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Riestra-Ayora J, Vaduva C, Esteban-Sánchez J, Garrote-Garrote M, Fernández-Navarro C, Sánchez-Rodríguez C, Martin-Sanz E. ChatGPT as an information tool in rhinology. Can we trust each other today? Eur Arch Otorhinolaryngol 2024; 281:3253-3259. [PMID: 38436756 DOI: 10.1007/s00405-024-08581-5] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 02/23/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE ChatGPT (Chat-Generative Pre-trained Transformer) has proven to be a powerful information tool on various topics, including healthcare. This system is based on information obtained on the Internet, but this information is not always reliable. Currently, few studies analyze the validity of these responses in rhinology. Our work aims to assess the quality and reliability of the information provided by AI regarding the main rhinological pathologies. METHODS We asked to the default ChatGPT version (GPT-3.5) 65 questions about the most prevalent pathologies in rhinology. The focus was learning about the causes, risk factors, treatments, prognosis, and outcomes. We use the Discern questionnaire and a hexagonal radar schema to evaluate the quality of the information. We use Fleiss's kappa statistical analysis to determine the consistency of agreement between different observers. RESULTS The overall evaluation of the Discern questionnaire resulted in a score of 4.05 (± 0.6). The results in the Reliability section are worse, with an average score of 3.18. (± 1.77). This score is affected by the responses to questions about the source of the information provided. The average score for the Quality section was 3.59 (± 1.18). Fleiss's Kappa shows substantial agreement, with a K of 0.69 (p < 0.001). CONCLUSION The ChatGPT answers are accurate and reliable. It generates a simple and understandable description of the pathology for the patient's benefit. Our team considers that ChatGPT could be a useful tool to provide information under prior supervision by a health professional.
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Affiliation(s)
- Juan Riestra-Ayora
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain.
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.500, Getafe, 28905, Madrid, Spain.
| | - Cristina Vaduva
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.500, Getafe, 28905, Madrid, Spain
| | - Jonathan Esteban-Sánchez
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.500, Getafe, 28905, Madrid, Spain
| | - María Garrote-Garrote
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.500, Getafe, 28905, Madrid, Spain
| | - Carlos Fernández-Navarro
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.500, Getafe, 28905, Madrid, Spain
| | - Carolina Sánchez-Rodríguez
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
| | - Eduardo Martin-Sanz
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, 28670, Madrid, Spain
- Department of Otolaryngology-Head and Neck Surgery, Hospital Universitario de Getafe, Carretera de Toledo, Km 12.500, Getafe, 28905, Madrid, Spain
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Rüttgers M, Waldmann M, Vogt K, Ilgner J, Schröder W, Lintermann A. Automated surgery planning for an obstructed nose by combining computational fluid dynamics with reinforcement learning. Comput Biol Med 2024; 173:108383. [PMID: 38555704 DOI: 10.1016/j.compbiomed.2024.108383] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/26/2024] [Accepted: 03/24/2024] [Indexed: 04/02/2024]
Abstract
Septoplasty and turbinectomy are among the most common interventions in the field of rhinology. Their constantly debated success rates and the lack of quantitative flow data of the entire nasal airway for planning the surgery necessitate methodological improvement. Thus, physics-based surgery planning is highly desirable. In this work, a novel and accurate method is developed to enhance surgery planning by physical aspects of respiration, i.e., to plan anti-obstructive surgery, for the first time a reinforcement learning algorithm is combined with large-scale computational fluid dynamics simulations. The method is integrated into an automated pipeline based on computed tomography imaging. The proposed surgical intervention is compared to a surgeon's initial plan, or the maximum possible intervention, which allows the quantitative evaluation of the intended surgery. Two criteria are considered: (i) the capability to supply the nasal airway with air expressed by the pressure loss and (ii) the capability to heat incoming air represented by the temperature increase. For a test patient suffering from a deviated septum near the nostrils and a bony spur further downstream, the method recommends surgical interventions exactly at these locations. For equal weights on the two criteria (i) and (ii), the algorithm proposes a slightly weaker correction of the deviated septum at the first location, compared to the surgeon's plan. At the second location, the algorithm proposes to keep the bony spur. For a larger weight on criterion (i), the algorithm tends to widen the nasal passage by removing the bony spur. For a larger weight on criterion (ii), the algorithm's suggestion approaches the pre-surgical state with narrowed channels that favor heat transfer. A second patient is investigated that suffers from enlarged turbinates in the left nasal passage. For equal weights on the two criteria (i) and (ii), the algorithm proposes a nearly complete removal of the inferior turbinate, and a moderate reduction of the middle turbinate. An increased weight on criterion (i) leads to an additional reduction of the middle turbinate, and a larger weight on criterion (ii) yields a solution with only slight reductions of both turbinates, i.e., focusing on a sufficient heat exchange between incoming air and the air-nose interface. The proposed method has the potential to improve the success rates of the aforementioned surgeries and can be extended to further biomedical flows.
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Affiliation(s)
- Mario Rüttgers
- Jülich Supercomputing Centre, Forschungszentrum Jülich GmbH, Wilhelm-Johnen-Straße, 52425 Jülich, Germany; Institute of Aerodynamics and Chair of Fluid Mechanics, RWTH Aachen University, Wüllnerstraße 5a, 52062 Aachen, Germany; Jülich Aachen Research Alliance, Center for Simulation and Data Science, 52074 Aachen, Germany.
| | - Moritz Waldmann
- Institute of Aerodynamics and Chair of Fluid Mechanics, RWTH Aachen University, Wüllnerstraße 5a, 52062 Aachen, Germany; Jülich Aachen Research Alliance, Center for Simulation and Data Science, 52074 Aachen, Germany
| | - Klaus Vogt
- Faculty of Medicine, Center of Experimental Surgery, University of Latvia, 1586 Riga, Latvia
| | - Justus Ilgner
- Department of Otorhinolaryngology, Head and Neck Surgery, Uniklinik RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany
| | - Wolfgang Schröder
- Institute of Aerodynamics and Chair of Fluid Mechanics, RWTH Aachen University, Wüllnerstraße 5a, 52062 Aachen, Germany; Jülich Aachen Research Alliance, Center for Simulation and Data Science, 52074 Aachen, Germany
| | - Andreas Lintermann
- Jülich Supercomputing Centre, Forschungszentrum Jülich GmbH, Wilhelm-Johnen-Straße, 52425 Jülich, Germany; Jülich Aachen Research Alliance, Center for Simulation and Data Science, 52074 Aachen, Germany
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Aljeraisi T. Efficacy and safety of turbinate reduction surgery in children: a systematic review. Eur Arch Otorhinolaryngol 2024; 281:1629-1641. [PMID: 37943317 DOI: 10.1007/s00405-023-08327-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/28/2023] [Indexed: 11/10/2023]
Abstract
PURPOSE Inferior turbinate hypertrophy is not a rare problem in children, it causes chronic nasal obstruction which can severely impact the quality of life. This study aimed to investigate the efficacy and safety of turbinate reduction surgery in children with impaired nasal breathing due to hypertrophied inferior turbinate that's refractory to medical treatment. METHODS We included 23 articles with various study designs: randomized controlled trials, single-arm clinical trials, and prospective and retrospective cohort studies. We searched PubMed, Scopus, Cochrane Library, and Web of Science with the relevant keywords till April 9th, 2023. The inclusion criteria were studied with the three prespecified study design that addressed children under 18 years who underwent turbinate reduction with any technique and evaluating the improvement whether by objective or subjective methods. RESULTS Studies used objective measures favor turbinate surgery except two that showed no significant difference between pre and postoperative results. All studies used subjective measures showed an improvement postoperatively except one study. Complication rates are rare, with crust formation is being the commonest (6.03%), however, the procedure is generally safe in children. In addition, follow-up periods varied widely between 2 weeks and more than 5 years. CONCLUSION Turbinate reduction in children is an effective as a treatment method for nasal blockage due to inferior turbinate hypertrophy which is resistant to medical treatment. It is a safe procedure with low rates of complications, however, due to the heterogenicity of the study designs, with a possible risk of bias we could not conduct a meta-analysis besides our systematic review.
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Affiliation(s)
- Talal Aljeraisi
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia.
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Maniaci A, Calvo-Henriquez C, Cammaroto G, Garcia-Magan C, Garcia-Paz V, Iannella G, Jiménez-Huerta I, La Mantia I, Lechien JR, Leong SC, Lobo-Duro D, Maza-Solano J, Mitchell R, Otero-Alonso A, Peng Y, Radulesco T, Simon F, Teissier N, Cocuzza S, Saibene AM. Pediatric Inferior Turbinate Hypertrophy: Diagnosis and Management. A YO-IFOS Consensus Statement. Laryngoscope 2024; 134:1437-1444. [PMID: 37497872 DOI: 10.1002/lary.30907] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/06/2023] [Accepted: 07/08/2023] [Indexed: 07/28/2023]
Abstract
OBJECTIVE Pediatric inferior turbinate hypertrophy (PedTH) is a frequent and often overlooked cause or associated cause of nasal breathing difficulties. This clinical consensus statement (CCS) aims to provide a diagnosis and management framework covering the lack of specific guidelines for this condition and addressing the existing controversies. METHODS A clinical consensus statement (CCS) was developed by a panel of 20 contributors from 7 different European and North American countries using the modified Delphi method. The aim of the CCS was to offer a multidisciplinary reference framework for the management of PedTH on the basis of shared clinical experience and analysis of the strongest evidence currently available. RESULTS A systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria was performed. From the initial 96 items identified, 7 articles were selected based on higher-evidence items such as randomized-controlled trials, guidelines, and systematic reviews. A 34-statement survey was developed, and after three rounds of voting, 2 items reached strong consensus, 17 reached consensus or near consensus, and 15 had no consensus. CONCLUSIONS Until further prospective data are available, our CCS should provide a useful reference for PedTH management. PedTH should be considered a nasal obstructive disease not necessarily related to an adult condition but frequently associated with other nasal or craniofacial disorders. Diagnosis requires clinical examination and endoscopy, whereas rhinomanometry, nasal cytology, and questionnaires have little clinical role. Treatment choice should consider the specific indications and features of the available options, with a preference for less invasive procedures. LEVEL OF EVIDENCE 5 Laryngoscope, 134:1437-1444, 2024.
