Nasal cavity fungus ball discovered accidentally:A case report

BACKGROUND Fungal balls within the nasal cavity are an exceedingly rare clinical entity,typically presenting with nonspecific symptoms or being identified incidentally.CASE SUMMARY This report presents an incidental discovery of a fungal ball in the nasal cavity during routine imaging,with no associated clinical symptoms.CONCLUSION This case underscores the importance of considering the possibility of asympto-matic presentations of nasal fungal balls,which may be detected incidentally during imaging evaluations.

Intranasal administration of carbamazepine-loaded carboxymethyl chitosan nanoparticles for drug delivery to the brain

Epilepsy is considered as a common and diverse set of chronic neurological disorders and its symptoms can be controlled by antiepileptic drugs(AEDs). The presence of p-glycoprotein and multi-drug resistance transporters in the blood-brain barrier could prevent the entry of AEDs into the brain, causing drug resistant epilepsy. To overcome this problem, we propose using carboxymethyl chitosan nanoparticles as a carrier to deliver carbamazepine(CBZ) intranasally with the purpose to bypass the blood-brain barrier thus to enhance the brain drug concentration and the treatment efficacy. Results so far indicate that the developed CBZNPs have small particle size(218.76 ± 2.41 nm) with high drug loading(around 35%) and high entrapment efficiency(around 80%). The in vitro release profiles of CBZ from the NPs are in accordance with the Korsmeyer-peppas model. The in vivo results show that both encapsulation of CBZ in nanoparticles and the nasal route determined the enhancement of the drug bioavailability and brain targeting characteristics.

Preparation, characterization and in vivo evaluation of alginate-coated chitosan and trimethylchitosan nanoparticles loaded with PR8 influenza virus for nasal immunization

For efficient mucosal vaccine delivery, nanoparticulate antigens are better taken by microfold cells in the nasal associated lymphoid tissue and also dendritic cells. Nanoparticles based on polymers such as chitosan(CHT) and its water soluble derivative, trimethylchitosan(TMC), could be successfully used as carrier/adjuvant for this purpose. Sodium alginate, a negatively charged biopolymer, could modify the immunostimulatory properties of CHT and TMC NPs and increase their stability. Sodium alginate(ALG)-coated chitosan(CHT)and trimethylchitosan(TMC) nanoparticles(NPs) loaded with inactivated PR8 influenza virus were successfully prepared by direct coating of the virus with CHT or TMC polymers to evaluate their immunoadjuvant potential after nasal immunization. After nasal immunizations in BALB/c mice, PR8-CHT formulation elicited higher IgG2 a and Ig G1 antibody titers compared with PR8-TMC. ALG coating of this formulation(PR8-CHT-ALG) significantly decreased the antibody titers and a less immune response was induced than PR8-TMC-ALG formulation. PR8-TMC-ALG formulation showed significantly higher Ig G2 a/Ig G1 ratio, as criteria for Th1-type immune response, compared with PR8-CHT-ALG and PR8 virus alone. Altogether, the PR8-TMC-ALG formulation could be considered as an efficient intranasal antigen delivery system for nasal vaccines.

Diagnostic errors of nasal fractures in the emergency department:A monocentric retrospective study

Nasal bone fracture is one of the most common face bone injuries and the third most frequent of all body fractures.[1]Clinical examination is considered to be the gold standard to confirm the diagnosis of a nasal fracture.However,diagnosis may be challenging in case of haematoma and oedema of adjacent tissues,this leading to the use of X-rays to confirm or infirm the hypothesis.[2]Radiographic explorations for midface traumas can also be indicated for forensic purposes.[3]

Effect of nursing intervention on rehabilitation of patients with chronic sinusitis and nasal polyps after nasal endoscopy

