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H Gudziol

Publications and source records attributed to H Gudziol.

At least 19 recordsLinked to original sources
PubMed2006

Normative data for the "Sniffin' Sticks" including tests of odor identification, odor discrimination, and olfactory thresholds: an upgrade based on a group of more than 3,000 subjects.

"Sniffin' Sticks" is a test of nasal chemosensory function that is based on pen-like odor dispensing devices, introduced some 10 years ago by Kobal and co-workers. It consists of tests for odor threshold, discrimination, and identification. Previous work established its test-retest reliability and validity. Results of the test are presented as "TDI score", the sum of results obtained for threshold, discrimination, and identification measures. While normative data have been established they are based on a relatively small number of subjects, especially with regard to subjects older than 55 years where data from only 30 healthy subjects have been used. The present study aimed to remedy this situation. Now data are available from 3,282 subjects as compared to data from 738 subjects published previously. Disregarding sex-related differences, the TDI score at the tenth percentile was 24.9 in subjects younger than 15 years, 30.3 for ages from 16 to 35 years, 27.3 for ages from 36 to 55 years, and 19.6 for subjects older than 55 years. Because the tenth percentile has been defined to separate hyposmia from normosmia, these data can be used as a guide to estimate individual olfactory ability in relation to subject's age. Absolute hyposmia was defined as the tenth percentile score of 16-35 year old subjects. Other than previous reports the present norms are also sex-differentiated with women outperforming men in the three olfactory tests. Further, the present data suggest specific changes of individual olfactory functions in relation to age, with odor thresholds declining most dramatically compared to odor discrimination and odor identification.

Adolescent↗
PubMed2006

[Subjective and objectifying olfactometry by means of flow-olfactometer].

BACKGROUND: Is the flow-olfactometer OM2S suitable for subjective and objectifying screening of olfactory function, additional to its use for chemosensory evoked potentials? METHODS: 53 normosmics were challenged prenasally and synchronously with inspiration by two short weak, moderate and strong hydrogen sulfide (H (2)S)- and phenylethyl alcohol (PEA)-stimuli. The subject pressed a button if there was an olfactory perception. The respiratory nasal pressure changes were recorded continuously via a differential pressure transducer. The alterations of breathing pattern during olfactory stimulation were calculated using a custom made LabView software. The interstimulus interval was at least 3 minutes, the respiration had to be regular. RESULTS: The detection-rate (79 - 98 %) was dependent on quality of odor and its concentration during stimulation. H (2)S-stimuli were detected more frequently than PEA-stimuli. The frequency of detection with simultaneous alteration of breathing pattern was independent of quality of odor and strength of odor concentration. 64 % of the subjects detected both weak H (2)S as well as changed synchronously their first poststimulatory breath. CONCLUSION: The H (2)S-detection threshold was estimated both by subjective data and by data of olfactory evoked respiration changes. The flow-olfactometer by Kobal is very well suitable for subjective and respiration-olfactometry, too.

Adult↗
PubMed2006

[How do pleasant and unpleasant odours change the breathing pattern?].