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Affiliation(s)
- Antonino Maniaci
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Italy
| | - Christian Calvo-Henriquez
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Service of Otolaryngology, Rhinology Unit, Hospital Complex at the University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Giovanni Cammaroto
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Otolaryngology Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - Carlos Garcia-Magan
- Department of Pediatrics, Hospital Complex at the University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanesa Garcia-Paz
- Allergy Department, Hospital Complex at the University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Giannicola Iannella
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Otorhinolaryngology Department, Sapienza University of Rome, Rome, Italy
| | - Ignacio Jiménez-Huerta
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Service of Otolaryngology, Pediatric Otolaryngology Unit, Gregorio Marañon University Hospital, Madrid, Spain
| | - Ignazio La Mantia
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Italy
| | - Jérome R Lechien
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium
| | - Samuel C Leong
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- The Liverpool Head and Neck Centre, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - David Lobo-Duro
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Otolaryngology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Juan Maza-Solano
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Otolaryngology Service, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Ron Mitchell
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Children's Health, Children's Medical Center Dallas, Dallas, Texas, U.S.A
| | - Andrea Otero-Alonso
- Allergy Department, Hospital Complex at the University of Santiago de Compostela, Santiago de Compostela, Spain
| | - You Peng
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Department of Otolaryngology-Head & Neck Surgery, Western University, London, Ontario, Canada
| | - Thomas Radulesco
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Department of Otorhinolaryngology and Head and Neck Surgery, APHM, IUSTI, CNRS, La Conception University Hospital, Aix Marseille University, Marseille, France
| | - François Simon
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Otolaryngology Service, Université Paris Cité, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Natasha Teissier
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Pediatric Otolaryngology Department, Robert-Debré Hospital, Paris 7 Denis Diderot University, Paris, France
| | - Salvatore Cocuzza
- Department of Medical, Surgical Sciences and Advanced Technologies G.F. Ingrassia, University of Catania, Catania, Italy
| | - Alberto M Saibene
- Young Otolaryngologists-International Federation of Otorhinolaryngological Societies, Paris, France
- Otolaryngology Unit, ASST Santi Paolo E Carlo, Department of Health Sciences, Università Degli Studi Di Milano, Milan, Italy
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Snoeks S, Velasco E, Talavera K, Hellings PW. Nasal Obstruction: Overview of Pathophysiology and Presentation of a Clinically Relevant Preoperative Plan for Rhino(Septo)plasty. Facial Plast Surg 2024. [PMID: 38224694 DOI: 10.1055/s-0043-1777850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
Impairment of nasal breathing is a highly prevalent and bothersome symptom that affects daily functioning and/or sleep quality. Those surgeons dealing with patients seeking rhinoplasty need to carefully analyze the preoperative nasal breathing capacity and predict the positive or even negative impact of rhino(septo)plasty on nasal breathing. Given the lack of correlation between the subjective feeling of suboptimal nasal breathing and the objective measurements of nasal flow and nasal resistance, a critical and mainly clinical evaluation of all anatomical, mucosal, and sensory mechanisms involved in nasal obstruction is mandatory. Indeed, thermo-, mechano-, and chemosensory receptors on the nasal mucosa, airflow, and respiratory dynamics might all contribute to the overall perception of nasal breathing capacity. In this review, we provide an overview of the factors determining suboptimal nasal breathing including different diagnostic and experimental tests that can be performed to evaluate nasal flow and nasal resistance and current limitations in our understanding of the problem of nasal breathing in an individual patient. An algorithm for the preoperative or diagnostic workup for nasal obstruction is included that might be useful as a guide for clinicians dealing with patients seeking nose surgery.
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Affiliation(s)
- Simon Snoeks
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium
| | - Enrique Velasco
- Department of Cellular and Molecular Medicine, Catholic University of Leuven Faculty of Medicine, Leuven, Belgium
| | - Karel Talavera
- Department of Cellular and Molecular Medicine, Catholic University of Leuven Faculty of Medicine, Leuven, Belgium
| | - Peter W Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospitals, Leuven, Belgium
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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Weiland T, Gellner V, Pondorfer P, Hortobagyi D, Maitz E, Kiss P, Borenich A, Reininghaus EZ, Thurnher D, Tomazic PV. Endoscopic trans-sphenoidal pituitary surgery does not impact postoperative nasal quality of life. Eur Arch Otorhinolaryngol 2024; 281:245-256. [PMID: 37650929 PMCID: PMC10764578 DOI: 10.1007/s00405-023-08203-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/21/2023] [Indexed: 09/01/2023]
Abstract
PURPOSE The aim of this prospective longitudinal study was to assess both subjective quality of life using questionnaires and objective examination of nasal function with regard to olfaction, nasal air flow and mucociliary clearance in patients after minimally invasive, turbinate-preserving endoscopic transnasal trans-sphenoidal pituitary surgery. METHODS Patients undergoing endoscopic transnasal pituitary surgery were recruited prospectively and examined during three study visits, preoperatively and 3 and 6 months postoperatively. We examined nasal function using sniffin' sticks test, rhinomanometry, saccharin transit time test, and endoscopic and radiological scores. In addition, the influence on subjective quality of life and mental health was recorded using the Sinonasal-Outcome-Test-20 (SNOT-20) and the Hospital-Anxiety-and-Depression-Scale (HADS). RESULTS 20 patients undergoing endoscopic pituitary tumor resections were included. No significant changes in olfaction or mucociliary clearance were noted. Nasal air flow showed a tendency to increase in the postoperative course lacking significance. Both the endoscopy and the radiological scores showed a significant deterioration, especially after 3 months, with a trend towards improvement over time. However, neither the SNOT-20 nor the HADS showed significant changes compared to baseline. CONCLUSIONS Our concept of minimally invasive endoscopic tumor resections on the pituitary gland with preservation of nasal turbinates shows low morbidity for the patient. Despite objectifiable surgery-associated changes in the nose, nasal physiology in terms of smell, airflow and mucociliary clearance can be preserved and the subjective quality of life of our patients remains stable.
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Affiliation(s)
- Thomas Weiland
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria.
| | - Verena Gellner
- Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - Prisca Pondorfer
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - David Hortobagyi
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Emanuel Maitz
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Peter Kiss
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Andrea Borenich
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Eva Z Reininghaus
- Department for Psychiatry and Psychotherapy, Medical University of Graz, Graz, Austria
| | - Dietmar Thurnher
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
| | - Peter Valentin Tomazic
- Department of Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Auenbruggerplatz 26, 8036, Graz, Austria
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Alessandri-Bonetti M, Costantino A, Cottone G, Carbonaro R, Cardone F, Amendola F, De Virgilio A, Robotti E, Persichetti P, Vaienti L. Efficacy of Septoplasty in Patients with Nasal Obstruction: A Systematic Review and Meta-analysis. Laryngoscope 2023; 133:3237-3246. [PMID: 37017244 DOI: 10.1002/lary.30684] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/07/2023] [Accepted: 03/21/2023] [Indexed: 04/06/2023]
Abstract
OBJECTIVE Septoplasty is the most frequently performed ENT surgery to correct nasal septal deviation (NSD). The present study aimed to quantify the effectiveness of septoplasty with or without turbinate surgery according to NOSE questionnaire scores, with the hypothesis that it is able to clinically improve patient-reported nasal obstructive symptoms in the post-operative follow-up. METHODS An electronic search was performed on PubMed/MEDLINE, Embase, and Cochrane Library. The primary outcome was the change in NOSE score at 6 months after surgery. It was assessed with the mean difference (MD) between baseline and postoperative results. RESULTS A total of 2577 patients (males: 65.1%, 95% CI: 59.9-70.2) with a mean age of 33.3 years (n = 1456, 95% CI: 30.4-36.2) were included in this meta-analysis. The pooled baseline NOSE mean score was 68.1 (n = 2577, 95% CI: 64.3-71.9). The pooled MD in NOSE score at 6-months follow-up compared to baseline was -48.8 (n = 1730, 95% CI: -54.6 to -42.9). CONCLUSIONS Functional septoplasty with or without turbinate surgery shows a critical improvement of obstructive symptoms and quality of life according to the validated NOSE score. LEVEL OF EVIDENCE NA Laryngoscope, 133:3237-3246, 2023.
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Affiliation(s)
- Mario Alessandri-Bonetti
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano - Milan, Italy
| | - Giuseppe Cottone
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Riccardo Carbonaro
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Federica Cardone
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Francesco Amendola
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele - Milan, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano - Milan, Italy
| | - Enrico Robotti
- Private Practice, Clinica Sant'Apollonia, Via Giovanni Motta, 37-24123, Bergamo, Italy
| | - Paolo Persichetti
- Department of Reconstructive and Aesthetic Plastic Surgery, Campus Bio-Medico University of Rome, Via Alvaro Del Portillo, 200, Rome, Italy
| | - Luca Vaienti
- Department of Reconstructive and Aesthetic Plastic Surgery, I.R.C.C.S. Istituto Galeazzi, University of Milan, Via Riccardo Galeazzi 4, 20161, Milan, Italy
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8
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Plaza Moral V, Alobid I, Álvarez Rodríguez C, Blanco Aparicio M, Ferreira J, García G, Gómez-Outes A, Garín Escrivá N, Gómez Ruiz F, Hidalgo Requena A, Korta Murua J, Molina París J, Pellegrini Belinchón FJ, Plaza Zamora J, Praena Crespo M, Quirce Gancedo S, Sanz Ortega J, Soto Campos JG. GEMA 5.3. Spanish Guideline on the Management of Asthma. Open Respir Arch 2023; 5:100277. [PMID: 37886027 PMCID: PMC10598226 DOI: 10.1016/j.opresp.2023.100277] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Abstract
The Spanish Guideline on the Management of Asthma, better known by its acronym in Spanish GEMA, has been available for more than 20 years. Twenty-one scientific societies or related groups both from Spain and internationally have participated in the preparation and development of the updated edition of GEMA, which in fact has been currently positioned as the reference guide on asthma in the Spanish language worldwide. Its objective is to prevent and improve the clinical situation of people with asthma by increasing the knowledge of healthcare professionals involved in their care. Its purpose is to convert scientific evidence into simple and easy-to-follow practical recommendations. Therefore, it is not a monograph that brings together all the scientific knowledge about the disease, but rather a brief document with the essentials, designed to be applied quickly in routine clinical practice. The guidelines are necessarily multidisciplinary, developed to be useful and an indispensable tool for physicians of different specialties, as well as nurses and pharmacists. Probably the most outstanding aspects of the guide are the recommendations to: establish the diagnosis of asthma using a sequential algorithm based on objective diagnostic tests; the follow-up of patients, preferably based on the strategy of achieving and maintaining control of the disease; treatment according to the level of severity of asthma, using six steps from least to greatest need of pharmaceutical drugs, and the treatment algorithm for the indication of biologics in patients with severe uncontrolled asthma based on phenotypes. And now, in addition to that, there is a novelty for easy use and follow-up through a computer application based on the chatbot-type conversational artificial intelligence (ia-GEMA).
