SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Sinusitis

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Balloon dilation may offer a more expedient and cost-effective treatment method compared with traditional endoscopic sinus surgery for chronic maxillary atelectasis. We sought to demonstrate the feasibility of balloon dilation of the maxillary os as a treatment modality for patients with chronic maxillary atelectasis by investigating the short-term outcomes in a retrospective case series of 4 patients representing 5 sinuses treated between 2011 and 2013. All sinuses were successfully balloon dilated without complications. Follow-up ranged from 1 week to 4 months. Aeration of the treated sinuses without restenosis was confirmed by postoperative endoscopy, sinus computed tomography, or both. All patients reported subjective symptomatic improvement. Balloon dilation of the maxillary os may be a feasible treatment option for maxillary sinus atelectasis. Longer follow-up and a larger study sample will be needed to validate the safety of this technique and determine the rate of restenosis.

Concepts: Sinusitis, Retrospective, Maxillary sinus, Endoscopy, Case series, Dilation, Cervical dilation

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In this report, we discuss the case of a 39-year-old woman presenting with a case of chronic maxillary sinusitis.

Concepts: Sinusitis, Maxillary sinus

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AIM:: To present first experience of the use N-butyl cyanoacrylate with metacryloxisulfolane (Glubran 2) synthetic surgical glue, in the nonsurgical closure of oroantral communication (OAC). MATERIAL AND METHODS:: Two OACs, created after the exodontia of tooth 27 in 2 female patients, were sealed and closed with Glubran 2 surgical glue and monitored OACs, until the epithelization of the sockets was ended successfully. Two months postclosure of OACs, the sealed OACs were evaluated on the panoramic image and Water’s view radiography. RESULTS:: The extraction wounds with OACs were monitored until 23rd and 25th postinterventional days, when epithelization of socket ended successfully. On the panoramic image and Water’s view radiography, there were no radiological signs of maxillary sinus pathoses. CONCLUSION:: Glubran 2 can be successfully applied in the closure of OAC from 3 to 5 mm in diameter.

Concepts: Sinusitis, Maxillary sinus, Metric space, Panorama

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Allergic rhinitis is the most common atopic disorder seen in ENT clinics. It is diagnosed by history, physical exam and objective testing. Patient education, environmental control measures, pharmacotherapy, and allergen-specific immunotherapy are the cornerstones of allergic rhinitis treatment and can significantly reduce the burden of disease. Current treatment guidelines include antihistamines, intranasal corticosteroids, oral and intranasal decongestants, intranasal anticholinergics, intranasal cromolyn, and leukotriene receptor antagonists. In the mechanism of allergic rhinitis, histamine is responsible for major allergic rhinitis symptoms such as rhinorrhea, nasal itching and sneezing. Its effect on nasal congestion is less evident. In contrast, leukotrienes result in increase in nasal airway resistance and vascular permeability. Antihistamines and leukotriene receptor antagonists are commonly used in the treatment of allergic rhinitis. The published literature about combined antihistamines and leukotriene antagonists in mono- or combination therapy is reviewed and presented.

Concepts: Asthma, Sinusitis, Allergy, Mast cell, Rhinitis, Leukotriene, Montelukast, Leukotriene antagonist

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Balloon dilation technology (BDT), also known as balloon sinuplasty, has been in clinical use since September, 2005. Prior to BDT, surgeons performed a procedure called FESS, or functional endoscopic sinus surgery, for patients with chronic sinusitis. As is true with any new technology or procedure in medicine, a debate often ensues between early adopters and mainstream practitioners. Over the past 7 years, much has been discussed, debated, and learned about BDT. What follows is a review of the origins of the BDT: the theory, technology, indications and applications; and a review of the pertinent outcomes literature. Independent of how one feels about BDT, the evidence strongly supports its safety, efficacy, and growing popularity among patients and physicians alike.

