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ABSTRACT: Loss of sense of smell is one of the most frequent complaints in patients with nasal polyposis (NP). The aim of this study was to evaluate the impact of asthma and its severity on the sense of smell.
Patients with massive NP and healthy controls were included. More than half of patients presented with asthma. Olfactometry by Barcelona Smell Test 24, nasal symptoms score, nasal endoscopy, allergy study, and paranasal sinus CT scan were assessed.
NP patients showed a significant impairment in smell detection, identification, and forced choice compared to the control. Asthmatics reported lower scores for detection, identification, and forced choice than non-asthmatic patients. Patients with persistent asthma had an increased impairment of sense of smell on detection, identification, and forced choice than patients with intermittent asthma. No significant differences were found between mild, moderate, and severe persistent asthmatics. Paranasal sinuses opacification was inversely correlated with smell detection, identification and forced choice.
These findings suggest that patients with NP have an impaired sense of smell, that asthma -particularly persistent asthma- has a further impact on sense of smell, and that loss of smell may be used as a clinical tool to identify the severity of both NP and asthma.
Rhinology 12/2011; 49(5):519-24. · 1.32 Impact Factor
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ABSTRACT: Wine experts show higher accuracy than novices in selecting a wine that matches a sample. Only one study has compared wine experts with non-trained healthy controls on smell. The aim of this study was to compare the smell characteristics, both sensorial and cognitive, of wine tasters with Spanish healthy population using the Barcelona Smell Test-24.
Wine tasters were tested for smell and compared with a control group of healthy volunteers, by tasting 20 odours and scoring smell detection, identification, intensity, irritability, freshness, pleasure and forced choice.
Wine tasters performed significantly better on identification and forced choice than healthy controls. In addition, wine tasters perceived more odours as intense, but fewer as irritating than controls.
Probably linked to smell education, wine tasters show better cognitive but not sensorial smell skills than a non-trained healthy population.
Rhinology 09/2010; 48(3):273-6. · 1.32 Impact Factor
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ABSTRACT: Acoustic rhinometry (AR) accuracy in the diagnosis and follow-up of nasal polyps is as yet unclear. Our objective was to study its accuracy compared with computed tomography (CT) in patients with nasal polyps.
We studied 29 patients diagnosed of nasal polyposis by nasal endoscopy. In all patients sinunasal CT-scan, AR and nasal nitric oxide (NO) were assessed. Nasal volumes between 0 and 5 (V(0-5)) and 5 and 9 (V(5-9)) centimetres from nasal inlet were measured with AR and CT-scan, by using Pearson and intraclass correlation coefficient tests.
All patients (29,79% males, mean age 48.2 yr [range 34-61]) had nasal polyps (score 2-3 on Lildholdt classification, score 0-3). Measurements (right plus left sides) were: AR 8.9 +/- 0.8 cm(3) (V(0-5)) and 15.5 +/- 3.6 cm(3)(V(5-9)); CT 6.5 +/- 0.4 cm(3) (V(0-5)) and 6.3 +/- 0.8 cm(3) (V(5-9)). Pearson correlation was r = 0.67 (p < 0.01) for V(0-5) and r = 0.62 (p < 0.05) for V(5-9). Intraclass correlation coefficient test was 0.51 (V(0-5)) and 0.28 (V(5-9)) for consistency; and 0.43 (V(0-5)) and 0.23 (V(5-9)) for absolute agreement. Low levels of NO (312.3 +/- 43.8 ppb) were found and the correlation between NO levels and volumes (V(0-5) or V(0-9)) measured by AR was not statistically significant.
Compared to CT-scan, AR measurements accurately reflect the geometry of nasal cavity volumes in patients with nasal polyps, with a better assessment in the anterior part of the nasal cavity.
Rhinology 06/2010; 48(2):224-7. · 1.32 Impact Factor
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ABSTRACT: The nose and the bronchi belong, in anatomical and physiopathological terms, to the concept of united airways. Associations between upper and lower airways diseases have been demonstrated in allergic rhinitis and asthma, nasal polyposis (NP) and asthma, chronic rhinosinusitis (CRS) and chronic obstructive pulmonary disease, and more recently CRS/NP and bronchiectasis (BQ).
To evaluate the impact of CRS on quality of life (QoL) of patients with BQ, and to correlate these findings with the pulmonary status, nasal symptoms, and general health status.
