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chronic sinusitis and treatment

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https://www.readbyqxmd.com/read/28218486/determinants-and-outcomes-of-upfront-surgery-versus-medical-therapy-for-chronic-rhinosinusitis-in-cystic-fibrosis
#1
Noel Ayoub, Andrew Thamboo, Al-Rahim Habib, Jayakar V Nayak, Peter H Hwang
BACKGROUND: The indications for surgical management of chronic rhinosinusitis (CRS) in patients with cystic fibrosis (CF) are poorly defined. In this study we compare outcomes of medical versus surgical treatment and examine trends associated with the transition from medical to surgical therapy in CF patients. METHODS: One hundred thirty-six patients with CF referred to a tertiary rhinology practice were retrospectively divided into 3 cohorts: Medical, Upfront Surgery, or Crossover, if they converted from medical to surgical management...
February 20, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28215205/effectiveness-of-extensive-sinus-surgery-with-post-operative-medical-management-for-chronic-rhinosinusitis
#2
A J Wood, L Zhou, S Wilkinson, R G Douglas
OBJECTIVE: To prospectively assess treatment outcomes of chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery and post-operative medical treatment over a prolonged follow-up period. METHODS: Patients undergoing functional endoscopic sinus surgery in the tertiary referral practice of a single surgeon were studied prospectively. Symptoms were scored by patients pre-operatively and over a minimum follow-up period of 12 months. RESULTS: The study comprised 200 non-consecutive patients...
February 20, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28209676/what-is-hidradenitis-suppurativa
#3
REVIEW
Erika Yue Lee, Raed Alhusayen, Perla Lansang, Neil Shear, Jensen Yeung
OBJECTIVE: To provide family physicians with an understanding of the epidemiology, clinical features, diagnosis, and management of hidradenitis suppurativa (HS). SOURCES OF INFORMATION: A PubMed literature search was performed using the MeSH term hidradenitis suppurativa. MAIN MESSAGE: Hidradenitis suppurativa is a chronic, recurrent, and debilitating skin condition. It is an inflammatory disorder of the follicular epithelium, but secondary bacterial infection can often occur...
February 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28194809/prodromal-symptoms-in-hidradenitis-suppurativa
#4
H C Ring, P Theut Riis, K Zarchi, I M Miller, D M Saunte, G B Jemec
BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, inflammatory skin disease, which presents as recurrent nodules and sinus tracts (tunnels) with subsequent scarring, predominantly involving the intertriginous regions. Although prodromal symptoms (i.e. various symptoms preceding the eruption of the HS lesions) are often mentioned, there have been no formal investigations into this aspect. Insight into prodromal symptoms may enable patients with HS or dermatologists in choosing a more targeted treatment at a much earlier stage, potentially increasing treatment efficacy and quality of life...
February 14, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28194802/safe-treatment-of-ethmoid-sinusitis-utilizing-minimally-invasive-ethmoid-punch-sinusotomy-eps-in-chronic-rhinosinusitis-without-polyposis-crssnp-patients
#5
Nathalia Velasquez, Andrew Thamboo, Waleed M Abuzeid, Jayakar V Nayak
OBJECTIVES/HYPOTHESIS: Current rhinologic practice is devoid of minimally invasive procedures dedicated to the treatment of ethmoid sinusitis to improve ventilation and topical drug delivery. We have recently described a handheld spiral punch to create minimally invasive ethmoid punch sinusotomy (EPS) sites into the ethmoid bulla and basal lamella, which significantly increased irrigant access to the ethmoid sinuses in cadaver models. Here, we conducted a clinical feasibility study to determine the initial safety evaluation of EPS in chronic rhinosinusitis without polyposis (CRSsNP) patients with active ethmoid disease...
February 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28182331/establishing-utility-values-for-the-22-item-sino-nasal-outcome-test-snot-22-using-a-crosswalk-to-the-euroqol-five-dimensional-questionnaire-three-level-version-eq-5d-3l
#6
R Trafford Crump, Ernest Lai, Guiping Liu, Arif Janjua, Jason M Sutherland
BACKGROUND: Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L)...
