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Landis BN, Coattrenec Y, Soyka MB. Olfactory Function and Biologic Treatments: Comment on Available Real-Life Studies. J Investig Allergol Clin Immunol 2023; 33:502-503. [PMID: 38095496 DOI: 10.18176/jiaci.0929] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023] Open
Affiliation(s)
- B N Landis
- Department of Otorhinolaryngology - Head and Neck Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - Y Coattrenec
- Divison of Immunology and Allergology, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Mauthe T, Holzmann D, Soyka MB, Mueller SA, Balermpas P, Held U, Freiberger SN, Rupp NJ, Meerwein CM. Overall and disease-specific survival of sinonasal adenoid cystic carcinoma: a systematic review and meta-analysis. Rhinology 2023; 61:508-518. [PMID: 37703531 DOI: 10.4193/rhin23.204] [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: 09/15/2023]
Abstract
This meta-analysis aims to investigate the outcome of sinonasal adenoid cystic carcinoma (snAdCC). We followed PRISMA guidelines and included studies reporting 5-year overall survival (OS) rates for snAdCC. Eligible studies were identified through a literature search and assessed using JBI critical appraisal checklist. A total of 17 studies were included comprising 2259 patients (mean age: 58.1 years, 52.7% female, 47.3% male). The meta-analysis demonstrated that the 5-year OS, 10-year OS, and 5-year disease-free survival (DFS) were 68%, 40%, and 47.2%, respectively. Descriptive statistics on study level showed high rates of locally advanced tumor stages at diagnosis: 23% cT3, 53% cT4, 3.4% N+, and 4.2% M+. 29.7% of the tumors were in the nasal cavity, 67.6% in the paranasal sinuses. The maxillary, ethmoid, sphenoid, and frontal sinus were affected in 50.9%, 7.2%, 4%, and 0.5%, of cases. A combination of surgery and radiotherapy was used in 45.4% of the patients and 19.3% of patients received surgery only. In conclusion, these findings emphasize the significance of thorough surveillance for individuals with snAdCC to identify any potential recurrence or progression of the disease.
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Affiliation(s)
- T Mauthe
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - S A Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - P Balermpas
- Department of Radiation Oncology, University Hospital of Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - U Held
- Department of Biostatistics at Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - S N Freiberger
- Department of Biostatistics at Epidemiology, Biostatistics, and Prevention Institute, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - N J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - C M Meerwein
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland and Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Runggaldier D, Schindler V, Luo Y, Kleinjung T, Soyka MB. Novel oral anticoagulation treatment is not associated with recurrent or severe epistaxis. Rhinology 2021; 59:219-221. [PMID: 33377891 DOI: 10.4193/rhin20.541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- D Runggaldier
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland;University of Zurich, Switzerland
| | - V Schindler
- University of Zurich, Switzerland;Division of Gastroenterology and Hepatology, University Hospital Zurich, Switzerland
| | - Y Luo
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland; University of Zurich, Switzerland
| | - T Kleinjung
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland; University of Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Switzerland; University of Zurich, Switzerland
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Steiner UC, Bischoff S, Valaperti A, Ikenberg K, Starzyk J, Bucher S, Bachmann LM, Soyka MB. Endotypes of chronic rhinosinusitis with nasal polyps with and without NSAID â€" intolerance. Rhinology 2021; 58:544-549. [PMID: 32692786 DOI: 10.4193/rhin19.423] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2-dominated inflammatory disease of the upper air- ways. A subgroup of patients with CRSwNP suffer from intolerance to nonsteroidal anti-inflammatory drugs (NSAID) and develop NSAID-exacerbated respiratory disease (NERD). The aim of the study was to compare the cytokine based inflammatory endotype of nasal secretions of CRSwNP patients with and without NSAID intolerance. METHODS Nasal secretions were collected from twenty-six patients suffering from CRSwNP, thirteen with NERD and thirteen without NSAID intolerance. As control, nasal secretions were collected from fifteen healthy donors. Tryptase and ten human cyto- kines were analyzed: interleukin (IL)-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, IL-17A, IL-23, IFN-g, and TNF-a by a cytokine multiple array on a Luminex 200 platform. RESULTS Grade of polyposis and frequency of polyp surgery was more severe in NERD- compared to non-NERD patients. IL-6 and IL-5 in CRSwNP was significantly increased compared to healthy participants. IL-5 and IL-13 were significantly increased in subjects suffering from NERD compared to CRSwNP patients without NERD. CONCLUSION We identified IL-13 as a possible specific biomarker in nasal secretions of patients with NERD, which allows us to differentiate between CRSwNP with vs. without NERD. The characterization of inflammatory endotypes in CRSwNP enables the introduction of the best available therapy in the context of precision medicine.
