Maxillary sinusitis as an indicator of respiratory health in past populations

Chronic infectious respiratory disease in a past human population is investigated through the quantification of maxillary sinusitis among Iroquoian horticulturists. Three hundred forty-eight right and left maxillae of a Southern Ontario Iroquoian skeletal sample, Uxbridge Ossuary, ca. AD 1440, were examined for evidence of chronic infection (minimum number of individuals = 207: 114 adults, 22 adolescents, 38 juveniles and 33 infants). Modern clinical criteria were applied to differentiate lesions of respiratory and dental origin. Osseous lesions of the maxillary sinuses were observed in 50% of the individuals examined. These lesions are morphologically consistent with nonspecific lesions observed in other past populations that have been attributed to the presence of pathogens. The prevalence of maxillary sinusitis increases with age. Osseous changes suggestive of maxillary sinusitis of respiratory origin are at a maximum prevalence in juveniles and adolescents. In adults, infection of dental origin becomes a confounding factor in the identification of sinusitis of respiratory origin. Fifteenth century Iroquoians were experiencing high airborne pathogen levels and poor indoor air quality. The prevalence of maxillary sinusitis and the exploration of the origin of tissue injury may contribute to our reconstruction of the quality of life and the respiratory health status of past human populations.     

Microflora of nasal mucosa in patients with maxillar sinusitis

Quantitative and qualitative composition of microflora of nasal mucosa as well as carriage of staphylococci was assessed in patients with chronic and acute forms of maxillary sinusitis. Changes in microflora of nasal mucosa and presence of pathogenic and persistence-associated characteristics of staphylococci in both forms of maxillary sinusitis were revealed. Increase of resistance staphylococci to antibiotics in patients with chronic form of maxillary sinusitis was shown.     

Immunity features in patients with upper respiratory tract disease caused by Chlamydia

Comparative analysis of results of clinical and laboratory evaluation of patients with chronic nasal or nasal sinuses' diseases (chronic rhinitis or maxillary sinusitis) associated or not associated with Chlamydia infection was performed. It was shown that in patients infected with Chlamydia, along with unidirectional changes typical for all patients irrespective from presence or absence of Chlamydia, the features of immune response against these infectious agents take place.     

不同手术方式治疗慢性鼻-鼻窦炎对上颌窦黏膜纤毛传输功能的影响

目的:比较不同手术方式治疗慢性鼻-鼻窦炎的疗效及其对上颌窦黏膜纤毛传输功能的影响,为临床制定治疗慢性鼻-鼻窦炎的优选术式提供参考依据。方法:选取2013年9月-2014年12月于本院耳鼻咽喉科就诊的160例确诊为慢性鼻-鼻窦炎的患者作为研究对象,将其随机分为4组,分别为治疗组1~4,每组各60例。治疗组1接受上颌窦自然开口扩大术,治疗组2接受上颌窦开窗术,治疗组3接受经泪前隐窝上颌窦开放术,治疗组4接受上颌窦口球囊扩张术。观察和比较4组患者的术后鼻腔黏膜的覆盖、水肿、囊泡形成、骨质暴露、瘢痕形成等情况,上颌窦窦腔内分泌物性状、蓄积情况以及术后3个月和6个月时行上颌窦腔糖精实验及窦口周黏膜活检情况。结果:四组手术后均取得较好临床疗效,而组4的临床总有效率显著高于其他三组(均P0.05)。术后3、6个月,组4Lund-Kennedy评分和MMT时间均明显低于其他三组(均P0.05);在上颌窦黏膜活检方面:术后炎性细胞数量及状细胞和黏膜下腺体细胞形态及黏膜下结构水肿改善程度亦在中组四最为显著(P0.05)。结论:上颌窦窦球囊扩张术治疗慢性鼻-鼻窦炎疗效较高,可有效改善状细胞和黏膜下腺体细胞形态及鼻窦黏膜水肿、窦口通畅引流等作用,且安全性高。     

