• Perilla frutescens
• Quercetin
• allergic rhinitis (AR)
• exhaled nitric oxide
• nasal cytology
• nasal nitric oxide
• nutraceuticals
• pediatric allergy
• randomized controlled trial (RCT)
• vitamin D3

• airway resistance
• mouth breathing
• rhinomanometry

• Alt a1
• Alternaria Alternata
• Modigoid
• allergic rhinitis (AR)
• anterior active rhinomanometry (AAR)
• children
• nasal FeNO (nFeNO)
• nasal citology
• precision medicine
• subcutaneus immunotherapy

• active anterior rhinomanometry
• age
• children
• height
• reference values

• adenoid hypertrophy
• aerosol transport
• nasal airway
• numerical simulation
• obstruction
• olfactory

• Adenoid hypertrophy
• Adenoidectomy
• Rhinitis
• Rhinomanometry
• Turbinate enlargement

• Allergic rhinitis
• Functional endoscopic endonasal surgery
• Inferior turbinate
• Nasal obstruction
• Pediatrics

• Allergy test
• Anterior rhinomanometry
• Children
• Nasal obstruction
• Nasal provocation test

• allergic rhinitis
• children
• nasal microbiome
• passive smoke
• serum cotinine

• allergic rhinitis
• anterior active rhinomanometry
• asthma
• children
• exhaled nitric oxide
• nasal nitric oxide

• Cephalometry
• Child
• Craniofacial growth
• Malocclusion
• Nasal obstruction
• Septoplasty

• allergic rhinitis
• bronchial asthma
• children
• rhinomanometry
• spirometry

• Allergic rhinitis
• Nose Obstruction Symptom Evaluation Score
• children
• nasal airway obstruction
• sonoelastography

Allergic rhinitis (AR) and adenoid hypertrophy (AH) are, in children, the main cause of partial or complete upper airway obstruction and reduction in airflow. However, limited data exist about the impact of the increased resistance to airflow, on the nasal microbial composition of children with AR end AH. Allergic rhinitis (AR) as well as adenoid hypertrophy (AH), represent extremely common pathologies in this population. Their known inflammatory obstruction is amplified when both pathologies coexist. In our study, the microbiota of anterior nares of 75 pediatric subjects with AR, AH or both conditions, was explored by 16S rRNA-based metagenomic approach. Our data show for the first time, that in children, the inflammatory state is associated to similar changes in the microbiota composition of AR and AH subjects respect to the healthy condition. Together with such alterations, we observed a reduced variability in the between-subject biodiversity on the other hand, these same alterations resulted amplified by the nasal obstruction that could constitute a secondary risk factor for dysbiosis. Significant differences in the relative abundance of specific microbial groups were found between diseased phenotypes and the controls. Most of these taxa belonged to a stable and quantitatively dominating component of the nasal microbiota and showed marked potentials in discriminating the controls from diseased subjects. A pauperization of the nasal microbial network was observed in diseased status in respect to the number of involved taxa and connectivity. Finally, while stable co-occurrence relationships were observed within both control- and diseases-associated microbial groups, only negative correlations were present between them, suggesting that microbial subgroups potentially act as maintainer of the eubiosis state in the nasal ecosystem. In the nasal ecosystem, inflammation-associated shifts seem to impact the more intimate component of the microbiota rather than representing the mere loss of microbial diversity. The discriminatory potential showed by differentially abundant taxa provide a starting point for future research with the potential to improve patient outcomes. Overall, our results underline the association of AH and AR with the impairment of the microbial interplay leading to unbalanced ecosystems.

• adenoid hypertrophy
• allergic rhinitis
• chronic inflammation
• core microbiota
• nasal microbiota

• RME
• RPE
• Rapid maxillary expansion
• Rapid palatal expansion
• Rhinomanometry

• Doppler echocardiography
• allergic rhinitis
• mouth breathing
• nasal airway obstruction
• pulmonary hypertension
• rhinomanometry

• Arterial Pressure
• Child
• Cross-Sectional Studies
• Humans
• Hypertrophy
• Mouth
• Nasal Obstruction/diagnostic imaging
• Rhinitis, Allergic

