1
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Ramadan HH. Pediatric chronic rhinosinusitis. Eur Arch Otorhinolaryngol 2024; 281:1131-1137. [PMID: 37899371 DOI: 10.1007/s00405-023-08307-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/18/2023] [Indexed: 10/31/2023]
Abstract
PURPOSE An up-to-date overview of diagnosis, differential diagnosis, comorbidities, and current medical and surgical management of pediatric chronic rhinosinusitis (PCRS). METHODS Review of current evidence-based literature on PCRS. RESULTS Diagnosis of PCRS seems to be improving based on recent evidence using nasal endoscopy as well as computed tomography scanning. Recent literature supports the fact that chronic adenoiditis can be an independent etiology of symptoms of chronic sinusitis, that are very similar to chronic adenoiditis. Allergic rhinitis and immune deficiency play important roles in the management of PCRS. Surgery for PCRS has evolved significantly in the last 15-20 years to include adenoidectomy as well as endoscopic sinus surgery. CONCLUSIONS PCRS is very common in children causing poor QOL for these children. Medical management remains the main stay of treatment with attention to management of co-morbidities that may contribute to the disease severity. Making the correct diagnosis will help with the choice of surgical intervention if medical management fails.
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Affiliation(s)
- Hassan H Ramadan
- Department of Otolaryngology-Head and Neck Surgery, Health Sciences Center, West Virginia University School of Medicine, PO Box 9200, Morgantown, WV, USA.
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2
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Israeli A, Grinblat G, Shochat I, Sarid M, Dudkiewicz M, Braverman I. Clinical Efficacy of Topical Nasal Pomegranate Fruit Extract for Chronic Rhinitis and Chronic Rhinosinusitis. EAR, NOSE & THROAT JOURNAL 2024; 103:NP148-NP157. [PMID: 34555945 DOI: 10.1177/01455613211044224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective: To evaluate the clinical efficacy of topical nasal Pomegranate Fruit Extract (PFE) for Chronic Rhinitis (CR), Chronic Rhinosinusitis with Nasal Polyposis (CRSwNP), and Chronic Rhinosinusitis without Nasal Polyposis (CRSsNP). Methods: Prospective, double-blinded, randomized study including 111 consecutive patients, between April 2012 and January 2017, afflicted by CRSwNP, CRSsNP, and CR. Patients from each group were randomly assigned to either PFE treatment or placebo twice daily for 30 days. Therapeutic efficacy was assessed by Ear Nose and Throat, blood and tomographic examinations, and the SNOT-20 questionnaire. Results: CR patients treated with PFE suffered significantly less from thick nasal discharge, difficulty falling asleep, reduced productivity, reduced concentration, and sadness (P = .004, P = .02, P = .03, P = .007 and P = .02, respectively). Conclusions: Topical nasal PFE was found to have some benefits for CR patients, however, not for CRS with or without Nasal Polyposis.
