1.Determining the severity of symptoms among patients with eosinophilic chronic rhinosinusitis with nasal polyposis versus non-eosinophilic chronic rhinosinusitis with nasal polyposis at the Veterans Memorial Medical Center
Geoffrey John S. Hizon ; Jay P. Espanto ; Kathleen M. Rodriguez-Labrador
Philippine Journal of Otolaryngology Head and Neck Surgery 2024;39(2):17-20
Objective:
To compare the severity of symptoms of patients diagnosed with Eosinophilic Chronic Rhinosinusitis with Nasal Polyposis (eCRSwNP) versus Non - Eosinophilic Chronic Rhinosinusitis with Nasal Polyposis (non-eCRSwNP) using the Filipino Sinonasal Outcome Test (Filipino SNOT 22) and determine the most common symptoms experienced by patients with eCRSwNP versus non-eCRSwNP.
:
Methods
Design:
Cross-Sectional Study
Setting:
Tertiary Government Training Hospital
Participants:
A total of 68 patients diagnosed with Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP) from November 7, 2018 to August 31, 2022 were included in the study.
Results:
Of the 68 patients included in the study, 33 (48.5%) had non-eCRSwNP while 35 (51.5%) had eCRSwNP. The age of the patients with non-eCRSwNP group was 50.6 + 18.45 and those with eCRSwNP was 52.9 + 16.6 years old. Non-eCRSwNP patients had a lower mean Filipino SNOT 22 score of 39.7 ± 16.1 compared with eCRSwNP with a score of 62.7± 13.5. The non-eCRSwNP patients had symptom severity classified as mild in 2 (6.1%), moderate in 25 (75.8%) and severe in 6 (18.2%) based on Filipino SNOT-22. Among the eCRSwNP group, majority of the patients, 29 (82.9%) were classified as severe, 6 (17.1%) as moderate, and none with mild severity. Using the Filipino SNOT 22, the most common symptoms of patients with eCRSwNP were item 2 (baradong ilong; nasal blockage) at 28.6%, then item 7 (malapot na sipon; thick nasal discharge) at 25.7%, Item 8 (pagbabara ng tenga; ear fullness) and item 12 (pagkawala/ pagkabawas ng panlasa/ pang amoy; decreased sense of smell/taste) were tied at 14.3%, item 13 (hirap sa pagtulog; difficulty falling asleep) at 25.7%, and item 17 (pagkapagod; fatigue during the day) at 31.4% while patients with no-eCRSwNP were noted with item 2 (baradong ilong; nasal blockage) at 48.5%, followed by item 4 (hindi tumitigil na pagtulo ng sipon; runny nose) at 21.2%, item 11 (pananakit ng mukha; facial pain) at 33.3%, Item 7 (malapot na sipon; thick nasal discharge) at 18.2%, and item 20 (pagiging irritable/pagkainis; irritability) at 21.2%.
Conclusion
Our present study suggests that the higher the SNOT 22 score, the more likely it is to be eosinophilic chronic rhinosinusitis. Although nasal blockage was the most common symptom found in both patients with eCRSwNP and non-eCRSwNP, patients with thick nasal discharge, decreased sense of smell/taste and ear fullness were more likely to be suffering from eCRSwNP, while patients with runny nose, facial pain and thick nasal discharge were more likely to have non-eCRSwNP.
Sinusitis
;
Endoscopic Surgical Procedure
;
Endoscopy
;
SNOT-22
;
Sino-Nasal Outcome Test
;
Nasal Blockage
;
Nasal Obstruction
4.Comparison of septoplasty with three high
Journal of Central South University(Medical Sciences) 2021;46(1):69-74
OBJECTIVES:
To compare the operation time, subjective and objective outcomes of septoplasty with three high-tension line resection and two high-tension line resection.
METHODS:
A prospective randomized controlled study was conducted to identify patients with septal deviation and symptomatic nasal obstruction. The patients were classified into a three high-tension line resection and senior physician group (Group A), a two high-tension line resection and senior physician group (Group B), a three high-tension line resection and junior physician group (Group C), a two high-tension line resection and junior physician group (Group D). In addition, according to whether there were the anterior deviation, some of patients were also divided into a three high-tension line resection and anterior deviation group (Group E) and a two high-tension line resection and anterior deviation group (Group F). The operation time was recorded. The patients completed the Nasal Obstruction Symptom Evaluation (NOSE) Scale (subjective symptom), nasal endoscopy (bodily sign) and rhinomanometry (objective examination) before and 6 months after septoplasty. The operation time and the efficacy were compared between three high-tension line resection operation and two high-tension line resection operation.
RESULTS:
There was no significant difference in the operation time between the Group A and the Group B (
CONCLUSIONS
The effect of septoplasty with two high-tension line resection is as good as septoplasty with three high-tension line resection. The septoplasty with two high-tension line resection is more suitable to junior physician because it is easier and the operation time is shorter.
