Septal extension grafts (SEGs) can increase projection. However, it requires a large amount of graft and can result in a frozen tip. Thus, this study introduces a modified SEG, called a partial SEG. Partial SEGs minimize the amount of graft material requirement, avoid the occurrence of frozen tips, and increase nasal tip projection. This method is comparable to the fixed-mobile SEG (Rohrich et al. in Plast Reconstr Surg 149: 1350-1356, 2022) and anterior nasal septal angle (ANSA) banner (Neves and Tagle in Ann Plast Reconstr Surg 4(3): 1059, 2020); however, unlike those techniques, the tip is not sutured to the graft and the alar complex is not fixed, allowing free movement of the nasal tip within its anatomical limits. To further prevent long-term displacement or minimize loss of nasal tip projection, a method of fixing the graft with Prolene and a third end-to-end SEG method for preventing sliding between grafts were used, which was also effective. Among the patients who underwent surgery between September 2019 and September 2023, 238 were followed up for over 6 months. Most patients were satisfied with the natural and flexible nature of the nasal tip. In conclusion, the alar wrap around a slender SEG technique can be an option for who want a flexible nasal tip that is projected adequately rather than excessively.Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

RSV infection remains a serious threat to the children all over the world, especially, in the low-middle income countries. Vaccine delivery via the mucosa holds great potential for inducing local immune responses in the respiratory tract. Previously, we reported the development of highly immunogenic RSV virus-like-particles (RSV-VLPs) based on the conformationally stable prefusogenic-F protein (preFg), glycoprotein and matrix protein. Here, to explore whether mucosal delivery of RSV-VLPs is an effective strategy to induce RSV-specific mucosal and systemic immunity, RSV-VLPs were administered via the nasal, sublingual and pulmonary routes to BALB/c mice. The results demonstrate that immunization with the VLPs via the mucosal routes induced minimal mucosal response and yet facilitated modest levels of serum IgG antibodies, enhanced T cell responses and the expression of the lung-homing marker CXCR3 on splenocytes. Immunization with VLPs via all three mucosal routes provided protection against RSV challenge with no signs of RSV induced pathology.

OBJECTIVE: To compare the effects of intranasal (IN) and intramuscular (IM) midazolam-butorphanol-ketamine on intraocular pressure (IOP), tear production (TP) and sedation in rabbits.
METHODS: Prospective, randomized, crossover experimental study.
METHODS: Fourteen male New Zealand White rabbits, aged 1-2 years, body mass 3.1 ± 0.8 kg (mean ± standard deviation).
METHODS: Rabbits were administered midazolam (1 mg kg-1), butorphanol (1.5 mg kg-1) and ketamine (5 mg kg-1) via IN and IM routes. IOP, TP and sedation scores were assessed at 0 (before drug administration), 5, 15, 30, 45 and 60 minutes after drug administration. Heart rate (HR), respiratory rate (fR), rectal temperature (RT), noninvasive mean arterial blood pressure (MAP) and peripheral hemoglobin oxygen saturation (SpO2) were simultaneously recorded until 45 minutes after drug administration. The onset and duration of sedation and sedation scores were recorded.
RESULTS: Drug delivery route had no significant impact on mean IOP (p = 0.271) or TP (p = 0.062), and there were no significant changes over time for IOP (p = 0.711) or TP (p = 0.372). Similarly, delivery route had no significant impact on HR (p = 0.747), fR (p = 0.872), RT (p = 0.379), MAP (p = 0.217) and SpO2 (p = 0.254). Sedation onset was faster with IN (3.0 ± 1.0 minutes) than with IM administration (4.9 ± 0.7 minutes) (p = 0.011), but sedation duration was significantly longer with IM (52.6 ± 7.2 minutes) than with IN delivery (30.7 ± 6.8 minutes) (p = 0.004). There was no significant difference in sedation scores between the two delivery routes at any of the recorded time points.
CONCLUSIONS: The combination of midazolam-butorphanol-ketamine had minimal impact on physiological and ocular variables regardless of the route of administration, whereas IN drug administration led to a shorter onset and duration of action than IM administration.

Background: The secretion of alarmin cytokines by epithelial cells, including thymic stromal lymphopoietin (TSLP), interleukin (IL)-25, and IL-33, initiates inflammatory cascades in asthma. However, alarmin cytokine expression in the upper airways in asthma remains largely unknown. Methods: We recruited 40 participants with asthma into four groups as per the Global Initiative for Asthma (GINA) steps (10 in each group of GINA 1/2, 3, 4, and 5). Cells were derived from nasal, buccal, and throat brushings. Intracellular cytokine expression (TSLP, IL-25, and IL-33) was assessed by flow cytometry in cytokeratin 8+ (Ck8+) epithelial cells immediately following collection. Results: TSLP was significantly increased (p < 0.001) in GINA 5 patients across nasal, buccal, and throat Ck8+ epithelial cells, while IL-25 was elevated in nasal and throat samples (p < 0.003), and IL-33 levels were variable, compared with GINA 1-4 patients. Individual GINA subgroup comparison showed that TSLP levels in nasal samples from GINA 5 patients were significantly (p = 0.03) elevated but did not differ between patients with and without nasal comorbidities. IL-25 and IL-33 (obtained from nasal, buccal, and throat samples) were not significantly different in individual groups. Conclusions: Our study demonstrates for the first time that Ck8+ nasal epithelial cells from GINA 5 asthma patients express elevated levels of TSLP.

