Impact of nonallergic rhinitis on chemosensory function.
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Humans↗
Biomedical subjects
Thomas Zahnert
Publications and source records attributed to Thomas Zahnert.
Behavior of evoked otoacoustic emission under low-frequency tone exposure: Objective study of the bounce phenomenon in humans.
The bounce phenomenon has been investigated in humans, evaluating alterations of click evoked otoacoustic emission (EOAE) after presentation of 250-Hz frequency loud tones during 3 min. EOAE changes were manifested in initial augmentation followed by reduction, peaking at 1 and 3 min of post-exposure time, respectively. Recoveries took 5-7 min afterwards. Under linear and nonlinear EOAE acquisition modes both manifestations of bounce appeared similar. At lower exposure intensities, 65-75dB SPL, augmentations prevailed over reductions. At higher intensities, 80-95 dB SPL, augmentations and reductions were of similar magnitudes. At highest intensity, 100 dB SPL, an obvious EOAE drop has hardly been preceded by any augmentation. Based upon these data, the bounce is considered to be a compound of two opposite events, appearance of each being dependent upon the exposure level. Subjects with high bounce indices in one ear displayed comparable indices in other ear too. Low bounce magnitudes were accordingly typical for particular subjects irrespective of the ears tested. EOAE alterations were observed under ipsilateral, but not contralateral exposures of tones. It has been concluded therefore that the bounce involves peripheral receptor rather than central neural mechanisms. No EOAE shifts were seen under application of clicks without any low-frequency exposure tones. Correspondingly, the bounce is judged to reflect inner-ear processes triggered by low-frequency tones, but not by regular presentations of test-stimuli.
Acoustic Stimulation↗
Topographical differences in the trigeminal sensitivity of the human nasal mucosa.
The aim of the study was to investigate differences in the distribution of intranasal trigeminal receptors in humans using an electrophysiological measure of trigeminally induced activation, the negative mucosa potential. A total of 29 young, healthy volunteers participated, results were on the basis of data from 18 participants. The trigeminal irritant CO2 was presented using a computer-controlled olfactometer. Negative mucosa potential recording sites included the anterior olfactory cleft, the anterior septum, and the lower turbinate. Lowest amplitudes of the negative mucosa potential were found in the olfactory cleft, maximum amplitudes at the septum. Intranasal measurements of CO2 concentrations suggested that these differences were not due to the intranasal distribution of CO2. These results are compatible with the idea that the trigeminal system acts as a sentinel of the human airways.
Adult↗
Investigations in subjects with cough following upper respiratory tract infection.
The study aimed to investigate subjects with cough following acute upper respiratory tract infection (URTI), and to compare those subjects unable to suppress cough ("non-suppressors") with those who were able to suppress cough ("suppressors"). Forty-three URTI subjects participated, 31 with cough associated with acute URTI and 12 healthy controls; 21 of the coughing subjects were "suppressors", 10 were "non-suppressors". We obtained responses to chemical and mechanical stimulation of the nasal cavity or the pharynx using both psychophysical measures and event-related potentials. The study provided the following results: (1) "non-suppressors" did not exhibit significantly different intensity ratings or event-related potentials in comparison to "suppressors" in terms of responses to intranasal irritant, mechanical, or olfactory stimuli; (2) when pharyngeal mechanical stimuli were investigated "suppressors" rated the stimuli as more intense than "non-suppressors" and controls; (3) latencies of event-related potentials to pharyngeal stimuli were longest in "non-suppressors". Keeping in mind the relatively small sample size, it appears possible to differentiate certain types of cough during uncomplicated URTI. This may help to explain interindividual differences in responsiveness to cough medication.
Adolescent↗
Effects of professional singing education on vocal vibrato--a longitudinal study.
Vocal vibrato is regarded as one of the essential characteristics of voice quality in classical singing. Professional singers seem to develop vibrato automatically, without actively striving to acquire it. In this longitudinal investigation, the vocal vibrato of 22 singing students was examined at the beginning of and after 3 years of professional singing education. Subjects sang an ascending-descending triad pattern in slow tempo on vowel [a:] at a comfortable pitch level twice at soft (piano) and twice at medium (mezzoforte) loudness. The top note of the triad pattern was sustained for approximately 5s. The mean and the standard deviation (SD) of the vibrato rate were measured for this note. Results revealed that after 3 years of training, voices with vibrato slower than 5.2 Hz were found to have a faster vibrato, and voices with vibrato faster than 5.8 Hz were found to have a slower vibrato. Standard deviation of vibrato rate was higher in soft than in medium loudness, particularly before the education. Also high values of SD of vibrato rate, exceeding 0.65 Hz, had decreased after the education. These findings confirm that vibrato characteristics can be affected by singing education.