In a prospective study, patients with BQ (n = 80) were evaluated for CRS and NP using EP(3)OS criteria, and severity of BQ using chest high resolution computed tomography (HRCT)-scan. Quality of life was assessed in all patients by using specific [Sinonasal Outcome Test-20 (SNOT-20), St George Respiratory Questionnaire (SGRQ)], and generic (Short Form-36; SF-36) questionnaires.
Using SNOT-20, patients with CRS had worse QoL (2.1 +/- 0.1; P < 0.001) than patients without CRS (0.4 +/- 0.06). Using SGRQ total score, patients with CRS had worse QoL (43.7 +/- 2.2; P < 0.001) than patients without CRS (24.7 +/- 2.5). Using SF-36, patients with CRS had worse QoL, both in the physical summary (64 +/- 3.4; P < 0.05) and the mental summary (65.5 +/- 4.7; P < 0.05), than patients without CRS (physical summary [PS]: 76.2 +/- 3.3; mental summary [MS]: 78.3 +/- 5.3, respectively). Sinonasal Outcome Test-20 was correlated with SGRQ total score (r = 0.72; P < 0.01), and SF-36 physical summary (r = -0.63; P < 0.01). St George Respiratory Questionnaire was correlated with SF-36 on physical summary (r = -0.58; P < 0.05) and with forced expiratory volume in 1 s (r = -0.41; P < 0.05).
These results suggested that CRS, measured by both specific and generic questionnaires, has a considerable impact on the QoL of patients with BQ.
Allergy 10/2009; 64(10):1524-9. · 6.27 Impact Factor
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ABSTRACT: Although various relationships between the lower and upper airways have been found, the association of bronchiectasis with chronic rhinosinusitis and nasal polyps has not been thoroughly evaluated. This study was undertaken to examine the association of idiopathic and postinfective bronchiectasis with chronic rhinosinusitis and nasal polyposis.
In a prospective study, 56 patients with idiopathic and 32 with postinfective bronchiectasis were evaluated for chronic rhinosinusitis and nasal polyposis by using EP(3)OS criteria and assessing: symptoms score, nasal endoscopy, sinonasal and chest CT scan, nasal and lung function and nasal and exhaled NO.
Most bronchiectasis patients (77%) satisfied the EP(3)OS criteria for chronic rhinosinusitis, with anterior (98.5%) and posterior (91%) rhinorrhea and nasal congestion (90%) being the major symptoms. Patients presented maxillary, ethmoidal and ostiomeatal complex occupancy with a total CT score of 8.4 +/- 0.4 (0-24). Using endoscopy, nasal polyps with a moderate score of 1.6 +/- 0.1 (0-3) were found in 25% of patients. Nasal NO was significantly lower in patients with nasal polyposis (347 +/- 62 ppb) than in those without them (683 +/- 76 ppb; P < 0.001), and inversely correlated (R = -0.36; P < 0.01) with the ostiomeatal complex occupancy. In the chest CT scan, patients with chronic rhinosinusitis showed a higher bronchiectasis severity score (7.2 +/- 0.5; P < 0.001) than patients without (3.7 +/- 0.7). The prevalence of chronic rhinosinusitis, nasal polyps and other outcomes were similar in idiopathic and postinfective bronchiectasis.
The frequent association of chronic rhinosinusitis and nasal polyposis with idiopathic and postinfective BQ supports the united airways concept, and it suggests that the two type of bronchiectasis share common etiopathogenic mechanisms.
Allergy 02/2009; 64(5):790-7. · 6.27 Impact Factor
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ABSTRACT: Sudden sensorineural hearing loss (SSHL) has been proposed as a symptom of underlying vascular problems. The purpose of this work is to evaluate the genetic and acquired risk factors.
Ninety-nine patients were tested for the presence of common polymorphisms related to thrombophilia (prothrombin and factor V Leiden) in order to assess genetic risk factors, and several parameters classically associated with vascular disorders (cardiovascular events, brain stroke and antiphospholipid syndrome) were evaluated. Additional assessments of personal and familial history risk factors for vascular disorders were performed in each patient.
Thrombophilia studies did not demonstrate statistically relevant differences between the patients and control group. However, lipidemia profile and directed personal and familial histories showed positive trends for SSHL.
The lack of clear relationships between SSHL and other vascular risk factors suggests multicausality as a predominant disease profile. Although preliminary results point at a vascular involvement in SSHL, a long-term prospective study is necessary to demonstrate that SSHL represents an early vascular symptom.
