Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with t...Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.展开更多
BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental d...BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental discovery of a fungal ball in the nasal cavity during routine imaging,with no associated clinical symptoms.CONCLUSION This case underscores the importance of considering the possibility of asympto-matic presentations of nasal fungal balls,which may be detected incidentally during imaging evaluations.展开更多
This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total ...This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.展开更多
Objective To get the basic data of nasal figure of the Han nationality individuals in Xi'an area and provide for junsprudence and the reconstruction of skull. Methods Nasal height, length, depth and breadth of 313...Objective To get the basic data of nasal figure of the Han nationality individuals in Xi'an area and provide for junsprudence and the reconstruction of skull. Methods Nasal height, length, depth and breadth of 313cases in Xi'an area, which had different age and sex, were measured by magnetic resonance imaging (MRI). Results Image of MRI could clearly show the figure of nose and the position we selected were correct and accuracy. The specific data were: Nasal length (male:34. 47±4.29 ～52.20±3.47, female:33. 11±3.33～46. 94±3.83); Nasal height(male: 39.22±3.68～59.49±2.30, female: 33.89±3.95～51.75±3.68); Nasal depth(male: 11.89±1.76～16.68±2.48, female: 10.69±1. 81～16.46±2.04);Nasal breadth(male: 33. 09±3. 83～42. 49±2.72,female:32.00±1.94～38. 86±2.61). So the results were credible. Conclusion The nasal figure of individuals in Xi'an area is different as their different age and sex. It promotes that the influence factors of age and sex must be considered in the facial reconstruction and medico legally reconstructing skull.展开更多
Background: Reconstruction of Nasal Tip Columella (NTC) subunits is one of the most challenging aspects in functional aesthetic rhinoplasty. Moreover, racial variation for Asian nose rhinoplasty could even demand soph...Background: Reconstruction of Nasal Tip Columella (NTC) subunits is one of the most challenging aspects in functional aesthetic rhinoplasty. Moreover, racial variation for Asian nose rhinoplasty could even demand sophistication of tip and columella strut graft infrastructure enhancement. Various autogenous graft options such as 6th costal cartilage, septal cartilage and conchal cartilage are very commonly considered whilst the 10th costal cartilage is scarcely reported. Objective and Method: The purpose of this manuscript is to illustrate the detailed operative steps to harvest the 10th costal cartilage for infrastructural grafting at NTC subunits by a case illustration. The pros and cons of different cartilage options will be discussed, particularly its application in cleft nose rhinoplasty in Chinese patient. We have adopted the 10th rib as the key option for NTC reconstruction in 11 cases of Chinese cleft secondary rhinoplasty since 2019 and have achieved good and stable results without complications. Conclusion: The 10th costal cartilage is one of the best options in Nasal Tip Columella subunits reconstruction, particularly in complex cleft nose or failure revision aesthetic rhinoplasty cases, due to its safety of harvesting, and the sufficient quality and quantity of grafting materials it provides for simultaneous adjunctive augmentation purpose.展开更多
BACKGROUND In diabetic patients,persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria,resulting in severe complications.Con-sequently,chronic rhinosinusitis(CRS)complicat...BACKGROUND In diabetic patients,persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria,resulting in severe complications.Con-sequently,chronic rhinosinusitis(CRS)complicated by diabetes is highly pre-valent in clinical settings.AIM To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.METHODS A retrospective analysis was conducted on the clinical data of 203 diabetic pa-tients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023.Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial suscept-ibility.Based on a one-year follow-up,patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data.Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.RESULTS Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS.A total of 134 pathogenic bacteria strains were isolated and identified,including 81 strains(60.4%)of gram-positive bacteria and 53 strains(39.6%)of gram-negative bacteria.Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin,while remaining highly sensitive to vancomycin,gentamicin,and rifampicin.Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin,but showed high sensitivity to imipenem,meropenem,cefepime,and ceftazidime.Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels,smoking history,Lund-Mackay scores,visual analog scale(VAS)scores,nasal septum deviation,allergic rhinitis,bronchial asthma,postoperative infection,long-term use of nasal decongestants,and adherence to medical prescriptions.Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.CONCLUSION In CRS patients with nasal polyps(CRSwNP),the detection rate of nasal pathogens is relatively high,and most of the isolated bacteria exhibit antimicrobial resistance.Additionally,the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.展开更多
