Search Results (3,670)

Background and Objectives: Chronic rhinosinusitis (CRS) frequently recurs following endoscopic sinus surgery (ESS), yet reported recurrence rates, risk factors, and treatment responses differ significantly across regions. This review aims to synthesize current evidence on recurrence patterns, predictive models, and treatment strategies, with a focus on comparing Asian and Western populations. Materials and Methods: A structured narrative review was conducted by searching PubMed, Embase, and Cochrane Library from January 2010 to June 2025. A total of 116 studies were included based on predefined criteria regarding recurrence definitions, risk factors, prediction models, and postoperative management. Results: Recurrence rates ranged from 12% to 76.6%, with wide variability attributed to differences in follow-up duration and recurrence definitions. Key risk factors included tissue eosinophilia, comorbid asthma, and type 2 inflammation. Asian predictive models emphasized inflammatory biomarkers such as tissue and blood eosinophils, whereas Western models incorporated imaging, prior surgical history, and symptom burden. While biologics are widely used in the West, their adoption remains limited in Asia, where endotype-driven corticosteroid strategies are predominant. Conclusions: CRS recurrence after ESS is influenced by inflammatory endotypes, comorbidities, and regional treatment paradigms. Cross-regional differences in immune profiles and healthcare access necessitate the development of standardized definitions and validated, endotype-driven prediction tools. Tailored treatment strategies, especially for non-type 2 CRS, are essential to achieving equitable and effective care globally. Full article

Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by partial or complete blockage of the upper airway during sleep, leading to disrupted airflow and fragmented sleep. Maxillary expansion has emerged as a promising treatment option, as widening the maxilla can increase nasal airway volume and improve airflow. The treatment options for maxillary expansion include rapid maxillary expansion (RME) for pediatric patients, mini-screw-assisted rapid palatal expansion  (MARPE) for adolescents and adults, surgically assisted rapid palatal expansion (SARPE) for skeletally mature individuals, and distraction osteogenesis maxillary expansion (DOME) for adults with severe maxillary constriction and nasal obstruction.  This comprehensive review explores the role of maxillary expansion in the management of OSA, examining its clinical applications and potential effectiveness as a therapeutic intervention. Full article

This study aimed to compare the therapeutic effects of fresh (CMF) and dried (CMD) Centipeda minima against allergic rhinitis (AR), elucidate their underlying molecular mechanisms, and identify the bioactive compounds responsible for their immunomodulatory actions. An ovalbumin-induced AR mouse model was treated with CMF or CMD extracts, followed by evaluation of nasal symptoms, serum biomarkers (IgE, histamine, cytokines), and nasal mucosa histopathology. Transcriptomics and widely targeted metabolomics were integrated with network pharmacology to identify differentially expressed genes and bioactive components, which were further validated in RAW264.7 and RBL-2H3 cells. CMF and CMD exhibited distinct anti-AR mechanisms: CMF predominantly suppressed Th2 responses (reducing IgE, IL-6, and histamine while elevating IL-10), whereas CMD enhanced Th1 activity (increasing IFN-γ). Metabolomic analysis revealed CMF was rich in amino acids while CMD contained higher flavonoids, with neocnidilide and 6-gingerol identified as key bioactive compounds that modulated TNF-α, IL-6, and IL-10 via NF-κB and JAK-STAT pathways. These findings demonstrate that CMF and CMD exert complementary anti-inflammatory effects through Th2 inhibition and Th1 activation, respectively, providing a molecular basis for the traditional use of Centipeda minima and highlighting its bioactive compounds as potential therapeutics for inflammatory diseases. Full article

Background: The efficacy of a novel combined vaccine targeting porcine circovirus types 2a/d (PCV2a/d), Mycoplasma hyopneumoniae, and M. hyorhinis was evaluated in a controlled challenge study. Methods: A total of 45 pigs were randomly allocated into nine groups (five pigs per group). Vaccinated groups received a single 2 mL intramuscular dose of the combined vaccine and were subsequently challenged with PCV2a, PCV2d, M. hyopneumoniae, and M. hyorhinis. Unvaccinated groups received a single 2 mL intramuscular dose of phosphate-buffered saline (0.01 M, pH 7.4). Growth performance, systemic adaptive immune (humoral and cellular) responses, viremia, laryngeal and nasal mycoplasma loads, and histopathological lesions were assessed. Results: Vaccinated pigs exhibited enhanced growth performance and elicited systemic immune responses, including both humoral and cellular immunity, against all four pathogens. Vaccination also significantly reduced viremia, mycoplasmal loads in laryngeal and nasal swabs, and the severity of associated lesions compared with unvaccinated controls. Conclusions: These results indicated that the combined vaccine was efficacious and conferred protection against PCV2a, PCV2d, M. hyopneumoniae, and M. hyorhinis challenge under experimental conditions. This combined vaccine represented an effective strategy to enhance growth performance and control complex co-infection in swine populations. Full article

