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Winkelmann S, Korth A, Voss B, Nasr MA, Behrend N, Pudszuhn A, Hofmann VM, Schendzielorz P, Maetzler C, Hermes A, Borzikowsky C, Bahmer T, Lieb W, Schreiber S, Stork S, Montellano FA, Witzenrath M, Keil T, Krawczak M, Laudien M, On Behalf Of The Napkon Study Group NSG. Persisting chemosensory dysfunction in COVID-19 - a cross-sectional population-based survey. Rhinology 2023; 61:12-23. [PMID: 36323438 DOI: 10.4193/rhin22.176] [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: 02/02/2023]
Abstract
BACKGROUND Chemosensory dysfunction (CD) has been reported as a common symptom of SARS-CoV-2 infection, but it is not well understood whether and for how long changes of smell, taste and chemesthesis persist in infected individuals. METHODOLOGY Unselected adult residents of the German federal state of Schleswig-Holstein with Polymerase Chain Reaction (PCR)-test-confirmed SARS-CoV-2 infection were invited to participate in this large cross-sectional study. Data on the medical history and subjective chemosensory function of participants were obtained through questionnaires and visual analogue scales (VAS). Olfactory function (OF) was objectified with the Sniffin Sticks test (SST), including threshold (T), discrimination (D) and identification (I) test as well as summarized TDI score, and compared to that in healthy controls. Gustatory function (GF) was evaluated with the suprathreshold taste strips (TS) test, and trigeminal function was tested with an ampoule containing ammonia. RESULTS Between November 2020 and June 2021, 667 infected individuals (mean age: 48.2 years) were examined 9.1 months, on average, after positive PCR testing. Of these, 45.6% had persisting subjective olfactory dysfunction (OD), 36.2% had subjective gustatory dysfunction (GD). Tested OD, tested GD and impaired trigeminal function were observed in 34.6%, 7.3% and 1.8% of participants, respectively. The mean TDI score of participants was significantly lower compared to healthy subjects. Significant associations were observed between subjective OD and GD, and between tested OD and GD. CONCLUSION Nine months after SARS-CoV-2 infection, OD prevalence is significantly increased among infected members of the general population. Therefore, OD should be included in the list of symptoms collectively defining Long-COVID.
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Affiliation(s)
- S Winkelmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - A Korth
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - B Voss
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - M A Nasr
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - N Behrend
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - A Pudszuhn
- Department of Otorhinolaryngology, Head and Neck Surgery, Charity-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - V M Hofmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Charity-Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin, Humboldt-Universitat zu Berlin and Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany
| | - P Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wurzburg, Wurzburg, Germany
| | - C Maetzler
- Neurology Department, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - A Hermes
- Institute of Epidemiology, Kiel University, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - C Borzikowsky
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - T Bahmer
- Division of Pneumology, Department of Medicine 1, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - W Lieb
- Institute of Epidemiology, Kiel University, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - S Schreiber
- Internal Medicine Department I, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
| | - S Stork
- Comprehensive Heart Failure Center and Dept. Internal Medicine I, University Hospital Wurzburg, Wurzburg, Germany
| | - F A Montellano
- Comprehensive Heart Failure Center and Dept. Internal Medicine I, University Hospital Wurzburg, Wurzburg, Germany; Institute of Clinical Epidemiology and Biometry, University of Wurzburg, Wurzburg, Germany; Department of Neurology, University Hospital Wurzburg, Wurzburg, Germany
| | - M Witzenrath
- Department of Infectious Diseases and Respiratory Medicine, Charity - Universitatsmedizin Berlin, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
| | - T Keil
- Institute of Clinical Epidemiology and Biometry, University of Wurzburg, Wurzburg, Germany; Institute of Social Medicine, Epidemiology and Health Economics, Charity-Universitatsmedizin Berlin, Berlin, Germany
| | - M Krawczak
- Institute of Medical Informatics and Statistics, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
| | - M Laudien
- Department of Otorhinolaryngology, Head and Neck Surgery, Kiel University, University Medical Centre Schleswig-Holstein, Kiel, Germany