BACKGROUND Chronic sinusitis is a kind of chronic suppurative inflammation of the sinus mucosa.Nasal endoscopy is a good method to treat nasal polyps.However postoperative rehabilitation and care should not be neglected.AIM To investigate the Effect of nursing intervention on the rehabilitation of patients with chronic sinusitis and nasal polyps(CSNPS)after nasal endoscopy.METHODS A total of 129 patients with CSNPS hospitalized from February 2017 to February 2019 were studied.Using the digital parity method,we investigated nursing cooperation strategies for endoscopic surgery.The comparison group(64 cases):Surgical nursing was carried out with traditional nursing measures;experimental group(65 cases):Surgical nursing was carried out by traditional nursing countermeasures+comprehensive nursing measures.We compared postoperative recovery rates,nursing satisfaction rates,and nasal cavity ratings between the two groups.RESULTS Experimental group patients with CSNPS had a significantly higher recovery rate(98.46%)compared to the control group(79.69%).This difference was statistically significant(χ2=11.748,P<0.05).Additionally,the satisfaction rate with treatment was also significantly higher in the experimental group(98.46%)compared to the control group(79.69%),with a statistically significant difference(χ2=11.748,P<0.05).Before nursing,there was no significant difference in sinus nasal cavity scores between the experimental group(20.29±7.25 points)and the control group(20.30±7.27 points)(t=0.008,P>0.05).However,after nursing,the sinus nasal cavity score in the experimental group(8.85±3.22 points)was significantly lower than that in the control group(14.99±5.02 points)(t=8.282,P<0.05).CONCLUSION Comprehensive nursing intervention in patients with CSNPS can significantly improve the total recovery rate after endoscopic surgery.

Treatment of primary nasal tuberculosis with anti-tumor necrosis factor immunotherapy:A case report

BACKGROUND Primary nasal tuberculosis(TB)is a rare form of extrapulmonary TB,particularly in patients receiving anti-tumor necrosis factor(TNF)immunotherapy.As a result,its diagnosis remains challenging.CASE SUMMARY A 58-year-old male patient presented to the ear,nose,and throat department with right-sided nasal obstruction and bloody discharge for 1 month.He was diagnosed with psoriatic arthritis and received anti-TNF immunotherapy for 3 years prior to presentation.Biopsy findings revealed chronic granulomatous inammation and a few acid-fast bacilli,suggestive of primary nasal TB.He was referred to our TB management department for treatment with oral anti-TB agents.After 9 months,the nasal lesions had disappeared.No recurrence was noted during follow-up.CONCLUSION The diagnosis of primary nasal TB should be considered in patients receiving TNF antagonists who exhibit thickening and crusting of the nasal septum mucosa or inferior turbinate,particularly when pathological findings suggest granulomatous inflammation.

Efficacy and Safety of Nasal Administration of “Na-no-L-DOPA” Based on PLGA Nanoparticles

Inclusion of L-DOPA, the standard Parkinson’s disease medication, into polymeric particles (PLGA) results in optimization the drug metabolism and increasing its bioavailability, significantly increases of physical endurance, better coordination and lower anxiety in Wistar rats, when chronically administered nasally.

Erratum to "Boeravinone B ameliorates allergic nasal inflammation by modulating the GATA-3/T-bet signaling pathway in a mouse model of allergic rhinitis"

In the article entitled“Boeravinone B ameliorates allergic nasal inflammation by modulating the GATA-3/T-bet signaling pathway in a mouse model of allergic rhinitis”,published on pages 245-252,Issue 6,Volume 14 in Asian Pacific Journal of Tropical Biomedicine,the weight number was misspelled as“18.5 g”on page 246,first line,under 2.2.Animals paragraph.The correct weight should be“(18.5±5)g”.

