Search

Exosomes mediate inflammation and immune responses. The aim of the study was to examine the expression profiles of plasma exosomal microRNAs (miRNAs) and analyze their target gene functions in participants with chronic rhinosinusitis with nasal polyps (CRSwNP). We measured plasma exosomal miRNAs in five patients with CRSwNP and five controls. Transcripts per million (TPM) was used to assess miRNAs expression and the Benjamini–Hochberg procedure was employed for multiple comparisons correction. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene ontology (GO) analyses revealed biological annotation and functional prediction of target genes. Compared with controls, we found that 159 exosomal miRNAs were differentially expressed by miRNA sequencing in CRSwNP. The top three upregulated miRNAs were novel_miR_677, novel_miR_1037, and novel_miR_79, while the top three downregulated miRNAs were novel_miR_192, novel_miR_1022, and novel_miR_4. The target functions in the GO and KEGG analyses included axon guidance, extracellular matrix (ECM)–receptor interaction, protein digestion and absorption, the calcium, the Hippo, the Notch, the ErbB, the cAMP signaling pathway, and focal adhesion. This study describes the dissection of plasma exosomal miRNA profiling in CRSwNP. Our findings may provide a certain basis for further mechanism research and exploration of diagnostic values.

The aim of this study was to identify hub genes closely related to the pathogenesis and prognosis of thyroid carcinoma (THCA) by integrated bioinformatics analysis. In this study, through differential gene expression analysis, 1916 and 665 differentially expressed genes (DEGs) were obtained from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database, and 7 and 11 co-expressed modules were identified from the TCGA-THCA and GSE153659 datasets, respectively, by weighted gene co-expression network analysis. We identified 162 overlapping genes between the DEGs and co-expression module genes as candidate hub genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses of the 162 overlapping DEGs identified significant functions and pathways of THCA, such as thyroid hormone generation and metabolic process. A protein–protein interaction (PPI) analysis detected the top 10 hub genes (QSOX1, WFS1, EVA1A, FSTL3, CHRDL1, FABP4, PRDM16, PPARGC1A, PPARG, COL23A1). Finally, survival analysis, clinical correlation analysis, and protein abundance validation confirmed that 3 of the 10 hub genes were associated with survival prognosis of patients with THCA, and 8 of them were associated with the clinical stages of THCA. In summary, we identified hub genes and key modules that were closely related to THCA, and validated these genes by survival analysis, clinical correlation analysis, and Human Protein Atlas image analysis. Our results provide important information that will help to elucidate the pathogenesis of THCA and identify novel candidate prognostic biomarkers and potential therapeutic targets., GRAPHICAL ABSTRACT

Objectives: The aim of this study was to compare the efficacy of bioabsorbable steroid-eluting sinus stents versus absorbable Nasopore packs after endoscopic sinus surgery (ESS) for the treatment of chronic rhinosinusitis (CRS). Methods: One hundred eighty-one patients with CRS who underwent ESS were randomly assigned to receive a steroid-eluting sinus stent in one ethmoid sinus cavity, whereas the contralateral control side received a Nasopore pack. Endoscopic evaluations were performed 14, 30, and 90 days after the ESS. Postoperative intervention, polyp formation, adhesions, and middle turbinate (MT) position were assessed as efficacy outcomes. Results: The stents were successfully deployed in all 181 sinuses. Thirty days after the ESS, the stents significantly reduced the need for surgical intervention compared to the Nasopore ( P < .0001). The percentage of cases with polyp formation was significantly lower on the stent sides compared with the Nasopore sides ( P < .0001) at 14, 30, and 90 days after ESS. The percentage of severe adhesion was significantly lower on the stents sides than on the Nasopore sides at postoperative day 90 ( P = .0003), whereas they were not significantly lower at postoperative days 14 and 30. There were no significant differences between the stent sides and the Nasopore sides regarding the frequency of MT lateralization at all end points. No device-related adverse events occurred. Conclusions: Our study demonstrated significant improvement in the early postoperative outcomes by reducing the need for postoperative surgical intervention and polyp formation using steroid-eluting stents when compared with absorbable Nasopore packs. The steroid-eluting sinus stents and the Nasopore packs were each effective in preserving the ethmoid sinus patency and in preventing MT lateralization. A further prospective cohort study with long-term postoperative outcomes is warranted.

