Injection of Platelet Rich Plasma in the Olfactory Cleft for COVID-19 Patients With Persistent Olfactory Dysfunction: Description of the Technique.

peer reviewedIn this paper, we described technique of platelet rich plasma injection into the olfactory cleft in a 22-year-old female with 24-month post-COVID-19 anosmia. The technique starts with the blood extraction and the isolation of PRP through a 10-min centrifugation. The supernatant was injected in nasal regions after a local anesthesia through a 0° rigid optic. Several points of .2-.5 mL were performed in the nasal septum in regard of the head of the middle turbine and in the head of the middle turbine in both sides. The baseline threshold, discrimination, and identification scores were 1, 8, and 0, and the Olfactory Disorder Questionnaire score was 51, respectively. The injection of PRP in olfactory cleft was done without complication and mild pain. The patient perception of recovery of smell sense occurred at 3-week post-injection. From this time, the smell sense progressively improved to the 2-month consultation. At 2-month post-injection, the TDI scores reached 16, 16, and 16 (48), while the Olfactory Disorder Questionnaire was 73. The injection of PRP into the olfactory cleft appears to be a safe and easiness new approach that may improve the recovery of smell sense. Future controlled studies are needed

Editorial: Advances in the Involvement of Human Papilloma Virus in Head and Neck Squamous Cell Carcinoma.

peer reviewe

Post-thyroidectomy dysphonia and swallowing symptoms: The role of cricopharyngeal sphincter

Dear Editor, We read the paper of Kim et al. entitled “Persistent subjective voice symptoms for two years after thyroidectomy” [1]. Authors observed that some voice quality parameters improved from pre-to post-treatment, while others deteriorated such as the Thyroidectomy-related Voice and Symptoms' Questionnaire scores. Voice abuse history in professional users was associated with worse vocal quality after thyroidectomy. We congratulate authors to have investigated this controversial topic through a prospective study. Post-thyroidectomy voice disorders are prevalent in otolaryngological consultations, but this topic is poorly investigated in the current literature [2]. In this letter, we would like to draw attention to an important condition that was not considered in the study, which is the impairment of the upper esophageal sphincter (UES) during the surgery

Platelet-rich plasma injection in the olfactory clefts of COVID-19 patients with long-term olfactory dysfunction.

peer reviewed[en] OBJECTIVE: To investigate safety, feasibility, and effectiveness of platelet-rich plasma (PRP) injection into the olfactory clefts of COVID-19 patients with persistent olfactory dysfunction (OD). METHODS: From March 2022 to July 2022, COVID-19 patients with persistent OD were consecutively recruited to benefit from PRP injection into the olfactory clefts. Patient pain, annoyance, time of procedure, and adverse events were evaluated. Olfactory function was evaluated at baseline and 2-month post-injection with the olfactory disorder questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. RESULTS: Eighty-seven patients with anosmia (N = 30), hyposmia (N = 40), or parosmia (N = 17) with a mean OD duration of 15.7 months completed the evaluations. The PRP injection was successfully performed in all patients with a mean procedure time of 18.4 ± 3.4 min. The adverse events included transient epistaxis (N = 31), parosmia related to xylocaine spray (N = 10), and vasovagal episode (N = 2). The injection procedure was evaluated as somewhat or moderately painful by 41 (47%) and 22 (25%) patients, respectively. Thirty-seven patients were assessed after 2 months post-injection. The mean ODQ and TDI scores significantly improved from baseline to 2-month post-injection (p < 0.01). The olfactory improvement occurred after a mean of 3.6 ± 1.9 weeks. CONCLUSION: The injection of PRP into the olfactory clefts is safe and associated with adequate patient-reported outcomes. The findings of this preliminary study suggest possible efficacy on subjective and psychophysical evaluations, but future randomized controlled studies are needed to determine the superiority of PRP injection over placebo

Screening Evaluation for Laryngopharyngeal Reflux Disease.

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SARS-CoV-2 Effects on Psychophysical Olfactory Scores: Prospective Study With Evaluation Before and 60-Days After Infection

The aim of this study was to prospectively evaluate the olfactory function in a series of individuals infected with SARS-CoV-2 and who had undergone psychophysical olfactory assessment prior to infection. Individuals unexposed to SARS-CoV-2 infection underwent a psychophysical evaluation of smell with the Sniffin' Sticks test. The subjects were followed prospectively and included in the study if they developed SARS-CoV-2 infection with a second test 60 days after recovery. At the 60-day follow-up of the 41 included subjects, 2 (4.9%) self-reported persistent olfactory dysfunction (OD). The differences between TDI scores before and after infection were statistically significant (37 [interquartile range (IQR), 34.25-39.25] vs 34.75 [IQR, 32.25-38]; p = .021). Analyzing the individual olfactory domains, the differences were significant for threshold (T) (9.75 [IQR, 9-11.25] vs 8.25 [IQR, 7.25-10.25]; p = .009) but not for odor discrimination (D) (p = .443) and identification (I) (p = .159). SARS-CoV-2 causes a significant reduction in the olfactory function, in particular affecting the olfactory threshold, even in subjects who do not self-report an OD

