Ajnacska Rozsasi

Medium-term symptom outcomes after paranasal sinus surgery in children and young adults with cystic fibrosis

Objective: To determine the effectiveness of paranasal sinus surgery (PSS) for individual symptoms and recurrence of nasal polyposis in children and young adults with cystic fibrosis and chronic rhinosinusitis (CRS).

Tracheal climate in laryngectomees after use of a heat and moisture exchanger.

Objective/Hypothesis: Heat and moisture exchangers (HME) are frequently used in the treatment and prevention of tracheobronchial dryness and infections. In this study, the short‐term influence of the HME Prim‐Air System (Heimomed, Kerpen, Germany) in laryngectomized patients was tested.

Nasal conditioning in perennial allergic rhinitis after nasal allergen challenge

Background Antigen challenge in seasonal allergic rhinitis is considered to be associated with an increased ability of the nose to condition inspired air. In contrast, little is known about air conditioning after antigen challenge in perennial allergic rhinitis (PAR).

Video-endoscopy and digital image analysis of the nasal valve area

The aim of this study was to evaluate the benefit of digital image analysis of video-endoscopic images of the valve area to study changes in cross-sections of the nasal valve area before and after nasal surgery. Fifty patients scheduled for septoplasty or septorhinoplasty were included. Successful recordings of the valve area and digitally calculated cross-sections of the nasal valve area served as main outcome measures. First, various endoscopes (rigid 0°- and 25°-endoscopes and fibreoptic 0°-endoscope) were tested and video-endoscopy was standardised in 39 patients. Second, preoperative and postoperative images of the nasal valve area in 11 patients with obstruction of the nasal valve area were digitally analysed and compared. In these patients, a significant widening of the valve area could be shown postoperatively. We conclude that digital image analysis of the nasal valve area can be helpful in the measurement of cross-sections of the nasal valve area before and after nasal surgical procedures in selected patients.

Measurement of Tracheal Humidity and Temperature

Background: After tracheostomy, patients often present with chest complaints. Measurement of objective parameters of the tracheal climate is important to evaluate ‘artificial noses’ or humidifying devices. Objectives: The purpose of this study was to present an experimental setup for measurement of tracheal temperature and humidity for possible use in clinical studies in tracheotomized patients. Methods: The study design was a prospective study. Patients with tracheal stoma were chosen as study participants. Tracheal temperature and humidity during the respiratory cycle were measured using a miniaturized thermocouple and a humidity sensor connected to a suction system. Results: Accurate measurement of tracheal temperature and humidity was feasible in patients with tracheal stoma. Tracheal humidity and temperature values measured in this study were similar to values reported earlier by other working groups. Conclusions: The experimental setup presented may reliably be used in the evaluation of ‘artificial noses’ or other passive humidifiers in tracheotomized patients.

The impact of septorhinoplasty and anterior turbinoplasty on nasal conditioning.

Background Septorhinoplasty and turbinoplasty is a frequently performed operation in facial plastic surgery. The aim of this study was to investigate nasal conditioning after septorhinoplasty and inferior turbinoplasty in patients with internal and external nasal deformities and hypertrophy of the inferior turbinates and to determine its relation to nasal patency. Methods Ten patients and 10 volunteers as controls were enrolled into this study. Measurement of nasal conditioning and active anterior rhinomanometry were performed before and 4–6 months after functional-esthetic septorhinoplasty and inferior turbinoplasty. Results Nasal airflow was significantly higher postoperatively than preoperatively. The preoperative nasal temperature (TEMP) and heat increase (HI) was lower in the patients compared with the controls. The postoperative TEMP, HI, total water content, and water gradient were significantly higher than the preoperative values. Conclusion Based on this relatively small series, functional-esthetic septorhinoplasty in combination with inferior turbinoplasty may be associated with improved nasal conditioning.

Lower airway humidification in spontaneously breathing tracheostomized patients: comparative study of trachea spray versus heated humidifier.

Our aim was to compare inhalation with molecular water (vaporizing humidifier) and particulate water (trachea spray) in spontaneously breathing tracheostomized patients.

Nasal conditioning after endonasal surgery in chronic rhinosinusitis with nasal polyps.

Background Endoscopic sinus surgery (ESS) is a frequently performed operation for chronic rhinosinusitis (CRS). The aim of this study was to investigate nasal conditioning after ESS with/without septoplasty and turbinoplasty in patients with CRS with nasal polyps and to determine its relation to nasal patency and geometry. Methods Twenty-one patients were enrolled into this study. Nasal conditioning, AAR, and acoustic rhinometry were measured before and 4-8 months after endonasal surgery. Results The temperature and humidity gradient across the nose increased significantly after operation. High nasal volumes and patency were positively correlated with elevated nasal conditioning. No correlation between preoperative and postoperative changes in nasal geometry and nasal airflow with changes in conditioning values was found. Conclusion Patients with CRS with nasal polyps seem to profit from ESS with/without septoplasty and turbinoplasty because nasal conditioning is improved postoperatively. Properly performed ESS has its importance within the variety of nasal surgical procedures ensuring improved nasal function.

Influence of passive humidification on respiratory heat loss in tracheotomized patients

The aim of this study was to evaluate changes in total respiratory heat loss during use of a heat and moisture exchanger (HME) in tracheotomized patients.

Influence of passive humidification on nasal conditioning.

Background Passive humidifiers (PH) have been beneficial to upper and lower airway humidity, especially in patients who are in a long-time ventilated intensive care unit. The goal of this pilot study was to provide nasal conditioning data and measure the benefit of a nasal PH to spontaneously breathing, conscious subjects. Methods Eleven healthy volunteers had to wear a PH for 1 hour, which was introduced into both nasal vestibules. The PH had a heat and moisture restoring body of polyurethane foam with an open-pore structure. Before and after application of the nasal PH, nasal conditioning was measured and nasal symptoms were assessed by the participants. Results Ten minutes after removal of the PH a significant increase was observed for the scores for nasal patency and nasal humidity. Conclusion We hypothesize that the nasal PH could provide a valuable contribution to the supportive therapy of diseases that accompany nasal mucosal dryness.