Mucolytic and Antioxidant Effects of Intranasal Acetylcysteine Use on Acute Rhinosinusitis in Rats with an Acute Rhinosinusitis Model.

INTRODUCTION: The aim of this study was to investigate whether N-acetylcysteine (NAC) is effective in the treatment murine model of acute rhinosinusitis in rats. MATERIALS AND METHODS: Twelve rats were included in the study. The left nasal cavity of all rats was infected with Streptococcus pneumoniae. Group 1 was the group in which NAC was administered into the left nasal cavity twice daily. Group 2 was selected as the control group. All rats were then sterilely sacrificed under anesthesia after intracardiac blood sampling. After sacrifice, sterile culture samples were collected from the posterior nasal cavity. RESULTS: Total oxidant status and oxidative stress index (OSI), interleukin 1ß, interleukin 6, and tumor necrosis factor α levels decreased significantly in the treatment group. Total antioxidant status was significantly increased. There was a statistically significant increase in total serum thiol levels and native thiol levels. Histopathologic evaluation showed a statistically significant decrease in submucosal gland hypertrophy in the treatment group. CONCLUSION: According to our study, intranasal application of NAC can decrease the inflammatory findings in murine acute rhinosinusitis.

The Onlay Rotated Flap (ORF): An Original Technique for Nasal Tip Plasty.

OBJECTIVE: The reshaping of the nasal tip in rhinoplasty according to the expectations of the patient and the surgeon is called tip plasty. in this article, the onlay rotated flap (ORF) is presented as a new technique for reshaping, supporting, and projecting the nasal tip without any resection or grafting. METHODS: Thirty-two patients (26 female and 6 male) were included in the study retrospectively. Primary rhinoplasty with ORF was performed to all patients. The follow-up period was between 9 and 12months. The nasal tip projection (NTP) with Goode method and nasal tip rotation (NTR) according to nasolabial angle were calculated in standardized preoperative and postoperative(6th month) photographs with image J. SPSS Version 21.0 was used for statistical analysis. RESULTS: There were no complications resulting from our procedure. There were no visible tip flaps, no distortion, no asymmetry, and no alar retraction. Revision surgery was not required in any patient. The preoperative and postoperative means of nasolabial angle (Mean ± SD) were 92.06 ±â€Š7.73° and 99.71 ±â€Š6.06°, respectively. The preoperative and postoperative means of NTP (Mean ± SD) were 0.535 ±â€Š0.041 and 0.57 ±â€Š0.386, respectively. The postoperative nasal tip rotation and NTP values of the ORF procedure were found to be statistically significantly higher than the preoperative values (P < 0.05). CONCLUSIONS: The ORF technique is another alternative for achieving adequate nasal tip definition and projection and has many advantages and very successful postoperative results. The alar retraction was not encountered in our technique and this is the superior aspect of our technique over similar methods described in the literature.

The Effect of Passive Smoking on Mucociliary Clearance and Inferior Concha Reactivity.

INTRODUCTION: The aim of this study is to investigate the effect of cigarette smoke on turbinate reactivity and mucociliary clearance (MCC) in passive smokers. METHODS: 60 adult patients (30 passive smokers and 30 healthy subjects as the control group) were recruited for this study. Following a questionnaire on passive smoke exposure, MCC measurement using the saccharin test was carried out to all participants. The baseline and after decongestant acoustic rhinometry values (MCA1, MCA2, VOL1, VOL2) were measured and the percentage changes between the two test values (ie; response to nasal decongestants = concha reactivity) were recorded. RESULTS: All 60 patients, including 37 women (61.7%) and 23 men (38.3%) were between 18-57 years of age . MCC's average measurements were 11.13 minutes in the passive smokers group, 7.87 minutes in the control group, which was statistically significantly different (p < 0.05). There was a statistically significant difference between the passive smokers and control group for acoustic rhinometric measurement of the ratio of MCA2 and VOL2 values before and after decongestant application (p < 0.05). DISCUSSION: Passive smoking can damage the nasal mucosa at least as active smoking. The number of studies on this subject is limited. There are no studies in the literature showing the effect of cigarette smoke on the inferior turbinate mucosal response. In our study, the inferior turbinate decongestant capacity was found to be significantly decreased in the passive smokers compared to the control group. CONCLUSION: As a result of cigarette exposure, the erectile function of the lower turbines may be impaired. The task of the ENT physicians is to warn the passive smokers in this regard.

The Effect of Nasal Functions on the Integrity of Grafts after Myringoplasty.

