A multicenter approach to evaluate omalizumab effectiveness in Samter’s triad

Omalizumab proved to be very effective in improving control of severe atopic asthma. Many small-sized studies suggested a potential role for omalizumab in the management of aspirin-exacerbated respiratory disease. The aim of this study is to describe the effectiveness of omalizumab in a multicentre group of patients with Samter’s triad. We retrospectively enrolled eight patients (5 females) with Samter’s triad who underwent at least one year of omalizumab therapy. Clinical data, functional parameters and questionnaires for asthma and nasal polyposis control were collected at baseline and follow-up. We observed a significant reduction of moderate-to-severe asthma exacerbations, together with an increase of FEV1 and a reduction of steroids intake. An improvement in asthma control and nasal symptoms was also reported. This multicenter study confirms the effectiveness of omalizumab in patients affected by Samter’s triad. Omalizumab may represent a potential therapeutic option for the management of this disease.

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Transoral Endoscopic Adenoidectomy

International Journal of Otolaryngology ◽

10.1155/2009/949315 ◽

2009 ◽

Vol 2009 ◽

pp. 1-4 ◽

Cited By ~ 8

Author(s):

Amr El-Badrawy ◽

Mosaad Abdel-Aziz

Keyword(s):

High Risk ◽

Nasal Allergy ◽

Nasal Endoscope ◽

Experienced Surgeon ◽

Nasal Symptoms ◽

Recent Advancement ◽

Long Time ◽

One Year ◽

Telephone Questionnaire

Objective. Adenoid curette guided by an indirect transoral mirror and a headlight is a simple and quick procedure that has already been in use for a long time, but this method carries a high risk of recurrence unless done by a well-experienced surgeon. The purpose of this paper was to evaluate the efficacy of transoral endoscopic adenoidectomy in relieving the obstructive nasal symptoms.Methods. 300 children underwent transoral endoscopic adenoidectomy using the classic adenoid curette and St Claire Thomson forceps with a Hopkins 4-mm nasal endoscope introduced through the mouth and the view was projected on a monitor. Telephone questionnaire was used to follow-up the children for one year. Flexible nasopharyngoscopy was carried out for children with recurrent obstructive nasal symptoms to detect adenoid rehypertrophy.Results. No cases presented with postoperative complications. Only one case developed recurrent obstructive nasal symptoms due to adenoid regrowth and investigations showed that he had nasal allergy which may be the cause of recurrence.Conclusion. Transoral endoscopic adenoidectomy is the recent advancement of classic curettage adenoidectomy with direct vision of the nasopharynx that enables the surgeon to avoid injury of important structures as Eustachian tube orifices, and also it gives him the chance to completely remove the adenoidal tissues.

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Anaphylaxis in a Patient Undergoing FESS for Nasal Polyposis: Revisting Samter’s Triad

Archives of Anesthesia and Critical Care ◽

10.18502/aacc.v7i4.7636 ◽

2021 ◽

Author(s):

Santvana Kohli ◽

Mudit Varshney ◽

Sahil Diwan

Keyword(s):

Intensive Care ◽

Nasal Polyps ◽

Nasal Polyposis ◽

Complete Recovery ◽

Young Female ◽

Sinus Surgery ◽

Aspirin Exacerbated Respiratory Disease ◽

Intensive Care Stay ◽

Analgesic Agents ◽

Samter’S Triad

Patients with nasal polyposis frequently have associated bronchial asthma and hypersensitivity to NSAIDs. When the three conditions co-exist, it is referred to as the Samter’s triad. Patients with Samter’s triad are an important subset of those with aspirin-exacerbated respiratory disease (AERD). We present a case of a young female patient undergoing endoscopic sinus surgery for nasal polyps, who although did not show any other features of AERD, went on to develop florid anaphylaxis to diclofenac administration intra-operatively. After adequate resuscitation and intensive care stay, the patient made a complete recovery. NSAIDs must be avoided in patients with nasal polyps, despite showing no other features of this syndrome. Other analgesic agents that can be used include IV paracetamol and opioids like tramadol.

