Rhinitis is divided into allergic and non-allergic rhinitis. Non-allergic rhinitis includes inflammatory rhinitis, such as non-allergic rhinitis with eosinophilia syndrome (NARES) and infective rhinitis, and non-inflammatory rhinitis, such as vasomotor rhinitis and idiopathic rhinitis. Allergic rhinitis is diagnosed based on the presence of allergen-specific IgE and the documentation of relationship between the allergen and symptoms in patients with typical rhinitis symptoms, such as rhinorrhea, nasal obstruction, itchiness and/or sneezing. Local allergic rhinitis can be considered for differential diagnosis. Allergic rhinitis should be differentiated from non-allergic rhinitis by using skin prick test, serum specific IgE test, nasal cytology and/or allergen nasal provocation test. Allergic rhinitis should be differentiated from structural nasal diseases, such as septal deviation and nasal polyps. Rhinitis is frequently accompanied by paranasal sinusitis, which should be recognized in clinical practice. Management strategies differ between allergic and nonallergic rhinitis. In addition to pharmacotherapy, allergen avoidance and allergen-specific immunotherapy can be tried in patients with allergic rhinitis. Thus, the exact diagnosis is very important for the effective treatment in allergic rhinitis. The diagnostic tests for allergic rhinitis are reviewed.
Cell Biology ; Diagnosis* ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Drug Therapy ; Eosinophilia ; Humans ; Immunoglobulin E ; Immunotherapy ; Nasal Obstruction ; Nasal Polyps ; Nasal Provocation Tests ; Nose Diseases ; Rhinitis* ; Rhinitis, Allergic, Perennial ; Rhinitis, Vasomotor ; Sinusitis ; Skin ; Skin Tests ; Sneezing

Rhinitis is divided into allergic and non-allergic rhinitis. Non-allergic rhinitis includes inflammatory rhinitis, such as non-allergic rhinitis with eosinophilia syndrome (NARES) and infective rhinitis, and non-inflammatory rhinitis, such as vasomotor rhinitis and idiopathic rhinitis. Allergic rhinitis is diagnosed based on the presence of allergen-specific IgE and the documentation of relationship between the allergen and symptoms in patients with typical rhinitis symptoms, such as rhinorrhea, nasal obstruction, itchiness and/or sneezing. Local allergic rhinitis can be considered for differential diagnosis. Allergic rhinitis should be differentiated from non-allergic rhinitis by using skin prick test, serum specific IgE test, nasal cytology and/or allergen nasal provocation test. Allergic rhinitis should be differentiated from structural nasal diseases, such as septal deviation and nasal polyps. Rhinitis is frequently accompanied by paranasal sinusitis, which should be recognized in clinical practice. Management strategies differ between allergic and nonallergic rhinitis. In addition to pharmacotherapy, allergen avoidance and allergen-specific immunotherapy can be tried in patients with allergic rhinitis. Thus, the exact diagnosis is very important for the effective treatment in allergic rhinitis. The diagnostic tests for allergic rhinitis are reviewed.
Cell Biology ; Diagnosis* ; Diagnosis, Differential ; Diagnostic Tests, Routine ; Drug Therapy ; Eosinophilia ; Humans ; Immunoglobulin E ; Immunotherapy ; Nasal Obstruction ; Nasal Polyps ; Nasal Provocation Tests ; Nose Diseases ; Rhinitis* ; Rhinitis, Allergic, Perennial ; Rhinitis, Vasomotor ; Sinusitis ; Skin ; Skin Tests ; Sneezing

OBJECTIVETo explore the feasibility of the extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach.

METHODSEight patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach for maxillary sinus lesions. The indications, surgical management and outcomes of the surgery were presented.

RESULTSThere were 2 cases of maxillary dentigerous cyst with oroantral fistula, 2 cases of antrochoanal polyp, 2 cases of maxillary sinus inverted papillomas, 1 case of odontogenic maxillary sinusitis with oroantral fistula, and 1 case of maxillary sinus mucocele. All patients underwent extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach without intraoperative complication, with good access to the lesions. Complete resection could be achieved through this approach, no postoperative complications occurred except one patient had a delayed wound healing of inferior turbinate, all patients were free of recurrence with the average postoperative follow-up of 7.8 months (range 4-12 months).

CONCLUSIONThe extended inferior meatal maxillary antrostomy through inferior turbinate reversing approach is recommended for some maxillary pathology owing to its good access to the lesions and complete resection.