Background A concha bullosa (CB) of the middle turbinate is frequently observed on the nondeviated side of patients with a nasal septal deviation (NSD). However, the impact of the CB on nasal airflow characteristics in patients with NSD has been incompletely defined. Objective The purpose of this study was to evaluate the impact of a CB in patients with NSD on nasal airflow characteristics using a computational fluid dynamics (CFD) approach. Methods Twenty patients with NSD and a unilateral CB of the middle turbinate on the nondeviated side (study group) were recruited. Another 20 patients with NSD without the formation of a CB (control group) were also enrolled. Using CFD, the maximal airflow velocity, nasal resistance, maximal wall shear stress, and minimal temperature in the bilateral nostrils of each group were assessed. Moreover, the volume of the nasal tract, surface area-to-volume ratio, and the total nasal resistance were compared between the study and control groups. Results In the study group, no significant differences of airflow dynamics between the bilateral nasal cavities were observed. In the control group, however, there were statistically significant differences for maximal airflow velocity, nasal resistance, maximal wall shear stress, and minimal airflow temperature between the bilateral nostrils. The surface area-to-volume ratio and total nasal resistance in the study group was significantly higher and the nasal volume was significantly decreased than that in the control group. Conclusion CB of the middle turbinate on the nondeviated side of patients with NSD rendered airflow characteristics more evenly distributed between the bilateral nostrils as assessed by CFD. From an aerodynamics perspective, a CB may represent a compensatory action to normalize airflow dynamics. However, a CB may also result in constriction of the ipsilateral nasal cavity.

Background: The functional significance of the posterior segment of the septum is not fully understood.Aims/Objectives: The purpose of this study was to evaluate the impact of posterior septum rese...

In order to obtain the physiological information and key features of source images to the maximum extent, improve the visual effect and clarity of the fused image, and reduce the computation, a multi-modal medical image fusion framework based on feature reuse is proposed. The framework consists of intuitive fuzzy processing (IFP), capture image details network (CIDN), fusion, and decoding. First, the membership function of the image is redefined to remove redundant features and obtain the image with complete features. Then, inspired by DenseNet, we proposed a new encoder to capture all the medical information features in the source image. In the fusion layer, we calculate the weight of each feature graph in the required fusion coefficient according to the trajectory of the feature graph. Finally, the filtered medical information is spliced and decoded to reproduce the required fusion image. In the encoding and image reconstruction networks, the mixed loss function of cross entropy and structural similarity is adopted to greatly reduce the information loss in image fusion. To assess performance, we conducted three sets of experiments on medical images of different grayscales and colors. Experimental results show that the proposed algorithm has advantages not only in detail and structure recognition but also in visual features and time complexity compared with other algorithms.

Importance: The nasal bone is one of the most commonly fractured bones of the midface. However, the frequency of coincident fractures of adjacent bones such as the frontal process of the maxillary bone, nasal septum, and medial or inferior orbital walls has not been fully evaluated. Objective: The purpose of this study was to investigate the incidence of fractures of adjacent structures in the setting of a nasal bone fracture. Second, we propose a new classification system of nasal bone fractures with involvement of adjacent bony structures. Design, Setting, and Participants: One thousand, one hundred ninety-three patients with midfacial fractures were retrospectively reviewed. The characteristics of fractures of the nasal bone and the incidence of coincident fractures of the frontal process of maxilla, bony nasal septum, medial, or inferior orbital walls were analyzed. Exposure: All patients included in the study presented with nasal trauma. Main Outcomes and Measures: The coincident fractures of adjacent midfacial structures were assessed, and a new classification of midfacial fractures based on computed tomography (CT) scan images was proposed. Results: Among the 1193 cases, bilateral fractures of the nasal bone were most common (69.24%), and coexistent fracture of the frontal process of the maxilla and bony nasal septum was 66.89% and 42.25%, respectively. Coincident fracture of the orbital walls was observed in 16.51% of cases. The major etiology of fracture for the younger and elderly groups was falls, compared with assault as the most common etiology in the adult group. A classification scheme was generated in which fractures of the nasal bone were divided into five types depending on coexisting fractures of adjacent structures. Conclusions and Relevance: External force applied to the nasal bone can also lead to coexistent fracture of adjacent bony structures including the frontal process of the maxilla, nasal septum, and orbital walls. The proposed classification of nasal fracture based on CT imaging helps to incorporate coincident disruption of adjacent structures.

Study objectives The aim of the study was to evaluate the clinical efficacy of nasal surgery in the treatment of obstructive sleep apnoea (OSA) by comparing the improvement of subjective symptoms and objective metrics before surgery and after 6 months of surgery. Methods Patients with the main complaint of nasal congestion combined with habitual snoring who were hospitalized and treated were selected. Patients underwent subjective symptom tests and objective indicator monitoring both before surgery and 6 months after surgery. Comparisons between groups were performed using the independent samples t-test. Results Subjective scale evaluations demonstrated that nasal congestion, daytime sleepiness, snoring, nose-related symptoms, and sleep symptoms in patients with simple snoring or with OSA were improved after nasal surgery. Additionally, vitality was improved in all groups except for the patients with simple snoring and emotional consequence was improved in patients with simple snoring and mild OSA. Objective evaluations indicated the apnoea-hypopnoea index (AHI), the thickness of the soft palate, and the maximum cross-sectional area of the sagittal plane of the soft palate decreased after surgery in patients with mild OSA. The lowest blood oxygen concentration (LSaO2) and anteroposterior diameter of the soft palate increased after surgery in patients with mild OSA. The arousal index also significantly decreased in patients with mild and moderate OSA. The nasal cavity volumes (NCVs) and the nasal minimal cross-sectional areas (NMCAs) of all groups showed significant differences after surgery. Conclusions Nasal surgery can effectively improve nose and sleep symptoms in patients with simple snoring or with OSA. It can significantly reduce the nasal resistance and increase the ventilation volume. Statement of significance Obstructive sleep apnoea (OSA) is becoming a global health problem. OSA is associated with several coexisting conditions, reduced health-related quality of life, and impaired work productivity. This study performed nasal surgery on OSA patients with the main complaint of nasal congestion combined with snoring and patients with simple snoring to compare the improvement of subjective symptoms and objective metrics before and after surgery. We found that: (1) symptoms such as nasal congestion, daytime sleepiness or snoring were improved after nasal surgery; (2) the apnoea-hypopnoea index (AHI) and arousal index decreased after surgery in patients with OSA; (3) the nasal and oropharyngeal cavity volumes increased after surgery. These findings suggest that patients with OSA or with simple snoring could benefit from nasal surgery.

