Comparison of nasal mucociliary clearance in adenoid hypertrophy with or without otitis media with effusion

WOS: 000338608100034PubMed ID: 24837868Objective: To investigate pre- and postoperative mucociliary clearance in patients with adenoid hypertrophy or combined with otitis media with effusion. Methods: Patients were divided into two groups: Group 1-patients with adenoid hypertrophy (AH), and Group 2 patients with AH and otitis media with effusion (AHOME). In all patients, AH size was recorded, and the Andersen saccharin and methylene blue tests were conducted before and 1 month after surgery to obtain mucociliary clearance time (MCT). Nasal cavity length was measured intraoperatively to establish mucociliary clearance velocity (MCV). Patients with allergic rhinitis, active infection, and history of nasal or ear surgery were excluded. Results: This study included 64 patients with a mean age of 8.34 +/- 2.98 years (range: 3-18 years). Pre- and postoperative MCT were 14.60 +/- 4.83 and 9.48 +/- 2.63 min in Group 1 and 16.03 +/- 4.31 and 12.12 +/- 3.78 mm-in Group 2, respectively. Pre- and postoperative MCV were 0.77 +/- 0.30 and 1.16 +/- 0.42 mm/min in Group 1 and 0.67 +/- 0.16 and 0.89 +/- 0.28 mm/min in Group 2, respectively. MCT and MCV were significantly improved postoperatively in both groups (p < 0.001). In addition, the postoperative MCT and MCV of Group 1 were significantly better than those of Group 2(p < 0.001). Exposure to cigarette smoking and adenoid size had negative correlations with mucociliary clearance. Conclusions: Otitis media was associated with impaired mucociliary clearance and further studies should be performed to demonstrate the causes of this deficiency

New routes of allergen immunotherapy

WOS: 000390857000001PubMed: 28124639Objectives: Allergen immunotherapy is the only cure for immunoglobulin E mediated type I respiratory allergies. Subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are the most common treatments. In this article, we reviewed new routes of allergen immunotherapy. Methods: Data on alternative routes to allow intralymphatic immunotherapy (ILIT), epicutaneous immunotherapy (EPIT), local nasal immunotherapy (LNIT), oral immunotherapy (OIT), and oral mucosal immunotherapy (OMIT) were gathered from the literature and were discussed. Results: ILIT features direct injection of allergens into lymph nodes. ILIT may be clinically effective after only a few injections and induces allergen-specific immunoglobulin G, similarly to SCIT. A limitation of ILIT is that intralymphatic injections are required. EPIT features allergen administration by using patches mounted on the skin. EPIT seeks to target epidermal antigen-presenting Langerhans cells rather than mast cells or the vasculature; this should reduce both local and systemic adverse effects. LNIT involves the spraying of allergen extracts into the nasal cavity. Natural or chemically modified allergens (the latter, termed allergoids, lack immunoglobulin E reactivity) are prepared in a soluble form. OIT involves the regular administration of small amounts of a food allergen by mouth and commences with low oral doses, which are then increased as tolerance develops. OMIT seeks to deliver allergenic proteins to an expanded population of Langerhans cells in the mucosa of the oral cavity. Conclusions: ILIT, EPIT, LNIT, OIT, and OMIT are new routes for allergen immunotherapy. They are safe and effective.Continuous Education and Scientific Research AssociationWith the exception of data collection, the preparation of this manuscript (including design and planning) was supported by the Continuous Education and Scientific Research Associatio

The role of Onodi cells in sphenoiditis: results of multiplanar reconstruction of computed tomography scanning,

Abstract Introduction Onodi cells are the most posterior ethmoid air cells and extend superolateral to the sphenoid sinus. These cells are also intimately related with the sphenoid sinus, optic nerve, and carotid artery. Radiologic evaluation is mandatory to assess for anatomic variations before any treatment modalities related to the sphenoid sinus. Objective To evaluate the effect of Onodi cells on the frequency of sphenoiditis. Methods A retrospective analysis was performed in 618 adult patients who underwent high-resolution computed tomography between January 2013 and January 2015. The prevalence of Onodi cells and sphenoiditis was evaluated. Whether the presence of Onodi cells leads to an increase in the prevalence of sphenoiditis was investigated. Results Onodi cell positivity was observed in 326 of 618 patients and its prevalence was found to be 52.7%. In the study group, 60.3% (n = 73) were ipsilaterally (n = 21) or bilaterally (n = 52) Onodi-positive, whereas 39.7% (n = 48) were Onodi-negative (n = 35) or only contralaterally Onodi-positive (n = 13). Of the control group, 48.3% (n = 240) were Onodi-positive and 51.7% (n = 257) were Onodi negative. The co-existence of Onodi cells ipsilaterally was observed to increase the identification of sphenoiditis 1.5-fold, and this finding was statistically significant (p < 0.05). Conclusion The prevalence of sphenoiditis appears to be higher in patients with Onodi cells. However, it is not possible to state that Onodi cells are the single factor that causes this disease. Further studies are needed to investigate contributing factors related to sphenoiditis