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Not for further distribution unless allowed by the License or with the express written permission of Cambridge University Press.
https://doi.org/10.1258/002221505774783377
https://doi.org/10.1258/002221505774783377 Published online by Cambridge University Press
2022-04-14T02:42:23+00:00
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-0.005 Tc 6 0 0 6 198.00909 400.7578 Tm
(15)Tj
-0.0051 Tc 0.2007 Tw 10 0 0 10 207.8558 396.7578 Tm
[(T)40(here is however)]TJ
0.12759 Tw -14.93201 -1.1127 Td
(little evidence to suggest these organisms cause the)Tj
0.12711 Tw T*
[(disease;)-317(they may be secondary invaders)55(.)]TJ
/T1_1 1 Tf
0 Tw 18.33859 0 Td
[(Bor)18(detella)]TJ
0.01489 Tc -18.33859 -1.11259 Td
[(bronc)12(hiseptica)]TJ
/T1_2 1 Tf
7.4151 0 Td
(and )Tj
/T1_1 1 Tf
0.72971 Tw 2.6515 0 Td
[(P)55(asteurella multocida )]TJ
/T1_2 1 Tf
0 Tw 11.23421 0 Td
(are)Tj
0.3912 Tw -21.3008 -1.1127 Td
[(implicated in )55(AR in pigs)55(.)]TJ
0 Tw 6 0 0 6 184.9418 356.2516 Tm
(23)Tj
0.3912 Tw 10 0 0 10 197.6843 352.25169 Tm
(It is possible that)Tj
-0.0051 Tc 0.0481 Tw -13.9149 -1.1127 Td
(superinfection with a mixed flora of these organisms)Tj
0.01489 Tc 0.47549 Tw T*
(causes ciliostasis with resultant destruction of)Tj
0.6678 Tw T*
[(epithelium and progressive mucosal changes)55(.)]TJ
-0.0051 Tc 0.12421 Tw T*
(Cilioinhibition by )Tj
/T1_1 1 Tf
0 Tw 8.0443 0 Td
[(K.)-314(ozaenae)]TJ
/T1_2 1 Tf
0.12421 Tw 5.1658 0 Td
(has been studied as a)Tj
0.02499 Tw -13.2101 -1.11259 Td
[(mechanism in the pathogenesis of )55(AR.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 224.7052 300.6189 Tm
(24)Tj
/T1_1 1 Tf
-0.0051 Tc 0.183 Tw 10 0 0 10 58.5354 274.36591 Tm
[(Developmental disor)18(ders)]TJ
/T1_2 1 Tf
0.18311 Tw 10.74361 0 Td
[(.)-373(Structural changes during)]TJ
0.0596 Tw -10.74361 -1.1127 Td
(development of the nasal and faciomaxillary regions)Tj
0.16499 Tw T*
(perhaps have a role to play in the development of)Tj
0.2355 Tw T*
[(AR.)-426(P)47(oor pneumatization of the maxillary sinuses)]TJ
0.16229 Tw T*
[(and congenitally spacious nasal cavities)55(,)-352(excessively)]TJ
0.00191 Tw T*
(patent nasal cavities in relation to the shape and type)Tj
0.2693 Tw T*
(of skull and platyrrhinia are associations that are)Tj
0 Tw T*
(mentioned.)Tj
-0.005 Tc 6 0 0 6 107.2056 200.48 Tm
(1,15,25)Tj
/T1_1 1 Tf
-0.0051 Tc 0.0197 Tw 10 0 0 10 58.5354 174.22701 Tm
(Nutritional deficiency)Tj
/T1_2 1 Tf
9.159 0 Td
[(.)-210(P)47(oor nutrition is considered to)]TJ
0.1709 Tw -9.159 -1.11259 Td
[(be an important factor in the development of )55(AR.)]TJ
0.10941 Tw 0 -1.11259 TD
[(Some authors consider this to be an iron deficienc)18(y)]TJ
0 Tw T*
[(disease)37(.)]TJ
-0.005 Tc 6 0 0 6 91.38271 144.84731 Tm
(26)Tj
-0.0051 Tc 0.24451 Tw 10 0 0 10 102.21741 140.8474 Tm
[(F)74(at-soluble vitamin deficienc)18(y \(especially)]TJ
0.33611 Tw -4.36819 -1.1127 Td
[(vitamin )55(A\) is also believed to be a factor)18(.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 260.64259 133.72079 Tm
(15)Tj
-0.0052 Tc 10 0 0 10 271.84441 129.72079 Tm
(An)Tj
0.1884 Tw -21.3309 -1.1127 Td
[(interesting study from P)47(oland attempts to find out)]TJ
0.16479 Tw 0 -1.1127 TD
(why ozaena is almost absent in the well-developed)Tj
0.01489 Tc 0.5211 Tw T*
(regions and why it commonly occurs in the)Tj
-0.0051 Tc 0.041 Tw T*
(developing and underdeveloped countries where the)Tj
0.02499 Tw T*
[(everyday diet is poor in iron,)-215(proteins and vitamins)55(.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 279.5984 78.0881 Tm
(27)Tj
/T1_1 1 Tf
0.01489 Tc 0.56351 Tw 10 0 0 10 309.5433 758.80701 Tm
(Phospholipid deficiency)Tj
/T1_2 1 Tf
11.2149 0 Td
[(.)-719(T)40(he possible role of)]TJ
0.4149 Tw -11.2149 -1.1129 Td
[(surfactant deficienc)18(y in )55(AR has been studied.)]TJ
-0.0051 Tc 0.0399 Tw 0 -1.1129 TD
(Biochemical analysis of the nasal aspirate in cases of)Tj
0.01489 Tc 0.3974 Tw T*
(primary atrophic rhinitis revealed a significant)Tj
-0.0051 Tc 0.3616 Tw T*
(decrease in the total phospholipids compared to)Tj
0.02499 Tw T*
[(normal cases)55(.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 366.92439 707.1638 Tm
(28)Tj
/T1_1 1 Tf
0.01489 Tc 0.355 Tw 10 0 0 10 309.5433 692.03529 Tm
[(A)18(utonomic disor)18(ders)]TJ
/T1_2 1 Tf
9.63319 0 Td
[(.)-565(Excessive vasoconstriction)]TJ
0.5849 Tw -9.63319 -1.1129 Td
(from autonomic imbalances as a reason for)Tj
-0.0051 Tc 0.2319 Tw T*
[(development of )55(AR has been described.)]TJ
0 Tc 0 Tw 6 0 0 6 492.69321 673.778 Tm
(5)Tj
-0.0051 Tc 0.2319 Tw 10 0 0 10 499.883 669.778 Tm
[(T)40(here is)]TJ
-0.0071 Tw -19.034 -1.1129 Td
(also a hypothesis that vasomotor rhinitis and primary)Tj
0.1546 Tw T*
(atrophic rhinitis are diseases at the two ends of an)Tj
-0.0291 Tw T*
[(autonomic spectrum and,)-161(further)18(,)-161(that the dimensions)]TJ
0.0795 Tw T*
(and sensory receptors of the anterior nasal aperture)Tj
0.2662 Tw T*
(play a vital role in the aetiopathogenesis of both)Tj
0.17349 Tw T*
(these conditions through reflex autonomic action.)Tj
-0.005 Tc 0 Tw 6 0 0 6 530.77 607.0063 Tm
(29)Tj
0.01489 Tc 0.46049 Tw 10 0 0 10 309.5433 591.8777 Tm
(AR is also compared to a transient regional)Tj
-0.0051 Tc 0.03619 Tw T*
[(osteoporosis with related neurogenic pathogenesis)55(.)]TJ
0 Tw 6 0 0 6 528.80341 584.74899 Tm
(30-)Tj
-0.005 Tc -36.5434 -1.8548 Td
(32)Tj
-0.0051 Tc 0.12759 Tw 10 0 0 10 318.6595 569.6205 Tm
(An initial stage of vasodilatation and hyperaemic)Tj
0.0135 Tc 0.3564 Tw -0.91161 -1.1129 Td
(decalcification of the turbinates is followed by)Tj
-0.0051 Tc 0.15601 Tw T*
(collapse of the bones as seen in reflex sympathetic)Tj
0.31261 Tw T*
[(dystrophic syndrome)37(.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 404.6433 540.2346 Tm
(31,32)Tj
-0.0051 Tc 0.31261 Tw 10 0 0 10 423.0201 536.2346 Tm
[(T)40(he autonomic theory is)]TJ
0.2215 Tw -11.3477 -1.1129 Td
(also supported by the effectiveness of attempts to)Tj
0.3613 Tw T*
[(overcome the vasoconstriction in )55(AR by stellate)]TJ
0.02499 Tw T*
[(ganglion blocks and cervical sympathectomy)92(.)]TJ
/T1_1 1 Tf
0.01489 Tc 0.4989 Tw 0 -2.22569 TD
(Endocrine imbalances)Tj
/T1_2 1 Tf
0.49899 Tw 10.32581 0 Td
[(.)-709(Oestrogen deficienc)18(y is)]TJ
-0.0051 Tc 0.1243 Tw -10.32581 -1.1129 Td
[(implicated as a causative factor by some authors)55(.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 526.33 473.46291 Tm
(1,33)Tj
-0.0051 Tc 0.2404 Tw 10 0 0 10 309.5433 458.3343 Tm
[(T)40(he incidence of the disease in pubertal girls)55(,)-431(the)]TJ
0.21761 Tw 0 -1.1129 TD
(aggravation of symptoms during menstruation and)Tj
0.3183 Tw T*
[(pregnanc)18(y)92(,)-508(and the improvement of symptoms in)]TJ
0.0027 Tc 0.3672 Tw T*
(some cases with oestrogen therapy support this)Tj
-0.0051 Tc 0 Tw T*
[(theory)92(.)]TJ
/T1_1 1 Tf
0.25771 Tw 0 -2.22569 TD
[(Allergy and immune disor)18(ders)]TJ
/T1_2 1 Tf
13.5874 0 Td
[(.)-393(T)111(ype I allergy was)]TJ
0.07899 Tw -13.5874 -1.1129 Td
[(evident in 85 per cent of )55(T)40(hai patients with )55(AR in a)]TJ
0.0085 Tc 0.3614 Tw 0 -1.1129 TD
[(recent study)92(.)]TJ
0 Tw 6 0 0 6 368.912 373.3053 Tm
(11)Tj
0.3613 Tw 10 0 0 10 380.6665 369.3054 Tm
(Another study evaluated cellular)Tj
-0.0051 Tc 0.22169 Tw -7.1123 -1.1129 Td
[(immunity in patients with )55(AR using the leucoc)18(yte)]TJ
0.03951 Tw T*
(migration and spontaneous rosette test )Tj
/T1_1 1 Tf
17.08591 0 Td
(in vitro)Tj
/T1_2 1 Tf
0 Tc 0 Tw 3.08369 0 Td
(;)Tj
-0.005 Tc 6 0 0 6 513.689 351.0481 Tm
(34 )Tj
-0.0052 Tc 10 0 0 10 521.3358 347.0482 Tm
(this)Tj
0.01489 Tc 0.3824 Tw -21.17931 -1.1129 Td
(confirmed altered cellular reactivity or loss of)Tj
-0.0051 Tc -0.01759 Tw T*
[(tolerance to nasal tissues)55(.)-118(V)111(arious factors such as viral)]TJ
0.1819 Tw T*
[(infections)55(,)-372(malnutrition and immunodeficienc)18(y may)]TJ
0.2159 Tw T*
(trigger a destructive autoimmune process with the)Tj
0.01489 Tc 0.4671 Tw T*
(release of antigens of nasal mucosa into the)Tj
-0.0051 Tc 0.14571 Tw T*
[(circulation.)-281(A study of immunoglobulins revealed a)]TJ
-0.03461 Tw T*
(rise in serum IgM without a rise in IgG and IgA levels)Tj
-0.0434 Tw T*
(in AR.)Tj
-0.005 Tc 0 Tw 6 0 0 6 338.30341 262.0192 Tm
(35)Tj
-0.0051 Tc 0.01151 Tw 10 0 0 10 346.8082 258.0192 Tm
(In a recent study on immunology in a family)Tj
0.01489 Tc 0.6286 Tw -3.7265 -1.1129 Td
[(affected by ozaena,)-839(positivity for IgG class)]TJ
0.8242 Tw T*
(anticardiolipins was correlated with disease)Tj
-0.0051 Tc 0 Tw T*
(manifestation.)Tj
-0.005 Tc 6 0 0 6 370.7773 228.6333 Tm
(36)Tj
-0.0051 Tc 0.0096 Tw 10 0 0 10 378.71359 224.63341 Tm
[(T)40(he disease certainly develops and is)]TJ
0.0643 Tw -6.91701 -1.1129 Td
(transmitted by a multitude of factors and multigenic)Tj
0 Tw T*
[(modes)55(.)]TJ
-0.005 Tc 6 0 0 6 339.5291 206.3761 Tm
(14)Tj
/T1_1 1 Tf
-0.0051 Tc 0.02499 Tw 10 0 0 10 309.5433 177.2475 Tm
(Secondary atrophic rhinitis )Tj
/T1_2 1 Tf
0.21111 Tw 0 -1.4129 TD
[(AR may be secondary to a number of conditions)55(.)]TJ
/T1_1 1 Tf
0.1777 Tw 0 -1.1129 TD
(Extensive accidental maxillofacial and nasal trauma)Tj
/T1_2 1 Tf
0.0042 Tc 0.3658 Tw T*
(can cause extensive damage to nasal and sinus)Tj
-0.0051 Tc -0.0296 Tw T*
[(mucosa with resultant crusting and atrophy)92(.)]TJ
/T1_1 1 Tf
0 Tw 18.64951 0 Td
(Extensive)Tj
0.354 Tw -18.64951 -1.1129 Td
(nasal surgery)Tj
/T1_2 1 Tf
0.3539 Tw 6.52699 0 Td
(such as submucus resection of the)Tj
0.1933 Tw -6.52699 -1.1129 Td
[(septum,)-383(turbinate surgeries and sinonasal surgeries)]TJ
0.09061 Tw T*
[(may also result in mucosal denudation,)-281(crusting and)]TJ
-0.03 Tw T*
[(progressive atrophy of underlying tissues)55(.)-105(T)40(he malady)]TJ
0.3511 Tw T*
(\324empty nose syndrome\325 associated with extensive)Tj
0.0166 Tw T*
[(turbinate surgeries has been discussed exhaustively)92(.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 530.77 66.9613 Tm
(37)Tj
0 Tc 9.5 0 0 9.5 58.5354 777.3167 Tm
(844)Tj
0.0005 Tc 0.0249 Tw 7.12 0 0 7.12 433.731 779.0643 Tm
[(S N DUTT)92(,)-220(M KAMESW)93(ARAN)]TJ
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/T1_0 1 Tf
-0.0051 Tc 0.3606 Tw 10 0 0 10 58.811 758.80701 Tm
[(T)111(urbinate surgeries have been both accused and)]TJ
0.0495 Tw 0 -1.13139 TD
(acquitted in the literature as aetiology for secondary)Tj
0.01489 Tc 0.4718 Tw T*
[(atrophic rhinitis)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 137.35001 740.1787 Tm
(7)Tj
/T1_1 1 Tf
0.01489 Tc 0.47189 Tw 10 0 0 10 147.8085 736.1788 Tm
[(Recurrent acute and c)12(hronic)]TJ
-0.0042 Tc 0.3741 Tw -8.8997 -1.13139 Td
(suppurative infections)Tj
/T1_0 1 Tf
10.26489 0 Td
(of the nose and paranasal)Tj
-0.0051 Tc 0.23621 Tw -10.26489 -1.13139 Td
[(sinuses may result in )55(AR.)-426(It is believed that with)]TJ
-0.0041 Tw T*
[(longstanding suppurative sinusitis in childhood,)-186(there)]TJ
0.01489 Tc 0.45641 Tw T*
(is proliferation of connective tissue cells that)Tj
-0.0051 Tc -0.011 Tw T*
[(contract,)-179(leading to reduced nourishment to the nasal)]TJ
0.0504 Tw T*
[(mucus membrane)37(,)-241(and hence shrinkage and atrophy)92(.)]TJ
0.05209 Tw T*
[(V)37(iral exanthems during childhood may also result in)]TJ
0 Tw T*
(AR.)Tj
/T1_1 1 Tf
0.24789 Tw 2.2887 0 Td
[(Chronic granulomatous disor)18(ders)]TJ
/T1_0 1 Tf
15.20711 0 Td
(of the nose)Tj
0.146 Tw -17.4958 -1.13139 Td
(such as )Tj
/T1_1 1 Tf
3.5854 0 Td
[(tuberculosis)55(,)-336(lupus vulgaris)55(,)-336(syphilis)55(,)-336(leprosy)55(,)]TJ
0.1196 Tw -3.5854 -1.13139 Td
[(rhinoscleroma \(atrophic stage\),)-310(yaws and pinta)]TJ
/T1_0 1 Tf
-0.005 Tc 0 Tw 20.6788 0 Td
(have)Tj
0.00301 Tc 0.3669 Tw -20.6788 -1.13139 Td
[(been strongly associated with secondary )55(AR.)]TJ
0.0031 Tc 0 Tw 6 0 0 6 272.43311 615.7238 Tm
(38,39)Tj
-0.0051 Tc 0.2619 Tw 10 0 0 10 58.811 600.4097 Tm
[(Some cases of )55(AR have been described in )]TJ
/T1_1 1 Tf
0 Tw 20.17931 0 Td
(AIDS)Tj
-20.17931 -1.13139 Td
(patients)Tj
/T1_0 1 Tf
0.0137 Tw 3.4968 0 Td
(in Zambia.)Tj
-0.005 Tc 0 Tw 6 0 0 6 140.6376 593.0956 Tm
(40)Tj
/T1_1 1 Tf
-0.0051 Tc 0.0137 Tw 10 0 0 10 149.16451 589.0957 Tm
(Radiation exposure)Tj
/T1_0 1 Tf
8.4888 0 Td
(of nasal and)Tj
0.15199 Tw -17.5242 -1.13139 Td
