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Nasofacial Zygomycosis by Conidiobulus Coronatus Responsive to Itraconazole.

Aru HANDA ; K K HANDA ; AK KARAK ; Abhay SINHA

Journal of Rhinology.2000;7(2):157-159.

Conidiobolomycosis/Nasofacial zygomycosis is a relatively rare disease entity. It is almost always caused by Conidiobolus coronatus and is also known as conidiobolomycosis. It has been more commonly reported in tropical countries than in other regions. Diagnosis is made mainly on a clinical and pathological basis as fungal cultures may be difficult to grow. Different antimycotic drugs have been tried for its treatment. This report probably is the first case in English literature that has shown a very good response to treatment with itraconazole.
Conidiobolus ; Diagnosis ; Itraconazole* ; Rare Diseases ; Zygomycosis*

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A Case of Allergic Mucin Sphenoiditis without Fungus.

Ic Tae KIM ; Sang Yoon SONG ; Ki Hyun CHANG ; Byung Ho SONG ; Hye Rim PARK

Journal of Rhinology.2000;7(2):154-156.

Allergic fungal sinusitis is characterized by eosinophilic allergic mucin with fungal hyphae in histopathologic aspect. "Allergic mucin sinusitis without fungus" or "Allergic fungal sinusitis-like syndrome" is a new term used to describe patients who have clinical and histopathologic features of allergic fungal sinusitis but fail to demonstrate fungi in histopathologic sections or cultures of sinus tissue. In this study, we report on a case of allergic mucin sinusitis which involved only sphenoid sinus of the left side in a 31 year old female.
Adult ; Eosinophils ; Female ; Fungi* ; Humans ; Hyphae ; Mucins* ; Sinusitis ; Sphenoid Sinus

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Inhibition of Murine Allergic Response by Monoclonal Interleukin-4 Receptor Antibody.

Chul Hee LEE ; Ja Bock YUN ; Chae Seo RHEE ; Seok Won PARK ; Jeong Whun KIM

Journal of Rhinology.2000;7(2):149-153.

BACKGROUND AND OBJECTIVES: Several strategies were used to control the IgE production by interfering the functional activities of IL-4. However, most of them revealed limited effects to reduction of allergic response. This study was aimed to investigate the effects of interleukin-4 receptor (IL-4R) antibody on allergic response in animal model of allergic rhinitis. MATERIALS AND METHODS: Male BALB/C mice were sensitized with intraperitoneal injection of ovalbumin (OVA). IL-4R antibody was injected intravenously before intranasal challenge of OVA with ultrasonic nebulizer. Allergic symptoms, a number of eosinophils in nasal mucosa and serum level of OVA-specific IgE were evaluated. RESULTS: In IL-4R antibody treated mice, allergic symptom score were decreased (53.5%) than in control mice. The number of eosinophils in nasal mucosa were also reduced (47.4%). However, serum level of OVA-specific IgE were not obviously reduced (14.3%). CONCLUSION: These results suggested that IL-4R antibody has a potential effect for the treatment of allergic rhinitis in vivo.
Animals ; Eosinophils ; Humans ; Immunoglobulin E ; Injections, Intraperitoneal ; Interleukin-4* ; Male ; Mice ; Models, Animal ; Nasal Mucosa ; Nebulizers and Vaporizers ; Ovalbumin ; Ovum ; Rhinitis ; Ultrasonics

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Lengthening of Short Noses.

Dong Hak JUNG ; Jong Chul CHOI ; Tae Young JANG ; Min Wook KIM ; Jin KIM

Journal of Rhinology.2000;7(2):142-148.

