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Manole F, Bayar Muluk N, Oğuz O, Ulusoy S, Scadding GK, Prokopakis E, Kalogjera L, Rombaux P, Cingi C. Local allergic rhinitis - a narrative review. Eur Rev Med Pharmacol Sci 2024; 28:1077-1088. [PMID: 38375713 DOI: 10.26355/eurrev_202402_35344] [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: 02/21/2024]
Abstract
This narrative review aims to provide an up-to-date definition of local allergic rhinitis (LAR), its classification, mechanisms, comorbidities, recommendations for diagnosis and treatment, and define needs in this area. Both 'PubMed' and 'Science Direct' literature was reviewed systematically, and a manual search for studies not previously encountered in the databases was also carried out. Published studies were identified in PubMed covering the period from 1947 to 2022. The following keyword search strategy was used: (local allergic rhinitis* OR entopy* OR local Immunoglobulin E * OR nasal specific Immunoglobulin E). LAR involves Type 2 nasal inflammation with local IgE and cannot be diagnosed by systemic methods, such as skin prick or blood IgE tests. A nasal allergen challenge is necessary for diagnosis. LAR can respond to usual AR treatments, including allergen specific immunotherapy (AIT). LAR is a novel entity that requires additional investigation in terms of prevalence, proper diagnosis, treatment, and prognosis. The target outcomes and possible benefits of this review are to achieve a consensus for the study and diagnosis of LAR and increase interest in this area.
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Affiliation(s)
- F Manole
- Department of ENT, Faculty of Medicine, University of Oradea, Oradea, Romania.
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2
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Ulusoy S, Bayar Muluk N, Scadding GK, Passali GS, Dilber M, Gevaert P, Passali D, Resuli AS, Van Gerven L, Kalogjera L, Prokopakis E, Rombaux P, Hellings P, Cingi C. The intranasal trigeminal system: roles in rhinitis (allergic and non-allergic). Eur Rev Med Pharmacol Sci 2022; 26:25-37. [PMID: 36524908 DOI: 10.26355/eurrev_202212_30479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this paper is to review intranasal trigeminal system and associated reflexes. The literature survey was performed on PubMed, ProQuest Central database of Kirikkale University and Google Scholar. The intranasal trigeminal system and associated reflexes play an important role in humans in both health and disease, including in rhinitis of non-allergic and mixed type. The intranasal trigeminal nerve provides sensory perception to the lining of the nose, supplying information on how patent the nasal airway is and responding to various chemical signals. The reflexes known to exist within the intranasal trigeminal system are nasobronchial reflex, trigemino-cardiac reflex, nasogastric reflex, and nasal cycle. The intranasal trigeminal system and its reflexes play a vital role in normal human physiology. Alterations in how this system operates may underlie multiple forms of rhinitis and more research is needed to fully understand the mechanisms involved.
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Affiliation(s)
- S Ulusoy
- Department of Otorhinolaryngology, Medical Faculty, Halic University, Istanbul, Turkey.
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Huart C, Philpott C, Konstantinidis I, Altundag A, Whitcroft KL, Trecca EMC, Cassano M, Rombaux P, Hummel T. Comparison of COVID-19 and common cold chemosensory dysfunction. Rhinology 2020; 58:623-625. [PMID: 32812014 DOI: 10.4193/rhin20.251] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anosmia constitutes a prominent symptom of COVID-19. However, anosmia is also a common symptom of acute colds of various origins. In contrast to an acute cold, it appears from several questionnaire-based studies that in the context of COVID-19 infection, anosmia is the main rhinological symptom and is usually not associated with other rhinological symptoms such as rhinorrhoea or nasal obstruction. Until now, no study has directly compared smell and taste function between COVID-19 patients and patients with other causes of upper respiratory tract infection (URTI) using valid and reliable psychophysical tests. In this study, we aimed to objectively assess and compare olfactory and gustatory functions in 10 COVID-19 patients (PCR diagnosed, assessed on average 2 weeks after infection), 10 acute cold (AC) patients (assessed before the COVID-19 outbreak) and 10 healthy controls, matched for age and sex. Smell performance was assessed using the extended "Sniffin' Sticks" test battery (4), while taste function was assessed using "taste strips" (5). Receiver Operating Characteristic (ROC) curves were built to probe olfactory and gustatory scores in terms of their discrimination between COVID-19 and AC patients. Our results suggest that mechanisms of COVID-19 related olfactory dysfunction are different from those seen in an AC and may reflect, at least to some extent, a specific involvement at the level of central nervous system in some COVID-19 patients. In the future, studies to assess the prevalence of persistent anosmia and neuroanatomical changes on MRI correlated to chemosensory function, will be useful to understand these mechanisms.
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Affiliation(s)
- C Huart
- Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C Philpott
- The Norfolk Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - I Konstantinidis
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - A Altundag
- Department of Otorhinolaryngology, Acibadem Taksim Hospital, Istanbul, Turkey
| | - K L Whitcroft
- UCL Ear Institute, University College London, London, UK
| | - E M C Trecca
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - M Cassano
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - Ph Rombaux
- Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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4
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Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, Toppila-Salmi S, Bernal-Sprekelsen M, Mullol J, Alobid I, Terezinha Anselmo-Lima W, Bachert C, Baroody F, von Buchwald C, Cervin A, Cohen N, Constantinidis J, De Gabory L, Desrosiers M, Diamant Z, Douglas RG, Gevaert PH, Hafner A, Harvey RJ, Joos GF, Kalogjera L, Knill A, Kocks JH, Landis BN, Limpens J, Lebeer S, Lourenco O, Meco C, Matricardi PM, O'Mahony L, Philpott CM, Ryan D, Schlosser R, Senior B, Smith TL, Teeling T, Tomazic PV, Wang DY, Wang D, Zhang L, Agius AM, Ahlstrom-Emanuelsson C, Alabri R, Albu S, Alhabash S, Aleksic A, Aloulah M, Al-Qudah M, Alsaleh S, Baban MA, Baudoin T, Balvers T, Battaglia P, Bedoya JD, Beule A, Bofares KM, Braverman I, Brozek-Madry E, Richard B, Callejas C, Carrie S, Caulley L, Chussi D, de Corso E, Coste A, El Hadi U, Elfarouk A, Eloy PH, Farrokhi S, Felisati G, Ferrari MD, Fishchuk R, Grayson W, Goncalves PM, Grdinic B, Grgic V, Hamizan AW, Heinichen JV, Husain S, Ping TI, Ivaska J, Jakimovska F, Jovancevic L, Kakande E, Kamel R, Karpischenko S, Kariyawasam HH, Kawauchi H, Kjeldsen A, Klimek L, Krzeski A, Kopacheva Barsova G, Kim SW, Lal D, Letort JJ, Lopatin A, Mahdjoubi A, Mesbahi A, Netkovski J, Nyenbue Tshipukane D, Obando-Valverde A, Okano M, Onerci M, Ong YK, Orlandi R, Otori N, Ouennoughy K, Ozkan M, Peric A, Plzak J, Prokopakis E, Prepageran N, Psaltis A, Pugin B, Raftopulos M, Rombaux P, Riechelmann H, Sahtout S, Sarafoleanu CC, Searyoh K, Rhee CS, Shi J, Shkoukani M, Shukuryan AK, Sicak M, Smyth D, Sindvongs K, Soklic Kosak T, Stjarne P, Sutikno B, Steinsvag S, Tantilipikorn P, Thanaviratananich S, Tran T, Urbancic J, Valiulius A, Vasquez de Aparicio C, Vicheva D, Virkkula PM, Vicente G, Voegels R, Wagenmann MM, Wardani RS, Welge-Lussen A, Witterick I, Wright E, Zabolotniy D, Zsolt B, Zwetsloot CP. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 2020; 58:1-464. [PMID: 32077450 DOI: 10.4193/rhin20.600] [Citation(s) in RCA: 537] [Impact Index Per Article: 134.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.
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Affiliation(s)
- W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - P W Hellings
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, KU Leuven, Belgium.,Upper Airways Research Laboratory and ENT Department, University Hospital Ghent, Ghent, Belgium
| | - R Kern
- Department of Otorhinolaryngology - Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | | | - I Alobid
- Rhinology and Skull Base Unit, ENT Department, Hospital Clinic de Barcelona, Universidad de Barcelona, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - W Terezinha Anselmo-Lima
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Sao Paulo, Brazil
| | - C Bachert
- Upper Airways Research Laboratory and ENT Department, University Hospital Ghent, Ghent, Belgium.,Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden
| | - F Baroody
- Department of Otorhinolaryngology-Head and Neck Surgery, The University of Chicago Medicine and the Comer Children's Hospital, Chicago, IL, USA
| | - C von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Hospital, Copenhagen, Denmark
| | - A Cervin
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Brisbane and Women's Hospital.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - N Cohen
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L De Gabory
- Rhinology and Plastic Surgery Unit, Otorhinolaryngology, Head and Neck Surgery and Pediatric ENT Department, CHU de Bordeaux, Hospital Pellegrin, Centre F-X Michelet, Bordeaux, France
| | - M Desrosiers
- Department of ORL-HNS, Universite de Montreal, Montreal, Canada
| | - Z Diamant
- Dept of Respiratory Medicine and Allergology, Skane University in Lund, Sweden.,Research Director Respiratory and Allergy, at QPS-Netherlands, Groningen, Netherlands.,Affiliate to Charles University, Dept of Respiratory Diseases, in Prague, Czech Republic
| | - R G Douglas
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - P H Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - A Hafner
- University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - R J Harvey
- Rhinology and Skull Base Department, Applied Medical Research Centre, UNSW (Conjoint) and Macquarie University (Clinical), Sydney, Australia
| | - G F Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - L Kalogjera
- ENT Department, Zagreb School of Medicine.,University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| | - A Knill
- Patient representative, Opuscomms, London, UK
| | - J H Kocks
- Department of Inhalation Medicine, Observational Pragmatic Research Institute, Singapore
| | - B N Landis
- Rhinology-Olfactology Unit, Otorhinolaryngology Department, University Hospital of Geneva, Geneva, Switzerland
| | - J Limpens
- Medical Information Specialist, Medical Library, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Lebeer
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - O Lourenco
- FCS - UBI Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal
| | - C Meco
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, Turkey.,Department of Otorhinolaryngology, Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - P M Matricardi
- Department of Pediatric Pneumology and Immunology, Charite - Universitatsmedizin Berlin, Berlin, Germany
| | - L O'Mahony
- Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
| | - C M Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK.,ENT Department, James Paget University Hospital, Great Yarmouth, UK
| | - D Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Optimum Patient Care, Cambridgeshire, UK
| | - R Schlosser
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, USA
| | - B Senior
- UNC Otorhinolaryngology / Head and Neck Surgery, Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery and Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - T L Smith
- Division of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - T Teeling
- Patient representative, Task Force Healthcare, WTC Den Haag, The Netherlands
| | - P V Tomazic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - D Y Wang
- Department of Otorhinolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - D Wang
- Rhinology Division, ENT Department.,Eye and ENT Hospital, Fudan University, Shanghai, China
| | - L Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, China
| | - A M Agius
- Department of Medicine and Surgery in the University of Malta
| | | | - R Alabri
- ENT Division, Surgery Department, College of Medicine and Health and Sciences, Sultan Qaboos University, Muscat, Oman
| | - S Albu
- Department of Otorhinolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - A Aleksic
- ENT Department, University Clinical Centre, University of Banja Luka, Bosnia and Herzegovina
| | - M Aloulah
- ENT Department, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - M Al-Qudah
- Department of Otorhinolaryngology, Jordan University of Science and Technology, Irbid, Jordan
| | - S Alsaleh
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - M A Baban
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Sulaimani, Sulaimayniha, Iraq
| | - T Baudoin
- Dept. of ORL-HNS Sisters of Mercy University Medical Center, School of Medicine University of Zagreb, Croatia
| | - T Balvers
- Department of Neurology, Leiden University Medical Center (LUMC)
| | - P Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - J D Bedoya
- Department of Otorhinolaryngology, Universidad de Antioquia, Medellin, Colombia
| | - A Beule
- Department of Otorhinolaryngology, University Clinic of Munster, Germany
| | - K M Bofares
- Department of Otorhinolaryngology, Omar Al-Moukhtar University, Albyeda, Libya
| | - I Braverman
- Department of Otorhinolaryngology - Head and Neck Surgery, Hillel Yaffe Medical Center, Israel
| | - E Brozek-Madry
- Department of Otorhinolaryngology, Medical University of Warsaw, Poland
| | - B Richard
