Salih Canakcioglu

Long-term efficacy of sublingual immunotherapy in patients with perennial rhinitis.

Background: Sublingual immunotherapy has a documented clinical efficacy, but only a few long‐term studies have been performed in people with perennial rhinitis.

Comparison of the Long-Term Efficacy of Subcutaneous and Sublingual Immunotherapies in Perennial Rhinitis

Background: Both sublingual and subcutaneous immunotherapies have a documented clinical efficacy, but only a few comparative studies have been performed. Objectives: To evaluate and compare the long-term efficacies of subcutaneous and sublingual immunotherapy. Methods: One hundred and ninety-three patients with house dust mite allergies, out of an original total of 230, were treated with subcutaneous and sublingual house dust mite-specific immunotherapies for 3 years and also observed for 3 years after discontinuation of the treatment. The patients were randomized into 2 groups: the sublingual group (97 patients) and the subcutaneous group (96 patients). The therapy’s success was evaluated using the symptom score, skin prick test results, and the nasal allergen challenge score. The patients were evaluated at the beginning of the study, at the end of years 1, 2, and 3, and also at the end of the 1st and 3rd years after discontinuation of the specific immunotherapy treatment. Results: Immunotherapy induced a significant improvement during the treatment and the follow-up period. We found a greater improvement in the subcutaneous group compared to the sublingual group when we looked at the comparative results of the total 6 years. Conclusion: We suggest subcutaneous immunotherapy for patients with perennial allergic rhinitis due to the better results that were obtained during our study period. Nevertheless, sublingual immunotherapy is now accepted by WHO as a valid alternative to the subcutaneous route and should be used in all patients who require immunotherapy and do not accept the subcutaneous route of allergen administration.

Nasal Sound Analysis: A New Method for Evaluating Nasal Obstruction in Allergic Rhinitis

Objective: Current measurements of nasal obstruction are unreliable and may be improved with the development of new techniques. The effectiveness of odiosoft‐rhino (OR) in the evaluation of nasal obstruction was investigated in a blind comparison at a referral center, institutional practice.

Evaluation of nasal cytology in subjects with chronic rhinitis: a 7-year study

BACKGROUND No diagnostic test had been specifically developed to diagnose nonallergic rhinitis (NAR). Also a negative nasal smear for eosinophils does not rule out the diagnosis. There is a significant diagnostic problem in patients with NAR. How can we solve this problem? OBJECTIVES Assessment of other cells than eosinophils present in the cytogram such as basophils, neutrophils, and goblet cells may help us to classify and management of diagnostic problem of rhinitis. We sought to characterize the cellular pattern of patients with allergic rhinitis (AR) and compare them with those of NAR. METHODS According to the skin prick test positivity or negativity, individuals were divided into AR and NAR groups, respectively. Allergic rhinitis group was further divided into seasonal, perennial, and mixed subgroups. Nonallergic rhinitis group was also divided into the following 5 subgroups according to the nasal smear cytologic result: basophilic, neutrophilic, eosinophilic, mixed, and nonallergic noninfectious type. So the frequency rates of the subgroups were calculated and also smear cytologic results were compared. RESULTS Frequency of AR was approximately equal to NAR in subjects with chronic rhinitis. Neutrophilic, eosinophilic, mixed, and nonallergic noninfectious types were the common types of NAR. An evident nasal eosinophilia was found in AR and eosinophilic NAR, whereas a higher percentage of goblet cells were determined in nonallergic noninfectious rhinitis. There is no significant difference between cytologic results from NAR and AR patients. CONCLUSION In the patient with positive skin test result, the presence of nasal eosinophilia strongly supports the diagnosis of AR. No diagnostic test had been specifically developed to diagnose chronic NAR. Also, a negative nasal smear for eosinophils does not rule out the diagnosis. Assessment of other cells present in the cytogram such as basophils, neutrophils, and goblet cells may also provide valuable information for differential diagnosis and management of these conditions.

Detection of the nasal cycle in daily activity by remote evaluation of nasal sound.

OBJECTIVES To detect the nasal cycle in healthy subjects while they were performing their daily activities, using the Odiosoft-Rhino (OR) software program and to investigate the ability of the OR program to perform this procedure. DESIGN Prospective analysis. SETTING Tertiary referral center. PATIENTS Twenty healthy adult volunteers. INTERVENTIONS Investigation of the nasal cycles of volunteers by the OR program every 30 minutes over a period of 12 hours on 4 different days in the same week. Each subject performed expiration every 30 minutes into a microphone, and the nasal sounds were recorded separately for each nasal cavity. MAIN OUTCOME MEASURES The OR data collected during 12 hours for 4 days were analyzed for cyclic nasal obstruction. RESULTS The nasal sounds were calculated for each of the nasal cavities and a 2000- to 4000-Hz frequency interval was used for evaluation. In all of the individuals investigated in this study, a cyclic change of nasal patency was detected by the OR program. All of the data were calculated to be significantly different for each nasal cavity (P < .05 for all comparisons). Changes of nasal sounds and comparison of the 2 sides demonstrated that the total amount of cyclic changes ranged between 30 minutes and 2 to 2.5 hours. CONCLUSIONS With the help of the OR program, we detected the nasal cycles in all of the volunteers, and the periods were not less than 30 minutes or more than 2.5 hours. Because the data collection period was long and the patient compliance was maximal, we believe that the results in the study are more reliable and natural.

Odiosoft-Rhino versus rhinomanometry in healthy subjects.