Background: Hospital-based data can complement registry estimates for cranio-maxillofacial (CMF) oncology, particularly in under-reported regions. We aimed to describe the institutional case-mix of CMF tumor diagnoses, standardized to ICD-10 sites, and to quantify trends using visit-normalized indicators. Methods: We conducted a retrospective, observational, single-center, hospital-based study of diagnosis-level encounters (2012–2016). Diagnoses were recoded to ICD-10 and restricted to CMF sites (lip, oral cavity, major salivary glands, oropharynx/hypopharynx, nasal cavity/middle ear, paranasal sinuses, eye/adnexa). The primary indicator uses a strict CMF set (malignant CMF codes plus D00.0 and D14.1); odontogenic cysts and non-neoplastic jaw lesions (K09–K10) were excluded, while benign CMF neoplasms are reported descriptively for site distributions. Results: We identified 2729 malignant CMF diagnoses over 2012–2016, peaking in 2014 (n = 751) and lowest in 2016 (n = 367). The combined malignant rate (per 1000 total visits) was 30.6, 43.9, 52.6, 34.4, and 26.7 for 2012→2016. The proportion of malignancies within the strict CMF set was 99.2%, 97.3%, 97.9%, 96.8%, and 95.1%, respectively (overall 97.4%). The most frequent malignant sites cumulatively were the palate (n = 416), parotid gland (n = 376), floor of mouth (n = 344), gingiva (n = 282), and mouth, unspecified (n = 179). Conclusions: After ICD-10 recoding and restriction to CMF sites, malignant tumors predominated within the institutional, diagnosis-level case-mix, with a 2014 peak followed by a decline. These indicators are case-mix monitors and not population incidences; interpretation should consider coding practices and service-mix changes across years. Full article

Background: Staphylococcus aureus is a major zoonotic and foodborne pathogen with substantial One Health implications, yet its prevalence, resistance, and virulence potential within the aquaculture sector in Nigeria remains poorly characterized. Objectives: To supplement existing information, this current study investigated the prevalence, clonal distribution, antimicrobial resistance, and virulence gene profiles of S. aureus isolates from fish, fish water, and occupationally exposed fish handlers in Anambra State, Southeast Nigeria. Methods: A total of 607 samples—comprising 465 surface swabs from raw and processed fish, 36 fish water samples, and 106 nasal swabs from fish handlers—were processed using selective culture, biochemical tests, antimicrobial susceptibility testing, DNA microarray analysis, spa typing, and SCCmec typing. Results: S. aureus was recovered from 16.5% (100/607) of the samples. Fourteen (14%) isolates were methicillin-resistant (MRSA), harboring mecA and SCCmec types IV and V, with a combined MRSA prevalence of 2.3%. Multidrug resistance was observed in 52.2% of isolates (mean Multiple Antimicrobial Resistance index: 0.23), with 19 resistance genes spanning nine antimicrobial classes—including heavy metal and biocide resistance. Twenty-eight spa types across 13 clonal complexes (CCs) were identified, with CC1, CC5, and CC8 predominating. The detection of shared spa types between fish and handlers indicates potential cross-contamination. Detected virulence genes included those for accessory gene regulators (agrI-IV), Pantone–Valentine leucocidin (lukFS-PV), toxic shock syndrome (tsst-1), hemolysins (hla, hlb, hld/hlIII, hlgA), biofilm formation (icaA, icaD), immune evasion (chp, scn, sak), enterotoxins (sea, seb, sec, sed, egc, and others), exfoliative toxins (etA, etB), epidermal cells differentiation (edinA, edinB), and capsular types (cap5, cap8). Conclusions: This study reveals that the aquaculture sector in Southeast Nigeria serves as a significant reservoir of genetically diverse, multidrug-resistant S. aureus strains with robust virulence profiles. These findings highlight the necessity of integrated One Health surveillance and targeted interventions addressing antimicrobial use and hygiene practices within aquatic food systems. Full article

