1. |
- Asplund, Monika Stenkvist, et al.
(författare)
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Chemotherapy in severe nasal polyposis - a possible beneficial effect? : A report of three cases
- 2010
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 48:3, s. 374-376
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nasal polyposis is an inflammatory process of the nasal mucosa. Treatment has changed from surgery to an anti-inflammatory approach, but neither of these treatments addresses the underlying cause. Topical steroids and occasional use of systemic steroids in patients with nasal polyposis can frequently control the polypoid disease. In a few cases, when the disease is more aggressive, the repeated application of systemic steroids together with sinus surgery is required. Material and Methods: We present our experience with one case of rheumatoid arthritis and two cases with malignant diseases, all of which were treated with chemotherapy and were also accompanied by severe nasal polyposis. All of our patients had eosinophilic polypoid disease. Various chemotherapeutic treatment schemes were utilized. Results: During chemotherapy all three patients were markedly improved symptomatically including olfaction along with a significant reduction in their nasal polyposis. Duration of remission lasted for a few months in two cases and for three years, in a third case. Conclusion: This is the first report describing the successful treatment of severe nasal polyposis with chemotherapy. Based on this experience, we suggest a phase II trial with chemotherapy, preferably "low dose" methotrexate, in patients with severe nasal polyposis.
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2. |
- Bengtsson, Caroline, et al.
(författare)
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Sinonasal outcome test-22 and peak nasal inspiratory flow : valuable tools in obstructive sleep apnoea
- 2020
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 58:4, s. 341-348
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sinonasal complaints contribute to low adherence to continuous positive airway pressure (CPAP) treatment. We aimed to investigate sinonasal health in obstructive sleep apnoea (OSA) patients, using the sinonasal outcome test-22 (SNOT-22), and to analyse whether SNOT-22 is affected by CPAP adherence. We also aimed to investigate whether peak nasal inspiratory flow (PNIF) was able to predict adherence to CPAP. Methods:The study population comprised 197 OSA patients (60 females) initiating CPAP treatment The SNOT-22, PNIF and the Epworth Sleepiness Scale were assessed at baseline and follow-up. One-night polygraphy, the Hospital Anxiety and Depression Scale, peak expiratory flow and health-related issues were assessed at baseline. At follow-up, the patients were categorised into adherent (>4 hours/night) and non-adherent (<4 hours/night) to CPAP treatment. Results: The average time for following up CPAP treatment was (mean +/- SD) 24.0 +/- 23.9 days and it did not differ significantly between the groups.The SNOT-22 score was elevated among all OSA patients, 36.1 +/- 19.4.There was a larger improvement in the SNOT-22 score at follow-up among adherent CPAP users compared with non-adherent users (-10.4 +/- 13.9 vs. -3.2 +/- 15.4). A PNIF value of < 100 litres/min increased the risk of non-adherence to CPAP with an adjusted odds ratio (OR) of 2.40 ((95% CI 1.16-5.00)). Conclusions: The SNOT-22 was elevated in patients with OSA, indicating a considerable sinonasal disease burden.The SNOT-22 improved with good CPAP adherence. A low PNIF value was able to predict poor CPAP adherence. Both the SNOT-22 and PNIF can be valuable tools in the evaluation of OSA patients and in the management of CPAP treatment.
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3. |
- Bohman, Anton, et al.
(författare)
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Heredity of nasal polyps
- 2015
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 53:1, s. 25-28
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nasal polyps is a common disease but little is known about its' pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps. Methodology: Patients with nasal polyps who attended the clinic were recruited to the study and were asked whether they had any close adult relatives (siblings, parents or children). We intended to recruit two relatives per patient, one of each gender, for nasal endoscopy. The prevalence of nasal polyps in these relatives was compared with the prevalence of nasal polyps in a general population. Results: During a 4-year period, 368 patients and 410 relatives were recruited to the study. Although we were unable to recruit two close relatives for every patient, we were able to calculate nasal polyp prevalence within families as being 19.2%. Compared with the prevalence of nasal polyps among individuals in a general Swedish population from the same geographical area, the relative risk for polyps among relatives was almost five times higher. Conclusion: This study strongly indicates that heredity is a factor of importance for development of nasal polyps.
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4. |
- Brämerson, Annika, 1960, et al.
(författare)
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Olfactory loss after head and neck cancer radiation therapy
- 2013
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 51:3, s. 206-209
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A reduced sense of smell may be one explanation for why patients with cancer in the ear, nose and throat (ENT) region who are treated with radiation therapy lose weight. The purpose of this study was to investigate whether radiation therapy has a negative effect on olfactory function and, if so, whether this effect is dose-related.METHODOLOGY: Seventy-one patients were tested using odour-detection sensitivity and olfactory identification tests before radiation therapy and 20 months after it.RESULTS: Patients who received radiation close to the olfactory organ showed a reduced sense of smell, in both tests. A multiple regression analysis showed that the radiation dose was related to decline in the olfactory function, while age, sex, chemotherapy and interactions between these variables were not.CONCLUSION: Radiation therapy can damage olfactory cells.
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5. |
- Davidsson, Åke, 1956-, et al.
