Objective: To report the association of acquired nasolacrimal duct obstruction and orbital cellulitis in patients with a history of chronic intranasal cocaine abuse. Methods: Retrospective, consecutive case series. Results of imaging, histopathologic examinations, and clinical courses of these patients were studied. Results: Five women and 2 men (mean age, 41 years) with a history of chronic intranasal cocaine abuse (mean, 11 years; range, 5-20 years) presented with epiphora and in some cases acute onset ofperiorbital pain, edema, and erythema associated with fever. The suspicion of intranasal cocaine abuse was made on anterior rhinoscopy with the detection of an absent nasal septum and inferior turbinate. Computed tomographic and magnetic resonance imaging findings in 4 patients included extensive bony destruction of the normal orbital wall architecture, opacification of the sinuses, and the presence of an intraorhital tissue mass. Histopathologic examination of the nasolacrimal duct in 2 patients and of the orbital mass in a third patient revealed marked chronic inflammation with fibrosis causing secondary nasolacrimal duct obstruction. Six patients were treated with systemic antibiotics followed by dacryocystorhinostomy in 3 patients, and a pericranial flap to insulate the exposed orbit in 1 patient. Conclusions: Chronic intranasal cocaine abuse can result in extensive bony destruction of the orbital walls with associated orbital cellulitis, and should be included in the differential diagnosis of acquired nasolacrimal duct obstruction. Anterior rhinoscopy is very helpful in establishing the correct diagnosis in these patients.

Nasolacrimal duct obstruction and orbital cellulitis associated with chronic intranasal cocaine abuse

Introduction: Due to the close anatomic relationship between paranasal structures and NLC, the morphometric measure of the nasolacrimal canal (NLC) could be affected by the osteomeatal complex (OMC) anatomical variations. The present study aimed to assess the effect of OMC variations on the NLC morphometric features using cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study consisted of CBCT images of 150 subjects in the case group with at least one OMC variation and 40 cases in the control group without any OMC variation within the age range of 18-50 years. The presence of the OMC variations, including agger nasi, nasal septum deviation, concha bullosa, Haller cells, paradoxical middle turbinate, and pneumatization of the uncinate process, was evaluated in each patient. The NLC morphometric measurements were performed and compared between the case and control groups. Results: The middle anteroposterior diameter and middle sectional area of NCL were significantly higher in patients with OMC variations, as compared to that in the control group. The NLC volume was significantly higher in patients with agger nasi, nasal septum deviation, concha bullosa, and pneumatization of the uncinate process, as compared to that in the control group. Nonetheless, no significant difference in NLC angulation with the nasal floor or Frankfurt horizontal plane was observed in the presence of each OMC variation. Conclusions: As evidenced by the obtained results, a higher volume of the canal was revealed in the presence of some of the OMC variations. Therefore, it can be suggested that OMC variations cannot be a predisposing factor in cases with primary acquired nasolacrimal duct obstruction.

Are Osteomeatal Complex Variations Related to Nasolacrimal Canal Morphometry?

The paper describes the results of an experimental study of a polyurethane material treated by ion implantation technology. The problems of crack growth in the near-surface layer carbonized by ion treatment were investigated using digital optical microscopy. The methods of atomic force microscopy allowed studying the possibility of carbonized layers delamination from the substrate. As a result, the technology for the production of a multilayer polyurethane material with nanofillers (nanotubes, nanodiamonds, fullerenes, graphenes) and its optimal modification by ion implantation treatment was developed, which makes it possible to improve the biocompatibility of polyurethane implants with human tissues.

pdf/crack-resistance-of-carbonized-layer-of-multilayer-428hm1837b.pdf

Crack resistance of carbonized layer of multilayer polyurethane with nanofillers. Combination of casting, solution, carbonization by ion implantation technologies

Abstract Background To determine the paranasal changes and inflammatory markers that may cause primary acquired nasolacrimal duct obstruction (PANDO) and to determine their relationship with success rates on different types of surgeries. Main body We retrospectively reviewed the blood sample and computed tomography (CT) results on 92 patients who underwent dacryocystorhinostomy (DCR) surgery for PANDO and 82 healthy controls. Age, gender, paranasal abnormalities, hemogram values, International Normalized Ratio (INR) values, type of surgery, and recurrence rate were recorded; systemic Immune-inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), monocytes-to- lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) were calculated in both groups. In the case group, total white blood cells, monocytes, and INR values were significantly lower ( p &lt; 0.05). Platelet, lymphocyte, neutrophil, PLR, MLR, NLR, and SII values did not differ significantly between the control and case groups ( p &gt; 0.05). There was no significant difference in the CT results between the groups ( p &gt; 0.05). No correlation was found between CT findings and inflammatory markers. Dacryocystitis (DC) was seen in 20% of patients and they were all in the case group. No correlation was found between recurrence rate and age, gender, type of surgery, CT findings, and blood results ( p &gt; 0.05). The recurrence rate was significantly higher in patients with bilateral PANDO and with DC ( p &lt; 0.05). Short conclusion The incidence of PANDO may not be directly related to paranasal abnormalities and systemic inflammation. Low INR values may cause obstruction in the nasolacrimal duct. Age, gender, type of surgery, CT findings, and inflammation level do not affect the success of the surgery. 

