Identification of the phase composition of solid microparticles in the nasal mucosa of patients with chronic hypertrophic rhinitis using Raman microspectroscopy

Solid particles, predominantly in micron and submicron sizes, have repeatedly been observed as a threat to a human health unique compared to the other textures of the same materials. In this work, the hypothesis the solid metal-based particles play a role in the pathogenesis of chronic hypertrophic rhinitis was investigated in patients who had not responded positively to medication. In the group of 40 randomly selected patients indicated for surgical mucotomy, the presence of solid micro- and submicron particles present in their nasal mucosa was assessed. For comparison, a set of 13 reference samples from patients without diagnosed chronic hypertrophic rhinitis was evaluated. The analysis was performed using Raman microspectroscopy. The advantage of this method is the direct identification of compounds. The main detected compounds in the mucosa samples of patients with chronic hypertrophic rhinitis were TiO2, carbon-based compounds, CaCO3, Ca(Fe, Mg, Mn)(CO3)2 MgCO3, Fe2O3, BaSO4, FeCO3 and compounds of Al and Si, all of which may pose a health risk to a living organism. In the reference samples, only TiO2 and amorphous carbon were found. In the control group mucosa, a significantly lower presence of most of the assessed compounds was found despite the longer time they had to accumulate them due to their higher mean age. Identification and characterisation of such chemicals compounds in a living organism could contribute to the overall picture of the health of the individual and lead to a better understanding of the possible causes not only in the chronic hypertrophic rhinitis, but also in other mucosal and idiopathic diseases.

Clinical and treatment aspects in chronic hypertrophic rhinitis in children

Background: Chronic hypertrophic rhinitis is a common problem in childhood and adolescence and has a negative impact on both physical, social and psychological well-being. Chronic hypertrophic rhinitis in the prevalence of children is 20-55%, and in the last 5 years this index is increasing. Material and methods: The study included 65 patients, aged 5 to 18 years, being hospitalized in the ENT department of the Emilian Cotaga Clinic of the Institute of Mother and Child, Chisinau, diagnosed with rhinitis complicated chronic hypertrophic over the years January 2018 – December 2020. The study was conducted by retrospective analysis of complicated data from clinical observation sheets and documents accompanying the data. Treatment methods studied: laser coagulation, electrocoagulation, radiofrequency, mucotomy. In most cases, lasercoagulation was chosen. Results: Nasal permeability in children with chronic hypertrophic rhinitis is altered in most cases. The most frequently affected age groups were 10-14 years with a rate of 61.53%, the majority being from urban living environment in 63.08%. The most representative clinical signs and symptoms according to this study are difficult nasal breathing in 96.93% and mouth breathing – 89.24%. From the indicated surgical methods, laser coagulation of the nasal cornets was performed in 47.7% of cases. It proved to be more effective and less invasive compared to electrocoagulation performed in 44.6% of cases and partial mucotomy in 4.62%. Conclusions: From the data obtained in the study, we opted for laser coagulation of the lower nasal horns, which has a faster healing period, shorter postoperative complications, greater acceptability from the doctor and patient.

