Introduction

Claude Lenfant

iii

Preface

Contributors

vii

Part One ANATOMY AND PHYSIOLOGY OF THE UPPER AND LOWER AIRWAYS

1. Comparative Anatomy of the Nasal and Tracheal/Bronchial Airways

(52)

Fuad M. Baroody and Brendan J. Canning

I. Gross Anatomy of the Airways

(6)

II. Histology of the Airways

(15)

III. Vascular and Lymphatic Supplies

(5)

IV. Neural Supply to the Airways

(9)

V. Mucociliary Transport

(4)

VI. Specialized Functions of the Nasal Airways

(3)

VII. Conclusion

(10)

2. The Impact of Nasal Function and Dysfunction on the Lower Airways

(34)

Alkis Togias and Hugh Windom

I. Conditioning of Inhaled Air

(12)

II. Neural Responses of the Nose

(2)

III. The Nose and Nitric Oxide

(2)

IV. Impact of Nasal Stimulation on the Lower Airways

(16)

3. Upper Airway Reflexes and Involvement of the Lower Airway

(18)

Ronald Eccles

I. Sensory Nerve Supply to the Upper Airways

(2)

II. Sensory Receptors and Modalities of Sensation

(3)

III. Upper Airway Reflexes

(5)

IV. Interactions Between the Upper and Lower Airways

(2)

V. Conclusions

100

(5)

Part Two EPIDEMIOLOGY AND PATHOGENESIS OF UPPER AND LOWER AIRWAY DISEASE

4. Epidemiological Evidence for the Relationship Between Upper and Lower Airway Diseases

105

(34)

Isabella Annesi-Maesano

I. Direct Evidence

106

(15)

II. Indirect Evidence

121

(7)

III. Conclusions

128

(11)

5. Comparative Pathogenesis of Upper and Lower Airway Allergic Disease

139

(36)

K. Rajakulasingam and Stephen R. Durham

I. Role of Atopy, IgE, and Its Receptors

140

(1)

II. Early and Late Phase Responses to Allergen

141

(2)

III. Bronchial and Nasal Hyperresponsiveness

143

(1)

IV. The Role of Inflammatory Cells in Asthma and Rhinitis

144

(8)

V. Role of Epithelium in Asthma and Rhinitis

152

(2)

VI. Mechanisms of Cellular Infiltration

154

(1)

VII. Microvascular Leakage and Plasma Protein Exudation

155

(2)

VIII. Comparative Effects of Therapeutic Agents

157

(1)

IX. Conclusions

158

(17)

6. Pathogenetic Links Between Rhinitis and Asthma

175

(12)

Jean Bousquet, A. Maurizo Vignola, and Pascal Demoly

I. Rhinitis and Nonspecific Bronchial Hyperreactivity

175

(1)

II. Common Causative Agents in Rhinitis and Asthma

176

(1)

III. Nasal Inflammation in Patients with Asthma

176

(1)

IV. Bronchial Inflammation and Asthma in Patients with Rhinitis

177

(1)

V. "Bidirectional" Relationship Between Nasal and Bronchial Inflammation

178

(1)

VI. Systematic Nature of Allergic Inflammation

179

(1)

VII. Rhinitis and Asthma: A Continuum of Disease?

180

(7)

7. Viral Infections: Effects on Nasal and Lower Airway Functions

187

(36)

Inuran R. Hussain and Sebastian L. Johnston

I. Identification of Respiratory Viruses in Samples

188

(1)

II. Viral Infection and the Upper Airways

189

(2)

III. Studies Investigating Immune Responses to Respiratory Virus Infection of the Upper Airway

191

(5)

IV. Studies Investigating Immune Responses to Respiratory Virus Infection of the Lower Airway

196

(4)

V. Physiological Response of the Upper Respiratory Tract to Infection

200

(1)

VI. Physiological Response of the Lower Respiratory Tract to Infection

200

(1)

VII. Virus Infection of the Upper Airways: Lower Airway Functional Changes

201

(4)

VIII. Methodology for Eliminating URT Contamination

205

(2)

IX. Linking of the Upper and Lower Airways

207

(2)

X. Timing of Symptoms in Upper Airway Infection

209

(2)

XI. Conclusion

211

(12)

8. Experimental Animal Models of Upper-Lower Airways Interactions

223

(28)

Charles G. Irvin

I. Creating a Relevant Model: The Problems

224

(2)

II. Asthma and Sinusitis

226

(1)

III. Rabbit Model of Asthma and Sinusitis

227

(10)

IV. Rat Model of Asthma and Sinusitis

237

(3)

V. Mouse Models of Asthma/Sinusitis

240

(2)

VI. Conclusions

242

(9)

Part Three DIAGNOSIS AND TREATMENT OF RHINO-SINUSITIS AND ASTHMA

9. Diagnostic Evaluation of Sinusitis in Patients with Asthma

251

(24)

Sheldon Speclor, Michael Diament, and Dale Rice

I. Symptoms and Signs of Sinusitis

251

(1)

II. Nasal Cytology

252

(2)

III. Sinus Ultrasound

254

(2)

IV. Radiographic Imaging of the Paranasal Sinuses

256

(7)

V. Endoscopy of the Nose and Sinuses

263

(12)

10. Management of Allergic Rhinitis in Patients with Asthma

275

(22)

Jonathan Corren and Jean Bousquet

I. Allergen Avoidance Measures

275

(3)

II. Pharmacological Therapy

278

(6)

III. Allergen Immunotherapy

284

(1)

IV. Treatment Considerations in Special Groups

284

(2)

V. Future Therapies

286

(1)

VI. Effects of Rhinitis Therapy on Asthma

287

(3)

VII. Summary

290

(7)