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Affiliation(s)
- Asaf Israeli
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Golda Grinblat
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Otorhinolaryngology, Head and Neck Surgery, Hillel Yaffe Medical Center, Hadera, Israel
| | - Isaac Shochat
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Otorhinolaryngology, Head and Neck Surgery, Hillel Yaffe Medical Center, Hadera, Israel
| | - Miri Sarid
- Head of Learning Disabilities Department, Western Galilee College, Acco, Israel
| | - Mickey Dudkiewicz
- Department of Otorhinolaryngology, Head and Neck Surgery, Hillel Yaffe Medical Center, Hadera, Israel
- Directory of Hillel Yaffe Medical Center, Hadera, Israel
| | - Itzhak Braverman
- Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Otorhinolaryngology, Head and Neck Surgery, Hillel Yaffe Medical Center, Hadera, Israel
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3
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Suzuki M, Miyaji K, Watanabe R, Suzuki T, Matoba K, Nakazono A, Nakamaru Y, Konno A, Psaltis AJ, Abe T, Homma A, Wormald P. Repetitive simulation training with novel
3D
‐printed sinus models for functional endoscopic sinus surgeries. Laryngoscope Investig Otolaryngol 2022; 7:943-954. [PMID: 36000044 PMCID: PMC9392405 DOI: 10.1002/lio2.873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 07/01/2022] [Accepted: 07/03/2022] [Indexed: 11/30/2022] Open
Abstract
Background The purpose of this study was to find a utility of a newly developed 3D‐printed sinus model and to evaluate the educational benefit of simulation training with the models for functional endoscopic sinus surgery (FESS). Material and methods Forty‐seven otolaryngologists were categorized as experts (board‐certified physicians with ≥200 experiences of FESS, n = 9), intermediates (board‐certified physicians with <200 experiences of FESS, n = 19), and novices (registrars, n = 19). They performed FESS simulation training on 3D‐printed models manufactured from DICOM images of computed tomography (CT) scan of real patients. Their surgical performance was assessed with the objective structured assessment of technical skills (OSATS) score and dissection quality evaluated radiologically with a postdissection CT scan. First we evaluated the face, content, and constructive values. Second we evaluated the educational benefit of the training. Ten novices underwent training (training group) and their outcomes were compared to the remaining novices without training (control group). The training group performed cadaveric FESS surgeries before and after the repetitive training. Results The feedback from experts revealed high face and content value of the 3D‐printed models. Experts, intermediates, and novices demonstrated statistical differences in their OSATS scores (74.7 ± 3.6, 58.3 ± 10.1, and 43.1 ± 11.1, respectively, p < .001), and dissection quality (81.1 ± 13.1, 93.7 ± 15.1, and 126.4 ± 25.2, respectively, p < .001). The training group improved their OSATS score (41.1 ± 8.0 to 61.1 ± 6.9, p < .001) and dissection quality (122.1 ± 22.2 to 90.9 ± 10.3, p = .013), while the control group not. After training, 80% of novices with no prior FESS experiences completed surgeries on cadaver sinuses. Conclusion Repeated training using the models revealed an initial learning curve in novices, which was confirmed in cadaveric mock FESS surgeries. Level of evidence N/A
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Affiliation(s)
- Masanobu Suzuki
- Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Kou Miyaji
- Graduate School of Information Science and Technology Hokkaido University Sapporo Japan
| | - Ryosuke Watanabe
- Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Kotaro Matoba
- Department of Forensic Medicine, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Akira Nakazono
- Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Yuji Nakamaru
- Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Atsushi Konno
- Graduate School of Information Science and Technology Hokkaido University Sapporo Japan
| | - Alkis James Psaltis
- Department of Surgery–Otorhinolaryngology Head and Neck Surgery Central Adelaide Local Health Network and the University of Adelaide Adelaide South Australia Australia
| | - Takashige Abe
- Department of Urology, Hokkaido University Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Akihiro Homma
- Department of Otolaryngology‐Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine Hokkaido University Sapporo Hokkaido Japan
| | - Peter‐John Wormald
- Department of Surgery–Otorhinolaryngology Head and Neck Surgery Central Adelaide Local Health Network and the University of Adelaide Adelaide South Australia Australia
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4
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Abstract
Rhinosinusitis is a common diagnosis encountered by providers of all disciplines. Pediatric acute and chronic rhinosinusitis account for up to 2% of the total annual visits to the outpatient clinics and emergency departments. Once correct diagnosis is made, appropriate treatment measures can be initiated. It is important to recognize rhinosinusitis in children due to the potential serious complications and the impact it may have on quality of life of those children. Medical management is the mainstay of treatment, and, fortunately, it is successful in most of those children. When medical management fails, or a complication occurs, surgery may be required.