Maxillary sinusitis in Medieval Chichester,England

Maxillary sinusitis is a common medical complaint, affecting more than 30 million people per year in the United States alone. Very little palaeopathological work on this disease has been carried out, probably because of the enclosed nature of the sinuses in intact skulls and the lack of a suitable method for examination. This study tested the hypothesis that maxillary sinusitis was more common in people with leprosy than in people without it in Medieval England. The prevalence of maxillary sinusitis by age and sex was recorded in 133 individuals, some diagnosed as being leprous, derived from a later Medieval (12th to 17th centuries AD) urban hospital population at Chichester, Sussex, England using both macroscopic and endoscopic methods of examination. Of the 133 individuals with one or both sinuses available for examination, 54.9% (73) had evidence of bone change within the sinuses. There was no difference in prevalence between those with leprosy and those without, although clinical studies suggest that over 50% of lepromatous leprous individuals may develop sinusitis. Comparison with another study on Medieval British sites with a 3.6% prevalence (3 of 83) indicates that the prevalence at Chichester is much greater. The problems with diagnosing sinusitis are addressed and reasons behind the high frequency in this study are discussed. Aetiological factors predisposing to maxillary sinusitis are considered with reference to possible environmental conditions prevailing in the later Medieval period in Britain. © 1995 Wiley-Liss, Inc.     

黑水国遗址汉代人群的上颌窦炎症

上颌窦是位于鼻腔周围最大的骨质腔,由于其所处位置及结构的特殊性,相比额窦、筛窦、蝶窦,上颌窦更容易受到感染产生炎症反应,因此上颌窦炎是现代社会最常见的炎症性疾病之一。通过对黑水国遗址汉代人群上颌窦的观察,发现该墓地中有40.5%的个体上颌窦内出现骨形态的改变,以穗状骨片为主。女性上颌窦炎出现率远高于男性,但无统计学上的显著差异,男性上颌窦炎左侧出现率高于右侧,女性右侧高于左侧。按照不同的年龄段划分,从未成年期到中年期上颌窦炎的出现率随着年龄的增长而增长,但是通过二元逻辑回归检验,发现上颌窦炎与年龄之间并无统计学上的显著意义。在患有上颌窦炎的个体中,有66.7%的个体都出现了牙周病,一半以上的个体出现了龋齿。这似乎预示着上颌窦炎与牙齿疾病之间有着一定的联系。张掖黑水国遗址汉代人群上颌窦炎的高出现率可能是多因素导致的结果,包括寒冷干燥的气候环境、空气污染、牙齿疾病以及病原微生物等。     

The maxillary sinus of Paradolichopithecus sushkini (late Pliocene, southern Tajikistan) and its phyletic implications

Paradolichopithecus sushkini is a large fossil cercopithecine from the late Pliocene discovered at Kuruk-Say, southern Tajikistan. Despite its rather long face and large size, many authorities regard Paradolichopithecus not as a baboon, but as a large macaque, mainly based on the cranial morphology of European specimens. Among Old World monkeys, macaques are the only species that possess a maxillary sinus. Thus, we evaluated the presence/absence and morphology of this feature in P. sushkini using computed tomography (CT) scans of two Kuruk-Say cranial specimens in order to assess this species' taxonomic affinities. One of the specimens shows a thin bony wall separating a small area from the nasal cavity. Posterior to this structure is a pair of bony ridges: one protrudes from the alveolar process and the other descends from the superior portion of the nasal wall. A similar configuration was detected in the other specimen. These features strongly suggest the presence of a maxillary sinus in this species. This interpretation is supported by the fact that the superior portion of the alveolar process is excavated in the adult specimen. Thus, both specimens exhibit a maxillary sinus expanding laterally to share the external thin wall of the muzzle, and such a configuration may depend on the reduction of the maxillary bone, i.e., the presence of a maxillary fossa. The Kuruk-Say specimens probably retained a small maxillary sinus, despite the reduced size of the maxillary body. Thus, based on this evidence, P. sushkini probably belongs to the macaque lineage rather than that of baboons, although structural influences of the maxillary fossa leading to formation of the maxillary sinus have yet to be evaluated in extant macaques and baboons.     