(författare)
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Allergen-induced changes of B-cell phenotypes in patients with allergic rhinitis
- 1994
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Ingår i: Rhinology. - Amsterdam, Netherlands : International Rhinologic Society. - 0300-0729 .- 1996-8604. ; 32:4, s. 184-190
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Tidskriftsartikel (refereegranskat)abstract
- We investigated sub-populations of B-lymphocytes in nasal mucosa and peripheral blood of 17 patients with seasonal allergic rhinitis (birch pollen) and 10 controls. The study included provocation with allergen during the non-pollen season, during which no participant used medication. Samples were also taken during the pollen season. Subsets of B-cells as expressed by different CD antigens were investigated by immunohistochemistry on frozen sections and by flow cytometry of peripheral blood. Nasal CD23+ B-cells decreased in allergic patients during provocation, indicating that mature virgin CD23+ B-cells switch into a memory B-cell phenotype with loss of CD23 expression. This indicates differentiation towards cells that can represent a local source for IgE synthesis. No decrease was observed during the pollen season when the patients used medication. Serum IgE was significantly higher in allergic patients on all occasions. The observed up-regulation of CD40 expression on peripheral blood B-cells in allergic patients during the pollen season clearly indicate B-cell activation. Furthermore, a relative increase of CD19+ B-cells was observed in peripheral blood during provocation. Upregulation (by IL-4) of CD40 on B-cells which then may be stimulated by gp39 (CD40 ligand) can constitute an early and important event in the IgE-mediated allergic reaction.
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6. |
- Havel, Miriam, et al.
(författare)
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Effects of functional endoscopic sinus surgery on the acoustics of the sinonasal tract
- 2017
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Ingår i: Rhinology. - : INT RHINOLOGIC SOC. - 0300-0729 .- 1996-8604. ; 55:1, s. 81-89
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Tidskriftsartikel (refereegranskat)abstract
- Background: Nasal and paranasal cavities are supposed to contribute substantially to the vocal tract resonator properties. However, their acoustical effects as well as the effects of sinus surgery on the voice remain unclear. In this work we investigate resonance phenomena of paranasal sinuses prior to and after various rhinosurgical procedures in cadaveric human sinonasal tracts and corresponding 3D casts. Methodology: Nasal and paranasal cavities of formalin-preserved cadavers and corresponding 3D replicas were excited by sine tone sweeps from an earphone placed in the epipharynx.The response was picked up by a microphone at the nostrils. Different FESS procedures were performed and the acoustical responses following excitation were recorded.The measured acoustical changes in the obtained transfer functions were then evaluated. Results: Marked low frequency dips were detected in the transfer functions when sinus cavities were included in the nasal resonator system. These dips showed a significant correlation with sinus volumes. Following FESS procedures they moved upwards in frequency depending on the extent of the surgical intervention. Conclusions: The transfer functions obtained in cadaveric situs and 3D replicas showed dips at the resonance frequencies of the paranasal cavities. Marked acoustic effects in terms of increase in dip frequency following FESS procedures were reproducibly documented.
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7. |
- Havel, Miriam, et al.
(författare)
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Resonator properties of paranasal sinuses : preliminary results of an anatomical study
- 2014
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 52:2, s. 178-182
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Tidskriftsartikel (refereegranskat)abstract
- Background: The contribution of the nasal and paranasal cavities to vocal tract resonator properties is unclear as are voice effects of sinus surgery. Here we investigate resonance phenomena of paranasal sinuses with and without selective occlusion of the middle meatus and maxillary ostium in a cadaver. Methodology: Nasal and paranasal cavities of a Thiel-embalmed cadaver were excited by sine-tone sweeps from an earphone in the epipharynx.The response was picked up by a microphone at the nostrils. Different conditions with blocked and unblocked middle meatus were tested. Additionally, infundibulotomy was performed allowing direct access to and selective occlusion of the maxillary ostium. Results: Responses showed high reproducibility. Minor effects appeared after removal of meatal occlusion. A marked low frequency dip was detected after removal of occlusion of maxillary ostium following infundibulotomy. Conclusion: Reproducible frequency responses of nasal tract can be derived from cadaver measurements. Marked acoustic effects of the maxillary sinus appeared only after direct exposure of the maxillary ostium following infundibulotomy.
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8. |
- Hedén Blomqvist, Ebba, et al.
(författare)
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Consequences of olfactory loss and adopted coping strategies
- 2004
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Ingår i: Rhinology. - Utrecht : International rhinologic society. - 0300-0729 .- 1996-8604. ; 42:4, s. 189-194
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Tidskriftsartikel (refereegranskat)abstract
- The aims of this study were to investigate the effects of loss of smell as regards the quality of life and the coping strategies used. Methods: Seventy-two patients with anosmia (46%) or hyposmia (54%) filled in the validated Multi-Clinic Smell and Taste Questionnaire, the validated General Well-being Schedule (GWBS), and answered other questions shown to be of good validity. Results: Several kinds of negative effects, risks associated with the loss, interference with daily routines and deteriorations in well-being were common. Physical health, financial security, profession, partnership, friendship, emotional stability and leisure were also deemed to be negatively affected and GWBS scores show compromised psychological well-being. The importance of olfaction seemed to be more noticeable after the loss of smell, and several kinds of problem- and emotion-focused coping strategies were adopted by these patients. Conclusions: We found that the loss of smell had substantial adverse affects on the quality of life and that high priority should be given to its diagnosis and treatment and to further research in this field. Furthermore, a combination of problem- and emotion-focused coping strategies may be suggested to patients who have recently lost the sense of smell.