Volumetric osteoconchoplasty method

Introduction. Pathology of the inferior turbinates (IT) was found in 76.1% of patients with difficulty in nasal breathing. If nasal breathing cannot be restored with conservative measures, surgical intervention becomes the method of choice.Materials and methods. Under local infiltration anesthesia, the IT is fractured and retracted medially (medialization). In the anterior section of the HHP, a vertical incision 0.5 cm long to the bone is made, through which the mucosa is peeled off from the bone base of the concha with a raspator-suction and a small tunnel from 2 to 3 cm long is created. shell surfaces and a small area of the mucosa of the lateral surface of the IT and the lateral wall of the nasal cavity. After insertion into the created tunnel of the required size of the "spreader-implant" plate, treated with a thin layer of LTK glue, the shell is slightly pressed with a self-inflating latex-foam rubber swab introduced into the IT for 10–15 minutes. At the end of the operation, after removing the tampon, the edges of the incision are processed with LTK glue.Results. The results of the study demonstrate the effectiveness of the developed method for the rapid restoration of nasal breathing after rhinosurgical interventions. We use this technique in the overwhelming majority of cases of fibrous and bone forms of IT hypertrophy. In cases of the cavernous form, we perform a submucous conchotomy with a shaver, which makes it possible to very accurately remove exactly that part of the concha that violates the patency of the nasal cavity. In all cases, we consider it compulsory to carry out the IT lateroposition according to our method, which significantly improves the result of the operation. The surface of the shell remains completely covered with mucosa and as a result of matching the edges of the incision, the wound surface is absent. At the same time, after the operation, the shell remains full anatomically and functionally, i.e. consists of the bone skeleton and the corresponding volume of soft tissues.Conclusion. The question of how to predict in the long-term postoperative period the normal size of the modeled IT, apparently, is currently not answered even by highly qualified rhinosurgeons. In this regard, there remains a need to search for new technologies for treating patients with chronic hypertrophic rhinitis.

Turbinate Submucosal Reduction Operation Reduced Migraine Admission among Patients with Chronic Hypertrophic Rhinitis

Rhinitis increases migraine risk. Chronic hypertrophic rhinitis can be treated with turbinate submucosal reduction operation. The relationship between migraine and chronic hypertrophic rhinitis after turbinate submucosal reduction operation is still unclear. The goal of this study was to evaluate the correlation between turbinate submucosal reduction operation and subsequent migraine admission in Asian chronic hypertrophic rhinitis patients. We identified patients suffering from chronic hypertrophic rhinitis and receiving turbinate submucosal reduction operation. The control group was selected from patients with chronic hypertrophic rhinitis without operation. The event was migraine admission. The risk factors of migraine admission were established using multivariate Cox proportional hazard regression. The risk of migraine admission after turbinate submucosal reduction operation is represented by a hazard ratio (HR) of 0.858 (95% confidence interval (CI): 0.633–0.962). The higher risk of migraine included depression with HR 4.348 (95% CI: 2.826–6.69), anxiety with HR 3.75 (95% CI: 2.267–6.203), fibromyalgia with HR of 7.326 (95% CI: 3.427–15.661), and asthma with HR 1.969 (95% CI: 1.11–3.491). Our study revealed that turbinate submucosal reduction operation led to a 14.2% reduction in migraine admission. Clinicians should understand the benefit of turbinate submucosal reduction operation and provide suitable treatments for comorbid conditions. Further prospective studies are required to confirm our findings.

Endoscopic versus conventional method for partial inferior turbinectomy in chronic hypertrophic rhinitis

Background: The main goal of inferior turbinate surgery is to relieve obstruction while preserving the function of the turbinates as much as possible. Partial inferior turbinectomy (PIT) is an accepted and effective treatment in relieving the nasal obstruction while preserving the turbinate function. The use of endoscope provides complete visualization of the operating field and thus decreases the risk of excessive or inadequate resection. Methods: A prospective single blinded randomized controlled trial was carried out in Department of ENT, Manipal Teaching Hospital, Pokhara, Nepal from September 2008 to March 2010 with an objective to compare between the conventional and endoscopic method of PIT in terms of outcome and post-operative morbidity in chronic hypertrophic rhinitis. Hundred cases were taken and assigned randomly into two groups; i.e. endoscopic PIT and conventional PIT. The post-operative findings were compared between the two groups using Fischer Exact test for proportion and t test for mean. Results: There was 94% improvement in nasal obstruction in conventional group and 100% in endoscopic group at 1 month whereas improvement was 100% in both the groups at 3 months. Though no significant difference was seen statistically yet improvement was more in endoscopic group. There was significant difference in the SNOT 22 change score between endoscopic and conventional method at 1 month and 3 months. Significantly higher rates of post- operative morbidities were seen in case of conventional PIT at 1 month. Conclusion: Endoscopic PIT is better than conventional in terms of improvement in nasal obstruction and decreased postoperative morbidity. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 102-107 DOI: http://dx.doi.org/10.3126/njms.v2i2.8945