Using platelet-rich fibrin scaffolds with diced cartilage graft in the treatment of empty nose syndrome

Empty nose syndrome (ENS) is a rare entity in patients who undergo sinonasal surgery due to over-resection of the turbinate. This syndrome leads to debilitating symptoms that include dry nose, painful nasal breathing, paradoxical nasal obstruction, crusting, and sleep disorder. The goal of surgical treatment is to reestablish the volume of the turbinates to rehabilitate the nasal resistance. Endonasal microplasty with cartilage implants on the lateral wall of the nasal cavity is useful for creating the neoturbinate. Here, we present 2 cases that describe the management of empty nose syndrome by endonasal microplasty using platelet-rich fibrin (PRF) scaffolds embedded with a diced cartilage graft. The integration of the PRF scaffolds with diced cartilage efficiently facilitated the reestablishment of the neoturbinate. This autologous biomaterial is suitable for the treatment of ENS.

Nasal secretion insufficiency syndrome (new concept of ozena)

The patient complained of nasal odor and was referred to a psychiatrist by the Department of Otolaryngology as a case of olfactory reference syndrome. The patient had a strong nasal odor. The doctor denied the existence of atrophic rhinitis and rhinophobia. If you look around the internet, there are many who suffer from similar conditions. Almost all of them complain of an unusually dry nose. It was thought that Pseudomonas aeruginosa or some fungus grew abnormally in the devastated nasal mucosa of the endogenous nasal cavity, and due to inadequate nasal secretion, the bacterial metabolites could not be forced down the throat or other parts of the body, giving off a strong nasal odor. This disorder is often neglected or diagnosed by psychiatrists as olfactory reference syndrome. The term "nasal secretion insufficiency syndrome" is used to describe this condition. This is a new concept of nasal odor disease, which remains unnoticed, partly because there is no crusting or atrophy of the native nasal cavity, and partly because endoscopy reveals only the devastation of the nasal mucosa, and partly because it is hidden behind the veil of atrophic rhinitis and ozena. In all seven cases, the foul odor is weakened, albeit temporarily, by the use of saliva-enhancing drugs.

Role of α-Tocopherol Acetate on Nasal Respiratory Functions: Mucociliary Clearance and Rhinomanometric Evaluations in Primary Atrophic Rhinitis

Primary atrophic rhinitis is a disease of the nose and of paranasalsinuses characterized by a progressive loss of function of nasal and paranasal mucosa caused by a gradual destruction of ciliary mucosalepithelium with atrophy of serous–mucous glands and loss of bonestructures.The aim of this study was to evaluate the therapeutic effects of topic α-tochopherol acetate (vitamin E) in patients with primary atrophicrhinitis based on subjective and objective data.We analyzed 44 patients with dry nose sensation and endoscopic evidence of atrophic nasal mucosa. We analyzed endoscopic mucosascore, anterior rhinomanometry, and nasal mucociliary clearance before and after 6 months of topic treatment with α-tochopherol acetate. For statistical analysis, we used paired samples t test (95% confidence interval [CI], P < .05) for rhinomanometric and muciliary transit time evaluations and analysis of variance 1-way test (95% CI, P < .05) for endoscopic evaluation. All patients showed an improvement in “dry nose” sensation and inperception of nasal airflow. Rhinomanometric examination showed increase of nasal airflow at follow-up ( P < .05); nasal mucociliaryclearance showed a reduction in mean transit time ( P < .05); and endoscopic evaluation showed significative improvement of hydration of nasalmucosa and significative decreasing nasal crusts and mucusaccumulation ( P < .05). Medical treatment for primary atrophic rhinitis is not clearly documented in the literature; in this research, it was demonstrated that α-ochopherol acetate could be a possible treatment for atrophic rhinitis.

Intranasal Zinc in the Management of the Common Cold

Because zinc ions may prevent rhinovirus from attaching to and infecting cells in the nasal cavity, it has been recently hypothesized that direct application of ionic zinc to the nasal mucosa would be effective in reducing the duration of rhinovirus-associated colds. Five studies that compare intranasal zinc to placebo were identified in the medical literature. These studies provide conflicting results and are reviewed in detail. In the clinical trials that found efficacy, intranasal zinc was administered within the first 24 to 48 hours of the onset of cold symptoms. Adverse effects reported in clinical trials include nasal stinging or burning, epistaxis, headache, dry nose, dry mouth, nasal irritation, throat irritation, and nasal pain. Also of importance, case reports of intranasal zinc—induced persistent anosmia (complete loss of the sense of smell) have been reported in the literature. It is important that pharmacists inform their patients who want to use intranasal zinc of this possible complication.

The Effect of Topical Xylometazoline on the Mucosal Temperature of the Nasal Septum

Background The purpose of this study was to determine the short-term influence of the α2-adrenoreceptor agonist xylometazoline on the nasal mucosal temperature. Methods Thirty healthy subjects were enrolled into the study. Fifteen of these subjects got xylometazoline and 15 subjects, matched to age, got saline solution as control. A miniaturized thermocouple was used for continuous detection of the septal mucosal temperature without interruption of nasal breathing before and after application of nose spray. Results In the anterior nasal segment, the mucosal temperatures before decongestion were significantly higher than after decongestion (p < 0.05). These changes could not be found in the control group after saline solution. The mean end-expiratory mucosal temperatures were significantly higher than the end-inspiratory ones in both study groups (p < 0.005). Conclusions The reduction of the nasal mucosal blood flow because of vasoconstriction and the increase of the nasal cavity volume after decongestion with xylometazoline seem to cause a significant decrease of the septal mucosal temperature in the anterior nasal segment. This might be one possible causative factor of the common symptom of the “dry nose” in patients with nasal decongestant abuse.