No abstract available.
Congenital Abnormalities*

The mucus secretion of airway glands is known to be controlled by the various autonomic neurotransmitters such as noradrenalin and acetylcholine. However, a recent study suggests that non-adrenergic, non-cholinergic (NANC) nerves may contribute to the secretory activity of glands. Substance P (SP) has been proposed as a neurotransmitter of the NANC nervous system. SP is present within nerve fibers innervating the airway mucosa and is known to be released from sensory nerves via an axonal reflex. SP activity is controlled by neutral endopeptidase (NEP) which degrades SP. In this study, we evaluated the effects of NEP inhibitor (thiorphan) and substance P on nasal mucosa and histamine on the nasal mucosa in healthy males. In the thiorphan-substance P experimental group, the nasal volume decreased after nebulization of substance P in proportion to the concentration of histamine. In the thiorphan-substance P experimental group, the frequency of sneezing increased in proportion to the concentration of histamine, but there was no increased frequency of sneezing from thiorphan, SP and normal saline. The results of this study suggest that axonal reflexes can play a role in the pathogenesis of nasal mucosal hypersensitivity and neurogenic inflammation.
Acetylcholine ; Axons* ; Histamine ; Humans ; Hypersensitivity* ; Male ; Mucous Membrane ; Mucus ; Nasal Mucosa ; Neprilysin ; Nerve Fibers ; Nervous System ; Neurogenic Inflammation ; Neurotransmitter Agents ; Reflex* ; Sneezing ; Substance P* ; Thiorphan

Active anterior rhinomanometry (AAR) was performed in 42 patients with low-profile or saddle noses before augmentation rhinoplasty (AR) and after AR. The purpose was to measure nasal airway resistance (NAR) and nasal airflow (NAF). There were 38 females and 4 males, whose ages ranged from 15 to 42 years (mean 29.6 years). Preoperative total NAR at 75 Pascals (Pa) was 0.24+/-0.09 and 0.20+/-0.06 Pa/ml/sec for the non-decongested and decongested value respectively. Two weeks postoperatively, the total NAR was 0.19+/-0.06 and 0.15+/-0.05 Pa/ml/sec for the non-decongested and decongested value respectively, which was significantly less than the preoperative value. The postoperative total NAF was 422.31+/-137.05 cm3 and 514. 57+/-152.45 cm3 for the non-decongested and decongested value respectively, which was significantly increased when compared to the preoperative value (342.57+/-109.27 cm3 and 399.90+/-106.98 cm3 for the non-decongested and decongested value respectively). The comparison between the changes in NAR and subjective nasal breathing showed that the postoperative NAR decreased in 88.10% of patients while subjective nasal breathing improved in only 52.38%. Postoperative NAR increased in 9.52% of patients, while subjective nasal breathing was worsened in 2.38%. The results of this study indicate that AR has decreased the NAR and increased NAF, and thus improving the nasal breathing. From this preliminary study it is concluded that AR is useful not only for the aesthetic aspect but also for its effect on the function of the nose, especially on the improvement of nasal breathing.
Airway Resistance* ; Female ; Humans ; Male ; Nose ; Respiration ; Rhinomanometry ; Rhinoplasty*

To date, there has not been sufficient experimental evidence to demonstrate the pharmacological effect of secretolytic and mucolytic drugs. Scintigraphic studies to detect the mucociliary clearance in the maxillary sinus before and after application of a secretolytic drug (Gelomyrtol(R) forte, G.Pohl-Boskamp, Hohenlockstedt, Germanym) were perfomed on four healthy persons and one patient having undergone sinus surgery. The most important parameters was the mucociliary transport velocity of the "region of interest-maxillary sinus" and the increase of radioactivity accumulated in a swab placed in the middle nasal meatus. Measurements were done with a gamma-camera, 99m Technetium-sulphur colloid was used as the radiopharmacon. A dose of 1 Mbq in 0.2 ml NaCl-solution was injected into the maxillary sinus. The results showed a clear increase of mucociliary transport velocity in the maxillary sinus after intake of secretolytics in connection with an increase of radioactivity in the swab. The results can be explained by the secretolytic and secretomotoric effects of the investigated drug. The study reveals that ethereal oils have secretolytic effects and also have a pharmacological effect on the mucociliary apparatus.
Colloids ; Ether ; Humans ; Maxillary Sinus* ; Mucociliary Clearance* ; Oils ; Radioactivity

Because Mongoloids have been considered to have a wider nasal valve angle than Caucasians, fewer Japanese patients experience nasal obstruction due to stenotic nasal valve. However, there have been no studies measuring the nasal valve angle of Mongoloids. Accordingly, one aim of this study is to measure the nasal valve angle in Japanese subjects and obtain its standard value. Another aim is to measure the cross-sectional area at the nasal valve area. One hundred and sixteen healthy adult Japanese volunteers showing no symptoms or histories of nasal disease participated in this study. Each subject's nose was scanned, by endoscopy, and images of the subjects' nasal valve area were recorded using a video camera. The nasal valve angle was measured in video-printed photographs. Acoustic rhinometry was performed in each case. The subject's mean nasal valve angle was 28.9+/-6.3 degree, ranging from 16 to 45. The mean cross-sectional area at the I-notch was 0.95+/-0.16 cm2 . No relationship was found between the nasal valve angle and the cross-sectional area around the valve.
Adult ; Asian Continental Ancestry Group* ; Endoscopy ; Humans ; Nasal Obstruction ; Nose ; Nose Diseases ; Rhinometry, Acoustic ; Volunteers

