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Chronic rhinosinusitis

Jennifer K Mulligan, Kunal Patel, Tucker Williamson, Nicholas Reaves, William Carroll, Sarah E Stephenson, Peng Gao, Richard R Drake, Benjamin A Neely, Stephen Tomlinson, Rodney J Schlosser, Carl Atkinson
Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory disease with an unknown etiology. Recent studies have implicated the complement system as a potential modulator of disease immunopathology. We performed proteomic pathway enrichment analysis of differentially increased proteins, and found an enrichment of complement cascade pathways in the nasal mucus of individuals with CRSwNP as compared to control subjects. Sinonasal mucus levels of complement 3 (C3) correlated with worse subjective disease severity, whereas no significant difference in systemic C3 levels could be determined in plasma samples...
June 15, 2018: Mucosal Immunology
Qinying Wang, Haihong Chen, Yang Yang, Bo Wang
OBJECTIVE: Adherence of pathogen to nasal mucosa and colonization is the first step of bacterial biofilm(BBF) formation in patients with chronic rhinosinusitis (CRS).Terminal sialic acids presenting on cell surface are potential targets for bacterial binding, thus may partly contribute to the pathogenesis of CRS. However, little has been published in this respect, the purpose of our study aimed to investigate the expression of sialic acids on the nasal mucosa in CRS patients and its possible effect on BBF formation...
June 12, 2018: Microbial Pathogenesis
Carlotta Pipolo, Alberto Maria Saibene, Giovanni Felisati
Headache secondary to sinonasal disease is still overestimated in the diagnostic pathway of cephalalgia. Contrary to belief, so-called sinus headaches are fairly uncommon and seen mostly in acute sinusitis or acute exacerbations. Even though literature has written extensively about the prevalence of migraines in self-diagnosed or primary care-diagnosed sinus headache, there is only a small body of literature regarding the real prevalence of pain and headache occurring during acute and chronic sinusitis.We reviewed the current literature and clarified the differences in presentation of pain for acute and chronic sinusitis, highlighting the higher prevalence of pain in chronic rhinosinusitis without polyps versus with polyps...
June 2018: Neurological Sciences
Soo Kyoung Park, Soung Yong Jin, Sun Hee Yeon, Sung Bok Lee, Jun Xu, Young Hoon Yoon, Ki Sang Rha, Yong Min Kim
BACKGROUND: Nasal polyposis is characterized by persistent inflammation and remodeling in sinonasal mucosa. Toll-like receptor 9 (TLR9) is a DNA receptor of the innate immune system that plays a pivotal role in fibrosis and inflammatory responses. The aim of this study is to explore the expression, activity, and potential pathogenic role of TLR9 signaling in tissue remodeling in nasal polyp-derived fibroblasts (NPDFs). METHODS: Fibrotic and inflammatory responses elicited by type A CpG oligonucleotides were examined in the NPDFs by a combination of real-time quantitative polymerase chain reaction, Western blot analysis, enzyme-linked immunosorbent assay, and immunofluorescence staining...
June 14, 2018: International Forum of Allergy & Rhinology
Christopher C Xiao, Mitchell Anderson, Lucas D Harless, Jonathan Liang
BACKGROUND: Chronic rhinosinusitis (CRS) is a prevalent illness in the United States that accounts for 18-22 million physician visits annually. The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) has defined diagnostic criteria, but a recent study demonstrated that nearly all patients diagnosed by nonspecialists did not meet these criteria. In this study we aimed to evaluate the diagnostic rate of CRS by primary care physicians and otolaryngologists. METHODS: We retrospectively reviewed a random sample of adult patients diagnosed with CRS in 2016, based on ICD-10 codes from primary care and otolaryngology departments...
June 14, 2018: International Forum of Allergy & Rhinology
Gonca Doğru, Ayşe Balkarli, Atalay Dogru
Objectives: This study aims to evaluate the frequency of chronic cough due to dryness in the trachea and the relationship between depression and chronic cough in patients with primary Sjögren's syndrome (pSS). Patients and methods: Eighty non-smoking patients (7 males, 73 females; mean age 47.6±9.2 years; range 18 to 70 years) with newly diagnosed pSS were included. All patients were evaluated clinically, radiologically, and physiologically. Patients with cough were assessed using the Leicester Cough Questionnaire and visual analog scale...
