Search

Olfactory neuroblastoma (ON) is a rare tumor commonly presenting between 50 and 60 years of age. In pediatric age this tumor is even rarer, with an estimated incidence of 0.1 per 100,000 children up to 15 years. It arises from the olfactory neurorepithelium of the nasal cavity, and it can be locally aggressive, spreading to the orbital cavity, skull base, intracranial cavity. In rarer cases it can also give distant metastasis, more frequently to regional lymph nodes and less commonly to distant sites like liver, lungs and bones. Prognosis varies depending on the stage at presentation (including dural invasion, regional nodal involvement, and distant metastasis), the histological grade, and aspects related to the treatment, such as the possibility to achieve clear margins with surgery and the multimodal approach. Chemotherapy, surgery and radiotherapy have been used to treat these patients and the different approaches have been reported in the literature. Given the rarity of the disease no shared guidelines exist for the management of this entity in children, but some suggestions can be given to optimize the ON management.This study presents the internationally recognized recommendations for the diagnosis and treatment of ON in children and adolescents, established by the European Cooperative Study Group for Pediatric Rare Tumors (EXPeRT) group within the EU-funded project Pediatric Rare Tumors Network - European Registry (PARTNER).

Myoepithelial carcinoma of the nasal cavity is extremely rare. We report the case of a 66-year-old man with myoepithelial carcinoma of the nasal cavity. Computed tomography (CT) and magnetic resonance imaging revealed a lobulated soft tissue mass with central necrosis and hemorrhage, as well as an invasion of the skull base and left orbit. The patient presented with continuous nasal congestion and heavy head and had no elevated level of squamous cell carcinoma-related antigen. CT, magnetic resonance imaging, or 18F-fluorodeoxyglucose (FDG) positron emission tomography/CT revealed no evidence of a metastatic lesion. 18F-FDG accumulation in the tumor was inhomogeneous and moderate. Histopathological examination of the resected specimen confirmed a well-circumscribed solid tumor with septa, a small area of hemorrhage, and necrosis. The subsequent diagnosis was a myoepithelial carcinoma of the left nasal cavity. This case shows that nasal myoepithelial carcinoma might appear as a well-defined lobulated mass with hemorrhagic necrosis and intense contrast enhancement in the solid component. We conjecture that hemorrhagic necrosis and intense enhancement values may be potential markers of nasal myoepithelial carcinoma.

After nasopharyngeal carcinoma treatment, secondary malignant tumors of the nasal cavities in the irradiated zone are extremely rare, with an estimated frequency of 0.15%-0.75%. They are more common in young persons who do not have traditional risk factors. The clinical symptomatology is dominated by nasal obstruction. The major goal of the CT-MRI imaging workup is to figure out the optimal treatment plan. However, histological confirmation of the diagnosis is required. The purpose of this case report is to explain the radiological characteristics of squamous cell carcinoma as seen on MRI, as well as to examine the literature on the carcinogenic risk of radiotherapy and chemotherapy.

Introduction: Obstructive sleep apnea is a consequence of upper airway collapse. Any obstructive sector in the upper airway can contribute to pharyngeal collapse. Obesity and obesity-related disorders play an important role in obstructive sleep apnea and its relationship with increased upper airway resistance. Objective: This study was designed to evaluate the relationship between obesity and properties of the nasal cavity in patients with obstructive sleep apnea. Methods: The study was conducted retrospectively by review of medical records of adult patients. The nasal obstruction symptom evaluation, NOSE instrument, was used to measure nasal obstruction. Sleep breathing disorders were evaluated by polysomnography exams. Nasal volume was obtained by computed tomography scans and volumetric reconstruction of nasal airway. Nasal anatomic alterations were assessed by nasal endoscopy. Results: Analysis of 83 patient records, among whom 54 were male and 29 females, found the mean body mass index of 28.69 kg/m2. Obese and non-obese groups were determined by using cut-off 30 kg/m2. In the comparison between groups, the obese group had a positive and significant correlation with apnea/hypopnea index (p = 0.02), NOSE instrument (p = 0.033) and inferior turbinate hypertrophy (p = 0.036), with odds ratio 1.983 (95% IC 1.048 − 3.753). nasal septum deviation (p = 0.126) and nasal airway volume evaluation (p = 0.177) showed no significant results. Conclusion: Obesity was significantly correlated with subjective nasal obstruction, NOSE scale, and inferior turbinate hypertrophy in patients with obstructive sleep apnea. There was no correlation with the nasal volume evaluation. Level of Evidence: 3b - Individual case-control study.