Audiology and Neurotology 12/2008; 14(3):139-45. · 2.46 Impact Factor
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ABSTRACT: Histological affected or close margin is an adverse factor in conventional surgery of larynx-hypopharynx cancer. Our objective was to analyze the relevance of the margins in transoral laser microsurgery (TLM). A retrospective study of 357 consecutive patients with cancer of the larynx and hypopharynx (T1-T4) treated with TLM. Three possible margins were considered: tumor free, affected, and uncertain. An affected margin showed marked tumor infiltration. An uncertain margin was defined when the sample was insufficient, when it showed carbonization impeding accurate evaluation, or when tumor cells were less than 2 mm. Margins were free in 254 (71.1%) patients, affected in 64 (17.9%) and uncertain in 39 (10.9%). One hundred and three patients (28.9%) presented tumor relapse. The margins were associated with tumor relapse (P < 0.001), but were not significantly related to the tumor site (P = 0.307), the pT classification (P = 0.183), or the difficulty of surgical exposure (P = 0.427). Distant metastases were found in 4.7% of the patients with free margins, in 7.7% of those with uncertain margins, and in 14.1% with affected margins. These differences were statistically significant (P = 0.028). Tumor involvement of the surgical margin was associated with higher rates of local relapse, distant metastasis and the necessity of salvage surgery, together with a lower specific actuarial survival rate.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 10/2007; 264(9):1045-51. · 1.29 Impact Factor
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ABSTRACT: The goal of this article is to highlight relevant diagnostic tools to assess chronic epiphora and recurrent dacryocystitis in order to avoid unnecessary diagnostic explorations. Probing of the canaliculi is important for the differential diagnosis of chronic epiphora. Surgical steps are detailed, such as the inferiorly based mucosal flap on the AGGER NASI, which is repositioned at the end of the surgery improving wound healing on the lateral wall. Potential complications are presented, as well as measures to avoid and to treat them. Long-term follow-up of 750 endoscopic DCR confirms the good results in more than 90% after endoscopic dacryocystorhinostomies in adults and in children.
Laryngo-Rhino-Otologie 09/2007; 86(8):597-606; quiz 607-8. · 0.97 Impact Factor
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ABSTRACT: Bronchiectasis (BQs) is an uncommon disease with the potential to cause devastating complications. All patients with BQs have cough and chronic sputum production that may have a great impact on patient's quality of life. Upper airway symptoms are also frequent in patients with BQs. Associations between upper and lower airways diseases have been demonstrated in allergic rhinitis and asthma, nasal polyposis and asthma, chronic obstructive lung disease and chronic rhinosinusitis.
(1) To investigate the impact of bronchiectasis and nasal symptoms on quality of life. (2) To evaluate the added impact of nasal polyposis on quality of life in patients with BQs.
Sixty patients with bronchiectasis and upper airway symptoms were included. Patients were evaluated for nasal symptoms, nasal polyp size by endoscopy, and quality of life using the SF-36 generic questionnaire.
In comparison with the Spanish general population, patients with BQs had worse scores in all SF-36 domains (P<0.05). Males reported significantly higher quality of life scores on physical functioning and social functioning than females did. Although the age, pulmonary function, presence of nasal polyps, upper airway symptoms, tobacco smoking history, and disease duration was similar between them. Males with BQs had worse quality of life than males from the Spanish general population on body pain, general health, and vitality (P<0.05). Females with BQs had worse quality of life than females from the Spanish general population on physical function, body pain, general health, vitality, social function, and emotional role (P<0.05). Nasal polyps were found in 25 (41.6%) of 60 patients with BQs. No significant differences were observed on quality of life outcomes between patients with BQs with and without nasal polyposis.
These results suggest that BQs has a considerable impact on quality of life while nasal polyposis has no additional impact on the quality of life of patients with BQs.
Respiratory Medicine 12/2006; 100(11):1997-2003. · 2.47 Impact Factor
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ABSTRACT: The nose and lungs have both histological and functional similarities and differences. Sinonasal and bronchial involvement are associated in many diseases. Cystic fibrosis, primary ciliary dyskinesia, Young's syndrome, and alpha-1 antitrypsin deficiency are diseases in which bronchiectasis and rhinosinusitis are both present. This review considers the diseases in which bronchiectasis occurs along with sinonasal manifestations. We propose examining sinonasal disease from a new perspective by observing it in patients with bronchiectasis.
