• Clinical Endoscopy
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• v.57 no.2
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• pp.196-202
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• 2024

Background/Aims: Hypoxemia is a common side effect of propofol sedation during endoscopy. Applying mild positive airway pressure (PAP) using a nasal mask may offer a simple way to reduce such events and optimize the conditions for diagnostic and therapeutic upper gastrointestinal endoscopies. Methods: We compared overweight patients (body mass index >25 kg/m²) with a nasal PAP mask or standard nasal cannula undergoing upper gastrointestinal endoscopies by non-anesthesiologists who provided propofol sedation. Outcome parameters included the frequency and severity of hypoxemic episodes. Results: We analyzed 102 procedures in 51 patients with nasal PAP masks and 51 controls. Episodes of hypoxemia (oxygen saturation [SpO₂] <90% at any time during sedation) occurred in 25 (49.0%) controls compared to 8 (15.7%) patients with nasal PAP masks (p<0.001). Severe hypoxemia (SpO₂ <80%) occurred in three individuals (5.9%) in both groups. The mean delta between baseline SpO₂ and the lowest SpO₂ recorded was significantly decreased among patients with nasal PAP mask compared to controls (3.7 and 8.2 percentage points difference, respectively). There were significantly fewer airway interventions performed in the nasal PAP mask group (15.7% vs. 41.2%, p=0.008). Conclusions: Using a nasal PAP mask may be a simple means of increasing patient safety and ease of examination.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.28 no.1
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• pp.109-118
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• 2015

Objectives : We performed a clinical study to investigate characteristics of pattern identifications using nasal endoscopy for allergic rhinitis (AR). Methods : We assessed 32 patients with allergic rhinitis using nasal endoscopy, classifications of allergic rhinitis and it's impact on asthma (ARIA) and total nasal symptom score (TNSS). Results : The watery rhinorrhea score of nasal endoscopy was significantly high in 'persistent and moderate/severe' group (P<0.05). Patients were classified as rhinorrhea group and nasal obstruction group according to nasal endoscopy. TNSS and rhinorrhea score was significantly high in rhinorrhea group (P<0.05). Conclusions : The result may provide that the watery rhinorrhea of nasal endoscopy is useful as 'Cold' and 'Deficiency' pattern identification diagnostic tool.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.30 no.4
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• pp.97-103
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• 2017

Objectives : To identify whether pattern identification using nasal endoscopy for rhinitis can be applied as a tool for evaluating rhinitis in routine care setting, we performed a inter-rater reliability study on this pattern identification. Methods : Two Korean medicine doctors assessed 290 left/right nasal endoscopy photograph cases of rhinitis patients with pattern identification using nasal endoscopy. This pattern identification consist of four assessment items, nasal membrane color(pale/hyperemia), nasal membrane humidity(dryness/dampness), rhinorrhea(watery/yellow), and turbinate membrane edema(atrophic/edematous). Cohen's kappa statistic and Percentage agreement were used to evaluate the inter-rater reliability. Results : Inter-rater percentage agreement and Kappa coefficient for left nasal endoscopy photograph cases was from 'slight' to 'moderate'(% agreement: 40.00-67.59%/Kappa: 0.06-0.407). Only the agreement of 'rhinorrhea (watery/yellow)' item was moderate(% agreement: 67.59%/Kappa: 0.407). Inter-rater percentage agreement and Kappa coefficient for right nasal endoscopy photograph cases was also from 'slight' to 'moderate'(% agreement: 42.41-68.97%/Kappa: 0.109-0.465). Only the agreement of 'rhinorrhea(watery/yellow)' item was moderate(% agreement: 68.97%/Kappa: 0.465). Conclusions : It is necessary to resolve problems such as cut-off value setting, bipolar evaluation values(pale/hyperemia, dryness/dampness, watery/yellow, atrophic/edematous) and weighting items. Further rigorous studies that overcome the limitations of the current research are warranted.