(sinus cavities may result in excessive nasal crusting)Tj
0.01489 Tc 0.5074 Tw T*
[(and atrophy of the tissues)55(.)-717(Radiotherapy for)]TJ
-0.0051 Tc 0.00571 Tw T*
(nasopharyngeal cancer may result in atrophic rhinitis)Tj
0.01489 Tc 0.625 Tw T*
(that may be made worse with the use of)Tj
0.73441 Tw T*
[(chemotherapeutic agents and decongestants)55(.)]TJ
0 Tw 6 0 0 6 279.9178 536.52521 Tm
(41)Tj
/T1_1 1 Tf
-0.0051 Tc 0.2043 Tw 10 0 0 10 58.811 521.21111 Tm
(Unilateral AR)Tj
/T1_0 1 Tf
0.25909 Tw 6.67081 0 Td
(has been observed in patients with)Tj
0.3322 Tw -6.67081 -1.13139 Td
(gross deviation of the nasal septum.)Tj
-0.005 Tc 0 Tw 6 0 0 6 228.06911 513.897 Tm
(42)Tj
/T1_1 1 Tf
-0.0051 Tc 10 0 0 10 239.7805 509.89709 Tm
(Anhidrotic)Tj
0.01489 Tc 0.9377 Tw -18.09689 -1.13139 Td
[(ectodermal dysplasia \(Christ-Siemens-T)92(ouraine)]TJ
-0.0051 Tc 0 Tw T*
(syndrome\))Tj
/T1_0 1 Tf
0.0386 Tw 4.8497 0 Td
(is a rare genetic disorder of the ectoderm)Tj
0.2003 Tw -4.8497 -1.13139 Td
[(that may rarely present with atrophic rhinitis)55(.)-335(T)40(his)]TJ
0.01489 Tc 1.0629 Tw T*
[(may be a cause of congenital )55(AR.)]TJ
0 Tw 6 0 0 6 272.14771 468.64059 Tm
(43,44)Tj
/T1_1 1 Tf
-0.0051 Tc 0.26221 Tw 10 0 0 10 58.811 453.3266 Tm
[(Osteoc)12(hondroplastic trac)12(heobronc)12(hopathy)]TJ
/T1_0 1 Tf
0.2623 Tw 18.7906 0 Td
(is a rare)Tj
0.06889 Tw -18.7906 -1.13139 Td
(disease with accumulation of bony and cartilaginous)Tj
0.2114 Tw T*
(nodules in the tracheal and bronchial mucosa and)Tj
0.01489 Tc 0.6248 Tw T*
(may be sometimes associated with ozaena.)Tj
0 Tw 6 0 0 6 279.91789 423.38429 Tm
(45)Tj
/T1_1 1 Tf
-0.0051 Tc 0.255 Tw 10 0 0 10 58.811 408.0703 Tm
[(Ic)12(hthyosis vulgaris)]TJ
/T1_0 1 Tf
8.62151 0 Td
(is another autosomal dominant)Tj
0.0612 Tw -8.62151 -1.13139 Td
[(condition that may be associated with )55(AR.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 244.0871 400.7561 Tm
(46)Tj
-0.0051 Tc 0.0612 Tw 10 0 0 10 252.53999 396.7562 Tm
(AR has)Tj
0.0309 Tw -19.37289 -1.13139 Td
(been reported as an unusual complication of )Tj
/T1_1 1 Tf
0 Tw 19.4704 0 Td
(typhoid)Tj
-19.4704 -1.13139 Td
(fever)Tj
/T1_0 1 Tf
0 Tc 2.0844 0 Td
(.)Tj
-0.005 Tc 6 0 0 6 82.1049 378.1279 Tm
(47)Tj
/T1_1 1 Tf
-0.0051 Tc 0.3154 Tw 10 0 0 10 93.649 374.12801 Tm
(Occupational exposure to phosphorite and)Tj
0.02499 Tw -3.4838 -1.13139 Td
(apatite dusts)Tj
/T1_0 1 Tf
5.4808 0 Td
[(is associated with )55(AR.)]TJ
-0.005 Tc 0 Tw 6 0 0 6 208.87 366.8139 Tm
(48)Tj
/T1_2 1 Tf
-0.0051 Tc 10 0 0 10 58.811 337.4998 Tm
[(P)55(athology)]TJ
/T1_0 1 Tf
0.01489 Tc 0.47729 Tw 0 -1.4314 TD
(Atrophic rhinitis is characterized by )Tj
/T1_1 1 Tf
0 Tw 18.7657 0 Td
(\324atrophic)Tj
0.41299 Tw -18.7657 -1.13139 Td
[(c)12(hanges of all parts of the nose\325)]TJ
/T1_0 1 Tf
16.2941 0 Td
[(.)-568(T)40(he normal)]TJ
0.47279 Tw -16.2941 -1.13139 Td
(respiratory epithelium changes to cuboidal or)Tj
-0.0051 Tc 0.13969 Tw 0 -1.13139 TD
[(stratified squamous epithelium \(metaplasia\).)-330(Partial)]TJ
0.127 Tw T*
(to severe metaplasia may be found with or without)Tj
0.1376 Tw T*
[(keratinization.)-273(T)40(here is atrophy of the cilia and the)]TJ
0.01489 Tc 0.5645 Tw T*
[(mucosal and submucosal glands)55(.)-720(T)40(he mucosa)]TJ
-0.0051 Tc 0.28661 Tw T*
[(becomes pale with thick,)-477(viscid,)-477(scanty secretions)55(,)]TJ
0.12801 Tw T*
(drying up to form greenish or grayish yellow crusts)Tj
0.13811 Tw T*
[(and scabs)55(.)-328(Secondary bacterial infections produce a)]TJ
0.3277 Tw T*
[(foetid odour)18(.)-518(Characteristic changes of squamous)]TJ
-0.0025 Tc 0.37241 Tw T*
[(metaplasia in )55(T)40(hai patients with )55(AR have been)]TJ
-0.0051 Tc 0 Tw T*
(described.)Tj
-0.005 Tc 6 0 0 6 102.4837 191.4166 Tm
(11)Tj
-0.0051 Tc 0.07001 Tw 10 0 0 10 111.02409 187.4167 Tm
[(T)40(he lamina propria and submucosa may)]TJ
0.23891 Tw -5.2213 -1.13139 Td
[(show chronic cellular infiltration,)-429(granulations and)]TJ
0 Tw T*
[(fibrosis)55(.)]TJ
0.118 Tw 1 -1.13139 Td
(A rarefying osteitis of the inferior turbinates and)Tj
0.28951 Tw -1 -1.13139 Td
(the ethmoid turbinates is observed with resultant)Tj
0.01489 Tc 0.36099 Tw T*
[(atrophy)92(.)-516(T)100(aylor and )55(Y)92(oung)]TJ
0 Tw 6 0 0 6 187.2717 134.84621 Tm
(49)Tj
0.36099 Tw 10 0 0 10 199.7114 130.8463 Tm
(showed a positive)Tj
-0.0051 Tc 0.01559 Tw -14.09 -1.13139 Td
(alkaline phosphatase reaction in the endothelial cells)Tj
0.00259 Tc 0.36729 Tw T*
(lining the capillaries that suggested active bone)Tj
-0.0051 Tc 0.02541 Tw T*
[(resorption.)-161(T)40(he nasal cavities thus become extremely)]TJ
0.01489 Tc 0.7254 Tw T*
[(roomy)92(.)-881(T)111(wo characteristic types of vascular)]TJ
0.5182 Tw T*
(involvement have been documented by these)Tj
-0.0051 Tc 0 Tw T*
[(authors)55(.)]TJ
-0.005 Tc 6 0 0 6 93.1451 66.96159 Tm
(49)Tj
/T1_1 1 Tf
-0.00011 Tc -0.02991 Tw 10 0 0 10 309.81889 758.80701 Tm
[(AR T)92(ype )-55(I)]TJ
/T1_0 1 Tf
0.1481 Tw 0 -1.4066 TD
(In this common type \(50\32080 per cent of all cases\),)Tj
0.00999 Tc 0.3649 Tw 0 -1.1066 TD
[(there is endarteritis obliterans)55(,)-570(periarteritis and)]TJ
-0.00011 Tc 0.2101 Tw T*
(periarterial fibrosis of the terminal arterioles as a)Tj
0.36861 Tw T*
(result of chronic infections with round cell and)Tj
0.00909 Tc 0.3658 Tw T*
[(plasma cell infiltration.)-570(Logically)92(,)-570(these are the)]TJ
-0.00011 Tc 0.0995 Tw T*
(patients that benefit from the vasodilator effects of)Tj
0.02499 Tw T*
[(oestrogen therapy)92(.)]TJ
/T1_1 1 Tf
-0.02991 Tw 0 -2.50661 TD
[(AR T)92(ype )-55(II)]TJ
/T1_0 1 Tf
0.1387 Tw 0 -1.4066 TD
(Believed to be less common \(20\32050 per cent of all)Tj
-0.02299 Tw 0 -1.1066 TD
[(cases\),)-172(there is capillary vasodilatation in this variety)92(.)]TJ
-0.01469 Tw T*
[(T)40(he endothelial cells of dilated capillaries have more)]TJ
0.0536 Tw T*
[(c)18(ytoplasm than normal and show a positive alkaline)]TJ
0.0199 Tc 0.6781 Tw T*
(phosphatase reaction suggesting active bone)Tj
-0.00011 Tc 0.2312 Tw T*
[(resorption,)-426(which is a feature of the disease)37(.)-371(T)40(his)]TJ
0.0199 Tc 0.3914 Tw T*
[(variety is not amenable to oestrogen therapy)92(.)]TJ
-0.00011 Tc 0.21249 Tw T*
[(However)18(,)-408(in one study)92(,)-408(80 per cent of cases were)]TJ
0.0199 Tc 0.44 Tw T*
[(compatible with the )55(T)111(ype II histopathological)]TJ
-0.00011 Tc 0.02499 Tw T*
(classification with capillary vasodilatation.)Tj
0 Tc 0 Tw 6 0 0 6 493.3326 543.61349 Tm
(11)Tj
/T1_2 1 Tf
-0.00011 Tc 10 0 0 10 309.81889 514.5473 Tm
(Immunology)Tj
/T1_0 1 Tf
0.0199 Tc 0.4001 Tw 0 -1.4066 TD
[(T)40(he leucoc)18(yte migration test and spontaneous)]TJ
-0.00011 Tc 0.22211 Tw 0 -1.1066 TD
(rosette test were performed )Tj
/T1_1 1 Tf
13.164 0 Td
(in vitro)Tj
/T1_0 1 Tf
3.7784 0 Td
(to assess the)Tj
0.0537 Tw -16.9425 -1.1066 Td
[(cellular immunity status of patients with )55(AR.)]TJ
0 Tc 0 Tw 6 0 0 6 507.2319 482.3483 Tm
(34)Tj
-0.0002 Tc 10 0 0 10 515.7195 478.3484 Tm
[(W)37(ith)]TJ
-0.00011 Tc 0.29469 Tw -20.5901 -1.1066 Td
[(the leucoc)18(yte migration test,)-490(the mean migration)]TJ
-0.0285 Tw T*
[(percentage in patients with )55(AR was lower than in the)]TJ
0.13831 Tw T*
(control group indicating recognition of the antigen)Tj
0.03481 Tw T*
[(by circulating leucoc)18(ytes)55(.)-230(In the spontaneous rosette)]TJ
-0.007 Tw T*
[(test,)-188(patients with )55(AR did not form or formed poorly)]TJ
0.36 Tw T*
[(a rosette compared to the control group)40(.)-500(T)40(hese)]TJ
0.0199 Tc 0.5816 Tw T*
(features suggest poor cellular immunity and)Tj
-0.00011 Tc -0.0247 Tw T*
[(reactivity in )55(AR.)-115(Also)40(,)-170(a study of immunoglobulins in)]TJ
0.0199 Tc 0.42 Tw T*
(AR revealed a rise in serum IgM without a)Tj
-0.00011 Tc 0.02499 Tw T*
(corresponding rise in the levels of IgG and IgA.)Tj
0 Tc 0 Tw 6 0 0 6 518.27409 371.6853 Tm
(35)Tj
/T1_2 1 Tf
-0.00011 Tc 0.02499 Tw 10 0 0 10 309.81889 342.61909 Tm
[(Clinical featur)10(es)]TJ
/T1_0 1 Tf
0.2354 Tw 0 -1.4066 TD
[(Primary )55(AR is nearly six times more common in)]TJ
0.0199 Tc 0.3571 Tw 0 -1.1066 TD
[(females and is usually bilateral.)-517(T)40(he following)]TJ
-0.00011 Tc 0.3145 Tw T*
(symptoms are observed in patients with primary)Tj
0 Tw T*
(AR.)Tj
0 Tc 6 0 0 6 328.4761 299.35381 Tm
(2,15)Tj
-0.00011 Tc 0.1059 Tw 10 0 0 10 341.98621 295.3539 Tm
[(T)40(he nose emits a foul smell,)-301(due to crusting)]TJ
0.0199 Tc 0.5399 Tw -3.21671 -1.1066 Td
[(and secondary infections)55(,)-755(which is the main)]TJ
-0.00011 Tc 0.18871 Tw T*
[(characteristic of the disease)37(.)-384(It is this factor alone)]TJ
0.3262 Tw T*
(that leads to social problems for the patient by)Tj
0.2269 Tw T*
[(keeping relatives and friends away)92(.)-422(It is famously)]TJ
0.1799 Tw T*
[(said of an )55(AR patient:)]TJ
0 Tc 0 Tw 6 0 0 6 412.34821 244.02229 Tm
(2)Tj
-0.00011 Tc 0.1799 Tw 10 0 0 10 419.09821 240.0224 Tm
[(\322T)40(he patient is often only)]TJ
-0.0005 Tw -10.9279 -1.1066 Td
(made aware of the loathsome effluvium surrounding)Tj
0.12019 Tw T*
(her by the reluctance of others to come within her)Tj
0 Tw T*
[(vicinity)92(.)55(\323)]TJ
0.1443 Tw 1 -1.1066 Td
[(T)40(he patient herself is commonly anosmic due to)]TJ
0.0872 Tw -1 -1.1066 Td
[(the following reasons:)-282(the atrophic process involves)]TJ
0.0829 Tw T*
(the olfactory epithelium and the bipolar nerve cells)Tj
0.1974 Tw T*
[(and nerve fibres;)-392(there is an insufficient and non-)]TJ
0.1667 Tw T*
(uniform air blast that may not reach the olfactory)Tj
0.0863 Tw T*
[(areas;)-281(and there may be a genuine obstruction with)]TJ
0.19431 Tw T*
(large crusts blocking the air blast to the olfactory)Tj
0.189 Tw T*
[(area in the roof of the nose)37(.)-384(Some patients suffer)]TJ
0.1595 Tw T*
(from cacosmia when they smell a foul odour even)Tj
0.02499 Tw T*
[(with pleasant ones)55(.)]TJ
0.0276 Tw 1 -1.1066 Td
(Nasal obstruction is often the chief complaint and)Tj
-0.0365 Tw -1 -1.1066 Td
[(is brought on by a number of factors such as:)-158(inability)]TJ
0.13319 Tw T*
(of the patient to perceive the passage of air in the)Tj
0 Tc 0 Tw 9.5 0 0 9.5 522.7657 777.3167 Tm
(845)Tj
0.0004 Tc 0.02499 Tw 7.12 0 0 7.12 58.811 779.0643 Tm
[(AETIOLOGY )55(AND MAN)37(A)55(GEMENT OF )55(A)74(TR)18(OPHIC RHINITIS)]TJ
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BT
/T1_0 1 Tf
0.0199 Tc 0.4073 Tw 10 0 0 10 58.5354 758.80701 Tm
(nose due to anaesthesia of the nasal mucosa)Tj
-0.00011 Tc -0.0141 Tw 0 -1.13139 TD
[(\(\324blunting effect\325\);)-181(large crusts causing obstruction to)]TJ
0.15919 Tw T*
(air flow and disruption of the normal laminar and)Tj
0.0199 Tc 0.55389 Tw T*
(eddy current pattern of the inspiratory and)Tj
-0.00011 Tc 0.1346 Tw T*
[(expiratory air flows)55(.)-330(Patients may also complain of)]TJ
0.01019 Tw T*
[(headache)37(.)-150(T)40(hick purulent discharge with a foul smell)]TJ
0.16299 Tw T*
[(due to anaerobic bacteria is common.)-358(Periodically)92(,)]TJ
0.24139 Tw T*
(dark greenish crusts are brought out through the)Tj
0.2731 Tw T*
[(nostrils and are foul smelling)18(.)-468(Rarely)92(,)-468(crusts may)]TJ
0.3418 Tw T*
(dislodge into the pharynx to cause foreign-body)Tj
0.09689 Tw T*
[(sensation and choking)18(.)-292(Minor bleeds from the nose)]TJ
0.0199 Tc 0.3701 Tw T*
[(may be observed with dislodgement of crusts)55(.)]TJ
-0.00011 Tc 0.214 Tw T*
[(Occasionally)92(,)-409(patients may complain of dryness in)]TJ
0.02499 Tw T*
(the nose and throat \(pharyngitis sicca\).)Tj
0.21429 Tw 1 -1.13139 Td
[(T)40(he signs of primary )55(AR are as follows:)]TJ
0 Tc 0 Tw 6 0 0 6 254.3078 604.4097 Tm
(2,15)Tj
-0.03979 Tc 10 0 0 10 268.90131 600.4097 Tm
[(Th)-40(e)]TJ
-0.00011 Tc 0.1801 Tw -21.03661 -1.13139 Td
(patient is usually gloomy and there is presence of)Tj
0.06641 Tw T*
[(foetor sometimes detected from a distance)37(.)-207(T)40(here is)]TJ
0.3567 Tw T*
[(a wide capacity of the nasal passages)55(.)-552(Greenish)]TJ
0.31219 Tw T*
(yellow and black crusts of various sizes may be)Tj
0.0199 Tc 0.3598 Tw T*
[(noticed lining the nasal cavities)55(.)-575(Bleeding and)]TJ
-0.00011 Tc 0.04739 Tw T*
(ulcerated mucosa is seen when crusts are separated.)Tj
0.2511 Tw T*
[(T)40(he turbinates)55(,)-446(especially the inferior and middle)]TJ
0.11349 Tw T*
