Turbinates

鼻甲
  • 文章类型: Journal Article
    本研究旨在调查肥厚性瘢痕(HTS)患者下鼻甲肥大(ITH)的存在和严重程度。
    本病例对照研究是对在皮肤病学检查中诊断为HTS的患者和没有HTS的对照组进行的。耳鼻喉科医师通过前鼻镜检查评估下鼻甲肥大的存在和严重程度。
    ITH在HTS患者中比对照组更常见(64%,34%,分别)(p=0.014)。在HTS组中,48%的患者为2级,16%的患者为3级;在对照组中,24%为2级,10%为3级(p=0.046)。此外,抱怨瘙痒或疼痛的患者ITH较高(83%,80%,分别)在HTS中高于无症状HTS患者(p=0.020)。
    与对照组相比,HTS患者的ITH数量更高,尤其是那些报告与疤痕相关的瘙痒或疼痛的人。鉴于对HTS和ITH的全部发病机制和治疗的了解有限,它们的关联可能为这些相关条件提供新的见解。
    UNASSIGNED: This study aimed to investigate the presence and severity of inferior turbinate hypertrophy (ITH) in patients with hypertrophic scars (HTS).
    UNASSIGNED: This case-control study was conducted with patients diagnosed with HTS during dermatologic examination and a control group without HTS. An otolaryngologist evaluated the presence and severity of inferior turbinate hypertrophy by anterior rhinoscopy.
    UNASSIGNED: ITH was more common in patients with HTS compared to the control group (64%, and 34%, respectively) (p=0.014). In the HTS group, 48% of patients had grade 2, and 16% had grade 3 ITH; in the control group, 24% had grade 2, and 10% had grade 3 ITH (p=0.046). Also, ITH was higher in patients who complained of pruritus or pain (83%, and 80%, respectively) in the HTS than in asymptomatic HTS patients (p=0.020).
    UNASSIGNED: A higher number of patients with HTS had ITH compared to the control group, especially those who reported pruritus or pain associated with scar. Given the limited understanding of the full pathogenesis and treatment of HTS and ITH, their association potentially provides new insights into these related conditions.
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  • 文章类型: Journal Article
    目的:本研究的目的是回顾性评估射频体积组织减少术(RFVTR)对多水平手术(MLS)中短头犬的肥厚性鼻甲和临床结局的影响。
    方法:临床回顾性多中心研究。
    方法:132只客户拥有的短头犬。
    方法:用RFVTR作为上气道MLS的一部分,对132只患有高度短脑阻塞气道综合征(BOAS)和肥厚性鼻甲的短头犬进行治疗。在RFVTR之前和之后6个月,通过计算机断层扫描(CT)和前/逆行鼻镜检查评估鼻内梗阻。临床记录,我们回顾了CT图像和鼻镜检查视频,并使用标准化问卷评估了临床演变.对数据进行半定量评分。
    结果:在这项研究中,132名患者被纳入120周的随访期。RFVTR导致轻微并发症,包括所有狗术后第一周的浆液性鼻腔分泌物,24.3%的患者在治疗后3-8周出现间歇性鼻塞。对33例患者进行了鼻镜检查和CT随访。治疗后6个月,鼻内空域增加(p=0.002),粘膜接触点的存在和总量减少(p=0.039)。
    结论:MLS与RFVTR在6个月的随访检查中导致鼻甲体积显着减少,并在120周的长期内显着临床改善。这表明RFVTR作为BOAS犬鼻内阻塞的鼻甲保留治疗的可行性。
    结论:RFVTR是一种用于BOAS犬鼻内阻塞的微创鼻甲成形术技术,可以包括在MLS中,而不会增加并发症的发生率。
    OBJECTIVE: The objective of this study was to retrospectively assess the effect of Radiofrequency Volumetric Tissue Reduction (RFVTR) on hypertrophic turbinates and clinical outcome in brachycephalic dogs when included in multi-level surgery (MLS).
    METHODS: Clinical retrospective multicenter study.
    METHODS: 132 client-owned brachycephalic dogs.