• The Journal of Internal Korean Medicine
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• v.35 no.3
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• pp.274-287
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• 2014

Objectives: This study was aimed to figure out an agreement between the diagnosis of nasal endoscopy and a preexisting questionnaire focusing on Cold-Heat pattern. Methods: 52 patients with cough who met the criteria filled out a pattern questionnaire and the examiner looked at their nasal cavities through nasal endoscopy. According to the checked questionnaire results, the subjects were identified by 6 patterns. After examining subject's mucous membrane of oropharynx and nasal cavity through nasal endoscopy, we classified each to the Cold or Heat group. Correlation between questionnaire and nasal endoscopy results was analyzed. Results: In diagnosing Cold-Heat, there was no significant difference by McNemar test (p=0.227) between nasal endoscopy and the questionnaire, and the two methods agreed moderately (${\kappa}=0.428$). The color of mucous membrane of oropharynx and the Cold-Heat pattern on questionnaire agreed slightly (${\kappa}=0.133$). The color of mucous membrane of nasal cavity and the Cold-Heat pattern on questionnaire agreed fairly (${\kappa}=0.384$). In the patients with cough related to upper respiratory tract, they got higher diagnosis accuracy than the patients with cough related to lower respiratory tract did. Similarly, external cough patients got higher diagnosis accuracy than internal cough patients did. Conclusions: To identify Cold or Heat, examining oropharynx and nasal cavity using nasal endoscopy is a meaningful method in patients with cough, showing that two diagnosis methods which use nasal endoscopy and questionnaire agreed moderately. Especially, it is more useful diagnosing patients with cough related to the upper respiratory tract than diagnosing the patients with cough related to the lower respiratory tract.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.28 no.4
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• pp.1-11
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• 2015

Objective : The aim of this study was to suggest guidelines using Nasal endoscopy index for objective pattern identification in allergic rhinitis patients. we performed a clinical study to investigate the relationship between Nasal endoscopy index and Cold-heat pattern identification for allergic rhinitis patients.Methods : We assessed 32 patients with allergic rhinitis using Nasal endoscopy index and the patients filled in Cold-Heat pattern questionnaires. Then, we analyzed the relationship between Nasal endoscopy index and Cold-heat pattern identification.Results : Pale and watery rhinorrhea scores were positively correlated with Cold questionnaire score (P<0.05).Conclusion : The results suggest that pattern identification using nasal endoscopy for allergic rhinitis can be useful for assessing the diagnosis of Cold-heat pattern identification and deciding guidelines of treatment.Acknowledgments : This work was supported by a Grant of the Traditional Korean Medicine R&D Project, Ministry of Health and Welfare, Republic of Korea (HI12C1889 and HI13C0530).

• Korean Journal of Bronchoesophagology
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• v.2 no.2
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• pp.244-247
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• 1996

Most of bronchial foreign bodies can be removed by ventilation bronchoscopy through transoral route but sometimes, ventilation bronchoscopy through tracheostomy is helpful procedure. Recently, we have experienced a case of bronchial foreign body which could be easily removed by nasal endoscopy and Blakesley forcep instead of bronchoscopy. So we report this case with a review of literatures.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.26 no.2
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• pp.10-18
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• 2013

Objectives : We performed a pilot study to investigate inter- and intra-rater reliability of pattern identification using nasal endoscopy for allergic rhinitis(AR). Methods : Eight experts of ophthalmology, otolaryngology and dermatology of Korean medicine evaluated 20 nasal endoscopy photograph cases of AR patients with pattern identification index using nasal endoscopy for AR including the nasal membrane color(pale / hyperemia), nasal membrane humidity(dryness / dampness), rhinorrhea(watery / yellow), and membrane edema (atrophic / edematous) on nasal endoscopy. Results : Intra-rater agreement(%) and Kappa coefficient was generally from 'moderate' to 'good'(% agreement: 73.13-90% / Kappa coefficient: 0.547-0.748). Inter-rater agreement(%) and Kappa coefficient was also from 'moderate' to 'good' (% agreement: 65-85% / Kappa: 0.475-0.778) except 'humidity(dryness / dampness)' item (% agreement: 55.98% / Kappa: 0.340). In findings of subgroup analysis according to affiliation of raters, Inter-rater agreement(%) and Kappa coefficient of raters in same affiliation was higher than inter-rater agreement(%) and Kappa coefficient of raters in different affiliation except 'dryness / dampness' item. Conclusions : It is necessary to improve objectivity and reproducibility of pattern identification using nasal endoscopy for allergic rhinitis(AR) through the development of detail-oriented criteria and enhanced training of clinicians with development of standard operating procedures(SOPs).