[(turbinates)55(,)-309(may be shriveled significantly)92(.)-254(T)40(he nasal)]TJ
0.3495 Tw T*
(mucous membrane appears lusterless because of)Tj
0.0927 Tw T*
[(absence of mucous glands)55(.)-233(A probe test may reveal)]TJ
0.0721 Tw T*
[(insensitivity of the nasal mucosa.)-212(A spatula test will)]TJ
0.0782 Tw T*
[(reveal widely patent nasal airways)55(.)-273(Clinical features)]TJ
-0.0247 Tw T*
[(of sequelae such as sinusitis)55(,)-170(atrophic pharyngitis and)]TJ
0.0199 Tc 0.6201 Tw T*
[(laryngitis and otitis media,)-835(and features of)]TJ
-0.00011 Tc -0.0146 Tw T*
[(complications such as septal perforation,)-180(saddle nose)]TJ
0.22189 Tw T*
[(deformity and myiasis \(maggots\) may be seen.)-417(In)]TJ
0.3562 Tw T*
[(cases of secondary )55(AR,)-551(features of the primary)]TJ
0.08 Tw T*
[(disease such as tuberculosis)55(,)-275(leprosy)92(,)-275(and so on may)]TJ
0.0251 Tw T*
(be observed.)Tj
/T1_1 1 Tf
0 -2.5314 TD
(Sequelae and complications)Tj
0.1338 Tw 0 -1.4314 TD
(Nasal septal perforation and saddle nose deformity)Tj
/T1_0 1 Tf
0 Tc 0 Tw 22.4697 0 Td
(.)Tj
-0.00011 Tc 0.131 Tw -22.4697 -1.13139 Td
(Severe cases left untreated may be complicated by)Tj
0.24049 Tw 0 -1.13139 TD
[(destruction of nasal bone and cartilage)37(.)-381(T)40(his may)]TJ
0.2863 Tw T*
(eventually lead to septal perforations and saddle)Tj
0.0199 Tc 0.6311 Tw T*
[(nose deformities)55(.)-846(Correction of saddle nose)]TJ
-0.00011 Tc 0.2021 Tw T*
(deformity and septal perforation in cases of long-)Tj
0.0215 Tw T*
[(standing atrophic rhinitis are formidable tasks)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 260.7355 281.92931 Tm
(50)Tj
-0.03979 Tc 10 0 0 10 268.9012 277.9294 Tm
[(Th)-40(e)]TJ
-0.00011 Tc 0.1286 Tw -21.03661 -1.13139 Td
(thick and puckered skin secondary to longstanding)Tj
0.2178 Tw T*
(disease makes the creation of a dorsal subdermal)Tj
0.013 Tc 0.36189 Tw T*
[(pocket difficult.)-515(T)40(hese patients do not tolerate)]TJ
-0.00011 Tc 0.1145 Tw T*
(synthetic implants well and also show an unusually)Tj
0.02499 Tw T*
[(high rate of absorption of autologous bone grafts)55(.)]TJ
/T1_1 1 Tf
-0.0083 Tw 0 -2.2628 TD
(Secondary rhinosinusitis)Tj
/T1_0 1 Tf
10.46629 0 Td
[(.)-187(It is difficult to tell whether)]TJ
-0.0182 Tw -10.46629 -1.13139 Td
[(this is the cause or an effect of )55(AR.)-122(T)40(here is no doubt)]TJ
0.08211 Tw 0 -1.13139 TD
[(however that rhinosinusitis is a co-morbidity in )55(AR)]TJ
0 Tw T*
[(patients)55(.)]TJ
/T1_1 1 Tf
0.2457 Tw 0 -2.2628 TD
(Local and systemic spread of infection)Tj
/T1_0 1 Tf
0.2458 Tw 17.5878 0 Td
[(.)-441(Spread of)]TJ
0.065 Tw -17.5878 -1.13139 Td
[(infection to the pharynx,)-260(larynx,)-260(lungs and ears)55(,)-260(and)]TJ
0.0132 Tw 0 -1.13139 TD
(intracranial spread in immunocompromised patients)Tj
0.28461 Tw T*
[(is possible)37(.)-425(A case of pyogenic liver abscess and)]TJ
0.1386 Tw T*
(septic pulmonary emboli associated with )Tj
/T1_1 1 Tf
0 Tw 18.498 0 Td
(Klebsiella)Tj
-18.498 -1.13139 Td
(ozaenae)Tj
/T1_0 1 Tf
0.06419 Tw 3.8136 0 Td
(bacteraemia has been reported.)Tj
0 Tc 0 Tw 6 0 0 6 235.26489 89.5899 Tm
(51)Tj
-0.00011 Tc 0.0641 Tw 10 0 0 10 243.8567 85.5899 Tm
(A case of)Tj
0.03081 Tw -18.5321 -1.13139 Td
(cerebral abscess caused by )Tj
/T1_1 1 Tf
0 Tw 11.8452 0 Td
[(K.)-226(ozaenae)]TJ
/T1_0 1 Tf
0.03081 Tw 5.0338 0 Td
(has also been)Tj
0 Tw -16.879 -1.13139 Td
(reported.)Tj
0 Tc 6 0 0 6 98.8186 66.96159 Tm
(52)Tj
/T1_1 1 Tf
-0.00011 Tc 0.0323 Tw 10 0 0 10 309.5433 758.80701 Tm
(Atrophic pharyngitis and laryngitis)Tj
/T1_0 1 Tf
15.01669 0 Td
[(.)-227(Pharyngitis sicca)]TJ
0.0199 Tc 0.3941 Tw -15.01669 -1.1129 Td
[(is a frequent co-morbidity in )55(AR with a dry)]TJ
0.00301 Tc 0.3719 Tw 0 -1.1129 TD
[(pharyngeal mucosa.)-570(Dislodged crusts may cause)]TJ
-0.00011 Tc 0.02499 Tw T*
[(choking episodes)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 385.931 729.4211 Tm
(2,3)Tj
/T1_1 1 Tf
-0.00011 Tc 0.0061 Tw 10 0 0 10 309.5433 703.16389 Tm
(Chronic dacryocystitis)Tj
/T1_0 1 Tf
9.53391 0 Td
[(.)-146(A rare complication of )55(AR in)]TJ
0.1548 Tw -9.53391 -1.1129 Td
[(the form of dacryoc)18(ystitis has been noted where a)]TJ
0.0006 Tc 0.3743 Tw T*
[(successful endoscopic dacryoc)18(ystorhinostomy was)]TJ
-0.00011 Tc 0 Tw T*
(performed.)Tj
0 Tc 6 0 0 6 358.1541 673.778 Tm
(53)Tj
/T1_1 1 Tf
0.0049 Tc 0.463 Tw 10 0 0 10 309.5433 647.5208 Tm
(Nasal myiasis)Tj
/T1_0 1 Tf
6.38879 0 Td
[(.)-608(T)40(his is an extremely distressing)]TJ
-0.01511 Tc 0.32179 Tw -6.38879 -1.1129 Td
[(condition seen in neglected cases of primary )55(AR,)]TJ
0.2106 Tw T*
(especially in patients of lower socioeconomic status)Tj
0.00729 Tw T*
[(living in poor hygienic conditions)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 450.45351 618.1349 Tm
(2)Tj
-0.01511 Tc 0.00729 Tw 10 0 0 10 455.23689 614.13499 Tm
[(T)40(he putrefied nasal)]TJ
0.00439 Tc 0.3555 Tw -14.5694 -1.1129 Td
(debris and foul smell attract flies of the genus)Tj
/T1_1 1 Tf
-0.01511 Tc 0.19521 Tw T*
[(Chrysomia \(C)37(.)-375(bezianna vilteneauve\))]TJ
/T1_0 1 Tf
15.8569 0 Td
[(.)-320(T)40(hese flies lay)]TJ
0.078 Tw -15.8569 -1.1129 Td
[(eggs which later hatch into larvae known as maggots)55(.)]TJ
0.2683 Tw T*
[(T)111(ens to hundreds of maggots may infest the nasal)]TJ
0.0235 Tw T*
(cavities and eat away the mucosal soft tissues down to)Tj
0.20329 Tw T*
[(bone! )55(T)40(hey create tunnels in the soft tissues of the)]TJ
0.22231 Tw T*
[(nose)37(,)-402(sinuses)55(,)-402(nasopharynx,)-402(pharyngeal walls)55(,)-402(orbital)]TJ
-0.0061 Tw T*
[(tissues)55(,)-174(lacrimal apparatus)55(,)-174(facial tissues and skull base)37(,)]TJ
0.03169 Tw T*
(and may even cause meningitis and death.)Tj
-0.015 Tc 0 Tw 6 0 0 6 487.395 517.97729 Tm
(54 )Tj
-0.01511 Tc 0.03169 Tw 10 0 0 10 494.8149 513.9774 Tm
[(T)40(hey may)]TJ
0.1543 Tw -18.52721 -1.1129 Td
(also cause bone destruction resulting in nasal dorsal)Tj
0.1344 Tw T*
[(deformities)55(,)-315(facial deformities)55(,)-315(and septal and palatal)]TJ
0 Tw T*
[(perforations)55(.)]TJ
/T1_2 1 Tf
0.02499 Tw 0 -2.51289 TD
[(In)18(v)18(estigations and diagnosis)]TJ
/T1_0 1 Tf
0.10789 Tw 0 -1.4129 TD
[(Diagnosis is by a high index of clinical suspicion:)-288(the)]TJ
-0.0065 Tc 0.36639 Tw 0 -1.1129 TD
[(triad of characteristic foetor)18(,)-555(greenish crusts and)]TJ
-0.01511 Tc 0.2518 Tw T*
(roomy nasal cavities is diagnostic of the condition.)Tj
0.0256 Tw T*
(General and systemic examination of a patient should)Tj
0.0562 Tw T*
[(include thorough evaluation of possible causes of )55(AR)]TJ
0.0201 Tw T*
[(such as tuberculosis)55(,)-200(leprosy)92(,)-200(scleroma and syphilis)55(.)-145(All)]TJ
0.1965 Tw T*
[(the classical features and so called )55(\324stigmata\325 of the)]TJ
0.0049 Tc 0.3949 Tw T*
[(above conditions are looked for)18(.)-595(Chronic sinus)]TJ
-0.01511 Tc 0.0128 Tw T*
[(suppuration on its own,)-193(suppurating adenoidal disease)]TJ
0.0273 Tw T*
[(in adolescents)55(,)-207(and neglected foreign bodies/rhinoliths)]TJ
0.0049 Tc 0.3999 Tw T*
(in unilateral cases have to be excluded before)Tj
-0.01511 Tc 0.02499 Tw T*
[(\324labeling\325 a patient as primary )55(AR.)]TJ
-0.0015 Tc 0.3614 Tw 1 -1.1129 Td
(Investigations are considered only to rule out)Tj
0.0049 Tc 0.87511 Tw -1 -1.1129 Td
[(secondary causes of )55(AR and other nasal)]TJ
1.65131 Tw T*
[(granulomatous conditions)55(.)-1796(T)40(hese include)]TJ
-0.01511 Tc 0.211 Tw T*
[(haematological studies)55(,)-391(radiological assessments and)]TJ
-0.0128 Tc 0 Tw T*
[(biopsy)92(.)]TJ
6 0 0 6 338.5809 267.2764 Tm
(2,15)Tj
/T1_1 1 Tf
10 0 0 10 354.8761 263.2765 Tm
(Haemoglobin)Tj
/T1_0 1 Tf
0.3727 Tw 6.3589 0 Td
(estimation is necessary as)Tj
-0.01511 Tc 0.16451 Tw -10.8922 -1.1129 Td
(some patients have anaemia.)Tj
/T1_1 1 Tf
0.1644 Tw 12.877 0 Td
(A total and differential)Tj
0 Tw -12.877 -1.1129 Td
(count)Tj
/T1_0 1 Tf
0.0854 Tw 2.6348 0 Td
[(of the leucoc)18(ytes along with a )]TJ
/T1_1 1 Tf
13.08411 0 Td
(peripheral blood)Tj
0 Tw -15.7189 -1.1129 Td
(smear)Tj
/T1_0 1 Tf
0.0374 Tw 2.75191 0 Td
[(study is essential;)-218(it may show leucoc)18(ytosis with)]TJ
0.09351 Tw -2.75191 -1.1129 Td
[(infections and a microc)18(ytic hypochromic picture with)]TJ
0.0049 Tc 0.9306 Tw T*
[(iron deficienc)18(y anaemia.)-1131(Raised )]TJ
/T1_1 1 Tf
0 Tw 17.89281 0 Td
(erythrocyte)Tj
0.87421 Tw -17.89281 -1.1129 Td
(sedimentation rate)Tj
/T1_0 1 Tf
9.8983 0 Td
(is found especially with)Tj
-0.01511 Tc 0.1297 Tw -9.8983 -1.1129 Td
[(granulomatous infections such as tuberculosis)55(.)]TJ
/T1_1 1 Tf
0 Tw 20.1122 0 Td
(Blood)Tj
-20.1122 -1.1129 Td
(sugars)Tj
/T1_0 1 Tf
0.0322 Tw 2.63271 0 Td
[(,)-212(both fasting and two-hour post-prandial levels)55(,)]TJ
0.14951 Tw -2.63271 -1.1129 Td
[(are assessed for diabetes mellitus)55(.)]TJ
/T1_1 1 Tf
14.931 0 Td
[(T)92(otal iron binding)]TJ
0.185 Tw -14.931 -1.1129 Td
(capacity and total serum iron levels)Tj
/T1_0 1 Tf
15.7765 0 Td
(may have to be)Tj
0.11591 Tw -15.7765 -1.1129 Td
[(estimated if the peripheral smear shows a microc)18(ytic)]TJ
0.13499 Tw T*
[(hypochromic picture)37(.)-315(Patients with malnutrition may)]TJ
-0.0069 Tc 0.36681 Tw T*
(require estimation of )Tj
/T1_1 1 Tf
10.31081 0 Td
(serum proteins and plasma)Tj
-0.00481 Tc 0.3647 Tw -10.31081 -1.1129 Td
(vitamin levels)Tj
/T1_0 1 Tf
6.1033 0 Td
[(.)-500(An immunological study including)]TJ
/T1_1 1 Tf
0.00211 Tc 0.3578 Tw -6.1033 -1.1129 Td
[(autoimmune assa)18(ys )]TJ
/T1_0 1 Tf
0.0022 Tc 9.29311 0 Td
[(may be necessary)92(.)]TJ
/T1_1 1 Tf
0.00211 Tc 0 Tw 9.0218 0 Td
(Leucocyte)Tj
-0.01511 Tc -0.03149 Tw -18.3149 -1.1129 Td
(migration and spontaneous rosette tests)Tj
/T1_0 1 Tf
16.1608 0 Td
(are of academic)Tj
0 Tw -16.1608 -1.1129 Td
[(value)37(.)]TJ
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[(T)111(wenty-five per)]TJ
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(bicarbonate in the mixture\) and 56.7 g of sodium)Tj
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[(chloride \(makes the solution isotonic\).)-957(One)]TJ
0.58411 Tw T*
(teaspoonful of the above mixture \(pulverized)Tj
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(water is used to douche the nasal cavities vigorously to)Tj
0.205 Tw T*
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0.0164 Tw T*
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0.2937 Tw T*
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[(asepto syringes)55(,)-371(Birmingham glass syringes)55(,)-371(fountain)]TJ
0.0013 Tw T*
[(syringes)55(,)-181(Higginson syringes or enema cans)55(,)-181(or even by)]TJ
0.2738 Tw T*
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0.118 Tw T*
(useful to instruct the patient to bend forward during)Tj
0.0477 Tw T*
[(the procedure and keep saying )55(\324K,)-228(K,)-228(K ...)55(\325 so that the)]TJ
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-0.00999 Tw T*
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0.02499 Tw T*
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(Several commercial brands of nasal irrigation)Tj
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0.0049 Tc 0.4568 Tw T*
[(douching)18(.)-602(An interesting study from California)]TJ
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/T1_1 1 Tf
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[(.)-416(T)111(wenty-five per cent)]TJ
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0.0049 Tc 0.48689 Tw T*
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[(T)40(hese nose drops should be applied three or four times)]TJ
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[(.)-136(Although liquid paraffin is)]TJ
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[(Oestradiol in arac)12(his oil)]TJ
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(for instillation into the nose as drops and sprays \(10)Tj
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(000 units/ml\).)Tj
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/T1_0 1 Tf
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[(K)55(emicetene antiozaena solution)]TJ
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[(.)-111(T)40(his again is a popular)]TJ
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[(solution containing 90 mg of chloramphenicol,)-168(0.64 mg)]TJ