Exogenous lipoid pneumonia is a rare and under recognized pulmonary disorder caused by the inhalation or aspiration of fat-like substances.Nasal decongestants containing mineral oils or paraffin are emerging as overlo...Exogenous lipoid pneumonia is a rare and under recognized pulmonary disorder caused by the inhalation or aspiration of fat-like substances.Nasal decongestants containing mineral oils or paraffin are emerging as overlooked etiological agents.This review consolidates existing literature to delineate the clinical,radiological,and pathological features of exogenous lipoid pneumonia induced by nasal decongestants,highlight diagnostic challenges,and underscore the importance of thorough patient history in early diagnosis and management.This condition,while preventable,can result in serious pulmonary complications if not recog-nized early.It necessitates a multidisciplinary approach that incorporates careful history taking,high-resolution imaging,cytological assessment,and public health vigilance.展开更多
BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients.Its occurrence in the nasal dorsum is extremely rare and poses significant diagnost...BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients.Its occurrence in the nasal dorsum is extremely rare and poses significant diagnostic and therapeutic challenges.CASE SUMMARY We report the case of a 65-year-old woman with diabetes mellitus and hypertension who presented with a dorsal nasal mass.The initial differential diagnosis favored hemangioma-based clinical examination on imaging.Histopathological examination after excision revealed MCC,necessitating a complex management strategy.A 3 cm×2 cm nasal mass,initially suspected to be a hemangioma,was excised but revealed MCC with positive margins.Positron emission tomography–computed tomography confirmed metastatic cervical lymphadenopathy.The patient underwent bilateral neck dissection,revealing metastases in seven nodes.Residual activity was treated with radiation therapy,leading to a favorable response after 6 months.CONCLUSION This case highlights the importance of considering MCC in the differential diagnosis of nasal masses,and integrated management.展开更多
BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr...BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr virus infection.AIM To explore the anxiety and depression status of patients with NK/T-cell NHL in the nasal cavities and paranasal sinuses and analyzes the relevant influencing factors.METHODS A retrospective analysis was performed,which included 30 patients with primary nasal NK/T-cell NHL treated in Shaanxi Provincial People’s Hospital from January 2017 to January 2023.An additional 50 healthy volunteers were selected as the control group.Both groups were assessed using the self-rating anxiety scale(SAS)and Self-rating(SDS).SDS and SAS scores of patients with NHL at different disease stages were analyzed,and they were further grouped into negative emotion(NE)(n=19)and non-NE(n=11)groups based on their depression and anxiety.Factors affecting the occurrence of NEs in patients with NHL were analyzed using univariate and multivariate logistic regression models.RESULTS Patients with NHL exhibited higher SDS and SAS scores than healthy controls.Moreover,patients with NHL at stages III and IV had higher SDS and SAS scores than those in stage I.Among the 30 patients,there were 13 patients with depression(43.3%),16 patients with anxiety(53.3%),and 10 patients with both anxiety and depression(33.3%).Univariate analysis identified a higher proportion of people in the NE group with stage III-IV NHL,an educational level≤high school,and a monthly household income<5000 yuan compared with the non-NE group.Multiple logistic regression analysis further revealed that stage III-IV was a risk factor for NEs in patients with NHL.CONCLUSION The stage of NK/T-cell NHL in nasal cavities and paranasal sinuses is closely related to patient anxiety and depression.The higher the staging,the greater the incidence of anxiety and depression.展开更多
Patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)often suffer from respiratory failure and require respiratory support therapy.High-flow nasal cannula oxygen therapy(HFNC)and non-invasive...Patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)often suffer from respiratory failure and require respiratory support therapy.High-flow nasal cannula oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)are commonly used non-invasive respiratory support methods.HFNC can provide precisely heated and humidified high-flow oxygen,reducing dead space and increasing alveolar ventilation.NIPPV can supply stable high-concentration oxygen and improve gas exchange.This article reviews the application of HFNC and NIPPV in the acute exacerbation stage of COPD,aiming to provide references for reasonable clinical selection.展开更多
BACKGROUND Nasal trauma presents a risk of foreign body invasion into the nasal cavity.However,in the early treatment stage of nasal trauma,patients and doctors are not always aware of possible foreign body invasion,r...BACKGROUND Nasal trauma presents a risk of foreign body invasion into the nasal cavity.However,in the early treatment stage of nasal trauma,patients and doctors are not always aware of possible foreign body invasion,resulting in delayed detection.We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow,purulent,and bloody discharge.CASE SUMMARY Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment,resulting in a glass fragment retained in the nasal cavity adjacent to the orbit.After admission,computerized tomography(CT)confirmed the presence of the foreign body in the patient’s left nasal–maxillary sinus.The nasal foreign body led to symptoms such as chronic sinusitis,nasal polyps,fungal infection,and deviated nasal septum.The foreign body was successfully removed by nasal endoscopy,polypectomy,sinus fungal removal,left middle turbinate conchoplasty,fenestration via the right inferior meatus,nasal endoscopic maxillary sinus cystectomy,and septolplasty.The operation was successful and without any complications.CONCLUSION CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma.Surgical planning should be tailored to the patient’s specific situation.The surgical method should be carefully selected,and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.展开更多
Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar...Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.Results: All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.Conclusion: Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.展开更多
Aim To investigate the relationship between pH environment of meptazinolhydrochloride (MEP) and its nasal absorption. Methods In situ nasal peifusion was performed to studythe effect of pH environment on the nasal abs...Aim To investigate the relationship between pH environment of meptazinolhydrochloride (MEP) and its nasal absorption. Methods In situ nasal peifusion was performed to studythe effect of pH environment on the nasal absorption. Its effect on the transport from nose tobrain was further researched by in vivo experiment. Results In in situ perfusion experiment, thenasal absorption of MEP in basic environment was significantly higher than that in acid condition,but the difference was not observed in in vivo experiment. Conclusion The pH environment ofmeptazinol hydrocloride in formulation cannot be regarded as an important factor influencing nasalabsorption and transport from nose to brain.展开更多
This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration. A cohort of 20 patients was assessed for the distribution of nasal spray befo...This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration. A cohort of 20 patients was assessed for the distribution of nasal spray before and after nasal septum surgery. Sprays were dyed and administered one puff per nostril when patients hold their head up in an upright position. Before and after decongestant admini-stration, the intranasal distribution was semi-quantitatively determined by nasal endoscopy. The results showed that the dyed drug was preferentially sprayed onto the nasal vestibule, the head of the inferior turbinate, the anterior part of septum and nasal floor. As far as the anterior-inferior segment of the nasal cavity was concerned, the distribution was found to be influenced neither by the decongestant nor by the surgery （P〉0.05）. However, both the decongestant and surgery expanded the distribution to the anatomical structures in the superior and posterior nasal cavity such as olfactory fissure, middle turbinate head and middle nasal meatus. No distribution was observed in the sphenoethmoidal recess, posterior septum, tail of inferior turbinate and nasopharynx. It was concluded that nasal septum surgery and decongestant administration significantly improves nasal spray distribution in the nasal cavity.展开更多
We studied the effects of nasal thermosensible gels containing Chinese medicine Xingbi on Bufo gargarizans maxillary mucosal cilia movement and the ciliotoxicity in rats nasal mucosa. The saline water was used as a bl...We studied the effects of nasal thermosensible gels containing Chinese medicine Xingbi on Bufo gargarizans maxillary mucosal cilia movement and the ciliotoxicity in rats nasal mucosa. The saline water was used as a blank control, and 1% hydrochloric acid of methamphetamine Massachusetts was used as the negative control. Compared with normal saline control, the relative percentage of the lasting time of ciliary movement treated with Chinese medicine Xingbi was 94.1%. There was no remarkable pathological change in the tissue slice of nasal mucosa, and no stimulation on nasal mucous membrane was observed. So these data suggest that nasal thermosensible gel of Chinese medicine Xingbi is of high safety. It has no damage to the mucosa of toads and rats and can be used for intranasal administration.展开更多
AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV)use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric in...AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV)use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric intensive care unit(PICU)or inpatient general pediatrics between January 2013 and December 2015 at two academic centers.Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included.Data included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortalityⅢ(PRIsM-Ⅲ)scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and complications.Patients who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV)were defined as NIMV nonresponders.NIMV responders were compared to NIMV non-responders.RESULTS Forty-two patients met study criteria.six(14%)failed treatment and required MV.The majority of the patients(74%)had a primary diagnosis of bronchiolitis.The median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P=0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲscores.The duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P<0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory support.No patients had aspiration pneumonia,pneumothorax,or skin breakdown.CONCLUSION Most of our patients responded to NIMV.NIMV failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.展开更多
