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Radulesco T, Serrano E, Michel J. The Role of Ear, Nose, and Throat Specialists in the Nose-to-Brain Pathway. JAMA Otolaryngol Head Neck Surg 2023; 149:769-770. [PMID: 37471082 DOI: 10.1001/jamaoto.2023.1550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
This Viewpoint discusses the role of ear, nose, and throat specialists in the understanding, development, growth, and administration of direct nose-to-brain delivery route devices and therapies.
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Affiliation(s)
- Thomas Radulesco
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Aix-Marseille University, APHM, IUSTI, CNRS, La Conception University Hospital, Marseille, France
| | - Elie Serrano
- Department of Otorhinolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse Cedex, France
| | - Justin Michel
- Department of Oto-Rhino-Laryngology Head and Neck Surgery, Aix-Marseille University, APHM, IUSTI, CNRS, La Conception University Hospital, Marseille, France
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Sandhu KS, Singh SP, Thomas O, Choudhary P, Singh A, Singh M. To Study the Long Term Outcome of Endoscopic Septoplasty with Microdebrider Assisted Inferior Turbinoplasty (MAIT) Versus Medial Flap Turbinoplasty (MFT). Indian J Otolaryngol Head Neck Surg 2022; 74:863-869. [PMID: 36452757 PMCID: PMC9701925 DOI: 10.1007/s12070-020-01936-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 06/23/2020] [Indexed: 11/28/2022] Open
Abstract
To study the long term outcome of endoscopic septoplasty with microdebrider assisted inferior turbinoplasty (MAIT) versus medial flap turbinoplasty (MFT). The present study was conducted in the Department of ENT, Government Medical College, Amritsar. Patients with symptomatic persistent nasal obstruction were recruited from ENT outdoor clinics. The nasal obstruction was persistent despite medical therapy that included a minimum 4 weeks. The study was primarily a double blinded prospective randomized control study including 120 patients, where all patients enrolled at odd numbers were taken for endoscopic septoplasty with microdebrider assisted inferior turbinoplasty and all patients with even numbers were taken for endoscopic septoplasty with MFT. Patient-scored nasal obstruction (1-5) along with blindly assessed nasal airway patency ratings (1-4) was done at 3 and 24 months postoperatively. A total of 120 patients were recruited in the study. The mean ages of the MAIT and MFT groups were 28.61 ± 14.8 and 30.25 ± 8.36 years, respectively. Average follow-up period was 21.9 ± 6.3 months. Nasal obstruction was improved in both techniques at 3 months, but after long term follow up, it was highly significant for MFT along with improvement in preoperative symptoms p < 0.001. No patients complained of worsening of their obstruction. Nasal patency at 24 months, a significant proportion of patients had a greater nasal assessment by a blind assessor with 97.1% in MFT and 81.9% MAIT with mild to no obstruction. In MAIT group 16.6% had pain/discomfort, 23.6% had discharge which were the major complications, but crusting (MAIT 10% and MFT 3.3%), adhesions (MAIT 13.8% and MFT 1.6%). The medial flap inferior turbinoplasty (MFT) is technically straight forward procedure that provides long term more effective and satisfactory the patient in relieving nasal obstruction, without significant risk of complications. The long term follow up of MAIT is required as there was increase in need of decongestion and they might require second procedure as MFT.
