ABSTRACT
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Subject(s)
Humans , Female , Middle Aged , Carcinoma, Neuroendocrine/diagnosis , Carcinoma, Neuroendocrine/radiotherapy , Carcinoma, Neuroendocrine/surgery , Tongue Neoplasms/diagnosis , Tongue Neoplasms/radiotherapy , Tongue Neoplasms/surgery , Oropharyngeal Neoplasms/diagnosis , Tomography, X-Ray Computed , Drug Therapy/methods , Radiotherapy/methodsABSTRACT
Objetivo: Evaluar el efecto de la presión positiva continua en la vía aérea (CPAP) sobre las fosas nasales de pacientes con síndrome de apnea hipopnea del sueño y su impacto en la calidad de vida, e identificar factores predictivos de cumplimiento. Métodos: Estudio prospectivo longitudinal. Treinta y seis pacientes consecutivos evaluados antes y 2 meses tras CPAP usando las siguientes variables clínicas (síntomas otorrinolaringológicos, test de Epworth, escala de ansiedad/depresión, calidad de vida general y específica para rinoconjuntivitis); anatómicas (exploración otorrinolaringológica, tomografía computarizada); funcionales (función auditiva y tubárica, flujo nasal, transporte mucociliar); biológicas (citología nasal), y polisomnográficas. Se dividió la muestra entre cumplidores (≥4 h/d) y no cumplidores (<4 h/d). Resultados: Se objetivó una mejoría significativa en la somnolencia diurna (p = 0,000), la ansiedad (p = 0,006) y la depresión (p = 0,023). Se evidenció sequedad nasal (p = 0,000), aumento de neutrófilos en la citología nasal (p = 0,000) y deterioro de la función ciliar, especialmente en cumplidores. No se evidenciaron diferencias significativas en el resto de las variables. La somnolencia inicial fue el único factor pronóstico de cumplimiento. Conclusiones: El tratamiento con CPAP en pacientes sin patología nasal previa mejora una serie de parámetros clínicos y provoca rinitis y sequedad en la vía aérea. Algunas de las variables otorrinolaringológicas empeoran en los cumplidores. La somnolencia fue el único factor pronóstico de mala tolerancia
Objective: To evaluate the effect of continuous positive airway pressure (CPAP) on the nostrils of patients with sleep apnea-hypopnea syndrome and its impact on quality of life, and to identify predictive factors for compliance. Methods: Longitudinal prospective study. Thirty-six consecutive patients evaluated before and 2 months after CPAP using the following variables: clinical (eye, nose and throat [ENT] symptoms, Epworth test, anxiety/depression scales, general and rhinoconjunctivitis-specific quality of life); anatomical (ENT examination, computed tomography); functional (auditive and Eustachian tube function, nasal flow, mucociliary transport); biological (nasal cytology); and polisomnographics. The sample was divided into compliers (≥4 h/d) and non-compliers (<4 h/d). Results: A significant improvement was observed in daytime sleepiness (p = 0.000), anxiety (P = .006), and depression (P = .023). Nasal dryness (P = .000), increased neutrophils in nasal cytology (P = .000), and deteriorating ciliary function were evidenced, particularly in compliers. No significant differences were observed in the other variables. Baseline sleepiness was the only factor predictive of compliance. Conclusions: CPAP in patients without previous nasal pathology leads to an improvement in a series of clinical parameters and causes rhinitis and airway dryness. Some ENT variables worsened in compliers. Sleepiness was the only prognostic factor for poor tolerance
Subject(s)
Humans , Male , Female , Aged , Middle Aged , Continuous Positive Airway Pressure/adverse effects , Continuous Positive Airway Pressure/psychology , Nasal Mucosa/pathology , Sleep Apnea Syndromes/therapy , Patient Compliance , Acoustic Impedance Tests , Anxiety , Quality of Life , Audiometry, Pure-Tone , Depression/etiology , Fatigue/etiology , Mucociliary Clearance , Polysomnography , Rhinitis/etiology , Risk Factors , Prospective StudiesABSTRACT
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Subject(s)
Humans , Male , Aged , Laryngeal Neoplasms/radiotherapy , Laryngeal Neoplasms/surgery , Laryngeal Neoplasms , Adenocarcinoma/complications , Adenocarcinoma/radiotherapy , Cystoscopy/methods , Neoplasm Metastasis/pathology , Neoplasm Metastasis , Epiglottis/pathology , Epiglottis/surgery , Immunohistochemistry/methods , Immunohistochemistry , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: To evaluate the effect of continuous positive airway pressure (CPAP) on the nostrils of patients with sleep apnea-hypopnea syndrome and its impact on quality of life, and to identify predictive factors for compliance. METHODS: Longitudinal prospective study. Thirty-six consecutive patients evaluated before and 2 months after CPAP using the following variables: clinical (eye, nose and throat [ENT] symptoms, Epworth test, anxiety/depression scales, general and rhinoconjunctivitis-specific quality of life); anatomical (ENT examination, computed tomography); functional (auditive and Eustachian tube function, nasal flow, mucociliary transport); biological (nasal cytology); and polisomnographics. The sample was divided into compliers (≥4h/d) and non-compliers (<4h/d). RESULTS: A significant improvement was observed in daytime sleepiness (p=0.000), anxiety (P=.006), and depression (P=.023). Nasal dryness (P=.000), increased neutrophils in nasal cytology (P=.000), and deteriorating ciliary function were evidenced, particularly in compliers. No significant differences were observed in the other variables. Baseline sleepiness was the only factor predictive of compliance. CONCLUSIONS: CPAP in patients without previous nasal pathology leads to an improvement in a series of clinical parameters and causes rhinitis and airway dryness. Some ENT variables worsened in compliers. Sleepiness was the only prognostic factor for poor tolerance.
