Osteonecrosis of the jaw after treatment with bisphosphonates: is irreversible, so the focus must be on prevention.
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Bone Density Conservation Agents↗
Biomedical subjects
Basile Nicolas Landis
Publications and source records attributed to Basile Nicolas Landis.
Postoperative/posttraumatic gustatory dysfunction.
Clinical taste testing in humans is far from being routinely performed in ear, nose and throat (ENT) clinics. Consequently, most reports on posttraumatic and postoperative taste disorders are case reports and mainly consist of qualitative (e.g. dysgeusia, metallic taste) taste changes after either head injury or ENT surgery. Since quantitative taste deficiencies (ageusia, hypogeusia) often go unnoticed by the patients, the real incidence of ageusia and hypogeusia after head trauma and various surgical procedures remains largely unknown. This lack of reliable clinical data is partly due to the lack of easy, reproducible and rapid clinical taste testing devices. The present chapter tries to resume the current knowledge on postoperative and posttraumatic taste disorders. Despite the sparse literature, the chapter focuses on those ENT surgical procedures where at least some prospective and systematic studies on gustatory dysfunction exist. Accordingly, taste disorders after middle ear surgery, tonsillectomy and dental interventions are largely discussed.
Brain Injuries↗
Mechanical obstruction of the olfactory cleft reveals differences between orthonasal and retronasal olfactory functions.
Following up on recent observations in patients with nasal polyposis (NP), the present study aimed to investigate whether a mechanical obstruction of the anterior olfactory cleft (OC) would produce differential effects on orthonasal and retronasal olfactory functions. To this end, we studied 33 healthy subjects in a randomized trial. Sponges with high content of saline were either placed in the OC or on the respiratory epithelium, such that this was blinded to both subject and observer. The results indicated that orthonasal (P = 0.04) but not retronasal (P = 0.15) olfactory identification ability was lower when the OC was blocked. This confirms the idea that differences between orthonasal and retronasal olfactory functions, as observed in NP patients, are, at least to some degree, due to mechanical obstruction of the anterior portion of the OC. The present data also suggest that mechanical obstruction is a means to induce reversible hyposmia void of side effects which can be performed in a blinded fashion. This might become a valuable model of hyposmia for future investigations.
Adult↗
Differences between orthonasal and retronasal olfactory functions in patients with loss of the sense of smell.
OBJECTIVE: To investigate differences between orthonasal and retronasal olfaction in patients with loss of the sense of smell without taste complaints. DESIGN: Electrophysiological and psychophysical testing of orthonasal and retronasal olfactory functions. SETTING: Outpatient clinics. PATIENTS: A series of 18 patients who had olfactory loss due to various reasons but no "taste" complaints. MAIN OUTCOME MEASURES: Orthonasal and retronasal olfactory functions assessed by olfactory event-related potentials and psychophysical smell tests. RESULTS: Psychophysical testing revealed retronasal olfaction to be normal or slightly altered, whereas orthonasal olfaction was either absent or severely compromised. Findings from nasal endoscopic examinations and computed tomographic scans were within the reference range in all subjects. In response to orthonasal stimulation there were neither detectable olfactory event-related potentials nor any with small amplitudes, whereas olfactory event-related potentials in response to retronasal stimulation were clearly present in some patients. CONCLUSION: These clinical observations, together with the psychophysical and electrophysiological findings, suggest that orthonasal and retronasal olfaction might be processed differently.
Adult↗
Hemorrhage risk after quinsy tonsillectomy.
BACKGROUND: The goal of the study was to evaluate the incidence and possible predictive factors of post-tonsillectomy hemorrhage (PTH) in patients with peritonsillar abscess, treated by acute abscess tonsillectomy. METHODS: A retrospective cohort study was performed on 205 patients who underwent bilateral abscess tonsillectomy under general anesthesia. Age, sex, smoking habits, history of recurrent tonsillitis or prior peritonsillar abscess, current medical treatment, side of the peritonsillar abscess, initial treatment, surgeon's experience, procedure duration, intra- and postoperative anti-inflammatory medications, and side of bleeding were analyzed. RESULTS: Bleeding occurred in 27 patients (13%). Ipsilateral hemorrhage was observed in 8 patients (4%) and contralateral hemorrhage in 19 patients (9%). The higher incidence of PTH in the side contralateral to the abscess was found to be statistically significant (P = 0.02). Male gender (P = 0.042), smoking (P = 0.009), and aspirin intake (P = 0.008) were statistically significant factors associated with an increased PTH risk. CONCLUSION: The risk of bleeding following abscess tonsillectomy seems higher than reported in elective tonsillectomy. This high incidence is mainly due to patients with prior aspirin intake or to bleeding in the side contralateral to the abscess. Postoperative bleeding could be reduced by performing a unilateral acute abscess tonsillectomy in selected patients. An algorithm is proposed for the management of peritonsillar abscess based on age, prior history of pharyngo-tonsillar infections, aspirin intake, and clinical improvement after initial drainage and antibiotherapy. EBM RATING: C.