Extreme climate,rather than population history,explains mid‐facial morphology of northern asians

Previous studies have examined mid‐facial cold adaptation among either widely dispersed and genetically very diverse groups of humans isolated for tens of thousands of years, or among very closely related groups spread over climatically different regions. Here we present a study of one East Asian and seven North Asian populations in which we examine the evidence for convergent adaptations of the mid‐face to a very cold climate. Our findings indicate that mid‐facial morphology is strongly associated with climatic variables that contrast the temperate climate of East Asians and the very cold and dry climate of North Asians. This is also the case when either maxillary or nasal cavity measurements are considered alone. The association remains significant when mtDNA distances among populations are taken into account. The morphological contrasts between populations are consistent with physiological predictions and prior studies of mid‐facial cold adaptation in more temperate regions, but among North Asians there appear to be some previously undescribed morphological features that might be considered as adaptive to extreme cold. To investigate this further, analyses of the seven North Asian populations alone suggest that mid‐facial morphology remains strongly associated with climate, particularly winter precipitation, contrasting coastal Arctic and continental climates. However, the residual covariation among North Asian mid‐facial morphology and climate when genetic distances are considered, is not significant. These findings point to modern adaptations to extreme climate that might be relevant to our understanding of the mid‐facial morphology of fossil hominins that lived during glaciations. Am J Phys Anthropol 153:449–462, 2014. © 2013 Wiley Periodicals, Inc.     

Comparative study of the prevalence of maxillary sinusitis in later Medieval urban and rural populations in Northern England

Six hundred sixty-three Medieval individuals from Wharram Percy, a rural settlement in the Yorkshire Wolds, and 1,042 individuals from St. Helen-on-the-Walls, a poor parish in the Medieval city of York, were examined in order to test the hypothesis that maxillary sinusitis would be more prevalent in an urban population due to social and environmental conditions characteristic of an industrialized settlement. The results showed that the individuals from St. Helen-on-the-Walls, living in the urban environment, had a greater prevalence of maxillary sinusitis than the rural population; 39% (106) of the individuals from Wharram Percy had evidence of sinusitis compared to 55% (134) of the individuals from St. Helen-on-the-Walls. It is suggested that this pattern may be attributed to occupation and industrial air pollution in the Medieval city of York. © 1995 Wiley-Liss, Inc.     

真菌球型上颌窦炎鼻内镜下两种手术路径的临床研究

目的:比较鼻内镜下中鼻道联合下鼻道小视窗双路径术和单独下中鼻道开窗术治疗真菌球型上颌窦炎的临床疗效。方法:采用前瞻性随机对照试验,将2013年8月~2015年5月在我院择期行手术治疗的50例真菌球型上颌窦炎患者分为观察组与对照组,每组25例,对照组行鼻内镜单独下中鼻道开窗术,观察组在对照组的基础上联合下鼻道小视窗术。术前及术后6个月采用鼻腔鼻窦结局测试20条量表(SNOT-20)对两组患者进行评分,术后6个月对鼻黏膜纤毛清除功能及疗效进行评估,比较两组手术时间及术中出血量。结果:术后6个月两组SNOT-20量表评分显著低于术前,且观察组显著低于对照组(P0.05)。术后6个月观察组粘膜纤毛传输时间(MTT)显著低于对照组(P0.05)。两组总有效率、手术时间及术中出血量比较,差异均无统计学意义(P0.05)。结论:鼻内镜下以上两种手术路径治疗真菌球型上颌窦炎的疗效相近,但鼻内镜下中鼻道联合下鼻道小视窗双路径术更有利于减轻患者症状及促进鼻黏膜纤毛清除功能恢复。     

Geographic patterns of craniofacial variation in pre-Hispanic populations from the Southern Cone of South America