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Affiliation(s)
| | - Isam Alobid
- Otorrinolaringología, Hospital Clinic de Barcelona, España
| | | | | | - Jorge Ferreira
- Hospital de São Sebastião – CHEDV, Santa Maria da Feira, Portugal
| | | | - Antonio Gómez-Outes
- Farmacología clínica, Agencia Española de Medicamentos y Productos Sanitarios (AEMPS), Madrid, España
| | - Noé Garín Escrivá
- Farmacia Hospitalaria, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | | | - Javier Korta Murua
- Neumología Pediátrica, Hospital Universitario Donostia, Donostia-San, Sebastián, España
| | - Jesús Molina París
- Medicina de familia, semFYC, Centro de Salud Francia, Fuenlabrada, Dirección Asistencial Oeste, Madrid, España
| | | | - Javier Plaza Zamora
- Farmacia comunitaria, Farmacia Dr, Javier Plaza Zamora, Mazarrón, Murcia, España
| | | | | | - José Sanz Ortega
- Alergología Pediátrica, Hospital Católico Universitario Casa de Salud, Valencia, España
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Merma-Linares C, Martinez MD, Gonzalez M, Alobid I, Figuerola E, Mullol J. Management of Mechanical Nasal Obstruction Isolated or Associated to Upper Airway Inflammatory Diseases in Real Life: Use of both Subjective and Objective Criteria. Curr Allergy Asthma Rep 2023; 23:567-578. [PMID: 37561310 PMCID: PMC10506933 DOI: 10.1007/s11882-023-01104-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE OF REVIEW Mechanical nasal obstruction (MNO) is a prevalent condition with a high impact on patient's quality-of-life (QoL) and socio-economic burden. The aim of this study was to determine the usefulness of both subjective and objective criteria in the appropriate management of MNO, either alone or associated to upper airway inflammatory diseases such as allergic rhinitis (AR) or chronic rhinosinusitis with nasal polyps (CRSwNP). RECENT FINDINGS A long debate persists about the usefulness of subjective and objective methods for making decisions on the management of patients with nasal obstruction. Establishing standards and ranges of symptom scales and questionnaires is essential to measure the success of an intervention and its impact on QoL. To our knowledge this is the first real-life study to describe the management of MNO using both subjective and objective criteria in MNO isolated or associated to upper airway inflammatory diseases (AR or CRSwNP). Medical treatment (intranasal corticosteroids) has a minor but significant improvement in MNO subjective outcomes (NO, NOSE, and CQ7) with no changes in loss of smell and objective outcomes. After surgery, all MNO patients reported a significant improvement in both subjective and objective outcomes, this improvement being higher in CRSwNP. We concluded that in daily clinical practice, the therapeutic recommendation for MNO should be based on both subjective and objective outcomes, nasal corrective surgery being the treatment of choice in MNO, either isolated or associated to upper airway inflammatory diseases, AR or CRSwNP.
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Affiliation(s)
- Carla Merma-Linares
- Department of Otorhinolaryngology- Head and Neck Surgery, Hospital Universitari de Tarragona Joan XXIII, Doctor Mallafre Guasch 4, 43005, Tarragona, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Catalonia, Spain.
- Clinical & Experimental Respiratory Immunoallergy, Institute of Biomedical Research "August Pi i Sunyer" (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain.
- Universitat Rovira i Virgili, Tarragona, Spain.
| | - M Dolores Martinez
- Department of Otorhinolaryngology- Head and Neck Surgery, Hospital Universitari de Tarragona Joan XXIII, Doctor Mallafre Guasch 4, 43005, Tarragona, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Catalonia, Spain
| | - Miriam Gonzalez
- Department of Otorhinolaryngology- Head and Neck Surgery, Hospital Universitari de Tarragona Joan XXIII, Doctor Mallafre Guasch 4, 43005, Tarragona, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Catalonia, Spain
| | - Isam Alobid
- Skull Base Unit, ENT department, Hospital Clinic of Barcelona, Barcelona, Spain
- Clinical & Experimental Respiratory Immunoallergy, Institute of Biomedical Research "August Pi i Sunyer" (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain
| | - Enric Figuerola
- Department of Otorhinolaryngology- Head and Neck Surgery, Hospital Universitari de Tarragona Joan XXIII, Doctor Mallafre Guasch 4, 43005, Tarragona, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Tarragona, Catalonia, Spain
| | - Joaquim Mullol
- Department of Otorhinolaryngology, Rhinology Unit & Smell Clinic, ENT Department, Hospital Clínic of Barcelona, Barcelona, Catalonia, Spain.
- Clinical & Experimental Respiratory Immunoallergy, Institute of Biomedical Research "August Pi i Sunyer" (IDIBAPS), CIBERES, Barcelona, Catalonia, Spain.
- Universitat de Barcelona, Barcelona, Spain.
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10
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Wang YT, Tsai YT, Hsu CM, Tsai MS, Tsai HY, Chang GH. Nasal Patency in Sitting, Supine, and Prone Positions in Individuals with and without Allergic Rhinitis. Life (Basel) 2023; 13:life13051226. [PMID: 37240871 DOI: 10.3390/life13051226] [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: 02/19/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 05/28/2023] Open
Abstract
(1) Background: Physiological changes in nasal patency in response to posture contribute to sleep-related problems. Previously, we reported that the supine and prone positions cause a significant decrease in nasal patency in subjective and objective assessments of healthy individuals. Therefore, we conducted a study to evaluate the effect of posture on nasal patency in patients with allergic rhinitis (AR); (2) Methods: The present study comprised 30 patients diagnosed with AR and 30 healthy subjects without nasal disease (non-AR). Changes in nasal patency were evaluated in the sitting, supine, and prone positions. We used the visual analog scale to evaluate subjective nasal blockage. Acoustic rhinometry and endoscopy were used to objectively measure changes in nasal patency; (3) Results: In the non-AR group, the prone position had a significant effect on subjective nasal blockage compared with the sitting position, with significant decreases in the minimal cross-sectional area (mCSA) measured by acoustic rhinometry. Furthermore, endoscopy demonstrated a significantly increased inferior turbinate hypertrophy in the non-AR group. In the AR group, there was no statistical difference in subjective nasal blockage symptoms between the different positions. However, in objective examinations (acoustic rhinometry and endoscopy), the prone position showed significantly decreased nasal patency; (4) Conclusions: In patients with AR, subjective nasal blockage did not significantly increase in the supine or prone position. Endoscopy demonstrated increased inferior turbinate hypertrophy in supine and prone positions resulting in a significant reduction in nasal cavity mCSA, indicating an objective reduction in nasal patency.
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Affiliation(s)
- Yun-Ting Wang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Yao-Te Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Cheng-Ming Hsu
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Ming-Shao Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsin-Yi Tsai
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
| | - Geng-He Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
- Faculty of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Head and Neck Infection Treatment Center, Chang Gung Memorial Hospital, Chiayi 613, Taiwan
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11
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Wise SK, Damask C, Roland LT, Ebert C, Levy JM, Lin S, Luong A, Rodriguez K, Sedaghat AR, Toskala E, Villwock J, Abdullah B, Akdis C, Alt JA, Ansotegui IJ, Azar A, Baroody F, Benninger MS, Bernstein J, Brook C, Campbell R, Casale T, Chaaban MR, Chew FT, Chambliss J, Cianferoni A, Custovic A, Davis EM, DelGaudio JM, Ellis AK, Flanagan C, Fokkens WJ, Franzese C, Greenhawt M, Gill A, Halderman A, Hohlfeld JM, Incorvaia C, Joe SA, Joshi S, Kuruvilla ME, Kim J, Klein AM, Krouse HJ, Kuan EC, Lang D, Larenas-Linnemann D, Laury AM, Lechner M, Lee SE, Lee VS, Loftus P, Marcus S, Marzouk H, Mattos J, McCoul E, Melen E, Mims JW, Mullol J, Nayak JV, Oppenheimer J, Orlandi RR, Phillips K, Platt M, Ramanathan M, Raymond M, Rhee CS, Reitsma S, Ryan M, Sastre J, Schlosser RJ, Schuman TA, Shaker MS, Sheikh A, Smith KA, Soyka MB, Takashima M, Tang M, Tantilipikorn P, Taw MB, Tversky J, Tyler MA, Veling MC, Wallace D, Wang DY, White A, Zhang L. International consensus statement on allergy and rhinology: Allergic rhinitis - 2023. Int Forum Allergy Rhinol 2023; 13:293-859. [PMID: 36878860 DOI: 10.1002/alr.23090] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/11/2022] [Accepted: 09/13/2022] [Indexed: 03/08/2023]
Abstract
BACKGROUND In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document. METHODS ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work. RESULTS ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost. CONCLUSION The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment.
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Affiliation(s)
- Sarah K Wise
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Cecelia Damask
- Otolaryngology-HNS, Private Practice, University of Central Florida, Lake Mary, Florida, USA
| | - Lauren T Roland
- Otolaryngology-HNS, Washington University, St. Louis, Missouri, USA
| | - Charles Ebert
- Otolaryngology-HNS, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Joshua M Levy
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Sandra Lin
- Otolaryngology-HNS, University of Wisconsin, Madison, Wisconsin, USA
| | - Amber Luong
- Otolaryngology-HNS, McGovern Medical School of the University of Texas, Houston, Texas, USA
| | - Kenneth Rodriguez
- Otolaryngology-HNS, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Ahmad R Sedaghat
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Elina Toskala
- Otolaryngology-HNS, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Baharudin Abdullah
- Otolaryngology-HNS, Universiti Sains Malaysia, Kubang, Kerian, Kelantan, Malaysia
| | - Cezmi Akdis
- Immunology, Infectious Diseases, Swiss Institute of Allergy and Asthma Research, Davos, Switzerland
| | - Jeremiah A Alt
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | | | - Antoine Azar
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuad Baroody
- Otolaryngology-HNS, University of Chicago, Chicago, Illinois, USA
| | | | | | - Christopher Brook
- Otolaryngology-HNS, Harvard University, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Raewyn Campbell
- Otolaryngology-HNS, Macquarie University, Sydney, NSW, Australia
| | - Thomas Casale
- Allergy/Immunology, University of South Florida College of Medicine, Tampa, Florida, USA
| | - Mohamad R Chaaban
- Otolaryngology-HNS, Cleveland Clinic, Case Western Reserve University, Cleveland, Ohio, USA
| | - Fook Tim Chew
- Allergy/Immunology, Genetics, National University of Singapore, Singapore, Singapore
| | - Jeffrey Chambliss
- Allergy/Immunology, University of Texas Southwestern, Dallas, Texas, USA
| | - Antonella Cianferoni
- Allergy/Immunology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | | | | | | | - Anne K Ellis
- Allergy/Immunology, Queens University, Kingston, ON, Canada
| | | | - Wytske J Fokkens
- Otorhinolaryngology, Amsterdam University Medical Centres, Amsterdam, Netherlands
| | | | - Matthew Greenhawt
- Allergy/Immunology, Pediatrics, University of Colorado, Children's Hospital Colorado, Aurora, Colorado, USA
| | - Amarbir Gill
- Otolaryngology-HNS, University of Michigan, Ann Arbor, Michigan, USA
| | - Ashleigh Halderman
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Jens M Hohlfeld
- Respiratory Medicine, Fraunhofer Institute for Toxicology and Experimental Medicine ITEM, Hannover Medical School, German Center for Lung Research, Hannover, Germany
| | | | - Stephanie A Joe
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Shyam Joshi
- Allergy/Immunology, Oregon Health and Science University, Portland, Oregon, USA
| | | | - Jean Kim
- Otolaryngology-HNS, Johns Hopkins University, Baltimore, Maryland, USA
| | - Adam M Klein
- Otolaryngology-HNS, Emory University, Atlanta, Georgia, USA
| | - Helene J Krouse
- Otorhinolaryngology Nursing, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Edward C Kuan
- Otolaryngology-HNS, University of California Irvine, Orange, California, USA
| | - David Lang
- Allergy/Immunology, Cleveland Clinic, Cleveland, Ohio, USA
| | | | | | - Matt Lechner
- Otolaryngology-HNS, University College London, Barts Health NHS Trust, London, UK
| | - Stella E Lee
- Otolaryngology-HNS, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Victoria S Lee
- Otolaryngology-HNS, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia Loftus
- Otolaryngology-HNS, University of California San Francisco, San Francisco, California, USA