Introduction: Actinomycosis of the nasal cavity is very rare. Objective: The purpose of this study was to investigate the clinical features, treatment methods, and treatment results of actinomycosis of the nasal cavity in our hospital. Methods: We retrospectively enrolled 11 patients with histopathologically identified actinomycosis of the nasal cavity from January 2010 to May 2020. Results: This study included five males and six females. The most common symptom was purulent nasal discharge (36.4%). Nasal actinomycosis occurred in the maxillary sinus in 5 (45.5%) patients, the ethmoid sinus in two, the hard palate in two, the frontal sinus in one, and the nasal septum in one. After surgery, intravenous administration of antibiotics was performed on average for 7.4 days and oral antibiotics were prescribed for about 120.5 days. The clinical characteristics of the patients with nasal actinomycosis and the duration of antibiotic usage were not significantly different. Trauma was significantly associated with repeated nasal actinomycosis infections (p

Introduction: Carcinoma ex-pleomorphic adenoma (CXPA) of the nasal cavity is an exceedingly rare malignancy with limited literature available regarding its diagnosis and management. This case report overviews the clinical course of a patient with a rare sinonasal CXPA. Case presentation: A 76-year-old female presented with an expanding nasal bridge mass over three months, preceded by 18 months of nasal pain, bilateral discharge, and headaches that were refractory to conservative therapies. Magnetic resonance imaging demonstrated a large, septal soft tissue mass associated with local bone and soft tissue invasion. Positron emission tomography did not identify regional or distant metastases. Excisional biopsy histopathology confirmed CXPA. The patient underwent wide local excision, with a frontoethmoidectomy and resections of the middle turbinate and cribriform plate, and subsequent craniofacial reconstruction. The postoperative course was uncomplicated and the patient was discharged on postoperative day six with a plan for adjuvant radiotherapy. Conclusion: CXPA is a rare but important differential diagnosis of minor salivary gland malignancies in the nasal cavity. Symptoms are non-specific and should be investigated when refractory to conservative therapies or there is clinical suspicion of malignancy. Tissue diagnosis and surgical intervention are the mainstays of management.

An intranasal tumour was diagnosed in a 5-year-old male neutered crossbreed dog following a 6-8 week history of intermittent epistaxis and nasal discharge. Computed tomography identified a mass in the right nasal cavity. Histologically, the mass was composed of sheets and indistinct clusters of predominantly clear or vacuolated round to polygonal cells; periodic acid-Schiff staining revealed glycogen granules within some tumour cells. Immunohistochemical labelling revealed that the tumour cells were immunopositive for vimentin and S100 and negative for pancytokeratin, Melan-A and PNL2, supporting a diagnosis of a clear cell variant of chondrosarcoma (CCC). Although the dog was treated with meloxicam, the owners opted for euthanasia 9 days after presentation. Considering that there is only one other reported case of a suspected CCC in a dog, also in the nasal cavity, this could represent a species-specific predilection site of this rare canine neoplasm., Competing Interests: Declaration of competing interests The authors declared no conflicts of interest in relation to the research, authorship or publication of this article., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

The nasal administration of therapeutic fluids and vaccines is used to treat allergic rhinitis, sinusitis, congestion, coronaviruses and even Alzheimer's disease. In the latter, the drug must reach the olfactory region, so it finds its way into the central nervous system. Effective administration techniques able to reach the olfactory region are challenging due to the tortuous anatomy of the nasal cavity, and are frequently evaluated in vitro using transparent anatomical models. Here, the liquid distribution inside a 3D printed human nasal cavity is quantified for model fluids resulting from the discharge of a 1-mL syringe with either a spray-generating nozzle, and a straight tip emitting a collimated fluid stream. Experiments using two model fluids with different viscosities suggest that a simple, correctly positioned straight tip attached to a syringe is able to efficiently deliver most of a therapeutic fluid in the human olfactory region in the side-laying position, avoiding the adoption of head-back and head-down positions that can be difficult for patients in the age range typical of Alzheimer's disease. Furthermore, we demonstrate by computer simulations that the conclusion is valid within a wide range of parameters., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 American Pharmacists Association. Published by Elsevier Inc. All rights reserved.)