- Department of ENT, Makerere University, Kampala, Uganda
| | - C Callejas
- Department of Otorhinolaryngology, Pontificia Catholic University, Santiago, Chile
| | - S Carrie
- Department of Otorhinolaryngology, Head and Neck Surgery, Newcastle University, United Kingdom
| | - L Caulley
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, Canada
| | - D Chussi
- Department of Otorhinolaryngology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - E de Corso
- Department of Otorhinolaryngology , La Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - A Coste
- ORL et Chirurgie Cervico-Faciale, Universite Paris-Est Creteil (UPEC), France
| | - U El Hadi
- Department of Otorhinolaryngology, American University of Beirut, Lebanon
| | - A Elfarouk
- Department of Otorhinolaryngology, Cairo University, Egypt
| | - P H Eloy
- Department of ENT, CHU UCL Namur, Yvoir, Belgium
| | - S Farrokhi
- Department of Immunology and Allergy, The Persian Gulf Tropical Medicine Research Center.,The Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - G Felisati
- Department of Head and Neck, University of Milan, Italy
| | - M D Ferrari
- Department of Neurology, Leiden University Medical Center (LUMC)
| | - R Fishchuk
- Department of ENT- Organs Microsurgery, Central city clinical hospital of lvano-Frankivsk city council, Ivano-Frankivsk, Ukraine
| | - W Grayson
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Alabama Birmingham, USA
| | - P M Goncalves
- ENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - B Grdinic
- ENT Department, General Hospital, Pula, Pula, Croatia
| | - V Grgic
- ENT Department, Zagreb School of Medicine.,University Hospital center 'Sestre milosrdnice', Zagreb, Croatia
| | - A W Hamizan
- Department of Otorhinolaryngology, University Kebangsaan, Kuala Lumpur, Malasyia
| | - J V Heinichen
- Department of ENT of Hospital de Clinicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, Paraguay
| | - S Husain
- Department of Otorhinolaryngology, Head and Neck Surgery, National University of Malaysia, Kuala Lumpur, Malaysia
| | - T I Ping
- Department ORLHNS, University Malaysia Sarawak, Kuching, Malaysia
| | - J Ivaska
- Clinic of Ear, Nose, Throat and Eye diseases, Vilnius University, Lithuania
| | - F Jakimovska
- ENT Department of Medical Faculty, St Cyril and Methodius University of Skopje, North Macedonia
| | - L Jovancevic
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - E Kakande
- Department of ENT Surgery, Mulago National Referral Hospital Kampala, Uganda
| | - R Kamel
- Department of Otorhinolaryngology, Head and Neck Surgery, Cairo University, Egypt
| | - S Karpischenko
- ENT Department, Director of Saint Petersburg Research Institute of Ear, Throat , Nose and Speech.,Professor and Chairman of First Pavlov State Medical University, Saint Petersburg, Russia
| | - H H Kariyawasam
- Department of Allergy and Clinical Immunology, Royal National ENT Hospital, London, England
| | - H Kawauchi
- 96. Department of Otorhinolaryngology, Shimane University, Matsue, Shimane, Japan
| | - A Kjeldsen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Southern Denmark, Odense, Denmark
| | - L Klimek
- Center of Rhinology and Allergology, Wiesbaden, Hesse, Germany
| | - A Krzeski
- Department of Otorhinolaryngology, Warsaw Medical University, Warsaw, Poland
| | - G Kopacheva Barsova
- Department of Otorhinolaryngology, University If Medicine, st. Ciril and Methodius, Skopje
| | - S W Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, Kyung Hee University, Seoul, South Korea
| | - D Lal
- Department of Otorhinolaryngology, Head and Neck Surgery, Mayo Clinic in Arizona, Phoenix, Arizona, USA
| | - J J Letort
- Department of Otorhinolaryngology, Pontifica Catholic University of Ecuador, Quito, Ecuador
| | - A Lopatin
- Department of Otorhinolaryngology, Policlinic No.1- Senior ENT Consultant and Surgeon.,President of Russian Rhinologic Society, Moscow, Russia
| | | | - A Mesbahi
- Department of Facial Surgery, Khodadoust Hospital, Ordibehesht Hospital, Shiraz, Iran
| | - J Netkovski
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Cyril and Methodius, Skopje, Republic of North Macedonia
| | - D Nyenbue Tshipukane
- Department of Otorhinolaryngology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - A Obando-Valverde
- Department of Otorhinolaryngology and Surgery, Hospital Mexico, University of Costa Rica, San Jose, Costa Rica
| | - M Okano
- Department of Otorhinolaryngology, International University of Health and Welfare, Narita , Japan
| | - M Onerci
- Department of Otorhinolaryngology, Hacettepe, Ankara, Turkey
| | - Y K Ong
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Singapore, National University Hospital, Singapore
| | - R Orlandi
- Department of Otorhinolaryngology, University of Utah, Salt Lake City, Utah, USA
| | - N Otori
- Department of Otorhinolaryngology at The Jikei University School of Medicine,Tokyo, Japan
| | - K Ouennoughy
- Department of Otorhinolaryngology-Head and Neck Surgery, Saad Dahleb Blida 1, Blida, Algeria
| | - M Ozkan
- Department of Otorhinolaryngology, University of Health Sciences, Ankara City Hospital, Turkey
| | - A Peric
- Department of Otorhinolaryngology, Military Medical Academy, Faculty of Medicine, University of Defense, Belgrade, Serbia
| | - J Plzak
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - N Prepageran
- Department of ENT, University Malaya, Kuala Lumpur, Malaysia
| | - A Psaltis
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - B Pugin
- Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - M Raftopulos
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.,Royal Australian College of Surgeons, Trainee Representative (Australia)
| | - P Rombaux
- Department of Otorhinolaryngology, University of Louvain, Brussels, Belgium
| | - H Riechelmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ulm, Baden-Wurttemberg, Germany
| | - S Sahtout
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - C-C Sarafoleanu
- ENT and H NS Department, Santa Maria Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - K Searyoh
- Surgery Ear, Nose and Throat Unit, School of Medicine and Dentistry, University of Ghana, Korle-Bu Teaching Hospital, Accra, Ghana
| | - C-S Rhee
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul, Seoul National University, Seoul, Korea
| | - J Shi
- Department of Rhinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - M Shkoukani
- Department of Otorhinolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - A K Shukuryan
- Department of Otorhinolaryngology, Yerevan State Medical University, Yerevan, Armenia
| | - M Sicak
- Department of Otorhinolaryngology, Head and Neck Surgery, Central Military Hospital, Slovakia, Slovak Health University Bratislava and Catholic University, Ruzom berok, Slovakia
| | - D Smyth
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal College of Surgeons in Ireland and University College Cork, Waterford, Ireland
| | - K Sindvongs
- Department of Otorhinolaryngology, Chulalongkorn University, Bangkok, Thailand
| | - T Soklic Kosak
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - P Stjarne
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - B Sutikno
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Airlangga, Surabaya, Indonesia
| | - S Steinsvag
- Department of ORL, University of Bergen, Norway
| | - P Tantilipikorn
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Thanaviratananich
- Department of Otorhinolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - T Tran
- Department of ENT Hospital of Ho Chi Minh city, Faculty of medicine of Ho Chi Minh city Vietnam National University, Vietnam
| | - J Urbancic
- Department of Otorhinolaryngology and cervicofacial surgery, UMC Ljubljana, University of Ljubljana, Medical Faculty, Ljubljana, Slovenia
| | - A Valiulius
- Department of Children's diseases, Vilnius University Medical Faculty, Institute of Clinical Medicine, Vilnius, Lithuania
| | - C Vasquez de Aparicio
- Department of Paediatric Surgery, National Hospital Benjamin Bloom, National University of El Salvador, San Salvador, El Salvador
| | - D Vicheva
- Department of Otorhinolaryngology, Medical University Plovdiv, Bulgaria
| | - P M Virkkula
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki, University Hospital, Helsinki, Finland
| | - G Vicente
- Department of Otolaryngology, St. Luke's Medical Centre, Quezon City, The Philippines
| | - R Voegels
- Department of Otorhinolaryngology, University of Sao Paulo, Sau Paulo, Brazil
| | - M M Wagenmann
- Department of Otorhinolaryngology, Dusseldorf University Hospital, Dusseldorf, German
| | - R S Wardani
- Department of Otorhinolaryngology Head and Neck Surgery, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | - A Welge-Lussen
- Department of Otorhinolaryngology, University Hospital Basel, University Basel, Switzerland
| | - I Witterick
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, Canada
| | - E Wright
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - D Zabolotniy
- State Institution of O.S. Kolomiychenko Institute of Othorhnilarungology of National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | - B Zsolt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
| | - C P Zwetsloot
- Department of Neurology, Dijklander Ziekenhuis, Purmerend, The Netherlandsn
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Huart C, Hummel T, Kaehling C, Konstantinidis I, Hox V, Mouraux A, Rombaux P. Development of a new psychophysical method to assess intranasal trigeminal chemosensory function. Rhinology 2019; 57:375-384. [PMID: 31576819 DOI: 10.4193/rhin19.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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 The aim of this study was to develop a new psychophysical test to assess intranasal trigeminal chemosensory function. METHODOLOGY The test is similar to the Sniffin’ Sticks test, but using pens impregnated with substances preferentially activating trigeminal afferents. Our test comprises detection threshold, discrimination, identification and lateralization tasks. In a first study, we evaluated healthy controls. In a second study, we evaluated the potential usefulness of this test in patients with rhinological conditions. RESULTS Study 1: 86 controls were included. Threshold, identification and lateralization performance decreased with age. Test-retest reliability was similar to that of olfactory tests. Study 2: results of the controls group were compared to those of 59 patients (14 allergic rhinitis, 11 chronic rhinosinusitis with nasal polyps (CRSwNP), 9 without nasal polyps (CRSsNP), and 25 with an olfactory disorder (OD)). Controls had 1) lower detection thresholds compared to CRSwNP, CRSsNP and OD, 2) better discrimination and identification scores compared to OD, and 3) better lateralization scores compared to CRSwNP and CRSsNP. CONCLUSIONS Our test allows to identify age-related changes in trigeminal chemosensory function. Trigeminal function seems to be differently affected in different pathologies. Further studies are necessary to validate our results and evaluate the impact of olfactory co-activation on the observed results.
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Affiliation(s)
- C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Institute of Neuroscience, Universite catholique de Louvain, Brussels, Belgium
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - C Kaehling
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - I Konstantinidis
- Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Hox
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - A Mouraux
- Institute of Neuroscience, Universite catholique de Louvain, Brussels, Belgium
| | - P Rombaux
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium; Institute of Neuroscience, Universite catholique de Louvain, Brussels, Belgium
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Hellings PW, Pugin B, Mariën G, Bachert C, Breynaert C, Bullens DM, Ceuppens JL, Clement G, Cox T, Ebo D, Gevaert P, Halewyck S, Hox V, Ladha K, Jacobs R, Rombaux P, Schrijvers R, Speleman K, Van der Brempt X, Van Gerven L, Vanderveken O, Verhaeghe B, Vierstraete K, Vlaminck S, Watelet JB, Bousquet J, Seys SF. Stepwise approach towards adoption of allergen immunotherapy for allergic rhinitis and asthma patients in daily practice in Belgium: a BelSACI-Abeforcal-EUFOREA statement. Clin Transl Allergy 2019; 9:1. [PMID: 30740211 PMCID: PMC6360767 DOI: 10.1186/s13601-019-0243-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/04/2019] [Indexed: 12/21/2022] Open
Abstract
Allergic rhinitis (AR) affects 23–30% of the European population with equal prevalence reported in Belgium. Despite guidelines on the correct use of effective treatment, up to 40% of AR patients remain uncontrolled. Allergen immunotherapy (AIT) has been shown to improve the level of control up to 84% of patients being controlled by AIT. Recently, new guidelines for AIT have been published, supporting the clinical evidence for effectiveness of various subcutaneous and sublingual products for AIT in patients who are allergic to airborne allergens. AIT in AR patients not only reduces nasal and/or ocular symptoms but also induces tolerance and has preventive potential. Adoption of AIT into daily clinical practice in Belgium and other European countries is hampered primarily by reimbursement issues of each of the single products but also by several patient- and physician-related factors. Patients need to be better informed about the effectiveness of AIT and the different routes of administration of AIT. Physicians dealing with AR patients should inform patients on tolerance-inducing effects of AIT and are in the need of a harmonized and practical guide that supports them in selecting eligible patients for AIT, in choosing evidence-based AIT products and in following treatment protocols with proven efficacy. Therefore, a stepwise and holistic approach is needed for better adoption of AIT in the real-life setting in Belgium.