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9. |
- Hellquist, H. B., et al.
(författare)
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Activated T cells in the nasal mucosa of patients with grass-pollen allergy. A pilot study
- 1992
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Ingår i: Rhinology. - Amsterdam, Netherlands : International Rhinologic Society. - 0300-0729 .- 1996-8604. ; 30:1, s. 57-63
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Tidskriftsartikel (refereegranskat)abstract
- Six patients with grass-pollen allergy were provoked with water-soluble grass pollen until a pronounced allergic reaction occurred. This was performed outside the grass-pollen season, and the allergen was administered on the edge of the inferior turbinate. Biopsies were taken both before provocation and during the reaction, 15-30 minutes after provocation. The nasal population of immunohistochemically positive cells for HLA-DR, CD1, interleukin-2-receptor, IgE, CD4 and CD8 were studied. There was a marked increase of IL2-R-positive cells (activated T lymphocytes) in the nasal mucosa after provocation, whilst the other cell populations approximately remained unchanged (apart from a certain increase of IgE). The increase of activated T lymphocytes may imply that certain subsets of T cells play a role in the allergic response, and that the role of helper T cells very likely is much more complex than the regulation of mast cells and eosinophils. The concomitant presence of Langerhans' cells (CD1-positive) and activated T lymphocytes may indicate a possible association on site between an antigen-presenting cell and both effector as well as memory cells in allergic reactions.
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10. |
- Holmström, Mats
(författare)
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The use of objective measures in selecting patients for septal surgery
- 2010
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 48:4, s. 387-393
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Forskningsöversikt (refereegranskat)abstract
- To improve results in septal surgery, patient selection is the mainstay of a successful outcome. Patient history is the basis as well as clinical examination but both are subjective and must be considered towards a background with a high frequency of septal deviation in the population and a lack of good correlation between function and status. Rhinomanometry and acoustic rhinometry as well as nasal peak inspiratory flow are tests of different nasal parameters as resistance to breathing, nasal dimensions and flow. This article illuminates the use of these more objective tests in selection of patients for septoplasty. Objective tests have in several studies shown to predict postoperative satisfaction while normal values can be a marker for a poor surgical outcome. Pros and cons with objective tests are discussed and the conclusion is: operate when there is a good correlation between the patient's status, history and the results of rhinometry!
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11. |
- Hsieh, Julien W., et al.
(författare)
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Can MRI predict olfactory loss and improvement in posttraumatic olfactory dysfunction?
- 2024
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 62:2, s. 172-182
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Although most patients with post-traumatic olfactory dysfunction (PTOD) undergo MRI, there is no consensus about its diagnostic or prognostic value.The aims were: 1) to classify the extent of post-traumatic neurodegeneration; 2) todetermine its relationship with chemosensory dysfunction (smell, taste, trigeminal); and 3) to establish whether MRI can predict olfactory improvement. METHODOLOGY: We conducted a retrospective cohort study based on a series of 56 patients with PTOD. All patients underwent validated psychophysical tests of their smell, taste, and trigeminal functions, otorhinolaryngologic evaluation, and MRI. An experiencedradiologist blinded to patient data evaluated 40 chemosensory-relevant brain regions according to a four-point scale (0=no lesion to 3=large lesion). Follow up data after 4 years (on average) were available in 46 patients. RESULTS:The cluster analysis showed 4 brain lesion patterns that differed in lesion localization and severity. They are associatedwith diagnostic categories: anosmia, hyposmia and normosmia. Two clusters were highly specific for anosmia (100% specificity)and could accurately predict this condition (100% positive predictive value). No clusters were associated with trigeminal or tastedysfunction. Regarding improvement, 72.7% of patients in the cluster with mild lesions experienced subjective and measurable olfactory improvement whereas this was only the case in 21.7-37.5% of patients with larger lesions. The odds of subjective smellimprovement were 5.9 times higher in patients within the milder cluster compared to larger ones. CONCLUSIONS: The analysis of brain lesions in PTOD allows corroboration of smell test results and prediction of subjective and measurable improvement.
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12. |
- Hydén, Dag, 1945-, et al.
(författare)
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On the sneeze-reflex and its control
- 2007
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 45:3, s. 218-219
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Tidskriftsartikel (refereegranskat)abstract
- Experiments in cats have shown that sneezing can be induced using low intensity electrical current. This study focusses on answering the question whether the sneezing-reflex can also be induced in man through electrical stimulation, whether it is reproducible, and if the response can be abolished pharmacologically? Three healthy males were tested using intranasal stimulation in different parts of the nose using a current from an electric pulse generator. Using currents in the range 2-11 mA, it was possible to induce and reproduce sneezing in the anterior portion of the nose corresponding to the distribution area of the anterior ethmoidal nerve. In one tested subject, local anaesthetics applied to the mucous membranes of the nose abolished the sneezing. Sneeze reflex-reduction may be one way to reduce viral contamination between subjects. Further research could include pharmacological investigations to identify a sneeze-inhibiting substance with small risks for side effects that can be added to common cold nasal sprays.