Objectives:This study aimed to evaluate subjective symptom changes in obstructive sleep apnoea hypopnea syndrome patients following nasal surgery, and to explore treatment efficacy in improving patient quality of life.Methods:Patients with nasal blockage accompanied by habitual snoring were stratified into four groups. Their subjective symptoms were evaluated before and after nasal surgery.Results:There was a significant decrease in the nasal blockage symptom visual analogue scale, Epworth Sleepiness Scale, Snore Outcomes Survey, Spouse/Bed Partners Survey and Sino-Nasal Outcome Test 20 scores for all patients at six months after surgery. The visual analogue scale score for subjective olfactory function was significantly improved in the severe obstructive sleep apnoea hypopnea syndrome patient group.Conclusion:Nasal surgery can effectively improve the subjective symptoms of patients with simple snoring accompanied by nasal blockage and of patients with obstructive sleep apnoea hypopnea syndrome, thus improving their quality of life.

There is clear correspondence between HU and histopathological evaluation of osteitis. It is feasible to evaluate bone remodeling in rabbit models with rhinosinusitis by measuring the HU.The objective of this study was to determine whether the HUs of rabbit CRS models can be used to objectively evaluate the degree of osteitis.Sixty rabbit models were inoculated with staphylococcus aureus. The rabbits were divided into three groups. Each group was divided into a medication administration team and a control team. The HU of the bone in each image was measured. All of the animals were executed after the CT exam. The samples for the mucous and bone changes using light microscope observation were scored. These scores and the HU measurements were compared to the actual bone remodeling over time to examine whether we could evaluate bone remodeling by measuring the HU.The average HU scores in Groups A, B, and C were significantly higher than those of normal rabbits (p .05). The mucous and bone scores increased as the experimental period lengthened (p = .042, 0.002). HU correlated with the mucous and bone scores in rabbit models with rhinosinusitis (coefficient r = .830, 0.641, 0.586, p = .000).

Nasal septal deviations (NSD) have been categorized into 7 types. The effect of these different deviations on airflow pattern and warming function has not been fully investigated. The purpose of this study was to utilize a computational fluid dynamics approach to assess the impact of NSD of varying types on nasal airflow and warming function. Patients with each type of NSD were enrolled in the study, and a normal participant as the control. Using a computational fluid dynamics approach, modeling of nasal function was performed. Indices of nasal function including airflow redistribution, total nasal resistance, airflow velocity, and airflow temperature were determined. Among all types of NSD, the maximal velocity and total nasal resistance were markedly higher in type 4 and 7 deviations. The flow partition and velocity distribution were also altered in type 4 and 7 as well as type 2 and 6 deviations. Airflow in all categories of NSD was fully warmed to a similar degree. From a computational aerodynamics perspective, the type of septal deviation may contribute to altered airflow characteristics. However, warming function was similar between septal deviation types. Future studies will help to ascertain the functional importance of septal deviation types and the applicability of these computational studies.

