Meredith M. Lamb, Kaitlyn DeHority, S. Russel, Sulgi Kim, Taylor J. Stack, Ibtisam Mohammad, Abdullah Zeatoun, Cristine N. Klatt-Cromwell, Charles S. Ebert, John M Baratta, Brent A Senior, A. Kimple
Background A subset of individuals suffering from Coronavirus Disease 2019 (COVID-19) will experience ongoing symptoms that last longer than three months (i.e., long-haul COVID). This includes olfactory dysfunction (OD), which is currently estimated to occur in 1-63.5% of patients at one-year post-infection. However, OD in individuals with long-haul COVID-19 is poorly understood, and there is little information regarding how initial SARS-CoV-2 variants correlate with long-haul symptoms. In this study, we investigated the prevalence and severity of OD in patients with long-haul COVID-19 and investigated how OD severity varied with SARS-CoV-2 variants. Methods Patients were recruited from the University of North Carolina-Chapel Hill COVID Recovery Clinic. Each patient completed the University of Pennsylvania Smell Identification Test (UPSIT). The dominant strain at the time of infection was determined using the date of COVID-19 diagnosis, and Centers for Disease Control and Prevention, World Health Organization, and North Carolina Department of Health and Human Services databases. Results Nearly 85% of patients with long-haul COVID-19 reported some degree of OD, which persisted in some patients for two or more years from the date of the initial infection. There was no association between the time since COVID-19 infection and severity of OD. No difference was detected between OD in patients with long-haul COVID-19 based on the dominant variant at the time of infection (p=0.0959). Conclusion A vast majority of patients with long-haul COVID-19 had some degree of ongoing olfactory complications, although the severity of symptoms was not dependent on the dominant SARS-CoV-2 variant at the time of infection.
{"title":"Characteristics of olfactory dysfunction in patients with long-haul covid-19.","authors":"Meredith M. Lamb, Kaitlyn DeHority, S. Russel, Sulgi Kim, Taylor J. Stack, Ibtisam Mohammad, Abdullah Zeatoun, Cristine N. Klatt-Cromwell, Charles S. Ebert, John M Baratta, Brent A Senior, A. Kimple","doi":"10.4193/rhinol/23.01","DOIUrl":"https://doi.org/10.4193/rhinol/23.01","url":null,"abstract":"Background A subset of individuals suffering from Coronavirus Disease 2019 (COVID-19) will experience ongoing symptoms that last longer than three months (i.e., long-haul COVID). This includes olfactory dysfunction (OD), which is currently estimated to occur in 1-63.5% of patients at one-year post-infection. However, OD in individuals with long-haul COVID-19 is poorly understood, and there is little information regarding how initial SARS-CoV-2 variants correlate with long-haul symptoms. In this study, we investigated the prevalence and severity of OD in patients with long-haul COVID-19 and investigated how OD severity varied with SARS-CoV-2 variants. Methods Patients were recruited from the University of North Carolina-Chapel Hill COVID Recovery Clinic. Each patient completed the University of Pennsylvania Smell Identification Test (UPSIT). The dominant strain at the time of infection was determined using the date of COVID-19 diagnosis, and Centers for Disease Control and Prevention, World Health Organization, and North Carolina Department of Health and Human Services databases. Results Nearly 85% of patients with long-haul COVID-19 reported some degree of OD, which persisted in some patients for two or more years from the date of the initial infection. There was no association between the time since COVID-19 infection and severity of OD. No difference was detected between OD in patients with long-haul COVID-19 based on the dominant variant at the time of infection (p=0.0959). Conclusion A vast majority of patients with long-haul COVID-19 had some degree of ongoing olfactory complications, although the severity of symptoms was not dependent on the dominant SARS-CoV-2 variant at the time of infection.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"17 1","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344221","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}
A middle-aged lady was referred to the Otolaryngology department for consideration of an endoscopic biopsy of a mass located in the right orbital apex. She had initially presented to the eye clinic with complaints of right proptosis and worsening vision. Upon examination, her right eye showed no perception of light, an amaurotic right pupil, and limited extraocular movement in all directions of gaze. Hertel's ophthalmometer revealed proptosis, and there was a loss of corneal sensation. Magnetic resonance imaging (MRI) of the orbits revealed an enhancing mass in the right orbital apex, extending into the cavernous sinus. She subsequently underwent an endoscopic trans-sphenoidal biopsy of the lesion. Histopathological analysis confirmed the pre- sence of squamous cell carcinoma (SCC). Further systemic evaluation did not reveal any other primary site or metastasis. Conside- ring the unresectable nature of the tumor and her poor candidacy for chemotherapy and radiotherapy, the patient was managed with best supportive care.
