Nasal Septum Deviation as the Consequence of BMP-Controlled Changes to Cartilage Properties.
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ABSTRACT:
SUBMITTER: Baddam P
PROVIDER: S-EPMC8265824 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Nasal septum deviation (NSD) is a common abnormality of the septal cartilage often associated with disordered breathing. The etiology of NSD is unknown. BMP7 neural crest-knockout mice, a well-characterized model for midfacial hypoplasia and nasal airway obstruction, develops a deviated septum by 4 weeks of age. Using comparative gene expression, quantitative proteomics, and immunofluorescence analysis we investigated the septum prior, immediately preceding, and with established deviation. We provide a detailed description of cellular and molecular changes leading to septum deviation, including changes to extracellular matrix organization, cell metabolism, and chondrocyte differentiation. Loss of BMP7 was associated with acquisition of elastic cartilage properties, a switch to glucose metabolism, and molecular characteristics commonly associated with osteoarthritis (OA). Many alterations preceded the deviation establishing that molecular changes to chondrocyte properties predispose to the deviation. Interestingly, NSD was associated with a persistent increase in BMP2. Genetic reduction of BMP2 in BMP7ncko mice restores WNT signalling, energy metabolism, and rescues NSD, showing the importance of balanced BMP signaling for normal cartilage. Many of the cellular and molecular changes have been described for knee osteoarthritis, suggesting that these two pathologies might have a similar underlying etiology.
2021-04-30 | PXD024813 | Pride
Project description:ObjectivesNasal Septal Deviation (NSD) is one of the most common causes of nasal obstruction. This study aims to further examine the clinical utility of imaging assessment in the workup and management of symptomatic nasal septal deviation, across all levels of medical training.Study designCross-sectional survey.MethodsCT scans of 10 confirmed NSD patients and 36 healthy controls (HC) were mixed and emailed through anonymous REDCap surveys to otolaryngologists in the US. The HC had no reported sinonasal obstruction symptoms-NOSE (NSD: 62.2 ± 12.5; HC: 5.69 ± 5.99, p < 0.05); SNOT-22 (NSD: 31.4 ± 14.5; HC: 9.72 ± 10.76, p < 0.05). The images consisted of a coronal slice at each subject's most deviated location. Participants were instructed to choose the patients suspected to present with symptoms of sinonasal obstruction.Results88 otolaryngologists responded to the survey. 18 were excluded due to incomplete responses. On average, they identified 64.2 ± 29.8% of symptomatic NSD subjects correctly, but misidentified 54.6 ± 34.6% of HC as symptomatic. Their decisions were strongly correlated to degree of NSD (r = 0.69, p < 0.05). There exists a significant degree of NSD among HC (38.7 ± 17.2%), which does not significantly differ from symptomatic subjects (51.0 + 18.7%, p = 0.09). Residents and fellows performed similarly, with responses correlated between levels of training (r = 0.84-0.96, p < 0.05).ConclusionsThe incorporation of a substantial number of otolaryngologists, large patient sample, and blind mixing with HC gives us greater insight to the relative contribution of the extent of septal deviation to symptoms of nasal obstruction. Although NSD is a common factor contributing to nasal obstruction, the results of this study suggest that it is difficult to reliably infer obstructive symptoms based on degree of NSD on CT.Level of evidenceThree.
| S-EPMC10229233 | biostudies-literature
Project description:The present study aimed to evaluate whether patients undergoing an operation for septum deviation exhibited a change in affective status. The temperament evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) was administered to all patients at the pre-operative and post-operative periods. The mean age of the patients was 32.46 ± 11.22 years. Of the patients, 34 (65.4%) were males and 18 (34.6%) were females. A significant difference was found between pre- and post-operative scores of the patients on all TEMPS-A subscales (p < 0.05). Patients with symptoms of upper airway obstruction may have mood disorders due to the decrease in blood oxygen levels. This condition can be corrected with septoplasty procedure. In the present study, it was demonstrated that patients had a better affective status post-operatively as compared to the pre-operative period.