December 2017: Archives of Rheumatology
Lin Lin, Zheng Chen, Xinyue Tang, Fei Dai, Jinjin Wei, Guangbin Sun
BACKGROUND: 5-Oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is a potent eosinophil chemoattractant and activator that is synthesized not only in inflammatory cells but also in bronchial epithelial cells. The purpose of this study is to clarify whether 5-oxo-ETE can promote the production of eosinophil cation protein (ECP) by eosinophils in nasal polyps (NP) in vitro, and whether normal nasal epithelial cells can produce this lipid mediator in response to oxidative stress. MATERIALS AND METHODS: Nasal biopsy samples were obtained from normal subjects or subjects with chronic rhinosinusitis with NP...
June 13, 2018: International Archives of Allergy and Immunology
Alessia Corrado, Monica Battle, Sarah K Wise, F Eun-Hyung Lee, David M Guidot, John M DelGaudio, Samuel A Molina, Joshua M Levy
BACKGROUND: The endocannabinoid system represents a highly conserved, innate signaling network with direct and indirect control of eicosanoid-mediated inflammation. Activation of the type 2 cannabinoid receptor (CB2R) leads to decreased type 2 inflammation and reduced production of arachidonic acid (AA). Given that altered AA metabolism is associated with aspirin-exacerbated respiratory disease (AERD), we hypothesized that expression of the CB2R gene CNR2 is increased in AERD. METHODS: Nasal polyps from consecutive patients undergoing endoscopic sinus surgery for AERD or allergic fungal rhinosinusitis (AFRS) were prospectively evaluated...
June 13, 2018: International Forum of Allergy & Rhinology
Toby O Steele, Amarbir Gill, Travis T Tollefson
PURPOSE OF REVIEW: Characterize indications, perioperative considerations, clinical outcomes and complications for concurrent endoscopic sinus surgery (ESS) and rhinoplasty. RECENT FINDINGS: Chronic rhinosinusitis and septal deviation with or without inferior turbinate hypertrophy independently impair patient-reported quality of life. Guidelines implore surgeons to include endoscopy to accurately evaluate patient symptoms. Complication rates parallel those of either surgery (ESS and rhinoplasty) alone and are not increased when performed concurrently...
June 11, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
R Jankowski, C Rumeau, D T Nguyen, P Gallet
Nasalisation is a surgical technique proposed for the treatment of nasal polyposis in 1995. The technique as initially described was based on large opening of the maxillary, sphenoidal and frontal ostia and resection of the middle turbinates, with the aim of resecting the mucosa of the lateral masses of the ethmoid as completely and safely as possible. Recent findings on the evolution and development of the nose and sinuses and sinus physiology allow both the concept and the technique of nasalisation to be updated...
June 7, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Michael Koennecke, Frederick Benecke, Anja Masche, Robert Linke, Karl-Ludwig Bruchhage, Ralph Pries, Ludger Klimek, Barbara Wollenberg
INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a significant health problem, but the pathogenesis remains unclear to date. Nitric oxide (NO) has known airway modulating functions. Therefore, we investigated nitric oxide production to determine the role of eNOS in nasal polyps, with additional analysis of the effect of the monoterpene oxide 1,8-cineol on the possible regulation of eNOS signaling and thus NO production. METHODS: We determined eNOS expression, as well as regulatory and effector proteins like NOSTRIN and CASP8, using whole genome microarray, immunohistochemistry and western blot...
June 6, 2018: Nitric Oxide: Biology and Chemistry
Justin H Turner, Ping Li, Rakesh K Chandra
BACKGROUND: Chronic rhinosinusitis (CRS) is a diverse clinical syndrome with a heterogeneous pathophysiology. Early attempts to identify CRS endotypes and biomarkers have largely relied on analysis of surgically obtained tissue, thus limiting their practical utility. This study examined the ability of mucus T helper 2 (Th2) biomarkers to predict CRS disease severity and clinical characteristics. METHODS: CRS (n = 90) and healthy control subjects (n = 17) were prospectively enrolled prior to surgical intervention and mucus levels of interleukin (IL)-4, IL-5, and IL-13 were determined using a multiplex cytometric bead assay...
June 8, 2018: International Forum of Allergy & Rhinology
Matti Penttilä
BACKGROUND: The ostiomeatal complex (OMC), comprising a small natural maxillary sinus ostium and narrow infundibulum, transmits the air diffusion into the antrum and mucociliary transport from the antrum, and is considered a key area in chronic rhinosinusitis (CRS). Thin membranous anterior and posterior fontanelle areas below the OMC can rupture forming a perforation, accessory maxillary ostium (AMO), that increases antral airflow changing the anatomy and function of the sinus. The purpose of this study was to report the first case series of CRS patients who had undergone repair of fontanelle defects aiming to reconstruct normal structures...
