
Desiderio PassaliUniversity of Siena | UNISI · ORL
Desiderio Passali
Professor and Chairman
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Introduction
Skills and Expertise
Publications
Publications (419)
Objectives: The current study examined the effectiveness of Rhinapi, a hypertonic saline nasal spray with Anatolian propolis added, on allergic rhinitis (AR) symptoms in a European population. Methods: Four hundred and forty AR patients (251 males and 189 females) from various European centers were enrolled. Nasal examination, overall symptom score...
Nasal polyposis is an inflammatory disease that occurs in 1–4% of the general population and about 25–30% of patients with chronic rhinosinusitis (CRS). Despite their appearance, nasal polyps are not to be considered simple edema but are more likely an inflammatory growth of the mucosa of the lateral wall of the nose, which represents a common endp...
The term "local allergic rhinitis" has gained popularity as a clinical entity in recent years. Despite the apparent contradiction in the definitions of "nasal" and "local," we offer insights based on our extensive experience in the field. Local allergic rhinitis has been recognized and treated for many years, so it is not a new discovery. The nasal...
Zika virus (ZIKV) is a member of the family Flaviviridae. In common with the other members of this group, it is a single-stranded RNA virus with an envelope and an icosahedral morphology [1]. The viral envelope consists of a lipid membrane densely studded with projecting glycoproteins [1].
The diagnosis and management of hypogeusia and hyposmia have been complicated in the past by an incomplete understanding of how smell and taste function physiologically and how disorder in these systems arises. Any change in the sense of taste or smell may occur secondarily or as a direct effect of disease [1].
Objective:
We conducted a national survey to understand how rhinology practice has changed with the advent of biologics and how this affected patients with uncontrolled, severe chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to analyse the results of the survey and infer practical recommendations for clinical practice.
Methods:
A gro...
The aim of this paper is to review intranasal trigeminal system and associated reflexes. The literature survey was performed on PubMed, ProQuest Central database of Kirikkale University and Google Scholar. The intranasal trigeminal system and associated reflexes play an important role in humans in both health and disease, including in rhinitis of n...
The aim of this paper is to review mechanisms and solutions for nasal drug delivery. Literature survey was performed via PubMed, Google Scholar, Google, and ProQuest Central database of Kirikkale University. The nasal lining presents a large area of endothelium of variable permeability and with a rich vascular supply. Advantages of this route inclu...
Background
Benzydamine hydrochloride is a locally-acting Non-Steroidal Anti-Inflammatory Drug (NSAID) with combined local anesthetic and analgesic properties, indicated for the symptomatic relief of pain in acute sore throat. The aim of this study was to obtain an European Consensus among pharmacists, general practitioners and pediatricians on the...
Background and aim
Rhinosinusitis (RS) is a common disease and is currently classified into two main types: acute RS (ARS) and chronic RS (CRS), which in turn includes CRS with or without nasal polyps. Different guidelines consider this classification. However, in clinical practice, other phenotypes exist.
Materials and methods
This article revise...
Background
Benzydamine for oromucosal use is indicated in the relief of pain and irritation of the mouth and throat. It is an indazole derivative, non-steroidal anti-inflammatory drug, with combined local anesthetic and analgesic properties, and antiseptic activity, marketed under the brand name “Tantum Verde”. The aim of this study was to explore...
Introduction Acute upper respiratory infection (AURI) is the most common cause of postinfectious olfactory dysfunction (PIOD).
Objective We investigated the prevalence of PIOD in a large group of patients reporting persistent smell impairment perception after the AURI resolution.
Methods Olfactometry was performed within 1 month after the common co...
Objective
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a frequently occurring condition involving type 2 inflammation. It has a global prevalence of approximately 4% and has a major effect on the quality of life of those affected by it. CRSwNP is a complex condition for otorhinolaryngologists to manage, since its precise pathogenic basis ha...
Respiratory infections ever represented a major problem for humankind since ancient times, strongly impacting on the development of humankind itself. Still today, millions of people die, every year, because of infections or because of their complications.
The COVID-19 pandemic era is causing a relevant issue for the health. There is no specific drug able to antagonize the SARS-CoV-2 infection. As a consequence, there is growing interest about potential molecules able to contrast infection. In this regard, HMGB, an alarmin, may play a relevant role in pathogenic mechanisms induced by SARS-CoV-2. As H...
