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PubMed1982

Blood supply to the nasal cavity of sheep (Ovis aries) and its significance to brain temperature regulation.

Blood supply to the nasal cavity of the sheep has been grossly studied on 25 specimens by employing different injection techniques. Following intramuscular injection of Rompun solution (Xylazine hydrochloride, 10 mg/lb body weight), the animals were killed either by bleeding or decapitation. Subsequently, the heads were perfused with physiologic saline solution, injected with various intravascular materials, and then either routinely dissected or macerated to trace the vessels. The nasal cavity of the sheep was mainly supplied by the sphenopalatine and ethmoidal, and indirectly by their anastomoses with the infraorbital, malar, major palatine, and the superior labial arteries. The venous drainage of the nasal cavity has connections with the cavernous sinus via: 1. the dorsal and/or the lateral nasal veins-angularis oculi vein-ophthalmic plexus; and 2. via the sphenopalatine vein-rostral branch of the deep facial-pterygoid plexus. The former venous pathway has also been confirmed by venography in one live anesthetized sheep. The internal carotid rete was found to be enmeshed in a venous plexus of the cavernous sinus. From their close relationship it may be inferred that their function is to accommodate flow in opposite directions and that such an arrangement has the necessary anatomic requirements expected of a countercurrent heat exchanger.

Animals↗
PubMed2000

Bone CT evaluation of nasal cavity of acromegalics--its morphological and surgical implication in comparison to non-acromegalics.

PURPOSE: In order to numerically compare the morphological differences of the nasal cavity and nasal sinus between acromegalics and non-acromegalics, bone window CT scans sliced parallel to the transsphenoidal surgical route were performed. MATERIAL AND CASES: Acromegalic patients had small or large macroadenomas and were 13 (7 men and 6 women) in number, aged 53.2 +/- 16.1 years. Non-acromegalic patients had pituitary tumors and were 44 (21 men and 23 women) in number, aged 52.1 +/- 12.5 years. RESULTS: The results of acromegalics are described in comparison to non-acromegalics in parentheses. a) The width of the surgical corridor: piriform aperture, 27.6 +/- 2.7 (25.9 +/- 2.6) mm; origin of inferior nasal concha, 29.4 +/- 9.4 (26.6 +/- 4.0) mm; and origin of middle nasal concha, 29.8 +/- 3.2 (26.2 +/- 4.2) mm. b) The depth of the surgical corridor: the upper lip thickness, 18.1 +/- 2.7 (13.3 +/- 1.4) mm; the distances between piriform aperture and sphenoid wall, 52.9 +/- 4.6 (49 +/- 4.2) mm; sphenoid wall and sellar floor, 17.3 +/- 4.1 (18.7 +/- 4.1) mm; and sellar floor to dorsum sellae, 17.6 +/- 3.4 (15.6 +/- 4.0) mm. c) Marked carotid prominence: 7/13=53.4% (8/44=18.25%). d) Sinusitis: 8/13=61.5% (12/44=27.3%). DISCUSSION & CONCLUSION: The data presented above show that morphological differences in bony nasal cavity and soft tissue may be responsible for a deeper and narrower surgical field for acromegalics. Acromegalics had a marked carotid prominence more frequently, which needs special attention to avoid carotid injury, when enlarging the surgical field. Knowing these morphological differences will provide useful information for peri- and intra-operative care.

Acromegaly↗
PubMed2005

The role of nasal cavity disinfection in the bacteriology of chronic sinusitis.

