•In higher Keros types, the AEA was detected away from the skull base.•When detected SOECs, the AEA was detected away from the skull base.•As SOECs present, AEA notch-ethmoid roof distance ...increased.•As SOECs present, AEA canal angle increased.
This study investigated the visualization of the anterior ethmoidal artery (AEA) as notch, canal and sulcus, its relationship between supraorbital ethmoid cells (SOECs) and the Keros classification of the olfactory fossa on paranasal sinus computerized tomography (PNSCT).
In this retrospective study, the paranasal sinus computerized tomography (PNsCT) images of 204 patients (103 males and 101 females) were analyzed. AEA canal, notch and sulcus, SOECs, the distance between AEA notch and ethmoid roof, AEA canal angle and Keros classification of the olfactory fossa were evaluated.
AEA notch in all patients and AEA canal (37.6 to 45.6%) and AEA sulcus (53.5 to 61.2%) were visualized. In the AEC canal and sulcus visualized patients, the Keros classification revealed higher. AEA notch and ethmoid roof distance increased in patients with higher Keros types. The presence of SOECs was significantly higher in males (41.7%) than females (19.8%) on the left side. There was a positive correlation between SOEC presence and Keros classification. In patients with SOEC, bilateral AEA canal and sulcus visualized more; and bilateral AEA notch and ethmoid roof distance increased. On the right side, the AEA canal angle of the males was significantly higher than that of the females. In patients with SOEC, the left AEA canal angle also increased.
When detected SOECs and higher Keros types, the AEA was detected away from the skull base, AEA notch-ethmoid roof distance increased; and the AEA canal angle increased. To avoid intracranial penetrations, PNSCT should be evaluated carefully during the preoperative period.
Objectives
We assessed the hearing level, sleep quality, depression status, and life quality of the employees.
Methods
The research group contains 380 (56.7%) of 669 employees working in the factory. ...We used a questionnaire, noise measurement (2016), pure tone audiometry test results of (2015, 2016). SF-12 (short form), mini sleep questionnaire (MSQ), and Beck depression scale.
Results
The employees’ mean working period is 13.5 ± 11.9 years. The mean ambient noise level of the factory is 75.5 ± 7.3 dB. We detected hearing loss at 18.6% and 23.2% in 2015 and 2016, respectively. The frequency of hearing loss is 4.7% at the employees working below 85 dB and 27.8% percent at the employees working above 85 dB. Mean working period of the employees with hearing loss (19.7 ± 11.7 years) is higher than mean working period of the employees without hearing loss(13.2 ± 11.8 years) (
p
< .0.05). The 27.8% of the employees working above 85 dB are used to earmuffs, 44.4% of them sometimes use earmuffs; 38.9% of them are used to earplug; and 44.4% of them sometimes use earplug. Back depression scales showed 31.1% minimal, moderate, or severe depression. The sleep quality of employees working above 85 dB is worse than the others (
p
< 0.05). SF-12 QoL scores were 39.41 ± 5.59 (physical health) and 36.10 ± 7.76 (mental health). There was not a statistically significant association between scale scores and ambient noise level and hearing level of the workers (
p
> 0.05).
Conclusion
We suggest the use of personal protective equipment. Working in the noise above 85 dB affected workers’ sleep quality to be poorer.
Anti-IgE treatment in allergic rhinitis Bayar Muluk, Nuray; Bafaqeeh, Sameer Ali; Cingi, Cemal
International journal of pediatric otorhinolaryngology,
December 2019, 2019-Dec, 2019-12-00, 20191201, Letnik:
127
Journal Article
Recenzirano
To review the efficacy of anti-IgE therapy in allergic rhinitis (AR).
Literature search was performed using the PubMed and Proquest Central databases at Kırıkkale University Library.