Introduction: Persistent unilateral sinonasal symptoms should be concerning for the presence of a sinonasal mass. Metastatic disease should be on the differential during diagnosis. Case presentation: A 76-year-old woman with a history of non-Hodgkin's lymphoma, alcoholic liver cirrhosis with hepatocellular carcinoma (HCC) status post primary liver resection and allotransplantation presented to the emergency department with one month of persistent right eye swelling. The patient had been treated with antibiotics by an outside provider for presumed bacterial sinusitis. On nasal endoscopy and biopsy, the diagnosis of metastatic poorly differentiated carcinoma with positive hepatocyte paraffin antigen-1 staining was made. Discussion: Sinonasal metastases from distant tumors are uncommon. Metastatic HCC after liver transplantation in this location are even rarer. Post-transplantation metastases to the nasopharynx have only been reported in two other cases. Conclusion: Patients with persistent unilateral sinonasal symptoms should be worked up for possible malignancy, particularly if that patient has a history of cancer. Metastases from recurrent disease in post-transplant patients are likely to increase over the coming decades as medical management of organ recipients improves.

Olfactory neuroblastoma is a rare neuroendocrine tumor derived from the olfactory epithelium. We report a case that showed peculiar histology in a late lymph node metastasis. The patient was a 78-year-old Japanese male, who had headache, epistaxis, and nasal obstruction following bloody sputum that was untreated for ten years. The initial biopsy was interpreted as anaplastic carcinoma, and after being referred to a regional university hospital, a total of 60 Gy of radiation therapy was performed prior to the excision of the residual tumor. Neck metastasis was found on the left side two years later, and the patient died of other disease with no recurrence five years after successful neck dissection.Retrospective examination of the biopsy specimen revealed a neurofibrillary matrix besides nesting growth of basophilic naked cells. The neck metastases exhibited similar histology, and a large number of rosette structures containing mucus and extensive squamous metaplasia were observed. Immunohistochemically, naked cells and neurofibrillary matrix were positive for synaptophysin and chromogranin A, and rosette structures and some naked cells were positive for AE1/AE3 and CAM5.2. While epithelial differentiation of olfactory neuroblastoma is a unique feature absent in neuroblastomas in other regions, it was clearly and prominently manifested in the present case.

Objective: The PN Naloxone Nasal Swab (Pocket Naloxone Corp., Bethesda, MD) is a swab optimized for drug delivery and intended for use by non-medical personnel for the emergency treatment of opioid overdose. The aim of this study (PNC-20-003) is to determine the safety of this nasal swab in a real-world environment., Methods: This was a single-institution, quantitative-qualitative prospective trial performed at an outpatient clinic. Patients with normal or abnormal nasal structure were recruited. A non-medically trained individual placed the nasal (soaked in fluorescein dye) on each side of the patient's nose. Endoscopy with recording was performed before and after swab placement. An independent reviewer rated degree of staining, mucosal bleeding, and trauma at nasal subsites., Results: Videos from 32 nasal cavities (16 participants) were reviewed. All cavities had high intensity staining at the septum and the inferior turbinate. No patients had staining within the middle meatus, agger nasi, or olfactory regions. In patients with normal anatomy, obstructive nasal anatomy or prior nasal surgery, all cavities had staining near the nasal septum. Only 7 cavities (22 %) had minor bleeding defined as ooze that stopped in 1-2min, and 3 (9 %) had minor trauma defined as mucosal disruption less than 5mm. There were no significant differences in comparing pre- and post-swab nasal cavity, trauma, or bleeding exams., Conclusions: These study results showed that this swab is atraumatic to the nasal mucosal membranes when administered by non-medical personnel. Analysis suggests contact with targeted sites for drug absorption regardless of anatomy., Competing Interests: Declaration of Competing Interest Citardi serves as a consultant for 3D-Matrix, Acclarent, Lynx MD, Medtronic, MicroGenDX and Neurent. Yen serves as a consultant for 3D-Matrix, Cyrano Therapeutics, Medtronic, Neubio North America, Neurent Medical, Oyster Point Pharmaceutical, Pocket Naloxone Corp., Regeneron, Sound Health, Stryker ENT. Pocket Naloxone Corp. funded the study. Frost, Wang, Mathai and Jarecki-Smith are employed by Pocket Naloxone Corp., (Published by Elsevier B.V.)