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Affiliation(s)
- Kulwinder Singh Sandhu
- Department of ENT and Head Neck Surgery, GMC, 357, B- Block, New Amritsar, Amritsar, Punjab India
| | - Satinder Pal Singh
- Department of ENT and Head Neck Surgery, GMC, H. No. 4580, Bhalla Colony, Chheharta, Amritsar, Punjab India
| | - Oshin Thomas
- Department of ENT and Head Neck Surgery, GMC, GMC Hostel, Amritsar, Punjab India
| | - Priyanka Choudhary
- Department of ENT and Head Neck Surgery, GMC, H. N. 328, Akash Avenue, FGC Road, Amritsar, Punjab India
| | - Arvinder Singh
- Department of ENT and Head Neck Surgery, GMC, H. No. B-2, GMC Campus, Amritsar, Punjab India
| | - Manjit Singh
- Department of ENT and Head Neck Surgery, GMC, GMC Campus, Amritsar, Punjab India
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Gagnieur P, Fieux M, Louis B, Béquignon E, Bartier S, Vertu‐Ciolino D. Objective diagnosis of internal nasal valve collapse by four‐phase rhinomanometry. Laryngoscope Investig Otolaryngol 2022; 7:388-394. [PMID: 35434327 PMCID: PMC9008170 DOI: 10.1002/lio2.784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/14/2022] [Indexed: 11/09/2022] Open
Affiliation(s)
- Pierre Gagnieur
- Service de chirurgie maxillo‐faciale et plastique de la face, Centre Hospitalier Lyon Sud Hospices Civils de Lyon Pierre Bénite cedex France
| | - Maxime Fieux
- Service d'ORL, d'otoneurochirurgie et de chirurgie cervico‐faciale, Centre Hospitalier Lyon Sud Hospices Civils de Lyon Pierre Bénite cedex France
- Université Lyon 1 Université de Lyon Lyon France
- INSERM, IMRB Université Paris Est Créteil Créteil France
- CNRS EMR 7000 Créteil France
| | - Bruno Louis
- INSERM, IMRB Université Paris Est Créteil Créteil France
- CNRS EMR 7000 Créteil France
| | - Emilie Béquignon
- INSERM, IMRB Université Paris Est Créteil Créteil France
- CNRS EMR 7000 Créteil France
- Service d'ORL et de chirurgie cervico‐faciale Centre Hospitalier Intercommunal de Créteil Créteil France
| | - Sophie Bartier
- INSERM, IMRB Université Paris Est Créteil Créteil France
- CNRS EMR 7000 Créteil France
- Service d'ORL et de chirurgie cervico‐faciale, AP‐HP Centre Hospitalier Universitaire Henri Mondor Créteil France
| | - Delphine Vertu‐Ciolino
- Université Lyon 1 Université de Lyon Lyon France
- Service d'ORL et de chirurgie cervico‐faciale, AP‐HP Centre Hospitalier Universitaire Henri Mondor Créteil France
- Hospices Civils de Lyon, hôpital Edouard Herriot Service d'ORL et de chirurgie cervico‐faciale Lyon France
- CNRS UMR 5305 LBTI Lyon France
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Dąbrowska-Bień J, Skarżyński H, Górski SF, Skarżyński PH. Quality of Life in Patients with Nasal Obstruction after Septoplasty: A Single Institution Prospective Observational Study. Int Arch Otorhinolaryngol 2021; 25:e575-e579. [PMID: 34737830 PMCID: PMC8558945 DOI: 10.1055/s-0040-1722162] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 10/25/2020] [Indexed: 10/27/2022] Open
Abstract
Introduction Nasal obstruction is a common symptom in otorhinolaryngological practice. It can impact significantly on the quality of life of the individual. Objective The primary goal of the present study was to evaluate quality of life after septoplasty in adults with nasal obstruction. A secondary goal was to assess the effectiveness of septoplasty. Methods This was a single institution prospective observational study. Patients had experienced septal deviation and symptomatic nasal obstruction with no benefit from medical treatment. There were 51 patients who completed the Nasal Obstruction Symptom Evaluation (NOSE-POL) scale as well as theVisual Analogue Scale (VAS) before undergoing septoplasty, 3 months later, and finally 7 months after surgery. Patients evaluated changes in their nasal obstruction and changes in their quality of life using the Clinical Global Impression Scale (CGI-S). Results There was a significant improvement in nasal obstruction after septoplasty. Before septoplasty, the mean score on NOSE was 60.3 ± 20.4; 3 months after surgery, it was 32.9 ± 16.8; and 7 months after surgery it was 39.6 ± 33.2. The VAS results also proved a significant enhancement in nasal obstruction after septoplasty. Patients reported an improvement in nasal obstruction as well as a positive change in quality of life, confirming the effectiveness of septoplasty. Conclusions In patients with deformed septum, septoplasty contributes to high satisfaction of the patient and a compelling improvement in disease-specific quality of life. The NOSE-POL questionnaire is a useful tool for measuring the outcomes of this procedure.
