Rhinology最新文献

Background: Smell tests in children need to be standardized and validated, include odors familiar to children, and be defined by age-dependent standards. This study aimed to adapt the Sniffin Kids Test (SKT) for Polish children and conduct validation and evaluation of the Sniffin Kids Poland Test ().

Methodology: The study included 382 children (4-14 years old) recruited in Poland, who were allocated into healthy (n=343) and sick (with subjective olfactory disorders, n=39), divided into 3 age subgroups, but also 13 anosmic children with Kallmann syndrome (KS) and olfactory bulb aplasia. Firstly, the smell testing was performed in 382 children using SKT, and subsequently, SKPOL was created using odors identified by at least 75% of healthy individuals. The 10th percentile of SKPOL results in healthy children was adopted as a cutoff point between norm and pathology. SKPOL validation and reliability were assessed using the KS group results.

Results: Odor identification score in SKT of Polish children in healthy 6-14-year-olds did not meet the criteria for a test adapted for population studies. An odor identification rate was obtained for 5 odors in 4-7 years old, 7 odors in 8-10 years old, and 9 odors in 11-14 years old. SKPOL was created using these odors. Age-dependent norms for SKPOL were 26.5+-7.5 to 29.1+-7.4, respectively. All KS children had SKPOL results below the 10th percentile.

Conclusions: Validation and evaluation of SKPOL confirmed good adaptation and high reproducibility of the test for Polish children aged 4-14 years.

The recurrence of nasal polyps has frequently been observed with chronic rhinosinusitis with nasal polyps (CRSwNP), especially with asthma and N-ERD (NSAID-exacerbated respiratory disease). Patients with eosinophilic tissue infiltration are diagnosed as having eosinophilic chronic rhinosinusitis (ECRS), a unique CRSwNP subtype. Since the terminology of CRSwNP might include the patients with inflammatory polyps in addition to ECRS, the classification of CRSwNP by endotype is necessary to select the patients who require T2I-targeted biologic treatments. The concept of ECRS was established in 2001. However, a global consensus has not been reached regarding its definition due to the lack of standard histopathologic criteria and methodology for its classification.

Olfactory testing and training constitute important foundations of diagnostic and therapeutic management of patients presenting with olfactory loss. The precise repertoire of human olfactory receptors engaged by standard odorants in olfactory detection thresholds, identification tests, and training is surprisingly under-investigated, limiting our understanding of these methods.

When going through the table of contents for this issue of Rhinology, I noticed a few titles containing "real-world" or "real-life", Real-world evidence, real-life evidence, real-world experience, et cetera, all refer to data obtained from day-to-day practice.

Background: Two primary surgical approaches, the transcranial approach (TCA) and the endoscopic endonasal approach (EEA), offer distinct advantages and disadvantages, but studies have yet to compare their outcomes for trigeminal schwannoma (TS) resection systematically.

Methodology: A retrospective review of TSs between 2013 and 2023 was performed, with clinical characteristics, surgical outcomes, and follow-up data collected and analyzed. The patients were divided into two surgical groups, and tumours within each group were further classified according to the Samii system into middle fossa (type A), dumbbell-shaped involving middle and posterior fossae (type C), and extracranial with intracranial extension (type D), excluding posterior fossa (type B).

Results: A total of 101 patients (44 via EEA, 57 via TCA) were included. The two groups exhibited comparable baseline characteristics, except for the prevalence of dizziness in the pooled data (types A, C, and D). In pooled data and type A tumours, the EEA was associated with a statistically significant differences in higher gross total resection rate, shorter operative time, lower intracranial infection rate, and greater improvement in facial numbness. EEA was also significantly associated with a lower neurological deficits and higher Karnofsky Performance Scale scores in pooled data. Both approaches resulted in similar outcomes for type C tumours. EEA was advantageous for type D tumours in the infratemporal fossa, pterygopalatine fossa, and medial orbital regions, and no neurological deficits were observed.

Conclusions: The optimal outcome of the surgical approach and minimization of morbidity for these complicated lesions depend on the meticulous selection of cases.

Background: Recent studies suggest that intranasally administered vitamin D can be an effective treatment for patients with chronic rhinosinusitis (CRS). We performed a double-blind, placebo-controlled, randomized clinical trial to evaluate the effect of adding calcifediol to saline sinus irrigation with budesonide for patients with CRS.

Methods: A total of 113 adult patients with CRS were enrolled. Patients were randomized to either calcifediol (n = 58, 51%) or placebo (n = 55, 49%) lavage and were instructed to irrigate both nasal cavities twice daily for 21 days, with either calcifediol or placebo dissolved in a solution of saline with budesonide. The primary outcome measure was the change in Sino-Nasal Outcome Test (SNOT-22) scores, endoscopic examination scored by the Lund-Kennedy (L-K) grading system, and physician-reported response to treatment, as measured with decreased need for nasal steroids/cessation of nasal steroids in the calcifediol group compared with the placebo group. The secondary outcome measures included the change in serum 25(OH)D concentration and the correlation of results with other clinical data.