Humans
;
Nasal Obstruction/surgery*
;
Nasal Septum/surgery*
;
Prospective Studies
;
Rhinoplasty
;
Treatment Outcome
5.Assessment of nasal airflow and pain, safety and cost of an improvised nasal airway (nasogastric) tube after endoscopic sinus surgery
Josephine Grace C. Rojo ; Rachel Zita H. Ramos
Philippine Journal of Otolaryngology Head and Neck Surgery 2020;35(2):22-26
Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP).
Methods:
Design: Quasi - Experimental Prospective Cohort Study
Setting: Tertiary Government Training Hospital
Participants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone.
Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A.
Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.
stents
;
nasal obstruction
;
nasal polyps
;
sinusitis
6.Nasal Nitric Oxide Is Correlated With Nasal Patency and Nasal Symptoms
Lei REN ; Wei ZHANG ; Yuan ZHANG ; Luo ZHANG
Allergy, Asthma & Immunology Research 2019;11(3):367-380
PURPOSE: Nitric oxide (NO) is an important endogenous mediator in both upper and lower respiratory systems. The purpose of the present study was to extract nasal NO (nNO) normal range of Chinese adults and the internal influencing factors. The differences in nNO levels between rhinitis and asymptomatic atopic subjects, and the diagnostic value of nNO in allergic rhinitis (AR) were further investigated. METHODS: One thousand adults were recruited from the general public. Participants were divided into different subgroups according to the questionnaires and skin prick tests. In all of these subjects, nNO, fractional exhaled NO (FeNO) and nasal airflow resistance were measured. The normal ranges of nNO and FeNO, the differences between subgroups, and the correlations between NO (nNO and FeNO) and other internal factors were analyzed. RESULTS: Both nNO and FeNO levels were significantly higher in AR patients than in healthy and asymptomatic atopic subjects. The nNO levels were significantly lower in asymptomatic atopic subjects than in normal adults. FeNO levels were significantly higher in non-AR patients than in the healthy and asymptomatic atopic adults. The cutoff value of nNO for the diagnosis of AR was 117.5 ppb (sensitivity, 50.9%; specificity, 63.9%). The nNO levels were correlated with FeNO levels, total nasal resistance measured at 75Pa, nasal volume within 0–7 cm from the anterior nares (V0–7cm) and nasal symptom visual analogue scale (VAS) scores, while the FeNO levels were correlated with age, height, weight, body surface area, nasal volume of V0–7cm and the nasal symptom VAS score. CONCLUSIONS: The nNO level can be significantly different between healthy and AR patients and may be significantly correlated with nasal symptoms and nasal patency of rhinitis patients. However, the clinical value of nNO is still in the exploration stage.
Adult
;
Asian Continental Ancestry Group
;
Body Weight
;
Diagnosis
;
Humans
;
Nasal Obstruction
;
Nitric Oxide
;
Reference Values
;
Respiratory System
;
Rhinitis
;
Rhinitis, Allergic
;
Sensitivity and Specificity
;
Skin
7.Two Cases of Recurrent Nasal Polyps in Siblings-Woakes' Syndrome
Chang Bae LEE ; Nam Yoon JUNG ; Young Jin LOH ; Woo Yong BAE
Korean Journal of Otolaryngology - Head and Neck Surgery 2019;62(4):250-254
Woakes' syndrome is a group of disease which include recurrent nasal polyps resulting in the broadening of the nasal pyramid, the onset of hypoplasia of frontal sinus and bronchiectasis, as well as the production of mucous discharge. Children and young adults are mostly susceptible to Woakes' syndrome due to the plasticity of the bone. Even though the exact etiology is unknown, genetic factor is thought to be influential because it is often diagnosed in siblings. Otolaryngologically, the mainstream method of removing nasal polyp by endoscopic sinus surgery as well as topical or systemic treatment can be helpful. We report two siblings who visited our clinic both complaining of nasal obstruction. The patients presented with recurrent nasal polyps and showed signs of bronchiectasis, which led to the diagnosis of Woakes' syndrome. These rare cases are presented here with a review of related literature.
Bronchiectasis
;
Child
;
Diagnosis
;
Fibrinogen
;
Frontal Sinus
;
Humans
;
Methods
;
Nasal Obstruction
;
Nasal Polyps
;
Plastics
;
Siblings
;
Young Adult
8.A Case of Septal Abscess and Sphenoid Sinusitis after Dental Implant
Jun LEE ; Su Jin KIM ; Myoung Su CHOI
Korean Journal of Otolaryngology - Head and Neck Surgery 2019;62(4):242-245
A nasal septal abscess results from the collection of purulent fluid between the cartilage of bony septum and overlying mucoperichondrium or mucoperiosteum. Unless early diagnosis and surgical treatment are performed, serious complications such as cavernous sinus thrombophlebitis, sepsis, and saddle nose may occur. We report a case of septal abscess and sphenoid sinusitis that occurred after dental implant. A 74-year-old female with diabetes and liver cirrhosis was referred to the hospital for management of rapidly aggravated perinasal pain, nasal obstruction, and headache. The patient had undergone dental implant in the right upper incisor area 6 days ago. A CT revealed septal abscess and bilateral sphenoid sinusitis. The patient was operated upon to drain septal abscess, and both sphenoid sinuses were opened widely.