Although the ...skin prick testing in patients suffering from AR is positive (indicating that antigen-specific Immunoglobulin E has been produced), there is no association with overall circulating IgE levels. Correlation was lacking between circulating IgE level and either skin prick tests or laboratory testing for specific IgE. Omalizumab binds to uncomplexed IgE in man more avidly than does Fc-epsilon. The effect of omalizumab is to lower the level of IgE and downgrade production of FceRI receptors (which bind IgE) in mast cells and basophils, causing less mast cell recruitment and responsivity and thus diminishing eosinophilic infiltration and activation. Anti-IgE therapy through omalizumab may shorten the lifetime of mast cells and causes dendritic cells to downgrade their production of FcεRI. There are reports indicating benefit from omalizumab in managing food allergies, nasal polyp formation, essential anaphylaxis, AR, venom allergy and eczema. Omalizumab acts to lessen circulating IgE levels, whilst reducing production of FceRI by mast cells and basophils. The fact that omalizumab influences how eosinophils respond may be down to disruption of the antigen-IgE-mast cell interactions, with mast cells being recruited at lower levels and thus chemotactic eosinophilic recruitment via cytokines being greatly reduced. Omalizumab has the effect in cases of perennial AR of blocking the increased eosinophilic recruitment and tissue infiltration initiated by seasonal antigens. Likewise, in omalizumab-treated cases, circulating unbound IgE levels showed significant decreases. For patients with perennial AR, the average daily nasal severity score was significantly reduced where omalizumab was administered, compared to placebo.
Omalizumab has efficacy in ameliorating symptoms and reduces the necessity for additional medication in both seasonal and perennial allergic rhinitis
Objectives
We reviewed the phenotyping and endotyping of chronic rhinosinusitis (CRS) and treatment options.
Methods
We searched PubMed, Google, Google Scholar, and the Proquest Central Database of ...the Kırıkkale University Library.
Results
Phenotypes are observable properties of an organism produced by the environment acting upon the genotype, that is, patients with a particular disorder are subgrouped according to common characteristics. Currently, CRS is usually phenotyped as being with (CRSwNP) or without (CRSsNP) nasal polyps. However, this is not immutable as some individuals progress from nonpolyp to polypoid CRS over time. Phenotypes of CRS are also based on inflammatory patterns, generally CRSwNP is eosinophilic, CRSsNP neutrophilic; but there is a spectrum, rather than a clear-cut division into 2 types. An endotype is a subtype of a condition defined by a distinct functional or pathobiological mechanism. Endotypes of CRS can be (1) nontype Th2, (2) moderate type Th2, and (3) severe type Th2 immune reactions, based on cytokines and mediators such as IL4, 5, 13. CRS endotyping can also include a (1) type 2 cytokine-based approach, (2) eosinophil-mediated approach, (3) immunoglobulin E-based approach, and (4) cysteinyl leukotriene-based approach. Subdivisions of CRSwNP can be made into nonsteroidal anti-inflammatory drug-exacerbated respiratory disease, allergic fungal sinusitis, and eosinophil pauci-granulomatous arteritis by testing. General treatment for all CRS is nasal douching. The place of surgery needs careful reconsideration. Endotype-directed therapies include glucocorticosteroids, antibiotics, aspirin, antifungals, anticytokines, and immunoglobulin replacement. The recognition of united airways and the co-occurrence of CRSwNPs and severe asthma should lead to common endotyping of both upper and lower airways in order to better direct therapy.
Conclusion
Endotyping can allow for the identification of groups of patients with CRS with a high likelihood of successful treatment, such as patients with a moderate type 2 immune reaction or those with acquired immune deficiency.
The effects of different climatic conditions on the quality of life (QoL) of patients following septoplasty or septorhinoplasty were investigated.
A total of 89 patients (47 males and 42 females) ...underwent either septoplasty or septorhinoplasty during the summer (summer group, n = 42) or winter (winter group, n = 47) season. To assess QoL, SinoNasal Outcome Test (SNOT)-22, Nasal Obstruction Symptom Evaluation (NOSE) scale, and Visual Analogue Scale were used. Postoperative (PO) pain, bleeding, and symptoms related to nasal packing (eating and sleep problems) were also evaluated.
