Search

Background: Computed tomography (CT) is the gold standard for diagnosing canine nasal diseases. However, it cannot easily detect minor abnormalities in inflammatory diseases because they are not accompanied by obvious morphological changes., Aim: The present study aimed to compare the differences in normal CT findings of turbinate structure and mucosa between breeds to establish criteria for CT diagnosis of inflammatory diseases of the nasal cavity., Methods: CT data from 77 dogs of 5 breeds without nasal diseases were retrospectively studied. The nasal air percentage, which reflects the volume of the nasal turbinate structure and mucosa, was measured. The nasal turbinate mucosa was measured for contrast enhancement reflecting blood flow. Measurements were performed in the ventral and ethmoid turbinate (ET) regions. Comparisons were made between breeds and sections., Results: The air percentage in the ventral and ET regions was significantly different between breeds. Contrast enhancement was significantly different between breeds only in the ET. Moreover, different breeds had different correlations between body weight, age, nose length, and air percentage., Conclusion: In this study, reference values for normal CT findings of the nasal structure and mucosa were obtained, taking into account the breed, measurement section, and patient factors. The results showed that the volume of the turbinate structure and contrast enhancement of nasal mucosa differed depending on the breed. The measured values also differed depending on the cross-sections and patient factors., Competing Interests: The authors declare that there are no conflicts of interest.

Objective: The aim of this study was to examine the distribution of olfactory filaments (OFs) in the nasal mucosa to facilitate preservation of olfactory function in endonasal approaches and preparation of a nasoseptal flap., Methods: One formalin-fixed and 9 fresh cadaveric silicone-injected specimens with 20 total sides were studied to measure the distance of the OFs to the anatomical landmarks and compare the OF presence in the nasal septum mucosa (NSM) and ethmoidal mucosa (EM)., Results: The mean distance from the first to the last OF was 19.37 ± 2.16 mm in the NSM and 23.44 ± 5.42 mm in the EM. The NSM had a mean of 7.55 ± 1.31 OFs and the EM had 14.3 ± 1.78. Average OF lengths were measured at 6.44 ± 1.48 (range 3.75-12.40) mm in the NSM and 8.05 ± 1.76 (range 4.14-13.20) mm in the EM. The mean values of the EM measurements were compared with those of the NSM; the number of OFs, the distance between the first and last OF, the average OF length, and the number of OFs between anterior and posterior ethmoidal arteries in the NSM were significantly less (p < 0.05) than those in the EM. The distance between the first OF to the nasal bone on the NSM was greater than on the EM., Conclusions: Compared with the EM, the OFs are significantly fewer in number and smaller in size in the NSM. The uppermost edge of the nasoseptal flap incision in the NSM might be safer to start below 12 mm from the cribriform plate for OF protection.

Our knowledge of nasal cavity anatomy has grown considerably with the advent of micro-computed tomography (CT). More recently, a technique called diffusible iodine-based contrast-enhanced CT (diceCT) has rendered it possible to study nasal soft tissues. Using diceCT and histology, we aim to (a) explore the utility of these techniques for inferring the presence of venous sinuses that typify respiratory mucosa and (b) inquire whether distribution of vascular mucosa may relate to specialization for derived functions of the nasal cavity (i.e., nasal-emission of echolocation sounds) in bats. Matching histology and diceCT data indicate that diceCT can detect venous sinuses as either darkened, "empty" spaces, or radio-opaque islands when blood cells are present. Thus, we show that diceCT provides reliable information on vascular distribution in the mucosa of the nasal airways. Among the bats studied, a nonecholocating pteropodid (Cynopterus sphinx) and an oral-emitter of echolocation sounds (Eptesicus fuscus) possess venous sinus networks that drain into the sphenopalatine vein rostral to the nasopharynx. In contrast, nasopharyngeal passageways of nasal-emitting hipposiderids are notably packed with venous sinuses. The mucosae of the nasopharyngeal passageways are far less vascular in nasal-emitting phyllostomids, in which vascular mucosae are more widely distributed in the nasal cavity, and in some nectar-feeding species, a particularly large venous sinus is adjacent to the vomeronasal organ. Therefore, we do not find a common pattern of venous sinus distribution associated with nasal emission of sounds in phyllostomids and hipposiderids. Instead, vascular mucosa is more likely critical for air-conditioning and sometimes vomeronasal function in all bats., (© 2021 American Association for Anatomy.)

Objectives/hypothesis: The objective of this radiological/anatomical study was to evaluate the feasibility of a new endoscopic technique that uses the anterior pedicled lateral nasal flap (APLNW) for the endonasal lining in complex nasal reconstructions., Study Design: An anatomical study was performed on 20 nasal fossae of cadaverous specimens to measure the area and lengths of the anterior pedicled nasal lateral wall flap. In addition, a radiological analysis with computed tomography was performed in 150 nostrils to determine the potential donor of the simple and extended flap in the nasal fossa floor. Complex nasal reconstruction with nasofrontal flap and internal lining using the lateral wall pedicled flap was performed in 3 patients., Results: Complete reconstruction for the inner lining of the nasal tip and lateral nasal wall was achieved in the cadaveric study (10 specimens). The surface areas of the simple and extended APLNW flaps were 7.53 (standard deviation [SD] 1.25) cm 2 and 24.6 (SD 3.14) cm 2 , respectively. Using computed tomography scans, we determined that to reconstruct defects secondary to full-thickness nasal defects, the APLNW flap surface for the simple and extended versions was 7.90 (SD 1.68) cm 2 and 23.64 (SD 4.7) cm 2 . We present one case were the APLNW flap was used., Conclusions: The simple or expanded APLNW flap represents a feasible option to reconstruct the internal lining in complex nasal reconstruction., Level of Evidence: NA Laryngoscope, 131:E1462-E1467, 2021., (© 2020 American Laryngological, Rhinological and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)

Background: Horses may acquire a range of paranasal sinus diseases. Clinical studies show slight differences regarding anatomical regions and age. Histopathological examination of tissue samples could play an important role in the diagnostic process. Therefore, detailed knowledge of the histological appearance of the paranasal sinus mucosa (PSM) and the nasomaxillary aperture mucosa (NAM) is essential. The objective of this study was to determine topographic and age-related differences within the healthy equine PSM. In addition, we aimed to gain detailed knowledge of the histological appearance of the NAM in comparison to the PSM., Results: The PSM had an average height of 75.72 ± 44.48 μm with a two-row pseudostratified columnar epithelium of 13.52 ± 4.78 μm. The parameters mucosal height, epithelial height and number of goblet cells revealed significant dependency of the sample site and age group. The maxillary and dorsal conchal sinus showed the highest values for these parameters. In terms of age, younger horses showed a significantly higher total mucosal height in contrast to a significantly lower epithelial height than older horses. Positive correlation was seen between the epithelial height and number of goblet cells. The NAM had an average height of 820.27 ± 653.21 μm. Its pseudostratified epithelium was usually arranged in three rows and had an average height of 44.9 ± 12.78 μm. The number of goblet cells in the NAM was five times higher than in the PSM. Serous glands were found in only 4% of the PSM samples and 100% of the NAM samples., Conclusions: There are significant histological differences between different paranasal sinus sites and between different groups of age. This may be related to an altered susceptibility for certain pathologies. The striking difference in the histological appearance of the NAM compared to the PSM could be due to an enhanced role in mucociliary clearance. Further studies are necessary to improve the understanding of mucosal function in specific paranasal sinus compartments and mucosal changes generated by different diseases.