BACKGROUND: Pleasant odours are thought to stimulate whereas unpleasant odours are thought to shorten it. This common breathing behaviour should be tested with short pure odour stimuli. The question was: Is there an influence on exhalation as well? METHOD: 53 normosmic subjects (33 female, 20 male, mean 22,3 years) had to breathe through one nostril. The other nostril was closed using a foam nose tip with a tube connected to a manometer to record the respiratory pressure. The signal was digitally converted and visualised with LabView-software. Odours were presented in front of the nose with a flow-olfactometer OM 2S by Kobal. Hydrogen sulphide (H2S) as an unpleasant pure odour and phenylethylalcohol (PEA) as a pleasant pure odour were used in weak, moderate and strong concentration. The stimulus duration was 200 ms. The onset of stimulus was triggered manually in late exhalation during regular breathing pattern. The interstimulus interval was at least 3 min. A trial consisted of 16 stimuli (4 weak, 2 moderate, 2 strong of both odours). From the recording the duration and the areas below the respiration curves of inhalation and exhalation were calculated. The changes of these four respiratory parameters were estimated using the ratio of the first breathing cycle after stimulus to the average from the five regular breathing cycles prior to stimulation. Only changes of more than +/- 20 % were defined as an olfactory evoked respiratory response (OERR). RESULTS: Short PEA stimuli evoked about three times more frequently an increase than a decrease of duration of inhalation. The area below the inhalatory curve was enlarged. The subjects inhaled the pleasant odour more deeply and for longer. Short H2S-stimuli evoked three times more frequently a decrease of duration of exhalation than an increase. Due to the forced exhalation an increase of the area below the exhalatory curve was observed in these cases. Changes of inhalation did not show any trend. The subjects exhaled quickly to breathe fresh air in the following cycle. Every subject showed some OERR. 52 subjects responded to both odours. One subject responded to PEA only. The individual frequency of OERRs in a trial ranged from 16 % to 84 %. CONCLUSIONS: In all normosmic subjects some OERRs are evoked by repeated H2S- and PEA-stimuli. Strong stimuli do not increase the rate of OERRs. Therefore, the use of perithreshold stimuli is recommended for respiration-olfactometry.

Adult↗
PubMed2005

[Olfactory and gustatory disorders--causes, diagnosis and treatment].

Olfactory and gustatory disorders are by no means uncommon, and may be associated with an appreciable impairment of the patient's quality of life. In many cases, diagnosis and treatment is not easy, and necessitates interdisciplinary cooperation between the general practitioner, internist, ENT specialist, neurologist and psychiatrist. Many of the non-evidence-based treatments still applied in hospitals and the physician's office should, for reasons of quality control and to avoid polypragmasy possibly associated with undesirable side effects, be employed with reservations. With reference to the guidelines issued by the working group Olfactologie/Gustologie der Deutschen Gesellschaft für HNO-Heilkunde, Kopf- und Hals-Chirurgie (Olfactology/Gustology of the German Society of ENT Medicine, Head and Neck Surgery), a review of the causes, diagnosis and treatment of olfactory and gustatory disorders [3,4] is presented.

Ageusia↗
PubMed2005

[Infectious mononucleosis].

The primary infection with Epstein-Barr virus in an immunocompetent individual leads to infectious mononucleosis with symptoms of diphtheroid angina, lymph node swelling in the neck and hepatosplenomegaly. The most common age of infection lies between 15 and 25 years. The illness can affect a number of organs simultaneously and thus requires interdisciplinary diagnostics. For differential diagnosis, a differential blood analysis and a EBV quick test are required. The presence of IgM antibodies demonstrates the presence of the infection. Ultrasound of the abdomen can be made to determine the involvement of additional organs. In most cases, recovery occurs without complications. Acute cases can usually be handled successfully with medication. If symptomatic treatment fails, pharyngeal airway obstruction is possible and a tonsillectomy may be necessary. Otherwise, surgical treatment is obsolete. Generally, the prognosis is good. Severe courses and complications are rare.

Humans↗
PubMed2004

[Olfactory dysfunctions. Epidemiology and therapy in Germany, Austria and Switzerland].

INTRODUCTION: Olfactory dysfunction has been reported to affect more than 200,000 patients a year in the USA. The aim of this survey was to obtain comparable epidemiological data and treatment information on olfactory dysfunction in German speaking countries. METHODS: Questionnaires were sent to all otorhinolaryngology departments in Germany, Austria and Switzerland; 52% of hospitals completed the survey. RESULTS: An average of 46 patients with olfactory dysfunction were treated per hospital every month. Hyp- and anosmia were most commonly caused by inflammatory diseases of the nose/paranasal sinuses (53%), respiratory dysfunction (19%), or postviral conditions (11%). Steroids were used most frequently for pharmacological treatment (topically 82%; orally 65%). Approximately one third of the clinics used B vitamins, or zinc; 80% of the hospitals performed surgery to treat underlying diseases. Acupuncture and smell training was used by approximately 20%. CONCLUSION: A total of 79,000 patients per year are treated for olfactory dysfunction in German hospitals. The vast majority of these disorders (72%) is caused by sinunasal diseases. The quality control of therapeutic strategies is urgently needed.