June 8, 2018: International Forum of Allergy & Rhinology
Hafizah Husna Johari, Irfan Mohamad, Ida Sadja'ah Sachlin, Mohd Ezane Aziz, Teoh Yuen Mey, Ramiza Ramza Ramli
OBJECTIVE: This study was done to determine frontal recess anatomy cell variations and its association with frontal sinusitis. The incidence of frontal recess cells in the population, the presence of frontal recess cell variations in chronic rhinosinusitis and non-chronic rhinosinusitis and the association of frontal recess cell variation in the development of frontal sinusitis were also assessed. METHODS: This was an observational, retrospective cross-sectional study of computed tomography (CT) scan of paranasal sinus that had been performed on patients in Hospital Universiti Sains Malaysia and Hospital Sultanah Bahiyah done from January 2009 until December 2016...
June 4, 2018: Auris, Nasus, Larynx
Peter H Hwang
No abstract text is available yet for this article.
June 7, 2018: JAMA Otolaryngology—Head & Neck Surgery
Sarah Tait, Dorina Kallogjeri, Jasmina Suko, Sara Kukuljan, John Schneider, Jay F Piccirillo
Importance: Recent studies suggest that budesonide added to saline nasal lavage can be an effective treatment for patients with chronic rhinosinusitis (CRS). Objective: To evaluate the incremental effect of adding budesonide to large-volume, low-pressure saline sinus irrigation. Design, Setting, and Participants: This double-blind, placebo-controlled, randomized clinical trial was conducted at a quaternary care academic medical center between January 1, 2016, and February 16, 2017...
June 7, 2018: JAMA Otolaryngology—Head & Neck Surgery
Keehoon Lee, Steven D Pletcher, Susan V Lynch, Andrew N Goldberg, Emily K Cope
Recent studies leveraging next-generation sequencing and functional approaches to understand the human microbiota have demonstrated the presence of diverse, niche-specific microbial communities at nearly every mucosal surface. These microbes contribute to the development and function of physiologic and immunological features that are key to host health status. Not surprisingly, several chronic inflammatory diseases have been attributed to dysbiosis of microbiota composition or function, including chronic rhinosinusitis (CRS)...
2018: Frontiers in Cellular and Infection Microbiology
De Yun Wang, Sang-Heon Cho, Horng-Chyuan Lin, Aloke Gopal Ghoshal, Abdul Razak Bin Abdul Muttalif, Sanguansak Thanaviratananich, Kaan Tunceli, Eduardo Urdaneta, Dongmu Zhang, Rab Faruqi
BACKGROUND: Allergic rhinitis (AR), asthma, chronic obstructive pulmonary disease (COPD), and rhinosinusitis are common and little studied in the Asia-Pacific region. OBJECTIVES: We sought to investigate real-world practice patterns for these respiratory diseases in India, Korea, Malaysia, Singapore, Taiwan, and Thailand. METHODS: This cross-sectional observational study enrolled adults (age ≥18 years) presenting to general practitioners (GP) or specialists for physician-diagnosed AR, asthma, COPD, or rhinosinusitis...
June 6, 2018: International Archives of Allergy and Immunology
Y J Chen, X B Chai
Chronic rhinosinusitis with or without nasal polyps mainly uses combination of medications represented by nasal glucocorticoids and functional sinus endoscopic surgery (FESS) and comprehensive treatment with antibiotics. The effect of oral antibiotics for CRS exacerbations on the microbial resistance rate in the population has not yet been fully assessed, but may be significant, and glucocorticoid-resistant CRS has also emerged. CRSwNP associated with complications of asthma is considered a more serious condition...
May 2018: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
Anthony Ca Yii, Tunn-Ren Tay, Xue Ning Choo, Mariko Sy Koh, Augustine Kh Tee, De-Yun Wang
United airways disease (UAD) is the concept that the upper and lower airways, which are anatomically and immunologically related, form a single organ. According to this concept, upper and lower airway diseases are frequently comorbid because they reflect manifestations of a single underlying disease at different sites of the respiratory tract. Allergic asthma-allergic rhinitis is the archetypal UAD, but emerging data indicate that UAD is a heterogeneous condition and consists of multiple phenotypes (observable clinical characteristics) and endotypes (pathobiologic mechanisms)...
June 5, 2018: Allergy
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