Conclusion Nasal obstruction can aggravate the psychological status of OSA patients, and nasal surgery should reduce this aggravation. Nasal surgery significantly improved sleep latency and ameliorated several polysomnographic characteristics. Background The aim of this study was to investigate the psychological status of patients with obstructive sleep apnea (OSA) and nasal obstruction and to evaluate the effects of nasal surgery on the psychological symptoms and polysomnographic (PSG) parameters of these patients. Methods The study was designed as a prospective comparative study. This study compared 30 patients (all male) with nasal obstruction and 30 matched patients without nasal obstruction using the Pittsburgh Sleep Quality Index (PSQI) and the Symptom Check List 90 (SCL-90). All of the patients had been previously diagnosed with OSA (apnea hypopnea index [AHI] ≥ 5 events/h) via a whole-night polysomnographic examination. Nasal obstruction was assessed using a visual analogue scale (VAS). The patients with nasal obstruction underwent nasal surgery, and their weight, VAS, nocturnal PSG characteristics, and psychological symptoms at baseline and 3 months after surgery were compared. Results The OSA patients with nasal obstruction suffered from significantly longer sleep latency on the PSQI and higher somatization and anxiety scores on the SCL-90 than the subjects without nasal obstruction (p 0.05). The nasal obstruction symptoms significantly improved after surgery (VAS decreased from 6.18 ± 1.85 to 1.87 ± 1.76, p 0.01). The assessments also showed a significant reduction in weight (from 84.60 ± 11.30 kg to 82.27 ± 9.87 kg, p 0.05) between the pre-operative and post-operative values. Although there was significant reduction in the AHI (from 49.67 ± 19.49/h to 43.07 ± 21.86/h, p 0.01) and a significant improvement in lowest oxygen saturation (LSpO2, from 73.83 ± 8.49% to 75.97 ± 9.86%, p 0.05), only 23.3% of patients achieved a response of nasal surgery that met Sher's criteria. Remarkable reductions were observed in the sleep latency scores, daytime dysfunction scores on the PSQI, anxiety and hostility scores, and the number of positive symptoms on the SCL-90 (p 0.05). There was a strong positive correlation between PSQI total score and some psychosomatic symptoms on the SCL-90, including inter-personal sensitivity, depression, hostility, paranoid ideation, psychoticism, global symptom index, and the number of positive symptoms (r 0.3, p 0.05).

Epithelial barrier dysfunction is involved in the pathogenesis of allergic disorders, such as nasal allergy. TWIK-related K(+) 1 (Trek1) potassium channels are required in the maintenance of the epithelial barrier function. This study aims to investigate the role of antigen-specific immunotherapy (SIT) in the regulation of Trek1 expression in the nasal mucosa. In this study, patients with nasal allergy were treated with SIT and/or Clostridium butyricum. The expression of Trek1 and histone demethylase 1 (HDAC1) in the nasal epithelia was assessed by real-time reverse transcription polymerase chain reaction and Western blotting. Serum cytokines were assessed by enzyme-linked immunosorbent assay. The results showed that Trek1 and HDAC1 were detected in the nasal epithelia. Trek1 was lower, whereas HDAC1 was higher in patients with allergic rhinitis as compared with healthy controls. Trek1-null RPMI2650 monolayers showed a markedly compromised epithelial barrier function. Treatment with SIT significantly increased the Trek1 levels in the nasal epithelia of allergic rhinitis patients that were further improved in conjunction of SIT and administration of probiotic C. butyricum. In conclusion, nasal epithelia express Trek1 that can be suppressed by allergic response. SIT can restore the expression of Trek1 in the nasal epithelia and can be further improved by conjunction with administration of C. butyricum.

The polysomnographic (PSG) effects of nasal surgery on positional obstructive sleep apnea/hypopnea syndrome (OSAHS) patients (PPs) and non-positional OSAHS patients (NPPs) were different.We aimed to determine the PSG data changes after nasal surgery and evaluate the PSG effect of nasal surgery on PPs and NPPs, respectively.A total of 79 OSAHS patients with nasal obstruction were recruited. Preoperative rhinomanometry and overnight polysomnography were recorded. Patients were distributed into three groups based on the severity level of the apnea and hypopnea indexes (AHI) (mild, moderate, and severe OSAHS). Three groups were each subdivided into two subgroups (PPs and NPPs). Postoperative data were obtained at least 6 months later.After surgery, although nasal resistance decreased significantly in all patients, the total rate of success and response in treating OSAHS was only 22.7%. Grouped on the basis of the severity level of AHI, the lowest SpO2 increased and AHI, supine AHI, and arousal indexes decreased significantly only in mild OSAHS (p0.05). Subdivided according to the presence or absence of positional dependency, the lowest SpO2 increased and supine AHI decreased significantly in both PPs and NPPs with mild OSAHS and in PPs with moderate OSAHS (p0.05). AHI significantly increased in PPs with severe OSAHS (p0.05). Supine sleep time was relatively prolonged significantly in PPs with moderate and severe OSAHS (p0.05).

Patients with a nasal septal perforation often exhibit symptoms associated with disturbed airflow, which can have an adverse effect on the warming function of the nasal cavity. The impact of this effect is not fully understood. The warming function is an important factor in the maintenance of nasal physiology. We conducted a study to investigate the impact of septal perforations of various sizes and locations on the warming function during inspiration in 5 patients—3 men and 2 women, aged 25 to 47 years. Three-dimensional computed tomography and computational fluid dynamics were used to model the flux of communication and temperature, and differences among patients were compared. All 5 patients exhibited an impairment of their nasal warming function. As the size of the perforation increased, the flux of communication increased and the warming function decreased. Perforations located in an anterior position were associated with greater damage to the warming function than those in a posterior position. In patients with a large or anteriorly located perforation, airflow temperature in the nasopharynx was decreased. Our findings suggest that septal perforations not only induce airflow disturbance, but they also impair the nasal warming function. Further analysis of warming function is necessary to better explore flow mechanisms in patients with structural abnormalities.

