Fluoroscopically guided balloon dilation in treatment of complete obstruction of the nasolacrimal system was assessed in 39 eyes of 35 patients. All patients had severe epiphora. With nasal endoscopic guidance, a 0.018-inch guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and was pulled out through the nasal aperture with a hemostat. A deflated angioplasty balloon catheter was passed retrograde over the guide wire through the inferior meatus until it straddled the stricture. Balloons were dilated with water-soluble contrast medium. No major complications occurred. At 7 days after balloon dilation, epiphora decreased in 22 of 39 eyes; 17 demonstrated complete resolution of severe epiphora, and five showed incomplete resolution. At 2 months, improvement had not been maintained in 10 of the 22 eyes. This technique for treatment of complete obstruction of the nasolacrimal system is simple and safe, but the high failure and recurrence rates in this study are not encouraging.

To investigate possible effects of corticosteroids on polyp formation and local bacterial colonization, pneumococcal sinusitis was experimentally induced in rabbits pretreated with betamethasone or saline. After 7 days, macroscopic polyps were counted post-mortem and on histologic slides after serial sectioning. Histologic sections were also examined with light microscopy. Macroscopic polyps were significantly fewer in animals given betamethasone, while there was no difference regarding the number of microscopic polyps. Ingrowth of pathogenic microorganisms was found in five of eight rabbits given placebo but in none of the animals treated with corticosteroids (P < 0.05). The reduced number of pathogenic strains in these animals may be explained by a better-preserved local host defense. The lower number of macroscopic polyps in the same animals could be because of a delayed mucosal repair and subsequent polyp formation.

Previous reports suggest that cytokines may be involved in proliferation of the epithelium. The aim of this study was to determine the effects of cytokines, IL-1 beta, TNF-alpha, and TGF-beta on proliferation of human nasal epithelial cells (HNECs) in vitro. Primary cells were cultured from HNECs on collagen gel matrix. Subcultured HNECs were incubated in a medium with recombinant human (rh) cytokines, rhIL-1 beta, rhTNF-alpha, and rhTGF-beta at different concentrations of 0.01 ng/mL, 0.1 ng/mL, 1 ng/mL, 10 ng/mL, and 100 ng/mL. After 2-day incubation with these cytokines, daily cell proliferation was measured by MTT assay for 6 days. While rhIL-1 beta inhibited proliferation of HNECs in concentration-dependent and time-dependent manners, rhTNF-a stimulated HNEC growth at concentrations ranging from 0.01 ng/mL to 10 ng/mL in concentration-dependent and time-dependent manner. In contrast, rhTGF-b inhibited HNEC growth irrespective of concentration and incubation time. This study suggests that IL-1 beta, TNF-alpha, and TGF-beta may have an important role in the repair of the nasal mucosa by regulating proliferation of the nasal epithelium.

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