Concentrations of H1-Receptor Antagonist in the Human Nasal Mucosa

Aims. To measure blood and tissue concentrations of the H1-receptor antagonist, bepotastine besilate (BB). Methods. Participants included 14 men and six women, whose age ranged from 13 to 76 years, with chronic rhinosinusitis, who underwent endoscopic sinus surgery at our university hospital. Among them, 10 participants had allergic rhinitis (AR) (Group I), and others did not have AR (Group II). Nasal mucosa and blood were collected 55 to 130 minutes after oral administration of BB 10 mg. Concentrations of the agent in the serum and nasal mucosa were measured by high-performance liquid chromatography. Results. Concentrations of BB of the serum in Group I and II were 98 ± 32 ng/mL and 112 ± 39 ng/mL. Those of the nasal mucosa tissue in Groups I and II were 101 ± 36 ng/g and 132 ± 44 ng/g. There was no significant difference in the values of concentration of BB between the serum and the nasal mucosa in either Group I or II (P = .757 and P = .2662, resp., Paired t-test). Conclusion. This preliminary study is considered the first report on the concentration of H1-receptor antagonists in nasal mucosa. The prompt absorption and transition to the nasal mucosa of BB seems to have an effect on allergic rhinitis

Solitary Fibrous Tumor Arising from the Sphenoid Sinus

Solitary fibrous tumor (SFT) is an uncommon neoplasm that usually arises from the pleura. To our knowledge, only 30 cases of SFTs in the nasal cavity and paranasal sinuses have been reported in the literature. We describe an SFT that arose from the right sphenoid sinus and extended to the nasal cavity and epipharynx. The tumor was completely removed by endoscopic sinus surgery without complication. The patient is taking an uneventful course without any evidence of recurrence of the disease 8 months after surgery now

Influence of effortful swallow on pharyngeal pressure: evaluation using a high-resolution manometry.

To evaluate the effect of effortful swallow on pharyngeal pressure while swallowing saliva and water using a novel high-resolution manometry (HRM) system

A case with posterior fossa epidermoid cyst showing audiovestibular symptoms caused by insufficiency of anterior inferior cerebellar artery - usefulness of free DICOM image viewing and processing software -

A 58-year-old Japanese man suddenly suffered from vertigo. On physical examination, left-beating horizontal torsional spontaneous nystagmus was observed; the direction did not change with gaze. Other neurotological examinations revealed findings within normal limits except the left side sensorineural hearing loss of approximately 32 dB on average. Diffusion-weighted MRI revealed no infarction in the brain, but demonstrated an epidermoid cyst in the left cerebello-pontine cistern region. Using free digital imaging and communications in medicine (DICOM) image viewing and processing software, it was found that the epidermoid cyst clearly compressed the left anterior inferior cerebellar artery (AICA). Therefore, we speculated that insufficiency of the left AICA caused his audiovestibular symptoms. This new technique used in the present study was considered useful when the site responsible for vertigo is suspected in the cerebello-pontine angle, where anatomic relationships between the nerves and the vessels are complicated.This is an electronic version of an article published in Acta oto-laryngologica. Supplementum, 562, pp.53-56; 2009. oto-laryngologica. Supplementum is available online at: http://www.informaworld.com with the open URL of your article (http://www.informaworld.com/openurl?genre=article&issn=0365-5237&issue=562&spage=53)

Subjective visual vertical test in patients with chronic dizziness without abnormal findings in routine vestibular function tests.

CONCLUSION: The subjective visual vertical (SVV) test can detect abnormality of the otolithic organs and the graviceptive pathways present in a considerable number of patients having dizziness but presenting no abnormal findings in conventional vestibular function tests. OBJECTIVE: To evaluate whether the SVV test can detect dysfunction of the otolithic organs and perception of gravity in patients with dizziness having no abnormal finding on routine tests for the vestibular system. PATIENTS AND METHODS: Forty-four patients who complained of chronic dizziness but had no abnormal finding on routine tests for vestibular system and on brain MRI studies were selected between 2004 and 2006. SVV tests were performed on these patients. Patients with chronic dizziness caused by apparent psychogenic disorders, such as depression, were excluded. RESULTS: Among the 44 patients, 3 showed abnormal tilts of SVV. The latter three patients had deep white matter hyperintensities on their MRI, probably due to aging

