Background: Idiopathic pseudotumour (IP) is a non-specific, non-neoplastic, inflammatory process without identifiable local or systemic causes. IP in the head and neck region present diagnostic and management issues. Methodology: Retrospective case series and literature review. Results: We describe clinical history, examination, laboratory investigations and image findings of three patients, all males who presented with facial pain and ophthalmoplegia. Scans revealed lesions in the pterygopalatine fossa. The diagnosis of idiopathic pseudotumour was confirmed by histopathology. We discuss their treatment pathways and prognosis. Conclusions: Idiopathic pseudotumours in the head and neck region especially those involving anterior skull base are rare. Understanding their presentation and characteristics might help an unsuspecting otorhinolaryngologist in the diagnosis and treatment of these lesions.
{"title":"Idiopathic pseudotumours of the pterygopalatine fossa: case series and a narrative review","authors":"M. Khan, J. Powell, ElBadawey, S. Carrie","doi":"10.4193/RHINOL/18.028","DOIUrl":"https://doi.org/10.4193/RHINOL/18.028","url":null,"abstract":"Background: Idiopathic pseudotumour (IP) is a non-specific, non-neoplastic, inflammatory process without identifiable local or systemic causes. IP in the head and neck region present diagnostic and management issues. Methodology: Retrospective case series and literature review. Results: We describe clinical history, examination, laboratory investigations and image findings of three patients, all males who presented with facial pain and ophthalmoplegia. Scans revealed lesions in the pterygopalatine fossa. The diagnosis of idiopathic pseudotumour was confirmed by histopathology. We discuss their treatment pathways and prognosis. Conclusions: Idiopathic pseudotumours in the head and neck region especially those involving anterior skull base are rare. Understanding their presentation and characteristics might help an unsuspecting otorhinolaryngologist in the diagnosis and treatment of these lesions.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45308079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
U. Walliczek-Dworschak, A. Zimmermann, S. Poletti, T. Hummel
Background: Numerous diseases are mediated by autoimmune mechanisms some of which have been shown to be associated with reduced olfactory function, e.g. systemic lupus erythematosus, Sjögren syndrome, psoriasis vulgaris. Postinfectious smell loss is a frequent cause of olfactory dysfunction. However, its nature is not fully understood, but connections to immune mediated processes might be possible. The primary aim of the present study was therefore to investigate the possible relation of postinfectious smell loss with autoimmune processes. Methods: Fifty-two patients (35 female, 17 male; mean age 57 years ± 12 years) with postinfectious smell loss and 56 controls (21 female, 35 male; mean age 58 years ± 13 years), with olfactory dysfunction of other causes (sinunasal, posttraumatic or idiopathic) were included in the present study. The patients’ olfactory function was measured using the extended test battery of the "Sniffin’ Sticks“. Furthermore venous blood samples were taken and analyzed for antinuclear autoantibodies. Results: Patients showed anti-nuclear antibodies (ANA) significantly more frequently compared to controls, although ANAs were typically only present at cut off levels of 1:100. In addition, there was a significant association between the presence of ANAs and odor thresholds. Conclusions: Results from this study indicate that postinfectious olfactory dysfunction may be associated with autoimmune processes, as they show significantly more ANAs – although not at a clincially significant level compared to patients with olfactory deficits of other origin.
