Smell and taste dysfunction after covid-19

The sense of smell is an ancient and vital perception in mammals, with the olfactory receptor gene family making up 1% of the mammalian genome, and the human olfactory system being able to discriminate among thousands of airborne chemicals at concentrations below the detection limits of the most complex analytical systems. However, people only realise the importance of smell when it is lost. The covid-19 pandemic has put both smell and taste disturbances in the spotlight because of the functional impact and severe distress caused by the loss of these senses, their fundamental diagnostic value, and, more recently, the high rate of long term dysfunction. The linked meta-analysis by Tan and colleagues (doi:10.1136/bmj-2021-069503) gives a clear picture of the challenge humans face. About 5% of people report smell and taste dysfunction six months after covid-19, and, given that an estimated 550 million cases of covid-19 have been reported worldwide as of July 2022, large numbers of patients will be seeking care for these disabling morbidities. Health systems should therefore be ready to provide support to these patients who often report feeling isolated when their symptoms are overlooked by clinicians

Metodi geofisici per la caratterizzazione degli ammassi rocciosi

Vengono illustrati i risultati che si possono ottenere nello studio delle caratteristiche fisiche degli ammassi rocciosi con le diverse tecniche grofisich

Usefulness of pepsin saliva measurement for the detection of primary burning mouth syndrome related to reflux.

peer reviewed[en] OBJECTIVES: To study the diagnostic value of salivary pepsin tests for detecting laryngopharyngeal reflux (LPR) in patients with primary burning mouth syndrome (BMS). METHODS: Patients with BMS and asymptomatic individuals were consecutively recruited from September 2018 to June 2023. Patients underwent hypopharyngeal-esophageal impedance pH-monitoring (HEMII-pH) and saliva collections to measure pepsin. Stomatology evaluation was carried out to exclude other causes of BMS. Oral, pharyngeal and laryngeal signs and symptoms were evaluated with Reflux Sign Assessment (RSA) and Reflux Symptom Score (RSS). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of pepsin test were calculated considering the highest values of pepsin tests at ≥ 16, ≥ 36, and ≥ 100 ng/mL cutoffs. Receiver operating characteristic curve (ROC) was evaluated. RESULTS: Forty-nine patients with both BMS and LPR at the HEMII-pH and 21 asymptomatic individuals were recruited. Pepsin test was 83.7%, 79.6%, and 71.4% sensitive at cutoffs ≥ 16, ≥ 36, and ≥ 100 ng/mL, respectively. The ROC analysis reported that a threshold of ≥ 21.5 ng/mL was associated with sensitivity, specificity, PPV and NPV of 81.6%, 81.0%, 90.1% and 65.4%, respectively. The severity score of burning mouth symptom was significantly associated with the saliva pepsin concentration (rs = 0.263; p = 0.029) and the oral RSA (rs = 0.474; p = 0.007). CONCLUSION: Pepsin test is a valuable diagnostic approach for detecting LPR in patients with BMS. Patients with high level of saliva pepsin reported more severe burning mouth symptoms. Future studies are needed to confirm the role of LPR in the primary BMS

Titanium Internal Fixator Removal in Maxillofacial Surgery: Is It Necessary? A Systematic Review and Meta-Analysis

: Titanium plates and screws are essential devices in maxillofacial surgery since late 1980s, but despite their wide use there is no consensus in titanium internal fixators removal after bone healing. A systematic literature review and meta-analysis were conducted on seventeen retrospective studies. Effect size and 95% confidence intervals were calculated for plate removal (per plate and per patient) and for removal causes (infection, pain, screws complications, exposition, palpability). Odds ratio, 95% confidence intervals, and χ 2 test were measured for sex, smoking, and implant site. Heterogeneity was evaluated with Cochran and Inconstancy test. Obtained data were used to design Forest and Funnel plots. The aim of the study is to identify and clarify reasons and risk factors for plates and screws removal. Infection is the most frequent reason; the habit of tobacco usage and implant site (mandibula) are the main risk factors. The administration of antibiotic prophylaxis is essential, and patients must quit smoking before and after surgery. In conclusion there is no scientific evidence supporting the removal of internal devices as mandatory step of the postoperative procedure

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

Erratum to: Scoping review of the relationship between xerostomia and voice quality (European Archives of Oto-Rhino-Laryngology, (2023), 280, 7, (3087-3095), 10.1007/s00405-023-07941-x)

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The detection of smell disorder depends on the clinical tools.

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Reflux symptoms may develop in cases of throat mucosa injury, stress and related-autonomic nerve dysfunction.

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Asthma, chronic rhinosinusitis and laryngopharyngeal reflux.

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Dysphagia after supraglottic laryngeal cancer surgery.

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