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At least 73 records · Page 4Linked to original sources
PubMed2001

Argon plasma surgery for the inferior turbinate of patients with perennial nasal allergy.

OBJECTIVES: Argon plasma coagulation (APC) is a new electrosurgical modality. The advantages of APC are coagulating of the target tissue without contact and the creation of uniformly deep devitalized and coagulated zones. The objectives of the present study were to determine the clinical effects of APC for the inferior turbinate of patients with nasal allergy and to clarify the histological changes in the mucosa after APC. STUDY DESIGN: In a prospective study, 95 patients with perennial nasal allergy were treated with APC. Nasal symptoms and intranasal findings were evaluated preoperatively and 1, 3, and 6 months, and 1 year after the APC. Mucosal specimens from the turbinates were examined under light and electron microscopy. RESULTS: Nasal stuffiness was improved in 77 of 79 (97.5%) patients after 1 month, in 50 of 51 (98.0%) patients after 3 months, in 20 of 23 (87.0%) patients after 6 months, and in 9 of 12 (75.0%) patients at 1 year after the APC. Rhinorrhea was improved in 46 of 75 (61.3%) patients after 1 month, in 40 of 51 (78.4%) patients after 3 months, in 16 of 21 (76.2%) patients after 6 months, and in 6 of 10 (60.0%) patients at 1 year after the APC. The sneezing was improved in 32 of 54 (59.3%) patients after 1 month, in 21 of 35 (60.0%) patients after 3 months, in 10 of 14 (71.4%) patients after 6 months, and in 6 of 8 (75.0%) patients at 1 year after the APC. In the intranasal findings, congestion of the inferior turbinate improved in 75 of 76 (98.7%) patients after 1 month, in 49 of 52 (94.2%) patients after 3 months, in 20 of 23 (87.0%) patients after 6 months, and in 7 of 11 (63.6%) patients at 1 year after the APC. The nasal discharge was reduced in 40 of 75 (53.3%) patients after 1 month, in 32 of 52 (61.5%) patients after 3 months, in 15 of 22 (68.2%) patients after 6 months, and in 5 of 11 (45.5%) patients at 1 year after the APC. No patients needed nasal packing after the APC. CONCLUSIONS: This is the first report on the clinical effects of turbinate surgery for nasal allergy using APC. APC was useful fer turbinate surgery of nasal allergy, especially for nasal stuffiness and congestion of the turbinate.

Adolescent↗
PubMed2001

Rationale for submucous resection of hypertrophied inferior turbinates in rhinoplasty: an evolution.

To achieve success in rhinoplasty, the plastic surgeon takes advantage of numerous intraoperative techniques designed to manipulate nasal soft tissue and the osseocartilaginous framework. Although the postoperative result may meet preoperative aesthetic goals, an element of nasal airway obstruction can persist from failure to acknowledge the role of inferior turbinates. Surgically responsive inferior turbinate hypertrophy is frequently not addressed secondary to inadequate history taking, incomplete physical examination, and/or surgeon reluctance to handle these sensitive structures. The goal of this article is to discuss the anatomy and physiology of the inferior turbinates, to present the role for inferior turbinate surgery during rhinoplasty, and to delineate the evolution of the current technique of submucosal resection of the inferior turbinates. Over the past 14 years, the senior author (R.J.R.) has performed inferior turbinates surgery on 648 patients as part of a rhinoplasty.

Adolescent↗
PubMed1988

Turbinate osteoporosis in pigs following intranasal inoculation of purified Pasteurella toxin: histomorphometric and ultrastructural studies.

Turbinate osteoporosis, induced by intranasal inoculation of purified toxin isolated from serotype D Pasteurella multocida, was investigated in 3- to 5-week-old, caesarean-derived, colostrum-deprived, isolation-reared pigs. Marked bilateral reduction in relative volume of trabecular bone occurred in osseous cores of turbinates of toxin-treated pigs relative to control pigs on post-inoculation day (p.i.d.) 3, 6, 9, 12, and 15. The fractional resorptive surface along turbinate bone was greater in toxin-treated pigs when compared to controls on p.i.d. 3 and 6. A significant decrease in resorptive surface occurred over time in toxin-treated pigs, whereas the fractional resorptive surface was constant over time in control pigs. Osteoclasts in medullary spaces separating bony trabeculae of turbinates were abundant in toxin-treated pigs and scant in controls on p.i.d. 3, 6, and 9. Degeneration and necrosis of bone forming cells, principally osteoblasts, were progressively more extensive with time and were associated with decreased mineralization and reduced thickness of osteoid and woven bone matrix. Osteoclasts along resorptive surfaces of turbinate bone in toxin-treated pigs had more abundant, more highly vacuolated cytoplasm, a more prominent microvillous border, and a greater number of nuclei per cell than osteoclasts from control pigs on p.i.d. 3 and 6. We conclude that this Pasteurella toxin stimulates osteoclastic osteolysis and inhibits osteogenesis in turbinates by causing degeneration and death of osteoblasts.