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13. |
- Jung Lee, Eun Jung, et al.
(författare)
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Analysis of expression profiling data suggests explanation for difficulties in finding biomarkers for nasal polyps
- 2020
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Ingår i: Rhinology. - : INT RHINOLOGIC SOC. - 0300-0729 .- 1996-8604. ; 58:4, s. 360-367
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Tidskriftsartikel (refereegranskat)abstract
- Background: Identification of clinically useful biomarkers for Nasal Polyposis in chronic rhinosinusitis (CRSwNP) has proven difficult. We analyzed gene expression profiling data to find explanations for this. Methods:We analyzed mRNA expression profiling data, GSE36830, of six uncinate tissues from healthy controls and six NP from CRSwNP patients. We performed Ingenuity Pathway Analysis (IPA) of differentially expressed genes to identify pathways and predicted upstream regulators. Results: We identified 1,608 differentially expressed genes and 177 significant pathways, of which Th1 and Th2 activation pathway and leukocyte extravasation signaling were most significant. We identified 75 upstream regulators whose activity was predicted to be upregulated.These included regulators of known pathogenic and therapeutic relevance, like IL-4. However, only seven of the 75 regulators were actually differentially expressed in NP, namely CSF1, TYROBP, CCL2, CCL11, SELP, ADORA3, ICAM1. Interestingly, these did not include IL-4, and four of the seven were receptors. This suggested a potential explanation for the discrepancy between the predicted and observed expression levels of the regulators, namely that the receptors, and not their ligands, were upregulated. Indeed, we found that 10 receptors of key predicted upstream regulators were upregulated, including IL4R. Conclusion: Our findings indicate that the difficulties in finding specific biomarkers for CRSwNP depend on the complex underlying mechanisms, which include multiple pathways and regulators, each of which may be subdivided into multiple components such as ligands, soluble and membrane-bound receptors. This suggests that combinations of biomarkers may be needed for CRSwNP diagnostics.
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14. |
- Lee, Eun Jung, et al.
(författare)
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Lack of correlation between serum 25(OH)D level and endoscopy-based chronic rhinosinusitis in Korean adults
- 2019
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Ingår i: Rhinology. - : International Rhinologic Society. - 0300-0729 .- 1996-8604. ; 57:2, s. 139-146
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Tidskriftsartikel (refereegranskat)abstract
- Several previous studies have shown that serum 25(OH)D deficiency is associated with increased risk of chronic rhinosinusitis (CRS) in adults and also correlated with disease severity. We aimed to investigate the correlation between serum 25(OH)D level and endoscopy-based CRS in adults using the Korean National Health and Nutrition Examination Survey.
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15. |
- Lindbom, John, 1960-, et al.
(författare)
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Phospholipase A2 mRNA expression in the nasal mucosa of healthy subjects and patients with seasonal allergic rhinitis
- 2004
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 42:2, s. 85-91
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Tidskriftsartikel (refereegranskat)abstract
- Phospholipase A2 (PLA2) is a family of enzymes that play different role(s) in inflammation, but their importance in seasonal allergic rhinitis (SAR) has not been clarified. Here, we determined the levels of messenger ribonucleic acid (mRNA) for different PLA2 types in the nasal mucosa of SAR patients (n=6) and healthy controls (n=5). Nasal brush samples were taken both during pollen season, when the symptoms of the patients were severe, and off-season, when the patients were free of symptoms. We found that PLA2 IB, IIA, IID,IIE, IIF III, IVA, IVB, IVC, VIA, VIB, VIIA, VIIB, VIIIA, VIIIB, X, XII and XIII were all expressed in each subject at both occasions. The mRNA levels of PLA2 VIIA (platelet-activating factor (PAF) acetylhydrolase) were lower in SAR patients than controls, both during pollen season (p = 0.03) and off season (p = 0.03). These findings demonstrate that a large number of PLA2 types are expressed in the nasal mucosa, regardless of whether there is ongoing allergic inflammation or not. The observation that PAF acetylhydrolase mRNA expression in the nasal mucosa is lower in SAR patients than in healthy subjects suggests the possibility that impaired ability to inactivate PAF might be of importance in SAR. Further studies are required to clarify whether the decreased PAF acetylhydrolase mRNA expression in SAR is accompanied by decreased enzyme activity and whether aberrations in PAF acetylhydrolase are present in infectious rhinitis patients as well.
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16. |
- Nordin, Steven, 1960-, et al.
