Background: In order to optimise the support of children with cochlear implants (CI), it is very important to detect slow developmental processes as early as possible. Data from the LittlEARS® Auditory Questionnaire (LEAQ) from children with early bilateral CI are evaluated and presented in relation to age and hearing age and compared with language development data recorded later.
Materials and methods: This retrospective multicentre study included data from a total of 554 children for whom at least one LEAQ was completed during the course of CI rehabilitation. Children without additional disabilities who received bilateral simultaneous or sequential CI treatment were included.
Results: As expected, there are high correlations between hearing age (HA) and the overall LEAQ total score. When analysed according to chronological age (CA), development runs roughly parallel to the development of children with normal hearing, albeit at a lower level. Children implanted early up to an age of ≤ 12 months consistently achieve approximately 7-8 raw points more. Only the LEAQ results of the later test times (from the age of 18 months) correlate with some areas of the speech development test for children (SETK; areas 3-5).
Conclusion: The earliest possible detection of critical developmental processes in children with CI is extremely important. In the case of very early CI fitting, the CA should be used as a reference measure in diagnostics. The LEAQ values determined for the group of children with CI are suitable to a limited extent as generally valid reference values for children with early bilateral CI. Further studies should continue to work out the correlations between early preverbal development and later speech development.
背景:为了优化对植入人工耳蜗(CI)儿童的支持,尽早发现发育缓慢的过程非常重要。本研究对早期双侧人工耳蜗植入儿童的 LittlEARS® 听觉问卷(LEAQ)数据进行了评估,并将其与年龄和听力年龄进行了比较,还将其与后来记录的语言发展数据进行了比较:这项回顾性多中心研究共包括 554 名儿童的数据,这些儿童在 CI 康复过程中至少完成了一次 LEAQ。研究对象包括接受双侧同步或顺序 CI 治疗的无额外残疾儿童:不出所料,听力年龄(HA)与 LEAQ 总分之间存在高度相关性。如果根据实际年龄(CA)进行分析,听力发育情况与听力正常儿童的发育情况大致相同,只是水平较低。早期植入助听器的儿童在 12 个月以下的听力水平一直比正常儿童高出约 7-8 分。只有较晚测试时间(18 个月以上)的 LEAQ 结果与儿童言语发展测试(SETK;3-5 区)的某些区域相关:结论:尽早发现 CI 儿童的关键发育过程极为重要。结论:尽早发现 CI 患儿的关键发育过程极为重要。在早期 CI 装配的情况下,CA 应作为诊断的参考指标。为一组 CI 儿童确定的 LEAQ 值在一定程度上适合作为早期双侧 CI 儿童的普遍有效参考值。应继续开展进一步研究,以确定早期学前发育与日后言语发育之间的相关性。
{"title":"[The LittlEARS® Auditory Questionnaire : An analysis of multicentre data of children after early bilateral cochlear implant placement].","authors":"Yvonne Seebens, Dennis Metzeld, Barbara Streicher, Cynthia Glaubitz, Dominique Kronesser, Kerstin Kreibohm-Strauß, Silke Helbig, Karolin Schäfer, Stefanie Kröger, Rainer Beck, Antje Aschendorff","doi":"10.1007/s00106-024-01509-9","DOIUrl":"https://doi.org/10.1007/s00106-024-01509-9","url":null,"abstract":"<p><strong>Background: </strong>In order to optimise the support of children with cochlear implants (CI), it is very important to detect slow developmental processes as early as possible. Data from the LittlEARS® Auditory Questionnaire (LEAQ) from children with early bilateral CI are evaluated and presented in relation to age and hearing age and compared with language development data recorded later.</p><p><strong>Materials and methods: </strong>This retrospective multicentre study included data from a total of 554 children for whom at least one LEAQ was completed during the course of CI rehabilitation. Children without additional disabilities who received bilateral simultaneous or sequential CI treatment were included.</p><p><strong>Results: </strong>As expected, there are high correlations between hearing age (HA) and the overall LEAQ total score. When analysed according to chronological age (CA), development runs roughly parallel to the development of children with normal hearing, albeit at a lower level. Children implanted early up to an age of ≤ 12 months consistently achieve approximately 7-8 raw points more. Only the LEAQ results of the later test times (from the age of 18 months) correlate with some areas of the speech development test for children (SETK; areas 3-5).</p><p><strong>Conclusion: </strong>The earliest possible detection of critical developmental processes in children with CI is extremely important. In the case of very early CI fitting, the CA should be used as a reference measure in diagnostics. The LEAQ values determined for the group of children with CI are suitable to a limited extent as generally valid reference values for children with early bilateral CI. Further studies should continue to work out the correlations between early preverbal development and later speech development.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-22DOI: 10.1007/s00106-024-01503-1
