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Jacquelynne P Corey

Publications and source records attributed to Jacquelynne P Corey.

13 recordsLinked to original sources
PubMed2007

Rhinitis in the elderly.

Very little has been published regarding rhinitis in the elderly. Changes in the nose due to aging include structural, hormonal, mucosal, olfactory, and neural effects. The effects of polypharmacy may contribute to causing congestion and dryness. Physicians should look for treatable causes of rhinitis such as allergic rhinitis or rhinosinusitis, and rule out neurodegenerative disorders if applicable. Treatments that may provide symptomatic relief include humidification and antiallergy therapies. Surgery for structural and skin conditions of the external nose may also provide relief in some cases. As the U.S. population ages and remains in overall better health, we may learn more about the effects of aging on rhinitis.

Aged↗
PubMed2006

Rhinitis in the elderly.

The effects of aging on the nose include structural, hormonal, mucosal, olfactory, and neural changes. As the US population ages and remains in overall better health, we will have more patients with rhinologic problems related to aging. In this manuscript, we review the available evidence on the structural and physiologic changes of the nose caused by aging, and we briefly describe management of common causes of rhinitis in the elderly.

Aged↗
PubMed2006

Acoustic rhinometry: should we be using it?

PURPOSE OF THE REVIEW: The purpose of this review is to examine the role of acoustic rhinometry in clinical practice. Although acoustic rhinometry was first described for clinical use in 1989, it is not in common use today. Should we be using it? Yes. I think we should be using it more often. This review provides an update of the new standard for interpretation and expanded clinical uses. RECENT FINDINGS: The most significant advances in the past year in this area have been the publication of standards for its clinical use. In addition, the repertoire of clinical problems that can be analyzed objectively with acoustic rhinometry has expanded to include turbinoplasty, sleep disorders, more types of cosmetic/reconstructive procedures, sinus surgery, vasomotor rhinitis, maxillofacial expansion procedures, and aspirin and methacholine challenge. (Its ability for pediatric disorders, such as adenoidectomy, has been reaffirmed.) Some case examples are included to demonstrate the utility of acoustic rhinometry for 'mixed' pathology. SUMMARY: Acoustic rhinometry is a rapid, objective, painless, noninvasive technique for assessing nasal airway obstruction. Recently, standards have been developed that aid its expansion for clinical use. Expanded clinical applications include sleep disorders, cosmetic/reconstructive and maxillofacial disorders, sinus and turbinate procedures, and pediatrics. Acoustic rhinometry should be utilized to improve our ability to practice evidence-based medicine in rhinology.

Adult↗
PubMed2004

Acoustic rhinometry and its uses in rhinology and diagnosis of nasal obstruction.

Acoustic rhinometry is a tool that can aid in the assessment of nasal obstruction. The test is noninvasive, reliable, convenient, and easy to perform. Common clinical and practical uses of acoustic rhinometry for the rhinologic surgeon include assessment of"mixed" nasal blockage, documentation of nasal alar collapse, and preoperative planning for reduction rhinoplasty. Acoustic rhinometry can also be used to document the positive effect of surgery on nasal airway obstruction.

Airway Resistance↗
PubMed2004

Quality of life in treatment of acute rhinosinusitis with clarithromycin and amoxicillin/clavulanate.

OBJECTIVES: Clarithromycin and amoxicillin/clavulanate (A/C) are first line antibiotics used to treat uncomplicated acute rhinosinusitis (ARS). This study examined the efficacy of clarithromycin and A/C for the treatment of ARS relative to the patient's quality of life (QOL). STUDY DESIGN: Twenty-two patients with uncomplicated ARS were randomly assigned treatment (single blinded relative to the investigator) using clarithromycin or A/C. Patients underwent assessment to confirm the diagnosis and treatment outcome at the initial screening and on completion of antibiotics (diagnosis + 14 days and 28 days). QOL was evaluated using the Allergy Outcomes Survey (AOS), the Rhinoconjunctivitis QOL Questionnaire (RQLQ), the Short Form 36 survey (SF-36), an instantaneous six-item Symptom Severity Survey (SSS-6), and a Visual Analogue Scale (VAS). Surveys were completed at the time of diagnosis, on completion of antibiotics, and at 28 days after diagnosis. RESULTS: Twenty patients completed the study. The SSS-6 and the RQLQ demonstrated significant improvement for all patients at week 4 (P =.002 and P =.003, respectively). The SSS-6 demonstrated significant improvement for clarithromycin at 14 days (P =.02) and at 28 days (P =.029), whereas A/C patients demonstrated significant improvement in symptoms only at 28 days (P =.046). The RQLQ, which reflects the previous 2 weeks, demonstrated significant improvement for the A/C patients at 28 days (P =.01). The Allergy Survey, the SF-36, and the VAS failed to demonstrate significant improvement in the combined data analysis. CONCLUSIONS: Clarithromycin and A/C were equally effective in treating ARS. The clarithromycin patients felt better more rapidly (at 14 days), but both groups of patients had long-term improvement in symptoms at 28 days.

