Ventilation of the Paranasal Sinuses. A study using the 133-Xenon Washout Technique

Abstract

A noninvasive 133-xenon washout technique was used to evaluate the ventilation of the paranasal sinuses in healthy subjects and in patients with sinus disease. A mixture of air and 133-xenon is insufflated into the nasal cavities and passage into the sinuses is facilitated by a pressure increase created by letting the subjects inflate a balloon. A scintillation camera allowing single photon emission computed tomography (SPECT) was used to follow the washout of 133-xenon from not only the frontal and maxillary sinuses, but also the posterior ethmoidal and sphenoidal sinuses. The washout halftimes were used as a measure of the ventilation of the sinuses. Factors influencing the washout such as nasal patency, insufflation pressure and body possition were studied in healthy subjects and the reproducibility of the method was evaluated.The results show that 133-xenon washout in combination with SPECT has sufficient reproducibility and that variations in nasal patency, insufflation pressure and body position do not influence sinus ventilation. Other factors influencing the washout such as ostial size, sinus volume and nasal ventilation were studied in a nose-sinus model and the ostial size was found to be most import in the washout of 133-xenon. Sinus ventilation was evaluated in patients with sinus disease before and after endoscopic sinus surgery (ESS). The washout times are significantly longer in patients with polyposis than in healthy subjects, and the washout times were significantly shorter after ESS on patients with chronic sinus disease. Furthermore, sinus ventilation was measured in healthy subjects before and after the administration of oxymetazoline as nasal drops or using nasal bellows. No effect of decongestants on the ventilation of the paranasal sinuses was observed.

Abstract (Swedish)

Popular Abstract in Swedish

Undersökning av bihåleventilation med 133-xenon washout teknik och gammakamera med tomografi, gör det möjligt att mäta ventilationen även i de djupa bihålorna som bakre ethmoidalsinus och sphenoidalsinus. Mätningar visar reproducerbara resultat hos friska försökspersoner där normala variationer i näsandningsmotstånd och kroppsläge ej påverkar mätresultaten. Bihåleventilationen hos patienter med näspolypos är nedsatt jämfört med bihålefriska individer. Modellförsök visar att ostiediametern är den viktigaste faktorn för variationer i halveringstid av 133-xenon washout från bihålorna. Bihåleventilationen mätt med 133-xenon washoutteknik förbättrades efter FESS (bihålekirurgi med endoscopisk teknik) och kan vara en värdefull teknik för objektiv värdering av bihåleventilation före och efter FESS.

• author: Paulsson, Bo
• supervisor: [unknown] [unknown]
• opponent: Associate Professor Holmström, Mats, Dept of ORL University Hospital in Uppsala Sweden
• organization: Department of Clinical Sciences, Lund
• publishing date: 2002
• type: Thesis
• publication status: published
• subject: Otorhinolaryngology
• keywords: auditive system and speech, single photon emission computed tomography, paranasal sinuses, ventilation, 133-xenon, chronic sinusitis, nose-sinus model, endoscopic sinus surgery, oxymetazoline, Otorhinolaryngology, Otorinolaryngologi, audiologi, hörsel- och talorganen, audiology
• pages: 132 pages
• defense location: Lund University Hospital in Lund Sweden
• defense date: 2002-03-21 10:15:00
• ISBN: 91-628-5116-0
• language: English
• LU publication?: yes
• additional info: Article: 1. Ventilation of the Paranasal Sinuses Studied with Dynamic Emission Computer TomographyBo Paulsson, MD; Mats Bende, MD; Ingemar Larsson, MScand Per Ohlin, MDLaryngoscope 1992; 102:451-7 Article: 2. Paranasal Sinus Ventilation in Healthy Subjects and in Patients with Sinus Disease Evaluated with the 133-Xenon Washout TechniqueBo Paulsson, MD; Jan Dolata, MD, PhD; Ingemar Larsson, MSc; Per Ohlin, MD, PhD and Sven Lindberg, MD, PhDAnn. Otol. Rhinol. Laryngol. 2001; 110: 667-74 Article: 3. Factors Influencing 133-Xenon Washout in a Nose-Sinus ModelBo Paulsson, MD; Jan Dolata, MD, PhD; Per Ohlin, MD, PhD andSven Lindberg, MD, PhDClin. Physiol. 2001; 21: 246-52 Article: 4. Washout of 133-Xenon as an Objective Assessment of Paranasal Sinus Ventilation in Endoscopic Sinus SurgeryBo Paulsson, MD; Sven Lindberg, MD, PhD and Per Ohlin, MD, PhDAnn Otol Rhinol Laryngol. 2002, in press. Article: 5. Effects of Oxymetazoline on the Ventilation of Paranasal Sinuses in Healthy SubjectsBo Paulsson, MD; Sven Lindberg, MD, PhD and Per Ohlin, MD, PhDAmerican Journal of Rhinology 2002, in press.
• id: 77192854-9618-45e2-92e7-d6cdb7879d16 (old id 464431)
• date added to LUP: 2016-04-04 11:25:14
• date last changed: 2018-11-21 21:04:45