Asthma and chronic rhinosinusitis (CRS) are prevalent chronic inflammatory conditions of the airways that frequently occur together, contributing to increased disease burden and reduced quality of life. This study aimed to synthesize findings from retrospective research to better understand the clinical and pathophysiological interrelations between these two conditions. A narrative review was conducted, including studies (2002–2025) assessing prevalence, lung function, biomarkers, quality of life, and treatment outcomes in patients with confirmed asthma and/or CRS. The results revealed a high prevalence of comorbidity, particularly in patients with CRS with nasal polyps (CRSwNP), where asthma co-occurrence exceeds 50% in certain phenotypes. Shared type 2 inflammatory mechanisms, including eosinophilic infiltration, cytokine overexpression (IL-4, IL-5, and IL-13), and tissue remodeling via matrix metalloproteinases, were frequently identified. These findings support the unified airway model and highlight the systemic nature of inflammation in these patients. Biologic therapies demonstrated effectiveness in reducing exacerbations and improving clinical outcomes, especially in patients with more severe phenotypes. The inclusion of dentistry and oral health as components of the systemic inflammatory burden offers an innovative perspective and reinforces the importance of holistic, interdisciplinary care. This study underscores the need for a multidisciplinary, phenotypically guided approach to treatment. Recognizing and systematically addressing this comorbidity can improve disease control and enhance patient quality of life. Full article

Background/Objectives: Radiobiology has shown heterogeneity in the sensitivity of cells to ionizing radiation, depending on a variety of conditions. The presence of an extracellular matrix (ECM) appears to confer a radioprotective effect on cells and can influence the cellular microenvironment by modulating the availability of oxygen and nutrients, which can affect cellular metabolism and stress responses. A three-dimensional cell culture allows the synergistic effect on cell survival to be obtained based not only on the radioprotective properties of the extracellular matrix but also on the stress-resistant endogenous properties of the cell culture. The aim of this study was to investigate the survival of chondrocytes in a 3D cell culture during high-dose ionizing irradiation. Methods: The properties of nasal chondrocytes were evaluated using a pellet culture model in which the cells were surrounded by a de novo synthesized extracellular matrix. Tissue cultures were exposed by gamma radiation at doses of 10, 100, and 1300 Gy. Cell viability was assessed after 2 days of irradiation by live/dead staining using confocal scanning laser microscopy. Results: Tissue-cultured chondrocytes survive after gamma-irradiation of low (10 Gy), medium (100 Gy), and high (1300 Gy) dosages; however, after irradiation of 1300 Gy, the percentage of surviving cells was lower. The average percentages of viable cells were evaluated as 82%, 79%, and 63% in low-, medium-, and high-dose groups, respectively. Conclusions: Under determined conditions, human cells are able to survive at doses of ionizing radiation that are significantly higher than the current limits. Full article

Nano- and microplastics (NMPs), with nanoplastics posing higher risks due to their smaller size and greater capacity for cellular and subcellular penetration, are being referred to as ubiquitous environmental neurotoxicants, due to their ability to pass through biological barriers, including the blood–brain barrier (BBB) and nasal olfactory epithelium, and to remain lodged in neural tissue. Upon uptake, such particles disturb neuronal homeostasis by multiple converging pathways, including oxidative stress, mitochondrial dysfunction, pathological protein aggregation, and chronic neuroinflammation, all closely involved with the molecular signatures of neurodegenerative disorders (Alzheimer’s, Parkinson’s, Amyotrophic Lateral Sclerosis—ALS). In addition to their neurotoxicity, recent findings suggest that NMPs could disturb synaptic communication and neuroplasticity, thereby compromising the brain’s capacity to recover from an injury, a trauma, or neurodegeneration, thus impacting the progression of the disease, our ability to treat it and eventually the efficacy of rehabilitation approaches. Despite these findings, our understanding remains hampered by analytical issues, the scarcity of standard detection methods, and a total lack of longitudinal studies in humans. This review combines multidisciplinary evidence on brain–plastic interactions and calls for accelerated advances in our ability to monitor bioaccumulation in humans, and to integrate neurotoxicology paradigms in the assessment of this underappreciated but growing threat to brain health. Full article

