectivos , Rinitis/diagnóstico , Rinitis/tratamiento farmacológico , Sinusitis/diagnóstico , Sinusitis/tratamiento farmacológico
18.
Med Clin North Am ; 105(5): 859-870, 2021 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34391539

RESUMEN

Based on a review of the most current medical literature, this article outlines the basic concepts and classifications of rhinosinusitis, and delineates best practices for clinical diagnoses and the most up-to-date management strategies. Learning to recognize and differentiate these conditions helps facilitate appropriate and timely diagnoses as well as helping practitioners provide their patients with better counseling and care.


Asunto(s)
Sinusitis/patología , Enfermedad Aguda , Administración Intranasal , Corticoesteroides/uso terapéutico , Antibacterianos/uso terapéutico , Enfermedad Crónica , Humanos , Descongestionantes Nasales/uso terapéutico , Atención Primaria de Salud , Sinusitis/diagnóstico , Sinusitis/tratamiento farmacológico , Sinusitis/cirugía
19.
Pan Afr Med J ; 38: 396, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34381540

RESUMEN

Introduction: chronic rhinosinusitis (CRS) is characterised by inflammation of the mucosal lining of the nose and paranasal sinuses for at least 12 weeks duration. Other than the diagnostic criteria that is based on clinical features; nasoendoscopy and/or computerized tomographic scan have been included in the diagnosis. This study seeks to outline the clinical evaluation and nasoendoscopic assessment of CRS patients. Methods: a hospital-based analytical study carried out on 154 participants. Clinical assessment and nasoendoscopy were performed and scored according to the discharge, inflammation and polyps/oedema (DIP) scale. Statistical analysis was carried out and results were presented in charts and tables. Results: of the 154 participants, 71 (46.1%) were males and 83 (53.9%) females with a male to female ratio of 1: 1.7. Nasal discharge and blockage were the commonest symptoms. Nasoendoscopy had higher yield in the examination of intranasal polyps (NPs) over anterior rhinoscopy. The prevalence of NPs was 26.6%. The result of DIP nasoendoscopic findings revealed more participants with moderate scores. There was a significant statistical difference between the presence of NPs on nasoendoscopy and DIP score. Conclusion: nasoendoscopy is an important aspect in the diagnosis and evaluation of patients with CRS. It provides a better visualization of NPs; therefore, it should be made routine in the clinical assessment and treatment of patients with CRS. The nasal endoscopic scoring of CRS should be considered as a common practice in clinical setting as well.


Asunto(s)
Endoscopía/métodos , Pólipos Nasales/diagnóstico , Rinitis/diagnóstico , Sinusitis/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Enfermedad Crónica , Femenino , Humanos , Inflamación/diagnóstico , Inflamación/patología , Masculino , Persona de Mediana Edad , Pólipos Nasales/patología , Nigeria , Rinitis/patología , Sinusitis/patología , Adulto Joven
20.
Rhinology ; 59(4): 330-339, 2021 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34350429

RESUMEN

BACKGROUND: Chronic Rhinosinusitis is currently classified into eosinophilic and non-eosinophilic, according to the histologic quantification of the number of eosinophils in nasal mucosa biopsy. There is a lack of unanimous histopathologic criteria and methodology for this classification and no consensus regarding a cut-off point for Eosinophils per High power field. METHODOLOGY: A systematic electronic search was performed on BVS, PUBMED, PUBMED PMC, SCOPUS, WEB OF SCIENCE, EMBASE, COCHRANE and PROQUEST databases looking for studies that reported a cut point for classification of Eosinophilic Chronic Rhinosinusitis (eCRS), and data concerning methodology of classification was extracted. RESULTS: We identified 142 studies that reported 29 different cut-off values for classification of eCRS, and different methods of histologic analysis. Out of these studies 13 reported their own methodology to establish the cut-off point, and used different reference standards as polyp recurrence, asthma and allergy, immunocytochemistry, quality of life index, standard deviation of the control population and cluster analysis. CONCLUSIONS: Further studies are needed to determine a precise cut-off point, especially international multicentered cluster analysis. Moreover, methodologic standardization of biopsy and analysis is needed to certify comparable results. Multiple biopsy sites, densest cellular infiltration area examination and oral steroids restriction at least four weeks before sampling are advisable.


Asunto(s)
Pólipos Nasales , Rinitis , Sinusitis , Enfermedad Crónica , Eosinófilos/patología , Humanos , Pólipos Nasales/patología , Calidad de Vida , Rinitis/diagnóstico , Rinitis/patología , Sinusitis/diagnóstico , Sinusitis/patología
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