{"title":"Antinuclear antibodies in postinfectious smell loss - a pilot study","authors":"U. Walliczek-Dworschak, A. Zimmermann, S. Poletti, T. Hummel","doi":"10.4193/rhinol/18.081","DOIUrl":"https://doi.org/10.4193/rhinol/18.081","url":null,"abstract":"Background: Numerous diseases are mediated by autoimmune mechanisms some of which have been shown to be associated with reduced olfactory function, e.g. systemic lupus erythematosus, Sjögren syndrome, psoriasis vulgaris. Postinfectious smell loss is a frequent cause of olfactory dysfunction. However, its nature is not fully understood, but connections to immune mediated processes might be possible. The primary aim of the present study was therefore to investigate the possible relation of postinfectious smell loss with autoimmune processes. Methods: Fifty-two patients (35 female, 17 male; mean age 57 years ± 12 years) with postinfectious smell loss and 56 controls (21 female, 35 male; mean age 58 years ± 13 years), with olfactory dysfunction of other causes (sinunasal, posttraumatic or idiopathic) were included in the present study. The patients’ olfactory function was measured using the extended test battery of the \"Sniffin’ Sticks“. Furthermore venous blood samples were taken and analyzed for antinuclear autoantibodies. Results: Patients showed anti-nuclear antibodies (ANA) significantly more frequently compared to controls, although ANAs were typically only present at cut off levels of 1:100. In addition, there was a significant association between the presence of ANAs and odor thresholds. Conclusions: Results from this study indicate that postinfectious olfactory dysfunction may be associated with autoimmune processes, as they show significantly more ANAs – although not at a clincially significant level compared to patients with olfactory deficits of other origin.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70416735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Klonaris, M. Doulaptsi, A. Karatzanis, Stylianos, Velegrakis, Athanasia Milioni, E. Prokopakis
Background: Chronic rhinosinusitis has been shown to have a significant impact on patients’ quality of life (QoL). We present and summarize current knowledge on assessment methods of Chronic Rhinosinusitis (CRS) burden and QoL. Methodology: Review of the literature using the PubMed database (search of terms “chronic rhinosinusitis”, “CRS”, “quality of life”, “QoL”, “outcome measures”, “assessment of CRS”, “CRS burden” separately or combined) limited to articles published in the English language. Results: Despite the plethora of objective methods available to assess and quantify burden of CRS, discrepancies are occasionally encountered when correlation with subjective measures of QoL is attempted via numerous patient self-reporting tools. Conclusion: CRS has a detrimental effect on QoL and assessing disease severity and burden is a difficult goal. The applicability of known assessment methodologies should be re-evaluated and validated according to research findings on CRS pathophysiology, and new tools should be developed based on the emerging knowledge and the need for personalized treatment and evaluation methods.
{"title":"Assessing quality of life and burden of disease in chronic rhinosinusitis: a review","authors":"D. Klonaris, M. Doulaptsi, A. Karatzanis, Stylianos, Velegrakis, Athanasia Milioni, E. Prokopakis","doi":"10.4193/RHINOL/18.067","DOIUrl":"https://doi.org/10.4193/RHINOL/18.067","url":null,"abstract":"Background: Chronic rhinosinusitis has been shown to have a significant impact on patients’ quality of life (QoL). We present and summarize current knowledge on assessment methods of Chronic Rhinosinusitis (CRS) burden and QoL. Methodology: Review of the literature using the PubMed database (search of terms “chronic rhinosinusitis”, “CRS”, “quality of life”, “QoL”, “outcome measures”, “assessment of CRS”, “CRS burden” separately or combined) limited to articles published in the English language. Results: Despite the plethora of objective methods available to assess and quantify burden of CRS, discrepancies are occasionally encountered when correlation with subjective measures of QoL is attempted via numerous patient self-reporting tools. Conclusion: CRS has a detrimental effect on QoL and assessing disease severity and burden is a difficult goal. The applicability of known assessment methodologies should be re-evaluated and validated according to research findings on CRS pathophysiology, and new tools should be developed based on the emerging knowledge and the need for personalized treatment and evaluation methods.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70416269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Jacques, G. Korres, N. Tatlas, S. Potirakis, B. Khotecha
Background: Selected adult patients with obstructive sleep apnoea-hypopnea syndrome (OSAHS) may benefit from surgical intervention. At present, the dominant technique for the diagnosis of the anatomical locus of upper airway obstruction during sleep is drug-induced sedation endoscopy (DISE). This technique is widespread, but has generated controversy related to its artificiality. Methodology: We present a technique for the acquisition of high-quality and consistent recordings of snoring sounds, suitable for advanced acoustic analysis and correlation with the findings of DISE. Results: Analysis of the generated recordings demonstrates distinct frequency-domain characteristics of snoring sounds generated by distinct anatomical subsites, for example the soft palate, or tongue base. Conclusions: Supplemental information may potentially be obtained from the waveform of snoring sounds produced by the patient; however, no robust quantitative “assay” has been developed or been clinically validated. This may in part be related to inconsistencies or insufficient quality of the sound data acquired. This novel technique may circumvent these difficulties and permit more advanced analysis techniques with potential clinical applicability.