Nasal obstruction is one of the most frequent symptoms of chronic sinusitis. Since 1989, acoustic rhinometry has proven to be relatively accurate in evaluating the severity of nasal obstruction in a clinical setting. This study was conducted to evaluate the efficacy of acoustic rhinometry before and after endoscopic surgery in relieving nasal obstruction in patients with chronic sinusitis. Nasal airway patency was measured by acoustic rhinometry, preoperatively and postoperatively, in 48 patients with chronic sinusitis. Total volume (TV), distances and areas of the first and second notches, and areas at 3.3 cm (A(3.3)), 4.0 cm (A(4.0)) and 6.4 cm (A(6.4)) from nose pieces were measured. The patients were divided into 4 groups according to the duration of their postoperative follow-up period. Group 1 had a postoperative follow-up period less than 1 year ; group 2, between 1 and 2 years ; group 3, between 2 and 3 years ; group 4, between 3 and 4 years. There was a significant increase in TV, A(4.0), and A(6.4) postoperatively (p<0.05, paired t-test). Postoperative values including TV, A(4.0), and A(6.4) increased significantly in group 1, group 2, and group 3, but decreased in group 4 (p<0.05, ANOVA). However, there was no significant difference between groups in distances and areas of the first and second notches. These results suggest that endoscopic sinus surgery is effective in relieving nasal obstruction of patients with chronic sinusitis and that acoustic rhinometry may be a useful tool in objectifying symptomatic improvement in patients with nasal obstruction following endoscopic sinus surgery.
Acoustics* ; Follow-Up Studies ; Humans ; Nasal Obstruction ; Nose ; Rhinometry, Acoustic* ; Sinusitis*

Several attempts have been made to correlate nasal obstruction and acoustic rhinometric parameters, so far failed to find any significant correlation. We evaluated the correlation between the sense of nasal obstruction and parameters measured with acoustic rhinometry, and searched any secondary variables calculated from primary parameters, to explain the sense of nasal obstruction objectively on 114 patients (72 men and 42 women) with nasal obstruction. The sense of nasal obstruction was measured with visual analogue scale. Nasal volume, minimal cross-sectional area, and equivalent resistance were measured by acoustic rhinometry. As secondary variables, we introduced the concept of decongestion rate which representing the amount of change in the parameters after application of nasal decongestant. Weak correlations were found between the sense of nasal obstruction and total minimal cross-sectional area. Significant correlations were found between the sense of nasal obstruction and decongestion rate of total nasal volume, and particularly in the wider cavity. Stronger correlations than in total population were found in male patients. The decongestion rate may have potential implication in explaining the sense of nasal obstruction.
Acoustics* ; Humans ; Male ; Nasal Obstruction* ; Rhinometry, Acoustic*

The high variability of measured olfactory thresholds in humans reflects very broad range of sensitivity within and among individuals. This can be derived from the strongly compressive nature of olfaction, which makes it relatively hard to compare the size of two stimuli in odor sensation. However, we know that some portion of the variation is the result of extrinsic factors e.g. the method used to measure the olfactory threshold. For this reason, in order to address the bias and reliability of a psycophysical method, we combined the use of the CCCRC (Connecticut Chemosensory Clinical Research Center) test with the step method in 40 normal Korean adults twice a week for the evaluation of threshold. The measured thresholds showed high test-retest reliability and the threshold estimates remained consistent during the testing without trial-biases. Based on the results, we can conclude that a combined test using the CCCRC test and step method can be used in the measurement of olfactory threshold in a clinical context.
Adult* ; Bias (Epidemiology) ; Humans ; Odors ; Sensation ; Smell

Local release of neurotransmitters from autonomic nerve fibers in the nasal mucosa is known to play an important role for the protection of the lower airways. In addition to classical neurotransmitters, a diverse collection of neuropeptides are found in the sensory, parasympathetic, and sympathetic nerve fibers and may act as co-transmitters or modulators of effects induced by classical neurotransmitters. In the nasal mucosa, these neuropeptides are known to regulate the blood flow and content, secretory activity, and other epithelial functions and to be involved in the regulation of immunological reactions. There are increasing evidences that neuropeptides may play an important role in the pathophysiologic events in both specific and nonspecific hyperreactivity. Further study on the neuropeptides is needed to clarify the pathophysiologic mechanisms of nasal mucosal hyperreactivity.
Autonomic Pathways ; Nasal Mucosa* ; Nerve Fibers ; Neuropeptides ; Neurotransmitter Agents

Differential diagnoses of the nasopharyngeal mass in an adolescent or in a young adult include the nasopharyngeal angiofibroma, hemangioma, antrochoanal polyp, or, in rare cases, malignant disease. A twenty one-year-old male patient visited our department with aggravated symptoms of left nasal obstruction and frequent epistaxis, which originated three years ago. Endoscopic examinations revealed a dark pinkish mass with bleeding tendency in the left nasopharynx and it was also observed in the right side due to its huge size. At first, we suspected a nasopharyngeal angiofibroma and evaluations including computed tomography and magnetic resonance imaging were performed. These studies showed a highly vascular mass confined in the nasopharynx. However, its origin was uncertain. After an angiography with embolization of feeding vessels, the mass was removed endoscopically. Unexpectedly, its origin was the posterior end of the left inferior turbinate, and the diagnosis of a cavernous hemangioma was confirmed with histopathological findings.
Adolescent ; Angiofibroma* ; Angiography ; Diagnosis ; Diagnosis, Differential ; Epistaxis ; Hemangioma ; Hemangioma, Cavernous* ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Male ; Nasal Obstruction ; Nasopharynx ; Polyps ; Turbinates* ; Young Adult