February 9, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28177596/evaluating-metrics-of-responsiveness-using-patient-reported-outcome-measures-in-chronic-rhinosinusitis
#7
Alcina K Lidder, Kara Y Detwiller, Caroline P E Price, Robert C Kern, David B Conley, Stephanie Shintani-Smith, Kevin C Welch, Rakesh K Chandra, Anju T Peters, Leslie C Grammer, Li-Xing Man, Robert P Schleimer, Bruce K Tan
BACKGROUND: Responsiveness, or sensitivity to clinical change, is important when selecting patient-reported outcome measures (PROMs) for research and clinical applications. This study compares responsiveness of PROMs used in chronic rhinosinusitis (CRS) to inform the future development of a highly responsive instrument that accurately portrays CRS patients' symptom experiences. METHODS: Adult CRS patients initiating medical therapy (MT; n = 143) or undergoing endoscopic sinus surgery after failing MT (ESS; n = 123) completed the 22-item Sino-Nasal Outcome Test (SNOT-22), European Position Statement on Rhinosinusitis (EPOS) visual analog scale (VAS), and 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29) at baseline and 3 months after treatment...
February 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28164779/hyaluronic-acid-for-post-sinus-surgery-care-systematic-review-and-meta-analysis
#8
REVIEW
E Fong, M Garcia, C M Woods, E Ooi
BACKGROUND: Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery. METHODS: Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates...
January 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28163938/evaluating-complications-of-chronic-sinusitis
#9
Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28152126/sinonasal-quality-of-life-in-children-after-outfracture-of-inferior-turbinates-and-submucous-inferior-turbinoplasty-for-chronic-nasal-congestion
#10
Brian Manzi, Kevin J Sykes, Julie L Wei
Importance: Chronic nasal congestion often persists in children despite empirical treatment using intranasal corticosteroids, systemic antihistamines, and/or leukotriene receptor antagonists. Symptoms are often reported even with negative results of skin or blood allergy testing. Inferior turbinoplasty has been effective in adults and children, but outfracture of inferior turbinates in children is rarely reported, as is use of validated quality-of-life measures to quantify improvements after intervention...
February 2, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28145930/combined-endoscopic-and-trans-palpebral-orbital-reconstruction-for-silent-sinus-syndrome
#11
Riccardo Tieghi, Nicola Malagutti, Luisa Valente, Giulia Carnevali, Luigi C Clauser
Silent Sinus Syndrome is defined as a painless spontaneous and progressive enophthalmos and hypoglobus with maxillary sinus hypoplasia and orbital floor resorption. It is caused by maxillary sinus atelectasis in a setting of ipsilateral chronic maxillary sinus hypoventilation. The syndrome was first described in 1964 by Montgomery, but the term "Silent Sinus Syndrome" was not coined until 1994 by Soparkar. The aetiology is still controversial: some authors postulate a basal hypoplastic sinus, other suggest an acquired process due to an obstruction of the ostium in the medium meatus...
January 31, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28141637/cervicofacial-primary-cutaneous-actinomycosis-surgical-treatment-for-complete-remission-of-the-disease
#12
Yeon Jin Jeong, Hyo Wan Suh, Hyung-Sup Shim
Actinomycosis, an infectious bacterial disease caused by Actinomyces species, is very rare and is characterized by contiguous spreading, subacute to chronic granulomatous inflammation and the formation of multiple abscesses and sinus tracts that may discharge sulfur granules. Actinomycosis that presents on the skin without endogenous origin is called primary cutaneous actinomycosis, and the occurrence and treatment of primary cutaneous actinomycosis is rarely reported. This report describes the treatment of primary cervicofacial actinomycosis with a literature review, and emphasizes the importance of surgical option for complete remission of the disease...
January 30, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28137751/lead-extraction-with-high-frequency-laser-sheaths-a-single-centre-experience
#13
Simon Pecha, Matthias Linder, Nils Gosau, Liesa Castro, Julia Vogler, Stephan Willems, Hermann Reichenspurner, Samer Hakmi
OBJECTIVES: Extraction of chronically implanted cardiac implantable electrophysiological devices leads can be difficult. Excimer laser-assisted extraction with 40 Hz sheaths has shown good results in challenging cases. In 2012, a new 80 Hz high-frequency laser sheath became available that delivers twice as many pulses per second. Here, we report our clinical experience with the new GlideLight 80 Hz laser sheath. METHODS: Between January 2012 and August 2016, 292 leads were treated in 151 patients using 80 Hz GlideLight laser sheath...