(författare)
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Prevalence of parosmia : the Skövde populationbased studies
- 2007
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Ingår i: Rhinology. - Leiden : International Rhinologic Society. - 0300-0729 .- 1996-8604. ; 45:1, s. 50-53
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Tidskriftsartikel (refereegranskat)abstract
- Aim: Parosmia can be defined as a qualitative odor distortion. Despite the consequences of this condition for quality of life, the scientific literature lacks information about the prevalence of parosmia in the general population, which was the objective of the present study. Methods: Random samples of 1,900 adult and 401 teenage inhabitants, stratified for age and gender, were drawn from the municipal population register of Skövde, Sweden. In total, 1,713 individuals (74% of the samples) agreed to participate, of which 1,387 (73%) were adults and 326 (81%) were teenagers. They responded to a question about parosmia by means of either a structured interview (adults) or a questionnaire (teenagers). Results: The overall prevalence of parosmia was 3.9% (4.0% in adults and 3.4% in teenagers), which was stable across gender, but differed somewhat between age groups, with highest prevalence in the age group 20-29 years. Conclusions: The rather high overall prevalence, 3.9%, does indeed suggest that parosmia deserves attention when attempting to better understand olfactory dysfunction in clinical settings and in the general population of both adults and teenagers.
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17. |
- Olsson, P., et al.
(författare)
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Quality of life is improved by endoscopic surgery and fluticasone in nasal polyposis with asthma
- 2010
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 48, s. 325-330
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to investigate the health impact of nasal polyposis with asthma and to study effects of endoscopic sinus surgery (ESS), and addition of fluticasone propionate nasal drops (FPND), on health related quality of life (HRQoL).Methods: Prospective study of 68 patients with nasal polyposis and asthma. Effects were measured with Study 36-Item Short Form (SF-36). A randomized, double-blind, placebo-controlled 14-weeks phase measuring additive effects of FPND 400 μg twice daily (b.i.d.) was included.Results: HRQoL was significantly decreased in both Physical Component Summary, PCS, and Mental Component Summary, MCS, vs reference population. ESS significantly improved PCS, and MCS after five weeks. We found significant additional benefit of FPND on three domains. The increase in HRQoL with FPND reached reference population levels in all domains, as well as in both PCS and MCS, five weeks after ESS. Conclusions: FPND 400 μg b.i.d. can be added to ESS in order to improve, and to reach population levels of, HRQoL already five weeks post-ESS. Physicians should evaluate HRQoL and consider ESS with nasal steroids early in their treatment of these patients.
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18. |
- Sunnergren, Ola, et al.
(författare)
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On the outcome of septoplasty
- 2024
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Ingår i: Rhinology. - : European Rhinologic Society. - 0300-0729 .- 1996-8604. ; 62:4, s. 509-510
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Tidskriftsartikel (refereegranskat)abstract
- In 2019 and 2023, two randomised controlled trials (RCTs) on the effectiveness of septoplasty were published (1,2). Part of the rationale for both studies was that the value of septoplasty had been questioned by policymakers, health insurance carriers and health care providers. The results of both studies showed that patients undergoing septoplasty had a better outcome than patients in the control group. Without questioning these results or the general perception in the rhinology community that septoplasty is of great value to the right patient, we still see the need for caution when interpreting the outcome of the RCTs and when rhinologists try to transfer the results to routine clinical practice. Van Egmond et al. draw the conclusion that the results from their RCT should be applicable to all patients with nasal obstruction due to a deviated septum.
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19. |
- Thomas-Danguin, T., et al.
(författare)
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Development of the ETOC: A European Test of Olfactory Capabilities
- 2003
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 41:3, s. 142-151
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Tidskriftsartikel (refereegranskat)abstract
- A number of smell tests designed to evaluate human olfactory capabilities have been published, but none have been validated cross-culturally. The aim of this study was therefore to develop a reliable and quick olfactory test that could be used to evaluate efficiently the olfactory abilities of a European population. This test, named ETOC and based on a combination of a supra-threshold detection task and an identification task, was designed to be a cross-cultural tool that would measure the decline in olfactory performance with ageing. Two versions of the ETOC, one easy and one less easy, were used to test the olfactory performance of European citizens in three countries (France, Sweden and the Netherlands). The results indicated that neither version of the ETOC is culture-dependent, and that both give scores that well reflect the decrease in olfactory abilities with increasing age. A retest session showed that the less easy (and final) version of the ETOC is also highly reliable.
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20. |
- Thorold, Hanna, et al.
(författare)
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The effect of smoking on physiological decongestion of the nasal mucosa in human.
- 2010
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Ingår i: Rhinology. - Amsterdam, the Netherlands : International Rhinologic Society. - 0300-0729 .- 1996-8604. ; 48:4, s. 438-440
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Exercise is known to decongest the nasal mucosa which results in increased nasal patency. In a recent study it was suggested that smoking might influence the effect of exercise on the nasal mucosa. This implies that smoking may cause neurological damage to the normal nasal physiology, which has not previously been shown. The aim of this study was to investigate whether there was a difference in nasal mucosal reaction to exercise between smokers and non-smokers.METHODOLOGY: Forty-two smokers and non-smokers underwent acoustic rhinometry to register nasal geometry before and after cycling on an ergometer cycle. A structured interview was used for questions about smoking habits and airway symptoms.RESULTS: Both smokers and non-smokers had a significant increase in MCA (minimal cross-section area) and total nasal volume after exercise. There was no statistical significant difference between smokers and non-smokers.CONCLUSIONS: Smoking does not seem to affect the normal physiological decongestion of the nasal mucosa after exercise.
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21. |
- Thulesius, Helle L, et al.