Austria↗
PubMed2004

[Thermal irritation of the organ of equilibrium by means of heat radiation (NIR)].

BACKGROUND AND OBJECTIVE: Convection and conduction are the main factors involved in caloric response. Heat radiation has also been discussed as an important factor. The present work tests whether heat radiation is an essential part of the caloric response and whether caloric irritation of the semicircular canals is possible using two sources with a different near infrared (NIR) spectrum. In addition, we tested whether it is possible to induce a detectable nystagmus reaction using either NIR-radiation sources. RESULTS: NIR is able to penetrate bone tissue. The temperature elevation in dry and wet bones was almost immediately registered. With high optical power, specific temperature maxima could be seen by focal and selective broad spectrum and monochromatic NIR irritation of the three semicircular canals. Nystagmus could be generated after using both NIR emission sources in five probands. CONCLUSIONS: NIR generates temperature differences and nystagmus. By using a broad scale as well as a monochromatic NIR-emission source, it is possible to generate a nystagmus. The procedure of NIR-irritation occurs without physical contact, is painless and quiet.

Animals↗
PubMed2004

[Olfactory dysfunction. Epidemiology, pathophsiological classification, diagnosis and therapy].

The present manuscript is the result of a collaborative effort within the framework of the Working Group of Olfactology and Gustology of the German Society for ENT, Head and Neck Surgery. It provides a comprehensive overview about the current views on the epidemiology, terminology, diagnostics, and therapy of olfactory dysfunction, and aims to offer a framework for the standardized procedures for the diagnosis and therapy of olfactory disorders.

Algorithms↗
PubMed2004

[Etiology, diagnostic and therapeutic management of taste disorders].

Taste disorders can be subdivided in ageusia, which is the inability to detect any qualitative gustatory sensation and hypogeusia, which is a decreased sensitivity to all tastants. Dysgeusia or pargeusia is a distortion or perversion in the perception of a tastant in contrast to phantosmia, which is a perception of taste that occurs in the absence of a tastant. The site of lesion can usually be determined by history and clinical examination. History taking should always include the assessment of current and former medication. Conditions that interfere with access of a tastant to the taste bud are differentiated from conditions that either injure the receptor cell or damage the gustatory afferent nerves and the central pathways. Psychophysical taste evaluation includes identification of quality using sprays or taste strips and testing of intensity perception measuring threshold using the 3-drop technique. Moreover, measurement of taste in localized areas can be performed either with conventional chemicals or using an electrogustometer. Gustatory evoked potentials are not yet routinely elicited. Therapy has to be planned according to the cause of the disorder.

Diagnosis, Differential↗
PubMed2004

[Herpes zoster oticus: symptom constellation and serological diagnosis].

