Patients with sleep-disordered breathing including forty patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), aged 21 to 69 years (35 men and 5 wemen), underwent septoplasty with submucosal inferior turbinectomy (ER) consisting of a septoplasty and submucosal inferior turbinectomy with lateral displacement. Three months later, the postoperative effect of the ER was evaluated using polisomunography without electroencephalography, the Epworth sleepiness scale (ESS), rhinomanometry, and the SF36v2 questionnaire for evaluating quality of life. The indexes of apnea, hypopnea, apnea-hypopnea, and ESS as well as snoring (as evaluated using a visual analogue scale) all improved significantly.

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Patients with postnasal drip syndrome occasionally feel the uncomfortable and intractable sensation of foreign body in the nasal cavity. It is assumed that the cause of such sensation is mainly from chronic sinusitis or allergic rhinitis. Because the incidence of postnasal drip due to allergic rhinitis has not been considered to be clinically significant, no detailed examinations of such cases have so far been carried out. However, it is recognized that patients with allergic rhinitis often complain the subjective symptoms of postnasal drip and show deterioration the degree of quality of life. We therefore consider that postnasal drip symptoms in allergic patients are clinically important.
We herein conducted a clinical study on nine allergic patients who chiefly complained postnasal drip. We evaluated effectiveness of administration of leukotriene receptor antagonists for the treatment of postnasal drip symptoms in those patients. The subjective symptoms as evaluated by VAS scales remarkably improved in due course. Twelve weeks after treatment, improvement rates of the subjective symptom scores and objective measure were 88.9% and 88.9%, respectively. Based on our findings, it is suggested that several action of leukotrienes might be closely associated with the onset and prolongation of postnasal drip.

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Allergy-related diseases such as pollinosis are a significant public-health issue. In Japan, where persons with allergic rhinitis are increasing annually, especially among children. We studied the prevalence of allergic rhinitis sensitization among those under 15 years old. We examined it for 171 patients-107 boys and 64 girls- aged 2 to 15 years showing performed serum-specific IgE antibodies in the CAP-radioallergosorbent test between 2000 and 2008. Senstivity to for house dust was 77.8%, to dermatophagoides farinae 69.6%, to Japanese cedar 55.0%, and to animal antigen was 50.3%.
Among those tested the 50% of without dermatophagoides farina antibody has Japanese cedar antibody, while 19% of those with Japanese cedar antibody had no dermatophagoides farina antibody. Japanese cedar sensitization thus does not depend on dermatophagoides farina.
These findings underscore the importance of developing a way to protect children against Japanese cedar sensitization.

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A rare example of a malignant peripheral nerve sheath tumor (MPNST) arising in the right nasal cavity is reported. A 38-year-old woman was admitted for surgery to remove a progressively enlarging mass in the right nasal cavity. Following detailed imaging studies, the tumor was resected endoscopically.
Based on the proliferation of spindle-shaped cells showing distinct nuclear atypia and positivity for S-100, vimentin, bcl-2, and p53, the tumor was definitively diagnosed as an MPNST. The woman showed no clinical manifestation of neurofibromatosis, and has had no apparent recurrence or metastasis in the year since surgery. The MPNST is typically highly aggressive and, unless completely resected, local recurrence tend to be relatively quick. Fortunately, MPNST in the present case appears to have been a of relatively-low grade malignancy.

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We report a case of oncocytic Schneiderian papilloma confined to the maxillary sinus and initially detected using positron emission tomography with 18F-fluorodeoxyglucose (FDG-PET) at a very early stage. A 77-year-old man was based on computed tomography and magnetic resonance imaging findings, suspected of having a benign tumor, but positive FDG-PET uptake suggested malignancy. The tumor was resected via a Caldwell-Luc approach, and the histopathological diagnosis was oncocytic Schneiderian papilloma.
Although we found FDG-PET to be highly useful in detecting hidden tumorous lesions, it was not entirely so in differentiating between benign and malignant tumors.

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We analyzed the results of a questionnaire on intranasal/peroral medication against nasal allergy given to subjects with seasonal allergic rhinitis treated by otorhinolaryngologists from January to May 2009. Valid responses were obtained from 273 patients (108 men and 165 women). Epinastine hydrochloride showed high drug compliance (93%) and satisfaction (76%). Many patients prefered peroral medication (61%) over internasal medication. Administration frequency for intranasal spray to treat nasal allergy varied from once (36%) to twice (36%) a day and others (28%). These results provided information useful to otorhinolaryngologist in devising better strategies in nasal allergy therapy.

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Nasal obstruction is the major symptom in patients with allergic rhinitis, which has become a health problem in Japan. Dilated nasal mucosal blood vessels and enhanced capillary permeability occurs due to the direct action of chemical mediators such as leukotrienes (LTs), thromboxane (TX), prostaglandins (PGs) and platelet-activating factor (PAF). Vasodilatation is also due to neural reflexes through the nucleus and by release of chemical mediators and inflammatory proteins from inflammatory cells. The precise action of such chemical mediators remains unclear, and it appears to be important to determine the direct effect of such mediators and their functions. We studied the nasal mucosal blood vessel response to chemical mediators using an in vitro muscle tension detector and nasal mucosa specimens from guinea pigs and humans. We conducted an in vitro bioassay of responses to LTD₄, TXA₂, PGD₂, and PAF. LTD₄, TXA₂ and PAF showed only a contractile response. The dilation response occurred in human nasal mucosa reacting to PGD₂, suggesting that PGD₂ is involved in nasal obstruction. A specific differences in chemical mediators' response were thus observed, and that of guinea pigs resembled that of humans closely enough to substitute the nasal guinea pig mucosa for that of human beings. Individual receptor antagonists showed antagonism toward corresponding chemical mediators, which are apparently highly involved in the development of allergic rhinitis. It is therefore important to further clarify mediator mechanisms.

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