Background: To assess the change of the Schneider membrane thickness measured by CBCT before and after root canal treatment, retreatment and pulp capping procedures., Methods: This retrospective study was conducted on CBCT scans of a patient population of Guy's Hospital NHS Foundation Trust, London. Three groups of patients were studied: Group 1 consisted of patients referred for primary endodontic treatment; Group 2 for endodontic retreatment; Group 3 for indirect pulp capping procedures (serving as a control group). Follow up scans were carried out 1 year after treatment. Measurements were carried out on CBCT scans and data were analysed statistically by Wilcoxon Signed Rank Test. Linear regression was used to assess predictive parameters for membrane thickness., Results: A statistically significant reduction of the Schneider membrane thickness was observed one year after endodontic treatment and retreatment (P < 0.05) but no significant reduction was observed after pulp capping procedures. Linear regression showed that age and gender were significant predictors influencing the Schneider membrane thickness., Conclusions: Within the limitations of this retrospective study, following root canal treatment and re-treatment a Schneiderian membrane thickness reduction occurred at 1-year follow-up. The removal of odontogenic infection following endodontic treatment may help reducing the thickness of the Schneider membrane.

Objective: To evaluate the colour values of nasal mucosa for the purpose of presenting an objective parameter of allergic rhinitis., Methods: Seventy-three patients with allergic rhinitis (allergy group) and 73 normal healthy individuals (control group) were included in the study. Endoscopic examinations were conducted, and endoscopic photographs of the septum and both inferior turbinates were taken. The Adobe Photoshop Elements 7.0 software program was used to measure the numerical values of red-green-blue (RGB) colour components in the endoscopic photographs of nasal mucosa., Results: The G and B values were significantly higher in the allergy group compared to the control group (both p < 0.05). Cumulative R, G and B values of all measurement points were significantly higher in the allergy group compared to the control group (p < 0.05)., Conclusion: Nasal mucosa discolouration can be measured objectively with RGB analysis to aid the diagnosis of allergic rhinitis.

The aim of the present study was to fabricate a thermosensitive gel containing chlorpheniramine maleate (CPM)-loaded nanoparticles following intranasal administration for effective treatment of allergic rhinitis. Chitosan-based nanoparticles were prepared by a precipitation method followed by the addition of developed NPs within the poloxamer 407- and carbopol 934P-based mucoadhesive thermoreversible gel. Developed formulations were evaluated for particle size, PDI, % entrapment efficiency, and % cumulative drug permeation. NP3 formulation was found to be optimized on the basis of minimum particle size (143.9 nm), maximum entrapment efficiency (80.10 ± 0.414%), and highest drug permeation (90.92 ± 0.531%). The optimized formulation NP3 was then formulated into thermoreversible in situ gel. This intensifies the contact between the nasal mucosa and the drug and increases and facilitates the drug absorption which results in increased bioavailability. G4 formulation was selected as the optimized formulation on the basis of gelation ability and mucoadhesive strength. Histology was carried out to examine the damage caused by the optimized G4 formulation. Results revealed no visual signs of tissue damage thus indicated safe nasal delivery of nanoparticulate in situ gel formulation G4. Thus, intranasal CPM NP-loaded in situ gel was found to be a promising formulation for the management of allergic rhinitis.

Purpose: To provide a review of the anatomy of the lacrimal drainage system and lateral wall of the nose pertaining to endoscopic dacryocystorhinostomy., Methods: The authors performed a PubMed search of articles published pertaining to the anatomy of the lateral wall of the nose and the anatomy of endonasal and external dacryocystorhinostomy surgery., Results: The article covers the regional surface and surgical anatomy for endoscopic dacryocystorhinostomy (DCR), including the maxillary line, middle turbinate, agger nasi air cell, lacrimal sac and fossa and the upper portion of the nasolacrimal drainage system. It also explores the dimensions and location of bony ostium formation to ensure full exposure and marsupialisation of the lacrimal sac. Finally, it covers the anatomy of potential complications of endoscopic DCR surgery including penetration of the skull base and orbit, inadvertent entry to the maxillary sinus and breach of the skin., Conclusion: A good understanding of the anatomy of the lacrimal drainage system and the lateral wall of the nose will increase the likelihood of successful surgery and minimize the risk of complications and damage to neighbouring structures such as the orbit and skull base., (Crown Copyright © 2019. Published by Elsevier GmbH. All rights reserved.)

Cerebrospinal fluid (CSF) flows through the brain, transporting chemical signals and removing waste. CSF production in the brain is balanced by a constant outflow of CSF, the anatomical basis of which is poorly understood. Here, we characterized the anatomy and physiological function of the CSF outflow pathway along the olfactory sensory nerves through the cribriform plate, and into the nasal epithelia. Chemical ablation of olfactory sensory nerves greatly reduced outflow of CSF through the cribriform plate. The reduction in CSF outflow did not cause an increase in intracranial pressure (ICP), consistent with an alteration in the pattern of CSF drainage or production. Our results suggest that damage to olfactory sensory neurons (such as from air pollution) could contribute to altered CSF turnover and flow, providing a potential mechanism for neurological diseases., Competing Interests: JN, QZ, DC, AC, TR, PD No competing interests declared, (© 2019, Norwood et al.)

Originally discovered in elasmobranchs by Fritsh in 1878, the nervus terminalis has been found in virtually all species, including humans. After more than one-century debate on its nomenclature, it is nowadays recognized as cranial pair zero. The nerve mostly originates in the olfactory placode, although neural crest contribution has been also proposed. Developmentally, the nervus terminalis is clearly observed in human embryos; subsequently, during the fetal period loses some of its ganglion cells, and it is less recognizable in adults. Fibers originating in the nasal cavity passes into the cranium through the middle area of the cribiform plate of the ethmoid bone. Intracranially, fibers joint the telencephalon at several sites including the olfactory trigone and the primordium of the hippocampus to reach preoptic and precommissural regions. The nervus terminalis shows ganglion cells, that sometimes form clusters, normally one or two located at the base of the crista galli, the so-called ganglion of the nervus terminalis. Its function is uncertain. It has been described that its fibers facilitates migration of luteinizing hormone-releasing hormone cells to the hypothalamus thus participating in the development of the hypothalamic-gonadal axis, which alteration may provoke Kallmann's syndrome in humans. This review summarizes current knowledge on this structure, incorporating original illustrations of the nerve at different developmental stages, and focuses on its anatomical and clinical relevance. Anat Rec, 302:394-404, 2019. © 2018 Wiley Periodicals, Inc., (© 2018 Wiley Periodicals, Inc.)

Background: Intersubject variability in nasal deposition of inhaled aerosol is significant because of the differences in nasal anatomy and breathing rate. The notable limitation of the majority of previously developed predictive correlations is including a limited number of subjects. A few recent studies have considered a wide age range of subjects, but the resulting correlations require the knowledge of the dimensions of the nasal airways and the properties of inhaled gas. In this study empirical correlations are proposed to predict aerosol deposition in nasal airways of subjects of different age as a function of intranasal pressure drop and the particle aerodynamic diameter., Methods: The experimental nasal deposition and pressure drop data in anatomically correct nasal replicas of 5 adults, 13 children aged 4-14 years, and 11 infants aged 3-18 months were reanalyzed. The range of aerodynamic diameter was 0.5-5.3 μm and physiological breathing at different activity levels was considered. Correlations between nasal deposition and a deposition parameter including the aerodynamic size of inhaled aerosol and nasal pressure drop were developed with nonlinear least-square algorithms. The general coefficient of determination r 2 was used to evaluate the fitting accuracy for each correlation., Results: New correlations were developed to predict the intranasal deposition of particles as a function of intranasal pressure drop and particle size for pediatric and adult subjects. The intranasal deposition fraction in adults and children can be calculated using the same correlation, whereas the intranasal deposition in infants followed a different trend line because of higher intranasal pressure drop in infants., Conclusion: This study was the first offering correlations to predict intranasal deposition in multiple age groups using only the aerodynamic size of inhaled aerosol and nasal pressure drop. These correlations include the effects of intersubject variability in nasal deposition within each age group and among different age groups.

