scholarly journals Endoscopic Laser Treatment for Pediatric Nasal Allergy

2000 ◽  
Vol 6 (4) ◽  
pp. 189-192 ◽  
Author(s):  
Susumu Araki ◽  
Nobuhiro Suzuki ◽  
Harushiro Sato ◽  
Taro Yamaguchi ◽  
Hiroyuki Fujita ◽  
...  
Keyword(s):  
Inferior Turbinate ◽  
Normal Mucosa ◽  
Symptomatic Improvement ◽  
Nasal Allergy ◽  
Endoscopic Control ◽  
Flexible Fiber ◽  
Endoscopic Laser ◽  
Gallium Aluminium Arsenide ◽  
Laser Devices ◽  
Different Characteristics

We have used the carbon dioxide (CO2) laser and the gallium aluminium arsenide (GaAlAs) diode laser with flexible fiber delivery instruments for vaporization of the inferior nasal turbinate in pediatric patients since 1993. Under endoscopic control, the whole inferior turbinate was vaporized by 5–10 W laser output delivered via an optical fiber. Generally, the nasal mucosa changes into normal mucosa, and symptoms improve. The greatest symptomatic improvement was in nasal obstruction. The results obtained by the two laser devices were similar although they have had different characteristics. Endoscopic laser surgery is effective in the treatment of pediatric nasal allergy.

Subjective Comparison of Nd:YAG, Diode, and CO2 Lasers for Endoscopically Guided Inferior Turbinate Reduction Surgery

1998 ◽  
Vol 12 (3) ◽  
pp. 209-212 ◽  
Author(s):  
Ari DeRowe ◽  
Roy Landsberg ◽  
Yaron Leonov ◽  
Abraham Katzir ◽  
Dov Ophir
Keyword(s):  
Postoperative Bleeding ◽  
Inferior Turbinate ◽  
Nasal Airway ◽  
Objective Data ◽  
Treatment Groups ◽  
Endoscopic Control ◽  
Tissue Interactions ◽  
Significant Difference ◽  
Laser Systems ◽  
Turbinate Reduction

Lasers using different wavelengths and delivery systems have been used to reduce the inferior turbinate mass when hypertrophic inferior turbinates obstruct the nasal airway. Different laser systems produce different laser-tissue interactions. This study presents a comparison between three laser systems: CO2, Nd:YAG, and Diode lasers for inferior turbinate reduction surgery, all performed under endoscopic control. A total of 46 patients were randomized into three treatment groups and followed for more than 1 year. Subjective and objective data were collected. Subjective impressions of improved nasal airway was achieved in 41% (Diode), 47% (Nd: YAG) and 57% (CO2) and was not statistically significant. There was more postoperative bleeding in the CO2 laser group, with 3 patients requiring tamponade. The CO2 laser procedure also took longer to perform. These results failed to show a significant difference between the different lasers for inferior turbinate reduction. Overall, the results were not impressive.

scholarly journals Surgical management of cerebrospinal fluid rhinorrhea under endoscopic control

2004 ◽  
Vol 62 (3b) ◽  
pp. 827-831 ◽  
Author(s):  
José Alberto Landeiro ◽  
Marlo S. Flores ◽  
Bruno C.R. Lázaro ◽  
Maria Helena Melo
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Management ◽  
Inferior Turbinate ◽  
Saline Injection ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Endoscopic Control ◽  
Free Grafts ◽  
Cranial Approach ◽  
Csf Leaks

The surgical management of cerebrospinal fluid (CSF) rhinorrhea has changed after the introduction of functional endoscopic sinus surgery.The following three cases illustrate the repair of CSF leaks with the use of rigid endoscope. Two patients had the diagnosis and the site confirmed after intrathecal fluoresceine saline injection. The obliteration of the CSF was achieved with fat free, mucoperichondrial or mucoperiostal free grafts taken from middle or inferior turbinate and kept in place by fibrin glue. Primary closure was achieved in all patients. The repair of the CSF rhinorrhea by endonasal endoscopic surgery is safe, effective and is a valid alternative to the cranial approach.