OBJECTIVES: Several factors may influence the results of bacteriological studies in chronic rhinosinusitis. We investigated the potential role of nasal cavity disinfection in the bacteriology of the bulla ethmoidalis in patients suffering from chronic sinusitis. MATERIAL AND METHODS: Bacteriology of the bulla ethmoidalis was studied in 176 consecutive adult patients presenting a chronic sinusitis refractory to standard medical treatment who underwent functional endoscopic sinus surgery. Two different techniques were used: (A) a technique with nasal vestibule and facial disinfection with chlorhexedin (N = 89 patients and 165 samples) vs. (B) a technique with facial, nasal vestibule and nasal cavity disinfection with a povidone-iodine solution followed by a cleansing of the nasal cavity (N = 87 patients and 166 samples). RESULTS: Culture rate was 89.6% (183 bacterial isolates) for technique (A) vs 76.5% (164 bacterial isolates) for technique (B) (p < 0.001). Major bacteria encountered in the (A) group and in the (B) group were respectively: Coagulase Negative Staphylococcus: 77 vs 40 isolates (p < 0.001); Coagulase positive Staphylococcus: 44 vs 30 isolates (p = 0.061); Streptococcus pneumoniae: 4 vs 5 isolates; Others: Streptococcus sp.: 12 vs 16 isolates; Haemophilus influenzae: 8 vs 6 isolates; Enterobacteriacea: 33 vs 53 isolates (p = 0.013) and others Gram Negative Bacilli: 3 vs 7 isolates. CONCLUSIONS: The standard (A) technique to study the bacteriology of the bulla ethmoidalis in patients with chronic sinusitis yielded a higher percentage of positive culture and of bacterial isolates than a more advanced (B) technique. This is mainly due to the higher percentage of contaminant bacteria such as Coagulase Negative Staphylococcus recovered with the standard technique. Enterobacteriacea and others Gram Negative Bacilli were more often encountered into the bulla ethmoidalis with the technique where disinfection of the nasal cavity was performed.

Adult↗
PubMed1993

[A clinical and pathological study of non-Hodgkin's lymphoma of the nasal cavity and paranasal sinuses].

We studied 30 patients with early stage malignant lymphomas involving the nasal cavity and/or paranasal sinus who were treated between 1972 to 1991 in Hokkaido University Hospital. The mean age of the patients was 60.6 yr, and the male-to-female ratio was 2.6. The predominant histologic type was diffuse large cell type (n = 23). Treatment policy differed depending on time: radiotherapy (RT) alone between 1972 and 1980 (n = 15), RT followed by modified CVP or CHOP between 1981 and 1988 (n = 10) and BACOP followed by RT between 1989 and 1991 (n = 5). Overall five-year survival was 53%. Better survival was observed in patients with B-cell type (72%), smaller mass (tumor limited to the unilateral nasal cavity or paranasal sinus) (76%), and patients who were treated with combination chemotherapy (BACOP) followed by RT (100%). Eleven patients experienced recurrence. Four of nine local recurrences were in patients with T-cell lymphoma. CNS relapse was observed in three patients with T-cell lymphoma. We conclude that T-cell lymphoma arising at the nasal cavity and/or paranasal sinus needs careful follow-up for its high frequency of local and CNS relapse. More intensive treatment such as prophylactic whole brain RT, intrathecal administration of MTX or third generation chemotherapy (e.g. MACOP-B) might improve survival in these patients.

Adolescent↗
PubMed1992

Supra-neuroectodermal cells and fibers on the primary nasal cavity and in the fourth ventricle of mouse and human embryos: scanning and transmission electron microscopic studies.

Neuroectoderm-derived epithelia of the primary nasal cavity and the fourth ventricular floor and roof were observed by scanning (SEM) and transmission electron microscopy (TEM) and SEM-TEM correlative views in mouse embryos of 9th to 13th days of gestation, and in 38 externally normal human embryos ranging at Carnegie stages from 13 to 18 (about 5 to 7 weeks of gestation). Smooth-surfaced spindle-shaped cells with one or more cytoplasmic processes and cord-like cytoplasmic structures were observed by SEM on the wall of the primary nasal cavity of both species. They had morphological features similar to those of neuronal type 1 supraependymal (SE) cells and SE fibers on the floor and roof of the fourth ventricle in both species. Type 1 SE cells, SE fibers, and corresponding structures in the primary nasal cavity were localized in relation to the underlying developing nerve and vascular systems. Furthermore, their processes and fibers ran roughly parallel to these underlying structures and they penetrated the epithelial layer at the ends, suggesting a connection with underlying structures. From TEM and SEM-TEM correlative observations, SE fibers in the fourth ventricle and cord-like structures in the primary nasal cavity, both with a larger diameter, were deduced as single axon-like processes or bundles of processes. Those fibers and cord-like structures of smaller diameters were interpreted as elongated telophase bridges; both contained parallel packed microtubules and connected distant cells. Since these processes and fibers were generally longer and became fewer at later developmental stages, they appeared to be transient neuronal structures. They may play a development-related role in such morphogenetic cell movements as in the developing nerve and vascular systems in the epithelial and/or subepithelial layers, but not as direct rudiments of adult nerve tissues.