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(56)Tj
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(Placental extract injections)Tj
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0.1133 Tw T*
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0.0489 Tw T*
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0.0347 Tw T*
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0.30521 Tw T*
(while systemic human placental extracts have also)Tj
0.3531 Tw T*
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[(years)55(.)]TJ
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(57,58)Tj
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[(Acetylc)12(holine with or without pilocarpine)]TJ
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[(.)-123(T)40(his has also)]TJ
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(847)Tj
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[(AETIOLOGY )55(AND MAN)37(A)55(GEMENT OF )55(A)74(TR)18(OPHIC RHINITIS)]TJ
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(59)Tj
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(60)Tj
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[(More recently)92(,)-570(ciprofloxacin in a)]TJ
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(daily dose of 500\320750 mg bid for one to three months)Tj
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(supplements)Tj
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[(.)-800(T)40(hese have been recommended)]TJ
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(2)Tj
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[(V)92(asodilators)]TJ
/T1_1 1 Tf
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[(.)-570(Xanthinol nicotinate)37(,)-570(c)18(yclandelate)37(,)]TJ
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0.05251 Tw T*
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0.24631 Tw T*
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0.2494 Tw T*
(derivatives have been used both systemically and)Tj
0.02499 Tw T*
(topically by several authors in the past.)Tj
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(6,61,62 )Tj
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(Prostheses)Tj
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[(.)-683(Non-surgical closure of the nasal)]TJ
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(vestibule using prostheses has been described,)Tj
0.0099 Tc 0.0338 Tw T*
(including occlusion of the nostril with an obturator)Tj
0.0383 Tw T*
[(made from dimethylpolysiloxane)37(.)]TJ
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(12)Tj
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[(T)40(his is useful in)]TJ
0.0295 Tw -15.73309 -1.13139 Td
[(cases of secondary )55(AR where formal closure of the)]TJ
0.123 Tw T*
(nostril is contraindicated in view of the treatment)Tj
0.09441 Tw T*
[(necessary for the primary disease)37(.)-245(Another similar)]TJ
0.0251 Tw T*
[(device made of clear acrylic resin called a )55(\324pin-hole)]TJ
0.02991 Tc 0.6868 Tw T*
(nasal prosthesis\325 has been described more)Tj
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[(recently)92(.)]TJ
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(63)Tj
/T1_0 1 Tf
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[(V)92(accines)]TJ
/T1_1 1 Tf
0.0762 Tw 3.6843 0 Td
[(.)-216(V)111(accines have been evaluated in pigs with)]TJ
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[(progressive )55(AR using various challenge models)]TJ
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(including )Tj
/T1_0 1 Tf
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[(Bor)18(detella bronc)12(hiseptica)]TJ
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(and )Tj
/T1_0 1 Tf
2.0627 0 Td
[(P)55(asteurella)]TJ
-18.0527 -1.13139 Td
(multocida)Tj
/T1_1 1 Tf
0.1559 Tw 4.6837 0 Td
[(infection.)-296(T)40(he results need to be further)]TJ
0.0199 Tc 0.48129 Tw -4.6837 -1.13139 Td
(studied and evaluated for human therapeutic)Tj
-0.00011 Tc 0 Tw T*
[(applications)55(.)]TJ
0 Tc 6 0 0 6 112.71271 276.30119 Tm
(9)Tj
-0.00011 Tc 0.06419 Tw 10 0 0 10 118.3055 272.30119 Tm
[(A)74(utogenous vaccines to Perez bacillus)]TJ
0.0251 Tw -5.97701 -1.13139 Td
(have also been tried.)Tj
/T1_0 1 Tf
0.0199 Tc 0.66499 Tw 0 -2.2628 TD
(Decongestants or antihistamines)Tj
/T1_1 1 Tf
15.6716 0 Td
[(.)-880(It must be)]TJ
0.3808 Tw -15.6716 -1.13139 Td
(remembered that the use of these is )Tj
/T1_2 1 Tf
0 Tw 19.07851 0 Td
(strongly)Tj
-0.00011 Tc -19.07851 -1.13139 Td
(contraindicated)Tj
/T1_1 1 Tf
0.0264 Tw 7.0547 0 Td
[(in )55(AR as they worsen the pathology)]TJ
0.02499 Tw -7.0547 -1.13139 Td
[(and hence the clinical course of the disease)37(.)]TJ
/T1_2 1 Tf
0 -2.5314 TD
[(Surgical tr)10(eatment)]TJ
/T1_1 1 Tf
-0.0096 Tw 0 -1.4314 TD
[(T)40(he principles of surgery may be divided largely into)]TJ
0.0285 Tw 0 -1.13139 TD
[(four groups)55(.)-169(T)40(here may be some surgical procedures)]TJ
0.0593 Tw T*
(that achieve more than one therapeutic goal among)Tj
0.15401 Tw T*
[(the ones listed below)74(.)-294(T)40(here may be an overlap of)]TJ
0.02499 Tw T*
(some of the principles as well.)Tj
0 Tw 0.9921 -2.2628 Td
(\(1\))Tj
/T1_0 1 Tf
0.1442 Tw 1.8329 0 Td
[(Decreasing the siz)18(e of the nasal cavities)55(.)]TJ
/T1_1 1 Tf
-0.0002 Tc 0 Tw 18.0448 0 Td
[(T)40(his)]TJ
0.0199 Tc 0.4389 Tw -18.0448 -1.13139 Td
(helps in reducing the turbulence of air)Tj
0.0043 Tc 0.37061 Tw T*
(currents in the roomy cavities and hence)Tj
-0.00011 Tc 0.02499 Tw T*
[(prevents drying of the mucosa and crusting)18(.)]TJ
0 Tw 23.2679 69.5845 Td
(\(2\))Tj
/T1_0 1 Tf
0.0199 Tc 0.4968 Tw 1.8329 0 Td
(Promoting regeneration of normal nasal)Tj
-0.0051 Tc 0 Tw 0 -1.1129 TD
(mucosa.)Tj
/T1_1 1 Tf
0.0291 Tw 3.7115 0 Td
[(T)40(his may be achieved by allowing the)]TJ
0.3232 Tw -3.7115 -1.1129 Td
(nasal cavities to rest by temporary closure)Tj
0.02969 Tw T*
(\(complete or partial\) of the nostrils and hence)Tj
0.19479 Tw T*
(reduction of air turbulence or blast into the)Tj
-0.0352 Tw T*
[(roomy cavities)55(.)-100(T)40(his promotes the regeneration)]TJ
0.15109 Tw T*
[(of the nose\325)18(s own normal anatomy)92(,)-341(histology)]TJ
0.02499 Tw T*
[(and physiology in many ways)55(.)]TJ
-0.00011 Tc 0 Tw -1.8329 -1.1129 Td
(\(3\))Tj
/T1_0 1 Tf
-0.013 Tw 1.8329 0 Td
(Increasing lubrication of the dry nasal mucosa.)Tj
/T1_1 1 Tf
0.202 Tw T*
[(T)40(his is achieved by increasing the secretory)]TJ
0.0047 Tw T*
(abilities of the nasal cavities or by introducing)Tj
0.02499 Tw T*
[(secretions from elsewhere)37(.)]TJ
0 Tw -1.8329 -1.1129 Td
(\(4\))Tj
/T1_0 1 Tf
0.36031 Tw 1.8329 0 Td
[(Impro)18(ving vascularity of the nasal cavities)55(.)]TJ
/T1_1 1 Tf
0.0199 Tc 0.427 Tw T*
[(T)40(his is achieved either by blocking the)]TJ
-0.00011 Tc 0.0157 Tw T*
(sympathetic nervous system \(stellate ganglion)Tj
0.09891 Tw T*
(block or cervical sympathectomy\) subserving)Tj
0.0199 Tc 0.4944 Tw T*
[(the nose or by introducing grafts \(e)37(.g)18(.)]TJ
0.4126 Tw T*
[(placenta,)-628(maxillary mucosal flaps)55(,)-628(buccal)]TJ
-0.00011 Tc 0.02499 Tw T*
[(flaps\) that improve vascularity)92(.)]TJ
/T1_0 1 Tf
-2.825 -2.51289 Td
[(Decreasing the siz)18(e of the nasal cavities)]TJ
/T1_1 1 Tf
0.00661 Tw 0 -1.4129 TD
(Lautenschlager was the first surgeon to embark on a)Tj
-0.02499 Tw 0 -1.1129 TD
[(definitive surgical procedure for )55(AR.)-170(He reduced the)]TJ
0.0235 Tw T*
[(size of the roomy cavities to bring in some normalc)18(y)]TJ
0.05231 Tw T*
(to the nasal air flow by medializing the lateral nasal)Tj
-0.01559 Tw T*
(wall or the medial wall of the maxillary antrum using)Tj
-0.0304 Tw T*
(a Caldwell-Luc type of approach.)Tj
0 Tc 0 Tw 6 0 0 6 452.4893 467.59151 Tm
(64)Tj
-0.00011 Tc -0.0305 Tw 10 0 0 10 460.6846 463.5916 Tm
(Reducing the size)Tj
0.36501 Tw -15.11411 -1.1129 Td
[(of the roomy cavities)55(,)-560(sometimes referred to as)]TJ
0.1555 Tw T*
[(\324recalibration\325 of the nasal fossae)37(,)-351(has seen several)]TJ
0.0199 Tc 0.50259 Tw T*
(modifications and led to the use of various)Tj
-0.00011 Tc 0.3419 Tw T*
(substances and implants that are endonasally or)Tj
0.0733 Tw T*
[(sublabially inserted into the floor)18(,)-268(septum or lateral)]TJ
0.0067 Tw T*
[(walls of the nose)37(.)]TJ
0 Tc 0 Tw 6 0 0 6 383.8212 400.81979 Tm
(65)Tj
-0.00011 Tc 0.0067 Tw 10 0 0 10 391.83881 396.8199 Tm
[(T)40(he list includes autologous bone)]TJ
0.1449 Tw -8.2296 -1.1129 Td
[(\(cortical or cancellous chips\),)-340(cartilage)37(,)-340(fat,)-340(muscle;)]TJ
-0.02521 Tw T*
[(homologous lyophilized bone)37(,)-170(cartilage)37(,)-170(fat,)-170(placenta;)]TJ
-0.00841 Tw T*
[(synthetics such as glass beads)55(,)-187(acrylics)55(,)-187(plastic gauzes)55(,)]TJ
0.203 Tw T*
[(T)111(eflon,)-398(Proplast,)-398(Dacron,)-398(silicone or silastic grafts)55(,)]TJ
0.02499 Tw T*
[(glycerine)37(,)-220(paraffin or dental pastes)55(,)-220(and so on.)]TJ
0.0751 Tw 1 -1.1129 Td
(Good results from the submucosal injections of a)Tj
0.0155 Tc 0.35941 Tw -1 -1.1129 Td
[(suspension of powdered )55(T)111(eflon in 50 per cent)]TJ
-0.00011 Tc 0.09731 Tw T*
(glycerin paste have been reported.)Tj
0 Tc 0 Tw 6 0 0 6 462.6149 311.79089 Tm
(66)Tj
-0.00011 Tc 0.09731 Tw 10 0 0 10 471.5386 307.79089 Tm
(An autologous)Tj
0.186 Tw -16.19949 -1.1129 Td
(medullary \(cancellous\) bone graft as a single long)Tj
0.24091 Tw T*
(piece of bone has been tried.)Tj
0 Tc 0 Tw 6 0 0 6 446.049 289.5336 Tm
(67)Tj
-0.00011 Tc 0.24091 Tw 10 0 0 10 456.4088 285.53371 Tm
[(A)74(utologous costal)]TJ
0.2892 Tw -14.68649 -1.1129 Td
(cartilages have been used for reducing the nasal)Tj
0.0145 Tw T*
[(cavity size with good outcomes)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 445.94589 267.2764 Tm
(68)Tj
-0.00011 Tc 0.0145 Tw 10 0 0 10 454.0416 263.2765 Tm
(An osteoperiosteal)Tj
0.114 Tw -14.4498 -1.1129 Td
(flap from the anterior wall of the maxilla has been)Tj
0.00481 Tc 0 Tw T*
(described.)Tj
6 0 0 6 354.20621 245.0192 Tm
(69)Tj
0.3701 Tw 10 0 0 10 366.5152 241.0192 Tm
(Hydroxylapatite implants have been)Tj
-0.00011 Tc 0.1871 Tw -5.6972 -1.1129 Td
(placed under the mucosa of the septum and floor)Tj
0.2923 Tw T*
[(with favourable long-term results)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 464.42149 222.7619 Tm
(70)Tj
-0.00011 Tc 0.2923 Tw 10 0 0 10 475.29559 218.76199 Tm
(A method of)Tj
0.06039 Tw -16.5752 -1.1129 Td
(submucous implantation using pedicled auto-flap of)Tj
0.01559 Tc 0.3593 Tw T*
(cheek muscle and maxillary periosteum of the)Tj
-0.00011 Tc 0.0907 Tw T*
(piriform aperture has been described in 32 patients)Tj
0.11169 Tw T*
[(with )55(AR,)-307(with stable long-term outcomes)55(.)]TJ
0 Tc 0 Tw 6 0 0 6 494.8891 178.2475 Tm
(71)Tj
-0.00011 Tc 10 0 0 10 503.95689 174.2475 Tm
[(T)111(riosite)]TJ
0.1106 Tw -19.44141 -1.1129 Td
(implants with fibrin glue have been used to reduce)Tj
0.24969 Tw T*
(the size of the nasal fossae via a labial vestibule)Tj
-0.0062 Tw T*
[(route)37(.)-189(No rejection occurred in the nine patients that)]TJ
0.0183 Tc 0.3566 Tw T*
[(had the implants and the osseocoalescence)37(,)-570(as)]TJ
-0.00011 Tc 0.19521 Tw T*
[(evaluated by CT at six months)55(,)-390(was good.)]TJ
0 Tc 0 Tw 6 0 0 6 501.28329 122.6044 Tm
(72)Tj
-0.0002 Tc 10 0 0 10 511.7354 118.60451 Tm
(Good)Tj
-0.00011 Tc 0.2121 Tw -20.21919 -1.1129 Td
(results have been reported by inserting plastipore)Tj
0.0199 Tc 0.50121 Tw T*
(plates \(high-density polyethylene sponge with)Tj
0.62579 Tw T*
(micropores to enable tissue ingrowths\) into)Tj
-0.00011 Tc 0.2374 Tw T*
[(submucosal pockets in the floor and septum,)-433(and)]TJ
0.02499 Tw T*
[(thus reducing the volume of the nasal fossae)37(.)]TJ
0 Tc 0 Tw 6 0 0 6 504.8188 66.9613 Tm
(73)Tj
9.5 0 0 9.5 58.5354 777.3167 Tm
(848)Tj
0.0005 Tc 0.0249 Tw 7.12 0 0 7.12 433.731 779.0643 Tm
[(S N DUTT)92(,)-220(M KAMESW)93(ARAN)]TJ
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/T1_0 1 Tf
-0.00011 Tc 0.02499 Tw 10 0 0 10 58.811 758.80701 Tm
(Promoting regeneration of normal nasal mucosa)Tj
0.0087 Tc 0.3662 Tw 0 -1.4175 TD
[(Y)92(oung\325)74(s operation)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 8.26781 0 Td
(.)Tj
0.0087 Tc 6 0 0 6 144.0768 748.632 Tm