Among the numerous long COVID symptoms, olfactory dysfunction persists in ∼10 % of patients suffering from SARS-CoV-2 induced anosmia. Among the few potential therapies, corticoid treatment has been used for its anti-inflammatory effect with mixed success in patients. In this study, we explored its impact using hamster as an animal model. SARS-CoV-2 infected hamsters lose their smell abilities and this loss is correlated with damage of the olfactory epithelium and persistent presence of innate immunity cells. We started a dexamethasone treatment 2 days post infection, when olfaction was already impacted, until 11 days post infection when it started to recover. We observed an improvement of olfactory capacities in the animals treated with corticoid compared to those treated with vehicle. This recovery was not related to differences in the remaining damage to the olfactory epithelium, which was similar in both groups. This improvement was however correlated with a reduced inflammation in the olfactory epithelium with a local increase of the mature olfactory neuron population. Surprisingly, at 11 days post infection, we observed an increased and disorganized presence of immature olfactory neurons, especially in persistent inflammatory zones of the epithelium. This unusual population of immature olfactory neurons coincided with a strong increase of olfactory epithelium proliferation in both groups. Our results indicate that persistent inflammation of the olfactory epithelium following SARS-CoV-2 infection may alter the extent and speed of regeneration of the olfactory neuron population, and that corticoid treatment is effective to limit inflammation and improve olfaction recovery following SARS-CoV-2 infection., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

This paper presents a case of a patient with a 3-month history of recurrent right-sided epistaxis with heavy bleeding for 4-days. Leech infestation in the nasal cavity was found to be the main cause of the epistaxis via endoscopic examination. Epistaxis caused by leech infestation although rare, can cause serious problems. When the clinicians meet the patients with unexplained intermittent epistaxis, leech infections must be taken into consideration. In this case, a 5-cm in length dark brown leech was removed with ethmoid forceps under local anesthesia by nasal endoscopy.

Sino nasal undifferentiated (SNUC) is a highly aggressive neoplasm of the nasal cavity and paranasal sinuses. SNUC is characterized by poor differentiation making the diagnosis difficult to distinguish from other tumors of the sinonasal tract. The imaging features of SNUC are nonspecific and patients often present with an advanced stage neoplasm following rapid onset of symptoms. Given the rarity and aggressive nature of SNUC, the optimal treatment remains to be determined. The prognosis is poor and the literature is limited to case reports and case series. Survival rate is estimated to be 5 years with a wide variation throughout the literature. We present a unique case of a 31-year-old Bosnian male who presented with headaches, facial pain, and epistaxis. MRI of the head revealed a destructive sinonasal mass with intracranial extension into the anterior cranial fossa, right cavernous sinus and the sella/pituitary gland. Biopsy of the paranasal sinus revealed a discohesive epithelioid neoplasm with necrosis, consistent with high grade nasopharyngeal carcinoma. We reviewed this case in the setting of reported literature concerning SNUC with emphasis on the epidemiology, pathology, diagnosis, and emerging management protocols of SNUC.

