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Loperfido A, Cavaliere C, Begvarfaj E, Ciofalo A, D’Erme G, De Vincentiis M, Greco A, Millarelli S, Bellocchi G, Masieri S. The Impact of Antibiotics and Steroids on the Nasal Microbiome in Patients with Chronic Rhinosinusitis: A Systematic Review According to PICO Criteria. J Pers Med 2023; 13:1583. [PMID: 38003898 PMCID: PMC10671981 DOI: 10.3390/jpm13111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND The nasal microbiome represents the main environmental factor of the inflammatory process in chronic rhinosinusitis (CRS). Antibiotics and steroids constitute the mainstay of CRS therapies. However, their impact on microbial communities needs to be better understood. This systematic review summarizes the evidence about antibiotics' and steroids' impact on the nasal microbiota in patients with CRS. METHODS The search strategy was conducted in accordance with the PRISMA guidelines for systematic reviews. The authors searched all papers in the three major medical databases (PubMed, Scopus, and Cochrane Library) using the PICO tool (population, intervention, comparison, and outcomes). The search was carried out using a combination of the key terms "Microbiota" or "Microbiome" and "Chronic Rhinosinusitis". RESULTS Overall, 402 papers were identified, and after duplicate removal (127 papers), excluding papers off-topic (154) and for other structural reasons (110), papers were assessed for eligibility; finally, only 11 papers were included and summarized in the present systematic review. Some authors used only steroids, other researchers used only antibiotics, and others used both antibiotics and steroids. With regard to the use of steroids as exclusive medical treatment, topical mometasone and budesonide were investigated. With regard to the use of antibiotics as exclusive medical treatments, clarithromycin, doxycycline, roxithromycin, and amoxicillin clavulanate were investigated. Regarding the use of both antibiotics and steroids, two associations were investigated: systemic prednisone combined with amoxicillin clavulanate and topical budesonide combined with azithromycin. CONCLUSIONS The impact that therapies can have on the nasal microbiome of CRS patients is very varied. Further studies are needed to understand the role of the nasal microbiome, prevent CRS, and improve therapeutic tools for personalized medicine tailored to the individual patient.
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Affiliation(s)
| | - Carlo Cavaliere
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | - Elona Begvarfaj
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | - Giovanni D’Erme
- UOC Otorinolaringoiatria, Policlinico Umberto I, 00161 Rome, Italy
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University, 00185 Rome, Italy
| | | | | | - Simonetta Masieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, 00185 Rome, Italy
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De Corso E, Pasquini E, Trimarchi M, La Mantia I, Pagella F, Ottaviano G, Garzaro M, Pipolo C, Torretta S, Seccia V, Cantone E, Ciofalo A, Lucidi D, Fadda GL, Pafundi PC, Settimi S, Montuori C, Anastasi F, Pagliuca G, Ghidini A, Cavaliere C, Maffei M, Bussu F, Gallo S, Canevari FRM, Paludetti G, Galli J. Dupilumab in the treatment of severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP): A multicentric observational Phase IV real-life study (DUPIREAL). Allergy 2023; 78:2669-2683. [PMID: 37203259 DOI: 10.1111/all.15772] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/08/2023] [Accepted: 05/01/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is associated with significant morbidity and reduced health-related quality of life. Findings from clinical trials have demonstrated the effectiveness of dupilumab in CRSwNP, although real-world evidence is still limited. METHODS This Phase IV real-life, observational, multicenter study assessed the effectiveness and safety of dupilumab in patients with severe uncontrolled CRSwNP (n = 648) over the first year of treatment. We collected data at baseline and after 1, 3, 6, 9, and 12 months of follow-up. We focused on nasal polyps score (NPS), symptoms, and olfactory function. We stratified outcomes by comorbidities, previous surgery, and adherence to intranasal corticosteroids, and examined the success rates based on current guidelines, as well as potential predictors of response at each timepoint. RESULTS We observed a significant decrease in NPS from a median value of 6 (IQR 5-6) at baseline to 1.0 (IQR 0.0-2.0) at 12 months (p < .001), and a significant decrease in Sino-Nasal Outcomes Test-22 (SNOT-22) from a median score of 58 (IQR 49-70) at baseline to 11 (IQR 6-21; p < .001) at 12 months. Sniffin' Sticks scores showed a significant increase over 12 months (p < .001) compared to baseline. The results were unaffected by concomitant diseases, number of previous surgeries, and adherence to topical steroids, except for minor differences in rapidity of action. An excellent-moderate response was observed in 96.9% of patients at 12 months based on EPOS 2020 criteria. CONCLUSIONS Our findings from this large-scale real-life study support the effectiveness of dupilumab as an add-on therapy in patients with severe uncontrolled CRSwNP in reducing polyp size and improving the quality of life, severity of symptoms, nasal congestion, and smell.
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Affiliation(s)
- Eugenio De Corso
- Otorhinolaryngology Unit, A.Gemelli University Hospital Foundation IRCCS, Rome, Italy
| | - Ernesto Pasquini
- Otorhinolaryngology Unit, Ospedale Bellaria Dip Chirurgie Specialistiche AUSL, Bologna, Italy
| | - Matteo Trimarchi
- Otorhinolaryngology Unit, Head and Neck Department, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Ignazio La Mantia
- Department of Medical-Surgical Sciences and Advanced Technologies, E.N.T. Unit, P.O. "G. Rodolico", University of Catania, Catania, Italy
| | - Fabio Pagella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Giancarlo Ottaviano
- Department of Neurosciences, Otolaryngology Section, University of Padova, Padova, Italy
| | - Massimiliano Garzaro
- Department of Otorhinolaryngology, Rhinology Unit, Eastern Piedmont University, Maggiore Hospital, Novara, Italy
| | - Carlotta Pipolo
- Otorhinolaryngology Unit, Department of Health Sciences, ASST Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Milan, Italy
| | - Sara Torretta
- Department of Clinical Sciences and Community Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico", University of Milan, Milan, Italy
| | - Veronica Seccia
- Otolaryngology, Audiology and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology and Critical Care Medicine, Azienda Ospedaliera Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, Head and Neck Department-ENT Section, University of Naples Federico II, AOU Federico II, Naples, Italy
| | - Andrea Ciofalo
- Rhinology Unit, Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Daniela Lucidi
- Department of Otolaryngology-Head and Neck Surgery, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Gian Luca Fadda
- Department of Otorhinolaryngology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Pia Clara Pafundi
- Epidemiology and Biostatistics Core Facility, Gemelli Science and Technology park, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Stefano Settimi
- Department of Head, Neck and Sensory Organs, Catholic University of The Sacred Heart, Rome, Italy
| | - Claudio Montuori
- Department of Head, Neck and Sensory Organs, Catholic University of The Sacred Heart, Rome, Italy
| | - Francesca Anastasi
- Otorhinolaryngology Unit, Ospedale San Giovanni Evangelista, Tivoli, Italy
| | - Giulio Pagliuca
- Otolaryngology University Unit, "S. M. Goretti Hospital", Latina, Italy
| | - Angelo Ghidini
- ENT Department, Azienda USL Reggio Emilia-IRCCS, Reggio Emilia, Italy
| | - Carlo Cavaliere
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Marianna Maffei
- Otolaryngology Head and Neck Surgery Unit, AORN Ospedali della Colli, Naples, Italy
| | - Francesco Bussu
- Division of Otorhinolaryngology, Department of Medicine, Surgery and Pharmacy, Azienda Ospedaliera Universitaria di Sassari, University of Sassary, Sassari, Italy
| | - Stefania Gallo
- Otorinolaryngology Unit, Head and Neck Department, ASST Sette Laghi and UPLOAD Research Center, University of Insubria, Varese, Italy
| | | | - Gaetano Paludetti
- Department of Head, Neck and Sensory Organs, Catholic University of The Sacred Heart, Rome, Italy
| | - Jacopo Galli
- Department of Head, Neck and Sensory Organs, Catholic University of The Sacred Heart, Rome, Italy
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Loperfido A, Ciofalo A, Cavaliere C, Begvarfaj E, Cascone F, Alfonzo G, Cadeddu R, Millarelli S, Bellocchi G, Greco A, de Vincentiis M, Masieri S. Dupilumab's Impact on Blood Parameters in Nasal Polyposis: 18-Month Follow-Up in Real Life. J Immunol Res 2023; 2023:4027701. [PMID: 37745203 PMCID: PMC10516700 DOI: 10.1155/2023/4027701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/30/2023] [Accepted: 08/25/2023] [Indexed: 09/26/2023] Open
Abstract
Background Dupilumab represents the first approved biological for severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). Objective Aim of this paper is to provide a multicentric real-life study about treatment with dupilumab for CRSwNP with a special focus on blood parameters and IgE, IgG, and IgA. Method A retrospective data collection was jointly conducted at the Otolaryngology departments of San Camillo Forlanini Hospital and University of Rome "La Sapienza" from December 2020 to January 2023. Results A total of 130 patients were included in the study. Monitoring our patients for 18 months, we observed a reduction in nasal polyposis and an improvement in symptoms and their impact on quality of life. Regarding blood tests, a transient increase in blood eosinophils was found in most cases. Total IgE showed a gradual decrease in values. IgG and IgA also showed a slight reduction of values, while remaining within normal ranges. Conclusion To the best of our knowledge, this is the first study to evaluate the impact of dupilumab on several blood parameters in patients receiving treatment for CRswNP. Further studies are needed to confirm our results and to understand the underlying immunological mechanisms.
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Affiliation(s)
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Carlo Cavaliere
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Elona Begvarfaj
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | - Giacomo Alfonzo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Rosalba Cadeddu
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | | | - Antonio Greco
- Department of Sense Organs, Sapienza University, Rome, Italy
| | | | - Simonetta Masieri
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
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Giallini I, Inguscio BMS, Nicastri M, Portanova G, Ciofalo A, Pace A, Greco A, D’Alessandro HD, Mancini P. Neuropsychological Functions and Audiological Findings in Elderly Cochlear Implant Users: The Role of Attention in Postoperative Performance. Audiol Res 2023; 13:236-253. [PMID: 37102772 PMCID: PMC10136178 DOI: 10.3390/audiolres13020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
Objectives: The present study aimed to investigate in a group of elderly CI users working memory and attention, conventionally considered as predictors of better CI performance and to try to disentangle the effects of these cognitive domains on speech perception, finding potential markers of cognitive decline related to audiometric findings. Methods Thirty postlingually deafened CI users aged >60 underwent an audiological evaluation followed by a cognitive assessment of attention and verbal working memory. A correlation analysis was performed to evaluate the associations between cognitive variables while a simple regression investigated the relationships between cognitive and audiological variables. Comparative analysis was performed to compare variables on the basis of subjects’ attention performance. Results: Attention was found to play a significant role in sound field and speech perception. Univariate analysis found a significant difference between poor and high attention performers, while regression analysis showed that attention significantly predicted recognition of words presented at Signal/Noise +10. Further, the high attention performers showed significantly higher scores than low attentional performers for all working memory tasks. Conclusion: Overall findings confirmed that a better cognitive performance may positively contribute to better speech perception outcomes, especially in complex listening situations. WM may play a crucial role in storage and processing of auditory-verbal stimuli and a robust attention may lead to better performance for speech perception in noise. Implementation of cognitive training in auditory rehabilitation of CI users should be investigated in order to improve cognitive and audiological performance in elderly CI users.
