Abstract:
OBJECTIVES:Inadvertent intracranial injury from nasogastric tube (NGT) placement is a described and potentially fatal complication following endoscopic transsphenoidal hypophysectomy (TSH). This cadaver study assessed the role of middle turbinate (MT) preservation and medialization in preventing accidental skull base injury from NGT insertion after TSH. Methods: Standard approach for TSH was performed on 3 human cadavers. MTs were placed into neutral position (MTN), then medialized via suture pexy to the septum (MTP), and subsequently resected (MTR). After each stage, 3 blinded individuals passed a 10 F Dobhoff and a 16 F NGT on each side of each cadaver (5 passes per side). Using endoscopic visualization, each pass was scored by a blinded reviewer based on the first contact point of the tube (0 = nasopharynx, 1 = inferior sphenoid face, 2 = sphenoid sinus), with higher scores suggestive of increased risk of intracranial injury. Results: There were 270 Dobhoff and 270 NGT passes scored. Data was divided into 3 groups based on presence and position of the MT. Significant differences were demonstrated between all three groups [one-way ANOVA: Dobhoff F(2,267) = 6.981, p = 0.001], [NGT F(2,267) = 17.582, p < 0.001]. There were significant differences between means for MTN versus MTP groups [Dobhoff (0.43 vs 0.22, p = 0.007), NGT (0.73 vs 0.28, p < 0.001)] and MTP versus MTR groups [Dobhoff (0.22 vs 0.55, p < 0.001), NGT (0.28 vs 0.81, p < 0.001)], indicating that the presence and position of the MT can significantly affect the accessibility of the sphenoid sinus interior after TSH. There was a trend toward lower means in the MTN group compared to the MTR group. Conclusion: MT preservation and deliberate medialization against the septum may reduce risk of inadvertent intracranial NGT injury in postop TSH patients. This simple maneuver should be considered in all routine TSH procedures.
journal_name
Am J Rhinol Allergyjournal_title
American journal of rhinology & allergyauthors
Shah J,Tang D,Grafmiller K,Cappello ZJ,Roxbury C,Sindwani Rdoi
10.1177/1945892420933173subject
Has Abstractpub_date
2021-01-01 00:00:00pages
59-63issue
1eissn
1945-8924issn
1945-8932journal_volume
35pub_type
杂志文章abstract:BACKGROUND:Liquid-based cytology (LBC) has achieved great success in cytological diagnosis of various cancers when compared with conventional smear methods. However, its application in diagnosing nasopharyngeal carcinoma (NPC) has never been studied. METHODS:Eighty-four consecutive patients who underwent nasopharyngea...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2009.23.3341
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Although nasal steroids are the mainstay treatments in nasal polyposis, up to one-half of patients do not respond and need surgical treatment. This study aimed to evaluate whether oxymetazoline administration produces any additive effect on nasal steroid therapy and whether rebound congestion develops after ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2016.30.4294
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Viral respiratory tract infections are associated with a significant burden of disease and represent one of the leading causes of mortality worldwide. The current Coronavirus Disease 2019 (COVID-19) pandemic highlights the devastating toll that respiratory viruses have on humanity and the desperate need to u...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,评审
doi:10.1177/1945892420947929
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:There is a correlation between (18)F-fluorodeoxyglucose (FDG) uptake and the level of intracellular metabolic tumor activity, which in turn may be associated with active proliferation, invasion, and prognosis as well as distant metastases in head and neck cancer. This study was designed to assess whether tum...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3848
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Nonallergic rhinitis (NAR) is characterized by nasal symptoms similar to allergic rhinitis (AR) without an IgE-mediated immune response. Limited data are available on the natural history of NAR in its progression toward AR, particularly in children. This study evaluates the development of AR in children who...