OBJECTIVE The study aims to evaluate intranasal(i.n.)curcumin at 5mg·kg-1,its absorption through nasal mucosa reaching blood and lungs and investigate its anti-allergic and anti-asthmatic potentiality in ameliora...OBJECTIVE The study aims to evaluate intranasal(i.n.)curcumin at 5mg·kg-1,its absorption through nasal mucosa reaching blood and lungs and investigate its anti-allergic and anti-asthmatic potentiality in ameliorating ovalbumin induced asthma in mouse model.METHODS A simple and sensitive high performance liquid chromatography method using UV detection(HPLC-UV)was developed and validated for the determination of nasal curcumin 5mg·kg-1 in nasal mucosa,plasma and lungs from 15min-6hof post dosing and further applied to determine the pharmacokinetics parameter.Further,for the anti-asthmatic study,BALB/c mice were sensitized(day 1,7and 14)and challenged with ovalbumin(day 19-22)and treated with intranasal curcumin 5mg·kg-1(in the form of nasal drops)before an hour of challenge(day 19-22)to investigate its therapeutic effect on various parameters of airway inflammation as detected in the bronchoalveolar lavage fluid,serum and lung tissue.Serum was also used to study the liver kidney function test for the toxicity.RESULTS The validated method of HPLC was sensitive with a lower limit of quantitation of 5μg·mL-1 and the calibration curve represented good linearity(r2≥0.999)over the linear range of 5-50μg·mL-1.HPLC study reveals,absorption and quantification of curcumin as 1.9μg·mL-1 in the nasal mucosal scrapping at 15 min elevating to 4.9μg·mL-1 till 1h and declining to 3.2μg·mL-1 till 3h after intranasal administration of curcumin(5mg·kg-1).The plasma showed 0.9μg·mL-1 after 15 min spiking upto 1.5μg·mL-1 till 3h while lung homogenate retained up to 3.6μg·mL-1 of curcumin till 3h,which was detectable from 15min(0.27μg·mL-1)and was on higher side as compared to earlier studies.The same pharmacological dose(5mg·kg-1,i.n.)has shown anti-asthmatic potential by inhibiting airway inflammation(eosinophilic inflammation),bronchoconstriction and modulation in cytokines level of Th2(IL-4,IL-5),Th1(IFN-γ)and proinflammatory(TNF-α)cytokines in ovalbumin induced asthma without having any side effect as detected by liver kidney function test.CONCLUSION The study reveals nasal mucosa as a viable route for the absorption of intranasal curcumin and accommodating increased transportation to the blood and lungs.Also,the nasal route is effective in retaining the level of curcumin till 6h without any degradation and hence could be a promising route to improve its biological activities.Present study may prove the possibility of curcumin as complementary medication in the development of nasal drops or through nebulizer in human subjects.Further,pharmacodynamic study is in progress to prove its effectiveness not only in pulmonary disorders but also for systemic disorders.展开更多
Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to ...Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to the sella, it entails complications such as nasal bleeding, impaired olfactory function, atrophic rhinitis, synechiae, etc. No studies have yet reported potential morbidities such as empty nose syndrome (ENS), although patients have a relatively empty nasal cavity after surgery. Therefore, we sought to verify the percentage of patients who truly met the diagnostic criteria for ENS after endoscopic transnasal sellar surgery, determine the variation between pre- and postoperative scores in each Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) item, and further evaluate the symptoms that may affect the patients the most after surgery. Methods: Between March 2015 and January 2019, eventually 11 patients who underwent extended endoscopic transnasal sellar surgery in Shin Kong Wu Ho-Su Memorial Hospital, a tertiary referral medical center in Taipei, Taiwan, were enrolled. The patients completed the recently validated ENS6Q after surgery. Results: One patient met the objective diagnostic criteria for ENS (score ≥ 11 in ENS6Q). Significant differences were observed in the pre- and postoperative total ENS6Q scores. The pre- and postoperative scores of “nose feeling too open” and nasal crusting showed statistically significant differences. Further, compared with the other items, the postoperative score of nasal crusting increased most obviously, and it may be the most apparent operation-related symptom. Conclusion: This study is the first to report the possibility of developing ENS after endoscopic transnasal sellar surgery. Although the transnasal endoscopic approach is a safe and minimally invasive procedure for the treatment of sellar lesions, possible complications such as ENS should be considered.展开更多
文摘Background:It is found to have association of facial parameters with trisomy 21 fetuses(T 21).We have compared prenasal thickness(PNT),nasal bone length(NBL),and the PNT:NBL ratio of normal fetuses with fetuses with trisomy 21(T 21)between 16 and 25 weeks of gestation as a diagnostic tool for T 21.Methods:Facial profile images in the two dimensional(2D)gray scale were assessed to measure fetal NBL and PNT between 16 and 25 weeks of gestation.The PNT:NBL ratio of the fetuses was calculated.Nomograms were constructed from the data of morphologically normal fetuses at live birth.The PNT,NBL,and PNT:NBL ratio of fetuses with confirmed T 21(n=31)and morphologically normal fetuses at live birth(controls,n=3485)were compared.Results:Nomograms for PNT,NBL,and the PNT:NBL ratio were constructed.In T 21 fetuses,PNT(>95th percentile),NBL(<5th percentile),and the PNT:NBL ratio(>95th percentile)showed a sensitivity of 25%,29%,and 45%for PNT,NBL,and PNT:NBL,respectively,and specificity of 95%,96%,and 94%,for PNT,NBL,and PNT:NBL,respectively.All of these markers showed a negative predictive value of 99%.Conclusion:PNT,NBL,and the PNT:NBL ratio have high diagnostic value for fetuses with Down syndrome and can be incorporated easily in the current second trimester screening protocol for T 21.PNT,NBL,and the PNT:NBL ratio are more specific markers for Down syndrome than those used in previous studies.
文摘BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental discovery of a fungal ball in the nasal cavity during routine imaging,with no associated clinical symptoms.CONCLUSION This case underscores the importance of considering the possibility of asympto-matic presentations of nasal fungal balls,which may be detected incidentally during imaging evaluations.
