0000000000266554
AUTHOR
Boris R. Haxel
Olfactory training is helpful in postinfectious olfactory loss: A randomized, controlled, multicenter study
Objectives/Hypothesis: The aim of this study was to evaluate the effects of olfactory training (OT) on olfactory function in patients with persistent postinfectious olfactory dysfunction (PIOD). Study Design: Randomized, single-blind, controlled, multicenter crossover study. Methods: Twelve tertiary university medical centers participated. Investigations were performed at three visits (base- line, after 18 weeks, and after 36 weeks), including only subjects with PIOD of <24-months duration. At each visit, partici- pants received detailed assessment of olfactory function. Seventy subjects trained with high concentrations of four odors for 18 weeks; the other half (n 5 74) trained with low co…
Vascular endothelial growth factor expression in nasal polyps of aspirin-intolerant patients.
Objective To study differences between aspirin-tolerant patients and aspirin-intolerant patients concerning vascular endothelial growth factor (VEGF) expression. Recent publications strongly suggest the involvement of VEGF and its receptors in the pathophysiologic process of nasal polyps. Design We subjected 43 polyp specimens to semiquantitative immunohistochemical analysis. We quantified VEGF and its receptors (Flk, Flt, and neuropilin) in all samples. To gain insight into potential VEGF-mediated cellular responses, we determined proliferative (Ki67) and apoptotic (caspase 3) indices. Patients Polyp samples were obtained from 22 aspirin-intolerant patients and from 21 aspirin-tolerant pat…
Cetuximab, fluorouracil and cisplatin with or without docetaxel for patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CeFCiD) : an open-label phase II randomised trial (AIO/IAG-KHT trial 1108)
Abstract Background The combination of cisplatin, 5-fluorouracil (5-FU) and cetuximab (PFC) is the reference first-line treatment for recurrent/metastatic (R/M) squamous cell carcinoma of the head and neck (SCCHN). We analysed whether treatment intensification by the addition of docetaxel to PFC improved efficacy in R/M SCCHN. Methods A total of 180 patients with R/M SCCHN (1:1) were assigned to receive either cisplatin (40 mg/m2), docetaxel (40 mg/m2) and 5-FU (2000 mg/m2) at days 1 and 8 and cetuximab (400/250 mg/m2) at days 1, 8 and 15 (DPFC) or standard cisplatin (100 mg/m2) at day 1, 5-FU (1000 mg/m2) at days 1–4 and cetuximab (400/250 mg/m2) at days 1, 8 and 15 (PFC). Chemotherapy was…
Comparison of subjective olfaction ratings in patients with and without olfactory disorders
AbstractObjective:Olfactory dysfunction is common. The reliability of self-assessment tools for smell testing is still controversial. This study aimed to provide new data about the accuracy of olfactory self-assessment compared with a standardised smell test.Design:Prospective, controlled, cohort study of patients with olfactory disorders and healthy controls.Subjects:Ninety-six patients with a smell deficit and 71 controls were asked to rate their sense of smell on a visual analogue scale. Their olfactory abilities were also evaluated with the Sniffin' Sticks tests.Results:The whole cohort showed a significant correlation between visual analogue scale smell scores and Sniffin' Sticks total…
Olfactory Dysfunction After Head Injury
Objective: To determine the incidence of olfactory dysfunction after head trauma using clinical and radiologic findings, quantitative assessment, and electro-physiologic methods. Participants: A total of 190 patients with head trauma of different severity (n = 32 with mild traumatic brain injury (TBI), n = 94 with signs of moderate TBI, and n = 64 with severe TBI) 6 to 32 months prior to the study. Design: Patients were selected retrospectively, surveyed by telephone (n = 190), and screened for olfactory function with Brief Smell Identification Test (n = 82). Those with olfactory dysfunction were assessed as outpatients using the Sniffin' Sticks (n = 19) and olfactory-evoked potential recor…
Olfaction in chemotherapy for head and neck malignancies
Abstract Objective Systemic chemotherapy for different malignancies occurs alongside various side effects, including reduced sensory function. To date, little is known about the effect of chemotherapeutic agents on olfaction. The aim of this study was to provide new data about changes in sense of smell during chemotherapy among patients with advanced squamous cell carcinomas of the head and neck region. Methods In a prospective, controlled cohort study of patients undergoing up to three courses of chemotherapy (cis- or carboplatin, 5-fluorouracil and docetaxel), olfaction was evaluated prior to and directly following completing a cycle, as well as 3 weeks later with the beginning of the nex…
Correlation of Skin Test Results and Specific Immunoglobulin E Blood Levels with Nasal Provocation Testing for House-Dust Mite Allergies
Background Allergen-specific immunotherapy for house-dust mite (HDM) allergies is associated with lower success rates when compared with similar treatments for other inhalant allergens, such as grass or birch. One reason might be the greater difficulty in diagnosing patients with assumed HDM allergies because symptoms occur perennially and may differ from those of a conventional allergic rhinitis. Objective The aim of the study was to compare the different methods of diagnosis in patients with assumed HDM allergy. Methods We performed a retrospective analysis of nasal provocation tests (NPT) from patients (n = 161) evaluated for Dermatophagoides pteronyssinus (n = 127) and Dermatophagoides …
Controlled trial for long-term low-dose erythromycin after sinus surgery for chronic rhinosinusitis
