Olavo Mion

Allergic rhinitis in the child and associated comorbidities

Sih T, Mion O. Allergic rhinitis in the child and associated comorbidities.
Pediatr Allergy Immunol 2010: 21: e107–e113.
© 2009 John Wiley & Sons A/S

Alterações funcionais do sistema estomatognático em pacientes com rinite alérgica: estudo caso-controle

A respiracao oral pode acarretar alteracoes estruturais e funcionais do sistema estomatognatico. OBJETIVO: Verificar a presenca de alteracoes das funcoes de respiracao, mastigacao, degluticao e fala em pacientes com rinite alergica e relaciona-as com a intensidade dos sintomas da rinite. MATERIAL E METODOS: Para este estudo prospectivo, foram avaliados 170 pacientes com faixa etaria entre 6 e 55 anos de idade. Todos os pacientes passaram por avaliacao otorrinolaringologica e fonoaudiologica. Foram colhidos os dados referentes as funcoes de respiracao, mastigacao, degluticao e fala e dados da consulta medica. Os dados foram comparados e analisados estatisticamente. RESULTADOS: A diferenca dos escores de sinais e sintomas entre GR e GC mostrou-se estatisticamente significante. Quando comparada a presenca de alteracao nas funcoes estudadas entre GR e GC, foi observada diferenca estatisticamente significante no modo respiratorio e nos padroes de mastigacao e degluticao. A correlacao existente entre o escore de obstrucao nasal e a presenca de alteracao funcional foi significante na analise do modo respiratorio e do padrao de mastigacao. CONCLUSAO: O paciente com rinite alergica apresenta alteracoes funcionais do sistema estomatognatico e o aumento do escore de obstrucao nasal pode ser considerado um indicativo destas alteracoes.

The Role of Rhinitis in Chronic Otitis Media

OBJECTIVE: We investigated the role of allergic rhinitis in chronic otitis media (otitis media with effusion [OME] and chronic perforation of the tympanic membrane) in São Paulo, Brazil and whether there is any association between these diseases. STUDY DESIGN AND SETTING: We studied 51 patients followed in the otologic group of the Otorhinolaryngology Division of the University of São Paulo Hospital. The patients were divided into 3 groups: allergic rhinitis, nonallergic rhinitis with eosinophils syndrome (NARES), and patients with types of rhinitis or without rhinitis. We analyzed the age, gender, intensity of the nasal disease, surgical procedure, and surgical results in each group. RESULTS: We found about 50% of patients presenting with nasal disease and nasal eosinophilia (33.33% of allergic and 15.69% of NARES). CONCLUSION: Nasal disease has an impact on otologic middle ear disease, considering that the normal nasal mucosa do not have eosinophils.

Methods for studying mucociliary transport

UNLABELLED Mucociliary transport dysfunctions can impair the quality of life of patients suffering from chronic rhinossinusitis and lead to severe consequences such as alterations in respiratory physiology or even death as in cases of cystic fibrosis and primary ciliary dyskinesia. Therefore, it is crucial to understand the physiology of the mucociliary apparatus and how its components (cilia, mucus-periciliary layer and its interaction) affect the clearance of respiratory secretions. AIMS This paper aims to review and to discuss different techniques for studying mucociliary transport and their clinical and experimental applicability. CONCLUSIONS The methods listed in this revision provide us with valuable information about different aspects of the mucociliary transport. Some of the methods listed are more suitable for clinical practice and present reproducible results. Others, show only applicability in experimental settings due to technical difficulties or financial limitations. However, it is important to emphasize that up to now there is no method that can evaluate ciliary beating frequency (CBF) in vivo and in situ. Such a method would become a valuable tool in the scientific scenario and in the clinical practice, supporting the diagnosis of ciliary dyskinesias and avoiding the use of invasive procedures to corroborate the clinical suspicion.

Métodos de estudo do transporte mucociliar

Mucociliary transport dysfunctions can impair the quality of life of patients suffering from chronic rhinossinusitis and lead to severe consequences such as alterations in respiratory physiology or even death as in cases of cystic fibrosis and primary ciliary dyskinesia. Therefore, it is crucial to understand the physiology of the mucociliary apparatus and how its components (cilia, mucus-periciliary layer and its interaction) affect the clearance of respiratory secretions. AIMS: This paper aims to review and to discuss different techniques for studying mucociliary transport and their clinical and experimental applicability. CONCLUSIONS: The methods listed in this revision provide us with valuable information about different aspects of the mucociliary transport. Some of the methods listed are more suitable for clinical practice and present reproducible results. Others, show only applicability in experimental settings due to technical difficulties or financial limitations. However, it is important to emphasize that up to now there is no method that can evaluate ciliary beating frequency (CBF) in vivo and in situ. Such a method would become a valuable tool in the scientific scenario and in the clinical practice, supporting the diagnosis of ciliary dyskinesias and avoiding the use of invasive procedures to corroborate the clinical suspicion

Nasal valve: anatomy and physiology

UNLABELLED The anterior portion of the nasal cavities, from the nostril to the nasal valve (NV), is the place of highest nasal resistance to airflow, paramount to nasal physiology. There are different terminologies for the same anatomic structures in the literature. AIM The aim of this paper was to study the NV function and define clearly the structures of the anterior portion of the nasal cavities, mainly the region of the NV. CONCLUSION Internum ostium is the anterior segment and isthmus nasi is the posterior segment of the NV region.