Animals↗
PubMed1978

Acetylcholinesterase levels in nasal turbinate congestion.

In a previous communication, one of the authors discussed prolonged congestion of the turbinates following nasal surgery. The clinical factors responsible were allergy or the traumatic effects of nasal packing on the turbinates. A study of turbinate function was done to find the factor responsible for this congestion. Biopsies of an inferior turbinate were obtained preoperatively and two weeks after surgery. The specimens were examined for the level of acetylcholinesterase by histochemical assay and were also studied by examining sections histologically. In the majority of cases, the level of acetylcholinesterase fell with the appearance of congestion and rose when the turbinates returned to normal. These results suggest a connection between turbinate congestion and levels of tissue acetylcholinesterase in the presence of inflammation or allergy.

Acetylcholinesterase↗
PubMedDate not supplied

Mucin mRNA expression in normal and vasomotor inferior turbinates.

Mucins are the major glycoprotein component of respiratory tract secretions. Little is known about their expression in the upper respiratory tract. In order to define this expression, in situ hybridization was performed on 19 normal and 4 vasomotor rhinitis (VMR) inferior turbinates to identify mucin mRNA. MUC1, MUC2, MUC4, MUC5AC, MUC5B, and MUC7 were expressed in both the normal and VMR turbinates. MUC4 and MUC5AC were the most highly expressed mucins. MUC1, MUC2, MUC4, and MUC5AC were expressed mainly by the epithelial border, whereas MUC5B and MUC7 were expressed by the submucosal glands. MUC1 and MUC4 exhibited a diffuse expression by multiple cell types along the mucosal border, whereas MUC2 and MUC5AC expression appeared to be limited to a subpopulation of epithelial cells, most likely goblet cells. Although MUC1, MUC4, and MUC5AC showed sporadic submucosal glandular expression, MUC5B and MUC7 appeared to be the predominant submucosal gland mucins in the inferior turbinates. MUC3 and MUC6 expression, which have been found primarily in the gastric mucosa, were not seen in any of the inferior turbinate samples examined. The only difference seen between normal and VMR turbinates was a slight decrease in MUC1 expression in the VMR group. The variety of mucins expressed and the diversity of their expression patterns may have significance in terms of the rheologic and particle clearance properties of nasal secretions. Understanding the expression patterns in normal turbinates will serve as the foundation for further study of these mucins in disease states.

Adult↗
PubMed2000

[Treatment of diseased middle turbinate in endoscopic sinus surgery].

OBJECTIVE: To study the clinical significance of reservation of the middle turbinate in functional endoscopic sinus surgery (FESS) for sinusitis and/or nasal polyps. METHOD: According to anatomic criteria of the middle turbinate surgery in adult, 32 cases who had sinusitis and/or nasal polyps were treated and followed up. The recovery of middle turbinate contour, postoperative ethmoid cavity and the rate of patency of the maxillary sinus ostium were observed postoperatively. RESULT: 1. After 6 months, the form of middle turbinate returned to normal in 24 cases (75%), adhesions occurred in 8 cases (25%), including the closure of ethmoid sinus cavity in 2 cases. 2. The patency of maxillary sinuses ostium maintained well in 25 cases (78.1%), stenosed in 6 cases (18.8%) and closed in 1 case (3.1%). The diseased middle turbinate can recover to normal contour in most cases, often plastics in FESS. CONCLUSION: Reservation of middle turbinate plays an important role in promoting the clinical cure rate.

Adolescent↗
PubMed2003

[Selection of operative manner of inferior turbinate on hypertrophic rhinitis].