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Affiliation(s)
- P W Hellings
- 1ENT Clinical Department, University Hospital Leuven, Kapucijnenvoer 33, 3000 Louvain, Belgium.,2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - B Pugin
- 2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium.,European Forum for Research and Education in Allergy and Airway Diseases, Brussels, Belgium
| | - G Mariën
- European Forum for Research and Education in Allergy and Airway Diseases, Brussels, Belgium
| | - C Bachert
- 4ENT Clinical Department, University Hospital Ghent, Ghent, Belgium.,5Upper Airways Research Laboratory, University of Ghent, Ghent, Belgium
| | - C Breynaert
- 2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium.,6Internal Medicine Clinical Department, UZ Leuven, Louvain, Belgium
| | - D M Bullens
- 7Pediatrics Clinical Department, UZ Leuven, Louvain, Belgium
| | - J L Ceuppens
- 2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium.,6Internal Medicine Clinical Department, UZ Leuven, Louvain, Belgium
| | - G Clement
- 8ENT Clinical Department, AZ Damiaan, Ostend, Belgium
| | - T Cox
- 9ENT Clinical Department, Jessa Hospital, Hasselt, Belgium
| | - D Ebo
- 10Immunology-Allergology-Rheumatology, University Hospital Antwerp, Antwerp, Belgium
| | - P Gevaert
- 4ENT Clinical Department, University Hospital Ghent, Ghent, Belgium.,5Upper Airways Research Laboratory, University of Ghent, Ghent, Belgium
| | - S Halewyck
- 11ENT Clinical Department, UZ Brussel, Brussels, Belgium.,ENT Clinical Department, ASZ Aalst, Aalst, Belgium
| | - V Hox
- 13ENT Clinical Department, Clinique Universitaires Saint-Luc, Brussels, Belgium
| | - K Ladha
- 14Pediatrics Clinical Department, CHU Charleroi, Charleroi, Belgium
| | - R Jacobs
- 15ENT Clinical Department, AZ Sint-Blasius, Dendermonde, Belgium
| | - P Rombaux
- 13ENT Clinical Department, Clinique Universitaires Saint-Luc, Brussels, Belgium
| | - R Schrijvers
- 2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium.,6Internal Medicine Clinical Department, UZ Leuven, Louvain, Belgium
| | - K Speleman
- 16ENT Clinical Department, AZ Sint-Jan, Brugge, Belgium
| | | | - L Van Gerven
- 1ENT Clinical Department, University Hospital Leuven, Kapucijnenvoer 33, 3000 Louvain, Belgium
| | - O Vanderveken
- 18ENT Clinical Department, University Hospital Antwerp, Antwerp, Belgium
| | - B Verhaeghe
- ENT Clinical Department, St-Andries ziekenhuis, Tielt, Belgium
| | - K Vierstraete
- 20ENT Clinical Department, AZ Groeninge, Kortrijk, Belgium
| | - S Vlaminck
- 21ENT Clinical Department, AZ Delta Roeselare, Roeselare, Belgium
| | - J-B Watelet
- 4ENT Clinical Department, University Hospital Ghent, Ghent, Belgium
| | - J Bousquet
- 22Department of Respiratory Disease, University Hospital Arnaud de Villeneuve, Montpellier, France
| | - S F Seys
- 1ENT Clinical Department, University Hospital Leuven, Kapucijnenvoer 33, 3000 Louvain, Belgium.,2Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
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7
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Huart C, Rombaux P, Hummel T. Neural plasticity in developing and adult olfactory pathways – focus on the human olfactory bulb. J Bioenerg Biomembr 2019; 51:77-87. [DOI: 10.1007/s10863-018-9780-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/23/2018] [Indexed: 01/18/2023]
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8
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Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehne A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology 2018. [PMID: 29528615 DOI: 10.4193/rhino16.248] [Citation(s) in RCA: 373] [Impact Index Per Article: 62.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major
health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following:
• Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy
with small diameter endoscopes.
• Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability.
• Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour
threshold, and/or one of odour identification or discrimination.
• Comprehensive chemosensory assessment should include gustatory screening.
• Smell training can be helpful in patients with olfactory loss of several aetiologies. Conclusions We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.
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9
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Hellings PW, Akdis CA, Bachert C, Bousquet J, Pugin B, Adriaensen G, Advani R, Agache I, Anjo C, Anmolsingh R, Annoni E, Bieber T, Bizaki A, Braverman I, Callebaut I, Castillo Vizuete JA, Chalermwatanachai T, Chmielewski R, Cingi C, Cools L, Coppije C, Cornet ME, De Boeck I, De Corso E, De Greve G, Doulaptsi M, Edmiston R, Erskine S, Gevaert E, Gevaert P, Golebski K, Hopkins C, Hox V, Jaeggi C, Joos G, Khwaja S, Kjeldsen A, Klimek L, Koennecke M, Kortekaas Krohn I, Krysko O, Kumar BN, Langdon C, Lange B, Lekakis G, Levie P, Lourijsen E, Lund VJ, Martens K, Mő Sges R, Mullol J, Nyembue TD, Palkonen S, Philpott C, Pimentel J, Poirrier A, Pratas AC, Prokopakis E, Pujols L, Rombaux P, Schmidt-Weber C, Segboer C, Spacova I, Staikuniene J, Steelant B, Steinsvik EA, Teufelberger A, Van Gerven L, Van Gool K, Verbrugge R, Verhaeghe B, Virkkula P, Vlaminck S, Vries-Uss E, Wagenmann M, Zuberbier T, Seys SF, Fokkens WJ. EUFOREA Rhinology Research Forum 2016: report of the brainstorming sessions on needs and priorities in rhinitis and rhinosinusitis. Rhinology 2017; 55:202-210. [PMID: 28501885 DOI: 10.4193/rhin17.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.
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Affiliation(s)
- P W Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Christine-Kuhne Center for Allergy Research and Education, Davos, Switzerland
| | - C Bachert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - J Bousquet
- Department of Respiratory Disease, University Hospital Arnaud de Villeneuve, Montpellier, France
| | - B Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - G Adriaensen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - R Advani
- Health Education North West, Manchester, UK
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - C Anjo
- Department of Otorhinolaryngology, Hospital Sao Jose, Hospital Centre of Central Lisbon, Lisbon, Portugal
| | - R Anmolsingh
- Department of Otorhinolaryngology, Wigan Wrightington and Leigh NHS Foundation Trust, Wigan, UK
| | | | - T Bieber
- Department of Dermatology and Allergy, Christine Kuhne-Center for Allergy Research and Education, Friedrich-Wilhelms-University, Bonn, Germany
| | | | - I Braverman
- Hillel Yaffe Medical Center, Hadera Technion Faculty of Medicine, Haifa, Israel
| | - I Callebaut
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | | | - T Chalermwatanachai
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - R Chmielewski
- Department of Otolaryngology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - C Cingi
- Department of Otolaryngology, Head and Neck Surgery, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - L Cools
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - C Coppije
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - M E Cornet
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I De Boeck
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - E De Corso
- Agostino Gemelli Hospital Foundation, Catholic University of the Sacred Heart, Head and Neck Surgery Area, Institute of Otorhinolaryngology, Rome, Italy
| | - G De Greve
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - M Doulaptsi
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - R Edmiston
- Health Education North West, Manchester, UK
| | - S Erskine
- Norwich Medical School, University of East Anglia, UK
| | - E Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - P Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - K Golebski
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - C Hopkins
- ENT Departments, Guys and St Thomas Hospitals NHS Trust, London and James Paget University Hospital, Gorieston, United Kingdom
| | - V Hox
- Departement Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - C Jaeggi
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - G Joos
- Department of Respiratory Medicine, Ghent University, Belgium
| | - S Khwaja
- Department of Otolaryngology, University Hospital of South Manchester, Manchester, UK
| | - A Kjeldsen
- Department Of Otorhinolaryngology, Odense University Hospital, Denmark
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - M Koennecke
- University Hospital Schleswig-Holstein, Campus Lubeck, Department of Otorhinolaryngology, Lubeck, Germany
| | | | - O Krysko
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - B N Kumar
- Department of Otolaryngology-Head and Neck, WWL NHS Foundation Trust and NIHR CRN, Greater Manchester, UK
| | - C Langdon
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Clinical and Experimental Respiratory Immunology, IDIBAPS, Barcelona, Spain
| | - B Lange
- Department of Otolaryngology, University Hospital of South Manchester, Manchester, UK
| | - G Lekakis
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - P Levie
- ENT Clinic Messidor, Brussels, Belgium
| | - E Lourijsen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals, London, United Kingdom
| | - K Martens
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - R Mő Sges
- Faculty of Medicine, Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - J Mullol
- Clinical and Experimental Respiratory Allergy, IDIBAPS, CIBERES. Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - T D Nyembue
- Department of OtoRhinoLaryngology, University of Kinshasa, Congo
| | - S Palkonen
- European Federation of Allergy and Airways Diseases Patients Associations (EFA), Brussels, Belgium
| | - C Philpott
- Norwich Medical School, University of East Anglia, UK
| | - J Pimentel
- Hospital de Egas Moniz and Hospital da Luz, Lisbon, Portugal
| | - A Poirrier
- ENT department, University Hospital of Liege, Belgium
| | - A C Pratas
- Norwich Medical School, University of East Anglia, UK
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Greece
| | - L Pujols
- Clinical and Experimental Respiratory Allergy, IDIBAPS, CIBERES. Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - P Rombaux
- Departement d Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - C Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
| | - C Segboer
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I Spacova
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - J Staikuniene
- Lithuanian Universitys of health sciences, Department of Immunology and allergology, Kaunas, Lithuania
| | - B Steelant
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - E A Steinsvik
- Department of Otorhinolaryngology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Teufelberger
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - L Van Gerven
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | | | | | - B Verhaeghe
- Department of Otorhinolaryngology, Sint-Jozefskliniek, Izegem, Belgium
| | - P Virkkula
- Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - S Vlaminck
- Department of Otorhinolaryngology, AZ St. Johns Hospital, Bruges, Belgium
| | | | - M Wagenmann
- Department of Otorhinolaryngology, University Hospital Dusseldorf, Dusseldorf, Germany
| | - T Zuberbier
- Comprehensive Allergy-Centre-Charite, Department of Dermatology and Allergy, Charite-Universitatsmedizin Berlin, Germany
| | - S F Seys
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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10
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Cingi C, Gevaert P, Mösges R, Rondon C, Hox V, Rudenko M, Muluk NB, Scadding G, Manole F, Hupin C, Fokkens WJ, Akdis C, Bachert C, Demoly P, Mullol J, Muraro A, Papadopoulos N, Pawankar R, Rombaux P, Toskala E, Kalogjera L, Prokopakis E, Hellings PW, Bousquet J. Multi-morbidities of allergic rhinitis in adults: European Academy of Allergy and Clinical Immunology Task Force Report. Clin Transl Allergy 2017; 7:17. [PMID: 28572918 PMCID: PMC5452333 DOI: 10.1186/s13601-017-0153-z] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 05/12/2017] [Indexed: 12/14/2022] Open
Abstract
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects. This report provides up-to-date usable information to: (1) improve the knowledge and skills of allergists, so as to ultimately improve the overall quality of patient care; (2) to increase interest in this area; and (3) to present a unique contribution to the field of upper inflammatory disease.
