Sense of smell in patients with bilateral nasal polyposis
01 Mar 2004-Medicinski Pregled (Med Pregl)-Vol. 57, pp 164-167
TL;DR: Olfactory deficit in patients with bilateral nasal polyposis is explained by difficult or impossible passage of odors into the olfactory region.
Abstract: Introduction Sense of smell is susceptible to various changes, both in physiological and in numerous pathological conditions. Of quantitative disorders of smell, hyposmia and anosmia are quite common, whereas of qualitative disorders parosmia is most frequent. The aim of this paper was to examine impact of bilateral nasal polyposis on olfactory function. Material and methods The research was carried out at the Nose, Ear and Throat Clinic in Novi Sad. It included 80 examinees, 40 (20 male, 20 female) with bilateral nasal polyposis, while 40 examinees belonged to the control group (20 male, 20 female) without symptoms of nasal polyposes. Fortunato-Niccolini olfactometer was used for this examination. Results and discussion In patients with bilateral nasal polyposis the average perception threshold values for examined odors were 15.50 ccm of odorous air, while in the control group they were 10,20 ccm of odorous air. The average identification threshold values for examined odors in patients with bilateral nasal polyposis were 18.80 ccm of odorous air, while in the control group they were 13.55 ccm of scented air. T-test showed that values of both tresholds were statistically significantly higher (p< 0,01) in patients with bilateral nasal polyposis in relation to the control group. Conclusion Olfactory deficit in patients with bilateral nasal polyposis is explained by difficult or impossible passage of odors into the olfactory region.
01 Jan 2007-American Journal of Rhinology
TL;DR: Intrapolyp steroid injection is associated with a significantly lower rate of complication than is surgical excision of sinonasal polyps and also may decrease the need for further surgical intervention of polyps.
Abstract: BACKGROUND Sinonasal polyps are treated with topical steroids, systemic oral steroids, surgical excision, and intrapolyp steroid injection. Use of steroid injection is not widespread because of reported complications. The objective of this study was to evaluate the complications of intrapolyp steroid injections and compare it to the complications of surgical removal of polyps. METHODS All patients seen between 1994 and 2003 with a diagnosis of nasal polyps were reviewed retrospectively. Demographics, complications, follow-up, and comorbidities were collected. Frequency of each treatment modality used and complications of each treatment were compared. RESULTS Three hundred fifty-eight patients were in the study with a mean follow-up of 30 months. Respiratory comorbidities were asthma alone (35%), aspirin triad (16%), and cystic fibrosis (15%). Other comorbidities were smokers (21%). Treatment modalities were medical treatment alone (14%); medical treatment and steroid injections (19%); medical treatment and surgery (33%); and medical treatment, injections, and surgery (34%). Patients who underwent injection had fewer surgeries (p < 0.001). There was 1 minor complication associated with 1495 injections and 11 major and 16 minor complications associated with the 310 surgeries. The differences in complication rates were statistically significant (p < 0.001). There was no significant difference in demographics, follow-up, or comorbidities between patients who received injections and patients who underwent surgery. CONCLUSION Intrapolyp steroid injection is associated with a significantly lower rate of complication than is surgical excision of sinonasal polyps. Steroid injection also may decrease the need for further surgical intervention of polyps.
01 Jan 2007-The Polish otolaryngology
TL;DR: The taste and olfactory estimation ought to be integral part of routine patient examination in otolaryngology department and correlation between taste and smell perception threshold and polyps size was not confirmed.
Abstract: Summary Aim The purpose of this study was estimation of taste and smell senses functioning in patients with nasal polyps and the analysis of correlation between taste and smell perception threshold and polyps size. Material and method The study included 86 persons. The 35 of them were patients of Otolaryngology Department of Warsaw Military Institute with nasal polyps diagnosis. There were 51 healthy people as a control group. The smell perception examination was performed using Elsberg-Levy method in Pruszewicz modification. The gustatory function was investigated using gustatory method by Borstein and electrogustometry. The Borstein method based on four substances (each of them in three increasing concentrations) related to four basic tastes: sweet (glucose), bitter (chininum hydrochloride), sour (citric acid) and salty (sodium chloride). The taste feeling threshold (POS), that meant the lowest concentration of each solution being correctly recognized by a person, was noticed for each taste. For quantitative estimation of taste perception threshold we included impulse electrogustometry with bipolar electrode. Results In our study the taste disturbances were observed, depending on kind of taste, in 20–70% cases in gustometry and for 13 patients in electrogustometry. Abnormal olfactory results we diagnosed in more then 57% patients. We did not confirm correlation between taste perception threshold and polyps size but polyps size influenced olfactory results. Conclusions Smell and taste disturbances are very often symptoms of nasal polyposis. The taste and olfactory estimation ought to be integral part of routine patient examination in otolaryngology department.