In this study we analyzed the relationships and patterns of spatial variation from morphological cranial variability of 17 population samples representing the ancient inhabitants of the central territory of Argentina (archaeologically known as "Sierras Centrales") and other pre-Hispanic populations from different ecological and geographic regions of the Southern Cone of South America (Argentina and Uruguay), based on the analysis of 10 craniofacial measurements. Results obtained from D2 distances can be interpreted as evidence of a similar biological history for the populations that inhabited the Sierras Centrales and the population of Santiago del Estero. Matrix correlation analysis demonstrated that craniometric variation is significantly influenced by geography, suggesting that populations that lived at lower geographical distance share more biological similarity. Global spatial autocorrelation analysis suggests a clinal pattern for the biological variation, although Moran's I estimates calculated for each variable demonstrate that only nasal height and breadth show this spatial pattern of variation. Results from spatial regression techniques show a significant effect of altitude modeling nasal shape, in agreement with previous studies suggesting that nasal morphology is strongly influenced by environment variables.     

The role of anaerobic bacteria in sinusitis

The normal oropharyngeal flora contained aerobic and anaerobic bacteria that can cause respiratory infections including sinusitis. Some of these bacteria can interfere with the growth of potential pathogens and may play a role in preventing infections. Anaerobic bacteria emerge as pathogens as the infection becomes chronic. This may be the result of the selective pressure of antimicrobial agents that enable resistant anaerobic organisms to survive, and from the development over time of conditions appropriate for anaerobic growth, which include the reduction in oxygen tension and an increase in acidity within the sinus cavity. Anaerobes were isolated in acute maxillary sinusitis of odontogenic origin and in over half of the patients with chronic sinusitis whenever proper techniques for their cultivation were employed. These organisms were also recovered in acute sinusitis that was associated with dental infections. The predominant isolates were pigmented Prevotella and Porphyromonas, Fusobacterium and Peptostreptococcus spp.     

Variation in human nasal height and breadth

It has been suggested that the long-standing association of variability in the human nasal index [100 × (nasal breadth)/(nasal height)] with climatic variation is spurious evidence for natural selection in humans (Hoyme, 1965; St. Hoyme and Iscan, 1989). The argument is based principally on the observation that nasal height is globally more variable than nasal breadth, with nasal breadth thus contributing little to variation in the index. This argument does not take into account the confounding effect of absolute size of these variables on their variances. In this study we compare the intrinsic variation in skeletal nasal height and breadth within and among 26 mixed-sex populations (N = 2,408) at globally diverse localities (Howells, 1989), using 2 × 2 variance-covariance matrices of the logarithmically transformed variates. Hypothesis tests for homogeneity of matrices and equalvariance/equal-covariance indicate that the intrinsic variation in nasal breadth is greater than that for nasal height within populations, and that nasal breadth and nasal height exhibit equivalent intrinsic variation among populations. The argument that nasal breadth contributes little to the worldwide variation in the human nasal index is rejected. Given our present understanding of nasal physiological morpho-function, these results support, but do not demonstrate, an adaptive role for human nasal index variation. Promising methods for elucidating natural selection on human nasal form are suggested.     

Nasal shape,prognathism and adaptation in man

The association between nasal shape, prognathism and the shape of the maxillary dental arch has been examined within samples of Negro and European skulls. Prognathism tends to be accompanied by an increasingly broad and short nose. Particularly high correlations exist between nasal height and the length of the cranial base and between nasal breadth and the distance which separates the upper canine teeth. Regression analysis has yielded quantitative estimates of the effect on a given dimension of variation in one or more of the others. It seems probable that both nasal shape and the maxillary dental arch-prognathism complex may be subject to direct selection by environmental stress. The morphological association between these complexes suggests that a part of the interpopulation variation in prognathism may be a secondary effect of selection acting on the nose. Similarly, selection acting on the dental arch or maxilla could produce secondary changes in the nasal index (i.e. a non-adaptive component of nasal variation).     