Nasal congestion caused by long-term retention of a nasal foreign body near the orbit:A case report

BACKGROUND Nasal trauma presents a risk of foreign body invasion into the nasal cavity.However,in the early treatment stage of nasal trauma,patients and doctors are not always aware of possible foreign body invasion,resulting in delayed detection.We describe the case of an adult patient admitted to the hospital due to left nasal congestion accompanied by yellow,purulent,and bloody discharge.CASE SUMMARY Consultation with the patient revealed a history of nasal trauma 30 years prior that did not receive thorough examinations and imaging during treatment,resulting in a glass fragment retained in the nasal cavity adjacent to the orbit.After admission,computerized tomography(CT)confirmed the presence of the foreign body in the patient’s left nasal–maxillary sinus.The nasal foreign body led to symptoms such as chronic sinusitis,nasal polyps,fungal infection,and deviated nasal septum.The foreign body was successfully removed by nasal endoscopy,polypectomy,sinus fungal removal,left middle turbinate conchoplasty,fenestration via the right inferior meatus,nasal endoscopic maxillary sinus cystectomy,and septolplasty.The operation was successful and without any complications.CONCLUSION CT scans should be performed in addition to necessary debridement sutures to avoid possible foreign body invasion during nasal trauma.Surgical planning should be tailored to the patient’s specific situation.The surgical method should be carefully selected,and sufficient preparation should be undertaken before the surgery to avoid possible displacement of the nasal foreign body.

Postoperative pneumocranium after endoscopic transnasal optic canal decompression

Dear Editor,We present the first time,a case of a patient developed cerebrospinal fluid(CSF)leak and pneumocranium following optic canal decompression(OCD).INTRODUCTION Indirect traumatic optic neuropathy(ITON)impairs visual functions and quality of life.Endoscopic transnasal optic canal decompression(ETOCD)is one of the standard treatment strategies for the ITON.During the ETOCD,the optic nerve sheath are usually incised for sufficient decompression of optic nerve after removal of optic canal,which is associated with complications like CSF leakage,ophthalmic artery injury,and optic nerve injury[1].Generally,the mild CSF leak is common and can heal spontaneously using conventional treatment,the severe CSF leak requires surgical repair[2].

Classification and reconstructive algorithm for nasal alar defect in Asians

Background:The nasal alar defect in Asians remains a challenging issue,as do clear classification and algorithm guidance,despite numerous previously described surgical techniques.The aim of this study is to propose a surgical algorithm that addresses the appropriate surgical procedures for different types of nasal alar defects in Asian patients.Methods:A retrospective case note review was conducted on 32 patients with nasal alar defect who underwent reconstruction between 2008 and 2022.Based on careful analysis and our clinical experience,we proposed a classification system for nasal alar defects and presented a reconstructive algorithm.Patient data,including age,sex,diagnosis,surgical options,and complications,were assessed.The extent of surgical scar formation was evaluated using standard photography based on a 4-grade scar scale.Results:Among the 32 patients,there were 20 males and 12 females with nasal alar defects.The predominant cause of trauma in China was industrial factors.The majority of alar defects were classified as type Ⅰ C(n=8,25%),comprising 18 cases(56.2%);there were 5 cases(15.6%)of type Ⅱ defect,7(21.9%)of type Ⅲ defect,and 2(6.3%)of type Ⅳ defect.The most common surgical option was auricular composite graft(n=8,25%),followed by bilobed flap(n=6,18.8%),free auricular composite flap(n=4,12.5%),and primary closure(n=3,9.4%).Satisfactory improvements were observed postoperatively.Conclusion:Factors contributing to classifications were analyzed and defined,providing a framework for the proposed classification system.The reconstructive algorithm offers surgeons appropriate procedures for treating nasal alar defect in Asians.