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Ottaviano G, De Corso E, Cantone E, Ciofalo A, Saccardo T, Bernardi R, Mairani E, Montuori C, Roccuzzo G, Soldati L, Randon B, Zampollo S, Chicco AD, Visconti F, Scarpa B, Nicolai P. Measuring Nasal Patency and the Sense of Smell in CRSwNP Patients Treated with Dupilumab. J Pers Med 2023; 13:jpm13020234. [PMID: 36836468 PMCID: PMC9962970 DOI: 10.3390/jpm13020234] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023] Open
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) in the most severe forms is associated with a poor quality of life. Dupilumab has been suggested as an add-on treatment option for severe CRSwNP. Severe CRSwNP patients treated with dupilumab in different rhinological units were followed up at 1, 3, 6 and 12 months from the first administration and were considered for this study. At baseline (T0) and at each follow-up, patients underwent nasal endoscopy and completed the sinonasal outcome test (SNOT)-22, a visual analogue scale (VAS) for smell/nasal obstruction, peak nasal inspiratory flow (PNIF) and the Sniffin' Sticks identification test (SSIT). The aim of the present study was to evaluate the effects of dupilumab in patients with severe uncontrolled CRSwNP on recovering nasal obstruction and smell impairment. Moreover, the method between PNIF and SSIT with the highest correlation with patients' response to dupilumab was evaluated. One hundred forty-seven patients were included. All parameters improved during treatment (p < 0.001). At T0, no correlations were found between PNIF and nasal symptoms. Nevertheless, during the following evaluations significant correlations between PNIF changes and both nasal symptoms and NPS were observed (p < 0.05). At T0, SSIT did not correlate with SNOT-22. Similarly to PNIF, during the follow-up SSIT changes significantly correlated with nasal symptom and NPS (p < 0.05). Comparing PNIF and SSIT correlations with SNOT-22 and NPS, PNIF showed a higher correlation with both. Dupilumab improves nasal obstruction and the sense of smell. PNIF and SSIT are effective tools in monitoring patients' response to dupilumab.
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Affiliation(s)
- Giancarlo Ottaviano
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
- Correspondence: ; Tel.: +39-(0)-49-8214470; Fax: +39-(0)-49-8213113
| | - Eugenio De Corso
- ENT Department of A. Gemelli Unversitary Hospital IRCCS, 00168 Rome, Italy
| | - Elena Cantone
- Reproductive and Odontostomatological Sciences-ENT Section, Department of Neuroscience, University of Naples Federico II, 80131 Naples, Italy
| | - Andrea Ciofalo
- Rhinology Unit, Department of Sensory Organs, Sapienza University of Rome, 00161 Rome, Italy
| | - Tommaso Saccardo
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Riccardo Bernardi
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Edoardo Mairani
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Claudio Montuori
- ENT Department of A. Gemelli Unversitary Hospital IRCCS, 00168 Rome, Italy
| | - Giuseppe Roccuzzo
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Livia Soldati
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Benedetto Randon
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Sonny Zampollo
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Alessandra Di Chicco
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Francesca Visconti
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, 35100 Padova, Italy
| | - Piero Nicolai
- Otolaryngology Section, Department of Neurosciences DNS, University of Padova, 35128 Padova, Italy
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Gilardi A, Ciofalo A, Colizza A, Altomari R, de Vincentiis M. A Rare Case of Extracranial Schwannoma of the Hypoglossal Nerve Located in the Parapharyngeal Space Mimicking a Deep Neck Abscess. Ear Nose Throat J 2023; 102:NP46-NP48. [PMID: 33459562 DOI: 10.1177/0145561320988365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Schwannomas are neurogenic benign tumors originating from the myelin sheath of peripheral nerves, and hypoglossal Schwannomas account for 5% of nonvestibular ones. Extracranial localizations are substantially rare, especially those affecting exclusively the parapharyngeal space; for this reason, the retrostyloid neoformations could initially masquerade as a carotid tumor or deep organized neck abscess. The purpose of this report is to highlight the importance of a multidisciplinary approach in the correct management of differential diagnosis.
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Affiliation(s)
- Antonio Gilardi
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Roger Altomari
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University, Rome, Italy
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7
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Macchi A, Giorli A, Cantone E, Carlotta Pipolo G, Arnone F, Barbone U, Bertazzoni G, Bianchini C, Ciofalo A, Cipolla F, De Massimi A, De Vita C, Di Lieto C, Ghidini A, Govoni M, Gramellini G, Maselli Del Giudice A, Ottaviano G, Seccia V, Sireci F, Sollini G, Staffieri C, Gallo S, Heffler E, Mantia IL, De Corso E, Canevari FR, Lombardo N, Malvezzi L, Orietti G, Pasquini E, Presutti L, Monti G. Sense of smell in chronic rhinosinusitis: A multicentric study on 811 patients. Front Allergy 2023; 4:1083964. [PMID: 37152304 PMCID: PMC10160403 DOI: 10.3389/falgy.2023.1083964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 03/28/2023] [Indexed: 05/09/2023] Open
Abstract
Introduction The impairment of the sense of smell is often related to chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP, CRSsNP). CRSwNP is a frequent condition that drastically worsens the quality of life of those affected; it has a higher prevalence than CRSsNP. CRSwNP patients experience severe loss of smell with earlier presentation and are more likely to experience recurrence of their symptoms, often requiring revision surgery. Methods The present study performed a multicentric data collection, enrolling 811 patients with CRS divided according to the inflammatory endotype (Type 2 and non-Type 2). All patients were referred for nasal endoscopy for the assessment of nasal polyposis using nasal polyp score (NPS); Sniffin' Sticks olfactory test were performed to measure olfactory function, and SNOT-22 (22-item sinonasal outcome test) questionnaire was used to assess patients' quality of life; allergic status was evaluated with skin prick test and nasal cytology completed the evaluation when available. Results Data showed that Type 2 inflammation is more common than non-type 2 (656 patients versus 155) and patients suffer from worse quality of life and nasal polyp score. Moreover, 86.1% of patients with Type 2 CRSwNP were affected by a dysfunction of the sense of smell while it involved a lesser percentage of non-Type 2 patients. Indeed, these data give us new information about type-2 inflammation patients' characteristics. Discussion The present study confirms that olfactory function weights on patients' QoL and it represents an important therapeutic goal that can also improve patients' compliance when achieved. In a future - and present - perspective of rhinological precision medicine, an impairment of the sense of smell could help the clinician to characterize patients better and to choose the best treatment available.
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Affiliation(s)
- Alberto Macchi
- ENT Clinic Asst Sette Laghi – University of Insubria, Varese, Italy
| | | | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat. Federico II University, NaplesItaly
| | - Giorgia Carlotta Pipolo
- Otorhinolaryngology Unit ASST Santi Paolo e Carlo Hospital. Department of Health Sciences, University of Milan, Milan, Italy
| | - Flavio Arnone
- Otorhinolaryngology Unit ASST Santi Paolo e Carlo Hospital. Department of Health Sciences, University of Milan, Milan, Italy
| | | | | | | | - Andrea Ciofalo
- Ent Department, Azienda Ospedaliera Universitaria S.Anna, Ferrara, Italy
| | - Federica Cipolla
- Unit of Otorhinolaryngology – IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Alessio De Massimi
- Istituto di ORL, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | - Carla De Vita
- SS ORL San Vito al Tagliamento – Azienda Sanitaria Friuli Occidentale, S. Vito al Tagliamento, Italy
| | - Cristina Di Lieto
- SS ORL San Vito al Tagliamento – Azienda Sanitaria Friuli Occidentale, S. Vito al Tagliamento, Italy
| | | | - Marco Govoni
- ENT Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | | | | | | | - Veronica Seccia
- UOC Azienda Ospedaliero Universitaria Mater Domini, Catanzaro, Italy
| | | | - Giacomo Sollini
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero Universitaria Policlinico di Sant’Orsola, Bologna, Italy
| | | | - Stefania Gallo
- ENT Clinic Asst Sette Laghi – University of Insubria, Varese, Italy
| | | | - Ignazio La Mantia
- Unit of Otorhinolaryngology – IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | | | - Frank Rikki Canevari
- Otorhinolaryngology Section, Department of Biomedicine, Neuroscience and Advanced Diagnostics (BIND) University of Palermo, Palermo, Italy
| | | | | | - Gabriele Orietti
- ENT Department, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy
| | | | - Livio Presutti
- Otolaryngology and Audiology Unit, IRCCS Azienda Ospedaliero Universitaria Policlinico di Sant’Orsola, Bologna, Italy
| | - Giulia Monti
- ENT Unit Bari Adria Trani, Bari, Italy
- Correspondence: Giulia Monti
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8
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Ciofalo A, Fatuzzo I, Lo Re F, Gilardi A, Messineo D, Greco A, de Vincentiis M. A silent laryngeal trauma case: an unexpected late fracture of the superior portion of the thyroid cartilage superior horn. Ear Nose Throat J 2022:1455613221115119. [PMID: 36125267 DOI: 10.1177/01455613221115119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Attempts to analyze clinical unexpected cases of laryngeal fractures based on mild symptoms and physical findings. Even though a laryngeal fracture is rare in a living patient and when happens it is related to severe airways emergency, this case reported seems important to offer a possible differential diagnosis in patients who present with the same symptoms, if no other causes have been detected, like another one benign laryngeal disease.
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Affiliation(s)
- Andrea Ciofalo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Irene Fatuzzo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Federica Lo Re
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Antonio Gilardi
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Daniela Messineo
- Department of Radiology, Oncology and Anatomopathological, Sapienza University, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University, Rome, Italy
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9
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Cavaliere C, Segatto M, Ciofalo A, Colizza A, Minni A, Messineo D, Lambiase A, Greco A, de Vincentiis M, Masieri S. Benralizumab reduces eosinophils and inflammatory markers in patients with severe eosinophilic asthma and chronic rhinosinusitis with nasal polyps: A pilot real-life study. Immunol Lett 2022; 248:70-77. [PMID: 35752279 DOI: 10.1016/j.imlet.2022.06.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 06/20/2022] [Indexed: 11/25/2022]
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) and Severe Eosinophilic Asthma (SEA) are both frequently sustained by eosinophilic inflammation and are probably the manifestation of a unique disease of upper and lower respiratory tract. We retrospectively observed 11 patients with severe CRSwNP and concomitant SEA under add-on therapy with benralizumab evaluating symptoms using Sino Nasal Outcome Test-22 (SNOT-22), Visual Analogue Scale (VAS), and Asthma Control Test (ACT) and Nasal polyp size by endoscopic and radiological score by Nasal Polyp Score (NPS) and Lund-Mackay Score (LMS). At 6 and 12 months, the expression of cationic eosinophil protein (ECP), Interleukin 17 (IL-17), Interferon gamma (INF-γ), and vascular endothelial growth factor (VEGF) was measured by nasal scraping to assess mucosal inflammation. After 12 months of benralizumab treatment, SNOT-22 decreased from 45 (23-97) to 14 (5-53) (p < 0.05), total VAS of rhinologic symptoms decreased from 30 (17-44) to 9 (5-37) (p ≤ 0.01) and ACT score increased from 10 (5-15) to 24 (20-25) (p ≤ 0.01). NPS decreased from 5 (3-6) to 3 (2-4) after 6 months (p < 0.05) and to 2 (2-3) after one year respectively (p < 0.05) and LMS total score from 21 (15-24) to 17 (8-21) (p ≤ 0.01) after 12 months from starting treatment. Nasal mucosa scraping found differences in INF-γ and VEGF expression in patients compared to 10 healthy subjects, with a normalization of these markers during eosinophils depletion induced by benralizumab. This is the first pilot real-life study conducted with an anti-IL5R monoclonal antibody in severe eosinophilic asthma and severe CRSwNP patients showing that this treatment can induce benefit both diseases not only from the clinical, but also from the inflammatory point of view. Moreover, our research pointed out that INF-γ and VEGF may represent potential response biomarker.
