Perapun Jareoncharsri

Acoustic rhinometry of Asian noses.

Background Each ethnic group has different nasal cavity geometries. The reference value of the minimal cross-sectional area (MCA) and the nasal volume (NV) is mandatory for rhinologic evaluation in regular practice and for research. This study was designed to study the normal value of acoustic rhinometry (AR) in Asian subjects in comparison with other ethnic groups. Methods AR was performed in 135 healthy Thai subjects. Subjects were divided into two groups: group I, with normal anterior rhinoscopic appearance; group II included subjects with asymptomatic, slightly deviated nasal septa. Results The mean of the MCA was 0.61 ± 0.60 cm2 before decongestion and 0.64 ± 0.14 cm2 after decongestion. The mean distance from the nostril to the point of MCA (D) was 1.66 ± 0.59 cm before decongestion and 1.41 ± 0.74 cm after decongestion. The mean of the NV measured between 0 and 4 cm was 3.66 ± 0.67 cm3 before decongestion and 4.18 ± 0.75 cm3 after decongestion. Before decongestion, there were no significant differences in the mean of the MCA, D, and NV between group I and group II subjects; however, there were significant differences in mean MCA and NV after decongestion. There were no differences in the parameters between male and female subjects before decongestion, except for the D, but after decongestion the mean values of the MCA, D, and NV were significantly higher in male subjects compared with female subjects. Conclusion The results of this study can be used as a reference value for Asian ethnicities. Thai subjects had measurements comparable with those of the European study and somewhat different from the study in black populations.

Efficacy of Spiramycin as an Alternative to Amoxicillin in the Treatment of Acute Upper Respiratory Tract Infections

SummaryThis study compared the efficacy of spiramycin with that of amoxicillin in treating patients with acute community-acquired upper respiratory tract infections (URTIs). The study was an open, randomised, comparative parallel design and patients received either spiramycin 3 MIU (2 tablets, 500mg or 1.5 MIU per tablet) twice daily after meals, i.e. 6 MIU/day for 7 days or amoxicillin (500 mg/capsule) 1 capsule three times daily after meals, i.e. 1500 mg/day for 7 days. Patients attending the ENT outpatient clinic at Siriraj Hospital in Bangkok for treatment of acute URTIs were included in the study after giving their informed consent. Eligible patients comprised those aged 18 years and over, of either gender, who had at least two of the following symptoms: fever (≥38°C oral), nasal discharge/obstruction, sore throat, cough and/or hoarseness of voice that did not require parenteral drug therapy or hospitalisation. A total of 99 patients were included in this study, 49 patients received spiramycin and 50 received amoxicillin. Of the 45 assessed patients treated with spiramycin, 40 were judged by the investigators as a ‘success’ (89%), and five were judged a ‘non-success’ (11%), compared with 48 assessed patients in the amoxicillin group where 40 patients were classified as a ‘success’ (83.3%) and 8 were judged a ‘non-success’ (16.7%). No statistically significant differences between treatments were demonstrated regarding the overall efficacy of treatment.This study demonstrated that the prescribed regimens of spiramycin and amoxicillin were similarly effective in the treatment of adult acute URTIs. The tolerability of both drugs was also similar. Furthermore, it was noted that the convenient twice-daily dosage regimen of spiramycin may allow better patient compliance.