Early screening to identify and diagnose primary nasal tuberculosis in patients with tumor necrosis factor inhibitors

In this editorial,we comment on the article by Liu et al.Based on our analysis of a case report,we consider that early screening and recognition of primary nasal tuberculosis are crucial for patients undergoing treatment with tumor necrosis factor inhibitor(TNFi).While TNFi therapy increases the risk of reactivating latent tuberculosis,primary nasal tuberculosis remains rare due to the protective mechanisms of the nasal mucosa.Risk factors for primary nasal tuberculosis include minimally invasive nasal surgery,diabetes,and human immunodefi ciency virus.Patients with early symptoms such as nasal congestion,rhinorrhea,altered olfaction,epistaxis,or ulceration,and unresponsive to conventional antibiotics and antihistamines should undergo early rhinoscopy,possibly followed by repeated tissue biopsies and acid-fast bacilli culture when necessary.When diagnosis is challenging,it is essential to consider local tuberculosis epidemiology and the efficacy of diagnostic antituberculosis treatment.The preferred method for tuberculosis screening is the Interferon Gamma Release Assay,with a general recommendation for screening at 3 and 6 months after initial treatment and then every six months.However,the optimal frequency is not yet consensus-driven and may be increased in economically viable settings.

Classification and a decade-long follow-up of rat bite injuries in the nasal region

Background:Nasal defects due to rat bites are frequently encountered in rural regions of China.In addition to serving as disease vectors,rats can also inflict bite injuries.In this study,we delineated the characteristics of rat bite injuries in the nasal region and discussed the clinical features observed during a 10-year follow-up period.Methods:We retrospectively reviewed hospital records for patients admitted due to rat bites.This study outlines the demographics,clinical features,and follow-up outcomes supported by comprehensive photo documentation of the patients’progress.Results:Twenty-five patients,with a mean age of 29 years,were admitted due to rat bites.Treatment was provided for three distinct types of injuries:nasal tip defect(type Ⅰ),nasal defect(type Ⅱ),and full-thickness nasal defect with loss of surrounding tissues(type Ⅲ).All patients recovered fully.Conclusions:The treatment for rat bites should be based on the wound type.The long-term follow-up outcomes are more favorable when fewer subunits of the nose affected.We recommend early surgical intervention,along with psychological therapy,to prevent interference with growth and development.

Effect of Centipeda Herba Volatile Oil on Allergic Rhinitis by Nasal Sniffing

[Objectives] To explore the efficacy of different concentrations of Centipeda Herba volatile oil in the treatment of allergic rhinitis (AR) by nasal sniffing and the optimal drug concentration.[Methods] Forty-eight mice were randomly divided into control group, blank group, alcohol treatment group, low concentration group, medium concentration group and high concentration group, with 8 mice in each group. Except for the blank group, each mouse in the other groups was intraperitoneally injected with 1 mL of a mixture of 50 μgOVA+5 mg [Al(OH)_(3)] +1 mL of normal saline for 14 d. The allergic rhinitis mouse model was successfully established by intranasal instillation of 5% OVA solution on both sides (20 μL per side, once a day) from the 15 th day after stimulation for 7 d. The blank group was treated with the same amount of saline as above. The volatile oil of Centipeda Herba was obtained by steam distillation and petroleum ether extraction, and then was made into 1.25%, 2.5% and 5% volatile oil of Centipeda Herba with 75% alcohol. The control group was stimulated once every other day with reagent 2 after 7 d of stimulation (maintenance) until the end of treatment. The blank group was treated with 5 mL saline by nasal sniffing for 30 d, twice in the morning and evening, 30 min each time. The alcohol treatment group was treated with 5 mL of 75% alcohol, and the low concentration group, the medium concentration group and the high concentration group were treated with 5 mL of 1.25%, 2.5% and 5% Centipeda Herba volatile oil, respectively. The treatment time was the same as that of the blank group, and the treatment process was carried out in their respective closed contamination boxes. Before and after the treatment, the frequency of sneezing, the frequency of scratching nose, the amount of nasal discharge, activity and other general characteristics of the mice were observed, and the allergic behavior score was carried out. Besides, the IgE content in the serum of the mice was determined, and the eosinophils in the nasal discharge were counted.[Results] The scores of mice before and after treatment showed that there was no significant difference in the alcohol treatment group before and after treatment ( P >0.05), and there was significant difference in the low, medium and high concentration groups before and after treatment ( P <0.05), except that there was no significant difference between the control group and the alcohol treatment group ( P >0.05), and there was significant difference among the other groups ( P <0.05). The levels of IgE and the number of eosinophils in peripheral serum of mice in the control group, alcohol treatment group, low concentration group, medium concentration group and high concentration group were higher than those in the blank group ( P <0.05), and there was no significant difference between the two groups ( P >0.05).[Conclusions] Volatile oil of Centipeda Herba can be used to treat allergic rhinitis by nasal sniffing, and 5% volatile oil of Centipeda Herba has the best effect. During the treatment, sneezing and runny nose in mice were reduced. The results showed that nasal sniffing was less irritating to the nasal cavity and not easy to produce discomfort, the utilization rate of drugs was higher than that of traditional therapy, and the volatile oil could be preserved longer than that of traditional Chinese medicine.

