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Allergy & Rhinology

B Chauhan, M Gupta, K Chauhan
BACKGROUND: Antioxidants have a preventive or therapeutic role in oxygen free radical-mediated cell and tissue damage. The study aimed to investigate the therapeutic effects of antioxidants and intranasal steroid fluticasone furoate (FF) on the clinical outcome of patients with perennial allergic rhinitis. METHODS: Subjects with perennial allergic rhinitis (n = 61) were randomly divided into two groups, group A (n = 30) received FF and group B (n = 31) received FF with antioxidants for 6 weeks...
July 26, 2016: Allergy & Rhinology
William C Yao, Kevin S Emerick, Stefan Kraft, Eric H Holbrook
BACKGROUND: The progression from a benign pigmented lesion on the skin to cutaneous melanoma is better understood, and it could be presumed that a similar progression occurs with mucosal lesions. However, to our knowledge, there has never been documentation of melanosis transforming into melanoma over time. OBJECTIVE: To describe a transformation of a mucosal melanosis into melanoma. METHODS: A 53-year-old man with diffuse melanosis of the nasal cavity underwent surgical resection...
January 1, 2016: Allergy & Rhinology
Ajnacska Rozsasi, Akos Heinemann, Tilman Keck
BACKGROUND: The release of cyclooxygenase-2 (COX-2) and lipoxin A4 (LXA4) from blood mononuclear cells in patients with aspirin-exacerbated respiratory disease (AERD) is only partially understood. OBJECTIVE: To investigate the presence of COX-2 and LXA4 in peripheral blood mononuclear cells (PBMC) derived from patients with AERD and with nasal polyps (NP) (designated as the AERD-NP group), patients with NP without AERD (the NP group), and healthy controls without sinus disease (the control group)...
January 1, 2016: Allergy & Rhinology
Jessica Bewick, Francesco M Egro, Liam Masterson, Amin R Javer, Carl M Philpott
BACKGROUND: It is recognized that patients who undergo endoscopic sinus surgery (ESS) do not always achieve control of their disease. The causes are multifactorial; variations in surgical practice have been identified as possible factors in refractory disease. OBJECTIVE: To reflect on the frequent anatomic findings of patients with chronic rhinosinusitis (CRS) who require revision ESS. METHODS: A retrospective review of patients who required revision ESS at a tertiary institution over a 3-year period...
January 1, 2016: Allergy & Rhinology
Joseph S Schwartz, Bobby A Tajudeen, Nithin D Adappa, James N Palmer
OBJECTIVES: Odontogenic chronic rhinosinusitis (CRS) is an epidemiologically important disease process due, in part, to the increasingly commonplace use of dental restorative procedures such as zygomatic implantation. Traditional management of this clinical entity typically entails extraction of the infected hardware via an open or endoscopic approach. We describe a novel management strategy of odontogenic CRS following bilateral zygomatic implantation for oral rehabilitation that we surgically salvaged via a modified endoscopic medial maxillectomy...
January 1, 2016: Allergy & Rhinology
Angelique M Berens, Greg E Davis, Kris S Moe
BACKGROUND: Anterior and posterior ethmoid arteries supply the paranasal sinuses, septum, and lateral nasal wall. Precise identification of these arteries is important during anterior skull base procedures, endoscopic sinus surgery, and ligation of ethmoid arteries for epistaxis refractory to standard treatment. There is controversy in the literature regarding the prevalence of supernumerary ethmoid arteries. OBJECTIVE: This study examined the prevalence of supernumerary ethmoid arteries by using direct visualization after transorbital endoscopic dissection...
January 1, 2016: Allergy & Rhinology
Jun Kido, Megumi Hirata, Hiroe Ueno, Natsuko Nishi, Masaho Mochinaga, Yasushi Ueno, Masaaki Yanai, Masayoshi Johno, Tomoaki Matsumoto
BACKGROUND: Although considerable efforts have been made to develop diagnostic tools for predicting the outcome of oral food challenges, tests for predicting the outgrowth of food allergies are lacking. OBJECTIVE: The aim of this study was to assess the diagnostic value of the wheal size and skin index (SI) (the ratio of an allergen-induced wheal to a histamine-induced wheal diameter) of the skin-prick test based on the outcome of a controlled oral provocation test for cow's milk...