Objective: To endoscopically determine the incidence of Schneiderian membrane perforation during transcrestal maxillary sinus floor elevation (SFE), in relation to the bone preparation technique, amount of bone graft, membrane elevation height and different surgical steps., Materials and Methods: Seven cadaver heads corresponding to 12 maxillary sinuses were used to perform three SFE via transcrestal approach per sinus (36 elevations). Each sinus was randomly assigned to either the Sinus Crestal Approach (SCA) drill kit technique (experimental group) or the conventional osteotome technique (control group). During all phases of the surgery, the integrity of the sinus membrane was monitored through endoscopic examination., Results: A significant difference was found in the incidence of perforation (p = 0.007) and vertical elevation height (p < 0.001) between the study groups, favoring the experimental group. A safety elevation threshold of 5 mm without bone graft and implant placement was estimated. A significant correlation was observed between the residual ridge height and the incidence of perforation (p < 0.001; OR = 0.51)., Conclusion: The SCA drill kit may demonstrate superior osteotomy preparation and membrane elevation capabilities to the osteotome technique, and significantly when a 6-mm SFE is indicated. Residual ridge height and vertical elevation height are risk determinant factors., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The aim of this study was to evaluate thickening of the Schneiderian membrane and to determine its association with periapical pathologies, using computerized cone beam tomography. An observational, analytical, cross-sectional retrospective study was conducted. A total 179 maxillary sinuses were evaluated using CBCT. The presence of sinus membrane thickening and its association with unhealthy teeth was analyzed. Results are shown as percentages with 95% confidence intervals (95%CI); Chi square test was used with a significance level of 5%.Sinus membrane thickening was detected in 70 cases (39%; 95%CI=32% to 46%) and no sinus membrane thickening was observed in 109 (61%; 95%CI = 54% to 68%) (p<0.05). The 70 cases showing sinus membrane thickening included 46 of odontogenic origin (66%; 95%CI = 54% to 76%) and 24 (34%; 95%CI = 24% to 46%) of non odontogenic origin (p<0.05). The frequency of odontogenic causes followed a heterogeneous distribution (p<0.05): penetrating caries, failing endodontic therapy, root remnants, deep restorations, implants, periodontal pathology. The main cause was caries (46%; 95%CI=32% to 60%) followed by failing endodontic therapy (26%, 95% CI=16% to 40%). The frequency distribution of involved teeth was uneven (p<0.05), with tooth 16 (33%; 95%CI=21% to 47%) being the most frequently involved, followed by tooth 26 (30%; 95%CI=19% to 45%).The high incidence of sinus pathology of odontogenic origin shows the need for interdisciplinary work involving dentists and ear-nose-throat specialists. Caries, inadequate restorations, periodontal lesions, implants, and the presence of root remnants are the main causes of Schneiderian membrane thickening. The use of CBCT for diagnosis and treatment planning allows detecting maxillary sinus membrane thickening and determining its association with an odontogenic etiology., (Sociedad Argentina de Investigación Odontológica.)

In order to search for new approaches to treat glioma, intranasal administration has been proposed as an alternative route to deliver drugs into the brain. Among the drug alternatives, kaempferol (KPF) has been reported to induce glioma cell death. This study aimed to prepare nanoemulsions containing KPF with and without chitosan to investigate their potential for brain delivery following intranasal administration, and to evaluate their antitumor activity against glioma cells. KPF-loaded nanoemulsion (KPF-NE) and KPF-loaded mucoadhesive nanoemulsion (KPF-MNE) were prepared by high-pressure homogenization technique and were characterized for their globule size, zeta potential, drug content, pH, viscosity, mucoadhesive strength and morphology. KPF from KPF-MNE showed significantly higher permeation across the mucosa in ex vivo diffusion studies. Histopathological examination suggests both nanoemulsions to be safe for the nasal mucosa and able to preserve KPF antioxidant capability. KPF-MNE enhanced significantly the amount of drug into rat's brain following intranasal administration (5- and 4.5-fold higher than free drug and KPF-NE, respectively). In addition, KPF-MNE reduced C6 glioma cell viability through induction of apoptosis to a greater extent than either free KPF or KPF-NE. The mucoadhesive nanoemulsion developed for intranasal administration may be a promising system for delivery to the brain, and KPF-MNE is a candidate for further antiglioma trials., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objectives: It has been speculated that certain Schneiderian membrane thickness (SMT) might be more prone to perforation. This investigation was aimed at studying the mechanical characteristics of the Schneiderian membrane under one- and two-dimensional tests and their correlation to the histological SMT in human samples., Material and Methods: Sixteen Schneiderian membranes were collected from 11 cadaver heads treated with Thiel's embalming method. The samples were processed and analyzed clinically and histologically. One-dimensional maximum elongation until perforation and two-dimensional resistance to ball penetration were performed after the biopsy. Data was analyzed by using the Wilcoxon rank test and the Spearman's rank correlation., Results: The histological SMT was 1.36 ± 0.42 mm, whereas the clinical thickness was 0.27 ± 0.21 mm, yielding statistical significance (p = 0.000). The resistance under ball penetration was 0.59 ± 0.43 N and the mean maximum elongation in the one-dimension test 11.19 ± 7.14 mm. Expressed in percentage, the mean stretch was 241.36 ± 227.97% (range 31.5 up to 947%). A weak positive correlation was found between the ball penetration test and the SMT (r = 0.10, p = 0.711), while a weak negative correlation was found between stretching test and the SMT (r = -0.021, p = 0.94)., Conclusions: Mechanical tests seem to indicate that SMT might not significantly predispose to Schneiderian membrane perforation. Hence, other anatomical and operator's factors should be considered of surpassing importance., Clinical Relevance: Thinner SM might be more prone to perforation when detaching it from the maxillary sinus antrum; however, a thick membrane is not prevented to tear, as their resistance under elastic forces is not higher than thinner ones.

The distributions of β-defensin 1 and 2 in secretory host defense system throughout respiratory tract of healthy rats were immunohistochemically investigated. In the nasal epithelium, a large number of non-ciliated and non-microvillous cells (NCs) were immunopositive for both β-defensin 1 and 2, whereas a small number of goblet cells (GCs) were immunopositive only for β-defensin 1. Beta-defensin 2-immunopositive GCs were few. In the nasal glands, a small number of acinar cells and a large number of ductal epithelial cells were immunopositive for both β-defensins. In the laryngeal and tracheal epithelia, a very few NCs and GCs were immunopositive for both β-defensins. In laryngeal and tracheal glands, a very few acinar cells and a large number of ductal epithelial cells were immunopositive for both β-defensins. In the extra-pulmonary bronchus, a small number of NCs were immunopositive for both β-defensins. A small number of GCs were immunopositive for β-defensin 1, whereas few GCs were immunopositive for β-defensin 2. From the intra-pulmonary bronchus to alveoli, a very few or no epithelial cells were immunopositive for both β-defensins. In the mucus and periciliary layers, β-defensin 1 was detected from the nose to the extra-pulmonary bronchus, whereas β-defensin 2 was weakly detected only in the nose and the larynx. These findings suggest that the secretory sources of β-defensin 1 and 2 are mainly distributed in the nasal mucosa and gradually decrease toward the caudal airway in healthy rats.