Peter M Mair, Thomas Mayr, Georg Sprinzl, Astrid Magele
An isolated fracture of the handle of the malleus is a rare entity in otorhinolaryngology and manifests clinically as acute-onset unilateral hearing loss. Several factors may cause this injury, including acute barotraumatic pressure changes or traumatic events. Various therapeutic approaches such as tympanoplasty, autologous graft, or application of bone cement are discussed. We report the case of a 46-year-old female patient who developed acute hearing loss in her left ear after finger manipulation. Clinical evaluation revealed axial displacement of the handle of the malleus and audiometry indicated conductive hearing loss. After otoscopy, audiometry, and computed tomography, tympanoscopy was indicated due to suspicion of ossicular chain disruption. Intraoperatively, an isolated fracture of the handle of malleus was found, which was treated with glass ionomer cement. Following postoperative examination, there was progressive improvement in the acoustic transmission component, such that a normal hearing threshold was observed 4 months postoperatively. This case report underlines the importance of precise diagnosis and individualized treatment for rare middle ear injuries.
{"title":"[An unusual case: fracture of the handle of the malleus due to finger manipulation].","authors":"Peter M Mair, Thomas Mayr, Georg Sprinzl, Astrid Magele","doi":"10.1007/s00106-024-01503-1","DOIUrl":"10.1007/s00106-024-01503-1","url":null,"abstract":"<p><p>An isolated fracture of the handle of the malleus is a rare entity in otorhinolaryngology and manifests clinically as acute-onset unilateral hearing loss. Several factors may cause this injury, including acute barotraumatic pressure changes or traumatic events. Various therapeutic approaches such as tympanoplasty, autologous graft, or application of bone cement are discussed. We report the case of a 46-year-old female patient who developed acute hearing loss in her left ear after finger manipulation. Clinical evaluation revealed axial displacement of the handle of the malleus and audiometry indicated conductive hearing loss. After otoscopy, audiometry, and computed tomography, tympanoscopy was indicated due to suspicion of ossicular chain disruption. Intraoperatively, an isolated fracture of the handle of malleus was found, which was treated with glass ionomer cement. Following postoperative examination, there was progressive improvement in the acoustic transmission component, such that a normal hearing threshold was observed 4 months postoperatively. This case report underlines the importance of precise diagnosis and individualized treatment for rare middle ear injuries.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-05-27DOI: 10.1007/s00106-024-01477-0
Katharina Bader, Dennis Zelle, Anthony W Gummer, Ernst Dalhoff
Background: To date, there is no consensus on how to standardize the assessment of ototoxicity in serial measurements. For the diagnosis of damage to the cochlear amplifier, measurement methods are required that have the highest possible test-retest reliability and validity for detecting persistent damage. Estimated distortion-product thresholds (LEDPT) based on short-pulse distortion-product otoacoustic emission (DPOAE) level maps use individually optimal DPOAE stimulus levels and allow reliable quantitative estimation of cochlea-related hearing loss.
Materials and methods: Hearing thresholds were estimated objectively using LEDPT and subjectively using modified Békésy tracking audiometry (LTA). Recordings were performed seven times within three months at 14 frequencies (f2 = 1-14 kHz) in 20 ears (PTA4(0.5-4kHz) < 20 dB HL). Reconstruction of the DPOAE growth behavior as a function of the stimulus levels L1, L2 was performed on the basis of 21 DPOAE amplitudes. A numerical fit of a nonlinear mathematical function to the three-dimensional DPOAE growth function yielded LEDPT for each stimulus frequency. For the combined analysis, probability distributions of hearing thresholds (LTA, LEDPT), DPOAE levels (LDP), and combinations thereof were determined.