Results: 108 patients completed the trial. Significant changes in SNOT-22 score, L-K score and serum 25(OH)D were reported between the 2 study groups. A significant percentage of participants in the calcifediol group could cease nasal steroids.

Conclusion: Calcifediol in saline nasal lavage with budesonide results in clinically significant benefits beyond the benefits of saline with budesonide alone for patients with CRS.

Background: Nasal dysbiosis is implicated in the pathogenesis of nasal diseases, yet microbiome-host interplay remains poorly understood.

Methodology: We conducted a cross-sectional analysis comparing 43 CRSwNP patients, 27 NIP patients, and 34 controls using dual 5R 16S rRNA sequencing and host transcriptomics to characterize microbiome profiles and host-microbial interactions.

Results: Distinct microbiome patterns were identified in CRSwNP and NIP mucosal microenvironments. Host-microbiome interaction analysis revealed both shared and disease-specific associations. Common to both disorders were immune-related pathway enrichments, while CRSwNP uniquely demonstrated microbial recognition/immune activation links and NIP showed predominant proliferative pathway correlations. Notably, Bayesian network analysis identified Geobacillus stearothermophilus abundance as significantly associated with NF-kB pathway activation in nasal polyps - a finding subsequently experimentally validated.

Conclusion: Our findings delineate disease-specific microbiome-host interplay in nasal pathologies, with CRSwNP exhibiting immune-focused interactions versus NIP's proliferative associations. These insights advance our understanding of nasal disease mechanisms and support the development of targeted microbiome-modulating therapies.

Introduction: There is no data in the literature regarding the appropriate management of patients with an incidental finding of paranasal sinus fungal ball (FB) or its natural history. This study examined the long-term outcomes of a cohort of patients with FB, pooled from a large imaging database.

Methods: A retrospective screening of 108,369 head imaging studies for phrases indicative of FB in a tertiary referral center, during 2012-2023.

Results: A total of 1,716 patients were identified according to the search criteria and their imaging studies were evaluated by the authors. 83 (4.83%) patients were noted to have findings compatible with FB. Mean age was 78.3+-11.8 years and median follow-up (FU) time was 59.2 (10.2-178.8) months. The most involved sinuses were maxillary (50.6%) and sphenoid (43.4%). Intra-sinus calcifications and sinus opacification were observed in all patients. Additionally, sinus wall bony sclerosis, and erosion were observed in 44.5% and 2.4%, respectively. 5 (6.0%) patients underwent surgery during follow-up. 4 (4.8%) patients had FB-associated symptoms, and 1 patient (1.2%) had posterior sphenoid sinus wall erosion. No morbidity or complications were reported for the remaining 78 (94%) patients who did not receive treatment. During a median interval of 50 months, 34/49 (69.4%) patients with >=2 consecutive imaging studies showed no worsening of radiographic findings.

Conclusion: During an average FU of 5 years of patients with incidental FB findings, the vast majority remained asymptomatic and without complications. Thus, upfront surgical intervention for asymptomatic FB in elderly fragile patients may not be mandatory and a clinical and imaging FU can be a reasonable treatment plan.

Background: The nose is a resonator, the acoustic properties of which are determined by its shape. Due to its complex anatomy and hence intricate acoustical response the identification of universal acoustic characteristics of nasalized vowels and consonants is challenging. The purpose of this investigation was to 1) elucidate acoustic properties of the nasal resonator, 2) document how the paranasal sinuses affect it, and 3) examine if 3D-replicas of anatomical specimens provide reliable data for acoustic analysis.

Methods: In this experimental study the resonance properties of the nasal tract were analyzed in ex-vivo specimens as well as in their 3-D replicas. Their sound transfer characteristics were recorded by sending a sinewave, gliding from low to high frequency from an earphone airtightly sealed into the velopharyngeal port. The response was picked up at a nostril. The acoustical influence of the sinuses was reversibly eliminated by occlusion of the sinus ostia.

Results: Response curves of the nasal tract were found to possess two main resonances, one in the vicinity of 600-750 Hz and one in the 2500 â€" 3500 Hz range. Comparison of the acoustical responses obtained while including and excluding the influence of the paranasal cavities showed a great inter-individual variation in the response curve morphology. The cavities were found to introduce V-shaped sound level minima in the response curves.

Conclusions: When the influence of the paranasal cavities is eliminated, the nasal cavity presents two main resonances, which are determined mainly by its anatomical length. The resonances of the paranasal cavities introduce minima and maxima in the frequency response of the nasal tract at frequencies with substantial inter-individual variation. Replicas of anatomical specimens provide reliable data for acoustic analysis.

We read with great interest the systematic review by Choulakis et al. Traditional herbal medicine in the treatment of acute and chronic rhinosinusitis. This comprehensive analysis provides valuable insights into evidence-supported herbal interventions for rhinosinusitis, particularly highlighting preparations like BNO-1016 for acute rhinosinusitis (ARS) and Xiangju for chronic rhinosinusitis (CRS). The rigorous methodology, including risk-of-bias assessments, strengthens the review’s credibility.