Acute Disease↗
PubMed2004

Vasomotor rhinitis update.

PURPOSE OF REVIEW: This review was conducted to examine new data on vasomotor rhinitis, a common clinical problem. RECENT FINDINGS: Recent publications highlight advances in the study of the pathophysiology of vasomotor rhinitis. Electron microscopic and ultracytochemical evaluation of the nasal mucosa in vasomotor rhinitis demonstrates an emerging role of neuropeptides and nitric oxide in the pathogenesis of vasomotor rhinitis. Ozone, cigarette smoke, and other environmental factors may trigger neurogenic mechanisms that lead to vasomotor rhinitis. Objective tests have documented the presence of hypoactive sympathetic autonomic dysfunction. Such assessments also suggest autonomic dysfunction as a possible link between vasomotor rhinitis and gastroesophageal reflux disease. Recent publications propose nasal secretory protein analysis as a possible diagnostic tool. Evidence-based review of treatment outcomes shows topical sprays of azelastine, budesonide, and ipratropium to be of benefit in vasomotor rhinitis. SUMMARY: A better understanding of the role of nitric oxide and neuropeptides in the pathogenesis of vasomotor rhinitis has opened new avenues in research, diagnosis, and management. Clinical diagnosis may be aided by the analysis of nasal secretory proteins. Effective treatments include antihistamine, anticholinergics, and steroid nasal sprays.

Autonomic Nervous System↗
PubMed2004

A comparison of skin endpoint titration and skin-prick testing in the diagnosis of allergic rhinitis.

Among the many methods of allergy diagnosis are intradermal testing (IDT) and skin-prick testing (SPT). The usefulness of IDT has been called into question by some authors, while others believe that studies demonstrating that SPT was superior might have been subject to bias. We conducted a study to compare the validity of SPT and IDT--specifically, the skin endpoint titration (SET) type of IDT--in diagnosing allergic rhinitis. We performed nasal provocation testing on 62 patients to establish an unbiased screening criterion for study entry. Acoustic rhinometric measurements of the nasal responses revealed that 34 patients tested positive and 28 negative. All patients were subsequently tested by SET and SPT. We found that SPT was more sensitive (85.3 vs 79.4%) and more specific (78.6 vs 67.9%) than SET as a screening procedure. The positive predictive value of SPT was greater than that of SET (82.9 vs 75.0%), as was the negative predictive value (81.5 vs 73.0%). None of these differences was statistically significant; because of the relatively small sample size, our study was powered to show only equivalency. The results of our study suggest that the information obtained by the SET method of IDT is comparable to that obtained by SPT in terms of sensitivity, specificity, and overall performance and that both SET and SPT correlate well with nasal provocation testing for ragweed. Therefore, the decision as to which to use can be based on other factors, such as the practitioner's training, the desire for quantitative results, the desire for rapid results, and the type of treatment (i.e., immunotherapy or pharmacotherapy) that is likely to be chosen on the basis of test results.

Adult↗
PubMed2003

The role of leukotrienes in nasal allergy.

OBJECTIVE: This review focuses on the role of cysteinyl leukotrienes (cysLTs) in nasal allergy. The purpose was to provide knowledge of the role of cysLTs in the pathophysiology of nasal allergy and the role of antileukotrienes in the treatment of nasal allergies. Materials and methods We conducted a literature review. RESULTS: The proinflammatory effects of cysLTs have been well described in asthma. Antileukotrienes have proved to be an effective anti-inflammatory treatment for asthma patients. Similar to pathogenesis of asthma, cysLTs exert potent inflammatory effects in the upper airways and play a role in the pathogenesis of allergic rhinitis and other nasal allergies. CONCLUSION: Antileukotriene treatment appears to be beneficial in nasal allergies. Allergic rhinitis is a complex, IgE-mediated inflammatory disease of the upper airways. It is the most common allergic disease, occurring in 10% to 30% of adults and up to 30% of children. It may be perennial or seasonal. Sneezing, itching, watery rhinorrhea, and nasal obstruction are classic symptoms. It may impair cognition, school/work performance and productivity, behavior, mood, and quality of life. On physical examination, clear secretions, nasal congestion, pink-bluish nasal mucosa, the allergic salute, and allergic shiners may be detected. Allergic rhinitis is a common comorbid condition with asthma, sinusitis, otitis media, nasal polyposis, and respiratory infections.