Background: Historical reports describe the sphenopalatine ganglion (SPG) as positioned directly under the nasal mucosa. This is the basis for the topical intranasal administration of local anaesthetic (LA) towards the sphenopalatine foramen (SPF) which is hypothesized to diffuse a distance as short as 1 mm. Nonetheless, the SPG is located in the sphenopalatine fossa, encapsulated in connective tissue, surrounded by fat tissue and separated from the nasal cavity by a bony wall. The sphenopalatine fossa communicates with the nasal cavity through the SPF, which contains neurovascular structures packed with connective tissue and is covered by mucosa in the nasal cavity. Endoscopically the SPF does not appear open. It has hitherto not been demonstrated that LA reaches the SPG using this approach., Methods: Our group has previously identified the SPG on 3 T-MRI images merged with CT. This enabled us to measure the distance from the SPG to the nasal mucosa covering the SPF in 20 Caucasian subjects on both sides (n = 40 ganglia). This distance was measured by two physicians. Interobserver variability was evaluated using the intraclass correlation coefficient (ICC)., Results: The mean distance from the SPG to the closest point of the nasal cavity directly over the mucosa covering the SPF was 6.77 mm (SD 1.75; range, 4.00-11.60). The interobserver variability was excellent (ICC 0.978; 95% CI: 0.939-0.990, p < 0.001)., Conclusions: The distance between the SPG and nasal mucosa over the SPF is longer than previously assumed. These results challenge the assumption that the intranasal topical application of LA close to the SPF can passively diffuse to the SPG.

Objective: The aim of this retrospective study was to measure the sinus membrane's dimensional changes following maxillary sinus augmentation via a lateral approach, and to examine the variables affecting changes in the membrane's thickness., Method and Materials: Sixty-six sinuses corresponding to 50 patients (15 males and 35 females) who underwent lateral wall maxillary sinus augmentation (34 unilateral and 16 bilateral) were retrospectively evaluated. The sinus membrane thickness was measured on cross-sectional cone beam computed tomography (CBCT) scans which were performed prior to and 9 to 11 months' post maxillary sinus augmentation. The Wilcoxon signed-rank test and the Mann Whitney U test were both used to compare between baseline and postoperative sinus membrane thickness. Pearson correlation tests were used to analyze correlations between graft height and sinus membrane thickness changes., Results: The mean age was 53 ± 4 years (45 to 71 years). A total of 132 CBCT scans were analyzed pre- and postoperatively (n = 66). The mean thickness of the sinus membrane before the procedure was 2.61 ± 3.61 mm, while the mean thickness of the membrane after the procedure was 2.94 ± 3.51 (P > .20). Thin membranes at baseline (< 1.56 mm) thickened by a mean of 2.21 ± 2.34 mm, range -0.413 to 10.62 mm, (P < .0001); thicker membranes (≥ 1.56 mm) lost 1.46 ± 3.96 mm thickness, range -7.8 to 9.31 mm (P < .0001). A moderate negative correlation between the baseline membrane thickness and change in thickness was observed (P < .0001, r = -.52). No correlation was found between the graft height and changes in the sinus membrane thickness., Conclusion: Lateral wall maxillary sinus augmentation seems to affect the sinus membrane thickness. These changes are associated with the preoperative thickness of the membrane.

Purpose: Sinus membrane thickness has been associated with the incidence of membrane perforation during the sinus elevation procedure. Understanding the sinus membrane thickness is essential for prevention of this specific surgical complication. Therefore, the aim of this retrospective study was to investigate the impact of sex, age, and season on the membrane thickness., Materials and Methods: The charts of 144 healthy patients were included in the study. Cone beam computed tomography (CBCT) images from these patients were analyzed to determine the sinus membrane thickness in the coronal and sagittal views. Sex, age, and season were correlated with the membrane thickness., Results: The mean thickness of the sinus membrane was 1.81 ± 1.66 mm (range: 0.47 to 9.49 mm). In 22.12% of the CBCT images, the sinus membrane was not visible. Membrane thickness of less than 2 mm was found in 70.8% of the cases. Age was found to be strongly correlated (P < .05) with sinus membrane thickness but not sex or season., Conclusion: Based on CBCT assessment, age was found to be a factor influencing sinus membrane thickness but not sex or season.

The aim of this study was to evaluate the effectiveness of platelet-rich fibrin (PRF) in repairing of Schneiderian membrane perforations in rabbit maxillary sinus. A total of 42 female New Zealand rabbits were randomly divided into two groups. Symmetrical bony defects were created 1 cm in diameter and the sinus membranes were exposed. The Schneiderian membranes were elevated in both sinuses and each membrane was perforated with a 1 cm incision. No treatment was applied to the right perforations in both groups. Left-sided perforations were closed with collagen membrane in the first group and PRF membrane in the other group. Seven animals randomly selected from each group were sacrificed at weeks 1, 2 and 4 in order to be able to examine the amounts of lymphocytes, fibroblasts, veins, and collagen fibers in the area where the membranes were applied. Histological analyses showed that there were no statistically significant differences between the collagen membrane and the PRF membrane in the healing of sinus perforation area. PRF may be considered as an alternative application to collagen membrane in sinus membrane perforations., (Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

The objective of this study was to comparatively evaluate 3 different sinus lift tools, namely umbrella-shaped sinus lift curette YSL-04, our recently designed probe-improved sinus lift curettes, and our newly invented elevator 014, using our previous developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time. Goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time were generated according to our previously developed protocol. The effectiveness for each tool was evaluated through the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions. The results showed that all 3 sinus lift tools could transcrestally detach the maxillary sinus mucosa and create extra space under the elevated sinus floor on the goat ex vivo sinus models. Moreover, our newly invented elevator 014 had advantages over the other 2 in term of the capability to detach the sinus mucosa. Our newly invented elevator 014 might be a promising tool for detaching maxillary sinus mucosa in transcrestal maxillary sinus floor elevation.

Background: Association between Schneiderian membrane thickness and membrane perforation is examined in lateral window sinus augmentation., Methods: This retrospective study reviewed records of 551 patients who underwent lateral sinus augmentation at Tufts University School of Dental Medicine, Boston, Massachusetts, from June 1, 2006 to May 31, 2015. Preoperative cone-beam computed tomography images were analyzed to evaluate possible association among membrane thickness, residual bone height, and membrane perforation. Data were evaluated using Mann-Whitney U test at P <0.05., Results: Total 167 patients (95 males and 72 females) met the eligibility criteria and were included in the study. Among them, 47 patients had Schneiderian membrane perforation (perforation group). Mean membrane thickness was 0.84 ± 0.67 mm in the perforation group and 2.65 ± 4.02 mm in the non-perforation group. There was a statistically significant difference in membrane thickness between groups (P <0.001). Mean residual ridge thickness was 2.78 ± 1.37 mm in the perforation group and 4.21 ± 2.09 mm in the non-perforation group. There was a statistically significant difference in residual alveolar bone height (P <0.001)., Conclusions: Patients who experienced membrane perforation had a thinner membrane compared with patients without membrane perforation. Schneiderian membrane perforation was associated with decreased residual bone height.