PO pain scores were lower in the winter group than that in the summer group (p<0.05). After pack removal, there was a slight serohemorrhagic nasal discharge in 2.1% of the patients in the winter group, but no patient required intervention. Slight leakage was detected in 47.6% of the patients and 2.4% of the patients called for intervention (p<0.05) in the summer group. The SNOT-22 values did not differ between the groups (p>0.05). NOSE scores in the winter group were higher than that in the summer group (p<0.05). In each group, SNOT-22 (padjusted<0.175) and NOSE scores (p<0.05) were lower at 1 month after surgery. The winter group patients rated headache, facial pain, and nasal crusting higher than those in the summer group did (p<0.05). However, nasal discharge and loss of smell were less troubling in the summer group than that in the winter group (p<0.05).
Regardless of climate or season, septoplasty or septorhinoplasty increases patients’ QoL. However, problematic PO bleeding was detected at a higher frequency in patients who underwent surgery in summer. The advantage of surgery in winter is that it leads to less frequent problematic bleeding PO.
We investigated the relationship between sphenoid sinus (SS) pneumatization types, carotid canal types and carotid canal-intersinus septa connection.
The paranasal sinus computed tomography (PNSCT) ...images of 274 patients (141 males and 133 females) were evaluated retrospectively. SS pneumatization, SS intersinus septation, SS intersinus septa deviation, carotid canal classification, carotid canal dehiscence, carotid canal-intersinus septa connection and presence of Onodi cells were evaluated.
In presellar and sellar SS, type 1 carotid canal was detected. However, type 3 carotid canal was detected more in postsellar SS. On the left side, in 26.4% of the postsellar SS, carotid canal dehiscence was detected. On the right side, carotid canal-intersinus septa connection was detected in 55.8% of the postsellar SS and 35.1% of the sellar SS. On the left side, it was detected 58.3% of the postsellar SS and 30.9% of the sellar SS. In postsellar type SS pneumatized cases, right caroid canal-intersinus septa connection increased by 5.4 fold and left carotid canal-intersinus septa connection increased by 7.3 fold compared to presellar type SS pneumatization. In 2≥ intersinus septa group, left carotid canal-intersinus septa connection increased 5.0 fold compared to 'no septa' group.
In this study, we evaluated SS pneumatization types and their relation with carotid canal types and carotid canal-intersinus septa connections. Type 3 carotid canal (protrudation to SS wall) was detected more in postsellar SS. In these cases, surgeons should be very careful during surgery to avoid damage to the internal carotid artery (ICA).
Objectives: The aim of this article is to review safer orthognathic surgery. Methods: The literature survey was performed in PubMed, EBSCO, UpToDate, ProQuest Central databases of Kırıkkale ...University, and Google and Google Scholar databases. Results: Patients with dentofacial skeletal defects may benefit from orthognathic surgery, which entails surgically modifying parts of the facial skeleton to restore the right anatomic and functional relationship. Careful investigation of the soft tissue via clinical examination and supporting pictures, evaluation of the structure via standardized radiographs, and evaluation of the dental via study dental casts are all necessary to successfully correct maxillofacial abnormalities. Orthognathic surgery can involve either the maxilla, the mandible, or both. Improving the dynamics of nasal airflow may necessitate simultaneous intranasal surgery consisting of septoplasty and reduction of the inferior turbinate. In some patients, a genioplasty and neck liposuction may be recommended to enhance the final result. Le Fort I osteotomy, Le Fort II osteotomy, Le Fort III osteotomy, maxillary segmental osteotomies, sagittal split osteotomy of the mandibular ramus, vertical Ramal osteotomy, inverted L and C osteotomies, and mandibular body segmental osteotomies are all examples of well-established osteotomies that can be used to reposition facial skeletal elements and redefine the face. Conclusion: Preventative strategies for risk-free orthognathic surgery include maintaining blood flow, shielding teeth, bone, and neurovascular systems, and bolstering the patient’s diet.
We investigated the peripheral and central smell regions in patients with idiopathic intracranial hypertension (IIH) by cranial MRI.
