Regarding the nose feeling stuffy.
After turbinectomy or Fess with Submucus Resction of septum and turbinate,
one sees a nose wide open. Yet the patient complains bitterly that he can't
breathe! Measuring the cilia usually finds that the cilia have slowed or
even stopped! Restoring the cilia corrects the complaint of "can't breathe
through my nose, my nose burns, etc". Someday I hope to publish these
numbers.
>Dear group members,
>
>In a recent study we found a benificial effect of topical capsaicin in
>patients with a non-allergic non-infectious perennial rhinitis.
>Suggestions have been made, amongst others by Lacroix, that this
>benificial effect is generated through modulation of the anti-dromic
>reflex which is presumed to be overactive in NANIPER patients. Capsaicin
>treatment should either through toxicity or receptor modulation of the
>unmyelinated C-afferent system diminish the anti-dromic reflex. A
>beautifull hypothesis.
>
>Fang"s group, Wolf's group, and our group, however, were unable to
>gather evidence for an increased neuropeptide concentration in the nasal
>mucosa of NANIPER patients. This means we have to evaluate the
>hypothesis again.
>In a recent publication in Nature by Caterina the capsaicin receptor was
>identified as a heat activated ion channel. Moreover capsaicin was shown
>to kill cells expressing the heat receptor.
>
>The sensation of airflow is generated by cooling of the turbinates.
>(Eccles, 1983). Cold receptors may have been identified (Krause's
>corpuscles). A big problem in NANIPER patients is the sensation of
>decreased nasal passage.
>
>I would like to suggest the hypothesis that the efficacy of capsaicin in
>this group of patients is the result of a decrease of the number of
>functional heat receptors. As the number of cold receptors is not
>modulated the net effect in the cortex is the sensation of increased
>nasal flow. Of course this train of thought requires a balance between
>heat and cold receptors. Unfortunately I'm not aware of the existence of
>such a mechanism.
>
>I would very much like your comments on this hypothesis.
>
>With kind regards,
>Henk Blom, ENT-surgeon.
Murray Grossan, M.D. http://www.ent-consult.com tell a friend
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