{"title":"Use of a contact microphone for high-quality recording of snoring during natural or drug-induced sleep","authors":"T. Jacques, G. Korres, N. Tatlas, S. Potirakis, B. Khotecha","doi":"10.4193/RHINOL/18.029","DOIUrl":"https://doi.org/10.4193/RHINOL/18.029","url":null,"abstract":"Background: Selected adult patients with obstructive sleep apnoea-hypopnea syndrome (OSAHS) may benefit from surgical intervention. At present, the dominant technique for the diagnosis of the anatomical locus of upper airway obstruction during sleep is drug-induced sedation endoscopy (DISE). This technique is widespread, but has generated controversy related to its artificiality. Methodology: We present a technique for the acquisition of high-quality and consistent recordings of snoring sounds, suitable for advanced acoustic analysis and correlation with the findings of DISE. Results: Analysis of the generated recordings demonstrates distinct frequency-domain characteristics of snoring sounds generated by distinct anatomical subsites, for example the soft palate, or tongue base. Conclusions: Supplemental information may potentially be obtained from the waveform of snoring sounds produced by the patient; however, no robust quantitative “assay” has been developed or been clinically validated. This may in part be related to inconsistencies or insufficient quality of the sound data acquired. This novel technique may circumvent these difficulties and permit more advanced analysis techniques with potential clinical applicability.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48295083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. B. Dinis, T. Matos, M. Sardinha, P. L. Alves, J. Vital, A. Carvalho, J. Vítor
Background: The role played by Helicobacter pylori in the sinuses, and its association with the same organism’s gastric infection, are still unclear. Methods: In order to compare H.pylori colonization patterns in the nose and stomach we conducted a cohort analysis of 14 patients, eligible for sinus surgery due to chronic medically refractory rhinosinusitis, who were tested for simultaneous presence of H. pylori, by histology, culture and polymerase chain reaction, in pathologic sinus tissue collected during surgery and in gastric mucosa obtained through gastroduodenal endoscopy. Results: H. pylori DNA was found in the sinus mucosa of 15.4% of patients with chronic rhinosinusitis, and all of them showed concurrent H. pylori stomach infection. Sinus colonization was not found without simultaneous gastric colonization, although most patients with gastric infection did not have the bacterial DNA in their sinuses. H. pylori’s presence in the nose was not associated with local inflammatory status, and no cultures could be obtained from any of the sinus tissue samples, including those positive for H. pylori DNA. Conclusions: Only H. pylori DNA, and not the culturable active form of the microorganism, could be found in the sinus mucosa of some patients with H. pylori gastric infection. We could not find evidence, however, that the bacterium’s presence in the nose contributes to local mucosal inflammation.