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Affiliation(s)
- Carlo Cavaliere
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
| | - Marco Segatto
- Department of Biosciences and Territory, University of Molise, Pesche, IS, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Andrea Colizza
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Antonio Minni
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Daniela Messineo
- Radiology, Oncology, and Anatomopathological Department, Sapienza University of Rome, Rome, Italy
| | | | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
| | - Simonetta Masieri
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Rome, Italy
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10
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Rizzo MI, Fallico N, Beneduce N, Ruoppolo G, Ciofalo A, Vagnoni S, Palmieri A, De Virgilio A, Greco A, Zama M. Objective and subjective evaluation of Velopharyngeal Dysfunction (VPD) following surgical repair of the cleft palate using the furlow palatoplasty - A new tool. J Plast Reconstr Aesthet Surg 2022; 75:3448-3456. [PMID: 35768288 DOI: 10.1016/j.bjps.2022.02.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022]
Abstract
Velopharyngeal dysfunction (VPD) diagnosis and speech surgery outcomes are currently based solely on subjective evaluation criteria consisting of perceptual speech assessment and functional imaging. This study describes an objective and comparable method in VPD assessment and investigates the concurrence between the objective and subjective evaluations. The present study included 20 paediatric patients presenting with VPD after primary repair (intravelar veloplasty) of cleft palate. Our protocol was based on computerized analysis of voice parameters by means of an objective tool, spectrography integrated with Multi-Dimensional Voice Program (MDVP). The protocol also included perceptual evaluation by speech therapist and phoniatrician (consensus listening), and parents. This is a single surgeon, single centre experience and all patients underwent a secondary Furlow's palatoplasty. Assessments were performed pre- and postoperatively and upon completion of speech therapy. Results were compared using the two-tailed t student test for paired data. Statistical significance was set for p-values <0.05. Data analysis confirmed an improvement in velopharyngeal closure after surgery and speech therapy consistently with the results of perceptual evaluations. The results of the study confirmed the availability and reliability of an objective method for VPD evaluation based on the analysis of voice parameters with investigations that are simple and easily available in a hospital setting.
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Affiliation(s)
- M I Rizzo
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| | - N Fallico
- Spires Cleft Centre, Salisbury Oxford, UK
| | - N Beneduce
- Sapienza University, Department of Maxillofacial surgery, Viale del policlinico 155, 00161 Roma, Italy.
| | - G Ruoppolo
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - A Ciofalo
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - S Vagnoni
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
| | - A Palmieri
- Istituto Superiore di Sanità, Viale Regina Elena 299, 00161 Rome, Italy
| | - A De Virgilio
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - A Greco
- Sapienza University, Department of Otolaryngology, Viale del policlinico 155, 00161 Roma, Italy
| | - M Zama
- Ospedale Pediatrico Bambino Gesù, Department of Plastic and Maxillo-facial surgery, Piazza di Sant'Onofrio 4, 00165 Roma, Italy
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11
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Masala C, Cavazzana A, Sanna F, Cecchini MP, Zanini A, Gasperi F, Menghi L, Endrizzi I, Borgogno M, Drago S, Cantone E, Ciofalo A, Macchi A, Monti G, Parma V, Piochi M, Pinna I, Torri L, Cabrino G, Ottaviano G, Pendolino AL, Pignatelli A, Pighin F, Bochicchio V, Motta G, Fontana G, Pasquariello B, Cavaliere C, Iacono V, Hummel T. Correlation between olfactory function, age, sex, and cognitive reserve index in the Italian population. Eur Arch Otorhinolaryngol 2022; 279:4943-4952. [PMID: 35211821 PMCID: PMC8869341 DOI: 10.1007/s00405-022-07311-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 02/09/2022] [Indexed: 11/26/2022]
Abstract
Purpose Loss of smell decreases the quality of life and contributes to the failure in recognizing hazardous substances. Given the relevance of olfaction in daily life, it is important to recognize an undiagnosed olfactory dysfunction to prevent these possible complications. Up to now, the prevalence of smell disorders in Italy is unknown due to a lack of epidemiological studies. Hence, the primary aim of this study was to evaluate the prevalence of olfactory dysfunction in a sample of Italian adults. Methods Six hundred and thirty-three participants (347 woman and 286 men; mean age 44.9 years, SD 17.3, age range 18–86) were recruited from 10 distinct Italian regions. Participants were recruited using a convenience sapling and were divided into six different age groups: 18–29 years (N = 157), 30–39 years (N = 129), 40–49 years (N = 99), 50–59 years (N = 106), > 60 years (N = 142). Olfactory function, cognitive abilities, cognitive reserve, and depression were assessed, respectively, with: Sniffin’ Sticks 16-item Odor Identification Test, Montreal Cognitive Assessment, Cognitive Reserve Index, and the Beck Depression Inventory. Additionally, socio-demographic data, medical history, and health-related lifestyle information were collected. Results About 27% of participants showed an odor identification score < 12 indicating hyposmia. Multiple regression analysis revealed that OI was significantly correlated with age, sex, and cognitive reserve index, and young women with high cognitive reserve index showing the highest olfactory scores. Conclusion This study provides data on the prevalence of olfactory dysfunction in different Italian regions.
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Affiliation(s)
- Carla Masala
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042, Cagliari, Italy.
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Dresden, Germany.
| | - Annachiara Cavazzana
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Dresden, Germany
| | - Fabrizio Sanna
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042, Cagliari, Italy
| | - Maria Paola Cecchini
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Alice Zanini
- Section of Anatomy and Histology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Strada Le Grazie, 8, 37134, Verona, Italy
| | - Flavia Gasperi
- Research and Innovation Centre, Fondazione Edmund Mach, Via E. Mach, 1, San Michele All'Adige, 38010, Trento, Italy
- Center Agriculture Food Environment, University of Trento/Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
| | - Leonardo Menghi
- Research and Innovation Centre, Fondazione Edmund Mach, Via E. Mach, 1, San Michele All'Adige, 38010, Trento, Italy
- Center Agriculture Food Environment, University of Trento/Fondazione Edmund Mach, San Michele all'Adige, Trento, Italy
- Department of Technology and Innovation, University of Southern Denmark, Odense, Denmark
| | - Isabella Endrizzi
- Research and Innovation Centre, Fondazione Edmund Mach, Via E. Mach, 1, San Michele All'Adige, 38010, Trento, Italy
| | | | | | - Elena Cantone
- Neurosciences, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat, Federico II University, Naples, Italy
| | - Andrea Ciofalo
- Neurosciences, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat, Federico II University, Naples, Italy
| | - Alberto Macchi
- ORL Clinica, University of Insubria and Varese, ASST Settelaghi, Varese, Italy
| | - Giulia Monti
- ORL Clinica, University of Insubria and Varese, ASST Settelaghi, Varese, Italy
| | - Valentina Parma
- Monell Chemical Senses Center, 3500 Market Street, Philadelphia, 19104, USA
| | - Maria Piochi
- University of Gastronomic Sciences, Pollenzo, Cuneo, Italy
| | - Ilenia Pinna
- Department of Biomedical Sciences, University of Cagliari, SP8 Cittadella Universitaria Monserrato, 09042, Cagliari, Italy
| | - Luisa Torri
- University of Gastronomic Sciences, Pollenzo, Cuneo, Italy
| | | | | | | | - Angela Pignatelli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Faride Pighin
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | | | - Gaetano Motta
- Clinic of Otorhinolaryngology, Head and Neck Surgery Unit, Department of Anesthesiology, Surgical and Emergency Science, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giorgia Fontana
- Geriatric Unit A, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Carlo Cavaliere
- Unit of Rhinology, Department of Organi di Senso, University La Sapienza, Rome, Italy
| | - Valentina Iacono
- Division of Nephrology and Dialysis, "Santa Maria della Misericordia" Hospital, Rovigo, Italy
| | - Thomas Hummel
- Department of Otorhinolaryngology, Smell and Taste Clinic, TU Dresden, Dresden, Germany
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12
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Altissimi G, Colizza A, Cianfrone G, de Vincentiis M, Greco A, Taurone S, Musacchio A, Ciofalo A, Turchetta R, Angeletti D, Ralli M. Drugs inducing hearing loss, tinnitus, dizziness and vertigo: an updated guide. Eur Rev Med Pharmacol Sci 2021; 24:7946-7952. [PMID: 32767320 DOI: 10.26355/eurrev_202008_22477] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The awareness of audio-vestibular side effects of drugs, such as hearing loss, tinnitus, dizziness and vertigo, has widely increased in the recent years. The present guide represents an update of the previous documents published by the authors in 2005 and 2011 on drug-induced ototoxicity and vestibulotoxicity. MATERIALS AND METHODS The authors performed a comprehensive analysis of audio-vestibular side effects of commercially available drugs based on the British National Formulary, a pharmaceutical reference book that contains a wide range of useful information and advice on prescription and pharmacology. RESULTS Commercially available drugs and their active principles have been classified based on their audio-vestibular side effects, as reported by the pharmaceutical companies and/or health agencies. Drugs have been categorized based on the field of application, the therapeutic indication and the pharmacological properties. CONCLUSIONS General practitioners, otolaryngology, neurology and audiology specialists should be aware of possible audio-vestibular side effects of drugs, such as hearing loss, tinnitus, dizziness and vertigo. The present guide represents a practical tool to rapidly identify potential audio-vestibular side effects of drugs as reported by the pharmaceutical companies and/or health agencies.
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Affiliation(s)
- G Altissimi
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy.
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13
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Cavaliere C, Incorvaia C, Begvarfaj E, Orlando MP, Turchetta R, Musacchio A, Ralli M, Ciofalo A, Greco A, de Vincentiis M, Masieri S. The safety of sublingual immunotherapy, can the rare systemic reactions be prevented? Expert Opin Drug Saf 2021; 20:259-264. [PMID: 33427529 DOI: 10.1080/14740338.2021.1874917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: The safety of subcutaneous immunotherapy (SCIT), and particularly the dramatic issue of fatal reactions, has been an obstacle that limited the implementation of a therapy with unique characteristics of action on the causes of allergy. The introduction of sublingual immunotherapy (SLIT) was aimed at solving safety problems while maintaining clinical efficacy.Areas covered: For more than 20 years, SLIT has been based on allergen extracts in drops at low average doses. As evidenced by meta-analyses, the typical adverse events (AE) have consisted of local reactions in the mouth and throat. Unlike the injection route, no correlation was observed between the administered dose and AEs. The development of SLIT products in tablets, based on higher doses than drops, has somewhat changed the concept of SLIT safety. Although large trials, performed to obtain regulatory agency approval, have shown overall high safety, rare anaphylactic reactions have been described.Expert opinion: SLIT is globally safe, and no fatal reactions have ever been reported, but with currently available high biological potency products it is necessary to follow prudential rules, such as the administration of the first dose under medical supervision and the thorough education of patients to avoid taking of higher doses than recommended.
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Affiliation(s)
- Carlo Cavaliere
- Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy
| | | | - Elona Begvarfaj
- Integrated Activity Head Neck Department, Federico II University, Naples, Italy
| | | | | | | | - Massimo Ralli
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillo-Facial Sciences, Sapienza University, Rome, Italy
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14
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Ciofalo A, Pasquariello B, Iannella G, Manno A, Angeletti D, Gulotta G, Pace A, Magliulo G. The role of nasal cytology in the diagnosis of allergic and non-allergic rhinitis in adult and children. Eur Rev Med Pharmacol Sci 2020; 23:5065-5073. [PMID: 31298361 DOI: 10.26355/eurrev_201906_18170] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic rhinitis is a common disease with an incidence of 40% in the Western population. Allergic rhinitis (AR) affects half of the adult population, while in children prevalence of AR vs. non-allergic rhinitis (NAR) of 3-4:1 is reported. Nasal cytology is the diagnostic test that has made it possible to clarify the cellular population of the nasal mucosa. The aims of the present study were to define the distribution of chronic rhinopathy in adult and pediatric populations, to classify "cellular" NAR into subgroups based on cytological features, and to identify overlapped rhinitis (OR). PATIENTS AND METHODS A retrospective study was conducted on 907 patients, divided into two groups: 135 children (69 females and 66 males, average age 9.8 years (range 4-17) and 772 adults (392 females and 380 males, average age 45.28 years (range 18-90). All patients with a suspicion of rhinopathy were submitted to nasal endoscopy, Skin Prick test (SPT), dosage of serum specific IgE, CT scan of nasal, and sinusal structures when chronic rhinosinusitis was suspected. RESULTS In the adult population of the study, 61% presented a diagnosis of chronic rhinitis: 213 patients (45.2%) had AR, 31 (6.6%) OR, and 227 (48.2%) NAR (77.5% of these patients presented a pattern of "cellular" NAR). In the pediatric population, 83% patients presented a rhinopathy: 61 (54.5%) with AR, 38 (34%) with NAR, and 13 (11.5%) with OR. Within the NAR group, 71% had a "cellular" pattern. CONCLUSIONS Nasal cytology is a tool that provides a more precise differential diagnosis of chronic rhinitis through the study the of nasal mucosa and the identification of "cellular" NAR and OR, even in the pediatric population.