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Affiliation(s)
- C Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University School of Medicine, Eskisehir, Turkey
| | - P Gevaert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - R Mösges
- Institute of Medical Statistics, Informatics, and Epidemiology, Medical Faculty, University of Köln, Cologne, Germany
| | - C Rondon
- Allergy Unit, IBIMA, Regional University Hospital of Malaga, UMA, Malaga, Spain
| | - V Hox
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - M Rudenko
- London Allergy and Immunology Centre, London, UK
| | - N B Muluk
- ENT Department, Faculty of Medicine, Kirikkale University, Kirikkale, Turkey
| | - G Scadding
- Royal National Throat, Nose and Ear Hospital, London, UK
| | - F Manole
- Faculty of Medicine, ENT Department, University of Oradea, Oradea, Romania
| | - C Hupin
- Institut de Recherche Expérimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Centre (AMC), Amsterdam, The Netherlands
| | - C Akdis
- Christine Kuhne-Center for Allergy Research and Education, Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - C Bachert
- Upper Airway Research Laboratory, Ghent University Hospital, Ghent, Belgium
| | - P Demoly
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
| | - J Mullol
- Unitat de Rinologia i Clinica de l'Olfacte, Servei d'Otorinolaringologia, Hospital Clínic, Barcelona, Catalonia Spain
| | - A Muraro
- The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region, Department of Mother and Child Health, University of Padua, Padua, Italy
| | - N Papadopoulos
- Allergy Department, 2nd Pediatric Clinic, University of Athens, Athens, Greece
| | | | - P Rombaux
- Service d'ORL, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - E Toskala
- Department of Otorhinolaryngology-Head and Neck Surgery, Temple University, Philadelphia, PA USA
| | - L Kalogjera
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Sestre milosrdnice, Zagreb, Croatia
| | - E Prokopakis
- Department of Otorhinolaryngology, University Hospital of Crete, Crete, Greece
| | - P W Hellings
- Clinical division of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Louvain, Belgium
| | - J Bousquet
- Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France
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Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehner A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology 2017. [PMID: 28623665 DOI: 10.4193/rhin16.248] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [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 Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following: - Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy with small diameter endoscopes. - Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability. - Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour threshold, and/or one of odour identification or discrimination. - Comprehensive chemosensory assessment should include gustatory screening. - Smell training can be helpful in patients with olfactory loss of several aetiologies. CONCLUSIONS We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.
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Affiliation(s)
- T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - P Andrews
- UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - A Altundag
- Department of Otorhinolaryngoglogy, Istanbul Surgery Hospital, Istanbul, Turkey
| | - C Cinghi
- Department of Otolaryngology; Eskisehir Osmangazi University, Istanbul, Turkey
| | - R M Costanzo
- Smell and Taste Disorders Center, Department of Otolaryngology Head and Neck Surgery, VCU School of Medicine, Richmond, VA, USA
| | - M Damm
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne Medical Center, Cologne, Germany
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, QC, Canada
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - E Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - S C Hong
- Department of Otorhinolaryngology, Konkuk University Medical Center, Hwayang-dong, Gwangjin-gu, Seoul, South Korea
| | - D Hornung
- Dept. of Biology, St. Lawrence University, Canton, NY, USA
| | | | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - D A Leopold
- Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, University of Vermont Medical Center, Burlington, Vermont, USA
| | - A Macchi
- ENT Clinic, University of Insubria, ASST, sette laghi, Varese, Italy
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - R Moesges
- Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - J Mullol
- Rhinology Unit and Smell Clinic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - G C Passali
- Head and Neck section, Department of Aging, Neurosciences, Head and Neck and Orthopedic; Catholic University of Sacred heart, A. Gemelli Hospital Foundation, Rome, Italy
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V J Ramakrishnan
- Departments of Otolaryngology and Neurosurgery, University of Colorado, Aurora, CO, USA
| | - P Rombaux
- Universite Catholique de Louvain, Institute of Neurosciences, Unit of Otorhinolaryngology, Brussels, Belgium
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R A Schlosser
- Department of Otolaryngology, Head and Neck Surgery, Medical Univeristy of South Carolina, Charleston, SC, USA
| | - B Shu
- Department of Otolaryngology, Taipei Veterans General Hospital, National Yang Ming University School of Medicine Faculty of Medicine, Taipei, Taiwan
| | - G Soler
- Division of Otorhinolaryngology, Area of Smell and Taste, Hospital de Clinicas, University of Buenos Aires, Buenos Aires City, Argentina
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - B A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Germany
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
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Brion M, de Timary P, Vander Stappen C, Guettat L, Lecomte B, Rombaux P, Maurage P. FOC1-3CHEMOSENSORY DYSFUNCTION IN ALCOHOL-RELATED DISORDERS: A JOINT EXPLORATION OF OLFACTION AND TASTE. Alcohol Alcohol 2015. [DOI: 10.1093/alcalc/agv079.03] [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: 11/13/2022] Open
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Fonteyn S, Huart C, Deggouj N, Collet S, Eloy P, Rombaux P. Non-sinonasal-related olfactory dysfunction: A cohort of 496 patients. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131:87-91. [PMID: 24679542 DOI: 10.1016/j.anorl.2013.03.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [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: 10/30/2012] [Revised: 03/04/2013] [Accepted: 03/19/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIM There is a high prevalence of olfactory dysfunction in the general population. Several causes of olfactory dysfunction have been reported and this disorder is classically divided into sinonasal and non-sinonasal-related olfactory dysfunction. The aims of this study were firstly, to evaluate the frequency of the various aetiologies of olfactory dysfunction in a population of patients with non-sinonasal-related olfactory dysfunction and secondly, to evaluate the degree of olfactory impairment associated with these various aetiologies. MATERIAL AND METHODS We retrospectively reviewed a cohort of 496 patients with non-sinonasal-related olfactory dysfunction. The aetiology of the olfactory dysfunction was recorded for each patient. The aetiology was determined by a complete clinical assessment, including medical history, complete otorhinolaryngological examination, psychophysical testing of olfactory function, recording of olfactory event-related potentials and brain magnetic resonance imaging. Six groups of patients were defined on the basis of the aetiology of the disease and orthonasal and retronasal psychophysical olfactory performances were evaluated in each group. RESULTS Post-infectious and post-traumatic aetiologies were the most common causes, representing 37.9% and 33.1% of patients, respectively, followed by idiopathic (16.3%), congenital (5.9%), toxic (3.4%) and neurological (3.4%) olfactory dysfunction. Anosmia was significantly more frequent in congenital (93.1%) and post-traumatic (62.8%) olfactory dysfunction, whereas hyposmia was more frequent in the post-infectious group (59.6%). Orthonasal and retronasal olfactory function tests were significantly correlated in all groups except for the congenital group. CONCLUSIONS The data of this study confirm that the most common causes of non-sinonasal-related olfactory dysfunction are post-infectious and post-traumatic. Post-infectious olfactory dysfunction is mainly observed in middle-aged women and is mainly associated with hyposmia, whereas post-traumatic olfactory dysfunction is mainly observed in young men and is associated with a high rate of anosmia.
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Affiliation(s)
- S Fonteyn
- Département d'oto-rhino-laryngologie, cliniques universitaires Saint-Luc, avenue Hippocrate, 10, 1200 Brussels, Belgium
| | - C Huart
- Département d'oto-rhino-laryngologie, cliniques universitaires Saint-Luc, avenue Hippocrate, 10, 1200 Brussels, Belgium; Institute of neuroscience, université catholique de Louvain, avenue Hippocrate, 54, 1200 Brussels, Belgium
| | - N Deggouj
- Département d'oto-rhino-laryngologie, cliniques universitaires Saint-Luc, avenue Hippocrate, 10, 1200 Brussels, Belgium; Institute of neuroscience, université catholique de Louvain, avenue Hippocrate, 54, 1200 Brussels, Belgium
| | - S Collet
- Département d'oto-rhino-laryngologie, CHU de Mont-Godinne, 1, rue Docteur Gaston Therasse, 5530 Yvoir, Belgium
| | - P Eloy
- Département d'oto-rhino-laryngologie, cliniques universitaires Saint-Luc, avenue Hippocrate, 10, 1200 Brussels, Belgium; Département d'oto-rhino-laryngologie, CHU de Mont-Godinne, 1, rue Docteur Gaston Therasse, 5530 Yvoir, Belgium
| | - P Rombaux
- Département d'oto-rhino-laryngologie, cliniques universitaires Saint-Luc, avenue Hippocrate, 10, 1200 Brussels, Belgium; Institute of neuroscience, université catholique de Louvain, avenue Hippocrate, 54, 1200 Brussels, Belgium.
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Huart C, Rombaux P, Hummel T, Mouraux A. Clinical usefulness and feasibility of time-frequency analysis of chemosensory event-related potentials. Rhinology 2013; 51:210-21. [PMID: 23943727 DOI: 10.4193/rhino13.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [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 The clinical usefulness of olfactory event-related brain potentials (OERPs) to assess olfactory function is limited by the relatively low signal-to-noise ratio of the responses identified using conventional time-domain averaging. Recently, it was shown that time-frequency analysis of the obtained EEG signals can markedly improve the signal-to-noise ratio of OERPs in healthy controls, because it enhances both phase-locked and non phase-locked EEG responses. The aim of the present study was to investigate the clinical usefulness of this approach and evaluate its feasibility in a clinical setting. METHODOLOGY We retrospectively analysed EEG recordings obtained from 45 patients (15 anosmic, 15 hyposmic and 15 normos- mic). The responses to olfactory stimulation were analysed using conventional time-domain analysis and joint time-frequency analysis. The ability of the two methods to discriminate between anosmic, hyposmic and normosmic patients was assessed using a Receiver Operating Characteristic analysis. RESULTS The discrimination performance of OERPs identified using conventional time-domain averaging was poor. In contrast, the discrimination performance of the EEG response identified in the time-frequency domain was relatively high. Furthermore, we found a significant correlation between the magnitude of this response and the psychophysical olfactory score. CONCLUSION Time-frequency analysis of the EEG responses to olfactory stimulation could be used as an effective and reliable diagnostic tool for the objective clinical evaluation of olfactory function in patients.
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Affiliation(s)
- C Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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15
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Hupin C, Rombaux P, Bowen H, Gould H, Lecocq M, Pilette C. Downregulation of polymeric immunoglobulin receptor and secretory IgA antibodies in eosinophilic upper airway diseases. Allergy 2013; 68:1589-97. [PMID: 24117840 DOI: 10.1111/all.12274] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2013] [Indexed: 12/15/2022]
Abstract
BACKGROUND Immunoglobulin (Ig) A represents a first-line defence mechanism in the airways, but little is known regarding its implication in upper airway disorders. This study aimed to address the hypothesis that polymeric Ig receptor (pIgR)-mediated secretory IgA immunity could be impaired in chronic upper airway diseases. METHODS Nasal and ethmoidal biopsies, as well as nasal secretions, were collected from patients with chronic rhinosinusitis (CRS) with nasal polyps (CRSwNP) or without nasal polyps (CRSsNP), allergic rhinitis (AR) and controls, and assayed for IgA1/IgA2 synthesis, pIgR expression, production of secretory component (SC), IgA and relevant IgA antibodies, and correlated with local eosinophils and inflammatory features (IL-12, IL-13 and ECP). RESULTS pIgR expression was decreased in the ethmoidal mucosa in patients with CRSwNP (P = 0.003) and in AR (P = 0.006). This pIgR defect was associated with reduced levels of SC (P = 0.007) and IgA antibodies to Staphylococcus aureus enterotoxin B (SAEB) (P = 0.003) in nasal secretions from patients with CRSwNP, and with increased IgA deposition in subepithelial areas. pIgR downregulation was selectively observed in patients with tissue eosinophilia, whilst no clear relation to smoking history was observed. CONCLUSION Epithelial pIgR expression is decreased in patients with CRSwNP and AR and results in decreased SC and IgA antibodies to certain bacterial antigens (SAEB) in nasal secretions of patients with CRSwNP in parallel to subepithelial accumulation of IgA. This defect in mucosal immunity is associated with eosinophilic, Th2-related inflammation.
