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    Is G. cambogia a promising treatment? Effects on cultured nasal epithelial cells
    (Verduci Publisher, 2022) Dilber, M.; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. Mehtap; Cingi, C.
    OBJECTIVE: The purpose of this study is to assess the effects of applying Garcinia cambogia to cultured human nasal epithelial cells. MATERIALS AND METHODS: A cell culture was set up consisting of human primary nasal epithelial cells harvested during septorhinoplasty from volunteers. The cells came from individuals with no history of rhinosinusitis. One assay for assessing cytotoxicity in cell culture utilises MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide). This method allows visualization of fragmented DNA, condensation of nuclei and changes to the external cellular membrane or cytoskeleton. Our study employed this method. Nasal epithelial cells at 37 degrees C were exposed in culture to G. cambogia for a period of 24 hours. Afterwards an MTT assay was used in conjunction with confocal microscopy to assess evidence of toxicity. The proliferative capability of the nasal epithelial cells was also evaluated by inducing a scratch injury to cultured cells followed by light microscopic examination. RESULTS: Testing for cytotoxicity in this manner indicates that G. cambogia does not appear harmful to cultured nasal epithelial cells when applied directly. The cells exposed to this plant extract were still fully viable 24 hours afterwards. There was no increase in viability at the level of statistical significance. It was noted, however, that proliferation did increase slightly within the exposure period. The MTT assay and confocal microscopy confirm these findings. Under confocal microscopic examination, a compact morphology with unaltered nuclear and cytoskeletal appearances was observed. Thus, there is no evidence suggesting viability is impaired or that cytotoxicity occurs. Ordinary light microscopic examination showed the area denuded of cells had become re-covered completely within 24 hours in the cultures where G. cambogia had been applied. The result suggests that exposure to G. cambogia has nos ignificant effect in terms o f stimulating or inhibiting cellular proliferation. CONCLUSIONS: G. cambogia may offer clinibenefit as a supplementary topical treatment for inflammation of the nose and sinuses, as seen in chronic and acute rhinosinusitis, or nasal polyps. The plant appears to increase nasal epitheliocytic proliferation slightly, as revealed by the MTT assay. There were no indications of a cytotoxic effect on epithelial cells of the nose.
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    Septal extension graft use in the treatment of alar collapse
    (Verduci Publisher, 2023) Resuli, A. S.; Dilber, M.; Muluk, N. Bayar; Cingi, C.
    OBJECTIVE: In our study, we showed that the septal extension graft (SEG) technique, which we applied for nasal projection in rhinoplasty surgery, increases the tension of the lateral cartilage (LC) and alar structures. We also demonstrated that nasal congestion could be treated by applying this technique in patients with nasal obstruction due to bilateral dynamic alar collapse. PATIENTS AND METHODS: This study was conducted retrospectively on 23 patients with nasal obstruction due to alar collapse. Bilateral dynamic nasal collapse and (+) Cottle test was present in all patients. Nasal lateral wall tissue was also found flaccid on nasal palpation and collapsed to the extent of obstruction on deep inspiration. Standard septal extension graft (SEG) and tongue-in- groove techniques were applied to all patients. RESULTS: Septal cartilage was used for SEG in all patients. No complaints of nasal obstruction on deep inspiration were noted by the patients at six months postoperative follow-up, and Cottle tests were negative. The patients' mean respiratory score was 152 postoperatively, compared to 66.5 preoperatively. This difference was statistically significant using the Wilcoxon signed ranks test ( p< 0.001). In evaluating postoperative cosmetic appearance due to nasal tip projection (NTP) and cephalic rotation changes, 16 men and four women reported that it was better, while two men felt that there was no change. One woman reported that her cosmetic appearance was worse than before; a revision surgery was performed for her at seven months postoperatively. CONCLUSIONS: This method is effective for patients with bilateral nasal collapse and thickshort columella. With the applied surgery, the caudal edge of the LC diverges from the septum, alar region tension and resistance increase, the columella increases in length, nasal projection increases, and the vestibule cross-sectional area is enlarged. In this way, a significant increase in nasal vestibular volume was obtained.