| | - Sonya Marcus
- Otolaryngology-HNS, Stony Brook University, Stony Brook, New York, USA
| | - Haidy Marzouk
- Otolaryngology-HNS, State University of New York Upstate, Syracuse, New York, USA
| | - Jose Mattos
- Otolaryngology-HNS, University of Virginia, Charlottesville, Virginia, USA
| | - Edward McCoul
- Otolaryngology-HNS, Ochsner Clinic, New Orleans, Louisiana, USA
| | - Erik Melen
- Pediatric Allergy, Karolinska Institutet, Stockholm, Sweden
| | - James W Mims
- Otolaryngology-HNS, Wake Forest University, Winston Salem, North Carolina, USA
| | - Joaquim Mullol
- Otorhinolaryngology, Hospital Clinic Barcelona, Barcelona, Spain
| | - Jayakar V Nayak
- Otolaryngology-HNS, Stanford University, Palo Alto, California, USA
| | - John Oppenheimer
- Allergy/Immunology, Rutgers, State University of New Jersey, Newark, New Jersey, USA
| | | | - Katie Phillips
- Otolaryngology-HNS, University of Cincinnati, Cincinnati, Ohio, USA
| | - Michael Platt
- Otolaryngology-HNS, Boston University, Boston, Massachusetts, USA
| | | | | | - Chae-Seo Rhee
- Rhinology/Allergy, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Sietze Reitsma
- Otolaryngology-HNS, University of Amsterdam, Amsterdam, Netherlands
| | - Matthew Ryan
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Joaquin Sastre
- Allergy, Fundacion Jiminez Diaz, University Autonoma de Madrid, Madrid, Spain
| | - Rodney J Schlosser
- Otolaryngology-HNS, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Theodore A Schuman
- Otolaryngology-HNS, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Marcus S Shaker
- Allergy/Immunology, Dartmouth Geisel School of Medicine, Lebanon, New Hampshire, USA
| | - Aziz Sheikh
- Primary Care, University of Edinburgh, Edinburgh, Scotland
| | - Kristine A Smith
- Otolaryngology-HNS, University of Utah, Salt Lake City, Utah, USA
| | - Michael B Soyka
- Otolaryngology-HNS, University of Zurich, University Hospital of Zurich, Zurich, Switzerland
| | - Masayoshi Takashima
- Otolaryngology-HNS, Houston Methodist Academic Institute, Houston, Texas, USA
| | - Monica Tang
- Allergy/Immunology, University of California San Francisco, San Francisco, California, USA
| | | | - Malcolm B Taw
- Integrative East-West Medicine, University of California Los Angeles, Westlake Village, California, USA
| | - Jody Tversky
- Allergy/Immunology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Matthew A Tyler
- Otolaryngology-HNS, University of Minnesota, Minneapolis, Minnesota, USA
| | - Maria C Veling
- Otolaryngology-HNS, University of Texas Southwestern, Dallas, Texas, USA
| | - Dana Wallace
- Allergy/Immunology, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - De Yun Wang
- Otolaryngology-HNS, National University of Singapore, Singapore, Singapore
| | - Andrew White
- Allergy/Immunology, Scripps Clinic, San Diego, California, USA
| | - Luo Zhang
- Otolaryngology-HNS, Beijing Tongren Hospital, Beijing, China
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12
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Calvo-Henriquez C, Tucciarone M, Lechien JR, Maniaci A, Graham E, Maza-Solano J, Metwaly O, Martinez-Capoccioni G, Mariño-Sanchez F, Plaza G, Martin-Martin C. Turbinate surgery in pediatric patients: A worldwide survey. Acta Otorrinolaringologica (English Edition) 2023; 74:93-100. [PMID: 37005043 DOI: 10.1016/j.otoeng.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/04/2022] [Indexed: 04/03/2023]
Abstract
OBJECTIVE Impaired nasal breathing is a common condition among pediatric patients, being rhinitis the most common cause. In recent years, turbinate surgery, mainly turbinate radiofrequency ablation (TRA), has increased in popularity amongst pediatric otolaryngologists and rhinologists as a safe and useful technique to address turbinate hypertrophy in pediatric patients. The present paper is designed with the aim of assessing the current worldwide clinical practice regarding turbinate surgery in pediatric patients. METHODS The questionnaire was developed based on previous researches, by a group of 12 experts from the rhinology and pediatric otolaryngology research group belonging to the Young Otolaryngologists of the International Federation of Otorhinolaryngological societies (YO-IFOS). The survey was then translated to 7 languages and sent to 25 scientific otolaryngologic societies around the globe. RESULTS 15 scientific societies agreed to distribute the survey to their members. There were 678 responses from 51 countries. From them, 65% reported to usually perform turbinate surgery in pediatric patients. There was a statistically significant increased likelihood of performing turbinate surgery for those practicing rhinology, sleep medicine, and/or pediatric otolaryngology compared to other subspecialties. The main indication to perform turbinate surgery was nasal obstruction (93.20%); followed by sleep disordered breathing (53.28%), chronic rhinosinusitis (28.70%) and facial growth alterations (22.30%). CONCLUSIONS There is no general consensus on the indications and ideal technique for turbinate reduction in children. This dissension arises mainly from the lack of scientific evidence. The points with highest agreement (>75%) between respondents is the use of nasal steroids prior to surgery; reintroducing nasal steroids in allergic patients; and performing turbinate surgery as day-case surgery.
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13
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Calvo-Henriquez C, Rodríguez-Rivas P, Mayo-Yáñez M, González-Barcala FJ, Boronat-Catala B, Dds SMN, Martínez-Capoccioni G, Martin-Martin C. Allergic rhinitis and dental caries: A systematic review. Allergol Immunopathol (Madr) 2023; 51:168-176. [PMID: 36916103 DOI: 10.15586/aei.v51i2.752] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 12/05/2022] [Indexed: 03/08/2023]
Abstract
OBJECTIVE Dental caries is one of the most common chronic diseases affecting millions of people globally. Some studies revealed the presence of bidirectional relationship between allergic rhinitis (AR) and oral diseases, with each disease having a potential impact on the other. In this study we aimed to systematically review the literature and analyze the available evidence regarding whether AR contributes to the development of dental caries. METHODS Three authors, members of the YO-IFOS rhinology study group, independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing the relationship between rhinitis and caries, in adult and pediatric patients. RESULTS Eight studies met the inclusion criteria (87612 participants). Six studies were performed in children. A total of three studies found an association between AR and dental caries. Only two studies had adjusted the measure of effect for potentially confounding variables. Regarding the quality of the selected studies according to the NICE classification, the most observed methodological limitations detected were: (1) the cross-sectional design of the included studies which could have introduced a simultaneity bias, and (2) not clearly reporting the inclusion and exclusion criteria. CONCLUSION This systematic review can neither confirm nor deny the presence of an association between AR and caries. Despite the evidence is very scarce to conclude a relationship between AR and caries, the option for examining patients with repetitive caries by an otolaryngologist and those with AR by odontologist should be considered, as these examinations do not possess any risk for the patient.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Paula Rodríguez-Rivas
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Miguel Mayo-Yáñez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario A Coruña, A Coruña, Spain;
| | | | - Borja Boronat-Catala
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Gabriel Martínez-Capoccioni
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Martin-Martin
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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14
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Mayo-Yáñez M, Díaz-Díaz A, Calvo-Henríquez C, Lechien JR, Vaira LA, Figueroa A. Diamine Oxidase Activity Deficit and Idiopathic Rhinitis: A New Subgroup of Non-Allergic Rhinitis? Life (Basel) 2023; 13. [PMID: 36676189 DOI: 10.3390/life13010240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/15/2022] [Accepted: 01/12/2023] [Indexed: 01/18/2023] Open
Abstract
Idiopathic rhinitis represents more than 50% of non-allergic rhinitis, a heterogeneous group that involves the symptomatic inflammation of the nasal mucosa. The TRPV1 receptor of unmyelinated C-type neurons appears to be involved in its pathophysiology. Histamine, whose main catabolic enzyme is DAO, is one of the mediators that can activate this receptor. The failure of DAO causes an increase in the level of histamine in the body and, consequently, the activation of TRPV1. The objective was to investigate the existence of a DAO enzyme activity deficit in idiopathic rhinitis and its correlation with symptoms. A cross-sectional study was conducted in 116 idiopathic rhinitis patients, and DAO activity, nasal peak inspiratory flow, and rhinitis severity were recorded. The prevalence of a DAO activity deficit was 41.38% (95%CI 0.33−0.50; p = 0.05). The DAO activity in patients with mild rhinitis was 52.93 ± 8.72 HDU/mL, in those with moderate rhinitis it was 120.33 ± 71.63 HDU/mL, and in those with severe rhinitis it was 92.58 ± 27.75 HDU/mL (p = 0.006). The NPIF in patients with a DAO activity deficit was 107.92 ± 34.05 L/min, compared to 72.35 ± 27.16 L/min in patients with normal enzymatic activity (p < 0.001), demonstrating a linear correlation between activity levels and nasal obstruction (−0.45; p < 0.001). Therefore, patients with a DAO deficiency and idiopathic rhinitis could present a milder disease course, because the repeated and continuous activation of TRPV1 led to a partial or total decrease in their response (desensitization). This new theory represents a different perspective for the study of idiopathic rhinitis and its relationship with TRPV1, with the regulation or modulation of the desensitization of TRPV1 being an important therapeutic target for patients with idiopathic rhinitis in the future.
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15
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Calvo-Henriquez C, Tucciarone M, Lechien JR, Maniaci A, Graham E, Maza-Solano J, Metwaly O, Martinez-Capoccioni G, Mariño-Sanchez F, Plaza G, Martin-Martin C. Turbinate surgery in pediatric patients: A worldwide survey. Acta Otorrinolaringológica Española 2022. [DOI: 10.1016/j.otorri.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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16
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Sleurs K, Postelmans J, Smit JV. Radiofrequency Ablation for Inferior Turbinate Hypertrophy: Predictive Factors for Short and Long-Term Outcomes. Ann Otol Rhinol Laryngol 2022:34894221121407. [PMID: 36082420 DOI: 10.1177/00034894221121407] [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] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Radiofrequency Ablation (RFA) is a widely used technique for treatment of nasal obstruction due to inferior turbinate hypertrophy. This study aims to evaluate short and long-term outcome after RFA. Secondly, predictive factors for this outcome were evaluated. METHODS A prospective clinical study was performed in 65 patients to evaluate short-term outcome and predictive factors (Study A). To evaluate long-term outcome and predictive factors we performed a second clinical study in 124 patients (Study B). Patients scored nasal symptoms on a 1 to 5 points visual analogue scale (VAS) and filled in questionnaires about their comorbidity, previous nasal surgery, and medication use. RESULTS Study A: There was significant short-term (6-8 weeks after RFA) improvement in nasal obstruction (VAS -1.3, P < .001), trouble exercising (VAS -1.5, P < .001), trouble sleeping (VAS -0.9, P < .001), snoring (VAS -1.1, P< .001), and hyposmia (VAS -0.6, P = .004). Smoking (R2 = .065, P = .047) was a predictor for less optimized and previous use of decongestive nasal spray (R2 = .135, P = .005) for better short-term outcome. Study B: Nasal obstruction significantly decreased in the long term (1-5 years after RFA) compared to VAS before RFA (VAS -1.5, P < .001), but slightly increased compared to VAS 6 to 8 weeks after RFA (VAS +0.3, P = .036). Allergy (R2 = .066, P = .006), asthma (R2 = .068, P = .005), and previous use of corticosteroid nasal spray (R2 = .050, P = .016) were associated with a less optimized and older age (R2 = .217, P < .001) with better long-term outcome. CONCLUSION RFA is an efficient treatment for nasal obstruction, and improves sleeping, exercising, snoring, and hyposmia. Predictors for good short-term outcome were previous use of decongestive nasal spray and no smoking. Predictors for a less optimized long-term outcome were allergy, asthma, and previous use of corticosteroid nasal spray. Older age was associated with better long-term outcome.
