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Examination Stations
Published in Adnan Darr, Karan Jolly, Jameel Muzaffar, ENT Vivas, 2023
Adnan Darr, Karan Jolly, Keshav K. Gupta, Jameel Muzaffar
Anterior rhinoscopy: Mucosal assessment: Septum, turbinates (hypertrophy), telangiectasia, ulceration, congestionStructural: Polyps, masses, tumours, septal assessment
Common Office Tests and Procedures for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Fiberoptic rhinopharyngolaryngoscopy (commonly known as rhinoscopy) is a procedure that is being increasingly performed in the allergist’s office. The procedure is conducted with a rhinoscope, a device used to view anatomic structures in the nasal passages, sinuses, pharynx and larynx. The rhinoscope can be used in the diagnosis of diseases of the upper airway, including sinusitis, nasal polyps and vocal cord dysfunction. In the diagnosis of sinusitis, rhinoscopy has been shown to be more sensitive than sinus X-rays, but less so than a CT scan or MRI. On the other hand, in-office rhinoscopy is far less expensive compared to the latter. Moreover, it is useful in monitoring disease progression and response to therapy.
History Stations
Published in Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox, ENT OSCEs: A Guide to Passing the DO-HNS and MRCS (ENT) OSCE, 2019
Joseph Manjaly, Peter Kullar, Alison Carter, Richard Fox
A full examination of the nose should be undertaken using anterior rhinoscopy and rigid endoscopy. The areas of nasal crusting should be noted. The septum should be examined for perforations. Any suspicious areas should be biopsied (particularly irregular or granulating mucosa).
Identifying chronic rhinosinusitis without nasal polyps by analyzing aspirated nasal air with an electronic nose based on differential mobility spectrometry
Published in Acta Oto-Laryngologica, 2022
Jussi Virtanen, Anton Kontunen, Jura Numminen, Niku Oksala, Markus Rautiainen, Antti Roine, Ilkka Kivekäs
In all the above studies [6–8], patients with CRS were compared to healthy volunteers, which might have overestimated the diagnostic accuracy. Therefore, in this study, we aimed to distinguish two groups of patients with similar symptoms but with different etiology. In our control group, patients were symptomatic due to anatomical factors rather than inflammatory ones, although DS may predispose to chronic mucosal inflammation [13]. Though unproven, this may alter the measurement signature of the DMS and influence the accuracy. However, as the patients with DS did not undergo CT examination, some of the patients could have had mucosal changes in the paranasal sinuses, which may have also affected the DMS analysis. In addition, the exclusion of nasal polyps in the control group was conducted by anterior rhinoscopy which can, in some cases, result in false negative findings. Other paranasal diseases could also be confounding factors.
Management of adult asthma and chronic rhinitis as one airway disease
Published in Expert Review of Respiratory Medicine, 2021
Angelica Tiotiu, Plamena Novakova, Guidos Guillermo, Jaime Correira de Sousa, Fulvio Braido
According to the major etiologic factors, chronic rhinitis is classified into four groups: infectious (called generally chronic rhinosinusitis), allergic rhinitis (AR), nonallergic noninfectious rhinitis (NAR), and mixed rhinitis. In the group of NAR, several subgroups were described according to clinical phenotypes: nonallergic occupational rhinitis, hormonal rhinitis (including pregnancy rhinitis), drug-induced rhinitis, gustatory rhinitis, senile rhinitis, and idiopathic rhinitis. The diagnosis is based on a detailed medical history, skin prick testing, or determination of serum allergen-specific immunoglobulin E (sIgE) to identify the atopy, and anterior rhinoscopy/nasal endoscopy to evaluate endonasal cavity [1]. Allergen provocation testing could be performed to confirm AR or occupational rhinitis, nasal cytology, and biopsies for drug-induced rhinitis, while measurement of total or sIgE in nasal secretions, respectively, nasal hyperreactivity testing have limited indications in daily practice and are performed in a few specialized academic centers [1,2]. Anterior rhinoscopy is used to check for signs of infection, endonasal crust formation and anatomic deformities, while nasal endoscopy could evaluate the whole endonasal cavity including the ostiomeatal complex and reveal the presence of chronic rhinosinusitis [1]. The therapeutic strategy in rhinitis is based on the avoidance of triggers and pharmacologic treatement according to the etiology (e.g. nasal/oral corticosteroids, antihistamines, ipratropium bromide, capsaicin, allergen-specific immunotherapy) [1,2].
The impact of allergies and smoking status on nasal mucosa of hypertrophied turbinates – an immunohistologic analysis
Published in Inhalation Toxicology, 2020
Meir Warman, Evelyn Tiomkin, Monica Huszar, Doron Halperin, Ilan Asher, Oded Cohen
The study cohort consisted of fifty-three patients, male and female, with inferior turbinate hypertrophy that underwent turbinate reduction at Kaplan Medical Center between 2014 and 2016. All patients were evaluated preoperatively in our department’s outpatient clinic. The patients were asked regarding the duration of nasal blockage symptoms, existence of comorbidities and prior medical treatments, such as intranasal steroids. All patients underwent a complete examination including anterior rhinoscopy and fiberoptic examinations of both sides to exclude the presence of nasal polyps or a neoplastic etiology mandating additional surgery. Patients were eligible for surgery if the attending physician was impressed by the severity of complaints, correlation of symptoms with physical examination findings (i.e. hypertrophied turbinates blocking the nasal air passage), and failure of alternative medical treatment. Turbinate reduction was carried out under general anesthesia in an operating room, using cold instruments, to allow for a specimen biopsy. Biopsies were sent in formalin solution for permanent fixation in the pathology lab.