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Affiliation(s)
- Hassan H Ramadan
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA.
| | - Rafka Chaiban
- Department of Pediatrics, West Virginia University, Uniontown, PA, USA
| | - Chadi Makary
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
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5
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Bourhis T, Mouawad F, Szymanski C, Mortuaire G. Budesonide transnasal pulsating nebulization after surgery in chronic rhinosinusitis with nasal polyps. Drug Deliv Transl Res 2021; 12:925-930. [PMID: 33851363 DOI: 10.1007/s13346-021-00979-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 10/21/2022]
Abstract
Intranasal corticosteroid drugs are widely used in chronic rhinosinusitis with nasal polyps (CRSwNP). In contrast to classical delivery with nasal pump sprays, pulsating aerosols can deliver significant doses into superior and posterior sinonasal spaces. A case-control study was designed to assess the efficacy of corticosteroid transnasal nebulization on short-term mucosal recovery and quality of life (QoL) following endoscopic sinus surgery in CRSwNP. Thirty patients were prospectively enrolled to receive either 1-month budesonide nasal pump spray or 1-month budesonide 100-Hz acoustic pulsating nebulization at the first postoperative visit (day 8). Patients were evaluated with Lund-Kennedy endoscopic score at day 8 (D8) and 1 month later (M1). CRS-related QoL questionnaires (SNOT22 and RhinoQOL) were fulfilled at M1. The Lund-Kennedy endoscopic scores compared between D8 and M1 were suggestively improved in the group treated with budesonide nebulization (mean difference between groups, - 18.28 units; 95%CI, - 31.29 to - 5.28 units, p = 0.014). QoL measurements were comparable at M1 between the groups of patients. No unexpected adverse event was described with both budesonide delivery protocols. In the early postoperative period, patients with CRswNP may benefit from pulsating nebulization. Large studies should be conducted to confirm the results. Safety profile related to systemic steroid absorption and bioavailability in chronic respiratory diseases also need to be addressed for further use.
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Affiliation(s)
- Thomas Bourhis
- Otorhinolaryngology - Head and neck Department, Huriez Hospital, CHU Lille, 59000, Lille, France
| | - Francois Mouawad
- Otorhinolaryngology - Head and neck Department, Huriez Hospital, CHU Lille, 59000, Lille, France
| | - Claire Szymanski
- Otorhinolaryngology - Head and neck Department, Huriez Hospital, CHU Lille, 59000, Lille, France
| | - Geoffrey Mortuaire
- Otorhinolaryngology - Head and neck Department, Huriez Hospital, CHU Lille, 59000, Lille, France. .,Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, 59000, Lille, France.
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6
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Tai J, Lee K, Kim TH. Current Perspective on Nasal Delivery Systems for Chronic Rhinosinusitis. Pharmaceutics 2021; 13:246. [PMID: 33578812 PMCID: PMC7916625 DOI: 10.3390/pharmaceutics13020246] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/02/2021] [Accepted: 02/06/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic rhinosinusitis is an upper respiratory disease during which topical drug treatment via the nasal cavity is the most actively utilized therapeutic strategy. In addition to steroids, antibiotics, and antifungal agents, which are widely used in clinical practice, research on novel topical agents to improve the bacterial biofilm or mucociliary clearance remains ongoing. Moreover, owing to the complex structure of the nasal cavity, the effects of nasal drug delivery vary depending on factors related to delivery fluid dynamics, including device, volume, and compounds. In this article, we review methods and compounds that have been applied to chronic rhinosinusitis management and introduce recent advances and future perspectives in nasal drug delivery for upper respiratory diseases.
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Affiliation(s)
| | | | - Tae Hoon Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, College of Medicine, Korea University, Seoul 02841, Korea; (J.T.); (K.L.)
