Search

Conclusion: Systemic steroids improve nasal symptoms such as sneezing, purulent rhinorrhea, and nasal obstruction in patients with nasal polyposis, regardless of measurable response to systemic steroid. A history of allergic rhinitis is an independent prognostic factor for favorable response of nasal polyposis to systemic steroid. Overexpression of glucocorticoid receptor β is associated with glucocorticoid resistance. Objectives: This study was conducted to evaluate treatment outcomes and clinically useful predictive factors for systemic steroids in nasal polyposis. Methods: The study involved 47 consecutive patients diagnosed with nasal polyposis from December 2008 to May 2010. Twenty milligrams of prednisolone were administered daily for 14 days. The following parameters were analyzed: subjective nasal symptoms, history of allergic rhinitis and asthma, SNOT-20 score, olfactory function test, bronchial hyperreactivity, blood eosionophil count, atopy, Lund-Mackay score, tissue eosinophil infiltration ratio, and expression of glucocorticoid receptor α and β in the nasal polyp epithelium. Results: In all, 62% of the patients were responders, i.e. had a decreased polyp size >25% after treatment. SNOT-20 score tended to decrease for all patients but significantly only for the responder group ( p < 0.01). Eighteen of the responders had a medical history of allergic rhinitis, but only five of the nonresponders did ( p = 0.026, Odds ratio = 4.26). Responder group polyps showed significantly less immunoreactivity of glucocorticoid receptor β than polyps from the nonresponder group. [ABSTRACT FROM AUTHOR]

Conclusion: Reconstruction of a large anterior skull base defect (SBD) with the nasoseptal flap (SF) is feasible in Asians. We consider the width of the SF to be the determining factor. Increasing flap width by incorporating the mucoperiosteum of the nasal floor can compensate for the relatively small septum in Asians. Objectives: To assess the feasibility of the SF for reconstruction of large anterior SBD in Koreans, and attempt to provide tips for improving its design. Methods: Radioanatomic measurements and intraoperative findings were analyzed. Specific skull base landmarks were measured to estimate the anticipated SBD and actual SBD. The length and width of the potential SF dimension was also measured and compared with the defect size to assess its feasibility. Results: The lengths of the actual SBDs were longer than those of anticipated SBDs in all patients, while the width of actual SBDs showed less discrepancy. Length and anterior width of the potential SF exceeded the needed SF dimensions in two patients, while the posterior width of potential SF fell short of the needed dimension. In both patients, the length of harvested SF was long enough to repair the entire length of SBD, while shortage of SF width was encountered in one patient. [ABSTRACT FROM AUTHOR]