Narrow-band UVB phototherapy of nasal polyps: results of a pilot study.

Nasal polyposis (NP) is characterized by high recurrence rate despite medical and/or surgical treatment. The major mechanism of action of ultraviolet B light (UVB) is induction of apoptosis in inflammatory cells. Therefore phototherapy may represent a new therapeutic approach in NP. A pilot feasibility study was performed to assess the tolerability and clinical efficacy of UVB phototherapy in NP. Thirteen subjects with bilateral grade 1-3 NP were enrolled in an open-labeled prospective pilot study. Patients were exposed to gradually increasing doses of UVB light over a 12 week period (3 exposures/week). Subjects rated their nasal obstruction symptom scores weekly on a visual analogue scale from 0 to 6. The NOSE quality of life questionnaire was used at baseline and end of treatment period. Adverse events were monitored by endoscopy. Ten subjects completed the study. Nasal obstruction symptom scores and quality of life (NOSE) improved at end of treatment compared to baseline. Treatments were well tolerated and no device related adverse events were reported. The results suggest that phototherapy may represent a potential new treatment option in nasal polyps.

Woakes' syndrome and albinism.

Nasal polyposis is a very common and multifactorial disease. Whereas eosinophil-dominated polyps often are sensitive to anti-inflammatory treatment like corticosteroids, the therapy of polyps without eosinophils is more difficult and disappointing. We report the clinical course of a 29-year-old albino patient suffering from a extreme manifestation of Woakes' syndrome, which is characterized by severe recurrent nasal polyps, often without eosinophils on histological examination and with broadening of the nose. In this case, the recurrent fibrotic polyps without eosinophils were resistant to conventional medical and surgical treatment and required further treatment with radiotherapy with awareness of all possible future sequelae. The pathoetiology and treatment of Woakes' syndrome as well as of albinism were discussed.

[The supplement therapy of microwave after endoscopic maxillary sinus surgery].

OBJECTIVE: To observe therapeutic effect of microwave eliminating the remnant lesion located at walls of maxillary sinus after endoscopic maxillary sinus surgery and the effect of postoperative. METHOD: Twenty-six cases (37 sites) were treated with microwave coagulating through enlarged ostium completely by means of 70 degrees endoscopy-guided. RESULT: The remnant lesion located at walls of maxillary sinus of 23 cases (33 sites) were eliminated without any complication and the effective eliminating rate was 89.2% (33/37). The infected local secretion of maxillary sinus of 17 cases (22 sites) were disappeared. CONCLUSION: The therapy of microwave by means of nasal endoscopy-guided can get rid of the lesion which is located at walls of the maxillary sinus to avoid the trauma caused by Caldwell-Luc operation, etc. It can improve the effect of the endoscopic sinus surgery.

[Experimental study of biological tissue permeability to Nd-YAG laser irradiation with wave length 1.06 and 1.32 mm]. / Eksperimental'noe issledovanie pronitsaemosti biologicheskikh tkanei dlia izlucheniia IAG-Nd-lazera s dlinoi volny 1,06 i 1,32 mkm.

The author studied penetration of YAG-Nd laser radiation (1.06 and 1.32 mm) through some biological tissue. The least penetration of the laser rays occurred in the bone and cartilage tissue. Maximal difference in the penetration rate was recorded in more transparent for this radiation media - blood agar and nasal polyps. The above methodological approach and its results may be used for estimation of the energy needed for reaching different biotissue layers in remote and contact exposure to YAG-Nd laser.

A follow-up study of childhood nasopharyngeal radium irradiation in Washington County, Maryland.

In 1978 an epidemiologic study exploring the health consequences of nasopharyngeal radium irradiation among individuals treated for adenoid enlargement in Washington County, Maryland, found an excess risk of brain tumors and a deficit of female breast cancers. The study population included all persons first seen at the Washington County Clinic for the Prevention of Deafness in Children from 1940 to January 1, 1960. We will continue the follow-up of irradiated and nonirradiated patients to (1) assess the risk of brain tumors and other neoplasms of the head and neck developing during a 40-year period, (2) assess hormone-related disorders resulting from irradiation of the pituitary gland, and (3) compare cancer incidence and mortality rates among exposed and nonexposed groups. Of the 2135 persons eligible for this study, 93.5% have been traced, and 90% have replied to a mailed questionnaire that elicits information on demographic characteristics, reproductive and medical history, infertility, and other sources of radiation exposure. Information on cancer incidence and mortality is being obtained from the Washington County Cancer Registry and death certificate files from Washington County and the Social Security Administration. Statistical methods to be used in the data analysis include standardized mortality ratios, standardized cancer incidence ratios, and Kaplan-Meier survival analysis.

[Differential diagnosis of destructive processes of the skull base. Aggressive polypoid eosinophilic pansinusitis with expression of carcinoembryonic antigen (CEA)]. / Ein Beitrag zur Differentialdiagnose von destruierenden Prozessen der Schädelbasis. Die aggressive polypöse eosinophile Pansinusitis mit Expression von karzinoembryonalem Antigen (CEA).

We report a woman with extensive polypoid sinusitis and bony destruction of the middle and posterior skull base. Histological examination of the specimen from the paranasal sinuses and adjacent skull base revealed polypoid eosinophilic sinusitis: malignancy could be excluded histologically and clinically. Plasma-CEA-levels were elevated to 85 micrograms/l with no typical source of CEA expression, and they fell after therapy. Immunocytochemistry revealed a remarkable expression of CEA in the surface epithelia of the specimen obtained from the paranasal sinuses. CEA-immunoscintigraphy showed an enhancement in the regions of the paranasal sinuses without expression elsewhere in the body. The authors discuss the possibility of using CEA as a marker for aggressive forms of chronic sinusitis and suggest radiotherapy is a successful treatment option in addition to surgery. The observation period of almost two years confirms the value of the chosen therapy.