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Affiliation(s)
- A Ciofalo
- Organi di Senso Department, "Sapienza" University of Rome, Rome, Italy.
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15
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Pace A, Iannella G, Rossetti V, Visconti IC, Gulotta G, Cavaliere C, De Vito A, Maniaci A, Cocuzza S, Magliulo G, Ciofalo A. Diagnosis of Obstructive Sleep Apnea in Patients with Allergic and Non-Allergic Rhinitis. Medicina (Kaunas) 2020; 56:E454. [PMID: 32911862 PMCID: PMC7559128 DOI: 10.3390/medicina56090454] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/28/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022]
Abstract
Background and objectives: Rhinitis could be considered a risk factor for obstructive sleep apnea (OSA). Studies were conducted to evaluate the relation between OSA and Allergic rhinitis (AR). Non-allergic rhinitis with eosinophilia syndrome (NARES) is a condition with a symptomatology apparently similar to AR. The aim of this study was to evaluate the different presence of OSA in patients suffering from NARES and AR. Materials and Methods: Sixty patients were enrolled and subdivided into NARES, AR and control groups. NARES and AR diagnosis were performed using ARIA (Allergic Rhinitis and its Impact on Asthma) protocol. All patients were screened for OSA with home sleep apnea testing (HSAT) exam analyzing AHI (Apnea Hypopnea Index) values. Results: Results showed that 60% of patients affected by NARES presented OSA. On the contrary, altered AHI was found only in 35% of patients affected by AR and in 10% of patients belonging to the control group. Conclusions: In conclusion, data showed that there was an increased risk of OSA in NARES patients respect to AR patients and healthy patients.
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Affiliation(s)
- Annalisa Pace
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Giannicola Iannella
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Valeria Rossetti
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Irene Claudia Visconti
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Giampiero Gulotta
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Carlo Cavaliere
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Andrea De Vito
- Otorinolaringoatria Department, Santa Maria delle Croci Hospital of Ravenna, Viale Vincenzo Randi, 5, 48121 Ravenna, Italy;
| | - Antonino Maniaci
- Otorinolaringoiatria Department, University of Catania, Piazza Università, 2, 95131 Catania, Italy; (A.M.); (S.C.)
| | - Salvatore Cocuzza
- Otorinolaringoiatria Department, University of Catania, Piazza Università, 2, 95131 Catania, Italy; (A.M.); (S.C.)
| | - Giuseppe Magliulo
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
| | - Andrea Ciofalo
- Organi di Senso Department, Sapienza University of Rome, Via Gregorio VII n.80, 00165 Rome, Italy; (A.P.); (G.I.); (V.R.); (I.C.V.); (G.G.); (C.C.); (A.C.)
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16
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Cavaliere C, Begvarfaj E, Incorvaia C, Sposato B, Brunori M, Ciofalo A, Greco A, de Vincentiis M, Masieri S. Long-term omalizumab efficacy in allergic rhinitis. Immunol Lett 2020; 227:81-87. [PMID: 32798500 DOI: 10.1016/j.imlet.2020.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Omalizumab therapy was found to be safe and effective as an add-on therapy for patients with poorly controlled severe asthma. Although several studies over the last decade have demonstrated its efficacy in other Immunoglobulin E related diseases, its use in such conditions is off-label. OBJECTIVE This study aimed to assess the effectiveness of long-term therapy with Omalizumab in patients with persistent severe allergic rhinitis and inadequately controlled severe asthma. METHODS Patients with poorly controlled severe asthma and persistent allergic rhinitis were enrolled and treated with Omalizumab for 36 months with every four-week subcutaneous administration. The efficacy assessment included the severity of AR symptoms every six months using Visual Analogue Scale, Asthma Control Test, nasal endoscopy, spirometry, and biomarkers (blood eosinophils and neutrophils, fractional exhaled nitric oxide, total IgE). RESULTS Eleven patients aged between 26 and 70 years were enrolled, and 10 completed the study. A significant improvement of allergic rhinitis symptoms, Asthma Control Test, and lung function was observed. There was also a reduction in the status of the biomarkers at the end of the study. CONCLUSION Long-term therapy with Omalizumab was effective and safe in treating severe persistent allergic rhinitis and concomitant asthma.
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Affiliation(s)
- Carlo Cavaliere
- Department of Oral and Maxillo-Facial Sciences, Sapienza University, Piazzale Aldo Moro, 5, 00185, Rome, Italy.
| | - Elona Begvarfaj
- Integrated Activity Head Neck Department, Federico II University, Naples, Italy
| | | | - Bruno Sposato
- Azienda USL Toscana Sud-Est Pneumology Department, "Misericordia" Hospital, Grosseto, Italy
| | - Marco Brunori
- Department of Cardiovascular, Respiratory, Nephrologic, Anaesthesiologic and Geriatric Sciences, Sapienza University, Rome, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University, Rome, Italy
| | - Marco de Vincentiis
- Department of Oral and Maxillo-Facial Sciences, Sapienza University, Piazzale Aldo Moro, 5, 00185, Rome, Italy
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17
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Ciofalo A, Gulotta G, Iannella G, Pasquariello B, Manno A, Angeletti D, Pace A, Greco A, Altissimi G, de Vincentiis M, Magliulo G. Giant Cell Arteritis (GCA): Pathogenesis, Clinical Aspects and Treatment Approaches. Curr Rheumatol Rev 2019; 15:259-268. [DOI: 10.2174/1573397115666190227194014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/30/2019] [Accepted: 02/13/2019] [Indexed: 11/22/2022]
Abstract
:
Giant Cell Arteritis (GCA), or Horton’s Arteritis, is a chronic form of vasculitis of the
large and medium vessels, especially involving the extracranial branches of the carotid arteries, in
particular, the temporal artery, with the involvement of the axillary, femoral and iliac arteries too.
Arterial wall inflammation leads to luminal occlusion and tissue ischemia, which is responsible for
the clinical manifestations of the disease.
:
A substantial number of patients affected by GCA present head and neck symptoms, including ocular,
neurological and otorhinolaryngological manifestations.
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The aim of this article is to present pathogenesis, clinical aspects and treatment approaches of GCA
manifestations.
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Affiliation(s)
- Andrea Ciofalo
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Giampiero Gulotta
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Giannicola Iannella
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Benedetta Pasquariello
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Alessandra Manno
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Diletta Angeletti
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Annalisa Pace
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Antonio Greco
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Giancarlo Altissimi
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Marco de Vincentiis
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
| | - Giuseppe Magliulo
- Otorhinolaryngology Department, Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, 151 - 00161, Rome, Italy
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Magliulo G, Iannella G, Ciofalo A, Angeletti D, Pulvirenti F, Quinti I. The olfactory function in patients with common variable immunodeficiency. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:429-434. [PMID: 31196799 DOI: 10.1016/j.anorl.2018.02.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/24/2017] [Accepted: 02/16/2018] [Indexed: 11/28/2022]
Abstract
AIMS To determine the incidence of olfactory dysfunction in common variable immunodeficiency patients. To evaluate the correlation between olfactory dysfunction and chronic rhinosinusitis in this class of patients. MATERIALS AND METHODS Fifty patients, with a diagnosis of common variable immunodeficiency and under immunoglobulin replacement therapy, were submitted to an otolaryngology physical examination and a CT scan of the craniofacial structures in order to show the presence of signs of chronic rhinosinusitis. An olfactory function evaluation was executed using the Sniffin' Sticks Test, with assessment of olfactory threshold, discrimination, identification and overall composite scores (TDI: threshold-discrimination-identification score). RESULTS An olfactory dysfunction was found in 23 (46%) common variable immunodeficiency patients, with hyposmia and anosmia respectively present in 65% and 38% of them. The mean TDI score in the study group was 27.7. Common variable immunodeficiency patients with CRS presented a more suggestive increase of the olfactory threshold, discrimination and identification compared to those without chronic rhinosinusitis. CONCLUSION In conclusion, patients with common variable immunodeficiency seem to suffer from olfactory disorders more than healthy people. One of the causal factors could be considered the presence of rhinosinusal pathologies.
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Affiliation(s)
- G Magliulo
- Organi di Senso Department, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy.
| | - G Iannella
- Organi di Senso Department, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy
| | - A Ciofalo
- Organi di Senso Department, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy
| | - D Angeletti
- Organi di Senso Department, Sapienza University of Rome, Viale del Policlinico, 151, 00161 Rome, Italy
| | - F Pulvirenti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - I Quinti
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
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Magliulo G, Iannella G, Ciofalo A, Polimeni A, De Vincentiis M, Pasquariello B, Montevecchi F, Vicini C. Nasal pathologies in patients with obstructive sleep apnoea. ACTA ACUST UNITED AC 2019; 39:250-256. [PMID: 30933181 PMCID: PMC6734203 DOI: 10.14639/0392-100x-2173] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 05/24/2018] [Indexed: 11/23/2022]
Abstract
Nasal obstruction is a frequent condition in patients with obstructive sleep apnoea (OSA). Nasal obstruction leads to mouth breathing, which is thought to destabilise the upper airway and aggravate the condition. Three conditions could be considered as the cause of the nasal breathing obstruction: anatomical conditions of the nose (septum deviation, hypertrophy of the inferior turbinates), chronic rhinosinusitis (CRS) and chronic nasal inflammation caused by allergic rhinitis or non-allergic cellular rhinitis. In this prospective study, we present an evaluation of all these possible rhino-sinusal aspects in OSA patients to correlate different nasal pathologies with nasal obstruction. Fifty patients with a diagnosis of OSA were enrolled in the study. In 70% of OSA patients, nasal obstruction was confirmed by clinical evaluation and rhinomanometry testing. Normal rhino-sinus aspects were present in only 20% of OSA patients, whereas one or more pathological rhino-sinus conditions were present in the remaining 80%. The percentage of OSA patients with a diagnosis of allergic rhinitis and non-allergic rhinitis was 18% and 26% respectively. Non-allergic rhinitis with neutrophils (NARNE) was the most frequent type of cellular rhinitis diagnosed in OSA patients (20% of cases). The results of the present study support and extend the observation that rhinitis is present in OSA patients. Mucosal inflammation caused by these conditions could be the cause of upper airway patency impairment inducing nasal mucosa swelling.