Cysts ; Dentigerous Cyst ; Humans ; Maxilla ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; Maxillary Sinusitis ; Mucocele ; Nasal Polyps ; Papilloma, Inverted ; Paranasal Sinus Diseases ; surgery ; Postoperative Complications ; Turbinates ; surgery

BACKGROUND AND OBJECTIVES: Nitric oxide (NO) is present in high concentrations in the upper respiratory tract. The physiological role of this mediator is to contribute to the local host's defense, modulate ciliary motility and serve as an aerocrine mediator in helping to maintain adequate ventilation-perfusion matching in the lung. SUBJECTS AND METHOD: The purpose of the study was to assess the relationship of nasal NO (nNO) and exhaled NO (eNO) in nasal airway disease patients. NO concentration was measured using a chemiluminescence analyzer. nNO was analyzed by aspiration at a sampling flow rate of 700 mL/min with velum closure. eNO was analyzed during expiration against a constant resistance of 10 cm H2O. RESULTS: NO concentration of the normal control group (n=32) was compared with that of the allergic rhinitis group (n=31) and the rhinosinusitis with that of the nasal polyp group (n=30). The mean nNO level in the control group was 241+/-89 ppb and eNO was 20.5+/-6.4 ppb. The mean nNO level was significantly increased in the allergic rhinitis group (332+/-125 ppb) but decreased in the chronic sinusitis group (89+/-55 ppb). The mean eNO level was significantly increased both in the allergic rhinitis group (26.9+/-10.1 ppb) and chronic sinusitis group (29.8+/-12.8 ppb). CONCLUSION: nNO concentration was increased in patients with allergic rhinitis and decreased in patients with chronic sinusitis; however, eNO was increased in both patients. This shows that patients with upper respiratory inflammation may also have lower respiratory inflammation, supporting the concept of 'one airway, one disease'. This study shows that measurement of NO is useful for the study or evaluation of nasal diseases.
Humans ; Inflammation ; Luminescence ; Nasal Polyps ; Nitric Oxide ; Nose Diseases ; Respiratory System ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sinusitis

OBJECTIVETo evaluate the effect of endoscopic surgery for maxillary sinus inverted papilloma.

METHODSFrom 2000 to 2011, 50 patients with maxillary sinus inverted papilloma were treated with intranasal endoscopic surgery or combined approach. Among them, 39 cases were primary and 11 cases were recurrent, which included 17 patients with Krouse stage IIand 33 cases with Krouse stage III. Different surgical approaches were selected according to the range and positions of the lesions. One case with severe atypical hyperplasia received postoperative radiotherapy.

RESULTSAll cases were followed up for 3-14 years, 7 cases recurred. All occurrence within 2 years after operation. Malignant change and death was found in 1 case. After operation, epiphora occurred in 2 cases, maxillary sinus labiogingival groove fistula occurred in 2 cases, facial numbness occurred in 4 cases and incision hemorrhage occurred in 1 case. All the complications were cured after appropriate treatment.

CONCLUSIONSNaso-endoscopic surgery or combined approach is a safe, effective and microinvasive treatment for patients with maxillary sinus inverted papilloma. Accurate selection of suitable approach according to the range and positions of the lesions and correct management of the base of the tumor are critical to the success of the operation.

Endoscopy ; methods ; Humans ; Lacrimal Apparatus Diseases ; Maxillary Sinus ; surgery ; Maxillary Sinus Neoplasms ; surgery ; Nasal Surgical Procedures ; Neoplasm Recurrence, Local ; Nose ; Nose Neoplasms ; Papilloma, Inverted ; surgery ; Paranasal Sinus Neoplasms ; Postoperative Period ; Retrospective Studies

BACKGROUND AND OBJECTIVES: Previous studies have reported that irradiation influences mucociliary clearance by damaging ciliary motility in respiratory mucosa. The purpose of this study is to investigate the effect of radiotherapy (RT) on opacification of paranasal sinuses in patients with nasopharyngeal carcinoma, and to find out what kind of influence anatomic variations such as nasal septal deviation or concha bullosa may have on the pathogenesis of sinus opacification. MATERIALS AND METHODS: Subjects were 26 patients (19 males and 7 females, aged 23 to 69) of early nasopharyngeal carcinoma (T1, T2) who were treated with RT between 1989 and 1999. Pre-RT and post-RT Computerized Tomography (CT) and medical records were reviewed retrospectively. The mean radiation dosage was 6965 cGy and mean follow-up period was 30 months (6 months to 7 yeas 1 month). Eighteen patients had nasal septal deviation and 9 patients had nasal septal deviation with concha bullosa. A total of 52 maxillary sinuses and 52 ethmoid sinus sides were analyzed. RESULTS: In 15 (57.7%) of 26 patients, opacifications of sinuses were newly developed or were aggravated after RT. The prevalence of aggravated sinus opacification according to anatomic variations was as follows : 30.8% in no anatomic variations, 32.1% in the concave side of nasal septal deviation, 36.8% in the convex side of nasal septal deviation, 42.9% in the concave side of nasal septal deviation with concha bullosa, and 68.8% in the convex side of septal deviation with concha bullosa. There was a significant difference in sinus opacification between sinuses without variations and sinuses with septal deviations combined with concha bullosa (p<0.05). CONCLUSION: These data suggest that irradiation of the nasopharynx may induce or aggravate paranasal sinusitis, and anatomic variations such as nasal septal deviation or concha bullosa may contribute to the pathogenesis of sinusitis.
Ethmoid Sinus ; Female ; Follow-Up Studies ; Humans ; Male ; Maxillary Sinus ; Medical Records ; Mucociliary Clearance ; Nasopharyngeal Neoplasms* ; Nasopharynx ; Paranasal Sinus Diseases ; Paranasal Sinuses ; Prevalence ; Radiation Dosage ; Radiotherapy ; Respiratory Mucosa ; Retrospective Studies ; Sinusitis