BACKGROUND: Herpes zoster oticus is a rare illness with cutaneous symptoms (eruptions) and a colored picture of brain nerve failures. The clinical symptoms, the symptom constellation, diagnostics and therapy, however, have been examined till now only in few studies. PATIENTS AND METHODS: In this study 91 cases of a zoster oticus were looked at in retrospect from the complete archives of the university ENT clinic Jena/Germany in the period from 1932 to 2001. Inclusion criterion was the occurrence eruptions in the ear region. The demographic data, subjective and objective symptoms, the symptom constellations, diagnostic methods and the therapy were arranged. RESULTS: Women (68.1 %) were concerned more frequently than men (31.9 %). The average illness age was 51.2 days. The prodromal stage lasted for 2.2 days in the average. Earache (50.2 %) and headache (11.0 %) were the most frequent first symptoms. No prodroma appeared in 27.5 % of the cases. The facial nerve (86.8 %) was most frequently affected, the vestibular nerve in 76.9 % and the cochlear nerve in 36.3 %. Other brain nerve damages were extremly rare. The therapy success was identical with regard to the brain nerve regeneration at all times. A positive antibody titer for VZV-IgM and/or IgA or an IgG is a sign for an acute infektion. VZV-IgA antibody titers appeared more constantly, frequent and early than an IgM. CONCLUSIONS: Women have a greater risk of falling ill at a zoster oticus than men. Although more than 72 hours is behind the beginning of the symptoms in this study, treatment with virostatic drugs should always be carried out in zoster oticus. Different therapy methods do not have any influence to the success therapy of the therapy. The facial nerve showed the best cure trend. A postzosteric pain develops approximately the half of the cases at the zoster oticus. The serological diagnostic is not necessary in clinically clear cases.

Adolescent↗
PubMed2004

[Selective stimulation of the equilibrium organ using monochromatic near infrared].

BACKGROUND: The aim of this study was, to establish, if a selective thermal warm-stimulation using monochromatic near infrared radiation (NIR) in healthy persons, patients with chronic otitis media (chronic mucosal inflammation) and after radical surgery of one ear shows quantitative or qualitative changes of the nystagmus reaction. PATIENTS AND METHODS: Healthy persons (n = 3), patients with a large central defect of the tympanic membrane (n = 5) and after radical ear surgery (n = 6) were examined. In healthy persons a stimulation with monochromatic NIR (lambda = 980 nm) of several areals of the external auditory canal was performed. In patients with large defects of the tympanic membrane the promontorium was stimulated. In patients with a radical cave of the ear a selective NIR-stimulation of the region of the vertical and the anterior semicircular canal was performed. The horizontal semicircular canal was visible as a landmark. Registration of the nystagmus was performed by means of videonystagmography. RESULTS: In healthy persons the mean slow phase velocity of the nystagmus depended on the stimulated region. But there was no qualitative change of three dimensional eye movement. Stimulation of the promontorium showed a strong directional horizontal nystagmus. In patients with a radical cave the stimulation of the regions of the three semicircular canals showed a qualitative difference in three dimensional eye movement. NIR-stimulation showed in all cases a nystagmus into the stimulated ear. CONCLUSIONS: The method of monochromatic near infrared stimulation can be used for selective stimulation of several regions of the external auditory canal, the promontorium and the regions of the semicircular canals in a radical cave of the ear as well as to prove the warm reaction of the equilibrium organ. A specific nystagmus after stimulation of the semicircular canal-region in a radical cave of the ear could be an indication for a normal semicircular canal function.

Adult↗
PubMed2004

[Are there olfactory evoked alterations of breathing patterns?].

BACKGROUND: It is controversially discussed whether strictly olfactory stimuli are able to evoke changes of breathing patterns. A number work groups argue that the more or less noticeable irritative component of odors are responsible for a respiratory response. Other work groups regard changes of breathing pattern as an indicator for an intact smell ability during "pure" olfactory stimulation. METHODS: 12 normosmic young volunteers were repeatedly challenged with hydrogensulfide (H (2)S) for two seconds on inspiration in concentrations just above the threshold using a flow olfactometer. Clean air stimuli were presented randomly as control blanks. The breathing patterns were registered with a differential pressure transducer occluding one nostril via a tube. The signals were digitized and recorded on a PC. Nine parameters were calculated for each breath using a custom made LabView (R) software. The breath during stimulation was compared to the average of five breathing cycles prior to stimulation. An increase or reduction of each parameter was equally regarded by means of their absolute value. The sum was termed respiration index (RI). RESULTS: The mean RI (all trials of each test person) stimulated with H (2)S varied from 201 to 570; stimulated with clean air from 85 to 188. The difference was significant (p < 0,001). A significant group-difference for each single trial was seen as well. There was no significant increase or decrease of RI during 15 successive stimulations with H (2)S. CONCLUSIONS: Detectable short H (2)S-stimuli are able to evoke alterations of breathing patterns which can be identified by computer. Respiration-olfactometry is suitable to objectify odor perception.

