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Fermo S, Frosolini A, Parrino D, Chiappetta A, Marioni G, de Filippis C. Eustachian tube insufflation with thermal water: Effectiveness in the treatment of pediatric otitis media with effusion. Am J Otolaryngol 2022; 43:103504. [PMID: 35605520 DOI: 10.1016/j.amjoto.2022.103504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/06/2022] [Accepted: 05/09/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE Otitis media with effusion (OME) is the most common ear disease in childhood. The hearing loss associated with OME impacts on children's language development and behavior. Eustachian tube insufflation are among possible treatments for OME, but data regarding their effectiveness are scarce. The aim of this investigation was to analyze the effect of inhalatory thermal therapy and Eustachian tube insufflation in a consecutive cohort of pediatric patients with OME. MATERIALS AND METHODS Seventy-four pediatric patients referred for OME to the thermal medical center "La Contea" (Battaglia Terme, Padova, Italy) were considered. Data from tympanometry and pure tone audiometry performed immediately before (T0), at the end of treatment (T1) and at a follow-up control (T2) were analyzed. RESULTS Data from 148 ears were available. The pressure values of tympanometry significantly improved from T0 to T1 (p = 0.0001), and further improvement was recorded at T2, when 60.8% of patients had normal tympanograms. A significant gain of the air-conduction threshold in the T0-T2 interval was observed (p = 0.0001). At otoscopy, a significant reduction of tympanic membranes with fluid or air-fluid levels presence (p < 0.00001) and a significant increase of normal tympanic membranes (p = 0.0001) were found. CONCLUSION Eustachian tube insufflation represented a well-tolerated and effective treatment in children with OME. Further investigations should deepen these results in randomized, double-blind settings, possibly with long-term follow-up periods. A quality-of-life and cost-effectiveness evaluation of this treatment approach for pediatric OME could be helpful for public health decision-making.
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Affiliation(s)
- Salvatore Fermo
- Department of Neuroscience, Audiology Unit, University of Padova, Treviso, Italy
| | - Andrea Frosolini
- Department of Neuroscience, Audiology Unit, University of Padova, Treviso, Italy
| | - Daniela Parrino
- Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | | | - Gino Marioni
- Department of Neuroscience, Section of Otolaryngology, University of Padova, Padova, Italy.
| | - Cosimo de Filippis
- Department of Neuroscience, Audiology Unit, University of Padova, Treviso, Italy
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Nimmagadda SV, Schmale IL, Man LX. Crenotherapy as a Complementary and Integrative Treatment for Chronic Rhinosinusitis: A Systematic Review and Discussion of Current Evidence Limitations. Am J Rhinol Allergy 2022; 36:529-538. [PMID: 35195469 DOI: 10.1177/19458924221081235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) is a common condition that affects patients' quality of life. Standard treatments for CRS have known side effects and variable efficacy rates. Thus, complementary and integrative (CIM) treatments for CRS such as crenotherapy, which utilizes high mineral content water or vapor as an inhalation therapy, are of continued interest. OBJECTIVES To summarize and evaluate the current research investigating crenotherapy's therapeutic potential and clinical outcomes for the treatment of CRS. STUDY DESIGN Systematic review and qualitative analysis. METHODS A systematic review was performed, with a comprehensive search strategy applied to 6 databases from inception to March 2021: CINAHL, Cochrane, Embase, PubMed, Scopus, and Web of Science. Studies with at least 10 patients, which investigated crenotherapy as the sole or adjunctive treatment for CRS in humans were included. RESULTS In total, 10 articles out of 756 were included. Of these, 6 were randomized controlled trials. The remaining four articles were non-randomized prospective cohort studies. Six studies assessed clinical symptoms in response to crenotherapy, and there were unanimous improvements in Visual Analog Scale (VAS), Sino-Nasal Outcome Test-20 (SNOT-20), and other quality of life metrics. The studies that assessed inflammatory markers, cytology, or other measures showed significant improvement in neutrophil count, spores, ciliary motility, IgE, and manometry. Minimal to no adverse events were reported across all 10 studies. CONCLUSION There is limited data to support crenotherapy's effectiveness in treating patients with CRS. However, published studies suggest that for certain patients crenotherapy can both improve CRS symptoms and objective measures of nasociliary function with minimal side effects. Findings must be interpreted with caution due to study heterogeneity, inconsistent use of standard CRS definitions and outcomes measures, as well as other study design flaws. Given these results, as well as a growing interest in CIM, crenotherapy treatments for CRS deserve further investigation.