Animals↗
PubMed1998

[Application of maxillary bone eversion reduction on benign tumor in nasal cavity and paranasal sinus invading the skull base].

OBJECTIVE: To investigate the operative methods for benign tumors in nasal cavity and paranasal sinus invading the skull base. METHODS: Six cases of benign tumors in nasal cavity and paranasal sinus invading the skull base were reported. Of them, 3 were ossifying fibromas, 1 osteoma, 1 osteochondroma and 1 giant osteoid osteoma. The tumors were removed by combined approaches through unilateral maxillary bone eversion reduction. RESULTS: No complication was found. Follow-up was made 2-3 years after operation. Five cases were uneventful, 1 had a relapse of tumor but still alive. CONCLUSIONS: The method is appropriate for treating benign tumors in nasal cavity and paranasal sinus invading the skull base.

Adult↗
PubMed1998

Evaluation of drug disappearance from nasal cavity by the deposit method.

In order to evaluate antiallergic intranasal formulations, the rates of drug disappearance from rat nasal cavity were estimated by the deposit and perfusion methods. The deposit method, which estimates changes in the amount of residual drug in the nasal cavity following washout of the deposited drug over time after application, yielded a good correlation between apparent disappearance rate constant and the combination of lipophilicity and molecular weight. Since the deposit method can be used only with delivery of small amounts of drug to the nasal cavity, the physiological characteristics of the nasal membrane readily affect drug disposition in tests performed with it, and adsorptive drugs such as parabens exhibited rapid disappearance. Doses used clinically for intranasal administration are usually small, and in the case of antiallergic formulations, it is important to maintain the drug concentration in the nasal mucous membrane. The deposit method should be useful for evaluating intranasal antiallergic drug formulations.

Administration, Intranasal↗
PubMed2002

Prognostic implications of nasal cavity and cleft morphology in secondary bone grafting.

OBJECTIVE: To examine the prognostic significance of the skeletal morphology around the nasal cavity and the alveolar cleft in secondary bone grafting (SBG). DESIGN AND SETTING: Fifty-one alveolar clefts in 41 patients (10 bilateral and 31 unilateral cleft lips and palates) registered in the Tokushima University Dental Hospital were examined in this study. METHOD: Evaluation of the bony bridge after SBG using dental radiographs at 1 year after surgery. The clefts were divided into two groups: group I (54.9%) in which the upper border of the bony bridge was preferably maintained on or above the horizontal reference line (RL) constructed at the level of the root apex of the upper central incisor adjacent to the cleft, and group II (45.1%) in which the bone level was lower than the RL. Presurgical cleft width was determined by the dental radiographs. The cleft/nasal cavity ratio; the value of the cleft width divided by the nasal cavity width on the cleft side, which was analyzed by frontal cephalograms before the SBG; and the cleft/apertura piriformis ratio, the value analyzed by computed tomography, were used. RESULTS AND CONCLUSION: The age, sex, and eruptive stage of the canine teeth at the time of the SBG showed no significant difference between groups. The presurgical cleft width also showed no significant difference between group I (6.6 +/- 3.1 mm) and group II (7.9 +/- 3.3 mm). The cleft/nasal cavity ratio showed a significant difference between groups I and II (0.42 +/- 0.14, 0.75 +/- 0.25; p < .05). Furthermore, the cleft/apertura piriformis ratio also showed a significant difference between groups I and II (0.32 +/- 0.12, 0.65 +/- 0.26; p < .05). These results suggested that measurements of the skeletal morphology around the nasal cavity and alveolar cleft might aid in predicting the stability of the bony bridge after SBG.

