Chronic paranasal sinusitis is one of the most common disease in the field of otolaryngology, and endoscopic sinus surgery(ESS) is efficient and safe operative method of chronic paranasal sinusitis. We employed socalled symptom score to quantify the common sinusitis related symptoms before and after endoscopic sinus surgery which followed up to 6 months. A prospective study of 50 patients all having undergone ESS from June, 1995 to February, 1996 was performed and we analyzed the surgical results using questionaires which focused on six common sinusitis related symptoms-nasal obstruction, rhinorrhea, olfactory disturbance, postnasal drip, headache and sneezing. Postoperative symptom relief was apparent in all six common symptoms(p value<0.001) and the higher sinusitis stage, the more relief of sinusitis related symptoms(p value=0.029). It seems to be helpful to employ a symptom score in predicting and analyzing the surgical results in the treatment of chronic sinusitis.
Headache ; Humans ; Otolaryngology ; Prospective Studies* ; Sinusitis ; Sneezing

Capsaicin, a nonenamide derived from Capsicum plants, has proven to be useful in patients with vasomotor rhintitis. In this study, we estimated the effects of 10-5 M capsaicin spray in patients with hypersensitive rhinitis. The drug was given 3 times per day for 3 days to each patient by means of a spray delivered to the nasal mucosa. Patient's symptom score was recorded by the same physician. We repeated this method after 1 week, 2 week, 4week, 8week, 12week, 16week and recorded their symptom score. As a result, the mean symptom score involving nasal obstruction, sneezing, rhinorrhea and itching was remarkably reduced by capsaicin spray. The present findings suggest that capsacine spray is a good therpheutic method for hypersensitive rhinitis patients.
Capsaicin* ; Capsicum ; Humans ; Nasal Mucosa ; Nasal Obstruction ; Pruritus ; Rhinitis ; Sneezing

Capsaicin, a nonenamide derived from Capsicum plants, has proven to be useful in patients with vasomotor rhintitis. In this study, we estimated the effects of 10-5 M capsaicin spray in patients with hypersensitive rhinitis. The drug was given 3 times per day for 3 days to each patient by means of a spray delivered to the nasal mucosa. Patient's symptom score was recorded by the same physician. We repeated this method after 1 week, 2 week, 4week, 8week, 12week, 16week and recorded their symptom score. As a result, the mean symptom score involving nasal obstruction, sneezing, rhinorrhea and itching was remarkably reduced by capsaicin spray. The present findings suggest that capsacine spray is a good therpheutic method for hypersensitive rhinitis patients.
Capsaicin* ; Capsicum ; Humans ; Nasal Mucosa ; Nasal Obstruction ; Pruritus ; Rhinitis ; Sneezing

Orbital emphysema is an abnormal condition in which air is present within the orbit. It commonly occurs during or immediately after facial, nasal, or orbital trauma; however, in a few cases, the orbital emphysema occurs spontaneously without the presence of recent trauma. Subsequently, air can enter the soft tissue of orbit as a result of nose blowing, coughing or sneezing. Although sequelae are generally self limiting and resolve spontaneously, they are important because of potential complications such as loss of vision due to pressure effect. The following is a case report of a patient who developed unilateral orbital emphysema after nose blowing.
Cough ; Emphysema ; Humans ; Nose ; Orbit ; Sneezing ; Vision, Ocular

