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Objectives: The aim of this study was to compare the efficacy of bioabsorbable steroid-eluting sinus stents versus absorbable Nasopore packs after endoscopic sinus surgery (ESS) for the treatment of chronic rhinosinusitis (CRS). Methods: One hundred eighty-one patients with CRS who underwent ESS were randomly assigned to receive a steroid-eluting sinus stent in one ethmoid sinus cavity, whereas the contralateral control side received a Nasopore pack. Endoscopic evaluations were performed 14, 30, and 90 days after the ESS. Postoperative intervention, polyp formation, adhesions, and middle turbinate (MT) position were assessed as efficacy outcomes. Results: The stents were successfully deployed in all 181 sinuses. Thirty days after the ESS, the stents significantly reduced the need for surgical intervention compared to the Nasopore (P <.0001). The percentage of cases with polyp formation was significantly lower on the stent sides compared with the Nasopore sides (P <.0001) at 14, 30, and 90 days after ESS. The percentage of severe adhesion was significantly lower on the stents sides than on the Nasopore sides at postoperative day 90 (P =.0003), whereas they were not significantly lower at postoperative days 14 and 30. There were no significant differences between the stent sides and the Nasopore sides regarding the frequency of MT lateralization at all end points. No device-related adverse events occurred. Conclusions: Our study demonstrated significant improvement in the early postoperative outcomes by reducing the need for postoperative surgical intervention and polyp formation using steroid-eluting stents when compared with absorbable Nasopore packs. The steroid-eluting sinus stents and the Nasopore packs were each effective in preserving the ethmoid sinus patency and in preventing MT lateralization. A further prospective cohort study with long-term postoperative outcomes is warranted. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the effects of nasal surgery on airflow characteristics in patients with obstructive sleep apnea (OSA) by comparing the alterations of airflow characteristics within the nasal and palatopharyngeal cavities. Methods: Thirty patients with OSA and nasal obstruction who underwent nasal surgery were enrolled. A pre- and postoperative 3-dimensional model was constructed, and alterations of airflow characteristics were assessed using the method of computational fluid dynamics. The other subjective and objective clinical indices were also assessed. Results: By comparison with the preoperative value, all postoperative subjective symptoms statistically improved (p < 0.05), while the Apnea-Hypopnea Index (AHI) changed little (p = 0.492); the postoperative airflow velocity and pressure in both nasal and palatopharyngeal cavities, nasal and palatopharyngeal pressure differences, and total upper airway resistance statistically decreased (all p < 0.01). A significant difference was derived for correlation between the alteration of simulation metrics with subjective improvements (p < 0.05), except with the AHI (p > 0.05). Conclusion: Nasal surgery can decrease the total resistance of the upper airway and increase the nasal airflow volume and subjective sleep quality in patients with OSA and nasal obstruction. The altered airflow characteristics might contribute to the postoperative reduction of pharyngeal collapse in a subset of OSA patients. [ABSTRACT FROM AUTHOR]

Nasal septal deviations (NSD) have been categorized into 7 types. The effect of these different deviations on airflow pattern and warming function has not been fully investigated. The purpose of this study was to utilize a computational fluid dynamics approach to assess the impact of NSD of varying types on nasal airflow and warming function. Patients with each type of NSD were enrolled in the study, and a normal participant as the control. Using a computational fluid dynamics approach, modeling of nasal function was performed. Indices of nasal function including airflow redistribution, total nasal resistance, airflow velocity, and airflow temperature were determined. Among all types of NSD, the maximal velocity and total nasal resistance were markedly higher in type 4 and 7 deviations. The flow partition and velocity distribution were also altered in type 4 and 7 as well as type 2 and 6 deviations. Airflow in all categories of NSD was fully warmed to a similar degree. From a computational aerodynamics perspective, the type of septal deviation may contribute to altered airflow characteristics. However, warming function was similar between septal deviation types. Future studies will help to ascertain the functional importance of septal deviation types and the applicability of these computational studies. [ABSTRACT FROM AUTHOR]

The article discusses a study which analyzed the clinical data of 16 patients with chronic invasive fungal rhinosinusitis (CIFRS) who were diagnosed in the Department of Rhinology of Beijing Tongren Hospital during the period from 2006 to 2014. Topics covered include the pathological features of CIFRS, its insidious onset and gradual progression, and the proposed feasible diagnosis and treatment strategies.