Archivos de Bronconeumología 04/2006; 42(3):135-40. · 2.17 Impact Factor
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ABSTRACT: Hyoid chondrosarcomas (CSs) are uncommon cervical tumours with different features compared to laryngeal CSs. Herein we report a hyoid CS in a 36-year-old male and review the literature. Only eight cases of hyoid CS have been reported to date. We have found important differences between hyoid and laryngeal CSs in terms of the age at presentation, gender, clinical symptoms, time before diagnosis, histologic findings and tumour size.
Acta Oto-Laryngologica 07/2005; 125(6):683-6. · 1.08 Impact Factor
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ABSTRACT: Madelung's disease, also known as benign symmetric lipomatosis, multiple symmetrical lipomatosis or Lanois-Bensaude syndrome, consists of growth of fatty masses predominantly on the face, neck, shoulders, upper thorax and arms. These painless and symmetrical fatty deposits can cause important aesthetic changes in these patients. Middle-aged males are more commonly affected, with an increased prevalence in the Mediterranean area. Currently, the incidence in Italy is 1 in 25,000 males. The aetiology of Madelung's disease remains unknown, although approximately = 60% of affected patients are clinically overweight and there is an intimate association with chronic alcohol abuse. We report an unusual case of Madelung's disease in a 52-year-old male. The fatty deposits were completely resected by means of surgical lipectomy. The patient remains well and disease-free after 12 months of postoperative follow-up.
Acta Oto-Laryngologica 04/2005; 125(3):328-30. · 1.08 Impact Factor
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ABSTRACT: Ameloblastomas are the most frequent odontogenic tumours, accounting for 1% of all tumours of the maxilla and mandible. Sinonasal ameloblastomas are most common between the ages of 55 and 65, and mandibular ameloblastomas between 40 and 50. Incidence is higher in males than in females, and there are no differences between races. These locally aggressive tumours originate in the mandible in 80% of cases and in the maxilla in 15-20%. We report an unusual primary nasosinusal ameloblastoma presented in a 68-year-old male. The tumour was completely resected by (para)lateral rhinotomy and treated with postoperative radiotherapy. Histological analysis demonstrated a plexiform ameloblastoma. The patient remains well without disease after 50 months of postoperative follow-up.
Archiv für Klinische und Experimentelle Ohren- Nasen- und Kehlkopfheilkunde 08/2004; 261(6):304-6. · 1.29 Impact Factor
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ABSTRACT: The main goal of this study was to set up a database of vertigo patients that could serve as a reference for other ENT services treating these pathologies. We present a clinical and epidemiological study of vertigo in an ENT outpatient clinic in 2001 and describe our diagnosis protocol.
This was a prospective study of 591 patients (18% of the total number of 3283 first visits) controlled and treated at the ENT service of the Hospital Clinic in Barcelona. The main variables studied were sex, age, clinical characteristics and the results of physical and basic instrumental examinations.
After obtaining a clinical history and performing a physical examination, pure-tone audiometry, impedance audiometry and electronystagmography, 394 patients were discharged with a medical report, diagnosis and prescription for treatment. The other 197 patients whom the standard examination was unable to diagnose were referred to a multidisciplinary committee for re-evaluation.
A correct diagnosis is essential to ensure adequate treatment and attain an acceptable balance between cost and effectiveness.
Acta Oto-Laryngologica 02/2004; 124(1):49-52. · 1.08 Impact Factor
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ABSTRACT: The nose and lungs have both histological and functional similarities and differences. Sinonasal and bronchial involvement are associated in many diseases. Cystic fibrosis, primary ciliary dyskinesia, Young's syndrome, and α-1 antitrypsin deficiency are diseases in which bronchiectasis and rhinosinusitis are both present. This review considers the diseases in which bronchiectasis occurs along with sinonasal manifestations. We propose examining sinonasal disease from a new perspective by observing it in patients with bronchiectasis.La nariz y el bronquio presentan similitudes y diferencias tanto histológicas como funcionales. Son muchas las enfermedades en que se asocian la afección nasosinusal y la bronquial. La fibrosis quística, la discinesia ciliar primaria, el síndrome de Young y el déficit de alfa-1-antitripsina son enfermedades en las que se asocian bronquiectasias y rinosinusitis. En este artículo se realiza una revisión de las bronquiectasias y de las enfermedades que las asocian junto a afección nasosinusal. El propósito es dar un nuevo enfoque de la patología nasosinusal observada en los pacientes afectados de bronquiectasias.
Archivos de Bronconeumología ((English Edition)).