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Affiliation(s)
- U C Steiner
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - S Bischoff
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - A Valaperti
- Department of Immunology, University Hospital Zurich, Zurich, Switzerland
| | - K Ikenberg
- Department of Pathology and Molecular Pathology, University Hospital and University of Zurich, Zurich, Switzerland
| | - J Starzyk
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - S Bucher
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - L M Bachmann
- Medignition - Healthcare Innovations, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital and University of Zurich, Zurich,Switzerland
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Bischoff S, Poletti SC, Kunz S, Kiessling SY, Hinder D, Dreher A, Akdis CA, Soyka MB. Trigeminal endonasal perception - an outcome predictor for septoplasty. Rhinology 2021; 58:437-443. [PMID: 32500869 DOI: 10.4193/rhin19.292] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND No adequate test exists to predict outcome after septoplasty. Despite adequate surgery, patients still might experience nasal breathing impairment. The aim of this study was to determine if pre-operative trigeminal sensitivity can predict satisfaction after septoplasty. METHODS Single centre prospective cohort study in tertiary referral centre with follow-up time of 6 weeks postoperatively. Patients scheduled for septoplasty or septorhinoplasty with turbinoplasty were consecutively selected the day before surgery. Standard preoperative examinations (acoustic rhinometry and Sniffin’ Sticks 12 test), the evaluation of nasal obstruction on a visual analogue scale (VAS) and the trigeminal lateralisation task were performed before and 6 weeks after surgery. Biopsies were taken during surgery and TRPV1 mRNA expression was measured by PCR. RESULTS Thirty patients were included with a median age of 29 years and equal gender distribution. Trigeminal perception and sensation of nasal obstruction showed a significant correlation: preoperative lateralisation test scores, representing endonasal trigeminal sensitivity, correlated significantly with the mean VAS change scores, which demonstrate subjective improvement. A lateralisation test score of 31.5 and more had a sensitivity of 88% to predict an improvement of more than 3 VAS points. Additionally, high TRPV1 mRNA expression was linked with good postoperative VAS scores. CONCLUSION The preoperative evaluation of the trigeminal sensitivity could improve patients’ selection for septoplasty with a higher rate of satisfaction. Endonasal trigeminal sensitivity is directly linked with subjective outcome. Therefore, patients with low trigeminal sensitivity should undergo septoplasty only after thorough counselling.