OBJECTIVE: To analyses the features of three operative manner of inferior turbinate on hypertrophic rhinitis (HR) and to propose some suggestion for selection of operative manner on HR. METHOD: One hundred and sixty-two cases of HR were treated separately by submucoperiosteous resection of inferior turbinate bone (group A), partial inferior turbinectomy (group B) and submucosal hot-coagulation of inferior turbinate with microwave (group C). RESULT: Three groups of HR were followed up one year after operation, effective rate was 94.6% in group A, 83.7% in group B and 88.9% in group C respectively. Effective rate had no significant difference among three groups (P > 0.05). CONCLUSION: Submucoperiosteous resection of inferior turbinate bone is safe, effective manner for HR with inferior turbinate bony hypertrophy. The same is submucosal hot-coagulation of inferior turbinate by microwave for mucosal hypertrophy. Partial inferior turbinectomy should be preformed cautiously on HR in order to protect the anatomical structure and physiologic functions of nose.

Adult↗
PubMedDate not supplied

Resection of the inferior superior turbinate: does it affect olfactory ability or contain olfactory neuronal tissue?

BACKGROUND: One approach to the sphenoid sinus involves resection of the inferior portion of the superior turbinate. There is general agreement from anatomic investigations that this area contains olfactory mucosa. This study will determine if olfactory tissue can be found in the superior turbinate mucosa of patients with chronic sphenoiditis and what effect its removal has on a patient's olfactory ability. METHODS: The inferior one-third of the superior turbinate removed during endoscopic sphenoidotomy was stained with olfactory marker protein antibody, a marker for mature olfactory tissue. The specimens were graded for content of olfactory neuronal elements. All patients underwent uninasal 12-item smell identification testing before surgery and at least 3 weeks after surgery. RESULTS: Fifty-five superior turbinate samples were taken from 31 patients. Nine (16%) of 55 samples contained olfactory neuronal elements that stained with olfactory marker protein. When comparing the pre- and postoperative smell test results, 52% of the nostrils had no more than a one-item change, 35% of the nostrils had a more than one-item improvement, and only 12% had more than a one-item loss. None of the nostrils with a loss of olfactory ability after the surgery showed olfactory neuronal elements in their superior turbinate specimens. CONCLUSION: There is olfactory mucosa in approximately one-sixth of the superior turbinate specimens removed during the endoscopic transethmoidal sphenoidotomy procedure. Although 12% of the patients had a loss of olfactory ability in this study, none of the loss could be attributed to excision of olfactory tissue.

Female↗
PubMed2006

[The features of four types of operation for treating chronic hypertrophy rhinitis and ultrastructure observation of the inferior turbinate mucosa].

OBJECTIVE: To assess the features of four types of operation for treating chronic hypertrophy rhinitis and to observe the ultrastructure of inferior turbinate mucosa. METHOD: Eighty-eight cases of chronic hypertrophic rhinitis (HR) were treated by transnasal endoscopic submucous inferior turbinate resection (group A), thirty cases of HR were treated by partial inferior turbinectomy (group B), thirty six cases of HR were treated by bipolar radiofrequency ablation on inferior turbinate (group C), ten cases of HR were treated by injection of sclerosing agent (group D). The efficacy in the three groups (A,B,C) and the features of four types operation were compared and the ultrastructure of inferior turbinate was observed both preoperatively and postoperatively. RESULT: Four groups of HR were followed up 4 months to half year after operation, effective rate was 97.4 (group A) 100% (group B) and 93.4% (group C) respectively, while group A, group B and group C effective rate had no significant difference among them. Group A and group C have more advantages compared to the other 2 groups for they remained good ultrastructure of inferior turbinate mucosal cilia after 4 to 6 months postoperatively. CONCLUSIONS: The use of transnasal endoscopic submucous inferior turbinate resection and bipolar radiofrequency ablation for treatment of chronic hypertrophy rhinitis are effective modality for the treatment of chronic hypertrophy rhinitis.

Adolescent↗
PubMed1989

[Endoscopic surgery of the turbinates. Preliminary results].