BACKGROUND AND OBJECTIVES: Lengthening of short noses is one of the therapeutic dilemmas in facial plastic surgery. Aesthetically, short noses are characterized by a decreased distance from the root of the nose to the tip-defining point, and this extends less than one third the vertical height of the face. Also, concavity of the dorsum, a low and deep nasion, an overprojected tip, and an obtuse nasolabial angle of the nose will give a shortened appearance. Considering aesthetical and facial analytic factors, we discuss three techniques for the correction of this problem and propose useful procedure for the desired effect of lengthening in this study. MATERIALS AND METHODS: We have experienced eleven cases of lengthening of the short nose during the last 2 years. We categorized these patients into three groups according to nasolabial angle and tip projection which make a distribution in selecting procedure. On-lay graft on the caudal margin of the lower lateral cartilage is used to the patients with mild overrotated tip and proper nasal projection. Cartilage graft between the caudal septum and the lower lateral cartilge combined with on-lay graft on the caudal margin of the lower lateral cartilage is used to the patients with moderately overrotated tip. Full-length dorsal augmentation is applied to the patients with severely overroatated tip and problematic tip projection. RESULTS: We used three techniques aimed at the correction of the short nose. These techniques treated short nose patients and we obtained effective substantial lengthening results in this study. CONCLUSION: Aesthetical and facial analytic factors must be considered in properly selecting a procedure to lengthen the short nose.
Cartilage ; Humans ; Nose* ; Surgery, Plastic ; Transplants

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Effect of Hot Steam Inhalation on Microcirculation of Nasal Mucosa.

Hyun Ung KIM ; Sung Shik KIM ; Hyun Joong PARK ; Joo Heon YOON ; Jeung Gweon LEE

Journal of Rhinology.2000;7(2):137-141.

BACKGROUND AND OBJECTIVES: Nasal inhalation of hot humidified air may alleviate nasal symptoms associated with rhinologic disease. Thus, hot steam inhalation is often recommended as a home remedy for various nasal disorders such as the common cold and allergic rhinitis. But the mechanism of its effect is not fully known and correct guidelines for implementing hot steam inhalation have not been settled. We studied microcirculation of nasal mucosa using the nasal Laser Doppler Flowmetry (LDF) in ten healthy subjects in order to evaluate normal physiologic reactions to hot steam. MATERIALS AND METHODS: 10 healthy volunteers inhaled hot steam (about 42degrees C) 10 times, 20 times, 30 times, 50 times and 100 times respectively. Nasal LDF was then performed using a Peiflux 4001 (Perimed, Jartalla, Sweden) and the microcirculatory parameters perfusion, velocity, and concentration were each recorded at base line immediately, 15 minutes, 30 minutes, 60 minutes, 90 minutes and 120 minutes after hot steam inhalation. RESULT: Microcirculatory perfusion was highest at 15 minutes after hot steam inhalation regardless of how many times inhalation occurred. It was found that at 15 minutes, there was a significant increase of microcirculatory perfusion in subjects inhaling 50 times and 100 times (p<0.05). But, at 120 minutes, significant increase of microcirculatory perfusion was only seen in subjects inhaling 100 times (p<0.05). CONCLUSION: After inhalation of hot steam, an increased microcirculatory perfusion of nasal mucosa was registered. Up to inhaling of 100 times, it leads to effective increasement of microcirculation of nasal mucosa.
Common Cold ; Healthy Volunteers ; Inhalation* ; Laser-Doppler Flowmetry ; Medicine, Traditional ; Microcirculation* ; Nasal Mucosa* ; Nose Diseases ; Perfusion ; Rhinitis ; Steam*

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Effects of Saline Solution on Ciliary Movement in Human Nasal Epithelium in vitro.

Kang Soo LEE ; Chang Ho LEE ; Yang Gi MIN ; Chae Seo RHEE ; Chul Hee LEE ; Dong Wook LEE

Journal of Rhinology.2000;7(2):132-136.

