Surgical interventions for inferior turbinate hypertrophy.

BACKGROUND AND AIM: Nasal obstruction can be induced by various causes; however, inferior turbinate hypertrophy is considered the most frequent cause of this anatomical malfunctioning condition. The current surgical interventional study was focused on comparing the final outcomes of partial inferior turbinectomy (PIT) and powered endoscopic turbinoplasty (PET). SUBJECTS AND METHODS: The criterion followed for deciding the successfulness of each surgical method was the rate of occurrence of postoperative complications such as bleeding, crustation, and atrophic rhinitis. Fifty patients who suffered from nasal obstruction were randomly divided into two groups: PIT group, with 25 patients, of which 15 (52%) were males and 10 were (48%) females, at an average age of 27.40 ± 7.7 years, and PET group, with 25 patients, out of which 14 (48%) were males and 11 (62%) were females, at an average age of 26.68 ± 6.82 years. The surgical operations were performed at the Department of Otolaryngology, Al-Diwaniyah General Teaching Hospital, Diwaniyah City, Iraq, during the period between March 2015 and March 2020. RESULTS: The PET group showed significantly lower incidence (P < 0.05) of bleeding and crustation than those from the PIT group; however, no significant differences (P > 0.05) were observed between PIT and PET in the occurrence of atrophic rhinitis. CONCLUSION: PET showed promisingly less postoperative complications when compared to PIT.

Case Report: Nasal Myiasis in an Elderly Patient with Atrophic Rhinitis and Facial Sequelae of Leprosy.

We describe a case of nasal myiasis in an 89-year-old Brazilian patient affected by leprosy with severe nasal sequelae. An initial treatment comprising sinusectomy combined with nasal endoscopy removed more than 300 larvae, supplemented by systemic treatment using oral and topical ivermectin and levofloxacin. Infestation recurred after 2 months, was treated similarly, and resolved completely. The case could be attributed to severe nasal leprosy sequelae, with a lack of sneezing reflex, painless ulceration, atrophic rhinitis (ozena), and inability to clean the nose properly due to hand and nose impairment. This case illustrates the importance of long-term medical follow-up of patients with leprosy sequelae.

Atrophic rhinitis caused by Cedecea davisae with accompanying mucocele.

Atrophic rhinitis is a chronic inflammatory disease characterized by progressive atrophy of nasal mucosa. Cedecea davisae, a rare pathogen, is a new member of Enterobacteriaceae family. In this article, we report a patient with atrophic rhinitis whose culture test revealed Cedecea davisae. The patient was operated due to accompanying posterior ethmoid mucocele. Levofloxacin and nasal irrigation were administered for two months. Significant improvement was observed in patient's complaints and nasal signs at postoperative sixth month. In conclusion, Cedecea davisae has been thought to cause atrophic rhinitis and mucocele in this patient. Patient recovered with simple treatment. These bacteria should be kept in mind as a causative agent for atrophic rhinitis.

Rhinoplasty in atrophic rhinitis.

Rhinoplasty in atrophic rhinitis is a difficult surgery because the dorsal skin is adherent to the underlying structures. There is also more chance of postoperative infection. The experience of various types of rhinoplasty in 15 atrophic rhinitis patients is presented here. The patients were from the age group 17 to 35 years. Most of the operations were done under local anaesthesia. Commonest graft used was conchal-cartilage. Bone graft was avoided for augmentation because of its high rate of absorption in atrophic rhinitis. Young's operation was done in 5 patients in one side along with rhinoplasty. Young's operation was done only with skin layer.

Chemosensory function assessed with psychophysical testing and event-related potentials in patients with atrophic rhinitis.