TL;DR: Treatment options for sinonasal polyps are reviewed, focusing on the role of steroids and, specifically, intrapolyp steroid injection, as well as the risks and safety of injections.
Abstract: Purpose of reviewTo review treatment options for sinonasal polyps, focusing on the role of steroids and, specifically, intrapolyp steroid injection. History of steroid injections, comparison to other medical and surgical treatments, as well as the risks and safety of injections are all discussed.Rec
01 Jan 2010-Acta Otorrinolaringologica
TL;DR: It is demonstrated that incipient stages in sinonasal polyposis are detectable by olfactometry before radiological images, and that this detection is linked with a non-blocked area around the nasal meatus (where the olfactory cleft is located).
Abstract: Introduction The increasing demand for attention to olfactory disorders, along with the persistent presence of sinonasal polyposis, has opened the need to treat these pathologies in very early stages. Objectives To demonstrate that incipient stages in sinonasal polyposis are detectable by olfactometry before radiological images, and that this detection is linked with a non-blocked area around the nasal meatus (where the olfactory cleft is located). Methods This study is based on data obtained from a sinonasal polyposis (degree 0 or 1) patient group (n = 121) without allergies or asthma backgrounds. The patients underwent both fibroscopic and olfactometry explorations (first and fifth cranial nerve) and computed axial tomography (CT) assessment. The results were compared with the control group (n = 120). Results Significant values (P Conclusion Olfactory disorders linked to a non-blocked area around the nasal meatus (degree 1 or 2 polyposis), together with sinonasal CT scans showing beginnings of ethmoidal inflammation, should be interpreted as incipient sinonasal polyposis.
01 May 2010-Acta otorrinolaringológica española
TL;DR: Estudio confirmaron valores significativos de alteraciones olfativas con ausencia de ocupacion del espacio «extrameatal» (poliposis grado 1 o grado 2), acompanado de TAC nasosinusal con inicio oferta etmoidal, deberia ser interpretado como inicio de poliposis nasos inusal.
Abstract: Resumen Introduccion La creciente demanda de atencion sobre la patologia del olfato, junto con la persistente presencia de la poliposis nasosinusal, ha abierto la necesidad de tratar dichas patologias a niveles muy tempranos. Objetivos Demostrar primero que los estadios incipientes de la poliposis nasosinusal son detectables por olfatometria antes que por imagen radiologica; segundo, tal deteccion se halla vinculada a la ausencia de ocupacion del espacio «extrameatal» (donde se halla la hendidura olfativa). Metodos Estudio basado en los datos obtenidos a partir de un grupo (n=121) de pacientes con poliposis nasosinusal de grado 0 o grado 1, libres de alergias, triada de ASA y asma, sometidos a estudio fibroendoscopico, olfatometria (par craneal I y V) y TAC nasosinusal, comparandose el resultado con un grupo control (n=120). Resultados Se confirmaron valores significativos (p Conclusiones La presencia de alteraciones olfativas con ausencia de ocupacion del espacio «extrameatal» (poliposis grado 1 o grado 2), acompanado de TAC nasosinusal con inicio de ocupacion etmoidal, deberia ser interpretado como inicio de poliposis nasosinusal.
01 Jul 1999-The Journal of Allergy and Clinical Immunology
TL;DR: This study clearly demonstrated that the SF-36 questionnaire presented a high internal validity and reliability in patients with NP and impaired QOL to a greater degree than perennial allergic rhinitis.