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Allergic Rhinitis and Aspirin-Exacerbated Respiratory Disease as Predictors of the Olfactory Outcome after Endoscopic Sinus Surgery

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2009.23.3325 ◽

2009 ◽

Vol 23 (3) ◽

pp. 348-353 ◽

Cited By ~ 28

Author(s):

Michael Katotomichelakis ◽

Maria Riga ◽

Spyridon Davris ◽

Gregorios Tripsianis ◽

Maria Simopoulou ◽

...

Keyword(s):

Allergic Rhinitis ◽

Respiratory Disease ◽

Endoscopic Sinus Surgery ◽

Nasal Polyposis ◽

Sinus Surgery ◽

Olfactory Acuity ◽

Aspirin Exacerbated Respiratory Disease ◽

Negative Effect ◽

Time Frames

Background Unlike the functional outcomes of endoscopic sinus surgery, which have been thoroughly studied, the effect of the surgery on olfactory performance and the relative predictive factors have not been adequately assessed by literature. Allergic rhinitis and aspirin-exacerbated respiratory disease (AERD) are examined as potential confounding factors of the olfactory outcome in patients with extensive nasal polyposis and rhinosinusitis treated with functional endoscopic sinus surgery (FESS). Methods A population of 116 adults with severe nasal polyposis was subjected to FESS after failure of the appropriate medical treatment. The olfactory outcome was quantified by Sniffin’ Sticks at the 1st, 3rd, and 6th postoperative month in relation to the concomitant presence of allergic rhinitis (n = 62) or AERD (n = 18). Results Allergic patients seemed to perform worse than nonallergic patients at all time frames. However, when patients with similar olfactory acuity, age, and medical history are compared, allergic rhinitis does not seem to affect the postoperative improvement of the composite threshold-discrimination-identification scores. The same seems to apply for the likelihood of acquiring normosmia after surgery. On the contrary, AERD significantly limits the recovery of olfactory function at all follow-up examinations and patients with AERD are unlikely to become normosmic. Conclusion The olfactory recovery after FESS for nasal polyposis is significantly affected by the concomitant presence of AERD. Although allergy seems to have a general negative effect on olfactory acuity, it was not found to affect the extent of the olfactory improvement, when patients with comparable preoperative characteristics are addressed.

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Intratympanic corticosteroid perfusion in the therapy of Meniere’s disease

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1406291s ◽

2014 ◽

Vol 142 (5-6) ◽

pp. 291-295 ◽

Cited By ~ 1

Author(s):

Snezana Sankovic-Babic ◽

Rade Kosanovic ◽

Zoran Ivankovic ◽

Snezana Babac ◽

Milica Tatovic

Keyword(s):

Minimally Invasive ◽

Action Potentials ◽

Therapeutic Option ◽

Experimental Studies ◽

Hearing Threshold ◽

Minimally Invasive Surgical ◽

Hearing Function ◽

One Year

Introduction. Over the last two decades the intratympanic perfusion of corticosteroids has been used as a minimally invasive surgical therapy of Meniere?s disease. According to experimental studies the antiinflammatory, immunoprotective, antioxidant and neuroprotective role of the locally perfused corticosteroids was noticed in the inner ear structures. The recovery of action potentials in the cells of the Corti organ was confirmed as well as a decreased expression of aquaporine-1, a glycoprotein responsible for labyrinth hydrops and N and K ions derangement. Objective. The study showed results of intratympanic perfusion therapy with dexamethasone in patients with retractable Meniere?s disease who are resistant to conservative treatment. Methods. Single doses of 4 mg/ml dexamethasone were given intratympanically in 19 patients with retractable Meniere?s disease. Six single successive doses of dexamethasone were administered in the posteroinferior quadrant of the tympanic membrane. Follow-up of the patients was conducted by using a clinical questionnaire a month after completed perfusion series as well as on every third month up to one year. Results. One month after completed first course of perfusions, in 78% of patients, vertigo problems completely ceased or were markedly reduced. The recovery of hearing function was recorded in 68% and marked tinnitus reduction in 84% of patients. After a year of follow-up, in 63% of patients the reduction of vertigo persisted, while hearing function was satisfactory in 52%. Tinitus reduction was present in 73% of patients. Conclusion. Intratympanic perfusion of dexamethasone in patients with Meniere?s disease is a minimally invasive therapeutic method that contributes to the reduction of the intensity of vertigo recurrent attacks, decrease of the intensity of tinnitus and improvement of the average hearing threshold. Patients with chronic diseases and Meniere?s disease who are contraindicted for systemic administration of cortocosteroids (hypertension, diabetes, glaucoma, peptic ulcer, etc.) have an additional therapeutic option by dexamethasone intratympanic perfusion.