Conclusion. Odiosoft-Rhino (OR) is a non-invasive test that is completed in an extremely short period of time. It is easy to perform and little patient cooperation is needed. OR is safe and could be used in the rhinological setting if further improved. Objective. To evaluate nasal obstruction objectively with a new technique, OR, and to compare the results with a widely accepted method, rhinomanometry, in normal subjects. Subjects and methods. OR and anterior RMM were performed in 79 subjects without any rhinologic symptoms and signs. Visual analogue scales (VAS) of nasal obstruction, nasal airway resistance and nasal expiratory and inspiratory sounds were analysed. Results. VAS of nasal obstruction was found to be correlated with OR findings of expiration at 2000–4000 Hz frequency interval on both sides (r=0.564, p<0.01 for the left side, r=0.533, p<0.01 for the right side). Correlations were found (p<0.05) between left 2000–4000 Hz in expiration OR and left expiration RMM, left 4000–6000 Hz in expiration OR and left expiration RMM, right 2000–4000 Hz in expiration OR and right expiration RMM, and right 4000–6000 Hz in expiration OR and right expiration RMM. No correlation was seen between VAS, anterior RMM and OR at inspiration in any interval.

Expiratory nasal sound analysis as a new method for evaluation of nasal obstruction in patients with nasal septal deviation: comparison of expiratory nasal sounds from both deviated and normal nasal cavity

BACKGROUND The reliability of nasal obstruction measurements could be improved, and several new techniques are being developed. Our objective was to investigate the use of a new software program, Odiosoft-Rhino, in the assessment of nasal obstruction via analysis of the sounds of nasal expiration. METHODS We compared the nasal symptom scores and Odiosoft-Rhino and acoustic rhinometry test results for 61 patients with known nasal septal deviation. RESULTS We found a significant difference, and a correlation, between Odiosoft-Rhino results at 2000-4000 Hz and 4000-6000 Hz intervals, and the minimal cross-sectional area 2.2 cm from the nostril, in the right nasal cavity in patients with right-sided deviations. Similar results were observed for the left nasal cavity in patients with left-sided deviations. CONCLUSIONS The Odiosoft-Rhino software test is noninvasive, requires minimal cooperation and experience, and provides results that can be saved as digital data. Additionally, data from the Odiosoft-Rhino test are strongly correlated with acoustic rhinometry results and visual analogue scores of nasal obstruction. It seems that sound intensity within the 2000-4000 Hz and 4000-6000 Hz intervals is more sensitive than other sound intensity intervals. Thus, we speculate that Odiosoft-Rhino testing could be used as a new diagnostic method in order to evaluate nasal airflow in clinical practice.

Comparison of Odiosoft-Rhino and rhinomanometry in evaluation of nasal patency.

OBJECTIVE To conduct a preliminary study testing the validity of the Odiosoft-Rhino (OR) in the evaluation of nasal patency in patients with nasal septal deviation and compare the results with visual analogue score (VAS) of nasal obstruction and rhinomanometry (RMM). METHODS OR and RMM were performed on 68 patients with nasal septal deviation and 61 healthy controls. VAS, nasal resistance values and nasal sound analysis were noted for the left and right nasal cavities. RESULTS There are statistically significant differences between VAS, RMM and nasal endoscopic findings between the patient and the control group. The OR results at expiratory and inspiratory 2000 - 4000 Hz and 4000 - 6000 Hz intervals for both nasal cavities show a statistically significant difference between the patient and control groups. Nasal endoscopic findings, RMM, OR results of the deviated sides in the 2000 - 4000 Hz interval correlate well with VAS. CONCLUSIONS OR may be a practical test in assessment of nasal patency. OR at the 2000 - 4000 Hz interval shows a correlation with VAS. However, showing a correlation between a test and a variable is not the same as proving that it is a useful diagnostic test. Therefore, more studies with larger series are needed.

Nasal Expiratory Sound Analysis in Healthy People

OBJECTIVE: To evaluate the practicability of Odiosoft-Rhino (OR), a new experimental method for assessing the nasal airflow and resistance, in normal subjects and to compare the results with acoustic rhinometry (AR) findings. STUDY DESIGN AND SETTING: OR and AR were carried out in 72 healthy subjects. Their visual analogue scales of nasal obstruction, minimal cross sectional areas (MCA1 and MCA2), and nasal expiration sounds were analyzed and noted for both nasal cavities. RESULTS: Statistically significant correlations (P < 0.05) were found between OR and AR in 2,000 to 4,000 Hz and 4,000 to 6,000 Hz with MCA1 and MCA2. CONCLUSIONS: OR is a noninvasive and rapid test. It is easy to carry out and requires little patient cooperation. It seems that it may give compatible results with other reliable methods that assess nasal airflow. SIGNIFICANCE: We assume that OR is a sensitive method for evaluating nasal airflow in normal subjects in an easy way. EBM rating: A-1b

Nasal patency by rhinomanometry in patients with sensation of nasal obstruction.

Background The objective assessment of nasal patency is a common challenge in clinical practice. This study was designed to show and compare the values of active anterior rhinomanometry (RMM) in patients with sensation of nasal obstruction. Methods According to the physical examination, 7283 individuals with sensation of nasal obstruction were divided into the nasal septal deviation (NSD) group and normal nasal anatomy group. The NSD group and normal nasal anatomy group were further divided into subgroups according to skin-prick test positivity or negativity, respectively. Nasal airway resistances (NARs) of the subgroups were evaluated and compared. Results The mean value of total inspiratory NAR was 0.51 and 0.34 Pa/cm3 per second at 150-Pa pressure point in allergic rhinitis subjects with and without NSD, respectively; 0.48 and 0.32 Pa/cm3 per second were the mean values of total inspiratory NAR in nonallergic rhinitis subjects with and without NSD, respectively. The total inspiratory resistances in groups with NSD were significantly higher than the others. Conclusion We believe that the results of so large a number of participants in this test will make an obvious contribution to the medical literature.