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The Innate Immune Responses in Pathogenesis of Chronic Rhinosinusitis.

Journal of Rhinology.2014;21(1):22-27.

Chronic rhinosinusitis (CRS) is a multifactorial and heterogeneous disease, and variousfactors, such as inflammation, infection, fungus, and superantigens, have been proposed to play crucial roles in its pathogenesis. Recently, the dominant mechanismof CRS pathogenesis has shiftedfrom microbial infection and environmental factors to host susceptibility. Host susceptibility relies not only on adaptive immunity, but also on innate immunity, and there has recently been much research into innate immunity. Innate immunity is an evolutionally conserved immune system that recognizes microbial signature molecules via pattern recognition receptors and is a primary defense system that elicits inflammatory and bactericidal responses. Dysfunction of the host response to pathogens is suggested to be involved in pathogenesis of CRS and an irrelevant response of the host's innate immunity could cause a failure toeradicate the pathogens, thereby contributing to CRS pathogeneses. Among these innate immune systems, toll-like receptors and epithelial barrier functions have been studied extensively, and new players, such as innate lymphoid cells,have beensurfacing. Betterunderstanding of innate immunity couldhelp to investigateand treat this complex disease. In this review, toll-like receptors, epithelial barrier functions, and innate lymphoid cells,among many subjects related to innate immunity,will be discussed in terms of pathogenesis.
Adaptive Immunity ; Fungi ; Immune System ; Immunity, Innate* ; Inflammation ; Receptors, Pattern Recognition ; Superantigens ; Toll-Like Receptors

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Endoscopic Management of Cerebrospinal Fluid Rhinorrhea.

Sung Jae HEO ; Jung Soo KIM

Journal of Rhinology.2014;21(1):15-21.

Cerebrospinal fluid (CSF) rhinorrhea has become a relatively common disease due to increasingincidents oftraffic accidents and endoscopic sinus surgeries, including skull base surgery. Improvements in surgical skills and endoscopicequipment have contributed to broadening the indicationsforendoscopic management ofCSF rhinorrhea. Precise identification of the etiology and leakage site is important for the treatment of CSF rhinorrhea. A variety of sealing techniques, such as overlay, underlay, and bath-plug, showed similar surgical outcomes. In addition, the type of graft material did not make a difference inthe surgical results. Therefore, thechoice of technique and graft material depends on the judgment of the surgeon. Endoscopic management of CSF rhinorrhea demonstrated anexcellent success rate and low morbidity. There were only few complications duringendoscopic management of CSF rhinorrhea and these were not serious. In conclusion, endoscopic management is effective for CSF rhinorrhea and should be initially considered for the treatment of CSF leakage.
Cerebrospinal Fluid ; Cerebrospinal Fluid Rhinorrhea* ; Endoscopes ; Judgment ; Skull Base ; Transplants

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Otorhinolaryngologic Application of Stem Cells.

Byung Ki YOON ; Dong Kyu KIM ; Dae Woo KIM ; Hong Ryul JIN

Journal of Rhinology.2014;21(1):8-14.

Stem cells can be isolated from almost any tissue in the body and are capable of proliferating in an undifferentiated manner and, under appropriate inductive conditions, differentiating into multiple cell lineages. Numerous studies are being conducted around the world using stem cells in various medical fields, including otorhinolaryngology. This review provides a brief overview of the method used for human stem cell isolation, the current status of clinical applications in the field of otorhinolaryngology as well as in general medicine, and lastly, suggests the future potential of stem cells in otorhinolaryngologic surgery. Within the field of otorhinolaryngology, stem cells have been clinically used or studied in four main areas: bony framework reconstruction, soft tissue augmentation, cartilage repair and wound healing. Outcomes of stem cell application appear promising; however, further basic research and clinical studies with longer follow-up periods are needed to develop safe and successful clinical applications.
Cartilage ; Cell Lineage ; Humans ; Otolaryngology ; Stem Cells* ; Tissue Engineering ; Wound Healing

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What Do We Know about Septal Deformities?.

Ranko MLADINA ; Ljubisa BASTAIC

Journal of Rhinology.1997;4(2):79-89.

No abstract available.
Congenital Abnormalities*

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The Effect of Substance P on Nasal Mucosal Hypersensitivity through Sensory Nerve Axonal Reflex.

Do Young JANG ; Joong Saeng CHO ; Dong Yeup LEE ; Nam Pyo HONG ; Hwoe Young AHN

Journal of Rhinology.1997;4(1):38-42.

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

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A Study of Nasal Airway Resistance and Nasal Airflow in Augmentation Rhinoplasty.

Perapun JAREONCHARSRI ; Phadej DACHPUNPOUR ; Kittirat UNKANONT ; Chaweewan BUNNAG

Journal of Rhinology.1997;4(1):34-37.

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*

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The Influence of a Secretolytic Drug on Mucociliary Clearance of the Maxillary Sinus.

Oliver KASCHKE ; Hans BEHRBOHM ; Karin SYDOW

Journal of Rhinology.1997;4(1):29-33.

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

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Measurement of the so-called "Nasal Valve" in Japanese Subjects.

Keiichi ICHIMURA ; Tetsuo ISHIZUKA

Journal of Rhinology.1997;4(1):26-28.

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

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Nasal Patency Assessed by Acoustic Rhinometry after Endoscopic Sinus Surgery for Chronic Sinusitis.

Chong Nahm KIM ; Soon Kwan HONG ; Ji Ae LEE ; Ok Kyung JUNG ; Moon Hee CHANG ; Moon Jung KIM ; Yang gi MIN

Journal of Rhinology.1997;4(1):23-25.

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*

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Correlation between Nasal Obstruction and Parameters in Acoustic Rhinometry.

Seung Kyu CHUNG ; Yoo Seok JUNG ; Hun Jong DHONG ; Jun Sun RYU

Journal of Rhinology.1997;4(1):18-22.

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*

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