(författare)
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What happens to patients with nasal stuffiness and pathological rhinomanometry left without surgery?
- 2009
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 47:1, s. 24-7
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Tidskriftsartikel (refereegranskat)abstract
- In this study we explored long term outcomes of patients with nasal stuffiness and high nasal airway resistance (NAR) that did not undergo nasal surgery. The same investigation was repeated on average 8 years after a baseline investigation with an ENT-examination, a rhinomanometric survey and a rhinomanometry. We did follow-up investigations in 44 out of 59 non-operated patients with a pathological NAR on at least one side. At follow-up 2 persons (4%) had no complaints, 14 (32%) had reduced, 22 (50%) unchanged, and 6 (14%) increased complaints of nasal stuffiness. Rhinomanometry showed that NAR values decreased significantly between baseline and follow-up on both wider and narrower sides after decongestion. There was no correlation between subjective nasal complaints and NAR-values. In logistic regression models increasing age and allergy prevalence at baseline were significantly associated with having no, or reduced nasal stuffiness at follow-up. The results show that both NAR and subjective nasal stuffiness decreased with age. Consequently, we suggest that NAR normal values should be age adjusted. Also, a wait and see policy towards nasal stuffiness seems relevant since 36% of our patients had no or reduced nasal stuffiness while their NAR-values were reduced after 8 years.
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22. |
- Wedbäck, Anna, et al.
(författare)
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Seasonal non-allergic rhinitis (SNAR)--a new disease entity? : A clinical and immunological comparison between SNAR, seasonal allergic rhinitis and persistent non-allergic rhinitis
- 2005
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 43:2, s. 86-92
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Tidskriftsartikel (refereegranskat)abstract
- We have earlier described a group of patients suffering from rhino-conjunctivitis during the early pollen season, but with negative allergological investigation. The present study aimed to evaluate this syndrome called Seasonal Non-Allergic Rhinitis (SNAR). Seventeen patients with SNAR were compared with 20 patients with seasonal allergic rhinitis (SAR) and 13 patients with persistent non-allergic rhinitis (PNAR). They were analyzed with skin prick tests (SPT) and nasal provocation tests (NPT) with pollen extracts, and for IgE antibodies in serum and inflammation mediators in nasal lavage. Daily symptoms and medicine consumption were recorded. Late reactions after SPT occurred in two SNAR, eight SAR and two PNAR patients. Weak immediate and late reactions after NPT were induced in 3/15 and 7/15 SNAR patients, respectively, and in 1/13 and 5/13 PNAR patients. All SAR patients had immediate and 9/18 had late reactions. The total IgE levels were lower in SNAR compared to SAR. In the SNAR group 1/15 was positive in Phadiatop. Increased tryptase levels after NPT were only observed in SAR. The SNAR patients had high daily symptom scores already before birch pollen season. Sneezing was more common in SNAR and SAR than in PNAR; eye-symptoms more prominent in SAR than in SNAR or PNAR. SNAR seems to be different from SAR and PNAR regarding immunological mechanism and symptom period. We conclude that the cause of SNAR is unknown
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23. |
- Wehling, Eike, et al.
(författare)
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Even cognitively well-functioning adults are unaware of their olfactory dysfunction : Implications for ENT clinicians and researchers
- 2015
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Ingår i: Rhinology. - Utrecht, Netherlands : International Rhinologic Society. - 0300-0729 .- 1996-8604. ; 53:1, s. 89-94
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Tidskriftsartikel (refereegranskat)abstract
- Background: Past findings of an impact of cognitive impairment on awareness of olfactory dysfunction, and high prevalence of age-associated cognitive impairment motivated the present study of whether middle-aged and elderly adults are unaware of an olfactory dysfunction despite being carefully screened for cognitive impairment. Methodology: The sample included 203 Norwegian participants, aged 46-79 years, 134 women and 69 men, who underwent comprehensive neuropsychological assessment for screening of cognitive impairment. Subjective assessment of olfactory function ("How would you estimate your sense of smell?") was compared with outcome on objective assessment of olfactory function with the Scandinavian Odor Identification Test, which in the present study was shown to be valid for use on Norwegian populations. Results: We found that 79% of this cognitively healthy sample with objectively assessed olfactory dysfunction reported normal olfactory function (57% of functionally anosmics reported normal function). In contrast, only 9% with objectively assessed normal olfactory function reported olfactory dysfunction. Conclusion: A large proportion of cognitively well-functioning middle-aged and elderly adults with an olfactory dysfunction are unaware of their dysfunction.The ENT physician who suspects that the sense of smell may be compromised should, in addition to an anamnesis, assess the patient's olfactory function objectively.
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27. |
- Bergqvist, Joel, et al.