journal_title:American journal of rhinology & allergy
pub_type: 临床试验,杂志文章
doi:10.2500/ajra.2013.27.3839
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The association between olfactory dysfunction (OD) and cognitive decline is becoming apparent in the emerging literature. However, the literature demonstrating a similar effect between gustatory dysfunction (GD) and cognition is not well established. OBJECTIVE:To determine whether OD and GD are independentl...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.1177/1945892418824451
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Gelsolin is an actin-binding protein with multiple cellular functions including apoptosis and is reported to be down-regulated in various cancers and premalignant lesions. The objective of this study was to identify gelsolin and caspase-3 expression in inverted papilloma (IP) and investigate the role of gels...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2012.26.3753
更新日期:2012-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the amount and type of osteitis observed in chronic rhinosinusitis with nasal polyposis (CRSwNP) and compare it with that of chronic rhinosinusitis without nasal polyposis (CRSnNP). SETTING:Sisli Etfal Research and Education Hospital, Istanbul, Turkey. STUDY DESIGN:Prospective, single-blind, coh...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2015.29.4240
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:The clinical importance of serum squamous cell carcinoma antigen (SCCA) and SCCA subclasses has not been established for treating inverted papilloma (IP). The aim of this study was to clarify the clinical importance of serum SCCA and its subclasses in IP, compared with maxillary squamous cell carcinoma and ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2012.26.3797
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The management of allergic rhinitis (AR) encompasses education, pharmacotherapy, immunotherapy, and surgery. FK506 (tacrolimus) is an immunosuppressant that inhibits allergic reactions. The purpose of this study was to reveal whether FK506 treatment reduces allergic inflammation in an AR mouse model and to ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2012.26.3743
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Conclusive evidence exists that biofilms are present on the mucosa of chronic rhinosinusitis (CRS) patients. Less is known about the species constituting these biofilms. This study developed a fluorescence in situ hybridization (FISH) protocol for characterization of bacterial and fungal biofilms in CRS. ME...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2009.23.3413
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Patients report nasal congestion as the most bothersome seasonal allergic rhinitis (SAR) symptom. Measurement of this symptom in previous research has largely been based on subjective patient ratings. This study was designed to measure efficacy, onset, and duration of action of the corticosteroid mometasone ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2010.24.3548
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Chronic rhinosinusitis (CRS) has a multifactorial etiology, with a debate about the role of inhalant allergy in the pathogenesis of CRS. OBJECTIVE:This study assessed the impact of allergy status on externalized paranasal sinuses after tumor resection to determine if a predisposition to inhalant allergy bro...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2017.31.4388
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Sinonasal papillomas are benign epithelial neoplasms arising from Schneiderian mucosa. The three subtypes, exophytic, oncocytic, and inverted (inverted papilloma [IP]), should be distinguished from one another histopathologically. This study (1) highlights the histopathological and clinical differences betwe...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3904
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:This study reports the combined experience of the University of Miami and University of Pittsburgh with endoscopic endonasal resection of esthesioneuroblastoma (ENB). A retrospective case series review was performed in a tertiary care university hospital. METHODS:Twenty-three patients, 16 men and 7 women, w...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,多中心研究
doi:10.2500/ajra.2009.23.3269
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Assessing surgical competency in otolaryngology is challenging, and residency programs are now responsible for ensuring the surgical competency of their graduates. Therefore, more objective assessment tools are being incorporated into the evaluation process. Objective structured assessment of technical skill...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2014.28.4051
更新日期:2014-07-01 00:00:00
abstract:BACKGROUND:Nasal obstruction (NO) is a very common symptom, but its effect on nasal physiology has not been fully understood. We performed this study to determine the effect of severity of NO due to inferior turbinate hypertrophy on airflow pattern using the computational fluid dynamics simulations. METHODS:A three-di...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2009.23.3287
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Laryngeal edema is a life-threatening manifestation of hereditary angioedema (HAE), an autosomal-dominant disorder caused by quantitative or functional C1 esterase inhibitor (C1 INH) deficiency. The preparation of nanofiltered C1 INH (C1 INH-nf) used in this study is indicated for routine prophylaxis against...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3973