Rinometria acústica: correlacão anatômica dos dois primeiros entalhes encontrados no rinograma

The graphic obtained by acoustic rhinometry in Caucasian adult individuals with no nasal affections clearly shows two notches at the beginning of the nasal echogram. However, there are controversies in the literature concerning their anatomic correlation. AIM: The aim of this study was to obtain data that would contribute to the anatomic correlation of these two notches. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: We analyzed the nasal echogram of 35 volunteers in basal conditions, after decongestion and after obstruction of the nasal valve by using cotton impregnated with Vaseline. RESULTS: We identified statistically significant reduction and increase of the cross-sectional area only for the second notch after obstruction of the nasal valve and after decongestion, respectively. CONCLUSION: The analysis of the results suggested that the first notch of the nasal echogram refers to the nostril and the second notch refers to the nasal valve as a whole.

Avaliação da cavidade nasal e nasofaringe através da rinometria acústica antes e após adenoidectomia

INTRODUCAO: A hipertrofia adenoideana e vista com frequencia na pratica otorrinolaringologica e e importante avaliar a patencia nasal antes do inicio do tratamento. Neste trabalho, os autores buscam avaliar as mudancas na geometria nasal e nasofaringe antes e apos adenoidectomia atraves de um metodo objetivo de mensuracao da patencia nasal, a rinometria acustica. FORMA DE ESTUDO: Clinico prospectivo. OBJETIVO: Os autores avaliam a area de seccao transversal minima (ASTM) e o volume das cavidades nasais e nasofaringe atraves da rinometria acustica (RA) antes e apos a cirurgia de adenoidectomia. MATERIAL E METODO: Vinte e tres criancas que tinham indicacao cirurgica para adenoidectomia com ou sem tonsilectomia foram submetidas ao exame de RA antes e 15 dias apos a cirurgia. RESULTADOS: A ASTM das fossas nasais variou, antes do uso de vasoconstritor (VC), de 0,73 cm2 antes da cirurgia para 0,79 cm2 apos a cirurgia; apos o uso de VC variou de 0,87 cm2 para 0,93 cm2. O volume das fossas nasais variou, antes do uso de VC, de 6,18 cm3 antes da cirurgia para 6,47 cm3 apos a cirurgia; apos o uso de VC variou de 8,31 cm3 para 8,65 cm3. Na nasofaringe a ASTM variou, antes do uso de VC, de 2,43 cm2 antes da cirurgia para 2,69 cm2 apos a cirurgia; apos o uso de VC variou de 2,76 cm2 para 3,79 cm2. Na nasofaringe o volume variou, antes do uso de VC, de 5,57 cm3 antes da cirurgia para 6,14 cm3 apos a cirurgia; apos o uso de VC variou de 6,51 cm3 para 8,78 cm3. CCINCLUSAO: O aumento de ASTM e volume da nasofaringe, indicando melhora da permeabilidade nasal, concorda com a melhora dos sintomas obstrutivos referidos pelo paciente e familiares apos a cirurgia de adenoidectomia.

Acoustic rhinometry: anatomic correlation of the first two notches found in the nasal echogram

UNLABELLED The graphic obtained by acoustic rhinometry in Caucasian adult individuals with no nasal affections clearly shows two notches at the beginning of the nasal echogram. However, there are controversies in the literature concerning their anatomic correlation. AIM The aim of this study was to obtain data that would contribute to the anatomic correlation of these two notches. STUDY DESIGN Clinical prospective. MATERIAL AND METHOD We analyzed the nasal echogram of 35 volunteers in basal conditions, after decongestion and after obstruction of the nasal valve by using cotton impregnated with Vaseline. RESULTS We identified statistically significant reduction and increase of the cross-sectional area only for the second notch after obstruction of the nasal valve and after decongestion, respectively. CONCLUSION The analysis of the results suggested that the first notch of the nasal echogram refers to the nostril and the second notch refers to the nasal valve as a whole.

A systematic review to assess the anatomical correlates of the notches in acoustic rhinometry

Background:  The graph obtained by Acoustic Rhinometry in most studies of normal adult Caucasian individuals clearly shows two notches at the beginning of the rhinogram. However, we found different opinions in the literature regarding the anatomical correlation of the anterior notches.