(författare)
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Dose-dependent relationship between nocturnal gastroesophageal reflux and chronic rhinosinusitis in a middle-aged population: results from the SCAPIS pilot
- 2023
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Ingår i: Rhinology. - 0300-0729. ; 61:2, s. 118-123
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Gastroesophageal reflux (GER) has been associated with several upper- and lower-airway diseases. It would be plausible if nightly occurring reflux via laryngopharyngeal reflux (LPR) might affect the upper airways. Still, the role of nocturnal gastroesophageal reflux (nGER) in chronic rhinosinusitis (CRS) is not fully established. The aim of this population-based study was to investigate the association between nGER and CRS. METHODOLOGY: This cross-sectional population-based study comprises 1,111 randomly selected subjects from Gothenburg, Sweden, aged 50-64 years. The study is based on self-reported validated questionnaires. CRS was defined according to EPOS criteria. nGER was reported in relation to frequency. RESULTS: CRS was more common among subjects with nGER than in those without (13 vs. 4.8%). There was a dose-response association between the frequency of nGER episodes and the risk of having CRS. In the logistic regression adjusted for (age, sex, BMI, educational level, smoking, and asthma). CRS was associated with nGER, OR 1.43 and the odds ratio increased if episodes were reported 'almost every night' OR 4.6. CONCLUSIONS: The study shows an association between nocturnal GER and CRS in a middle-aged population. The revealed dose dependency supports, though does not prove causality.
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28. |
- Björk-Eriksson, Thomas, 1960, et al.
(författare)
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Fewer problems with dry nasal mucous membranes following local use of sesame oil
- 2000
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Ingår i: Rhinology. - 0300-0729. ; 38:4, s. 200-3
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Tidskriftsartikel (refereegranskat)abstract
- Many people experience problems with a dry nasal mucous membrane, often without wondering why. Their noses itch and burn and dried mucus collects there. These problems are exacerbated during the winter, in air-conditioned environments and after nasal irradiation. Twenty patients experiencing problems with dryness of the nose were selected from outpatient clinics, together with twenty patients who had previously undergone nasal irradiation. During the first five days no treatment was administered. For the following twenty days the patients sprayed sesame oil into each nostril three times a day. For the last five days no treatment was given. When both groups received treatment and sprayed sesame oil (Nozoil) in their noses, the nasal problems decreased significantly. The greatest effect is exerted on dryness. The side effects from using this oil are few in number and mild.
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- Bohman, Anton, et al.
(författare)
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Heredity of nasal polyps.
- 2015
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Ingår i: Rhinology. - 0300-0729. ; 53:1, s. 25-8
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Tidskriftsartikel (refereegranskat)abstract
- Nasal polyps is a common disease but little is known about its` pathogenesis. Our hypothesis was that there are genetic factors involved in the development of this disease. The aim of this study was to examine close relatives of patients with nasal polyps and comparing them with a general population with regard to prevalence of polyps.
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31. |
- Cervin, Anders, et al.
(författare)
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Intranasal steroids and septum perforation--an overlooked complication? A description of the course of events and a discussion of the causes
- 1998
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Ingår i: Rhinology. - 0300-0729. ; 36:3, s. 128-132
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Tidskriftsartikel (refereegranskat)abstract
- The use of intranasal steroids for the treatment of allergic and vasomotor rhinitis has doubled during the past 5 years. The number of reported cases of nasal septum perforation has increased correspondingly. The mechanism behind this is unknown, and steroid-induced septum perforation is rarely described in the literature. In order to describe the course of events and to form an idea of the extent of the problem, we have reviewed the cases reported at our clinic and compiled reports on side-effects from the Swedish Medical Products Agency. In our department we found 32 patients with septum perforation (21 women and 11 men). The most common risk factor for septum perforation was steroid treatment, 11 cases (10 women, 1 man, average age 33 years, range 19-49 years). The information obtained from the Swedish Medical Products Agency showed that 38 cases of steroid induced septum perforation had been reported during the past 10 years. The number of side-effects per million Defined Daily Dose (DDD) was averaged to 0.21. The risk of perforation is greatest during the first 12 months of treatment and the majority of cases involves young women. We conclude that septum perforation due to nasal sprays are underreported in Sweden and that perforations are most likely to appear in young females during their first months of medication.
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- Cervin, Anders, et al.
(författare)
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Macrolide therapy of chronic rhinosinusitis
- 2007
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Ingår i: Rhinology. - 0300-0729. ; 45:4, s. 259-267
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Forskningsöversikt (refereegranskat)abstract
- There is growing evidence that several antibiotics exert their beneficial effect not only by inhibiting or killing bacterial pathogens but also by down-regulating pro-inflammatory mechanisms. This review aims to give an overview of the immunomodulatory properties of macrolide antibiotics in chronic rhinosinusitis and to present a treatment algorithm for managing the difficult CRS patient with long-term, low-dose macrolide antibiotics. The most prominent effect of macrolides noted in vitro is the inhibition of pro-inflammatory cytokines such as interleukin-8. This effect is probably secondary to inhibition of the activation of transcription factor NF-kappa B. As a result an attenuation of neutrophilic inflammation takes place. Moreover, macrolides inhibit bacterial virulence and biofilm formation. In vivo, a reduction of pro-inflammatory cytokines is evident in nasal lavage as well as a reduction in nasal secretions. The clinical effect is shown in less facial pain, less headache, less post nasal drip, fewer exacerbations of sinusitis and improved quality of life The treatment should be targeted towards the non-atopic patients with bilateral disease whereas in unilateral disease, surgery is the first option. Macrolide resistant bacterial strains have to be monitored, but to date they have not been of clinical importance.
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34. |
- Cervin, Anders, et al.