Turbinate surgery has become more precise thanks to miniaturisation and improvements in optical systems, therby allowing endoscopic surgery throughout the procedure including its posterior portion. Endoscopic turbinate surgery includes surgery of the hypertrophied middle turbinate "concha bullosa" which requires diagnosis for successful treatment (septoplasty, endonasal ethmoid surgery). Endoscopy has improved inferior turbinate cauterisation which has become more complete and precise especially for the posterior portion of the turbinate. It allows the use of new techniques: the YAG laser and the CO2 laser. Endoscopy allows good control during resection of the tail of the inferior turbinate and ensures hemostasis in the event of hemorrhage occurring during this procedure.

Endoscopy↗
PubMed1989

Turbinate perimeter ratio as an indicator of conchal atrophy for diagnosis of atrophic rhinitis in pigs.

Transverse sections of snouts from 171 cross-bred (principally Yorkshire X American Landrace) pigs were evaluated for evidence of turbinate atrophy by use of conventional (atrophic rhinitis [AR] score) and morphometric methods. Of the 171 pigs, 35 were clinically normal (AR score, 0), 65 had mild AR (AR score, 1), 41 had moderate AR (AR score, 2), and 30 had severe AR (AR score, 3). Turbinate cross-sectional area (TA) and the ratio of TA to nostril cross-sectional area, called turbinate area ratio (TAR), had the lowest correlations (r = 0.24 to 0.55) with conventional AR score. Among clinically normal pigs, TA was greater in older pigs as expected, but the TAR values also were significantly (P less than 0.0001) different between 15-week-old pigs (55 kg) and 22-week-old pigs (100 kg). Turbinate perimeter and turbinate perimeter ratio (TPR) were not influenced by pig age or source. The TPR values were closely correlated with subjective visual AR scores (r = 0.73), with AR scores derived by measuring the space between the ventral portion of the scroll and the floor of the nasal cavity (r = 0.72), and the actual size of this space in millimeters (r = 0.71). Mean TPR values for pigs assigned visual AR scores of 0, 1, 2, or 3 were 1.54, 1.25, 0.97, and 0.73, respectively. The 95% confidence intervals around these mean TPR values were discreet and did not overlap. Turbinate perimeter ratio, therefore, may be a more reliable morphometric measure of atrophic rhinitis and also provides parametric data suitable for quantitative analysis.

Animals↗
PubMed1988

Induction of nasal turbinate atrophy in germ-free pigs, using Pasteurella multocida as well as bacterium-free crude and purified dermonecrotic toxin of P multocida.

To establish the role of the dermonecrotic toxin (DNT) of Pasteurella multocida in the cause and pathogenesis of atrophic rhinitis, germ-free pigs were inoculated with several strains of P multocida, crude DNT, or purified DNT. In some experiments, the aforementioned inocula were combined with Bordetella bronchiseptica. All DNT-producing P multocida strains induced severe turbinate atrophy. Histologic examination of the remnants of the nasal turbinates revealed intact, but undulated, ciliated epithelium and numerous osteoclasts. Inflammation was minimal or absent. A DNT-producing B bronchiseptica strain induced only mild turbinate atrophy. The lesions were characterized histologically by loss of cilia and ciliated cells and by an infiltration of predominantly mononuclear cells. Bone formation seemed impaired. Turbinate lesions were most severe in pigs infected with a combination of B bronchiseptica and a DNT-producing P multocida strain. Intranasal administration of sterile DNT-containing culture filtrate of P multocida or purified DNT of P multocida did not result in turbinate atrophy. In contrast, turbinate atrophy developed when these preparations were injected IM or when intranasal administration of DNT was preceded by inoculation of B bronchiseptica.

Animals↗
PubMed2006

Efforts to reduce mortality to hydroelectric turbine-passed fish: locating and quantifying damaging shear stresses.

Severe fluid forces are believed to be a source of injury and mortality to fish that pass through hydroelectric turbines. A process is described by which laboratory bioassays, computational fluid dynamics models, and field studies can be integrated to evaluate the significance of fluid shear stresses that occur in a turbine. Areas containing potentially lethal shear stresses were identified near the stay vanes and wicket gates, runner, and in the draft tube of a large Kaplan turbine. However, under typical operating conditions, computational models estimated that these dangerous areas comprise less than 2% of the flow path through the modeled turbine. The predicted volumes of the damaging shear stress zones did not correlate well with observed fish mortality at a field installation of this turbine, which ranged from less than 1% to nearly 12%. Possible reasons for the poor correlation are discussed. Computational modeling is necessary to develop an understanding of the role of particular fish injury mechanisms, to compare their effects with those of other sources of injury, and to minimize the trial and error previously needed to mitigate those effects. The process we describe is being used to modify the design of hydroelectric turbines to improve fish passage survival.