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Voelker J, Voelker C, Voelker J, Engert J, Schendzielorz P, Hagen R, Rak K. Button batteries and typical swallowed foreign bodies can be differentiated in high-resolution X-Rays. Int J Pediatr Otorhinolaryngol 2021; 142:110604. [PMID: 33421671 DOI: 10.1016/j.ijporl.2020.110604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Button battery ingestions have emerged as an increasing medical issue in recent years, especially for children. The frequent use of these energy sources in small appliances and toys is responsible for their ubiquitous occurrence in households. In addition to other possible foreign bodies, button batteries are particularly dangerous as they can cause severe complications in the aerodigestive tract. OBJECTIVE The study aimed for a detailed analysis of specific radiographic identifiers of button batteries and similarly configured potential esophageal foreign bodies in high-resolution X-ray scans. METHODS A selection of potentially hazardous button batteries - in cases of ingestion (CR2032) or aspiration (LR44, LR1130) - was made. Other clinically relevant radio-opaque objects of similar size and shape have been selected accordingly. High-resolution X-ray scans (33.3 lp/mm) were made using an in vitro model in porcine esophageal preparations. A systematic, comparative analysis was carried out with the digital radiographic images. FINDINGS In the study described, the selected foreign bodies were scanned at distinct angles in high image quality. Using button batteries, radiographically details of their internal structures were shown that have not yet been described. The known markers, as well as new detailed characteristics, were found in the experimental setting. The differentiation from other typical esophageal foreign bodies was possible by analyzing four relevant identification features: the edge properties, internal structures, the size, and differences in 0°/90° scans. CONCLUSIONS The study results reveal that specific features of potential esophageal foreign bodies can be identified by improved radiographic resolution, contrast, and dynamics. Thus, the diagnostic reliability in distinguishing 'high-risk foreign bodies' from less dangerous ones could be increased. In the future, button batteries could be detected more reliably with intelligent digital image analysis and enhanced radiographic technology. This may further support clinical triage algorithms and help reduce medical complications in cases of foreign body ingestions.
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Affiliation(s)
- Johannes Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany.
| | - Christine Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Joachim Voelker
- Department of Diagnostic and Interventional Radiology, St. Josef's Hospital Wiesbaden, Beethovenstr. 20, Wiesbaden, D-65189, Germany; Academic Teaching Hospital of Johannes Gutenberg University, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Jonas Engert
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Phillipp Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
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Rak K, Ilgen L, Taeger J, Schendzielorz P, Voelker J, Kaulitz S, Müller-Graff FT, Kurz A, Neun T, Hagen R. Influence of cochlear parameters on the current practice in cochlear implantation : Development of a concept for personalized medicine. HNO 2021; 69:24-30. [PMID: 33459799 DOI: 10.1007/s00106-020-00969-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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] [Accepted: 11/11/2020] [Indexed: 11/26/2022]
Abstract
Since the introduction of cochlear implants into clinical routine, the interest in measuring cochlear parameters, particularly the cochlear duct length (CDL) has increased, since these can have an influence on the correct selection of the electrode. On the one hand, coverage of an optimal frequency band is relevant for a good audiological result, and on the other hand, cochlear trauma due to too deep insertion or displacement of the electrode must be avoided. Cochlear implants stimulate the spiral ganglion cells (SGC). The number of SGC and particularly their distribution can also have an influence on the function of a cochlear implant. In addition, the frequency assignment of each electrode contact can play a decisive role in the postoperative success, since the frequency distribution of the human cochlea with varying CDL shows substantial interindividual differences. The aim of this work is to provide an overview of the methods used to determine the cochlear parameters as well as of relevant studies on the CDL, the number and distribution of SGZ, and the frequency assignment of electrode contacts. Based on this, a concept for individualized cochlear implantation will be presented. In summary, this work should help to promote individualized medicine in the field of cochlear implants in the future, in order to overcome current limitations and optimize audiological outcomes.