{"title":"Helicobacter pylori in both the sinuses and the stomach","authors":"P. B. Dinis, T. Matos, M. Sardinha, P. L. Alves, J. Vital, A. Carvalho, J. Vítor","doi":"10.4193/RHINOL/18.035","DOIUrl":"https://doi.org/10.4193/RHINOL/18.035","url":null,"abstract":"Background: The role played by Helicobacter pylori in the sinuses, and its association with the same organism’s gastric infection, are still unclear. Methods: In order to compare H.pylori colonization patterns in the nose and stomach we conducted a cohort analysis of 14 patients, eligible for sinus surgery due to chronic medically refractory rhinosinusitis, who were tested for simultaneous presence of H. pylori, by histology, culture and polymerase chain reaction, in pathologic sinus tissue collected during surgery and in gastric mucosa obtained through gastroduodenal endoscopy. Results: H. pylori DNA was found in the sinus mucosa of 15.4% of patients with chronic rhinosinusitis, and all of them showed concurrent H. pylori stomach infection. Sinus colonization was not found without simultaneous gastric colonization, although most patients with gastric infection did not have the bacterial DNA in their sinuses. H. pylori’s presence in the nose was not associated with local inflammatory status, and no cultures could be obtained from any of the sinus tissue samples, including those positive for H. pylori DNA. Conclusions: Only H. pylori DNA, and not the culturable active form of the microorganism, could be found in the sinus mucosa of some patients with H. pylori gastric infection. We could not find evidence, however, that the bacterium’s presence in the nose contributes to local mucosal inflammation.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42698898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Mackenzie, D. Waite, K. Biswas, R. Douglas, Michael W Taylor
Methods: In this study, three techniques were assessed for microbial DNA enrichment: 1. A series of centrifugation steps, 2. Enrichment of microbial DNA using the NEBNext® Microbiome DNA Enrichment kit, and 3. Whole-genome amplification following the previous enrichment strategies. A no-treatment control and a whole-genome amplified control were also included. Swab samples from three adult patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis (CRS) were collected intraoperatively for this study. Paired-end shotgun metagenome sequencing was conducted using Illumina HiSeq and bacterial 16S rRNA gene amplicon sequencing using Illumina MiSeq to assess bacterial community composition.
{"title":"Assessment of microbial DNA enrichment techniques from sino-nasal swab samples for metagenomics","authors":"B. Mackenzie, D. Waite, K. Biswas, R. Douglas, Michael W Taylor","doi":"10.4193/RHINOL/18.052","DOIUrl":"https://doi.org/10.4193/RHINOL/18.052","url":null,"abstract":"Methods: In this study, three techniques were assessed for microbial DNA enrichment: 1. A series of centrifugation steps, 2. Enrichment of microbial DNA using the NEBNext® Microbiome DNA Enrichment kit, and 3. Whole-genome amplification following the previous enrichment strategies. A no-treatment control and a whole-genome amplified control were also included. Swab samples from three adult patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis (CRS) were collected intraoperatively for this study. Paired-end shotgun metagenome sequencing was conducted using Illumina HiSeq and bacterial 16S rRNA gene amplicon sequencing using Illumina MiSeq to assess bacterial community composition.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43341201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Maza-Solano, J. González-García, R. Moreno-Luna, J. Ambrosiani-Fernández, E. Domínguez-Durán, S. Sánchez-Gómez
{"title":"“ABCDEF Checklist\" based on 3D radiological images for preoperative planning of endoscopic sinus surgery","authors":"J. Maza-Solano, J. González-García, R. Moreno-Luna, J. Ambrosiani-Fernández, E. Domínguez-Durán, S. Sánchez-Gómez","doi":"10.4193/RHINOL/18.054","DOIUrl":"https://doi.org/10.4193/RHINOL/18.054","url":null,"abstract":"","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42447083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The middle turbinate is an important landmark during endoscopic sinus procedures. Well orientation of the appropriate planes, attachments and relations of the different parts of the middle turbinate helps achieve safe and effective endoscopic sinus surgery. Aim of work: To discuss the complex anatomy of the middle turbinate via a paper model of the middle turbinate and to validate its impact on clarifying the planes and attachments of the different parts of the middle turbinate. Study design: descriptive. Methods: Utilizing origami, a paper model of the middle turbinate was introduced by the author resembling its three parts. The model was used to demonstrate the planes and attachments of the different parts of the middle turbinate. Ten MCQs were administered to 76 candidates, prior and post demonstration, during three basic endoscopic sinus surgery courses. The pre and post scores were statistically analyzed. Results: The mean of pre-total score was 6.05 (range 0-10, SD 2.39) and the mean of the post-total score was 9.22 (range 7-10, SD 1.05). The difference of pre and post total score means was 3.17 (SD 2.32) which showed high statistical significance. Conclusion: The Kamel’s middle turbinate paper model is a valid educational tool. It is simple to assemble and useful to interpret the planes, attachments and relations of the different parts of MT. Moreover it has many fruitful clinical applications that may help achieve effective and safe endoscopic sinus surgery.