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Affiliation(s)
- Kristien Sleurs
- Department of Ear, Nose, Throat, Head and Neck Surgery, University Hospital of Leuven, Leuven, Belgium
| | - Job Postelmans
- Department of Ear, Nose, Throat, Head and Neck Surgery, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Jasper V Smit
- Department of Ear, Nose, Throat, Head and Neck Surgery, Zuyderland Medical Center, Heerlen, The Netherlands
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Calvo-Henriquez C, Martínez-Seijas P, Boronat-Catalá B, Faraldo-García A, Martínez-Capoccioni G, Alobid I, Banegassi IM, Martin-Martin C. Assessing the ability of children and parents to rate their nasal patency. A cross sectional study. Int J Pediatr Otorhinolaryngol 2022; 156:111094. [PMID: 35290944 DOI: 10.1016/j.ijporl.2022.111094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/19/2022] [Accepted: 03/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Nasal obstruction is a common complaint in pediatric otolaryngology. There are several concerns about how nasal obstruction should be measured. This debate is even more important in children, as they can experience difficulties in being sensitive to their symptoms or even expressing them. In this research we aim to explore the ability of children (and their parents) to assess their nasal obstruction. PARTICIPANTS AND METHODS: An observational cross-sectional study was performed. Four cohorts of children were consecutively selected from a third level referral Hospital. Cohort A (children suffering solely turbinate enlargement), B (adenoid enlargement only), and C (adenoid and turbinate enlargement), while cohort D were healthy controls. Children and parents were asked to rate nasal patency through a Likert scale from 0 (no patency, complete obstruction of the nose) to 10 (complete patency, it is easy to breathe through the nose). All participants underwent rhinomanometry. Results of nasal resistance were relativized according to pediatric reference values per each age subgroup. RESULTS 146 participants were included. Cohort A (54), B (40), C (28), D (24). There is a poor but significant correlation between parents' assessment and nasal resistance (rho = -0.28; p = 0.004). In children, there is no significant correlation with nasal resistance (rho = -0.14; p = 0.17). Stratified by severity, only children (and their parents) with good nasal breathing demonstrated good correlation values with the visual analogue score (VAS). Stratified by age, the correlation is only significant for parents of children older than 12 years old. CONCLUSIONS This study has demonstrated a good ability to rate nasal patency by healthy children and their parents, but a poor ability for children suffering from impaired nasal breathing. We suggest combining subjective assessment of nasal patency with objective measurements such as rhinomanometry in children.
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Guo Y, Wu H, Wei Y. Nocturnal nasal congestion is associated with uncontrolled blood pressure in patients with hypertension comorbid obstructive sleep apnea. Eur Arch Otorhinolaryngol 2022; 279:5215-5221. [PMID: 35362753 DOI: 10.1007/s00405-022-07352-4] [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: 02/09/2022] [Accepted: 03/09/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine the independent role of nasal obstruction on blood pressure (BP) control in patients with hypertension comorbid obstructive sleep apnea (OSA). SUBJECTS AND METHODS This cross-sectional study comprised of 326 newly diagnosed OSA comorbid hypertension patients from March 2018 to December 2021. Sixty-six patients have controlled hypertension, two hundred and nine with uncontrolled hypertension and fifty-one with resistant hypertension. Information on demographic characteristics, sleep data, hypertension status was collected. Multivariate logistic regression models were used to determine the odds ratios (OR). RESULTS Patients with nocturnal nasal congestion had more difficult to control blood pressure, with more numbers of antihypertensive drugs. They tended to have more severe OSA, lower nocturnal oxygen saturation and more severe sleepiness. Univariate analysis showed that nocturnal nasal congestion and Nasal Obstruction Symptom Evaluation (NOSE) Scale scores were associated with uncontrolled BP. After adjusting for age, sex, smoking, alcohol use, OSA severity and CT90, multivariate logistic analysis models showed that nocturnal nasal congestion was independently associated with uncontrolled hypertension (OR = 2.09, p = 0.023). When analyzed more severe resistant hypertension, nocturnal nasal congestion showed a higher association (OR = 2.96, p = 0.014). CONCLUSION This cross-sectional study demonstrated that the nocturnal nasal congestion was independently associated with uncontrolled BP. The use of nasal decongestants or nasal surgery may be a potential therapeutic target for resistant hypertension in the future.
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Affiliation(s)
- Yaxin Guo
- Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China
| | - Hao Wu
- Beijing AnZhen Hospital, Capital Medical University, Beijing, China
| | - Yongxiang Wei
- Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing, China. .,Beijing AnZhen Hospital, Capital Medical University, Beijing, China. .,Capital Institute of Pediatrics, Beijing, China.
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Calvo-Henriquez C, Lechien JR, Méndez-Benegassi I, Benoliel AL, Faraldo-García A, Martínez-Capoccioni G, Neves JC, Martin-Martin C. Pediatric turbinate radiofrequency ablation improves quality of life and rhinomanometric values. A prospective study. Int J Pediatr Otorhinolaryngol 2022; 154:111050. [PMID: 35065329 DOI: 10.1016/j.ijporl.2022.111050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 12/05/2021] [Accepted: 01/16/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE turbinate surgery in pediatric patients is gradually increasing in popularity amongst pediatric otolaryngologists. However, despite this, there is scarce information regarding this surgical procedure in children. The present research is designed with the aim of assessing changes in nasal resistance, nasal airflow and quality of life in pediatric patients undergoing turbinate radiofrequency ablation. METHODS A prospective uncontrolled intervention clinical trial design was followed. Children between 4 and 15 years old undergoing turbinate radiodiofrequency ablation (TRA) were consecutively selected. Children were examined preoperatively and 1, 3, 6 and 12 months after turbinate surgery. Anterior active rhinomanometry with and without nasal decongestant and examination of the turbinates and adenoid size were carried out in each follow-up visit. The SN5 quality of live survey was answered by parents. RESULTS 81 children were included, 28 with associated adenoidectomy. A significant improvement in quality of life was demonstrated since the first month after TRA. Regarding nasal resistance, there was an improvement 1 month after surgery, but it only reached statistical significance for the whole sample (p < 0.001)) and for the cohort of isolated turbinate surgery (p < 0.001) at 3 months, while the values for the cohort of children who underwent adenoidectomy reached significance at 6 months after surgery (p = 0.04). The difference in nasal resistance before and after decongestant was compared to the change in nasal resistance after surgery. It demonstrated a strong correlation with the change in nasal resistance at 1 month (R = 0.985; p < 0.001), 3 months (R = 0.995; p < 0.001), 6 months (R = 0.98; p < 0.001) and 12 months (R = 0.98; p < 0.001) after surgery. CONCLUSIONS turbinate surgery in pediatric patients seems to be a safe procedure which objectively and subjectively improves the symptoms of children suffering from nasal obstruction.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Rhinology Unit. Hospital Complex of Santiago de Compostela. - Santiago de Compostela, Spain.
| | - Jerome R Lechien
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology. Foch Hospital, University of Paris Saclay, Paris, France
| | - Iván Méndez-Benegassi
- Service of Otolaryngology, Rhinology Unit. University Hospital Rey Juan Carlos, Madrid, Spain
| | - Alejandro Lowy Benoliel
- Service of Otolaryngology, Pediatric Otolaryngology Unit. Gregorio Marañol University Hospital, Madrid, Spain
| | - Ana Faraldo-García
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Pediatric Otolaryngology acUnit. Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Gabriel Martínez-Capoccioni
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Rhinology Unit. Hospital Complex of Santiago de Compostela. - Santiago de Compostela, Spain
| | - J Carlos Neves
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; MyFace Clinics and Academy. Lisbon, Portugal
| | - Carlos Martin-Martin
- Service of Otolaryngology, Rhinology Unit. Hospital Complex of Santiago de Compostela. - Santiago de Compostela, Spain
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Mayo-Yáñez M, Herranz-Larrañeta J, Calvo-Henríquez C. Commentary on can sex improve nasal function?-An exploration of the link between sex and nasal function. Ear Nose Throat J 2022:1455613221077601. [PMID: 35152782 DOI: 10.1177/01455613221077601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology-Head and Neck Surgery Department, 16811Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), 16780Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
| | - Jesús Herranz-Larrañeta
- Otorhinolaryngology-Head and Neck Surgery Department, 16811Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), 16780Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
| | - Christian Calvo-Henríquez
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), 16780Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain
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Calvo-Henriquez C, Branco AM, Lechien JR, Maria-Saibene A, DeMarchi MV, Valencia-Blanco B, Boronat-Catalá B, Rangel-Chávez J, Martin-Martin C. What is the relationship between the size of the adenoids and nasal obstruction? A systematic review. Int J Pediatr Otorhinolaryngol 2021; 151:110895. [PMID: 34537548 DOI: 10.1016/j.ijporl.2021.110895] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 08/06/2021] [Accepted: 08/20/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE adenoidectomy is one of the most common surgical procedure in pediatric otolaryngology practice. Clinical guidelines (such as the Spanish or American) suggest adenoidectomy when the enlargement of the adenoids is associated with nasal obstruction. Nasal endoscopy and cephalograms are adequate methods to estimate the size of the adenoids. However, they do not measure nasal patency. This systematic review is designed with the objective of exploring the relationship between adenoid size and nasal ventilation through rhinomanometry. REVIEW METHODS 3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing both nasal resistance and/or nasal airflow in rhinomanometry and adenoid size by any method (endoscopy, cephalogram, direct examination). RESULTS A total of 10 studies with a total population of 969 participants met the inclusion criteria. 5 authors explored the size of the adenoids through endoscopy. 4 authors explored the adenoids through lateral cephalograms. Finally, a further 2 authors explored adenoid size studying the resected tissue. Five studies explored the correlation between adenoid size and nasal resistance in rhinomanometry, which ranged from 0.20 to 0.84. Finally, 5 studies used nasal decongestant. It was found higher sensitivity and specificity, a higher area under the curve for the receiver operating characteristic curve, and higher correlation with adenoid size for rhinomanometry under nasal decongestion. CONCLUSION Up to now, there is no ideal diagnostic method for adenoid hypertrophy. Therefore, it seems prudent to use a combination of all currently available tools, as they provide complementary, rather than supplementary information. Available evidence suggests that rhinomanometry combined with nasal decongestant could help to elucidate the existence of nasal obstruction in intermediate cases of adenoid hypertrophy, as well as throw light on other possible causes for nasal obstruction, mainly turbinate hypertrophy.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology. Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Ana María Branco
- College of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jerome R Lechien
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Foch Hospital, University of Paris Saclay, Paris, France
| | - Alberto Maria-Saibene
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, San Paolo Hospital, University of Milan, Milan, Italy
| | - Maria Victoria DeMarchi
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Italiano, Buenos Aires, Argentina
| | - Beatriz Valencia-Blanco
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology. Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Borja Boronat-Catalá
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology. Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jesús Rangel-Chávez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Nuestra Señora de La Salud, San Luis de Potosi, Mexico
| | - Carlos Martin-Martin