{"title":"Orbital apex squamous cell carcinoma","authors":"Yong Jie, Chengyao Kelvin Lim, Alex Tham","doi":"10.4193/rhinol/23.011","DOIUrl":"https://doi.org/10.4193/rhinol/23.011","url":null,"abstract":"A middle-aged lady was referred to the Otolaryngology department for consideration of an endoscopic biopsy of a mass located in the right orbital apex. She had initially presented to the eye clinic with complaints of right proptosis and worsening vision. Upon examination, her right eye showed no perception of light, an amaurotic right pupil, and limited extraocular movement in all directions of gaze. Hertel's ophthalmometer revealed proptosis, and there was a loss of corneal sensation. Magnetic resonance imaging (MRI) of the orbits revealed an enhancing mass in the right orbital apex, extending into the cavernous sinus. She subsequently underwent an endoscopic trans-sphenoidal biopsy of the lesion. Histopathological analysis confirmed the pre- sence of squamous cell carcinoma (SCC). Further systemic evaluation did not reveal any other primary site or metastasis. Conside- ring the unresectable nature of the tumor and her poor candidacy for chemotherapy and radiotherapy, the patient was managed with best supportive care.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139352438","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: Allergic rhinitis, rhinosinusitis, and upper respiratory tract infections, including the common cold, are caused by inflammation of nasal cavity areas. A key symptom is nasal congestion, which can be relieved with nasal spray medications. A key goal in developing a nasal spray medication delivery device for the relief of nasal congestion is delivering a fine mist to the inflamed areas while providing user comfort and convenience. Methodology: Using a Koken nasal cast model, we studied the deposition patterns of 2 xylometazoline and 1 oxymetazoline for- mulations with 2 different nasal pumps, the currently marketed Freepod and the investigational laterally actuated device. Effects of nasal tip orientation and breathing were investigated. Additionally, the degree of xylometazoline and oxymetazoline dripping down the back of the cast was assessed. Results: The largest coverage overall was observed with the xylometazoline formulation with the laterally actuated pump and without breath simulation. The laterally actuated pump used at a 30° angle resulted in deposition to the inferior, middle, and superior turbinates of the nasal cast, with less variability than the Freepod. Drippage at the back of the cast was observed with the Freepod device but not with the laterally actuated device. Conclusions: Using a nasal cast model, the laterally actuated pump used at a 30° angle produced a full mist covering areas inflamed with the common cold, allergic rhinitis, and rhinosinusitis with no dripping at the back of the cast, an improvement compared with the Freepod pump. In vivo studies are needed to confirm nasal cast results.
{"title":"Nasal cast deposition for xylo- and oxymetazoline formulations using two different nasal pumps","authors":"M. Hagen, G. Shanga, S. Caron, G. Debnath","doi":"10.4193/rhinol/23.002","DOIUrl":"https://doi.org/10.4193/rhinol/23.002","url":null,"abstract":"Background: Allergic rhinitis, rhinosinusitis, and upper respiratory tract infections, including the common cold, are caused by inflammation of nasal cavity areas. A key symptom is nasal congestion, which can be relieved with nasal spray medications. A key goal in developing a nasal spray medication delivery device for the relief of nasal congestion is delivering a fine mist to the inflamed areas while providing user comfort and convenience. Methodology: Using a Koken nasal cast model, we studied the deposition patterns of 2 xylometazoline and 1 oxymetazoline for- mulations with 2 different nasal pumps, the currently marketed Freepod and the investigational laterally actuated device. Effects of nasal tip orientation and breathing were investigated. Additionally, the degree of xylometazoline and oxymetazoline dripping down the back of the cast was assessed. Results: The largest coverage overall was observed with the xylometazoline formulation with the laterally actuated pump and without breath simulation. The laterally actuated pump used at a 30° angle resulted in deposition to the inferior, middle, and superior turbinates of the nasal cast, with less variability than the Freepod. Drippage at the back of the cast was observed with the Freepod device but not with the laterally actuated device. Conclusions: Using a nasal cast model, the laterally actuated pump used at a 30° angle produced a full mist covering areas inflamed with the common cold, allergic rhinitis, and rhinosinusitis with no dripping at the back of the cast, an improvement compared with the Freepod pump. In vivo studies are needed to confirm nasal cast results.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49414500","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}