{"title":"Understanding the complex anatomy of the middle turbinate via educational origami","authors":"R. Kamel","doi":"10.4193/rhinol/18.072","DOIUrl":"https://doi.org/10.4193/rhinol/18.072","url":null,"abstract":"Background: The middle turbinate is an important landmark during endoscopic sinus procedures. Well orientation of the appropriate planes, attachments and relations of the different parts of the middle turbinate helps achieve safe and effective endoscopic sinus surgery. Aim of work: To discuss the complex anatomy of the middle turbinate via a paper model of the middle turbinate and to validate its impact on clarifying the planes and attachments of the different parts of the middle turbinate. Study design: descriptive. Methods: Utilizing origami, a paper model of the middle turbinate was introduced by the author resembling its three parts. The model was used to demonstrate the planes and attachments of the different parts of the middle turbinate. Ten MCQs were administered to 76 candidates, prior and post demonstration, during three basic endoscopic sinus surgery courses. The pre and post scores were statistically analyzed. Results: The mean of pre-total score was 6.05 (range 0-10, SD 2.39) and the mean of the post-total score was 9.22 (range 7-10, SD 1.05). The difference of pre and post total score means was 3.17 (SD 2.32) which showed high statistical significance. Conclusion: The Kamel’s middle turbinate paper model is a valid educational tool. It is simple to assemble and useful to interpret the planes, attachments and relations of the different parts of MT. Moreover it has many fruitful clinical applications that may help achieve effective and safe endoscopic sinus surgery.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41516787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Sahota, T. Bidder, R. Livingston, S. Douglas, Robinson, V. Lund, Matthew P. Su, H. Kariyawasam
Background: Chronic rhinosinusitis with and without nasal polyps (CRSwNP and CRSsNP respectively) can be difficult to treat and biologics offer potential as a future therapeutic intervention. CRS and severe asthma often co-exist. Omalizumab is currently licenced for the treatment of severe allergic asthma. Objective: The aim was to determine which blood biomarkers and treatment variables were associated with clinical response for sinonasal symptoms in patients with allergic CRSsNP and CRSwNP who were treated with omalizumab for severe allergic asthma. Methods: Sinonasal outcome test (SNOT)-22 scores were recorded in a cohort of patients with allergic CRSsNP (n=10) or CRSwNP (n=15) treated with omalizumab for severe asthma according to UK guidelines. Using a linear modelling approach, the improvement in the SNOT-22 score as the treatment variable against several disease and treatment predictor variables was modelled. Results: SNOT-22 significantly decreased with omalizumab treatment. Increased blood eosinophil count and omalizumab dosing every two weeks (as opposed to every 4 weeks) were associated with greater reductions in SNOT-22 after 16 weeks of omalizumab treatment. Conclusion: Our study confirms that omalizumab is an effective treatment for CRS, and suggests that improvements are greater in those with eosinophilic disease. Further studies are required to determine long term efficacy and whether this treatment could reduce the need for surgery.