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Affiliation(s)
- S Bischoff
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - S C Poletti
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland; Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universitat Dresden, Dresden, Germany; Department of Otorhinolaryngology-Head and Neck Surgery, University of Tubingen, Tubingen, Germany
| | - S Kunz
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - S-Y Kiessling
- Department of Otorhinolaryngology Head and Neck Surgery, Kantonsspital St.Gallen, St.Gallen, Switzerland
| | - D Hinder
- Department of Otorhinolaryngology Head and Neck Surgery, Luzerner Kantonsspital, Luzern, Switzerland
| | - A Dreher
- Swiss Institute of Asthma and Allergy Research (SIAF), University of Zurich, Davos Switzerland
| | - C A Akdis
- Swiss Institute of Asthma and Allergy Research (SIAF), University of Zurich, Davos Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Bucher S, Kunz S, Deggeller M, Holzmann D, Soyka MB. Open rhinoplasty using a columellar strut: effects of the graft on nasal tip projection and rotation. Eur Arch Otorhinolaryngol 2020; 277:1371-1377. [PMID: 32062744 DOI: 10.1007/s00405-020-05836-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 01/30/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Despite the discordance in the literature concerning the effect of columellar strut grafts on nasal tip rotation, this method is often used when an increase in nasolabial angle or nasal tip projection is desired. OBJECTIVES We aimed to elucidate the change in nasolabial angles and nasal tip projections after exclusive columellar strut graft implantations and in addition to other surgical steps. Furthermore, differences in these parameters between patients with conchal and septal columellar strut grafts were investigated. METHODS A monocentric retrospective cohort study of 173 open septorhinoplasties with columellar strut graft technique, between 2006 and 2016, was conducted. The pre- and postoperative nasal tip projection, nasolabial and nasofrontal angle and interalar distance were determined and the Goode-ratio was calculated. RESULTS In cases where uprotation was not specifically desired, neither nasolabial angles nor tip projections changed significantly, irrespective of whether a columellar strut graft was used alone or with additional surgical steps. If an uprotation through surgery was desired, a significant mean increase in nasolabial angle of 4.4° was achieved. Furthermore, conchal instead of septal columellar strut grafts showed significantly better results. CONCLUSION In our study, a columellar strut graft-without any additional surgical step-does only have an improving impact on nasal tip rotations and projections, if specifically intended to by the surgeon. In other words, if the strut graft was not chosen for an uprotational intention, it did not relevantly impact on the nasolabial angle or nasal tip projection. However, in patients where an uprotation is desired, the columellar strut graft still represents a meaningful tool. Since conchal instead of septal columellar strut grafts showed better results, we suggest using them for these patients. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- S Bucher
- University of Zurich, Zurich, Switzerland
- Department for Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zürich, Switzerland
| | - S Kunz
- University of Zurich, Zurich, Switzerland
- Department for Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zürich, Switzerland
| | - M Deggeller
- University of Zurich, Zurich, Switzerland
- Department for Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zürich, Switzerland
| | - D Holzmann
- University of Zurich, Zurich, Switzerland
- Department for Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zürich, Switzerland
| | - M B Soyka
- University of Zurich, Zurich, Switzerland.
- Department for Otorhinolaryngology Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zürich, Switzerland.
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Bischoff S, Gerth-Kahlert C, Holzmann D, Soyka MB. Longstanding diplopia after ethmoidal artery ligation for epistaxis. Eur Arch Otorhinolaryngol 2019; 277:161-167. [PMID: 31667574 DOI: 10.1007/s00405-019-05686-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE In the rare case of intractable, posterior, non-sphenopalatine artery epistaxis, ligation of ethmoidal arteries using an external approach like a Lynch-type incision is required. Orbital complications, especially extra-ocular motility disorders with diplopia, are known, but in the literature rarely described. Our aim was to analyse the complication type, rate, and outcome of ethmoidal artery ligation for epistaxis. MATERIALS AND METHODS Data between 2012 and 2017 of patients treated with ethmoidal artery ligation were analysed retrospectively and through a telephone interview using a non-standardized questionnaire. RESULTS Data of 18 patients (m/f = 3/15) aged 53-83 years were reviewed. Epistaxis recurred in only one patient after 1 month. Five patients (28%) suffered from diplopia shortly after surgery. Motility analysis revealed full recovery with free motility in four out of five reported cases after 4-8 months, one patient still reports intermittent mild diplopia more than 1 year postoperatively. CONCLUSION In patients with intractable, non-sphenopalatine artery epistaxis, anterior ethmoidal artery ligation was highly effective. Diplopia, however, occurred in one-third of our patient group. Information about motility restriction with longer standing diplopia are mandatory when consenting patients for ligation of ethmoidal arteries. Special care needs to be taken during dissection in the region of the trochlea and superior oblique muscle. LEVEL OF EVIDENCE Case Series, level 4.
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Affiliation(s)
- S Bischoff
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - C Gerth-Kahlert
- Department of Ophthalmology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Frauenklinikstrasse 24, 8091, Zurich, Switzerland.