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Affiliation(s)
- Justyna Dąbrowska-Bień
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland
| | - Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland
| | - Sebastian Filip Górski
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland
| | - Piotr Henryk Skarżyński
- Institute of Physiology and Pathology of Hearing, Warsaw, Poland.,Otorhinolaryngology Surgery Clinic, World Hearing Center, Nadarzyn/Warsaw, Poland.,Department of Heart Failure and Cardiac Rehabilitation, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland.,Institute of Sensory Organs, Kajetany/Warsaw, Poland
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Bohman A, Oscarsson M, Holmberg K, Johansson L, Millqvist E, Nasic S, Bende M. Relative frequencies of symptoms and risk factors among patients with chronic rhinosinusitis with nasal polyps using a case-control study. Acta Otolaryngol 2018; 138:46-49. [PMID: 28826302 DOI: 10.1080/00016489.2017.1366052] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the relative frequency of important symptoms of chronic rhinosinusitis with nasal polyps (CRSwNP), the link between CRSwNP and the lower airways and the importance of smoking in CRSwNP. METHOD Three hundred and sixty-eight patients with CRSwNP and 1349 controls were recruited to the study and underwent a structured interview about symptoms from the upper and lower airways, and about smoking habits. Furthermore, all participants were clinically examined using nasal endoscopy. RESULTS Due to interactions between the outcome variables, a multiple logistic regression model was fitted to the data. Nasal secretions, nasal blockage and impaired sense of smell were symptoms associated with CRSwNP. Furthermore, male gender, increasing age and asthma were also associated with the disease. Current smoking was less frequent among patients with CRSwNP. CONCLUSION By comparing symptoms and risk factors of patients with CRSwNP with those of a large population-based control group and testing them in a multiple logistic regression model, we have been able to generate data that address key research interests in CRSwNP.
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Affiliation(s)
- Anton Bohman
- Department of Otorhinolaryngology, Uppsala University Hospital, Uppsala, Sweden
| | - Martin Oscarsson
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Kenneth Holmberg
- Department of Otorhinolaryngology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Leif Johansson
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
| | - Eva Millqvist
- Department of Internal Medicine/Respiratory Medicine and Allergology, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Salmir Nasic
- Research and Development Centre, Skaraborg Hospital, Skövde, Sweden
| | - Mats Bende
- Department of Otorhinolaryngology, Skaraborg Hospital, Skövde, Sweden
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Boelke G, Berger U, Bergmann KC, Bindslev-Jensen C, Bousquet J, Gildemeister J, Jutel M, Pfaar O, Sehlinger T, Zuberbier T. Peak nasal inspiratory flow as outcome for provocation studies in allergen exposure chambers: a GA 2LEN study. Clin Transl Allergy 2017; 7:33. [PMID: 28932387 PMCID: PMC5604509 DOI: 10.1186/s13601-017-0169-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 09/04/2017] [Indexed: 12/24/2022] Open
Abstract
Background The GA2LEN chamber has been developed as a novel mobile allergen exposure chamber (AEC) allowing standardized multicenter trials in allergy. Hitherto, subjective nasal symptom scores have been the most often used outcome parameter, but in standardized modern trials objective parameters are preferred. Despite its practicability, the objective parameter peak nasal inspiratory flow (PNIF) has been rarely used for allergy trials in the setting of allergen exposure chambers. This study aims to evaluate PNIF as an outcome parameter for provocation studies in AECs. Methods In a randomized controlled blinded setting subjects suffering from allergic rhinitis were exposed to grass pollen, birch pollen, house dust mite and/or placebo in the GA2LEN chamber. Different allergen concentrations were used to evaluate symptom severities. Patients had to perform PNIF before and every 30 min during a challenge using a portable PNIF meter. Results 86 subjects participated in 203 challenges, altogether. House dust mite provocations caused the greatest reduction in PNIF values, followed by grass pollen and birch pollen. Provocations with every allergen or pollen concentration led to a significant decrease (p < 0.05) in PNIF compared to baseline. Furthermore, positive correlations were obtained between PNIF and peak expiratory flow, height and weight, and inverse correlations between PNIF and total nasal symptom score, nasal congestion score and visual analog scale of overall subjective symptoms. Conclusion PNIF is a helpful and feasible tool for conducting provocation trials with allergens, especially grass pollen and house dust mite, in an AEC. Electronic supplementary material The online version of this article (doi:10.1186/s13601-017-0169-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Georg Boelke