Acetates↗
PubMed2002

Acoustic rhinometry findings in patients with mild sleep apnea.

BACKGROUND: Nasal obstruction may contribute to the development of obstructive sleep apnea (OSA). Acoustic rhinometry (AR) measures nasal patency and congestion, which are useful parameters in objectively evaluating nasal obstruction. The nasal obstruction produced by allergic rhinitis may contribute to the development of OSA and can be easily assessed with AR. OBJECTIVE: This study was undertaken to assess the degree of nasal obstruction seen in allergic patients with and without OSA. STUDY DESIGN AND SETTING: This study was a retrospective data analysis from a tertiary referral center. The AR data from 10 patients with and 40 patients without mild OSA were compared. RESULTS: The mean congestion factors at the first cross-sectional area (CSA1) on the AR graph were found to be significantly higher in the OSA group than in the non-OSA group (P = 0.03). The classification of change in congestion factors demonstrated significant differences at CSA1, CSA2, and CSA3 and in volume (t distributions <0.001, 0.0312, <0.001, and <0.001, respectively). The non-OSA patients noted a significant subjective improvement in nasal congestion after topical nasal decongestion, whereas the OSA patients did not (P <or= 0.0001 and 0.064, respectively). CONCLUSION: Although the role of nasal obstruction in OSA is controversial, our study lends evidence to the thought that the nasal obstruction associated with allergic rhinitis is associated with the presence of mild OSA. SIGNIFICANCE: Whether allergic rhinitis is a direct cause of OSA is debatable, but we have shown that greater nasal congestion is related to the presence of OSA in a population of patients with allergic rhinitis.

Adolescent↗
PubMed2002

An interpretation method for objective assessment of nasal congestion with acoustic rhinometry.

OBJECTIVES: Acoustic rhinometry is a relatively new modality for evaluating the status of the nose. It assesses the geometry of the nasal cavity by analyzing reflected sound waves. Despite its expanding use, there is no established interpretation method. Our aims in the present descriptive study were to develop and test a protocol as a possible method to read these graphs for clinical use. STUDY DESIGN: We formulated a reading protocol to grade the congestion state of the nasal cavity. The percentile difference of cross-sectional area and volume values between the baseline and decongested states were classified into five categories based on normative values. METHODS: Fifty-six patients with allergic rhinitis were used. All the acoustic rhinometry readings were performed in blinded fashion according to the protocol; later, the clinical information was paired with the interpretation of the graph. RESULTS: The mean percentile differences of baseline and decongestion values in patients with allergic rhinitis were in the mild to moderate range difference according to our reading system. The range of nasal congestion in patients with allergic rhinitis patients was increased with additional pathological conditions such as sleep apnea. CONCLUSION: The percentile difference between the baseline values and values for maximally decongested state reflect mucosal congestion as a "congestion factor," which can be graded as mild, moderate, severe, or markedly severe, for objective evaluation of nasal congestion.

Acoustics↗
PubMedDate not supplied

Physiological change in nasal patency in response to changes in posture, temperature, and humidity measured by acoustic rhinometry.

BACKGROUND: Acoustic rhinometry has been used to assess nasal patency and to calculate nasal cavity volume. This study used acoustic rhinometry to assess changes in nasal patency after alterations in posture, unilateral mechanical obstruction, temperature, and humidity. METHODS: Eight healthy adult volunteer subjects underwent acoustic rhinometry during the following conditions: (1) sitting position (control), (2) supine position, (3) left lateral recumbent position, (4) nostril unilaterally mechanically blocked, (5) ice pack on neck, (6) drinking cold water, (7) drinking hot water, (8) nasal nebulizer, and (9) oxymetazoline decongestant. RESULTS: Two distinct patterns emerged based on the total nasal cavity volumes in response to the decongestant. Subjects with initial unilateral nasal cavity volumes near the mean had an expected increase in total volume after the topical decongestant administration. There were two subjects with initial volumes of 1 SD above the mean that had a paradoxical decrease in total volume in response to the decongestant. In all subjects, there was a significant decrease in the volume of each of the nasal cavities in response to ingestion of hot water at 1 minute. There was a significant decrease in the volume of the smaller of the two nasal cavities in response to nebulizer treatment and hot water ingestion at 5 minutes. Total nasal cavity volume changes were not significant for any of the variables. CONCLUSION: Changes in nasal cavity volumes were detected by acoustic rhinometry after alterations in posture, unilateral mechanical obstruction, temperature, and humidity. Nebulizer treatment and hot water ingestion caused a significant decrease in nasal volume. The nose of a healthy patient was able to adapt to environmental and physiological changes to maintain a consistent total nasal volume within 15 minutes.

Adult↗