EEG signatures change during unilateral Yogi nasal breathing

Airflow through the left-and-right nostrils is said to be entrained by an endogenous nasal cycle paced by both poles of the hypothalamus. Yogic practices suggest, and scientific evidence demonstrates, that right-nostril breathing is involved with relatively higher sympathetic activity (arousal states), while left-nostril breathing is associated with a relatively more parasympathetic activity (stress alleviating state). The objective of this study was to further explore this laterality by controlling nasal airflow and observing patterns of cortical activity through encephalographic (EEG) recordings. Thirty subjects participated in this crossover study. The experimental session consisted of a resting phase (baseline), then a period of unilateral nostril breathing (UNB) using the dominant nasal airway, followed by UNB using the non-dominant nasal airway. A 64-channel EEG was recorded throughout the whole session. The effects of nostril-dominance, and nostril-lateralization were assessed using the power spectral density of the neural activity. The differences in power-spectra and source localization were calculated between EEG recorded during UNB and baseline for delta, theta, alpha, beta and gamma bands. Cluster-based permutation tests showed that compared to baseline, EEG spectral power was significantly (1) decreased in all frequency bands for non-dominant nostril UNB, (2) decreased in alpha, beta and gamma bands for dominant nostril UNB, (3) decreased in all bands for left nostril UNB, and (4) decreased in all bands except delta for right nostril UNB. The beta band showed the most widely distributed changes across the scalp. our source localisation results show that breathing with the dominant nostril breathing increases EEG power in the left inferior frontal (alpha band) and left parietal lobule (beta band), whereas non-dominant nostril breathing is related to more diffuse and bilateral effects in posterior areas of the brain.These preliminary findings may stimulate further research in the area, with potential applications to tailored treatment of brain disorders associated with disruption of sympathetic and parasympathetic activity.

299 An Unusual Nasal Lump

A 70-year-old man received a few courses of various antibiotics for left dacrocystitis under the care of ophthalmologists. Despite the treatment, the lump was not improving. The patient, in the meantime, presented to his GP with recurrent left-sided epistaxis and it became apparent that he was also experiencing ipsilateral nasal blockage. He reported a 3-year history of left-sided tinnitus but no other red flag symptoms. He was subsequently referred as 2-Week-Wait to ENT and nasoendoscopy revealed complete blockage of the left nostril with the postnasal space fully obstructed by enlarged mucosal tissue and no palpable lymph nodes. CT showed an aggressive locally invasive sinonasal tumour and a necrotic posterior mediastinal lesion. MRI further defined the extent of invasion and revealed a significant level 2 lymph node. A gastroscopy and EUA nose were arranged to obtain histology to confirm the differential diagnosis of sinonasal SCC. This case highlights the importance of lateral thinking when presented with a refractory symptom, as a more sinister diagnosis can be detected earlier. It also reinforces the need for examination of surrounding anatomy that may influence the condition.

Haemorrhagic nasal polyp mimicking melanoma in an 83-year-old on rivaroxaban

An 83-year-old woman presented with rapid onset unilateral nasal obstruction after sneezing. She had a history of hypertension and atrial fibrillation, and was on rivaroxaban. Examination revealed a dark red polypoidal lesion completely obstructing the left nostril. She underwent CT and MRI, and proceeded to urgent excision biopsy of the lesion. Intraoperative appearance was in keeping with a haemorrhagic polyp arising from the nasal septum. Histology revealed haematoma within a layer of nasal mucosa. There was no evidence of haemangioma underlying the polyp. Our literature search has identified this case as the first described haemorrhagic polyp of the nasal septum. It is likely that rivaroxaban contributed to the formation of this haemorrhagic polyp, and it is important to differentiate benign haemorrhagic lesions from malignant conditions such as melanoma. Similar cases may become more common in the future as the proportion of the population on anticoagulants increases.

