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1.
Journal of Rhinology ; : 149-154, 2023.
Article in English | WPRIM | ID: wpr-1001563

ABSTRACT

Background and Objectives@#Turbinoplasty may be an option in patients with persistent symptoms of allergic rhinitis (AR) despite adequate medication. The two most frequently used surgical techniques for turbinoplasty are radiofrequency ablation and microdebriderassisted turbinoplasty. This study compared the outcomes of these two surgical techniques and assessed the long-term treatment effects. @*Methods@#This study included patients with AR who underwent turbinoplasty between January 2010 and June 2017. We examined the medication scores, overall treatment satisfaction scores, and medical records. Based on the type of surgery, patients were classified into microdebrider and coblator groups. A telephone survey was conducted to collect data on the 5-year post-treatment efficacy parameters. Scores for allergic symptoms, prescription medicines taken after surgery, and general satisfaction were compared. @*Results@#Of the total 241 patients, 192 (79.7%) and 49 (20.3%) underwent microdebrider-assisted turbinoplasty and radiofrequency ablation turbinoplasty, respectively. Both the microdebrider and coblator groups showed remarkable improvements in AR symptoms at the 5-year follow-up (p<0.001). Although the degree of symptom improvement did not differ significantly between the two groups, the coblator group did show significant improvements in medication scores when compared with the microdebrider group (p<0.05), and there were significant differences in postoperative satisfaction scores between the two groups. @*Conclusion@#In terms of 5-year postoperative outcomes, radiofrequency-ablation turbinoplasty and microdebrider-assisted turbinoplasty were equally beneficial for reducing nasal symptoms and enhancing medication ratings in patients with AR.

2.
Journal of Rhinology ; : 155-160, 2023.
Article in English | WPRIM | ID: wpr-1001562

ABSTRACT

Background and Objectives@#In 2021, biologics were approved for treating chronic rhinosinusitis with nasal polyps (CRSwNP) in Korea. However, CRS is a heterogeneous disease, and its characteristics are thought to differ between Western and Korean populations. This study aimed to evaluate the experiences of members of the Korean Rhinologic Society during the first year of biologic usage for the treatment of nasal polyps. @*Methods@#An anonymous survey consisting of 15 items was conducted from November to December 2021. The survey included questions about participant demographics, use of biologics for treating CRSwNP, and expectations regarding the effectiveness of biologics for treating CRSwNP. @*Results@#In total, 44 members participated in the survey. Approximately half of the respondents were in their 40s (50.0%) and had 5–9 years of clinical experience as otorhinolaryngologists (47.7%). The majority of participants held academic positions (95.4%). About half of them worked in Gyeonggi Province. The utilization of biologics did not differ significantly based on clinical experience (p=0.192). When asked about the factors considered for prescribing biologics, the most common reason was recurrence of polyps after surgery (87.2%). The most frequent reason for discontinuing biologics was cost (48.6%). When asked about the extent to which they expected that the availability of biologics for CRSwNP treatment would reduce endoscopic sinus surgery (ESS), 45.5% of members expected a reduction of approximately 10%–29%. In addition, 20.5% expected a reduction of 50% or more. However, 61.4% expected a reduction of less than 10% in primary ESS. In addition, most respondents (93.2%) agreed with the need for Korea-specific guidelines for biologic treatment. @*Conclusion@#There are discrepancies between the current guidelines for biologic treatment of CRSwNP and the reality of the situation, highlighting the need for the development of Korea-specific guidelines.