文摘This study aimed to investigate the effect of evidence-based nursing intervention on patients undergoing nasal endoscopic resection of nasal polyps,particularly focusing on its impact on MIGILL’s pain scores.A total of 74 patients who underwent endoscopic nasal polyp resection were randomly divided into two groups using a random number table method.The outcomes of evidence-based nursing intervention in the observation group were compared with those of the control group.The results showed that the MIGILL pain scores in the observation group were significantly lower than those in the control group,and both hospitalization time and cost were notably reduced(P<0.05).Additionally,patients in the observation group demonstrated better psychological states and experienced fewer postoperative complications compared to the control group(P<0.05).Furthermore,the quality of life scores were significantly higher in the observation group(P<0.05).These findings suggest that evidence-based nursing intervention after endoscopic resection of nasal polyps is highly effective in alleviating postoperative pain,improving emotional well-being,minimizing complications,reducing hospital stay and expenses,and enhancing overall quality of life,indicating its potential value for broader clinical application.
文摘Objective To get the basic data of nasal figure of the Han nationality individuals in Xi'an area and provide for junsprudence and the reconstruction of skull. Methods Nasal height, length, depth and breadth of 313cases in Xi'an area, which had different age and sex, were measured by magnetic resonance imaging (MRI). Results Image of MRI could clearly show the figure of nose and the position we selected were correct and accuracy. The specific data were: Nasal length (male:34. 47±4.29 ～52.20±3.47, female:33. 11±3.33～46. 94±3.83); Nasal height(male: 39.22±3.68～59.49±2.30, female: 33.89±3.95～51.75±3.68); Nasal depth(male: 11.89±1.76～16.68±2.48, female: 10.69±1. 81～16.46±2.04);Nasal breadth(male: 33. 09±3. 83～42. 49±2.72,female:32.00±1.94～38. 86±2.61). So the results were credible. Conclusion The nasal figure of individuals in Xi'an area is different as their different age and sex. It promotes that the influence factors of age and sex must be considered in the facial reconstruction and medico legally reconstructing skull.
文摘Background: Reconstruction of Nasal Tip Columella (NTC) subunits is one of the most challenging aspects in functional aesthetic rhinoplasty. Moreover, racial variation for Asian nose rhinoplasty could even demand sophistication of tip and columella strut graft infrastructure enhancement. Various autogenous graft options such as 6th costal cartilage, septal cartilage and conchal cartilage are very commonly considered whilst the 10th costal cartilage is scarcely reported. Objective and Method: The purpose of this manuscript is to illustrate the detailed operative steps to harvest the 10th costal cartilage for infrastructural grafting at NTC subunits by a case illustration. The pros and cons of different cartilage options will be discussed, particularly its application in cleft nose rhinoplasty in Chinese patient. We have adopted the 10th rib as the key option for NTC reconstruction in 11 cases of Chinese cleft secondary rhinoplasty since 2019 and have achieved good and stable results without complications. Conclusion: The 10th costal cartilage is one of the best options in Nasal Tip Columella subunits reconstruction, particularly in complex cleft nose or failure revision aesthetic rhinoplasty cases, due to its safety of harvesting, and the sufficient quality and quantity of grafting materials it provides for simultaneous adjunctive augmentation purpose.
文摘BACKGROUND In diabetic patients,persistent hyperglycemia creates an optimal environment for the proliferation of pathogenic bacteria,resulting in severe complications.Con-sequently,chronic rhinosinusitis(CRS)complicated by diabetes is highly pre-valent in clinical settings.AIM To analyze the results of nasal secretion cultures in diabetic patients with CRS and identify the factors influencing postoperative recurrence.METHODS A retrospective analysis was conducted on the clinical data of 203 diabetic pa-tients with CRS with nasal polyps who underwent the Messerklinger technique at Qingdao Hiser Hospital Affiliated of Qingdao University between January 2021 and January 2023.Preoperative nasal secretions were cultured to determine the types and distribution of pathogenic bacteria and assess antimicrobial suscept-ibility.Based on a one-year follow-up,patients were categorized into recurrence and nonrecurrence groups to analyze differences in their clinical data.Univariate and multivariate analyses were used to identify factors influencing postoperative recurrence.RESULTS Pathogens were detected in 153 of the 203 nasal secretion specimens collected from diabetic patients with CRS.A total of 134 pathogenic bacteria strains were isolated and identified,including 81 strains(60.4%)of gram-positive bacteria and 53 strains(39.6%)of gram-negative bacteria.Gram-positive bacteria exhibited relatively high resistance to penicillin G and erythromycin,while remaining highly sensitive to vancomycin,gentamicin,and rifampicin.Gram-negative bacteria demonstrated relatively high resistance to cefazolin and gentamicin,but showed high sensitivity to imipenem,meropenem,cefepime,and ceftazidime.Univariate analysis revealed statistically significant differences between the recurrence and nonrecurrence groups in fasting blood glucose levels,smoking history,Lund-Mackay scores,visual analog scale(VAS)scores,nasal septum deviation,allergic rhinitis,bronchial asthma,postoperative infection,long-term use of nasal decongestants,and adherence to medical prescriptions.Multivariate regression analysis identified fasting blood glucose levels and VAS-measured nasal symptom severity scores as independent factors influencing postoperative recurrence.CONCLUSION In CRS patients with nasal polyps(CRSwNP),the detection rate of nasal pathogens is relatively high,and most of the isolated bacteria exhibit antimicrobial resistance.Additionally,the blood glucose level of patients with CRS combined with CRSwNP is a risk factor for postoperative recurrence.