(74,75)Tj
0.3662 Tw 10 0 0 10 163.54041 744.632 Tm
[(T)40(his procedure essentially)]TJ
0.0199 Tc 0.4016 Tw -10.4729 -1.11749 Td
(closes one nostril and hence the nasal cavity)Tj
-0.00011 Tc 0.14 Tw 0 -1.11749 TD
[(completely under local or general anaesthesia.)-280(T)40(he)]TJ
-0.0007 Tw T*
(surgery involves raising skin folds in the vestibule by)Tj
-0.03 Tw T*
[(circumferential incisions and suturing them together)18(.)]TJ
0.0602 Tw T*
[(T)40(he advantages are that the blast and turbulence of)]TJ
0.0399 Tw T*
(air through a roomy cavity is removed giving rest to)Tj
0.13319 Tw T*
[(the nasal mucosa,)-328(a medium with the CO)]TJ
0 Tc 0 Tw 6 0 0 6 245.3398 664.6075 Tm
(2)Tj
-0.00011 Tc 0.13319 Tw 10 0 0 10 252.17149 666.40759 Tm
(and pH)Tj
-0.0173 Tw -19.336 -1.11749 Td
(conducive for regeneration of respiratory epithelium)Tj
0.0199 Tc 0.36011 Tw T*
[(is created,)-575(and finally a negative post-choanal)]TJ
-0.00011 Tc 0.23579 Tw T*
(pressure that is produced with the closure of the)Tj
0.0751 Tw T*
(nostril may cause a certain degree of vasodilatation)Tj
0.2925 Tw T*
[(within the cavity)92(.)-488(It has been shown that partial)]TJ
0.04539 Tw T*
[(surgical closure of the nostril in )55(AR has a beneficial)]TJ
0.19431 Tw T*
(effect on the nasal mucosa and reverses the basic)Tj
0.2113 Tw T*
[(pathologic alterations in its microanatomy)92(.)]TJ
0 Tc 0 Tw 6 0 0 6 251.6127 581.0081 Tm
(76,77)Tj
-0.03979 Tc 10 0 0 10 269.1769 577.0081 Tm
[(Th)-40(e)]TJ
0.0199 Tc 0.77921 Tw -21.03661 -1.11749 Td
[(disadvantages of )55(Y)92(oung\325)18(s operation include)]TJ
0.5023 Tw T*
[(difficulty in raising the skin flap)40(,)-717(suture-line)]TJ
-0.00011 Tc 0.0636 Tw T*
[(breakdown,)-259(excessive scarring)18(,)-259(and hence vestibular)]TJ
0.0686 Tw T*
[(stenosis)55(.)-264(Some patients may experience snoring and)]TJ
0.29739 Tw T*
[(sleep apnoea.)-438(T)40(he following are modifications to)]TJ
0.02499 Tw T*
[(Y)92(oung\325)18(s operation.)]TJ
/T1_0 1 Tf
0.0074 Tc 0.36749 Tw 0 -2.235 TD
(Sinha modification)Tj
/T1_1 1 Tf
0 Tc 0 Tw 8.64211 0 Td
(.)Tj
0.00751 Tc 6 0 0 6 147.8071 491.6087 Tm
(58)Tj
0.36749 Tw 10 0 0 10 160.147 487.6087 Tm
(Because there is complete)Tj
-0.00011 Tc 0.1021 Tw -10.13361 -1.11749 Td
[(closure of the nostril,)-242(Y)92(oung\325)18(s procedure cannot be)]TJ
0.08771 Tw 0 -1.11749 TD
[(done bilaterally)92(.)-283(Sinha )]TJ
/T1_0 1 Tf
10.11861 0 Td
(et al)Tj
/T1_1 1 Tf
1.8372 0 Td
[(.)-283(modified the technique)]TJ
0.1308 Tw -11.9558 -1.11749 Td
(leaving a small 3mm-diameter hole within the skin)Tj
0.10429 Tw T*
[(membrane)37(.)-244(Any further increase in size of the hole)]TJ
0.34129 Tw T*
[(decreased the success rate rapidly)92(.)-481(As such,)-536(this)]TJ
0.0062 Tc 0.3687 Tw T*
(procedure may be carried out on both nostrils)Tj
-0.00011 Tc 0 Tw T*
[(simultaneously)92(.)]TJ
/T1_0 1 Tf
0.2112 Tw 0 -2.235 TD
(Gadre modification)Tj
/T1_1 1 Tf
0 Tc 0 Tw 8.627 0 Td
(.)Tj
6 0 0 6 147.5811 391.0343 Tm
(78)Tj
-0.00011 Tc 0.2112 Tw 10 0 0 10 158.19341 387.03439 Tm
[(In this technique)37(,)-406(instead of)]TJ
0.0145 Tc 0.3604 Tw -9.9382 -1.11749 Td
(reflecting the skin of the vestibule forward as)Tj
-0.00011 Tc 0.24409 Tw 0 -1.11749 TD
[(suggested by )55(Y)92(oung)18(,)-439(mucosal flaps are developed)]TJ
0.28281 Tw T*
(backwards from the mucocutaneous junction and)Tj
0.2301 Tw T*
[(sutured in the midline)37(.)-370(T)40(he end result is a three-)]TJ
0.3051 Tw T*
(layered membrane with an outer epithelial layer)Tj
0.2691 Tw T*
[(continuous with the skin,)-464(an inner mucosal layer)]TJ
0.30099 Tw T*
[(continuous with the nasal mucosa,)-496(and a middle)]TJ
0.02499 Tw T*
[(layer of fibrous tissue)37(.)]TJ
/T1_0 1 Tf
0.3358 Tw 0 -2.235 TD
[(Ghosh\325)74(s vestibuloplasty)]TJ
/T1_1 1 Tf
10.4024 0 Td
[(.)-531(Based on the hypothesis)]TJ
0.1655 Tw -10.4024 -1.11749 Td
[(that primary )55(AR belongs to a group of conditions)]TJ
0.31599 Tw 0 -1.11749 TD
[(under the heading )55(\324reflex sympathetic dystrophic)]TJ
0.0963 Tw T*
[(syndrome\325,)-291(the author has developed an interesting)]TJ
0.0309 Tw T*
[(surgical technique termed )55(\324vestibuloplasty\325.)-171(A flap is)]TJ
0.20821 Tw T*
(raised from the lateral wall of the nasal vestibule)Tj
-0.0341 Tw T*
[(antero-posteriorly and is sutured on itself)50(,)-161(decreasing)]TJ
0.0517 Tw T*
[(the lateral flow of air into the nasal cavity)92(.)-192(T)40(hus)55(,)-247(the)]TJ
0.1806 Tw T*
(technique directs the stream of air away from the)Tj
0.0199 Tc 0.40691 Tw T*
(turbinates and dissipates the force of the air)Tj
-0.00011 Tc 0 Tw T*
[(currents)55(.)]TJ
0 Tc 6 0 0 6 96.31351 167.5358 Tm
(31,32)Tj
/T1_0 1 Tf
-0.00011 Tc 0.22861 Tw 10 0 0 10 58.811 141.186 Tm
(El Kholy modification)Tj
/T1_1 1 Tf
0 Tc 0 Tw 10.0687 0 Td
(.)Tj
6 0 0 6 161.99789 145.1859 Tm
(79)Tj
-0.00011 Tc 0.22861 Tw 10 0 0 10 172.78349 141.186 Tm
[(Recently)92(,)-424(El Kholy )]TJ
/T1_0 1 Tf
0.2285 Tw 9.09441 0 Td
(et al)Tj
/T1_1 1 Tf
0 Tc 0 Tw 1.9781 0 Td
(.)Tj
0.0199 Tc 1.64371 Tw -22.4697 -1.11749 Td
(have described an interesting septal)Tj
-0.00011 Tc 0.11459 Tw T*
(mucoperichondrial flap for closure of the nostril in)Tj
0.21359 Tw T*
[(AR.)-354(T)40(he technique overcomes the difficulties and)]TJ
0.0638 Tw T*
[(shortcomings of the classical )55(Y)92(oung\325)18(s operation and)]TJ
0.02499 Tw T*
[(some of its modifications)55(.)]TJ
/T1_0 1 Tf
-0.0051 Tc 0.04021 Tw T*
[(Reversal of )55(Y)92(oung\325)74(s operation and its modifications)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 21.8777 0 Td
(.)Tj
-0.005 Tc 6 0 0 6 280.0378 78.1364 Tm
(80)Tj
-0.0051 Tc 0.2197 Tw 10 0 0 10 58.811 62.9615 Tm
(It is useful to visualize periodically with the nasal)Tj
0.0435 Tw 25.1008 69.5845 Td
(endoscope \(Hopkins rod-lens telescope or fibreoptic)Tj
0.0128 Tc 0.3571 Tw 0 -1.1031 TD
(scope\) the nasal cavities of patients who have)Tj
-0.0051 Tc 0.22411 Tw T*
[(undergone )55(Y)92(oung and modified )55(Y)92(oung operations)55(.)]TJ
0.09959 Tw T*
(Diagnostic endoscopy would demonstrate reduction)Tj
0.36501 Tw T*
[(of crusts following surgery)92(,)-555(reappearance of free)]TJ
0.10851 Tw T*
(mucus suggesting respiratory mucosal regrowth and)Tj
0.01489 Tc 0.53391 Tw T*
(hence the need to plan for reversal of the)Tj
-0.0051 Tc 0 Tw T*
[(procedure)37(.)]TJ
-0.005 Tc 6 0 0 6 355.90359 685.5916 Tm
(13)Tj
-0.0051 Tc -0.004 Tw 10 0 0 10 319.81889 670.5609 Tm
[(Recanalization of a )55(\324Y)92(oung\325)18(s obturator membrane\325)]TJ
-0.00439 Tw -1 -1.1031 Td
[(after months or a year is a daunting task.)-186(Reporting a)]TJ
0.01489 Tc 0.4785 Tw T*
[(five-year follow up of )55(AR patients who had)]TJ
-0.0051 Tc 0.0452 Tw T*
[(undergone this surgery)92(,)-180(Y)92(oung)]TJ
-0.005 Tc 0 Tw 6 0 0 6 440.7119 641.46851 Tm
(74)Tj
-0.0051 Tc 0.0452 Tw 10 0 0 10 449.554 637.4686 Tm
[(wrote:)-180(\322the aperture)]TJ
0.0936 Tw -13.9735 -1.1031 Td
(that is created \(by excision of the membrane\) tends)Tj
-0.0087 Tw T*
(to close and more than one operation may have to be)Tj
-0.0229 Tw T*
[(done before the opening is satisfactory)92(.)55(\323)-167(Gadre )]TJ
/T1_0 1 Tf
20.1761 0 Td
(et al)Tj
/T1_1 1 Tf
0 Tc 0 Tw 1.7016 0 Td
(.)Tj
-0.005 Tc 6 0 0 6 531.0455 608.37621 Tm
(80)Tj
0.01489 Tc 0.5871 Tw 10 0 0 10 309.81889 593.3455 Tm
(have described a useful three-flap technique)Tj
0.0029 Tc 0.367 Tw T*
(involving reopening of the obturator membrane)Tj
-0.0051 Tc 0.02499 Tw T*
[(followed by stenting with tubes for six weeks)55(.)]TJ
/T1_0 1 Tf
-0.00011 Tc 0 -2.5031 TD
(Increasing lubrication of the dry nasal mucosa)Tj
0.0199 Tc 0.42081 Tw 0 -1.40311 TD
[(W)18(ittmaac)12(k\325)74(s operation \(1948\))]TJ
/T1_1 1 Tf
0 Tc 0 Tw 13.9641 0 Td
(.)Tj
0.02 Tc 6 0 0 6 452.15961 536.2224 Tm
(15)Tj
0.4207 Tw 10 0 0 10 464.7574 532.2225 Tm
[(T)40(his procedure)]TJ
0.6217 Tw -15.4938 -1.1031 Td
(increases nasal secretion and lubrication by)Tj
-0.00011 Tc 0.149 Tw 0 -1.1031 TD
[(implantation of a Stensen\325)18(s \(parotid\) duct into the)]TJ
0.02499 Tw T*
(maxillary antrum.)Tj
/T1_0 1 Tf
0.0199 Tc 0.653 Tw 0 -2.2061 TD
[(Raghav Sharan\325)74(s operation)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 13.34509 0 Td
(.)Tj
0.02 Tc 6 0 0 6 445.9698 481.0686 Tm
(81)Tj
0.653 Tw 10 0 0 10 460.8898 477.0687 Tm
(A conventional)Tj
-0.00011 Tc 0.05901 Tw -15.1071 -1.1031 Td
(Caldwell-Luc procedure is carried out to include an)Tj
0.16611 Tw 0 -1.1031 TD
[(intranasal antrostomy through the inferior meatus)55(.)]TJ
0.03951 Tw T*
[(T)40(he mucosa of the maxillary antrum is elevated and)]TJ
0.1384 Tw T*
(brought into the nasal cavity on each side through)Tj
0.0491 Tw T*
[(the antrostomy)92(.)-189(T)40(he benefits are perhaps three-fold:)]TJ
0.3382 Tw T*
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[(.)-491(W)37(ith the sympathetic)]TJ
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0.1544 Tw T*
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0.23599 Tw T*
[(the cervical sympathetic chain,)-431(a stellate ganglion)]TJ
0.29111 Tw T*
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0.0443 Tw T*
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-0.0247 Tw T*
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0.2489 Tw T*
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-0.0213 Tw T*
(success of the procedure is judged by the appearance)Tj
0.1335 Tw T*
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0.0199 Tc 0.69769 Tw T*
(tympanic membrane and congestion of the)Tj
-0.00011 Tc 0.1377 Tw T*
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0.07111 Tw T*
(daily blocks on the affected side are recommended.)Tj
0.002 Tc 0.37289 Tw T*
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-0.00011 Tc 0.0067 Tw T*
(alternate days to avoid the risk of bilateral recurrent)Tj
0.09779 Tw T*
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0.1524 Tw T*
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0.12759 Tw T*
(that this is maintained for up to four to eight days)Tj
-0.0367 Tw T*
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(82)Tj
0.0199 Tc 0.41521 Tw 10 0 0 10 309.81889 140.17661 Tm
[(T)40(he procedure carries a big risk of transient)]TJ
-0.00011 Tc 0.17419 Tw T*
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0.11771 Tw T*
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0.13071 Tw T*
[(the sympathetic chain,)-326(and has no sustained effect.)]TJ
0.12309 Tw T*
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0.02499 Tw T*
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/T1_0 1 Tf
0.2981 Tw T*
(Cervical sympathectomy)Tj
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10.7679 0 Td
[(.)-438(T)40(his is a classic surgical)]TJ
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(technique based on the same principle as stellate)Tj
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(849)Tj
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[(AETIOLOGY )55(AND MAN)37(A)55(GEMENT OF )55(A)74(TR)18(OPHIC RHINITIS)]TJ
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[(T)40(he general)]TJ
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(conclusions are that ESS in combination with)Tj
0.39951 Tw T*
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0.2542 Tw 0 -2.24229 TD
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/T1_0 1 Tf
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[(.)-449(One study reported cure of)]TJ
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(AR and its features paradoxically by performing a)Tj
0.23801 Tw 0 -1.1212 TD
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0.02499 Tw T*
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(87)Tj
/T1_2 1 Tf
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0.3748 Tw T*
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0.08479 Tw T*
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0.3295 Tw T*
(oil has also been applied locally in the nose in)Tj
0.06619 Tw T*
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-0.02879 Tw T*
[(ingredients)55(,)-166(chaulmoogric acid and hydnocarpic acid,)]TJ
0.0199 Tc 0.81281 Tw T*
(have bacteriostatic and bactericidal actions)Tj
-0.00011 Tc -0.0056 Tw T*
[(specifically against acid-fast bacilli.)-135(Also contained is)]TJ