3.
Clinical and Experimental Otorhinolaryngology ; : 5-23, 2022.
Article in English | WPRIM | ID: wpr-925709

ABSTRACT

The Korean Society of Otorhinolaryngology-Head and Neck Surgery and Korean Rhinologic Society appointed a guideline development group (GDG) to establish a clinical practice guideline, and the GDG developed a guideline for nasal irrigation for adult patients with chronic rhinosinusitis (CRS). The guideline focuses on knowledge gaps, practice variations, and clinical concerns associated with nasal irrigation. Nasal irrigation has been recommended as the first-line treatment for CRS in various guidelines, and its clinical effectiveness has been demonstrated through a number of studies with robust evidence. However, no guidelines have presented a consistent nasal irrigation method. Several databases, including OVID Medline, Embase, the Cochrane Library, and KoreaMed, were searched to identify all relevant papers using a predefined search strategy. When insufficient evidence was found, the GDG sought expert opinions and attempted to fill the evidence gap. Evidence-based recommendations for practice were ranked according to the American College of Physicians grading system. The committee developed 11 evidence-based recommendations. This guideline focuses on the evidence-based quality improvement opportunities deemed the most important by the GDG. Moreover, the guideline addresses whether nasal lavage helps treat CRS, what type of rinsing solution should be used, and the effectiveness of using additional medications to increase the therapeutic effect.

4.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 321-326, 2021.
Article in Korean | WPRIM | ID: wpr-920237

ABSTRACT

Background and Objectives@#The conjunctivodacryocystorhinostomy (CDCR) is rarely performed in epiphora, which is caused by complete proximal bicanalicular obstruction. The purpose of this study is to analyze the characteristics, clinical results and complications of patients who underwent CDCR.Subjects and Method We enrolled 12 patients who underwent CDCR due to proximal canalicular obstruction from 2006 to 2019. We retrospectively analyzed the causes of epiphora, trauma history, the cause of revision operation and the clinical outcome. @*Results@#A total of 12 patients (7 males and 5 females) underwent CDCR (mean age 46 years). The causes of trauma were such as laceration (n=7, 58%) and iatrogenic (n=1, 8%), idiopathic obstruction (n=4, 33%). After the initial surgery, 5 patients (41%) were categorized in good outcome and the Jones tube was located well in 6 (50%) patients. Revision surgery was performed in 6 (50%) cases, with 4 cases having good outcome. The success rate of CDCR, including revision surgery, was increased to 83%. Most common cause of revision surgery was tube migration. In addition, the subjective outcome in patients with traumatic causes were worse but it had no statistical significance compared to that of patients with idiopathic and iatrogenic causes (p=0.07). @*Conclusion@#About a half of the patients had good recovery rate after the initial operation. The outcome increased to 83% after revision operation. The success rate of CDCR for traumatic patients was worse than for those with idiopathic and iatrogenic causes. It seems that accompanied eyelid damage in traumatic patients may have affected the result of success rate.

5.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 197-201, 2021.
Article in Korean | WPRIM | ID: wpr-920224

ABSTRACT

A 50-year-old woman visited the hospital with persistent watery rhinorrhea which she had for 2 months. Endoscopic examination revealed a mass in the right nasal cavity and rdiological findings revealed a bony defect on the lateral wall of the sphenoid sinus associated with the protrusion of the mass lesion. Endoscopic skull base reconstruction was performed via transpterygoid approach, including a watertight closure of the dural defect with both underlay and overlay repairs. Cerebrospinal fluid (CSF) leakage persisted after reconstruction. The right lateral lamella was identified as a secondary CSF leakage site. CSF leakage is common among patients with meningoencephalocele. However, a secondary CSF leakage accompanied with meningoencephalocele in other areas is uncommon. The present patient experienced CSF leakage from multiple sites—one associated with the original meningoencephalocele and another from a secondary defect at the skull base. This complication is rare in clinical practice. Here, we describe this rare case with a brief literature review.

6.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 13-18, 2021.
Article in Korean | WPRIM | ID: wpr-920192

ABSTRACT

Background and Objectives@#Fungus ball is the most common type of fungal sinusitis commonly associated with good prognosis. However, postoperative results depending on the extent of the lesion has not been investigated. This study aimed to identify differences in postoperative results depending on the location and extent of the fungus ball.Subjects and Method Medical records of 165 patients who underwent endoscopic sinus surgery and who were diagnosed with fungus balls by biopsy from 2010 to 2019 were retrospectively reviewed. Patients were classified into four grades according to the location and extent of the fungus ball based on their endoscopic and CT findings. Poor outcome is defined as any pathologic signs such as nasal secretion, granulation, and polyps or narrowing of the natural ostium observed postoperatively according to Kennedy’s criteria, whereas good outcome is defined as absence of pathologic signs. @*Results@#A total of 23 patients were Grade 1, 38 Grade 2, 67 Grade 3, and 37 Grade 4. Grades 1 and 2 were mostly asymptomatic. However, as the location of the fungus ball became closer to the natural ostium, patients complained postnasal drip and purulent discharge. Grades 3 and 4, who have much severe and more extensive lesions than those of Grades 1 and 2, had poor outcome (p=0.007) and took longer time to completely recover (p<0.001). @*Conclusion@#Wound healing was delayed and poor when the fungus ball was located closer to the natural ostium of the maxillary sinus. Therefore, preoperative consultation using endoscopic and CT findings could be useful for predicting their postoperative results.