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Bucher S, Kugler A, Probst E, Epprecht L, Stadler RR, Holzmann D, Soyka MB. Occurrence of occult CSF leaks during standard FESS procedures. Rhinology 2018; 56:166-171. [PMID: 29550855 DOI: 10.4193/rhin17.117] [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: 11/08/2022]
Abstract
OBJECTIVE To determine the incidence of occult cerebrospinal fluid leaks (CSF) after functional endoscopic sinus surgery (FESS) and to evaluate the diagnostic performance of beta2-transferrin in blood-contaminated conditions. STUDY DESIGN Prospective cohort study. METHODS An analysis of 57 intraoperative samples using hydrogel 6 beta2-transferrin assay after FESS was undertaken. In case of CSF positive samples and continuing rhinorrhea, reanalysis after more than 1 year was conducted. In-vivo analysis of a primary spontaneous CSF leak sample took place to verify difficulties in detecting beta2-transferrin in blood-contaminated settings. Own titrations were performed to evaluate detection limits of CSF by beta2-transferrin and beta-trace protein assays in these settings. RESULTS An incidence of 13% for occult CSF leaks after FESS was found. In blood-contaminated conditions, routine beta2-transferrin assays showed low sensitivity. In over 1 year follow-up, all samples were negative for CSF and none of them developed clinical relevant CSF leaks or meningitis. CONCLUSION Occult and clinically irrelevant CSF leaks do occur in a significant proportion of patients during and shortly after FESS. Intra- and postoperatively, routine beta2-transferrin assays show low sensitivity. They should not be used in these settings. The clinical course of patients with occult CSF leaks indicated possibility of an uneventful follow-up.
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Affiliation(s)
- S Bucher
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - A Kugler
- Department of Otorhinolaryngology Head and Neck Surgery, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - E Probst
- Department of Immunology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - L Epprecht
- Department of Immunology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - R R Stadler
- Department of Immunology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Immunology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Immunology, University of Zurich and University Hospital Zurich, Zurich, Switzerland
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Deggeller MA, Holzmann D, Soyka MB. Prospective evaluation of a nonsurgical device for rhinoplasty. Rhinology 2018; 56:73-81. [PMID: 29150922 DOI: 10.4193/rhin17.133] [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: 11/08/2022]
Abstract
BACKGROUND Rhinoplasty represents one of the most challenging and frequently performed procedures in plastic surgery and non-surgical rhinoplasty is rarely considered. The aim of this study was to investigate whether the Nasella Nose Former (NNF), a newly developed non-surgical rhinoplasty device, could improve objective and subjective results following surgical rhinoplasty and even correct the shape of the nose without any surgery at all. METHODOLOGY In this prospective, monocentric, two-armed, non-blinded randomized, controlled clinical trial, a total of 43 participants were included. In the Surgical group, 22 patients undergoing open or closed rhinoplasty with osteotomies were randomised based on their birth year; 15 of them got to wear the NNF over 8 weeks postoperatively and 7 patients getting surgery without the NNF formed the control group. In the Cosmetic group, 21 participants wore the NNF without surgery over 14 months. At every follow-up exam, angles for crookedness, nasal hump and width were measured, the investigator assessed the patients nose and asked for patient satisfaction using a Likert-scale. RESULTS Patients in the Surgical group wearing the NNF did not show any significant difference concerning objective measurements, investigator assessments and patient satisfaction compared to those not wearing the NNF. In the Cosmetic group, participants did not show objective improvements in measurements and investigator assessment. However, participants were significantly more satisfied after 14 months with their nasal back, nasal axis and outer nose in general. CONCLUSIONS Considering the results of this study, we conclude that this perfectly customised external device to enhance surgical rhinoplasty outcomes or correct the shape of the nose without surgery does not seem to be effective and that further investigations in this field are not meaningful.