Results: LTA and LEDPT each exhibited a test-retest reliability with a median of absolute differences (AD) of 3.2 dB and 3.3 dB, respectively. Combining LEDPT, LDP, and LTA into a single parameter yielded a significantly smaller median AD of 2.0 dB.
Conclusion: It is expected that an analysis paradigm based on a combination of LEDPT, suprathreshold LDP, and fine-structure-reduced LTA would achieve higher test performance (sensitivity and specificity), allowing reliable detection of pathological or regenerative changes in the outer hair cells.
{"title":"[Pulsed DPOAEs in serial measurements : Combined analysis paradigm of simultaneously occurring changes in hearing thresholds and DPOAEs. German version].","authors":"Katharina Bader, Dennis Zelle, Anthony W Gummer, Ernst Dalhoff","doi":"10.1007/s00106-024-01477-0","DOIUrl":"10.1007/s00106-024-01477-0","url":null,"abstract":"<p><strong>Background: </strong>To date, there is no consensus on how to standardize the assessment of ototoxicity in serial measurements. For the diagnosis of damage to the cochlear amplifier, measurement methods are required that have the highest possible test-retest reliability and validity for detecting persistent damage. Estimated distortion-product thresholds (L<sub>EDPT</sub>) based on short-pulse distortion-product otoacoustic emission (DPOAE) level maps use individually optimal DPOAE stimulus levels and allow reliable quantitative estimation of cochlea-related hearing loss.</p><p><strong>Materials and methods: </strong>Hearing thresholds were estimated objectively using L<sub>EDPT</sub> and subjectively using modified Békésy tracking audiometry (L<sub>TA</sub>). Recordings were performed seven times within three months at 14 frequencies (f<sub>2</sub> = 1-14 kHz) in 20 ears (PTA<sub>4</sub> <sub>(0.5-4</sub> <sub>kHz)</sub> < 20 dB HL). Reconstruction of the DPOAE growth behavior as a function of the stimulus levels L<sub>1</sub>, L<sub>2</sub> was performed on the basis of 21 DPOAE amplitudes. A numerical fit of a nonlinear mathematical function to the three-dimensional DPOAE growth function yielded L<sub>EDPT</sub> for each stimulus frequency. For the combined analysis, probability distributions of hearing thresholds (L<sub>TA</sub>, L<sub>EDPT</sub>), DPOAE levels (L<sub>DP</sub>), and combinations thereof were determined.</p><p><strong>Results: </strong>L<sub>TA</sub> and L<sub>EDPT</sub> each exhibited a test-retest reliability with a median of absolute differences (AD) of 3.2 dB and 3.3 dB, respectively. Combining L<sub>EDPT</sub>, L<sub>DP</sub>, and L<sub>TA</sub> into a single parameter yielded a significantly smaller median AD of 2.0 dB.</p><p><strong>Conclusion: </strong>It is expected that an analysis paradigm based on a combination of L<sub>EDPT</sub>, suprathreshold L<sub>DP</sub>, and fine-structure-reduced L<sub>TA</sub> would achieve higher test performance (sensitivity and specificity), allowing reliable detection of pathological or regenerative changes in the outer hair cells.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-24DOI: 10.1007/s00106-024-01492-1
Tobias Albrecht, Valentin Burkhardt, Christian Offergeld
Midface fractures present a clinical challenge in otorhinolaryngology due to their often complex injury pattern and nonspecific symptoms. Precise diagnostics, including differentiated imaging procedures, are required. Interdisciplinary consultation between otorhinolaryngology, maxillofacial surgery, neurosurgery, and ophthalmology is often necessary. When selecting radiographic modalities, radiation hygiene should be taken into account. Sonography provides a radiation-free imaging alternative for fractures of the nasal framework and anterior wall of the frontal sinus. The goal of treatment is to achieve stable and symmetrical reconstruction. Depending on the injury pattern, different osteosynthesis materials, individual access routes, and various surgical procedures can be used. In clinical practice, the management of midface fractures requires a multidisciplinary, flexible, and pragmatic approach based on the fracture pattern and clinical experience.
