Clinical features of chronic fungal rhinosinusitis in Korean geriatric and non-geriatric patients.

PURPOSE: Worldwide, the incidence of chronic fungal rhinosinusitis (CFRS) has increased. Although ageing leads to weakening of the immune system, which increases susceptibility to CFRS, the CFRS characteristics in geriatric patients are unclear. Therefore, we comparatively analysed the clinical characteristics of CFRS in geriatric and non-geriatric patients. METHODS: This retrospective analysis compared the demographics, rhinologic symptoms, multiple allergen simultaneous tests, olfactory function tests, paranasal sinus computed tomography findings, and outcomes of 131 patients with CFRS who underwent functional endoscopic sinus surgery and 131 enrolled patients were divided in geriatric (> 65 years) and non-geriatric (≤ 65 years) groups. RESULTS: Among the geriatric and non-geriatric participants (n = 65, 49.6% and n = 66, 50.4%, respectively), hypertension and diabetes mellitus were more common in the geriatric group. Demographics, including symptoms, showed no significant intergroup differences. Normosmia and hyposmia were significantly less prevalent, whereas phantosmia and parosmia were more prevalent in the geriatric group than in the non-geriatric group (p = 0.03 and p = 0.01, respectively). Sphenoidal sinus involvement was significantly higher in geriatric patients than in non-geriatric patients (p = 0.02). CONCLUSION: Based on greater sphenoidal sinus involvement, a deeper anatomical area is more vulnerable to fungal infection in the geriatric group than in the non-geriatric group. Increasing clinicians' awareness of CFRS in geriatric patients with olfactory dysfunction, including phantosmia and parosmia, is important for early intervention.

Association between poly-sensitisation and sensitisation to staphylococcal enterotoxin A and B affecting allergic severity in children.

PURPOSE: Accumulating evidence suggests that Staphylococcus aureus plays a significant role as a disease modifier in upper and lower airway diseases. We aimed to assess the association between staphylococcal enterotoxins (SEs) with allergic diseases and the degree of allergen sensitisation in children, which remains unclear. METHODS: We retrospectively reviewed the medical records of 455 patients aged 3-18 years between March 2018 and March 2022. Clinical history and demographic data were obtained. The baseline study included paranasal sinus X-ray scan, multiple allergen simultaneous test, and ImmunoCAP® for measuring serum total and specific immunoglobulin E (IgE) levels to allergens and staphylococcal enterotoxin A and B (SEA and SEB). RESULTS: The mean age was 9.77 ± 4.3 years. 133 patients (29.2%) were sensitised to one inhalant allergen, and 188 patients (41.3%) showed polysensitisation. Patients sensitised to SEs showed higher total and specific IgE levels and total eosinophil counts compared to non-SE-sensitised patients. Sensitisation to SEs is closely associated with polysensitisation to inhalant allergens and allergic multimorbidity. When the SE-IgE value was 0.35 or higher, the odds ratio for allergen polysensitisation was significantly higher than when the SE-IgE value was lower than 0.35. CONCLUSIONS: Association between polysensitisation and sensitisation to SEs in children shows the higher the specific IgE levels for SEs, the higher the likelihood of polysensitisation. Considering the relationship between polysensitisation, high IgE levels, and the severity of allergic morbidity, sensitisation to SEs is thought to be related to allergy severity.

Occurrence of a postoperative maxillary mucocele 20 years after orbital wall reconstruction.

Mucoceles of the paranasal sinus are epithelial-lined cystic structures filled with mucus and have multiple etiologies, including recurrent inflammation, trauma, or intrinsic disease. Particularly, a postoperative maxillary mucocele (POMM) is a delayed complication of radical surgery of the maxillary sinus, and most cases occur after Caldwell-Luc operations. Patients mainly complain of facial swelling, toothache, and tenderness. POMM has rarely been reported from other causes; however, there have been no reports on the occurrence of POMM following orbital wall reconstruction. Herein, we report a case of a patient with a POMM that developed 20 years after the aforementioned surgery. The patient complained of facial pain with visual disturbance, and underwent marsupialization using a combination of sublabial and endoscopic approaches, and the symptoms improved without recurrence.

Measurement of Skull Size on Computed Tomography Images for Developing a Bone Conduction Headset Suitable for the Korean Standard Head Size.

BACKGROUND AND OBJECTIVES: We aimed to measure the head dimensions on computed tomography (CT) images, to compare them to directly measured head dimensions, and to predict a new parameter of bone thickness for aiding bone conduction implant (BCI) placement. SUBJECTS AND METHODS: We reviewed the facial and mandibular bone CT images of 406 patients. Their head sizes were analyzed using five parameters included in the 6th Size Korea project, and they were divided into age groups (ranging from the 10s to the 80s). We compared the head length, head width, sagittal arc, bitragion arc, and head circumference in the CT and Size Korea groups. We also added the parameter bone thickness for aiding BCI placement. RESULTS: All the head size parameters measured using CT were significantly smaller than those measured directly, with head length showing the smallest difference at 7.85 mm. The differences in the other four parameters between the two groups according to patient age were not statistically significantly different. Bone thickness had the highest value of 4.89±0.93 mm in the 70s and the lowest value of 4.10±0.99 mm in the 10s. Bone thickness also significantly correlated with head width (p=0.038). CONCLUSIONS: Our findings suggested that the CT and direct measurements yielded consistent data. Moreover, CT enabled the measurement of bone sizes, including bone thickness, that are impossible to measure directly. CT measurements may complement direct measurements in the Size Korea data when used for developing bone conduction hearing devices (BCIs and headsets) for the Korean population.

Engraftment and regenerative effects of bone marrow stromal cell transplantation on damaged rat olfactory mucosa.

To develop a new therapeutic method to treat olfactory deficits, we investigated the engraftment and regenerative effects of transplanted bone marrow stromal cells (BMSCs) on damaged rat olfactory mucosa. To induce olfactory nerve degeneration, one side of the olfactory mucosa of Sprague-Dawley rats was damaged via Triton X-100 irrigation. Phosphate-buffered saline containing syngeneic BMSCs was injected into the olfactory mucosa for transplantation. PKH fluorescent cell dye labeling of BMSCs was used to monitor the transplanted cells. After transplantation of BMSCs, the thickness and regeneration of olfactory mucosa were analyzed using hematoxylin-eosin (H&E) staining. S100 immunohistochemical staining was used to measure nerve sheath regeneration. The increase in NGF (nerve growth factor) level in the olfactory mucosa was measured by Western blot analysis. Transplanted bone marrow stromal cells were engrafted to the lamia propria of damaged mucosa. The mean time for normalization of thickness and morphological recovery of the olfactory mucosa was 4 weeks in the therapeutic group and 9 weeks in the control group. S100 immunoreactivity was higher on the BMSC-treated side than on the control side. During regeneration, the expression of NGF increased in the olfactory mucosa of the experimental group. Based on these results, BMSC transplantation accelerated regeneration of olfactory mucosa damaged by Triton X-100, and NGF may be essential to this regenerative process.