Animals↗
PubMed1999

Use of pocket-sized turbine spirometer in monitoring exercise-induced bronchospasm and bronchodilator responses in children.

For field studies of asthma, portable hand-held pulmonary function testing devices are required. Other than for peak flow measurements, little has been done to validate their use in children. Fifty children aged 5-15 years having asthma symptoms were examined using an exercise challenge (8 min free running outdoors) and a bronchodilation test (salbutamol inhalation at a dose of 0.15 mg/kg). Pulmonary function was measured with a turbine spirometer, with a Wright peak flow meter (WPEF) and with a flow-volume spirometer (FVS). A fall of 15% or more in peak expiratory flow associated with wheezing or cough was considered diagnostic for bronchial hyper-responsiveness to exercise (BHRE). A rise of 15% or more from baseline in peak expiratory flow after salbutamol inhalation was considered as a positive bronchodilator response (BDR). BHRE was present in 16 children (32%). Using the limit of a 15% or greater fall in FEV1, turbine spirometry identified 12 as BHRE-positive and no additional cases, giving a sensitivity of 75% and a specificity of 100%. The turbine spirometer showed lower FEV1 values than the FVS, the difference increasing with airway obstruction. BDR was positive in eight children (16%). Using the limit of a 10% or greater rise in FEV1, turbine spirometry was positive in six cases. FEV1 measured by turbine spirometry could not be used interchangeably with conventional FVS. However, the turbine spirometer offers the possibility to measure FEV1 repeatedly in field conditions, such as during exercise challenges outdoors.

Adolescent↗
PubMed2006

Uncertainty analysis of integrated gasification combined cycle systems based on Frame 7H versus 7F gas turbines.

Integrated gasification combined cycle (IGCC) technology is a promising alternative for clean generation of power and coproduction of chemicals from coal and other feedstocks. Advanced concepts for IGCC systems that incorporate state-of-the-art gas turbine systems, however, are not commercially demonstrated. Therefore, there is uncertainty regarding the future commercial-scale performance, emissions, and cost of such technologies. The Frame 7F gas turbine represents current state-of-practice, whereas the Frame 7H is the most recently introduced advanced commercial gas turbine. The objective of this study was to evaluate the risks and potential payoffs of IGCC technology based on different gas turbine combined cycle designs. Models of entrained-flow gasifier-based IGCC systems with Frame 7F (IGCC-7F) and 7H gas turbine combined cycles (IGCC-7H) were developed in ASPEN Plus. An uncertainty analysis was conducted. Gasifier carbon conversion and project cost uncertainty are identified as the most important uncertain inputs with respect to system performance and cost. The uncertainties in the difference of the efficiencies and costs for the two systems are characterized. Despite uncertainty, the IGCC-7H system is robustly preferred to the IGCC-7F system. Advances in gas turbine design will improve the performance, emissions, and cost of IGCC systems. The implications of this study for decision-making regarding technology selection, research planning, and plant operation are discussed.

Coal↗
PubMed1986

Mucociliary clearance and particle retention in the maxillary and ethmoid turbinate regions of beagle dogs.

In this study, the retention and clearance of particles instilled onto the epithelium at two sites in the nasal cavity were examined. Polystyrene microspheres (3 micron geometric diameter) were labeled with 141Ce or 85Sr and instilled simultaneously on the maxillary and ethmoid turbinates of beagle dogs. The retention and clearance patterns of the microspheres were followed for 30 d after instillation. Tissue samples, excreta content, and autoradiography of the radiolabels provided the basis for defining the fate of the microspheres or the radiolabels dissolved from the microspheres. Early nasal mucus velocity was significantly faster (p less than 0.05) from the maxillary turbinate region (2.5 +/- 0.7 mm/min, mean +/- SE) than from the ethmoid turbinate region (0.6 +/- 0.4 mm/min). Retention at both instillation sites at 30 d after instillation was approximately 0.1% of the amount initially instilled. Radioactivity was excreted primarily via the feces during the first few days. Radiolabel measured in urine and tissues other than turbinates was small (less than 0.05% of the initial burden), indicating minimal dissolution of the radiolabel from the particles. Autoradiographs of turbinate tissue revealed particles sporadically located in the epithelial submucosa. From these data, it was concluded that a significant difference in early clearance for particles exists between the ethmoid and maxillary turbinates, but there was no difference in the fraction of particles retained in these two areas for long periods of time.