Nasal and Laryngeal Rhinosporidiosis in Horses Treated with Electrocautery

Background: Rhinosporidiosis is considered an endemic disease in some countries and can affect several species of animals, among them, also equines. In this specie, although the nasal cavity is the most common site of infection, in some cases, it could also be spotted in the larynx region. The present study had as an objective to describe two cases of rhinosporidiosis in horses, one of them nasal and the other in the laryngeal area.Cases: Horse 1. A 12-year-old male Standardbred was sent to the veterinary hospital for the resection of the formation presented in the mucocutaneous junction of the left nostril. During the physical exam, a red mass of a moderately consistency, with an irregular, verrucous, pedunculated and ulcerated surface was observed, measuring approximately 2 centimeters in diameter. The surgical procedure for the resection of the mass was done through the use of the electrocautery technique, with the animal sedated with a romifidine dose of 0.08 mg/kg, a butorphanol dose of 0.04 mg/kg and a local anesthesia of 2% lidocaine. Eight months after the surgical procedure, the animal returned to the hospital and the presence of three new masses was noted in the same nostril, around the region where the extracted mass used to be found and they resembled the previous lesions. The horse’s owner didn’t authorize a new surgery or a new histopathological exam of the lesions. Horse 2. The other case refers to an asymptomatic 15-year-old male mixed breed. During a routine gastroscopic exam, the presence of several reddish coloration nodular and polypoid formations of irregular surface was observed in the larynx. Only one formation in the dorsal portion of the pharynx was observed. During the macroscopic exam, it was observed heterogeneously formation with a grayish-white color and soft consistency aspect. The surgical procedure for the resection of the mass, also through electrocautery, was performed with the animal, previously sedated with a detomidine dose of 0.01 mg/kg and a butorphanol dose of 0.02 mg/kg through intravenous. The contact plate of the electrocautery was fixed to the left side of the animal's neck. After the introduction of the endoscope through the nostril and advancing to the pharynx and larynx, lidocaine 2% without a vasoconstrictor was sprayed in the region. The polyps were individually wrapped by the polypectomy loop, passed through the endoscope operational channel and, at this time, the electrocautery was activated. After the treatment, periodical return appointments were made for the next two months. During the fourth appointment, the animal presented, in the endoscopy, a relapse of a few formations which were, again, removed with electrocautery. The histopathological exam in both cases was characterized by the presence of sporangia that was distributed homogeneously across the submucosal blade interspersed with mild to moderate mixed inflammatory infiltration composed predominantly of lymphoplasmic cells, followed by neutrophils and macrophages, as well as some hemorrhage area and the presence of macrophages with hemosiderin. These histopathological findings were consistent with rhinosporidiosis.Discussion: Rhinosporidiosis in horses, although rare, must be considered not only in cases of nasal formations, their most common form, but also in laryngeal cases, while the use of electrocautery is an efficient technique in the removal of the lesions, allowing for a good tissue healing and no postoperative complications. Nevertheless, follow-ups after treatment is always recommended to identify possible relapses.

Rhinitis as the Presenting Symptom of Pineal Region Epidermoid Tumor: A Case Report

Brain tumors are the rarest cause of cerebrospinal fluid rhinorrhea. Non-traumatic cerebrospinal fluid rhinorrhea is also a relatively rare condition. It may be misdiagnosed as allergic rhinitis or chronic sinusitis and lead to unsuitable treatment. We described a 34-yearold man who came to our allergy clinic with a chief complaint of clear rhinorrhea from his left nostril with more than four years of duration. Only hypertrophy of left inferior concha was found in the clinical examination. His rhinorrhea aggravated when bending forward. So we were suspicious of CSF rhinorrhea.MRI was done for him and demonstrated a large tumor in the pineal region. The patient underwent surgery with resection of the mass via an infratentorial-supracerebellar approach. This case showed the role of maintaining differential diagnosis for a common complaint; rhinitis which is seen as usual.