Respiratory syncytial virus is the major cause of acute lower respiratory tract infections in young children, causing extensive mortality and morbidity globally, with limited therapeutic or preventative options. Cathelicidins are innate immune antimicrobial host defence peptides and have antiviral activity against RSV. However, upper respiratory tract cathelicidin expression and the relationship with host and environment factors in early life, are unknown. Infant cohorts were analysed to characterise early life nasal cathelicidin levels, revealing low expression levels in the first week of life, with increased levels at 9 months which are comparable to 2-year-olds and healthy adults. No impact of prematurity on nasal cathelicidin expression was observed, nor were there effects of sex or birth mode, however, nasal cathelicidin expression was lower in the first week-of-life in winter births. Nasal cathelicidin levels were positively associated with specific inflammatory markers and demonstrated to be associated with microbial community composition. Importantly, levels of nasal cathelicidin expression were elevated in infants with mild RSV infection, but, in contrast, were not upregulated in infants hospitalised with severe RSV infection. These data suggest important relationships between nasal cathelicidin, upper airway microbiota, inflammation, and immunity against RSV infection, with interventional potential.

Massive sequencing of a fragment of 16S rRNA gene allows the characterization of bacterial communities in different body sites: the microbiota. Nasal microbiota can be analyzed by DNA extraction from nasal swabs, amplification of the specific fragment of interest, and posterior sequencing. The raw sequences obtained need to go through a computational process to check their quality and then assign the taxonomy. Here, we will describe the complete process from sampling to get the microbial diversity of nasal microbiota in health and disease.

UNASSIGNED: We will describe the use of nasolabial Burow\'s advancement flaps (perialar crescentic advancements) to repair multi subunit defects of the nasal sidewall including the adjacent cheek, dorsum, tip, and ala without the need of additional flaps.
UNASSIGNED: This retrospective single centre study analyzed 6 month postoperative photographs using the Manchester Scar scale. The operative technique is described in detail.
UNASSIGNED: Of 355 cases, 336 were available for analysis. The median Manchester Scar scale was 7 for both sidewall defects and multi-subunit defects. There were low rates of infection or necrosis.
UNASSIGNED: With the correct technique, the nasolabial Burow\'s advancement alone is suitable to repair even large multi-subunit defects involving the nasal sidewall, cheek, dorsum, tip, and ala with high-level aesthetic and functional results.

A variety of diseases can affect the nasal vestibule. It might be challenging to diagnose and treat a nasal vestibular tumor due to the anatomical characteristics of the nasal vestibule. Neurilemmoma is a tumor derived from Schwann cells of the nerve sheath. Less than 4% of these tumors invade the nasal cavity and sinuses. Nasal vestibule neurilemmoma is rare, it is often overlooked when a mass discovered. The diagnosis of it is mainly based on clinical symptoms, nasal endoscopy, and imaging, The mainstay of treatment is complete resection surgery. Pathological examination provides the final diagnosis. We present a patient with nasal vestibule neurilemmoma who underwent a successful endoscopic surgery without cosmetic deformity, and discuss the clinical manifestations, histological features, imaging features, differential diagnosis, treatment options, then reviewed relevant literature of this rare benign lesion.

A 14-y-old intact female llama (Lama glama) was presented for evaluation of a right maxillary swelling of 3-mo duration. Clinically, the animal had mild nasal discharge, abnormal retropulsion of the right eye, and moderate gingival disease. An incisional biopsy of the maxillary mass revealed pleomorphic and mitotically active neoplastic spindle-to-stellate cells organized in haphazard lacunae embedded in abundant chondroid matrix. Given the poor prognosis, euthanasia was elected. Postmortem examination and sectioning of the head exposed a large solid, white, firm mass that vastly expanded the right infraorbital region, extending to the maxilla, effacing the right nasal conchae and ipsilateral zygomatic bone. Collectively, postmortem dissection, cytology, and histopathology of the primary mass supported a diagnosis of sinonasal chondrosarcoma. To our knowledge, this entity had not been reported previously in this species and should be considered a differential for facial deformities in New World camelids.

OBJECTIVE: To describe the CT findings of Australian dogs and cats with nasal cryptococcosis over a 12-year period.
METHODS: 12 dogs and 9 cats diagnosed with nasal cryptococcosis from 2008 through 2020.
METHODS: CT findings were compared among enrolled cases from Australian veterinary referral centers. Disease severity was compared between a subset of patients with cryptococcal speciation performed (n = 6 dogs; n = 3 cats) and geographic domicile.
RESULTS: Dogs demonstrated diffuse disease affecting numerous nasal regions and sinuses. Cats displayed more focal nasal and nasopharyngeal disease. Dogs were more likely to have a nasal mass, whereas cats were more likely to have a nasopharyngeal mass. Cribriform plate lysis was common in dogs but not observed in cats. Sinonasal osteolysis was a common feature in both species. Mandibular lymph nodes were commonly enlarged in dogs, whereas in cats, the retropharyngeal lymph nodes were more likely enlarged. There was no obvious difference in disease severity or lesion distribution in relation to the causal species of Cryptococcus, although to determine if this finding is robust, an appropriately powered prospective study is warranted.
CONCLUSIONS: There are numerous studies describing the clinical features, treatment, and outcomes of dogs and cats with cryptococcosis. To the best of our knowledge, there is only 1 previous study describing the CT features of nasal cryptococcosis, undertaken in one part of North America. Our study describes the CT features of nasal Cryptococcus sp in an Australian canine and feline cohort, adding new pertinent observations while reinforcing reported radiological observations.