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Affiliation(s)
- G Magliulo
- Department of "Organi di Senso", University "Sapienza", Rome, Italy
| | - G Iannella
- Department of "Organi di Senso", University "Sapienza", Rome, Italy
| | - A Ciofalo
- Department of "Organi di Senso", University "Sapienza", Rome, Italy
| | - A Polimeni
- Department of Oral and Maxillo Facial Sciences, University "Sapienza", Rome, Italy
| | - M De Vincentiis
- Department of "Organi di Senso", University "Sapienza", Rome, Italy
| | - B Pasquariello
- Department of "Organi di Senso", University "Sapienza", Rome, Italy
| | - F Montevecchi
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - C Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
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20
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Magliulo G, De Vincentiis M, Iannella G, Ciofalo A, Pasquariello B, Manno A, Angeletti D, Polimeni A. Olfactory evaluation in obstructive sleep apnoea patients. Acta Otorhinolaryngol Ital 2018; 38:338-345. [PMID: 30197425 PMCID: PMC6146584 DOI: 10.14639/0392-100x-1981] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 01/24/2018] [Indexed: 12/31/2022]
Abstract
The sense of smell has a high impact on the quality of life. The aim of the present study was to investigate olfactory dysfunction in patients with obstructive sleep apnoea syndrome (OSAS) and correlate the severity of disease with olfactory dysfunction. The relationships between nasal obstruction, nasal mucociliary cleareance and olfactory tests were also evaluated. Sixty patients with a diagnosis of OSAS were enrolled and underwent olfactory function evaluation. In all patients olfactory performance was tested with the Sniffin' Sticks method. Mucociliary transport times and anterior rhinomanometry were performed to identify eventual nasal obstruction and deficits in nasal mucociliary clearance. Olfactory dysfunction was present in 22 (36.6%) patients of the study group: of these, hyposmia was present in 19 (86.4%) and anosmia in 3 (13.6%). The mean TDI score in the study group was 30. A strong correlation between the olfactory dysfunction and severity of sleep apnoea measured using the AHI was found. Patients with OSA would seem to have a high incidence of olfactory dysfunction. The degree of olfactory dysfunction appears to be related to the severity of disease. However, other co-factors such as nasal obstruction and reduced mucociliary clearance might also play a role in of the aetiology of this condition.
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Affiliation(s)
- G. Magliulo
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | | | - G. Iannella
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - A. Ciofalo
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - B. Pasquariello
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - A. Manno
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - D. Angeletti
- Department of Organi di Senso, University Sapienza, Rome, Italy
| | - A. Polimeni
- Department of Oral and Maxillo Facial Sciences, University Sapienza, Rome, Italy
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Greco A, De Virgilio A, Ralli M, Ciofalo A, Mancini P, Attanasio G, de Vincentiis M, Lambiase A. Behçet's disease: New insights into pathophysiology, clinical features and treatment options. Autoimmun Rev 2018; 17:567-575. [PMID: 29631062 DOI: 10.1016/j.autrev.2017.12.006] [Citation(s) in RCA: 168] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 12/21/2017] [Indexed: 12/12/2022]
Abstract
Behçet's disease (BD) is a rare systemic vasculitis characterized by oral aphthous ulcers, genital ulcers, ocular lesions and other systemic manifestations. BD occurs most frequently in Eurasian populations along the ancient trading route known as the "Silk Road" which extends from eastern Asia to the Mediterranean basin. The causes of BD are unknown: it is believed to be due to an autoimmune process triggered by an infectious or environmental agent in genetically predisposed individuals. HLA-B51 allele located in the MHC locus, on chromosome 6p, has been the most strongly associated risk factor for BD in areas along the Old Silk Route. Herpes simplex virus-1 and Streptococcus have been postulated as possible environmental triggers of BD. T cell homeostasis perturbation, especially Th1 and Th17 expansion and decreased regulation by Tregs are now supposed to be the cornerstone of BD pathogenesis. The histology shows vasculitis that involves both arteries and veins, and vessels of any size. BD is a systemic vasculitis with significant neutrophil infiltration, endothelial cell swelling, and fibrinoid necrosis. The diagnosis of BD is only supported by clinical criteria and requires the exclusion of other diagnoses based on clinical presentation. There are no pathognomonic laboratorial findings of BD. This rare disease often leads to blindness and fatal systemic involvement. Main causes of death include major vessel disease and central nervous system involvement. Corticosteroids are commonly used to treat clinical manifestations of BD in combination with immunosuppressant drugs. Tumor necrosis factor (TNF)-blocking agents such as Infliximab, Etanercept, and Adalimumab have been reported to have success in patients with BD.
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Affiliation(s)
- Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Armando De Virgilio
- Department of Otolaryngology-Head and Neck Surgery, Humanitas Clinical and Research Center, via Manzoni 56, 20089 Rozzano, MI, Italy
| | - Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Patrizia Mancini
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Giuseppe Attanasio
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Marco de Vincentiis
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
| | - Alessandro Lambiase
- Department of Sense Organs, Sapienza University of Rome, Viale del Policlinico 155, 00100 Rome, Italy.
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Ciofalo A, De Vincentiis M, Iannella G, Zambetti G, Giacomello P, Altissimi G, Greco A, Fusconi M, Pasquariello B, Magliulo G. Mild traumatic brain injury: evaluation of olfactory dysfunction and clinical–neurological characteristics. Brain Inj 2018; 32:550-556. [DOI: 10.1080/02699052.2018.1432074] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Andrea Ciofalo
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Marco De Vincentiis
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Giannicola Iannella
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Giampietro Zambetti
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Paola Giacomello
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Giancarlo Altissimi
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Antonio Greco
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Massimo Fusconi
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Benedetta Pasquariello
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
| | - Giuseppe Magliulo
- Department of ‘Organi di Senso’, University “Sapienza”, Rome, Italy
- Department of Social Sciences and Economics, University “ Sapienza”, Rome, Italy
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Magliulo G, de Vincentiis M, Iannella G, Ciofalo A, Manno A, Pasquariello B, Angeletti D, Pace A, Gulotta G, Polimeni A. Eustachian tube evaluation in patients with obstructive sleep apnea syndrome. Acta Otolaryngol 2018; 138:159-164. [PMID: 28990834 DOI: 10.1080/00016489.2017.1385846] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Investigate the presence of Eustachian Tube Dysfunction (ETD) in Obstructive sleep apnea (OSA) patients. Correlate the ET function and the severity of the sleep apnea syndrome. Correlate nasal resistance and nasal mucociliary clearance with the onset of ETD in these patients. MATERIALS AND METHODS Forty patients affected by OSA were enrolled in our clinical prospective study. Thirty patients were also investigated as a control group. All of the analyzed subjects underwent ENT examination, anterior rhinomanometry and test for mucociliary transport time. To evaluate Eustachian tube function the Eustachian tube score-7 (ETS-7) were employed. RESULTS Twenty percent of the patients with a diagnosis of OSA had a diagnosis of ETD (ETS-7 ≤ 7) with a statistical difference with control group (p = .03). No differences regarding ETD in OSA sub-groups were found. CONCLUSION This study showed that ET blockage or delayed openings were found in most adult patients with OSA when evaluated by a sensible score as the ETS-7. Our data suggest that an evaluation of the Eustachian tube function should be performed in patients suffering from obstructive sleep apnea syndrome.
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Affiliation(s)
- Giuseppe Magliulo
- ‘Organi di Senso’ Department, Sapienza University of Rome, Rome, Italy
| | | | | | - Andrea Ciofalo
- ‘Organi di Senso’ Department, Sapienza University of Rome, Rome, Italy
| | - Alessandra Manno
- ‘Organi di Senso’ Department, Sapienza University of Rome, Rome, Italy
| | | | - Diletta Angeletti
- ‘Organi di Senso’ Department, Sapienza University of Rome, Rome, Italy
| | - Annalisa Pace
- ‘Organi di Senso’ Department, Sapienza University of Rome, Rome, Italy
| | - Giampiero Gulotta
- ‘Organi di Senso’ Department, Sapienza University of Rome, Rome, Italy
| | - Antonella Polimeni
- Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Rome, Italy
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24
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Abstract
Modulation of tinnitus characteristics such as pitch and loudness has been extensively described following movements of the head, neck and limbs, vertical or horizontal eye gaze, pressure on myofascial trigger points, cutaneous stimulation of the hands, electrical stimulation of the median nerve, and transcranial direct current stimulation. Modulation of tinnitus follows complex interactions between auditory and somatosensory afferents and can be favored by underlying somatic disorders. When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus. A correct diagnosis and treatment of somatic disorders underlying tinnitus play a central role for a correct management of somatic tinnitus. However, the identification of somatic tinnitus may be complex in some cases. In this paper, after a general review of the current evidences for somatic tinnitus available in the literature, we present and discuss some cases of patients in which somatic modulation of tinnitus played a role-although different from case to case-in their tinnitus, describing the diagnostic and therapeutic approaches followed in each individual case and the results obtained, also highlighting unexpected findings and pitfalls that may be encountered when approaching somatic tinnitus patients.
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Affiliation(s)
- Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Italy
| | | | | | | | - Lucia Longo
- Department of Sense Organs, Sapienza University of Rome, Italy
| | - Andrea Ciofalo
- Department of Sense Organs, Sapienza University of Rome, Italy
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25
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Ciofalo A, Zambetti G, Altissimi G, Fusconi M, Soldo P, Gelardi M, Iannella G, Pasquariello B, Magliulo G. Pathological and cytological changes of the nasal mucosa in acute rhinosinusitis: the role of hyaluronic acid as supportive therapy. Eur Rev Med Pharmacol Sci 2017; 21:4411-4418. [PMID: 29077152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the reparative role of hyaluronic acid in acute rhinosinusitis (ARS). PATIENTS AND METHODS 48 patients affected by ARS were submitted to nasal endoscopy, nasal cytology, mucociliary transport evaluation (MCTt) and visual analogue scale questionnaire (VAS) at T0, after 14-18 days (T1) and after 30-35 days (T2). The patients were randomized into two groups, A and B, and received Levofloxacin and Prednisone. Moreover, using a nebulizer ampoule for nasal douche, Group A received high molecular weight Sodium Hyaluronate (3%) plus saline solution (NaCl 0.9%) twice a day for 30 days; Group B received saline solution twice a day for 30 days. RESULTS At T0 only the VAS score showed differences regarding nasal discharge and post-nasal drip. At T1, in Group A MCTt and the number of bacteria were significantly lower than in Group B. The VAS score showed improvement in Group A. At T2 in Group A, MCTt and number of neutrophils were significantly lower than in Group B. The VAS score showed statistically significant differences between the two groups regarding nasal discharge. CONCLUSIONS In ARS patients sodium hyaluronate plus saline solution significantly improved symptoms, MCT time and reduced neutrophil count on nasal cytology.
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Affiliation(s)
- A Ciofalo
- Organi di Senso Department, "Sapienza" University of Rome, Rome, Italy.