- Service of Otolaryngology. Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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Calvo-Henriquez C, Branco AM, Lechien JR, Sandoval-Pacheco V, Maldonado-Alvarado B, Maza-Solano J, Trozzi M, Rivero-Fernández I, Martínez-Capoccioni G, Martin-Martin C. Assessing the effect of adenoidectomy on nasal resistance and airflow. A systematic review and meta-analysis. Int J Pediatr Otorhinolaryngol 2021; 151:110969. [PMID: 34781112 DOI: 10.1016/j.ijporl.2021.110969] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Clinical guidelines suggest adenoidectomy when enlarged adenoids are associated with nasal obstruction and other symptoms. Given that nasal obstruction is the leading symptom of adenoid hypertrophy, it should be thoroughly explored. However, there is no consensus regarding what could be the best approach. This systematic review is designed with the objective of exploring the extent to which adenoidectomy can decrease nasal resistance through rhinomanometry. REVIEW METHODS 3 authors members of the YO-IFOS rhinology study group independently analyzed the data sources (Pubmed, the Cochrane Library, EMBASE, SciELO) for papers assessing the change in nasal resistance and/or nasal airflow in rhinomanometry after adenoidectomy in pediatric patients. RESULTS A total of 9 studies with a total population of 423 participants (323 patients excluding healthy controls) met the inclusion criteria. All of them found decreased nasal resistance after adenoidectomy. 5 studies could be combined in a metanalysis, which revealed a statistically significant difference of 0.52 Pa in basal conditions, and 0.64 Pa in rhinomanometry under nasal decongestion. 4 authors explored changes in nasal airflow. All of them found a statistically significant increase in nasal airflow after adenoidectomy. However, their results could not be merged in a meta-analysis. CONCLUSION This systematic review and meta-analysis demonstrated the existence of a systematic decrease in nasal resistance and increase in nasal airflow with and without nasal decongestant after adenoidectomy. The available evidence suggests that rhinomanometry with nasal decongestant could help in intermediate cases of adenoid hypertrophy, in order to identify the presence of nasal obstruction and, when present, the possibility of other causes for it rather than enlarged adenoids, mainly turbinate hypertrophy.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Ana María Branco
- College of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Jerome R Lechien
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Foch Hospital, University of Paris Saclay, Paris, France
| | - Vilma Sandoval-Pacheco
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Byron Maldonado-Alvarado
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Juan Maza-Solano
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Virgen de la Macarena University Hospital, Seville, Spain
| | - Marilena Trozzi
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Bambino Gesù Children's Hospital, Rome, Italy
| | - Irene Rivero-Fernández
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, 12 de Octubre University Hospital, Madrid, Spain
| | - Gabriel Martínez-Capoccioni
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Carlos Martin-Martin
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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马 瑞, 郑 国, 鄂 殿, 胡 真, 娄 淼, 佟 振, 王 玉, 郭 刚, 王 波, 张 亚. [Study on changes of nasal resistance based on 3D printing transparent nasal cavity models]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2021; 35:1101-1106. [PMID: 34886624 PMCID: PMC10127642 DOI: 10.13201/j.issn.2096-7993.2021.12.009] [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] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Indexed: 06/13/2023]
Abstract
Objective:To investigate the causal relationship between the minimum cross-sectional area of nasal cavity and nasal resistance. Methods:Thirty transparent detachable 3D printing nasal cavity models were made. The airway was completely blocked with sealing material at different anatomical sections. Then ventilatable nasal drainage tubes with different cross-sectional areas were used to pass through the nasal cavity. Nasal resistance was measured. SPSS was used for statistical analysis. Results:①The postoperative nasal resistances of patients and 3D printing nasal cavity models were (0.38±0.15)Pa· s/mL and (0.39±0.02)Pa· s/mL respectively. There was no statistical difference between the two groups.The preoperative nasal resistance of patients was (0.56±0.09)Pa· s/mL, and the postoperative nasal resistance of the models was significantly descreased by 31% compared with preoperative nasal resistance of the patients, with statistically significant difference(P<0.05). ②When the ventilatable nasal drainage tubes with a cross-sectional area of 3.14 square millimeters was located in the the upper part of common meatus and the nasal valve area, the nasal cavity is moderately blocked, and the nasal resistances were (1.80±0.30) times and (2.02±0.36) times of that before the obstruction respectively. When the ventilatable nasal drainage tube was located in the lower part of common meatus,the nasal resistance was (1.68±0.28) times of that before the obstruction. ③When the ventilatable nasal drainage tubes with a cross-sectional area of 6.28 square millimeters and were located in the lower part of common meatus, the upper part of common meatus and nasal valve area, the nasal resistances were (1.44±0.23) times, (1.50±0.25) times and (1.60±0.27) times of those before obstruction, respectively. ④When the ventilatable nasal drainage tubes with a cross-sectional area of 9.42 square millimeters were located in the above areas, nasal ventilation was nearly normal without obvious nasal obstruction. The nasal resistances were (1.17±0.18) times, (1.26±0.21) times and (1.33±0.24) times of those before obstruction, respectively. ⑤The nasal resistance was statistically significant correlated with the cross-sectional area of the ventilation tubes and the obstruction sites. The correlation coefficients were -0.895 and 0.339, respectively (P<0.05). Conclusion:①3D printing can quickly and accurately replicate anatomical structure of the nasal cavity, and can be used as a research method for quantifitative measurement of nasal resistance. ②The minimum cross-sectional area of nasal cavitiy is the main determinant of nasal resistance. ③The obstruction site is the secondary determinant of nasal resistance. When the degree of nasal obstruction is the same , the nasal resistance in the nasal valve area is sightly higher than that in the common meatus.
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Affiliation(s)
- 瑞萍 马
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 国玺 郑
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 殿玉 鄂
- 江西理工大学 江西省颗粒系统仿真与模拟重点实验室Jiangxi University of Science and Technology, Key Laboratory of Jiangxi Provincial Particle System Simulation
| | - 真真 胡
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 淼 娄
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 振博 佟
- 东南大学能源与环境学院 能源热转换及其过程测控教育部重点实验室School of Energy and Environment, Southeast University, Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education
| | - 玉升 王
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 刚 郭
- 东南大学能源与环境学院 能源热转换及其过程测控教育部重点实验室School of Energy and Environment, Southeast University, Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education
| | - 波涛 王
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - 亚 张
- 西安交通大学第二附属医院耳鼻咽喉头颈外科(西安,710004)Department of Otolaryngology Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
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Abstract
Nasal airway obstruction is a very common phenomenon that can significantly decrease patients' quality of life. This review article summarizes in an evidence-based fashion the diagnosis and treatment of nasal airway obstruction. The nasal airway may be obstructed at the level of the nasal valve, septum, nasal turbinates, sinonasal mucosa, or nasopharynx. Nasal valve obstruction and septal deviations are usually treated surgically depending on the level of valve obstruction. Isolated turbinate hypertrophy is usually managed medically as part of the treatment of rhinitis, with surgery reserved for cases refractory to medical care. Sinonasal and nasopharyngeal conditions are treated according to the diagnosis.
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Calvo-Henriquez C, Mariño-Sánchez F, Lechien JR, Maldonado-Alvarado B, Maniaci A, Maza-Solano J, Martínez-Capoccioni G, Neves JC, Martin-Martin C. Radiofrequency ablation turbinoplasty improves the sense of smell in pediatric patients: A prospective study. Int J Pediatr Otorhinolaryngol 2021; 150:110935. [PMID: 34649156 DOI: 10.1016/j.ijporl.2021.110935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/25/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The olfactory sense is of paramount importance for the adequate development of a child. Olfactory loss in children might have different origins. One of the most common is conductive, when nasal obstruction prevents odorants from reaching the olfactory epithelium. Rhinitis and turbinate enlargement have been proven to diminish the sense of smell in pediatric patients. A common treatment for resistant rhinitis in these patients is turbinate radiofrequency ablation (TRA). However, despite an increasing research effort in this field, there are no studies instrumentally assessing olfaction in children undergoing turbinate surgery to date. This study was designed with the aim of assessing changes in olfaction through validated instrumental tools in pediatric patients undergoing TRA for the first time. METHODS A prospective uncontrolled intervention clinical trial design was conducted. Two cohorts of children ranging 4-15 years old were consecutively selected from a third level referral Hospital and subjected to the universal sniff test (U-Sniff), alcohol sniff test (AST), and sniffin sticks threshold test (SST) before and 1, 3 and 6 months after surgery. Cohort A consisted of children solely undergoing TRA. Cohort B consisted of children on whom adenoidectomy and TRA had been performed. Additionally, a cohort of Spanish healthy controls, paired by sex and age, were asked to perform the U-Sniff. RESULTS A total of 81 participants with a mean age of 10.31 ± 2.56 years were included. Fifty-three patients underwent TRA exclusively and 28 were subjected to associated adenoidectomy. Despite a tendency toward improvement in the U-sniff scores, there were no statistically significant differences after surgery. However, statistically significant differences were obtained for threshold tasks measured with SST and AST, revealing differences at 1, 3 and 6 months after surgery compared to preoperative scores. CONCLUSIONS In summary, this research demonstrated adequate levels in the sense of smell regarding identification tasks, but decreased olfactory threshold scores in pediatric patients suffering from TE. TRA, alone or with adenoidectomy, improved smell threshold scores, but had no significant effect on identification tasks.
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Affiliation(s)
- Christian Calvo-Henriquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Franklin Mariño-Sánchez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Rhinology and Skull Base Surgery Unit, Otorhinolaryngology Department, Ramon y Cajal University Hospital, Madrid, Spain
| | - Jerome R Lechien
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Foch Hospital, University of Paris Saclay, Paris, France
| | - Byron Maldonado-Alvarado
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - Antonino Maniaci
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia", ENT Section, ENT Department of University of Catania, Catania, Italy
| | - Juan Maza-Solano
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Rhinology and Skull Base Surgery Unit, Otolaryngology Department, Hospital Virgen de la Macarena, Seville, Spain
| | - Gabriel Martínez-Capoccioni
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - J Carlos Neves
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; MyFace Clinics and Academy, Lisbon, Portugal
| | - Carlos Martin-Martin
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
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Valtonen O, Ormiskangas J, Harju T, Rautiainen M, Kivekäs I. Three-Dimensional Measurements in Assessing the Results of Inferior Turbinate Surgery. Ann Otol Rhinol Laryngol 2021; 131:527-534. [PMID: 34192975 PMCID: PMC9016672 DOI: 10.1177/00034894211028516] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Acoustic rhinometry is widely used in evaluating patients with nasal
congestion, but it only has a partial correlation with patient symptoms. The
use and focus of cone beam computed tomography (CBCT) scans are mainly on
the paranasal sinuses and less on the nasal cavities. Therefore, information
acquired from CBCT scans is not used to its full extent. In our present
study, we have studied patients with enlarged inferior turbinates. Our aim
was to investigate and compare the use of 3D volumetric measurements and
cross-sectional area measurements taken from CBCT scans to results obtained
from acoustic rhinometry. Material and methods: In total, 25 patients with enlarged inferior turbinates were studied. CBCT
scans were obtained preoperatively and at twelve months postoperatively. 3D
volumetric and cross-sectional area measurements were compared to results
from acoustic rhinometry, the visual analogue scale (VAS) and Glasgow Health
Status Inventory (GHSI) questionnaires. Results: A statistically significant change in 3D volume and cross-sectional area was
measured in the anterior part of the inferior turbinate and surrounding air
space after inferior turbinate surgery. VAS and GHSI results had mild
correlations with the 3D volume and cross-sectional area measurements of the
anterior part of the inferior turbinate. Acoustic rhinometry correlated with
the air space 3D volume measurements in the anterior part. Conclusions: Fully utilized CBCT scans provide more comprehensive and accurate
information. Furthermore, 3D analysis of the inferior turbinates provides
valuable information and more precise measurements compared to acoustic
rhinometry.