Mucociliary clearance in chronic sinusitis: related human nasal clearance and in vitro bullfrog palate clearance

Nasal mucociliary clearance was measured in both healthy subjects and patients with chronic sinusitis using saccharin granule technique. Nasal mucociliary transit time (ST) was significantly slower in the patients with chronic sinusitis compared with that in controls (p less than 0.005). Nasal mucus collected from each nasal cavity was used for in vitro bullfrog palate clearance studies and compared to the in vivo nasal ST. Mucociliary clearance rate (MTR) on frog palate was 12.5 +/- 2.5 mm/min in the mucus from control subjects, 6.1 +/- 1.5 mm/min in the mucus from the patients. The difference was statistically significant (p less than 0.005). The MTR on frog palate in the patients whose nasal ST was within normal range was significantly slower than that in controls (p less than 0.005), but not significantly different from that in the patients whose nasal ST was over the normal range. These results suggest that the nasal mucous properties which decreased the mucociliary clearance on frog palate did not contribute to the mucociliary clearance of the patients who had a normal one. No significant correlation existed between MTR on frog palate and nasal ST in both control and chronic sinusitis. In chronic sinusitis patients, decelerated nasal ST was recovered significantly by normal saline nebulization compared with the value before the nebulization (p less than 0.01). None of the significant change of ST was observed in control before and after the nebulization.     

鼻内镜手术合并大环内酯类抗生素治疗鼻窦炎43例

目的：评价鼻内镜手术治疗合并术后利用大环内酯类抗生素治疗鼻窦炎的疗效,探讨鼻窦炎患者治疗前后血清中IL-17及其受体的表达及血清中总IgE的变化。方法：鼻窦内窥镜行病侧上颌寞自然口扩大及下鼻道开窗双进路,彻底清除鼻腔、鼻窦病变组织,术后采用大环内酯类抗生素治疗;采用酶联免疫法检测30例患者治疗前后血清中IL-17,IL-17R及IgE的含量。结果：治疗30例,其中术后病理证实鼻寞真菌球20例,治愈20例;曲霉菌感染23例,治愈10例,6个月随访无复发;与只治疗前相比,手术治疗后鼻窦炎患者血清IL-17,IL-17R及IgE的含量均明显降低。结论：鼻内镜手术是治疗真菌性鼻一鼻窦炎的主要方法,IL-17和IL-17R均参与鼻窦炎的发病过程,可作为诊断鼻窦炎的新指标,鼻内镜术后使用大环内酯类抗生素进一步巩固治疗,可降低复发率。     

Physical characteristics of Chinese Hakka

Using standard and internationally validated methods,86 anthropologic characteristics were determined in 650 male(305 from urban areas and 345 from rural areas) and 704 female(331 from urban areas,373 from rural areas) Chinese Hakka adults living in Guangdong and Jiangxi.The data were used to calculate 24 anthropologic indices,which were analyzed statistically.The physical characteristics of Hakka subjects were analyzed and compared with reference ethnic data.There were four main findings of this study.First,a small proportion of Hakka adults had an eye fold on the upper eyelid,but a large proportion had a mongoloid fold.The eye slits were narrow in most adults,had a medium nasal root height and straight bridges,and most of the external angles were prominent.The nasal base was upturned in most men.The distributions of the three types of nasal base in women were similar.The proportions of subjects with middle and high alae nasi heights were high and similar.Males with a maximum nostril diameter were mostly classified as transverse and oblique,while many women were classified as transverse and had relatively wide alae nasi.The round lobe type was the most common.Upper lip skin height was mostly classified as medium.Lips were classified as thin.The hair was black,eyes were brown,and the skin was yellowish.Second,the head length was long in male Hakka.The minimum frontal breadth,face breadth,lip height,and interocular breadth were similar to those of North-Asian populations.Meanwhile,head breadth,morphological facial height,nose breadth,mouth breadth,and nose height were similar to those of South-Asian populations.Head length was long in female Hakka.The minimum frontal breadth,face breadth,lip height,and interocular breadth were similar to those of North-Asian populations.Head breadth,nose breadth,and mouth breadth were similar to those of South-Asian populations.Third,the stature of male and female Hakka in urban and rural areas was classified as medium.The proportions of male and female Hakka classified as mesocephaly(length-breadth index of the head),hypsicephalic type,metriocephalic type(breadth-height index of the head) mesorrhiny,long trunk,subbrachyskelic type,broad shoulder breadth,and narrow distance between iliac crests were higher than those of other types.Finally,principal component analyses showed that the physical characteristics of Hakka were between those of South-Asian and North-Asian ethnic populations,but were generally closer to those of North-Asian populations in China.     