Laryngopharyngeal reflux may be acute, recurrent or chronic disease: preliminary observations.

peer reviewed[en] OBJECTIVE: To investigate the mid-to-long-term symptom evolution and treatment findings of laryngopharyngeal reflux (LPR) patients. METHODS: Patients with LPR and treated between September 2016 and December 2017 were prospectively followed. The diagnosis consisted of > 1 pharyngeal event at the hypopharyngeal-esophageal multichannel intraluminal impedance-pH monitoring. The treatment consisted of 3- to 9-months diet, stress management and medication according to the type of LPR. Reflux symptom score was used to assess the therapeutic response. Patients were surveyed yearly to know the reflux evolution, the potential recurrence(s) of symptoms, and the approaches used to control the disease. RESULTS: A total of 77 patients completed the evaluations (45 females). The initial treatment duration was 3, 6, or 9 months in 25 (32.5%), 23 (29.9%), and 6 (7.7%) cases before weaning, respectively. Twenty-three patients (29.9%) reported chronic course of the disease. According to the reduction of reflux symptom score, symptoms did not change in 11 (14.3%) patients, while the rest of the patients reported symptom reduction or relief (responder rate of 85.7%). Over time, LPR symptoms never relapsed in 31% of cases, while 38% of patients reported one or several recurrences a year. The recurrence episodes of patients were all adequately treated with medication or diet and did not require long-term medication. CONCLUSION: Chronic course of the disease was observed in 31% of patients who required long-term medication. Preliminary observations reported that LPR may be classified as acute, recurrent, or chronic disease. The medication weaning is possible in most patients, leading to reduction of cost burden related to LPR treatment

Platelet-Rich Plasma (PRP) in the Treatment of Long COVID Olfactory Disorders: A Comprehensive Review

Background: Long COVID has brought numerous challenges to healthcare, with olfactory dysfunction (OD) being a particularly distressing outcome for many patients. The persistent loss of smell significantly diminishes the affected individual's quality of life. Recent attention has been drawn to the potential of platelet-rich plasma (PRP) therapy as a treatment for OD. This comprehensive review aims to evaluate the effectiveness of PRP therapy in ameliorating OD, especially when associated with long-term COVID-19. Methods: We executed a comprehensive search of the literature, encompassing clinical trials and observational studies that utilized PRP in treating OD limited to COVID-19. We retrieved and comprehensively discussed data such as design, participant demographics, and reported outcomes, focusing on the efficacy and safety of PRP therapy for OD in COVID-19 patients. Results: Our comprehensive analysis interestingly found promising perspectives for PRP in OD following COVID-19 infection. The collective data indicate that PRP therapy contributed to a significant improvement in olfactory function after COVID-19 infection. Conclusions: The evidence amassed suggests that PRP is a promising and safe therapeutic option for OD, including cases attributable to Long COVID-19. The observed uniform enhancement of olfactory function in patients receiving PRP highlights the necessity for well-designed, controlled trials. Such studies would help to refine treatment protocols and more definitively ascertain the efficacy of PRP in a broader, more varied patient cohort

Biomarkers in Laryngeal Squamous Cell Carcinoma: The Literature Review

Laryngeal squamous cell carcinoma (LSCC) is the second most common cancer among head and neck cancers. Despite a lower incidence of laryngeal carcinoma, new diagnostic techniques, and more targeted therapies, the overall survival has not changed significantly in the last decades, leading to a negative prognosis in advanced stages. Recently, several studies have focused on the identification of biomarkers that may play a critical role in the pathogenesis of LSCC. Reviewing the literature on the main databases, this study aims to investigate the role of some biomarkers in LSCC that are correlated with oxidative stress and inflammation: heat shock proteins; metallothioneins; nuclear factor erythroid 2-related factor 2; heme oxygenase; cyclooxygenase-2; and micro ribonucleic acids. This review shows that biomarker expression depends on the type, grade of differentiation, stage, and site of carcinoma. In addition, the role of these biomarkers in LSCC is still little-known and little-studied. However, the study of biomarker expression and the detection of a possible correlation with patients’ epidemiological, clinicopathological, and therapeutics data may lead to better awareness and knowledge of the tumor, to the identification of the best therapeutic strategy, and the most proper follow-up protocol tailored for each patient. In conclusion, the achievement of these goals may improve the prognosis of LSCC patients