In this retrospective study, cranial MRI images of 43 adult ...patients with IIH (Group 1) and 43 healthy adults without IIH (Group 2) were included. In both groups, peripheral Olfactory bulb (OB) volume and Olfactory sulcus (OS) depth and central smell regions (insular gyrus and corpus amygdala area, and thalamus volume) were measured in cranial MRI.
Bilateral OB volume and insular gyrus area, and right corpus amygdala and thalamus volumes of the IIH group were significantly lower than those of the control group (p < 0.05). In the IIH group, OB volume of the right side was significantly lower, and insular gyrus area of the right side was significantly higher than those of the left side (p < 0.05). In the IIH group, there were positive correlations between OB volumes; OS depths; insular gyrus areas; corpus amygdala areas; and thalamus volumes bilaterally (p < 0.05). In older patients, right OS depth and right corpus amygdala area decreased (p < 0.05).
In conclusion, IIH may be related to olfactory impairment. Cranial MRI images showed a decrease in peripheral (OB volume) and central (insular gyrus and corpus amygdala area and thalamus volume) smell regions. To prevent olfactory impairment in IIH patients, treatment should be done in IIH patients to decrease intracranial pressure. It is very important to prevent the circulation of CSF with increased pressure between the sheets of the olfactory nerve in IIH patients.
We examined how topically-applied naproxen sodium affects human nasal epitheliocytes in culture.
Samples of healthy human primary nasal epithelium (NE) harvested during septoplasty from volunteers ...without rhinosinusitis were incubated in cell culture. MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assays may be utilised when assessing cellular damage (toxicity), as evidenced by DNA fragmentation, nuclear condensation, alteration in the outer plasma membrane and cytoskeletal alteration. This was the method used in the study. Cultured epitheliocytes were incubated with naproxen sodium for 24 h at 37 °C. The MTT assay was then performed and the cells' morphology was examined by confocal microscopy. Additionally, cellular proliferation was assessed by the artificial scratch method followed by light microscopy.
The results indicated that naproxen sodium does not cause any cytotoxic effects upon nasal epithelial cells when applied topically. There was no evidence indicating cytotoxicity on the nasal epitheliocytes in culture for the 24 h period over which the drug was applied. In particular, there was no alteration in cellular morphology, damage to the intracellular organelles structure or the cytoskeleton secondary to naproxen sodium. Furthermore, cellular proliferation occurred normally in these conditions, as on scratch test.
Topical naproxen sodium may be used on nasal epithelial cells without inducing toxicity. This agent is therefore suitable, given its known anti-inflammatory effects, for use in patients suffering from diseases involving nasal and paranasal sinusal inflammation, including rhinosinusitis (both chronic and acute) and nasal polyposis which should be investigated. In the future, topical medication forms for nasal usage should be developed.
We investigated senile volume and density changes in infraorbital fat to evaluate by computed tomography (CT).
CT examinations of a total of 120 patients (60 males and 60 females) were included in 3 ...age groups: 18–29 (group 1), 30–49 (group 2), and 50 years and older (group 3). Body weight and height and BMI were recorded, and infraorbital fat tissue volume and density were measured on CT.
Body weight and BMI of ≥50 years of age were significantly higher than the younger ones. In overweight and obesity groups, infraorbital fat volume increased and density decreased compared to the underweight and normal weight groups. In ≥50 years of age group, infraorbital fat volume was higher; density was lower than 18–29 years of age. Female's infraorbital fat volume was higher; density was lower than males. In each age group, the infraorbital fatty tissue density of the females was significantly lower than those in the males. There was a negative correlation between infraorbital fat volume and density. In older patients and as age groups, body weight and BMI increased, infraorbital fat volume increased, and infraorbital fat density decreased.
By aging, BMI and body weight and infraorbital fat volume increased, and infraorbital fat density decreased, especially at ≥50 years of age that is thought to be one of the factors that play a role in the downward bulging of infraorbital fat tissue. Females’ higher infraorbital fat volume and infraorbital fat density may be a reason for the females’ bulging in the infraorbital fat region.