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Effects of topical administration of beclomethazone dipropionate on the symptoms of chronic rhinitis

Vojnosanitetski pregled ◽

10.2298/vsp0301029u ◽

2003 ◽

Vol 60 (1) ◽

pp. 29-34 ◽

Cited By ~ 2

Author(s):

Dejan Ursulovic ◽

Ljiljana Janosevic ◽

Slobodanka Janosevic ◽

Vojko Djukic

Keyword(s):

Beclomethasone Dipropionate ◽

Nasal Polyposis ◽

Topical Therapy ◽

Topical Administration ◽

Average Score ◽

Nasal Symptoms ◽

Daily Dose ◽

Symptom Scores ◽

Significant Change

The aim of this study was to evaluate the effect of topical administration of corticosteroid beclomethasone dipropionate on common nasal symptoms in moderate allergic and non-allergic hyperreactive eosinophilic rhinitis, and in allergic and non-allergic hyperreactive eosinophilic rhinitis associated with bilateral moderate nasal polyposis. The study was prospective and controlled. During the study 106 patients were examined, out of whom 66 were treated, while 40 had no therapy. Beclomethasone diproprionate nasal spray was administered in the daily dose of 400 ?g. Patients with isolated rhinitis underwent 3 otorhinolaryngologic examinations during the six-week treatment. Patients with nasal polyposis underwent 4 otorhinolaryngologic examinations during six-month treatment. One-week therapy showed highly significant decrease of the average score of symptoms of isolated rhinitis in relation to basal condition. No further significant change was noted after six-week therapy. Six-week therapy of nasal polyposis exerted significantly reduced score of symptoms in relation to basic condition. During further treatment no significant reduction of symptoms was noted. Follow-up period of all control subgroups showed no significant change of symptom scores. Topical therapy with beclomethasone dipropionate represented a significant medication of the first therapeutic line in moderate isolated eosinophilic rhinitis, as well as in moderate bilateral eosinophilic nasal polyposis.

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LSTR AND ITS POTENTIAL ROLE IN CONSERVATIVE MANAGEMENT OF NON-VITAL PRIMARY MOLAR: A CASE REPORT.

10.36106/paripex/4601320 ◽

2021 ◽

pp. 37-38

Author(s):

Kapil Gandhi ◽

Ritika Ahuja Malhotra ◽

Sharon Jaiswal ◽

Shabana Alam ◽

Babita Jangra ◽

...

Keyword(s):

Case Report ◽

Tissue Repair ◽

Primary Teeth ◽

Potential Role ◽

Root Resorption ◽

Primary Molar ◽

Pulp Therapy ◽

Triple Antibiotic Paste ◽

One Year

Lesion sterilization and tissue repair (LSTR) treatment is very effective in disinfecting the root canal using triple antibiotic mixed in a suitable vehicle. This report is highlighting a case where LSTR therapy was done using triple antibiotic paste in primary molar showing peri-radicular pathosis and root resorption. On one-year follow-up, the tooth was asymptomatic with reduction in peri-radicular pathosis and root resorption. Thus, LSTR can be successful for nonvital pulp therapy in primary teeth with peri-radicular pathosis and root resorption. And also, LSTR therapy can be used as an alternative option to extraction in treating primary teeth with peri-radicular pathosis.

