The contribution of erectile elements to nasal patency: an examination with nasal sound analysis.

BACKGROUND: The objective of this work was to determine the role of nasal sound analysis using a software called Odiosoft-Rhino (OR) in evaluation of nasal erectile elements as a cause of nasal obstruction. Comparisons of nasal resistance, amplitude of the nasal sound frequency spectra, and visual analogue score (VAS) were made. METHODS: Nasal endoscopy, VAS, rhinomanometry (RMM), and OR were performed on 64 patients with inferior turbinate hypertrophy but without any other nasal problems, both untreated and 15 minutes after the application of topical decongestants (TDs). Results were compared and any correlation was investigated. RESULTS: For inspiration, the OR intervals for both sides at all 5 frequency intervals changes significantly with decongestion, except for the left side at 0.5 to 1 kHz. For expiration, the OR intervals for both sides changed significantly for 0.2 to 0.5 KHz and 2 to 4 kHz, but not for the other 3 frequency intervals. VAS correlated well with physical examination, both inspiratory and expiratory RMM, and 2 to 4 kHz inspiratory and expiratory nasal sound on both sides both before and after TD application. The 2 to 4 kHz inspiratory and expiratory nasal sound on both sides correlated well with inspiratory and expiratory RMM on both sides both before and after TD application. CONCLUSION: OR is an efficient and reliable method to evaluate the role of the erectile components in nasal patency in the absence of allergy or septal deviation. It is practical and may be used in routine clinical practice.

Comparison of Odiosoft-Rhino and rhinomanometry in evaluation of nasal patency.

OBJECTIVE: To conduct a preliminary study testing the validity of the Odiosoft-Rhino (OR) in the evaluation of nasal patency in patients with nasal septal deviation and compare the results with visual analogue score (VAS) of nasal obstruction and rhinomanometry (RMM). METHODS: OR and RMM were performed on 68 patients with nasal septal deviation and 61 healthy controls. VAS, nasal resistance values and nasal sound analysis were noted for the left and right nasal cavities. RESULTS: There are statistically significant differences between VAS, RMM and nasal endoscopic findings between the patient and the control group. The OR results at expiratory and inspiratory 2000 - 4000 Hz and 4000 - 6000 Hz intervals for both nasal cavities show a statistically significant difference between the patient and control groups. Nasal endoscopic findings, RMM, OR results of the deviated sides in the 2000 - 4000 Hz interval correlate well with VAS. CONCLUSIONS: OR may be a practical test in assessment of nasal patency. OR at the 2000 - 4000 Hz interval shows a correlation with VAS. However, showing a correlation between a test and a variable is not the same as proving that it is a useful diagnostic test. Therefore, more studies with larger series are needed.

Lack of Chlamydophila pneumoniae and predominance of Alloiococcus otitidis in middle ear fluids of children with otitis media with effusion.

OBJECTIVE: To investigate the presence of Chlamydophila pneumoniae and other bacterial pathogens in middle ear effusion samples obtained from children with otitis media with effusion (OME). MATERIALS AND METHODS: Twenty-eight children (mean age 7.03; standard deviation 2.18) with OME unresponsive to medical therapy were included in the study. All of the children underwent ventilation tube insertion under general anesthesia. Eighteen patients were bilaterally affected whereas 10 children had unilateral disease. The middle ear fluids (46 samples in total) were collected during ventilation tube insertion, and were evaluated subsequently for the presence of C. pneumoniae and other bacterial pathogens using polymerase chain reaction (PCR). RESULTS: Although all samples were negative for C. pneumoniae, bacterial DNA was detected in 21 of 46 samples. Overall 40% of the patients (4/10) with unilateral involvement, and 61% of the patients (11/18) with bilateral involvement were positive for bacterial DNA. In 6 patients with bilateral OME bilateral samples were positive, whereas 5 patients with bilateral OME showed only unilateral positivity. According to the results of DNA sequencing analysis, all of the positive samples harbored only one bacterial species. In 12 of 46 samples Alloiococcus otitidis DNA (26%), in 7 Haemophilus influenzae DNA (15%), in one Streptococcus pneumoniae DNA (2%) and in one Moraxella catarrhalis DNA (2%) were present. CONCLUSIONS: Our findings support that C. pneumoniae does not seem to have a role in OME in children whereas A. otitidis was found to be more frequent than the other common pathogens. Further studies are required to elucidate the exact pathogenetic role of these microorganisms in OME.