Atrophic rhinitis (AR) is a chronic inflammation of the nose characterized by an atrophy of the nasal mucosa. This is typically associated with an impaired sense of smell and a subjective sensation of poor nasal breathing. The aim of this study is to assess chemosensory function in patients suffering from AR using psychophysical testings and event-related potentials (ERP) responses. A cohort of nine patients was extensively studied. Eight out of nine had secondary AR sequela of a bilateral total inferior turbinectomy whereas one patient had a primary AR. All the patients had a clinical evaluation using Sniffin' Sticks test and a retro-olfaction test and an electrophysiological evaluation based upon ERPs obtained after both olfactory and trigeminal stimuli. All the patients complained of a poor nasal breathing and presented a distortion of the chemosensory function. Actually, the orthonasal psychophysical testing showed that four patients out of nine had anosmia, three out of nine had hyposmia and two out of nine were normosmic. All the patients demonstrated retro-olfaction scores inferior to the normal values. The chemosensory ERP showed that seven patients had no olfactory response whereas six had no trigeminal response. Four patients had neither olfactory nor trigeminal ERP response. In conclusion, this study demonstrates that most patients with AR secondary to a total bilateral inferior turbinectomy have a reduction of the chemosensory function measured objectively by psychophysical testings and ERP [corrected].

Pneumocephalus: a rare complication of nasal myiasis.

Infestation of ear, nose, and throat by maggots, the larvae of the fly (genus Chrysomyia) [J Laryngol Otol 1976:393-399], is termed "myiasis." Prevalent in tropical countries, atrophic rhinitis is the most common predisposing factor for this condition. The maggots burrow into delicate membranes and feed on underlying structures, causing considerable destruction of tissues, resulting in complications such as extensive erosion of the nose, face, and orbit, with rarely meningitis and death as a result of intracranial involvement [J Laryngol Otol 1989;103:489-491]. We report a rare complication of pneumocephalus after atrophic rhinitis with nasal myiasis.

Endoscopic dacryocystorhinostomy in cases of dacryocystitis due to atrophic rhinitis.

Atrophic rhinitis is a chronic inflammatory disease of the nose, which is more common in India. Chronic dacryocystitis is its rare complication. The authors found four cases of chronic dacryocystitis from March 2002 to October 2003 due to atrophic rhinitis. It was diagnosed clinically by the regurgitation test and lacrimal syringing. These cases were treated conservatively for a period of six weeks to make the nasal mucosa healthier and were then subjected to endoscopic dacryocystorhinostomy (end-DCR) under local anaesthesia. The procedure was found to be more difficult due to bleeding and the healing time was prolonged as compared to other cases of end-DCR. After one to one and half years of follow-up the primary success rate was 75 per cent but after revision surgery in one case, all cases were successful. Hence it was concluded that atrophic rhinitis is no more a contraindication for end-DCR. However, meticulous initial preparation and post-operative follow-up is necessary to improve the result.

[Comparison of the mucociliary transport rate of rhinitis sicca and atrophic rhinitis].

OBJECTIVE: To study the mucociliary transport function of rhinitis sicca and atrophic rhinitis, and to explore the standard of diagnosis. METHOD: The MTR of normal control group, the rhinitis sicca group and the atrophic rhinitis were determined by using saccharin, and then compared. Then MTR of rhinitis sicca treatment group were compared before and after treatment. RESULT: The MTR of normal group: (9.15 +/- 0.86) mm/min; the rhinitis sicca group: (5.84 +/- 0.48) mm/min and the atrophic rhinitis group: (3.36 +/- 0.07) mm/min. There were significant difference among them (P < 0.05). 25 patients of rhinitis sicca were treated by administering the pill of Gelomyrtol forte in 2 weeks. The MTR of rhinitis sicca were no significant difference before and after treatment (P > 0.05). CONCLUSION: Rhinitis sicca is a separate nasal disease, which is different from atrophic rhinitis. It is important to find an effective treatment for the disease.

Self-inserted sphenoid sinus foreign bodies.

This report describes the case of a patient who inserted 3 foreign bodies into her right sphenoid sinus. The possible consequences of sphenoid sinus foreign bodies are described, as well as the importance of a psychiatric workup in such cases.

Tracheobronchopathia osteochondroplastica. Report of a young man with severe disease and retrospective review of 18 cases.

Tracheobronchopathia osteochondroplastica (TPO) is a rare condition of unclear cause. Sporadic cases have been published from all over the world, but some geographical differences in the occurrence may exist. The condition is characterized by cartilaginous or bony outgrowths into the lumen of the tracheobronchial tree. Clinicians should include this disease in the list of differential diagnoses when confronted with symptoms like persistent and often productive cough, haemoptysis, dyspnoea and wheeze. If the condition is extensive, there may occur unexpected and acute clinical problems. We describe the case of a young man in whom we diagnosed a severe form of TPO while examining him for asthma. This patient suffered also from ozaena and the combination of these two conditions is rather common. We also retrospectively reviewed our material of 18 cases with this condition.