Abstract: Background: Nasal polyposis (NP) is a frequent inflammatory chronic disease of the upper respiratory tract, which may impair quality of life (QOL). The NP impact, which is frequently associated with lower respiratory disorders, has never before been studied. Objective: We initiated this prospective study to establish internal validity and reliability of the generic SF-36 questionnaire in NP and to determine to what level daily functioning becomes impaired as a result of NP. Methods: Forty-nine consecutive patients with NP were included. They were assessed for the severity of nasal symptoms and underwent pulmonary function tests. The QOL profiles in patients with NP were compared with those of patients with perennial rhinitis (n = 111) and healthy subjects (n = 116). Results: Cronbach's coefficient α demonstrated the high reliability and validity of the SF-36 questionnaire for patients with NP (α = .89). NP impaired QOL more than perennial allergic rhinitis ( P P < .05). SF-36 scores appeared highly correlated to pulmonary function (FEV 1 , maximal midexpiratory flow, forced vital capacity), suggesting relationships between QOL in NP and associated bronchial obstruction. Severity of nasal symptoms were not related to QOL scales. In addition, sequential evaluations of QOL, nasal symptoms, and pulmonary function were performed 10 months after the first evaluation in 28 patients with NP. These evaluations demonstrated that NP treatment either with nasal steroids or endonasal ethmoidectomy significantly improved both nasal symptoms and QOL without significant change of pulmonary function. Conclusion: Our study clearly demonstrated that the SF-36 questionnaire presented a high internal validity and reliability in patients with NP. NP impaired QOL to a greater degree than perennial allergic rhinitis. QOL improvement after NP treatment is related to nasal symptoms improvement. (J Allergy Clin Immunol 1999;103:79-84.)
01 Dec 2000-Laryngoscope
TL;DR: Results are analyzed in light of current understanding of the pathophysiology of anosmia and dysosmia following head trauma and focus is placed on potential mechanisms of human regeneration and recovery.
Abstract: Objectives This study demonstrates histopathologic and immunocytochemical changes in the olfactory bulb of a patient with post-traumatic olfactory dysfunction. These results are analyzed in light of current understanding of the pathophysiology of anosmia and dysosmia following head trauma. Emphasis is placed on potential mechanisms of human regeneration and recovery. Study Design The current study documents the history of a patient with the initial complaint of complete anosmia following minor head trauma. Two months after the injury the patient developed persistent, severe dysosmia with debilitating weight loss. Neurosurgical treatment, including removal of the olfactory bulbs and tracts, resulted in permanent resolution of dysosmia. Methods Histopathologic and immunocytochemical analysis of the olfactory bulbs was undertaken and compared with age-matched control tissue. Results Pathological analysis of the olfactory bulb revealed a marked reduction in the number of nerve processes with few intact olfactory glomeruli compared with an age-matched control. Specific immunohistochemical staining for the olfactory neuron-specific protein OMP, however, demonstrated the presence of intact axonal projections between the olfactory mucosa and the bulb. Conclusions These results support the hypothesis that post-traumatic anosmia involves, at least in part, damage to peripheral olfactory nerve fibers with histological changes in the olfactory bulb. Potential mechanisms for the development of post-traumatic dysosmia are also discussed.
01 Apr 1999-Auris Nasus Larynx
TL;DR: Using simple clinical criteria, two patient populations could be defined, one in which recurrence is inevitable requiring continuous local steroid therapy after surgery and another group requiring occasional local treatment after an initial short course of local steroid spray.
Abstract: Objective : A trial to determine a simple way to predict recurrence of nasal polypi to determine the need for long term medical therapy. Methods : Retrospective clinical analysis of the records of 100 patients with nasal polypi and studying various parameters including radiological, intra-operative and bacteriological data. Results : Among the various parameters studied, maxillary antral involvement, and positive bacterial cultures seemed the most predictive criteria of recurrence. Patients without polypoid involvement of the maxillary sinus and/or with negative cultures were less likely to have early recurrence of their disease. Conclusion : Using simple clinical criteria, two patient populations could be defined. One in which recurrence is inevitable requiring continuous local steroid therapy after surgery and another group requiring occasional local treatment after an initial short course of local steroid spray.
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