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology and Allergy, Allergy-Center-Charité, Berlin, Germany
| | - Uwe Berger
- Department of Otorhinolaryngology, Aerobiology and Pollen Information Research Unit, Medical University of Vienna, Vienna, Austria
| | - Karl-Christian Bergmann
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology and Allergy, Allergy-Center-Charité, Berlin, Germany
| | | | - Jean Bousquet
- CHRU, Montpellier University Hospital Center, Montpellier, France
| | | | - Marek Jutel
- ALL-MED Medical Research Institute, Wrocław, Poland.,Department of Clinical Immunology, Wroclaw Medical University, Wrocław, Poland
| | - Oliver Pfaar
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Center for Rhinology and Allergology, Wiesbaden, Germany
| | | | - Torsten Zuberbier
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Dermatology and Allergy, Allergy-Center-Charité, Berlin, Germany
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Ottaviano G, Fokkens WJ. Measurements of nasal airflow and patency: a critical review with emphasis on the use of peak nasal inspiratory flow in daily practice. Allergy 2016; 71:162-74. [PMID: 26447365 DOI: 10.1111/all.12778] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2015] [Indexed: 12/26/2022]
Abstract
Objective measures can be used to assist the clinician to diagnose and treat nasal obstruction and also to quantify nasal obstruction in research. Objective measurements of nasal obstruction are as important as objective measurements of lung function. peak nasal inspiratory flow (PNIF), acoustic rhinometry (AR) and rhinomanometry (RM), with their specific peculiarity, assess different aspects of nasal obstruction. From the studies available in the literature, it seems that these methods roughly correlate with each other and that all of them can be alternatively utilized very well in research as well as in clinical practice. This review describes the various methods that can be used to measure nasal patency, airflow and resistance, mainly peak nasal inspiratory flow, rhinomanometry and acoustic rhinometry. PNIF has been demonstrated to be reproducible and as good an indication of objective nasal patency as formal rhinomanometry and has the advantage to be cheap, simple and suitable for serial measurements and for home use even in the paediatric population. PNIF normative data are available for children, adults and elderly subjects, and the availability of unilateral PNIF normal values allows evaluation of nasal sides separately. Just as in the lower airways, objective and subjective evaluation gives different information that together optimizes the diagnosis and the treatment of our patients. We argue that PNIF should be used regularly in every outpatient clinic that treats patients with nasal obstruction.
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Affiliation(s)
- G. Ottaviano
- Otolaryngology Section; Department of Neurosciences; University of Padova; Padova Italy
| | - W. J. Fokkens
- Department of Otorhinolaryngology; Academic Medical Centre; Amsterdam The Netherlands
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Dinesh Kumar R, Rajashekar M. Comparative Study of Improvement of Nasal Symptoms Following Septoplasty with Partial Inferior Turbinectomy Versus Septoplasty Alone in Adults by NOSE Scale: A Prospective Study. Indian J Otolaryngol Head Neck Surg 2016; 68:275-84. [PMID: 27508126 DOI: 10.1007/s12070-015-0928-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022] Open
Abstract
To compare the symptomatic improvement of nasal symptoms following septoplasty with partial inferior turbinectomy (groups A) versus septoplasty alone (groups B) and to assess the improvement of nasal symptoms in both surgical groups before and after surgery by NOSE scale. This Tertiary Hospital based study was carried out between August 2012 and April 2014. 60 cases with septal deviation and contralateral inferior turbinate hypertrophy. Nasal Obstruction Symptom Evaluation (NOSE) scale for evaluating nasal symptoms. Patients were alternatively divided into two surgical groups, group A. Septoplasty with partial inferior turbinectomy and group B septoplasty alone. Post-operative patient's symptoms evaluated by NOSE scale at 1, 3 and 6 months. Data analysed using tables, graph and percentage and test of significance like paired t test, Friedman test, Chi square test used. Post operative improvement following both group A septoplasty with partial inferior turbinectomy and group B in those undergoing septoplasty alone was highly significant (p < 0.001) at post-op 1, 3 and 6 months subjectively. When both groups were compared those undergoing partial inferior turbinectomy surgery with septoplasty had highly significant results (p < 0.001) for subjective assessment by NOSE scale. This study showed that hypertrophied turbinate need to be addressed in chronic cases of nasal obstruction with deviated nasal septum and contralateral turbinate hypertrophy. partial inferior turbinectomy should be done in addition to septoplasty, its highly effective modality for the treatment of nasal obstruction in patients with deviated nasal septum. NOSE score can be used as a subjective tool for symptomatic measurement of patients with nasal obstruction.