Staphylococcal bacterial biofilm plays an important role in the pathogenesis and bacterial persistence of chronic rhinosinusitis. N-acetyl cysteine (NAC) has an inhibitory role in biofilm formation, suppressing adhesion and matrix production or favoring dispersal of preformed biofilm. The aim of this study was to examine the in vitro effect of NAC on Staphylococcal biofilm formation by bacterial strains isolated from tissue samples of patients with chronic rhinosinusitis with or without nasal polyps (CRSwNP and CRSsNP). Prospective study included 75 patients with CRS. The biofilm-forming capacity of isolated strains was detected by microtiter-plate method and the effects of sub-inhibitory (1/2x, 1/4x, and 1/8x minimal inhibitory concentration, MIC) and supra-inhibitory minimal concentrations (2x, 4x, and 8xMIC) of NAC on biofilm production were investigated. Staphylococcal bacterial strains were isolated in 54 (72%) patients, and the most frequently isolated species were Staphylococcus aureus (40.7%). Coagulase-negative Staphylococci species were weak producers of biofilm, while S. aureus was a strong biofilm producer. Concentration of 3.1 mg/mL (1/2 MIC) was sufficient to completely prevent biofilm formation in 77.8% of the isolates, where 49.6 mg/mL (8xMIC) led to the complete eradication of formed biofilm in 81.5% of the isolates. The subinhibitory and eradication effects were dose- and strain-dependent. There were no significant differences in MIC values between isolates from patients with CRSwNP and CRSsNP isolates. NAC proved to be effective in inhibiting biofilm formation and reducing formed biofilm by Staphylococcal isolates from patients with CRS. A comparable antibiofilm effect was exhibited in both phenotypes of CRS, indicating that NAC’s antibiofilm activity was independent of the underlying clinical phenotype, and more targeted on biofilm matrix components. Full article

Sinibotia species, investigated for morphology and species divergence owing to comparable body patterns and frequent sympatric occurrences, show high morphological similarity and close phylogenetic relationships, which challenge their accurate distinguishing via conventional morphological methods. Hence, multivariate morphometric (MM) and geometric morphometric (GM) analyses were used to assess the morphological differences between Sinibotia species (S. superciliaris, S. reevesae, S. robusta, S. pulchra, and S. zebra) habiting the Tuo River (Zizhong County) and Li and Lipu Rivers (Pingle County) based on 40 morphological traits and 34 landmarks. The morphological traits of S. robusta contrasted with those of S. pulchra and S. zebra, whereas S. superciliaris and S. reevesae showed similar morphologies, consistent with the cluster results. MM analysis using discriminant function analysis along with GM methods such as canonical variate analysis and relative distortion analysis enabled the differentiation between the Sinibotia species. Morphological variations were primarily reflected in snout length, nasal snout distance, head depth, body depth, caudal fin length, and dorsal fin length. MM effectively quantified linear size differences, whereas GM better captured and visualized complex variations in overall shape. The combined morphological evidence presented in this study contributes significantly to the identification of species, phylogenetic relationships, and ecological adaptations of Sinibotia species, thereby strengthening the theoretical rationale for the conservation and sustainable utilization of this genus. Full article

Objective. This randomized controlled trial evaluated the efficacy of lavender–neroli oil aromatherapy in managing dental anxiety and pain in children undergoing inferior alveolar nerve block (IANB) anesthesia. Methods. Fifty-four children aged 6–11 years were randomly assigned to either a control group or an aromatherapy group. Children in the control group were asked to wear a regular scented-free nitrous oxide mask. Children in the control group were asked to wear a regular scented-free nitrous oxide mask. Children in the intervention group inhaled lavender–neroli oil via a nitrous oxide nasal mask for 5 min before and during IANB administration. Anxiety and pain levels were assessed pre-and post-treatment using the Facial Image Scale (FIS), Face–Legs–Activity–Cry–Consolability (FLACC) scale, and vital signs (heart rate, blood pressure, oxygen saturation). The collected data were statistically analyzed using SPSS software 20. The Mann–Whitney U test was used for analyzing FIS results, and the independent T test and T Paired test were used for analyzing heart rate, blood pressure, and oxygen saturation results. Results. Results demonstrated significantly lower anxiety, heart rate, blood pressure, and pain scores in the aromatherapy group compared to the control group (p < 0.05), with no significant change in oxygen saturation. Conclusions. Lavender–neroli aromatherapy is a safe, low-cost, and effective adjunct to reduce anxiety and discomfort during pediatric dental anesthesia. Full article

Background and Clinical Significance: Granulomatosis with polyangiitis (GPA), an immune-mediated systemic small-vessel vasculitis affecting the upper/lower respiratory tracts and kidneys, frequently presents with non-specific nasal symptoms that lead to misdiagnosis. Case Presentation: We report a case of a 55-year-old female with GPA complicated by Bartter syndrome. She presented with one month of left nasal congestion, rhinorrhea, epistaxis, and headache. Initial diagnosis was acute sinusitis. Computed tomography (CT) revealed left maxillary and ethmoid sinus inflammation with bone destruction, while metagenomic next-generation sequencing (mNGS) suggested conventional bacterial infection. Postoperative pathology demonstrated chronic mucosal inflammation with lymphoid tissue hyperplasia. GPA was ultimately diagnosed based on PR3-ANCA seropositivity and chest CT findings of cavitary pulmonary nodules. Postoperatively, severe hypokalemia and hypomagnesemia secondary to Bartter syndrome emerged. Following electrolyte correction, induction therapy with glucocorticoids and cyclophosphamide was initiated. Conclusions: This case underscores that GPA’s head and neck manifestations are frequently misdiagnosed as infections or malignancies. Early diagnosis requires vigilance for GPA ‘red flags’, such as refractory nasal symptoms to conventional therapy (e.g., bloody rhinorrhea), characteristic CT findings (e.g., sinus opacification without ostiomeatal complex obstruction), and nasal endoscopy findings (e.g., ulcers/crusting). Otolaryngologists play a pivotal role in recognizing early disease onset and initiating timely treatment. Full article