{"title":"[Trauma of the midface : Symptoms, diagnostics and treatment].","authors":"Tobias Albrecht, Valentin Burkhardt, Christian Offergeld","doi":"10.1007/s00106-024-01492-1","DOIUrl":"10.1007/s00106-024-01492-1","url":null,"abstract":"<p><p>Midface fractures present a clinical challenge in otorhinolaryngology due to their often complex injury pattern and nonspecific symptoms. Precise diagnostics, including differentiated imaging procedures, are required. Interdisciplinary consultation between otorhinolaryngology, maxillofacial surgery, neurosurgery, and ophthalmology is often necessary. When selecting radiographic modalities, radiation hygiene should be taken into account. Sonography provides a radiation-free imaging alternative for fractures of the nasal framework and anterior wall of the frontal sinus. The goal of treatment is to achieve stable and symmetrical reconstruction. Depending on the injury pattern, different osteosynthesis materials, individual access routes, and various surgical procedures can be used. In clinical practice, the management of midface fractures requires a multidisciplinary, flexible, and pragmatic approach based on the fracture pattern and clinical experience.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-27DOI: 10.1007/s00106-024-01470-7
Nadine Gunder, Thomas Hummel
Objectives: A large number of patients with olfactory impairment are affected by parosmia or phantosmia. This study aimed to examine the demographic and clinical characteristics of parosmia.
Methods: We performed a retrospective data analysis of patients consulting at our Smell and Taste Outpatient Clinic. A total of 297 patients were included (203 women, mean age 44.4 ± 13.7 years). Olfactory function was quantified using the "Sniffin' Sticks" composite TDI (odor threshold, determination, and identification) score. The presence of qualitative olfactory impairment was assessed trough medical history and a parosmia questionnaire.
Results: Most of the patients showed olfactory impairment after an infection with SARS-CoV‑2 (84%) and were diagnosed with parosmia (49%). Patients with parosmia (PAR) (n = 201) were significantly younger compared to the group without parosmia (noPAR; n = 92) (PAR 43.2 ± 13 years vs. noPAR 47 ± 15.1 years, p = 0.03) and had a slightly shorter duration of disease, without reaching statistical significance (PAR 10.3 ± 4.9 months, noPAR 13.6 ± 37.6 months, p = 0.23). They also had higher TDI scores (PAR 24.3 ± 7 points, noPAR 21.4 ± 8.2 points, p = 0.003).
Conclusions: Patients affected by parosmia were younger and had a better olfactory function compared to patients without parosmia.
{"title":"Parosmia in patients with post-infectious olfactory dysfunction in the era of COVID-19-associated olfactory impairment.","authors":"Nadine Gunder, Thomas Hummel","doi":"10.1007/s00106-024-01470-7","DOIUrl":"10.1007/s00106-024-01470-7","url":null,"abstract":"<p><strong>Objectives: </strong>A large number of patients with olfactory impairment are affected by parosmia or phantosmia. This study aimed to examine the demographic and clinical characteristics of parosmia.</p><p><strong>Methods: </strong>We performed a retrospective data analysis of patients consulting at our Smell and Taste Outpatient Clinic. A total of 297 patients were included (203 women, mean age 44.4 ± 13.7 years). Olfactory function was quantified using the \"Sniffin' Sticks\" composite TDI (odor threshold, determination, and identification) score. The presence of qualitative olfactory impairment was assessed trough medical history and a parosmia questionnaire.</p><p><strong>Results: </strong>Most of the patients showed olfactory impairment after an infection with SARS-CoV‑2 (84%) and were diagnosed with parosmia (49%). Patients with parosmia (PAR) (n = 201) were significantly younger compared to the group without parosmia (noPAR; n = 92) (PAR 43.2 ± 13 years vs. noPAR 47 ± 15.1 years, p = 0.03) and had a slightly shorter duration of disease, without reaching statistical significance (PAR 10.3 ± 4.9 months, noPAR 13.6 ± 37.6 months, p = 0.23). They also had higher TDI scores (PAR 24.3 ± 7 points, noPAR 21.4 ± 8.2 points, p = 0.003).</p><p><strong>Conclusions: </strong>Patients affected by parosmia were younger and had a better olfactory function compared to patients without parosmia.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"[Recurrent syncope : When does the otorhinolaryngologist get involved?]","authors":"Luca Gazzini, Remo Accorona, Sandra Gazzini, Raffaele Cerullo, Luca Calabrese","doi":"10.1007/s00106-023-01399-3","DOIUrl":"10.1007/s00106-023-01399-3","url":null,"abstract":"","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139049815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-02-15DOI: 10.1007/s00106-024-01425-y