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Mortuaire G, de Gabory L, François M, Massé G, Bloch F, Brion N, Jankowski R, Serrano E. Rebound congestion and rhinitis medicamentosa: Nasal decongestants in clinical practice. Critical review of the literature by a medical panel. Eur Ann Otorhinolaryngol Head Neck Dis 2013; 130:137-44. [DOI: 10.1016/j.anorl.2012.09.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 09/06/2012] [Accepted: 09/12/2012] [Indexed: 02/06/2023]
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Louis B, Papon JF, Croce C, Caillibotte G, Sbirlea-Apiou G, Coste A, Fodil R, Isabey D. Frictional resistance sheds light on the multicomponent nature of nasal obstruction: a combined in vivo and computational fluid dynamics study. Respir Physiol Neurobiol 2013; 188:133-42. [PMID: 23727227 DOI: 10.1016/j.resp.2013.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 05/19/2013] [Accepted: 05/22/2013] [Indexed: 10/26/2022]
Abstract
Exploring nasal flow contributes to better understanding of pathophysiological functions of nasal cavities. We combined the rhinomanometry measurements of 11 patients and computational fluid dynamics (CFD) simulations in 3 nasal airway models to dissect the complex mechanisms that determine nasal flow obstruction: spatial complexity and pressure-dependent deformability of nasal airways. We quantified spatial complexity by calculating longitudinal variations of hydraulic diameter, perimeter and area of nasal cavities, and their impact on flow characteristics by examining the longitudinal variations of the kinetic energy coefficient and the kinetic to potential energy ratio. Airway distensibility variably affected in vivo pressure-flow relationships through the appearance of flow-limitation patterns characterized by maximum flow and/or flow plateau. We quantified deformability and spatial complexity effects on nasal airway resistance by normalizing all data with averaged reference parameters. The results show that discrepancies in nasal flow resistances reflect airway deformability and geometrical complexity, and thereby constitute a framework to better characterize nasal obstruction.
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Affiliation(s)
- Bruno Louis
- Inserm, U955, Equipe 13, Cell and Respiratory Mechanics Department, 8, rue du Général Sarrail, F-94010 Créteil Cedex, France.
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Bende M, Millqvist E. Prevalence of chronic cough in relation to upper and lower airway symptoms; the Skövde population-based study. Front Physiol 2012; 3:251. [PMID: 22934008 PMCID: PMC3429028 DOI: 10.3389/fphys.2012.00251] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Accepted: 06/18/2012] [Indexed: 11/13/2022] Open
Abstract
The aim of this study was to determine the prevalence of chronic cough in relation to upper airway symptoms, in a cross-sectional, population-based epidemiological study. Another aim was to relate coughing to other explanatory variables and risk factors. A random sample of 1900 inhabitants from the age of 20, stratified for age and gender, was recruited. Subjects were invited for clinical examinations that included questions about general odor intolerance, respiratory symptoms, and smoking habits, and a smell identification test. In total, 1387 volunteers (73% of the sample) were investigated. The overall prevalence of self-reported chronic cough was 6.3% [95% confidence interval (CI): 5.0-7.6%]. Female gender, age, height, BMI, and smoking were significantly related to cough. Furthermore, nasal blockage, nasal secretion, sneezing, asthma, odor and cold air sensitivity, and aspirin intolerance also related to cough with statistical significance, indicating a close connection between chronic cough and upper airway symptoms. In keeping with other studies, this study demonstrates that chronic cough is a widespread problem in society, and is about twice as common in women than in men.
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Affiliation(s)
- Mats Bende
- Department of Otorhinolaryngology, Central Hospital Skövde, Sweden
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Stefanini R, Tufik S, Soares MCM, Haddad FLM, Bittencourt LRA, Santos-Silva R, Gregorio LC. Systematic evaluation of the upper airway in the adult population of São Paulo, Brazil. Otolaryngol Head Neck Surg 2012; 146:757-63. [PMID: 22298684 DOI: 10.1177/0194599811434256] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To study the prevalence of otorhinolaryngologic symptoms and findings of physical examination of the upper airway (UA) of a representative sample of the adult population of São Paulo, Brazil, and the association between these findings. STUDY DESIGN Cross-sectional survey. SETTING Population sample. METHODS A total of 1101 randomly selected volunteers representing the adult population of São Paulo according to sex, age, and socioeconomic class were included in this study. Otorhinolaryngological evaluation included investigation of nasal complaints, physical examination of the UA, and a facial inspection. RESULTS A total of 993 volunteers (53.9% women), with a mean age of 41.8 ± 0.89 years, underwent otorhinolaryngologic examination. The most prevalent symptoms were the following: symptoms suggestive of rhinitis (44.9%), snoring (42.8%), mouth breathing (39.3%), and nasal obstruction (33.3%). In physical examination, the most common findings were a web palate (redundant posterior pillar; 62.9%), septum deviation (56.9%), and inferior turbinate hypertrophy (37.7%). Significant associations were found between nasal obstruction and septum deviations, inferior turbinate hypertrophy, high-arched palate, and class II dental occlusion; between symptoms of rhinitis and inferior turbinate hypertrophy; and between snoring and obstructive deviated septum, modified Mallampatti grades III and IV, increased neck circumference, and age greater than or equal to 50 years. CONCLUSIONS The prevalence of otorhinolaryngologic symptoms and alterations in physical examination of the UA were high in the adult population of São Paulo, Brazil. The snoring and nasal symptoms were significantly associated with findings from UA physical examination and inspection of the facial skeleton.