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Affiliation(s)
- Olli Valtonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jaakko Ormiskangas
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.,Faculty of Engineering and Natural Sciences, Automation Technology and Mechanical Engineering Unit, Tampere University, Tampere, Finland
| | - Teemu Harju
- Department of Otorhinolaryngology - Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Markus Rautiainen
- Department of Otorhinolaryngology - Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Ilkka Kivekäs
- Department of Otorhinolaryngology - Head and Neck Surgery, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Calvo-Henríquez C, Abelleira R, González-Barcala FJ. Positional nasal congestion. Sleep apnea's forgotten cousin. Arch Bronconeumol 2021; 57:453-454. [PMID: 35698949 DOI: 10.1016/j.arbr.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 12/09/2020] [Indexed: 06/15/2023]
Affiliation(s)
- Christian Calvo-Henríquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), París, France; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, La Coruña, Spain.
| | - Romina Abelleira
- Service of Pneumology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, La Coruña, Spain
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Iwasaki T, Papageorgiou SN, Yamasaki Y, Ali Darendeliler M, Papadopoulou AK. Nasal ventilation and rapid maxillary expansion (RME): a randomized trial. Eur J Orthod 2021; 43:283-292. [PMID: 33564835 DOI: 10.1093/ejo/cjab001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 11/14/2022]
Abstract
OBJECTIVE To assess three rapid maxillary expansion (RME) appliances in nasal ventilation. TRIAL DESIGN Three-arm parallel randomized clinical trial. METHODS Sixty-six growing subjects (10-16 years old) needing RME as part of their orthodontic treatment were randomly allocated (1:1:1 ratio) to three groups of 22 patients receiving Hyrax (H), Hybrid-Hyrax (HH), or Keles keyless expander (K). The primary outcome of nasal ventilation (pressure and velocity) and secondary outcomes (skeletal, dental, soft tissue, and nasal obstruction changes) were blindly assessed on the initial (T0) and final (T1, 6 months at appliance removal) cone-beam computed tomography (CBCT) data by applying computational fluid dynamics (CFD) method. Differences across groups were assessed with crude and adjusted for baseline values and confounders (gender, age, skeletal maturation, expansion amount, mucosal/adenoid hypertrophy, nasal septum deviation) regression models with alpha = 5%. RESULTS Fifty-four patients were analysed (19H, 21HH, 14K). RME reduced both nasal pressure (H: -45.8%, HH: -75.5%, K: -63.2%) and velocity (H: -30%, HH: -58.5%, K: -35%) accompanied with nasal obstruction resolution (H: 26%, HH: 62%, K: 50%). Regressions accounting for baseline severity indicated HH expander performing better in terms of post-expansion maximum velocity (P = 0.03) and nasal obstruction resolution (P = 0.04), which was robust to confounders. Mucosal/adenoid hypertrophy and nasal septum deviation changes were variable, minimal, and similar across groups. The HH resulted in significantly greater increase in the nasal cross-sectional area (62.3%), anterior (14.6%), and posterior (10.5%) nasal widths. Nasal obstruction resolution was more probable among younger (P = 0.04), skeletally immature (P = 0.03), and male patients (P = 0.02) without pre-treatment mucosal hypertrophy (P = 0.04), while HH was associated with marginal greater probability for obstruction resolution. CONCLUSIONS RME resulted in improvement of nasal skeletal parameters and simulated ventilation with the former being in favour of the HH and the latter not showing significant differences among the three appliances. LIMITATION Attrition in the K group due to blocked activation rods possibly leading to limited sample to identify any existing group differences. HARMS Replacement of blocked Keles expanders for finalizing treatment. PROTOCOL The protocol was not published before the trial commencement. REGISTRATION Australian and New Zealand Clinical Trial Registry; ACTRN12617001136392.
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Affiliation(s)
- Tomonori Iwasaki
- Department of Pediatric Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Youichi Yamasaki
- Field of Developmental Medicine, Health Research Course, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - M Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Australia
| | - Alexandra K Papadopoulou
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Australia
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Mayo-Yáñez M, Díaz-Díaz A, Vázquez-Barro JC, Herranz González-Botas J, Figueroa A, Martín-Martín CS. Relationship between allergic rhinitis and diamine oxidase activity: A preliminary report. Allergol Select 2021; 5:187-194. [PMID: 34235375 PMCID: PMC8240126 DOI: 10.5414/als400537] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/14/2021] [Indexed: 11/18/2022] Open
Abstract
AIM To analyze the diamine oxidase (DAO), the main catabolic enzyme of histamine, degradation activity and its relation with symptoms of persistent allergic rhinitis. METHODS In this descriptive and analytical observational study, we collected DAO activity levels and the nasal peak inspiratory flow. RESULTS Enzymatic activity deficit in 108 patients was 46.3% (95% CI, 0.44 - 0.63), 33.33% in mild and 47.92% in moderate/severe rhinitis (p = 0.376). The nasal peak inspiratory flow in patients with a deficit in DAO activity was 76.30 ± 28.40 L/min compared to 93.62 ± 37.50 L/min in patients with normal enzymatic activity (p = 0.010). CONCLUSIONS It seems that the lower the catabolic activity of DAO, the lower the nasal peak inspiratory flow observed. Although DAO activity levels could be a severity biomarker in allergic rhinitis, a cause-effect association cannot be concluded. The enzyme could be another actor in the pathophysiology of allergic rhinitis.
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Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Complex of A Coruña (CHUAC), A Coruña, Galicia
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), University of Santiago de Compostela (USC), Santiago de Compostela, Galicia
| | - Andrea Díaz-Díaz
- Epithelial Plasticity and Metastasis Group, Biomedical Research Institute of A Coruña (INIBIC), University Hospital Complex of A Coruña (CHUAC), University of A Coruña (UDC), A Coruña, Galicia
| | - Juan C. Vázquez-Barro
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Complex of A Coruña (CHUAC), A Coruña, Galicia
- School of Educational Sciences, University of A Coruña (UDC), A Coruña, Galicia
| | - Jesús Herranz González-Botas
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Complex of A Coruña (CHUAC), A Coruña, Galicia
- School of Medicine and Odontology, University of Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain, and
| | - Angélica Figueroa
- Epithelial Plasticity and Metastasis Group, Biomedical Research Institute of A Coruña (INIBIC), University Hospital Complex of A Coruña (CHUAC), University of A Coruña (UDC), A Coruña, Galicia
| | - Carlos S. Martín-Martín
- School of Medicine and Odontology, University of Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain, and
- Otorhinolaryngology, Head and Neck Surgery Department, University Hospital Complex of Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain
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Dor-Wojnarowska A, Radlińska A, Rabski M, Fal A, Liebhart J, Zaleska A, Babchyshyn M, Samoliński B. Investigation of Repeatability of Peak Nasal Inspiratory Flow Rate Measurements Under Baseline Conditions and After Administration of 0.05% Oxymetazoline. Am J Rhinol Allergy 2021; 36:41-46. [PMID: 33957801 DOI: 10.1177/19458924211015584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/15/2022]
Abstract
OBJECTIVES Peak nasal inspiratory flow (PNIF) measurement is an inexpensive and user-friendly method to assess nasal patency. However, the repeatability of PNIF measurements, as well as the threshold value of a change in PNIF, which can be considered significant remain unclear. This study aims to investigate the repeatability of PNIF measurements and the change in PNIF after the administration of 0.05% oxymetazoline. METHODS Repeated measurements of PNIF (Clement Clarke In-Check nasal inspiratory flow meter; Clement Clarke International, Ltd, Harlow, Essex, UK) were obtained in 333 healthy volunteers (174 women). Based on age, participants were categorized into three groups (6-7 years, 13-14 years, and 20-45 years). We obtained five measurements in each participant. PNIF was remeasured in 294 subjects 30 min after administration of 0.05% oxymetazoline. The variability in PNIF measurements was assessed using the coefficient of variation (CV = standard deviation × 100%/mean). RESULTS The first four PNIF measurements significantly differed from each other. The difference in PNIF measurements ceased to be statistically significant only between the fourth and fifth measurements (p = 0.19). PNIF repeatability was acceptable; the median CV was 15.5% (0-66), which did not significantly differ between age groups. The administration of 0.05% oxymetazoline led to a statistically significant increase in the PNIF value by 14.3% (-45, 157%) (p = 0.000000). CONCLUSIONS 1. No statistically significant difference was observed in PNIF values only between the fourth and fifth measurements; therefore, at least three measurements are essential to draw meaningful conclusions. 2. PNIF measurements were satisfactorily characterized by a relatively low CV (15%). 3. The administration of 0.05% oxymetazoline led to an increase in PNIF by approximately 14% over the baseline value.
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Affiliation(s)
- Anna Dor-Wojnarowska
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Anna Radlińska
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Marek Rabski
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Andrzej Fal
- Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
| | - Jerzy Liebhart
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Anna Zaleska
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Mariana Babchyshyn
- Department of Internal Diseases, Pneumonology and Allergology, Medical University of Wroclaw, Wroclaw, Poland
| | - Bolesław Samoliński
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
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Calvo-Henríquez C, Chiesa-Estomba C, Lechien JR, Carrasco-Llatas M, Cammaroto G, Mayo-Yáñez M, Abelleira-Paris R, Gonzalez-Barcala FJ, Martinez-Capoccioni G, Martin-Martin C. The Recumbent Position Affects Nasal Resistance: A Systematic Review and Meta-Analysis. Laryngoscope 2021; 132:6-16. [PMID: 33720430 DOI: 10.1002/lary.29509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 02/20/2021] [Accepted: 02/23/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Nasal diseases are among the main motives for the early discontinuation of continuous positive airway pressure therapy and for long-term therapeutic compliance with mandibular advancement device. Although our clinical experience leads us to the belief that recumbency impacts nasal airflow in some patient populations, there is no consensus regarding the magnitude of this effect and the specific group of patients who are the most affected by this condition. In this study, we conducted a meta-analysis to assess the effect of the recumbent position on nasal resistance and nasal airflow. REVIEW METHODS PubMed (Medline), Cochrane Library, EMBASE, Scopus, and SciELO databases were checked for relevant studies by two members of the YO-IFOS study group. The two authors extracted the data. The main outcome was expressed as the difference between nasal resistance and nasal airflow before and after recumbency. RESULTS Nine studies with a total population of 291 individuals were included in the meta-analysis for nasal resistance after recumbency. We found a statistically significant difference in nasal airway resistance of -0.18 Pa sec/cm3 as compared to before and after recumbency through rhinomanometry (RMM) analysis. A subgroup analysis revealed a variation of -0.20 Pa sec/cm3 for patients with snoring or sleep apnea and - 0.10 Pa sec/cm3 for healthy individuals. Regarding nasal airflow measured with RMM, three studies (n = 32) in asymptomatic controls revealed a statistically significant difference of 47.33 ml/sec. CONCLUSIONS Recumbency increases nasal resistance and diminishes nasal airflow. This finding is of utmost importance in snorers and sleep apnea patients. Laryngoscope, 2021.