    METHODS: 132 brachycephalic dogs with high-grade Brachycephalic Obstructive Airway Ayndrome (BOAS) and hypertrophic turbinates were treated with RFVTR as part of MLS of the upper airways. Intranasal obstruction was evaluated by computer tomography (CT) and antero-/retrograde rhinoscopy before and 6 months after RFVTR. The clinical records, the CT images and the rhinoscopy videos were reviewed and clinical evolution was evaluated using a standardized questionnaire. The data was scored semi-quantitatively.
    RESULTS: In this study, 132 patients were included for a follow-up period of 120 weeks. RFVTR resulted in minor complications, including serous nasal discharge within the first postoperative week in all dogs, and intermittent nasal congestion between 3-8 weeks after treatment in 24.3% of the patients. Rhinoscopy and CT follow-ups were available for 33 patients. Six months after treatment intranasal airspace was increased (p = 0.002) and the presence and overall amount of mucosal contact points was reduced (p = 0.039).
    CONCLUSIONS: MLS with RFVTR led to a significant reduction in turbinate volume at the 6-month follow-up examination and significant clinical improvement over a long-term period of 120 weeks. This suggests the viability of RFVTR as a turbinate-preserving treatment for intranasal obstruction in dogs with BOAS.
    CONCLUSIONS: RFVTR is a minimally invasive turbinoplasty technique for intranasal obstruction in dogs with BOAS and can be included in MLS without increasing complication rates.
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  • 文章类型: Journal Article
    计算机断层扫描(CT)是诊断犬鼻疾病的金标准。然而,它不容易发现炎性疾病中的轻微异常,因为它们不伴有明显的形态学变化。
    本研究旨在比较品种间鼻甲结构和粘膜正常CT表现的差异,以建立鼻腔炎性疾病的CT诊断标准。
    回顾性研究了5个无鼻部疾病品种的77只犬的CT数据。鼻腔空气百分比,它反映了鼻甲结构和粘膜的体积,是测量的。测量鼻甲粘膜的对比增强以反映血流。在腹侧和筛鼻甲(ET)区域进行测量。在品种和切片之间进行了比较。
    腹侧和ET区域的空气百分比在品种之间存在显着差异。仅在ET中,品种之间的对比度增强显着不同。此外,不同品种的体重之间有不同的相关性,年龄,鼻子长度,空气百分比。
    在这项研究中,获得鼻腔结构和粘膜的正常CT表现的参考值,考虑到品种,测量部分,和患者因素。结果表明,鼻甲结构的体积和鼻粘膜的对比增强因品种而异。测量值也根据横截面和患者因素而不同。
    UNASSIGNED: Computed tomography (CT) is the gold standard for diagnosing canine nasal diseases. However, it cannot easily detect minor abnormalities in inflammatory diseases because they are not accompanied by obvious morphological changes.
    UNASSIGNED: The present study aimed to compare the differences in normal CT findings of turbinate structure and mucosa between breeds to establish criteria for CT diagnosis of inflammatory diseases of the nasal cavity.
    UNASSIGNED: CT data from 77 dogs of 5 breeds without nasal diseases were retrospectively studied. The nasal air percentage, which reflects the volume of the nasal turbinate structure and mucosa, was measured. The nasal turbinate mucosa was measured for contrast enhancement reflecting blood flow. Measurements were performed in the ventral and ethmoid turbinate (ET) regions. Comparisons were made between breeds and sections.
    UNASSIGNED: The air percentage in the ventral and ET regions was significantly different between breeds. Contrast enhancement was significantly different between breeds only in the ET. Moreover, different breeds had different correlations between body weight, age, nose length, and air percentage.
    UNASSIGNED: In this study, reference values for normal CT findings of the nasal structure and mucosa were obtained, taking into account the breed, measurement section, and patient factors. The results showed that the volume of the turbinate structure and contrast enhancement of nasal mucosa differed depending on the breed. The measured values also differed depending on the cross-sections and patient factors.
