Clinical studies were performed to evaluate the role of the vidian nerve at onset of symptoms in nasal allergy. A localized area of one side of the nasal cavity was stimulated with known allergen and 0.1% histamine chloride in patients with perennial nasal allergy. The effect of unilateral vidian neurectomy and sensory anesthesia on glandular and vascular response was evaluated. With localized nasal stimulation, hyperrhinorrhea was seen in both sides of the nasal cavity before vidian neurectomy. Unilateral vidian neurectomy blocked hyperrhinorrhea only in that nasal cavity in which the nerve was sectioned. However, hyperrhinorrhea from the contralateral side, with an intact vidian nerve, was blocked with sensory anesthesia of the opposite side of the nasal cavity where the stimulation was applied. Nasal hypersecretion in allergic rhinitis was assumed to be mostly due to stimulation of sensory receptors by a chemical mediator and reflexive stimulation of the nasal glands. Vidian neurectomy, however, did not have any apparent influence on the swelling of the nasal mucosa caused by localized stimulation of allergen and histamine.

Acoustic analysis of snoring and the site of airway obstruction in sleep related respiratory disorders. Acta Otolaryngol (Stockh) 1998; Suppl 537: 47 -51.Seventy-five adult patients with sleep related respiratory disorders were examined by polysomnography with simultaneous recordings of the intraluminal pressure of the upper airway and snoring sound. Obstructed sites in the upper airway during sleep were determined by comparing the amplitude of respiratory fluctuation of the pressures in the epipharynx, mesopharynx, hypopharynx and esophagus. A definite correlation existed between the intensity of snoring sound and the amplitude of respiratory fluctuation of the intraesophageal pressure. Based on the results of the intraluminal pressure partitioning, the subjects were divided into the soft palate type (28), the tonsil/tongue base type (14), the combined type (27) and the larynx type (6). The average value of fundamental frequency (ff) was 102.8 9 34.9 Hz in the soft palate type, 331.7 9144.8 Hz in the tonsil/tongue base type, 115.79 58.9 Hz in the combined type and around 250 Hz in the larynx type.

Lack of the upper airway function after laryngectomy creates unfavorable effects on the lower respiratory tract. The purpose of this study is to re-evaluate this relationship objectively. Respiratory function tests were performed on 13 laryngectomized patients. Pulmonary volumetry and ventilometry revealed increased RV and FRC, and decreased FEV1.0%, indicating evidence of obstructive changes in the lung, MEFV-recordings showed greater downward convexity than those of the normal at the lower volume level. The value of MEF50/body-height was definitely smaller than normal average in the same age group. Pulmonary resistance was in wide variety but definitely lower than normal because of lack of the upper airway resistance. If this component is added to the value, the total will be in normal range or even higher. Dynamic compliance remained mostly in the normal range when measured using a mask at the tracheostoma. The value was lower than normal when measured through a cuff-canula. The difference in static and dynamic compliances was greater than that in normal cases, which may indicate evidence of uneven distribution of air in the lung. Regular check-up and suitable respiratory care are recommended on the laryngectomized.

The purpose of the present paper is to examine whether hypersensitivity of nasal mucosa observed in nasal allergy is cause or result of allergic reaction using the subjects with pollinosis in which the exposure period can be clearly distinguished. Subjects are 30 cases of Japanese cedar pollinosis and orchard grass pollinosis and 25 normal controls. Inferior turbinate of unilateral nasal cavity was stimulated by a piece of filter paper soaked with 0.02 ml of 0.1% and 0.5% histamine hydrochloride. Frequency of sneezing and amount of nasal secretion were measured quantatively and were compared among the subjects with pollinosis in season, off season, and normal controls. In subjects with pollinosis when stimulated with extrinsic histamine, frequency of sneezing and amount of nasal secretion were markedly enhanced in season, but during off season no apparent difference was observed compared with normal subjects. Relationship between frequency of sneezing and amount of nasal secretion indicated positive correlation (alpha less than 0.01). Positive correlation was also observed in amount of nasal secretion in ipsilateral and contralateral nasal cavity when unilateral nasal cavity was stimulated with histamine (alpha less than 0.01). Hyperrhinorrhea was closely related with hypersensitivity of nasal mucosa. The present study showed that hypersensitivity of nasal mucosa characteristic of nasal allergy is nonspecific and that it is largely a result of antigen antibody reaction, which in turn works in causing exaggeration of the allergic symptoms and allergic reaction through vicious cycle.

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