Long-Term Outcomes of Transnasal Endoscopic Marsupialization through Middle, Inferior Meatal Antrostomy or Extended Middle Meatal Antrostomy in Maxillary Sinus Mucoceles

Backgroud and Objectives: There are few reports about long-term outcomes of transnasal endoscopic marsupialization of isolated maxillary sinus mucocele. The approach routes of endoscopic marsupialization in those papers were mainly through middle meatal antrostomy. However, it is difficult or impossible to treat maxillary sinus mucocele by transnasal endoscopic middle meatal antrostomy in some cases. The aim of this study was to investigate long-term outcomes of transnasal endoscopic marsupialization according to three different approach routes. Materials and Methods: We reviewed 20 consecutive patients underwent transnasal endoscopic marsupialization and followed up for at least 66 months, retrospectively. Ten patients were treated by transnasal endoscopic middle meatal antrostomy with marsupialization, four by inferior meatal antrostomy and six by extended middle meatal antrostomy. RESULTS: No evidence of recurrence and major complications were observed during follow-up periods ranging from 66 to 102 months (mean, 80 months) according to three different approach routes. CONCLUSION: Transnasal endoscopic marsupialization with the appropriate antrostomy route according to the location and bulging direction of maxillary sinus mucoceles is considered to be an effective therapeutic method with favorable long-term outcomes

Effect of Macrolides on the Interleukin-1beta-mediated MUC2/5AC Genes Expression and Mucin Secretion in Human Airway Epithelial Cells

BACKGROUND AND OBJECTIVES: Macrolide is a relatively effective drug in chronic bronchiolitis and chronic sinusitis with mucous hypersecretion. However, the anti-secretory effect of macrolide is not clear. The aim of this study was to evaluate the effect of macrolide on the interleukin -1beta (IL-1beta)-induced MUC2/5AC genes expression and mucin secretion. Matrials and Methods: We observed effects of roxithromycin and clarithromycin on the IL-1beta-induced MUC2/5AC genes expression and mucin secretion in cultured human airway NCI-H292 epithelial cells. The steady state mRNA levels of MUC2/5AC and mucin secretion were determined by reverse transcriptase-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay. RESULTS: Roxithromycin attenuated the IL-1beta-mediated MUC2/5AC genes expression and mucin secretion. When roxithromycin treated before exposure to IL-1beta and after exposure to IL-1beta in cultured cells, both treatment methods inhibited the IL-1beta-induced MUC2/5AC genes expression and mucin secretion. However, clarithromycin did not suppress the IL-1beta-mediated MUC2/5AC genes expression and mucin secretion. CONCLUSION: This result suggests that roxithromycin inhibits the IL-1beta-mediated mucin secretion through inhibition of MUC2/5AC genes expression.

Budesonide Down-regulates IL-1beta-Mediated MUC2/MUC5AC Genes Expression and Mucin Secretion in Human Airway Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mucus hypersecretion is a hallmark of many respiratory inflammatory diseases such as asthma, bronchitis and sinusitis. While the current therapeutic pharmacological approaches to reducing mucus hypersecretion are limited, clinical studies have suggested that glucocorticoids reduce mucus secretion in patients with airway disease. However, the effect of glucocorticoids on mucus hypersecretion is not clear. Recently, we observed that IL-1beta induces MUC2 gene expression and mucin secretion in a previous experiment. This study was designed to investigate the effects of budesonide on the IL-1beta-mediated MUC2/5AC genes expression and mucin secretion. MATERIALS AND METHOD: We observed the steady state mRNA level of MUC2/5AC genes using RT-PCR and mucin protein using immunoassay method in cultured human airway NCI-H292 epithelial cells. RESULTS: Budesonide attenuated IL-1beta-mediated MUC2/5AC gene expression as well as mucin secretion. The attenuated effect of budesonide was in a dose-dependent pattern. This attenuated effect of budesonide was blocked by glucocorticoid receptor antagonist, RU-486. CONCLUSION: This result suggests that budesonide suppresses the IL-1beta-mediated MUC2/5AC genes expression and mucin secretion via blockage of glucocorticoid receptor.

Regulation of IL-1beta-Mediated MUC2 Gene and Mucin in Human Airway Epithelial Cells / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Mucin secretion is regulated by the mucin genes (MUC) in the respiratory, gastrointestinal and reproductive system. Inflammation induces mucin hypersecretion in the human body. This study demonstrates the effects of IL-1beta on the regulation of mucin protein expression as well as the MUC2 gene in cultured airway epithelial cells. MATERIALS AND METHOD: Analysis of MUC2 gene was done by RT-PCR and the protein analysis was done by a flow cytometric analysis and an immunoassay method using cultured human airway epithelial cells, and NCI-H292 cells. RESULTS: The expression of MUC2 mRNA and protein induced by IL-1beta increased in a dose-and time-dependent manner. The maximum mRNA level of the MUC2 gene was approximately 3-fold, compared to that of the control cell. The IL-1beta-mediated MUC2 protein started at 6 hours of exposure to IL-1beta (20 ng/ml) and the maximum level was 12 hours. The MUC2 protein data of flow cytometric analysis corresponded to that of immunoassay analysis. The expression of MUC2 gene was suppressed by actinomycin D, but not attenuated by cycloheximide. CONCLUSION: These results suggest that the IL-1beta-mediated MUC2 gene and protein expression were increased in a dose- and time-dependent pattern and regulated by transcriptional step.

Transnasal Marsupialization of Large Infected Radicular Cyst in Immunocompromised Patients: Case Report / 대한이비인후과학회지

Radicular cyst is the most common inflammatory odontogenic abnormality which is associated with the crown of unerupted or developing maxillary and/or mandibular teeth. There have been many reported cases where radicular cysts were removed by means of enucleation through Caldwell-Luc's approach. However, there has been only a few reports about marsupialization of radicular cyst. In patients, who are old, aged and immunocompromised are intolerable to complete enucleation and are prone to pathologic fractures and postoperative complications, marsupialization is the only alternative method. For the first time in Korea, we encountered a 64-year old immunocompromised female patient with a large infected radicular cyst which was managed by marsupialization with wide inferior meatal antrostomy under transnasal endoscope and obtained successful results.