PURPOSE: We evaluated the efficacy of leukotriene receptor antagonist and second generation anti-histamine in children with moderate to severe persistent allergic rhinitis. METHODS: Twenty eight patients who were treated with second generation anti-histamine for 4 weeks (Zyrtec syrup(R), Group A) and 58 patients who were treated with leukotriene receptor antagonist for 4 weeks (Singulair(R), Group B) were enrolled in this study. Control group (n=22) was received only first generation anti-histamine (Hydroxyzine) intermittently. Efficacy were evaluated by nasal scores in nasal congestion, rhinorrhea, nasal itching, sneezing and total nasal symptom score (a sum of patient ratings of nasal congestion, rhinorrhea, nasal itching, sneezing) before treatment and at 2 and 4 weeks after treatment. RESULTS: There were no difference in the total IgE and total eosinophil count of 3 groups. There were also no significant difference in the initial symptom scores. For nasal congestion, group A and B showed significant improvement at 2 and 4 weeks after treatment compared with controls (each P=0.006, P=0.000, P=0.023, P=0.001). For sneezing, group A and B showed significant improvement at 2 weeks after treatment compared with controls (each P=0.048, P=0.011) and group B also showed significant improvement at 4 weeks after treatment compared with controls (P=0.041). In total nasal symptom score (TNSS), group A and B showed significant improvement at 2 and 4 weeks after treatment compared with controls (each P=0.014, P=0.005, P=0.008, P=0.005). CONCLUSION: In the moderate to severe persistent allergic rhinitis, leukotriene receptor antagonist or second generation anti-histamine is effective in nasal congestion and sneezing.
Child ; Eosinophils ; Estrogens, Conjugated (USP) ; Humans ; Immunoglobulin E ; Pruritus ; Receptors, Leukotriene ; Rhinitis ; Rhinitis, Allergic, Perennial ; Sneezing

BACKGROUND AND OBJECTIVES: High dorsal deflection of the nasal septum around cartilage or the perpendicular plate is technically difficult to correct. The objective of this study was to assess whether correction of high septal deviation during septoplasty is necessary to improve nasal airflow. PATIENTS AND SURGICAL METHOD: Twenty-one patients with high septal deviation around the septal cartilage or the perpendicular plate were included in this study. In order to improve nasal obstruction, septoturbinoplasty was performed, but high septal deviation was not corrected. Subjective and objective improvements were evaluated using the visual analogue scale and acoustic rhinometry 1 month before and 3 months after surgery. RESULTS: After correction of nasal septum deviation except high septal deviation and reduction of turbinate mucosal volume, postoperative nasal volume and minimum cross-sectional area were significantly increased. Subjective symptom scales for nasal obstruction, rhinorrhea, sneezing, and posterior nasal drip were considerably improved after limited septoturbinoplasty in patients who still had high dorsal deflection of the nasal septum. CONCLUSION: Our findings suggest that limited septoturbinoplasty without excessive resection of high dorsal deflection of the nasal septum can improve nasal airflow and reduce subjective symptoms, including nasal obstruction.
Cartilage ; Humans ; Methods ; Nasal Obstruction* ; Nasal Septum ; Rhinometry, Acoustic ; Sneezing ; Turbinates ; Weights and Measures

Ketotifen, a benzocycloheptathiophene, has an orally effective antiallergic as well as antihistaminic properties. In pervious studies, Ketotifen has shown encouraging results on patient with allergic rhinitis, either perennial or seasonal. 39 patients with allergic rhinitis had been treated with Ketotifen 1 mg twice daily for 8 weeks. And we obtained following results. 1) The efficacy rate in sneezing attack was 73.5%, in nasal discharge 71%, in nasal obstruction 58%. 2) Some improvements in at least one of three-major symptoms were noted within 1 week in 30.7%, within 2 weeks in 55.8%, within 3 weeks in 66.7%, within 8 weeks in 87.2%. 3) Physical findings such as colour, swelling of turbinate, character of rhinorrhea were not improved significantly. 4) Side effect was observed only in one patient with abdominal pain and diarrhea, which was subsided after interruption of administration. These results suggested that Ketotifen was effective in treatment of allergic rhinitis.
Abdominal Pain ; Diarrhea ; Humans ; Ketotifen* ; Nasal Obstruction ; Rhinitis, Allergic* ; Seasons ; Sneezing ; Turbinates

