Persistierende Riechminderung nach COVID-19 – Empfehlungen der Arbeitsgemeinschaft Olfaktologie und Gustologie der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Der Artikel soll die existierende Literatur zu mit COVID-19 („coronavirus disease 2019“) assoziierten Riechstörungen nicht vollständig aufarbeiten, sondern die für die HNO-ärztliche Praxis relevanten Forschungserkenntnisse zusammenfassen sowie Empfehlungen zur Diagnostik und Therapie bei persistierenden Riechstörungen nach COVID-19 geben

Diagnosis and treatment of snoring in adults-S2k Guideline of the German Society of Otorhinolaryngology, Head and Neck Surgery.

This guideline aims to promote high-quality care by medical specialists for subjects who snore and is designed for everyone involved in the diagnosis and treatment of snoring in an in- or outpatient setting.To date, a satisfactory definition of snoring is lacking. Snoring is caused by a vibration of soft tissue in the upper airway induced by respiration during sleep. It is triggered by relaxation of the upper airway dilator muscles that occurs during sleep. Multiple risk factors for snoring have been described and snoring is of multifactorial origin. The true incidence of snoring is not clear to date, as the incidence differs throughout literature. Snoring is more likely to appear in middle age, predominantly in males. Diagnostic measures should include a sleep medical history, preferably involving an interview with the bed partner, and may be completed with questionnaires. Clinical examination should include examination of the nose to evaluate the relevant structures for nasal breathing and may be completed with nasal endoscopy. Evaluation of the oropharynx, larynx, and hypopharynx should also be performed. Clinical assessment of the oral cavity should include the size of the tongue, the mucosa of the oral cavity, and the dental status. Furthermore, facial skeletal morphology should be evaluated. In select cases, technical diagnostic measures may be added. Further objective measures should be performed if the medical history and/or clinical examination suggest sleep-disordered breathing, if relevant comorbidities are present, and if the subject requests treatment for snoring. According to current knowledge, snoring is not associated with medical hazard, and generally, there is no medical indication for treatment. Weight reduction should be achieved in every overweight subject who snores. In snorers who snore only in the supine position, positional treatment can be considered. In suitable cases, snoring can be treated successfully with intraoral devices. Minimally invasive surgery of the soft palate can be considered as long as the individual anatomy appears suitable. Treatment selection should be based on individual anatomic findings. After a therapeutic intervention, follow-up visits should take place after an appropriate time frame to assess treatment success and to potentially indicate further intervention

A critical evaluation of surgery for sleep disordered breathing

Surgical strategies for the treatment of sleep disordered breathing, although widespread and frequently used, continue to be a controversial issue. Colleagues who primarily focus on conservative treatment options point to the limitations in the available data and remind us of serious methodological concerns surrounding the current literature for surgical treatment alternatives. In accordance with the principles of evidence based medicine the best available evidence should be used to assess the efficacy of surgical treatment. While placebo-controlled trials are feasible only in selected cases, recent examples of controlled clinical trials demonstrate that well designed prospective studies are indeed possible in the field of surgical treatment. Aim of the presented review is to critically evaluate current knowledge and evidence in this field and to give examples for how to overcome methodological issues in the future. Furthermore it will be demonstrated that even the "gold standard" of conservative treatment still leaves numerous questions open in regard to primary acceptance, long term compliance and surveillance. The assessment of treatment strategies is still based primarily on the effects seen in respiratory surrogate parameters under laboratory conditions. In the future, a broad spectrum of subjective and long-term objective parameters such as cardiovascular mortality needs to be kept in mind when critically evaluating beneficial effects of any kind of treatment for sleep disordered breathing. The presented review intends to initiate an open and critical discussion on the available treatment options

Schlafstörungen im Kindesalter

Stuck BA, Schlarb A. Schlafstörungen im Kindesalter. In: Stuck BA, Maurer JT, Schlarb A, Schredl M, Weeß H-G, eds. Praxis der Schlafmedizin. Diagnostik, Differenzialdiagnostik und Therapie bei Erwachsenen und Kindern. Berlin ; Heidelberg: Springer ; 2018: 275-315

UV-C Light-Based Surface Disinfection: Analysis of Its Virucidal Efficacy Using a Bacteriophage Model

Background: The reprocessing of medical devices has become more complex due to increasing hygiene requirements. Previous studies showed satisfactory bactericidal disinfection effects of UV-C light in rigid and flexible endoscopes. Especially in the context of the current COVID-19 pandemic, virucidal properties are of high importance. In the present study, the virucidal efficacy of UV-C light surface disinfection was analyzed. Methods: MS-2 bacteriophages were applied to the test samples and irradiated by UV-C light using the UV Smart D25 device; unirradiated test samples were used as controls. A dilution series of the samples was mixed with 1 × 108 Escherichia coli and assayed. Results: 8.6 × 1012 pfu could be harvested from the unprocessed test samples. In the control group without UV-C exposure, a remaining contamination of 1.2 × 1012 pfu was detected, resulting in a procedural baseline reduction rate with a LOG10 reduction factor of 0.72. The LOG10 reduction factor was found to be 3.0 after 25 s of UV-C light exposure. After 50 and 75 s of UV-C radiation LOG10 reduction factors 4.2 and 5.9, respectively, were found, with all reductions being statistically significantly different to baseline. Conclusions: The tested UV system seems to provide a significant virucidal effect after a relatively short irradiation time

Plasma cells, plasmablasts, and AID+/CD30+ B lymphoblasts inside and outside germinal centres: details of the basal light zone and the outer zone in human palatine tonsils

Plasma cells (PCs) in human palatine tonsils are predominantly located in the germinal centres (GCs), in the subepithelial space and near the deep connective tissue septa surrounding each crypt. We analysed the location, phenotype, and proliferation of GC PCs by immunohistology comparing them to PCs in the other two locations. Most PCs in GCs were strongly positive for CD38, CD138, CD27, IRF4, and intracellular (ic) IgG. They often accumulated in the basal light zone, but could also be found scattered in the entire light zone. In addition, rows of PCs occurred at the surface of the GC bordering the mantle zone, i.e., in the outer zone, and at the surface of the dark zone. The latter cells were often continuous with PCs in the extrafollicular area. The vast majority of GC PCs were negative for Ki-67. Only a few Ki-6