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Affiliation(s)
- C. Hupin
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
- Service d'ORL; Cliniques Universitaires St-Luc; Brussels Belgium
| | - P. Rombaux
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
- Service d'ORL; Cliniques Universitaires St-Luc; Brussels Belgium
| | - H. Bowen
- Randall Division of Cell and Molecular Biophysics; MRC/Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London; London UK
| | - H. Gould
- Randall Division of Cell and Molecular Biophysics; MRC/Asthma UK Centre in Allergic Mechanisms of Asthma; King's College London; London UK
| | - M. Lecocq
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
| | - C. Pilette
- Institut de Recherche Expérimentale et Clinique (IREC); Pole de Pneumologie; ORL & Dermatologie; Université catholique de Louvain (UCL); Brussels Belgium
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16
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Eloy P, Grenier J, Pirlet A, Poirrier AL, Stephens JS, Rombaux P. Sphenoid sinus fungall ball: a retrospective study over a 10- year period. Rhinology 2013; 51:181-8. [PMID: 23671900 DOI: 10.4193/rhino12.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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
A fungal ball consists of a dense conglomerate of fungal hyphae growing at the surface of the sinus mucosa without tissue infiltration. The maxillary sinus is by far the most commonly involved paranasal sinus cavity followed by the sphenoid sinus. The present study is a retrospective study of 25 consecutive cases treated during the last 10 years in the two hospitals be- longing to the Catholic University of Louvain (CHU Mont-Godinne and UCL Saint Luc). We report the symptomatology, the imaging and discuss the different surgical managements. We conclude that the clinician must have a high index of suspicion when dealing with a unilateral rhinosinusitis persisting despite a maximal and well conducted medical treatment. This is particularly so in elderly women when associated with facial pain and post nasal drip, particularly when the computed tomography shows an unilateral opacity of the sphenoid sinus with or without a sclerosis or an erosion of the bony walls, a polyp in the sphenoethmoidal recess or a hyperdensity mimicking a foreign body. An endonasal endoscopic sphenoidotomy is the treatment of choice in most cases, allowing good ventilation of the sinus and radical removal of all the fungal concretion. A biopsy of the sinus mucosa adjacent to fungal elements is of upmost important to confirm the non- invasiveness of the fungi within the tissue. Antifungal medication is not required in uncomplicated forms. All host factors producing some degree of immunosuppression must be corrected when present and must alert the clinician to rule out any forms of invasive disease.
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Affiliation(s)
- Ph Eloy
- ENT Department , CHU UCL Mont-Godinne, Yvoir, Belgium.
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17
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Eloy P, Poirrier AL, Nicoli T, Marlair C, Delahaut G, Leruth E, Rombaux P. Cystic dilation of the distal end of the nasolacrimal duct: underrated cause of epiphora in adults and its endoscopic treatment. Rhinology 2013. [PMID: 23181256 DOI: 10.4193/rhino12.067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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
Epiphora is a frequent reason for ophthalmologic consultation. Among the multiple causes, obstructions of the lacrimal excretory system are common. Sacal and postsacal obstructions are much more frequent than presacal obstructions. Obstruction at the level of the Hasner's valve is rare and likely underestimated. The authors report the clinical history and the imaging of 3 patients with a cystic dilation of the distal end of the nasolacrimal duct (NLD). These patients were easily managed by an ENT surgeon. In one case, the surgery consisted of an endonasal DCR where in the 2 other cases, a marsupialisation of the cystic expansion of the nasolacrimal duct was successfully performed with the micro- debrider. The authors review the world literature on this specific topic. They conclude that a coronal sinus CT scan and an inferior meatus endoscopy should be included in the ophthalmologic work-up performed in all cases of low obstruction of the lacrimal system. When there is a dilation of the distal end of the NLD the marsupialisation of the cystic expansion in the inferior meatus is the option of treatment instead of performing a DCR. ENTs must play a role in the assessment and treatment of low obstructions of the lacrimal excretory system.
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Affiliation(s)
- P Eloy
- HNS & ENT Department, CHU-Mont-Godinne, UCL, Yvoir, Belgium.
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18
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Abstract
Electroencephalographic techniques are widely used to provide an objective evaluation of the chemosensory function and to explore neural mechanisms related to the processing of chemosensory events. The most popular technique to evaluate brain responses to chemosensory stimuli is across trial time-domain averaging to reveal chemosensory event-related potentials (CSERP) embedded within the ongoing EEG. Nevertheless, this technique has a poor signal-to-noise ratio and cancels out stimulus-induced changes in the EEG signal that are not strictly phased-locked to stimulus onset. The fact that consistent CSERP are not systematically identifiable in healthy subjects currently constitutes a major limitation to the use of this technique for the diagnosis of chemosensory dysfunction. In this review, we will review the different techniques related to the recording and identification of CSERP, discuss some of their limitations, and propose some novel signal processing methods which could be used to enhance the signal-to-noise ratio of chemosensory event-related brain responses.
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Affiliation(s)
- Ph Rombaux
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium.
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19
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Bogaerts M, Deggoujf N, Huart C, Hupin C, Laureyns G, Lemkens P, Rombaux P, Ten Bosch JVDW, Gordts F. Physiology of the mouth and pharynx, Waldeyer's ring, taste and smell. B-ENT 2012; 8 Suppl 19:13-20. [PMID: 23431608] [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: 06/01/2023] Open
Abstract
This paper reviews the contribution of the different parts of the oral cavity and the pharynx to the basic physiology of breathing, phonation, speech, swallowing, and of Waldeyer's ring to the functioning of the immune system. We discuss the development of taste and smell, as well as possibilities for chemosensory testing in children.
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Affiliation(s)
- M Bogaerts
- Department of Otorhinolaryngology, Head and Neck Surgery, Ziekenhuis Oost Limburg, Genk, Belgium
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20
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Eloy P, Poirrier A, Marlair C, Delahaut G, Leruth E, Rombaux P. Cystic dilation of the distal end of the nasolacrimal duct: underrated cause of epiphora in adults and its endoscopic treatment. Rhinology 2012; 50:436-441. [DOI: 10.4193/rhin12.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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21
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Hantson P, Wittebole X, Rombaux P, Cosnard G. Locked-in syndrome as an unusual complication of acute otitis media. B-ENT 2012; 8:131-134. [PMID: 22896933] [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: 06/01/2023] Open
Abstract
BACKGROUND A 32-year-old woman developed altered consciousness two days after initial symptoms of acute otitis media, with purulent discharge from the right ear. She was quadriplegic, with spontaneous eye opening, mild neck stiffness, and lacking vestibular-ocular reflexes. METHODOLOGY Upon admission, the patient was subjected to brain computed tomography (CT), magnetic resonance imaging (MRI), and lumbar puncture. RESULTS CT was consistent with pansinusitis, right middle ear otitis, mastoiditis, and sphenoiditis. No brainstem lesion was evident; brain MRI demonstrated ischemic and secondary hemorrhagic lesions in the pons and cerebral peduncles. The dura mater in the petroclival space was intensely inflamed, and likely responsible for reduced basilar arterial blood flow. Lumbar puncture yielded clear cerebrospinal fluid; gram stain examination was negative and culture remained sterile. Streptococcus pneumoniae and Haemophilus influenzae were cultured from the purulent ear discharge. CONCLUSION The final diagnosis was locked-in syndrome consecutive to inflammatory changes compressing the basilar artery.
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Affiliation(s)
- P Hantson
- Department of Intensive Care, Université catholique de Louvain, Cliniques St-Luc, Brussels, Belgium.
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22
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Deggouj N, Castelein S, Grégoire A, Laroche H, De Graeuwe C, de Toeuf C, Desuter G, Rombaux P, Hupin C. Functional consequences of chronic ENT inflammation on the development of hearing and communicative abilities. B-ENT 2012; 8 Suppl 19:105-115. [PMID: 23431614] [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: 06/01/2023] Open
Abstract
Hearing processing and communication abilities development may be influenced by chronic inflammation of the airways in children, especially in case of otitis media and/or adenotonsillar hypertrophy. The present review summarizes the influence of adenotonsillar hypertrophy on speech abilities as well as the consequences of otitis media, with a particular focus on peripheral and central hearing, on the development of language, attention, and memory skills.
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Affiliation(s)
- N Deggouj
- Department of Otorhinolaryngology, Head and Neck Surgery, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium.
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Hupin C, Mahy P, Huart C, Pitance L, de Toeuf C, Rombaux P, Deggouj N. Consequences of chronic inflammation in children on facial growth, growth, behavioural disorders and smell. B-ENT 2012; 8 Suppl 19:117-122. [PMID: 23431615] [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: 06/01/2023] Open
Abstract
Adenotonsillar hypertrophy is a common paediatric/otolaryngological disorder that may be associated with secondary growth or facial growth impairment, sleep disturbances, neurocognitive deficits, or smell loss. Surgical removal of the hypertrophic tissue eliminates the mechanical obstacle of the airways and is therefore curative in most cases. The purpose of the present review is to outline the impact of adenotonsillar hypertrophy and adenotonsillectomy on growth, facial growth, sleep, behaviour and smell.
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Affiliation(s)
- C Hupin
- Department of Otorhinolaryngology, Head and Neck Surgery, Cliniques Universitaires Saint Luc, UCL, Brussels, Belgium.
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Huart C, Meusel T, Gerber J, Duprez T, Rombaux P, Hummel T. The depth of the olfactory sulcus is an indicator of congenital anosmia. AJNR Am J Neuroradiol 2011; 32:1911-4. [PMID: 21868619 DOI: 10.3174/ajnr.a2632] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE In congenital anosmia, the OB and OT can be aplastic or hypoplastic. In clinical routine, these are sometimes difficult to assess. We thus wanted to investigate morphologic differences of the OS in patients with IA since birth or early childhood in comparison with controls, to investigate whether there is a depth of OS that is predictive of IA. MATERIALS AND METHODS Within the context of a 2-center study, we investigated 36 patients with IA in comparison with 70 controls. MR imaging was performed with a standard quadrature head coil (1.5T; T1- and T2-weighted spin-echo sequences were used on the coronal plane). We assessed the depth of OS in the PPTE. RESULTS Looking at the depth of the OS in the PPTE, we found that patients with IA had a significantly smaller OS compared with controls (P < .001). None of the healthy controls exhibited a depth of <8 mm. In patients with IA, 10 had an OS deeper than 8 mm, while 26 had an OS smaller than 8 mm. Thus, a depth of the OS less than 8 mm clearly indicates IA, with a specificity of 1 and a sensitivity of 0.72. CONCLUSIONS In IA, the depth of the OS in the PPTE is a useful clinical indicator. Indeed, if it is ≤8 mm, it clearly indicates IA, with a specificity of 1.
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Affiliation(s)
- C Huart
- Department of Otorhinolaryngology, Université Catholique de Louvain, Brussels, Belgium.
