Level of sex hormones and their association with acetylsalicylic acid intolerance and nasal polyposis.

BACKGROUND: Chronic rhinosinusitis may be associated with nasal polyposis. Recurrence of disease is often observed and may be due to an intolerance of acetylsalicylic acid. Sex hormones are known to modulate allergic reactions and inflammation. Whether they may be involved in the development and progression of nasal polyposis has not been investigated yet. AIM: Examine the relationship between levels of sex hormones and nasal polyposis. METHODS: Hormonal levels (estradiol, testosterone and progesterone) in patients with nasal polyposis (n = 26) with or without acetylsalicylic acid-intolerance were determined and compared to hormonal levels in patients with septal deviation (n = 35). Cone-beam computed tomography scans were analysed by using scores as defined by Lund and Mackay and by Kennedy. RESULTS: Our results show a 5 times greater odds (p = 0.01) for developing nasal polyposis in the presence of lowered estradiol plasma levels than in the presence of normal / elevated levels. When analyzing females and males separately, a 6 times greater odds for females to develop nasal polyposis in the presence of lowered estradiol plasma levels was calculated (p = 0.02). Thus, females are more likely to develop nasal polyposis when they have lowered estradiol levels than males. In addition, female patients showed an increased risk for developing ASA intolerance (p = 0.01). CONCLUSION: Variation of sex hormones may be involved in nasal polyposis. Further studies including more patients to validate the presented results are required. SIGNIFICANCE: Retrospective clinical investigation suggesting a correlation between varying sex hormones and nasal polyposis.

Computed Tomography Versus Dacryocystography for the Evaluation of the Nasolacrimal Duct-A Study With 72 Patients.

OBJECTIVES: In patients with epiphora, imaging of the nasolacrimal duct is essential not only for differential diagnosis, but also for preoperative planning. Advances in imaging technology and introduction of cone beam computed tomography (CB-CT) enable the combination of contrast agent-based imaging with a three dimensional tomography with low radiation exposure. However, the value of CT/CB-CT as an alternative to conventional dynamic dacryocystography (DCG) has not been evaluated yet. STUDY DESIGN: Retrospective study. METHODS: Conventional DCG was performed preoperatively in 72 consecutive patients treated for epiphora between 01/2013 and 04/2015 in our department. CB-CT or conventional CT was performed afterward with the contrast media still in place. Three separate experts (two radiologists and one otorhinolaryngologist) analyzed the radiographic images without any information about the respective clinical or surgical findings. The presence of further findings in the CT/CB-CT (eg, septal deviation, sinusitis) that were not detected in DCG and the overall visibility of the lacrimal duct system in both modalities were evaluated. RESULTS: Good delineations of bone, soft tissue, and contrast agent in the lacrimal system were achieved with both methods. No side effects were noted. Beside the pathology of the lacrimal duct, CT/CB-CT scans enabled the additional diagnosis of pathologies in the nose and the sinus system in 65.7% of the patients. Accordance in the identified level of obstruction between the two modalities was achieved in 71.4% of the patients. CONCLUSION: Thus, CT/CB-CT should be used in conjunction with contrast agent to reliably identify the level of obstruction as preoperative standard and can be used as diagnostic tool in addition to or even instead of conventional DCG. LEVEL OF EVIDENCE: 4.

[The novel Propel mini stent - Indications, surgical technique and first clinical experience]. / Der neuartige Propel mini Stent ­ Indikationen, Operationstechnik und erste klinische Erfahrungen.

OBJECTIVE: The treatment of chronic frontal sinusitis is often problematic due to the anatomically narrow drainage into the nasal cavity. In addition to conservative methods, many surgical therapy procedures have been analysed, with and without the use of placeholders, but without long term therapeutic success. The aim of this work was the clinical testing of the practicability and the short- and long-term therapeutic success of the novel bioresorbable Propel mini stent. MATERIALS UND METHODS: In a prospective study on 21 patients with chronic rhinosinusitis and polyposis nasi, the surgical therapy and stent implantation during functional endoscopic surgery (FESS) were examined and the degradation of a total of 31 stents and the success of this therapy were endoscopically controlled and analysed over a period of 6 months. RESULTS: With regard to surgical practicability, the stent with insertion tool proved to be an uncomplicated and easy-to-use system. All stents were well tolerated by the patients. The average detectable absorption of the material lasted for 28 days. The patient collective showed a fully explorable neo-ostium of the frontal sinus in 94 % of cases after 3 months and in 87 % of cases after 6 months. CONCLUSION: Overall, the results of the prospective study show a good acceptance by the patients without complications as well as complete stent degradation. The follow-up examinations also showed satisfactory results over 6 months. Especially in terms of FESS, the stent system proved to be very practical.

Concurrent hyperbaric oxygen therapy and intratympanic steroid application as salvage therapy after severe sudden sensorineural hearing loss.

Concurrent hyperbaric oxygen therapy (HBOT) and intratympanic steroid application (ITS) are beneficial as salvage therapy for therapy-refractory sudden sensorineural hearing loss (SSNHL). The findings encourage further research on the treatment of noise-induced and idiopathic SSNHL with concurrent use of HBOT and ITS respecting also patients with long-term or therapy-refractory SSNHL.

Magnetic Beads Enhance Adhesion of NIH 3T3 Fibroblasts: A Proof-of-Principle In Vitro Study for Implant-Mediated Long-Term Drug Delivery to the Inner Ear.

INTRODUCTION: Long-term drug delivery to the inner ear may be achieved by functionalizing cochlear implant (CI) electrodes with cells providing neuroprotective factors. However, effective strategies in order to coat implant surfaces with cells need to be developed. Our vision is to make benefit of electromagnetic field attracting forces generated by CI electrodes to bind BDNF-secreting cells that are labelled with magnetic beads (MB) onto the electrode surfaces. Thus, the effect of MB-labelling on cell viability and BDNF production were investigated. MATERIALS AND METHODS: Murine NIH 3T3 fibroblasts-genetically modified to produce BDNF-were labelled with MB. RESULTS: Atomic force and bright field microscopy illustrated the internalization of MB by fibroblasts after 24 h of cultivation. Labelling cells with MB did not expose cytotoxic effects on fibroblasts and allowed adhesion on magnetic surfaces with sufficient BDNF release. DISCUSSION: Our data demonstrate a novel approach for mediating enhanced long-term adhesion of BDNF-secreting fibroblasts on model electrode surfaces for cell-based drug delivery applications in vitro and in vivo. This therapeutic strategy, once transferred to cells suitable for clinical application, may allow the biological modifications of CI surfaces with cells releasing neurotrophic or other factors of interest.