BACKGROUND AND OBJECTIVES: Osmolarity is known to affect ciliary beat frequency (CBF) ; however, little is known about the effects of saline spray or irrigation on ciliary activity in human nasal epithelium. The aim of this study was to assess whether CBF is affected by hypertonic, isotonic or hypotonic saline solution in vitro and whether histologic changes are associated with the alteration of ciliary movement. MATERIALS AND METHODS: Normal turbinate mucosa was exposed to five different concentrations including 0.06%, 0.12%, 0.9%, 3.0%, and 7.0% of phosphate-buffered saline solutions. CBF was measured up to 60 minutes after exposure to each concentration of saline solution and histologic changes were examined by transmission electron microscopy. RESULTS: Isotonic and hypotonic saline solutions produced no ciliary slowing ; however, ciliostasis was observed within a few minutes in 3.0% or 7.0% saline solution. Immediately after complete ciliostasis in the hypertonic solutions, the solutions were replaced with 0.12% or 0.9% saline solution in order to observe the reversibility of CBF. Only 0.12% hypotonic saline induced the recovery of ciliary movement. The ultrastructural changes demonstrated that the ciliary slowing might be attributed to epithelial damage by fluid transport toward the surrounding medium. CONCLUSION: Our results suggest that isotonic and hypotonic saline solutions may be more appropriate for nasal irrigation than hypertonic saline solutions.
Humans* ; Hypertonic Solutions ; Microscopy, Electron, Transmission ; Mucous Membrane ; Nasal Lavage ; Nasal Mucosa* ; Osmolar Concentration ; Saline Solution, Hypertonic ; Sodium Chloride* ; Turbinates

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Can the Acoustic Rhinometry Reflect the Real Volume Change of the Nasal Cavity?.

Jun Yeon WON ; Yoo Sam CHUNG ; Jae Ho KIM ; Yong Jae KIM ; Bong Jae LEE

Journal of Rhinology.2000;7(2):127-131.

BACKGROUND AND OBJECTIVES: Acoustic rhinometry (AR) measures nasal cavity geometry by analyzing reflected acoustic impulses. The authors aimed to find out whether AR could reflect the volume change developed from conchotomy. MATERIALS AND METHODS: To establish the test-retest reliability of the AR, 20 normal nasal cavities were tested with AR before conducting main study. The volumes of the 31 conchotomy specimens were measured with water displacement method (WDM). The nasal volume changes in accordance with conchotomy operations were measured with AR, and the paired values were compared. RESULTS: AR revealed highly consistent results as there was statistically significant correlation between test and retest values (r=0.98, p<0.0001). The volume of the conchotomy specimens measured with WDM was 1.40+/-0.63 cm3 (mean+/-SD) and the volume change measured with AR was 1.49+/-1.48 cm3 (mean+/-SD). There was statistically significant correlation between the two values (r=0.55, p<0.01), though they were not so consistent with each other. CONCLUSION: The nasal volume change after conchotomy measured with AR correlates with the conchotomy specimen volume with statistical significance, though the correlation between them does not always show consistency.
Acoustics* ; Nasal Cavity* ; Rhinometry, Acoustic* ; Water

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Enhancement of Microvascular Leakage in the Nasal Mucosa after Re-exposure to Capsaicin in a Rat Model Challenged/Rechallenged with Capsaicin.

Sea Yuong JEON ; Eun Ah KIM ; Jong Hwa SUNG ; Jin Pyeong KIM ; Tae Gee JUNG ; Eui Gee HWANG

Journal of Rhinology.2000;7(2):123-126.

It has been suggested that the role of neurogenic inflammation is to protect the airway from various noxious irritants in inhaled air. Repeated exposure to various irritating stimuli has become very common in daily life. However, the process that occurs in neurogenic inflammation after repeated exposure to irritating stimuli is not yet clearly understood. The aim of this study was to investigate the changes of microvascular leakage in the airways after re-exposure to capsaicin in an experiment using a rat model challenged/rechallenged with capsaicin. Twenty-four Sprague-Dawley rats were divided into four groups : a capsaicin-challenged group (10 microgram/kg of capsaicin, intravenous, n=6) and three capsaicin-rechallenged groups (10 microgram/kg of capsaicin, intravenous, n=6 in each group) corresponding to time intervals of 1, 3, or 6 hours after capsaicin-challenge. The amount of microvascular leakage in the nasal mucosa and trachea of the animal in each group was measured with extravasation of Evans blue dye (30 mg/kg, intravenous) using a spectrophotometer. In the nasal mucosa, a significant enhancement of microvascular leakage with capsaicin-rechallenge was observed at 3 hours after capsaicin-challenge (AVOVAR, * : p<0.01). However, there was no significant changes in the trachea. In conclusion, the protective mechanisms against repeated irritating stimuli in the nasal mucosa and trachea are different. After exposure to a noxious irritant, the airway defense mechanism mediated by an axon reflex in the nose may be up- regulated, while that in the trachea may not be changed.
Animals ; Axons ; Capsaicin* ; Evans Blue ; Irritants ; Models, Animal* ; Nasal Mucosa* ; Neurogenic Inflammation ; Nose ; Rats* ; Rats, Sprague-Dawley ; Reflex ; Trachea

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Trans-Inferior Turbinate Approach for Endoscopic Sphenopalatine Artery Ligation.

