Rhinology最新文献

Introduction: Nasopharyngeal cancer (NPC) is a relatively rare yet aggressive malignancy, primarily affecting regions of East and Southeast Asia. This study aims at providing an up-to-date quantification of the association between cigarette smoking and NPC risk, overall and by histological subsites.

Methods: We conducted a systematic review and meta-analysis of case-control and cohort studies on the association between cigarette smoking and NPC risk published up to May 2023. The methodology used is original and efficient and includes both a comprehensive umbrella review and a traditional review. We estimated pooled relative risks (RR) of NPC according to smoking status, intensity, duration, and time since quitting.

Results: Among 46 eligible articles, 40 original studies were included in this meta-analysis. Compared with never smokers, the pooled RR of NPC was 1.61 for current, 1.28 for former, and 1.62 for ever smokers. The RR for ever compared with never smokers was 2.37 for squamous cell NPC and 1.06 for undifferentiated NPC. NPC risk significantly increased linearly with smoking intensity and duration, and decreased linearly with increasing time since quitting.

Conclusion: This meta-analysis confirms the link between tobacco smoking and NPC, highlighting the significant risk posed even by moderate cigarette consumption. Additionally, our findings underscore the differential risk between squamous cell and undifferentiated subtypes of NPC, shedding light on the distinct implications for NPC prevention strategies.

Background: The intravenous olfactory test (alinamin test [AT]) is a retronasal olfactory assessment and may evaluate the flavour disorder; however, studies assessing whether AT accurately determines the severity of taste disorders are lacking. Our study aims to evaluate the relationship between AT and subjective taste disorders in the patiensts with olfactory disorder.

Methods: Between April 2019 and March 2020, 228 patients visited our smell clinic reporting olfactory disorders. Of these, 193 patients who underwent AT were included in this study. We evaluated the differences in AT response, latency time, and duration time between patients with and without subjective taste disorder. We also assessed the degree of subjective taste disorder experienced by patients using the visual analogue scale (VAS) and the correlation between latency and duration time of AT. To assess taste perception more broadly, we inquired about the presence of disorder using the term "taste" rather than "flavour" without focusing on any specific type of taste disorder.

Results: Of the included 193 patients, 62 reported awareness of a taste disorder. The duration time of AT was significantly shorter in patients with subjective taste disorder. A weak correlation was found between the VAS scores for subjective taste disorders and the duration time of AT.

Conclusions: Our results showed that among the patients with olfactory disorders, the duration time of AT was reduced for those with subjective taste disorders.

Background: Impairment of airflow perception by the intranasal trigeminal system may explain chronic nasal obstruction (CNO),especially in cases where no major deformity or mucosal inflammation can explain reduced airflow. We aim to characterize the effect of topical intranasal anesthesia on intranasal trigeminal sensitivity and consequently the sensation of nasal obstruction.

Methodology: We performed a crossover study of 16 healthy subjects, randomised for either treatment (topical intranasal anesthesia with 10% Xylocaine) or placebo (saline solution). We used the Trigeminal Lateralization Task (TLT) with eucalyptol to assess trigeminal sensitivity. We measured nasal patency objectively with Peak Nasal Inspiratory Flow (PNIF), and subjectively with a Visual Analog Scale (VAS), the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q), and the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire.

Results: Topical intranasal anesthesia significantly reduced intranasal trigeminal sensitivity. Further, after topical intranasal anesthesia,reduced trigeminal sensitivity was associated with the subjectively reduced nasal patency, as highlighted by ENS6Q and NOSE scores.

Conclusions: Topical intranasal anesthesia reduces intranasal trigeminal function resulting in subjectively reduced nasal patency. In future studies, the relation of reduced intranasal trigeminal function and subjective nasal obstruction needs to be addressed to open an avenue for potential interventions for an important portion of ENT patients.

Background: Cerebrospinal fluid (CSF) leaks may occur due to numerous etiologies and are associated with severe morbidity. Currently in the U.S., confirming the presence of a CSF leak requires protein electrophoresis testing, oftentimes involving specialized processing, and there exists no point-of-care (POC) device for CSF detection. We aimed to discover a single-stranded deoxyribonucleic acid (ssDNA) aptamer capable of selectively binding to CSF-specific biomarkers, with the future goal of developing an aptamer-based POC CSF detection device.

Methods: To identify a candidate aptamer, we performed Systematic Evolution of Ligands by EXponential enrichment (SELEX) using a DNA library containing a randomized 63-nucleotide (nt) stretch flanked by 2 primer-binding sites. Quantitative polymerase chain reaction (qPCR) and fluorescence anisotropy (FA) assessed aptamer binding affinity and kinetics.

Results: Following 14 SELEX cycles, 2 dominant and functionally viable 98-nt ssDNA sequences (C2 and C3) were found. C2 and C3 demonstrated ~586x and ~82x higher affinity for CSF compared to serum, respectively. Increases in FA upon aptamer exposure to higher CSF concentrations demonstrated a K1/2 of 5.0% and 14.1% for C2 and C3, respectively.

Conclusions: In vitro selection of a diverse pool of ssDNA sequences yielded 2 aptamers with high selectivity for CSF-specific biomarkers, with potential for integration into a rapid POC electrochemical diagnostic system.