Congresses as Topic ; Humans ; Infection ; Nose Diseases ; microbiology ; Nose Neoplasms ; Rhinitis, Allergic ; Rhinitis, Allergic, Perennial

Postnasal drip syndrome is one of the most common causes of chronic cough, and is caused by a variety of conditions including vasomotor rhinitis, allergic rhinitis, nasal polyps and chronic sinusitis. Postnasal drip syndrome is diagnosed based on clinical symptoms, and patients may complain of tickles or drainage of liquid in the back of the throat. Cobblestoning of the nasal or oropharyngeal mucosa may be observed upon physical examination. However, in many patients cough may be the only symptom of postnasal drip syndrome. Confirmation of the diagnosis may depend on the resolution of symptoms after treatments with antihistamines and intranasal or systemic corticosteroids.
Adrenal Cortex Hormones ; Cough ; Drainage ; Histamine Antagonists ; Humans ; Mucous Membrane ; Nasal Polyps ; Pharynx ; Physical Examination ; Rhinitis ; Rhinitis, Allergic, Perennial ; Rhinitis, Vasomotor ; Sinusitis

The nose and lung are both part of the respiratory tract. Often the diseases affecting the nose and/or the bronchi are treated separately. However, in recent years, numerous studies have highlighted the fact that the respiratory system is a single entity and the concept of "united airway disease" has become more and more important. The unity of the respiratory tract is confirmed both from a morphological and from a functional point of view. Nevertheless, this concept is also confirmed for the respiratory immune system, innervation and vascularization interesting all along the tract, from the nose to the bronchioles. When treating rhinitis, it is often necessary to assess the presence of asthma. Patients with sinusitis should be evaluated for a possible concomitant asthma. Conversely, patients with asthma should always be evaluated for possible nasal disease. The medications that treat nasal diseases appear to be useful in improving control of asthma and in reducing bronchial hyperresponsiveness as well. Physicians should always keep these notions in mind, and evaluate and treat respiratory diseases taking into account the unity of the respiratory tract.
Asthma ; Bronchi ; Bronchioles ; Humans ; Immune System ; Lung ; Nose ; Nose Diseases ; Respiratory System ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sinusitis

BACKGROUND AND OBJECTIVES: Laser vaporization on the inferior turbinate can be an valuable surgical method with safety, less morbidity and good efficacy. However, long term results are not exactly known. Furthermore, concrete data for success rates using different laser techniques is not available yet. The aim of this study is to evaluate the long-term result of laser surgery using different laser technique in patients with hypersensitive nasal diseases. SUBJECTS AND METHOD: We retrospectively reviewed 53 cases which had been treated with CO2 laser and followed up for more than 3 years. The subjects consisted of 29 patients with allergic rhinitis and 24 patients with vasomotor rhinitis. Laser surgical techniques were divided into two groups;vaporization of only inferior turbinate (conventional group) and inferior turbinate, upper septum, middle turbinate, agger nasi (extended group). Changes in the degree of nasal obstruction, watery rhinorrhea, sneezing were compared postoperatively between the two surgical procedure, and two different diseases. RESULTS: Long-term result (67%) was slightly lower than short-term result (69%). There was no difference in the success rates (68%) for both laser and surgical technique. Patients with vasomotor rhinitis (75%) showed better success rate than with allergic rhinitis (62%). Rate of success was better in the extended group than in the conventional group for watery rhinorrhea and sneezing. CONCLUSION: Success rate of laser surgery performed at Inha university hospital was 68%. The extended technique was more effective than the conventional technique for short-term result. However, there was no difference in the long-term results using different laser techniques.
Humans ; Laser Therapy* ; Lasers, Gas ; Nasal Obstruction ; Nose Diseases ; Retrospective Studies ; Rhinitis ; Rhinitis, Vasomotor ; Sneezing ; Turbinates