7.
Journal of Rhinology ; : 131-140, 2021.
Article in English | WPRIM | ID: wpr-915910

ABSTRACT

Well-characterized in chronic rhinosinusitis, type 2 inflammation is frequently associated with nasal polyps, comorbid asthma, and nonsteroidal anti-inflammatory drug hypersensitivity. Despite medical and surgical treatment, it recurs in a significant proportion of patients. Thus, severe uncontrolled type 2 chronic rhinosinusitis with nasal polyps is the most difficult-to-treat phenotype of chronic rhinosinusitis. Recently, dupilumab, a monoclonal antibody against IL-4 receptor α, and omalizumab, a monoclonal antibody against immunoglobulin E, were approved for patients with chronic rhinosinusitis with nasal polyps in the United States, Europe, and Korea. Therefore, rhinologists should understand novel biologics and their use. Here, we provide a literature review of several biologics with their indications, effectiveness, and safety.

8.
Journal of Korean Medical Science ; : e264-2021.
Article in English | WPRIM | ID: wpr-900048

ABSTRACT

Background@#Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes. @*Methods@#Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and LundMackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes. @*Results@#In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis (P 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [−0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) − 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed. @*Conclusion@#Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS.

9.
Journal of Korean Medical Science ; : e264-2021.
Article in English | WPRIM | ID: wpr-892344

ABSTRACT

Background@#Endoscopic sinus surgery (ESS) is the mainstay treatment for refractory chronic rhinosinusitis (CRS). Since various factors may contribute to the surgical outcome, it is challenging for physicians to predict surgical outcomes. The aim of study was to analyze the prognostic factors of postoperative outcomes and to establish the prediction model with the risk factors that impact the postoperative outcomes. @*Methods@#Medical records of CRS patients who underwent ESS at 9 institutions in 2005, 2010, and 2016 were retrospectively reviewed. We classified the patients into 2 groups based on postoperative objective endoscopic outcomes. Demographics, nose-specific symptoms, olfactory function, eosinophil counts in blood (EoB) and nasal tissue (EoT), and LundMackay CT score (LMS) were collected. Univariate and multivariate analyses were performed and established a prediction equation for postoperative endoscopic objective outcomes. @*Results@#In total (n = 1,249), 27.0% were not satisfied under postoperative endoscopic examination. Of 10 variables, LMS (> 5), sinus dominancy (maxillary sinus and ethmoid sinus), EoB (> 210), and EoT (> 100) were statistically significant in univariate analysis (P 100) and LMS (> 5) were significantly associated with poor postoperative outcome. Furthermore, 5 significant variables were employed to establish the risk model of postoperative outcomes and P (the value of prediction probability) = 1 / (1 + exp [−0.392 + 1.088 × EoT (> 100) + 0.123 × mean LMS (> 5) − 0.366 × sinus dominancy (maxillary) + 0.064 × sinus dominancy (similar) + 0.200 × EoB (4%) + 0.344 × EoB (> 210)] was developed. @*Conclusion@#Tissue eosinophil count and radiographic severity predispose to a poorer outcome of ESS and the risk model established may be helpful to predict postoperative outcomes of ESS.