Seasonal allergic rhinitis caused by Japanese cedar pollen (SAR-JCP) is a serious social problem in Japan, affecting 38.8% of the population. Omalizumab, a recombinant humanised monoclonal anti-immunoglobulin (Ig)E antibody, reduces serum-free IgE levels by 84â€"99%. The reduction of serum-free IgE levels induced by omalizumab ultimately downregulates FcÎ#181;RI expression in basophils and mast cells. Omalizumab significantly reduces nasal symptoms and improves the quality of life in patients with allergic rhinitis ; however, other than a decrease in free IgE, its biomarker activity is unclear. Allergic rhinitis reactions are more pronounced in nasal secretions and mucosa than in serum; however, no studies have examined the changes in proteins in nasal secretions after omalizumab administration. In this study, we aimed to elucidate the pathophysiology of the effect of omalizumab. This may serve as a basis for the identification of new biomarkers through the examination of proinflammatory proteins in nasal secretions, which may reflect the pathophysiology more accurately than peripheral blood.

Background: Allergen-specific immunotherapy (AIT) is a disease-modifying therapy and is effective to reduce the symptoms of grass pollen-allergy. The airway epithelium of these patients releases inflammatory mediators including type-2 cytokines, which are associated with cellular processes involved in the symptomatic response of the affected tissue. Aim of the study was to identify epithelial biomarkers indicating AIT progress.

Methods: In an exploratory, observational allergy cohort, we longitudinally phenotyped 56 grass pollen-allergic patients undergoing AIT for over three years and 18 controls using nasal secretions at critical time windows during therapy to assess peak-season responses along the course of therapy. Type-2 cytokine protein levels were analyzed using the high-sensitivity multiplex electrochemiluminescence mesoscale technique.

Results: The type-2 cytokines CCL26 and POSTN oscillated seasonally, in contrast to TSLP and IL-33. However, only POSTN was reduced over the three-year AIT progression. In addition to POSTN, IL-24 and IL-37 levels were continuously reduced during AIT, while IFN-g and CCL27 were increased. Compared to healthy individuals, AIT did not restore healthy secretion levels but rather induced a novel homeostasis CONCLUSION: Nasal secretions trace the epithelial response during different phases of AIT. We demonstrate that AIT only partially controls the epithelial type 2 cytokine CCL26, which also adapts to seasonal changes, while POSTN and IL-24 are potential indicators of therapy success. Therefore, nasal secretions represent a promising, non-invasive tool for monitoring seasonal progress of AIT.

Chronic rhinosinusitis with nasal polyps (CRSwNP) often co-exists with asthma and non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD), creating a more severe phenotype and an additional burden compared with CRSwNP disease alone. The relationship between these diseases in terms of shared immunological disbalance has been coined in the literature as "global airway disease" or "unified airway disease" and requires integrated treatment strategies. Our post hoc analysis of the Phase III randomised, double-blind, placebo-controlled, multicentre SYNAPSE study (GSK ID: 205687; NCT03085797) assessed the efficacy of mepolizumab, an anti-interleukin-5 monoclonal antibody, in simultaneously improving both CRSwNP and asthma outcomes versus placebo. By utilising a combined measure that accounts for quality of life, sinonasal symptoms and asthma control, we aimed to validate the potential of mepolizumab as an effective therapeutic option for global airway disease.

Chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and non-steroidal anti-inflammatory drug-exacerbated respiratory disease (N-ERD) frequently coexist, forming a complex multimorbid condition often referred to as "global airway disease". This concept reflects shared pathophysiological mechanisms of eosinophilic inflammation and underscores the need for integrated treatment strategies targeting both upper and lower airway manifestations (1). The burden of severe CRSwNP, asthma, and N-ERD is substantial, particularly in terms of reduced quality of life, recurrent exacerbations, revision endoscopic sinus surgeries (ESS), and healthcare utilization (2). Biologics represent a significant advancement in the treatment of global airway diseases.

Background: The COVID-19 pandemic led to a surge in olfactory dysfunction (OD), increasing the need for specialized care. Thi study explores the prevalence, characteristics, and clinical implications of OD in a specialized Smell & Taste Clinic established at the ENT-HNS department of the University Hospitals Leuven (UZ Leuven) in 2021.

Methodology: We included consecutive patients with OD in the observational longitudinal ProspeRo'Scent registry at UZ Leuven between September 2021 and April 2024. Chemosensory assessment was done with psychophysical tests (Sniffin' Sticks TDI and Taste sprays) and questionnaires.

Results: Of the 203 unique, consecutive patients, COVID-19-associated OD (C19OD) was the predominant etiology (50.2%), followed by idiopathic (25.1%), and post-traumatic (8.9%) OD. Parosmia was present in 60.2% of patients, with the highest prevalence in C19OD cases (80.9%). Sniffin' Sticks TDI testing indicated that patients with parosmia had better olfactory thresholds and discrimination scores than patients without. During follow-up (n=116; average 7.7 months), 31% of C19OD patients exhibited clinically relevant improvement in TDI scores, compared to 13% for the other etiologies. Quality of life, as assessed by sQOD-NS, was not significantly different between etiologies but correlated with higher parosmia scores.

Conclusions: C19OD patients suffered more from parosmia, correlating with worse quality of life, but had better baseline TDI scores and demonstrated a higher likelihood of clinically relevant improvement over time compared to other etiologies.

Nasal septal perforations (NSPs) are a common referral to specialist rhinology practice. A wide range of management options have been described but to be able to offer the most effective treatment modalities to our patients we must be able to capture quantitative data on patient symptom burden accurately and robustly.