Adult↗
PubMed2003

[Lyme disease--a reason for sudden sensorineural hearing loss and vestibular neuronitis?].

BACKGROUND: Lyme disease has been described as one possible cause of sudden sensorineural hearing loss and vestibular neuronitis. The necessity of serological diagnosis and its therapeutic consequences have been discussed controversially. PATIENTS AND METHODS: 344 patients with acute sensorineural hearing loss and 66 patients with vestibular neuronitis were examined in retrospect. By means of ELISA (Enzygnost Borreliosis, Dade Behring Marburg) the specific prevalences of IgG- and IgM-antibodies against borrelia in serum were evaluated. The frequency of seroprevalences for both diseases were compared to those given in the literature. Neurootological findings of the seropositive patients were compared with those of seronegative and analysed statistically. RESULTS: 15.7 % of the patients with sudden sensorineural hearing loss had positive levels of IgG-antibodies. IgM-titers were elevated in 4.7 % of the patients. The seroprevalences for IgM and IgG were above those described by other investigators for the healthy population. Patients with positive IgM-antibodies showed more often low frequency hearing loss than IgG-positive patients. 18.2 % of the patients with neuronitis vestibularis had IgG- and 1.5 % IgM-antibodies against Borrelia. Whereas IgG occurred more often than known for the healthy population, IgM was within the limit for the healthy population. The seropositive group did not show any remarkable neurootological signs compared with the seronegative group. CONCLUSIONS: Because of the elevated seroprevalences Borrelia infections may be one possible but very rare cause of sudden sensorineural hearing loss and vestibular neuronitis. Low frequency hearing loss may be a sign for an infection with Borrelia as an etiological factor especially in combination with seropositive titers. In case of the presence of IgM-antibodies, patients may be treated with oral antibiotics (Doxycyclin, Cefuroxim). In patients with neuronitis vestibularis a neuroborreliosis should be excluded by means of lumbar puncture.

Adolescent↗
PubMed2003

[Near infrared stimulation of the equilibrium organ--first clinical experiences].

BACKGROUND: A new method for the stimulation of the organ of equilibrium by means of a broad-scale and monochromatic near infrared emission was developed. This method should be examined within the framework of a pilot study, evaluated and its clinical possible applications examined. PATIENTS AND METHODS: Healthy probands (n = 15), patients with a radical cave of the ear (n = 5), patients with a defect of the tympanic membrane (n = 5) and spontaneous nystagmus (n = 5) were examined. In healthy probands an irritation with broad-scale as well as monochromatic near infrared (NIR) was performed and compared with a water irrigation (44 degrees, 50 ml in 30 seconds). The subjective, local feelings during the application and the appearance of giddiness according to irritation were recorded and the nystagmus was registered by means of videonystagmography. In patients with radical cave of the ear and tympanic membrane defects, a broad-scale NIR-irritation before a comparative irritation with warm air (44 degrees) was performed exclusively. RESULTS: In all healthy probands, a nystagmus reaction could be seen with broad-scale and monochromatic NIR. Compared to the hot water irritation slow phase velocity (SPV) was decreased however registrable by means of Frenzel glasses and electronystagmography during the culmination stage. In patients with radical cave (n = 4) and tympanic membrane defects (n = 3) showing paradoxical nystagmus reaction during hot air irritation, a nystagmus to the site of stimulation resulted by means of light calorisation. In patients with a spontaneous nystagmus an attenuation (n = 1) or inversion (n = 2) could be achieved by NIR-radiation. CONCLUSIONS: The method of the NIR-radiation is suitable in clinical practice for the caloric test proofing warm reaction. Vaporization cold does not occur. The application of heat charm is better proportionable and steerable than during air irritation. The procedure is sterile, noiseless and non-contact. Difficulties in interpretation of results of vestibular tests because of evaporation coldness do not occur.