S. Schneider, M. Masalha, A. Margulis, Y. Rosman, M. Masarwa, R. Landsberg
BACKGROUND: Most endoscopic sinus surgeons instruct their patients to avoid certain activities during the postoperative period. Due to the scarcity of empirical data on this issue, most instructions are based on surgeons’ personal insights. In this study we evaluated if restrictions for performing specific activities have a consensus among endoscopic sinus surgeons. METHODOLOGY: A nationwide survey was conducted among experienced Israeli endoscopic sinus surgeons. Participants were asked to note the optimal postoperative time restrictions of 25 different activities. RESULTS: The response rate was 30/36 (83%). Surgeons’ responses regarding time restrictions of specific activities postoperatively showed high variance. The greatest variance was noted for using a hair dryer, light physical activities, nose blowing, driving a car, having sexual intercourse, eating/drinking hot food or beverages, taking hot showers and drinking alcohol. CONCLUSIONS: The time restrictions given by endoscopic sinus surgeons for specific activities postoperatively vary greatly among them. The study findings call upon rhinology boards to establish consensus-based guidelines for postoperative management after endoscopic sinus surgery.
{"title":"Postoperative instructions after endoscopic sinus surgery: is there a consensus?","authors":"S. Schneider, M. Masalha, A. Margulis, Y. Rosman, M. Masarwa, R. Landsberg","doi":"10.4193/rhinol/22.022","DOIUrl":"https://doi.org/10.4193/rhinol/22.022","url":null,"abstract":"BACKGROUND: Most endoscopic sinus surgeons instruct their patients to avoid certain activities during the postoperative period. Due to the scarcity of empirical data on this issue, most instructions are based on surgeons’ personal insights. In this study we evaluated if restrictions for performing specific activities have a consensus among endoscopic sinus surgeons. METHODOLOGY: A nationwide survey was conducted among experienced Israeli endoscopic sinus surgeons. Participants were asked to note the optimal postoperative time restrictions of 25 different activities. RESULTS: The response rate was 30/36 (83%). Surgeons’ responses regarding time restrictions of specific activities postoperatively showed high variance. The greatest variance was noted for using a hair dryer, light physical activities, nose blowing, driving a car, having sexual intercourse, eating/drinking hot food or beverages, taking hot showers and drinking alcohol. CONCLUSIONS: The time restrictions given by endoscopic sinus surgeons for specific activities postoperatively vary greatly among them. The study findings call upon rhinology boards to establish consensus-based guidelines for postoperative management after endoscopic sinus surgery.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44875956","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}
Meredith M Lamb, Kaitlyn DeHority, Sarah M Russel, Sulgi Kim, Taylor Stack, Ibtisam Mohammad, Abdullah Zeatoun, Cristine Klatt-Cromwell, Charles S Ebert, John M Baratta, Brent A Senior, Adam J Kimple
Background: A subset of individuals suffering from Coronavirus Disease 2019 (COVID-19) will experience ongoing symptoms that last longer than three months (i.e., long-haul COVID). This includes olfactory dysfunction (OD), which is currently estimated to occur in 1-63.5% of patients at one-year post-infection. However, OD in individuals with long-haul COVID-19 is poorly understood, and there is little information regarding how initial SARS-CoV-2 variants correlate with long-haul symptoms. In this study, we investigated the prevalence and severity of OD in patients with long-haul COVID-19 and investigated how OD severity varied with SARS-CoV-2 variants.
Methods: Patients were recruited from the University of North Carolina-Chapel Hill COVID Recovery Clinic. Each patient completed the University of Pennsylvania Smell Identification Test (UPSIT). The dominant strain at the time of infection was determined using the date of COVID-19 diagnosis, and Centers for Disease Control and Prevention, World Health Organization, and North Carolina Department of Health and Human Services databases.
Results: Nearly 85% of patients with long-haul COVID-19 reported some degree of OD, which persisted in some patients for two or more years from the date of the initial infection. There was no association between the time since COVID-19 infection and severity of OD. No difference was detected between OD in patients with long-haul COVID-19 based on the dominant variant at the time of infection (p=0.0959).