• Journal of Society of Preventive Korean Medicine
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• v.17 no.1
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• pp.199-207
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• 2013

Objectives : The prevalence of Allergic Rhinitis (AR) has increased during the last decade. However, a lot of decisions on the assessment and treatment of AR are made depending on the personal experiences and choices of physicians. To suggest preferable approaches and to minimize the variations according to physicians, guidelines for assessing anterior nasal cavity using nasal endoscopy on AR is needed. Methods : The Korean Oriental Medical Ophthalmology, Otolaryngology and Dermatology Society and the Korean Oriental Preventive Medical Society has set out to develop the guidelines for the assessing anterior nasal cavity using nasal endoscopy on AR. Results & Conclusions : This is the first Korean guideline for the assessment of AR and should be revised and supplemented in the future as new evidence becomes available.

• The Korean journal of internal medicine
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• v.39 no.1
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• pp.86-94
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• 2024

Background/Aims: A catheter is inserted through the nasal cavity during high-resolution esophageal manometry (HRM), which may cause adverse events such as pain or epistaxis. Despite these possible safety considerations, studies on this subject are very limited. We aimed to investigate the usefulness of nasal cavity evaluation before HRM to reduce the risk of adverse events and test failure. Methods: Patients who underwent HRM after consultation with the ear-nose-throat department for nasal evaluation were retrospectively enrolled between December 2021 and May 2022. The included patients had a previous history of sinonasal disease or surgery or had subjective nasal discomfort. All patients answered the Sino-Nasal Outcome Test (SNOT-22) questionnaire, and subjective nasal discomfort was scored using a visual analog scale. Nasal endoscopy and acoustic rhinometry were performed for disease evaluation and volumetric assessment. Results: The analysis included 22 patients with a mean age of 58.9 years. The mean SNOT-22 score was 24.2, and 16 patients (72.7%) complained of subjective nasal obstruction. The HRM catheter was successfully inserted in 20 patients (90.9%), without any significant adverse events. The objective measurement outcomes of acoustic rhinometry and sinus endoscopy did not always correspond to subjective symptoms. Narrowed nasal airways unresponsive to decongestants were observed in two patients with failed catheter insertion. Conclusions: To reduce the risk of adverse events and test failure during HRM, a site-specific questionnaire to evaluate nasal obstruction might be helpful. When nasal obstruction is suspected, objective nasal cavity evaluation could be recommended for the safe and successful performance of HRM.

• The Journal of Internal Korean Medicine
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• v.36 no.3
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• pp.323-334
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• 2015

Objectives This study was designed to analyze the characteristics of craniofacial hyperhidrosis and palmar/plantar hyperhidrosis by nasal endoscopy and body composition test. Methods The study sample consisted of 20 and 22 patients with craniofacial hyperhidrosis and palmar/plantar hyperhidrosis, respectively, who answered questionnaires and underwent nasal endoscopy and body composition test. The questionnaires estimated the quality of life by Dermatology Life Quality Index score (DLQI), and the degree of obesity was evaluated using body mass index (BMI), percent body fat (PBF), and waist-hip ratio (WHR). The state of nasal cavity was evaluated by color, humidity, and swelling of the mucous membranes, and runny nose. Results BMI, PBF, and WHR were higher in patients with craniofacial hyperhidrosis than in patients with palmar/plantar hyperhidrosis. Rhinitis score was not significantly different between craniofacial hyperhidrosis and palmar/plantar hyperhidrosis. There was a positive correlation between rhinitis score and DLQI. Conclusions The degree of obesity was higher in patients with craniofacial hyperhidrosis than in those with palmar/plantar hyperhidrosis. The state of nasal cavity was not significantly different between craniofacial hyperhidrosis and palmar/plantar hyperhidrosis, but was associated with quality of life of hyperhidrosis patients.