[Osteochondroplastic tracheobronchopathy--relation to rhinitis atrophica and iron deficiency]. / Tracheobronchopatia osteochondroplastyczna--relacja z ozena i niedokrwistoscia z niedoboru zelaza.

Tracheobronchopathia osteochondroplastica (TO) is a rare disease with accumulation of bony and cartilaginous nodules in the tracheal and bronchial mucosa. In some cases rhinitis atrophica (ozena) has been associated. A case of TO coexisting with ozena and iron deficiency anaemia was described.

Computed tomographic findings in atrophic rhinitis.

Computed tomography (CT) has been used increasingly in the assessment of patients with symptoms of sinonasal disease since the introduction of functional endoscopic surgery for the treatment of chronic sinusitis. The association of sinusitis and atrophic rhinitis will inevitably lead to more frequent imaging of patients with atrophic rhinitis. Correct interpretation of the CT appearances of atrophic rhinitis is important as misinterpretation may have serious implications during sinus surgery. These appearances have not been described previously. We describe and discuss the CT findings in three patients with clinical evidence of atrophic rhinitis.

Adherence of Bordetella bronchiseptica 276 to porcine trachea maintained in organ culture.

Two organ culture models have been adapted for porcine tracheae in order to study colonization by Bordetella bronchiseptica. Rings or segments excised from tracheae of newborn piglets were incubated overnight at 37 degrees C in a nutrient medium under 5% CO2-95% air conditions. Tracheal segments were infected with B bronchiseptica 276, and after different incubation times, bacterial counts were done. B. bronchiseptica adhered well to tracheae maintained in culture, and no statistically significant differences between the two models were observed. Noninfected tracheal mucosae maintained a normal appearance for several days, whereas infected mucosae showed typical damage caused by B. bronchiseptica, namely, loss of ciliary activity and cilia and sloughing of ciliated cells. Our data indicated that porcine tracheal organ culture could be advantageously used to study in vitro colonization by B. bronchiseptica.

Management of saddle nose deformity in atrophic rhinitis.

Correction of a saddle nose deformity due to atrophic rhinitis is a formidable task. The thick and puckered skin secondary to long standing disease makes the creation of a dorsal subdermal pocket difficult. On the one hand, these patients tolerate synthetic implants poorly and on the other they show an unusually high rate of absorption of autologous bone graft. Our experience of treating 15 patients with saddle nose deformity secondary to atrophic rhinitis is presented.

Relationship of growth performance to pneumonia and atrophic rhinitis detected in pigs at slaughter.

Three commercial swine herds were selected for study, because pigs at slaughter consistently had lung lesions typical of bronchopneumonia and snout lesions consistent with atrophic rhinitis. Pigs were reared in the conventional system for each herd except that they were identified at birth and weighted at various intervals. At slaughter, individual pig lungs and snout were examined for lesions of pneumonia and atrophic rhinitis, respectively. Lesions were scored and correlated with growth indicators for each pig. Included in the growth indicators were: average daily gain (growing phase), average daily gain (finishing phase), average daily gain (total), and days to reach 104.5-kg body weight. Additionally, for each pig, scores for lung lesions were correlated to grades for snout lesions. Three correlation coefficients for measurements of pigs within herd B were significant and included days to 104.5-kg body weight and grades for snout lesions, -0.15 (P less than 0.02); average daily gain (finishing) and grades for snout lesions, 0.17 (P less than 0.01); and average daily gain (total) and grades for snout lesions, 0.16 (P less than 0.01). Contrary to findings in other investigations, pigs that attained market weight at the youngest age did not have the lowest score for lung lesions, the lowest grade for snout lesions, or the least extensive or severe lesions. Combining data from all 3 herds, the mean scores for lung lesions and mean grades for snout lesions decreased significantly (P less than 0.05) as the age of pigs at slaughter increased. All other statistical correlations were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)