Objectives/Hypothesis: To compare the aerodynamic differences around ostiomeatal complex between the convex side and concave side in patients with concurrent nasal septal deviation and chronic rhinosinusitis, and to explore the potential correlation between nasal septal deviation and chronic rhinosinusitis occurrence from the perspective aerodynamics. Study Design: Retrospective case series. Methods: Fifty-six patients with concurrent nasal septal deviation and chronic rhinosinusitis were recruited. Nasal septal deviation was divided into mild, moderate, and severe deviations according to deviation angle. Using computational fluid dynamics, indices such as maximal velocity, maximal turbulence kinetic energy, maximal wall shear stress, and minimal temperature around the ostiomeatal complex were calculated and compared between the convex side and concave side, and among patients with varying severities of deflection. Results: The proportion for mild, moderate, and severe deviations was 12.5%, 32.1%, and 55.4%, respectively. Significant differences for maximal velocity, maximal wall shear stress, maximal turbulence kinetic energy, and minimal temperature around the ostiomeatal complex between the convex side and concave side could be detected. No significant difference of aerodynamic characteristics around the osteomeatal complex could be detected with the increasing of deviation angles. The incidence for chronic rhinosinusitis in convex, concave, and bilateral sides was 16.1%, 25%, and 58.9%, respectively. Conclusions: From the aerodynamics perspective, both sides of nasal cavity have the potential to predispose the occurrence of chronic rhinosinusitis in patients with nasal septal deviation. The increased deviation angle did not aggravate aerodynamic disturbance around the osteomeatal complex. The contributing role of nasal septal deviation in the pathogenesis of chronic rhinosinusitis should not be emphasized in excess. Laryngoscope, 2012

To investigate the relationship between the maxillary sinus flow field, temperature field and the maxillary sinus ostium size, and to provide a reference for endoscopic surgery according to the maxillary sinus scope.One case of adult female CT image data was obtained, and used to build a three-dimensional model of nasal cavity and maxillary sinus. Computational fluid dynamics method was used to study the airflow and temperature of the maxillary sinus, as well as the physiological function of the maxillary sinus. Simulation surgery by means of different maxillary sinus diameters (normal, 8 mm, 10 mm, 12 mm and 15 mm) was used to describe the maxillary sinus airflow and temperature change.It was found that by numerical simulation the airflow of maxillary sinus and nasal cavity showed lower speed (average speed 0.062 m/s) than that in the middle nasal meatus (average speed of 3.260 m/s), and the average temperature in the normal maxillary sinus was 34°C, which was higher than that in the middle nasal meatus (temperature 28.7°C). With the increase of the diameter of the maxillary sinus, the air temperature change was not obvious.The physiological function of the maxillary sinus can be studied through the numerical simulation. With the increase of the ostia diameter of maxillary sinus, the sinus temperature and ventilation is not affected. It provides a reference for quantification of clinical endoscopic maxillary sinus surgery.

Our purpose is to simulate the airflow inside the healthy Chinese nose with normal nasal structure and function by computational fluid dynamics (CFD) method and to analyze the relationship between the airflow and physiological function. In this study, we used the software MIMICS 13.0 to construct 20 3-dimensional (3-D) models based on the computer tomography scans of Chinese adults' nose with normal nasal structure and function. Thereafter, numerical simulations were carried out using the software FLUENT 6.3. Then the characteristics of airflow inside the airway and sinuses were demonstrated qualitatively and quantitatively in steady state. We found that during the inhalation phase, the vortices and turbulences were located at anterior part and bottom of the nasal cavity. But there is no vortex in the whole nasal cavity during the expiratory phase. The distributions of pressure and wall shear stress are different in two phases. The maximum airflow velocity occurs around the plane of palatine velum during both inspiratory and expiratory phases. After the airflow passed the nasal valve, the peak velocity of inhaled airflow decreases and it increases again at the postnaris. Vice versa, the exhaled airflow decelerates after it passed the postnaris and it accelerates again at nasal valve. The data collected in this presentation validates the effectiveness of CFD simulation in the study of airflow in the nasal cavity. Nasal airflow is closely related to the structure and physiological functions of the nasal cavity. CFD may thus also be used to study nasal airflow changes resulting from abnormal nasal structure and nasal diseases.