10.
Journal of Rhinology ; : 14-18, 2021.
Article in Korean | WPRIM | ID: wpr-874943

ABSTRACT

Otorhinolaryngologic symptoms such as cough, rhinorrhea, anosmia, ageusia, and fever can precede development of COVID-19. Otolaryngologists are vulnerable to potential COVID-19 infection because early cases of COVID-19 have been asymptomatic or show mild manifestations. Otolaryngologists should wear adequate personal protective equipment (PPE) according as location or situation. PPE includes medical masks, goggles, and fluid-resistant gown and gloves. Authors provide clinical recommendations based on PPE for otorhinolaryngologists during the COVID-19 pandemic. In addition, we reviewed the literature related to clinical guidelines of foreign otorhinolaryngology societies with regard to COVID-19.

11.
Journal of Rhinology ; : 1-13, 2021.
Article in Korean | WPRIM | ID: wpr-874942

ABSTRACT

The novel SARS-CoV-2 virus that causes COVID-19 has emerged rapidly and the virus has caused a global pandemic since it was first diagnosed in December 2019. SARS-CoV-2 is the seventh virus associated with human transmission among corona viruses. Otorhinolaryngologists could be vulnerable to this viral transmission due to the high viral load in the nasal cavity and nasopharynx. Hence, it is essential to understand the novel COVID-19 from the perspective of otorhinolaryngologists. We provide literature reviews of previous human coronaviruses and the novel COVID-19 with clinical hallmarks, diagnostic approaches, and possible treatment options. Further study is necessary to elucidate viral features and standardize treatment protocols with curable anti-viral agents and vaccines.

12.
Allergy, Asthma & Respiratory Disease ; : 3-11, 2021.
Article in English | WPRIM | ID: wpr-874070

ABSTRACT

Recently, air pollution has become more and more severe globally and has decreased the quality of life significantly in subjects with or without allergic diseases. Air pollution more severely affects patients with allergic diseases, including allergic rhinitis (AR); therefore, it could devastate quality of life. Many epidemiological studies have shown that air pollutants increased outpatient clinic visits as well as the prevalence/severity of AR and decreased quality of life in patients with AR. Traffic-related air pollution also increases the severity and occurrence rate of AR, and heavy traffic is also associated with an increased prevalence of AR. Immunologically, air pollutants increase airway inflammation and mucin production by triggering the generation of reactive oxygen species and inducing the nucleotide-binding domain, leucine-rich repeat protein 3 inflammasome and apoptosis. Since air pollution affects both the upper and lower airways and is known to be a risk factor for AR, proper diagnosis and treatment should be applied. In this review article, we will address several epidemiological and clinical studies about the effects of air pollution on AR, mechanisms by which air pollutants aggravate AR, and treatment of AR triggered by air pollutant.

13.
Clinical and Experimental Otorhinolaryngology ; : 396-406, 2020.
Article in English | WPRIM | ID: wpr-831342

ABSTRACT

Objectives@#. Limited information is available regarding strain-related differences in mouse models of allergic rhinitis induced by Dermatophagoides farinae (Der f1). In this study, we compared differences between two mouse strains and determined the optimal dose of Der f1 for allergic rhinitis mouse models. @*Methods@#. Forty-eight mice were assigned to the following six groups (n=8 per group): group A (control, BALB/c), group B (Der f1-sensitized BALB/c, 25 µg), group C (Der f1-sensitized BALB/c, 100 µg), group D (control, C57BL/6), group E (Der f1-sensitized C57BL/6, 25 µg), and group F (Der f1-sensitized C57BL/6, 100 µg). Allergic inflammation was induced with Der f1 and alum sensitization, followed by an intranasal challenge with Der f1. Rubbing and sneezing scores, eosinophil and neutrophil infiltration, and immunoglobulin, cytokine, and chemokine levels in the nasal mucosa and from splenocyte cultures were assessed. @*Results@#. Rubbing and sneezing scores were higher in groups B, C, E, and F than in groups A and D, with a similar pattern in both strains (i.e., group B vs. E and group C vs. F). Serum immunoglobulin levels were significantly elevated compared to the control in groups B and C, but not in groups E and F. Eosinophil and neutrophil infiltration increased (all P0.05). BALB/c mice (group B) showed a greater elevation of splenic interleukin (IL)-4 (P<0.01), IL-5 (P<0.01), and IL-6 levels (P<0.05) and nasal IL-4 mRNA levels (P<0.001) than the C57BL/6 mice (group E). Interestingly, mice treated with 100 µg Der f1 showed a weaker allergic response than those treated with 25 µg. @*Conclusion@#. We found 25 µg to be a more appropriate dose for Der f1 sensitization. BALB/c mice are more biased toward a Th2 response and are a more suitable model for allergic rhinitis than C57BL/6 mice. This study provides information on the appropriate choice of a mouse model for allergic rhinitis.