Recurrent sebaceous carcinoma with wide intraepithelial spread to the nasal cavity: Report of two cases

Background: Sebaceous carcinoma (SC) is a relatively rare tumor that usually arises from the eyelid. Local extension down the nasolacrimal duct is relatively rare event for SC.Method: We herein report two cases of recurrent SC in the nasal cavity. Both patients had previously received primary treatment for SC of the eyelid. Seven years after the initial treatment, the first patient presented with a mass on the left medial canthus of the eyelid. Sixteen months after the initial treatment, the second patient presented with a large mass in the right nasal cavity.Results: The wide intraepithelial spread of SC over 30 mm from the initial surgical margin was beyond our expectations. The first patient is currently alive with local recurrence following the administration of chemoradiotherapy 46 months after treatment, while the second patient died of distant metastasis.Conclusion: This report focuses on the unique clinical features of intranasal recurrence of SC after treatment

Effects of a tongue-holding maneuver during swallowing evaluated by high-resolution manometry.

OBJECTIVE: This study aimed to investigate the effects of a tongue-holding maneuver (THM) during swallowing using a novel high-resolution manometry (HRM) system. STUDY DESIGN: Case series with planned data collection. MATERIALS AND METHODS: Thirty-three asymptomatic Japanese adults were studied. A solid-state HRM assembly with 36 circumferential sensors spaced 1-cm apart was positioned to record pressures from the velopharynx to the upper esophagus at rest and during swallowing. The maximum values of the dry swallowing pressures at the velopharynx, mesohypopharynx, upper esophageal sphincter (UES), and distance from the nostril to each point of maximum values with and without the THM were measured. RESULTS: The distance from the nostril to the UES was statistically shorter when swallowing with the THM than without the THM (paired t test, P=0.009). The maximum pressure at UES was greater when swallowing with the THM than without the THM, although there was no statistically significant difference (paired t test, P=0.051). There was no difference in the pressures and the distance between swallowing with or without the THM at any other site. CONCLUSIONS: These findings suggest that the THM may not have a potential to facilitate compensatory swallowing power when swallowing

Relationship between airborne pollen count and treatment outcome in Japanese cedar pollinosis patients.

In Japan, information on daily Japanese cedar pollen counts is made public during pollen season. If symptom severity and treatment outcome are predictable according to these pollen counts, management of seasonal allergic rhinitis may become more precise. The aims of the study were to evaluate the relationship between airborne pollen counts, symptom severity and treatment outcome in Japanese cedar pollinosis patients. In the randomized study, patients with moderate to most severe Japanese pollinosis were treated with fexofenadine (60 mg BD) or fexofenadine and nasal corticosteroids for 2 weeks. During the same period daily airborne pollen counts were measured. A total of 105 adult patients were enrolled. No difference of treatment efficacy was seen among groups. Detailed results of efficacy and safety were previously described elsewhere. In univariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study tended to affect symptom severity (P = 0.053) and the mean cumulative amount of airborne pollen during the treatment period tended to show difference among five treatment outcome categories (P = 0.066). In multivariate analysis, the mean cumulative amount of airborne pollen exposure for 4 days prior to the study was identified as the only significant factor of symptom severity (P = 0.0327) and cumulative amount of airborne pollen during the treatment period (P = 0.027) and allergic history (P = 0.027) were significant factors of treatment outcomes. No serious adverse effect was reported during the study. The amount of airborne pollen may be predictive of both symptom severity and treatment outcome

The patulous eustachian tube complicated with amyotrophic lateral sclerosis: a video clip demonstration.

We report a 60-year-old case diagnosed as the amyotrophic lateral sclerosis with patulous eustachian tube (ET). To our knowledge, this is the first case report of the amyotrophic lateral sclerosis complicating patulous ET in the literature, demonstrating the movement of the tympanic membrane, the pharyngeal orifice of the ET and abnormal movement of the uvula because of paralysis of the soft palate on video.In order to view the file "VideoClip 1-3", you will need the Adobe® Acrobat® Reader™ version 9 or later