Background Olfactory disorders are a common syndrome in the rhinology clinic. Olfactory event–related potential (OERP) has been considered as an important alternative method to evaluate olfactory function. The aim of this study was to find the consistency of OERP and the psychophysics olfactory test (T&T olfactometry assessment) in rhinosinusitis patients with or without nasal polyposis. Methods Both the psychophysics olfactory test and the OERP were performed in all patients before functional endoscopic sinus surgery (FESS). Detailed information including demographic, comorbidity, subjective symptoms, CT, and endoscopic examination were recorded. Six months later, the T&T test and OERP were reexamined in patients with preoperative identified OERP. Results Preoperative OERP was identified in 26 patients of the nonpolyp group and 12 patients of the polyp group. Good correlation existed between T&T scores and amplitude and latency of N1 and P2 in 26 nonpolyp patients (p < 0.05). No meaningful correlation was apparent in 12 polyp patients (p > 0.05). Significant correlation existed in 7 polyp patients with a free olfactory cleft (OC) according to CT (p < 0.05). The other 5 patients with partial OC obstruction were anosmic according to the psychophysics olfactory test; however, OERP was present. Six months later, T&T scores decreased significantly only in these five patients (p < 0.05). Significant correlation was obtained between postoperative T&T scores and OERP in both polyp and nonpolyp groups (p < 0.05). Conclusion OERP can be used to investigate olfactory function of rhinosinusitis patients. Nasal polyp obstruction in specific parts of the OC might influence the consistency between the psychophysics olfactory test and OERP.

The modified septoplasty with three tension lines resection is an effective and well-tolerated procedure, which can improve the objective and subjective outcomes, and provide a good approach that is applicable for various septal deviations, especially caudal deviation.According to the biomechanics of the septal deviation, a modified septoplasty with three high tension lines resection was redefined. The purpose of this study was to review the surgical technique and objective and subjective outcomes.A retrospective review was conducted to identify patients undergoing septoplasty between 2005 and 2006 at Beijing Tongren Hospital. The records were reviewed for demographic data, intraoperative technique, surgical indications, objective and subjective outcomes, and postoperative complications.A total of 54 patients were identified. The follow-up period ranged from 6 to 12 months. Indications for septoplasty included nasal obstruction (40.7%) and access (59.3%). The data showed that both the objective and subjective outcomes improved after septoplasty. Complications included transient dental pain/hypesthesia (5.6%), synechiae formation (7.4%), epistaxis (1.9%), septal hematoma (3.7%), asymptomatic septal perforation (0%), and nasal deformity (0%).

The mucosa compliance in lesions is determined by the congestion index, enabling us to determine whether the patient is sensitive to pharmacotherapy and to choose surgical management rationally.To explore the correlation between the nasal mucosa congestion index and tissue remodeling in chronic rhinosinusitis (CRS) and to provide objective evidence for clinical choice of therapeutic methods.Forty-four patients with CRS who underwent nasal endoscopic surgery were enrolled in the study. The congestion indexes of the nasal mucosa were measured using an acoustic rhinometer and specimens were taken from the uncinate process mucosa to evaluate vascular density and degree of fibrosis. The correlations were statistically analyzed.There was an inverse correlation between the congestion index and degree of fibrosis (r=- 0.522, p=0.00) and a direct correlation between the congestion index and vascular density (r=0.838, p=0.00) in nasal mucosa. There was a significant correlation between the congestion index and the combination of degree of fibrosis and vascular density with a determination coefficient (R(2)) of 0.778.

Objective: This study was designed to investigate the clinical microbiology of fungal ball (FB) rhinosinusitis by culturing fungal clumps collected under endoscopic surgery. Methods: From April to November of 2012, fungal clumps were sampled by endoscopic surgery from patients diagnosed with FB using clinical and histopathological methods. The specimens were subjected to smear microscopy, and cultured for bacteria and fungi analysis. Results: Out of the 81 specimens from 80 patients, 69 (69/81, 85.19%) specimens were detected a mixed infection of bacteria and fungi. However, only 25 (25/81, 30.86%) specimens resulted in fungal growth. There were 12 (12/81, 14.81%) specimens with fungal infections alone. The cultured fungi included 36 strains belonging to five genera, and most of them were Aspergillus spp. (30/36, 83.3%). The cultured bacteria included 94 strains belonging to 16 genera, and the most frequently seen was Staphylococcus spp. (23/94, 35.94%). When it was fungal and Pseudomonas aeruginosa mixed infection, the fungal growth was inhibited (P = 0.002). Conclusion: Patients with fungal ball usually have mixed fungal and bacterial infections. The fungi from these samples are sometimes difficult to culture, which may be the result of the inhibition by bacteria in vitro and in vivo.

This study determined the microbial composition in maxillary sinusitis and determined the predominant fungal and bacterial species. Samples were obtained from 11 patients with fungal sinusitis and 2 healthy patients. The 13 samples were sequenced using an Illumina Hi-Seq 2000, and mapping to the human, bacterial, and the fungal genomes were based on several steps. Bioinformatics and statistical analyses were then performed for bacterial and fungal expressions in the samples. All samples were cultures for fungal growth. The sequencing data revealed that Aspergillus flavus and Aspergillus oryzae were the dominant fungal strains in the rhinosinusitis samples, and Bacillus cereus and Bacillus thuringiensis were the dominant bacterial strains. Indeed, the fungi and bacteria were associated with the development of fungal rhinosinusitis. Furthermore, B. cereus and B. thuringiensis may cooperate with Pseudomonas aeruginosa to inhibit the growth of fungal mycelia. Knowledge of the microbial composition can provide a diagnostic reference for patients with maxillary sinusitis.