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  • 文章类型: Journal Article
    哺乳动物的鼻腔是四足动物中独特的结构复合体,沿着一系列主要发生在中生代的主要形态转变而获得,在Synapsida进化枝里面.特别是,非哺乳动物状的cynodonts记录了颅骨的几种形态变化,在三叠纪时期,代表哺乳动物bauplan的第一步。我们在这里探索五个犬齿类群的鼻腔,即Thrinaxodon,Chiniquodon,Prozostrodon,Riograndia,还有巴西,为了讨论这个头骨区域的主要变化。我们没有在这些分类群的鼻腔中发现骨化的鼻甲,如果存在的话,作为非骨化结构,它们不一定与温度控制或吸热的发展有关。我们有,然而,请注意,在这些哺乳动物的先行者中,将鼻腔分开并将其与大脑区域分开的软骨锚定结构的复杂性。
    The nasal cavity of living mammals is a unique structural complex among tetrapods, acquired along a series of major morphological transformations that occurred mainly during the Mesozoic Era, within the Synapsida clade. Particularly, non-mammaliaform cynodonts document several morphological changes in the skull, during the Triassic Period, that represent the first steps of the mammalian bauplan. We here explore the nasal cavity of five cynodont taxa, namely Thrinaxodon, Chiniquodon, Prozostrodon, Riograndia, and Brasilodon, in order to discuss the main changes within this skull region. We did not identify ossified turbinals in the nasal cavity of these taxa and if present, as non-ossified structures, they would not necessarily be associated with temperature control or the development of endothermy. We do, however, notice a complexification of the cartilage anchoring structures that divide the nasal cavity and separate it from the brain region in these forerunners of mammals.
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  • 文章类型: Journal Article
    目的:比较和测量各种手术技术减少下鼻甲肥大(ITH)的术后结果,并确定与患有这种疾病的患者进行鼻甲成形术的临床结果相关的因素。
    方法:于2021年1月至2022年12月在利雅得阿卜杜勒阿齐兹国王医疗城的耳鼻咽喉科进行了一项横断面研究,沙特阿拉伯。共纳入301例成人ITH患者,并将其分为不同的组。术后1周后完成随访评估,一个月,和6个月,以评估与每种手术技术相关的结果和并发症;描述性分析,交叉制表,和精确逻辑回归作为数据分析方法。
    结果:两组中的大多数患者在手术后都有部分或完全的改善,92%的人表现出积极的结果。常见的临床体征包括鼻中隔偏曲和外鼻畸形。而鼻塞是最常见的主要症状。术后出血发生在3.7%的病例中;没有发现粘连。Microdebrider,内侧皮瓣,外骨折,和粘膜下透热技术的改善率均明显高于其他技术。
    结论:已确定的改良率较高的技术为选择最佳手术入路提供了循证指导,而研究的局限性需要进一步的前瞻性研究来验证这些发现。最终,它为耳鼻咽喉科领域贡献了宝贵的知识,旨在提高患者预后并改善全球ITH的管理。
    OBJECTIVE: To compare and measure post-operative outcomes among various surgical techniques for reducing inferior turbinate hypertrophy (ITH), and to identify the factors associated with the clinical outcomes of turbinoplasty in patients with this condition.
    METHODS: A cross-sectional study was carried out from January 2021 to December 2022 at the Otorhinolaryngology Department of King Abdulaziz Medical City in Riyadh, Saudi Arabia. A total of 301 adult patients with ITH were included and were divided into different groups. Postoperative follow-up assessments were completed after one week, one month, and 6 months to evaluate outcomes and complications associated with each surgical technique; descriptive analysis, cross-tabulation, and exact logistic regression were utilized as data analysis methods.
    RESULTS: Most patients in both groups experienced partial or complete improvement after surgery, with 92% showing positive outcomes. Common clinical signs included deviated nasal septum deviation and external nasal deformity, while nasal obstruction was most frequently reported as the primary symptom. Post-surgery bleeding occurred in 3.7% of cases; no adhesions were noted. Microdebrider, medial flap, out-fracture, and submucosal diathermy techniques all demonstrated significantly higher improvement rates than others.