Evaluation of nasal cytology in subjects with chronic rhinitis: a 7-year study.

BACKGROUND: No diagnostic test had been specifically developed to diagnose nonallergic rhinitis (NAR). Also a negative nasal smear for eosinophils does not rule out the diagnosis. There is a significant diagnostic problem in patients with NAR. How can we solve this problem? OBJECTIVES: Assessment of other cells than eosinophils present in the cytogram such as basophils, neutrophils, and goblet cells may help us to classify and management of diagnostic problem of rhinitis. We sought to characterize the cellular pattern of patients with allergic rhinitis (AR) and compare them with those of NAR. METHODS: According to the skin prick test positivity or negativity, individuals were divided into AR and NAR groups, respectively. Allergic rhinitis group was further divided into seasonal, perennial, and mixed subgroups. Nonallergic rhinitis group was also divided into the following 5 subgroups according to the nasal smear cytologic result: basophilic, neutrophilic, eosinophilic, mixed, and nonallergic noninfectious type. So the frequency rates of the subgroups were calculated and also smear cytologic results were compared. RESULTS: Frequency of AR was approximately equal to NAR in subjects with chronic rhinitis. Neutrophilic, eosinophilic, mixed, and nonallergic noninfectious types were the common types of NAR. An evident nasal eosinophilia was found in AR and eosinophilic NAR, whereas a higher percentage of goblet cells were determined in nonallergic noninfectious rhinitis. There is no significant difference between cytologic results from NAR and AR patients. CONCLUSION: In the patient with positive skin test result, the presence of nasal eosinophilia strongly supports the diagnosis of AR. No diagnostic test had been specifically developed to diagnose chronic NAR. Also, a negative nasal smear for eosinophils does not rule out the diagnosis. Assessment of other cells present in the cytogram such as basophils, neutrophils, and goblet cells may also provide valuable information for differential diagnosis and management of these conditions.

Nasal patency by rhinomanometry in patients with sensation of nasal obstruction.

BACKGROUND: The objective assessment of nasal patency is a common challenge in clinical practice. This study was designed to show and compare the values of active anterior rhinomanometry (RMM) in patients with sensation of nasal obstruction. METHODS: According to the physical examination, 7283 individuals with sensation of nasal obstruction were divided into the nasal septal deviation (NSD) group and normal nasal anatomy group. The NSD group and normal nasal anatomy group were further divided into subgroups according to skin-prick test positivity or negativity, respectively. Nasal airway resistances (NARs) of the subgroups were evaluated and compared. RESULTS: The mean value of total inspiratory NAR was 0.51 and 0.34 Pa/cm3 per second at 150-Pa pressure point in allergic rhinitis subjects with and without NSD, respectively; 0.48 and 0.32 Pa/cm3 per second were the mean values of total inspiratory NAR in nonallergic rhinitis subjects with and without NSD, respectively. The total inspiratory resistances in groups with NSD were significantly higher than the others. CONCLUSION: We believe that the results of so large a number of participants in this test will make an obvious contribution to the medical literature.

Detection of the nasal cycle in daily activity by remote evaluation of nasal sound.

OBJECTIVES: To detect the nasal cycle in healthy subjects while they were performing their daily activities, using the Odiosoft-Rhino (OR) software program and to investigate the ability of the OR program to perform this procedure. DESIGN: Prospective analysis. SETTING: Tertiary referral center. PATIENTS: Twenty healthy adult volunteers. INTERVENTIONS: Investigation of the nasal cycles of volunteers by the OR program every 30 minutes over a period of 12 hours on 4 different days in the same week. Each subject performed expiration every 30 minutes into a microphone, and the nasal sounds were recorded separately for each nasal cavity. MAIN OUTCOME MEASURES: The OR data collected during 12 hours for 4 days were analyzed for cyclic nasal obstruction. RESULTS: The nasal sounds were calculated for each of the nasal cavities and a 2000- to 4000-Hz frequency interval was used for evaluation. In all of the individuals investigated in this study, a cyclic change of nasal patency was detected by the OR program. All of the data were calculated to be significantly different for each nasal cavity (P < .05 for all comparisons). Changes of nasal sounds and comparison of the 2 sides demonstrated that the total amount of cyclic changes ranged between 30 minutes and 2 to 2.5 hours. CONCLUSIONS: With the help of the OR program, we detected the nasal cycles in all of the volunteers, and the periods were not less than 30 minutes or more than 2.5 hours. Because the data collection period was long and the patient compliance was maximal, we believe that the results in the study are more reliable and natural.

