151 research outputs found
Reply to letter to the editor on: when details matter: clarifying study design and outcomes in facial nerve trauma research
No full textDiagnosing odontogenic sinusitis and avoiding the trap of maxillary sinus mucosal thickening on computed tomography: A clinical report
No full textOdontogenic sinusitis (ODS) refers to bacterial maxillary sinusitis caused by infectious maxillary
dental pathology or dental procedures. ODS is the most common cause of unilateral sinusitis and
a common cause of extrasinus infectious complications, including orbital and brain abscesses.
While managing ODS has been highly successful, the greatest challenge can be recognizing and
confirming the diagnosis. Diagnosing ODS requires confirming infectious maxillary dental
pathology with appropriate examination and imaging and, very importantly, infectious sinusitis
through nasal endoscopy. Sinus computed tomography is an important complimentary diagnostic
method of confirming the location(s) of sinus disease but can be misleading if done without nasal
endoscopy. Critical to note, clinicians must distinguish purulent ODS from maxillary sinus mucosal
thickening (MSMT) seen on computed tomography, a reactive mucosal inflammation (mucositis)
commonly seen with maxillary dental disease or dental treatment. MSMT is usually not infectious
and, therefore, not usually ODS. The clinical scenario presented highlights the devastating
progression from MSMT to ODS and ultimately a fatal brain abscess, all which had gone
undetected for years. Recognizing and managing ODS requires increased ODS awareness and
coordinated care between dental providers and otolaryngologists. Such interdisciplinary care will
optimize outcomes for patients with ODS and may help prevent catastrophic complications
Prevalence of pain due to rhinosinusitis : a review
No full textHeadache secondary to sinonasal disease is still overestimated in the diagnostic pathway of cephalalgia. Contrary to belief, so-called sinus headaches are fairly uncommon and seen mostly in acute sinusitis or acute exacerbations. Even though literature has written extensively about the prevalence of migraines in self-diagnosed or primary care-diagnosed sinus headache, there is only a small body of literature regarding the real prevalence of pain and headache occurring during acute and chronic sinusitis. We reviewed the current literature and clarified the differences in presentation of pain for acute and chronic sinusitis, highlighting the higher prevalence of pain in chronic rhinosinusitis without polyps versus with polyps. Furthermore, we stressed the need for a rethinking in the clinical diagnosis of sinusitis based on pain as a major symptom
Isolation of putative stem cells present in human adult olfactory mucosa
No full textThe olfactory mucosa (OM) has the unique characteristic of performing an almost continuous and lifelong neurogenesis in response to external injuries, due to the presence of olfactory stem cells that guarantee the maintenance of the olfactory function. The easy accessibility of the OM in humans makes these stem cells feasible candidates for the development of regenerative therapies. In this report we present a detailed characterization of a patient-derived OM, together with a description of cell cultures obtained from the OM. In addition, we present a method for the enrichment and isolation of OM stem cells that might be used for future translational studies dealing with neuronal plasticity, neuro-regeneration or disease modeling
Evaluation of Wisconsin and CaPTHUS indices usefulness for predicting monoglandular and multiglandular disease in patients with primary hyperparathyroidism through the analysis of a single-center experience
No full textBackground. The main challenge for treating primary hyperparathyroidism (PHPT) is to understand if it is caused by a single adenoma (80–85% of the cases) or by a multiglandular disease (15–20%), both preoperatively and intraoperatively. For this reason, some preoperative scores were proposed in the literature, to perform focused parathyroidectomy, avoiding intraoperative parathormone assay (ioPTH). The most known are the CaPTHUS test and the Wisconsin index. We applied them to our experience. Methods. A retrospective cohort study on 462 patients referred for parathyroidectomy to Thyroid and Parathyroid Unit at Santi Paolo e Carlo Hospital, Milan, Italy, from 2011 to 2021. Only patients affected with benign PHPT and neck ultrasound performed at our institution were included. Both patients for whom preoperative imaging agreed with the localization of a single diseased parathyroid and those with only ultrasound or scintigraphy positive for parathyroid localization underwent Mini-Invasive Video-assisted parathyroidectomy. In all cases, ioPTH assay was performed. The conversion to bilateral neck exploration was decided based on the drop in ioPTH. CaPTHUS score and the Wisconsin index (Win) were applied to the series. CaPTHUS score ≥3 and Win index >1600, according to the original studies of the literature, were considered at high probability of monoglandular disease. Outcomes in these two groups were examined. Results. 