14.
Allergy, Asthma & Immunology Research ; : 507-522, 2020.
Article in English | WPRIM | ID: wpr-811062

ABSTRACT

PURPOSE: Th17-associated inflammation is increased in chronic rhinosinusitis with nasal polyp (CRSwNP), and is associated with disease severity and steroid resistance. Overexpressed interleukin (IL)-17A affects CRSwNP by tissue remodeling, eosinophilic accumulation, and neutrophilic infiltration. We aimed to identify the role of IL-17A in CRSwNP and to evaluate the effects of anti-IL-17A blocking antibody on nasal polyp (NP) formation using a murine NP model. Moreover, we sought to investigate whether the inhibition of mechanistic target of the rapamycin (mTOR) signal pathway could suppress IL-17A expression and NP formation.METHODS: Human sinonasal tissues from control subjects and patients with chronic rhinosinusitis (CRS) were analyzed using immunohistochemistry (IHC) and immunofluorescence staining. The effects of IL-17A neutralizing antibody and rapamycin were evaluated in a murine NP model. Mouse samples were analyzed using IHC, quantitative real-time polymerase chain reaction, and enzyme-linked immunosorbent assay.RESULTS: IL-17A+ inflammatory cells were significantly increased in number in NP from patients with CRSwNP compared to that in uncinate process tissues from control subjects and patients with CRS without NP or CRSwNP. CD68+ M1 macrophages dominantly expressed IL-17A, followed by neutrophils and T helper cells, in NP tissues. Neutralization of IL-17A effectively reduced the number of NPs, inflammatory cytokines, and IL-17A-producing cells, including M1 macrophages. Inhibition of IL-17A via the mTOR pathway using rapamycin also attenuated NP formation and inflammation in the murine NP model.CONCLUSIONS: IL-17A possibly plays a role in the pathogenesis of CRSwNP, the major cellular source being M1 macrophage in NP tissues. Targeting IL-17A directly or indirectly may be an effective therapeutic strategy for CRSwNP.


Subject(s)
Animals , Humans , Mice , Antibodies, Neutralizing , Cytokines , Enzyme-Linked Immunosorbent Assay , Eosinophils , Fluorescent Antibody Technique , Immunohistochemistry , Inflammation , Interleukin-17 , Interleukins , Macrophages , Nasal Polyps , Neutrophils , Real-Time Polymerase Chain Reaction , Signal Transduction , Sinusitis , Sirolimus , T-Lymphocytes, Helper-Inducer
15.
Journal of Rhinology ; : 32-37, 2019.
Article in Korean | WPRIM | ID: wpr-766203

ABSTRACT

BACKGROUND AND OBJECTIVES: Chronic pediatric sinusitis continues to be a challenging problem to otolaryngologists and has been reported to show worse prognosis than that of adults. However, most studies were performed with short-term follow-up. In this study, we aimed to assess the clinical outcome of pediatric endoscopic sinus surgery (ESS) with a longer follow-up and to determine the effect of age on postoperative outcome. SUBJECTS AND METHOD: A retrospective analysis was performed on pediatric patients than 15 years with ESS younger from 2005 to 2014 in a tertiary referral hospital. All patients completed a questionnaire regarding symptoms before to from 1 to 9 years after surgery. Telephone survey was performed to evaluate symptoms including nasal obstruction, nasal discharge, PND, and headache at 1 to 9 years after surgery. RESULTS: Seventy-one pediatric patients with bilateral chronic sinusitis were treated with ESS. They showed gradual symptom improvement from 5 year after surgery for the following: nasal obstruction (p=0.032), PND (p=0.005), and headache (p=0.048). However, there was improvement in rhinorrhea after 9 years (p=0.042). In addition, when analyzed in terms of age, the outcome was poor in children younger than 13 years (p=0.003) compared with the older age group. Multivariate analysis showed that preoperative nasal obstruction was dependent on AR, and postoperative symptoms were dependent on presence of AR and involuntary smoking. Nasal discharge was dependent on presence of AR and involuntary smoking preoperatively and postoperatively. These suggest the importance of AR and involuntary smoking as risk factors for prognosis. CONCLUSION: Chronic pediatric sinusitis showed gradual improvement after ESS and should be more carefully monitored on a long-term basis. We should keep in mind that long-term follow-up is needed for pediatric ESS cases.