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Affiliation(s)
- M A Deggeller
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - D Holzmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
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Diener VN, Gay A, Soyka MB, Attin T, Schmidlin PR, Sahrmann P. What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets. BMC Oral Health 2018; 18:62. [PMID: 29625605 PMCID: PMC5889595 DOI: 10.1186/s12903-018-0521-7] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/20/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND For periodontal treatment, the full mouth disinfection approach suggests disinfection of oral soft tissues, such as tongue and tonsils concomitant to scaling and root planning since patients might benefit from treatment of these oral niches either. Periodontopathogenes in tonsillar tissue support this hypothesis. This prospective controlled clinical study investigated the change in the oral flora of patients who underwent tonsillectomy. Pockets were tested for eleven bacterial species before and six weeks after the surgical intervention. METHODS Fifty generally healthy adults were included in this study. The test group consisted of 25 patients with tonsillectomy. The control group included 25 patients with otorhinolarynologic surgery without involvement of the oral cavity. Clinical parameters such as probing pocket depth, bleeding-on-probing index and plaque index were registered the evening before surgery. Also bacterial samples from the gingival sulcus and dorsum linguae were taken, and an additional sample from the removed tonsils in the test group. Six weeks after the intervention microbial samples of pockets and tongue were taken again. Data were tested for significant differences using Wilcoxon rank and Whitney-u-test. RESULTS No relevant intra- or intergroup differences were found for the change of the eleven investigated species. CONCLUSION Based on the results of the present study, tonsillectomy does not seem to have an immediate relevant effect on the bacterial flora of tongue or periodontium. This study design was approved by the ethical committee of Zurich (KEK-ZH-Nr.2013-0419). TRIAL REGISTRATION The trial was retrospectively registered in the German Clinical Trials Register ( DRK00014077 ) on February 20, 2018.
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Affiliation(s)
- V N Diener
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - A Gay
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Zaleska A, Eiwegger T, Soyer Ö, van de Veen W, Rhyner C, Soyka MB, Bekpen C, Demiröz D, Treis A, Söllner S, Palomares O, Kwok WW, Rose H, Senti G, Kündig TM, Ozoren N, Jutel M, Akdis CA, Crameri R, Akdis M. Immune regulation by intralymphatic immunotherapy with modular allergen translocation MAT vaccine. Allergy 2014; 69:1162-70. [PMID: 24934402 DOI: 10.1111/all.12461] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2014] [Indexed: 01/05/2023]
Abstract
BACKGROUND Allergen-specific immunotherapy (SIT) faces problems related to side effects and limited efficacy. Direct administration of allergen extracts into lymph nodes induces increased specific IgG production and T-cell responses using significantly lower allergen doses. METHODS In this study, mechanisms of immune regulation by MAT vaccines in vitro and in allergen-SIT of cat-allergic rhinitis patients, who received 3 inguinal intra-lymph node injections of MAT-Fel d 1 vaccine, were investigated in PBMC and cell cultures for specific T-cell proliferation, Fel d 1-tetramer-specific responses, and multiple immune regulatory molecules. RESULTS MAT-Fel d 1 vaccine was efficiently internalized by antigen-presenting cells. This was followed by precaspase 1 cleavage to caspase 1 and secretion of IL-1β, indicating inflammasome activation. Mat-Fel d 1 induced specific T-cell proliferation and an IL-10- and IFN-γ-dominated T-cell responses with decreased Th2 cytokines at 100 times lower doses than Fel d 1. Induction of immune tolerance by MAT-Fel d 1-ILIT involved multiple mechanisms of immune suppression. Early Fel d 1-specific T-cell activation was followed by full T-cell unresponsiveness to allergen after 1 year in the MAT-Fel d 1 group, characterized by increased allergen-specific T regulatory cells, decreased circulating Fel d 1 tetramer-positive cells, increased IL-10 and FOXP3 expression, and change in the HR2/HR1 ratio toward HR2. CONCLUSIONS This study demonstrates the induction of allergen tolerance after 3 intra-lymph node injections of MAT-Fel d 1 vaccine, mediated by increased cellular internalization of the allergen, activation of inflammasome, and generation of allergen-specific peripheral T-cell tolerance.