文摘Exogenous lipoid pneumonia is a rare and under recognized pulmonary disorder caused by the inhalation or aspiration of fat-like substances.Nasal decongestants containing mineral oils or paraffin are emerging as overlooked etiological agents.This review consolidates existing literature to delineate the clinical,radiological,and pathological features of exogenous lipoid pneumonia induced by nasal decongestants,highlight diagnostic challenges,and underscore the importance of thorough patient history in early diagnosis and management.This condition,while preventable,can result in serious pulmonary complications if not recog-nized early.It necessitates a multidisciplinary approach that incorporates careful history taking,high-resolution imaging,cytological assessment,and public health vigilance.
文摘BACKGROUND Merkel cell carcinoma(MCC)is a rare and aggressive skin cancer with high incidence in older and immunocompromised patients.Its occurrence in the nasal dorsum is extremely rare and poses significant diagnostic and therapeutic challenges.CASE SUMMARY We report the case of a 65-year-old woman with diabetes mellitus and hypertension who presented with a dorsal nasal mass.The initial differential diagnosis favored hemangioma-based clinical examination on imaging.Histopathological examination after excision revealed MCC,necessitating a complex management strategy.A 3 cm×2 cm nasal mass,initially suspected to be a hemangioma,was excised but revealed MCC with positive margins.Positron emission tomography–computed tomography confirmed metastatic cervical lymphadenopathy.The patient underwent bilateral neck dissection,revealing metastases in seven nodes.Residual activity was treated with radiation therapy,leading to a favorable response after 6 months.CONCLUSION This case highlights the importance of considering MCC in the differential diagnosis of nasal masses,and integrated management.
文摘BACKGROUND Natural killer(NK)/T-cell non-Hodgkin's lymphoma(NHL)in the nasal cavities and paranasal sinuses accounts for approximately 10%of all lymphomas,and the occurrence of nasal NHL is related to Epstein-Barr virus infection.AIM To explore the anxiety and depression status of patients with NK/T-cell NHL in the nasal cavities and paranasal sinuses and analyzes the relevant influencing factors.METHODS A retrospective analysis was performed,which included 30 patients with primary nasal NK/T-cell NHL treated in Shaanxi Provincial People’s Hospital from January 2017 to January 2023.An additional 50 healthy volunteers were selected as the control group.Both groups were assessed using the self-rating anxiety scale(SAS)and Self-rating(SDS).SDS and SAS scores of patients with NHL at different disease stages were analyzed,and they were further grouped into negative emotion(NE)(n=19)and non-NE(n=11)groups based on their depression and anxiety.Factors affecting the occurrence of NEs in patients with NHL were analyzed using univariate and multivariate logistic regression models.RESULTS Patients with NHL exhibited higher SDS and SAS scores than healthy controls.Moreover,patients with NHL at stages III and IV had higher SDS and SAS scores than those in stage I.Among the 30 patients,there were 13 patients with depression(43.3%),16 patients with anxiety(53.3%),and 10 patients with both anxiety and depression(33.3%).Univariate analysis identified a higher proportion of people in the NE group with stage III-IV NHL,an educational level≤high school,and a monthly household income<5000 yuan compared with the non-NE group.Multiple logistic regression analysis further revealed that stage III-IV was a risk factor for NEs in patients with NHL.CONCLUSION The stage of NK/T-cell NHL in nasal cavities and paranasal sinuses is closely related to patient anxiety and depression.The higher the staging,the greater the incidence of anxiety and depression.
基金2022 Inner Mongolia Autonomous Region Health and Wellness Science and Technology Program Project(Project No.:202201533)。
文摘Patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)often suffer from respiratory failure and require respiratory support therapy.High-flow nasal cannula oxygen therapy(HFNC)and non-invasive positive pressure ventilation(NIPPV)are commonly used non-invasive respiratory support methods.HFNC can provide precisely heated and humidified high-flow oxygen,reducing dead space and increasing alveolar ventilation.NIPPV can supply stable high-concentration oxygen and improve gas exchange.This article reviews the application of HFNC and NIPPV in the acute exacerbation stage of COPD,aiming to provide references for reasonable clinical selection.