0.1053 Tw T*
[(an endotoxin that may help develop immunity)92(.)-245(T)40(he)]TJ
0.0154 Tw T*
(results are satisfactory for as long as the patients are)Tj
0.31 Tw T*
[(on the medication,)-505(with recurrence of symptoms)]TJ
0.1788 Tw T*
(after stopping treatment.)Tj
0 Tc 0 Tw 6 0 0 6 170.1452 201.5007 Tm
(15,88)Tj
-0.00011 Tc 0.1788 Tw 10 0 0 10 187.9328 197.50079 Tm
[(P)47(owder of sea ka has)]TJ
0.2148 Tw -12.9397 -1.1212 Td
(been used in the past for ozaena with favourable)Tj
0 Tw T*
[(results)55(.)]TJ
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(89)Tj
-0.00011 Tc 0.0244 Tw 10 0 0 10 97.5625 175.0775 Tm
(Some authors have tried vibratory massage)Tj
0.02271 Tw -3.90269 -1.1212 Td
[(of nasal turbinates using Mandl\325)18(s paint or Balsam of)]TJ
0.129 Tw T*
(Peru carried on cotton-tipped probes to encourage)Tj
0.0199 Tc 0.5968 Tw T*
[(glandular activity)92(.)-757(A)74(uthors from China have)]TJ
0.3775 Tw T*
[(satisfactorily treated 23 cases of )55(AR by deep)]TJ
-0.00011 Tc 0.09869 Tw T*
(puncture at three points \(acupuncture\) in the nasal)Tj
0 Tw T*
(region.)Tj
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(90)Tj
-0.00011 Tc 0.00279 Tw 10 0 0 10 96.8 107.8076 Tm
[(T)40(he authors have shown functional changes)]TJ
0.0014 Tc 0.3735 Tw -3.82651 -1.1212 Td
[(in the nasal mucosa,)-570(mucociliary transport rate)37(,)]TJ
-0.00011 Tc 0.2547 Tw T*
[(surface temperature of the conchal mucosa,)-450(acid-)]TJ
0.18359 Tw T*
[(base scale of nasal secretion,)-379(and volume of nasal)]TJ
0.02499 Tw T*
(secretion after such treatment.)Tj
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0 0 0 1 k
/GS1 gs
BT
/T1_2 1 Tf
10 0 0 10 64.7047 471.7684 Tm
[(\245)-775(This pa)-10(per r)10(e)18(vie)18(ws the aetiology)92(,)-238(pr)10(esentation)]TJ
1.27499 -1.10001 Td
(and management of atrophic rhinitis)Tj
-1.27499 -1.39999 Td
[(\245)-775(Primary atrophic rhinitis)18(,)-238(mor)10(e common in)]TJ
1.27499 -1.10001 Td
[(arid r)10(egions)18(,)-238(is decr)10(easing in incidence)]TJ
-1.27499 -1.39999 Td
[(\245)-775(Man)10(y types of tr)10(eatment ha)18(v)18(e been described.)]TJ
1.27499 -1.10001 Td
[(The rationales for these v)18(arying surgical and)]TJ
0 -1.10001 TD
[(medical tr)10(eatments ar)10(e discussed)]TJ
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58.78999 496.35001 226.27 -116.13 re
S
/GS1 gs
BT
/T1_2 1 Tf
0 Tw 8.5 0 0 8.5 309.5433 759.9106 Tm
[(Refer)10(ences)]TJ
/T1_0 1 Tf
0.19299 Tw 0.5005 -1.4137 Td
[(1)-500(Zohar Y)111(,)-388(T)100(almi YP)150(,)-443(Strauss )-55(M,)-443(F)37(inkelstein Y)111(,)-443(Shvilli Y)111(.)]TJ
0.02499 Tw 0.9995 -1.06081 Td
(Ozena revisited.)Tj
/T1_1 1 Tf
7.2998 0 Td
(J Otolaryngol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.2168 0 Td
(1990;)Tj
/T1_2 1 Tf
2.25 0 Td
(19)Tj
/T1_0 1 Tf
1 0 Td
(:345\3209)Tj
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[(2)-500(W)74(eir N)74(,)-206(Golding-W)74(ood DG)74(.)-206(Infective rhinitis and sinusitis)55(.)]TJ
-0.0257 Tw 0.9995 -1.06081 Td
[(In:)-169(Mackay IS)60(,)-169(Bull )55(TR,)-169(eds)55(.)]TJ
/T1_1 1 Tf
12.01241 0 Td
[(Scott-Bro)18(wn\325)74(s Otolaryngology)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 12.96671 0 Td
(,)Tj
-0.00011 Tc 0.02499 Tw -24.979 -1.06081 Td
[(6th edn.)-220(Oxford:)-220(Butterworth-Heinemann,)-220(1997;)]TJ
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0 Tc 0 Tw 20.9335 0 Td
(4)Tj
/T1_0 1 Tf
0.5 0 Td
(:4,8,26\3208)Tj
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[(3)-500(Loch )55(WE,)-185(Loch )55(WE,)-185(Reiriz HM.)-130(Acute necrotizing rhinitis)]TJ
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(in man.)Tj
/T1_1 1 Tf
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(Rhinology)Tj
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0 Tc 4.7762 0 Td
(1978;)Tj
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2.25 0 Td
(16)Tj
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1 0 Td
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[(4)-480(Nielsen )-55(BC)25(,)-870(Olinder)55(-Nielsen AM,)-870(Malmborg AS)60(.)]TJ
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(Successful treatment of ozena with ciprofloxacin.)Tj
/T1_1 1 Tf
-0.00011 Tc 0 Tw 0 -1.06081 TD
(Rhinology)Tj
/T1_0 1 Tf
0 Tc 4.7762 0 Td
(1995;)Tj
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2.25 0 Td
(33)Tj
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1 0 Td
(:57\32060)Tj
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[(5)-500(Ruskin JL.)-109(A differential diagnosis and therapy of atrophic)]TJ
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(rhinitis and ozena.)Tj
/T1_1 1 Tf
8.2435 0 Td
[(Arc)12(h Otolaryngol)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 7.9274 0 Td
(1932;)Tj
/T1_2 1 Tf
2.25 0 Td
(15)Tj
/T1_0 1 Tf
1 0 Td
(:222\32057)Tj
-0.00011 Tc 0.16991 Tw -20.42039 -1.06081 Td
[(6)-500(Menzio P)150(.)-365(Nasal vasomotor modifications from nicotinic)]TJ
0.1881 Tw 0.9995 -1.06081 Td
(acid in simple atrophic rhinitis and in ozenous atrophic)Tj
-0.0002 Tc 0 Tw T*
[(rhinitis)55(.)]TJ
/T1_1 1 Tf
-0.00011 Tc 0.02499 Tw 3.4711 0 Td
[(Arc)12(h Ital Otol Rinol Laringol)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 13.0862 0 Td
(1950;)Tj
/T1_2 1 Tf
2.25 0 Td
(61)Tj
/T1_0 1 Tf
1 0 Td
(:19\32027)Tj
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[(7)-500(Moore EJ)92(,)-425(K)10(ern EB)74(.)-370(Atrophic rhinitis:)-425(a review of 242)]TJ
0 Tw 0.9995 -1.06081 Td
[(cases)55(.)]TJ
/T1_1 1 Tf
0.02499 Tw 2.6368 0 Td
(Am J Rhinol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 5.8248 0 Td
(2001;)Tj
/T1_2 1 Tf
2.25 0 Td
(15)Tj
/T1_0 1 Tf
1 0 Td
(:355\32061)Tj
-0.00011 Tc 0.21249 Tw -12.71111 -1.06081 Td
[(8)-500(Schoss P)150(.)-408(Diagnosis and control of progressive atrophic)]TJ
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[(rhinitis)55(.)]TJ
/T1_1 1 Tf
-0.00011 Tc 3.4711 0 Td
[(AL)92(TEX)]TJ
/T1_0 1 Tf
0 Tc 3.8497 0 Td
(1994;)Tj
/T1_2 1 Tf
2.25 0 Td
(11)Tj
/T1_0 1 Tf
1 0 Td
(:55\3208)Tj
-0.00011 Tc 0.0416 Tw -11.5703 -1.06081 Td
[(9)-500(Magyar T)92(,)-292(King VL,)-292(K)50(ovacs )-55(F)111(.)-292(Evaluation )-55(of )-55(vaccines )-55(for)]TJ
-0.0097 Tw 0.9995 -1.06081 Td
[(atrophic rhinitis \320 a comparison of three challenge models)55(.)]TJ
/T1_1 1 Tf
0 Tw T*
[(V)92(accine)]TJ
/T1_0 1 Tf
0 Tc 3.5704 0 Td
(2002;)Tj
/T1_2 1 Tf
2.25 0 Td
(20)Tj
/T1_0 1 Tf
1 0 Td
(:1797\320802)Tj
-0.00011 Tc 0.2377 Tw -8.32001 -1.06081 Td
[(10)-500(Duberstein LE,)-433(Hessler JR.)-433(P)47(orcine atrophic rhinitis:)-433(a)]TJ
0.0387 Tw 1.4995 -1.06081 Td
[(model for studying nasal physiology and pathophysiology)92(.)]TJ
/T1_1 1 Tf
0 Tw T*
(Rhinology)Tj
/T1_0 1 Tf
0 Tc 4.7762 0 Td
(1978;)Tj
/T1_2 1 Tf
2.25 0 Td
(16)Tj
/T1_0 1 Tf
1 0 Td
(:31\3209)Tj
-0.00011 Tc 0.01401 Tw -9.5258 -1.06081 Td
[(11)-500(Bunnag C)25(,)-209(J)74(areoncharsri P)150(,)-154(T)100(ansuriyawong P)150(,)-209(Bhothisuwan)]TJ
0.1741 Tw 1.4995 -1.06081 Td
[(W)111(,)-369(Chantarakul N)74(.)-369(Characteristics of atrophic rhinitis in)]TJ
0.0199 Tc 0.6795 Tw T*
[(T)40(hai patients at the Siriraj Hospital.)]TJ
/T1_1 1 Tf
0 Tw 20.56779 0 Td
(Rhinology)Tj
/T1_0 1 Tf
0 Tc -20.56779 -1.06081 Td
(1999;)Tj
/T1_2 1 Tf
2.25 0 Td
(37)Tj
/T1_0 1 Tf
1 0 Td
(:125\32030)Tj
-0.00011 Tc 0.1059 Tw -4.7495 -1.06081 Td
[(12)-500(Lobo CJ)92(,)-301(Hartley C)25(,)-301(F)74(arrington )55(WT)92(.)-301(Closure of the nasal)]TJ
0.0199 Tc 0.4254 Tw 1.4995 -1.06081 Td
(vestibule in atrophic rhinitis \320 a new non-surgical)Tj
-0.00011 Tc 0 Tw T*
[(technique)37(.)]TJ
/T1_1 1 Tf
0.02499 Tw 4.7113 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1998;)Tj
/T1_2 1 Tf
2.25 0 Td
(112)Tj
/T1_0 1 Tf
1.5 0 Td
(:543\3206)Tj
-0.00011 Tc -0.02991 Tw -17.1745 -1.06081 Td
[(13)-500(Kameswaran M.)-165(F)37(ibre-optic endoscopy in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0.02499 Tw 1.4995 -1.06081 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1991;)Tj
/T1_2 1 Tf
2.25 0 Td
(105)Tj
/T1_0 1 Tf
1.5 0 Td
(:1014\3207)Tj
-0.00011 Tc 0.0704 Tw -12.4632 -1.06081 Td
[(14)-500(Lu Z,)-266(Xie X,)-266(Liao L.)-211(A preliminary study on the etiology)]TJ
-0.0058 Tw 1.4995 -1.06081 Td
(of atrophic rhinitis in Zunyi \(In Chinese\).)Tj
/T1_1 1 Tf
18.1286 0 Td
(Zhonghua Er Bi)Tj
0.02499 Tw -18.1286 -1.06081 Td
[(Y)92(an Hou K)55(e Za Zhi)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 8.94991 0 Td
(1995;)Tj
/T1_2 1 Tf
2.25 0 Td
(30)Tj
/T1_0 1 Tf
1 0 Td
(:41\3203)Tj
-0.00011 Tc 0.2403 Tw -13.69949 -1.06081 Td
[(15)-500(Chaturvedi )55(VN)74(.)-381(Atrophic rhinitis and nasal myiasis)55(.)-435(In:)]TJ
0.09711 Tw 1.4995 -1.06081 Td
[(Kameswaran S)60(,)-292(Kameswaran M,)-292(eds)55(.)]TJ
/T1_1 1 Tf
16.48309 0 Td
[(ENT Disor)18(ders in a)]TJ
0.0199 Tc 0.7477 Tw -16.48309 -1.06081 Td
[(T)74(ropical Environment)]TJ
/T1_0 1 Tf
10.65759 0 Td
[(,)-963(2nd edn.)-963(Madras:)-963(MERF)]TJ
-0.00011 Tc 0 Tw -10.65759 -1.06081 Td
[(publications)55(,)-220(1999;119\32028)]TJ
0.0199 Tc 0.4686 Tw -1.4995 -1.06081 Td
[(1)20(6)-480(Amreliwala MS)60(,)-684(J)74(ain SKT)92(,)-684(Raizada RM,)-684(Sinha )55(V)129(,)]TJ
-0.00011 Tc 0.11839 Tw 1.4995 -1.06081 Td
[(Chaturvedi )55(VN)74(.)-259(Atrophic rhinitis:)-313(an inherited condition.)]TJ
/T1_1 1 Tf
0.02499 Tw T*
(Indian J Clin Pract)Tj
/T1_0 1 Tf
0 Tc 0 Tw 8.4894 0 Td
(1993;)Tj
/T1_2 1 Tf
2.25 0 Td
(4)Tj
/T1_0 1 Tf
0.5 0 Td
(:43\3206)Tj
-0.00011 Tc 0.0822 Tw -12.739 -1.06081 Td
[(17)-500(Singh I.)-222(Atrophic rhinitis is a familial disease? )]TJ
/T1_1 1 Tf
22.1922 0 Td
[(T)74(rop Doct)]TJ
/T1_0 1 Tf
0 Tc 0 Tw -20.6927 -1.06081 Td
(1992;)Tj
/T1_2 1 Tf
2.25 0 Td
(22)Tj
/T1_0 1 Tf
1 0 Td
(:84)Tj
-0.00011 Tc 0.12891 Tw -4.7495 -1.06081 Td
[(18)-500(Artiles F)111(,)-324(Bordes )55(A,)-324(Conde )55(A,)-324(Dominguez S)60(,)-324(Ramos JL,)]TJ
0.02499 Tw 1.4995 -1.06081 Td
[(Suarez S)60(.)-220(Chronic atrophic rhinitis and Klebsiella ozaenae)]TJ
0 Tw T*
(infection.)Tj
/T1_1 1 Tf
0.02499 Tw 4.3028 0 Td
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(2000;)Tj
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(18)Tj
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[(19)-500(Amreliwala MS)60(,)-549(J)74(ain SKT)92(,)-549(Chaturvedi )55(VN)74(,)-549(Narang P)150(.)]TJ
0.2907 Tw 1.4995 -1.06081 Td
(Bacteriological study of nose and maxillary antrum in)Tj
0.02499 Tw T*
[(atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
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(Indian Pract)Tj
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[(20)-500(Singh I,)-220(Raizada RM,)-220(Chaturvedi )55(VN)74(,)-220(J)74(ain SKT)92(,)-220(Narang P)150(.)]TJ
0.0199 Tc 0.37579 Tw 1.4995 -1.06081 Td
[(Atrophic rhinitis:)-591(a bacteriological profile)37(.)]TJ
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21.18491 0 Td
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[(21)-500(Loewenberg B)74(.)-348(Le microbe de l\325ozene)37(.)]TJ
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[(\(P)55(aris\))]TJ
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(8)Tj
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[(22)-500(Abel P)150(.)-443(Die aetiologie der ozaena.)]TJ
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[(23)-500(Rutter JM,)-104(T)100(aylor RJ)92(,)-159(Crighton )55(WH,)-159(Robertson IB)74(,)-159(Benson)]TJ
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[(J)74(A.)-398(Epidemiological study of Pasteurella multocida and)]TJ
0.36369 Tw T*
[(Bordetella bronchiseptica in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
21.6539 0 Td
[(V)92(et Rec)]TJ
/T1_0 1 Tf
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(115)Tj
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[(24)-500(F)37(erguson JL,)-165(McCaffrey )55(TV)129(,)-165(K)10(ern EB)74(,)-165(Martin )55(WJ II.)-165(Effect)]TJ
0.0199 Tc 0.517 Tw 1.4995 -1.06081 Td
(of Klebsiella ozaenae on ciliary activity in vitro:)Tj
0.013 Tc 0.36189 Tw T*
[(implications in the pathogenesis of atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
-0.00011 Tc 0.02499 Tw T*
[(Otolaryngol Head Nec)12(k Surg)]TJ
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(102)Tj
