We reviewed the foreign aspects in nasal septal deformities.
Mladina classification of the nasal septal deformities was used.
Types 5 and 6 have been dominantly inherited. The mechanism of the onset ...and possible connection to the trauma against the nose, as well as clinical implications of the remaining four types of the nasal septal deformities, have been explained and described in detail, giving the court expert witnesses the excellent opportunity to make a reliable and valuable finding.
Type 5 and type 6 nasal septal deformities are never the consequence of the trauma against the nose. In most of the cases, this also concerns type 3. This type as well as type 7 require the latero-lateral and anterior-posterior X-rays of the nasal bones in cases when the nasal pyramid is concurrently deformed. Types 1 and 2 in most of the cases are connected to trauma against the nose.
Summary Bacterial biofilms have been found in many human bacterial infectious processes including chronic rhinosinusitis. It was found also at the surface of nasal polyps, and both at the surface of ...the nasal part and the stalk of the antrochoanal polyp. However, our recent research clearly demonstrated the presence of the biofilm at the surface of the mucosa of the healthy paranasal sinuses as well. Our hypothesis therefore is that the biofilm in the nose and paranasal sinuses is nothing else but regular respiratory mucosal blanket, a part of the mucociliary system itself, containing variable number of bacteria.
The two holes syndrome Mladina, Ranko; Vuković, Katarina; Poje, Gorazd
American journal of rhinology & allergy,
11/2009, Volume:
23, Issue:
6
Journal Article
Peer reviewed
Defects in the fontanel region of the lateral nasal wall have been described in the literature as "accessory" or "secondary" ostia. The authors consider them a sign of chronic maxillary sinusitis. ...Along with mucus recirculation between the natural ostium and the fontanel defect, we call it the Two Holes Syndrome. The aim of this study was to determine the incidence of fontanel defects in patients with chronic rhinosinusitis (CRS) and in healthy subjects.
Eighty-eight hundred seventy-nine outpatients with CRS were examined by means of nasal fiberendoscopy. The control group consisted of 1442 healthy volunteers with no previous history of CRS.
Defect in the posterior fontanel was found in 1713/8879 CRS patients (19.3%). It was bilateral in 1165 cases (68.03%). Defect in the anterior fontanel was found in 54 patients (0.61%). The circulating mucus ring was identified in 162 patients with fontanel defects (9.17%). The defect in the posterior fontanel was found in 7/1442 healthy volunteers (0.48%). It was never bilateral, the circulating mucus was not observed and defect in the anterior fontanel was not found.
Posterior fontanel defects were found more frequently in CRS patients than in healthy subjects. These defects have been clinically related to chronic infection of the maxillary sinus and should not be called "accessory" or "secondary" ostia. CRS with defects of the fontanel region and mucus recirculation can promote a number of health disturbances (chronic postnasal drip, headache, and cough). We named this entity the Two Holes Syndrome.
Some alternative products instead of immunotherapy are used in patients with allergic rhinitis (AR).
In this paper, alternative products to treat allergic rhinitis and alternative routes for allergy ...immunotherapy are reviewed.
Alternative products and methods used instead of immunotherapy are tea therapy, acupuncture, Nigella sativa, cinnamon bark, Spanish needle, acerola, capsaicin (Capsicum annum), allergen-absorbing ointment, and cellulose powder. N. sativa has been used in AR treatment due to its anti-inflammatory effects. N. sativa oil also inhibits the cyclooxygenase and 5-lipoxygenase pathways of arachidonic acid metabolism. The beneficial effects of N. sativa seed supplementation on the symptoms of AR may be due to its antihistaminic properties. To improve the efficacy of immunotherapy, some measures are taken regarding known immunotherapy applications and alternative routes of intralymphatic immunotherapy and epicutaneous immunotherapy are used.
There are alternative routes and products to improve the efficacy of immunotherapy.