Objectives: Cone-beam computed tomography (CBCT) has been used in the literature to evaluate Schneiderian membrane thickness (SMT), but its accuracy has never been validated. The primary aim of this study was to compare the SMT measured by CBCT to the gold standard histological assessment. The correlations between SMT and anatomical structures of the maxillary sinus and alveolar bone were also tested., Materials and Methods: Fourteen fresh cadaver heads were used for the study, and 28 sinus lift augmentation procedures were performed to obtain the membrane samples. Samples were fixed in formalin and stained with hematoxylin-eosine and Masson trichrome. Specimens were measured by optic microscope at three points, and a mean was obtained. Anatomical landmarks were used to accurately position the CBCT slice, so the SMT could be measured in predetermined locations. Wilcoxon signed-rank test was used to compare values of histological and CBCT measurements, and Spearman's correlation coefficient was calculated to examine the relationship between thickness and anatomical parameters., Results: A total of 597 histological measurements were performed, and the mean SMT thickness was 0.30 ± 0.17 mm. The mean CBCT membrane thickness was 0.79 ± 0.52 mm. A statistically significant difference from histological and radiological readings was observed (P = 0.000). Interestingly, 87.77% histological measurements had membrane less than 0.5 mm in thickness compared to 26.66% in CBCT assessment., Conclusions: Within the limitation of this study, the median histological Schneiderian membrane thickness was 0.30 mm. Cone-beam computed tomography assessment was 2.6 times higher than the histological examination., (© 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Context: The selection of excipients and preformulation strategy plays a vital role for the development of nanoemulsion, due to anatomical and physiological challenges posed by nasal cavity., Objective: This attempt is focused on the selection and optimization of excipients for the development of a nanoemulsion system for intranasal delivery., Materials and Methods: Excipients were selected on the basis of solubility of active drug, compatibility interactions and nasal irritancy. Surfactant and co-surfactant combination and their ratio were finalized on the basis of nanoemulsion region obtained from constructed phase diagrams with Capmul MCM as oil phase. A validated cut and weigh method was employed for the optimization of different phase diagrams with respect to nanoemulsion region., Results and Discussion: The solubility of drug in Capmul MCM, Labrasol, and Transcutol-P was found to be superior with numeric values of 79.50 ± 1.68 mg/ml, 51.10 ± 1.39 mg/ml, and 36.60 ± 0.85 mg/ml, respectively. On the basis of phase diagram analysis, Labrasol and Transcutol-P in 3:1 ratio provides greater nanoemulsion region of 65.28 ± 0.18%. The validation of cut and weigh method revealed that there was no significant statistical difference (P > 0.05) with a %RSD value of 2.38 for intersheet variation., Conclusion: The results of validation studies for cut and weigh method suggests that it can be effectively used as an optimization method for the selection of nanoemulsion composition.

The nose is a complex structure important in facial aesthetics and in respiratory physiology. Nasal defects can pose a challenge to reconstructive surgeons who must re-create nasal symmetry while maintaining nasal function. A basic understanding of the underlying nasal anatomy is thus necessary for successful nasal reconstruction., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Purpose: To analyze the anatomical findings and alterations of the maxillary sinus in asymptomatic patients observed by cone beam computed tomography., Materials and Methods: A cross-sectional retrospective study of the anatomical variations and alterations of the maxillary sinus was made in 160 patients-71 males (44.3%) and 89 females (55.6%), with an age range of 18 to 74 years-measuring the thickness of the Schneiderian membrane and the cortical thickness of the lower margin of the maxillary sinus (in its most caudal portion), and correlations among the different study variables were assessed., Results: Sinus pneumatization was the most frequent anatomical finding (81.3%). A negative correlation was observed between the thickness of the Schneiderian membrane and the presence of Underwood septa (P < 0.005). Mucosal thickening of more than 2 mm was directly correlated with the presence of maxillary sinus lesions (opacification, discontinuity of the floor of the sinus, polypoid lesions, or air-liquid levels)., Conclusion: The presence or absence of septa seems to be related to the thickness of the Schneiderian membrane.

Objectives: To evaluate and compare nasal mucosal contact, septal deviation and caudal aberrant nasal turbinates in brachycephalic and normocephalic dogs using computed tomography., Methods: Dogs without nasal disease and having undergone computed tomography scan of the head (plica alaris to the cribiform plate) were retrospectively selected and divided into brachycephalic and normocephalic groups. Eighteen brachycephalic and 32 normocephalic dogs were included. Anatomic criteria were used to locate predetermined pairs of intranasal structures and nasal mucosal contact was described as present or absent for each site. Septal deviations were identified and measured using angle of septal deviation. Caudal aberrant nasal turbinates were identified and categorised when present., Results: Prevalence of nasal mucosal contact was significantly higher in brachycephalic dogs. No significant difference was seen in prevalence or in angle of septal deviation between groups. Prevalence of caudal aberrant nasal turbinates was significantly higher in brachycephalic dogs., Clinical Significance: Nasal mucosal contact and caudal aberrant nasal turbinates were significantly more prevalent in brachycephalic dogs than in normocephalic dogs in our study. Computed tomography can be a valuable aid in obtaining data on nasal mucosal contact, caudal aberrant nasal turbinates and septal deviations. Combination of computed tomography with endoscopy and functional airway testing would be useful to further evaluate the correlation between intranasal features and symptoms of brachycephalic airway syndrome., (© 2016 British Small Animal Veterinary Association.)

Background Reparation of large nasal septum perforations continues to be challenging. Bipedicled mucoperichondrial and inter-positional grafts currently show the most promising results. New implants have emerged to be used as a support membrane to carry on the mucosal cells, taking advantage of the innate proliferative properties of the mucosal tissue. Objective To compare the effectiveness of two kinds of material; non-absorbable dimethylsiloxane (silicone elastomers) and absorbable porcine small intestinal submucosa (Surgisis), both used as an inter-positional graft without neighbouring flaps to close nasal septal perforations in an experimental model. Methods Fifteen dogs were divided into three groups. One group received Surgisis, the other sheets of dimethylsiloxane and the last group a sham group. The dogs were followed for 6 weeks. Results The initial perforation of the nasal septum showed complete mucosal closure in the dimethylsiloxane group. The Surgisis group, on the other hand, had a smaller reduction than that at the beginning (final mean area = 23.0 ± 5.4 mm(2) (p < 0.05); however, complete closure was not achieved. Sham animals showed an inconstant and slight reduction in dimension from 100 mm(2) to 70 ± 16 mm(2) of mucosa and cartilage, but closure was not achieved. A significantly higher number of capillaries were observed in the Surgisis group compared to the dimethylsiloxane group (p < 0.05) without differences in inflammation, fibrosis, or necrosis. Conclusions The non-absorbable implant; dimethylsiloxane facilitates a better closure of the nasal septum.

Objectives: To investigate: (1) sinus membrane thickness in patients receiving lateral window sinus augmentation via cone-beam computed tomography (CBCT) and (2) the influence of Schneiderian membrane thickness upon membrane perforation during lateral window approach., Material and Methods: A total of 73 subjects with 81 sinus lift procedures between years 2010 and 2013 were recruited consequently. Each patient selected had CBCT images in initial and immediately after surgery. The values and correlation between variables of membrane thickness, perforation rate, membrane morphology, residual bone height, and elevated bone height were evaluated., Results: The mean thickness of the Schneiderian membrane was 1.32 ± 0.87 mm. Perforation rate was lowest (7.14%) when membrane thickness was 1-1.5 mm. As membrane became thicker (≥2 mm) or thinner (<1 mm), the perforation rate increased abruptly. When examined the membrane thickness category, Class B (between ≥1 mm and <2 mm) had the lowest perforation rate. Statistically significant correlation was found between the perforation and the membrane thickness. The amount of the remaining bone height did not significantly correlate to the membrane thickness nor influence the membrane perforation., Conclusions: This study demonstrated that membrane thickness was related to the sinus perforation during lateral window sinus augmentation. The perforation rate was lowest when the membrane thickness was 1-1.5 mm., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background/aims: Since the middle ear cavity plays an important role in middle ear effusion, the goal of this study is to examine the morphological and functional development of the middle ear mucosa in neonatal and adult gerbils., Methods: Gerbils aged between postnatal day 1 (P1) and P26 were used for the experiments. The morphological development of the middle ear cavity was measured by using the celloidin embedding method and scanning electronic microscope. Ciliary motion was determined and calibrated by a photodiode-based measurement system., Results: The area of the middle ear increased significantly from 0.42 ± 0.02 mm2 (n = 8) at P1 to 2.6 ± 0.03 mm2 (n = 8) at P26. At P1, all regions were covered by densely populated ciliated cells. A significant reduction of the density of ciliated cells was found between P8 and P18 (p < 0.05). The beat frequency at P1 is not statistically different from that of P8 (p > 0.05). However, the beat frequency increased significantly between P8 and P18 (p < 0.05)., Conclusion: Middle ear mucosa underwent a significant change between P1 and P18. The cilia morphology and function (ciliary motion) are fully mature at P18. This may explain the high incidence of middle ear effusion in the neonatal period in humans., (© 2016 S. Karger AG, Basel.)