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7
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Far J, Abdel-Haq M, Gruber M, Abu Ammar A. Developing Biodegradable Nanoparticles Loaded with Mometasone Furoate for Potential Nasal Drug Delivery. ACS OMEGA 2020; 5:7432-7439. [PMID: 32280885 PMCID: PMC7144157 DOI: 10.1021/acsomega.0c00111] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/16/2020] [Indexed: 05/30/2023]
Abstract
Intranasal drug administration is considered a routine in the treatment of many nasal conditions including chronic rhinosinusitis (CRS), which is a common disease involving long-term inflammation of the nasal mucosa. Topical nasal steroid treatment is safe and easy to use and plays a basic role in both nonsurgical and surgical treatments for CRS. Intranasal steroid therapy for various time intervals is commonly used before and after endoscopic CRS nasal surgeries to reduce inflammation and edema and to improve mucosal healing. The medication is currently administered via conventional nasal sprays; therefore, there is an incentive to develop more efficient drug delivery systems for the controlled release of topical steroids into the sinonasal cavities over a prolonged period of time. In this study, poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) loaded with mometasone furoate (MF) were generated using the nanoprecipitation method and characterized physicochemically and morphologically. MF NPs exhibited adequate physicochemical properties and high drug encapsulation efficiency and loading content. MF exhibited sustained release from NPs over 7 days in vitro with an initial burst release; various mathematical models were applied to determine the kinetics of drug release. Having demonstrated the ability to load MF in PLGA-NPs using the nanoprecipitation method for the first time, these NPs urge the need for additional investigations to demonstrate their therapeutic potential in nasal delivery applications.
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Affiliation(s)
- Jumana Far
- Department
of Pharmaceutical Engineering, Azrieli College
of Engineering Jerusalem, Jerusalem 9103501, Israel
| | - Muhammad Abdel-Haq
- Department
of Pharmaceutical Engineering, Azrieli College
of Engineering Jerusalem, Jerusalem 9103501, Israel
| | - Maayan Gruber
- Department
of Otolaryngology−Head and Neck Surgery, Galilee Medical Center, Nahariya 2210001, Israel
- Faculty
of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel
| | - Aiman Abu Ammar
- Department
of Pharmaceutical Engineering, Azrieli College
of Engineering Jerusalem, Jerusalem 9103501, Israel
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8
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Tsai M, Wonnaparhown A, Garcia-Lloret MI, Butte MJ. Chronic Rhinosinusitis in Pediatric Immunodeficiency. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-019-00230-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Shi L, Wu Y, Yang C, Ma Y, Zhang QZ, Huang W, Zhu XY, Yan YJ, Wang JX, Zhu T, Qu D, Zheng CQ, Zhao KQ. Effect of nicotine on Staphylococcus aureus biofilm formation and virulence factors. Sci Rep 2019; 9:20243. [PMID: 31882881 PMCID: PMC6934519 DOI: 10.1038/s41598-019-56627-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/10/2019] [Indexed: 12/23/2022] Open
Abstract
Staphylococcus aureus is a common pathogen in chronic rhinosinusitis (CRS) patients, the pathogenesis of which involves the ability to form biofilms and produce various virulence factors. Tobacco smoke, another risk factor of CRS, facilitates S. aureus biofilm formation; however, the mechanisms involved are unclear. Here, we studied the effect of nicotine on S. aureus biofilm formation and the expression of virulence-related genes. S. aureus strains isolated from CRS patients and a USA300 strain were treated with nicotine or were untreated (control). Nicotine-treated S. aureus strains showed dose-dependent increases in biofilm formation, lower virulence, enhanced initial attachment, increased extracellular DNA release, and a higher autolysis rate, involving dysregulation of the accessory gene regulator (Agr) quorum-sensing system. Consequently, the expression of autolysis-related genes lytN and atlA, and the percentage of dead cells in biofilms was increased. However, the expression of virulence-related genes, including hla, hlb, pvl, nuc, ssp, spa, sigB, coa, and crtN was downregulated and there was reduced bacterial invasion of A549 human alveolar epithelial cells. The results of this study indicate that nicotine treatment enhances S. aureus biofilm formation by promoting initial attachment and extracellular DNA release but inhibits the virulence of this bacterium.