Conclusion: A vast majority of patients with long-haul COVID-19 had some degree of ongoing olfactory complications, although the severity of symptoms was not dependent on the dominant SARS-CoV-2 variant at the time of infection.
{"title":"Characteristics of olfactory dysfunction in patients with long-haul covid-19.","authors":"Meredith M Lamb, Kaitlyn DeHority, Sarah M Russel, Sulgi Kim, Taylor Stack, Ibtisam Mohammad, Abdullah Zeatoun, Cristine Klatt-Cromwell, Charles S Ebert, John M Baratta, Brent A Senior, Adam J Kimple","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>A subset of individuals suffering from Coronavirus Disease 2019 (COVID-19) will experience ongoing symptoms that last longer than three months (i.e., long-haul COVID). This includes olfactory dysfunction (OD), which is currently estimated to occur in 1-63.5% of patients at one-year post-infection. However, OD in individuals with long-haul COVID-19 is poorly understood, and there is little information regarding how initial SARS-CoV-2 variants correlate with long-haul symptoms. In this study, we investigated the prevalence and severity of OD in patients with long-haul COVID-19 and investigated how OD severity varied with SARS-CoV-2 variants.</p><p><strong>Methods: </strong>Patients were recruited from the University of North Carolina-Chapel Hill COVID Recovery Clinic. Each patient completed the University of Pennsylvania Smell Identification Test (UPSIT). The dominant strain at the time of infection was determined using the date of COVID-19 diagnosis, and Centers for Disease Control and Prevention, World Health Organization, and North Carolina Department of Health and Human Services databases.</p><p><strong>Results: </strong>Nearly 85% of patients with long-haul COVID-19 reported some degree of OD, which persisted in some patients for two or more years from the date of the initial infection. There was no association between the time since COVID-19 infection and severity of OD. No difference was detected between OD in patients with long-haul COVID-19 based on the dominant variant at the time of infection (p=0.0959).</p><p><strong>Conclusion: </strong>A vast majority of patients with long-haul COVID-19 had some degree of ongoing olfactory complications, although the severity of symptoms was not dependent on the dominant SARS-CoV-2 variant at the time of infection.</p>","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"6 ","pages":"30-37"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10501207/pdf/nihms-1929736.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10653953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Chen, M. Biswas, M. Scott, M. Small, L. Lee, S. Ruiz, Dr. Emmanuel Osemeke Bienonwu
Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) affects up to 4% of individuals. Common symptoms include nasal congestion/obstruction, nasal discharge, facial pain, and reduced sense of smell. This study describes patient- and physician-reported CRSwNP symptom burden and health-related quality of life (HRQOL) in a real-world clinical setting. Methods: This multinational, geographically diverse, point-in-time survey invited physicians to evaluate 5 consecutive adults with confirmed bilateral moderate to severe CRSwNP (consecutive sampling) plus the next 2 patients with recurrent nasal polyps and ≥1 surgery for polyp removal (oversampling). Patients’ and physicians’ surveys were assessed in the entire consecutive sample and by categories of physician-determined CRSwNP severity, and by categories of asthma comorbidity (total sample). Patients’ and physicians’ responses were compared in a matched sample. Results: The total sample of 1,782 patients comprised 1,296 (72.7%) from consecutive sampling and 486 (27.3%) from oversampling. Among the consecutive sample (mean age, 46.9 years), 1,122 (86.6%) had moderate and 174 (13.4%) had severe CRSwNP. Of 1,697 patients from total sampling with known asthma status, 708 (41.7%) had asthma and 989 (58.3%) did not. Patients’ self-reported symptom frequency, severity, and burden on HRQOL worsened with increasing CRSwNP severity and comorbid asthma. Physicians underreported prevalence, severity, and impact of symptoms on daily activities compared with patients (matched sample). Conclusion: Patients and physicians from real-world settings both described a considerable burden of CRSwNP, but physicians consistently reported fewer and less severe symptoms than patients. This suggests a more patient-centric view is needed when assessing CRSwNP symptom burden and HRQOL.
