Olfactory evaluation in obstructive sleep apnoea patients

The sense of smell has a high impact on the quality of life. The aim of the present study was to investigate olfactory dysfunction in patients with obstructive sleep apnoea syndrome (OSAS) and correlate the severity of disease with olfactory dysfunction. The relationships between nasal obstruction, nasal mucociliary cleareance and olfactory tests were also evaluated. Sixty patients with a diagnosis of OSAS were enrolled and underwent olfactory function evaluation. In all patients olfactory performance was tested with the Sniffin’ Sticks method. Mucociliary transport times and anterior rhinomanometry were performed to identify eventual nasal obstruction and deficits in nasal mucociliary clearance. Olfactory dysfunction was present in 22 (36.6%) patients of the study group: of these, hyposmia was present in 19 (86.4%) and anosmia in 3 (13.6%). The mean TDI score in the study group was 30. A strong correlation between the olfactory dysfunction and severity of sleep apnoea measured using the AHI was found. Patients with OSA would seem to have a high incidence of olfactory dysfunction. The degree of olfactory dysfunction appears to be related to the severity of disease. However, other co-factors such as nasal obstruction and reduced mucociliary clearance might also play a role in of the aetiology of this condition

Nasal pathologies in patients with obstructive sleep apnoea

Nasal obstruction is a frequent condition in patients with obstructive sleep apnoea (OSA). Nasal obstruction leads to mouth breathing, which is thought to destabilise the upper airway to aggravate the condition. Three conditions could be considered as the cause of the nasal breathing obstruction: anatomical conditions of the nose (septum deviation, hypertrophy of the inferior turbinates), chronic rhinosinusitis (CRS) and chronic nasal inflammation caused by allergic rhinitis or non-allergic cellular rhinitis. In this prospective study, we present an evaluation of all these possible rhino-sinusal aspects in OSA patients to correlate different nasal pathologies with nasal obstruction. Fifty patients with a diagnosis of OSA were enrolled in the study. In 70% of OSA patients, nasal obstruction was confirmed by clinical evaluation and rhinomanometry testing. Normal rhino-sinus aspects were present in only 20% of OSAS patients, whereas one or more pathological rhino-sinus conditions were present in the remaining 80%. The percentage of OSA patients with a diagnosis of allergic rhinitis and non-allergic rhinitis was 18% and 26% respectively. Non-allergic rhinitis with neutrophils (NARNE) was the most frequent type of cellular rhinitis diagnosed in OSA patients (20% of cases). The results of the present study support and extend the observation that rhinitis is present in OSA patients. Mucosal inflammation caused by these conditions could be the cause of upper airway patency impairment inducing nasal mucosa swellin

Unusual symptomatology in eagle syndrome

A 20-year-old female presented a history of isolate left external ear pain. ENT valuation showed no alteration of the district, but an aberrant styloid process was tender to palpation in the left tonsillar fossa. Computer tomography was performed and confirmed it. Thereafter, the diagnosis of Eagle syndrome was made. The auricular branch of the vagal nerve (ABVN) was pressed by the styloid process causing the pain. This case pointed out the importance to consider anatomical alteration as elongated styloid process as a possible cause of external ear pain

Tympano-mastoid cholesterol granuloma: case report and review of the literature

Cholesterol granuloma (CG) is a rare condition histological consisting of a foreign body, giant cell reaction to cholesterol crystals and haemosiderin derived from the ruptured of the erythrocytes. A 25-year-old man came to our Department presenting signs and symptoms of tympano-mastoid cholesterol granuloma. He showed all the specific sign and symptoms of the disease. However, considering the lack of literature regarding TMCG, this study was performed with the aim of presenting the main characteristics of tympano-mastoid CG, describing the case report and reviewing the literature