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Conclusions:There is clear correspondence between HU and histopathological evaluation of osteitis. It is feasible to evaluate bone remodeling in rabbit models with rhinosinusitis by measuring the HU. Objective:The objective of this study was to determine whether the HUs of rabbit CRS models can be used to objectively evaluate the degree of osteitis. Methods:Sixty rabbit models were inoculated withstaphylococcus aureus. The rabbits were divided into three groups. Each group was divided into a medication administration team and a control team. The HU of the bone in each image was measured. All of the animals were executed after the CT exam. The samples for the mucous and bone changes using light microscope observation were scored. These scores and the HU measurements were compared to the actual bone remodeling over time to examine whether we could evaluate bone remodeling by measuring the HU. Results:The average HU scores in Groups A, B, and C were significantly higher than those of normal rabbits (p < .05). The mucous and bone scores increased as the experimental period lengthened (p = .042, 0.002). HU correlated with the mucous and bone scores in rabbit models with rhinosinusitis (coefficientr = .830, 0.641, 0.586,p = .000). [ABSTRACT FROM PUBLISHER]

Conclusion:From aspect of fluid dynamics, expanding patients’ nasopharyngeal coronal-sectional area to 48.3–54.7% of normal area will bring the airflow velocity back to normal in adenoidal hypertrophy children. It might provide a suggestion for adenoidectomy range selection and whether total resection is necessary. Objectives:To evaluate the nasopharyngeal airflow characteristics in pediatric OSA patients with adenoidal hypertrophy, and to explore the proper resection range for adenoidectomy Method:Nine OSA patients and four normal children were recruited. The CT scans of their upper airway were collected and used to construct three dimensional models for fluid dynamics analysis. Using computational fluid dynamics, indices such as velocity, pressure, and coronal-sectional area were calculated. Results:Compared with the normal, the OSA children showed three characteristics in nasopharyngeal: the airflow velocity was significantly higher (p < 0.05), the coronal-sectional area was significantly smaller (p < 0.01), while pressure showed no difference (p > 0.05). In a study of the relationship between velocity and coronal-sectional area, this study investigates different coronal-sectional areas from 30–300 mm2. It was found that, when patients’ nasopharyngeal coronal-sectional area was expanded over 155–170 mm2, namely 48.3–54.7% of normal area, airflow velocity in nasopharyngeal showed no difference than normal. [ABSTRACT FROM PUBLISHER]

Objective: Establish the anatomical parameters of the nasal septum and the area of each component in patients with nasal septum deviation, for the sake of guiding the scope of surgical resection for correction of nasal septum deviation. Methods: This is a retrospective study of 128 cases of sinus computer tomography images of patients with nasal septum deviation, marked 9 nasal septal anatomical locations, measured the area of the nasal septum and its components, and analyzed the trend of the percentage of the area of the nasal septum cartilage in the total area of the nasal septum with age. Results: The total area of the nasal septum in the 128 patients with nasal septum deviation is: （2951.96±305.91） mm², the area of nasal septal cartilage: （961.89±229.64） mm², the area of the vertical ethmoid plate: （1123.96±214.17） mm², the area of the vomerine: （652.77±108.09） mm². The area of male septum is larger than that of female. As age increases, the nasal septal cartilage gradually decreases, and the percentage of the nasal septal cartilage area in the total area of the nasal septum gradually decreases. Conclusion: Elderly people who undergo nasal septum correction should be carefully considered to grasp the scope of resection, and the influence of gender on the area of nasal septum should also be paid attention., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)