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Affiliation(s)
- Sai V Nimmagadda
- University of Rochester School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Li-Xing Man
- University of Rochester Medical Center, Rochester, NY, USA
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Zajac D. Inhalations with thermal waters in respiratory diseases. JOURNAL OF ETHNOPHARMACOLOGY 2021; 281:114505. [PMID: 34371115 DOI: 10.1016/j.jep.2021.114505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/16/2021] [Accepted: 08/05/2021] [Indexed: 05/21/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Inhalations with thermal waters are an old therapeutic method used in the therapy of respiratory diseases as a treatment of choice showing a long-lasting outcome with no side effects. Paradoxically, there is little well-established research on their mechanisms of action. AIM OF THE STUDY The aim of this paper is therefore to summarize the influence of inhalatory treatment with thermal waters on the main symptoms and features of respiratory disorders including allergy-like symptoms, inflammation, oxidant-anti-oxidant balance, cellular influx, disturbed mucus secretions, recurrent infections, pulmonary and nasal function and quality of life. A short history of inhalations is also presented. MATERIALS AND METHODS The present paper is a sum-up of research articles on the use of inhalations with thermal waters in respiratory disorders. RESULTS According to the herein presented literature, the use of thermal water inhalations is beneficial for almost all manifestations of respiratory diseases. The mode of their action remains still unclear; however, it seems that the most important one relies on the restoration of proper defense mechanisms of the organism. CONCLUSIONS Inhalations with thermal waters alleviate symptoms of respiratory diseases. They also improve the quality of life of the patients and seem to be a good add-on therapy in the treatment of disorders of the respiratory system.
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Affiliation(s)
- Dominika Zajac
- Department of Respiration Physiology, Mossakowski Medical Research Institute, Polish Academy of Sciences, ul. Pawinskiego 5, 02-106, Warsaw, Poland.
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Maccarone MC, Masiero S. Spa therapy interventions for post respiratory rehabilitation in COVID-19 subjects: does the review of recent evidence suggest a role? ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:46063-46066. [PMID: 34273080 PMCID: PMC8286038 DOI: 10.1007/s11356-021-15443-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/09/2021] [Indexed: 05/21/2023]
Abstract
Pulmonary rehabilitation is essential in post-COVID subjects, reporting respiratory impairment after the discharge from the hospital. Because the number of patients with respiratory outcomes is high and there are few facilities available, we wonder if a spa setting could represent a valid out-of-hospital alternative. We aim to explore recent evidence related to respiratory rehabilitation in the spa environment to understand if it can represent an appropriate setting for respiratory rehabilitation interventions in post-COVID subjects. Studies were found by screening PubMed, MEDLINE, and Google Scholar databases from 2011 up to February 2021. Studies were eligible if they were reviews, randomized controlled trials (RCTs), or clinical trials, investigating respiratory interventions in the spa environment. Recent evidence has shown that inhalations and mineral-rich water immersions are effective in fighting and preventing multiple chronic respiratory tract diseases. Therefore, these treatments could also be applied to post-COVID patients with medium long-term respiratory outcomes.
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Affiliation(s)
- Maria Chiara Maccarone
- Physical Medicine and Rehabilitation School, University of Padova, Via Giustiniani 3, 35128, Padua, Italy.
| | - Stefano Masiero
- Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua, Italy
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Costantino M, Izzo V, Conti V, Manzo V, Guida A, Filippelli A. Sulphate mineral waters: A medical resource in several disorders. J Tradit Complement Med 2019; 10:320-326. [PMID: 32695648 PMCID: PMC7365777 DOI: 10.1016/j.jtcme.2019.04.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 04/05/2019] [Accepted: 04/21/2019] [Indexed: 12/02/2022] Open
Abstract
Based on their chemical composition, salus per aquam (spa) mineral waters (or medical mineral waters) can be classified as sulphurous, sulphate, bicarbonate etc. Sulphate mineral waters where the predominant element is sulphate anion SO42−, are frequently used in clinical therapy. In this review, we describe and analyze the current scientific knowledge concerning the therapeutic effect of sulphate mineral waters in the treatment of several disorders. Moreover, we underline how important is to integrate spa treatments with other therapeutic approaches to meet the various needs that can arise during a specific pathological state. Now, there is no systematic Review on Sulphate mineral waters in literature. The Review focuses on the importance of spa treatment as complementary therapy. The Review highlights the efficacy and tolerability of the spa in several disorders.