OBJECTIVE: We aimed to evaluate the effects of nasal functions for the integrity of grafts after myringoplasty. METHODS: In our study 78 patients who underwent myringoplasty operation between 2011-2013 were included. Group I was defined as the group with an intact tympanic membrane following surgery. Group II was defined as the group with a tympanic membrane perforation following surgery. Group I consisted of 44 and Group II consisted of 34 patients. Subjective and objective measurements of nasal functions, Eustachian tube function (ETF), and allergic status were performed using nasal obstruction symptom evaluation (NOSE) scale, visual analog scale (VAS), and the score for allergic rhinitis (SFAR) questionnaires and acoustic rhinometry and saccharin test. It was investigated whether there was any difference between these two groups in terms of these parameters. RESULTS: There was statistically no significant difference between groups according to the age, sex and the presence of tubal dysfunction and allergic rhinitis (p>0.05). In the group of intact tympanic membranes, the likelihood of right ear being the operated one was significantly higher compared to the group of myringoplasty failures (p=0.037). The VAS and NOSE scales did not show any significant difference between groups in terms of successful outcome of myringoplasty (p>0.05). The nasal congestion index (NCI) and the mucociliary clearance (MCC) did not show any significant difference between groups in terms of successful outcome of myringoplasty (p>0.05). CONCLUSION: This study has shown that nasal functions measured by objective and subjective methods had no effects on the success of myringoplasty.

Classic Mediterranean type of epiglottic Kaposi sarcoma.

Kaposi sarcoma is a malignant, multifocal, vascular, and low-grade tumor that mostly occurs in mucocutaneous sites. Kaposi sarcoma is usually associated with acquired immunodeficiency syndrome and involves lymphatic nodes and visceral organs. In this report, an 81-year-old man with epiglottic Kaposi sarcoma who screened negative for human immunodeficiency virus is presented.

Does passive smoking have an effect on nasal mucociliary clearance?

OBJECTIVE: The aim of this study is to review the literature about nasal mucociliary clearance (MCC) and passive smoking in otorhinolaryngology by clearly explaining their relationship in a cross-sectional study. STUDY DESIGN AND SETTING: This cross-sectional study was conducted at the Umraniye Education and Research Hospital in Turkey. Umraniye Education and Research Hospital Ethical Committee approved the study, and informed consents of the patients were obtained. METHODS: Our study consisted of patients who presented to the Ear-Nose-Throat Department of Istanbul Umraniye Education and Research Hospital between February 2011 and July 2011. Three groups of subjects were evaluated: 15 passive smokers (group 1), 17 active smokers (group 2), and 15 healthy matched controls (group 3). All patients were asked to answer our questions regarding their smoking history, and nasal MCC time was assessed for all individuals of the 3 groups. RESULTS: The mean MCC value was 23.59 ± 12.41 in the smoking group, 12.6 ± 4.67 in the passive smoking group, and 6.4 ± 1.55 in the healthy group. The comparison of MCC values between the smoking group and passive smoking group and between the smoking group and healthy group revealed statistically significant differences (P < .01). There was also a significant difference between the MCC values of the passive smoking group and the healthy group (P < .01). In addition, we compared MCC values according to exposure number of cigarettes. CONCLUSION: In this study, we conclude that passive smoking affects nasal MCC. Both active and passive smoking increases nasal MCC time when compared with healthy controls.

Management of a pterygopalatine fossa hydatid cyst.

Hydatid cyst disease is a rare parasitic infestation caused by larvae of Echinococcus granulosus. Although larval stage of this parasite can thrive in any part of the body, especially lungs and liver; head and neck involvement is rare. Pterygopalatine fossa involvement is reported in two cases in the literature. In this report we represent a case with solitary, secondary pterygopalatine fossa hydatid cyst extending in to the maxillary sinus, orbita, sphenoid sinus and skull base.

Acoustic rhinometry evaluation of radiofrequency ablation of the turbinates.

OBJECTIVES: The objective of this study is to determine if acoustic rhinometry (AR) can predict the outcome of radiofrequency ablation (RFA) of the inferior turbinates. PATIENTS AND METHODS: Preoperative AR measurements of 19 subjects undergoing inferior turbinate RFA were analyzed before and after decongestant. The average total percentage change in cross sectional area (CSA) 1 and in total volume was calculated for each. Both the physician and patient assessed treatment success subjectively. If available, postoperative data was analyzed. RESULTS: The congestion factor of CSA1 was 72.76+/-75.58 before surgery and 42.32+/-27.79 after surgery (p>0.05). There were no significant differences in CSA1, CSA2, CSA3 and total volume after the radiofrequency ablation surgery. All patients were satisfied with the results of the surgery. Physician assessment was 'satisfactory' for 18 patients and 'partially satisfactory' for one. CONCLUSION: Nineteen patients had AR and RFA of the turbinate. Since all patients were satisfied with the operation, no conclusion can be drawn regarding the predictive value of AR. Although there was a trend to a larger volume postoperatively, none of the measured parameters were significantly different.