P Huber, S Becker, M Gröger
House dust mite (HDM) is the most significant indoor allergen, responsible for not only many cases of rhinoconjunctivitis but also for many cases of bronchial asthma, rendering it of considerable socioeconomic relevance. Besides symptomatic treatment and avoidance measures, allergen immunotherapy (AIT) is crucial, as the only causal, disease-modifying therapeutic approach. However, high diagnostic certainty is essential for initiating AIT. The challenge in making a correct diagnosis lies in interpreting the demonstrated HDM sensitization regarding its clinical relevance (clinically silent sensitization vs. allergy). While the risk of allergy increases with the level of IgE titers against HDM extract, Der p 1, or Der p 2, as well as with the breadth of the molecular sensitization profile against HDM components (Der p 1, Der p 2, Der p 23), no threshold can be defined for the presence of allergy, nor can sensitization to a specific component be confidently considered allergy inducing. It should be noted that at least in Southern Bavaria, the prevalence of Der p 23 sensitization is too low to be considered a major allergen, and Der p 23 is not able to molecularly differentiate all HDM sensitizations when added to the two major allergens Der p 1 and Der p 2. Evidently, HDM possesses a diverse profile of allergens, with some relevant ones possibly yet to be described. Unfortunately, patient history does not provide a sufficient assessment of the clinical relevance of a demonstrated HDM sensitization, necessitating allergen provocation testing before initiating AIT with HDM, despite the relatively large effort involved.
室内尘螨(HDM)是最重要的室内过敏原,不仅是许多鼻结膜炎病例的罪魁祸首,也是许多支气管哮喘病例的罪魁祸首,因此具有相当大的社会经济意义。除了对症治疗和避免接触过敏原的措施外,过敏原免疫疗法(AIT)也至关重要,因为它是唯一能改变疾病的治疗方法。然而,要启动过敏原免疫疗法,高度的诊断确定性是必不可少的。做出正确诊断的难点在于如何解释已证实的 HDM 致敏与临床的相关性(临床上无症状的致敏与过敏)。虽然过敏的风险会随着针对 HDM 提取物、Der p 1 或 Der p 2 的 IgE 滴度水平以及针对 HDM 成分(Der p 1、Der p 2、Der p 23)的分子致敏谱的广度而增加,但并不能确定存在过敏的阈值,也不能确信对特定成分的致敏会诱发过敏。值得注意的是,至少在南巴伐利亚州,Der p 23 的致敏率太低,不能被视为主要过敏原,而且当 Der p 23 与两种主要过敏原 Der p 1 和 Der p 2 相加时,也不能从分子上区分所有 HDM 致敏物质。由此可见,HDM 的过敏原多种多样,其中一些相关的过敏原可能尚未被描述。遗憾的是,患者病史并不能充分评估已证实的 HDM 致敏的临床相关性,因此在开始使用 HDM 的 AIT 之前必须进行过敏原激发试验,尽管这需要相对较大的工作量。
{"title":"[Pitfalls in the diagnosis of house dust mite allergy].","authors":"P Huber, S Becker, M Gröger","doi":"10.1007/s00106-024-01425-y","DOIUrl":"10.1007/s00106-024-01425-y","url":null,"abstract":"<p><p>House dust mite (HDM) is the most significant indoor allergen, responsible for not only many cases of rhinoconjunctivitis but also for many cases of bronchial asthma, rendering it of considerable socioeconomic relevance. Besides symptomatic treatment and avoidance measures, allergen immunotherapy (AIT) is crucial, as the only causal, disease-modifying therapeutic approach. However, high diagnostic certainty is essential for initiating AIT. The challenge in making a correct diagnosis lies in interpreting the demonstrated HDM sensitization regarding its clinical relevance (clinically silent sensitization vs. allergy). While the risk of allergy increases with the level of IgE titers against HDM extract, Der p 1, or Der p 2, as well as with the breadth of the molecular sensitization profile against HDM components (Der p 1, Der p 2, Der p 23), no threshold can be defined for the presence of allergy, nor can sensitization to a specific component be confidently considered allergy inducing. It should be noted that at least in Southern Bavaria, the prevalence of Der p 23 sensitization is too low to be considered a major allergen, and Der p 23 is not able to molecularly differentiate all HDM sensitizations when added to the two major allergens Der p 1 and Der p 2. Evidently, HDM possesses a diverse profile of allergens, with some relevant ones possibly yet to be described. Unfortunately, patient history does not provide a sufficient assessment of the clinical relevance of a demonstrated HDM sensitization, necessitating allergen provocation testing before initiating AIT with HDM, despite the relatively large effort involved.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-06-27DOI: 10.1007/s00106-024-01495-y