Long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome treatment

Background: The purpose of this study was to evaluate long-term subjective outcomes of barbed reposition pharyngoplasty for obstructive sleep apnea syndrome (OSAS) treatment using a specific questionnaire, the Palate Postoperative Problem Score (PPOPS). Methods: 140 patients who underwent barbed reposition pharyngoplasty (BRP) surgery in the Morgagni Pierantoni Hospital of Forlì, Italy were enrolled in the study. Postoperative outcomes were evaluated in a short- and long-term follow-up using the PPOPS questionnaire. The average period of follow-up was 26 months. All patients received the PPOPS questionnaire by telephone in a period between April and August 2019. Results: 51% of patients complained of swallowing problems after surgery. In 91% of cases, the problem cleared up spontaneously. At the time of the interview, only 9% of patients had a residual swallowing difficult. At the time of PPOPS evaluation, rhinolalia was observed in 8% of patients, whereas nose regurgitation was present in 2% of patients. In 20% of patients, the foreign body sensation was present during follow-up. The value of apnea-hypopnea index (AHI) reduced from the preoperative value of 31.5 to the postoperative value of 11.4. Conclusions: BRP surgery proved to be an effective technique, appreciated by the majority of patients. Use of the PPOPS questionnaire has demonstrated that the BRP technique seems to ensure efficacy and lower morbidity, with few complications after surgery

Il Museo dell’Osservatorio Vesuviano: dati statistici 2005

Il museo dell'Osservatorio Vesuviano, rinnovato nel 2000, nasce con l’obiettivo di informare la popolazione sui fenomeni vulcanici, sui pericoli connessi e sulla sorveglianza dei vulcani attivi in aree ad alto rischio; è situato nella sede storica dell’Osservatorio Vesuviano, il primo Osservatorio vulcanologico del mondo, attualmente sezione dell’Istituto Nazionale di Geofisica e Vulcanologia. Il percorso museale ha inizio con la presentazione delle diverse tipologie eruttive e dei fenomeni a esse associati e quindi dei pericoli per l’uomo e i manufatti. Si ripercorre la storia eruttiva del Somma-Vesuvio soffermandosi sulle eruzioni più note del 79 d.C. e del 1944, e sulle metodologie adottate dai vulcanologi per ricostruire la storia eruttiva di un vulcano attraverso lo studio dei suoi prodotti. Inoltre, sono esposti i prodotti delle eruzioni effusive ed esplosive, e i minerali che si formano in ambiente vulcanico. Il percorso è arricchito da documenti storici di notevole interesse vulcanologico quali: la carta vulcanologica di Henry James Johnston-Lavis e il volume “Campi Flegrei” di William Hamilton (in visione la riproduzione anastatica). Un altro tema portante della mostra riguarda il monitoraggio dei vulcani attivi. Sono esposti gli strumenti scientifici storici utilizzati per la sorveglianza, tra cui il primo sismografo del mondo costruito nel 1856 da Luigi Palmieri, direttore dell’Osservatorio Vesuviano dal 1855 al 1896. Una sala ospita monitor collegati in tempo reale alla sezione “segnali sismici” del sito web dell’Osservatorio Vesuviano. Si propongono inoltre filmati tratti da modelli fisico-matematici di simulazioni di eruzioni esplosive per la definizione degli scenari attesi in caso di eruzione. Infine, si affronta il problema del rischio mediante pannelli informativi sul piano Nazionale di emergenza al fine di promuovere atteggiamenti adeguati in caso di necessità. Gli strumenti utilizzati sono video, pannelli, webcam, internet. Nel rapporto sono presentati i dati statistici relativi al pubblico del museo nell’anno 2005

Risk factors for obstructive sleep apnea syndrome in children: state of the art

The obstructive sleep apnea syndrome (OSAS) represents only part of a large group of pathologies of variable entity called respiratory sleep disorders (RSD) which include simple snoring and increased upper airway resistance syndrome (UARS). Although the etiopathogenesis of adult OSAS is well known, many aspects of this syndrome in children are still debated. Its prevalence is about 2% in children from 2 to 8 years of age, mostly related to the size of the upper airways adenoid tissue. Several risk factors linked to the development of OSAS are typical of the pediatric age. The object of this paper is to analyze the state of the art on this specific topic, discussing its implications in terms of diagnosis and management