Sea Yuong JEON ; Jae Ho JEONG ; Dong Ju KIM ; Jong Hwa SUNG ; Jae Hong CHEON ; Jin Pyeong KIM

Journal of Rhinology.2000;7(2):119-122.

BACKGROUND AND OBJECTIVES: With the recent development of endoscopic nasal surgery, endoscopic sphenopalatine artery ligation allows for secure control of posterior epistaxis with considerably low recurrence and complications. Surgical approaches to the sphenopalatine foramen to ligate the sphenopalatine artery are transantral, intranasal, and transseptal. However, the procedures have considerable limitations. Therefore, we have revised the transturbinal approach, which was described by Togawa for intranasal vidian neurectomy in 1977, to ligate the sphenopalatine artery in two patients of intractable posterior epistaxis, and describe our technique of the trans-inferior turbinate approach for endoscopic sphenopalatine artery ligation. SURGICAL TECHNIQUE: A longitudinal incision is made along the lower border of the inferior turbinate, and the mucoperiosteal flaps are developed to the lateral nasal wall. The posterior two-thirds of the inferior turbinate bone is removed from the lateral nasal wall. The posterior lateral nasal artery on the upper flap is positively identified, and followed to the posterior end of the middle turbinate bone. The sphenopalatine foramen can be localized after removing the posterior end of the middle turbinate bone, and the sphenopalatine artery is ligated with hemoclips or divided with bipolar electrocautery. RESULTS: With the trans-inferior turbinate approach, it was possible to identify and ligate the sphenopalatine artery and its branches in the sphenopalatine foramen with no immediate or delayed complications. CONCLUSION: The trans-inferior turbinate approach provides unobscured surgical access to the posterior nasal cavity, and enough working space for endoscopic manipulation. The posterior lateral nasal artery is a reliable surgical landmark leading to the sphenopalatine foramen.
Arteries* ; Electrocoagulation ; Epistaxis ; Humans ; Ligation* ; Nasal Cavity ; Nasal Surgical Procedures ; Recurrence ; Turbinates*

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Measurement of Nasal Trigeminal Pungency Threshold: Comparison between Normals and Patients with Decreased Sense of Smell.

Kyung Hun YANG ; Chang Yun LEE ; Ic Tae KIM ; Young Min PARK ; Hyun Joon LIM

Journal of Rhinology.2000;7(2):113-118.

BACKGROUND AND OBJECTIVES: In order to measure the level of nasal trigeminal pungency threshold and to evaluate the interaction between olfactory and trigeminal nerves, we measured olfactory thresholds and trigeminal pungency thresholds using 1-butanol in 40 normal people and in 46 patients with decreased sense of smell by non-sinonasal origin. MATERIALS AND METHODS: Two-alternative forced-choice modified ascending method of limit (CCCRC test) was used for the measurement of olfactory and pungency thresholds, using 1-butanol plastic squeezable bottles successively threefold diluted by distilled water as stimulus, while distilled water as blank. RESULTS: There was a statistically significant difference in pungency threshold between normals (2.18+/-1.5 dilution step) and patients (1.11+/-1.0 dilution step)(p<0.001). CONCLUSION: The pungency thresholds of hyposmics and anosmics are higher than those of normals, which suggests that a loss or decrease of olfactory sensation is accompanied by a simultaneous decrease of trigeminal chemosensitivity.
1-Butanol ; Humans ; Olfaction Disorders ; Plastics ; Sensation ; Smell* ; Trigeminal Nerve ; Water

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