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Affiliation(s)
- K Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany.
| | - L Ilgen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - J Taeger
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - P Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - J Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - S Kaulitz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - F-T Müller-Graff
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - A Kurz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
| | - T Neun
- Institute for Diagnostic and Interventional Neuroradiology, University Hospital Würzburg, Würzburg, Germany
| | - R Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Würzburg, Josef-Schneider-Straße 11, 97080, Würzburg, Germany
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Roch C, Schendzielorz P, Scherzad A, van Oorschot B, Scheich M. [Needs and burdens of palliative care patients with advanced and/or metastatic head and neck tumors]. HNO 2020; 68:510-516. [PMID: 32430668 PMCID: PMC8241647 DOI: 10.1007/s00106-020-00888-z] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Hintergrund Neue Therapieformen ermöglichen auch bei Patienten mit fortgeschrittenen und metastasierten Kopf-Hals-Tumoren gute Behandlungsansätze. Gespräche über das Lebensende, vorausschauende Versorgungsplanung und auch palliativmedizinische Konzepte geraten dadurch oft in den Hintergrund. Ziel der Arbeit Analyse von Symptomen, Belastungen sowie dem Vorliegen von Vorsorgedokumenten, von stationär palliativmedizinisch mitbetreuten Patienten durch Selbsteinschätzung. Erhebung der Integration der spezialisierten Palliativversorgung in die Versorgung stationär verstorbener Patienten anhand des Qualitätsindikators nach Earle. Material und Methoden Retrospektive Analyse der vom Palliativdienst mitbetreuten Patienten mit Kopf-Hals-Tumoren durch Nutzung des standardisierten IPOS Fragebogens. Ergebnisse Die häufigsten physischen Symptome waren „Schwäche“ (77 %), „Appetitlosigkeit“ (65 %) und „eingeschränkte Mobilität“ (65 %). „Schmerzen“ wurden von 42 % der Patienten angegeben. Die häufigsten emotionalen und psychosozialen Belastungen waren „Traurigkeit“ (97 %) und „Sorgen des Patienten“ (94 %), die „fehlende Möglichkeit Gefühle“ zu teilen (77 %), „unzureichende Informiertheit“ (85 %) und „organisatorische Probleme“ (77 %). Bei 23 % der Patienten lagen Vorsorgedokumente vor. Das Qualitätsziel nach Earle wurde nicht erreicht. Diskussion Die Patienten berichten in der Auswertung in hohem Maß Symptome und Belastungen, am häufigsten im emotionalen Bereich und bezüglich kommunikativer und praktischer Bedürfnisse. Hier zeigt sich möglicherweise auch ein Gesprächsbedarf über Wünsche und Vorstellungen im Hinblick auf das Lebensende. Palliativdienste sollten deshalb besonders auf die psychosozialen Bedürfnisse einzugehen.
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Affiliation(s)
- C Roch
- Interdisziplinäres Zentrum Palliativmedizin, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland.