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Role of Biologics in Chronic Rhinosinusitis With Nasal Polyposis: State of the Art Review

Otolaryngology ◽

10.1177/0194599820939964 ◽

2020 ◽

pp. 019459982093996 ◽

Cited By ~ 1

Author(s):

Christine Kim ◽

Joseph Han ◽

Tara Wu ◽

Claus Bachert ◽

Wytske Fokkens ◽

...

Keyword(s):

Chronic Rhinosinusitis ◽

Large Scale ◽

Nasal Polyposis ◽

Therapeutic Option ◽

Cochrane Review ◽

Clinical Problem ◽

Randomized Controlled ◽

Systemic Treatments

Objective To review the current literature regarding the role of biologics in the treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP). Data Sources PubMed/MEDLINE, EMBASE, Cochrane Review, ClinicalTrials.gov Review Methods We conducted a comprehensive review of the literature on clinical studies investigating the efficacy of emerging biologics in CRSwNP, with a focus on randomized controlled trials. Conclusions There appears to be promising evidence to support the safety and efficacy of biologics in CRSwNP with and without asthma for select patients. However, additional large-scale randomized studies with longer follow-up are necessary to determine which patients would benefit the most from these novel systemic treatments. Implications for Practice Chronic rhinosinusitis with nasal polyposis refractory to medical and surgical therapy remains a challenging clinical problem for otolaryngologists. However, emerging biologic therapies may offer a new therapeutic option for such patients with recalcitrant disease.

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Influence of nasal corticosteroid therapy duration on its efficiency at nasal polyposis

Russian Pulmonology ◽

10.18093/0869-0189-2005-0-2-107-112 ◽

2005 ◽

pp. 107-112

Author(s):

B. A. Chernyak ◽

E. V. Nosulya ◽

L. B. Sekretareva ◽

I. A. Kim

Keyword(s):

Nasal Polyposis ◽

Clinical Effect ◽

Normal Values ◽

Minimal Level ◽

Functional Parameters ◽

Nasal Symptoms ◽

Nasal Steroids ◽

Trial Phase

Efficacy of fluticasone propionate (FP) – Flixonase, GSK, in 76 patients with nasal polyposis (NP) was studied. After the first 3-month trial phase (FP 400 mcg / day), 46 patients (the 1 st group) have continued the 12-month treatment with FP 200 mcg / day, and 23 patients (the 2-nd group) have stopped the therapy with nasal steroids. Intensity of nasal symptoms using a 4-point scale, need for topical vasoconstrictors, rhinometric ventilation parameters (nasal inspiratory flow, NIF, nasal resistance, NR) and endoscopic symptoms were evaluated every 3 months. Trial results showed various shifts in clinical and functional parameters in the compared groups. The intensity of NP symptoms in the 1-st group decreased and reached the minimal level in 6 to 12 months, NIF rate reduced and NR decreased while reaching the normal values after 12 months of the FP therapy. The 2-nd patient group had a considerable worsening of the NP symptoms and in the functional parameters of the nasal breath within 3 months after FP cancellation. After 6 month follow up these indices did not differ essentially from those at the baseline condition. Thus, the early FP cancellation can cause instability of clinical effect and fast recurrence to the initial status. Long-term (for several months) therapy of NP with decrease in the FP dose in 3 months not only can keep the achieved results, but also allows to improve them considerably.