scholarly journals Morphometric digital measurement of the luminal opening area of colonic crypts (pits) can differentiate the adenomas from other colonic lesions

2009 ◽  
Vol 46 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Carlos Saul ◽  
João Carlos Prolla ◽  
Vinicius D. da Silva ◽  
Cláudio R. Teixeira ◽  
Artur A. Parada
Keyword(s):  
Morphometric Analysis ◽  
Daily Practice ◽  
Normal Mucosa ◽  
Adenomatous Polyps ◽  
Digital Measurement ◽  
Endoscopic Removal ◽  
Morphometric Characteristics ◽  
Colonic Crypts ◽  
The Mean ◽  
Different Characteristics

CONTEXT: Differential diagnosis of hyperplastic vs adenomatous lesions is of crucial importance on the daily practice of colonoscopy. OBJECTIVES: This study aimed at quantifying digital morphometric characteristics of colonoscopic images obtained with magnification and chromoscopy of three different types of colonic lesions: hyperplastic, adenomas and carcinomas, and the normal mucosa surrounding the lesions. METHODS: A total of 2,177 consecutive colonoscopies were analyzed and 105 images were chosen for analysis, divided into 37 hyperplastic lesions, 42 adenomas and 26 carcinomas. Specific digital morphometry was used, to measure the diameter and area of the pits from hyperplastic lesions, adenomatous and carcinomatous lesions, always comparing them with the normal mucosa surrounding pits. RESULTS: Different morphometric measures were performed via image analysis software to measure the mean pit opening diameters and their respective area. The mean pit opening diameters and corresponding area measurements were statistically significant for all groups of lesions examined. CONCLUSIONS: The morphometric characteristics of colonoscopy images allowing the observer to compare differences between hyperplastic and adenomatous polyps and colorectal carcinoma lesions. Digital morphometric studies are feasible like the present study shows. This can help the colonoscopist in clinical decisions. A software with morphometric measures can apply and will permit the digital morphometric analysis. The data generated from the application of software, can provide valuable points in differentiation of various lesions, guiding the conduct clinical, already during the endoscopic procedure. Morphometric analysis is more an instance of decision to the colonoscopist and it has important value not for being subjective, but for being objective, since it generates digits of its measures. In these aspects, and among different characteristics, the measure of the area showed to be the most important measure in the differential aspect. Different lesions have different patterns of morphometric measures and theses patterns can be obtained from the study of the characteristics in databases. The endoscopic removal of adenomatous polyps (polypectomy), or a more detailed study of the neoplastic lesions for helping the decision if endoscopic removal (mucosectomy) or surgical resection, and a conservative position in hyperplastic lesions, are proceedings that morphometrics, with another parameters, can help to decide.

scholarly journals The Functional Diversity of Nitric Oxide Synthase Isoforms in Human Nose and Paranasal Sinuses: Contrasting Pathophysiological Aspects in Nasal Allergy and Chronic Rhinosinusitis

2021 ◽  
Vol 22 (14) ◽  
pp. 7561
Author(s):  
Tomohiro Kawasumi ◽  
Sachio Takeno ◽  
Chie Ishikawa ◽  
Daisuke Takahara ◽  
Takayuki Taruya ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Chronic Rhinosinusitis ◽  
Functional Diversity ◽  
Paranasal Sinuses ◽  
Treatment Strategies ◽  
Inferior Turbinate ◽  
No Production ◽  
Nasal Allergy ◽  
Cellular Components ◽  
Nos Isoforms