| S-EPMC3392349 | biostudies-literature
Project description:BackgroundThe association of the linear dimensions of the inferior turbinate hypertrophy with nasal septal deviation has been studied recently. However, the volumetric dimensions provide a more accurate status of the turbinate hypertrophy compared to linear measurements. The aim of this study was to analyze the association of inferior nasal turbinate volume with the degree of nasal septal deviation (NSD).MethodsA retrospective evaluation of the cone beam computed tomography (CBCT) scans of 412 patients was carried out to obtain 150 scans which were included in the study. The scans were categorized into three groups. Group 1 comprised of 50 scans of patients with no inferior turbinate hypertrophy (ITH) and no nasal septal deviation. Group 2 comprised of 50 scans of patients with ITH and no NSD; whereas Group 3 included 50 scans of patients with ITH and NSD. The total turbinate volume of inferior turbinates (bilateral) were determined by using Vesalius 3D software (PS-Medtech, Amsterdam, Netherlands).ResultsThe intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologists was 0.82. There were no significant age and gender related changes in the total turbinate volume. Patients in Group 3 had significantly higher (p = 0.001) total turbinate volume compared to Group 2 and Group 1. There was a positive and significant correlation (r = 0.52, p = 0.002) between the degree of septal deviation and total turbinate volume. When the total turbinate volume of the patients with different types of septal deviation was compared in Group 3, a statistically significant difference (p = 0.001) was observed. Regression analysis revealed that the septal deviation angle (SDA) (p = 0.001) had a relationship with total turbinate volume. From the results of the study we can conclude that the total turbinate volume is higher in patients with nasal septal deviation. It can also be concluded that the septal deviation angle has a positive correlation with total turbinate volume. The data obtained from the study can be useful in post-surgical follow up and evaluation of patients with nasal septal deviation and hypertrophied inferior nasal turbinate.
| S-EPMC9511997 | biostudies-literature
Project description:The present study was designed to test the hypothesis that there would be a correlation between nasal septum deviation (NSD) and a decreased maxillary sinus volume (MSV) in a Colombian population, using Cone Beam Computed Tomography (CBCT); other sinusal anatomical structures found during the reading were described and analyzed. A retrospective analysis of 537 CBCT scans of adult patients taken between January 2014 and January 2017 included measuring the maxillary sinus diameter in the vertical, horizontal, and sagittal planes. NSD was quantified and related to MSV using the same field of view (FOV). The volume of the right and left maxillary sinuses showed a median and interquartile range (IQR) of 8.18 mm3 (IQR: 6.2-10.33) and 8.3 mm3 (IQR: 6.4-10.36). Statistically significant differences were observed between sex and right and left MSV (p = 0.000), with higher MSV in men. The presence of NSD was observed in 96.81% of the sample and was evaluated in degrees, observing a median of 11° (IQR: 7-16) where 40% of the sample had moderate angles (9-15°). There was no correlation between NSD and a decreased MSV in the population studied. Detailed CBCT analysis with a large FOV is crucial for the analysis of anatomical structures before performing surgical procedures that involve the MS as a preventive diagnostic and therapeutic step for appropriate treatment.
| S-EPMC10969206 | biostudies-literature
Project description:The expanding nasal septal cartilage is believed to create a force that powers midfacial growth. In addition, the nasal septum is postulated to act as a mechanical strut that prevents the structural collapse of the face under masticatory loads. Both roles imply that the septum is subject to complex biomechanical loads during growth and mastication. The purpose of this study was to measure the mechanical properties of the nasal septum to determine (1) whether the cartilage is mechanically capable of playing an active role in midfacial growth and in maintaining facial structural integrity and (2) if regional variation in mechanical properties is present that could support any of the postulated loading regimens. Porcine septal samples were loaded along the horizontal or vertical axes in compression and tension, using different loading rates that approximate the in vivo situation. Samples were loaded in random order to predefined strain points (2-10%) and strain was held for 30 or 120 seconds while relaxation stress was measured. Subsequently, samples were loaded until failure. Stiffness, relaxation stress and ultimate stress and strain were recorded. Results showed that the septum was stiffer, stronger and displayed a greater drop in relaxation stress in compression compared to tension. Under compression, the septum displayed non-linear behavior with greater stiffness and stress relaxation under faster loading rates and higher strain levels. Under tension, stiffness was not affected by strain level. Although regional variation was present, it did not strongly support any of the suggested loading patterns. Overall, results suggest that the septum might be mechanically capable of playing an active role in midfacial growth as evidenced by increased compressive residual stress with decreased loading rates. However, the low stiffness of the septum compared to surrounding bone does not support a strut role. The relatively low stiffness combined with high stress relaxation under fast loading rates suggests that the nasal septum is a stress dampener, helping to absorb and dissipate loads generated during mastication.
| S-EPMC3910320 | biostudies-literature
Project description:Nasal septum deviation (NSD) typically occurs following otorhinolaryngologic surgery. However, there is a lack of biomechanical parameters able to accurately evaluate the severity of NSD. The present study aimed to determine whether the deformation rate (DR) is associated with visual analogue scale (VAS) and nasal airway resistance (NAR), and to evaluate the application of DR measurements in nasal septoplasty endoscopic surgery. In the present clinical trial, a total of 30 patients with NSD were enrolled, and DRs were calculated prior to surgery by three dimensional computer tomography (3D-CT) reconstruction techniques combined with mechanical analysis. The distribution of stress lines at the nasal septum deviation site was evaluated prior to operation. Following nasal septoplasty endoscopic surgery, pre and postoperation scores for VAS and NAR were compared. The results demonstrated that DR was significantly correlated with preoperational NAR (r=0.534) and VAS scores (r=0.397). According to preoperative CT measurements of NSD, DR and biomechanical properties, selective excision was performed to remove core areas of stress. It was observed that postoperative DR, NAR and VAS scores were significantly lower (all P<0.01) than those measured preoperation. Furthermore, over a follow-up period of 3 months, 23 cases (73.1%) were cured and 7 cases (23.3%) exhibited improvements. These results indicate that preoperative measurement of septum DR by 3D-CT reconstruction techniques may be important in determining the specific surgical approach of nasal septoplasty required.