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Affiliation(s)
- A. Zaleska
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department and Clinic of Internal Diseases, Geriatry and Allergology; Wroclaw Medical University; Wroclaw Poland
| | - T. Eiwegger
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Pediatrics; Medical University of Vienna; Vienna Austria
| | - Ö. Soyer
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - W. van de Veen
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - C. Rhyner
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - M. B. Soyka
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - C. Bekpen
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Molecular Biology and Genetics; Center for Life Sciences and Technology Research; Bogazici University; Istanbul Turkey
| | - D. Demiröz
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Molecular Biology and Genetics; Center for Life Sciences and Technology Research; Bogazici University; Istanbul Turkey
| | - A. Treis
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - S. Söllner
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - O. Palomares
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Biochemistry and Molecular Biology; School of Chemistry; Complutense University of Madrid; Madrid Spain
| | - W. W. Kwok
- Benaroya Research Institute at Virginia Mason; Seattle WA USA
| | - H. Rose
- ImVisioN GmbH; Hannover Germany
| | - G. Senti
- Clinical Trials Center; University Hospital Zurich; Zurich Switzerland
| | - T. M. Kündig
- Department of Dermatology; University Hospital Zurich; Zurich Switzerland
| | - N. Ozoren
- Department of Molecular Biology and Genetics; Center for Life Sciences and Technology Research; Bogazici University; Istanbul Turkey
| | - M. Jutel
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
- Department of Clinical Immunology; Wroclaw Medical University; Wroclaw Poland
| | - C. A. Akdis
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - R. Crameri
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
| | - M. Akdis
- Swiss Institute for Allergy and Asthma Research (SIAF); Davos Switzerland
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12
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Soyka MB, Treis A, Eiwegger T, Menz G, Zhang S, Holzmann D, Akdis CA, Meyer N. Regulation and expression of IL-32 in chronic rhinosinusitis. Allergy 2012; 67:790-8. [PMID: 22486709 DOI: 10.1111/j.1398-9995.2012.02820.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Activated T lymphocytes and their interaction with resident tissue cells, particularly epithelium, play important roles in inflammatory processes in chronic rhinosinusitis (CRS). IL-32 is a recently described cytokine, which is expressed in a variety of tissue cells and involved in the pathogenesis of several chronic inflammatory diseases. METHODS Human sinus epithelial cells were isolated from biopsies and stimulated with different cytokines, which play a role in the pathogenesis of CRS. IL-32 mRNA expression was analyzed using real-time-PCR, IL-32 protein was determined by Western blot and flow cytometry as well as immunofluorescent staining in primary sinus epithelial cells and nasal biopsies from patients with CRS and healthy controls. RESULTS IL-32 mRNA was upregulated by TNF-α and IFN-γ in primary sinus epithelial cells, whereas IL-1 β, IL-4, IL-13, and IL-17 did not influence IL-32 expression. IL-32 mRNA expression was significantly higher in human primary sinonasal epithelial cells (HSECs) cocultured with Th1 cells compared with HSECs cocultured with Th0 or Th2 cells. IL-32 mRNA expression was significantly higher in biopsies from sinus epithelial tissue of CRS patients with nasal polyps compared with healthy subjects (P = 0.01). IL-32 was detected in biopsies from patients with CRS, whereas it was scarcely present in control tissues. CONCLUSION The induction of IL-32 by TNF-α, IFN-γ and Th1 cells as well as its increased expression in sinus tissues from CRS patients with nasal polyps demonstrated a potential role for IL-32 in the pathogenesis of CRS.
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Affiliation(s)
| | - A. Treis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos; Switzerland
| | | | - G. Menz
- Hochgebirgsklinik Davos, Davos; Switzerland
| | | | - D. Holzmann
- Department of Otolaryngology Head and Neck Surgery; University Hospital Zurich; Zurich; Switzerland
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos; Switzerland
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13
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Abstract
BACKGROUND Epistaxis represents one of the most common emergencies in ENT clinics around the world. It creates great physical and emotional stress to the patient as well as a financial burden on health-care systems. A lot of research has been performed with regard to aetiology and possible treatment, however, not much effort has been put into analysing the effectiveness of common treatment forms. It is the objective of this study to clarify which of these treatment forms is reliable. STUDY DESIGN Retrospective cohort study. LEVEL OF EVIDENCE 2b. METHODS Between 03/2007 and 04/2008, all epistaxis therapies including relapses and treatment failures at the University Hospital of Zurich have been documented using a computerised questionnaire. Different treatments were compared to each other. RESULTS An analysis of 678 interventions in 537 patients was performed with emphasis on failure proportions and time to occurrence. The estimated failure proportions of coagulation in anterior epistaxis accounts for 14%. Successful treatment of epistaxis in posterior bleedings could be achieved in 62% by packing and in 97% by surgery with a statistically significant difference between the respective groups. CONCLUSION Using our treatment options, anterior epistaxis can be cured reliably by cauterisation. Surgical therapies in posterior bleedings are able to successfully salvage failed packing therapies.