Morphogenetic experiments in facial asymmetry: the nasal cavity

An experiment was designed to test the response of the nasal cavity and associated structures to maxillary deformity. Forty young M. mulatta were surgically produced in 20 animals, and the small maxillary segments moved medialward. Intrapair observation tests were applied to selected measurements and indices of symmetry relationships. Deformity of the surgically undisturbed nasal septum occurred in response to the maxillary deformation. The lateral walls were moved medially with the maxilla, but in six months symmetry relationships were similar to those found in the control animals. The lateral walls of the nasal cavity appeared to be relatively independent of the shape and position of the tooth carrying part of the maxilla. The development and use of primate models can contribute to understanding the extent of the adaptational response systems in facial morphogenesis.     

Vertical growth of the anterior face and cranium in inner city Negro children

A longitudinal cephalometric study was conducted on the vertical growth of the cranium and anterior face on 60 inner city American Negro children, an equal number of boys and girls from four to nine years. Three vertical measurements were used for the purpose of this study. The head height was measured from sellion to bregma, bony nasal height from nasion to anterior nasal spine, and lower facial height from anterior nasal spine and lower facial height from anterior nasal spine to menton. The data were analyzed at annual ages and observations made relative to the growth trends. The findings of this study were compared with those on Caucasian children. No significant statistical difference was found in the mean head (cranial vault) height between the Negro and Caucasian children. The mean bony nasal height expressed as a percentage of subnasal height was found to be less in the Negro children. The difference decreased with age. The annual increment of growth in head height was greater from four to seven years than from seven to nine years. The findings are considered to imply that severe malnutrition may influence child growth.     

Genotype-phenotype associations in Sotos syndrome: an analysis of 266 individuals with NSD1 aberrations

We identified 266 individuals with intragenic NSD1 mutations or 5q35 microdeletions encompassing NSD1 (referred to as "NSD1-positive individuals"), through analyses of 530 subjects with diverse phenotypes. Truncating NSD1 mutations occurred throughout the gene, but pathogenic missense mutations occurred only in functional domains (P < 2 x 10(-16)). Sotos syndrome was clinically diagnosed in 99% of NSD1-positive individuals, independent of the molecular analyses, indicating that NSD1 aberrations are essentially specific to this condition. Furthermore, our data suggest that 93% of patients who have been clinically diagnosed with Sotos syndrome have identifiable NSD1 abnormalities, of which 83% are intragenic mutations and 10% are 5q35 microdeletions. We reviewed the clinical phenotypes of 239 NSD1-positive individuals. Facial dysmorphism, learning disability, and childhood overgrowth were present in 90% of the individuals. However, both the height and head circumference of 10% of the individuals were within the normal range, indicating that overgrowth is not obligatory for the diagnosis of Sotos syndrome. A broad spectrum of associated clinical features was also present, the occurrence of which was largely independent of genotype, since individuals with identical mutations had different phenotypes. We compared the phenotypes of patients with intragenic NSD1 mutations with those of patients with 5q35 microdeletions. Patients with microdeletions had less-prominent overgrowth (P = .0003) and more-severe learning disability (P = 3 x 10(-9)) than patients with mutations. However, all features present in patients with microdeletions were also observed in patients with mutations, and there was no correlation between deletion size and the clinical phenotype, suggesting that the deletion of additional genes in patients with 5q35 microdeletions has little specific effect on phenotype. We identified only 13 familial cases. The reasons for the low vertical transmission rate are unclear, although familial cases were more likely than nonfamilial cases (P = .005) to carry missense mutations, suggesting that the underlying NSD1 mutational mechanism in Sotos syndrome may influence reproductive fitness.