{"title":"Symptom burden and health-related quality of life in moderate to severe chronic rhinosinusitis with nasal polyposis","authors":"S. Chen, M. Biswas, M. Scott, M. Small, L. Lee, S. Ruiz, Dr. Emmanuel Osemeke Bienonwu","doi":"10.4193/rhinol/22.023","DOIUrl":"https://doi.org/10.4193/rhinol/22.023","url":null,"abstract":"Background: Chronic rhinosinusitis with nasal polyposis (CRSwNP) affects up to 4% of individuals. Common symptoms include nasal congestion/obstruction, nasal discharge, facial pain, and reduced sense of smell. This study describes patient- and physician-reported CRSwNP symptom burden and health-related quality of life (HRQOL) in a real-world clinical setting. Methods: This multinational, geographically diverse, point-in-time survey invited physicians to evaluate 5 consecutive adults with confirmed bilateral moderate to severe CRSwNP (consecutive sampling) plus the next 2 patients with recurrent nasal polyps and ≥1 surgery for polyp removal (oversampling). Patients’ and physicians’ surveys were assessed in the entire consecutive sample and by categories of physician-determined CRSwNP severity, and by categories of asthma comorbidity (total sample). Patients’ and physicians’ responses were compared in a matched sample. Results: The total sample of 1,782 patients comprised 1,296 (72.7%) from consecutive sampling and 486 (27.3%) from oversampling. Among the consecutive sample (mean age, 46.9 years), 1,122 (86.6%) had moderate and 174 (13.4%) had severe CRSwNP. Of 1,697 patients from total sampling with known asthma status, 708 (41.7%) had asthma and 989 (58.3%) did not. Patients’ self-reported symptom frequency, severity, and burden on HRQOL worsened with increasing CRSwNP severity and comorbid asthma. Physicians underreported prevalence, severity, and impact of symptoms on daily activities compared with patients (matched sample). Conclusion: Patients and physicians from real-world settings both described a considerable burden of CRSwNP, but physicians consistently reported fewer and less severe symptoms than patients. This suggests a more patient-centric view is needed when assessing CRSwNP symptom burden and HRQOL.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41417417","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: Endoscopic endonasal approach for the management of sinonasal inflammatory pathologies and tumours has been a widely accepted procedure and used for many years. The aim of the study is to assess effectiveness and safety of endonasal endoscopic resection in removal of sinonasal vascular tumours and to evaluate outcomes and clinical behaviour of different subtypes with review of the literature. Material and Methods: A retrospective review of the patients treated for sinonasal and orbital apex vascular tumour was performed. Patient’s demographics, surgical approaches, complications, histopathological results, and long-term outcomes were evaluated. Results: Twenty-two patient included in this study. The mean tumour size ranged from 6 to 100 mm (30.45 ± 22.7 mm). Histopathological examination revealed 8 (36%) capillary hemangioma, 6 (33.3%) cavernous hemangioma, 2 (12%) mixed hemangioma, and 2(12%) vascular leiomyomas. Three (13.6%) patients were diagnosed as glomangiopericytoma and remaining 1 (4.4%) was angiosarcoma. Only in 1 patient with recurrent glomangiopericytoma preoperative embolization were needed. Five patients had preoperative biopsy in office settings. The mean follow-up was 72.9 (± 53.71) months. The recurrence was observed in 3 (13.6%) patients. Conclusion: Endonasal endoscopic approach for sinonasal vascular tumours is a safe and reliable method for resection. Our study suggested location of the tumour is more important than the size to achieve complete resection. Long-term follow-ups are important to detect recurrences early even after macroscopically complete resections.
