ABSTRACT
OBJECTIVES: Mucociliary clearance is an important defense mechanism for upper and lower airway. Chronic rhinosinusitis has been frequently associated with mucociliary dysfunction. Endoscopic sinus surgery (ESS) is recommended for treatment-resistant sinusitis in order to improve mucociliary function. The present study investigated the effect of ESS on the saccharin time (mucociliary clearance time) in relation to symptom profile assessed by the Sino-nasal Outcome Test (SNOT)-22, and disease severity based on the Lund-Kennedy endoscopic scores and Lund-Mackay computed tomographic (CT) scores. METHOD: The present cohort study included 22 patients with chronic rhinosinusitis who were considered a candidate for ESS due to lack of response to medical treatment. Saccharin test was used before and 3â¯months after ESS to evaluate changes in mucociliary function. The CT scan was used for preoperative assessment of sinonasal anatomy. In addition, diagnostic nasal endoscopy was performed before and 3â¯months after ESS. The CT scan and nasal endoscopy findings were respectively analyzed based on the Lund-Mackay and the Lund-Kennedy staging systems recommended for chronic rhinosinusitis. Symptom severity was assessed from before to 3â¯months after ESS using SNOT-22. RESULTS: The present study showed decreased saccharin time in patients with chronic rhinosinusitis three months after ESS. The mean pre-operative and post-operative saccharin time were 23.4 and 16.9â¯min, respectively. There was also a trend toward significance for the effect of changes in the SNOT-22 scores on changes in saccharin time. By contrast, no effects of age, gender, pre-operative Lund-Mackay CT scores, and changes in Lund-Kennedy endoscopy scores were observed on post-ESS saccharin time. CONCLUSION: The study confirms that ESS in patients with treatment-resistant chronic rhinosinusitis confers improvement in performance on the saccharin test of mucociliary function.
Subject(s)
Endoscopy , Mucociliary Clearance/physiology , Rhinitis/physiopathology , Rhinitis/surgery , Sinusitis/physiopathology , Sinusitis/surgery , Adolescent , Adult , Aged , Chronic Disease , Cohort Studies , Female , Humans , Male , Middle Aged , Rhinitis/complications , Sinusitis/complications , Symptom Assessment , Treatment Outcome , Young AdultABSTRACT
Chronic rhinosinusitis is a common disease which causes persisting inflammatory conditions of one or more sinuses. This study was designed to evaluate the effect of thyme honey nasal spray as an adjunctive medication on chronic rhinosinusitis after functional endoscopic sinus surgery. This was a randomized, placebo controlled, double-blind clinical study. 64 patients with chronic rhinosinusitis undergoing functional endoscopic sinus surgery were enrolled in this study. Patients were randomized and blinded to receive either placebo or thyme honey nasal spray in addition to the standard regimen postoperatively. Patients were visited on postoperative days 7, 30 and 60. The sino-nasal outcome test, endoscopic grading system and sinus CT-scan were scored before operation and on the day 60 after surgery. 54 patients completed the study. Significant improvement was observed in both treatment groups. There were no significant changes in SNOT-22, endoscopy and CT-scan scores between the two study groups. However, a greater reduction in endoscopic scores was shown in thyme honey group. The incidence of adverse effects was not significantly different between the groups, but synechiae formation and epistaxis were lower in treatment group. Thyme honey nasal spray seems to be a low-priced potential adjuvant remedy with excellent safety profile, to reduce inflammation and polyp formation and also fostering mucosal healing for patients suffering from chronic rhinosinusitis. However, further studies are recommended.
Subject(s)
Epistaxis , Honey , Nasal Sprays , Natural Orifice Endoscopic Surgery/adverse effects , Phytotherapy/methods , Postoperative Complications/drug therapy , Rhinitis/drug therapy , Sinusitis/drug therapy , Thymus Plant , Adult , Chronic Disease , Colonography, Computed Tomographic/methods , Double-Blind Method , Epistaxis/drug therapy , Epistaxis/etiology , Female , Humans , Male , Middle Aged , Natural Orifice Endoscopic Surgery/methods , Postoperative Period , Rhinitis/diagnosis , Rhinitis/physiopathology , Sinusitis/diagnosis , Sinusitis/physiopathology , Sinusitis/surgery , Treatment OutcomeABSTRACT
INTRODUCTION: Amyloidosis comprises a heterogeneous group of disorders characterized by the deposition of amyloid protein in various organs of the body. The larynx is one of the rarer sites where amyloidosis occurs. CASE REPORT: A 36-year-old man presented with a two-year history of hoarseness of voice. He had a positive history of smoking, but no history of long-term consumption of alcohol. Physical examination revealed a pinkish mass about 1.5× 1.5 cm in size on his left False Vocal Cord (FVC) extending to the left arytenoid, which resulted in asymmetry of the posterior larynx. He also had a chronic perforation of the right tympanic membrane with a conductive hearing loss consisting of a 50 dB gap in pure tune audiometry. The FVC mass was excised with a CO2 laser and on follow-up his voice got much better, but the hoarseness was not fully resolved. CONCLUSION: Amyloidosis of the larynx is a rare, usually benign process but the area is the most common site for isolated amyloid deposits to occur in the head and neck.