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26
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Gelardi M, De Candia N, Quaranta N, Russo C, Pecoraro P, Mancini M, Luperto P, Lombardo G, Macchi A, Bocciolini C, Ciofalo A, De Corso E, Ciprandi G. The relevance of counseling in patients with nasal polyps. Acta Otorhinolaryngol Ital 2017; 36:326-327. [PMID: 27734987 PMCID: PMC5066470 DOI: 10.14639/0392-100x-1315] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/23/2016] [Indexed: 11/23/2022]
Affiliation(s)
- M Gelardi
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
| | - N De Candia
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
| | - N Quaranta
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Italy
| | - C Russo
- U.O.C. of Otolaryngology, Ospedale Di Venere, Carbonara di Bari (BA), Italy
| | | | - M Mancini
- Section of Otolaryngology, Azienda Area Vasta Romagna-Riccione, Italy
| | - P Luperto
- Section of Otolaryngology, ASL BR1 Brindisi, Italy
| | - G Lombardo
- Section of Otolaryngology, ASP of Agrigento, Italy
| | - A Macchi
- ORL Clinic University of Insubriae, Varese, Italy
| | - C Bocciolini
- U.O.C. of Otolaryngology Hospital Maggiore of Bologna, Italy
| | - A Ciofalo
- Department of Sensory Organs, Sapienza University of Roma, Italy
| | - E De Corso
- Otorhinolaryngology, Fondazione Policlinico A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Ciprandi
- Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.), Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
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Ciofalo A, Fusconi M, Pecoraro P, Alesini F, Marasà S, Magliulo G. A case of nasal inverted papilloma cytology. Diagn Cytopathol 2017; 45:320-321. [PMID: 28128892 DOI: 10.1002/dc.23661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/24/2016] [Accepted: 12/06/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Andrea Ciofalo
- Department of Sensory Organs, University "Sapienza" of Rome, Italy
| | - Massimo Fusconi
- Department of Sensory Organs, University "Sapienza" of Rome, Italy
| | | | - Francesco Alesini
- Department of Oncologic, Radiologic and Pathology and Anatomical Sciences, University "Sapienza,", Rome, Italy
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Gelardi M, De Luca C, Taliente S, Fiorella ML, Quaranta N, Russo C, Ciofalo A, Macchi A, Mancini M, Rosso P, Seccia V, Guagnini F, Ciprandi G. Adjuvant treatment with a symbiotic in patients with inflammatory non-allergic rhinitis. J BIOL REG HOMEOS AG 2017; 31:201-206. [PMID: 28337893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Inflammatory non-allergic rhinitis (INAR) is characterized by the presence of an inflammatory infiltrate and a non-IgE-mediated pathogenesis. This retrospective, controlled, multicentre study investigated whether a symbiotic, containing Lactobacillus acidophilus NCFM, Bifidobacterium lactis, and fructo-oligosaccharides (Pollagen®, Allergy Therapeutics, Italy), prescribed as adjunctive therapy to a standard pharmacological treatment, was able to reduce symptom severity, endoscopic features, and nasal cytology in 93 patients (49 males and 44 females, mean age 36.3±7.1 years) with INAR. The patients were treated with nasal corticosteroid, oral antihistamine, and isotonic saline. At randomization, 52 patients were treated also with symbiotic as adjunctive therapy, whereas the remaining 41 patients served as controls. Treatment lasted for 4 weeks. Patients were visited at baseline, after treatment, and after 4-week follow-up. Adjunctive symbiotic treatment significantly reduced the percentages of patients with symptoms and endoscopic signs, and diminished inflammatory cells. In conclusion, the present study demonstrates that a symbiotic was able, as adjuvant treatment, to significantly improve symptoms, endoscopic feature, and cytology in patients with INAR, and its effect may be long lasting.
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Affiliation(s)
- M Gelardi
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - C De Luca
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - S Taliente
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - M L Fiorella
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - N Quaranta
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - C Russo
- U.O.C. of Otolaryngology Ospedale Di Venere Carbonara di Bari, Italy
| | - A Ciofalo
- Otolaryngology, Department of Sensory Organs, University Sapienza, Roma, Italy
| | - A Macchi
- ORL Clinic University of Insubriae, Varese, Italy
| | - M Mancini
- Section of Otolaryngology, Azienda Area Vasta Romagna-Riccione, Italy
| | - P Rosso
- Section of Otolaryngology, Ospedale Civico di Chivasso (TO), Italy
| | - V Seccia
- Otorhinolaryngology Unit, Department of Neuroscience, AOU Pisana, Pisa, Italy
| | - F Guagnini
- Medical and Scientific Department Allergy Therapeutics Italia, Milan, Italy
| | - G Ciprandi
- Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) - Azienda Ospedaliera Universitaria San Martino - IST, Genoa, Italy
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Altissimi G, Salviati M, Turchetta R, Orlando MP, Greco A, De Vincentiis M, Ciofalo A, Marinelli C, Testugini V, Mazzei F, Cianfrone G. When alarm bells ring: emergency tinnitus. Eur Rev Med Pharmacol Sci 2016; 20:2955-2973. [PMID: 27460721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of this study is to develop a diagnostic-therapeutic algorithm for those suffering from tinnitus who seek emergency aid. MATERIALS AND METHODS A literature review has been performed on articles from the last 30 years. RESULTS It is important to activate medical or surgical diagnostic and therapeutic strategies, in order to safeguard and rehabilitate the various functions affected. Psychiatric comorbidity is the most frequent pathological condition of those with serious or catastrophic tinnitus. In these cases, mortality risk is linked to suicide, morbidity to tinnitus-correlated distress. CONCLUSIONS Tinnitus, mainly linked to loss of hearing, is a frequent symptom among the population at large. About 7% of those affected by tinnitus turn to their doctor to solve their problem, while between 0.5 and 2% request urgent medical assistance. Their cry for help may be the result of an acute onset of tinnitus or the rapid impairment of an already chronic condition. Tinnitus is not considered an urgent ear, nose and throat (ENT) condition by the Associazione Otorinolaringologi Ospedalieri Italiani (AOOI) [Italian Association of Hospital ENT], even though there are many pathological conditions, sometimes serious, associated with tinnitus and emergency action is necessary to reduce the risk of morbidity and mortality.
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Affiliation(s)
- G Altissimi
- Department of Neurology and Psychiatry, Umberto I University Hospital, Sapienza University, Rome, Italy.
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Magliulo G, Iannella G, Granata G, Ciofalo A, Pasquariello B, Angeletti D, La Marra F, Quinti I. Otologic evaluation of patients with primary antibody deficiency. Eur Arch Otorhinolaryngol 2016; 273:3537-3546. [PMID: 26935054 DOI: 10.1007/s00405-016-3956-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 02/26/2016] [Indexed: 12/11/2022]
Abstract
Common variable immunodeficiency (CVID) represents the most frequent primary immunodeficiency, often encountered in the ENT clinical practice. The clinical spectrum of CVID is quite broad, but otitis media are certainly among the most common clinical manifestations. This prospective study enrolled 60 patients (34 males, 26 females) with a previous diagnosis of CVID with the aim of performing an otologic evaluation and a more precision characterization of incidence, diagnosis, and treatment of otitis media in this group of patients. In consideration that Eustachian tube dysfunction (ETD) could be the 'primum movens' of otitis media, we wanted to assess whether a Eustachian tube dysfunction was present in these patients. Besides, we propose a possible diagnostic algorithm of middle ear pathologies to use in all cases of primary antibody deficiency patients. Results of our otologic examination showed that: 5 % of patients had chronic suppurative otitis media, 25 % bilateral otitis media with effusion and 10 % reported unilateral OME with associated contralateral ETD. There was bilateral isolated ETD and unilateral isolated ETD in 5 and 15 % of patients, respectively. All patients with unilateral OME had associated contralateral ETD. Finally, 40 % of patients were bilaterally negative at otoscopic examination and all otologic tests.
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Affiliation(s)
- Giuseppe Magliulo
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy.
| | - Giannicola Iannella
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy
| | - Guido Granata
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy.,Department of Molecular Medicine, La Sapienza University, Rome, Italy
| | - Andrea Ciofalo
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy
| | - Benedetta Pasquariello
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy
| | - Diletta Angeletti
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy
| | - Fabiola La Marra
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy.,Department of Molecular Medicine, La Sapienza University, Rome, Italy
| | - Isabella Quinti
- 'Organi di Senso' Department, 'Sapienza' University of Rome, Via Gregorio VII n. 80, 00165, Rome, Italy.,Department of Molecular Medicine, La Sapienza University, Rome, Italy
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Gelardi M, Taliente S, Fiorella ML, Quaranta N, Ciancio G, Russo C, Mola P, Ciofalo A, Zambetti G, Caruso Armone A, Cantone E, Ciprandi G. Ancillary therapy of intranasal T-LysYal® for patients with allergic, non-allergic, and mixed rhinitis. J BIOL REG HOMEOS AG 2016; 30:255-262. [PMID: 27049100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction. Non-allergic rhinitis (NAR) is characterized by a non-IgE-mediated pathogenesis. Frequently, patients have the two disorders associated: such as mixed rhinitis (MR). Hyaluronic acid (HA) is a fundamental component of the human connective tissue. HA may exert anti-inflammatory and immune-modulating activities. Recently, an intranasal HA formulation was proposed: a supramolecular system containing lysine hyaluronate, thymine and sodium chloride (T-LysYal®). This randomized study investigated whether intranasal T-LysYal® (rinoLysYal®, Farmigea, Italy) was able to reduce symptom severity, endoscopic features, and nasal cytology in 89 patients (48 males and 41 females, mean age 36.3±7.1 years) with AR, NAR, and MR. Patients were treated with intranasal T-LysYal® or isotonic saline solution as adjunctive therapy to nasal corticosteroid and oral antihistamine for 4 weeks. Patients were visited at baseline, after treatment and after 4-week follow-up. Intranasal T-LysYal® treatment significantly reduced the quote of patients with symptoms, endoscopic features, and inflammatory cells. In conclusion, the present study demonstrates that intranasal T-LysYal® is able, as ancillary therapy, to significantly improve patients with AR, NAR, and MR, and its effect is long lasting.
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Affiliation(s)
- M Gelardi
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - S Taliente
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - M L Fiorella
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - N Quaranta
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - G Ciancio
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - C Russo
- U.O.C. di Otorinolaringoiatria - Ospedale Di Venere, Carbonara Di Bari (BA), Italy
| | - P Mola
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo, Italy
| | - A Ciofalo
- Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Umberto I General Hospital, La Sapienza University, Rome, Italy
| | - G Zambetti
- Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Umberto I General Hospital, La Sapienza University, Rome, Italy
| | | | - E Cantone
- Department of Neuroscience, Reproductive and Dentistry Science, ENT Unit; Federico II University, Naples, Italy
| | - G Ciprandi
- Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) - Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
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Gelardi M, Taliente S, Fiorella ML, Quaranta N, De Candia N, Russo C, Mola P, Ciofalo A, Zambetti G, Cantone E, Arnone F, Macchi A, Rosso P, Ciprandi G. Intranasal T-LysYal® as adjunctive therapy for patients after functional endoscopic sinus surgery. J BIOL REG HOMEOS AG 2016; 30:277-284. [PMID: 27049103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Functional Endoscopic Sinus Surgery (FESS) is a common day surgery technique for upper airway disorders. Hyaluronic acid (HA) is a fundamental component of the human connective tissue. HA may exert reparative, anti-inflammatory and immune-modulating activities. Recently, a new intranasal HA formulation has been proposed: a supramolecular system containing lysine hyaluronate, thymine and sodium chloride (T-LysYal®). This randomized study investigated whether intranasal T-LysYal® (RinoLysYal®, Farmigea, Italy) was able to reduce symptom severity, endoscopic features, and nasal cytology in 83 patients (49 males and 34 females mean age 45.4±6.2 years) treated with FESS. All patients were treated with isotonic saline solution for 4 weeks, and a sub-group (active group) was also treated with intranasal T-LysYal®. Patients were visited at baseline, after treatment, and after 4-week follow-up. Intranasal T-LysYal® treatment significantly reduced the quote of patients with symptoms, endoscopic features, and inflammatory cells in comparison to isotonic solution. In conclusion, the present study demonstrates that intranasal T-LysYal® is able to significantly improve patients after FESS and its effect is long lasting.
