Literature Review: A Roundup of Important Recent Studies

• Passive Smoke Affects Ultrastructure of Nasal Mucosa in Children
• Increased Eustachian Tube Dysfunction in Children with Obstructive Sleep Apnea
• Risk Factors for Spasmodic Dysphonia
• Predictors of Complications of Free Flap Reconstruction

 

Passive Smoke Affects Ultrastructure of Nasal Mucosa in Children

What is the effect of passive exposure to smoke on nasal respiratory mucosa in children?

Background: Most studies concerning the effects of passive, or secondhand, smoking have examined its carcinogenic effect on the lower respiratory tract, while the effects on nasal respiratory mucosa have not been widely studied.

Study design: Study of 20 children exposed and 10 not exposed to passive smoke.

Setting: Department of Otolaryngology-Head and Neck Surgery and Department of Pathology, Alexandria Medical School, Alexandria, Egypt.

Synopsis: Twenty children ages five to 11 years with a history of prolonged exposure to passive smoke and 10 children with a negative household smoking history had biopsies taken during tonsillectomy from the lower border of the inferior turbinate. Examination of the nasal mucosa showed several ultrastructural changes in those exposed to passive smoke, including patchy loss of cilia, generalized loss of cilia, squamous metaplasia, hyperplasia of goblet cells and seromucinous acini and vascular congestion. The authors said the changes in the respiratory nasal mucosa appeared to be directly proportionate to the duration of passive exposure to smoke. Additionally, they noted that their findings are contrary to those reported in patients with allergic rhinitis, and that, at the same time, they explain the absence of pericapillary and subepithelial edema, which are commonly described in allergic cases.

Bottom line: Children exposed to passive cigarette smoke may develop several structural changes in their respiratory nasal mucosa, with subsequent negative effects on ciliary activity and mucociliary function. As a result, defense mechanisms of the nose may be ruined or lost.

Reference: Elwany S, Ibrahim AA, Mandour Z, et al. Effect of passive smoking on the ultrastrucrure of the nasal mucosa in children. Laryngoscope. 2012;122(5):965-969.

—Reviewed by Sue Pondrom

 

Increased Eustachian Tube Dysfunction in Children with Obstructive Sleep Apnea

How common is Eustachian tube dysfunction (ETD) in children with obstructive sleep apnea (OSA), and what interventions are available?

Background: The prevalence of OSA in the general pediatric population is approximately 4 to 7 percent. However, no clear relationship between the severity of OSA and the presence of ETD has been established.

Study design: Retrospective medical record review.

Setting: Department of Otolaryngology, University of Pittsburgh; Department of Pediatric Otolaryngology and Department of Pediatrics, Children’s Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Penn.