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P288 Vedolizumab May Be An Effective Option For The Management Of Postoperative Recurrence Of Crohn’s Disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.412 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S320-S320

Author(s):

F S Macaluso ◽

M Cappello ◽

F Crispino ◽

M Grova ◽

A C Privitera ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Therapeutic Option ◽

Postoperative Recurrence ◽

Clinical Failure ◽

Endoscopic Recurrence ◽

Ileocolonic Resection ◽

One Year ◽

Rutgeerts Score

Abstract Background The role of Vedolizumab (VDZ) as therapeutic option for the postoperative recurrence of Crohn’s disease (CD) following ileocolonic resection is currently unknown. We aimed to assess the effectiveness of VDZ in this setting. Methods All consecutive CD patients with an available baseline colonoscopy at 6-12 months from the ileocolonic resection and treated with VDZ for the postoperative recurrence after the baseline colonoscopy were extracted from the cohort of the Sicilian Network for Inflammatory Bowel Diseases (SN-IBD). The primary outcome was endoscopic success, assessed at the first colonoscopy following initiation of VDZ. In patients with Rutgeerts score i0 or i1 at baseline, endoscopic success was defined by maintenance of Rutgeerts score i0 or i1; in patients with Rutgeerts score ≥ i2 at baseline, it was defined as reduction of at least one point of Rutgeerts score. The secondary outcome was clinical failure, assessed at one year and at the end of follow-up. Results Seventy patients were included (median follow-up: 23.5 months). All 9 patients without endoscopic recurrence at baseline (Rutgeerts score i0 or i1) and available post-treatment colonoscopy maintained a Rutgeerts score i0 or i1 (treatment success: 100%). In patients with endoscopic recurrence (Rutgeerts score ≥ i2 at baseline), a reduction of at least one point in the Rutgeerts score was obtained in 20 out of 42 patients (47.6%). By combining the two subgroups, the overall endoscopic success was achieved in 29 out of 51 patients (56.9%). Furthermore, 14 out of 42 patients (33.3%) with endoscopic recurrence at baseline achieved a Rutgeerts score i0 or i1 at the subsequent colonoscopy. Clinical failure was reported in 13/70 patients (18.6%) at one year, and in 23/70 patients (32.9%) at the end of follow-up. A new resection was required in 7/70 patients (10.0%). Conclusion VDZ may be a therapeutic option for the management of postoperative recurrence of CD. Further studies are needed to confirm these results.

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Spirometric assessment of lung transplanted patients: one year follow-up

Brazilian Journal of Transplantation ◽

10.53855/bjt.v11i4.309 ◽

2008 ◽

Vol 11 (4) ◽

pp. 1014-1019

Author(s):

Paulo Pêgo-Fernandes ◽

Fernando Conrado Abrão ◽

Frederico Leon Arrabal Fernandes ◽

Marlova Caramori ◽

Marcos Naoyuki Samano ◽

...

Keyword(s):

Lung Function ◽

Lung Transplantation ◽

Lung Transplant ◽

Statistical Difference ◽

Therapeutic Option ◽

Surgical Techniques ◽

First Year ◽

One Year ◽

Transplant Procedure

Purpose: The purpose of this study was to compare spirometric data between patients submitted to single-lung and double-lung transplantation along the first year after the transplant procedure. Introduction: Lung transplant was first described as an experimental method in 1963; it became a therapeutic option for patients with advanced pulmonary diseases due to improvements in the organ conservation, surgical techniques, immunosuppressive therapy, and treatment of post-operative infections. Methods: We retrospectively reviewed records of 39 patients, who received lung transplantation in our institution between August, 2003 and August, 2006. The Post-transplant survival after 1 year occurred in 29 patients, and all of them were followed-up. Results: Increase of the lung function in double-lung transplant group occurred earlier, presenting statistical difference after the 1st month both in the FEV1 and FVC compared to pre-transplant values (p <0.05). As to the group of patients with emphysema, comparison between two groups showed from the 3rd month a difference of the lung function. Discussion: Both analysis of the whole group added to the subgroup of emphysema patients supplied relevant data that points out the advantage of the bilateral over the unilateral transplantation. Although values of pre-transplant lung function were worse in the double-lung group, such difference did not occur again in the subsequent months to the surgery. Conclusion: There was a clear tendency to higher and earlier improvement in FVC and FEV1 in the bilateral transplant group.

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