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Affiliation(s)
- M Gelardi
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - S Taliente
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - M L Fiorella
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - N Quaranta
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - N De Candia
- Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - C Russo
- U.O.C. di Otorinolaringoiatria, Ospedale Di Venere, Carbonara Di Bari (BA), Italy
| | - P Mola
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo (TO), Italy
| | - A Ciofalo
- Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Umberto I General Hospital, La Sapienza University, Rome, Italy
| | - G Zambetti
- Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Umberto I General Hospital, La Sapienza University, Rome, Italy
| | - E Cantone
- Department of Neuroscience, Reproductive and Dentistry Science, ENT Unit, Federico II University, Naples, Italy
| | - F Arnone
- Clinica Otorinolaringoiatrica, Ospedale San Paolo, Milan, Italy
| | - A Macchi
- ORL Clinic University of Insubriae, Varese, Italy
| | - P Rosso
- S.C. Otorinolaringoiatra, Ospedale Civico di Chivasso (To), Italy
| | - G Ciprandi
- Department of Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (I.R.C.C.S.) - Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
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Zambetti G, Ciofalo A, Romeo R, Soldo P, Fusconi M, Greco A, Magliulo G, de Vincentiis M. Nasal histamine responses in nonallergic rhinitis with eosinophilic syndrome. Allergy Rhinol (Providence) 2015; 6:94-100. [PMID: 26302729 PMCID: PMC4541641 DOI: 10.2500/ar.2015.6.0125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: Nonallergic rhinitis with eosinophilic syndrome (NARES) is persistent, without atopy, but with ≥25% nasal eosinophilia. Hypereosinophilia seems to contribute to nasal mucosa dysfunction. Objectives: This analytical case-control study aimed at assessing the presence and severity of nonspecific nasal hyperactivity and at finding out whether eosinophilia may be correlated with the respiratory and mucociliary clearance functions. Materials: The symptom score was assessed in 38 patients and 15 controls whose nasal smear was also tested for eosinophils and mucociliary transport (MCT). Nonspecific nasal provocation tests (NSNPT) with histamine were also carried out, and total nasal resistance (TNR) was determined. Results: The symptom score of NARES after NSNPT were not significantly different from the control group, and there was poor or no correlation among the single symptoms and the differences studied for every nasal reactivity class. This correlation improved when using the composite symptom score. The most severe eosinophilia was observed in high reactivity groups, and it was correlated with an increase in TNR. MCT worsened as eosinophilia and nasal reactivity increased. Unlike controls, a significant correlation was observed between the increase in MCT and TNR. Conclusions: In NARES, nonspecific nasal hyperreactivity is the result of epithelial damage produced by eosinophilic inflammation, which causes MCT slow down, an increase in TNR, and nasal reactivity classes, with possible impact on classification, prognosis, and treatment control.
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Affiliation(s)
- Giampietro Zambetti
- Rhinology and Immuno-Allergy Unit, Sense Organs Department, Otolaryngology Section, Rome "Umberto I" General Hospital, "La Sapienza" University, Rome, Italy
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Fusconi M, Gallo A, Greco A, Ciofalo A, Martellucci S, Campo F, Marinelli C, De Vincentiis M. How to classify the stylohyoid complex syndrome in the ICHD. Cephalalgia 2015; 35:368-9. [DOI: 10.1177/0333102414541686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Andrea Gallo
- Department of Surgical Biotechnologies and Science, ENT Section, University “Sapienza” of Rome, Italy
| | | | | | - Salvo Martellucci
- Department of Surgical Biotechnologies and Science, ENT Section, University “Sapienza” of Rome, Italy
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Abstract
OBJECTIVE The aim of this study was to assess pre- and postoperative taste ability in patients undergoing middle ear surgery for otosclerosis or chronic otitis media. Olfactory function was also evaluated to rule out taste deficits due to concomitant nasal pathology. METHODS All patients underwent ear, nose, and throat examination, otomicroscopy, nasal endoscopy, anterior rhinomanometry, taste testing, and olfactory testing. Patients were evaluated at 1 to 5 days preoperatively (T0), and at 1 (T1), 6 (T6), and 12 (T12) months postoperatively. RESULTS Both groups of patients experienced worsening of the mean taste threshold postoperatively. This phenomenon was more serious in poststapedotomy patients. Follow-up showed progressive improvement in both groups. All values of olfactory testing were within the normal range for otosclerosis patients. Patients with chronic otitis media showed variable postoperative findings. CONCLUSION Chorda tympani function can be negatively affected by middle ear surgery. Deficits may be more marked in stapedotomy patients than in those undergoing tympanoplasty. Postoperative recovery of taste is satisfactory, although with different timelines for the 2 types of pathology.
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Affiliation(s)
- Andrea Ciofalo
- Organi di Senso Department, Sapienza University of Rome, Rome, Italy
| | | | - Martina Romeo
- Organi di Senso Department, Sapienza University of Rome, Rome, Italy
| | - Anna Rita Vestri
- Department of Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy
| | | | - Massimo Re
- Otorhinolaryngology Department, Marche Polytechnic University, Ancona, Italy
| | - Giuseppe Magliulo
- Organi di Senso Department, Sapienza University of Rome, Rome, Italy
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Dazzi F, Nitto SD, Zambetti G, Loriedo C, Ciofalo A. Alterations of the olfactory-gustatory functions in patients with eating disorders. Eur Eat Disord Rev 2013; 21:382-5. [PMID: 23788398 DOI: 10.1002/erv.2238] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 04/04/2013] [Accepted: 04/24/2013] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The purpose of this study was to assess olfactory-gustatory function impairment in patients with eating disorders. METHODS Nineteen patients with a diagnosis of bulimia nervosa, 18 patients with a diagnosis of anorexia nervosa and a control sample of 19 healthy subjects were recruited from the day hospital service of the Complex Operative Unit for Alimentary Conduct Disorders of the Policlinico Umberto I in Rome. Evaluation of olfactory and gustatory functions was performed on patients through the 'Sniffin' Sticks' method in order to assess the olfactory threshold, the capacity for discriminating and identifying olfactory stimuli, and the overall olfactory function, and through the 'taste strip' kit method in order to assess the gustatory function. The results were processed statistically to assess differences between patients with anorexia nervosa, patients with bulimia nervosa and healthy controls. RESULTS The two groups of patients with bulimia nervosa and anorexia nervosa showed a poorer olfactory and gustatory function compared with the healthy controls; discrimination of olfactory stimuli and overall olfactory function were reduced in both samples, as well as the overall gustatory function and the perception of bitter stimuli, whereas olfactory threshold was altered only in patients with bulimia nervosa. In both samples, scores for olfactory function fell within the range of hyposmia. DISCUSSION Our data suggest that patients with eating disorders have an altered perception of olfactory and gustatory stimuli. The alterations observed are worth further investigation.
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Ciofalo A, Zambetti G, Fusconi M, Soldo P, Greco A, Romeo M, Marinelli C, Macri G. North American Brain Injury Societyʼs Ninth Annual Conference on Brain Injury. J Head Trauma Rehabil 2011. [DOI: 10.1097/00001199-201109000-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zambetti G, Ciofalo A, Soldo P, Fusconi M, Romeo R, Greco A, Altissimi G, Macri GF, Marinelli C, Pagliuca G, De Vincentiis M. Autologous serum skin test reactivity and basophil histamine release test in patients with nasal polyposis: preliminary results. Int J Immunopathol Pharmacol 2010; 23:641-7. [PMID: 20646361 DOI: 10.1177/039463201002300228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
An eosinophilic inflammatory process is generally observed in patients suffering from nasal polyposis (NP), however its onset has not yet been defined. It has been suggested that immune activation of inflammatory cells may be the cause. The aim of this study is to verify whether autoantibodies and/or histamine-releasing factors are present in the serum of patients suffering from NP. In fact, we assume that autoantibodies and/or histamine-releasing factors, as already demonstrated in chronic idiopathic urticaria and asthma, may be involved in the pathogenesis of NP. In this case-control analytical study 40 patients with NP and 27 control subjects underwent the in vivo autologous serum skin test (ASST). The sera from 6 patients suffering from NP and 9 control group subjects, who had all been previously studied and randomly selected, underwent basophil histamine release assay from normal donor as a pilot study. The ASST showed positive results in 55% of patients suffering from NP versus 8% of the control group (p= .00006), the basophil histamine release test (BHRT) turned out positive in all patients tested and in 11% of the control group. We found a weak positive correlation between the percentage of histamine release and the wheal diameter. ASST reactivity is very frequent in patients suffering from NP, thus suggesting the presence of histamine-releasing factors in the blood stream. The BHRT was positive in the serum of all patients, thus suggesting the presence of anti-FcepsilonRI, anti-IgE autoantibodies and/or other histamine-releasing factors, the presence of which can play a role in triggering and maintaining the eosinophilic inflammatory process in NP.
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Benfari G, Fusconi M, Ciofalo A, Gallo A, Altissimi G, Celani T, De Vincentiis M. Radiotherapy alone for local tumour control in esthesioneuroblastoma. Acta Otorhinolaryngol Ital 2008; 28:292-297. [PMID: 19205593 PMCID: PMC2689543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/27/2008] [Accepted: 10/29/2008] [Indexed: 05/27/2023]
Abstract
Esthesioneuroblastoma is an uncommon tumour. Due to its low incidence, this neoplasm is difficult to evaluate and its treatment remains a matter of debate. Although the role of post-operative radiation is relatively well-defined, little is reported regarding the role of radiotherapy as the only treatment modality. A retrospective analysis of the literature has been conducted. With reference to the treatment of esthesioneuroblastoma, 55 patients submitted only to radiotherapy have been selected from publications of internationally indexed literature between 1979 and 2006. According to the Kadish classification, 6 patients were in stage A, 12 in stage B, and 37 in stage C. Response to therapy for each stage was assessed. There was no evidence of disease in: 6/6 stage A patients with a median follow-up period of 103.6 months, 7/12 stage B patients with a median followup period of 120 months, and 7/37 stage C patients with a median follow-up period of 77.3 months. A total of 27 patients died due to tumour-related causes and 5 due to intercurrent disease, while 3 patients were alive with disease (local recurrence and cervical lymph node metastasis). In conclusion, esthesioneuroblastoma is a malignant tumour which grows both locoregionally and distantly. For this reason, despite the satisfying results regarding response to radiotherapy alone in stage A patients, irradiation should be used only in early lesions arising below the cribriform plate, whereas all other cases require aggressive and multimodal therapy.
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Affiliation(s)
- G Benfari
- Department of Otorhinolaryngology, Audiology and Phoniatrics "G. Ferreri", University "La Sapienza", Rome, Italy
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Fusconi M, Ciofalo A, Greco A, Pulice G, Macci M, Mariotti M, Della Rocca C. Solitary Fibrous Tumor of the Oral Cavity: Case Report and Pathologic Consideration. J Oral Maxillofac Surg 2008; 66:530-4. [DOI: 10.1016/j.joms.2007.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2006] [Revised: 07/05/2007] [Accepted: 08/30/2007] [Indexed: 10/22/2022]
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Ciofalo A, Filiaci F, Romeo R, Zambetti G, Vestri AR. Epidemiological aspects of olfactory dysfunction. Rhinology 2006; 44:78-82. [PMID: 16550956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE This study aimed at assessing the most common aetiological factors causing total or partial olfactory deficit and the statistical analysis of some clinical aspects. MATERIALS AND METHODS 243 patients reporting alfactory dysfunction were enrolled in this STUDY A case history was drawn up for each patient, and all of them underwent otolaryngology objective examination, including nasal endoscopy, paranasal sinuses CT-scan, and Utrecht method (GITU) based smell indentification test. RESULTS Upper respiratory viral infections (40.2%), ceanial-facial traumas (39.3%), and rhinosinusal pathologies (6.3%) were the main aetiopathological factors indentified. A relevant number of case were recorded with unknown aetiology (14.2%). In 2 cases, olfactory dysfunction was due to neurological diseases, in 1 case it was due to intoxication and, in another case, it was congenital. The correlation between aetiology, gender, age, symptoms duration and deficit severity was studied. CONCLUSIONS many different aetiological factors caused the loss or weakening of the sense of smell. They mainly affected olfactory neurosensorial structures and odorant conduction. However, there were many cases of unknown aetiology. Women, over 40 in particular, were the most affected. Anosmia and severe hyposmia were mainly correlated with traumas and viral pathologies.
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Affiliation(s)
- Andrea Ciofalo
- Department of Otolaryngology "G. Ferreri", University "La Sapienza", Rome, Italy.