| | - P Schendzielorz
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Scherzad
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - B van Oorschot
- Interdisziplinäres Zentrum Palliativmedizin, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland
| | - M Scheich
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenkrankheiten, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
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Schendzielorz P, Hagen R, Scheich M. „58-jähriger Patient mit schmerzhafter, aphthöser Stomatitis und Konjunktivitis“. Laryngorhinootologie 2014; 93:537-8. [DOI: 10.1055/s-0034-1375655] [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: 10/25/2022]
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Klimek L, Schendzielorz P, Pinol R, Pfaar O. Specific subcutaneous immunotherapy with recombinant grass pollen allergens: first randomized dose-ranging safety study. Clin Exp Allergy 2013; 42:936-45. [PMID: 22909165 DOI: 10.1111/j.1365-2222.2012.03971.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Allergen-specific immunotherapy (SIT) with native allergen extracts and allergoids has been performed successfully for decades. Preliminary studies revealed the use of recombinant allergen-preparations as a promising option for SIT. OBJECTIVE The present study was designed to investigate the dose-ranging safety in SCIT with a mixture of five recombinant grass pollen allergens containing equimolar amounts of rPhl p 1, rPhl p2, rPhl p 5a, rPhl p 5b and rPhl p 6, adsorbed to aluminium hydroxide. METHODS A randomized, double blind, placebo-controlled, dose-ranging safety study (EudraCT number 2007-002808-18) was performed in 50 patients with allergic rhinoconjunctivitis, with or without asthma. Patients were randomized to groups of 10 to receive maximum doses of 20, 40, 80 or 120 μg of total grass pollen recombinant protein or placebo. The primary end-point of this trial was the number of patients with at least one systemic reaction with possible, probable or definite relationship to the study medication determined at the end of the up-dosing phase. Secondary end-points included titrated intracutaneous test with natural six-grass pollen extract, allergen-specific conjunctival provocation test as well as IgG and IgE-levels throughout the study. RESULTS Eight of the 50 patients revealed systemic reactions grade 1 or 2 corresponding to the primary end-point definition. No systemic reactions grade 3 or 4 occurred in any dosage group. The systemic reactions were well distributed among the active groups. Results of secondary end-points imply that the study medication is effective and provokes immunological effects. CONCLUSIONS AND CLINICAL RELEVANCE The first DBPC SCIT-DRF with a mixture of recombinant Phleum allergens (Phl p 1, 2, 5a, 5b, 6) in patients with rhinoconjunctivitis plus/minus asthma showed no major side effects in very high doses up to 120 μg.
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Affiliation(s)
- L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany.
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Abstract
The diagnostic possibility of high resolution real time sonography has been investigated in 31 patients with cysts in the neck. The method is of special value preoperatively by demonstrating neighbouring structures, such as the parotid and thyroid glands and the major vessels in the neck; it contributes to differential diagnosis and surgical planning. Lateral cysts, because of their contents, may be highly echogenic and may be difficult to distinguish from lymphomas. The differential diagnosis of various cysts in the neck is discussed. An important aspect of sonography of the neck is the experience of the operator and his detailed knowledge of the local anatomy.
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Schendzielorz P, Brusis T, Arnold G. [Accessory external ear in the oropharynx]. Laryngol Rhinol Otol (Stuttg) 1985; 64:586-7. [PMID: 4079620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
This report describes the case of a one-day old girl with an accessorial ear lobe in the region of the left soft palate. The girl was referred to us by the children's clinic because of shortness of breath and difficulties in swallowing. On inspecting the cavity of the mouth and the pharynx a pedunculated, ball-shaped, whitish, membranous tumour was identified. The size of the tumour was comparable to a cherry, hanging down from the left velum into the pharynx. It was possible to remove the tumour from its base by using the sling technique. The operation itself did not present any complications. The histological observation revealed a dystopical ear lobe. 13/4 years later, an oto-rhino- laryngological examination diagnosed normal hearing and faculty of speech. The origin as a surplus malformation of the embryological branchial archs is discussed. Due to the morphological result differentiation from a teratoid malformation is possible.
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Zanella FE, Schendzielorz P, Kubatova J. [Recurrent extensive pleomorphic adenoma (mixed tumor) of the submandibular gland--diagnosis and therapy]. Digitale Bilddiagn 1985; 5:135-7. [PMID: 2996824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The authors report an extensive recurrent pleomorphic adenoma of the submandibular gland with destruction of the ramus of the lower jaw. The advantages of computed tomography are the possibility of assessing the osseous structures, the extension of the soft parts, and the relation to the adjacent neck structures. Despite the unusual bone infiltration, histological examination did not point to malignancy.
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