January 1, 2016: Allergy & Rhinology
Georges K Ziade, Reem A Karami, Ghina B Fakhri, Elie S Alam, Abdul Latif Hamdan, Marc M Mourad, Usama M Hadi
OBJECTIVE: To study if nasal endoscope can be a reliable tool in assessing patients with allergic rhinitis. MATERIALS AND METHODS: A prospective study. Patients who were diagnosed with allergic rhinitis underwent a nasal endoscopic examination performed by two physicians blinded to the scoring of each other. A correlation was made among symptom severity, endoscopic findings, and interrater variability. RESULTS: Ninety patients were included in the study: 34 patients had mild disease and 56 had moderate-to-severe allergic rhinitis according to the Allergic Rhinitis and its Impact on Asthma guidelines...
January 1, 2016: Allergy & Rhinology
Kong-Sang Wan, Yu-Cheng Liu, Che-Sheng Huang, Yu-Mao Su
BACKGROUND: Macrolides exert anti-inflammatory and immunomodulatory effects beyond their purely antibacterial action, as demonstrated by several bronchial inflammatory disorders, including asthma. METHODS: Fifty-eight children with newly diagnosed mild persistent asthma were selected by using the Global Initiative for Asthma guidelines and were randomly divided into the study (group I) (n = 36) and control (group II) (n = 22) groups. Mycoplasma pneumonia-specific immunoglobulin G and -specific immunoglobulin M antibody levels of each participant were measured by enzyme-linked immunosorbent assay...
January 1, 2016: Allergy & Rhinology
Joseph T Ellenburg, Jay A Lieberman, Debendra Pattanaik
BACKGROUND: Although allergen immunotherapy (AIT) is effective and safe, nonadherence is common. Limited data exist regarding adherence to AIT, factors that affect adherence, and systemic reactions associated with AIT among veteran populations. OBJECTIVE: To evaluate adherence to AIT and the prevalence of reactions secondary to AIT among patients at the Veterans Affairs Medical Center, Memphis, Tennessee. METHODS: A retrospective chart review was performed of veterans who received AIT at a single Veterans Affairs facility...
January 1, 2016: Allergy & Rhinology
Samarendra Behera, Satyawati Mohindra, Sourabha K Patro, Ashok K Gupta
OBJECTIVE: To compare mucociliary clearance time and quality of life in patients who underwent sinus surgery using conventional and powered instruments, and in patients who were treated nonsurgically. METHODS: A total of 151 patients with chronic rhinosinusitis were included. Fifty-four patients were treated conservatively, 48 patients were managed surgically by using conventional instruments and 49 patients were managed by using a microdebrider. Kupferberg nasal endoscopy grades, 20-item Sino-Nasal Outcome Test scores, Lund-Mackay scores, and mucociliary clearance time were analyzed...
January 1, 2016: Allergy & Rhinology
Aleena Banerji, Murat Baş, Jonathan A Bernstein, Isabelle Boccon-Gibod, Maria Bova, John Dempster, Anete Sevciovic Grumach, Markus Magerl, Kimberly Poarch, Manuel Branco Ferreira
BACKGROUND: Published literature documents the substantial burden of hereditary angioedema (HAE) with C1 inhibitor deficiency on the quality of life and work productivity of patients. However, despite advances in the field and the availability of guidelines to advise health care providers (HCP) on the diagnosis and management of HAE, there are still many challenges to overcome. For example, delayed diagnosis and misdiagnosis are common, and treatment practices vary worldwide. OBJECTIVE: An international expert panel was convened to consider opportunities for improvements that would benefit patients with HAE...
January 1, 2016: Allergy & Rhinology
William Rae, Rainer Doffinger, Fenella Shelton, Eleanor Sproson, Hasnaa Ismail-Koch, Valerie J Lund, Philip G Harries, Efrem Eren, Rami J Salib
BACKGROUND: Chronic granulomatous invasive fungal rhinosinusitis (CGIFRS) is a rare disease. The underlying immune responses that drive the development of CGIFRS, as opposed to successful pathogen clearance and controlled inflammation, are not currently known. OBJECTIVE: To characterize the immune responses associated with CGIFRS. METHODS: In addition to a battery of basic investigations, more in-depth immunologic testing involves ex vivo whole-blood stimulation with the polyclonal T-cell mitogen phytohemagglutinin and fungal antigens with interleukin (IL) 12, was undertaken to investigate cell-mediated immune responses associated with CGIFRS...