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[(25)-500(Hagrass MA,)-313(Gamea )55(AM,)-313(El-Sherief SG)74(,)-313(El-Guindy )55(AS)60(,)]TJ
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[(El-T)100(atawi F)74(A.)-355(Radiological and endoscopic study of the)]TJ
0.2467 Tw T*
[(maxillary sinus in primary atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
20.28799 0 Td
(J Laryngol)Tj
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(Otol)Tj
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(106)Tj
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[(26)-500(Bernat I.)-220(Ozaena and iron deficienc)18(y)92(.)]TJ
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[(27)-500(Zakrzewski J)92(.)-510(On the etiology of systemic ozaena \(in)]TJ
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[(P)47(olish\).)]TJ
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[(Otolaryngol P)55(ol)]TJ
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(47)Tj
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[(28)-500(Sayed RH,)-366(Abou-Elhamd KE,)-366(Abdel-Kader M,)-421(Saleem)]TJ
0.0565 Tw 1.4995 -1.06081 Td
[(TH.)-252(Study of surfactant level in cases of primary atrophic)]TJ
-0.0002 Tc 0 Tw T*
[(rhinitis)55(.)]TJ
/T1_1 1 Tf
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(J Laryngol Otol)Tj
/T1_0 1 Tf
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(114)Tj
/T1_0 1 Tf
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(:254\3209)Tj
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(850)Tj
0.0005 Tc 0.0249 Tw 7.12 0 0 7.12 433.731 779.0643 Tm
[(S N DUTT)92(,)-220(M KAMESW)93(ARAN)]TJ
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[(29)-500(Raman R.)-182(V)111(asomotor rhinitis \320 atrophic rhinitis:)-237(two ends)]TJ
0.02499 Tw 1.4995 -1.07941 Td
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/T1_1 1 Tf
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(Singapore Med J)Tj
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[(30)-500(Arnstein AR.)-370(Regional )-55(osteoporosis)55(.)]TJ
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-0.00011 Tc -0.0358 Tw -6.1351 -1.07941 Td
[(31)-500(Ghosh P)150(.)-159(Primary atrophic rhinitis)55(.)-104(A new hypothesis for its)]TJ
0 Tw 1.4995 -1.07941 Td
[(aetiopathogenesis)55(.)]TJ
/T1_1 1 Tf
0.02499 Tw 8.1937 0 Td
(Indian J Otolaryngol)Tj
/T1_0 1 Tf
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(39)Tj
/T1_0 1 Tf
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-0.00011 Tc 0.138 Tw -22.2695 -1.07941 Td
[(32)-500(Ghosh P)150(.)-278(V)90(estibuloplasty \(a new one-stage operation for)]TJ
0.02499 Tw 1.4995 -1.07941 Td
(atrophic rhinitis\).)Tj
/T1_1 1 Tf
7.80099 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
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(1987;)Tj
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(101)Tj
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[(33)-500(Barbary AS)60(,)-375(Y)92(assin A,)-430(F)55(ouad )-55(H.)-430(Histopathological )-55(and)]TJ
0.0325 Tw 1.4995 -1.07941 Td
[(histochemical studies on atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0.03259 Tw 18.2753 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
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(1970;)Tj
/T1_2 1 Tf
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(84)Tj
/T1_0 1 Tf
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[(34)-500(F)55(ouad H,)-171(Afifi N)74(,)-226(F)74(att-hi )55(A,)-226(El Sheemy)92(,)-226(Iskandaer I,)-171(Abou)]TJ
0.35229 Tw 1.4995 -1.07941 Td
[(Saif MN)74(.)-492(Altered cell mediated immunity in atrophic)]TJ
-0.0002 Tc 0 Tw 0 -1.07941 TD
[(rhinitis)55(.)]TJ
/T1_1 1 Tf
-0.00011 Tc 0.02499 Tw 3.4711 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
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(1990;)Tj
/T1_2 1 Tf
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(94)Tj
/T1_0 1 Tf
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(:507\32014)Tj
0.0199 Tc 1.14751 Tw -15.4342 -1.07941 Td
[(3)20(5)-480(Makowska W)111(,)-1417(K)10(endziorek AM,)-1417(Zaursza )-55(E.)]TJ
-0.00011 Tc 0.1319 Tw 1.4995 -1.07941 Td
[(Immunoglobulin content and )55(T cell activity according to)]TJ
0.02499 Tw T*
(the rosette test in ozaena.)Tj
/T1_1 1 Tf
11.4019 0 Td
[(Otolaryngol P)55(ol)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 7.2187 0 Td
(1979;)Tj
/T1_2 1 Tf
2.25 0 Td
(33)Tj
/T1_0 1 Tf
1 0 Td
(:373\3206)Tj
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[(3)7(6)-493(Medina L,)-570(Benazzo M,)-570(Bertino G)74(,)-570(Montecucco CM,)]TJ
-0.00011 Tc 0.28551 Tw 1.4995 -1.07941 Td
[(Danesino C)25(,)-481(Martinetti M,)]TJ
/T1_1 1 Tf
10 0 0 10 180.2164 594.7607 Tm
(et al)Tj
/T1_0 1 Tf
8.5 0 0 8.5 200.5668 594.7607 Tm
[(.)-481(Clinical,)-481(genetic and)]TJ
0.13651 Tw -15.1772 -1.07941 Td
(immunologic analysis of a family affected by ozena.)Tj
/T1_1 1 Tf
0 Tw 23.5623 0 Td
(Eur)Tj
0.02499 Tw -23.5623 -1.07941 Td
[(Arc)12(h Otorhinolaryngol)]TJ
/T1_0 1 Tf
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(2003;)Tj
/T1_2 1 Tf
2.25 0 Td
(260)Tj
/T1_0 1 Tf
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[(37)-500(W)74(ang Y)111(,)-501(Liu T)92(,)-501(Qu Y)111(,)-501(Dong )-55(Z,)-446(Y)92(ang )-55(Z.)-501(Empty )-55(nose)]TJ
0.09081 Tw 1.4995 -1.07941 Td
(syndrome \(in Chinese\).)Tj
/T1_1 1 Tf
10.6078 0 Td
[(Zhonghua Er Bi )55(Y)92(an Hou K)55(e Za)]TJ
-0.0002 Tc 0 Tw -10.6078 -1.07941 Td
(Zhi)Tj
/T1_0 1 Tf
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(2001;)Tj
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(36)Tj
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[(38)-500(Carducci )55(A,)-391(Cervellera G)74(,)-391(De Cillis G)74(.)-391(Scleroma of the)]TJ
0.3568 Tw 1.4995 -1.07941 Td
[(upper respiratory tract and ozena:)-552(clinico-pathological)]TJ
0.0199 Tc 0.9158 Tw T*
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/T1_1 1 Tf
13.8438 0 Td
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(17)Tj
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[(39)-500(Mehta L,)-393(Kasbekar )55(V)129(,)-338(Apte N)74(,)-338(Antia NH.)-393(Evolution of)]TJ
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(Lepr)Tj
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(India)Tj
/T1_0 1 Tf
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(53)Tj
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[(40)-500(Xu Q)37(,)-445(Dong M,)-390(W)55(u )55(Y)111(.)-390(T)40(he clinical features of human)]TJ
0.1142 Tw 1.4995 -1.07941 Td
[(immunodeficienc)18(y virus \(HIV\) on ear)18(,)-309(nose)37(,)-309(throat,)-309(head)]TJ
0.04401 Tw T*
(and neck \(in Chinese\).)Tj
/T1_1 1 Tf
10.1507 0 Td
[(Lin Chuang Er Bi )55(Y)92(an Hou K)55(e Za)]TJ
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(Zhi)Tj
/T1_0 1 Tf
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(1999;)Tj
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(13)Tj
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0.2791 Tw 1.4995 -1.07941 Td
(nasal complications after radiotherapy in patients with)Tj
0.0199 Tc 0.37331 Tw T*
(nasopharyngeal carcinoma by logistic regression \(in)Tj
0 Tw T*
(Chinese\).)Tj
/T1_1 1 Tf
0.38429 Tw 4.91879 0 Td
[(Lin Chuang Er Bi )55(Y)92(an Hou K)55(e Za Zhi)]TJ
/T1_0 1 Tf
0 Tc 0 Tw -4.91879 -1.07941 Td
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(17)Tj
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[(42)-500(Gupta SC)25(.)-287(Septoplasty in unilateral atrophic rhinitis with)]TJ
0.02499 Tw 1.4995 -1.07941 Td
(deviated nasal septum.)Tj
/T1_1 1 Tf
10.13139 0 Td
(J Laryngol Otol)Tj
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(1985;)Tj
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(99)Tj
/T1_0 1 Tf
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0.0199 Tc 0.47279 Tw -22.0946 -1.07941 Td
[(4)20(3)-480(Sinha )55(V)129(,)-688(Sinha S)60(.)-633(Anhidrotic ectodermal dysplasia)]TJ
-0.00011 Tc 0.0163 Tw 1.4995 -1.07941 Td
[(presenting as atrophic rhinitis and maggots)55(.)]TJ
/T1_1 1 Tf
19.0719 0 Td
[(Indian P)55(ediatr)]TJ
/T1_0 1 Tf
0 Tc 0 Tw -19.0719 -1.07941 Td
(2003;)Tj
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(40)Tj
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[(44)-500(Sachidananda )-55(R,)-193(Nagadi A,)-193(Dass AA,)-193(Praveen )-55(K)50(umar )-55(BY)111(.)]TJ
0.2614 Tw 1.4995 -1.07941 Td
(Anhidrotic ectodermal dysplasia presenting as atrophic)Tj
-0.0002 Tc 0 Tw T*
[(rhinitis)55(.)]TJ
/T1_1 1 Tf
-0.00011 Tc 0.02499 Tw 3.4711 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(2004;)Tj
/T1_2 1 Tf
2.25 0 Td
(118)Tj
/T1_0 1 Tf
1.5 0 Td
(:556\3207)Tj
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[(45)-500(W)37(iatr E,)-186(Pirozynski M,)-186(Dobrzynski P)150(.)-186(Osteochondroplastic)]TJ
0.13969 Tw 1.4995 -1.07941 Td
(tracheobronchopathy \320 relation to rhinitis atrophica and)Tj
0.0199 Tc 0.42661 Tw T*
[(iron deficienc)18(y \(in P)47(olish\).)]TJ
/T1_1 1 Tf
0.3717 Tw 13.86189 0 Td
[(Pneumonol Alergol )-55(P)55(ol)]TJ
/T1_0 1 Tf
0 Tc 0 Tw -13.86189 -1.07941 Td
(1993;)Tj
/T1_2 1 Tf
2.25 0 Td
(61)Tj
/T1_0 1 Tf
1 0 Td
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[(46)-500(Reisser C)25(,)-450(Enzmann H,)-450(Gunzel S)60(,)-395(Anton-Lamprecht I,)]TJ
-0.0103 Tw 1.4995 -1.07941 Td
[(Born IA.)-185(Ozaena and allergic rhinitis in ichthyosis vulgaris)]TJ
0.02499 Tw T*
(\(in German\).)Tj
/T1_1 1 Tf
0 Tw 5.967 0 Td
(Laryngorhinootologie)Tj
/T1_0 1 Tf
0 Tc 9.77721 0 Td
(1992;)Tj
/T1_2 1 Tf
2.25 0 Td
(71)Tj
/T1_0 1 Tf
1 0 Td
(:302\3206)Tj
-0.00011 Tc 0.1282 Tw -20.4937 -1.07941 Td
[(47)-500(Singh I,)-268(Y)92(adav SP)150(,)-268(W)37(ig U)92(.)-268(Atrophic rhinitis \320 an unusual)]TJ
0.02499 Tw 1.4995 -1.07941 Td
[(complication of typhoid fever)18(.)]TJ
/T1_1 1 Tf
13.3322 0 Td
[(Med J )55(A)18(ust)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 5.1402 0 Td
(1992;)Tj
/T1_2 1 Tf
2.25 0 Td
(157)Tj
/T1_0 1 Tf
1.5 0 Td
(:287)Tj
-0.00011 Tc 0.1924 Tw -23.72189 -1.07941 Td
[(48)-500(Mickiewicz )-55(L,)-442(Mikulski T)92(,)-442(K)50(uzna-Grygiel W)111(,)-442(Swiech )-55(Z.)]TJ
-0.009 Tw 1.4995 -1.07941 Td
(Assessment of the nasal mucosa in workers exposed to the)Tj
0.17059 Tw T*
[(prolonged effect of phosphorite and apatite dusts)55(.)]TJ
/T1_1 1 Tf
22.91879 0 Td
[(P)55(ol J)]TJ
0.02499 Tw -22.91879 -1.07941 Td
(Occup Med Environ Health)Tj
/T1_0 1 Tf
0 Tc 0 Tw 12.3205 0 Td
(1993;)Tj
/T1_2 1 Tf
2.25 0 Td
(6)Tj
/T1_0 1 Tf
0.5 0 Td
(:277\32085)Tj
-0.00011 Tc 0.1244 Tw -16.57001 -1.07941 Td
[(49)-500(T)100(aylor M,)-265(Y)92(oung )55(A.)-320(Histopathological and histochemical)]TJ
-0.0051 Tc -0.0049 Tw 1.4995 -1.07941 Td
[(studies on atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
11.74989 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
-0.005 Tc 0 Tw 7.0442 0 Td
(1961;)Tj
/T1_2 1 Tf
2.22501 0 Td
(75)Tj
/T1_0 1 Tf
0.99001 0 Td
(:574\32090)Tj
-0.00011 Tc 0.2343 Tw -23.50861 -1.07941 Td
[(50)-500(Baser B)74(,)-429(Grewal DS)60(,)-429(Hiranandani NL.)-429(Management of)]TJ
0.0179 Tw 1.4995 -1.07941 Td
[(saddle nose deformity in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
18.3045 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw -18.3045 -1.07941 Td
(1990;)Tj
/T1_2 1 Tf
2.25 0 Td
(104)Tj
/T1_0 1 Tf
1.5 0 Td
(:404\3207)Tj
-0.00011 Tc 0.29649 Tw -5.2495 -1.07941 Td
[(51)-500(Chowdhury P)150(,)-492(Stein DS)60(.)-492(Pyogenic hepatic abscess and)]TJ
0.0199 Tc 0.422 Tw 1.4995 -1.07941 Td
(septic pulmonary emboli associated with Klebsiella)Tj
-0.00011 Tc 0.02499 Tw T*
(ozaenae bacteremia.)Tj
/T1_1 1 Tf
9.1328 0 Td
(South Med J)Tj
/T1_0 1 Tf
0 Tc 0 Tw 5.7139 0 Td
(1992;)Tj
/T1_2 1 Tf
2.25 0 Td
(85)Tj
/T1_0 1 Tf
1 0 Td
(:638\32041)Tj
-0.00011 Tc 0.19589 Tw -19.59621 -1.07941 Td
[(52)-500(Strampfer MJ)92(,)-391(Schoch PE,)-391(Cunha B)55(A.)-391(Cerebral abscess)]TJ
0.0199 Tc 0.7043 Tw 1.4995 -1.07941 Td
[(caused by Klebsiella ozaenae)37(.)]TJ
/T1_1 1 Tf
16.46539 0 Td
(J Clin Microbio)Tj
/T1_0 1 Tf
0 Tc 0 Tw 8.4859 0 Td
(l)Tj
-24.9512 -1.07941 Td
(1987;)Tj
/T1_2 1 Tf
2.25 0 Td
(25)Tj
/T1_0 1 Tf
1 0 Td
(:1553\3204)Tj
0.0199 Tc 0.4117 Tw -4.7495 -1.07941 Td
[(5)20(3)-480(Singh M,)-627(J)74(ain )55(V)129(,)-627(Singh SP)150(,)-627(Gupta SC)25(.)-627(Endoscopic)]TJ