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Huart C, Eloy P, Collet S, Rombaux P. Chemosensory function assessed with psychophysical testing and event-related potentials in patients with atrophic rhinitis. Eur Arch Otorhinolaryngol 2011; 269:135-41. [PMID: 21717190 DOI: 10.1007/s00405-011-1670-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 06/08/2011] [Indexed: 11/30/2022]
Abstract
Atrophic rhinitis (AR) is a chronic inflammation of the nose characterized by an atrophy of the nasal mucosa. This is typically associated with an impaired sense of smell and a subjective sensation of poor nasal breathing. The aim of this study is to assess chemosensory function in patients suffering from AR using psychophysical testings and event-related potentials (ERP) responses. A cohort of nine patients was extensively studied. Eight out of nine had secondary AR sequela of a bilateral total inferior turbinectomy whereas one patient had a primary AR. All the patients had a clinical evaluation using Sniffin' Sticks test and a retro-olfaction test and an electrophysiological evaluation based upon ERPs obtained after both olfactory and trigeminal stimuli. All the patients complained of a poor nasal breathing and presented a distortion of the chemosensory function. Actually, the orthonasal psychophysical testing showed that four patients out of nine had anosmia, three out of nine had hyposmia and two out of nine were normosmic. All the patients demonstrated retro-olfaction scores inferior to the normal values. The chemosensory ERP showed that seven patients had no olfactory response whereas six had no trigeminal response. Four patients had neither olfactory nor trigeminal ERP response. In conclusion, this study demonstrates that most patients with AR secondary to a total bilateral inferior turbinectomy have a reduction of the chemosensory function measured objectively by psychophysical testings and ERP [corrected].
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Affiliation(s)
- C Huart
- Unit of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Av Hippocrate 10, 1200 Brussels, Belgium.
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Cuevas I, Plaza P, Rombaux P, Mouraux A, Delbeke J, Collignon O, De Volder AG, Renier L. Chemosensory event-related potentials in early blind humans. B-ENT 2011; 7:11-17. [PMID: 21563551] [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: 05/30/2023] Open
Abstract
While the effects of early visual deprivation on auditory and tactile functions have been widely studied, little is known about olfactory function in early blind subjects. The present study investigated the potential effect of early blindness on the electrophysiological correlates of passive odour perception. Event-related potentials (ERPs) were recorded in eight early blind humans and eight sighted controls matched for age, sex and handedness during olfactory stimulation with 2-phenyl ethyl alcohol and trigeminal stimulation with CO2 Latencies, amplitudes and topographical distributions were analysed. As expected, the olfactory and trigeminal ERP components showed normal latencies, amplitudes and topography in both groups. Olfactory stimuli generated responses of smaller amplitude than those observed in response to trigeminal stimulation. In addition, ERP analyses did not reveal any major difference in electrocortical responses in occipital areas in early blind and sighted subjects. These results suggest that passive olfactory and trigeminal stimulation elicit the same electrophysiological responses in both groups, confirming that the neurophysiological correlates of the cross-modal compensatory mechanisms in early blind subjects do not appear during passive olfactory and trigeminal perception.
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Affiliation(s)
- I Cuevas
- Neural Rehabilitation Engineering Laboratory, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Abstract
INTRODUCTION A medial maxillectomy (MM) consists of a complete resection of the medial wall of the maxillary sinus. Traditionally the surgery is performed via an open approach. With more familiarity and expertise in endoscopic sinus surgery the endonasal approach is feasible. OBJECTIVE To expose the surgical technique and report the results of endonasal endoscopic MM in a series of 6 consecutive patients. MATERIALS AND METHODS Between August 2006 and October 2009, 6 patients were operated with this procedure. All were men. The mean age was 62-year-old (range: 43-83). In 5 cases, the surgery was performed for inverted papillomas confined to the maxillary sinus. In one case it was a primary surgery whereas it was a revision surgery for the others. The sixth patient was operated for a solitary extramedullary plasmocytoma inserted on the intersinonasal wall persistent after an external radiation therapy. RESULTS All the patients are free of disease at the time of writing with a mean follow-up of 18,2 months (range: 9-38). This has been confirmed by a nasal endoscopy and CT scans. There were no major per or postoperative complications. Patients suffered from crusting for at least 6 months postoperatively necessitating daily nasal douches. One patient is still complaining of intermittent epiphora when he is exposed to wind. CONCLUSION Endoscopic MM can be successfully performed for the resection of expanding processes involving the maxillary sinus and/or the intersinonasal wall. Compared to open approaches, it seems to be as effective with less postoperative morbidity. An important technical point is to do the anterior osteotomy in front of the nasolacrimal duct in order to expose the prelacrimal recess that is typically an area for possible recurrence. Exact determination of the tumor attachment during the surgery is another key point for success.
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Affiliation(s)
- Ph Eloy
- Department of ENT and Head and Neck Surgery, Cliniques Universitaires de Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium
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Buysschaert ID, Grulois V, Eloy P, Jorissen M, Rombaux P, Bertrand B, Collet S, Bobic S, Vlaminck S, Hellings PW, Lambrechts D. Genetic evidence for a role of IL33 in nasal polyposis. Allergy 2010; 65:616-22. [PMID: 19860791 DOI: 10.1111/j.1398-9995.2009.02227.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Little is known about the genetic factors that contribute to nasal polyposis (NP). A genome-wide association study identified 10 single nucleotide polymorphisms (SNPs) associated with eosinophilia. As eosinophils play a key role in the pathogenesis of NP, we assessed if any of these SNPs contribute to genetic susceptibility of NP. METHODS We recruited 284 patients with NP in four participating hospitals in Belgium and 427 healthy controls, and genotyped 10 SNPs affecting eosinophilia (rs1420101 in IL1RL1, rs12619285 in IKZF2, rs4431128 in GATA2, rs4143832 in IL5, rs3184504 in SH2B3, rs2416257 in WDR36, rs2269426 in MHC, rs9494145 in MYB, rs748065 in GFRA2, and rs3939286 in IL33) using MALDI-TOF. A two-stage design was used while correcting for multiple testing. RESULTS First stage analysis, involving 150 NP patients and 250 controls, identified rs3939286 nearby IL33 as a susceptibility factor for NP. Per at-risk A-allele, rs3939286 increased the risk for NP with an odds ratio (OR) of 1.60 (95% CI = 1.16-2.22; P = 0.0041). Second stage replication analysis in another 123 NP patients and 165 controls confirmed this association (OR = 1.43; CI = 1.00-2.06; P = 0.046). The combined analysis of both stages revealed an OR of 1.53 (CI = 1.21-1.96; P = 0.00041). Given the association of IL33 with NP, we also investigated rs1420101 in IL1RL1, which is the receptor for IL33. Although rs1420101 itself failed to associate with NP, a combined risk assessment of rs3939286 and rs1420101 further increased the risk for NP. CONCLUSION We provide unprecedented genetic evidence suggesting a role for the IL33 pathway in the pathogenesis of NP.
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Collet S, Grulois V, Eloy P, Rombaux P, Bertrand B. A Pott's puffy tumour as a late complication of a frontal sinus reconstruction: case report and literature review. Rhinology 2010; 47:470-5. [PMID: 19936379 DOI: 10.4193/rhin07.060] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [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
A Pott's Puffy Tumour (PPT) is a rare clinical entity, which, traditionally has been described as an acute abscess with periosteitis secondary to osteomyelitis of the external table of the frontal bone of the skull, complicating an acute frontal sinusitis. The aim of this article is to present a case of progressively evolving PPT, which emerged during the course of a common rhinitis, in a patient who, thirty years previously, had undergone a reconstruction of the frontal sinus involving osteosynthesis. The patient was treated with antibiotic therapy coupled with external access surgery using the Cairn Unterberger approach. This allowed the drainage of pus, the removal of infected osteosynthetic material and a complete debridement of osteomyelitic bone from the affected area. Frontal sinus obliteration was undertaken using methyl methacrylate, preferable in this case to hydroxyapatite, due to the direct communication with the neighbouring sinus cavities and the presence of defective bone in the superior orbit. A review of literature available on Medline up to January 2008 reveals that this is the third published case of PPT complicating a frontal reconstruction.
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Affiliation(s)
- S Collet
- Department of Otorhinolaryngology - Head & Neck Surgery, University Hospital of Mont-Godinne, Université Catholique de Louvain, Yvoir, Belgium.
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Rombaux P, Avram M, Lengelé B, de Toeuf C, Collet S, Bertrand B. The use of grafting material in rhinoseptoplasty. B-ENT 2010; 6 Suppl 15:89-96. [PMID: 21305929] [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: 05/30/2023] Open
Abstract
Grafting is one of the current range of instruments that rhinoplasticians deploy to achieve durable and desired aesthetic and functional outcomes. Grafts can be classified according to anatomical site and, in the vast majority of cases, they involve augmentation rhinoseptoplasty. Visible grafting material is used for aesthetic purposes and functional grafting may involve invisible grafts. This article reviews the more widely described and more common indications for grafts in rhinoseptoplasty. The authors' rhinoseptoplasty philosophy involves a preference for autogenous grafts rather than alloplastic implants to achieve both aesthetically and functionally favourable results, particularly in long-term follow-up. They also prefer grafts in an open approach, reserving graft insertion with an endonasal approach for selected cases. The rate of complications associated with grafting is very low. The aim of this paper is to discuss the relevant anatomy, functional purpose and terminology, and to describe the authors' philosophy for grafting in rhinoseptoplasty.
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Affiliation(s)
- P Rombaux
- Université Catholique de Louvain, Department of Otorhinolaryngology, Brussels, Belgium.
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Bertrand B, Collet S, Rombaux P, Eloy P. My surgery of the nasal valve. B-ENT 2010; 6 Suppl 15:69-76. [PMID: 21305927] [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: 05/30/2023] Open
Abstract
We discuss the physiopathology and relevant anatomy of the nasal valves--internal and external--paying particular attention to the dynamics of the airflows in this area. We describe and comment on methods for medical examination, anterior rhinoscopy, endoscopy and fibrescopy of the valve, as well as the causes and sites of nasal valve dysfunction. We propose a review of the various treatments, medical and surgical, with a special emphasis on nasal valve surgery. Surgical techniques commonly used by the authors in daily practice for nasal valvuloplasty (such as spreader grafts and Z-plasty of the nostrils) are discussed and illustrated in depth. Some one-year postoperative results are presented and discussed.
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Affiliation(s)
- B Bertrand
- ORL and HNS Department, Catholic University of Louvain (UCL), Cliniques Universitaires de Mont-Godinne, Yvoir, Belgium.
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Hupin C, Weynand B, Rombaux P. Lymphoepithelial cyst of the nasogenian sulcus: a case report. B-ENT 2010; 6:49-51. [PMID: 20420080] [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: 05/29/2023] Open
Abstract
A rare case of lymphoepithelial cyst formed in the nasogenian sulcus is reported. Lymphoepithelial cysts are comprised of a stratified squamous epithelial lining above dense lymphoid tissue. They are uncommon in the oral region and, to our knowledge, have never been reported in the nasogenian sulcus. Surgical excision was performed and no recurrence was noted after 6 months. In this report, we describe the etiopathogenesis of lymphoepithelial cysts, as well as the differential diagnosis of nasogenian sulcus swellings.
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Affiliation(s)
- C Hupin
- Department of Otorhinolaryngology and Head and Neck Surgery, Catholic University of Louvain, University Hospital St. Luc, Brussels, Belgium
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Gudziol V, Buschhüter D, Abolmaali N, Gerber J, Rombaux P, Hummel T. Increasing olfactory bulb volume due to treatment of chronic rhinosinusitis--a longitudinal study. ACTA ACUST UNITED AC 2009; 132:3096-101. [PMID: 19773353 DOI: 10.1093/brain/awp243] [Citation(s) in RCA: 115] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Differentiation of progenitor cells into neurons in the olfactory bulb depends on olfactory stimulation that can lead to an increase in olfactory bulb volume. In this study, we investigated whether the human olfactory bulb volume increases with increasing olfactory function due to treatment of chronic rhinosinusitis. Nineteen patients with chronic rhinosinusitis were investigated before and after treatment. For comparison, additional measurements were performed in 18 healthy volunteers. Volumetric measurements of the olfactory bulb were based on planimetric manual contouring of magnetic resonance scans. Olfactory function was evaluated separately for each nostril using tests for odour threshold, odour discrimination and odour identification. Measurements were performed on two occasions, 3 months apart. In healthy controls, the olfactory bulb volume did not change significantly between the two measurements. In contrast, the olfactory bulb volume in patients increased significantly from the initial 64.5 +/- 3.2 to 70.0 +/- 3.5 mm(3) on the left side (P = 0.02) and from 60.9 +/- 3.5 to 72.4 +/- 2.8 mm(3) on the right side (P < 0.001). The increase in olfactory bulb volume correlated significantly with an increase in odour thresholds (r = 0.60, P = 0.006, left side; r = 0.49, P = 0.03, right side), but not with changes in odour discrimination or odour identification. Results of this study support the idea that stimulation of olfactory receptor neurons impacts on the cell death in the olfactory bulb, not only in rodents but also in humans. To our knowledge, this is the first longitudinal study that describes an enlargement of the human olfactory bulb due to improvement of peripheral olfactory function.