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Affiliation(s)
- Le Shi
- Department of Otorhinolaryngology and Head and Neck Surgery, Eye & ENT Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Yang Wu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Chen Yang
- Department of Otolaryngology & Head and Neck Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China
| | - Yue Ma
- Department of Otorhinolaryngology and Head and Neck Surgery, Eye & ENT Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Qing-Zhao Zhang
- Department of Otorhinolaryngology and Head and Neck Surgery, Eye & ENT Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Wei Huang
- Medical Clinic, Hangzhou Haiqin Sanatorium, Hangzhou, Zhejiang, P.R. China
| | - Xiao-Yi Zhu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Ying-Jie Yan
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, P.R. China
| | - Jia-Xue Wang
- Department of Laboratory Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, P.R. China
| | - Tao Zhu
- Department of Preclinical Medicine, Wannan Medical College, Wuhu, P.R. China
| | - Di Qu
- Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
| | - Chun-Quan Zheng
- Department of Otorhinolaryngology and Head and Neck Surgery, Eye & ENT Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
| | - Ke-Qing Zhao
- Department of Otorhinolaryngology and Head and Neck Surgery, Eye & ENT Hospital, Shanghai Key Clinical Disciplines of Otorhinolaryngology, Shanghai Medical College, Fudan University, Shanghai, P.R. China.
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10
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Panchmatia R, Payandeh J, Al-Salman R, Kakande E, Habib AR, Mullings W, Javer AR. The efficacy of diluted topical povidone-iodine rinses in the management of recalcitrant chronic rhinosinusitis: a prospective cohort study. Eur Arch Otorhinolaryngol 2019; 276:3373-3381. [PMID: 31560120 DOI: 10.1007/s00405-019-05628-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/31/2019] [Indexed: 12/15/2022]
Abstract
PURPOSE Recalcitrant chronic rhinosinusitis is a persistent inflammatory condition of the sinonasal mucosa despite adequate medical therapy and sinus surgery. This study aimed to demonstrate the effectiveness and safety of dilute povidone-iodine (PVP-I) sinonasal rinses as an adjunctive therapy. METHODS Prospective cohort study. Twenty-nine recalcitrant CRS patients with endoscopic evidence of ongoing inflammation and purulent discharge were prescribed 0.08% diluted PVP-I rinses. Changes to endoscopic modified Lund-Kennedy (MLK) scores at 7 weeks post-PVP-I rinsing served as the primary outcome measure. RESULTS The median MLK-discharge score significantly decreased in all patients by 1.50 points post-PVP-I rinsing (p value < 0.01). The total MLK score significantly decreased in all patients by 1.50 points (p value = 0.01). Up to a 17% reduction in serum inflammatory markers was measured post-PVP-I rinsing. Sinonasal culture revealed a shift from moderate-heavy growth to lighter bacterial growth overall. Subjective SNOT-22 scores significantly improved overall by ≥ 1 minimal clinically important difference (MCID > 12; baseline median = 33; follow-up median = 20; p value < 0.01; n = 22). TSH levels increased non-significantly within normal ranges (baseline median = 1.59 mU/L; follow-up median = 1.92 mU/L; p = 0.10; n = 15). Mucociliary clearance time increased non-significantly within normal ranges (baseline median = 9 min; follow-up median = 10 min; p value = 0.53; n = 17). Olfactory Sniffin'16 scores non-significantly decreased within age-related normal ranges (baseline median = 14; follow-up median = 13; p value = 0.72; n = 18). CONCLUSION A dilute 0.08% PVP-I sinonasal rinse as an ancillary therapy in recalcitrant CRS significantly reduces signs of infection alongside notable symptom improvement, without affecting thyroid function, mucociliary clearance or olfaction.