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory condition of nasal mucosa and paranasal sinuses, predominantly mediated by type 2 inflammation and often associated with comorbid asthma and/or Exacerbated Respiratory Disease (N-ERD). The standard of care involves local and systemic corticosteroids and/or sinonasal s...
Background A randomized, double-blind placebo-controlled study investigated the use of bacteriophages in the treatment of chronic rhinosinusitis with nasal polyps. Materials and Methods 40 adult patients with сhronic rhinosinusitis with nasal polyps were examined. All patients underwent functional endoscopic sinus surgery. After the surgery, 20 pat...
In the 1980s, a global number of 72 fatalities were reported in the UK and the USA following the application of subcutaneous immunotherapy (SCIT). This resulted in a significant limitation of SCIT use and in the search of other routes of administration, among which sublingual immunotherapy (SLIT) showed the best balance between efficacy and safety....
Objective:
Most of the infections of the upper respiratory tract are caused by biofilm-forming microorganisms belonging to the Pseudomonas, Streptococcus, Staphylococcus, and Enterobacter genus. Many of these microorganisms also show antibiotic resistance, partly related to biofilm formation. The treatment of these affections may include inhalatio...
Chronic rhinosinusitis (CRS) is a common disease and is currently classified in two main phenotypes: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). A panel of international experts conducted the present survey. A questionnaire, containing 25 questions, was completed by each member of the panel. About half of patients with sus...
Laryngopharyngeal reflux (LPR) is an inflammatory reaction of the mucosa of the pharynx, larynx, and other associated upper respiratory organs, caused by a reflux of stomach contents outside the esophagus. LPR is considered a relatively new clinical entity with a vast number of clinical manifestations that are sometimes treated empirically and with...
Allergic rhinitis (AR) is a frequent disease caused by an IgE-mediated inflammation of the nose and characterized by typical symptoms. Diagnostic workup is directed to document the production of specific IgE (sensitization). Clinical management aims to relieve symptoms, resolve allergic inflammation, use medications, and potentially induce allergen...
Pseudomonas aeruginosa is an opportunistic human pathogen that frequently induces antibiotic resistance, as it mainly tends to form biofilms. Iron chelation may be an intriguing strategy to contrast bacterial growth. Lactoferrin is a natural compound able to chelate iron. A new multi-component medical device also contains lactoferrin. This study an...
Laryngopharyngeal reflux (LPR) is a common disease caused by the leaking beck of gastric material out of the esophagus. The main symptoms are dysphonia, dysphagia, and cough. There is an established use of proton pump inhibitors (PPI) in patients with suspected LPR in common practice. This habit is translated by the standard strategy to use PPI in...
COVID-19, the disease caused by the SARS - CoV - 2 pathogen, is currently a pandemic. At the moment there is not an available vaccine, so, scientific community is looking for strategies and drugs to implement prevention and prophylaxis. Several compounds are examined for this purpose. Glycyrrhizin, an alkaloid extracted from licorice plant (glycyrr...
In the pandemic coronavirus disease 2019 (COVID-19) era, the need to use preventive-curative treatments is compelling. A series of non-pharmacological compounds, including oligo-elements, vitamins, nutraceuticals, and bacteriotherapy, might affect the risk of COVID-19, both reinforcing the immune system and improving the inflammation resolution dur...
It is now more popular to refer to rhinosinusitis rather than sinusitis, since inflammation virtually never occurs in the sinuses alone, without a nasal component. It is probable that expert disagreement on how to define CRS stems from the multifaceted nature of the disorder and from our imperfect knowledge about the underlying pathogenesis of sinu...
Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updat...
Introduction:
Children with recurrent respiratory infections (RRI) represent a social issue for the economic burden and the negative family impact. Local Bacteriotherapy is an attractive therapeutic strategy that could be potentially effective in preventing infections. The current article remarks on the existing evidence of preventing RRI by Local...
Introduction: High mobility group protein box 1 (HMGB1) is a protein belonging to the alarmin family. HMGB1 has a relevant role in starting the inflammatory cascade by means of receptors, such as RAGE and TLR. HMGB1 supports transcription of many genes in interactions with many transcription factors, including NF-kB. The axis HMGB1-RAGE-NF-kB has,...
Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction consequent to the exposure to the causal allergen. Glycyrrhetic acid (GlyAc) is a natural compound extracted from the liquorice that exerts anti-inflammatory activity. This real-life study compared intranasal GlyAc, present in a medical device containing also glycerol and man...
Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects very young children with severe clinical course and sometimes causes serious complications. Most important risk factors are the young age (often>2 years), high fever, alteration of...
Laryngopharyngeal reflux (LPR) is a common disorder. Pepsin has been detected also at eye level, this was a starting point for newest theories about LPR impact on Dry Eye Syndrome. The current preliminary study compared two treatments in patients with Dry Eye Syndrome and LPR. Patients were treated with Gastroftal eye drops and Gastroftal tablets o...
Rhinosinusitis is a common disease that is classified in acute (ARS) and chronic (CRS). The current Survey was conducted on a sample of about 5,000 adult subjects in 5 Italian cities. A questionnaire, containing 15 questions, was administered on the road. RS affects about 20% of the general population. The most common diagnostic test was the skull...
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a frequent disorder. From a clinical and an immunopathological point of view, different phenotypes and endotypes have been identified. The frequent comorbidity with asthma allowed to pave the way to the use of biological agents for the treatment of CRSwNP. Biological agents are targeted to ant...
Allergic rhinitis (AR) is a very common disorder. The current Survey was conducted on a sample of about 5,000 adult subjects in 5 Italian cities. A questionnaire, containing 15 questions, was administered on the road. AR affects about 20% of the general population. The most common diagnostic test was the skin prick test, but only 12% of patients pe...
Epistaxis is one of the most common ear, nose and throat emergencies. The management of epistaxis has evolved significantly in recent years, including the use of nasal cautery and packs. However, a correct treatment requires the knowledge of nasal anatomy, potential risks, and complications of treatment. Epistaxis is often a simple and readily trea...
Nasal polyps (NP) are benign, edematous masses growing into nasal cavity that could have multiple etiological factors. Basic etiological factor for polyp formation is chronic inflammatory change and thus stromal nasal and paranasal mucosa edema. All theories about NP formation try to explain the edema formation. Edema and mucosal inflammation may o...
Objective:
Nasal administration of Streptococcus salivarius 24SMB and Streptococcus oralis 89a has been proposed to reduce the risk of new episodes of adenoiditis, tonsillitis and acute rhinosinusitis in children.
Patients and methods:
We enrolled 202 children with a recent diagnosis of recurrent upper respiratory tract infection. All the patien...
OBJECTIVE: The aim of our study was to search for evidence of a "staphylococcus superantigen" in chronic rhinosinusitis with nasal polyps.
PATIENTS AND METHODS: Sixty-nine patients with chronic rhinosinusitis with nasal polyps and 45 healthy controls were included in the study. All patients in the study and control groups underwent bacteriological...
OBJECTIVE: The aim of this review is to describe the most common recurring and chronic upper respiratory tract infections (URTI) in children and discuss the role of bacterial interference and bacteriotherapy in their prevention and treatment.
MATERIALS AND METHODS: A literature review has been performed on the following topics: acute otitis media,...
OBJECTIVE: Obstructive sleep apnea (OSA) is the primary indication for tonsillectomy, one of the most common pediatric surgical procedures, commonly performed in association with adenoidectomy. The objective of this review article is to evaluate the role of the otorhinolaryngologist in pediatric OSA.
MATERIALS AND METHODS: A literature review has b...
Obstructive Sleep Apnea Syndrome (OSAS) and snoring are relevant health issues in the pediatric population; however, the awareness of OSAS and snoring as a highly relevant health issue in children and adolescents is rather inadequate and there is a significant gap between the estimated number of children with OSAS and clinically diagnosed cases. In...
OBJECTIVE: This review paper aims to summarize the current state of knowledge on the role of the pneumologist in the diagnosis and respiratory treatment of children affected by obstructive Sleep Disordered Breathing (SDB).
MATERIALS AND METHODS: A literature review has been performed on the following topics: obstructive sleep disordered breathing...
OBJECTIVE: The aim of this review is to describe the most common recurring and chronic upper respiratory tract infections (URTI) in children and discuss the role of bacterial interference and bacteriotherapy in their prevention and treatment.
MATERIALS AND METHODS: A literature review has been performed on the following topics: acute otitis media,...
Dear Editor, the estimated prevalence of OSAS and habitual snoring in children is 0.1-13% and 6-12%, respectively 1 2. The lack of treatment of sleep-related breathing disorders puts patients at risk of hypertension, growth lag, hyperactivity, attention deficit, learning disabilities, low levels of educa- tion and literacy. Some studies have shown...