Objectives: The aim of this study was to compare the efficacy of bioabsorbable steroid-eluting sinus stents versus absorbable Nasopore packs after endoscopic sinus surgery (ESS) for the treatment of chronic rhinosinusitis (CRS)., Methods: One hundred eighty-one patients with CRS who underwent ESS were randomly assigned to receive a steroid-eluting sinus stent in one ethmoid sinus cavity, whereas the contralateral control side received a Nasopore pack. Endoscopic evaluations were performed 14, 30, and 90 days after the ESS. Postoperative intervention, polyp formation, adhesions, and middle turbinate (MT) position were assessed as efficacy outcomes., Results: The stents were successfully deployed in all 181 sinuses. Thirty days after the ESS, the stents significantly reduced the need for surgical intervention compared to the Nasopore ( P < .0001). The percentage of cases with polyp formation was significantly lower on the stent sides compared with the Nasopore sides ( P < .0001) at 14, 30, and 90 days after ESS. The percentage of severe adhesion was significantly lower on the stents sides than on the Nasopore sides at postoperative day 90 ( P = .0003), whereas they were not significantly lower at postoperative days 14 and 30. There were no significant differences between the stent sides and the Nasopore sides regarding the frequency of MT lateralization at all end points. No device-related adverse events occurred., Conclusions: Our study demonstrated significant improvement in the early postoperative outcomes by reducing the need for postoperative surgical intervention and polyp formation using steroid-eluting stents when compared with absorbable Nasopore packs. The steroid-eluting sinus stents and the Nasopore packs were each effective in preserving the ethmoid sinus patency and in preventing MT lateralization. A further prospective cohort study with long-term postoperative outcomes is warranted.

Objective: To investigate the relationship between the maxillary sinus flow field, temperature field and the maxillary sinus ostium size, and to provide a reference for endoscopic surgery according to the maxillary sinus scope., Methods: One case of adult female CT image data was obtained, and used to build a three-dimensional model of nasal cavity and maxillary sinus. Computational fluid dynamics method was used to study the airflow and temperature of the maxillary sinus, as well as the physiological function of the maxillary sinus. Simulation surgery by means of different maxillary sinus diameters (normal, 8 mm, 10 mm, 12 mm and 15 mm) was used to describe the maxillary sinus airflow and temperature change., Results: It was found that by numerical simulation the airflow of maxillary sinus and nasal cavity showed lower speed (average speed 0.062 m/s) than that in the middle nasal meatus (average speed of 3.260 m/s), and the average temperature in the normal maxillary sinus was 34°C, which was higher than that in the middle nasal meatus (temperature 28.7°C). With the increase of the diameter of the maxillary sinus, the air temperature change was not obvious., Conclusions: The physiological function of the maxillary sinus can be studied through the numerical simulation. With the increase of the ostia diameter of maxillary sinus, the sinus temperature and ventilation is not affected. It provides a reference for quantification of clinical endoscopic maxillary sinus surgery.

Objective: This study was designed to investigate the clinical microbiology of fungal ball (FB) rhinosinusitis by culturing fungal clumps collected under endoscopic surgery., Methods: From April to November of 2012, fungal clumps were sampled by endoscopic surgery from patients diagnosed with FB using clinical and histopathological methods. The specimens were subjected to smear microscopy, and cultured for bacteria and fungi analysis., Results: Out of the 81 specimens from 80 patients, 69 (69/81, 85.19%) specimens were detected a mixed infection of bacteria and fungi. However, only 25 (25/81, 30.86%) specimens resulted in fungal growth. There were 12 (12/81, 14.81%) specimens with fungal infections alone. The cultured fungi included 36 strains belonging to five genera, and most of them were Aspergillus spp. (30/36, 83.3%). The cultured bacteria included 94 strains belonging to 16 genera, and the most frequently seen was Staphylococcus spp. (23/94, 35.94%). When it was fungal and Pseudomonas aeruginosa mixed infection, the fungal growth was inhibited (P = 0.002)., Conclusion: Patients with fungal ball usually have mixed fungal and bacterial infections. The fungi from these samples are sometimes difficult to culture, which may be the result of the inhibition by bacteria in vitro and in vivo.