Correlation between Nasal Obstruction Symptoms and Objective Parameters of Peak Nasal Inspiratory Flow Metry and Acoustic Rhinometry

BACKGROUND AND OBJECTIVES: Measurement of the peak nasal inspiratory flow rate (PNIFR) is a useful technique for obtaining a quick measure of nasal obstruction and changes in PNIFR, reflecting changes in symptoms. The aim of the present study was to correlate changes in nasal obstruction symptoms with changes in several parameters of acoustic rhinometry (AR) and peak nasal inspiratory flow metry (PNIFM) before and after decongestion and to examine whether changes in PNIFR correlate with changes in nasal cross-sectional areas and volume. MATERIALS AND METHODS: The subjects of the current study were 30 patients with nasal obstruction symptoms and 20 normal subjects. Subjective nasal patency was assessed by visual analogue scale (VAS). We measured PNIFR and minimal cross-sectional area (MCA), cross-sectional area at distances of 3.3 (CA3.3), 4.0 (CA4.0), and 6.4 (CA6.4) cm from the nostril and volume from the nostril 6.4 cm (V6.4) towards the choanae, in each nasal cavity before and after decongestion. RESULTS: The VAS had no significant correlation with PNIFR, each cross-sectional area and volume in bilateral nasal cavities before decongestion. There was a significant correlation between the changes in VAS and PNIFR and MCA before and after decongestion. There was a significant correlation between changes in PNIFR and MCA and CA3.3 in one side and both sides of nasal cavity before and after decongestion. CONCLUSIONS: These results suggest that PNIFM and AR may have no sensitive diagnostic values in estimating the severity of nasal obstruction symptoms in the nondecongested state of the bilateral nasal cavities, but PNIFM and AR can be recommended especially in provocation studies because PNIFR and MCA reflect changes in subjective symptoms by mucosal changes.

Correlation between Nasal Obstruction Symptoms and Objective Parameters of Peak Nasal Inspiratory Flow Metry and Acoustic Rhinometry

BACKGROUND AND OBJECTIVES: Measurement of the peak nasal inspiratory flow rate (PNIFR) is a useful technique for obtaining a quick measure of nasal obstruction and changes in PNIFR, reflecting changes in symptoms. The aim of the present study was to correlate changes in nasal obstruction symptoms with changes in several parameters of acoustic rhinometry (AR) and peak nasal inspiratory flow metry (PNIFM) before and after decongestion and to examine whether changes in PNIFR correlate with changes in nasal cross-sectional areas and volume. MATERIALS AND METHODS: The subjects of the current study were 30 patients with nasal obstruction symptoms and 20 normal subjects. Subjective nasal patency was assessed by visual analogue scale (VAS). We measured PNIFR and minimal cross-sectional area (MCA), cross-sectional area at distances of 3.3 (CA3.3), 4.0 (CA4.0), and 6.4 (CA6.4) cm from the nostril and volume from the nostril 6.4 cm (V6.4) towards the choanae, in each nasal cavity before and after decongestion. RESULTS: The VAS had no significant correlation with PNIFR, each cross-sectional area and volume in bilateral nasal cavities before decongestion. There was a significant correlation between the changes in VAS and PNIFR and MCA before and after decongestion. There was a significant correlation between changes in PNIFR and MCA and CA3.3 in one side and both sides of nasal cavity before and after decongestion. CONCLUSIONS: These results suggest that PNIFM and AR may have no sensitive diagnostic values in estimating the severity of nasal obstruction symptoms in the nondecongested state of the bilateral nasal cavities, but PNIFM and AR can be recommended especially in provocation studies because PNIFR and MCA reflect changes in subjective symptoms by mucosal changes.

Expression of Glucocorticoid Receptor in Nasal Polyps and Nasal Mucosa / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Glucocorticoids are currently the most potent medication available for the treatment of nasal polyposis and allergic rhinitis, but exact mechanisms and cellular targets in the nasal mucosa are uncertain. Multifactorial effects of glucocorticoid are initiated by their binding to a specific cytoplasmic glucocorticoid receptor (GR). We performed this study to investigate the localization and distribution ot' human 4R and GR j3 isoform in nasal mucosa and to examine the influence of allergy and eosinophilic infiltration on GR and GR betaisoform expression in nasal polyps. MATERIALS AND METHODS: Nasal polyps (NP), middle turbinate mucosa (MT) and inferior turbinate (IT) mucosa were taken from 40 patients with chronic sinusitis and nasal polyps. We examined to have concomitant allergic rhinitis. Specimens were stained to quantify eosinophils and immunohistochemically stained to quantify GR and GR beta isaform in the unit area of tissues. RESULTS: Immunostaining of GR and GR betaisoform was predominantly localized in epithelial cell and infiltrating inflammatory cell in subepithelial layer, with lesser amounts in the endothelial cells and in the cells surrounding glands. Immunostaining of GR was mostly co-expressed with GR beta isoform. No correlation was found between Gk and GR beta isoform expression in subepithelial layer and the intensity of eosinophilic inflammation and allergy in NP. There was no significant differences in GR and GR beta isoform expression between NP, MT, and IT. CONCLUSION: Epithelial cells may be an important site of action for intranasal steroids, and the increased number of eosinophils infiltrating the mucosa and allergy did not amplify the number of immunostaining of GK and GR beta isoform.

Detection of Human Papillomavirus and Epstein-Barr Virus in Sinonasal Inverted Papillomas and Its Correlation with p53 and Proliferating Cell Nuclear Antigen Expression / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Sinonasal inverted papillomas are benign but topographically aggressive neoplasms that have a high recurrence rate and seem to be associated with malignancy. The etiology of inverted papilloma remains unknown, but some hypotheses suggest that nasal polyps proliferation and chronic inflammation are due to allergy or various infectious lesions. This study was to elucidate the biological characteristics and the role of human papillomavirus (HPV) and Ebstein -Barr virus (EBV) and the expression of p53 protein and proliferating cell nuclear antigen (PCNA) in sinonasal inverted papillomas. MATERIALS AND METHODS: We examined 26 specimens from 26 individuals with normal nasal mucosae (n=10) and inverted papillomas (n=16) to determine the occurance of HPV and EBV infection and the expression of p53 protein and PCNA. RESULTS: Of the 16 Inverted papillomas, HPV DNA was detected in eight cases, HPV 18 was detected in two cases (18%), HPV 16 and HPV 33 were both found in every case (6%), HPV 6 and HPV 16 were coinfected in one case (6%), and other types were found in 3 cases. HPV DNA was not detected in the normal nasal mucosae. EBV DNA was detected in 10 cases (62%) out of 16 inverted papillomas ancl in two cases (20%) of 10 normal nasal mocosae. The altered p53 protein expression was observed in four cases (25%), and positive PCNA staining was detected in four cases (25%) out of 16 inverted papillomas. One positive PCNA staining was detected among 10 normal mucosae. The mean PC10 index was 16.0% in the inverted papillomas group and 4.1% in normal nasal mucosae group. CONCLUSION: An inverse correlation may exist between oncogenic HPV infection and p53 alteration in sinonasa1 inverted papillomas.