| S-EPMC5526204 | biostudies-other
Project description:AbstractDermoid cyst is a congenital and benign disease with most occur on the head and neck. It is rarely that occur on the nasal tip and nasal septum at same time and rarely repair of using nasal septum mucosa. The authors treated a child with dermoid cyst in the nasal tip and septum. Only the dermoid cyst at the tip of the nose caused the change of appearance. Dermoid cyst of nasal septum did not cause any clinical symptoms. She underwent excision of the dermoid cyst at the tip of the nose and endoscopic surgery for the dermoid cyst in the nasal septum and used the nasal septum mucosa for repair at the same time. After 6 months of recovery, the appearance of the nasal tip recovered well without obvious scar, the nasal septum area recovered well, and the local stoma was unobstructed without recurrence. The authors found that this kind of nasal septal cyst with no clinical symptoms can achieve good therapeutic effect through endoscopic surgery and repair of using nasal septum mucosa, with less damage, rapid recovery, and good prognosis.
| S-EPMC9275844 | biostudies-literature
Project description:Bone morphogenetic protein (BMP) signaling plays many roles in skull morphogenesis. We have previously reported that enhanced BMP signaling through the BMP type IA receptor (BMPR1A) in cranial neural crest cells causes craniosynostosis during postnatal development. Additionally, we observed that 55% of Bmpr1a mutant mice show neonatal lethality characterized by a distended gastrointestinal tract. Here, we show that severely affected mutants exhibit defective nasal cartilage, failure of fusion between the nasal septum and the secondary palate, and higher levels of phosphorylated SMAD1 and SMAD5 in the nasal tissue. TUNEL demonstrated an increase in apoptosis in both condensing mesenchymal tissues and cartilage of the nasal region in mutants. The levels of p53 (TRP53) tumor suppressor protein were also increased in the same tissue. Injection of pifithrin-α, a chemical inhibitor of p53, into pregnant mice prevented neonatal lethality while concomitantly reducing apoptosis in nasal cartilage primordia, suggesting that enhanced BMP signaling induces p53-mediated apoptosis in the nasal cartilage. The expression of Bax and caspase 3, downstream targets of p53, was increased in the mutants; however, the p53 expression level was unchanged. It has been reported that MDM2 interacts with p53 to promote degradation. We found that the amount of MDM2-p53 complex was decreased in all mutants, and the most severely affected mutants had the largest decrease. Our previous finding that the BMP signaling component SMAD1 prevents MDM2-mediated p53 degradation coupled with our new data indicate that augmented BMP signaling induces p53-mediated apoptosis by prevention of p53 degradation in developing nasal cartilage. Thus, an appropriate level of BMP signaling is required for proper craniofacial morphogenesis.
| S-EPMC4378250 | biostudies-literature
Project description:ObjectiveNasal septum cartilage is a hyaline cartilage that provides structural support to the nasal cavity and midface. Currently, information on its cellular and mechanical properties is widely dispersed and has often been inferred from studies conducted on other cartilage types such as the knee. A detailed understanding of nasal cartilage properties is important for several biological, clinical, and engineering disciplines. The objectives of this scoping review are to (1) consolidate actual existing knowledge on nasal cartilage properties and (2) identify gaps of knowledge and research questions requiring future investigations.DesignThis scoping review incorporated articles identified using PROSPERO, Cochrane Library (CDSR and Central), WOS BIOSIS, WOS Core Collection, and ProQuest Dissertations and Theses Global databases. Following the screening process, 86 articles were considered. Articles were categorized into three groups: growth, extracellular matrix, and mechanical properties.ResultsMost articles investigated growth properties followed by extracellular matrix and mechanical properties. NSC cartilage is not uniform. Nasal cartilage growth varies with age and location. Similarly, extracellular matrix composition and mechanical properties are location-specific within the NSC. Moreover, most articles included in the review investigate these properties in isolation and only very few articles demonstrate the interrelationship between multiple cartilage properties.ConclusionsThis scoping review presents a first comprehensive description of research on NSC properties with a focus on NSC growth, extracellular matrix and mechanical properties. It additionally identifies the needs (1) to understand how these various cartilage properties intersect and (2) for more granular, standardized assessment protocols to describe NSC.
| S-EPMC9137313 | biostudies-literature