Modified midfacial degloving approach for sinonasal tumors.

A perfect surgical approach to nasal cavity and paranasal sinus tumors should provide a broad exposition preserving the important structures with no cosmetic defect. Midfacial degloving (MD) technique provides good exposure without incisions and scars in the face. Classic MD technique includes rhinoplasty incisions. However, combination of the facial plastic skills of the rhinoplasty techniques with an oncologic approach limits its popularity. We modified the classic technique, which is performed without classic rhinoplasty incisions. The surgical approaches to 55 patients with benign and malignant sinonasal neoplasms are reviewed, and the modification of MD technique performed without rhinoplasty incisions is described. The study includes 41 male and 13 female patients with both benign and malignant sinonasal neoplasms. The ages of the patients were between 9 and 78 years with a mean age of 41.15 years. Follow-up of the patients ranged from 2 to 96 months with a mean of 31.7 months. Most of the cases were angiofibroma and inverted papilloma. Modified MD approach was used for all patients, and in 6 cases, the technique was combined with subcranial approach. We successfully resected the tumors in all of the patients. The most frequently encountered complaint in the postoperative period was temporary nasal crusting and epistaxis. An important complication was the rupture of subpetrous part of the internal carotid artery in one patient and also a temporary facial palsy in another one. Palatal dysfunction, oroantral fistula, or vestibular stenosis, which are significant complications of MD, were not observed in any of our cases. In this modified technique, rhinoplasty incisions are not used; therefore, the duration of operation is shortened, the technique becomes easier, and the incisions of the rhinoplasty procedure, which could cause circular stenosis, are avoided.

Lateral osteotomies in rhinoplasty: a safer and less traumatic method.

BACKGROUND: Osteotomies are required to mobilize the bony pyramid for infracture, outfracture, or realignment. Using traditional techniques and instruments, mobilization of the bony pyramid often results in serious edema and ecchymosis. OBJECTIVE: The authors evaluate how the use of micro-osteotomes in lateral osteotomy influence postoperative healing. METHODS: A series of 36 rhinoplasties were evaluated to determine the postoperative effect on edema and ecchymosis of micro-osteotomes used in the lateral osteotomy. In the last stage of the operation, right lateral osteotomy was performed with a 2-mm, V-shaped osteotome and left lateral osteotomy with a 4-mm straight Cottle osteotome. Patients were assessed based on postoperative photos taken after 24 and 48 hours. RESULTS: There was a marked reduction in edema and ecchymosis in the micro-osteotome series compared with the series in which a 4-mm straight Cottle osteotome was used. CONCLUSIONS: 2-mm V-shaped osteotomes reduce postoperative edema and ecchymosis and can be maneuvered cephalically to the medial oblique osteotomy with the best cosmetic results.

Long-term immunotherapy for perennial allergic rhinitis: relationship of specific IgG levels to skin-prick test results and clinical symptoms and signs.

We studied 63 adults with perennial allergic rhinitis and positive skin-prick tests for Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df) who had not previously received any type of immunotherapy or pharmacotherapy for their condition. We injected these patients with a 50% Dp/50% Df modified allergen intradermally in accordance with the classic immunotherapy scheme once a week for 30 months. Specific immunotherapy (SIT) was administered until the specific IgG (sIgG) concentration reached level IV (>or=81% absorbance). We measured specific IgE and sIgG levels, obtained skin-prick test results, and evaluated clinical symptoms and signs before immunotherapy, at 6 months into therapy, at the completion of therapy (30 mo), and 1 year after the completion of therapy. In the group as a whole, differences between mean sIgG values and mean skin-prick test results before and after SIT were statistically significant (p < 0.05). At the 1-year follow-up, there was a negative correlation between sIgG levels and clinical symptom and sign scores, a positive correlation between skin-prick test results and clinical improvement, and a negative correlation between sIgG levels and skin-prick test results. Individually, at the 1-year follow-up, 50 of the 63 patients (79%) had experienced a resolution of clinical symptoms and/or signs and were thus deemed to have achieved clinical recovery.