Daniel Runggaldier, Roman Adam, Chiara Ermanni, Ursula Colotto-Vith, Miriam E F van Beek, Carsten Posovszky, Franziska Righini Grunder, Daniel Pohl, Jörg E Bohlender
Belching is the act of expelling air from the stomach or esophagus into the pharynx. Although the process is regarded as physiological, excessive belching might be associated with a significant burden for affected patients in the sense of a belching disorder. Diagnosis of a belching disorder is often challenging, and its differentiation from other conditions such as rumination syndrome, singultus, or aerophagia can be difficult. Treatment of these disorders also represents a challenge for otorhinolaryngologists. Hence, the aim of this review is to provide an interdisciplinary overview of these clinical syndromes and provide practical guidance for their diagnosis and treatment.
{"title":"[Gastric vs. supragastric belching, singultus, aerophagia, and differential diagnoses : An interdisciplinary perspective for otorhinolaryngologists].","authors":"Daniel Runggaldier, Roman Adam, Chiara Ermanni, Ursula Colotto-Vith, Miriam E F van Beek, Carsten Posovszky, Franziska Righini Grunder, Daniel Pohl, Jörg E Bohlender","doi":"10.1007/s00106-024-01495-y","DOIUrl":"10.1007/s00106-024-01495-y","url":null,"abstract":"<p><p>Belching is the act of expelling air from the stomach or esophagus into the pharynx. Although the process is regarded as physiological, excessive belching might be associated with a significant burden for affected patients in the sense of a belching disorder. Diagnosis of a belching disorder is often challenging, and its differentiation from other conditions such as rumination syndrome, singultus, or aerophagia can be difficult. Treatment of these disorders also represents a challenge for otorhinolaryngologists. Hence, the aim of this review is to provide an interdisciplinary overview of these clinical syndromes and provide practical guidance for their diagnosis and treatment.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11339109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01Epub Date: 2024-07-20DOI: 10.1007/s00106-024-01499-8
Guido Mühlmeier, Matthias Tisch
Diagnosis of allergic disease is primarily verified by IgE blood serum analysis. Determination in nasal secretions is technically more difficult, particularly due to a low specimen volume and the method of sample collection. Nasal secretions are frequently collected by lavage, which allows qualitative diagnostics, whereas swabs with defined amounts of mucus enable quantitative analyses. In the case of negative skin and serum tests, detection of IgE in nasal mucus combined with nasal provocation testing aids differentiation between local allergic and nonallergic rhinitis.
{"title":"[Immunoglobulin E in nasal secretions].","authors":"Guido Mühlmeier, Matthias Tisch","doi":"10.1007/s00106-024-01499-8","DOIUrl":"10.1007/s00106-024-01499-8","url":null,"abstract":"<p><p>Diagnosis of allergic disease is primarily verified by IgE blood serum analysis. Determination in nasal secretions is technically more difficult, particularly due to a low specimen volume and the method of sample collection. Nasal secretions are frequently collected by lavage, which allows qualitative diagnostics, whereas swabs with defined amounts of mucus enable quantitative analyses. In the case of negative skin and serum tests, detection of IgE in nasal mucus combined with nasal provocation testing aids differentiation between local allergic and nonallergic rhinitis.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}