Background: Nasal surgeries have been applied to obstructive sleep apnea (OSA) patients with nasal obstruction for decades. However, the efficiency of nasal surgery in improving OSA remains controversial. The aim of this study was to identify whether isolated nasal surgery can improve apnea–hypopnea index (AHI). Methods: Computerized searches were performed in MEDLINE, Web of Science, Cochrane Library, and Scopus from January 1, 2000 to April 30, 2016. A total of 18 articles and 587 participants were included. There were 1 randomized controlled trials, 2 nonrandomized trials, 11 prospective studies, and 4 retrospective studies. Data regarding study design (prospective/retrospective clinical trial, randomized, and controlled), population size, participant characteristics (age, gender, and body mass index), surgical intervention, and outcomes (AHI, Epworth sleep scale [ESS]) was collected. Results: Statistically significant improvement in AHI (subgroup 1: weighted mean difference [WMD] [95%confidence interval (CI)], −4.17 [−7.62, −0.73]; subgroup 2: WMD [95%CI], −4.19 [−7.51, −0.88]; overall: WMD [95%CI], −4.15 [−6.48, −1.82]) and ESS (subgroup 1: WMD [95%CI], −2.14 [−3.08, −1.19]; subgroup 2: WMD [95%CI], −4.70 [−5.95, −3.44]; overall: WMD [95%CI], −4.08 [−5.27, −2.88]) was revealed. Conclusion: Both AHI and ESS improved significantly after isolated nasal surgery, but the improvement of AHI is slightly significant. Future randomized controlled trials are needed to confirm the long-term benefits of nasal surgery on OSA.

Aberrant epithelial repair has been observed in chronic rhinosinusitis (CRS) patients; however, the mechanism of epithelial cell repair regulation is unclear. Epidermal growth factor (EGF) plays an important role in regulating epithelial cell repair in lower airway and may be a critical factor in the remodeling processes of CRS. The objective of our research is to evaluate the differences between CRS and normal subjects and between chronic rhinosinusitis without nasal polys (CRSsNP) and chronic rhinosinusitis with nasal polys (CRSwNP) in the regulation of EGF pathways and the regulating proliferative position of classic Ras/Raf/MEK/ERK pathways.We evaluated the proliferation rates of ethmoidal mucosal cells before and after stimulation with EGF, epidermal growth factor receptor (EGFR) kinase inhibitor AG1478, and extracellular signal-regulated kinase 1/2 (ERK1/2) inhibitor PD98059 using MTT assays. We also analyzed the sinonasal epithelial cells collected from control subjects and patients with CRS subtypes CRSsNP and CRSwNP for the expression of ERK1/2, phosphorylated ERK1/2, P21, P15, and P27 using western blotting analyses.The proliferation rates of sinonasal epithelial cells before and after EGF stimulation were lower in CRS patients than in the controls. AG1478 or PD98059 inhibitor treatment of control epithelial cells did not result in a significant difference in proliferation. Although, AG1478 and PD98059 inhibited the proliferation of CRS cells, the degree of proliferation inhibition was markedly different in CRSsNP. AG1478 suppressed the proliferation of CRSwNP epithelial cells, whereas PD98059 had no effect. The ratio of ERK1/2 phosphorylation in CRS cells was lower than that of the control cells. Cyclin-dependent kinase inhibitors were highly expressed in CRS cells compared with that of control cells. ERK1/2 and P27 showed differential expression in CRSsNP and CRSwNP.Differences existed in EGF pathways in CRS patients and normal subjects as well as in CRSsNP and CRSwNP. Classical Ras/Raf/MEK/ERK pathway may assume absolute superiority in control cells. Ras/Raf/MEK/ERK classical pathway and other pathways might be active at the same time to stimulate epithelial cell proliferation in CRSsNP. The function of Ras/Raf/MEK/ERK classical pathway was weaker in CRSwNP than in CRSsNP and when the classical pathway was blocked in CRSwNP, some other pathway could have completely compensated the proliferation induced by the Ras/Raf/MEK/ERK pathway.

Epithelial barrier dysfunction is involved in the pathogenesis of allergic disorders, such as nasal allergy. TWIK-related K(+) 1 (Trek1) potassium channels are required in the maintenance of the epithelial barrier function. This study aims to investigate the role of antigen-specific immunotherapy (SIT) in the regulation of Trek1 expression in the nasal mucosa. In this study, patients with nasal allergy were treated with SIT and/or Clostridium butyricum. The expression of Trek1 and histone demethylase 1 (HDAC1) in the nasal epithelia was assessed by real-time reverse transcription polymerase chain reaction and Western blotting. Serum cytokines were assessed by enzyme-linked immunosorbent assay. The results showed that Trek1 and HDAC1 were detected in the nasal epithelia. Trek1 was lower, whereas HDAC1 was higher in patients with allergic rhinitis as compared with healthy controls. Trek1-null RPMI2650 monolayers showed a markedly compromised epithelial barrier function. Treatment with SIT significantly increased the Trek1 levels in the nasal epithelia of allergic rhinitis patients that were further improved in conjunction of SIT and administration of probiotic C. butyricum. In conclusion, nasal epithelia express Trek1 that can be suppressed by allergic response. SIT can restore the expression of Trek1 in the nasal epithelia and can be further improved by conjunction with administration of C. butyricum.