Objectives/Hypothesis The efficacy of macrolides in chronic rhinosinusitis (CRS) is still under controversy. To date, only two double-blind, placebo-controlled studies have been published with differing results. None of these studies investigated the possible benefit of macrolides in the postoperative period. We conducted an investigator-initiated clinical trial using 250-mg erythromycin once a day over a period of 3 months, beginning the administration of either erythromycin or placebo 2 weeks after a surgical intervention for CRS. Study Design Randomized double-blind, placebo-controlled trial. Methods The concentrations of eosinophilic cationic protein (ECP) and myeloperoxidase in nasal s…
Evaluation of the efficacy of the ‘nasal airflow-inducing manoeuvre’ for smell rehabilitation in laryngectomees by means of the Sniffin′ Sticks test
Clin. Otolaryngol. 2011, 36, 17–23 Objective: To determine the efficacy of the nasal airflow-inducing manoeuvre (NAIM) as a method for olfactory rehabilitation in laryngectomees by the means of the Sniffin′ Sticks test. Study design: Prospective open interventional trial. Setting: Tertiary academic hospital. Participants: Thirty-seven patients after laryngectomy have been screened and 25 patients have been included into the study. The participant’s sense of smell was tested with the Sniffin′ Sticks test before and after learning the nasal airflow inducing manoeuvre. The individual level of threshold, discrimination and identification (TDI) was determined and the individual threshold, di…
Dysregulated Survivin Expression in Nasal Polyps of Individuals with Aspirin Exacerbated Respiratory Disease
Background A derailed balance of cell proliferation and apoptosis is presumed to result in cell hyperplasia as a typical feature of nasal polyps. Survivin, a protein of the inhibitors of the apoptosis family is proposed to promote polyp formation. However, studies concerning survivin expression in chronic rhinosinusitis (CRS) with nasal polyps are rare and the specificity of the survivin expression in nasal polyps from individuals with aspirin-exacerbated respiratory disease (AERD) has not been investigated. Methods Immunohistochemical survivin expression analysis was performed. Samples were taken from the ethmoid sinus of individuals with CRS with nasal polyps with and without AERD during …
Cetuximab, fluorouracil (5-FU), cisplatin, and docetaxel as first-line treatment in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Interim results of a randomized phase II clinical trial (CeFCiD).
e17021 Background: This study investigates efficacy and toxicity of docetaxel added to cetuximab, cisplatin and 5-FU for patients with R/M SCCHN. We here report a planned second interim analysis to compare response rates between arms in order to decide on continuing to full accrual. Methods: Inclusion criteria were: stage III/IV R/M SCCHN and ECOG 0-1. Patients were randomized to arm A: cetuximab (standard dose) plus a maximum of 6 cycles of docetaxel (40 mg/m², day 1+8), cisplatin (40 mg/m², day 1+8) and 5-FU (2000 mg/m², day 1+8) or to arm B: cetuximab (standard dose), cisplatin (100 mg/m², day 1) and 5-FU (1000 mg/m², day 1-4). Treatment was administered until progression or intolerabil…
The Candy Smell Test in Clinical Routine
Background The “Candy Smell Test” (CST) has been introduced as a new testing method for the evaluation of the human sense of smell. In contrast to other established orthonasal smell tests, the CST addresses the retronasal application of odors, typical for food aroma effects during mastication and swallowing. The aim of this study was to evaluate the CST in a clinical setting in patients with olfactory dysfunction and normal controls against the Sniffin’ Sticks test. Furthermore, cutoff points for normal and pathological results in the CST should be determined. Methods The olfactory performance of 96 patients presenting with olfactory disorders and 71 healthy controls was evaluated with the …
Recovery of olfaction after sinus surgery for chronic rhinosinusitis: A review
Objective Investigation of the postoperative olfactory function after sinus surgery for chronic rhinosinusitis (CRS) with and without polyps in a review. Data sources PubMed. Review methods A comprehensive literature search was conducted through June 2018 using relevant keywords. The titles/abstracts were reviewed to identify studies evaluating the sense of smell in CRS-patients pre- and postoperatively by either using the whole or parts of the University of Pennsylvania Smell Identification Test or the Sniffin' Sticks test. Study characteristics and outcome data of the included studies were extracted. Results In total, 106 studies were retrieved. Twenty-four studies comprising 1,956 patien…
Course of olfaction after sinus surgery for chronic rhinosinusitis
Background The influence of surgery on olfaction in patients who suffer from chronic rhinosinusitis (CRS) is still not fully understood. Most particularly, the time course of the recovery is poorly studied. Methods The prospective study describes the results of the Sniffin' Sticks identification test in 41 subjects before (V1), 2 weeks after (V2), and 6 months after (V3) endonasal sinus surgery (ESS). Influencing factors (gender, revision surgery, nasal polyposis, and initial olfactory score) on the changes of the smell testing were evaluated. Results The whole cohort showed a significant improvement in Identification scores, from 8.63 to 10.24 after 2 weeks and to 10.68 after 6 months. Pat…
Prostaglandin E2 activates the ciliary beat frequency of cultured human nasal mucosa via the second messenger cyclic adenosine monophosphate.
Prostaglandins influence the ciliary beat frequency (CBF) of ciliated nasal epithelial cells and a stimulatory effect has been described for prostaglandin E2 (PGE2). Until now, it is not known whether PGE2 has direct ciliostimulatory properties or acts through a second messenger. In this study we investigated whether cyclic adenosine monophosphate (cAMP) is implicated in the signal transduction pathway of PGE2-induced activation of CBF. Ciliated cells of the nasal mucosa were cultured for up to 5 days whereafter the culture medium was removed and the cells were incubated with different concentrations of test solutions. The ciliated cells were recorded under a phase-contrast microscope and v…