Adolescent↗
PubMedDate not supplied

Effects of anatomical variations of the nasal cavity on acoustic rhinometry measurements: a model study.

BACKGROUND: The goal of this study was to assess how anatomic variations of the nasal cavity affect the accuracy of acoustic rhinometry (AR) measurements. METHODS: A cast model of a human nasal cavity was used to investigate the effects of the nasal valve and paranasal sinuses on AR measurements. A luminal impression of a cadaver nasal cavity was made, and a cast model was created from this impression. To simulate the nasal valve, inserts of varying inner diameter were placed in the model nasal passage. To simulate the paranasal sinuses, side branches with varying neck diameters and cavity volumes were attached to the model. RESULTS: The AR measurements of the anterior nasal passage were reasonably precise when the passage area of the insert was within the normal range. When the passage area of the insert was reduced, AR measurements significantly underestimated the cross-sectional areas beyond the insert. The volume of the paranasal sinus had limited effect on AR measurements when the sinus ostium was small. However, when the ostium size was large, increasing the volume of the sinus led to significant overestimation of AR-derived areas beyond the ostium. CONCLUSION: The pathologies that narrow the anterior nasal passage result in the most significant AR error by causing area underestimation beyond the constriction. It also appears that increased paranasal sinus volume causes overestimation of areas posterior to the sinus ostium when the ostium size is large. If these physical effects are not considered, the results obtained during clinical examination with AR may be misinterpreted.

Computer Simulation↗
PubMed1999

Direct transport of cocaine from the nasal cavity to the brain following intranasal cocaine administration in rats.

Individuals who consume cocaine illegally have long since adopted or explored the nasal route of administration. This study was designed to determine in an animal model whether nasally applied cocaine could be transported directly from the nasal cavity to the central nervous system. Male Sprague-Dawley rats were used in the study. The nasal cavity was isolated to prevent drainage of nasally applied dosing solution to nonnasal regions. Cocaine was then administered, either by intranasal (in) administration or by intravenous (iv) injection. At different times post dose, blood and tissues from different regions of the brain were collected. Cocaine concentrations in plasma and tissue samples were analyzed by HPLC. After iv administration, similar cocaine contents in different brain regions were observed. Following in administration, cocaine content in samples collected within 60 min post dose were found to differ considerably in different brain regions. The highest content was observed in the olfactory bulb, followed by the olfactory tract and then the remaining part of the brain. To allow comparison of brain cocaine content after iv and in administration, brain cocaine contents were normalized by plasma cocaine concentrations. The ratios of the area under the cocaine concentration-time curve (AUC) between the olfactory bulb and plasma at early times following in administration were significantly higher than those obtained after the iv dose (13.4 +/- 5.56 vs 6.16 +/- 0.94, p < 0.05, for AUC ratio up to 2 min post dose; 9.39 +/- 1.47 vs 7.34 +/- 0.59, p < 0.05, for AUC ratio up to 4 min post dose). At 1 min post dose, the olfactory bulb-to-plasma cocaine concentration ratios following in administration was three times those obtained after iv administration. After 1 min, the olfactory bulb-to-plasma concentration ratios following in administration were found to be similar to or smaller than those obtained after iv administration. The tissue-to-plasma concentration ratios in other brain regions following in administration were found to be smaller than those obtained following iv dosing. We conclude that nasally administered cocaine was transported directly from the nasal cavity to the brain but that only a very small fraction of the dose was transported via the direct pathway.

Administration, Intranasal↗
PubMed1997

MRI of the nasal cavity, the paranasal sinuses and orbits in Wegener's granulomatosis.