(författare)
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The effect of intranasal budesonide spray on mucosal blood flow measured with laser Doppler flowmetry
- 2001
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Ingår i: Rhinology. - 0300-0729. ; 39:1, s. 13-16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Recent reports have shown that, although rare, findings of mucosal ulcers and perforations of the nasal septum in some cases may be associated with the use of topical nasal glucocorticosteroids (GCS). It can been speculated that, a reduction in septal mucosal blood flow causing ischemia may eventually induce septal perforations. AIM: To evaluate whether a single dose of a potent nasal GCS given in a clinically recommended dose may acutely reduce the mucosal blood flow on the nasal septum. METHODS: Six healthy subjects received in a randomised double blind placebo controlled crossover procedure one dose of 64 micrograms budesonide aqueous nasal spray (Rhinocort aqua, AstraZeneca R&D, Lund, Sweden) and placebo. One dose was delivered into each nasal cavity by means of a pump spray. As a positive control 140 micrograms of xylometazoline (Nezeril, AstraZeneca R&D, Lund, Sweden) was sprayed in the same way, but in an open fashion. A wash-out period of at least 3 days followed each session. Blood flow was measured on the nasal septum with Laser Doppler flowmetry up to 20 min after administration. RESULTS: Budesonide did not affect the nasal septal mucosal blood flow as compared to placebo, but xylometazoline reduced the septal mucosal blood flow by 60.9 +/- 7.1% measured from baseline values. CONCLUSION: A single dose of intranasal budesonide aqueous nasal spray has no acute effects on nasal septal mucosal blood flow.
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35. |
- Cervin, Anders, et al.
(författare)
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The effect of noradrenaline on mucociliary activity in the rabbit maxillary sinus
- 1993
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Ingår i: Rhinology. - 0300-0729. ; 31:1, s. 17-21
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Tidskriftsartikel (refereegranskat)abstract
- The effect of noradrenaline (NA) on mucociliary activity in the rabbit maxillary sinus was investigated in vivo by injecting it at increasing dosages (10(-11) to 10(-4) mol/kg) into the maxillary artery, the mucociliary response being recorded photoelectrically. NA increased mucociliary activity at a dosage of 10(-5) mol/kg, the maximal increase being 16.1 +/- 2.6%. The NA-induced stimulation of mucociliary activity had a latency of 20 s, and the activity returned to base-line level within 3 min. Pretreatment with the alpha-antagonist phentolamine (0.2 and 1.0 mg/kg) or the cholinergic antagonist atropine (1 mg/kg) did not alter mucociliary response to NA. Blockade with the beta-antagonist propranolol did not significantly reduce the maximal response to NA, which was 16.1 +/- 2.6% before and 11.1 +/- 3.0% after pretreatment with propranolol (n = 7; p = 0.2). In contrast, pretreatment with the prostaglandin-synthesis inhibitor indomethacin reduced the response from 12.9 +/- 2.9% to 6.3 +/- 1.3% (n = 6; p < 0.05), suggesting that at high dosages NA stimulates mucociliary activity via the cyclo-oxygenase pathway.
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36. |
- Clarhed, Ulrika, et al.
(författare)
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Occupational exposure and the risk of new-onset chronic rhinosinusitis - a prospective study 2013-2018.
- 2020
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Ingår i: Rhinology. - 0300-0729. ; 58:6, s. 597-604
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Tidskriftsartikel (refereegranskat)abstract
- The aetiology behind chronic rhinosinusitis (CRS) is still poorly understood. The aim of this study was to investigate the association between the onset of CRS and several common occupational exposures over time.An adult random population from Telemark, Norway, comprising 7,952 subjects, who answered a comprehensive respiratory questionnaire including questions on CRS and occupational exposure first in 2013 and again in 2018.New-onset CRS during the five-year follow-up was independently associated with occupational exposure to hair-care products, cleaning agents among women, super glue, strong acids, cooking fumes and wood dust.In this random population cohort from Norway, exposure to several common occupational agents, such as hair-care products, super glue and wood dust, was associated with the onset of CRS. It is important that physicians who see patients with CRS inquire about workplace exposure.
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- Fokkens, Wytske J., et al.
(författare)
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EPOS 2012: European position paper on rhinosinusitis and nasal polyps 2012. A summary for otorhinolaryngologists
- 2012
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Ingår i: Rhinology. - 0300-0729. ; 50:1, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- The European Position Paper on Rhinosinusitis and Nasal Polyps 2012 is the update of similar evidence based position papers published in 2005 and 2007. The document contains chapters on definitions and classification, we now also propose definitions for 'difficult to treat' rhinosinusitis, control of disease and better definitions for rhinosinusitis in children. More emphasis is placed on the diagnosis and treatment of acute rhinosinusitis. Throughout the document the terms chronic rhinosinusitis without nasal polyps (CRSsNP) and chronic rhinosinusitis with nasal polyps (CRSwNP) are used to further point out differences in pathophysiology and treatment of these two entities. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between the upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. Last but not least all available evidence for management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is analyzed and presented and management schemes based on the evidence are proposed. This executive summary for otorhinolaryngologists focuses on the most important changes and issues for otorhinolaryngologists.
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