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Affiliation(s)
- V Gudziol
- Smell & Taste Clinic, Department of Otorhinolaryngology, University of Dresden Medical School (Technische Universität Dresden), Fetscherstrasse 74, 01307 Dresden, Germany.
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Eloy P, Leruth E, Cailliau A, Collet S, Bertrand B, Rombaux P. Pediatric endonasal endoscopic dacryocystorhinostomy. Int J Pediatr Otorhinolaryngol 2009; 73:867-71. [PMID: 19380163 DOI: 10.1016/j.ijporl.2009.03.006] [Citation(s) in RCA: 20] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 03/10/2009] [Accepted: 03/11/2009] [Indexed: 10/20/2022]
Abstract
Dacryocystorhinostomy (DCR) in children is indicated in cases of common congenital nasolacrimal duct obstruction (CNLDO) unresponsive to medical therapy, probing or intubation. The purpose of this manuscript is to evaluate the effectiveness of endonasal endoscopic pediatric DCR. The authors present a series of eight children (seven boys and one girl) who underwent a pediatric endonasal DCR between September 2007 and December 2008. The mean age was: 4.3 years (range: 8 months to 9 years old). Three children had a craniofacial abnormality. There were ten primary DCRs and one revision DCR. In nine cases, the indication was a pure primary low mechanical obstruction persistent after one or more probings. In the 10th case there was also a stenosis of the inferior canaliculus diagnosed during the DCR. The revision DCR was indicated because of the closure of the stoma created 3 years ago. A silicone intubation was put in place only in two cases: in case of a stenosis of the inferior canaliculus (3 months) and the other in case of revision DCR (1 month). The follow-up for primary DCRs was 10.5 months (range: 6-15) and for revision surgery 6 months (after the retrieve of the stent). In primary DCRs, there was a complete resolution of symptoms in nine out of 10 cases. The 10th case experienced a transient slight epiphora during a viral rhinitis. In case of revision DCR, the child was free of symptoms. In conclusion pediatric DCR is a very effective and safe procedure for the treatment of a low mechanical obstruction of the lacrimal pathway in children unresponsive to previous probings. Stenosis of the inferior canaliculus can give some slight intermittent epiphora despite a wide and patent stoma. Moreover craniofacial abnormalities are more common in children than in adults undergoing a DCR.
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Affiliation(s)
- Ph Eloy
- ENT & HNS department, Cliniques universitaires de Mont-Godinne, Université Catholique de Louvain, 5530, Yvoir, Belgium.
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Rombaux P, Duprez T, Hummel T. Olfactory bulb volume in the clinical assessment of olfactory dysfunction. Rhinology 2009; 47:3-9. [PMID: 19382487] [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: 05/27/2023]
Abstract
The olfactory bulb collects the sensory afferents of the olfactory receptor cells located in the olfactory neuroepithelium. The olfactory bulb ends with the olfactory tract and is closely related to the olfactory sulcus of the frontal lobe. Many studies demonstrated that olfactory bulb volume assessed with magnetic resonance imaging is related to the olfactory function both in normal and pathological conditions. It has been shown that olfactory bulb volume changes with the degree of olfactory dysfunction, that it decreases with the duration of the olfactory loss and that patients with qualitative disorder such as parosmia have smaller olfactory bulbs than patients without parosmia. In this review, we will discuss the actual knowledge regarding olfactory bulb function, practical ways to measure olfactory bulb volume and olfactory sulcus depth, and report systematic observations regarding these measurements related to various causes of olfactory dysfunction, e.g. infection of the upper respiratory tract, head trauma, or neurodegenerative disease. Measurement of olfactory bulb volume may provide valuable information for patients with olfactory dysfunction.
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium.
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Rombaux P, Mouraux A, Collet S, Eloy P, Bertrand B. Usefulness and feasibility of psychophysical and electrophysiological olfactory testing in the rhinology clinic. Rhinology 2009; 47:28-35. [PMID: 19382491] [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: 05/27/2023]
Abstract
TOPIC Olfactory dysfunction may be assessed in the clinic with psychophysical testing and electrophysiological recording. Chemosensory event-related potentials (CSERPs) constitute an objective method to assess chemosensory function. Olfactory and trigeminal stimuli activate chemoreceptors from the olfactory neuroepithelium and from the nasal mucosa to evoke an electrophysiological response respectively called olfactory (OERPs) and trigeminal ERPs (TERPs). The purpose of this study is to assess the usefulness and feasibility of these diagnostic tools in the rhinology clinic and to correlate these results to the olfactory disorder aetiology. MATERIALS AND METHODS This study encompasses a cohort of 229 patients with a complaint of olfactory dysfunction from different origins. Orthonasal (Sniffing stick test with the treshold-discrimination-identification score: maximal score 48) and retronasal olfactory (maximal score 20) testing as well as CSERPs both after olfactory and trigeminal stimuli have been routinely performed. Olfactory dysfunction aetiologies were as follows: congenital (Cong.), chronic rhinosinusitis (CRS), idiopathic (Idiop.), post-medication (PM), neurologic (Neuro.), post-traumatic (PT) and post-infection (PI). RESULTS Mean orthonasal and retronasal scores were respectively: 11.8 and 10.1 for Cong., 18.5 and 13.1 for CRS, 15.6 and 10.4 for Idiop., 15.3 and 10.2 for PM, 17 and 10.6 for Neuro., 15 and 9.9 for PT and 18.3 and 12 for PI. Correlations between orthonasal and retronasal scores were present for all subgroups except congenital and chronic rhinosinusitis subgroups. Orthonasal and retronasal scores were different (p < 0.05) when comparing CRS vs Cong., CRS vs PT and PT vs PI. Technical problems (olfactometer or olfactory stimulation, EEG amplifier,...) and patients discomfort (anxiety, stress,...) did not allow to draw any conclusion in 2 patients. Three patients after olfactory stimulus and 6 patients after trigeminal stimulus demonstrated too much eye blinking or muscular artifacts that did not allow us to perform electrophysiological analysis and averaging as 60% of artifact-free recording was not achieved. Olfactory ERPs were recorded in 28% of the patients and trigeminal ERPs were obtained in almost every patient (95%). There was no statistical difference between each subgroup regarding the presence or absence of OERPs. CONCLUSIONS Psychophysical olfactory testing is a useful method to assess olfactory function in patients with olfactory loss and may help us to obtain a semi-objective and a basal evaluation of the olfactory performances. Feasibility and usefulness of CSERPs are also underlined in this study with only a limited number of patients who did not complete the examination. Psychophysical testing gives different results according to the aetiology of the olfactory disorder, which was not the case for electrophysiological recording. Olfactory acuity assessment should be based on psychophysical and CSERPs evaluation in a clinical setting.
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Hellings PW, Rombaux P. Medical therapy and smell dysfunction. B-ENT 2009; 5 Suppl 13:71-75. [PMID: 20084807] [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: 05/28/2023] Open
Abstract
Olfactory dysfunction is deemed to be a significant contributor to poor quality of life in different nasal inflammatory conditions like common cold, allergic rhinitis, and acute and chronic rhinosinusitis with and without nasal polyps (NP). The mechanism underlying olfactory impairment in inflammatory sinonasal disease relates to either the obstruction of the olfactory cleft due to congestion of the nasal mucosa, the presence of secretions or polyps inside the nasal cavity, or to dysfunction of the sensory mucosa of the olfactory bulb resulting from local inflammation. The reduction of smell capacity in nasal inflammatory conditions may have an acute or gradual onset, often with resolution of smell dysfunction after adequate medical treatment or surgery. In contrast to the well documented effects of surgery for rhinosinusitis on smell dysfunction, the available information about the effects of medical treatment is limited. Most studies have looked at corticosteroids, evaluating the restoration of olfactory capacity as a primary or secondary study outcome parameter. Both nasal and systemic corticosteroids have a beneficial effect on olfactory dysfunction, with systemic treatment being the most powerful. This review aims to provide an overview of current knowledge about medical treatment for rhinosinusitis and its effects on smell.
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Affiliation(s)
- P W Hellings
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
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Collet S, Grulois V, Bertrand B, Rombaux P. Post-traumatic olfactory dysfunction: a cohort study and update. B-ENT 2009; 5 Suppl 13:97-107. [PMID: 20084810] [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: 05/28/2023] Open
Abstract
OBJECTIVES Post-traumatic olfactory loss (PTOL) is the third most common aetiology for olfactory disorders. Mechanisms that lead to post-traumatic olfactory disorders include sinonasal affections, damage to the olfactory nerve and lesions of the cerebral olfactory centres. The purpose of this review is to present an update of this condition and to present a cohort study of 90 patients. METHODOLOGY A review of the literature was made on Medline Pubmed up to May 2009 and a review was also conducted of patients with post-traumatic olfactory loss. RESULTS The degree of olfactory impairment was related to the severity of head trauma and was particularly frequent in cases of occipital impact. Typically, patients experienced a sudden onset of olfactory symptoms and were more severely affected than in other aetiologies. Results from orthonasal and retronasal testing, chemosensory event-related potentials and olfactory bulb (OB) volume confirmed previous findings: patients are usually anosmic, OB volume correlates with the degree of olfactory loss (better correlation with retronasal scores than with orthonasal scores) and olfactory event-related potentials were recorded in only 18 patients. CONCLUSIONS Accuracy in the evaluation of PTOL patients is based on the expertise and the time spent by the clinician on defining the complaint. Failing treatment, complete evaluation of the PTOL patients may help in counselling for the recovery prognosis, and appropriate counselling must be given to secure the environment and alimentation.
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Affiliation(s)
- S Collet
- Department of Otorhinolaryngology -Head & Neck Surgery, Université Catholique de Louvain, Mont-Godinne, Yvoir, Belgium.
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Rombaux P, Martinage S, Huart C, Collet S. Post-infectious olfactory loss: a cohort study and update. B-ENT 2009; 5 Suppl 13:89-95. [PMID: 20084809] [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: 05/28/2023] Open
Abstract
Post-infectious olfactory loss is defined as an olfactory dysfunction in the course of an upper respiratory tract infection. Quantitative olfactory dysfunction is usually moderate to severe, with many patients experiencing a qualitative disorder such as parosmia. Diagnosis is made on the basis of patient history, normal clinical examination (no inflammatory disease in the olfactory cleft) and decreased olfactory function. This paper provides an update of pathophysiology, clinical management and prognosis, and also looks at the clinical characteristic of a cohort of 122 patients from our department. Results from orthonasal and retronasal testing, chemosensory event-related potentials and olfactory bulb volume confirmed previous findings: our post-infectious olfactory patients were middle-aged women (sex ratio 2.4; mean age 53.9), with 47.5% and 18% of them complaining of parosmia and phantosmia respectively. More of them were hyposmic than anosmic (64.7% and 35.3% respectively) and 18 suffered repeat episodes. Olfactory bulb volume was correlated to psychophysical olfactory testing and orthonasal to retronasal scores. Olfactory-event-related potentials were found in about one-third of the patients and the vast majority of them had reproducible intranasal trigeminal event-related potentials. As there is no proven medical therapy for this disease, complete clinical evaluation of the patients may help to counsel patients about the recovery prognosis that applies to one-third of them.