The purpose of this study was to evaluate diagnostic MRI criteria in Wegener's granulomatosis of the nasal cavity, the paranasal sinuses and orbits. Between March 1991 and January 1996, 62 patients with biopsy-proven Wegener's granulomatosis were studied with T1- and T2-weighted spin-echo (SE) sequences. In 32 patients coronal postcontrast T1-weighted images were obtained. Mucosal thickening of the nasal cavity and paranasal sinuses was demonstrated as high-intensity lesions on T2-weighted SE sequences in 57 patients (92%). Of this group, inflammatory granulomatous tissue was found on biopsy in 30 patients (48%) in the nasal cavity and in 4 patients (6%) in the paranasal sinuses. In 23 patients (37%) biopsy revealed unspecific inflammatory changes without evidence of granulomatous tissue. In 14 patients (23%) granulomas were depicted as low-signal intensity lesions on T1- and T2-weighted SE sequences in the paranasal sinuses and orbits. In 5 patients (8%) osseous destruction was found. After gadolinium injection, 12 of 14 granulomas showed inhomogeneous signal enhancement. In two granulomas no enhancement was found. The MRI technique is helpful in the diagnosis of patients with Wegener's granulomatosis. In the initial inflammatory process of Wegener's granulomatosis, it is not possible to differentiate between mucosal inflammation and granulomatous tissue in MRI. In the later stage of granulomatous transformation, granulomas can be depicted as low-signal-intensity lesions. Therefore, Wegener's granulomatosis should be included in the differential diagnosis of patients with low-signal-intensity lesions on T1- and T2-weighted SE sequences of the nasal cavity, paranasal sinuses and orbits.

Adult↗
PubMedDate not supplied

The pathology of head and neck tumors: squamous and mucous-gland carcinomas of the nasal cavity, paranasal sinuses, and larynx, part 6.

Carcinomas of the nasal cavity and paranasal sinuses are statistically dominated by squamous-cell lesions, which account for between 85% and 90% of the epithelial malignancies in these sites. Neoplasms of glandular derivation are far less frequent, accounting for between 4% and 8% of carcinomas in this region. Both classes of malignancy, however, indicate an ominous prognosis for their hosts, and for both, it is the extent of the cancer, and hence the clinical stage, that is the major determinant. The clinicopathologic characteristics of squamous-cell and glandular carcinomas of the nasal cavity and paranasal sinuses are presented, and for the latter, a review of their presentation in the larynx is also offered.

Adenocarcinoma↗
PubMed2001

Monotypic angiomyolipoma of the nasal cavity: a heretofore undescribed occurrence.

A monotypic angiomyolipoma of the nasal cavity in a 34-year-old woman is described. Tumor cells were spindled or epithelioid and contained glycogen and diastase-resistant PAS-positive granules. There were few mitoses, and necrosis was absent, indicating a benign tumor. The stroma was markedly vascular, and a few adipocytes were seen in one area. Cells were positive for melanocyte and muscle markers. Electron microscopy revealed abundant dense granules. Although melanin was absent histochemically, it was present using a chemical assay, and the granules may, therefore, be atypical melanosomes. Fine actin filaments, attachment plaques and lamina were present. Initial assessment of the lesion indicated malignant melanoma, but the immunostaining and histologic features indicated monotypic angiomyolipoma. To the best of our knowledge, this is the first such case in the nasal cavity.

Actins↗
PubMed2001

Lobular capillary haemangioma of the nasal cavity: observation of three specific cases.

Lobular Capillary Haemangioma of the nasal cavity: Observation of three specific cases. Lobular Capillary Haemangioma, unproperly called "Pyogenic granuloma", is a benign vascular tumour pedunculated on the skin and on mucous membranes of the oral and nasal cavities. Microtrauma and pregnancy are the most often evocated aetiologic factors. Epistaxis and nasal obstruction are the most marked symptoms of this irregular and friable mass. We report three cases (two adult and one paediatric) of this pathology. Two have as trigger factor a nasal microtrauma, the third an oestro-progestative impregnation. A clinical, radiological and histological description allows us to expose the characteristics of this lesion that remains obscure to many rhinologists. Lobular Capillary Haemangioma has to be evocated in the differential diagnosis of each haemorrhagic endonasal mass.