Subject(s)
Adult , Child , Humans , Follow-Up Studies , Headache , Methods , Multivariate Analysis , Nasal Obstruction , Prognosis , Retrospective Studies , Risk Factors , Sinusitis , Telephone , Tertiary Care Centers , Tobacco Smoke Pollution
16.
Clinical and Experimental Otorhinolaryngology ; : 237-238, 2019.
Article in English | WPRIM | ID: wpr-763324

ABSTRACT

No abstract available.


Subject(s)
Otorhinolaryngologic Diseases , Particulate Matter
17.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 395-403, 2019.
Article in Korean | WPRIM | ID: wpr-760141

ABSTRACT

BACKGROUND AND OBJECTIVES: The embryological development of paranasal sinuses has been revealed by previous articles although few studies have reported on the differences of paranasal sinus pneumatization according to age after adolescence. We evaluated changes in paranasal sinus pneumatization in the ages ranging from 10s to over 60s. SUBJECTS AND METHOD: A retrospective review was carried out for patients who underwent osteomeatal unit three-dimensional computed tomography from January 2008 to March 2017. Two hundred and forty patients were selected and matched for age, sex, and existence of sinusitis. The biggest cross-sectional area (CSA) of each sinus was selected from each patient, which was then corrected to the size of the face. CSA and corrected CSA (cCSA) values were used together for analysis. RESULTS: CSAs of frontal, maxillary, sphenoid sinuses gradually increased in the ages ranging in the 30s, and then significantly decreased from those in the 40s onwards. In particular, these tendencies were statistically significant in all types of sinuses between the 30s and 40s, (p0.05). CSAs in patients with chronic sinusitis were not different from those in patients without chronic sinusitis in every sinus and all age groups (p>0.05). CONCLUSION: This study shows that older people have smaller sinuses, and sex difference and existence of sinusitis have no effect on the pneumatization of the sinuses.


Subject(s)
Adolescent , Female , Humans , Male , Anatomy, Cross-Sectional , Methods , Paranasal Sinuses , Retrospective Studies , Sex Characteristics , Sinusitis , Sphenoid Sinus
18.
Allergy, Asthma & Immunology Research ; : 691-708, 2019.
Article in English | WPRIM | ID: wpr-762153

ABSTRACT

PURPOSE: Chronic rhinosinusitis (CRS) is a complex immunological condition, and novel experimental modalities are required to explore various clinical and pathophysiological endotypes; mere evaluation of nasal polyp (NP) status is inadequate. Therefore, we collected patient nasal secretions on filter paper and characterized the proteomes. METHODS: We performed liquid chromatography-mass spectrometry (MS)/MS in the data-dependent acquisition (DDA) and data-independent acquisition (DIA) modes. Nasal secretions were collected from 10 controls, 10 CRS without NPs (CRSsNP) and 10 CRS with NPs (CRSwNP). We performed Orbitrap MS-based proteomic analysis in the DDA (5 controls, 5 CRSsNP and 5 CRSwNP) and the DIA (5 controls, 5 CRSsNP and 5 CRSwNP) modes, followed by a statistical analysis and a hierarchical clustering to identify differentially expressed proteins in the 3 groups. RESULTS: We identified 2,020 proteins in nasal secretions. Canonical pathway analysis and gene ontology (GO) evaluation revealed that interleukin (IL)-7, IL-9, IL-17A and IL-22 signaling and neutrophil-mediated immune responses like neutrophil degranulation and activation were significantly increased in CRSwNP compared to control. The GO terms related to the iron ion metabolism that may be associated with CRS and NP development. CONCLUSIONS: Collection of nasal secretions on the filter paper is a practical and non-invasive method for in-depth study of nasal proteomics. Our proteomic signatures also support that Asian NPs could be characterized as non-eosinophilic inflammation features. Therefore, the proteomic profiling of nasal secretions from CRS patients may enhance our understanding of CRS endotypes.