{"title":"Experience with endonasal endoscopic resection of non-angiofibroma sinonasal and orbital apex vascular tumours","authors":"H. Başak, C. Meço","doi":"10.4193/rhinol/22.020","DOIUrl":"https://doi.org/10.4193/rhinol/22.020","url":null,"abstract":"Background: Endoscopic endonasal approach for the management of sinonasal inflammatory pathologies and tumours has been a widely accepted procedure and used for many years. The aim of the study is to assess effectiveness and safety of endonasal endoscopic resection in removal of sinonasal vascular tumours and to evaluate outcomes and clinical behaviour of different subtypes with review of the literature. Material and Methods: A retrospective review of the patients treated for sinonasal and orbital apex vascular tumour was performed. Patient’s demographics, surgical approaches, complications, histopathological results, and long-term outcomes were evaluated. Results: Twenty-two patient included in this study. The mean tumour size ranged from 6 to 100 mm (30.45 ± 22.7 mm). Histopathological examination revealed 8 (36%) capillary hemangioma, 6 (33.3%) cavernous hemangioma, 2 (12%) mixed hemangioma, and 2(12%) vascular leiomyomas. Three (13.6%) patients were diagnosed as glomangiopericytoma and remaining 1 (4.4%) was angiosarcoma. Only in 1 patient with recurrent glomangiopericytoma preoperative embolization were needed. Five patients had preoperative biopsy in office settings. The mean follow-up was 72.9 (± 53.71) months. The recurrence was observed in 3 (13.6%) patients. Conclusion: Endonasal endoscopic approach for sinonasal vascular tumours is a safe and reliable method for resection. Our study suggested location of the tumour is more important than the size to achieve complete resection. Long-term follow-ups are important to detect recurrences early even after macroscopically complete resections.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49275903","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}
S. Xu, M. Vallei, J. Hwang Siok Gek, C. Tze Choong, N. Wei Yang Teo
Background: Chronic rhinosinusitis is a heterogenous disease with variation in the endotypes of nasal polyps, with type 2 inflammation being more prevalent in Caucasian populations whereas Chinese populations are more heterogenous. We aim to describe the variation in endotypes for patients with chronic rhinosinusitis with nasal polyposis in our unique multiracial population. Methodology: Demographic, clinical and structured histopathological data of 66 patients who underwent sinus surgery for nasal polyposis were evaluated retrospectively. Results: 54.6% had eosinophilic disease, and 45.4% had non-eosinophilic disease with no significant demographic differences between the 2 populations. There were significantly higher peripheral eosinophil levels in patients with eosinophil-predominant inflammation on tissue histology (mean absolute eosinophil count 0.59 ± 0.18 x 109) compared with non-eosinophilic disease (mean absolute eosinophil count 0.24 ± 0.11 x 109). Structured histopathological reporting revealed that patients with eosinophilic disease had higher degree of inflammation and eosinophil aggregates. Conclusions: Our population is shown to have a slight preponderance toward eosinophilic disease, however the Chinese majority tended to have non-eosinophilic disease. Serum eosinophilia and the presence of asthma seems to correlate well with tissue eosinophilia, which can potentially be utilised as markers of type 2 inflammatory disease.
{"title":"Endotyping of nasal polyps in a multiracial Asian population","authors":"S. Xu, M. Vallei, J. Hwang Siok Gek, C. Tze Choong, N. Wei Yang Teo","doi":"10.4193/rhinol/22.026","DOIUrl":"https://doi.org/10.4193/rhinol/22.026","url":null,"abstract":"Background: Chronic rhinosinusitis is a heterogenous disease with variation in the endotypes of nasal polyps, with type 2 inflammation being more prevalent in Caucasian populations whereas Chinese populations are more heterogenous. We aim to describe the variation in endotypes for patients with chronic rhinosinusitis with nasal polyposis in our unique multiracial population. Methodology: Demographic, clinical and structured histopathological data of 66 patients who underwent sinus surgery for nasal polyposis were evaluated retrospectively. Results: 54.6% had eosinophilic disease, and 45.4% had non-eosinophilic disease with no significant demographic differences between the 2 populations. There were significantly higher peripheral eosinophil levels in patients with eosinophil-predominant inflammation on tissue histology (mean absolute eosinophil count 0.59 ± 0.18 x 109) compared with non-eosinophilic disease (mean absolute eosinophil count 0.24 ± 0.11 x 109). Structured histopathological reporting revealed that patients with eosinophilic disease had higher degree of inflammation and eosinophil aggregates. Conclusions: Our population is shown to have a slight preponderance toward eosinophilic disease, however the Chinese majority tended to have non-eosinophilic disease. Serum eosinophilia and the presence of asthma seems to correlate well with tissue eosinophilia, which can potentially be utilised as markers of type 2 inflammatory disease.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46473779","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}
H. Albaharna, S. Alsaleh, A. Alqahtani, O. Marglani
Background: Chronic rhinosinusitis (CRS) is a common disease that significantly impacts quality of life. Its prevalence varies between different geographical areas. This study aimed to validate the Arabic version of the EPOS criteria in the GA2LEN questionnaire to use it as a tool to estimate the prevalence of CRS in Arab countries. Methods: This is multicentric cross-sectional validation study. The original English EPOS criteria used in the GA2LEN survey (four main questions and two additional questions) were translated into Arabic. The study was conducted at King Abdulaziz University Hospital – Riyadh and Qatif Central Hospital – Qatif in the period between October 2020 and August 2021. Groups of CRS and non-CRS patients were selected randomly from databases of the hospital and asked to participate in the study through phone calls. Sensitivity, specificity, positive, and negative predictive values were calculated for the Arabic questionnaire. Results: Of 200 subjects contacted to complete the questionnaire, 128 agreed to participate and completed the survey. The Arabic version of the GA2LEN questionnaire was found to be reliable with high sensitivity and specificity. The reliability of the questionnaire increased when we added the question, “Has a doctor ever told you that you have chronic sinusitis?” to the main four questions. The sensitivity, specificity, and positive and negative predictive values were 93.9%, 59.6%, 71.25%, and 90.2%, respectively. Conclusions: The Arabic version of the EPOS criteria in the GA2LEN questionnaire is a valid and reliable tool for epidemiological studies to estimate the prevalence of CRS.