Adult↗
PubMed1984

Comparative light and scanning electron microscopic observations of nasal cavity carcinogenesis in rats treated with 1,4-dinitrosopiperazine.

Epithelial lesions in the nasal cavity of male F344 rats appeared as papillary and nodular hyperplasias progressing to invasive carcinomas during administration of 1,4-dinitrosopepirazine (DNP) at a dose of 0.01% in the drinking water. Observations with specific attention to the cells covering the luminal surface of the mucosa were made by scanning electron microscopy at 10-week intervals. After administration of DNP for 20 and 30 weeks three different types of light microscopically identifiable focal lesions, i.e., papillary hyperplasia, nodular hyperplasia and papilloma, of the epithelium in the nasal cavity were distinguished, and after 40 and 50 weeks areas of squamous cell carcinomas were also observed. In the scanning electron microscope, papillary hyperplasia appeared as a nodular elevation of the surface with a smoother appearance than the surrounding nonnodular areas. Areas of nodular (inverted) hyperplasias had irregularly shaped indentions of the surface. Papillomas appeared as pedunculated projections of the surface. Carcinoma presented as a protrusion of irregular cell masses. The surface cells in the areas of papillary and nodular hyperplasias and of papilloma had numerous short microvilli rather uniform in shape (short-uniform microvilli), unlike the normal epithelium in the nasal cavity, which possesses cilia or olfactory vesicles. The microvilli of carcinoma cells were more irregular in shape and size than those of hyperplastic cells (pleomorphic microvilli).

Animals↗
PubMedDate not supplied

Asymptomatic carriage of Cryptococcus neoformans in the nasal cavity of dogs and cats.

Nasal washings, obtained from a random source of dogs and cats, were concentrated by centrifugation and plated onto bird seed agar containing antibiotics. Cryptococcus neoformans var. neoformans was isolated from eight of 56 dogs (14%) and three of 45 cats (7%). More than 100 colonies of C. neoformans were present on the plates from seven of the 11 positive animals. Absence of cryptococcal antigen in the serum of these animals, and failure to demonstrate yeast-like organisms or significant pathology in nasal biopsies, suggests that the nasal cavity of these animals was not infected by C. neoformans but rather that blastoconidia and/or basidiospores were carried asymptomatically. These findings are discussed in relation to the likelihood of the upper respiratory tract being the primary site for cryptococcal infection in dogs and cats.

Animals↗
PubMed2000

Craniofacial resection for tumors of the nasal cavity and paranasal sinuses.

BACKGROUND AND PURPOSE: Craniofacial resection provides multidirectional approaches to remove nasal and paranasal tumors that involve the skull base. The purpose of this study was to determine the survival and local control rate in patients undergoing craniofacial resection for tumors of the nasal cavity, paranasal sinuses, and adjacent areas. METHODS: The medical records of 30 consecutive patients who had undergone craniofacial resection for tumors of the nasal cavity, paranasal sinuses, and adjacent areas were reviewed. The extent of disease, treatment results, complications, and prognoses were analyzed. RESULTS: Lesions were malignant in 28 patients and benign in two. Sixteen of the patients had dural or intradural involvement. There was no surgical mortality, and the rate of surgical morbidity was 7%. The 2-year survival of the 28 patients with malignancies was 46% and the mean follow-up time was 35 months. Local control was achieved in 53% of patients. Nine of 16 patients with dural or intradural invasion had a mean survival time of 17 months. There was no significant difference in the frequency of local control between previously treated and untreated patients. Patients who had a clear margin showed significantly better local control than those with an involved or questionable margin. CONCLUSIONS: Tumors of the nasal cavity and paranasal sinus that involve the skull base can be effectively treated using craniofacial resection, with a reasonable survival and low complication rate.

Adolescent↗