Allergic rhinitis (AR) and adenoidal hypertrophy (AH) are the most frequent causative disorders of nasal obstruction in children, leading to recurrent respiratory infections. Both nasal cavities are colonized by a stable microbial community susceptible to environmental changes and Staphylococcus aureus seems to play the major role. Furthermore, nasal microbiota holds a large number and variety of viruses with upper respiratory tract infections. This local microbiota deserves attention because its modification could induce a virtuous cross-talking with the immune system, with a better clearance of pathogens. Although AR and AH present a different etiopathogenesis, they have in common a minimal chronic inflammation surrounding nasal obstruction; hence it would be challenging to evaluate the effect of an immunomodulator on this minimal chronic inflammation with possible clinical and microbiological effects. The aim of this study is therefore to evaluate the efficacy of an immunomoldulator (Pidotimod) on nasal obstruction in children with AR and/or AH and whether its action involves a variation of nasal microbiota.

We enrolled 76 children: those with allergic rhinitis (AR) sensitized to dust mites entered the AR group, those with adenoidal hypertrophy (AH) the AH group, those with both conditions the AR/AH group and those without AR ± AH as controls (CTRL). At the first visit they performed: skin prick tests, nasal fiberoptic endoscopy, anterior rhinomanometry, nasal swabs. Children with.

AR ± AH started treatment with Pidotimod.

After 1 month they were re-evaluated performing the same procedures.

The primary outcome was the evaluation of nasal obstruction after treatment and the secondary outcome was the improvement of symptoms and the changes in nasal microflora.

All patients improved their mean nasal flow (mNF) in respect to the baseline. In AR children mNF reached that one of CTRL. In AH children±AR the mNF was lower in respect to CTRL and AR group. We did not find any differences among all the groups at the two different time points in nasal microflora.

Pidotimod is able to give an improvement in nasal obstruction, especially in AR children but this effect seems to be not mediated by changes in nasal microbiota.

• Microbiota
• Nasal obstruction
• Pidotimod
• Rhinomanometry

• Adenotonsillectomy
• Child
• Doppler echocardiography
• Mouth breathing
• Rhinomanometry

• Adenoidectomy
• Adenoids
• Nasal nitric oxide
• Primary ciliary dyskinesia
• Rhinomanometry

• Adolescent
• Asthma/complications
• Asthma/physiopathology
• Child
• Child, Preschool
• Female
• Humans
• Male
• Nasal Obstruction/complications
• Nasal Obstruction/physiopathology
• Rhinomanometry

• acoustic rhinometry
• healthy Chinese adults
• nasal resistance
• rhinomanometry
• standard reference intervals

• Adenoidectomy
• adenoids
• airway resistance
• nasal obstruction

• Nasal resistance
• nasal airflow rate
• pressure‐flow technique
• threshold load
• weber fraction

Upper and lower airways diseases share in part their pathogenic mechanisms and frequently occur simultaneously as “United Airway Disease.” Local treatment with nebulizers delivers anti-symptomatic drugs in either the upper or the lower airways, according to the particle size generated by the nebulizer. To our knowledge, no nebulizer combines both application ways.

The aim of this study is to test the efficacy and usability of a new nebulizer (OMRON A3 complete), generating aerosols with particles diameters of 2-4.5 μm, 4.5-7.5 μm or >7.5 μm, according to the user’s choice.

Seventy-seven patients between 5 and 17 years of age with a diagnosis of rhinitis or asthma were examined. Oxymetazoline or Salbutamol were prescribed according to best clinical practice guidelines. Both drugs were administered through the OMRON A3 Complete nebulizer, with a particle dimension of >7.5 μm to treat nasal obstruction and 2-4.5 μm for bronchial obstruction. The efficacy of treatment was assessed by total nasal inspiratory airflow and FEV-1, Tiffeneau index (FEV1/FVC) and MMEF 25/75 respectively, 10 min before and after treatment. Symptom improvement and usability were measured by patients’ and doctors’ questionnaires.

Overall, 77 patients seeking care for acute respiratory symptoms were assigned to the upper (n = 39) or lower (n = 38) airways disease group. For symptoms of the upper airways, 92% (95% CI, 77-97%) of the patients reported subjective improvement, while 87% (95% CI, 73-94%) did so for the lower airways. The average total nasal inspiratory airflow improved significantly (p = 0.030) among the patients with upper airways symptoms, from 275 ml/s (95% CI, 207-342 ml/s) to 359 ml/s (95% CI, 300-419 ml/s) after Oxymetazoline administration. All selected lung function parameters (FEV1, Tiffeneau Index and MMEF25-75) significantly improved among the patients with lower airways symptoms after inhalation of Salbutamol (p < 0.001). The nebulizer was assessed as “easy to use” by over 95% of participants in both groups.