{"title":"The GA2LEN survey for chronic rhinosinusitis prevalence studies: Arabic translation, cultural adaptation, and validation","authors":"H. Albaharna, S. Alsaleh, A. Alqahtani, O. Marglani","doi":"10.4193/rhinol/22.014","DOIUrl":"https://doi.org/10.4193/rhinol/22.014","url":null,"abstract":"Background: Chronic rhinosinusitis (CRS) is a common disease that significantly impacts quality of life. Its prevalence varies between different geographical areas. This study aimed to validate the Arabic version of the EPOS criteria in the GA2LEN questionnaire to use it as a tool to estimate the prevalence of CRS in Arab countries. Methods: This is multicentric cross-sectional validation study. The original English EPOS criteria used in the GA2LEN survey (four main questions and two additional questions) were translated into Arabic. The study was conducted at King Abdulaziz University Hospital – Riyadh and Qatif Central Hospital – Qatif in the period between October 2020 and August 2021. Groups of CRS and non-CRS patients were selected randomly from databases of the hospital and asked to participate in the study through phone calls. Sensitivity, specificity, positive, and negative predictive values were calculated for the Arabic questionnaire. Results: Of 200 subjects contacted to complete the questionnaire, 128 agreed to participate and completed the survey. The Arabic version of the GA2LEN questionnaire was found to be reliable with high sensitivity and specificity. The reliability of the questionnaire increased when we added the question, “Has a doctor ever told you that you have chronic sinusitis?” to the main four questions. The sensitivity, specificity, and positive and negative predictive values were 93.9%, 59.6%, 71.25%, and 90.2%, respectively. Conclusions: The Arabic version of the EPOS criteria in the GA2LEN questionnaire is a valid and reliable tool for epidemiological studies to estimate the prevalence of CRS.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44278238","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}
Rhinophyma is considered as a benign tumor of the exterior of the nose. It is a disfiguring soft tissue hypertrophy of the nasal skin, predominantly seen in older, white men. It is believed to be the final stage of acne rosacea. The main presentation of the patients with rhinophyma is the cosmetic disfigurement, although it may also cause nasal obstruction and visual disturbance. The rhinophyma is mainly treated by surgical intervention, which exists in different forms, but all will provide almost similar cosmetic results. Our presentation constitutes one case of rhinophyma treated by paring with a sharp scalpel. The case showed satisfied cosmetic results with a complete healing of the raw area without any skin graft reconstruction.
{"title":"Successful skin healing without any graft reconstruction after scalpel blade paring of huge rhinophyma: a case report and review of literature","authors":"K. Bofares","doi":"10.4193/rhinol/22.027","DOIUrl":"https://doi.org/10.4193/rhinol/22.027","url":null,"abstract":"Rhinophyma is considered as a benign tumor of the exterior of the nose. It is a disfiguring soft tissue hypertrophy of the nasal skin, predominantly seen in older, white men. It is believed to be the final stage of acne rosacea. The main presentation of the patients with rhinophyma is the cosmetic disfigurement, although it may also cause nasal obstruction and visual disturbance. The rhinophyma is mainly treated by surgical intervention, which exists in different forms, but all will provide almost similar cosmetic results. Our presentation constitutes one case of rhinophyma treated by paring with a sharp scalpel. The case showed satisfied cosmetic results with a complete healing of the raw area without any skin graft reconstruction.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44848159","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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