Comparison of the long-term efficacy of subcutaneous and sublingual immunotherapies in perennial rhinitis.

BACKGROUND: Both sublingual and subcutaneous immunotherapies have a documented clinical efficacy, but only a few comparative studies have been performed. OBJECTIVES: To evaluate and compare the long-term efficacies of subcutaneous and sublingual immunotherapy. METHODS: One hundred and ninety-three patients with house dust mite allergies, out of an original total of 230, were treated with subcutaneous and sublingual house dust mite-specific immunotherapies for 3 years and also observed for 3 years after discontinuation of the treatment. The patients were randomized into 2 groups: the sublingual group (97 patients) and the subcutaneous group (96 patients). The therapy's success was evaluated using the symptom score, skin prick test results, and the nasal allergen challenge score. The patients were evaluated at the beginning of the study, at the end of years 1, 2, and 3, and also at the end of the 1st and 3rd years after discontinuation of the specific immunotherapy treatment. RESULTS: Immunotherapy induced a significant improvement during the treatment and the follow-up period. We found a greater improvement in the subcutaneous group compared to the sublingual group when we looked at the comparative results of the total 6 years. CONCLUSION: We suggest subcutaneous immunotherapy for patients with perennial allergic rhinitis due to the better results that were obtained during our study period. Nevertheless, sublingual immunotherapy is now accepted by WHO as a valid alternative to the subcutaneous route and should be used in all patients who require immunotherapy and do not accept the subcutaneous route of allergen administration.

Evaluation of nasal obstruction with Odiosoft-Rhino in nasal septal deviation.

BACKGROUND: Evaluation of a recently developed method for measuring nasal obstruction. OBJECTIVE: To investigate the reliability of a new software program called Odiosoft-Rhino (OR) as a presumptive diagnostic method to evaluate the nasal airflow of patients who have nasal septal deviation and to compare OR results with the acoustic rhinometry (AR) results and visual analogue scale (VAS) of nasal obstruction. SETTING: Referral centre, institutional practice. METHODS: OR uses a software program to analyze the original sounds of nasal airflow and evaluate the sounds of both nasal inspiration and expiration and then performs spectral and frequency analysis. OR and AR were performed on 56 patients with nasal septal deviations and 52 healthy controls. Their VAS, minimal cross-sectional area (MCA)1, and MCA2 measurements and nasal expiratory sound analysis between 200 to 500, 500 to 1000, 1000 to 2000, 2000 to 4000, and 4000 to 6000 Hz frequencies were noted for the left and right nasal cavities. MAIN OUTCOME MEASURE: Assessment and comparison of nasal obstruction with OR and AR methods. RESULTS: There was a significant difference between the MCA1 and MCA2 values and the nasal expiratory sound intensity of the deviated patients at 200 to 500, 500 to 1000, 1000 to 2000, and 2000 to 4000 Hz of the patient group and the control group (p < .001). There was a correlation between the OR results of 2000 to 4000 and 4000 to 6000 Hz intervals and the MCA1 results of the deviated sides. From the receiver operating characteristic curve analysis, the pooled results showed that 81.8% of deviated patients in the 2000 to 4000 Hz frequency range were found under the curve (p < .001). Related to this, 83.4% sensitivity and 82.1% specificity with a 14.5 dB cutoff point were determined. CONCLUSION: The OR test is noninvasive and requires little cooperation. The sensitivity and specificity of the OR test are reliable, so we could propose to use OR as a new diagnostic method to evaluate the nasal airflow in clinical practice. However, more studies with wider series and some technical modification are needed.

Detection of HHV-8 and HPV in laryngeal carcinoma.