January 2016: Allergy & Rhinology
Nathan D Vandjelovic, Ian M Humphreys
OBJECTIVE: Immunoglobulin G4 (IgG4) related sclerosing disease (RSD) of the paranasal sinuses is a rare lesion of dense lymphoplasmacytic tissue, with a high proportion of IgG4+ plasma cells. We presented a rare case of IgG4-RSD with isolated involvement of the paranasal sinuses in the absence of multiorgan involvement. METHODS: A case report and comprehensive literature review. RESULTS: To our knowledge, only 11 cases of IgG4-RSD with paranasal sinus involvement have been reported...
January 2016: Allergy & Rhinology
Roshan K Verma, P Lokesh, Naresh K Panda
BACKGROUND: Bilateral congenital choanal atresia that presents in adulthood is rare. There are only eight reported cases in the literature. METHOD: We present a ninth case of adult bilateral choanal atresia diagnosed at the age of 20 years. Can a bilateral choanal atresia present so late in life when such a condition is considered incompatible with life? RESULTS AND CONCLUSION: Clinical details, diagnosis, and surgical steps with a clear depiction of photographs and comparison with all other previously reported cases, which can help novel otolaryngologists in their clinical practice are discussed...
January 2016: Allergy & Rhinology
Bhushan Chauhan, Manish Gupta, Komal Chauhan
BACKGROUND: Antioxidants have a preventive or therapeutic role in oxygen free radical-mediated cell and tissue damage. The study aimed to investigate the therapeutic effects of antioxidants and intranasal steroid fluticasone furoate (FF) on the clinical outcome of patients with perennial allergic rhinitis. METHODS: Subjects with perennial allergic rhinitis (n = 61) were randomly divided into two groups, group A (n = 30) received FF and group B (n = 31) received FF with antioxidants for 6 weeks...
January 2016: Allergy & Rhinology
Hirokuni Otsuka, Hiroyuki Tsukagoshi, Hirokazu Kimura, Ikuo Takanashi, Kimihiro Okubo
BACKGROUND: Respiratory virus infections are involved in asthma exacerbations. However, there are no reports of the relationship between respiratory virus infections and Japanese cedar pollinosis. OBJECTIVE: We studied the relationship between respiratory viral infection and the appearance of preseasonal symptoms and the severity of seasonal symptoms in Japanese cedar pollinosis. METHODS: In 36 patients with asthma and with no symptoms (PreAsyP) and 54 patients with asthma and with symptoms (PreSyP) before the cedar pollen shedding commenced (preseason), and 37 patients with mild-to-moderate severity (InMild/Mod) and 45 patients with severe to extreme severity (InSev/Ext) after cedar shedding commenced (in season), the occurrence of respiratory viruses and nasal smear cytology were examined...
January 2016: Allergy & Rhinology
Davis Lynn Erickson, Christopher Albert Coop
CASE REPORT: A 59-year old man currently on >5 years of angiotensin-converting enzyme inhibitor (ACEI) therapy presented to the emergency department with angioedema of the tongue and difficulty swallowing. After receiving conventional therapy of antihistamine, steroids, and epinephrine, the patient's condition continued to deteriorate, with imminent intubation. The patient was treated with a C1-esterase inhibitor (C1-INH) and experienced rapid resolution of symptoms, which avoided airway complications...
January 1, 2016: Allergy & Rhinology
Moira E Breslin, Joanna H Lin, Robert Roberts, Kellie J Lim, E Richard Stiehm
BACKGROUND: We reported on six infants between 5 and 11 months old, with transient hypogammaglobulinemia of infancy and severe refractory atopic dermatitis, who were treated with open-label immunoglobulin (Ig) after conventional therapy failed. All six infants had an IgG level of <225 mg/dL, elevated eosinophil and IgE levels, and no urine or stool protein losses, but they did exhibit hypoalbuminemia. OBJECTIVE: To evaluate the utility of open-label immunoglobulin in infants with severe atopic dermatitis for whom conventional therapy failed...
January 2016: Allergy & Rhinology
Edward C Kuan, Bobby A Tajudeen, Sunita M Bhuta, Miguel Fernando Palma Diaz, Paul A Kedeshian, Jeffrey D Suh
INTRODUCTION: Septoplasty, or surgical correction of the deviated septum, is an elective, routinely performed rhinologic procedure to address nasal airway obstruction. In many cases, resected septal cartilage and bone fragments are sent for pathologic review, although there is no consensus on this practice. We reported two cases of incidentally diagnosed lymphoma after elective septoplasty and discussed clinical presentation, diagnosis, and management. METHODS: Retrospective chart review of two patients who underwent septoplasty at a tertiary academic medical center and found to have incidental lymphoma based on histopathology...
January 2016: Allergy & Rhinology
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