Purpose: To determine whether identification and incorporation of the pyriform ligament in the alar cinch results in decreased alar base widening compared with standard alar cinch techniques., Materials and Methods: This was a retrospective case series and the sample was composed of patients undergoing Le Fort I osteotomy. Intraoperatively, the pyriform ligament was identified and incorporated in the alar cinch suture. Greatest alar width (GAW) measured immediately after closure was compared with GAW measured at least 5 months postoperatively. The change in alar base width was compared with that reported in the literature using other alar cinch techniques. Two case examples are reported., Results: The sample was composed of 15 patients (mean age, 27.1 yr; 27% female). The mean postoperative change in GAW was 1.0 ± 0.6 mm (2.59 ± 1.59%). Postoperative change in alar base width reported in the literature ranged from 0.5 to 10.8%., Conclusion: The pyriform ligament is easily identified during exposure of the maxilla and pyriform aperture and can be used to control widening of the alar base after Le Fort I osteotomy., (Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.)

In the present investigation, Quality by Design (QbD) approach was applied on the development and optimization of solid lipid nanoparticle (SLN) formulation of hydrophilic drug rivastigmine (RHT). RHT SLN were formulated by homogenization and ultrasonication method using Compritol 888 ATO, tween-80 and poloxamer-188 as lipid, surfactant and stabilizer respectively. The effect of independent variables (X1 - drug: lipid ratio, X2 - surfactant concentration and X3 - homogenization time) on quality attributes of SLN i.e. dependent variables (Y1 - size, Y2 - PDI and Y3 - %entrapment efficiency (%EE)) were investigated using 3(3) factorial design. Multiple linear regression analysis and ANOVA were employed to indentify and estimate the main effect, 2FI, quadratic and cubic effect. Optimized RHT SLN formula was derived from an overlay plot on which further effect of probe sonication was evaluated. Final RHT SLN showed narrow size distribution (PDI- 0.132±0.016) with particle size of 82.5±4.07 nm and %EE of 66.84±2.49. DSC and XRD study showed incorporation of RHT into imperfect crystal lattice of Compritol 888 ATO. In comparison to RHT solution, RHT SLN showed higher in-vitro and ex-vivo diffusion. The diffusion followed Higuchi model indicating drug diffusion from the lipid matrix due to erosion. Histopathology study showed intact nasal mucosa with RHT SLN indicating safety of RHT SLN for intranasal administration., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Objectives: Schneiderian membrane perforation is one of the main complications during sinus augmentation. The reasons may be associated with surgical technique, septum, inadequate ridge height, and membrane thickness. However, reports that used cone-beam computed tomography (CBCT) to quantify the thickness of sinus membrane were limited. The aims of this retrospective study were: to study the correlation between membrane thickness and perforation rate during transcrestal sinus lift and to propose a classification system of sinus membrane thickness based upon CBCT data., Material and Methods: One hundred and twenty-two subjects who received dental implant restorations over posterior maxilla with a total of 185 transcrestal sinus lift procedures between years 2010 to 2013 were selected consequently. Each patient selected had to have taken CBCT in the initial examination and immediately after surgery. The membrane thickness, perforation rate, residual bone height, and elevated bone height were recorded and processed for statistical analysis., Results: The mean thickness of the Schneiderian membrane was 1.78 ± 1.99 mm. There was a significant correlation between membrane thickness and perforation rate (P < 0.05), and the perforation rate was higher in thicker (≥3 mm) and thinner membrane (≤0.5 mm). Among the thickness group, Class B (between ≥1 and <2 mm) had the lowest perforation rate. No significant difference was between the perforation and the membrane morphology. A negative relationship between residual bone height and membrane thickness was found. Trend showed that in the thicker and the thinner residual bone height, the higher the perforation rate would be., Conclusions: There was a significant correlation between membrane thickness and perforation rate. The perforation rate was lowest when the thickness was 1.5-2 mm., (© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Purpose: To compare, in black Africans and Caucasians, the radiological anatomy of the intranasal structures and lacrimal sac fossa as relevant to dacryocystorhinostomy., Methods: 0.75 mm section cranio-orbital computed tomography scans from 72 patients (42 black Africans and 30 Caucasian) were included in this retrospective observational case series. Only one orbit from each scan was utilized. The main outcome measures were: the thickness and proportions of the lacrimal bone and frontal process of the maxilla evaluated at 3 axial planes (upper, middle, lower) in the lacrimal sac fossa; 2 measurements of maxillary thickness were obtained at each plane-namely, the "midpoint thickness" and the "maximum thickness." The anterior extent of the nasal mucosa was also evaluated., Results: The frontal process of the maxilla was thickest inferiorly (p < 0.001) and the maximum maxillary thickness was significantly thicker in black Africans as compared with Caucasians (p < 0.001) at all planes. At midfossa level, the proportion of maxillary bone forming the lacrimal fossa wall was significantly greater in black Africans (p < 0.01). In contrast, the length of nasal mucosa available for creation of an anastomosis, as estimated from the greatest mucosal height, was significantly greater in Caucasians (p < 0.01)., Conclusions: Black Africans have a lacrimal sac fossa bounded by thicker maxillary bone, this bone constituting a higher proportion of the fossa wall at its midpoint, and also have significantly less nasal mucosa available for soft-tissue anastomosis during lacrimal drainage surgery. The anterior lacrimal crest, comprising the frontal process of the maxilla, was thickest at the lowest plane in both black Africans and Caucasians.

Objective: This study aimed to compare the influence of alveolar ridge cortical bone and sinus floor cortical bone in sinus areabi-cortical dental implantation by means of 3D finite element analysis., Materials and Methods: Three-dimensional finite element (FE) models in a posterior maxillary region with sinus membrane and the same height of alveolar ridge of 10 mm were generated according to the anatomical data of the sinus area. They were either with fixed thickness of crestal cortical bone and variable thickness of sinus floor cortical bone or vice versa. Ten models were assumed to be under immediate loading or conventional loading. The standard implant model based on the Nobel Biocare implant system was created via computer-aided design software. All materials were assumed to be isotropic and linearly elastic. An inclined force of 129 N was applied., Results: Von Mises stress mainly concentrated on the surface of crestal cortical bone around the implant neck. For all the models, both the axial and buccolingual resonance frequencies of conventional loading were higher than those of immediate loading; however, the difference is less than 5%., Conclusion: The results showed that bi-cortical implant in sinus area increased the stability of the implant, especially for immediately loading implantation. The thickness of both crestal cortical bone and sinus floor cortical bone influenced implant micromotion and stress distribution; however, crestal cortical bone may be more important than sinus floor cortical bone.

