Disturbance of nasal airflow occurs in about 30% of human population. Turbinate hypertrophy is frequently the base of many nasal obturative diseases. The aim of this study was to determine short- term and long term effects of the radiofrequency therapy (RFT) for patients with turbinate hypertrophy. Forty- one patients with inferior turbinate hypertrophy (19 females and 22 males) were enrolled in this study prospectively. The examination included: rhinoscopy, subiective visual analogue scale (VAS) score, in which a patient described his symptoms in points from 0, (always very good nasal airflow) to 10 points (always total obstruction) and anterior rhinomanometry. The clinical assessment was before radiofrequency-turbinectomy and within the days 7 to 25 afther this therapy (follow-up 1) and 12 months later (follow-up 2). RFT was performed in local anesthesia (1% Lidocain) by means of CELON. Rhinoscopy before RFT revealed turbinate hypertrophy, which was decreased in the follow-up examination. Subjective improvement of nasal airflow was felt by 39 patients (95%) at follow–up 1. At follow–up 2 fifteen patients (37%) reported a decreased nasal airflow when compared with the follow-up 1. Rhinomanometric results were better at follow-up 1 for the left side (p = 0,0003), the right side (p = 0,0002) and both sides altogether (p = 0,0001). The improvement continued at follow-up 2 for the left side (p = 0,0004), the right side (p = 0,001) and both sides (p = 0,001) when compared with rhinomanometry before RFT. There were not statistically significant differences between the rhinomanometric results at follow–up 1 and follow-up 2. Bipolar radiofrequency thermal ablation is an effective method for the therapy of turbinate hypertrophy.
Introduction: Sleep is a physiological state essential for the proper functioning of the body. One of the reasons for its disturbance is obstructive sleep apnea syndrome (OSAS). Aim: The aim of this research is the histological evaluation of the soft palate in patients who suffered from various types of OSAS. Material and method: The study group consisted of patients with sleep-disordered breathing (SDB) in the form of primary snoring or OSAS. Patients with chronic tonsillitis, without a history of SDB, were included in the comparative group. Fragments of the mucous of the uvula (study group) and the palatoglossal pillar (comparative group) were obtained during surgery for histological evaluation. Using histological, histochemical and immunohistochemical methods, we assessed the inflammation and its severity (CD3, CD20, CD68), the structure of nerve fibers (S-100) and the size of blood vessels (CD34) in the examined tissue. Results: Patients with OSAS developed a local inflammatory process in the palatal tissues (stronger expression of CD3, CD20, CD68 in patients with OSAS). The severity of the immunohistochemical reaction with CD3 correlated with the stage of OSAS. A higher degree of fibrosis and a higher expression of CD34 and S-100 receptors were observed in patients with OSAS compared to snoring patients and patients from the comparative group. Conclusion: Most likely, snoring due to chronic tissue vibration leads to damage to the nerve fibers in the soft palate, which can intensify episodes of hypopneas during and increase the chance for sleep apneas.
Wstęp: Sen to stan fizjologiczny, który jest niezbędny do prawidłowego funkcjonowania organizmu. Jedną z przyczyn jego zaburzeń jest zespół obturacyjnych bezdechów podczas snu (OSAS). Cel: Celem pracy jest ocena histologiczna błony śluzowej podniebienia miękkiego u pacjentów z różnymi postaciami OSAS. Materiał i metoda: Grupę badaną stanowili pacjenci z zaburzeniami oddychania podczas snu o charakterze chrapania pierwotnego lub OSAS. Pacjenci z przewlekłym zapaleniem migdałków podniebiennych, bez wywiadu zaburzeń oddychania podczas snu zostali włączeni do grupy porównawczej. Fragmenty błony śluzowej języczka podniebiennego (grupa badana) i łuku podniebienno-językowego (grupa porównawcza) były pobierane do badań histologicznych podczas zabiegów operacyjnych. W badanej tkance, przy użyciu metod histologicznych, histochemicznych i immunohistochemicznych, oceniano: obecność i nasilenie stanu zapalnego (CD3, CD20, CD68), strukturę włókien nerwowych (S-100) oraz wielkość naczyń krwionośnych (CD34). Wyniki: U pacjentów z OSAS rozwijał się miejscowy proces zapalny w obrębie tkanek gardła środkowego (silniejsza ekspresja CD3, CD20, CD68 u pacjentów z OSAS). Nasilenie reakcji immunohistochemicznej z CD3 korelowało ze stopniem zaawansowania OSAS. Wykazano wyższy stopień włóknienia, wyższą ekspresję receptora CD34 oraz S-100 u chorych z OSAS w stosunku do pacjentów chrapiących i z grupy porównawczej. Wnioski: Chrapanie, poprzez przewlekłą wibrację tkanek, najprawdopodobniej prowadzi do uszkodzenia włókien nerwowych w obszarze podniebienia miękkiego, co może nasilać epizody spłyceń oddechowych podczas snu oraz zwiększać liczbę pojawiających się bezdechów.
The authors present the case of primary actinomycosis of maxillary sinus. The frequency of the disease, differential diagnosis and treatment we present.
Cysteinyl leukotrienes (CysLTs) have been implicated in the pathogenesis of chronic rhinosinusitis (CRS). This study was undertaken to better understand the role of CysLTs in the development of CRS through 1). assessment of the pattern of expression of CysLT1 receptor in nasal polyps from patients with CRS and 2). correlation of expression of CysLT1 receptor with clinical features. Expression of CysLT1 receptor was evaluated immunohistochemically in nasal polyps from 20 patients with CRS and nasal mucosa from 10 control subject undergoing plastic surgery of the nose. Patients with CRS showed significantly higher expression of CysLT1 receptor as compared with the control group (p<0.05). The expression of CysLT1 receptor in sub-epithelial inflammatory infiltrates tended to be higher in patients with CRS and allergy as compared with patients with CRS but without allergy (p=0.07). In particular, the expression of CysLT1 receptor in sub-epithelial inflammatory infiltrates was significantly greater in 3 patients with CRS and drug allergy as compared with patients with CRS but without drug allergy (p=0.03). Increased expression of CysLT1 receptor in inflamed mucosa of nasal polyps in patients with allergy might suggest particular role of CysLTs in the pathogenesis of nasal polyps in this group of patients.
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