Nasal Dermoid Cyst with Sinus Tract Intranasal Bone: A Case Report

Dermoid cysts are benign tumors originating from germ cells, which can form in various locations, including the nasal area in rare cases. They are of unknown exact etiology, but it is suggested that it is due to abnormal tissue migration during early embryonic development. Nasal dermoid cysts albeit rare, can present in various forms such as sinuses, fistulas, or intracranially extending tracts. They can be asymptomatic and incidentally discovered or present with a visible external mass or sinus that is either painful, infected or cosmetically concerning. If nasal dermoid cysts with an intra-nasal bone sinus tract are left untreated, they can lead to life-threatening complications. This report describes the case of a 6-year-old girl with a nasal dermoid cyst connected to a superficial punctum by an intra-nasal tract. She had undergone surgical excision of a nasal swelling previously diagnosed as a dermoid cyst. One year later, she returned to our clinic with a recurrence of the nasal swelling. Imaging tests revealed a nasal dermoid cyst with a tract extending to the nasal tip, without intracranial expansion. The cyst, along with the entire tract, was successfully removed surgically, and the postoperative follow-up indicated no complications. Histopathology confirmed the diagnosis of a dermoid cyst. This case underscores the significance of considering the dermoid tract in nasal cyst cases and the necessity of its complete removal to prevent recurrence.

Influence of pH Environment on Nasal Absorption of Meptazinol Hydrochloride

Aim To investigate the relationship between pH environment of meptazinolhydrochloride (MEP) and its nasal absorption. Methods In situ nasal peifusion was performed to studythe effect of pH environment on the nasal absorption. Its effect on the transport from nose tobrain was further researched by in vivo experiment. Results In in situ perfusion experiment, thenasal absorption of MEP in basic environment was significantly higher than that in acid condition,but the difference was not observed in in vivo experiment. Conclusion The pH environment ofmeptazinol hydrocloride in formulation cannot be regarded as an important factor influencing nasalabsorption and transport from nose to brain.

Root canal therapy combined with endoscopic sinus surgery for odontogenic sinusitis:Efficacy comparison in a cohort study