Purpose: To engineer a hybrid nanocarrier system based on lipid and polymer for the nasal delivery of tenofovir disoproxil fumarate (TDF), and further to investigate its physicochemical, molecular, microstructural, and stability aspects., Methods: Nanoparticles were prepared by melt emulsification-probe sonication technique. A 3(2) factorial design was used to identify key formulation variables influencing the characteristics of drug-loaded carrier. FT-IR, mass spectroscopy (MS) and (1)H NMR was used to probe molecular interactions among the components of the system, while the surface morphology was imagined through electron microscopy (TEM and SEM). Thermal analysis and powder X-ray diffraction (PXRD) was used to explore melting and crystallization behavior of drug and the carrier lipid. PLN-9 GEL was studied for its rheology, drug release, ex-vivo permeation, histopathology, and stability., Results: Batch PLN-9 had size of 239 nm, drug encapsulation of 87.14% and revealed spherical morphology. MS, FT-IR and (1)H NMR established compatibility between the drug (TDF) and the carrier lipid (Lauric acid), while, a strong H-bonding was identified between the amino (-NH2) group of drug and the carboxyl (-COOH) group of pemulen polymer. Thermal analysis confirmed an amorphous TDF within the carrier matrix. PXRD analysis indicated substantial change in the molecular packing and subcell structure of carrier lipid during the PLN processing. PLN-9 GEL had shear thinning rheology, an anomalous type (n>0.5) of drug release and possessed potential to transport TDF across the nasal mucosa with an average flux of 135.36 μg/cm(2)/h., Conclusion: The designed carrier can encapsulate TDF and accentuates its transnasal flux, thus could be used as a carrier for an effective nasal delivery of TDF., (Copyright © 2015 Elsevier B.V. All rights reserved.)

The aim of the present case series was to evaluate a simplified minimally invasive transalveolar sinus elevation technique utilizing calcium phosphosilicate (CPS) putty for hydraulic sinus membrane elevation. The simplified minimally invasive antral membrane elevation technique is based on the application of hydraulic pressure via a viscous bone graft that acts as an incompressible fluid. In this retrospective study, 21 patients (mean age: 48.5 ± 12 years) consecutively treated with the simplified minimally invasive transalveolar sinus elevation technique were evaluated. 28 tapered implants were placed in posterior maxillary sites with less than 6 mm of residual bone height as determined radiographically on cone beam volumetric tomographs. No sinus membrane perforations were noted and none of the patients complained of symptoms of sinusitis post-operatively (0%). The mean gain in bone height post-operatively was 10.31 ± 2.46 mm (p < 0.001). All implants successfully integrated (100% success rate) and were loaded with cement-retained prostheses. The proposed technique is a simple, efficacious, minimally invasive approach for sinus elevation that can be recommended for sites with at least 3 mm of residual height., (Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Thorough knowledge of the anatomy of the nose is an essential prerequisite for preoperative analysis and the understanding of surgical techniques. Like a tent supported by its frame, the nose is an osteo-chondral structure covered by a peri-chondroperiosteal envelope, muscle and cutaneous covering tissues. For didactic reasons, we have chosen to treat this chapter in the form of comments from eight key configurations that the surgeon should acquire before performing rhinoplasty., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

The nasal mucosa is involved in immune defense, as it is the first barrier for pathogens entering the body through the respiratory tract. The nasal cavity-associated lymphoid tissue (NALT), which is found in the mucosa of the nasal cavity, is considered to be the main mucosal immune inductive site in the upper respiratory tract. NALT has been found in humans and many mammals, which contributes to local and systemic immune responses after intranasal vaccination. However, there are very few data on NALT in avian species, especially waterfowl. For this study, histological sections of the nasal cavities of Cherry Valley ducks were used to examine the anatomical location and histological characteristics of NALT. The results showed that several lymphoid aggregates are present in the ventral wall of the nasal cavity near the choanal cleft, whereas several more lymphoid aggregates were located on both sides of the nasal septum. In addition, randomly distributed intraepithelial lymphocytes and isolated lymphoid follicles were observed in the regio respiratoria of the nasal cavity. There were also a few lymphoid aggregates located in the lamina propria of the regio vestibularis, which was covered with a stratified squamous epithelium. This study focused on the anatomic and histological characteristics of the nasal cavity of the duck and performed a systemic overview of NALT. This will be beneficial for further understanding of immune mechanisms after nasal vaccination and the development of effective nasal vaccines for waterfowls., (Copyright © 2014 Wiley Periodicals, Inc.)

Olanzapine (OZ) is atypical antipsychotic drug that suffers from low brain permeability due to efflux by P-glycoproteins and hepatic first-pass metabolism. The current work aimed to develop OZ-loaded micellar nanocarriers and investigate their nose-to-brain targeting potential. OZ-loaded (5mg/ml) micelles (F1-F12) were prepared, using a Pluronic(®) mixture of L121 and P123, adopting thin-film hydration method. The micelles were evaluated for turbidity, particle size, morphology, drug-entrapment efficiency (EE%), drug-loading characteristics, in vitro drug release and ex vivo nasal toxicity in sheep. The in vivo biodistribution and pharmacokinetic studies in the brain/blood following intravenous (i.v.) and intranasal (i.n.) administrations of technetium-labeled OZ-loaded micelles and OZ-solution were evaluated in rats. Spherical micelles ranging in size from 18.97 to 380.70 nm were successfully developed. (1)H NMR studies confirmed OZ incorporation into micelle core. At a drug:Pluronic(®) L121:Pluronic(®) P123 ratio of 1:8:32 (F11), the micelles achieved a conciliation between kinetic and thermodynamic stability, high drug-EE%, controlled drug-release characteristics and evoked minor histopathological changes in sheep nasal mucosa. The significantly (P<0.05) higher values for F11 micelles (i.n.); brain/blood ratio (0.92), drug targeting index (5.20), drug targeting efficiency (520.26%) and direct transport percentage (80.76%) confirm the development of a promising non-invasive OZ-loaded nose-to-brain delivery system., (Copyright © 2013 Elsevier B.V. All rights reserved.)

The antral septum, a commonly found anatomical variation, has been related to the occurrence of membrane perforation during sinus augmentation. The aims of this study were to review features of antral septa and to propose a classification system and options for managing antral septa during sinus augmentation. A literature search of the PubMed database was performed to identify articles investigating antral septa. Manuscripts using three-dimensional computed tomography, providing direct measurements of human subjects or cadavers, and reporting features of antral septa besides the prevalence were included. Antral septa presented in approximately 20% to 35% of maxillary sinuses. Single septum was much more common than multiple septa. Mediolaterally (transversely) oriented septa were more frequently found than anteroposteriorly (sagittally) oriented septa. Their size varies and commonly increases from the lateral to medial segment within one septum. The proposed classification consists of three categories--easy (E), moderate (M), and difficult (D)--based on the location, number, orientation, and size of antral septa. Corresponding treatment approaches were suggested for each category. Sinus augmentation is complicated by the presence of antral septa, the features of which determine the degree of surgical difficulty. Based on the results of the included studies and clinical experiences, a classification system and treatment strategies of antral septa were proposed and may assist surgeons in managing antral septa during sinus augmentation.

The nose is a complex entity, combining aesthetic and functional roles. Descriptive anatomy is a fundamental science that it can be difficult to relate directly to our daily surgical activity. Reasoning in terms of aesthetic subunits to decide on his actions appeared to us so obvious. The aim of this paper is to resume the anatomical bases relevant to our daily practice in order to fully apprehend the restorative or cosmetic procedures. We discuss the limits of the systematization of these principles in nasal oncology., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objective: The objective of this study was to investigate the suitability of beagles and Labrador retrievers as animal models for osteotome sinus floor elevation (OSFE) and dental implants in posterior maxilla subjacent to sinus., Study Design: Ten beagles and 8 Labrador retrievers were included. Their posterior maxillas subjacent to the sinus were studied by a gross survey, CT scan, and histologic analysis., Results: In the posterior maxilla subjacent to sinus, the bone height was significantly higher for Labrador retrievers than for beagles (P < .05). There was no significant difference in sinus size from the coronal section and its location from the sagittal section (P > .05) between Labrador retrievers and beagles., Conclusions: As an animal model, the Labrador is more suitable for OSFE and dental implants in posterior maxilla subjacent to sinus. The midpoint of the maxillary fourth premolar is an ideal site for implantation., (Copyright © 2013 Elsevier Inc. All rights reserved.)