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Affiliation(s)
- M B Soyka
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, Switzerland.
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14
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Haerle SK, Soyka MB, Schmid DT, Ahmad N, Huber GF, Crook DW, Hany TF. Improved treatment outcomes with 18F-FDG PET/CT for patients with advanced head and neck squamous cell carcinoma. Head Neck 2011; 34:1205-11. [DOI: 10.1002/hed.21887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Revised: 05/13/2011] [Accepted: 06/27/2011] [Indexed: 11/11/2022] Open
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15
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Haerle SK, Soyka MB, Fischer DR, Murer K, Strobel K, Huber GF, Holzmann D. The value of 18F-FDG-PET/CT imaging for sinonasal malignant melanoma. Eur Arch Otorhinolaryngol 2011; 269:127-33. [PMID: 21713453 DOI: 10.1007/s00405-011-1664-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Accepted: 05/31/2011] [Indexed: 11/29/2022]
Abstract
The aim this study was to evaluate imaging findings using position emission tomography (PET) in combination with computed tomography (CT) and 18F-fluorodeoxyglucose ((18)F-FDG) in sinonasal malignant melanoma (SNMM) of the head and neck in a retrospective analysis of a consecutive cohort of patients. (18)F-FDG-PET/CT examinations were performed for initial staging and compared with CT or magnetic resonance tomography (MRI), and (18)F-FDG-PET alone. Medical records were reviewed retrospectively with regard to the location and the size of the tumor. Furthermore, locoregional and distant metastases with a consecutive change in therapy detected by (18)F-FDG-PET/CT were assessed. Ten patients suffering from sinonasal malignant melanoma were staged and followed by (18)F-FDG-PET/CT imaging. A total of 34 examinations were obtained. (18)F-FDG-PET/CT depicted all primary tumors adequately. Aside from one cerebral metastasis all regional and distant metastases were truly identified by using this method. In summary, if available, (18)F-FDG-PET/CT is a valuable imaging modality for staging and re-staging sinonasal malignant melanoma to evaluate expansion of the primary tumor, locoregional disease, and distant metastases.
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Affiliation(s)
- S K Haerle
- Department of Otolaryngology-Head and Neck Surgery, University Hospital Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland.
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16
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Soyka MB, Treumann T, Schlegel CT. The Agger Nasi cell and uncinate process, the keys to proper access to the nasolacrimal drainage system. Rhinology 2010; 48:364-7. [PMID: 21038031 DOI: 10.4193/rhino09.136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Profound knowledge of the surgical anatomy is required to perform any dacryo-cysto-rhinostomy (DCR) procedure. In endoscopic endonasal DCR surgery, the uncinate process (UP) and/or agger nasi (AN) cell are frequently found to obstruct access to the lacrimal fossa. The aim of this study was to analyse the radiological anatomy of the UP and the AN cell in relation to the lacrimal sac. METHODS Preoperative computed tomography (CT) scans of patients undergoing DCR and other endoscopic sinus surgeries were analysed regarding their anatomical variations concerning the UP and the AN cell at the level of the common canaliculus. The covering of the lacrimal fossa by the UP was graded and a surgically relevant AN cell was sought after. RESULTS CT datasets of 60 sides were included. Analysis showed an AN cell overlying the upper parts of the lacrimal sac in 55% of patients. An anteriorly attaching UP covering at least 50% of the lacrimal fossa was found in 63% of individuals. CONCLUSION In this study more than 80% of all patients presented with either a very anteriorly attached UP or an AN cell that would have to be removed to perform effective endoscopic DCR. The AN cell and the UP need to be included in the endonasal surgical concept.
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Affiliation(s)
- M B Soyka
- Department Otolaryngology Head and Neck Surgery, Luzerner Kantonsspital, Lucerne, Swtizerland.
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