OBJECTIVE: In this study we aimed to investigate the presence of human herpesvirus 8 (HHV-8) and human papillomavirus (HPV) in laryngeal carcinoma. MATERIALS AND METHODS: Fifty patients operated on because of laryngeal carcinoma were included in the study. Forty-seven had squamous cell carcinoma (SCC) whereas three had verrucous carcinoma. Fresh tumoral tissues, or tumoral tissues obtained from archival paraffin-embedded blocks, were examined. HHV-8 DNA and HPV DNA were detected using polymerase chain reaction (PCR) and viral genotypes of HPV were determined via the hybrid capture method. The presence of HHV-8 DNA and HPV DNA were also investigated in normal appearing laryngeal tissue collected from 50 cadavers at autopsy. RESULTS: HPV DNA was detected in seven patients (7/50; 14%) (5 out of 47 patients with SCC (5/47; 10.6%) and two out of three patients with verrucous carcinoma). HHV-8 DNA was detected in five patients and they all had SCC (5/47; 10.6%). One case had both HHV-8 and HPV DNA. None of the control samples from cadavers harbored HHV-8 DNA, or HPV DNA. There was a statistically significant correlation between HHV-8 DNA and HPV DNA positivity and laryngeal SCC (Fisher exact test; p=0.023 for each). No statistically significant correlations were found between the presence of HHV-8 and/or HPV and age, gender, tumor stage, differentiation, the site of the tumor, smoking and alcohol use. CONCLUSIONS: The findings of the present study suggest that beside HPV, HHV-8 might have a role in laryngeal carcinogenesis. Further investigations are necessary to clarify the exact role of these viruses in laryngeal carcinoma.

Odiosoft-Rhino versus rhinomanometry in healthy subjects.

CONCLUSION: Odiosoft-Rhino (OR) is a non-invasive test that is completed in an extremely short period of time. It is easy to perform and little patient cooperation is needed. OR is safe and could be used in the rhinological setting if further improved. OBJECTIVE: To evaluate nasal obstruction objectively with a new technique, OR, and to compare the results with a widely accepted method, rhinomanometry, in normal subjects. SUBJECTS AND METHODS: OR and anterior RMM were performed in 79 subjects without any rhinologic symptoms and signs. Visual analogue scales (VAS) of nasal obstruction, nasal airway resistance and nasal expiratory and inspiratory sounds were analysed. RESULTS: VAS of nasal obstruction was found to be correlated with OR findings of expiration at 2000-4000 Hz frequency interval on both sides (r = 0.564, p < 0.01 for the left side, r = 0.533, p < 0.01 for the right side). Correlations were found (p < 0.05) between left 2000-4000 Hz in expiration OR and left expiration RMM, left 4000-6000 Hz in expiration OR and left expiration RMM, right 2000-4000 Hz in expiration OR and right expiration RMM, and right 4000-6000 Hz in expiration OR and right expiration RMM. No correlation was seen between VAS, anterior RMM and OR at inspiration in any interval.

[The validity of the Rhinosinusitis Disability Index in chronic sinusitis]. / Kronik sinüzitte Rinosinüzit Etkilenme Indeksi'nin geçerliligi.

OBJECTIVES: Quality of life in patients with chronic rhinosinusitis is affected more than many other chronic diseases. In this study, we evaluated the validity of the Rhinosinusitis Disability Index (RSDI) in assessing deterioration in the quality of life. PATIENTS AND METHODS: The Rhinosinusitis Disability Index consisting of 30 items was administered to 355 patients (206 males, 149 females; mean age 41 years; range 21 to 57 years) with chronic rhinosinusitis before and after treatment and to 112 healthy controls (44 males, 68 females; mean age 35 years; range 18 to 48 years). A detailed history was taken from the patients and skin-prick test was performed to eliminate allergic rhinitis. The scores of patients and physicians were compared. The score of the RSDI is inversely proportional to the quality of life. RESULTS: Spearman rank correlation test yielded a coefficient of 0.42 for comparisons between pre- and post-treatment scores and physician evaluation. Coefficients for correlations between the patients' and physicians' scores before and after treatment were 0.62 and 0.59, respectively. The mean RSDI scores of the patients before and after treatment were 35.2+/-14.3 and 13.9+/-10.8, respectively, compared to a score of 8.4+/-8.8 of the control group. Only 72.4% of the patients could answer the questions by themselves. CONCLUSION: If properly administered, the RSDI is a reliable method in evaluating quality of life; however, it is affected by the socioeconomic and education levels of the participants.