文摘BACKGROUND Nasal trauma presents a risk of foreign body invasion into the nasal cavity.However,in the early treatment stage of nasal trauma,patients and doctors are not always aware of possible foreign body invasion,resulting in delayed detection.We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow,purulent,and bloody discharge.CASE SUMMARY Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment,resulting in a glass fragment retained in the nasal cavity adjacent to the orbit.After admission,computerized tomography(CT)confirmed the presence of the foreign body in the patient’s left nasal–maxillary sinus.The nasal foreign body led to symptoms such as chronic sinusitis,nasal polyps,fungal infection,and deviated nasal septum.The foreign body was successfully removed by nasal endoscopy,polypectomy,sinus fungal removal,left middle turbinate conchoplasty,fenestration via the right inferior meatus,nasal endoscopic maxillary sinus cystectomy,and septolplasty.The operation was successful and without any complications.CONCLUSION CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma.Surgical planning should be tailored to the patient’s specific situation.The surgical method should be carefully selected,and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.
基金supported by the National Natural Science Foundation of China(grant nos.81701901 and 81801946)Natural Science Foundation of Shanghai Committee of Science and Technology(grant no.19ZR1430100)Shanghai Municipal Key Clinical Specialty(grant no.shslczdzk00901)。
文摘Background: The repair of alar defects is challenging in clinics. Although skin grafts and nasolabial flaps are reliable, they can cause secondary post-surgical deformities.Methods: In this report, we describe an alar spiral advancement flap with a subcutaneous pedicle combined with postoperative nasal stent therapy for the repair of alar defects.Results: All cases showed slight asymmetry immediately after surgery, but at a median follow-up of 24 months, no cases of dissatisfaction with the nose shape or abnormal respiratory function were found. Almost all incision scars subsided within 12 months. In addition, all flaps that were dissected and rotated during the surgeries healed, and no signs of necrosis or development of vascular compromise were observed.Conclusion: Our preliminary experience suggests that the alar spiral flap followed by nasal stent therapy provides stable recovery of appearance and function for alar defects during follow-ups and shows promise for future therapies.
文摘Aim To investigate the relationship between pH environment of meptazinolhydrochloride (MEP) and its nasal absorption. Methods In situ nasal peifusion was performed to studythe effect of pH environment on the nasal absorption. Its effect on the transport from nose tobrain was further researched by in vivo experiment. Results In in situ perfusion experiment, thenasal absorption of MEP in basic environment was significantly higher than that in acid condition,but the difference was not observed in in vivo experiment. Conclusion The pH environment ofmeptazinol hydrocloride in formulation cannot be regarded as an important factor influencing nasalabsorption and transport from nose to brain.
基金supported by a grant from National Natural Science Foundation of China(No.81070772)Zhuhai Medical Scientific Research Fund(No.PC20081046)
文摘This study prospectively examined the intranasal distribution of nasal spray after nasal septal correction and decongestant administration. A cohort of 20 patients was assessed for the distribution of nasal spray before and after nasal septum surgery. Sprays were dyed and administered one puff per nostril when patients hold their head up in an upright position. Before and after decongestant admini-stration, the intranasal distribution was semi-quantitatively determined by nasal endoscopy. The results showed that the dyed drug was preferentially sprayed onto the nasal vestibule, the head of the inferior turbinate, the anterior part of septum and nasal floor. As far as the anterior-inferior segment of the nasal cavity was concerned, the distribution was found to be influenced neither by the decongestant nor by the surgery （P〉0.05）. However, both the decongestant and surgery expanded the distribution to the anatomical structures in the superior and posterior nasal cavity such as olfactory fissure, middle turbinate head and middle nasal meatus. No distribution was observed in the sphenoethmoidal recess, posterior septum, tail of inferior turbinate and nasopharynx. It was concluded that nasal septum surgery and decongestant administration significantly improves nasal spray distribution in the nasal cavity.
基金National Natural Science Foundation of China (Grant No.81073117)the construction ofcollege service routines in fujian province key project(Grant No.2008FG-06)
文摘We studied the effects of nasal thermosensible gels containing Chinese medicine Xingbi on Bufo gargarizans maxillary mucosal cilia movement and the ciliotoxicity in rats nasal mucosa. The saline water was used as a blank control, and 1% hydrochloric acid of methamphetamine Massachusetts was used as the negative control. Compared with normal saline control, the relative percentage of the lasting time of ciliary movement treated with Chinese medicine Xingbi was 94.1%. There was no remarkable pathological change in the tissue slice of nasal mucosa, and no stimulation on nasal mucous membrane was observed. So these data suggest that nasal thermosensible gel of Chinese medicine Xingbi is of high safety. It has no damage to the mucosa of toads and rats and can be used for intranasal administration.