The human paranasal sinuses are the major source of intrinsic nitric oxide (NO) production in the human airway. NO plays several roles in the maintenance of physiological homeostasis and the regulation of airway inflammation through the expression of three NO synthase (NOS) isoforms. Measuring NO levels can contribute to the diagnosis and assessment of allergic rhinitis (AR) and chronic rhinosinusitis (CRS). In symptomatic AR patients, pro-inflammatory cytokines upregulate the expression of inducible NOS (iNOS) in the inferior turbinate. Excessive amounts of NO cause oxidative damage to cellular components, leading to the deposition of cytotoxic substances. CRS phenotype and endotype classifications have provided insights into modern treatment strategies. Analyses of the production of sinus NO and its metabolites revealed pathobiological diversity that can be exploited for useful biomarkers. Measuring nasal NO based on different NOS activities is a potent tool for specific interventions targeting molecular pathways underlying CRS endotype-specific inflammation. We provide a comprehensive review of the functional diversity of NOS isoforms in the human sinonasal system in relation to these two major nasal disorders’ pathologies. The regulatory mechanisms of NOS expression associated with the substrate bioavailability indicate the involvement of both type 1 and type 2 immune responses.

Short-term effect of argon plasma coagulation of the inferior turbinate in patients with perennial nasal allergy

2005 ◽  
Vol 32 (2) ◽  
pp. 145-150 ◽  
Author(s):  
Hisashi Tokano ◽  
Hirofumi Maehara ◽  
Hiroko Nakamura ◽  
Nao Makino ◽  
Akemi Iwasaki ◽  
...  
Keyword(s):  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Inferior Turbinate ◽  
Term Effect ◽  
Nasal Allergy ◽  
Short Term ◽  
Plasma Coagulation ◽  
Short Term Effect

Acetylcholine Hyperreactivity of the Nasal Mucosa in Allergic Rhinitis: A Mucosal Sensitivity Test Using a Fluorescein-Stained Thread Method

1992 ◽  
Vol 6 (2) ◽  
pp. 59-65
Author(s):  
Kiyoshi Makiyama ◽  
Ken-ichi Hisamatsu ◽  
Mutsuko Hara ◽  
Kenji Okazaki
Keyword(s):  
Nasal Mucosa ◽  
Test Procedure ◽  
Physiological Saline ◽  
Inferior Turbinate ◽  
Sensitivity Test ◽  
Nasal Discharge ◽  
Nasal Allergy ◽  
Anterior Portion ◽  
Pollen Dispersion ◽  
Acetylcholine Chloride

An acetylcholine sensitivity test for nonspecific responsiveness of the nasal mucosa was established using a fluoresceinstained thread to measure the volume of nasal discharge. This test procedure is safe, inexpensive, simple, and therefore, suitable to perform in an outpatient clinic. This sensitivity test was useful to detect nonspecific hyperresponsiveness of the nasal mucosa using acetylcholine chloride at a low concentration level, eliminating the trigeminal nerve triggering. Ten μL of acetylcholine chloride in physiological saline at a concentration of one μg/mL was dripped on the anterior portion of the inferior turbinate after elimination by aspirating retained nasal discharge, and provoked nasal discharge during 1 minute was measured using a fluorescein-stained thread. The mean dye migration distance was 0.87 ± 4.53 mm in normal control subjects, (n = 15), and it was significantly less than that of the house-dust nasal allergy group, 16.90 ± 12.60 mm (n = 16, t = 2.77, P <.01), and the cedar pollinosis group during the pollen-dispersion season, 24.30 ± 8.80 mm (n = 18, t = 6.17, P <.01). A negative correlation was found between the volume of the acetylcholine-induced nasal discharge and the threshold of the histamine sensitivity of the nasal mucosa in patients with nasal allergy (r = –0.451; n = 70; P <.01).