Caloric Tests↗
PubMed2002

[Medicolegal screening of olfactory function].

Prior to nose surgery the birhinal ability to smell should be tested routinely. From the medico-legal point of view a short screening-test consisting of 5 or 8 test items is not sufficient. It is recommended to use an identification test with 12 or 16 items. The results of these tests taken together with the patients' self estimation, the patients' history and the rhinoscopic findings offer a satisfactory evaluation of the patients' ability to smell in most cases. In case of discrepancies a more detailed test determining the TDI-value is recommendable. If the 16-identification test is used, it is sufficient to add the values of the threshold and the discrimination measurements with the "Sniffin' Sticks" to complete a full TDI score.

Algorithms↗
PubMed2001

[Acute and fulminant fungal sinusitis in immunosuppressed patients].

BACKGROUND: Acute and invasive fungal sinusitis represent rare diseases which can lead to life threatening complications. Immunosuppressed patients are affected primarily. The expansion of transplantation medicine and the progress in therapy of malignant diseases of the lymphatic system are associated with an increase of opportunistic systemic mycoses. Therefore the otorhinolaryngologist is confronted increasingly with these problems and questions for surgery, especially if the symptom of a periorbital inflammation occurs as a sign for a beginning orbital complication and radiological signs of involvement of the paranasal sinuses exist. PATIENTS: We report exemplary about two immunosuppressed patients with an invasive and fulminant fungal aspergillosis of the paranasal sinuses. In spite of systemic antifungal therapy and surgical intervention, intracranial and systemic complications caused a lethal course. CONCLUSIONS: In immunosuppressed patients with clinical and radiological signs for a sinusitis and a periorbital inflammation an invasive fungal sinusitis should be considered. Pathogenic aspergillus species are the most common identified in fungal sinusitis. The disease with often lethal outcome requires a careful and fast diagnostic and therapy as well as interdisciplinary co-operation. If and when limited or extensive surgery should be performed remains, because of the rarity and the lacking experience with this disease, still a controversially discussed issue and depends on several factors: the kind of disease, the immunity, the subtype of invasive fungal sinusitis and the degree of tissue invasion.

Acute Disease↗
PubMed2000

Multicenter investigation of 1,036 subjects using a standardized method for the assessment of olfactory function combining tests of odor identification, odor discrimination, and olfactory thresholds.

"Sniffin' Sticks" is a test of nasal chemosensory performance that is based on penlike odor-dispensing devices. It is comprised of three tests of olfactory function: tests for odor threshold, discrimination and identification. Previous work has already established its test-retest reliability and validity in comparison to established measures of olfactory sensitivity. The results of this test are presented as a composite TDI score--i.e., the sum of results obtained for threshold, discrimination and identification measures. The present multicenter investigation aimed at providing normative values in relation to different age groups. To this end, 966 patients were investigated in 11 centers. An additional study tried to establish values for the identification of anosmic patients, with 70 anosmics investigated in five specialized centers where the presence of anosmia was confirmed by means of olfactory evoked potentials. For healthy subjects, the TDI score at the 10th percentile was 24.5 in subjects younger than 15 years, 30.3 for ages from 16 to 35 years, 28.8 for ages from 36 to 55 years and 27.5 for subjects older than 55 years. While these data can be used to estimate individual olfactory abilities in relation to a subject's age, hyposmia was defined as the 10th percentile score of 16- to 35-year-old subjects. Our latter study revealed that none of 70 anosmics reached a TDI score higher than 15. This score of 15 is regarded as the cut-off value for functional anosmia. These results provide the basis for the routine clinical evaluation of patients with olfactory disorders using "Sniffin' Sticks."

Adolescent↗