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Affiliation(s)
- Rikesh Panchmatia
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Payandeh
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Rami Al-Salman
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Emily Kakande
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Al-Rahim Habib
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Warren Mullings
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada
| | - Amin R Javer
- Division of Otolaryngology, St. Paul's Sinus Centre, University of British Columbia, Vancouver, BC, Canada.
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11
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Moghadam SJ, Navarro L, Leclerc L, Hodin S, Pourchez J. Toward smart Nebulization: Engineering acoustic airflow to penetrate maxillary sinuses in chronic rhinosinusitis. Int J Pharm 2018; 546:188-193. [PMID: 29778823 DOI: 10.1016/j.ijpharm.2018.05.039] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 05/16/2018] [Accepted: 05/16/2018] [Indexed: 11/15/2022]
Abstract
Treating chronic rhinosinusitis (CRS) by nebulization requires an airflow capable to deliver medication to deep target sites beyond the nasal valve. Fixed frequency acoustic airflow technology is currently available, mainly as post-surgical therapy, but still have not been able to realize the full potential of direct nose to paranasal sinuses delivery. Reported herein are the application of frequency sweep acoustic airflow and the optimization of its frequency range, sweep cycle duration and intensity. The resonant frequencies of the model's maxillary sinuses can be estimated using the Helmholtz resonator theory. Results indicated a resonant frequency of 479 Hz for the right maxillary sinus and one of 849 Hz for the left maxillary sinus. The highest intrasinus deposition within the experiments are from sweep cycle duration of 1 s, intensity of 80 dB, and frequency range of 100-850 Hz. The optimal range of frequency determined from experiments is in good agreement with the corresponding frequency range obtained from the Helmholtz resonator theory. Results reveal a significantly enhanced maxillary sinus drug deposition. This technique affords the potential of treating CRS.
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Affiliation(s)
- Shima Jowhari Moghadam
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 Sainbiose, Centre CIS, F-42023 Saint-Etienne, France
| | - Laurent Navarro
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 Sainbiose, Centre CIS, F-42023 Saint-Etienne, France
| | - Lara Leclerc
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 Sainbiose, Centre CIS, F-42023 Saint-Etienne, France
| | - Sophie Hodin
- Université de Lyon, F-42023 Saint-Etienne, France; INSERM, U1059 Sainbiose, Dysfonction Vasculaire et Hémostase, Saint-Etienne, France
| | - Jérémie Pourchez
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 Sainbiose, Centre CIS, F-42023 Saint-Etienne, France.
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12
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Antibacterial Effect of Hypochlorous Acid Solution on Nasal Discharge from Patients with Chronic Rhinosinusitis. Int J Otolaryngol 2018; 2018:8568694. [PMID: 29681944 PMCID: PMC5848054 DOI: 10.1155/2018/8568694] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 01/31/2018] [Indexed: 11/18/2022] Open
Abstract
Purpose The antibacterial effect of hypochlorous acid (HOCl) solution on nasal secretion of patients with chronic rhinosinusitis (CRS) was investigated. Materials and Methods Five swab specimens were collected from the middle meatus of CRS patients. The first one was placed directly in a Thanswab tube while all of the others were placed randomly into 4 glass tubes containing either HOCl solution, normal saline (NS), 75% alcohol, or povidone-iodine (PVPI) solution for one minute in the first part and for 5 minutes in the second part of the study before transfer to a Thanswab tube. Results Bacteria were cultured from 27 of 50 specimens when they were put directly in a Thanswab tube and from 26 after soaking in HOCl solution, 27 in NS, 13 in 75% alcohol, and 25 in PVPI solution for one minute. In the second part of the study, bacteria were cultured from 14 of 32 specimens when they were put directly in a Thanswab tube and from 14 after soaking in HOCl solution, 13 in NS, 3 in 75% alcohol, and 11 in PVPI solution for 5 minutes. Conclusions This study showed that HOCL solution did not exert an antibacterial effect on nasal secretion from CRS patients within 5 minutes.
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