Long-term efficacy of sublingual immunotherapy in patients with perennial rhinitis.

BACKGROUND: Sublingual immunotherapy has a documented clinical efficacy, but only a few long-term studies have been performed in people with perennial rhinitis. OBJECTIVES: The purpose of this study was to evaluate the long-term efficacy of sublingual immunotherapy. METHODS: One hundred thirty-seven patients with allergies to house dust mites were treated with sublingual house dust-mite-specific immunotherapy for 2 or 3 years and were also observed for 3 years after discontinuation of the treatment. The patients were divided into 2 groups: group A (67 patients) received active treatment for 2 years and then 1 year for placebo, and group B (70 patients) received active treatment for 3 years. The success of the treatment was evaluated with the symptom score, skin prick test results, and the nasal allergen challenge score. RESULTS: According to our study results, we found a greater improvement in the 3 years of sublingual immunotherapy compared with the 2 years of sublingual immunotherapy when we looked at the comparative results of the total 6 years. CONCLUSION: We suggest 3 years of sublingual immunotherapy for patients with perennial allergic rhinitis who require immunotherapy and do not accept the subcutaneous route of allergen administration.

[Comparison of nasal histamine and allergen provocations in patients with allergic rhinitis]. / Alerjik rinitli hastalarda nazal histamin ve alerjen provokasyonunun karsilastirilmasi.

OBJECTIVES: We evaluated the effects of histamine and allergen provocations in the nasal mucosa. PATIENTS AND METHODS: Nasal provocations were performed with extracts of histamine, Dermatophagoides pteronyssinus (Dp) and mixed grass pollen (Mg) in patients with perennial and seasonal allergic rhinitis and in healthy subjects. Nasal airway resistance (NAR), the amount of secretions, and the number of sneezes were recorded and evaluated. RESULTS: Regarding NAR, histamine provocation resulted in a significant difference compared to Dp provocation, but the difference was not significant when compared to Mg provocation. Only associated antigen provocation caused a significant increase in secretion. No significantly different effect on sneezing was detected between allergens and histamine. Considering total scores, histamine did not cause an increase in nasal reactivity in healthy subjects. A significant but slight difference was found between allergens and histamine in terms of nasal hyperreactivity in patients with allergic rhinitis. CONCLUSION: As there is a weakly significant difference between allergens and histamine in terms of nasal hyperreactivity in patients with allergic rhinitis, histamine provocation can be used in conditions where allergen provocation is not available.

Efficacy of Odiosoft-Rhino in assessment of nasal obstruction: a comparative study with acoustic rhinometry after treatment with budesonide nasal spray in patients with perennial allergic rhinitis.

BACKGROUND: Odiosoft-Rhino (OR) is new software and equipment that can be used to measure changes in nasal obstruction after intranasal steroid treatment. OR is a promising method for measuring the degree of nasal obstruction. OR can precisely analyze nasal sound spectra in decibels, which is generated by nasal airflow. We studied the reliability of OR for assessing declining nasal obstruction after budesonide nasal spray treatment. METHODS: Sixty-five patients with perennial allergic rhinitis (PAR) were enrolled in the study, and 52 of these patients completed the study. Nasal endoscopic examination, acoustic rhinometry (AR), and OR were performed and symptom scores were compared before and after 3 months of treatment with intranasal budesonide. All of the patients received 7 days of placebo treatment before receiving budesonide. RESULTS: There was a significant difference in the visual analog scores of nasal obstruction and in the examination scores before and after the treatment for both the right and the left nasal cavities. Pretreatment AR findings and OR findings in the 2000- to 4000-Hz and 4000- to 6000-Hz intervals for both sides were significantly different from the posttreatment measurements (p = 0.000). Both AR and OR can assess the efficacy of budesonide nasal spray treatment for nasal obstruction in patients with PAR. CONCLUSION: Both AR and OR are effective for assessing nasal obstruction and monitoring treatment efficacy but, as a simple and noninvasive test, OR can be used with confidence.

Computed tomography findings in chronic rhinosinusitis patients with and without allergy.

