Comparison of Conventional Excision via a Sublabial Approach and Transnasal Marsupialization for the Treatment of Nasolabial Cysts: A Prospective Randomized Study

ObjectivesSurgical excision via a sublabial approach is considered the standard treatment for nasolabial cysts. Although transnasal marsupialization has been proposed as an alternative method, no prospective study has compared the effectiveness of these techniques. We thus compared the surgical procedure, operating time, postoperative pain, complications, and recurrence rate between the two surgical methods.MethodsTwenty patients diagnosed with nasolabial cysts were allocated randomly into two groups according to the surgical technique. In the sublabial approach group, the cysts were excised completely using a sublabial approach, while in the transnasal marsupialization group, the cysts were marsupialized transnasally under the guidance of nasal endoscopes. The pure operating time was measured and postoperative pain was evaluated using a visual analog scale. Complications after the procedure were assessed and recurrence was determined according to the clinical symptoms and postoperative radiologic findings.ResultsThe transnasal marsupialization group had significantly shorter operating times, less postoperative pain, lower complication rates, and shorter duration of side effects than the sublabial approach group. No recurrence occurred in either group after a 1-yr follow-up period.ConclusionAlthough both methods are effective for treating nasolabial cysts, the transnasal marsupialization of nasolabial cysts has many benefits over the conventional sublabial approach. Therefore, we propose that transnasal marsupialization be the treatment of choice for nasolabial cysts

Fatty Acid Binding Protein 1 Is Related with Development of Aspirin-Exacerbated Respiratory Disease

BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) refers to the development of bronchoconstriction in asthmatics following the ingestion of aspirin. Although alterations in eicosanoid metabolites play a role in AERD, other immune or inflammatory mechanisms may be involved. We aimed to identify proteins that were differentially expressed in nasal polyps between patients with AERD and aspirin-tolerant asthma (ATA). METHODOLOGY/PRINCIPAL FINDINGS: Two-dimensional electrophoresis was adopted for differential display proteomics. Proteins were identified by liquid chromatography-tandem mass spectrometry (LC-MS). Western blotting and immunohistochemical staining were performed to compare the amount of fatty acid-binding protein 1 (FABP1) in the nasal polyps of patients with AERD and ATA. Fifteen proteins were significantly up- (seven spots) or down-regulated in the nasal polyps of patients with AERD (n = 5) compared to those with ATA (n = 8). LC-MS revealed an increase in seven proteins expression and a decrease in eight proteins expression in patients with AERD compared to those with ATA (P = 0.003-0.045). FABP1-expression based on immunoblotting and immunohistochemical analysis was significantly higher in the nasal polyps of patients with AERD compared to that in patients with ATA. FABP1 was observed in epithelial, eosinophils, macrophages, and the smooth-muscle cells of blood vessels in the polyps. CONCLUSIONS/SIGNIFICANCE: Our results indicate that alterations in 15 proteins, including FABP1, may be related to the development of AERD

Clinical characteristics of the study subjects.

<p>Values are mean ± SE. P-values are obtained using the <i>t</i>-test or the x²-test between AERD and ATA.</p><p>ATA: aspirin tolerant asthma, AERD : aspirin-exacerbated respiratory disease,</p><p>*P<0.05 compared with ATA.</p>†<p>D.f, D.p, Strawdust, Haydust, Cockroach mix, Chrysanthemum P, Aster P, Cat fur, Ragweed polle.</p

Comparison of FABP1 expression in ATA and AERD patients.

<p>FABP1 abundance was measured in nasal polyp extract lysates of ATA (n = 3) and AERD (n = 3) patients using a mouse anti-human FABP1 monoclonal antibody. (A) Representative figure and (B) bar graph of the Western blot analysis of plasma from AERD and ATA samples.</p

List of differentially expressed proteins identified by LC-MS.

<p>List of differentially expressed proteins identified by LC-MS.</p

Representative figure showing the immunohistochemical analysis of nasal polyps from ATA (n = 3) and AERD (n = 3) patients.

<p>A mouse anti-human FABP1 monoclonal antibody (1∶100 dilution), goat anti-human CD163 polyclonal antibodies (1∶100 dilution), goat anti-human MBP polyclonal antibodies (1∶100 dilution), and a mouse anti-human alpha smooth muscle actin monoclonal antibody (1∶50, clone 1A4, DAKO, Glostrup, Denmark) were used. Magnification: 400×.</p

Photographs of two-dimensional electrophoresis (2-DE) separation of nasal polyps proteins obtained from ATA (n = 8) and subjects with AERD (n = 5).

<p>(A) one ATA, and one patient with AERD. Nasal polyp proteins (1 mg) were focused on a pH 3–10 immobilized pH gradient strip and then separated by 7.5–20% gradient SDS-PAGE and visualized as described in the Methods. Protein spots identified by LC-MS (arrows) are labeled with numbers. Spot #2 is enlarged in small boxes. (B) The Y-axis of each graph represents the relative intensity of the spot (%). P-values represent the difference between the ATA and AERD samples.</p