11. Medical Management of Sinusitis in Patients with Asthma

297

(24)

Larry Borish, James A. Wilde, William K. Dolen, Chester Stafford, and Raymond Slavin

I. Definitions and Pathophysiology

297

(2)

II. Approach to Treatment

299

(13)

III. Allergy Evaluation

312

(1)

IV. Medical Treatment of Sinusitis: Effects on Concomitant Asthma

313

(1)

V. Conclusions

314

(7)

12. Surgical Management of Rhinitis, Sinusitis, and Nasal Polyposis in Patients with Asthma

321

(14)

R. Jankowski

I. Definition and Preliminary Remarks

322

(1)

II. Surgical Management of Nasal Polyposis in Patients with Asthma

322

(4)

III. Surgical Management of Sinusitis in Patients with Asthma

326

(4)

IV. Surgical Management of Rhinitis in Patients with Asthma

330

(1)

V. Conclusion

331

(4)

13. Manifestations of Aspirin Sensitivity in the Upper and Lower Airways

335

(34)

Donald D. Stevenson

I. Clinical Entity

336

(1)

II. Sinusitis and Asthma in ASA-Sensitive Asmathics

337

(1)

III. Identification of ASA Sensitivity

338

(4)

IV. ASA Desensitization Procedures

342

(2)

V. ASA Cross-Sensitivity and Cross-Desensitization

344

(4)

VI. Pathogenesis

348

(7)

VII. Treatment

355

(14)

14. Effects of Sleep on Upper and Lower Airways

369

(20)

Robert D. Ballard

I. Sleep and Upper Airway Function

370

(1)

II. Obstructive Sleep Apnea and Airway Function in Patients Without Other Airways Disease

371

(1)

III. Obstructive Sleep Apnea and Asthma

372

(3)

IV. Sleep, Lung Volumes, and Intrapulmonary Blood Volume in Asthmatics with Nocturnal Worsening: A Potential Role for the Upper Airway

375

(3)

V. The Effect of Sleep and Circadian Rhythms on Manifestations of Viral and Allergic Rhinitis: Potential Implications for Asthmatic Patients

378

(2)

VI. Inflammatory Changes Associated with Obstructive Sleep Apnea: Potential Implications for Asthma

380

(2)

VII. Conclusion

382

(7)

15. Vocal Cord Dysfunction

389

(12)

Kenneth B. Newman

I. Demographics

390

(1)

II. Clinical History and Physical Examination

390

(1)

III. Laboratory Evaluation

391

(2)

IV. Laryngoscopy

393

(1)

V. Prevalence

394

(1)

VI. Psychological Factor

394

(1)

VII. Therapy

395

(1)

VIII. Conclusion

396

(5)

Part Four SYSTEMIC DISEASES AFFECTING UPPER AND LOWER AIRWAYS

16. Manifestations of Cystic Fibrosis in the Upper and Lower Airways

401

(20)

Peter Macguire, Robert Bocian, Judy Palmer, and Dale T. Umetsu

I. Pathophysiology of Cystic Fibrosis

402

(1)

II. Lower-Respiratory Tract Symptoms in Patients with Cystic Fibrosis

403

(1)

III. Upper Respiratory Tract Symptoms in Patients with Cystic Fibrosis

404

(2)

IV. Symptoms and Signs of Sinusitis in Cystic Fibrosis

406

(1)

V. Sinusitis and Reactive Airways Disease in Patients with Cystic Fibrosis

407

(2)

VI. Interaction of Upper- and Lower-Respiratory Airways

409

(1)

VII. Bacteriology of Sinusitis, Bronchitis, and Pneumonia in Patients with Cystic Fibrosis

410

(1)

VIII. Diagnostic Evaluation for Sinusitis in Cystic Fibrosis

410

(1)

IX. Treatment of Lower-Respiratory-Tract Disease

411

(1)

X. Experimental Therapies for CF

412

(3)

XI. Conclusions

415

(6)

17. The Sinobronchial Syndrome and Diffuse Panbronchiolitis

421

(22)

Yukihiko Sugiyama and Shoji Kudoh

I. Sinobronchial Syndrome

421

(2)

II. Diffuse Panbronchiolitis

423

(12)

III. Mechanisms of Erythromycin Therapy

435

(8)

18. Manifestations of Wegener's Granulomatosis in the Upper and Lower Airways

443

(18)

David B. Hellman

I. Upper Respiratory Tract Manifestations

444

(3)

II. Lower Respiratory Tract Manifestations

447

(3)

III. Pathology

450

(2)

IV. Etiology and Pathogenesis

452

(1)

V. Diagnosis

452

(1)

VI. Differential Diagnosis

453

(1)

VII. Treatment

453

(8)

19. Manifestation of Sarcoidosis in the Upper and Lower Airways

461

(32)

David R. Moller and Irina Petrache

I. General Features

461

(4)

II. Sarcoidosis of the Upper Respiratory Tract (SURT)

465

(2)

III. Pulmonary Sarcoidosis and Intrathoracic Airway Disease

467

(4)

IV. Diagnosis

471

(2)

V. Immunopathogenesis

473

(3)

VI. Clinical Course and Treatment

476

(17)

20. Manifestations of Immune Deficiency Syndromes in the Upper and Lower Airways

493

(18)

Jeffrey L. Kishiyama and Daniel C. Adelman

I. Host Defense

494

(2)

II. Humoral Immunodeficiency

496

(5)

III. Common Variable Immunodeficiency

501

(3)

IV. X-Linked Agammaglobulinemia

504

(1)

V. Laboratory Evaluation

505

(1)

VI. Treatment

506

(1)

VII. Summary

507

(4)

Index

511

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Upper and Lower Respiratory Disease

9780824707231

0824707230

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