A good old gateway theory that electronic-cigarettes (e-cigarettes) are widely recognized as safer tobacco substitutes. In actuality, demographics also show that vaping cannibalizes smoking, the best explanation of the data is the "common liability". However, the utilization of e-cigarette products remains a controversial topic at present. Currently, there has been a widespread and substantial growth in e-cigarette use worldwide owing to their endless new flavors and customizable characteristics. Furthermore, e-cigarette has grown widespread among smokers as well as non-smokers, including adolescents and young adults. And some studies have shown that e-cigarette users are at greater risk to start using combustible cigarettes while e-cigarettes use was also observed the potential benefits to people who want to quit smoking or not. Although it is true that e-cigarettes generally contain fewer toxic substances than combustible cigarettes, this does not mean that the chemical composition in e-cigarettes aerosols poses absolutely no risks. While concerns about toxic substances in e-cigarettes and their widespread use in the population are reasonable, it is also crucial to consider that e-cigarettes have been associated with the potential for promoting smoking cessation and the clinically relevant improvements in users with smoking-related pathologies. Meanwhile, there is still short of understanding of the health impacts associated with e-cigarette use. Therefore, in this review, we discussed the health impacts of e-cigarette exposure on oral, nasal, pulmonary, cardiovascular systems and brain. We aspire for this review to change people's previous perceptions of e-cigarettes and provide them with a more balanced perspective. Additionally, we suggest appropriate adjustments on regulation and policy for e-cigarette to gain greater public health benefits., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Introduction: The objective of this study was to evaluate the dental periodontal and skeletal response to ≥5 mm of expansion width achieved by C-expander treatment with posterior miniscrews placed between the first and second molars in adults., Methods: A total of 28 patients aged 21.91 ± 3.20 years with maxillary transverse deficiency underwent C-expander treatment. Anterior miniscrews were positioned between the first and second premolars, whereas posterior miniscrews were positioned between the first and second molars. Cone-beam computed tomography records were obtained before expansion and 3 months after expansion. The dental periodontal and skeletal changes for all patients were recorded., Results: The C-expander treatment expanded the palatal suture with slight buccal alveolar bone inclination. An increase in the nasal cavity width and a greater increase in the maxillary base bone width were observed after maxillary expansion. The expansion at the posterior nasal spine (3.78 mm) was approximately 85.7% of that at the anterior nasal spine (4.41 mm). No significant buccal dehiscence occurred after expansion, whereas the mesiobuccal alveolar bone thickness of the first molars was decreased at the 8 mm level with respect to the cementoenamel junction. The first molar showed decreased inclination (right, -0.45°; left, -0.38°, P >0.05), whereas the expansion at the apical level was less than that at the crown level. Age and the skeletal/dental expansion ratio had no discernible relationship., Conclusions: Miniscrew-assisted C-expander treatment can be effective for adults with maxillary transverse deficiency. Rearward placement of the miniscrews may create an approximately parallel expansion. Most maxillary expansion was derived from skeletal expansion with slight alveolar bone buccal inclination., (Copyright © 2023 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

There remains a striking overall mortality burden of COVID-19 worldwide. Given the waning effectiveness of current SARS-CoV-2 antivirals due to the rapid emergence of new variants of concern (VOC), we employed a direct-acting molecular therapy approach using gene silencing RNA interference (RNAi) technology. In this study, we developed and screened several ultra-conserved small-interfering RNAs (siRNAs) before selecting one potent siRNA candidate for pre-clinical in vivo testing. This non-immunostimulatory, anti-SARS-CoV-2 siRNA candidate maintains its antiviral activity against all tested SARS-CoV-2 VOC and works effectively as a single agent. For the first time, significant antiviral effects in both the lungs and nasal cavities of SARS-CoV-2 infected mice were observed when this siRNA candidate was delivered intranasally (IN) as a prophylactic agent with the aid of lipid nanoparticles (LNPs). Importantly, a pre-exposure prophylactic IN-delivered anti-SARS-CoV-2 siRNA antiviral that can ameliorate viral replication in the nasal cavity could potentially prevent aerosol spread of respiratory viruses. An IN delivery approach would allow for the development of a direct-acting nasal spray approach that could be self-administered prophylactically., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Y.T is the founding director for Prorenata Biotech. N.A.J.M and K.V.M are both consultants for Prorenata Biotech. K.V.M is the chief scientific officer (CSO) for The Gene Company. K.V.M. has submitted a provisional patent on the technologies reported here., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