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    The intranasal trigeminal system: roles in rhinitis (allergic and non-allergic)
    (Verduci Publisher, 2022) Ulusoy, S.; Muluk, N. Bayar; Scadding, G. K.; Passali, G. S.; Dilber, M.; Gevaert, P.; Passali, D.
    The aim of this paper is to review intranasal trigeminal system and associated reflexes. The literature survey was performed on PubMed, ProQuest Central database of Kirikkale University and Google Scholar. The intranasal trigeminal system and associated reflexes play an important role in humans in both health and disease, including in rhinitis of non-allergic and mixed type. The intranasal trigeminal nerve provides sensory perception to the lining of the nose, supplying information on how patent the nasal airway is and responding to various chemical signals. The reflexes known to exist within the intranasal trigeminal system are nasobronchial reflex, trigemino-cardiac reflex, nasogastric reflex, and nasal cycle. The intranasal trigeminal system and its reflexes play a vital role in normal human physiology. Alterations in how this system operates may underlie multiple forms of rhinitis and more research is needed to fully understand the mechanisms involved.
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    The superiority of Dexpanthenol or Vaseline as excipient in nasal formulations
    (Verduci Publisher, 2022) Develioglu, O. N.; Dilber, M.; Muluk, N. Bayar; Sezer, C. Vejselova; Kutlu, H. Mehtap; Topsakal, V.; Cingi, C.
    OBJECTIVE: Dexpanthenol is an ingredient in multiple topical pharmaceutical preparations thanks to its high penetration and localized concentration. It is included in many ointments or lotions for dermatological use, assisting in healing and reducing pruritus. Vaseline is a synthetic product obtained by distilling crude oil. It is commercially available in several grades. The study presented here examined how topically applied agents (dexpanthenol or vaseline) affect nasal epithelial cells in culture. In particular, the study aimed to identify any alterations to epithelial cells which might indicate toxicity. MATERIALS AND METHODS: The nasal epithelial cells used were sourced from mucosal tissue fragments left over the following septorhinoplasty on five patients not suffering from rhinosinusitis. The first step was to dissect the mucosal fragments into smaller pieces on a sterilized Petri dish. These fragments were then placed into the DMEM-F12 cell culture medium, which had been freshly prepared. The dexpanthenol and vaseline were diluted in dimethylsulfoxide (DMSO) to a concentration of 5 mg/ mL. The cells in the wells were exposed to varying concentrations of dexpanthenol or vaseline. The actual concentration of the test reagent to which the epithelial cells were exposed ranged from 0.15 mg/mL to 5 mg/mL. The exposure period was 24 hours. The cells were finally examined using a Leica SP5II confocal microscope. The features sought were DNA fragmentation, condensation of the nuclei, changes in the outer membrane, or cytoskeletal abnormality. RESULTS: The viability of the cultured nasal epithelial cells was unaltered by a 24-hour exposure to dexpanthenol, nor was the cellular proliferation rate affected at the level of statistical significance. There was evidence of a cytotoxic effect from exposing nasal epithelial cells to vaseline in liquid form for 24 hours. There was a reduction in cellular viability in the plates where the highest dose of vaseline (5 mg/mL) was used. Cellular viability was not affected significantly at any of the doses below 5 mg/mL. CONCLUSIONS: The absence of cytotoxic effects from the application of dexpanthenol to the nasal mucosa indicates that this agent may be safely used within the nose. The cytotoxic effects of liquid vaseline observed in this trial (condensed nuclear chromatin, loss of cellular volume) indicate that this agent may be harmful when used intranasally. For patients who require nasal packing due to nose bleeds or following endoscopic sinus surgical procedures, dexpanthenol should be preferred to vaseline from the point of view of maximizing healing of a nasal injury.