    CONCLUSIONS: The identified techniques with higher improvement rates offer evidence-based guidance for selecting optimal surgical approaches, while the study\'s limitations warrant further prospective research to validate these findings. Ultimately, it contributes valuable knowledge to the field of otorhinolaryngology, aiming to enhance patient outcomes and improve the management of ITH worldwide.
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  • 文章类型: Case Reports
    鼻塞是耳鼻咽喉科门诊部常见的问题。在这种情况下,一名青少年男孩从小就长期患有右侧鼻塞问题,寻求咨询。诊断性鼻内窥镜检查显示鼻中隔向左偏曲,再加上右下鼻甲肥大,全部覆盖健康粘膜。鼻和鼻旁窦的CT扫描进一步确定了骨性高密度病变,毛玻璃衰减,局限在右下鼻甲。随后的活检证实了青少年小梁骨化性纤维瘤(JTOF)。患者接受了内窥镜右内侧上颌骨切除术,最后的组织学证实了JTOF的诊断。
    Nasal obstruction is a commonly reported issue in the Otorhinolaryngology Outpatient Department. In this case, an early adolescent boy with a long-standing problem of right-sided nasal obstruction since childhood sought consultation. Diagnostic nasal endoscopy revealed a deviation of the nasal septum to the left, coupled with right inferior turbinate hypertrophy, all overlying healthy mucosa. A CT scan of the nose and paranasal sinuses further identified a bony hyperdense lesion with ground glass attenuation, confined to the right inferior turbinate. Subsequent biopsy confirmed juvenile trabecular ossifying fibroma (JTOF). The patient underwent endoscopic right medial maxillectomy, and the final histology affirmed the diagnosis of JTOF.
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  • 文章类型: Journal Article
    背景:帕金森病(PD)是最常见的神经退行性疾病之一,在阿尔茨海默病之后。PD的发作以黑质中多巴胺能神经元的丢失为特征。干细胞疗法在治疗神经退行性疾病方面具有巨大的潜力,和人鼻甲来源的干细胞(hNTSC)已被发现与间充质干细胞具有一些共同的特征。尽管Hippo信号通路最初被认为调节器官中的细胞大小,最近的研究表明,它还可以控制神经细胞的炎症。
    方法:从SH-SY5Y细胞(DA样细胞)分化出多巴胺能神经元样细胞,并用碘化1-甲基-4-苯基吡啶处理以刺激反应性氧化物质(ROS)产生。进行transwell测定以验证hNTSC对Hippo途径的作用。我们建立了MPTP诱导的PD小鼠模型,并通过立体定向手术将hNTSC移植到PD小鼠的黑质中。经过五周的行为测试,通过免疫印迹和免疫染色验证脑样本,以确认hNTSC的生态位控制.
    结果:体外实验表明,hNTSCs通过控制ROS介导的ER应激和海马信号通路因子,显着增加细胞存活并发挥抗炎作用。同样,体内实验证明抗炎作用和细胞存活率增加.hNTSCs移植后,PD小鼠模型显示改善的活动性和PD症状的缓解。
    结论:hNTSCs通过Yes相关蛋白(YAP)/带有PDZ结合基序的转录共激活因子(TAZ),通过减少炎性细胞因子来操纵海马通路,从而提高多巴胺能神经元的存活率。在这项研究中,我们发现控制hNTSCs的生态位对PD病变有治疗作用。
    BACKGROUND: Parkinson\'s disease (PD) is one of the most prevalent neurodegenerative diseases, following Alzheimer\'s disease. The onset of PD is characterized by the loss of dopaminergic neurons in the substantia nigra. Stem cell therapy has great potential for the treatment of neurodegenerative diseases, and human nasal turbinate-derived stem cells (hNTSCs) have been found to share some characteristics with mesenchymal stem cells. Although the Hippo signaling pathway was originally thought to regulate cell size in organs, recent studies have shown that it can also control inflammation in neural cells.