When the nose will become a periscope MLADİNA, Ranko; SKİTARELİĆ, Neven
Journal of health sciences and medicine : (Turkey),
07/2019, Volume:
2, Issue:
3
Journal Article
Peer reviewed
Open access
Dear Sir,The rhinologists all over the world are absolutely aware of the importance of the theoretical knowledge on the anatomy of the nose. But, it seems quite reasonable to start to observe this ...anatomy, particularly the anatomy of the nasal septum, through the prism of the medicine as a whole, not strictly being focused on the local problem, which in most of the cases is just a matter of the surgical procedure. The medicine as a whole lies over the sea surface, and the particular knowledge connected to the specializations and sub-specializations are just the submarines of various colors, living their lonesome, isolated, constrained life under the sea surface, in the darkness of the sea depths. The garrison members of the each particular submarine believe they are satisfied and content with their daily routine, almost proud of their professional life, but some of them have the problem because, from time to time, they simply start to think wider, over the given, well established frontiers. And because of their curiosity and their personal intellectual level, that allows them the productive reverie, they can easily get to some unusual ideas, previously unknown to the other colleagues, sailors in their submarine or to the sailors of the ships floating up there, on the sea surface. Someone has a new idea that doesn’t embed at all with already strongly and well established creeds on the cargo their submarine has been carrying around for decades? The upset commander of such a submarine immediately contacts the commanders of the closest submarines as to check with them the new situation he found himself in. The big question mark appears in commander’s mind: “What to do with such individuals? Are they desirable as a garrison member at my submarine?” However, neither the other commanders have any clear answer, but usually complain they have the same problem with some members of their submarine crew. Finally, the commanders make a consensus that everyone of these weird people will be kept under the radar, the commanders will not be paying any further attention to their fantasies and their weird, eccentric and embarrassing way of thinking. Problem solved! Is it really? No, it’s not! There is a problem for commanders which permanently continues to exist and usually remains unrecognized. It is not at all foreseen by the commanders. It goes for the deep, almost indigenous willingness, strong wish, which live in the mind of this “weird” people. It goes for their willing to take a look over the sea surface, to see what’s going on over there. The commanders, however, as in rule forget that every submarine, just like this one they are commanding with, has the periscope for this purpose. And, furthermore, they don’t want even to imagine a theoretical idea that the periscope will be, most probably in a secret, undercover way, used by the “weird sailors” sooner or later. They have a strong portent than from this very moment when the “weird ones” finally will take a look through the periscope, which is sticking out over the sea surface, everything in their submarine will start to change. The philosophy and the faith of their submarine will start to tear down. Day by day, week by week, month by month…They know every rule connected to the philosophy of their submarine, everyone of the crew members knows the rules as well, and nobody needs any changes, particularly not the substantial ones. So, why to look through the periscope unless there are the signs of approaching danger? Just for fun? No, not at all! Thanks, but no, thanks! But still, there is the question here, bothering most of them: what lies behind the local finding during the anterior rhinoscopy and the endoscopy of the nose? How and why this what we can see in the nose has aroused? Where did it come from? What are the roots? What are the roads leading to these roots and vice versa? Are we capable to portend any relationship of the structures we are looking at in the nose with their close anatomical neighbors or remote anatomical structures? Personally, I am afraid that in this very moment we mostly are not. Simply because we are not interested in at all. Still, because of the inevitable first beam of the morning sun, regardless whether or not the sky is or suddenly will be covered or just veiled by the clouds, there is a very first hope that the light of this first sun’s beam is approaching, the first completely new thought or idea maybe is approaching as well. One should be ready to see it and accept or decline it, sooner or later. The readiness depends on many unpredictable factors and, and, I believe, requires also four main prerequisites to portend possible relationships between the anatomy of intranasal structures and other anatomical structures in the same body: 1) Willingness to scientifically consider this possibility! (this is the first, crucial prerequisite)2) Individual mental and intellectual capability to portend and foresee (this is the second crucial prerequisite). 3) High level of the knowledge of both anatomy of the human body and its physiology 4) High degree of the knowledge on human pathology
But, first of all, the ocular and objective of the endoscope (periscope?) should be properly cleaned. If there is anything in front of the objective, or if the ocular is not perfectly clean, the image will not be clear at all. For instance, if the doctor enters someone’s nose with the endoscope, the image that can be seen could look like this one of the Figure 1. What’s that? Draggled objective? What a surprise! It’s obvious that the sailors of the submarine finally caught the occasion to get the periscope in their own hands, but they see only the formation resembling a cobweb, something that is full of subtle filaments. They checked both objective and ocular, they were not draggled at all! One of them fortunately knew what’s going on. He knew it was the “plantation” of two species of the intranasal moulds: Paecyllomyces and Fusarium spec. (Fig. 2 and 3). The most important fact from the clinical point of view regarding these two intranasal moulds is that they produce specific toxins, named paecylotoxins and fumonisins. The most important effect of these two mycotoxines is local anesthetic effect on the nasal mucosa because of which the patient has a subjective feeling of impaired nasal breathing! It goes for an absolutely new and so far scarcely internationally accepted diagnosis, but it seems that it plays an important role in everyday nasal pathophysiology1.Fortunately, it’s quite simple to remove this obstacle as to continue searching for a good sight through the periscope. The sterile (saline) water nasal spraying applied several times a day will help to remove totally these organisms, and the way and the sight will both be clear!