The aim of this research is to investigate penetration of Bromelain into sinonasal mucosa in patients with chronic rhinosinusitis (CRS) versus a control group. Bromelain is derived from pineapple (Ananas comosus) and has various pharmacological effects. 40 patients (20 patients and 20 controls) were enrolled in the study. Bromelain 500 mg tablet tw...
The proximate and amino acid compositions of Artocarpus altilis and Bucchholzia coriacea were investigated using standard analytical techniques. The respective proximate composition (%) for the Artocarpus altilis and Bucchholzia coriacea samples were: Moisture (5.91 and 5.67); ash (4.39 and 5.13); crude fat (4.42 and 2.76); crude protein (12.27 and...
p>The proximate and amino acid compositions of Artocarpus altilis and Bucchholzia coriacea were investigated using standard analytical techniques. The respective proximate composition (%) for the Artocarpus altilis and Bucchholzia coriacea samples were: Moisture (5.91 and 5.67); ash (4.39 and 5.13); crude fat (4.42 and 2.76); crude protein (12.27 a...
Introduction:
Migraine and allergies are a common occurrence. The aim of this study was to investigate the relationship between respiratory allergy and migraine in childhood.
Materials and methods:
We screened 800 children for headache and its characteristics. After that we investigated the presence of allergy performing prick tests, rhinoscopy,...
While internal laryngoceles rarely cause major clinical complaints, they may lead to airway obstruction and require emergency intervention on rare occasions. We report a 91-year-old patient who was referred to the Ear, Nose & Throat Clinic of the Policlinico Santa Maria alle Scotte, Siena, Italy, in 2017 due to recurrent episodes of severe dyspnoea...
Bacteriocins are peptides with antimicrobial efficacy produced by certain bacterial species. Probiotics indeed seem a promising method in the prevention of upper respiratory infections and our study would like to contribute to the results available in the literature, in order to underlie their true therapeutic potential role.
Our multicenter pilot...
Background
Allergic rhinitis (AR) is a global health problem and is characterised by one or more symptoms, including sneezing, itching, nasal congestion and rhinorrhea.
Objective
We investigated the features of AR and the physician's approach to the management of AR patients in four geographical regions.
Methods
In this cross-sectional study, a q...
Background
Mucociliary clearance is the main self-clearing system of the nasal cavity and paranasal sinuses.
This is a very important means of non specific defence against continuous organic and inorganic contamination conveyed by air. It works by trapping particles and microorganisms in the mucus and then by transporting the mucous film to the pha...
Background: Mucociliary clearance is the main self-clearing system of the nasal cavity and paranasal sinuses. This is a very important means of non specific defence against continuous organic and inorganic contamination conveyed by air. It works by trapping particles and microorganisms in the mucus and then by transporting the mucous film to the ph...
Foreign body aspiration remains a common and potentially serious pediatric problem. Most aspirated foreign bodies are food. The education of parents and caregivers about choking hazards and how to avoid them is critical to reduce the incidence of these events. The pediatricians play a key role in promoting injury prevention. We indicate the main ch...
Background Radon-222-enriched hot spring therapy, which is characterized by a safe level of radioactivity, is used for the treatment of rheumatic disorders, and its efficacy has already been studied in several clinical trials. Radon-water inhalation therapy for the treatment of upper and lower airway inflammatory diseases is used in many hot spring...
This article analyzes the role played by the ear, nose and throat (ENT) specialist in the diagnosis and treatment of the Obstructive Sleep Apnea Syndrome (OSAS).
Diagnosis:
The instrumental methods of investigation of otolaryngology expertise are fiberoptic rhinolaryngoscopy and sleep endoscopy. To better define and treat OSAS it is essential to...
Background and aim
The aim of our study has been to investigate the perception of aspects related to nasal perforation among experts in Rhinology and ENT surgeons. Our aim was reporting the situations in different Countries to improve the knowledge of colleagues interested in this topic.
Methods
A panel of experts prepared a 20-question questionna...
Obstructive sleep apnoea (OSAS) is an underdiagnosed chronic disease with a high prevalence in adults. It is becoming a significant social problem, since it is associated with a worsening in quality of life and increase in mortality. The cost-effectiveness ratio of diagnostic and therapeutic management of OSAS is a strategic issue to counteract the...
