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Diagnosis of surgical sinusitis using nasal endoscopy and computerized tomography

Nass RL; Holliday RA; Reede DL
The ability to identify surgical sinus disease using diagnostic nasal endoscopy and coronal CT scanning of the paranasal sinuses is studied prospectively. Fifty consecutive patients with symptoms of chronic sinusitis lacking surgical indications by traditional work-up comprise the patient population. Sixty percent had endoscopic or CT indications for surgery. There was a 90% correlation between endoscopy and CT examination with the combined work-up being more accurate than either modality alone. Functional endoscopic sinus surgery was performed in 18 cases. There were no major complications. Approximately 89% of the postoperative group report significant improvement, with 55.6% reporting total relief of symptoms. A complete endoscopic sinus work-up can often identify surgically correctable sinusitis despite normal routine rhinoscopic and plain-film examination. It is therefore, warranted in those patients with a suggestive history
PMID: 2811555
ISSN: 0023-852x
CID: 10432

Rhinomanometric evaluation of two nasal steroid sprays in rhinitis

Kohan D; Jacobs JB; Nass RL; Gonzalez S
A prospective, randomized study comparing the effectiveness of two nasal steroid sprays, flunisolide and beclomethasone dipropionate, in the treatment of nasal obstruction associated with allergic or vasomotor rhinitis has been conducted at New York University Medical Center-Bellevue Hospital. All patients underwent routine history and physical examinations and a modified radioallergosorbent test. Paranasal sinus films were used to exclude patients with sinusitis. The Rhinotest microprocessor rhinomanometer was used to quantify pretreatment and posttreatment total nasal air flow and resistance during a period of 2 months. These findings were assessed in conjunction with the patients' subjective complaints. Results demonstrated that anterior rhinomanometric assessment of the nasal airway during inhalant therapy correlated well with the patients' own subjective impressions of nasal air flow. Both steroid inhalants were effective; however, flunisolide provided for earlier and more substantial symptomatic relief. Beclomethasone dipropionate had milder side effects
PMID: 2508019
ISSN: 0194-5998
CID: 10487

Neurilemoma of the trachea [Case Report]

Nass, R L; Cohen, N L
Neurilemomas of the tracheobronchial tree are exceedingly rare. In this article we report what is, to our knowledge, the 12th case--the third such case of tracheal origin. Clinical features are referable to airway obstruction and local pressure effects. The gross appearance is of an encapsulated lesion. Histologically, there is a proliferation of Schwann cells that are found in either an ordered, palisaded configuration (Antoni type A), or a disordered, loosely textured configuration (Antoni type B). The two types may coexist in a single lesion. Endoscopic removal of nonvascular tracheobronchial masses with follow-up, including periodic chest x-ray films, is advocated. Major surgery is reserved for malignant disease or benign disease not amenable to endoscopic excision.
PMID: 426712
ISSN: 0003-9977
CID: 578142