Acute otitis media (AOM) is one of the most common infectious diseases in children. Nontypeable Haemophilus influenzae (NTHi) and Moraxella catarrhalis, Gram-negative bacteria, are considered major pathogens of AOM and respiratory tract infections. In this study, we used monophosphoryl lipid A (MPL) as a Toll-like receptor (TLR4) agonist to induce innate immune responses before challenge with NTHi and M. catarrhalis to enhance bacterial clearance from the nasopharynx. Mice were intranasally administered 40, 10, or 1 μg of MPL and challenged with NTHi and M. catarrhalis 12 and 24 h later. At 6 and 12 h after the bacterial challenge, the mice were killed and nasal washes were collected. The numbers of NTHi, M. catarrhalis, and inflammatory cells were quantitated. Inoculation of MPL produced a significant reduction in the number of bacteria recovered from the nasopharynx at 6 and/or 12 h after the bacterial challenge, when compared with control mice. The effect was dose dependent. MPL inoculation also induced the early accumulation of neutrophils in the nasopharynx after exposure to bacteria. MPL is effective for eliciting clearance of both NTHi and M. catarrhalis from the nasopharynx. These results indicate the possibility of a new strategy against Gram-negative bacterial infection that involves the stimulation of the innate immune system by TLR4 agonists such as MPL.
Branchial cleft cysts in the parapharyngeal space are rare. Various surgical approaches into the parapharygeal space have been reported. Due to its difficult access and close proximity to blood vessels and cranial nerves, any surgical complication would adversely affect the quality of life or could be life-threatening. Surgeons need to be mindful of their operating skills and limitations while undertaking a surgical procedure. Here, we describe the case of a young woman who suffered from repeated infection of a parapharyngeal branchial cleft cyst. She eventually underwent a combined transoral and endoscopic marsupialization surgery uneventfully and infection control was obtained. Therefore, this surgical technique could be an alternative approach for the extirpation of parapharyngeal cysts. It ensures the clearance of infection, minimizes complications, and requires no incisions on the neck. In addition, the endoscopic component of this approach aids visualization and confirmation of the diagnosis prior to the definitive surgery.
This study aimed to examine the characteristics of nasal and imaging findings of sinonasal lesions in granulomatosis with polyangiitis (GPA) patients and how these lesions change over time in both the active and remission phases of the disease.
Ameloblastoma is a slow-growing clinically benign tumor. If inadequately treated it recurs, therefore, oral surgeons and oral pathologists are particularly interested in this tumor. A 55-year-old woman has received a surgical operation by en bloc resection and immediate reconstruction with use of cortex of the mandible for the contracted ameloblastoma extending from the right body of the mandible to ramus. Intermaxillary fixation was applied by means of wires put in the upper and lower dentures. The postoperative result was satisfactory with good functioning of the jaw. The patient has had no recurrence fifteen months after operation.
Biphenotypic sinonasal sarcoma (BSNS) is a newly classified tumor that is characterized by neural and myogenic differentiation. The authors herein report a rare patient of the recurrence of BSNS with intracranial hemorrhaging and a review of the literature. A 70-year-old man presented with disturbance of consciousness and vomiting blood. He had undergone resection of a sinonasal tumor 11 years earlier and shown no recurrence at his last follow-up 4 years ago. Computed tomography showed cerebral hemorrhaging around a low-density mass that occupied the left frontal base and left ethmoid sinus. Total resection was performed. A histological examination of tumor specimens obtained from the first and the second resections revealed almost the same characteristic morphological features and the patient was diagnosed with BSNS. The lesion was negative for any fusion genes, as previously reported. The long-term progression of BSNS is not clear. This case appears to be the first reported recurrence of BSNS with cerebral hemorrhaging. Biphenotypic sinonasal sarcoma should be considered to need long-term follow-up.