Role of paranasal abnormalities and systemic inflammation on primary acquired nasolacrimal duct obstruction

Objective: In this study, the role of lateral nasal wall and sinus pathologies in the etiology of distal lacrimal duct disease has been investigated. Methods: Seventeen female and 11 male patients who were scheduled for endoscopic endonasal dacryocystorhinostomy and silicon tube intubation between April 1999 and September 2003 were included in the study. The patients underwent general ophthalmologic examinations such as Schirmer test, fluorescein dye disappearance test, Jones I-II tests, canalicular irrigation, canalicular probing, dacryocystography, dacryoscintigraphy for the diagnosis of lacrimal duct obstruction. In the clinics of ENT, for the detection of nasal cavity pathologies, anterior rhinoscopy and diagnostic nasal endoscopic examinations were performed. All patients were evaluated during paranasal computed tomographic examinations regarding osteomeatal complex disease, ethmoid cell opacification, concha bullosa and presence of agger nasi cells and data obtained were compared with findings of 50 control subjects using Fisher’s chi-square tests. Results: On the side where lacrimal duct obstruction exists, agger nasi cells were detected in 17 (60.7%) patients, concha bullosa in 10 (35.7%) patients, ethmoid cell opacification in 6 (21.4%) patients, osteomeatal complex disease in 4 (14.2%) patients, and one or more than one symptom were detected in 21 (75%) patients. Despite higher number of lateral nasal wall and sinus pathologies in the study group when compared with the control group, intergroup difference was not statistically significant (p>0.05). Conclusion: We have concluded that despite the higher rates of lateral nasal wall and sinus pathologies in patients with distal nasolacrimal system obstruction, its etiology has not been adequately expounded and paranasal computed tomographies will have increasing importance in the evaluation of these patients.

/pdf/examination-of-lateral-nasal-wall-pathologies-associated-22ggidryzt.pdf

Examination of lateral nasal wall pathologies associated with distal lacrimal duct obstruction

Methods: Thirty two patients with distal lacrimal system pathology who underwent endonasal endoscopic DCR surgery in the Ear Nose and Throat Clinic were examined with endoscopy and their computed tomographies were evaluated for the nasal and paranasal pathologies. These findings were compared with 50 healthy subjects’ physical examination and computed tomography results. During the DCR operation patients were re-evaluated peroperatively for the nasal pathologies to be corrected if necessary. Results: No statistically significant difference was detected for the nasal septal deviation, agger nasi, concha bullosa, osteomeatal complex or ethmoid pathologies.

http://turkarchotolaryngol.net/sayilar/55/buyuk/110-3.pdf

Evulation of Intranasal Anatomy and Pathologies in the Etiopathogenesis and Treatment of Nasolacrimal Duct Obstruction

Evulation of Intranasal Anatomy and Pathologies in the Etiopathogenesis and Treatment of Nasolacrimal Duct

/pdf/hydrogel-composition-for-modification-of-synthetic-vascular-2ytf2jg5.pdf

Hydrogel composition for modification of synthetic vascular implants

Objective. To study the resistance to medication washout from textile woven vascular prostheses with various types of polymer coatings experimentally.Materials and methods. Samples of a textile woven vascular prosthesis completely covered with one of three types of hydrogel coatings were examined. The resistance to washout of 1 % vancomycin and 0.2 % linezolid from the coatings was assessed by the magnitude of the antibacterial activity of the samples. The research methods were: disc diffusion and according to the ability to suppress the visible growth of Staphylococcus aureus ATCC 25923 (S. аureus) in Muller- Hinton broth.Results. All the samples of the textile woven vascular prosthesis with the coatings soaked for 30 minutes in 1 % vancomycin or 0.2 % linezolid solutions inhibit the growth of S. аureus culture on the surface of the agar, which leads to the formation of optically transparent sterility zones at the polymer-medium interface. The size of the sterility zone without washout is larger for all linezolid coatings. However, in 7 day washout, the size of the sterility zones is larger for all vancomycin coatings.Conclusion. Textile woven vascular prostheses with various types of polymer coatings and antibiotic vancomycin (1 %) are statistically significantly more resistant to washout during 7 days than with linezolid (0.2 %). The presence of L-aspartic acid in polymer coatings statistically significantly increases the resistance to antibiotic washout compared to hyaluronic acid, and the presence of polyvinylpyrrolidone statistically significantly reduces the resistance to antibiotic washout from polymer coatings.

/pdf/experimental-approbation-of-polymer-coatings-of-textile-2joaz6ke.pdf

Experimental approbation of polymer coatings of textile vascular prosthesis with prolonged antibacterial activity

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