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Affiliation(s)
- Maria Costantino
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
- Association non-profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and spa Sciences) in Italian National Register of Research of MIUR, Naples, Via marziale 21, 80070, Bacoli, NA, Italy
- Corresponding author. Via S. Allende,1, 84081, Baronissi, SA, Italy.
| | - Viviana Izzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
| | - Valeria Conti
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
| | - Valentina Manzo
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
| | - Antonella Guida
- General Directorate Health Protection, Campania Region, Centro Direzionale is C3, 80143, Naples, Italy
| | - Amelia Filippelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081, Baronissi, SA, Italy
- Association non-profit F.I.R.S.Thermae (Interdisciplinary Training, Researches and spa Sciences) in Italian National Register of Research of MIUR, Naples, Via marziale 21, 80070, Bacoli, NA, Italy
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Surda P, Fokkens WJ. Novel, Alternative, and Controversial Therapies of Rhinitis. Immunol Allergy Clin North Am 2016; 36:401-23. [PMID: 27083111 DOI: 10.1016/j.iac.2015.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Rhinitis is a multifactorial disease characterized by sneezing, rhinorrhea, postnasal drip, and nasal congestion. This condition affects 10% to 40% of the population and is responsible for billions of spent health care dollars and impairment in quality of life for those affected. Currently available medical and vaccine therapies are effective for a large segment of this population; however, a subset of patients still has difficult-to-control rhinitis. This article reviews the current progress being made in novel drug and vaccine development and delves into alternative medical, surgical, and homeopathic strategies that may be promising adjunctive treatments for the difficult-to-treat rhinitis patient.
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Affiliation(s)
- Pavol Surda
- Department of Otorhinolaryngology, Academic Medical Center, Meibergdreef 29, Amsterdam 1105 AZ, The Netherlands
| | - Wytske J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Meibergdreef 29, Amsterdam 1105 AZ, The Netherlands.
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Cantone E, Maione N, Di Rubbo V, Esposito F, Iengo M. Olfactory performance after crenotherapy in chronic rhinosinusitis in the elderly. Laryngoscope 2015; 125:1529-34. [PMID: 25639589 DOI: 10.1002/lary.25173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 12/17/2014] [Accepted: 12/31/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of crenotherapy on the olfactory performance of elderly patients with chronic rhinosinusitis (CRS). STUDY DESIGN A longitudinal case-control study of a cohort of elderly patients affected by CRS and olfactory dysfunction assessed with the Sniffin' Sticks (Burghart Medical Technology, Wedel, Germany) (SS) olfactory test. METHODS One hundred and thirty-seven elderly subjects with CRS were divided into two groups. The investigational arm (n = 69) underwent crenotherapy with hyperthermal water, rich in mineral salts, and the control group (n = 68) underwent NaCl 0.9% both for 12 days. At baseline and at 1 and 6 months after treatment, both groups underwent ear nose and throat assessment and SS. Self-report questionnaires were administered at baseline to evaluate the patients' own olfactory response, and after treatment to evaluate their degree tolerability. Olfactory performance was then evaluated in elderly subjects with hyposmia without CRS (n = 40) and in younger subjects with both hyposmia and CRS (n = 40). RESULTS No adverse reactions were reported after crenotherapy. The SS total score showed that crenotherapy induced a statistically significant improvement in the olfactory function of both the elderly and the younger subjects with hyposmia and CRS. By contrast, no improvement was observed in the control arm and in the elderly with hyposmia without CRS. All subjects showed a good degree of tolerability. CONCLUSIONS We demonstrated that crenotherapy effectively improves olfactory function in elderly patients with CRS. Finally, our study suggests that crenotherapy represents a safe therapeutic strategy for the treatment of CRS and olfactory dysfunction in the elderly.
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Affiliation(s)
- Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT.,Department of Molecular Medicine and Medical Biotechnology, "Federico II" University, Naples
| | - Nunzia Maione
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT
| | - Vittoria Di Rubbo
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT
| | - Fabrizio Esposito
- Department of Medicine and Surgery, University of Salerno, Baronissi (SA), Italy
| | - Maurizio Iengo
- Department of Neuroscience, Reproductive and Odontostomatologic Science, Section of ENT
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