Subject(s)
Humans , Asian People , Gene Ontology , Inflammation , Interleukin-17 , Interleukin-9 , Interleukins , Iron , Metabolism , Methods , Nasal Polyps , Neutrophils , Proteome , Proteomics , Sinusitis , Spectrum Analysis
19.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 395-403, 2019.
Article in Korean | WPRIM | ID: wpr-830038

ABSTRACT

BACKGROUND AND OBJECTIVES@#The embryological development of paranasal sinuses has been revealed by previous articles although few studies have reported on the differences of paranasal sinus pneumatization according to age after adolescence. We evaluated changes in paranasal sinus pneumatization in the ages ranging from 10s to over 60s.SUBJECTS AND METHOD: A retrospective review was carried out for patients who underwent osteomeatal unit three-dimensional computed tomography from January 2008 to March 2017. Two hundred and forty patients were selected and matched for age, sex, and existence of sinusitis. The biggest cross-sectional area (CSA) of each sinus was selected from each patient, which was then corrected to the size of the face. CSA and corrected CSA (cCSA) values were used together for analysis.@*RESULTS@#CSAs of frontal, maxillary, sphenoid sinuses gradually increased in the ages ranging in the 30s, and then significantly decreased from those in the 40s onwards. In particular, these tendencies were statistically significant in all types of sinuses between the 30s and 40s, (p0.05). CSAs in patients with chronic sinusitis were not different from those in patients without chronic sinusitis in every sinus and all age groups (p>0.05).@*CONCLUSION@#This study shows that older people have smaller sinuses, and sex difference and existence of sinusitis have no effect on the pneumatization of the sinuses.

20.
Korean Journal of Otolaryngology - Head and Neck Surgery ; : 624-630, 2019.
Article in Korean | WPRIM | ID: wpr-920041

ABSTRACT

BACKGROUND AND OBJECTIVES@#Unilateral sinusitis is caused by various factors. Odontogenic sinusitis; especially, is different from non-odontogenic sinusitis in clinical features and prognosis. The purpose of this study is to evaluate the prognosis of odontogenic sinusitis in accordance with the changes in diagnostic accuracy over time and the timing of dental treatment.SUBJECTS AND METHOD: 195 patients who underwent endoscopic sinus surgery for unilateral sinusitis within the interval from 2006 to 2017 were reviewed to analyze the etiologies and clinical characteristics. Preoperative CT was assessed to identify patients who had not been diagnosed with odontogenic sinusitis in the past. In the unilateral bacterial sinusitis, we identified changes in incidence, diagnostic accuracy, and outcome in the odontogenic sinusitis. We divided odontogenic sinusitis patients into three groups: preoperative and intraoperative dental treatment group, postoperative dental treatment group, and untreated group. Then we analyzed the difference in prognosis of these three groups.@*RESULTS@#The total number of patients with odontogenic sinusitis was 86 (44%), which accounted for about 36% until 2011, but increased to about 48% after 2013. From 2006 to 2011, there were 15 cases of missed diagnosis of odontogenic sinusitis, but there was 1 case in 2012 and no cases since 2013. The treatment outcome of unilateral bacterial sinusitis was significantly increased from 84.1% before 2011 to 96% after 2012. The success rate was 97.1% in the case of accurate diagnosis of odontogenic sinusitis, but the success rate was 43.8% in case of missed diagnosis. In odontogenic sinusitis, the success rate was low when dental treatment was not performed. However, there was no difference in success rate among different dental treatment timings.@*CONCLUSION@#The incidence of odontogenic sinusitis has steadily increased over the last decade. The prognosis has been improved by appropriate treatment under accurate diagnosis through preoperative examination and radiological evaluation. There was no difference in the prognosis of odontogenic sinusitis according to the dental treatment time. Therefore, it is a good choice for tooth preservation to have an endoscopic sinus surgery first and then decide the dental treatment timing.

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