Background/Objectives: The intranasal (IN) route of administration is a promising non-invasive approach for brain targeting, bypassing the blood–brain barrier and enhancing bioavailability. Citalopram hydrobromide (CT), a widely prescribed sparingly water-soluble selective serotonin reuptake inhibitor (SSRI), faces challenges with oral and intravenous administration, including delayed onset, adverse effects, and patient compliance issues. Methods: This study aimed to develop a novel thermoresponsive polymeric micelle (PM) system based on Pluronic^® copolymers (Pluronic F127 and Poloxamer 188) improving CT’s solubility, stability, and nasal permeability for enhanced antidepressant efficacy. A preliminary study was conducted to select the optimized formulation. The preparation process involved using the thin-film hydration method, followed by freeze-drying. Comprehensive evaluations of optimized formulation characteristics included Z-average, polydispersity index (PdI), thermal behavior (lower critical solution temperature, LCST), encapsulation efficiency, X-ray powder diffraction (XRPD), thermodynamic solubility, and biological stability. Additionally, in vitro CT release and CT permeability in nasal conditions were studied. Stability under storage was also evaluated. Results: The optimized CT-PM formulation showed nanoscale micelle size (Z-average of 31.41 ± 0.99 nm), narrow size distribution (polydispersity index = 0.241), and a suitable thermal behavior for intranasal delivery (lower critical solution temperature (LCST) ~31 °C). Encapsulation efficiency reached approximately 90%, with an amorphous structure confirmed via XRPD, leading to a 95-fold increase in CT solubility. The formulation demonstrated appropriate biological and physical stability. In vitro studies showed a 25-fold faster CT release from optimized formulation compared to the initial CT, while CT-PM permeability in nasal conditions increased four-fold. Conclusions: This novel nanoscale thermosensitive formulation is a value-added strategy for nasal drug delivery systems, offering enhanced drug solubility, rapid drug release, stability, and improved permeability. This smart nanosystem represents a promising platform to overcome the limitations of conventional CT administration, improving therapeutic outcomes and patient compliance in depression management. Full article

Introduction: Cleft lip and/or palate (CLP) is frequently associated with persistent nasal obstruction, often due to structural deformities unaddressed by primary surgical repair. While subjective assessment tools are commonly used to evaluate nasal patency, they underestimate functional impairment, particularly nasal valve collapse. This study aims to objectively evaluate nasal obstruction and identify its anatomical causes in CLP patients after primary rhinoplasty. Methods: We conducted an observational study involving 21 children aged 8–16 with CLP who had undergone primary cheilorhinoplasty but not secondary nasal surgery. Each participant underwent clinical evaluation, nasal endoscopy, acoustic rhinometry, and active anterior rhinomanometry (AAR), both before and after nasal decongestion. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess subjective symptoms. Obstructive sites were diagnosed based on established criteria combining endoscopic and functional findings. Results: Objective nasal obstruction was identified in 80.9% of patients, with nasal valve collapse observed in 66.7%, most commonly among unilateral and bilateral CLP subtypes. External nasal valve collapse was the predominant form (57.1%), followed by internal valve involvement (38.1%). Notably, the NOSE score did not reliably correlate with the AAR results, underlining the limitations of subjective assessment tools. Structural anomalies such as septal deviation (52.5%) and turbinate hypertrophy (23.8%) were also prevalent. Conclusions: This study highlights nasal valve collapse as a major, underrecognized contributor to persistent nasal obstruction in CLP patients after primary repair. Objective assessment methods like AAR and targeted endoscopy should be routinely integrated into secondary rhinoplasty planning. These findings advocate for a personalized approach to secondary nasal reconstruction in CLP patients, integrating objective functional data into surgical planning. Such strategies align with personalized medicine principles by tailoring interventions to individual anatomical and physiological characteristics. Full article