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Affiliation(s)
- Christian Calvo-Henríquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago, Spain
| | - Carlos Chiesa-Estomba
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Service of Otolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - Jerome R Lechien
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Foch Hospital, University of Paris-Saclay, Paris, France
| | | | - Giovani Cammaroto
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Department of Head-Neck Surgery, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - Miguel Mayo-Yáñez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Service of Otolaryngology, Hospital Complex of La Coruña, La Coruña, Spain
| | | | | | - Gabriel Martinez-Capoccioni
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Otorhinolaryngological Societies (YO-IFOS), Paris, France.,Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago, Spain
| | - Carlos Martin-Martin
- Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago, Spain
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Calvo-Henriquez C, Mayo-Yáñez M, Lechien JR, Moure JD, Faraldo-García A, Martinez-Capoccioni G, Esteller-More E, Neves JC, Martin-Martin C. Looking for a cutoff value for the decongestant test in children suffering with turbinate hypertrophy. Eur Arch Otorhinolaryngol 2021; 278:3821-6. [PMID: 33566176 DOI: 10.1007/s00405-021-06657-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/28/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The main causes for objectively confirmed chronic impaired nasal breathing in children are adenoid and turbinate hypertrophy. Turbinate hypertrophy may be addressed by turbinate surgery. However, specialized guidelines include no specific indications for pediatric patients. The decongestant test consists of simulating the effect of turbinate surgery by means of a nasal decongestant. This project, developed by the YO-IFOS rhinology group, aims to establish a cutoff value for the nasal decongestant test with rhinomanometry to select children for turbinate surgery. METHODS Children between 4 and 15 years of age were included. Cases were consecutively selected from children affected by turbinate hypertrophy undergoing turbinate radiofrequency ablation with or without adenoidectomy. Controls were consecutively selected from a sample of healthy children. All the subjects were examined with anterior active rhinomanometry with and without nasal decongestant. RESULTS Sample included 72 cases and 24 healthy controls. There was a statistically significant difference in the improvement with the decongestant between cases (57.91%) and controls (15.67%). The ROC curve revealed an area under the curve of 0.97. The highest amount of correctly classified individuals (93.44%) corresponded to the cutoff value of 31.66%. However, the value with the highest specificity and highest Youden's index was the 38.88% improvement in nasal resistance with nasal decongestant. CONCLUSIONS In conclusion, a preliminary cutoff value for the decongestant test used with rhinomanometry in children has been established. This test could help identify children for turbinate surgery.
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Calvo-Henríquez C, Abelleira R, González-Barcala FJ. Positional Nasal Congestion. Sleep Apnea's Forgotten Cousin. Arch Bronconeumol 2021:S0300-2896(20)30552-4. [PMID: 33509624 DOI: 10.1016/j.arbres.2020.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Christian Calvo-Henríquez
- Rhinology Study Group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), París, Francia; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, La Coruña, España.
| | - Romina Abelleira
- Service of Pneumology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, La Coruña, España
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Balsevicius T, Padervinskis E, Pribuisiene R, Kuzminiene A, Vaitkus S, Liutkevicius V. Cross-cultural adaptation and validation of Lithuanian-NOSE scale. Eur Arch Otorhinolaryngol 2020; 278:1053-1058. [PMID: 32886183 DOI: 10.1007/s00405-020-06341-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 04/16/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To evaluate validity and reliability of Lithuanian version of Nasal Obstruction Symptom Evaluation Scale (L-NOSE), designed for the assessment of nasal obstruction. METHODS Cross-cultural adaptation of L-NOSE was accomplished according to generally accepted methodology. L- NOSE was tested for its reliability, validity, and responsiveness in the group of 50 septoplasty patients and 100 healthy volunteers' controls. RESULTS L- NOSE showed good internal consistency (Cronbach's alpha coefficient 0.796 for test, 0.791 for retest, 0.792 for post-operative group, and 0.817 for control group) scores and high test-retest reliability (r = 0.94, p < 0.01) scores. In patients' group, positive moderate correlations between L-NOSE scores and Sino-nasal Outcome Test-22 logically similar domain scores were found, thus indicating good convergent construct validity. L-NOSE scores for control subjects were generally lower than for patients with nasal obstruction (p < 0.001), thereby indicating good discriminant validity of questionnaire. The exploratory factor analysis confirmed one-factor structure of questionnaire. The component matrix of L-NOSE ranged from 0.667 to 0.781 (KMO = 0.754, p < 0.0001). The mean L-NOSE score improved from 58.4 ± 18.2 points to 11.1 ± 9.5 points after septoplasty (p < 0.0001), indicating good responsiveness of questionnaire. CONCLUSION The L-NOSE questionnaire is a valid instrument with satisfactory reliability, validity, and responsiveness.
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Affiliation(s)
- Tomas Balsevicius
- Department of Otorinolaryngology of Lithuanian, University of Health Sciences, Eivenių g. 2, 50161, Kaunas, Lithuania.
| | - Evaldas Padervinskis
- Department of Otorinolaryngology of Lithuanian, University of Health Sciences, Eivenių g. 2, 50161, Kaunas, Lithuania
| | - Ruta Pribuisiene
- Department of Otorinolaryngology of Lithuanian, University of Health Sciences, Eivenių g. 2, 50161, Kaunas, Lithuania
| | - Alina Kuzminiene
- Department of Otorinolaryngology of Lithuanian, University of Health Sciences, Eivenių g. 2, 50161, Kaunas, Lithuania
| | - Saulius Vaitkus
- Department of Otorinolaryngology of Lithuanian, University of Health Sciences, Eivenių g. 2, 50161, Kaunas, Lithuania
| | - Vykintas Liutkevicius
- Department of Otorinolaryngology of Lithuanian, University of Health Sciences, Eivenių g. 2, 50161, Kaunas, Lithuania
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Calvo-Henriquez C, Capasso R, Martínez-Capoccioni G, Rangel-Chaves J, Liu SY, O'Connor-Reina C, Lechien JR, Martin-Martin C. Safeness, subjective and objective changes after turbinate surgery in pediatric patients: A systematic review. Int J Pediatr Otorhinolaryngol 2020; 135:110128. [PMID: 32485468 DOI: 10.1016/j.ijporl.2020.110128] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/23/2020] [Accepted: 05/18/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Inferior turbinates are the main structure related to impaired nasal breathing. When medical treatment fails, surgery is the next step, according to clinical guidelines. However, despite the widespread acceptance of this procedure, there is some controversy about performing it in children. DATA SOURCES Pubmed (Medline), the Cochrane Library, EMBASE, Scopus, Science direct, SciELO and Trip Database. REVIEW METHODS We looked for articles in which the individual outcome of turbinate surgery in pediatric patients was investigated independently of whether it was the main objective of the study or not. RESULTS 13 papers (1111 patients) met the inclusion criteria. 6 authors performed diverse objective assessment and 11 authors used subjective scales. All of them found improvement after surgery. Due to the heterogeneity of the methods used, they could not be included in a metanalysis. Eleven out of the 13 authors reported 3.12% complication rates, being minor bleeding the most common (1.30%), followed by crust (0.49%) and pain (0.47%). CONCLUSIONS There is a lack of high quality studies in children. Turbinate surgery in children is a safe technique with low complication rates. The available evidence suggests improvement in subjective outcomes after turbinate surgery in children. We cannot make a formal recommendation of a surgical technique in children given the lack of high quality studies, and since comparison between available papers is not possible. Although the evidence at our disposal is weak, it suggests that the safest techniques are MAIT, radiofrequency, coblation and laser.
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Affiliation(s)
- Christian Calvo-Henriquez
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Spain; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain.
| | - Robson Capasso
- Department of Otolaryngology - Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
| | - Gabriel Martínez-Capoccioni
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Spain; Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Spain
| | - Jesús Rangel-Chaves
- Department of Otolaryngology, Hospital Nuestra Señora de La Salud, San Luis de Potosi, Mexico
| | - Stanley Yung Liu
- Department of Otolaryngology - Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
| | | | - Jerome R Lechien
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Spain; Department of Otolaryngology-Head and Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Carlos Martin-Martin
- Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS) Rhinology Study Group, Spain; Department of Otolaryngology, University of Santiago de Compostela, Spain
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Sikorska-Szaflik H, Sozańska B. Peak nasal inspiratory flow in children with allergic rhinitis. Is it related to the quality of life? Allergol Immunopathol (Madr) 2020; 48:187-193. [PMID: 31864805 DOI: 10.1016/j.aller.2019.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 12/29/2022]
Abstract
INTRODUCTION AND OBJECTIVES Allergic rhinitis (AR) is the most common allergic disease in childhood. Nasal obstruction is a typical symptom of AR, however, its quantification by clinical examination is difficult. To provide an objective assessment of nasal patency, the peak nasal inspiratory flow (PNIF) is used. Symptoms of AR have a noticeable impact on the quality of life. The aim of this study was to assess which factors may have an impact on PNIF values and to evaluate the possible relationships between PNIF and QoL in children with AR. PATIENTS AND METHODS We recruited patients aged 6-17 years (n = 208, 89 girls and 119 boys) with AR. All children underwent PNIF measurements. Parents and children completed KINDL-R generic questionnaires, to assess the quality of life of the children. RESULTS The average PNIF value was 98.9 ± 37.4 L/min. A very strong (p < 0.001) relationship between the PNIF value and height, age and weight of the child was observed. The sex of the patient has no influence on the PNIF value. We showed that PNIF values significantly increased with each attempt. The children assessed their QoL at 45.6 ± 8.5 points in the KINDL-R questionnaire and the parents rated their children's QoL at 73.7 ± 10.7 points. We observed a weak negative correlation between PNIF and the QoL based on the parents' assessment and the child's self-assessment. CONCLUSIONS PNIF values depend mostly on height, but also on the child's age and weight. A learning effect (significant increase in PNIF upon each attempt) was shown. Higher PNIF does not improve the QoL.
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Affiliation(s)
- H Sikorska-Szaflik
- 1st Department and Clinic of Paediatrics, Allergology and Cardiology, Wroclaw Medical University, ul. Chalubinskiego 2a, 50-368 Wroclaw, Poland.
| | - B Sozańska
- 1st Department and Clinic of Paediatrics, Allergology and Cardiology, Wroclaw Medical University, ul. Chalubinskiego 2a, 50-368 Wroclaw, Poland.
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