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Huart C, Collet S, Rombaux P. Chemosensory pathways: from periphery to cortex. B-ENT 2009; 5 Suppl 13:3-9. [PMID: 20084801] [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: 05/28/2023] Open
Abstract
The aim of this article is to summarise the anatomy of the chemosensory pathways. The vomeronasal organ, the olfactory system, the trigeminal system and the gustatory system will be reviewed in succession. For each of these systems, we will provide a description of the anatomy of the pathways sending the sensory message from the peripheral receptor to the cortical areas, passing through different relays in the nervous system. Particular emphasis will be paid to the anatomical features of the structures involved in chemosensory perception. This will help us to understand better how these systems interact and influence our social lives, our memories and our behaviour, and to evaluate patients with chemosensory dysfunction better.
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Affiliation(s)
- C Huart
- Department of Otorhinolaryngology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
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Rombaux P, Grandin C, Duprez T. How to measure olfactory bulb volume and olfactory sulcus depth? B-ENT 2009; 5 Suppl 13:53-60. [PMID: 20084805] [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: 05/28/2023] Open
Abstract
In combination with psychophysical testing and electrophysiological studies, magnetic resonance imaging plays a role in the clinical evaluation of patients with an olfactory dysfunction. Quantitative measurements of olfactory bulb volume and of olfactory sulcus depth, and the morphological depiction of structural abnormalities, make synergistic contributions to the accurate radiological diagnosis of smell dysfunction. Moreover, the plasticity of our olfactory system can be demonstrated by temporal changes in OB volumetric measurements. In this paper, we provide an outline of how to measure olfactory bulb volume and olfactory sulcus depth, with numerous illustrative cases of patients with congenital anosmia, post-infectious or posttraumatic olfactory loss and sinonasal-related olfactory dysfunction.
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Rombaux P, Collet S, Martinage S, Eloy P, Bertrand B, Negoias S, Hummel T. Olfactory testing in clinical practice. B-ENT 2009; 5 Suppl 13:39-51. [PMID: 20084804] [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: 05/28/2023] Open
Abstract
Numerous techniques are available in the clinic for the investigation of chemosensory function. Psychophysical testing using orthonasal and retronasal stimulation routes may help to distinguish anosmic from hyposmic patients. These psychophysical tests are most frequently used for odour identification and odour threshold. Chemosensory event-related potentials using olfactory and trigeminal stimulation have become part of the routine investigation of patients with olfactory loss in specialised smell and taste centres. The interpretation of results from psychophysical testing is frequently supported by the assessment of chemosensory event-related potentials. This review will discuss these methods, including how to perform them, focusing on normative data and describing some clinical examples from our centre (olfactory and trigeminal event-related potentials).
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Rombaux P, Mouraux A, Keller T, Hummel T. Trigeminal event-related potentials in patients with olfactory dysfunction. Rhinology 2008; 46:170-174. [PMID: 18853866] [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: 05/26/2023]
Abstract
OBJECTIVE There are mutual interactions between the olfactory and trigeminal systems. The purpose of this study was (1) to assess trigeminal sensitivity using chemosensory event-related potentials (CSERPs) in patients with olfactory dysfunction and (2) to evaluate whether trigeminal ERPs were different with regard to the presence or absence of olfactory ERPs. MATERIALS AND METHODS Prospective study of 60 patients who presented with olfactory dysfunction (postinfectious olfactory loss: n = 19, posttraumatic olfactory loss: n = 28, and olfactory loss due to idiopathic, or toxic causes: n = 13). All patients were extensively evaluated with an orthonasal olfactory test based on the "Sniffin' Sticks". In addition, chemosensory ERPs were recorded in response to olfactory and trigeminal stimulation. RESULTS Olfactory/trigeminal ERPs were recorded in 25/60 patients, respectively. Patients with no detectable olfactory ERPs, considered as severely affected, demonstrated an altered trigeminal sensitivity as indicated by an increase in P2 latencies and a decrease in both, P2 and N1-P2 amplitudes compared to patients with detectable olfactory ERPs. A regression analysis showed a negative relation between P2 latencies and the "Sniffin' Sticks"score (r = -0.46, p < 0.001). CONCLUSIONS Patients with severe olfactory dysfunction demonstrated decreased trigeminal sensitivity as indicated by electrophysiological measures. This study supports the idea of interactions between the chemical senses. Whether altered responses to trigeminal stimulation may be used as a prognostic measure related to recovery from olfactory loss remains to be demonstrated.
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Affiliation(s)
- Ph Rombaux
- Department of Otorhinolaryngology, Cliniques Universitaires Saint Luc, Brussels, Belgium.
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Rombaux P, Guérit JM, Mouraux A. Lateralisation of intranasal trigeminal chemosensory event-related potentials. Neurophysiol Clin 2008; 38:23-30. [PMID: 18329547 DOI: 10.1016/j.neucli.2007.12.002] [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] [Received: 12/29/2006] [Revised: 10/17/2007] [Accepted: 12/19/2007] [Indexed: 10/22/2022] Open
Abstract
AIM OF THE STUDY To determine whether or not chemosensory event-related brain potentials (CSERP) elicited by nociceptive unilateral intranasal (CO2) trigeminal stimulation are lateralized and, if they are, whether this hemispheric lateralization is related to the side of the stimulated nostril. METHODS Nine healthy right-handed subjects participated to the study. CSERPs were recorded after left or right monorhinal CO2 stimulation. Latency and baseline-to-peak amplitude of each CSERP component were compared across stimulation conditions (left and right nostril), scalp locations (lower-frontal, frontal, mid-temporal, central, posterior-temporal, parietal) and hemispheres (left or right), using a three-factor analysis of variance (ANOVA) for repeated measures. RESULTS Intranasal trigeminal CO2 stimulation elicited a large N400-P550 complex. This complex was preceded by an earlier N300 component. Whatever the stimulated nostril, N300, N400 and P550 amplitudes were significantly higher on the right as compared to the left hemisphere, at lower-frontal recording sites. The side of chemosensory stimulation (left or right nostril) did not significantly affect CSERP components. CONCLUSIONS This study showed that in healthy right-handed volunteers with normal olfactory ability, intranasal chemosensory trigeminal stimulation may elicit a series of event-related brain potentials, which all display a significant right-hemisphere predominance, irrespective of the stimulated nostril. The observed lateralization was maximal at lower-frontal recording sites.
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, université catholique de Louvain, cliniques universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Brussels, Belgium.
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Hupin C, Lévèque N, Eloy P, Bertrand B, Rombaux P. Congenital dacryocystocele: five clinical cases. B-ENT 2008; 4:141-145. [PMID: 18949960] [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: 05/27/2023] Open
Abstract
Congenital dacryocystocele (CDC) is recognised as a cause of nasal airway obstruction or respiratory distress in newborns. CDC is caused by the distal obstruction of the lachrymal duct and presents as a cystic formation in the inferior meatus. We discuss five cases of dacryocystocele, together with surgical management and outcome. Endoscopic endonasal marsupialisation and appropriate postoperative care resulted in definitive recovery for all patients. In newborns or infants with nasal obstruction, CDC should be considered in the differential diagnosis, and prompt endoscopic endonasal marsupialisation is mandatory.
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Affiliation(s)
- C Hupin
- Department of Otorhinolaryngology and Head and Neck Surgery, University of Louvain, Cliniques Saint Luc, Brussels, Belgium
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Bachert C, Bertrand B, Daele J, Jorissen M, Lefèbvre R, Rombaux P, Schmelzer B. Belgian guidelines for the treatment of acute rhinosinusitis in general practice. B-ENT 2007; 3:175-177. [PMID: 18265721] [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: 05/25/2023] Open
Abstract
Management and treatment guidelines for rhinosinusitis and nasal polyps have been published by the European Academy for Allergy and Clinical Immunology (EAACI) task force in 2005, and have recently been updated. These guidelines are evidence-based and internationally recognized, and form the basis for the here presented "Belgian Guidelines for the treatment of ARS in general practice", developed by the sinusitis committee. This document is intended to establish evidence-based management procedures for ARS, one of the most frequent upper airway diseases, mostly treated by the general practitioner. It is recommended to treat ARS with topical glucocorticosteroids 200 mcg BID. Antibiotics are recommended for the treatment of severe ARS, if need be, together with topical glucocorticosteroids BID.
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Affiliation(s)
- C Bachert
- Upper Airway Research Laboratory, Department of Otorhinolaryngology, Ghent University Hospital, Gent, Belgium.
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Rombaux P, Mouraux A, Bertrand B, Guerit JM, Hummel T. Assessment of olfactory and trigeminal function using chemosensory event-related potentials. Neurophysiol Clin 2006; 36:53-62. [PMID: 16844543 DOI: 10.1016/j.neucli.2006.03.005] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
GOALS To give an overview on the theoretical and practical applications of chemosensory event-related potentials. METHODS Chemosensory event-related potentials (ERPs) may be elicited by brief and precisely defined odorous stimuli. Based on the principles of air-dilution olfactometry, a stimulator was developed in the late 1970s, which allows stimulation of the olfactory neuroepithelium and the nasal mucosa with no concomitant mechanical stimulation. Chemosensory ERPs were obtained after stimulation of the olfactory nerve (olfactory ERPs) or the trigeminal nerve (somatosensory or trigeminal ERPs). The characteristics of the stimulator for chemosensory research as well as the variables influencing the responses are discussed in this paper. RESULTS Implementation and normative data from our department are reported with different clinical examples from otorhinolaryngologic clinic. The bulk of the evoked response consists of a large negative component (often referred to as N1), which occurs between 320 and 450 ms after stimulus onset. This component is followed by a large positive component, often referred to as P2, occurring between 530 and 800 ms after stimulus onset. Absence of olfactory ERPs and presence (even with subtle changes) of somatosensory ERPs is a strong indicator of the presence of an olfactory dysfunction. CONCLUSIONS This review examines and discusses the methods of chemosensory stimulation as well as the electrophysiological correlates elicited by such stimuli. The clinical applications of chemosensory ERPs in neurology and otorhinolaryngology are outlined.
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Affiliation(s)
- P Rombaux
- Department of Otorhinolaryngology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, 10, Avenue Hippocrate, 1200 Brussels, Belgium.
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Rombaux P, Liistro G, Hamoir M, Bertrand B, Aubert G, Verses T, Rodenstein D. Nasal obstruction and its impact on sleep-related breathing disorders. Rhinology 2005; 43:242-50. [PMID: 16405266] [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: 05/06/2023]
Abstract
Upper airway patency is essential during sleep in order to avoid sleep-related breathing disorders (SRBD). Nasal obstruction may have a negative impact on sleep quality and must be considered to be a co-factor in the pathophysiology of SRBD. In this paper we will discuss the relation between nasal physiology at night and sleep quality and the possible mechanisms between nasal obstruction and obstructive sleep apnea-hypopnea syndrome (OSAS). We will review the effect of the relief of nasal obstruction (with nasal dilators, medication and/or surgery) on SRBD. Also an algorithm on the management of OSAS patients when nasal surgery is indicated will be proposed.
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Affiliation(s)
- Ph Rombaux
- Department of Otorhinolaryngology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium.
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Abstract
Acanthamoeba infection is a rare, difficult-to-treat, and often fatal, opportunistic parasitic infection in immunocompromised hosts, such as patients infected with HIV. We describe an aggressive nasal and sinus infection by Acanthamoeba spp. in a person with AIDS. The resolution of this Acanthamoeba infection was secondary to a multidisciplinary treatment approach involving a combination of surgery as well as high-dose amphotericin B plus 5-fluorocytosine. In the era of the HIV/AIDS pandemic, the present report underscores the need for early identification and prompt aggressive treatment to ensure successful management of this rare but potentially fatal opportunistic infection.
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Affiliation(s)
- J B Nachega
- Department of Internal Medicine, Universite Catholique de Louvain (UCL), Saint-Luc University Hospital, Brussels, Belgium.
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Nachega J, Rombaux P, Weynand B, Thomas G, Zech F. Case Report: Successful Treatment of Acanthamoeba Rhinosinusitis in a Patient with AIDS. AIDS Patient Care STDS 2005. [DOI: 10.1089/apc.2005.19.835] [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: 11/12/2022] Open
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