Concepts: Medicine, Hospital, Surgery, Sinusitis, Physician, Otolaryngology, Functional Endoscopic Sinus Surgery, Rhinology

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Sublingual immunotherapy (SLIT) use in the United States to date has been limited, despite common use and demonstrated efficacy elsewhere in the world. This is largely in part due to lack of FDA-approved SLIT products, lack of established dosing and administration guidelines, and cost concerns. Several recent studies have demonstrated efficacy and safety of two sublingual grass tablets and one ragweed tablet approved by the FDA, and one sublingual ragweed liquid currently pending FDA approval. With FDA approved SLIT products, there will be numerous challenges to the allergist and patient in deciding whether to pursue SLIT or SCIT (subcutaneous immunotherapy) for allergic rhinitis. This review highlights the current state of SLIT in the United States, and expected future directions.

Concepts: Asthma, United States, Sinusitis, Immunology, Allergy, Poverty in the United States, U.S. state, Allergology

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Headache, a nearly universal experience, remains costly, disabling, and often suboptimally managed. The most common presentations in the United States are migraine, tension-type headache (TTH) and “sinus” headache, but their extensive symptomatic overlap suggests that these conditions can be approached as variations in the same underlying pathology and managed accordingly. We use case studies of patients with varying prior diagnoses (none, migraine, TTH, and sinus headache), as well as a 4-question diagnostic screening tool, to illustrate how pharmacists can use this conceptual framework to simplify identification, management, and referral of patients with primary headache conditions of uncertain etiology.

Concepts: Medical terms, United States, Sinusitis, Classification of Pharmaco-Therapeutic Referrals, English language, Meningitis, Headache, Headaches

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Antrochoanal polyp is a benign polypoid lesion orginating from the maxillary sinus antrum and extending to the choana. Our aim was to assess the clinical presentation and associated rhinological findings of antrochoanal polyp patients and to evaluate results of 2 surgical treatments termed endoscopic sinus surgery (ESS) and ESS plus mini-Caldwell operation. The study included 46 patients. Factors such as patient age, sex, history of chronic sinusitis, allergic rhinitis, septal deviations, chonca bullosa, turbinate hypertrophy, and the origin of the polyp were assessed. We also evaluated ESS and ESS plus mini-Caldwell surgical procedures for recurrences, synechia, bleeding, and ostium stenosis. Overall, there were 27 men and 19 women. The ESS approach was used in 26 cases, and 20 cases had combined ESS and mini-Caldwell procedures. The statistical significant difference between the 2 groups was only recurrence (P ≤ 0.05). In the ESS group, bleeding, synechia, and ostium stenosis were seen more than in the ESS + mini-Caldwell group, but there was no significant difference between the 2 groups in bleeding, synechia, and ostium stenosis (P > 0.05). We thought that lower rate of recurrence found in ESS + Caldwell group in this study was associated with better visualization of the maxillary sinus walls and, therefore, easier resection of the remnant polyp. We concluded that higher incidences of bleeding and synechia were related to the mucosal damage occurring in the septum and the inferior concha due to excessive manipulation of endoscope and surgical instruments.

Concepts: Surgery, Sinusitis, Allergy, Maxillary sinus, Rhinitis, Functional Endoscopic Sinus Surgery, Concha bullosa, Inferior nasal concha

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Chronic rhinosinusitis is common in cystic fibrosis (CF), as CFTR defects equally affect the airway and sinonasal mucosa. However, therapeutic strategies for CF-associated chronic rhinosinusitis lag behind current approaches for pulmonary disease.

Concepts: Medicine, Pulmonology, Pneumonia, Sinusitis, Pseudomonas aeruginosa, Cystic fibrosis, Respiratory system, Mucus

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Pediatric orbital cellulitis is most often caused by ethmoid sinusitis. We present a description of 4 atypical cases of orbital cellulitis without sinusitis.

Concepts: Sinusitis, Ethmoid sinus