To understand inhaled nanoparticle transport and deposition characteristics in pediatric nasal airways with adenoid hypertrophy (AH), with a specific emphasis on the olfactory region, virtual nanoparticle inhalation studies were conducted on anatomically accurate child nasal airway models. The computational fluid-particle dynamics (CFPD) method was employed, and numerical simulations were performed to compare the airflow and nanoparticle deposition patterns between nasal airways with nasopharyngeal obstruction before adenoidectomy and healthy nasal airways after virtual adenoidectomy. The influence of different inhalation rates and exhalation phase on olfactory regional nanoparticle deposition features was systematically analyzed. We found that nasopharyngeal obstruction resulted in significant uneven airflow distribution in the nasal cavity. The deposited nanoparticles were concentrated in the middle meatus, septum, inferior meatus and nasal vestibule. The deposition efficiency (DE) in the olfactory region decreases with increasing nanoparticle size (1-10 nm) during inhalation. After adenoidectomy, the pediatric olfactory region DE increased significantly while nasopharynx DE dramatically decreased. When the inhalation rate decreased, the deposition pattern in the olfactory region significantly altered, exhibiting an initial rise followed by a subsequent decline, reaching peak deposition at 2 nm. During exhalation, the pediatric olfactory region DE was substantially lower than during inhalation, and the olfactory region DE in the pre-operative models were found to be significantly higher than that of the post-operative models. In conclusions, ventilation and particle deposition in the olfactory region were significantly improved in post-operative models. Inhalation rate and exhalation process can significantly affect nanoparticle deposition in the olfactory region., Competing Interests: Declaration of competing interest All authors report no potential competing interests. The content of the manuscript has not been published or submitted for publication elsewhere, and all authors have approved the manuscript for the submission to Computers in Biology and Medicine., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The aim of this prospective cohort study was to compare changes in nasal cavity and function between Le Fort I with and without horseshoe osteotomy after superior repositioning of the maxilla. The patients were divided into 2 groups, a Le Fort I alone (LF alone) group and a combination Le Fort I and horseshoe osteotomy (HS) group. The nasal cavity volume was measured using 3-dimensional computed tomographic images, and nasal resistance was assessed by anterior active mask rhinomanometry. The HS group consisted of 17 patients, and the LF alone group consisted of 15 patients. The magnitude of change in nasal cavity volume was significantly smaller in the HS group than in the LF alone group (p < 0.001), even though the mean amount of superior maxillary movement was considerably larger in the HS group than in the LF alone group (p < 0.001). Mean nasal resistance was significantly smaller postoperatively than preoperatively in the HS group (p < 0.05). Furthermore, the change in nasal resistance was smaller in the HS group than in the LF alone group (p < 0.001). Within the limitations of this study, it seems that horseshoe osteotomy is useful for maintaining the nasal cavity and function after superior repositioning of the maxilla., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Objectives: Upper airway assessment requires a fully-automated segmentation system for complete or sub-regional identification. This study aimed to develop a novel Deep Learning (DL) model for accurate segmentation of the upper airway and achieve entire and subregional identification., Methods: Fifty cone-beam computed tomography (CBCT) scans, including 24,502 slices, were labelled as the ground truth by one orthodontist and two otorhinolaryngologists. A novel model, a lightweight multitask network based on the Swin Transformer and U-Net, was built for automatic segmentation of the entire upper airway and subregions. Segmentation performance was evaluated using Precision, Recall, Dice similarity coefficient (DSC) and Intersection over union (IoU). The clinical implications of the precision errors were quantitatively analysed, and comparisons between the AI model and Dolphin software were conducted., Results: Our model achieved good performance with a precision of 85.88-94.25%, recall of 93.74-98.44%, DSC of 90.95-96.29%, IoU of 83.68-92.85% in the overall and subregions of three-dimensional (3D) upper airway, and a precision of 91.22-97.51%, recall of 90.70-97.62%, DSC of 90.92-97.55%, and IoU of 83.41-95.29% in the subregions of two-dimensional (2D) crosssections. Discrepancies in volume and area caused by precision errors did not affect clinical outcomes. Both our AI model and the Dolphin software provided clinically acceptable consistency for pharyngeal airway assessments., Conclusion: The novel DL model not only achieved segmentation of the entire upper airway, including the nasal cavity and subregion identification, but also performed exceptionally well, making it well suited for 3D upper airway assessment from the nasal cavity to the hypopharynx, especially for intricate structures., Clinical Significance: This system provides insights into the aetiology, risk, severity, treatment effect, and prognosis of dentoskeletal deformities and obstructive sleep apnea. It achieves rapid assessment of the entire upper airway and its subregions, making airway management-an integral part of orthodontic treatment, orthognathic surgery, and ENT surgery-easier., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing financial interests or personal relationships that may have influenced the work reported in this study., (Copyright © 2023. Published by Elsevier Ltd.)