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Silvagni C, Romeo R, Grandinetti P, Ciofalo A, Re M. [Horizontal glottectomy according to Calearo-Teatini for the treatment of tumors involving the anterior commissure of the larynx: oncological and functional results]. Acta Otorhinolaryngol Ital 2002; 22:366-71. [PMID: 12647585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Among the different surgical options proposed for the treatment of glottic neoplasms involving the anterior commissure is the Horizontal Glottectomy (HG) proposed in 1978 by Calearo and Teatini. This type of laryngectomy is now included with good reason among the reconstructive horizontal laryngectomies in that it calls for the complete removal of the vocal folds and corresponding thyroid cartilage, with reconstruction of the airways by means of a thyrocricopexy. The object of our study was to describe the indications, surgical technique and oncological and functional results on the basis of the experience acquired by the Authors in 21 patients affected by laryngeal carcinoma (juxta-commissural T1a with diffuse hyperkeratosis of the contralateral cord and T1b infiltration to the anterior commissure) who underwent Horizontal Glottectomy (HG) according to the Calearo-Teatinin technique. For 3 of the 21 patients, the follow-up was under 3 years; for 11 patients it was over 5 years; and in 4 cases, it was over 10 years, with a survival rate at 5 years of 91.5%. There were 5 deaths (27.7%), 2 of which were due to non-neoplastic intervening causes, and 1 of which for a recurrence of N (5.5%) a year after surgery. In 3 patients, postoperative RT (radiotherapy) was carried out due to infiltration of the resection borders. With regard to the functional results, the naso-gastric tube was maintained for 8 days on average (min 4, max 12 days), and the tracheal cannula remained in situ an average of 11 days (min 7, max 19 days), while the average hospital stay was 9.3 days. The treatment options currently available for glottic tumors involving the anterior commissure may be divided among radiotherapy (RT), conventional surgery including vertical laryngectomies (Tucker's frontoanterior and Leroux-Robert's frontolateral laryngectomies) and horizontal laryngectomies (Calearo-Teatini's horizontal glottectomy, Majer-Piquet's crico-hyoido-epiglottopexy, and Labayle's crico-hyoidopexy), as well as endoscopic laser surgery. Each procedure is adopted on the basis of the experience and philosophy of the surgeon. For tumors involving the anterior commissure, our treatment protocol prescribes HG to be performed whenever possible, as its oncological and functional result have confirmed the validity of the procedure, as long as the indications are followed carefully. Furthermore, when compared to the frontolateral procedure, it provides similar oncological results, but being a much more economical operation on the vertical plane, it avoids stenotic complications, while, compared to the Majer-Piquet procedure, it allows easier and faster rehabilitation, even in elderly patients.
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Affiliation(s)
- C Silvagni
- Clinica Otorinolaringoiatrica, Università di Roma La Sapienza
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Abstract
Skull base osteomyelitis arises as a complication of malignant external otitis, but it can be also due to middle ear and/or mastoid infection. Other causes can be infections of the paranasal sinuses or of the mandible or maxilla due to odontic caries. Generally, osteomyelitis involves elderly patients affected by diabetic immunodeficiency or microvascular disease. In this paper, we present 3 new cases of skull base osteomyelitis with atypical onset and evolution. The difficulties of diagnosis and details of the management are discussed.
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Affiliation(s)
- G Magliulo
- Second Otolaryngology Clinics, University La Sapienza, Rome, Italy
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Filiaci F, Zambetti G, Romeo R, Ciofalo A, Luce M, Germano F. Non-specific hyperreactivity before and after nasal specific immunotherapy. Allergol Immunopathol (Madr) 1999; 27:24-8. [PMID: 10217669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Specific local immunotherapy (SLIT) improves symptom scores for allergic rhinitis during treatment and after its conclusion, as confirmed by non-specific tests. However, the duration of clinical and instrumental improvement after discontinuing SLIT is unknown. OBJECTIVE To evaluate the changes in the non-specific reaction time of patients with allergy to Dermatophagoides pteronissinus before and during 3 years of SLIT, and 6, 12, 18, and 24 months after discontinuing SLIT. MATERIAL AND METHODS Sixteen patients were diagnosed by clinical history, positive skin test for D. pteronissinus, RAST, nasal provocation test (NPT) specific for D. pteronissinus, NPT with cold water solution. SLIT was administered by nasal spray. Patients were evaluated before, at 6, 12, 24, and 36 months of SLIT, and 6, 12, and 18 months after discontinuing SLIT. At the beginning of SLIT, the allergen concentration used was similar to that used in NPT. Maintenance doses were administered 3 times a week for 1 year and 2 times a week for 2 years. All patients kept a symptom diary. RESULTS After the first year of SLIT, total nasal resistance (TNR) decreased sharply. TNR then remained constant at the end of the second year and decreased at the end of the third year of treatment. Discontinuation of SLIT did not produce evident variations in average TNR at 6 or 12 months, but 3/16 patients at 6 months and 9/16 patients at 12 months complained of symptomatic deterioration. The most evident deterioration was noted at the 18-month post-SLIT visit, in which TNR values were similar to those recorded at the onset of treatment. Positive response to stimulation and increased TNR were found after SLIT in 8/16 patients at 6 months, 13/16 at 12 months, 12/13 at 18 months, and 7/7 at 24 months. The symptom score indicated the return of symptoms. Twelve months after discontinuing SLIT, the patients complained about increased secretion and itching. The initial non-specific hyperreactivity, which had been present in all patients, was not evident in 68.7% after 3 years of SLIT, but persisted in a milder form in 31.3%. CONCLUSION SLIT successfully reduced symptoms of D. pteronissinus sensitivity. Non-specific hyperreactivity was absent at the end of SLIT, but returned by 6 months after discontinuing SLIT. Therefore, SLIT did not maintain the clinical results achieved at the beginning of treatment for more than 12 months.
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Affiliation(s)
- F Filiaci
- Department of Otorhinolaryngology, University La Sapienza, Rome, Italy
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45
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Abstract
Chronic immunoglobulin administration decreases the incidence of bronchial and pulmonary infections in patients affected by chronic variable immunodeficiency (CVI). In this study, an ENT screening was carried out in 22 patients affected by chronic variable immunodeficiency and treated with chronic immunoglobulin administration. All the patients underwent ENT physical examination, nasal endoscopy by fiberoptics, mucociliary transport test (MTT), anterior rhinorheomanometry (RRM), nasal provocation test with cold water (ANPT), audiometry and impedentiometry, olfactory evaluation, and paranasal sinus X rays. Dysphagia was present in 91% of the patients, nasal secretion and obstruction in 77%, and hypoacusia, tinnitus, and otodinia in 57%. Rhinitis and pharyngitis were observed in 86% of the patients, and serous middle ear effusion in 50%. Confirmed maxillary sinusitis was observed in five patients. Hyposmia was observed in 50% of the patients. MTT was significantly longer in the patients than in the controls (18.0 +/- 10.5 vs. 11.2 +/- 2.4 min; p < .05). Nasal resistance was lower in patients than in controls (0.46 +/- 0.32 vs. 1.11 +/- 0.22 Pa/L.s-1; p < .001). ANPT was positive in 9 patients out of 25 versus 1 control out of 15 (p < .05). Finally, seven patients were affected by transmissive hypoacusia, and one patient by neurosensorial hypoacusia. Our results suggest that chronic immunoglobulin administration in CVI patients is not effective against ENT disorders, probably because of the important role played by nasal hyperreactivity. Frequent ENT examination and early treatment of ENT disorders are therefore suggested in order to prevent chronic disease.
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Affiliation(s)
- S Masieri
- ENT Clinic, University La Sapienza, Rome, Italy
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46
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Orlando MP, Masieri S, Pascarella MA, Ciofalo A, Filiaci F. Sudden hearing loss in childhood consequent to hepatitis B vaccination: a case report. Ann N Y Acad Sci 1997; 830:319-21. [PMID: 9616691 DOI: 10.1111/j.1749-6632.1997.tb51903.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M P Orlando
- ENT Clinic, University La Sapienza, Rome, Italy
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47
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Affiliation(s)
- A Corsi
- Department of Experimental Medicine and Pathology, University La Sapienza, Rome, Italy
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48
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Filiaci F, Zambetti G, Luce M, Ciofalo A. Local treatment of nasal polyposis with capsaicin: preliminary findings. Allergol Immunopathol (Madr) 1996; 24:13-8. [PMID: 8882755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The inflammatory process triggered by the nasal hyperreactivity, whether specific or aspecific, presents three components: immunomediation-neurogenic-interconnection between the nervous and the immunitary systems. Neuropeptides (eg SP and CGRP) are among the agents responsible for neurogenic phlogosis and, in our opinion, they contribute towards the onset of polyps. Capsaicin, which acts on the C fibres, has been applied locally (30 microns) by the AA in 15 patients affected by aspecific nasal hyperreactivity with polyps, in the course of a double blind study with an equal number of patients. Treatment was given once a week for 5 consecutive weeks in order to evaluate the effect on both the hyperreactivity and the polyps. Before and after each session and at the 1- and 3-month controls the following tests were carried out: assessment of symptoms, nasal endoscopy, sizing of the polyps, aspecific nasal provocation test and nasal cytology. Apart from an improvement in symptoms and in nasal hyperreactivity, results showed a reduction in the size of the polyps even though accompanied by a gradual increase of eosinophiles which was not correlated to a degranulation process.
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Affiliation(s)
- F Filiaci
- Otorhinolaryngology OLC Department of ENT-Immunology, University La Sapienza, Rome, Italy
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49
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Fanales-Belasio E, Ciofalo A, Zambetti G, Ansotegui IJ, Scala E, Paganelli R, Filiaci F. Intranasal immunotherapy with Dermatophagoides extract: in vivo and in vitro results of a double-blind placebo-controlled trial. Rhinology 1995; 33:126-31. [PMID: 8560161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Intranasal immunotherapy (IT) has been proposed as a means to induce an effective immunity of the nasal mucosa in patients with allergic rhinitis, avoiding systemic side effects. In the present study 20 individuals with chronic allergic rhinitis, and skin prick test reactive to Dermatophagoides pteronyssinus (DP) only, were randomized and subjected to a three months' double-blind placebo-controlled trial of intranasal IT with DP extract. All patients received also sodium cromoglycate as pre-medication. Before and at the end of the treatment the patients performed specific nasal provocation tests, and samples of serum and nasal secretions were collected to measure total and specific IgE, levels of eosinophil cationic protein (ECP), and mast-cell-derived tryptase. A clinical score was computed by the symptoms indicated by the patients. The clinical score did not change in the two groups after the treatment, whereas a decrease in nasal reactivity was observed. Total IgE increased only in secretions from placebo-treated patients, but were not modified in sera. IgE to DP in sera and nasal secretions did not change significantly. Tryptase levels in nasal secretions decreased in both groups, while ECP was unchanged after IT. Serum ECP levels decreased more in actively treated patients than in the placebo group. The data suggest that changes of IgE and inflammatory mediators may be affected by the use of sodium cromoglycate in both groups, but some parameters change early in different directions in IT- and placebo-treated groups.
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Affiliation(s)
- E Fanales-Belasio
- Department of Allergy and Clinical Immunology, University Hospital La Sapienza, Rome, Italy
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50
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Filiaci F, Zambetti G, Ciofalo A, Luce M, Masieri S, Lovecchio A. Local treatment of aspecific nasal hyperreactivity with capsaicin. Allergol Immunopathol (Madr) 1994; 22:264-8. [PMID: 7892815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Ten patients with vasomotor rhinitis underwent local treatment with capsaicin (30 micromol.), once per week for five weeks; controls were carried out at weekly intervals and 1, 3 and 6 months after therapy. Assessment was made using symptom score and nasal resistance scores both basal and subsequent to aspecific nasal provocation. Results showed abatement of symptoms, and reduction of nasal resistance and aspecific hyperreactivity already during the second week. This trend continued for six months, with endoscopic improvement also. Hence, this treatment proved to be efficient in reducing nasal reactivity.
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Affiliation(s)
- F Filiaci
- Department of Otorhinolaryngology C.L.O. III ENT Clinic, University of Rome La Sapienza
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