BACKGROUND Odontogenic maxillary sinusitis,often triggered by dental issues like periapical periodontitis,significantly contributes to chronic sinusitis,mainly affecting adults around 50 years old,emphasizing the need for a multidisciplinary diagnostic and treatment approach.AIM To investigate the therapeutic effect and clinical value of root canal therapy combined with nasal endoscopic surgery compared with simple root canal the-rapy in the treatment of severe odontogenic maxillary sinusitis caused by peria-pical periodontitis.METHODS The clinical data,diagnosis,and treatment of 200 patients with severe odonto-genic maxillary sinusitis caused by periapical periodontitis from October 2020 to October 2021 were analyzed retrospectively.Among them,63 patients were treated with simple root canal therapy as the control group,and 137 patients were treated with root canal therapy combined with nasal endoscopic surgery as the observation group.The therapeutic effect,Lund-Kennedy endoscopic score,paranasal sinus Lund-Mackay score,complication rate,recurrence rate,and patient satisfaction were compared between the two groups.RESULTS First,we compared the effective rates:23 cases were cured,22 were improved,and 8 were ineffective in the control group,yielding a total effective rate of 84.90%.Meanwhile,97 cases were cured,34 improved,and 6 were ineffective in the observation group,resulting in a total effective rate of 95.62%.The observation group had a higher total effective rate compared with the control group(P<0.05).Second,we compared the Lund–Kennedy endoscopic score.Before treatment,no significant difference(P>0.05)was observed in this score between the two groups.After treatment,the Lund–Kennedy endoscopic score decreased in both groups.The Lund–Kennedy endoscopic score of the observation group at 3 and 6 mo after treatment was lower compared to that of the control group(P<0.05).Third,we compared the Lund–Mackay score of paranasal sinuses.Before treatment,there was no significant difference in this score between the two groups(P>0.05).After treatment,the Lund–Mackay scores of paranasal sinuses decreased in both groups.The Lund–Mackay scores of paranasal sinuses in the observation group at 3 and 6 mo after treatment were lower compared to those of the control group(P<0.05).Fourth,we compared the incidence and recurrence rate of complications.Three months after treatment,no significant difference was found in the incidence and recurrence rate of complications between the observation group(6.56%)and the control group(9.52%)(P>0.05).However,6 mo after treatment,the incidence and recurrence rate of complications in the observation group(2.91%)was significantly higher compared to that of the control group(12.69%)(P<0.05).Fifth,we compared patient satisfaction.Six months after treatment,the patient satisfaction of the observation group(93.43%)was significantly better than that of the control group(84.12%)(P<0.05).CONCLUSION Root canal therapy combined with nasal endoscopic surgery has a good therapeutic effect on severe odontogenic maxillary sinusitis caused by periapical periodontitis,and it can reduce the injury of maxillary sinus mucosa and bone,and significantly reduce the incidence of complications and recurrence rate.Meanwhile,it has high patient satisfaction and remarkable therapeutic effect,which is suggested to be popularized and applied in clinic.

A novel frameshift mutation in the BCOR gene is associated with oculo-facio-cardio-dental syndrome:a case report

Dear Editor,Oculo-facio-cardio-dental(OFCD)syndrome is a rare X chromosome-linked dominant genetic disease with multiple system and site abnormalities.The typical traits shown in this disease are:1)eye abnormalities,notably congenital cataracts,microphthalmia,and secondary glaucoma;2)facial deformities,in particular long and narrow face,high nasal bridge,nasal tip cartilage division,and cleft palate.

The Phonosemantics of Nasal-Stop Clusters

The essay explores the meaning of nasal stop,in an attempt to provide more evidence to the hypothesis there is certain relation between sound and meaning,and foundation theory of phonosemantics.

CTAC/NaSal和PEO复合水溶液减阻和流变实验研究

深入研究表面活性剂和高分子聚合物复合水溶液减阻规律和流变特性,有助于理解复合减阻机理促进其在工程领域的应用。利用旋转圆盘减阻装置研究了温度、浓度和雷诺数对表面活性剂(CTAC/NaSal)、高分子聚合物(PEO)及其复合水溶液减阻率的影响;同时利用旋转流变仪研究了浓度、温度和剪切速率对三种减阻溶液表观黏度的影响。研究表明,PEO和CTAC/NaSal复合溶液的减阻率明显高于纯水溶液的减阻率,复合溶液具有减阻雷诺数和减阻温度范围宽及减阻率高的特点,且PEO浓度变化对复合溶液减阻率的影响小于CTAC/NaSal浓度变化的影响;在所测温度和雷诺数范围内,相同剪切速率下复合溶液的表观黏度基本高于纯溶液的,一些浓度组合的复合溶液在较低剪切速率和较高剪切速率下均出现剪切增稠现象,温度升高使复合溶液剪切增稠现象推迟、次数减小以及表观黏度峰值降低。