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Affiliation(s)
- Renato Stefanini
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil.
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Abstract
OBJECTIVES/HYPOTHESIS The effects of smoking on endonasal geometry and airflow remain largely unknown. Our study examined the relationship between smoking status and objective measures of nasal cavity dimensions, nasal congestion, and nasal airflow, using acoustic rhinometry (AR) and peak nasal inspiratory flow (PNIF). STUDY DESIGN Cross-sectional study. METHODS Included in the study were 2,523 consecutive patients referred for evaluation of chronic nasal or sleep-related complaints. Smoking history was recorded, and AR and PNIF were measured at baseline and after decongestion of the nasal mucosa. Minimal cross-sectional areas (MCA), nasal cavity volumes (NCV), and PNIF, as well as quantified reversible mucosal congestion based on nasal congestion indexes (NCI) were analyzed to reveal possible associations with smoking status. Linear and logistic regressions were applied adjusting for possible confounders. RESULTS Smokers exhibited lower values of MCA, NCV, and PNIF than nonsmokers, both at baseline and after decongestion. Further, smokers had a lower decongestive capacity of the nasal mucosa, reflected by lower NCI for AR measures. Cigarette consumption, expressed as either pack-years or cigarettes smoked per day, showed a similar inverse relationship with the rhinometric measures even though a linear dose-response relationship could not be established. CONCLUSIONS We have clearly demonstrated that smokers exhibit lower MCA and NCV, achieve lower PNIF values, and have a less-compliant nasal mucosa than nonsmokers. Our results are unique, and provide evidence that smoking has adverse effects on the nasal airway, possibly due to mucosal inflammation. This might have further implications because altered nasal function could compromise the lower airways.
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Affiliation(s)
- Thomas Kjaergaard
- Department of Otolaryngology-Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
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Kjærgaard T, Cvancarova M, Steinsvåg SK. Cigarette smoking and self-assessed upper airway health. Eur Arch Otorhinolaryngol 2010; 268:219-26. [PMID: 20512499 DOI: 10.1007/s00405-010-1287-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2010] [Accepted: 05/11/2010] [Indexed: 11/24/2022]
Abstract
Habitual smoking represents a chronic insult to the airway. However, the effects of smoking on upper airway health remains poorly described. Our objective was to examine the relationship between cigarette smoking and self-assessed upper airway health and evaluate dose-response relationships between exposure and complaints in a sample of 2,523 patients. Eligible subjects were adults referred to ENT specialist for evaluation of chronic nasal or sleep-related complaints. Thirteen specific symptoms and conditions, mainly related to the upper airway, were graded based on visual analog scales (VAS). Smokers, representing 33% of the sample, were more likely to report severe upper airway complaints compared to non-smokers (odds ratio 1.31-2.08) and exhibited significantly higher visual analog scale scores than non-smokers for 9 out of 13 outcome variables (p < 0.001-0.007). Further, significant associations were found between cigarette consumption and severity of complaints (p < 0.001-0.01), heavy smokers generally being more likely to exhibit high VAS scores than light smokers. In several cases smoking status and self-reported asthma/allergy had similar impact on subjective outcomes. Cigarette smoking was clearly associated with impaired upper airway health and seemed to be an important determinant in subjects seeking medical attention due to chronic nasal or sleep-related complaints. Both threshold and dose-response like relationships were evident between cigarette consumption and the outcome measures.
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Affiliation(s)
- Thomas Kjærgaard
- Department of Otolaryngology, Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway.
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Bermüller C, Kirsche H, Rettinger G, Riechelmann H. Diagnostic Accuracy of Peak Nasal Inspiratory Flow and Rhinomanometry in Functional Rhinosurgery. Laryngoscope 2008; 118:605-10. [DOI: 10.1097/mlg.0b013e318161e56b] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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