Subject(s)
Continuous Positive Airway Pressure , Nasal Mucosa , Patient Compliance , Sleep Apnea Syndromes/therapy , Acoustic Impedance Tests , Aged , Anxiety/etiology , Audiometry, Pure-Tone , Continuous Positive Airway Pressure/adverse effects , Continuous Positive Airway Pressure/psychology , Depression/etiology , Fatigue/etiology , Female , Humans , Male , Middle Aged , Mucociliary Clearance , Nasal Mucosa/pathology , Polysomnography , Prospective Studies , Quality of Life , Rhinitis/etiology , Risk Factors , Sleep Apnea Syndromes/complicationsSubject(s)
Carcinoma, Small Cell/diagnosis , Tongue Neoplasms/diagnosis , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Small Cell/drug therapy , Carcinoma, Small Cell/radiotherapy , Carcinoma, Small Cell/secondary , Cisplatin/administration & dosage , Combined Modality Therapy , Epiglottis/pathology , Etoposide/administration & dosage , Fatal Outcome , Female , Humans , Lymphatic Metastasis , Middle Aged , Neoplasm Invasiveness , Radiotherapy, Intensity-Modulated , Smoking/adverse effects , Tongue Neoplasms/drug therapy , Tongue Neoplasms/pathology , Tongue Neoplasms/radiotherapySubject(s)
Adenocarcinoma/secondary , Epiglottis/pathology , Laryngeal Neoplasms/pathology , Penile Neoplasms/secondary , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Adenocarcinoma/diagnostic imaging , Biopsy , Diagnosis, Differential , Epiglottis/diagnostic imaging , Fatal Outcome , Humans , Laryngeal Neoplasms/diagnostic imaging , Lymphatic Metastasis , Male , Middle Aged , Penile Diseases/diagnosis , Penile Neoplasms/complications , Priapism/etiology , Smoking/adverse effects , Urinary Tract Infections/diagnosis , Urination Disorders/etiologyABSTRACT
BACKGROUND: Rhinitis is a potential side effect of nasal continuous positive airway pressure (nCPAP). Heated Humidification (HH) is applied to treat rhinitic symptoms, but its usefulness is controversial. Confounding factors such as previous rhinitis or nasal obstruction make it difficult to draw definitive conclusions. Animal models could therefore be useful. OBJECTIVES: To study the effects of HH as a mechanism that may reduce nasal inflammation during nCPAP application in the presence or absence of an oral leak (OL). METHODS: Prospective controlled animal study. Setting I: Sixty Sprague-Dawley rats were distributed into noCPAP (naïve), sham-CPAP with HH, 5 and 10cm H(2)O nCPAP, and 10cm H(2)O nCPAP with HH for 5h. Setting II: Thirty-three rats were exposed to nCPAP, nCPAP with a controlled OL, and nCPAP with controlled OL and HH (n=11 each). The degree of nasal inflammation was assessed by directly evaluating the percentage of neutrophils in the nasal mucosa. RESULTS: Percentage of neutrophils was higher after 5h of 10cm nCPAP compared to the control group (0.96+/-0.26% vs. 0.18+/-0.05%; p=0.001). When HH was applied, the percentage of neutrophils did not differ from that observed in the nCPAP group. The addition of a controlled OL, did not show significant differences in the neutrophils count compared to nCPAP alone (0.75+/-0.19% vs. 0.83+/-0.29%; p=0.70). Moreover, the application of HH to the rat with OL did not change the percentage of neutrophils. CONCLUSIONS: HH applied to an acute rat model of nCPAP with and without a controlled OL does not seem to reduce nasal inflammation.