{"title":"Chronic rhinosinusitis and omalizumab: eosinophils not IgE predict treatment response in real-life","authors":"J. Sahota, T. Bidder, R. Livingston, S. Douglas, Robinson, V. Lund, Matthew P. Su, H. Kariyawasam","doi":"10.4193/RHINOL/18.077","DOIUrl":"https://doi.org/10.4193/RHINOL/18.077","url":null,"abstract":"Background: Chronic rhinosinusitis with and without nasal polyps (CRSwNP and CRSsNP respectively) can be difficult to treat and biologics offer potential as a future therapeutic intervention. CRS and severe asthma often co-exist. Omalizumab is currently licenced for the treatment of severe allergic asthma. Objective: The aim was to determine which blood biomarkers and treatment variables were associated with clinical response for sinonasal symptoms in patients with allergic CRSsNP and CRSwNP who were treated with omalizumab for severe allergic asthma. Methods: Sinonasal outcome test (SNOT)-22 scores were recorded in a cohort of patients with allergic CRSsNP (n=10) or CRSwNP (n=15) treated with omalizumab for severe asthma according to UK guidelines. Using a linear modelling approach, the improvement in the SNOT-22 score as the treatment variable against several disease and treatment predictor variables was modelled. Results: SNOT-22 significantly decreased with omalizumab treatment. Increased blood eosinophil count and omalizumab dosing every two weeks (as opposed to every 4 weeks) were associated with greater reductions in SNOT-22 after 16 weeks of omalizumab treatment. Conclusion: Our study confirms that omalizumab is an effective treatment for CRS, and suggests that improvements are greater in those with eosinophilic disease. Further studies are required to determine long term efficacy and whether this treatment could reduce the need for surgery.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42511449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Amin, T. Jacques, F. Ting, C. Hopkins, P. Surda
Background: Combined transorbital and transnasal endoscopic surgery for access to the skull base has contributed to the gradual expansion of the remit of the endoscopic skull base surgeon. Method: We present our technique of Silastic® sheet aided combined transorbital and transnasal endoscopic resection of anterior skull base malignancies, with a description of surgical technique and our method of safeguarding the orbital contents with appropriate suggested indications. Results: Patient underwent resection of non-intestinal type adenocarcinoma. There were no immediate or delayed postoperative complications related to transorbital access. Conclusion: In cases where tumour infiltrates medial orbital wall and there is an indication to remove the lamina papyracea and/ or periorbita, we find the initial transorbital approach advantageous to find a dissection plane in healthy tissue and to achieve partial devascularisation of tumour by cauterisation of anterior and posterior ethmoidal artery. Moreover, this approach can be combined with intraorbital placement of Silastick sheet to prevent a prolapse of orbital contents into the nasal cavity during transnasal resection which may lead to its damage.
{"title":"Protective Silastic® sheet in combined transorbital and transnasal resection of sinonasal lesions","authors":"N. Amin, T. Jacques, F. Ting, C. Hopkins, P. Surda","doi":"10.4193/RHINOL/18.048","DOIUrl":"https://doi.org/10.4193/RHINOL/18.048","url":null,"abstract":"Background: Combined transorbital and transnasal endoscopic surgery for access to the skull base has contributed to the gradual expansion of the remit of the endoscopic skull base surgeon. Method: We present our technique of Silastic® sheet aided combined transorbital and transnasal endoscopic resection of anterior skull base malignancies, with a description of surgical technique and our method of safeguarding the orbital contents with appropriate suggested indications. Results: Patient underwent resection of non-intestinal type adenocarcinoma. There were no immediate or delayed postoperative complications related to transorbital access. Conclusion: In cases where tumour infiltrates medial orbital wall and there is an indication to remove the lamina papyracea and/ or periorbita, we find the initial transorbital approach advantageous to find a dissection plane in healthy tissue and to achieve partial devascularisation of tumour by cauterisation of anterior and posterior ethmoidal artery. Moreover, this approach can be combined with intraorbital placement of Silastick sheet to prevent a prolapse of orbital contents into the nasal cavity during transnasal resection which may lead to its damage.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49455653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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