-0.00011 Tc 0.22031 Tw 1.4995 -1.07941 Td
[(dacryoc)18(ystorhinostomy in cases of dacryoc)18(ystitis due to)]TJ
0.02499 Tw T*
[(atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
7.3571 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(2004;)Tj
/T1_2 1 Tf
2.25 0 Td
(118)Tj
/T1_0 1 Tf
1.5 0 Td
(:426\3208)Tj
-0.00011 Tc 0.0652 Tw -19.8203 -1.07941 Td
[(54)-500(Sharma H,)-260(Dayal D)74(,)-205(Agrawal SP)150(.)-260(Nasal myiasis:)-260(review of)]TJ
0 Tc 0.02499 Tw 1.4995 -1.07941 Td
[(10 years experience)37(.)]TJ
/T1_1 1 Tf
-0.00011 Tc 9.03841 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1989;)Tj
/T1_2 1 Tf
2.25 0 Td
(103)Tj
/T1_0 1 Tf
1.5 0 Td
(:489\32091)Tj
-0.00011 Tc 0.02139 Tw 8.0287 82.03529 Td
[(55)-500(T)100(omooka L)92(T)92(,)-216(Murphy C)25(,)-216(Davidson )55(TM.)-216(Clinical study and)]TJ
0.0199 Tc 0.5125 Tw 1.4995 -1.07941 Td
(literature review of nasal irrigation.)Tj
/T1_1 1 Tf
0 Tw 18.89799 0 Td
(Laryngoscope)Tj
/T1_0 1 Tf
0 Tc -18.89799 -1.07941 Td
(2000;)Tj
/T1_2 1 Tf
2.25 0 Td
(111)Tj
/T1_0 1 Tf
1.5 0 Td
(:1189\32093)Tj
-0.00011 Tc 0.26489 Tw -5.2495 -1.07941 Td
[(56)-500(J)74(akabfi I,)-460(K)50(osa D)74(.)-405(T)40(he local treatment of ozaena with)]TJ
0.02499 Tw 1.4995 -1.07941 Td
[(streptomycin and Novocaine)37(.)]TJ
/T1_1 1 Tf
-0.00031 Tc 0 Tw 12.9278 0 Td
(HNO)Tj
/T1_0 1 Tf
0 Tc 2.7184 0 Td
(1975;)Tj
/T1_2 1 Tf
2.25 0 Td
(23)Tj
/T1_0 1 Tf
1 0 Td
(:253\3204)Tj
-0.00011 Tc 0.2184 Tw -20.39571 -1.07941 Td
[(57)-500(Sinha SM,)-414(Gupta SC)25(,)-414(Samuel KC)25(,)-414(Misra UC)25(.)-414(Placental)]TJ
0.1153 Tw 1.4995 -1.07941 Td
[(extract therapy in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0.1154 Tw 15.7993 0 Td
[(Eye Ear Nose )55(Throat)]TJ
-0.0002 Tc 0 Tw -15.7993 -1.07941 Td
(Mon)Tj
/T1_0 1 Tf
0 Tc 2.3307 0 Td
(1976;)Tj
/T1_2 1 Tf
2.25 0 Td
(55)Tj
/T1_0 1 Tf
1 0 Td
(:59\32061)Tj
-0.00011 Tc 0.0437 Tw -7.0802 -1.07941 Td
[(58)-500(Sinha SM,)-239(Sardana DS)60(,)-239(Rjvanshi )55(VS)60(.)-184(A nine years\325 review)]TJ
0.217 Tw 1.4995 -1.07941 Td
(of 273 cases of atrophic rhinitis and its management.)Tj
/T1_1 1 Tf
0 Tc 0 Tw 24.7852 0 Td
(J)Tj
-0.00011 Tc 0.02499 Tw -24.7852 -1.07941 Td
(Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.4948 0 Td
(1977;)Tj
/T1_2 1 Tf
2.25 0 Td
(91)Tj
/T1_0 1 Tf
1 0 Td
(:591\320600)Tj
-0.00011 Tc 0.1965 Tw -11.2444 -1.07941 Td
[(59)-500(Dudley JP)150(.)-337(Atrophic rhinitis:)-392(antibiotic treatment.)]TJ
/T1_1 1 Tf
-0.0002 Tc 0.19659 Tw 24.2276 0 Td
(Am J)Tj
-0.00011 Tc 0 Tw -22.7281 -1.07941 Td
(Otolaryngol)Tj
/T1_0 1 Tf
0 Tc 5.49789 0 Td
(1987;)Tj
/T1_2 1 Tf
2.25 0 Td
(8)Tj
/T1_0 1 Tf
0.5 0 Td
(:387\32090)Tj
0.0161 Tc 0.3588 Tw -9.74741 -1.07941 Td
[(6)16(0)-483(Qizilbash )55(AAH,)-570(Daif M.)-515(Atrophic rhinitis revisited.)]TJ
/T1_1 1 Tf
-0.00011 Tc 0.02499 Tw 1.4995 -1.07941 Td
[(P)55(akistan J Otolaryngol)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 10.1602 0 Td
(1992;)Tj
/T1_2 1 Tf
2.25 0 Td
(8)Tj
/T1_0 1 Tf
0.5 0 Td
(:197\3209)Tj
-0.00011 Tc -0.0186 Tw -14.40981 -1.07941 Td
[(61)-500(Larger J)92(.)-176(Local treatment of atrophic rhinitis with nicotinic)]TJ
0.0199 Tc 0.3945 Tw 1.4995 -1.07941 Td
[(acid derivatives \(in F)37(rench\).)]TJ
/T1_1 1 Tf
14.5029 0 Td
(Ann Otolaryngol Chir)Tj
-0.00011 Tc 0 Tw -14.5029 -1.07941 Td
(Cervicofac)Tj
/T1_0 1 Tf
0 Tc 4.8839 0 Td
(1955;)Tj
/T1_2 1 Tf
2.25 0 Td
(72)Tj
/T1_0 1 Tf
1 0 Td
(:332\3203)Tj
-0.00011 Tc 0.0282 Tw -9.63341 -1.07941 Td
[(62)-500(Bruk )55(AM.)-223(Use of streptomycin,)-223(nicotinic acid and vitamin)]TJ
0.28999 Tw 1.4995 -1.07941 Td
(A in ozaena \(in Russian\).)Tj
/T1_1 1 Tf
12.6792 0 Td
(Zh Ushn Nos Gorl Bolezn)Tj
/T1_0 1 Tf
0 Tc 0 Tw -12.6792 -1.07941 Td
(1965;)Tj
/T1_2 1 Tf
2.25 0 Td
(25)Tj
/T1_0 1 Tf
1 0 Td
(:63\3207)Tj
-0.00011 Tc 0.0887 Tw -4.7495 -1.07941 Td
[(63)-500(Shenoy )55(VK,)-284(Shetty P)150(,)-229(Alva B)74(.)-284(Pin hole nasal prosthesis:)-284(a)]TJ
0.02499 Tw 1.4995 -1.07941 Td
(clinical report.)Tj
/T1_1 1 Tf
6.5224 0 Td
(J Prosthet Dent)Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.93539 0 Td
(2002;)Tj
/T1_2 1 Tf
2.25 0 Td
(88)Tj
/T1_0 1 Tf
1 0 Td
(:359\32061)Tj
-0.00011 Tc 0.0919 Tw -18.20731 -1.07941 Td
[(64)-500(Arndt HJ)92(,)-287(Eggers )55(TH.)-287(Ozaena and its surgical treatment.)]TJ
0.16611 Tw 1.4995 -1.07941 Td
[(Late results of Lautenschlager\325)18(s operation \(in German\).)]TJ
/T1_1 1 Tf
-0.00031 Tc 0 Tw T*
(HNO)Tj
/T1_0 1 Tf
0 Tc 2.7184 0 Td
(1966;)Tj
/T1_2 1 Tf
2.25 0 Td
(14)Tj
/T1_0 1 Tf
1 0 Td
(:193\3207)Tj
0.0199 Tc 0.4081 Tw -7.4679 -1.07941 Td
[(6)20(5)-480(Udrescu S)60(,)-623(F)37(irica D)74(.)-623(Proposed modification of the)]TJ
0.0031 Tc 0.3718 Tw 1.4995 -1.07941 Td
(Lautenschlager method for recalibration of the nasal)Tj
0.0139 Tc 0.36099 Tw T*
(fossae in ozaena \(in Romanian\).)Tj
/T1_1 1 Tf
0 Tw 16.4209 0 Td
(Otorinolaringologie)Tj
/T1_0 1 Tf
0 Tc -16.4209 -1.07941 Td
(1971;)Tj
/T1_2 1 Tf
2.25 0 Td
(16)Tj
/T1_0 1 Tf
1 0 Td
(:275\3208)Tj
0.0072 Tc 0.36771 Tw -4.7495 -1.07941 Td
[(6)7(6)-492(W)37(ilson )55(TG)74(.)-515(T)111(eflon in glycerine paste in rhinology)92(.)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 26.28481 0 Td
(J)Tj
-0.00011 Tc 0.02499 Tw -24.7852 -1.07941 Td
(Laryngol Otol )Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.4948 0 Td
(1964;)Tj
/T1_2 1 Tf
2.25 0 Td
(78)Tj
/T1_0 1 Tf
1 0 Td
(:953\3208)Tj
-0.00011 Tc 0.0143 Tw -11.2444 -1.07941 Td
[(67)-500(Chatterji P)150(.)-154(A)74(utogenous medullary \(cancellous\) bone graft)]TJ
0.02499 Tw 1.4995 -1.07941 Td
(in ozaena.)Tj
/T1_1 1 Tf
4.63451 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1980;)Tj
/T1_2 1 Tf
2.25 0 Td
(94)Tj
/T1_0 1 Tf
1 0 Td
(:737\32049)Tj
-0.00011 Tc 0.0883 Tw -16.5977 -1.07941 Td
[(68)-500(W)37(iecko J)92(,)-283(F)37(ruba J)92(,)-283(Karpowa J)92(.)-228(T)111(reatment of ozena by the)]TJ
0.2726 Tw 1.4995 -1.07941 Td
[(transplantation of autologous rib cartilages \(in P)47(olish\).)]TJ
/T1_1 1 Tf
0.02499 Tw T*
[(Otolaryngol P)55(ol)]TJ
/T1_0 1 Tf
0 Tc 0 Tw 7.2187 0 Td
(1985;)Tj
/T1_2 1 Tf
2.25 0 Td
(39)Tj
/T1_0 1 Tf
1 0 Td
(:199\320203)Tj
-0.00011 Tc 0.0081 Tw -11.9682 -1.07941 Td
[(69)-500(Rasmy E.)-203(Osteoperiosteal flap in the treatment of ozaena.)]TJ
0.02499 Tw 1.4995 -1.07941 Td
[(New technique)37(.)]TJ
/T1_1 1 Tf
6.98599 0 Td
(Ann Otol Rhinol Laryngol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 11.87981 0 Td
(1986;)Tj
/T1_2 1 Tf
2.25 0 Td
(95)Tj
/T1_0 1 Tf
1 0 Td
(:645\3206)Tj
-0.00011 Tc 0.2907 Tw -23.6154 -1.07941 Td
[(70)-500(Reck R,)-431(A)74(urbach G)74(.)-431(T)40(herapy of ozaena \(in German\).)]TJ
/T1_1 1 Tf
0 Tw 1.4995 -1.07941 Td
(Laryngorhinootologie)Tj
/T1_0 1 Tf
0 Tc 9.77721 0 Td
(1991;)Tj
/T1_2 1 Tf
2.25 0 Td
(70)Tj
/T1_0 1 Tf
1 0 Td
(:21\3203)Tj
-0.00011 Tc 0.3163 Tw -14.5267 -1.07941 Td
[(71)-500(W)74(ang Z,)-511(Ren J)92(,)-511(Qiu )55(Y)111(.)-511(Submucous implantation with)]TJ
0.0704 Tw 1.4995 -1.07941 Td
(pedicle auto-flap of cheek muscle for atrophic rhinitis \(in)Tj
0.0199 Tc 0 Tw T*
(Chinese\).)Tj
/T1_1 1 Tf
0.52409 Tw 5.0585 0 Td
[(Zhonghua Er Bi )55(Y)92(an Hou K)55(e Za Zhi)]TJ
/T1_0 1 Tf
0 Tc 0 Tw -5.0585 -1.07941 Td
(1994;)Tj
/T1_2 1 Tf
2.25 0 Td
(29)Tj
/T1_0 1 Tf
1 0 Td
(:137\3209)Tj
-0.00011 Tc 0.0679 Tw -4.7495 -1.07941 Td
[(72)-500(Bertrand B)74(,)-263(Doyen )55(A,)-263(Eloy P)150(.)-208(T)111(riosite implants and fibrin)]TJ
0.157 Tw 1.4995 -1.07941 Td
[(glue in the treatment of atrophic rhinitis:)-352(technique and)]TJ
0 Tw T*
[(results)55(.)]TJ
/T1_1 1 Tf
3.2484 0 Td
(Laryngoscope)Tj
/T1_0 1 Tf
0 Tc 6.38609 0 Td
(1996;)Tj
/T1_2 1 Tf
2.25 0 Td
(106)Tj
/T1_0 1 Tf
1.5 0 Td
(:652\3207)Tj
0.0199 Tc 0.41451 Tw -14.884 -1.07941 Td
[(7)20(3)-480(Goldenberg D)74(,)-630(Danino J)92(,)-630(Netzer )55(A,)-630(J)50(oachims HZ.)]TJ
-0.00011 Tc 0.1481 Tw 1.4995 -1.07941 Td
(Plastipore implants in the surgical treatment of atrophic)Tj
0.3083 Tw T*
[(rhinitis:)-503(technique and results)55(.)]TJ
/T1_1 1 Tf
14.3475 0 Td
[(Otolaryngol Head Nec)12(k)]TJ
0 Tw -14.3475 -1.07941 Td
(Surg)Tj
/T1_0 1 Tf
0 Tc 2.2757 0 Td
(2000;)Tj
/T1_2 1 Tf
2.25 0 Td
(122)Tj
/T1_0 1 Tf
1.5 0 Td
(:794\3207)Tj
-0.00011 Tc 0.2476 Tw -7.5253 -1.07941 Td
[(74)-500(Y)92(oung )55(A.)-443(Closure of the nostrils in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 26.28481 0 Td
(J)Tj
-0.00011 Tc 0.02499 Tw -24.7852 -1.07941 Td
(Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.4948 0 Td
(1967;)Tj
/T1_2 1 Tf
2.25 0 Td
(81)Tj
/T1_0 1 Tf
1 0 Td
(:515\32024)Tj
-0.00011 Tc 0.2476 Tw -11.2444 -1.07941 Td
[(75)-500(Y)92(oung )55(A.)-443(Closure of the nostrils in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 26.28481 0 Td
(J)Tj
-0.00011 Tc 0.02499 Tw -24.7852 -1.07941 Td
(Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 6.4948 0 Td
(1971;)Tj
/T1_2 1 Tf
2.25 0 Td
(85)Tj
/T1_0 1 Tf
1 0 Td
(:715\3208)Tj
-0.00011 Tc 0.33411 Tw -11.2444 -1.07941 Td
[(76)-500(Gray RF)111(,)-529(Barton RP)150(,)-474(Wright JL,)-529(Dilly PN)74(,)-529(Moss RF)111(.)]TJ
0.0614 Tw 1.4995 -1.07941 Td
[(Primary atrophic rhinitis:)-257(a scanning electron microscopic)]TJ
0.02499 Tw T*
[(\(SEM\) study)92(.)]TJ
/T1_1 1 Tf
5.9863 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1980;)Tj
/T1_2 1 Tf
2.25 0 Td
(94)Tj
/T1_0 1 Tf
1 0 Td
(:985\32092)Tj
0.0199 Tc 0.4991 Tw -17.94949 -1.07941 Td
[(7)20(7)-480(Elwany S)60(.)-714(Ultrastructural observations on primary)]TJ
-0.00011 Tc 0.20239 Tw 1.4995 -1.07941 Td
[(atrophic rhinitis)55(.)-398(Effect of partial closure of the nostril.)]TJ
/T1_1 1 Tf
0.02499 Tw T*
(ORL J Otorhinolaryngol Relat Spec)Tj
/T1_0 1 Tf
0 Tc 0 Tw 15.87379 0 Td
(1988;)Tj
/T1_2 1 Tf
2.25 0 Td
(50)Tj
/T1_0 1 Tf
1 0 Td
(:389\32096)Tj
-0.00011 Tc 0.0159 Tw -20.62331 -1.07941 Td
[(78)-500(Gadre KC)25(.)-211(Modification in the technique of closure of the)]TJ
0 Tw 1.4995 -1.07941 Td
(nostril.)Tj
/T1_1 1 Tf
0.02499 Tw 3.24809 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1973;)Tj
/T1_2 1 Tf
2.25 0 Td
(87)Tj
/T1_0 1 Tf
1 0 Td
(:903\3204)Tj
-0.00011 Tc 0.1649 Tw -15.2114 -1.07941 Td
[(79)-500(El Kholy )55(A,)-360(Habib O)74(,)-305(Abdel-Monem MH,)-305(Abu Safia S)60(.)]TJ
0.2825 Tw 1.4995 -1.07941 Td
(Septal mucoperichondrial flap for closure of nostril in)Tj
0.02499 Tw T*
[(atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0 Tw 7.3571 0 Td
(Rhinology)Tj
/T1_0 1 Tf
0 Tc 4.7762 0 Td
(1998;)Tj
/T1_2 1 Tf
2.25 0 Td
(36)Tj
/T1_0 1 Tf
1 0 Td
(:202\3203)Tj
-0.00011 Tc 0.14349 Tw -16.8829 -1.07941 Td
[(80)-500(Gadre )55(AK,)-339(Savant R,)-339(Gadre KC)25(,)-339(Bhargava KB)74(,)-339(J)50(uvekar)]TJ
0.08771 Tw 1.4995 -1.07941 Td
[(R)74(V)129(.)-283(Reopening of the closed nostril in atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
0 Tc 0 Tw 24.7852 0 Td
(J)Tj
-0.00011 Tc 0.02499 Tw -24.7852 -1.07941 Td
(Laryngology Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 8.0507 0 Td
(1988;)Tj
/T1_2 1 Tf
2.25 0 Td
(102)Tj
/T1_0 1 Tf
1.5 0 Td
(:411\3203)Tj
-0.00011 Tc 0.2068 Tw -13.30029 -1.07941 Td
[(81)-500(Sharan R.)-347(T)111(ransplantation of maxillary sinus mucosa in)]TJ
0.02499 Tw 1.4995 -1.07941 Td
[(atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
7.3571 0 Td
(Indian J Otolaryngol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 9.3262 0 Td
(1978;)Tj
/T1_2 1 Tf
2.25 0 Td
(30)Tj
/T1_0 1 Tf
1 0 Td
(:14\3206)Tj
0.01289 Tc 0.362 Tw -21.43291 -1.07941 Td
[(8)13(2)-487(Sharma )55(AN)74(,)-570(Sardana DS)60(.)-570(Stellate ganglion block in)]TJ
-0.00011 Tc 0.02499 Tw 1.4995 -1.07941 Td
[(atrophic rhinitis)55(.)]TJ
/T1_1 1 Tf
7.3571 0 Td
(J Laryngol Otol)Tj
/T1_0 1 Tf
0 Tc 0 Tw 7.2137 0 Td
(1966;)Tj
/T1_2 1 Tf
2.25 0 Td
(80)Tj
/T1_0 1 Tf
1 0 Td
(:184\3206)Tj
-0.00011 Tc -0.026 Tw -19.3203 -1.07941 Td
[(83)-500(Furstner J)92(.)-169(Novocaine block of pterygopalatine fossa in the)]TJ
0.0199 Tc 0.71049 Tw 1.4995 -1.07941 Td
[(treatment of atrophic rhinitis \(in F)37(rench\).)]TJ
/T1_1 1 Tf
0 Tw 23.29939 0 Td
(Ann)Tj
-0.00011 Tc 0.02499 Tw -23.29939 -1.07941 Td
(Otolaryngol Chir Cervicofac)Tj
/T1_0 1 Tf
0 Tc 0 Tw 12.60139 0 Td
(1955;)Tj
/T1_2 1 Tf
2.25 0 Td
(72)Tj
/T1_0 1 Tf
1 0 Td
(:404\3208)Tj
9.5 0 0 9.5 522.7657 777.3167 Tm
(851)Tj
0.0004 Tc 0.02499 Tw 7.12 0 0 7.12 58.811 779.0643 Tm
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