The promising diagnostic performance of rapid antigen tests (RATs) using non-invasive anterior nasal (AN) swab specimens to diagnose COVID-19 has been reported. A large number of RATs are commercially available; however, the careful assessment of RATs is essential prior to their implementation in clinical practice. We evaluated the clinical performance of the GLINE-2019-nCoV Ag Kit as a RAT using AN swabs in a prospective, blinded study. Adult patients who visited outpatient departments and received SARS-CoV-2 tests between August 16 and September 8, 2022, were eligible for this study. Patients who were aged under 18 years and patients without appropriate specimens were excluded. Two sets of AN and nasopharyngeal (NP) swabs were collected from all patients. Each set of specimens was tested by the RAT and quantitative reverse-transcription polymerase chain reaction (RT-qPCR). Of the 138 recruited patients, 84 were positive and 54 were negative by RT-qPCR using NP swabs. The positive agreement rate between RT-qPCR using NP swabs and RAT using AN swabs was 78.6% (95% confidence interval [CI], 68.3%-86.8%), the negative agreement rate was 98.1% (95% CI, 90.1%-99.9%), and the overall agreement rate was 86.2% (95% CI, 79.3%-91.5%), with a κ coefficient of 0.73. The positive agreement rate in the early phase (≤3 days from symptom onset) was >80%, but this fell to 50% in the late phase (≥4 days). This study demonstrates that the GLINE-2019-nCoV Ag Kit using AN swabs has good clinical performance and might be a reliable alternative method for diagnosing COVID-19., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interests., (Copyright © 2023 Japanese Society of Chemotherapy, Japanese Association for Infectious Diseases, and Japanese Society for Infection Prevention and Control. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was to investigate the change of nasal patency after maxillary advancement and impaction (MAX ADV + IMP ) in subjects with skeletal class III malocclusion (cases) and after removal of maxillary cysts in close proximity to the nasal floor in subjects that served as controls. NOSE score, volume derived by computed tomography (VOL), and acoustic rhinometry and rhinomanometry were retrospectively evaluated, before and one year after surgery. The movement of specific landmarks was also measured. NOSE score did not change after surgery, neither in 17 cases (p = 0.10) nor in 17 controls (p = 0.14). In cases, VOL postop (10088 ± 4200 mm 3 ) was significantly higher than VOL preop (7807 ± 3721 mm 3 ; p = 0.036). Maxillary advancement and inferior displacement of the ventral maxilla were noted by the movement of incisive foramen in the coronal (3.9 ± 5.4; p = 0.011) and Frankfurt Horizontal plane (2.2 ± 2.0; p = 0.001), respectively. In controls, VOL postop (9749 ± 3654 mm 3 ) was also significantly higher than VOL preop (8473 ± 2624 mm 3 ; p = 0.050). Cross-sectional areas, nasal flow and nasal resistance changed significantly after surgery in cases (6/30 pairs; p < 0.018), but not in controls (all p > 0.066). MAX ADV + IMP increased nasal patency, but did not change the feeling of nasal breathing. Physicians should proceed with caution when informing patients about improvement of nasal breathing after MAX ADV + IMP ., Competing Interests: Declaration of competing interest None., (Copyright © 2023 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Opresente documento tem por objetivo esclarecer àqueles que tratam das doenças nasossinusais, tanto especialistas quanto generalistas, sobre as terapêuticas tópicas nasais. Por meio de uma revisão das evidências científicas, a Academia Brasileira de Rinologia vem proporcionar sua visão prática e atualizada sobre as medicações tópicas nasais mais utilizadas, excetuando-se as medicações que possuam antibióticos tópicos na sua formulação.This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.