Acute Disease↗
[Clinical aspects of dysosmia and presentation of European Olfactory Test of "sniffin sticks": a review].
The medical community has neglected olfactory dysfunction for a long time. However, over the last two decades, remarkable progress has been made in terms of understanding the sense of smell and both the assessment and diagnosis of olfactory dysfunction. Currently, there are only a few validated olfactory tests. The most commonly used one is the University of Pennsylvania Smell Identification Test. Owing to its cultural biases, this test is mostly used in the United States. "Sniffin' Sticks" are one of the first European tests to be widely used. Since their development in 1996, they have been applied in numerous studies and have found increasing use in otolaryngology clinics. The goal of this article is to present Sniffin' Sticks and to provide a review of clinical olfactory research during recent years.
Bacterial Infections↗
Pneumopericardium after manual strangulation.
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Adult↗
Chronic panrhinosinusitis without nasal polyps: long-term outcome after functional endoscopic sinus surgery.
OBJECTIVE: The goal of this study was to evaluate the long-term outcome after functional endoscopic sinus surgery (FESS) for chronic panrhinosinusitis without nasal polyps by using symptom scoring and an endoscopic outcome evaluation. STUDY DESIGN: Seventy-seven patients with chronic panrhinosinusitis without nasal polyps (Kennedy computed tomography [CT] scan stages I to III) were followed up for at least 3 years after FESS. Preoperative evaluation included a CT scan and an immunoallergologic evaluation. Three years after FESS, all patients were interviewed and scored endoscopically. RESULTS: Ninety-two percent of the patients showed a marked global improvement after FESS. The endoscopic control showed normal findings in 54% of all ethmoidal cavities. The postoperative endoscopic score correlated significantly with the subjective satisfaction ratings (P < 0.001). The preoperative CT staging proposed by Kennedy was predictive for necessity of revision surgery in 15% of the patients. CONCLUSIONS: Our data suggest that FESS for chronic panrhinosinusitis without nasal polyps has a good long-term outcome on subjective symptoms and endoscopic findings. SIGNIFICANCE: According to this study, subjective improvement correlates significantly with the postoperative endoscopic findings in the ethmoidal cavities of patients with chronic panrhinosinusitis without polyps at a long-term follow-up.
Adolescent↗
Objective and subjective evaluation of endoscopic nasal surgery outcomes.
BACKGROUND: Chronic rhinosinusitis (CRS) symptoms include nasal obstruction, rhinorrhea, and facial pain associated with rhinosinusitis disability. When resistance to medical treatment is associated with endonasal anomalies, endoscopic nasal surgery (ENS) can be proposed. However, objective and subjective assessment criteria regarding the evaluation of ENS outcomes remain unclear. The aims of this study were to evaluate the correlation between the inflammation in the nasal mucosa, objective recordings of nasal airway resistance (NAR), subjective evaluation of symptom intensity, and the impact of ENS on patient-perceived rhinosinusitis disability. METHODS: Sixty-one consecutive patients (35 men and 26 women; mean age, 37.5 years) suffering from CRS were monitored at 4 months and 2 years after ENS. All middle turbinate mucosa were analyzed for the density of nonspecific inflammatory cells. All patients scored their own subjective rhinosinusitis symptoms and complaints of rhinosinusitis disability. An active anterior rhinomanometry was performed. RESULTS: A good correlation was observed between subjective and objective NAR (p < 0.001). We found a significant correlation between the density of inflammatory cells in the nasal mucosa, subjective nasal obstruction, and the rhinosinusitis disability score (p < 0.001). Recurrent CRS was seen only in subjects with moderate to severe inflammation of the middle turbinate mucosa sampled at the first surgical intervention. Subjective rhinosinusitis symptoms, objective NAR, and rhinosinusitis disability improved significantly after ENS. CONCLUSION: The degree of inflammation seems to be a good prognostic indicator regarding CRS recurrence. Long-term outcome after ENS for CRS showed significant improvement in subjective rhinosinusitis-specific symptoms, objective NAR, and rhinosinusitis disability.
Adolescent↗