PURPOSE: The efficacy of intranasal corticosteroids for the treatment of allergic rhinitis has been reported. But the efficacy of intranasal corticosteroids has not been compared between perennial nonallergic rhinitis (PNAR) and perennial allergic rhinitis (PAR). METHODS: Twenty-three patients with PNAR and 19 patients with PAR were enrolled in this study. Every patient received fluticasone propionate (FP) 200 g (100 g, bid) daily for 4weeks. Control group (n=16) was received only anti-histamine (hydroxyzine 0.6 mg/kg/dose) intermittently. Efficacy of FP was evaluated by the mean change in nasal congestion, rhinorrhea, nasal itching, sneezing and total nasal symptom score (a sum of patient ratings of nasal congestion, rhinorrhea, nasal itching, and sneezing). RESULTS: Both groups (PNAR and PAR) showed similar improvement of nasal symptom with FP 200 g compared with control. (P< 0.05) In the total population, both groups showed significant improvements from baseline in TNSS compared with control during each week of treatment. (P< 0.05) In PNAR and PAR, nasal congestion was significantly improved more than in control. (P< 0.01, P< 0.01) Rhinorrhea and itching in PAR were improved more than in control. (P=0.02, P=0.03) In sneezing, all three groups showed no differences. (P=1.00, P=0.31, P= 0.29) CONCLUSION: Intranasal FP is an effective treatment for perennial nonallergic rhinitis as same as perennial allergic rhinitis.
Adrenal Cortex Hormones ; Diethylpropion ; Estrogens, Conjugated (USP) ; Humans ; Pruritus ; Rhinitis* ; Sneezing ; Fluticasone

Background & Objectives: Vasomotor rhinitis (VMR) is a chronic non-allergic rhinitis without the increased Ig E level and eosinophilia. Azelastine hydrochloride is a second generation anti-histamine medication with anti-inflammatory properties that inhibits the synthesis of inflammatory materials. There are reports that azelastine hydrochloride can be effective in the treatment of VMR. Therefore, this study examined the clinical efficacy of intranasal azelastine hydrochloride spray in comparison with placebo for the treatment of VMR. MATERIALS AND METHOD: This study was a prospective double blind randomized test. The subjects consisted of 84 VMR patients. Among them, 54 patients were treated with intranasal azelastine hydrochloride for 4 weeks and 30 patients with intranasal normal saline. Following the treatment, an analysis of the symptom score was performed in order to compare the treatment effects between the study group and the control group. RESULTS: In the study group, the symptom score was significantly improved in the areas of sneezing (1.38 to 0.72), rhinorrhea (1.57 to 0.76), nasal obstruction (1.76 to 1.01) and postnasal drip (1.43 to 0.65). In the control group, however, the symptom score was significantly improved in a single area of rhinorrhea (1.73 to 0.65). Patients in the study group, thus, displayed greater improvements in the areas of sneezing, rhinorrhea, nasal obasturction and postnasal drip comparative to the control group. Consequently, the study group patients were more satisfied with their quality of life than those of the control group. CONCLUSION: Azelastine chloride is a useful medicine for the treatment of VMR, especially in controlling sneezing, rhinorrhea, nasal obstruction and postnasal drip.
Eosinophilia ; Humans ; Nasal Obstruction ; Prospective Studies ; Quality of Life ; Rhinitis ; Rhinitis, Vasomotor* ; Sneezing

Although histamine and methacholine challenge tests are commonly used to evaluate the hypersensitivity in allergic rhinitis, some controversies still remain to standardize the test. This study was designed to evaluate the usefulness of the methacholine challenge test for the evaluation of hyperreactivity in allergic rhinitis. Twenty three patients with perennial allergic rhinitis and 17 normal subjects were included in this study. All subjects underwent saline nasal challenge and methacholine nasal challenge test with different doses (6 mg, 12 mg, 24 mg / in 0.5 ml of saline). We measured the nasal cavity volume by acoustic rhinometry in each step and counted the number of sneezes for 15 minutes. The volume of nasal secretion was also measured by tissue paper method. Besides that, we compared the data between allergic patients with a short (under 1 year) and long duration (more than 1 year). There were no differences in the frequency of sneezing and nasal volume change to each amount of methacholine in both groups. Nasal secretion increased after methacholine challenge in both groups. However, the allergic group showed significant increase after the methacholine challenge of 12 mg compared to the control group. And the volume of nasal secretion significantly increased in patients with a long duration. The nasal methacholine challenge test can be used as a diagnostic tool to detect hyperreactivity in perennial allergic rhintis. The optimal dilution was 12 mg (in 0.5 ml of saline) for the nasal methacholine challenge test.
Histamine ; Humans ; Hypersensitivity ; Methacholine Chloride* ; Nasal Cavity ; Rhinitis* ; Rhinometry, Acoustic ; Sneezing