We report a case of leiomyosarcoma of the inferior nasal turbinate. The patient, a 68-year-old Caucasian male, presented with 4–6 weeks of epistaxis that was resistant to nasal packing and septal cautery. Upon inspection in the operating room, a small mass was excised from the inferior turbinate. High-power H&E-stained microscopy demonstrated bundles of malignant smooth muscle cells, and immunohistochemical stains were strongly positive for desmin, smooth muscle actin and vimentin, while negative for pankeratin EA1/EA3 and CaM 5.2, suggesting leiomyosarcoma as the diagnosis. Clear margins were obtained at a second surgery. At the time of this writing it is 8 months since his last surgery and he has remained symptom free.

A área anterior da cavidade nasal desempenha papel fundamental na fisiologia respiratória. OBJETIVO: Analisar durante um período do crescimento possível alteração da área transversal mínima (MCA) e do volume nasal da região anterior da cavidade nasal. MATERIAL E MÉTODO: Foram avaliadas 29 crianças (14 meninos, 15 meninas) com média de idade de 7,81 anos no primeiro exame (M1) e de 11,27 anos no segundo exame (M2), sem sintomas de obstrução nasal. O intervalo entre os exames foi de 36-48 meses. As crianças foram submetidas ao exame de rinometria acústica, registrando-se as áreas transversais mínimas, volumes e suas correlações com os gêneros. FORMA DE ESTUDO: Estudo de coorte. RESULTADOS: A média da área transversal da cavidade nasal de MCA para as meninas foi de 0,30±0,09cm2 (M1) e de 0,30±0,14cm2 (M2), enquanto que para os meninos foi de 0,24±0,12cm2 (M1) e de 0,32±0,10cm2 (M2). As médias dos volumes totais encontradas, para toda a amostra, foram de 2,17±0,23cm3 (MCA1-M1), 2,56±0,27cm3 (MCA1-M2), 4,24±1,17cm3 (MCA2-M2) e de 4,63±1,10cm3 (MCA2-M2). CONCLUSÃO: Não houve alteração significativa da área transversal mínima da região anterior da cavidade nasal. Não houve diferença significativa entre os gêneros, tanto para MCA como para o volume. Houve aumento significativo do volume em MCA1.The area above the nasal cavity plays a role in respiratory physiology. AIM: To analyze, during a period of growth, a possible change in the minimum cross sectional area (MCA) and nasal volume of the anterior nasal cavity. MATERIALS AND METHODS: We evaluated 29 children (14 boys and 15 girls) with a mean age of 7.81 years at first examination (M1) and 11.27 years in the second examination (M2), without symptoms of nasal obstruction. The interval between examinations was 36-48 months. Children were subjected to the examination of acoustic rhinometry in which we recorded the minimum cross-sectional areas, volumes and their correlations with gender. STUDY DESIGN: Cohort. RESULTS: The mean cross-sectional area of the nasal cavity of MCA for girls was 0.30 ± 0.09 cm2 (M1) and 0.30 ± 0.14 cm2 (M2), while for boys was 0.24 ± 0.12 cm2 (M1) and 0.32 ± 0.10 cm2 (M2). The mean values of the total volumes found for the whole sample were 2.17 ± 0.23 cm3 (MCA1-M1), 2.56 ± 0.27 cm3 (MCA1-M2), 4.24 ± 1.17 cm3 (MCA2- M2) and 4.63 ± 1.10 cm3 (MCA2-M2). CONCLUSION: There was no significant change in the minimum cross sectional area of the anterior nasal cavity. There was no significant difference between genders for both MCA and for the volume. There was a significant increase in MCA1.