January 30, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28137718/bacterial-meningitis-a-rare-complication-of-an-unrecognised-nasal-foreign-body-in-a-child
#14
Jana van der Veen, Simon Thorne
We present an interesting case of a 7-year-old child who developed severe bacterial meningitis requiring admission to paediatric ICU. Initial investigations failed to identify the reason for this otherwise healthy child to develop this life-threatening condition. The child recovered fully with no long-term sequelae. Further on-going unilateral purulent rhinorrhoea lead to ENT referral. CT head from a previous admission showed mucosal thickening and fluid within paranasal sinuses. Reluctance to expose the child to further radiation meant that no formal scan of sinuses was organised and the child was diagnosed with chronic rhinosinusitis...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28134737/dermatophytic-pseudomycetoma-of-the-scalp
#15
Eduardo Castro-Echeverry, Katherine Fiala, Martin P Fernandez
Dermatophytic pseudomycetoma represents a chronic infection characterized by a tumor-like growth containing dermatophytes arranged as clustered aggregates (grains) within the dermis. In contrast to mycetomas, they lack sinus tracts and are more common in the scalp. We describe a dermatophytic pseudomycetoma arising in the scalp of an 18-year-old African-American woman. Histopathologic examination showed a dense, mixed-cell infiltrate expanding the dermis. Accompanying this infiltrate were numerous grains scattered throughout the dermis...
February 2017: American Journal of Dermatopathology
https://www.readbyqxmd.com/read/28124653/practice-patterns-in-pediatric-chronic-rhinosinusitis-a-survey-of-the-american-rhinologic-society
#16
Daniel M Beswick, Hassan Ramadan, Fuad M Baroody, Peter H Hwang
BACKGROUND: The management of pediatric chronic rhinosinusitis (PCRS) is evolving. OBJECTIVE: To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS. METHODS: A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership. RESULTS: The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%)...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124652/culture-directed-topical-antibiotic-treatment-for-chronic-rhinosinusitis
#17
Victoria S Lee, Greg E Davis
BACKGROUND: Topical antibiotics, delivered optimally as high-volume culture-directed sinus irrigations, are being increasingly used for recalcitrant chronic rhinosinusitis (CRS). Their impact on subjective and objective outcome measures, however, is still unclear. OBJECTIVE: To assess if the use of topical antibiotics in recalcitrant CRS is associated with improved 20-Item Sino-Nasal Outcome Test and Lund-Kennedy endoscopic scores, and to determine the negative posttreatment culture "control" rate...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28122105/acetylcysteine-in-the-treatment-of-subacute-sinusitis-a-double-blind-placebo-controlled-clinical-trial
#18
Mehrzad Bahtouee, Gholamhosein Monavarsadegh, Mohammadjavad Ahmadipour, Mazyar Motieilangroodi, Niloofar Motamed, Jamshid Saberifard, Seyyedsajjad Eghbali, Hooman Adibi, Hesam Maneshi, Hasan Malekizadeh
Sinusitis is a common disease with harmful effects on the health and finances of patients and the economy of the community. It is easily treated in most of its acute stages but is associated with some management difficulties as it goes toward chronicity. Therefore, we tried to improve the treatment of subacute sinusitis by using acetylcysteine, which is a safe mucolytic and antioxidant agent. Thirty-nine adult patients with subacute sinusitis proved by computed tomography (CT) were enrolled in a double-blind, placebo-controlled trial...
January 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28117948/bactericidal-antibiotics-promote-oxidative-damage-and-programmed-cell-death-in-sinonasal-epithelial-cells
#19
Michael A Kohanski, Anuj Tharakan, Nyall R London, Andrew P Lane, Murugappan Ramanathan
BACKGROUND: Antibiotics are widely and heavily used in the treatment of chronic sinusitis. Bactericidal antibiotics can stimulate reactive oxygen species (ROS) formation, a proinflammatory response, and cell death in cultured human sinonasal epithelial cells (SNECs). Sulforaphane (SFN) is a potent stimulator of the antioxidant nuclear factor erythroid 2-related factor 2 (Nrf-2) system and a suppressor of inflammation. In this study we utilized SFN to further explore the relationship between levofloxacin treatment, ROS formation, and the cell death response...
January 24, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28116488/antibiofilm-effects-of-topical-corticosteroids-and-intranasal-saline-in-patients-with-chronic-rhinosinusitis-with-nasal-polyps-depend-on-bacterial-species-and-their-biofilm-forming-capacity
#20
Ivana Cirkovic, Bojan Pavlovic, Dragana D Bozic, Ana Jotic, Ljubica Bakic, Jovica Milovanovic
Microbial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal application of corticosteroids and saline is a reliable option for their management. The aim of our study was to evaluate in vitro antibiofilm effects of corticosteroids and isotonic and hypertonic nasal saline in CRSwNP patients. The sinus mucosal specimens were harvested from the ethmoid cavity of 48 patients with CRSwNP and further subjected to hematoxylin-eosin staining and microbiology analysis...
January 23, 2017: European Archives of Oto-rhino-laryngology
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