基金supported by NIH National Center for Advancing Translational Science,No.UL1TR001881
文摘AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV)use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric intensive care unit(PICU)or inpatient general pediatrics between January 2013 and December 2015 at two academic centers.Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included.Data included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortalityⅢ(PRIsM-Ⅲ)scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and complications.Patients who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV)were defined as NIMV nonresponders.NIMV responders were compared to NIMV non-responders.RESULTS Forty-two patients met study criteria.six(14%)failed treatment and required MV.The majority of the patients(74%)had a primary diagnosis of bronchiolitis.The median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P=0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲscores.The duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P<0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory support.No patients had aspiration pneumonia,pneumothorax,or skin breakdown.CONCLUSION Most of our patients responded to NIMV.NIMV failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.
基金The project supported by University Grant Commission,New Delhi(P-01/634)
文摘OBJECTIVE The study aims to evaluate intranasal(i.n.)curcumin at 5mg·kg-1,its absorption through nasal mucosa reaching blood and lungs and investigate its anti-allergic and anti-asthmatic potentiality in ameliorating ovalbumin induced asthma in mouse model.METHODS A simple and sensitive high performance liquid chromatography method using UV detection(HPLC-UV)was developed and validated for the determination of nasal curcumin 5mg·kg-1 in nasal mucosa,plasma and lungs from 15min-6hof post dosing and further applied to determine the pharmacokinetics parameter.Further,for the anti-asthmatic study,BALB/c mice were sensitized(day 1,7and 14)and challenged with ovalbumin(day 19-22)and treated with intranasal curcumin 5mg·kg-1(in the form of nasal drops)before an hour of challenge(day 19-22)to investigate its therapeutic effect on various parameters of airway inflammation as detected in the bronchoalveolar lavage fluid,serum and lung tissue.Serum was also used to study the liver kidney function test for the toxicity.RESULTS The validated method of HPLC was sensitive with a lower limit of quantitation of 5μg·mL-1 and the calibration curve represented good linearity(r2≥0.999)over the linear range of 5-50μg·mL-1.HPLC study reveals,absorption and quantification of curcumin as 1.9μg·mL-1 in the nasal mucosal scrapping at 15 min elevating to 4.9μg·mL-1 till 1h and declining to 3.2μg·mL-1 till 3h after intranasal administration of curcumin(5mg·kg-1).The plasma showed 0.9μg·mL-1 after 15 min spiking upto 1.5μg·mL-1 till 3h while lung homogenate retained up to 3.6μg·mL-1 of curcumin till 3h,which was detectable from 15min(0.27μg·mL-1)and was on higher side as compared to earlier studies.The same pharmacological dose(5mg·kg-1,i.n.)has shown anti-asthmatic potential by inhibiting airway inflammation(eosinophilic inflammation),bronchoconstriction and modulation in cytokines level of Th2(IL-4,IL-5),Th1(IFN-γ)and proinflammatory(TNF-α)cytokines in ovalbumin induced asthma without having any side effect as detected by liver kidney function test.CONCLUSION The study reveals nasal mucosa as a viable route for the absorption of intranasal curcumin and accommodating increased transportation to the blood and lungs.Also,the nasal route is effective in retaining the level of curcumin till 6h without any degradation and hence could be a promising route to improve its biological activities.Present study may prove the possibility of curcumin as complementary medication in the development of nasal drops or through nebulizer in human subjects.Further,pharmacodynamic study is in progress to prove its effectiveness not only in pulmonary disorders but also for systemic disorders.
文摘Background: Several large series have established endoscopic transnasal sellar surgery as the procedure of choice for removal of tumors in the sellar area. Although this procedure provides a less invasive approach to the sella, it entails complications such as nasal bleeding, impaired olfactory function, atrophic rhinitis, synechiae, etc. No studies have yet reported potential morbidities such as empty nose syndrome (ENS), although patients have a relatively empty nasal cavity after surgery. Therefore, we sought to verify the percentage of patients who truly met the diagnostic criteria for ENS after endoscopic transnasal sellar surgery, determine the variation between pre- and postoperative scores in each Empty Nose Syndrome 6-Item Questionnaire (ENS6Q) item, and further evaluate the symptoms that may affect the patients the most after surgery. Methods: Between March 2015 and January 2019, eventually 11 patients who underwent extended endoscopic transnasal sellar surgery in Shin Kong Wu Ho-Su Memorial Hospital, a tertiary referral medical center in Taipei, Taiwan, were enrolled. The patients completed the recently validated ENS6Q after surgery. Results: One patient met the objective diagnostic criteria for ENS (score ≥ 11 in ENS6Q). Significant differences were observed in the pre- and postoperative total ENS6Q scores. The pre- and postoperative scores of “nose feeling too open” and nasal crusting showed statistically significant differences. Further, compared with the other items, the postoperative score of nasal crusting increased most obviously, and it may be the most apparent operation-related symptom. Conclusion: This study is the first to report the possibility of developing ENS after endoscopic transnasal sellar surgery. Although the transnasal endoscopic approach is a safe and minimally invasive procedure for the treatment of sellar lesions, possible complications such as ENS should be considered.