Computational fluid dynamics (CFD) methods can provide detailed information on airflow characteristics in models of septal deviation. Different locations of septal deviation lead to variation of nasal airflow. Both the location of the septal deviation and the inferior turbinate hypertrophy in the concave side may play an important role in airflow patterns and airflow velocity.To investigate the airflow patterns and air velocity in different septal deviation models during inspiration, using CFD methods.Commercial software was used to construct three-dimensional (3D) models of nasal cavities with paranasal sinuses from the computed tomography (CT) scans of 15 patients with septal deviation and 4 controls. Considering the location of the most prominent point of the nasal septum, patients were classified into caudal, anterior, and media deviation groups.Unlike airflow in the controls, airflow in the septal deviation models showed asymmetry in bilateral nasal cavities. The airflow patterns varied in the convex and concave sides in different septal deviation models. Caudal septal deviation models had the maximal peak velocity, while the the minimal peak velocity was found in the media deviation models. The peak velocity was not always located in the convex side, but was sometimes in the concave side.

Analyzing the prognostic factors in endoscopic surgery of juvenile nasopharyngeal angiofibromas (JNA).Forty-seven records of JNA, treated with the endoscopic, from 2002 to 2008 were reviewed retrospectively. Previous surgery in other hospitals, sites involved, whether selective embolization was performed before surgery, feeding vessels, operative techniques and follow-up results were recorded. Evaluated factors include previous surgery for resection of JNA, vascular supply from carotid artery, surgery after selective embolization, involvement of cavernous bone in the root of pterygoid process, greater wing of sphenoid bone, interpterygoid fossa, infratemporal fossa and orbit. Chi-square test was used.Operations were done under general anesthesia. The follow-up time was 12 to 87 month (median 35 month). During follow up, six patients presented recurrent lesions. Chi-square test showed that deep invasion of the cavernous bone in the root of pterygoid process was related to recurrence (P0.05). There was no statistically significant difference between other factors and recurrence. Imaging examination showed that recurrent tumor was around the root of pterygoid process.Deep invasion of the cavernous bone in the root of pterygoid process which was related to recurrence deserve close attention before and after endoscopic surgery.

To evaluate effects of septoplasty on bilateral nasal cavities with acoustic rhinometry and rhinomanometry objectively.Twenty-two patients who underwent septoplasty were examined with rhinomanometry and acoustic rhinometry before and 6 to 12 months after surgery. Of the 22 patients, 1 patient whose rhinomanometry and acoustic rhinometry datum were not available for the bilateral nasal obstruction, 3 patients with bilateral turbinectomy and 2 patients with unilateral turbinectomy wide nasal cavities were excluded. Finally, 18 narrow side nasal cavities and 16 wide side nasal cavities were analyzed.Rhinomanometry: nasal resistance on the deviation side decreased significantly (P0.05), whereas on the contralateral side decreased slightly (P0.05). Acoustic Rhinometry: the predecongestion nasal minimal cross-sectional area (NMCA) and 0-5 cm NCV on the deviation side increased significantly due to the operation (P0.01). The corresponding postdecongestion increased were the same. Whereas on the contralateral side NMCA decreased and 0-5 cm NCV increased slightly before decongestion and after decongestion (P0.05). Only slight median increases were noted in the bilateral assessment postoperatively in NCV (P0.05) before and (P0.05) after decongestion.The nasal patency on the deviation side is undoubtedly increased after septoplasty, and the airway on the wide side is not worsened after the operation.

To investigate the character of damaged vestibular hair cells caused by gentamycin, and to identify whether apoptosis and phosphorylation of JNK occurs in the damaged cells.Healthy guinea pigs were divided into experimental group and control group randomly with 15 in each group, animals in experimental and control group received systemic injection of gentamycin [100 mg/(kg x d)] and saline respectively for 7 consequent days. All the animals were sacrificed on the 8th day, the crista vestibular of each were observed by preparation and frozen dissection. The apoptosis of hair cell were detected by TUNEL method and phosphorylation of JNK were detected by immunochemistry.The lesion and apoptosis of hair cells could be seen in the experimental group,and the phosphorylation could be observed too; the hair cells of control group showed no sign of apoptosis or phosphorylation of JNK.Gentamycin cause vestibular hair lesion by inducing apoptosis and activation of JNK plays an important role in the procedure of apoptosis.