Chronic Sinusitis: Comparison of Amoxicillin Concentration in Diseased versus Normal Mucosa

1996 ◽  
Vol 10 (5) ◽  
pp. 267-270
Author(s):  
Philip D. Kooiker ◽  
James M. Chow ◽  
James A. Stankiewicz ◽  
Ashok K. Singh
Keyword(s):  
Medical Management ◽  
Nasal Polyps ◽  
Chronic Sinusitis ◽  
Treatment Strategies ◽  
Inferior Turbinate ◽  
Normal Mucosa ◽  
Ethmoid Sinus ◽  
Current Medical ◽  
Number Of Patients ◽  
Sinus Mucosa

Despite advances in diagnostic and treatment strategies, chronic sinusitis remains both a common entity and a difficult disease to eradicate. Current medical management, which consists primarily of extended antibiotic therapy, is effective in temporarily alleviating symptoms, but is ineffective in a number of patients in eradicating the infection. One hypothesis for the failure of medical management may be due in part to inadequate penetration of antimicrobials into the diseased sinus mucosa. In order to investigate this, mucosal specimens consisting of nasal polyps and/or diseased anterior ethmoid mucosa were harvested from 19 patients with chronic sinusitis who were being treated with Augmentin® and analyzed for amoxicillin concentrations by high pressure liquid chromatography. A biopsy of normal-appearing mucosa from the inferior turbinate was obtained from the same patient and served as the control, and was analyzed for amoxicillin concentration. Nine of 14 (64%) patients who had polyps harvested had amoxicillin concentrations in the polyps less than the amoxicillin concentration in the inferior turbinate. Two of the 14 (14%) patients had amoxicillin concentrations in the polyps greater than the amoxicillin concentration in the inferior turbinate, and the remaining three patients had amoxicillin concentrations in the polyps similar to the amoxicillin concentration in the inferior turbinate, (P = 0.029). Five of the 10 (50%) patients who had diseased anterior ethmoid sinus mucosa had amoxicillin concentrations in the diseased anterior ethmoid sinus less than the amoxicillin concentration in the inferior turbinate. Two of the 10 (20%) patients had similar amoxicillin concentrations in the diseased anterior ethmoid sinus and in the inferior turbinate and three of 10 (30%) patients with diseased anterior ethmoid sinus mucosa had amoxicillin concentrations greater than the amoxicillin concentration in the inferior turbinate. (P = 0.3725). These data suggest that there is impaired penetration of amoxicillin into nasal polyps and possibly a trend toward impaired penetration of amoxicillin into diseased anterior ethmoid sinus mucosa.

Epithelial Damage of Nasal Mucosa in Nasal Allergy

1998 ◽  
Vol 107 (7) ◽  
pp. 564-570 ◽  
Author(s):  
Kensuke Watanabe ◽  
Chôsei Kiuna
Keyword(s):  
Light Microscopy ◽  
Basal Area ◽  
Inferior Turbinate ◽  
Goblet Cells ◽  
Allergen Exposure ◽  
Nasal Allergy ◽  
Epithelial Layer ◽  
Epithelial Damage ◽  
Biopsy Specimens ◽  
Electron And Light Microscopy

Epithelial alterations arising from moderate nasal allergy to house dust were examined and compared to findings in epithelia from nonallergic controls. Biopsy specimens were taken during natural allergen exposure from two different sites: 1) the anterior tip of the inferior turbinate and 2) 2 cm behind it. The tissues were examined by both electron and light microscopy. In the allergic group, epithelial damage was found to be remarkable in the anterior nasal mucosae, where nonciliated cells were prevalent, but minor in the posterior nasal mucosae comprising ciliated and goblet cells. In the anterior nasal mucosae, conspicuous intercellular edema, epithelial shedding, and clusters of eosinophils in the epithelial layer were observed, whereas only a little epithelial shedding and edema in the basal area of the epithelium was noted in the ciliated areas. In controls, pathologic changes were not observed, although a little epithelial shedding was seen in the anterior turbinate. Although there are arguments for and against epithelial shedding in nasal allergy, this study confirms its presence even in patients with moderate allergy.

Sign in / Sign up

Export Citation Format

Share Document