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Cigarette smoke exposure (CSE) results in extensive inflammation in the upper and lower airways. Reactive oxygen species, such as superoxide, have been shown to be potent mediators of this inflammation. METHODS:Mucosal biopsy specimens were collected from patients undergoing sinonasal surgery and were used ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2009.23.3400
更新日期:2009-11-01 00:00:00
abstract::Chronic rhinosinusitis (CRS) affects 12.5% of the U.S. POPULATION:CRS can be divided into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps. Some individuals with CRSwNP do not respond to standard-of-care medical and surgical management. For these individuals, targeted biologic agents are emerging as an imp...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,评审
doi:10.2500/ajra.2017.31.4412
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:MUC5AC, a major secreted mucin, is increased in chronic inflammatory airway disease. Spleen tyrosine kinase (SYK) is a mediator, which acts as an important regulator of intracellular signal transduction in the inflammatory response. SYK was originally identified in hematopoietic cells, and its expression in ...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2016.30.4276
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Over the past 10 years, the management of juvenile nasopharyngeal angiofibroma (JNA) has been redefined because of the improvement of transnasal skull base techniques. However, the limits of endoscopic resection still have to be fully defined. The purpose of this study was to report on a series of patients p...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2009.23.3322
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Nasal polyposis represents the end point of multiple inflammatory pathways and controversy continues as to the exact roles of medical and surgical approaches in the management of nasal polyposis. METHODS:A combination of both is often required to manage polyps adequately with surgery and intranasal steroids...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,评审
doi:10.2500/ajra.2011.25.3681
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Patients who suffer from hyposmia and anosmia report a negative effect on their overall quality of life. Smell disturbance of patients with chronic rhinosinusitis (CRS) can improve after endoscopic sinus surgery (ESS). Although several studies have shown that 50-83% of patients may notice an improvement in o...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2013.27.3939
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Criterion standard treatment of allergic fungal sinusitis (AFS) is primary surgery followed by adjuvant therapy. Even after good surgery, recurrence rates vary from 10 to 79%. Antifungals, e.g., itraconazole, and steroids have shown varying success rates in delaying recurrences given after surgery. Itracon...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2015.29.4187
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:CD203c is a basophil surface marker and its expression is rapidly up-regulated after cross-linking of high-affinity immunoglobulin E (IgE) receptor (FcepsilonR1) by an allergen. CD203c basophil activation tests have been studied for the in vitro diagnosis of several allergic conditions. However, there is li...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2011.25.3723
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Antibiotics are frequently used to treat acute rhinosinusitis (ARS; acute sinusitis), although many episodes are viral. Because of community resistance concerns, current evidence provides limited support for the use of antibiotics in ARS. We conducted a retrospective comparative effectiveness outcomes asses...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2012.26.3781
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Specific antibody deficiency may predispose patients to recurrent respiratory tract infections. There is limited literature assessing specific antibody deficiency in chronic rhinosinusitis (CRS). This study evaluated the role of specific antibody deficiency in patients with CRS who have failed medical therap...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2011.25.3653
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:The nasal tip position and shape is critical to the overall view of the external nose and is significant in planning rhinoplasty procedures. This study was designed to review our experience in nasal tip surgery and to describe our own version of the suture technique in patients having endonasal rhinoplasty....
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章
doi:10.2500/ajra.2011.25.3678
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Concerns over radiation exposure with paranasal sinus computed tomography (CT) have recently evolved. Magnetic resonance imaging (MRI) may be more advantageous in this regard, but the diagnostic assessment of MRI in chronic rhinosinusitis (CRS) has not been reported. The purpose of this study was to determin...
journal_title:American journal of rhinology & allergy
pub_type: 杂志文章,随机对照试验
doi:10.2500/ajra.2009.23.3260
更新日期:2009-01-01 00:00:00