The OMRON A3 efficiently delivers anti-symptomatic drugs in both upper and lower airways in a user-friendly way. This device may be useful to facilitate adherence to a complete treatment of respiratory symptoms in patients with symptoms of the so-called United Airway Disease.

• Asthma
• Children
• Nebulizer
• Oxymetazoline
• Rhinitis
• Salbutamol

• cystic fibrosis
• nasal patency
• rhinoscopy
• sinonasal outcome test
• upper airways

Chronic rhinitis is a very common disease, as the prevalence in the general population resulted to be 40%. Allergic rhinitis has been considered to be the most frequent form of chronic rhinitis, as non-allergic rhinitis has been estimated to account for 25%. However, several evidences suggested that non-allergic rhinitis have been underrated, especially in children. In pediatrics, the diagnostic definition of non-allergic rhinitis has been often limited to the exclusion of an allergic sensitization. Actually, local allergic rhinitis has been often misdiagnosed as well as mixed rhinitis has not been recognized in most cases. Nasal cytology is a diagnostic procedure being suitable for routine clinical practice with children and could be a very useful tool to characterize and diagnose non-allergic rhinitis, providing important clues for epidemiological analysis and clinical management.

• Pediatric chronic rhinitis
• Non-allergic rhinitis
• Nasal cytology
• Local allergic rhinitis

• Nasal obstruction
• Nasal resistance
• Oronasal pressure
• Pressure-flow technique
• Upper airways

• Computational fluid dynamics (CFD)
• Nasal cavity
• Obstructive sleep apnea
• Pharyngeal wall pressure

• Adult
• Computer Simulation
• Humans
• Hydrodynamics
• Male
• Models, Biological
• Nasal Cavity/physiology
• Pharynx/physiology
• Pressure
• Sleep Apnea, Obstructive/physiopathology

• Children
• Intranasal budesonide
• Nasal patency
• Persistent allergic rhinitis
• Rhinomanometry

• Administration, Intranasal
• Budesonide/administration & dosage
• Child
• Female
• Glucocorticoids/administration & dosage
• Humans
• Male
• Nasal Obstruction/diagnosis
• Nasal Obstruction/drug therapy
• Nasal Obstruction/etiology
• Rhinitis, Allergic/complications
• Rhinitis, Allergic/drug therapy
• Rhinomanometry
• Symptom Assessment/methods
• Treatment Outcome

• Children
• Pulmonary function testing
• Rhinomanometry
• Seasonal allergic rhinitis
• Seasonal effect
• Symptom scores

• Adult
• Analysis of Variance
• Case-Control Studies
• Diagnostic Techniques, Respiratory System/instrumentation
• Equipment Design
• Female
• Humans
• Male
• Middle Aged
• Nasal Cavity/physiopathology
• Nasal Obstruction/diagnosis
• Nasal Obstruction/physiopathology
• Polyvinyls
• Reference Values
• Rhinomanometry/instrumentation
• Rhinomanometry/methods
• Transducers
• Visual Analog Scale

• allergic rhinitis
• children
• exercise
• nasal airflow
• nasal resistance

Sleep disordered breathing (SDB) might affect craniofacial growth and children with obstructive sleep apnea syndrome present an increase in total and lower anterior heights of the face and a more anterior and inferior position of the hyoid bone when compared to nasal breathers.

To investigate the correlation between rhinomanometric and cephalometric parameters in children with primary snoring (PS), without apnea or gas exchange abnormalities.

Thirty children with habitual snoring (16 females and 14 males) aged 4–8 years (mean age 6.85±1.51 years) were selected by a SDB validate questionnaire. All subjects underwent lateral cephalometric, panoramic radiographies.

