Impact of Intraoperative Hydrodebrider Treatment on Postoperative Sinonasal Inflammation

Banglawala, Sarfaraz M.; Mulligan, Jennifer K.; Psaltis, Alkis J.; Wang, Eric; Nguyen, Shaun A.; Mulligan, R. M.; Crosby, Brittany; Schlosser, Rodney J.

doi:10.2500/ajra.2014.28.4073

Cited by 5 publications

(5 citation statements)

References 19 publications

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“…We used a hydrodebrider to remove the allergic mucin and pathologic mucosa, as it has been proven effective in removing clusters of fungi in the paranasal sinus mycosis or biofilms evident in the paranasal sinusitis [23]. It has also been reported that surgical operation using a hydrodebrider results in postoperative effects on cytokines [24], which suggests it is a useful device for the treatment of intractable AFS.…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Allergic Fungal Sinusitis with Differing Postoperative Course

Matsumoto

Yokoi

Kawada

et al. 2019

Case Reports in Otolaryngology

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Allergic fungal sinusitis (AFS) often develops in unilateral paranasal sinuses, which must be differentiated from tumors. When AFS develops on both sides, however, it must be differentiated from eosinophilic chronic sinusitis with evident eosinophilic infiltration at nasal/paranasal sinus mucosa; both conditions are highly recurrent and commonly considered intractable paranasal sinusitis. Surgical correction is the primary treatment method for AFS, as it is essential to connect the paranasal sinus communication to ensure exhaustive resection of the pathologic mucosa and for nasal steroids to reach each paranasal sinus. We recently encountered two AFS cases with differing postoperative courses. Case 1 showed evident exacerbation in the computed tomography findings, which suggests progression to eosinophilic sinusitis. Case 2 showed a benign prognosis without recurrence. Close long-term follow-up should be mandatory after surgery for the treatment of AFS.

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Section: Discussionmentioning

confidence: 99%

Two Cases of Allergic Fungal Sinusitis with Differing Postoperative Course

Matsumoto

Yokoi

Kawada

et al. 2019

Case Reports in Otolaryngology

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“…Additionally, an earlier pilot study from our group found decreased postoperative levels of IL-17A when an intraoperative hydrodebrider sinus irrigation system was used in CRS mixed patients. 55 These findings combined show the impact nasal mucus may have in deciding aggressive upfront surgery as well as acute versus chronic postoperative management.…”

Section: Nasal Lavagementioning

confidence: 97%

Utilization of Nasal Mucus to Investigate the Pathophysiology of Chronic Rhinosinusitis

Parra-Ferro

Justice

Lobo

et al. 2022

Am J Rhinol�Allergy

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Background Nasal mucus is proving to be a useful means by which to study the pathogenesis of chronic rhinosinusitis (CRS). Given the increase in publications examining nasal mucus and the lack of a review on this topic, we will focus on this noninvasive approach to studying CRS. Particular attention will be drawn towards inflammatory cytokines and biomarkers and their influence on disease severity. Methods A literature review of papers published in English pertaining to nasal mucus was performed using the PubMed database. The search utilized combinations of the following keywords: sinusitis, polyps, sample collection, nasal mucus, or nasal secretion. Studies solely on acute or bacterial sinusitis, allergic rhinitis, or cystic fibrosis were not included. Results A wide variety of materials and methods have been used to collect nasal mucus. Numerous assay types have been performed with the most common being ELISA, cytometric bead array, and proteomics. Most studies have focused on examining the levels of Th1/Th2 cytokines along with chemokines associated with type 2 immunity. Other factors identified include growth factors, senescence-associated proteins, complement, and antimicrobial defenses have also been identified. Nasal mucus cytokines have proven useful in cluster analysis and predicting postoperative improvement in Sino-nasal Outcome Test (SNOT-22) scores. One limitation of the use of nasal mucus is that some studies have suggested that nasal mucus does not always reflect the tissue microenvironment. Conclusions Nasal mucus represents a critical tool by which to examine the sinonasal microenvironment in a noninvasive manner. Unlike studies of tissue, it can be utilized in both surgically and medically managed patients and avoids the trauma of biopsies. However, studies are still needed to determine the most effective method for nasal mucus collection. Studies should also take care to confirm that nasal mucus markers do, in fact, reflect the levels of the product studied in the tissue.

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“…These shearing forces have been shown to disrupt biofilm adherence to sinonasal mucosa. Furthermore, this effect seems to be greater when the hydrodebrider is used in conjunction with a topical surfactant [12,23,24]. In vivo studies, however, have shown less promising results.…”

Section: Topical Treatmentsmentioning

confidence: 99%

“…In vivo studies, however, have shown less promising results. Ultimately, a larger randomized trial is needed to truly find the full positive or negative effects of the hydrodebrider on clinical outcomes [24].…”

Section: Topical Treatmentsmentioning

confidence: 99%

Tips and tricks for management of the dysfunctional maxillary sinus

Chung¹,

Halderman²

2022

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of reviewTo review the various factors associated with the most common cause of maxillary sinus dysfunction; recalcitrant chronic maxillary sinusitis (RCMS). In addition, available medical and surgical management options are discussed along with various tips and tricks for optimal management.Recent findingsDefects in mucociliary clearance, immunodeficiency, anatomic factors, and infectious etiologies have been implicated in dysfunction of the maxillary sinus leading to RCMS. Medical management including oral antibiotics or topical drugs have shown varying degrees of success. Endoscopic modified medial maxillectomy (EMMM) has been shown to significantly improve symptoms in patients with RCMS.SummaryA dysfunctional maxillary sinus presents a clinical challenge. A thorough evaluation of any potential contributing factors must be done in addition to an assessment of the adequacy of prior surgical treatment of the maxillary sinus. Beyond the middle meatal antrostomy, EMMM can be used to effectively address RCMS. In cases that fail EMMM, removal of the condemned mucosa to encourage auto-obliteration of the sinus can be considered.

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Impact of Intraoperative Hydrodebrider Treatment on Postoperative Sinonasal Inflammation

Abstract: Intraoperative HSI at the time of ESS failed to establish any improvement in postoperative endoscopy or most local cytokine levels after ESS.

Cited by 5 publications

References 19 publications

Two Cases of Allergic Fungal Sinusitis with Differing Postoperative Course

Two Cases of Allergic Fungal Sinusitis with Differing Postoperative Course

Utilization of Nasal Mucus to Investigate the Pathophysiology of Chronic Rhinosinusitis

Tips and tricks for management of the dysfunctional maxillary sinus

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