Abscess
;
Aged
;
Cartilage
;
Cavernous Sinus Thrombosis
;
Dental Implants
;
Early Diagnosis
;
Female
;
Headache
;
Humans
;
Immunocompromised Host
;
Incisor
;
Liver Cirrhosis
;
Nasal Obstruction
;
Nasal Septum
;
Nose
;
Sepsis
;
Sphenoid Sinus
;
Sphenoid Sinusitis
9.Clinical Analysis of Benign and Malignant Nasal Septal Tumors
Dong Hoon LEE ; Sang Chul LIM ; Sung Ho YOON ; Tae Gu KANG ; Jong Min PARK
Korean Journal of Otolaryngology - Head and Neck Surgery 2019;62(4):228-232
BACKGROUND AND OBJECTIVES: The purpose of this study was to review the clinical characteristics and treatment outcomes of benign and malignant nasal septal tumors. SUBJECTS AND METHODS: A total of 34 patients who underwent the treatment for nasal septal tumor between 2004 and 2015 were included in this study. Demographic characteristics, sinonasal chief complaints, size and localization of nasal septal tumor, imaging findings, surgical method, histopathologic results, treatment outcomes, and postoperative complications were reviewed. RESULTS: Of the 34 patients with nasal septal tumor used in this study, 22 (64.7%) had benign tumors and 12 (35.3%) had malignant tumors. The most common sinonasal complaint of both benign and malignant nasal septal tumors was nasal obstruction. The most common benign tumor was inverted papilloma (n=7), whereas the most common malignant tumors were malignant melanoma (n=2), plasmacytoma (n=2), and metastatic carcinoma (n=2). All patients except two cases underwent endoscopic tumor removal. There were 4 recurrences in malignant nasal septal tumors. There was no recurrence in benign tumors. No major complications resulting from surgical intervention were found. CONCLUSION: Endoscopic surgery with complete excision is a safe and effective procedure for benign nasal septal tumors. Recurrence is more common in malignant nasal septal tumor. Therefore, long term follow-ups with regular radiologic and endoscopic examinations are necessary for patients with malignant nasal septal tumor.
Follow-Up Studies
;
Humans
;
Melanoma
;
Methods
;
Nasal Obstruction
;
Nasal Septum
;
Papilloma, Inverted
;
Plasmacytoma
;
Postoperative Complications
;
Radiotherapy
;
Recurrence
10.Effects of Vacuuming Mattresses on Allergic Rhinitis Symptoms in Children
You Hoon JEON ; Yong Ju LEE ; Myung Hyun SOHN ; Hae Ran LEE
Allergy, Asthma & Immunology Research 2019;11(5):655-663
PURPOSE: To evaluate the effects of daily vacuuming of mattresses on the concentration of house dust mite (HDM) allergens and on allergic rhinitis (AR) symptoms in children sensitized to HDM. METHODS: Forty children between the ages of 6 and 12 years with mild persistent AR and sensitized only to HDM were enrolled and randomly allocated to 2 groups. Caregivers of children in the experimental group cleaned the children's rooms and vacuumed their mattresses daily for 2 weeks. Caregivers of children in the control group cleaned the children's rooms without vacuuming mattresses. Symptoms of AR were checked weekly and dust samples were collected from the mattresses before and after the study. RESULTS: Demographics at the beginning of the study were not significantly different between the 2 groups. In the experimental group, symptoms of AR and dust weight were significantly decreased after 2 weeks (total symptoms of AR, P <0.001; sneezing, P < 0.001; rhinorrhea, P <0.001; nasal obstruction, P < 0.001; itching, P <0.001; and dust weight, P = 0.006). The concentrations of HDM allergens were not changed significantly (Der p1, P = 0.333; Der f1, P = 0.841). In the control group, there were no significant changes in symptoms of AR, dust weight, or the concentration of HDM allergens. CONCLUSIONS: Our findings showed that daily vacuuming of mattresses reduced dust weight and symptoms of AR. However, the concentration of HDM allergens did not significantly decrease.
Allergens
;
Beds
;
Caregivers
;
Child
;
Demography
;
Dermatophagoides pteronyssinus
;
Dust
;
Humans
;
Nasal Obstruction
;
Pruritus
;
Pyroglyphidae
;
Rhinitis, Allergic
;
Sneezing
;
Vacuum


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