Computerized rhinomanometry: a study of total nasal resistance normal values.

Computerized rhinomanometry with the practical software programmes is used widely as a research tool to evaluate objectively nasal air flow and resistance parameters, while the increase of its clinical application may be facilitated by further standardization of the method. The aim of the study was to determine the total nasal resistance normal values in healthy adult population using a method of computerized rhinomanometry. A randomized sample of 108 white healthy adults (216 nasal cavities), both sexs with a mean age of 32 (20-45) years comprised the test group. Nasal patency was measured by active anterior rhinomanometry in non-decongested mucosa ("at rest") during 10 repetitive measurements at inspiratory and expiratory reference pressure of 150 Pa. Nasal resistance was measured and calculated according to the recommendations of the Committee on objective assessment of the nasal airway, International Rhinologic Society. The mean total nasal resistance in the sample was found to be 0.179 Pa/cm3/s with the confidant interval from 0,167 to 0,191 Pa/cm3/s at the probability level of 95%. Total nasal resistance was very significantly influenced by sex (t = -4.614), height (F=11.625) and weight (F=11.529) of the examinees. This paper provides additional information on total nasal resistance normal values in healthy adult population important for computirezed rhinomanometry normative parameters standardization.

[Postoperative histopathologic findings in sino-nasal polyposis].

INTRODUCTION: Sino-nasal polyposis is a frequent condition in clinical practice and various pathohistological features that they exhibit can be significant for clinical picture and prognosis of the illness. Aim of this research was to examine pathohistological characteristics of sino-nasal polyposis and according to references from literature to make a pathohistological classification. MATERIALAND METHOD: In the period from May to October 2009. we have analyzed pathohistological characteristics of sino-nasal polyposis in 25 patients. All patients were operated with funcional endoscopic surgery at the Institute of Otorhinolaryngology and Maxillofacial Surgery and pathohistologycal researches were done at the Institute of Pathology, University Medical School of Belgrade. RESULTS: Pathohistological findings in all operated patients confirmed sino-nasal polyposis and classification was establish in following pattern: 16 patients with edematous or eosinophilic polyps (64%), 6 patients with fibro-inflamatory polyps (24%) and 3 patients with hyperplasia of sero-mucous glands (12%). In 3 cases (12%) we have found atypical stromal cells but because of the rest of predominant pathohistological characteristics we did not separate these patients in additional group. CONCLUSION: Edematous or eosinophilic polyps represents predominant pathohistological type which is according to data from literature.

[Fungal sinusitis diagnostic management and classification].

The aim of this paper is to present the current classification of fungal sinusitis and share our experiences in diagnostic procedures and treatment outcomes. The study includes 31 patients operated since 2000-2009 in whom some form of fungal infection had been dignosed. There were 10 patients with mycetoma, and 16 patients with chronic non-invasive fungal sinusitis, while in five patients allergic fungal sinusitis was proven. All patients were treated postoperatively with topical steroids and irrigation with saline solution, without use of fungicides. Characteristics of chronic non-invasive fungal sinusitis and mycetoma are CT with specific opacification and calcification with involement of maxillary sinus unilaterally or bilateral together with pathohistological finding of positive staining by Grocott with the identification of fungi from secret or tissue. Allergic fungal Sinusitis is characterized by eosinophilia, positive skin test to fungal allergens, elevated serum level of both specific IgE antibodies to causal fungus and total IgE, as well as, pathohistological finding of allergic mucus which include non-invasive hifa. Fungal sinusitis in immunocompetent patients is classified into the following categories: mycetoma, chronic non-invasive fungal sinusitis, chronic indolent sinusitis (which does not occur in our population) and allergic fungal sinusitis.

[Pharmacomodulation of hypersensitivity rhinitis]. / Mogucnosti farmakomodulacije hipersenzitivnog rinitisa.

INTRODUCTION: Hypersensitive rhinitis is characterized by accumulation of mast cells and eosinophils (believed to be primary effector cells) in the nasal epithelium. Treatment of hypersensitive rhinitis is directed towards reducing either tissue accumulation of these activated cells or the end-organ effects of the released mediators. The aim of this study was to examine effects of local corticosteroid treatment on the number of eosinophils in nasal secretion of patients with isolated hypersensitive rhinitis. MATERIAL AND METHODS: A total of 55 subjects were included in a prospective controlled trial. Thirty-seven patients with hypersensitive rhinitis were included in the experimental group, and 18 patients with hypersensitive rhinitis in the control group. A local corticosteroid, beclomethasone dipropionate, aqueous nasal spray, was administrated every 12 hours (400 micrograms per day) to the experimental group during 6 weeks. Patients of both groups were regularly controlled during the study period by ENT and cytological examination of nasal secretions. RESULTS AND DISCUSSION: Very significant differences in regard to the number of eosinophils were found in the nasal secretion of experimental patients with hypersensitive rhinitis, whereas they were insignificant in patients from the control group. Strong antieosinophilic effect of beclomethasone was evident. Eosinophil apoptosis at the inflammatory site appeared to be delayed when interleukin-5 was generated by neighbouring cells, or this delay is due to autocrine production of this cytokine. CONCLUSION: Local corticosteroid treatment of hypersensitive form of chronic rhinitis significantly reduces the number of eosinophils and thus probably modulates the pathogenesis of this inflammatory process.

Intradermal tests with vasomotor agents in perennial non-allergic rhinitis.

Nasal reactivity in non-allergic rhinitis patients is well known, but the skin reactivity of these patients is less examined. The aim of this prospective study was to examine the skin reactivity to four vasomotor agents in healthy subjects and perennial non-allergic rhinitis patients and to determine whether rhinitis patients differ from healthy subjects or not. Seventy four perennial non-allergic rhinitis patients and fourty two healthy subjects were undergone to intradermal testing with papaverine (5 mg/ml), metacholine (0.02, 0.2 and 2.0 mg/ml), histamine (0.01, 0.1 and 10.0 micrograms/ml) and compound 48/80 (0.01, 0.1, 1.0 and 10.0 micrograms/ml). It was found that the frequency of pathological skin reactivity to papaverine in perennial non-allergic rhinitis patients (34%) was significantly greater (p = 0.007) then in healthy subjects (9.5%). There was no significant difference for metacholine, histamine, compound 48/80 and saline between these two groups. The frequency of the total pathological skin reactivity to vasomotor agents, singly and in combinations, in perennial non-allergic rhinitis patients (80%) was significantly greater (p = 1.8.10(-6)) then in healthy subjects (33%). These findings suggest that the pathological skin reactivity to vasomotor agents is a feature of perennial non-allergic rhinitis patients as well as healthy subjects and indicate that a difference in the skin reactivity between these groups is noticed.