    METHODS: Dopaminergic neuron-like cells were differentiated from SH-SY5Y cells (DA-Like cells) and treated with 1-Methyl-4-phenylpyridinium iodide to stimulate Reactive oxidative species (ROS) production. A transwell assay was conducted to validate the effect of hNTSCs on the Hippo pathway. We generated an MPTP-induced PD mouse model and transplanted hNTSCs into the substantia nigra of PD mice via stereotaxic surgery. After five weeks of behavioral testing, the brain samples were validated by immunoblotting and immunostaining to confirm the niche control of hNTSCs.
    RESULTS: In-vitro experiments showed that hNTSCs significantly increased cell survival and exerted anti-inflammatory effects by controlling ROS-mediated ER stress and hippocampal signaling pathway factors. Similarly, the in-vivo experiments demonstrated an increase in anti-inflammatory effects and cell survival rate. After transplantation of hNTSCs, the PD mouse model showed improved mobility and relief from PD symptoms.
    CONCLUSIONS: hNTSCs improved the survival rate of dopaminergic neurons by manipulating the hippocampal pathway through Yes-associated protein (YAP)/transcriptional coactivator with a PDZ-binding motif (TAZ) by reducing inflammatory cytokines. In this study, we found that controlling the niche of hNTSCs had a therapeutic effect on PD lesions.
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  • 文章类型: Journal Article
    背景:脑脊液(CSF)清除率降低已被认为是阿尔茨海默病(AD)的病理特征。由于在非人类哺乳动物中的大量文献和相互矛盾的人类神经影像学数据,鼻粘膜是否是人类的CSF引流部位仍然未知。这里,我们使用动态PET和[1-11C]-丁醇,一种高度可渗透的放射性示踪剂,没有明显的大脑结合,以检验以下假设:来自鼻通路的示踪剂引流反映了来自脑的CSF引流。作为对假设的检验,我们检查了脑和鼻液引流时间是否相关以及是否受脑淀粉样蛋白的影响。
    方法:对24名认知正常受试者(≥65岁)进行动态PET成像60分钟。使用[1-11C]-丁醇。用[11C]-PiB或[18F]-FBB成像鉴定8个淀粉样蛋白PET阳性(Aβ+)和16个Aβ-受试者。MRI确定的感兴趣区域(ROI)包括:颈动脉,外侧眶额叶(LOF)大脑,筛板,和一个由上级组成的全鼻甲区域,中间,和下鼻甲。双侧颞肌和颈静脉作为控制区。区域时间活动被用来模拟示踪剂流入,出口,AUC。
    结果:LOF和全鼻甲60分钟AUC呈正相关,从而暗示了大脑和鼻子之间的联系。Further,Aβ+亚组示踪剂动力学受损,以示踪剂流入减少和出口变慢为标志。
    结论:数据表明,脑和鼻甲的示踪剂动力学彼此相关,并且都反映了脑的淀粉样蛋白状态。因此,这些数据增加了鼻通路是人类潜在的CSF引流部位的证据.这些数据保证了对神经退行性疾病中脑和鼻对蛋白质清除的贡献的进一步研究。
    BACKGROUND: Reduced clearance of cerebrospinal fluid (CSF) has been suggested as a pathological feature of Alzheimer\'s disease (AD). With extensive documentation in non-human mammals and contradictory human neuroimaging data it remains unknown whether the nasal mucosa is a CSF drainage site in humans. Here, we used dynamic PET with [1-11C]-Butanol, a highly permeable radiotracer with no appreciable brain binding, to test the hypothesis that tracer drainage from the nasal pathway reflects CSF drainage from brain. As a test of the hypothesis, we examined whether brain and nasal fluid drainage times were correlated and affected by brain amyloid.
    METHODS: 24 cognitively normal subjects (≥ 65 years) were dynamically PET imaged for 60 min. using [1-11C]-Butanol. Imaging with either [11C]-PiB or [18F]-FBB identified 8 amyloid PET positive (Aβ+) and 16 Aβ- subjects. MRI-determined regions of interest (ROI) included: the carotid artery, the lateral orbitofrontal (LOF) brain, the cribriform plate, and an All-turbinate region comprised of the superior, middle, and inferior turbinates. The bilateral temporalis muscle and jugular veins served as control regions. Regional time-activity were used to model tracer influx, egress, and AUC.