The purpose of this study was to compare the paranasal sinus mucosal thickenings, bony changes consistent with chronic sinusitis, and bony anatomic variations detected by computed tomography (CT) in chronic rhinosinusitis patients with and without allergy. Three hundred and thirty-nine patients with chronic rhinosinusitis were analyzed for their allergic status by performing skin prick test. Two hundred and thirteen patients (62.8%) had at least one positive skin prick test (allergic patients, male/female: 85/128, mean age: 29.1 +/- 1.2). One hundred and twenty-six patients (37.2%) were included in the non-allergic group (male/female: 53/73, mean age: 31 +/- 2.2). Maxillary mucosal thickening and frontal hypoplasy were significantly more common in allergic chronic rhinosinusitis patients. Moreover, pneumatized uncinate process is apparently more common in the allergic group than non-allergic group, and statistical analysis revealed marginal significance (p = 0.0535). In conclusion CT findings of allergic chronic rhinosinusitis patients are comparable to the CT findings of chronic rhinosinusitis patients without allergy. However, presence of maxillary mucosal thickening, frontal hypoplasia or pneumatized uncinate process in the CT scan of a patient with chronic rhinosinusitis could be of clinical significance, and might guide the otolaryngologist for the evaluation of the presence of allergy.

Nasal sound analysis: a new method for evaluating nasal obstruction in allergic rhinitis.

OBJECTIVE: Current measurements of nasal obstruction are unreliable and may be improved with the development of new techniques. The effectiveness of odiosoft-rhino (OR) in the evaluation of nasal obstruction was investigated in a blind comparison at a referral center, institutional practice. PATIENTS: Forty-eight patients with perennial allergic rhinitis and 52 healthy subjects were studied. Nasal endoscopic examination, acoustic rhinometry (AR), and OR were performed and symptom scores compared. MAIN OUTCOME MEASURE: Assessment of nasal blockage with OR method was the main outcome measure. RESULTS: Using the OR technique, significant differences were observed between the patient and control groups. OR data correlated with symptom scores and endoscopic examination. However, this was not observed with AR. A 15.5-dB cutoff point for the left side and 14.5 dB cutoff point for the right side at the 2,000 to 4,000 Hz frequency interval resulted in 93.8% sensitivity and 92.3% specificity and 72.9% sensitivity and 80.8% specificity, respectively. A 8.5-dB cutoff point for the left and right sides at the 4,000 to 6,000 Hz frequency interval resulted in 87.5% sensitivity and 80.8% specificity and 70.8% sensitivity and 78.8% specificity, respectively. CONCLUSION: OR is a simple, noninvasive test for assessing nasal obstruction. The OR technique can detect nasal obstruction with high sensitivity and specificity, and these findings correlate with symptoms and physical examination.

[The use of serum and nasal eosinophilic cationic protein in the evaluation of the effectiveness of immunotherapy in patients with allergic rhinitis]. / Alerjik rinitli hastalarda serum ve nazal eozinofilik katyonik proteinin immünoterapi etkinliginin degerlendirilmesindeki rolü

OBJECTIVES: We investigated the use of eosinophilic cationic protein (ECP) as an indicator of clinical efficiency of specific immunotherapy (SIT) in patients with allergic rhinitis sensitive to house dust mites. PATIENTS AND METHODS: Specific immunotherapy was administered to 49 patients (20 males, 29 females; mean age 34.2 years; range 16 to 66 years) with perennial allergic rhinitis. Nasal secretion and serum ECP levels were measured before, at the 6th month of, and two years after completion of, treatment. Comparisons were made within the patient group and with a control group of 16 healthy subjects (10 males, 6 females; mean age 23 years; range 17 to 26 years). RESULTS: Pretreatment nasal ECP levels were significantly higher than those found after the treatment (p<0.001). Nasal ECP levels measured before SIT were significantly different from those of the control group (p<0.05). However, serum ECP levels did not differ significantly between the two groups (p>0.05). Serum ECP levels in the patient group tended to decrease with treatment (p>0.05). CONCLUSION: We conclude that, in addition to the symptoms and clinical findings, nasal ECP measurement may be a reliable and suitable laboratory method to monitor and evaluate the effectiveness of treatment.