High-mobility group box 1 (HMGB1) is a nuclear non-histone protein, playing a critical role as a mediator between innate and acquired immunity; when released extracellularly, it coordinates the cellular stress response (under necrosis, bacterial lipopolysaccharide stimulation) and acts as an inflammatory marker and cytokine. The aim of the study wa...
Introduction Obstructive Sleep Apnea Syndrome (OSAS) is characterized by recurrent episodes of prolonged partial or complete obstruction of the upper airways. Several study groups studied the effect of snoring and OSAS on auditory function, showing an increase in the incidence of hearing loss in apneic patients, an earlier onset and/or a degree of...
To extend our understanding of previous studies on the pathogenesis and mechanism of high mobility group box 1 (HMGBl) in chronic rhinosinusitis with nasal polyps (CRSwNP), here we show that Sirtuin 6 (Sirt6), one of the Sirtuin family members which are widely studied in aging, DNA repair, metabolism, inflammation and cancer, was expressed in norma...
Background and aim:
The aim of our study has been to investigate the perception of aspects related to nasal perforation among experts in Rhinology and ENT surgeons. Our aim was reporting the situations in different Countries to improve the knowledge of colleagues interested in this topic.
Methods:
A panel of experts prepared a 20-question questi...
Nasolacrimal duct obstruction (NLDO) is a common event in clinical practice. The authors, all members of the Italian Society of Rhinology, analysed 100 cases from different ENT Departments. The causes of NLDO, according to the etiology, can be divided into two classes: idiopathic primary acquired nasolacrimal duct obstruction and secondary. The aim...
Introduction This study is a systematic review on recent developments about the importance of HMGB1 protein in the pathogenesis of rhino-sinusal inflammatory diseases. We also report data on the use of 18-β-glycyrrhetic acid (GA), which has been shown able to inhibit the pro-inflammatory activities of HMGB1, in young patients affected by allergic r...
The inflammatory diseases of the nose, rhino-pharynx and paranasal sinuses (allergic and non allergic rhinitis, NARES; rhinosinusitis with/without nasal polyposis, adenoidal hypertrophy with/without middle ear involvement) clinically manifest themselves with symptoms and complications severely affecting quality of life and health care expenditure....
Obstructive sleep apnoea syndrome (OSAS) is a sleep disorder that leads to metabolic abnormalities and increased cardiovascular risk. This study aimed to define the expression and clinical significance of biomarkers involved in oxidative stress in patients with OSAS. A prospective study was designed to compare outcomes of oxidative stress laborator...
Cervical and parotideal abscess is a rare finding in all populations and even more so in the paediatric population. The antibiotic resistance of the bacteria that cause these diseases can make it very dangerous. We present a paediatric case in which there is a combined left-cervical and parotideal abscess in a female 3-month-old baby who presented...
Background:
Aeroallergen immunotherapy (AIT) should be considered for patients who exhibit symptoms of allergic rhinitis (AR), rhinoconjunctivitis, and/or asthma after natural exposure to allergens and who also demonstrate specific immunoglobulin E antibodies against relevant allergens.
Methods:
In this paper, clinical efficacy of immunotherapy...
Chronic rhinosinusitis (CRS) is a very prevalent inflammatory disease. Treatments vary in different countries. In the present study, we explored the approaches of physicians in 50 countries. In this cross-sectional study, a
rhinosinusitis survey (RSS) was completed by Honorary and Corresponding Members (otorhinolaryngologists) of the Italian Societ...
The paranasal sinus epithelium is exposed to the environment and therefore to a variety of biological, chemical and mechanical insults. Surfactant protein A (SP-A) is a 34–36 kD pulmonary surfactant-associated protein that appears to play an important role in mammalian first-line host defence. Recent studies have reported the possibility of local p...
The inflammatory diseases of the nose, rhino-pharynx and paranasal sinuses (allergic and non allergic rhinitis, NARES; rhinosinusitis with/without nasal polyposis, adenoidal hypertrophy with/without middle ear involvement) clinically manifest themselves with symptoms and complications severely affecting quality of life and health care expenditure....
Effervescence is defined as the evolution of gas bubbles from a liquid as a result of a chemical reaction. For medicinal use, effervescent tablets have specific characteristics that allow rapid adsorption of the intended drug. In this manner, a medication can be absorbed easily and effectively if it dissolves easily in water and is present at a suf...