Stabilizing Effect of Yawning on Nasal Cycle

The dominant passability of the left or right nostril in terms of nasal air resistance can be classified into 4 main modes. In the first mode, both nostrils are closed and have equal and low air passability. In the second mode, the passability of the right nostril is higher than the left. In the third mode, the passability of the left nostril is higher than the right. In the fourth mode, both nostrils are open and passability of nostrils is equal and high. The first and fourth modes are unstable (with duration- minutes). The second and third modes are stable (with duration-hours). Author presents a yawning as physiological reflex leading to transition from unstable to stable modes.

Partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary polyvinylchloride stent

Case summary A 3-year-old male neutered domestic shorthair cat presented for further investigation of a swollen left eyelid and a hard, non-painful bony swelling over the left frontal sinus. Physical examination revealed no nasal discharge or airflow through the left nostril. A CT of the head revealed a left frontal sinus obstruction with expansile remodelling and osteolucency. Drainage of the frontal sinus obstruction was alleviated via placement of a temporary polyvinylchloride (PVC) stent that was left in place for 6 weeks. Purulent material removed from the frontal sinus returned a positive culture for Pseudomonas aeruginosa susceptible to marbofloxacin that was continued for 4 weeks, and for an additional 2 weeks after stent removal. A left-sided mucoid nasal discharge returned 3 months after removal of the stent. Repeat CT performed 20 months after surgery found the presence of a gas-filled frontal sinus and partial resolution in the amount of fluid within the mid and rostral nasal cavity. A repeat positive culture for P aeruginosa was also obtained. The exact cause of the chronic unilateral sinonasal obstruction remains unclear, but an underlying chronic rhinitis with secondary obstructive frontal sinusitis or sinus mucocoele with secondary nasal extension was suspected. Relevance and novel information Chronic rhinosinusitis in cats can be a challenging condition to treat and cure. This case illustrates the partial resolution of chronic unilateral sinonasal obstructive disease in a cat using a temporary PVC stent.

Effects of unpleasant odors on emotion recognition: The right hemisphere and valence-specific hypotheses

The right hemisphere has traditionally been considered as dominant in odor and emotion perception, whereas little is known about odor influence on emotion recognition. This study aimed to examine a possible difference in the recognition of basic emotions presented to the left or the right visual field following short-term left or right nostril treatment with an unpleasant odor. A total of 60 right-handed female participants completed an emotion recognition task in conditions of the right and left nostril treatment with an unpleasant odor (isovaleric acid). Results showed the right hemisphere advantage in speed, but not in the accuracy of basic emotion recognition after the right nostril treatment with an unpleasant odor, while the left nostril treatment had no effect. The right hemisphere and valence-specific hypotheses in emotion recognition were not confirmed, whereas the model of the right hemisphere dominance in odor perception was confirmed.

Effect of Unilateral Left Nostril Breathing (Chandra Anga Pranayama) on Cognitive Function in Healthy Yoga-Naïve Individuals: A Randomized, Controlled, Pilot Study

Introduction: Breathing modulates cortical neuronal activity. Various breathing exercises are purported to have specific effects on emotional and cognitive functions. Objective: To determine the effect of unilateral left nostril breathing (ULNB) on nonlateralized, overall cognitive functions using computerized psychometric tests. Methods: A randomized, controlled, pilot study was conducted among 20 healthy yoga-naïve medical students. ULNB was performed for 15 min by the test group (n = 10) and breath awareness by the control group (n = 10). Attention and processing speed, memory, and executive function were assessed using the Letter-Digit Substitution Test, Sternberg Memory Task, and Victoria Stroop Test, respectively. Baseline, pre- and postintervention scores were recorded. Results: There was no significant difference between the groups in baseline scores. In the Sternberg Memory Task, a statistically significant decrease in response time was seen in the test (t(9) = 3.855, p = 0.004) as well as the control group (t(9) = 3.120, p = 0.012); there was no significant difference between the groups. No significant effect of UNLB was seen in the Letter-Digit Substitution Test and Stroop Test. Conclusions: Our study showed no difference in the effects of 15-min practice of ULNB and breath awareness on cognitive functions; both improved memory but not attention or executive function.