In this three-center, prospective, non-randomized, controlled trial, we performed a qualitative and quantitative histological and morphometric assessment of the normal uncinate process (UP). The soft tissue and bony elements of the normal UP of 16 adults were investigated and compared with 28 age- and gender-matched archival reference-group samples of neighboring structures of the inferior and middle turbinates. A series of measurements were taken and included the thickness of the mucosal layers and bone, epithelial height, basement membrane thickness, number of lamina propria inflammatory cells, and the area fraction (AF) of the epithelium, connective tissue, glands, veins and arteries. The data showed that the medial and lateral mucosal layers are built of loose connective tissue and harbor various inflammatory cell population, abundant glands, and thin-walled small-caliber venules. In-between, there is a thin lamellar compact bone (≤ 80 μm) or a significantly thicker cancellous bone (110-400 μm; P < 0.001). Both mucosal layers are similar in thickness, epithelial height, basement membrane thickness, and AF of soft-tissue constituents. A comparison with the lateral aspect of the inferior and middle turbinates showed that the AF of the connective tissue, total submucosal glands, submucosal serous and mucous glands, and veins of the lateral mucosa are significantly different (all P < 0.001). This diversity may point to different physiological roles for the UP and the inferior and middle turbinates. The UP rich glandular network, which is probably responsible for drainage and ventilation of the maxillary sinus into the ethmoid infundibulum laterally and the frontal sinus into the middle meatus medially, supports the argument that it is preferable, particularly for the less complicated cases, to keep the normal physiology of the ethmoid infundibulum and use bone- and mucosa-sparing techniques for the management of refractory chronic sinus disease.

Background: Osseo-integrated implants are increasingly being used to restore functional dentition; however, in the posterior region, implant placement can be problematic because of inadequate bone height. In this condition, maxillary sinus floor elevation surgery has become the treatment of choice. The presence of anatomic variations within the maxillary sinus such as Underwood's septa and thin Schneiderian membrane decreases the success of the sinus floor elevation., Purpose: In this study, we tried to determine the relationship between the anatomic variations of the maxillary sinus: Underwood's septa, Schneiderian membrane thickness, and the cortical thickness of the inferior border of the maxillary sinus., Material and Methods: The left and right maxillary sinus images of 74 patients were obtained by using dental computed tomography (CT). The Schneiderian membrane and the cortical thickness of the inferior border of the maxillary sinus were measured on the coronal images of dental CT scans at the deepest portion of the sinus cavity. The presence of Underwood's septa was identified on the axial images. The correlations between these variables were assessed., Results: We found that there was only a negative correlation between the Schneiderian membrane thickness and the presence of Underwood's septa (r = -0.168 p = .042)., Conclusion: It is suggested that Underwood's septa may be the reason for the thinness of the Schneiderian membrane. However, future studies among larger groups are necessary for confirming the finding by using well-designed clinical studies., (© 2011 Wiley Periodicals, Inc.)

Venlafaxine, a dual acting antidepressant is a new therapeutic option for chronic depression. Depression is a common mental disorder associated with the abnormalities in neuronal transport in the brain. Since the nose-to-brain pathway has been indicated for delivering drugs to the brain, we analyzed the transport of venlafaxine through sheep nasal mucosa. Transmucosal permeation kinetics of venlafaxine were examined using sheep nasal mucosa mounted onto static vertical Franz diffusion cells. Nasal mucosa was treated with venlafaxine in situ gel (100 μl; 1% w/v) for 7h. Amount of venlafaxine diffused through mucosa was measured using validated RP-HPLC method. After the completion of the study histopathological investigation of mucosa was carried out. Ex vivo studies through sheep nasal mucosa showed sustained diffusion of venlafaxine with 66.5% permeation in 7h. Transnasal transport of venlafaxine followed a non-Fickian diffusion process. Permeability coefficient and steady state flux were found to be 21.11×10(-3) cmh(-1) and 21.118 μg cm(-2)h(-1) respectively. Cumulative amount permeated through mucosa at 7h was found to be 664.8 μg through an area of 3.14 cm(2). Total recovery of venlafaxine at the end of the permeation study was 87.3% of initial dose distributed (i) at the mucosal surface (208.4 μg; 20.8%) and (ii) through mucosa (664.8 μg; 66.5%). Histopathological examinations showed no significant adverse effects confirming that the barrier function of nasal mucosa remains unaffected even after treatment with venlafaxine in situ gel. Permeation through sheep nasal mucosa using in situ gel demonstrated a harmless nasal delivery of venlafaxine, providing new dimension to the treatment of chronic depression., (Copyright © 2012 Elsevier B.V. All rights reserved.)

The study was undertaken to develop buffered nanoemulsion of ziprasidone hydrochloride (fifth generation antipshychotic) and evaluate its potential for efficacious nose to brain delivery drug delivery in animal models. Homogeneous buffered ziprasidone nanoemulsions (BZNE) were prepared by aqueous (phosphate buffer, pH 8.0) titration method using capmul MCM, labrasol and transcutol as oil, surfactant and cosurfactant respectively. The NEs (F1-F7) were characterized for pharmaceutical characteristics (% transmittance, PDI value, Zeta potential, globule size, viscosity and diffusion coefficient) and F6 with mean globule size of 145.24 ± 4.75nm (PDI = 0.186 ± 0.40) and diffusion coefficient of 0.1901± 0.04cm2/min was thermodynamically stable and was developed as buffered mucoadhesive nanoemulsions. The buffered mucoadhesive NE (βmax = 0.57) that contained 0.5% by weight of chitosan (BZMNE) exhibited 1.79 times higher diffusion coefficient (0.3418 ± 0.03) than BZNE. Pharmacodynamic study confirmed the superiority of BZMNE over BZNE in locomotor activity test (p < 0.05) and paw test (p < 0.05). Nasal ciliotoxicity study revealed the optimized BZMNE to be free from acute toxicity. Conclusively, a stable and efficacious buffered mucoadhesive NE of ziprasidone hydrochloride, that can be safely administered by intranasal route was developed.

The aim of this review is to provide an understanding of the anatomical and histological structure of the nasal cavity, which is important for nasal drug and vaccine delivery as well as the development of new devices. The surface area of the nasal cavity is about 160 cm2, or 96 m2 if the microvilli are included. The olfactory region, however, is only about 5 cm2 (0.3 m2 including the microvilli). There are 6 arterial branches that serve the nasal cavity, making this region a very attractive route for drug administration. The blood flow into the nasal region is slightly more than reabsorbed back into the nasal veins, but the excess will drain into the lymph vessels, making this region a very attractive route for vaccine delivery. Many of the side effects seen following intranasal administration are caused by some of the 6 nerves that serve the nasal cavity. The 5th cranial nerve (trigeminus nerve) is responsible for sensing pain and irritation following nasal administration but the 7th cranial nerve (facial nerve) will respond to such irritation by stimulating glands and cause facial expressions in the subject. The first cranial nerve (olfactory nerve), however, is the target when direct absorption into the brain is the goal, since this is the only site in our body where the central nervous system is directly expressed on the mucosal surface. The nasal mucosa contains 7 cell types and 4 types of glands. Four types of cells and 2 types of glands are located in the respiratory region but 6 cell types and 2 types of glands are found in the olfactory region.