After cleaning the periscope once more time (for any case) and the field around it using the surgical suction, the brave and curious sailors expect to finally see what’s going on over the sea surface. But, unexpectedly, just before emerging the head of their periscope above the sea surface, they saw an image like this (Fig. 4). They were convinced they were faced to some shallow reef, overgrown by nice, red corals…
Foreign body (FB) aspiration/inhalation is a serious problem because it is still a cause of death in children, especially among those younger than 4 years. The objective of this paper is to ...characterize the risk of complications and prolonged hospitalization due to foreign bodies (FB) in the upper airways in terms of the characteristics of the injured patients (age, gender), typology and features of the FBs, the circumstances of the accident and the hospitalization details. A retrospective study in the major hospitals of 19 European countries was realized on injuries occurred in the years 2000–2002 and identified by means of the International Classification of Diseases, Ninth Revision (ICD-9) codes listed on hospital discharge records. In 170 cases, it was reported an injury due to the presence of a FB in the pharynx and larynx (ICD933) and in 552 records, it was reported a FB located in the trachea, bronchi and lungs (ICD934). Unlike the complications that occurred in 70 (12.7%) of cases, the hospitalizations were present in 433 (77.6) of the total injuries. One patient died. A higher incidence in males (63%) was observed. Median age for children who experienced complications was 2 years. The most common FB removal technique was laryngoscopy and bronchoscopy. In majority of the cases, children were treated by ENT department. The most common FBs were nuts, seeds, berries, corn and beans. In general, small, round crunchy foods pose a risk of choking. Since prevention is the most essential key to deal with these types of injuries, more effort in caregivers’ public education is warranted.
Respiratory epithelial adenomatoid hamartomas (REAHs) of the nose and paranasal sinuses are relatively rare. These tumors usually do not extend over the boundaries of the nose and sinuses. The ...authors presented a 65-year-old man experiencing progressive hyposmia, followed by intermittent stubborn headache. The symptoms lasted for almost 2 years and were getting worse very slowly. Fiberendoscopy showed relatively discrete polypoid tissue occupying the olfactory cleft bilaterally. The computed tomography and magnetic resonance imaging suggested the possible lack of the cribriform plate and the unity and uniformity of the tissues located both in the endocranium and high in the nasal cavity. The clinical picture resembled very much a esthesineuroblastoma.The patient underwent endoscopic sinus surgery under the general hypotensive anesthesia. Frozen sections during the surgery showed REAH. The entire tumor was removed in a piece meal way, including both olfactory bulbs because they were involved within the pathologic tissue as well.This case showed that REAH could also be a locally aggressive process, penetrating even into the endocranium.
Summary During the last few decades several authors tried to clarify the anthropological aspects of the shape of the human nose and why it has so emphasized projection. Our hypothesis suggests the ...essentiality of the role of morphologic changes of the human skull which occurred during the phylogenesis. It seems that erectile posture of the man caused remarkable morphological changes of the skull base shape thus being a part of morphologic evolution. The changes in the shape of the human spine from birth to adulthood show a philogenesis in short: a newborn has an almost flat spine like quadrupeds (except in the sacro-coccigeal region), but the spine gets increasingly bent as the person grows (lumbar lordosis, thoracic kyphosis, cervical lordosis). It is well known that the sphenoidal angle was less emphasized in prehistoric man than in modern man. In addition, the cervical spine position in the gorilla, Neanderthal man and modern man is quite different in terms of anterior inclination. Accordingly, there is a great degree of maxillary and mandible reduction in humans. The same differences can be seen when comparing the skull shapes of gorilla, gibbons, Neanderthals and modern man. A major reason for the maxillary and mandible reduction in humans is that their way of feeding has changed remarkably with time. In lower primates and other animals, nasal function, particularly olfaction, may be essential for day-to day survival. In humans, however, this is less important although both impaired nasal breathing and olfaction may affect the function in the other body organs and, of course, influence the quality of life. Nasal configuration in recent humans seems to be associated with the internal nasal cavity wideness and nasal bridge elevation which just happened because of newly developed physiological needs. The skull base angulation leads directly to obvious changes in splanchocranium on the account of neurocranium, since previous is getting “squeezed”, by angulation of the surrounding bones, and the other one gets more room for the further development according to human’s intellectual needs. The final morphologic result of the squeezing of the splanchocranium, in fact a side-effect of these phylogenetic changes, is a protrusion of its most anterior parts more anteriorly, that is a prominent nose in humans which is a hallmark of the modern man.
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