Adult↗
Different swelling mechanisms in nasal septum (Kiesselbach area) and inferior turbinate responses to histamine: an optical rhinometric study.
OBJECTIVE: To determine whether the inferior turbinate, which contains swelling bodies, and the nasal septum (Kiesselbach area), characterized by a dense arterial mesh, exhibit different swelling mechanisms in allergic nasal reactions. DESIGN: Two optical rhinometers were used to examine 11 patients in the clinic. Optical rhinometry is based on the transillumination of the nasal septum and inferior turbinate or the whole nose with monochromatic light. The instrument's wavelength can be adjusted to the absorption characteristics of reduced hemoglobin, oxygen-saturated hemoglobin, and water. SETTING: Outpatient university otolaryngology clinic. PATIENTS: Eleven young, healthy, nonsmoking, nonpregnant subjects (6 men and 5 women), mean age, 32.4 years (age range, 27-37 years), with no history of exposure to toxic substances, allergies, or other significant diseases. INTERVENTIONS: Optic rhinometry evaluation during the course of nasal histamine administration. MAIN OUTCOME MEASURES: Light extinction at various wavelengths. RESULTS: Following administration of histamine, in the nasal septum, the wavelength of 950 nm (edema) showed the strongest increase of light extinction; in the inferior turbinate, it was the wavelength of 786 nm (oxygenated hemoglobin). In the whole nose, the wavelength of 880 nm (edema plus hemoglobin) exhibited the largest increase of extinction. CONCLUSIONS: Swelling of the nasal septum (Kiesselbach area) in nasal allergic reactions is caused mainly by edema, whereas swelling of the inferior turbinate is due mainly to an increase in volume of blood that is highly saturated with oxygen. Swelling of the whole nose is characterized by the combination of both, edema and increase in blood volume.
Adult↗
Loss of trigeminal sensitivity reduces olfactory function.
The trigeminal and olfactory nerves share overlapping innervation areas in the nasal cavity and seem to work in an interactive way. Loss of olfactory function leads to a decreased trigeminal sensitivity, as shown in anosmic subjects. To report the impact of disturbed trigeminal sensitivity on the olfactory function, we present a patient with unilateral loss of trigeminal function resulting from a meningeoma. Thresholds to a selective olfactory stimulus were elevated by a factor of 64 on the affected side. Recordings of event-related potentials in response to olfactory stimuli showed a significantly reduced response on the affected side. This report indicates that loss of trigeminal function may affect the sense of smell.
Female↗
Clinical significance of results from olfactory testing.
BACKGROUND: Although widely used in healthy subjects and patients with olfactory loss, the significance of changes of scores from validated olfactory tests is unknown. AIM AND METHODS: The aim of the present study was to relate the self-assigned changes of olfactory function in terms of "better," "unchanged," and "worse" in patients with smell disorders with the results from olfactory testing by means of a validated test set. Olfactory function of 83 anosmic or hyposmic patients (40 women, 43 men; age 12-84 yr) was tested on two occasions (mean interval 136 days, minimum 7 days, maximum 6.7 yr). Olfactory function was assessed using a validated technique ("Sniffin' Sticks"). This test consists of three subtests, one for odor threshold (T), odor discrimination (D), and odor identification (I), with possible results ranging up to 16 points each. From the sum of the results from the three subtests a composite "TDI" score was obtained. RESULTS: Forty-four patients indicated an improvement of olfactory function, whereas 39 patients reported no change. No subject reported deterioration of olfactory sensitivity. Subjects assigned to group BETTER had higher TDI scores in the second olfactory tests than subjects assigned to the group UNCHANGED, both in absolute terms and as compared with the first olfactory test (effect "test occasion" by "self-assessed improvement," P < .001). There was no significant difference between groups with respect to age and sex (P = .99 and .84, respectively). Logistic regression showed that more than 60% of the subjects reported an improvement of olfactory sensitivity when the TDI score increased by 5.5 points. CONCLUSION: We show that there is a statistically significant relation between measured and perceived improvement of olfactory function in patients who first presented with the diagnosis of anosmia or hyposmia. The results indicate that improved olfactory function in patients with olfactory deficiency is perceived as such in everyday life and is quantitatively related to an improvement in the composite TDI score of the "Sniffin' Sticks" olfactory test battery. This is the basis for the application of a specific therapy for olfactory loss because of a possible gain in quality of life for the patients.
Adolescent↗
Extension of intracranial thrombosis after unilateral dissection of the internal jugular vein.