    RESULTS: LOF and All-turbinate 60 min AUC were positively associated, thus suggesting a connection between the brain and the nose. Further, the Aβ+ subgroup demonstrated impaired tracer kinetics, marked by reduced tracer influx and slower egress.
    CONCLUSIONS: The data show that tracer kinetics for brain and nasal turbinates are related to each other and both reflect the amyloid status of the brain. As such, these data add to evidence that the nasal pathway is a potential CSF drainage site in humans. These data warrant further investigation of brain and nasal contributions to protein clearance in neurodegenerative disease.
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  • 文章类型: Journal Article
    虽然腺样体扁桃体切除术是儿童阻塞性睡眠呼吸暂停(OSA)的主要治疗方法,手术后持续性OSA很常见,可能是由于鼻部残留阻塞所致,鼻咽部,和/或上颚。理想情况下,对持续性小儿OSA的综合评估包括临床检查(有或没有清醒的鼻内窥镜)以及药物诱导的睡眠内窥镜检查,以准确识别残留梗阻的来源。根据阻塞部位的不同,一些手术治疗选择包括下鼻甲粘膜下切除术,中隔成形术,腺样体切除术,和扩张括约肌咽成形术。
    While adenotonsillectomy is the primary treatment of pediatric obstructive sleep apnea (OSA), persistent OSA after surgery is common and may be due to residual obstruction at the nose, nasopharynx, and/or palate. Comprehensive evaluation for persistent pediatric OSA ideally includes clinical examination (with or without awake nasal endosocpy) as well as drug-induced sleep endoscopy in order to accurately identify sources of residual obstruction. Depending on the site of obstruction, some of the surgical management options include submucous inferior turbinate resection, septoplasty, adenoidectomy, and expansion sphincter pharyngoplasty.
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  • 文章类型: Journal Article
    我们调查了(1)鼻中隔穿孔(NSP)如何改变鼻气流和空调特性,以及(2)鼻气流的改变如何受到NSP的大小和位置的影响。对14名具有NSP的受试者进行计算机断层扫描以生成鼻腔模型。进行NSP的虚拟修复以检查NSP对气流的唯一影响。计算流体动力学技术用于评估NSP周围和鼻咽中的几何和气流参数。净交叉气流速率,壁剪切应力(WSS)的增加和NSP后表面的表面水汽通量与穿孔的大小无关。在虚拟关闭NSP之后,相对湿度(RH)的水平,呼肠和鼻咽部的空气温度(AT)和鼻阻力均未明显改善。与鼻甲体积相关的几何参数,表面积-体积比(SAVR),被证明是测定RH和AT的重要因素,即使在NSP存在的情况下。与NSP的大小和位置相比,SAVR对choanae和鼻咽中RH和AT的影响更大。
    We investigated (1) how nasal septal perforations (NSPs) modify nasal airflow and air-conditioning characteristics and (2) how the modifications of nasal airflow are influenced by the size and location of the NSP. Computed tomography scans of 14 subjects with NSPs were used to generate nasal cavity models. Virtual repair of NSPs was conducted to examine the sole effect of NSPs on airflow. The computational fluid dynamics technique was used to assess geometric and airflow parameters around the NSPs and in the nasopharynx. The net crossover airflow rate, the increased wall shear stress (WSS) and the surface water-vapor flux on the posterior surface of the NSPs were not correlated with the size of the perforation. After the virtual closure of the NSPs, the levels in relative humidity (RH), air temperature (AT) and nasal resistance did not improve significantly both in the choanae and nasopharynx. A geometric parameter associated with turbinate volume, the surface area-to-volume ratio (SAVR), was shown to be an important factor in the determination of the RH and AT, even in the presence of NSPs. The levels of RH and AT in the choanae and nasopharynx were more influenced by SAVR than the size and location of the NSPs.
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