A multi-center observation of the therapeutic efficacy of Bencycloquidium bromide in the treatment of seasonal allergic rhinitis with predominant symptoms of rhinorrhea / 临床耳鼻咽喉头颈外科杂志

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.

Complementary and alternative medicine for rhinitis and sinusitis / 中华耳鼻咽喉头颈外科杂志

Complementary and alternative medicine (CAM) describes a broad category of practices and treatments for the prevention or treatment of disease outside the realm of conventional medicine. CAM is widely used in the treatment of allergic rhinitis, acute and chronic rhinosinusitis. This article summarizes a variety of CAM and the efficacy in the treatment of rhinitis and sinusitis, with the purpose of increasing people′s awareness of CAM and enriching the treatment of rhinitis and sinusitis, so that patients can benefit from it.

Research progress on intralymphatic immunotherapy / 中华耳鼻咽喉头颈外科杂志

Intralymphatic immunotherapy (ILIT) is an effective and safe causative treatment for allergic diseases. Compared with conventional specific immunotherapy such as subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT), ILIT could significantly reduce treatment duration. This article will review the results of previous researches focusing on ILIT.

Allergic factors affect on severity of chronic rhinosinusitis and postoperative outcomes / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate whether the allergic factors impact the severity of chronic rhinosinusitis or not, further more, to explore the relationship between allergic rhinitis and chronic rhinosinusitis.@*METHOD@#A retrospective review was done on 103 patients. All of these patients were under functional intranasal endoscopic sinus surgery after expectant treatment is ineffective. We devided the patients into different groups according to the result of skin prick and specific IgE and if there is difference in VAS score, Lund and Kennedy endoscopic score, Lund-Mackay CT score between the groups. We also analysed the symptoms in different chronic rhinosinusitis patients allerged to variant kinds of allergen. The SPSS 17.0 software was used to analyze the data. Statistical analysis was performed by t-test, rank order test or χ2 test.@*RESULT@#The duration of the disease, VAS score of nasal blockage, score of Lund-Mackay CT and Lund and Kennedy endoscopic before the operation were in no statistical sense after when compared with the two groups of patients with chronic rhiriosinusitis who grouped according the result of skin prick and specific IgE. The VAS score of facial pressure and loss of smell was higher in patients with chronic rhinosinusitis which the skin prick and specific IgE were positive. The VAS score of nasal discharge was higher in patients with chronic rhinosinusitis who got negative skin prick and specific IgE result. The symptoms of chronic rhinosinusitis improved with operation no matter the group of skin prick and specific IgE positive or negative and VAS score of nasal blockage improved significantly in negative group. The symptoms of sneezing, rhinorrhoea and rhinocnesmus improved after operation among the chronic rhinosinusitis patients with skin prick and specific IgE. The number of cockroach allergy is larger among the patients with chronic rhinosinusitis without polyps than the one among the patients with chronic rhinosinusitis with polyps.@*CONCLUSION@#Allergic factor didn't impact much the severity of chronic rhinosinusitis patients who were failed in expectant treatment, besidesthe postoperative outcomes showed that only influence the severity of nasal discharge, facial pressure and loss of smell. Different kinds of allergen were found between the patients of chronic rhinosinusitis with or without polyps. No significantly functional endoscopic sinusitis sugrery outcome were related to the allergic factor. But the allergic factor may interfere the remission of nasal discharge after surgery.

Expression of SleX and CD24 in nasal inverted papilloma / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the expression of SleX and CD24 in nasal inverted papilloma and its pathologic features.METHODS HE staining were conducted to study the pathologic features in specimens of 11 cases with nasal inverted papilloma. Further,immunohistochemistry stain for SleX and CD24 were performed in total specimens.RESULTS One case(9.1%) was diagnosed as severe atypical hyperplasia but tumor cells did not invaded basal membranes.SleX staining located at cell membranes. Positive SleX staining was found in 9 specimens (81.8%) and 1 normal nasal epithelium (16.7%).CD24 staining located in cytoplasm.Positive CD24 staining was found in 8 specimens of nasal inverted papilloma (72.7%). CD24 was negative in nasal epithelial cells and only a few lymphocytes were positive.CONCLUSION Some cases of nasal inverted papilloma are diagnosed with severe atypical hyperplasia.Most of cases express CD24,so nasal inverted papilloma may be a borderline tumor.Expression of SleX and infiltration of inflammatory cells suggest that nasal inverted papilloma may be related to inflammatory reactions.

Clinic analysis of hidden epistaxis / 中国耳鼻咽喉头颈外科

OBJECTIVE To demonstrate the bleeding sites and the major blood supply in patients with hidden epistaxis. METHODS The clinical data of 106 patients with hidden epistaxis were studied retrospectively. The bleeding sites and hemorrhagic focus was not found by routine anterior nasoscope examination was defined as hidden epistaxis. The bleeding sites were located and the bleeding was stopped under nasal endoscope. RESULTS The hemorrhagic foci were found in the following sites: 55.7%(59/106)at the top of inferior meatus, 33.0% (35/106)middle turbinate and the top of middle meatus, 9.4%(10/106)olfactory cleft and the nasal septum, and 1.9%(2/106)unknown. The bleeding sites were found and the bleeding was stopped with radiofrequency under nasal endoscope in 104 cases. Bleeding was stopped by treatment once in 102 cases(96.2%)and treatment twice in 2 cases(1.9%). All the patients were followed up for over one month without recurrence and the cure rate was 98.1%. Bleeding sites were not found in 2 cases because of heavy damage of the nasal mucosa. CONCLUSION ①The majority of hidden epistaxis is supplied by the sphenopalatine artery. ②To find the bleeding sites and stop the bleeding in hidden epistaxis patients under nasal endoscope using radiofrequency is effective, minimally invasive and worth of clinic application extensively.

Surgical approaches for maxillary sinus cyst / 中国耳鼻咽喉头颈外科

OBJECTIVE To investigate the surgical approaches for maxillary sinus cyst. METHODS A total of 32 patients with maxillary sinus cyst underwent operation for removal the cysts. Among them, 8 patients with maxillary sinus cyst and sinusitis were operated on through Messerklinger approach, 19 patients with maxillary cyst received modified Caldwell-Luc operation under nasal endoscope and 5 patients received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. RESULTS All the patients were followed up for 6 months to one year. There was no recurrence found in patients received modified Caldwell-Luc operation. There were 2 patients recurred in 8 patients who were operated on through Messerklinger approach and one patient had closure of the maxillary sinus ostium and adhesion of nasal cavity. One patient recurred and 2 lost follow up in 5 patients who received endoscopic removal of maxillary cyst through the maxillary sinus antrostomy at the inferior nasal meatus. CONCLUSION The optimal surgical method for maxillary cyst is modified Caldwell-Luc operation under nasal endoscope. Messerklinger technique may suitable for patients with complicated sinusitis.