Animals↗
PubMed1987

Turbine flowmeter vs. Fleisch pneumotachometer: a comparative study for exercise testing.

The purpose of this study was to investigate the characteristics of a newly developed turbine flowmeter (Alpha Technologies, model VMM-2) for use in an exercise testing system by comparing its measurement of expiratory flow (VE), O2 uptake (VO2), and CO2 output (VCO2) with the Fleisch pneumotachometer. An IBM PC/AT-based breath-by-breath system was developed, with turbine flowmeter and dual-Fleisch pneumotachometers connected in series. A normal subject was tested twice at rest, 100-W, and 175-W of exercise. Expired gas of 24-32 breaths was collected in a Douglas bag. VE was within 4% accuracy for both flowmeter systems. The Fleisch pneumotachometer system had 5% accuracy for VO2 and VCO2 at rest and exercise. The turbine flowmeter system had up to 20% error for VO2 and VCO2 at rest. Errors decreased as work load increased. Visual observations of the flow curves revealed the turbine signal always lagged the Fleisch signal at the beginning of inspiration or expiration. At the end of inspiration or expiration, the turbine signal continued after the Fleisch signal had returned to zero. The "lag-before-start" and "spin-after-stop" effects of the turbine flowmeter resulted in larger than acceptable error for the VO2 and VCO2 measurements at low flow rates.

Carbon Dioxide↗
PubMed2004

Localization of T cells and subtypes in the paranasal sinus and turbinate mucosa in patients with chronic sinusitis.

The aim of this study was to quantitate total T lymphocytes (total CD3+ cells) and T-lymphocyte subtypes (CD4+ [T helper] and CD8+ [T suppressor] cells) in patients with chronic sinusitis who were treated with functional endoscopic sinus surgery (FESS) and to investigate the pathophysiology of persistent inflammation in chronic sinusitis. This prospective study was conducted in study and control groups. The study group consisted of 32 patients (20 male, 12 female) with chronic sinusitis who underwent FESS. The control group consisted of 8 nonsinusitis patients (5 male, 3 female) who underwent septoplasty. Specimens from the study group were excised from five regions: the uncinate process, maxillary and ethmoid sinuses, and middle and inferior turbinates. The specimens were examined with x10 magnification by light microscopy, and the slides with a severe inflammatory process were included. Punch biopsy of the control group was taken from the inferior turbinate with patients' written approval. The surgical specimens from the study and control groups were examined with an immunohistochemical staining technique with monoclonal antibodies against CD3, CD4, and CD8 surface antigens of T lymphocytes. In every specimen, the numbers of CD3+, CD4+, and CD8+ cells were calculated in 3 to 4 high magnification field on light microscopy, and the mean number of these cells in the epithelium, subepithelial layer of the lamina propria, and deep paraglandular layer of the mucosa was determined. Statistical analysis by Kruskal-Wallis analysis of variance and the Mann-Whitney U test with Bonferroni correction revealed that the CD3 epithelial layer value of the inferior turbinate (p = .030) and the CD4 deep layer value of the middle turbinate (p = .048) were significantly higher than the corresponding values of the control group. In the epithelial (p = .018) and subepithelial (p = .012) layers of the uncinate process group, in the epithelial (p = .050) and subepithelial (p = .012) layers of the ethmoid sinus group, and in the subepithelial (p = .018) and deep paraglandular (p = .012) layers of the middle turbinate group, the difference between the CD4+ and CD8+ cell counts was found to be statistically significant by the Wilcoxon signed rank test. The number of CD4+ cells was higher than the number of CD8+ cells. In conclusion, T cells play a role in the pathophysiology of chronic sinusitis. CD4+ T helper cells, in particular, are predominant at the initiation and regulation of inflammation. The uncinate process, ethmoid sinus, and middle and inferior turbinates have the main roles by T cells and subtypes in the defense system in chronic sinusitis.

Adolescent↗