236 patients were eligible for the study. The pathology resulted in multiglandular disease in 24 patients (10.2%). Among these, 18 (75.0%) obtained a CaPTHUS score ≥3, and 20 (83.3%) had a Win index>1600. Intraoperative PTH allowed to identify multiglandular disease in 16 of 18 cases with CaPTHUS ≥3 and in 18 of 20 cases with win >1600, who could have been lost, based only on the results of these 2 tests. Conclusion. Based on our experience, CaPTHUS test and Wisconsin index were not so useful in predicting multiglandular disease as ioPTH
Dental Evaluation: Oral Surgery-Related Complications
No full text: The article provides an in-depth review focused on diagnosing oral surgery-related complications that may cause odontogenic sinusitis (ODS). It emphasizes the importance of evaluating patients with prior oral surgical procedures to determine whether the prior procedure is an ongoing infectious source of the ODS. Specifically, diagnostic evaluations will be described for detecting oroantral communications and fistulas, dental implant dislocation or protrusion, and whether implants and graft placed in maxillary sinuses are infected. It highlights the role of different oral examination techniques, optimal imaging modalities, and the importance of otolaryngologic collaboration to evaluate for infectious ODS
In reference to Treatment of epilepsy by stimulation of the vagus nerve from head-and-neck surgical point of view
No full textQuail egg homogenate with zinc as adjunctive therapy in seasonal allergic rhinitis: A randomized controlled trial
No full textObjective. Since most available treatments manage seasonal allergic rhinitis (SAR) show some side effects without reducing recurrences, natural anti-allergic products could represent an interesting treatment addition. We aimed to study the efficacy and tolerance of quail egg as adjunctive therapy in SAR. Methods. In a CONSORT compliant framework, patients with SAR were prospectively randomized to receive mometasone nasal spray for four weeks (M) or the same topic corticosteroid therapy plus oral commercially available quail egg and zinc tablets (M+N). Results. Forty patients were enrolled. The M+N group showed a greater reduction in nasal itching, sneezing, and total nasal symptom scores than the M group. A higher proportion of participants in the M+N group had good rhinitis control than in the M group, with no need for rescue medications. Conclusion. Despite the need for further larger study, quail egg preliminary appears as an effective adjunct to topical steroid therapy in SAR
Maxillary Sinus Grafting Complications: Diagnosis, Management, Patient Outcomes, and Role of Multidisciplinary Care
No full textBackground: Maxillary sinus grafting (MSG) is often crucial for successful dental implant placement in the atrophic maxilla. However, it carries the risk of sinonasal complications, with outcomes frequently influenced by the patient's sinonasal health and the subjective assessment of surgeons. Thorough preoperative evaluation by otolaryngologists is vital to reduce these risks. Purpose: This study emphasizes the importance of interdisciplinary collaboration in managing sinonasal complications following MSG. By highlighting the role of otolaryngologists in preoperative evaluations and proposing a systematic approach, it aims to improve surgical planning and optimize patient outcomes. Discussion: Sinonasal complications after MSG can be classified into early and delayed categories, each requiring distinct management approaches. Early complications, such as infections and graft migration, demand immediate attention, while delayed issues, like implant osseointegration failure, pose longer term challenges. Accurate diagnosis is often difficult due to the overlap of symptoms with other sinus conditions, necessitating comprehensive clinical evaluations, endoscopic findings, and radiographic imaging. Collaboration between dental and otolaryngology specialists is essential, underscoring the need for a multidisciplinary strategy in managing these complications. Conclusion: Managing sinonasal complications post-MSG requires prompt diagnosis and a combination of medical and surgical interventions. Early detection and treatment, supported by a structured interdisciplinary approach, are key to improving patient outcomes. Integrating dental and otolaryngological expertise is critical to ensuring the success of MSG procedures and enhancing overall patient care
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