In our sample 10 children (33%) had snoring 3 nights/week, 11 (37%) 4–6 nights/week and 9 (30%) every night/week. Overall 7 patients (23.3%) were affected by adenoid hypertrophy (AH), 4 (13.3%) by tonsillar hypertrophy (TH) and 13 (43.3%) by AH and TH. We found a more vertical position of the hyoid bone to the mandibular plane (H⊥VT) in patients with a higher frequency (7.3±2.7 vs 7.6±3.7 vs 10.9±2.5 in children snoring 3 nights/week, 4–6 nights/week and every night/week respectively; p = 0.032). Concerning nasal patency significant correlations were found with ANB (maxillary and jaw position with respect to the cranial base), NS∧Ar (growth predictor), sumangle, FMA (total divergence), SnaSnp∧GoMe (inferior divergence), BaN∧PtGn (facial growth pattern), Phw1_PsP (posterosuperior airway space), AHC3H (the horizontal distance between the most anterosuperior point of the hyoid bone and the third cervical vertebra).

The present study supports the relationship between nasal obstruction and specific craniofacial characteristics in children with primary snoring and lead us to hypothesize that nasal obstruction might explain the indirect link between snoring and cephalometric alterations.

• Cephalometry
• Child
• Child, Preschool
• Female
• Humans
• Male
• Nose/physiopathology
• Snoring/physiopathology

• Enuresis
• polysomnography
• sleep apnoeas

Allergy represents a risk factor at the base of sleep-disordered breathing in pediatric age. Among allergic diseases, the atopy is characterized by a tendency to be “hyperallergic.” Sleep-disordered breathing is also known in orthodontics as correlated with the morphology of craniofacial complex. The aim of this study was to investigate the relation between atopy and sleep-disordered breathing (oral breathers with habitual snoring), comparing atopic children with sleep-disordered breathing (test group) with nonatopic ones with sleep-disordered breathing (control group), in the prevalence of dento-skeletal alterations and other risk factors that trigger sleep-disordered breathing, such as adenotonsillar hypertrophy, turbinate hypertrophy, obesity, and alteration of oxygen arterial saturation.

In a group of 110 subjects with sleep-disordered breathing (6 to 12 years old), we grouped the subjects into atopic (test group, 60 subjects) and nonatopic (control group, 50 subjects) children and compared the data on the following: skin allergic tests, rhinoscopy, rhinomanometry, night home pulsoxymetry, body mass index, and dento-facial alterations.

Even if our results suggest that atopy is not a direct risk factor for sleep-disordered breathing, the importance of a physiologic nasal respiration in the pathogenesis of sleep-disordered breathing seems to be demonstrated in our study by the higher prevalence of hypertrophy in the adenotonsillar lymphatic tissue, odontostomatological alterations, alterations of the oxygen saturation to pulsoxymetry, and higher prevalence of obesity observed in our children with sleep-disordered breathing, in percentages higher than that of the general pediatric population previously observed in the literature.

The importance of a physiologic nasal respiration in the pathogenesis of sleep-disordered breathing is demonstrated in our study.

• raised volume rapid thoracoabdominal compression
• infant lung function
• expiratory flow limitation
• nasal airway resistance
• vital capacity
• jaw thrust
• bronchodilator response

• Airway Resistance
• Behavioral Symptoms/diagnosis
• Behavioral Symptoms/epidemiology
• Case-Control Studies
• Cephalometry
• Child
• Child, Preschool
• Cognition Disorders/diagnosis
• Cognition Disorders/epidemiology
• Cohort Studies
• Female
• Health Surveys
• Humans
• Intelligence Tests
• Male
• Neuropsychological Tests
• Polysomnography
• Rhinomanometry
• Sleep Apnea Syndromes/complications
• Sleep Apnea Syndromes/pathology
• Sleep Apnea Syndromes/psychology
• Snoring/etiology
• Snoring/pathology
• Snoring/psychology

• Age Factors
• Child
• Child, Preschool
• Confidence Intervals
• Cross-Sectional Studies
• Female
• Finland/epidemiology
• Health Status Indicators
• Humans
• Logistic Models
• Male
• Nasal Obstruction/chemically induced
• Nasal Obstruction/epidemiology
• Odds Ratio
• Parents
• Prospective Studies
• Rhinitis, Allergic, Perennial/chemically induced
• Rhinitis, Allergic, Perennial/epidemiology
• Rhinomanometry
• Sleep Apnea, Central
• Tobacco Smoke Pollution/adverse effects