OBJECTIVE: Resection of the internal jugular vein can be necessary in cases of radical neck dissection or even in cases involving benign neoplasms such as glomus tumors. According to the triad described by Virchow (ie, stasis of blood flow, damage to the endothelium, and changes in hemostasis), the development of a thrombosis in the venous vessels superior to the resected internal jugular vein seems to be possible. The aim of this study was to determine the extension of possible intracranial thrombosis after wound healing. DESIGN: A total of 17 patients requiring resection of the internal jugular vein were evaluated prospectively using magnetic resonance imaging and 2-dimensional (time-of-flight) magnetic resonance angiography after the surgical treatment. Preoperative magnetic resonance images were obtained in all 17 patients for staging purposes as well as to exclude preoperative thrombosis of the internal jugular vein. Sixteen patients had malignant tumors, and 1 patient had a glomus tumor. RESULTS: Intracranial thrombosis with thrombosis of the sigmoid sinus was found in 4 patients, and thrombosis of the transverse sinus was found in 3 patients. There were no complications such as intracranial hemorrhage or signs of increased intracranial pressure in any patients. There was no evidence of intracranial thrombosis in 10 cases. In these cases, thrombosis of the venous vessels superior to the resected vein ranged from none to complete thrombosis of the superior bulb of the internal jugular vein. After unilateral resection of the internal jugular vein, the venous blood leaves the brain mainly via the venous network of the contralateral side of the neck. CONCLUSIONS: Although intracranial thrombosis of the sigmoid or transverse sinus seems to occur more frequently than was previously thought, intracranial complications such as venous infarction or increased intracranial pressure appear to be very rare. After unilateral radical neck dissection, the venous blood leaves the brain mainly via the venous system of the other side of the neck and the ipsilateral collateral veins.
Aged↗
Acoustic properties of different cartilage reconstruction techniques of the tympanic membrane.
OBJECTIVES/HYPOTHESIS: The use of cartilage in reconstruction of the tympanic membrane has been established especially in cases such as tubal dysfunction and adhesive processes. Cartilage offers the advantage of higher mechanical stability compared with membranous transplants but may alter the acoustic transfer characteristics of the graft. Apart from material properties, it can be assumed that, also, the microsurgical reconstruction technique might influence the sound transmission properties of the reconstructed tympanic membrane. The purpose of the study was to investigate the acoustic transfer characteristics of different cartilage transplants being typically used in different reconstruction techniques of the tympanic membrane. METHODS: Cartilage plates of different thicknesses (1.0, 0.7, 0.5, and 0.3 mm), cartilage palisades, and cartilage island transplants of varying size were investigated by means of an ear canal-tympanic membrane model. In contrast to former single-point measurements, sound-induced vibrational amplitudes of the entire transplant were measured by scanning laser Doppler vibrometry (measuring points, n = 133) (PSV-200, Polytec, Waldbronn, Germany). Frequency response functions (displacement vs. sound pressure) of all measured points were determined in the frequency range of 200 Hz to 4 kHz for the different transplants. RESULTS: Cutting thick cartilage transplants into thin plates or palisades decreased the first resonance frequency and increased its amplitude, reflecting improved sound transmission properties of the transplant. From an acoustical point of view, the 0.5-mm cartilage plate seems preferable compared with the palisade technique. Cartilage island techniques showed vibration characteristics superior to plate or palisade techniques. CONCLUSIONS: Apart from material characteristics, the sound transmission properties of the reconstructed tympanic membrane are strongly influenced by the reconstruction technique. The choice of the surgical technique should consider requirements based on mechanical stability and acoustic transfer characteristics of the transplant.
Acoustics↗
Studies on the effects of ice collars on nasal blood volume using optical rhinometry.
BACKGROUND: The possible benefit of ice collars for treatment of nosebleed is controversial. The aim of this study was to investigate changes of nasal blood volume before and after application of ice collars to the neck. Nasal blood volume was investigated using optical rhinometry. METHODS: A total of 15 young, healthy volunteers participated. After ice collars were placed on the neck area of the subjects, changes in the blood volume of the nose were measured by means of optical rhinometry for the whole nose, but also regionally at the nasal septum (Kiesselbach's area). After baseline measurements over 1 minute, the ice collar was applied. Optical rhinometric measurements were performed continuously. RESULTS: Although the ice collar showed no effect on the blood volume of the whole nose, there was a significant decrease in blood volume (p < 0.01) at the septum. CONCLUSION: Application of ice collars to the neck area of the subjects is followed by a decrease in blood volume of Kiesselbach's area, which may provide the basis for the clinical observation that ice collars are helpful in the treatment of nosebleeds.
Adult↗