Clinically important impairment of chemosensory perception occurred in the SS group compared with age- and gender-matched controls. Assessment using SF-12 suggests that this impairment contributed to the reduced health-related QoL that characterized these individuals.
Hypogeusia is an uncommon complication of uvulopalatopharyngoplasty (UPPP) and few reports in the literature have documented it. Excision of part of the soft palate and damage to the glossopharyngeal nerve or its lingual branch as a result of diathermy or surgery are the possible causes. The case of a 45-year-old male who suffered hypogeusia following UPPP is reported herein. He reported no improvement over a 6-month period. Quantitative assessment of his taste threshold for the 4 basic tastes using taste strips showed a score of 7/18, indicating hypogeusia. The possibility of taste disorder as a postoperative complication should be discussed before patients consent to UPPP Postoperative taste threshold assessment should be done using taste strips if the patient complains of taste disorders.
Objective To assess the prevalence of abnormal rhinological findings in a Sjögren's syndrome population. Methods A cohort-matched, prospective, cross-sectional, observational study was conducted. Sixty-seven subjects (30 patients and 37 controls) were enrolled. Rhinological assessment including smell threshold was evaluated using a standardised, validated clinical test as part of a larger study. Results Smell thresholds were –4.4 and –5.4 in the Sjögren's syndrome and control groups, respectively (p = 0.001). Hyposmia (threshold values of less than −4.5) was demonstrated in the Sjögren's syndrome group (47 per cent). Smell was negatively correlated with age (p = 0.040). Nasal septal perforation was noted in 3 Sjögren's syndrome patients (10 per cent) and nasal mucosal dryness in 10 patients (33 per cent), but none of the control group were affected. Conclusion Hyposmia in Sjögren's syndrome was demonstrated using the Smell Threshold Test. Nasal septal perforation and nasal mucosa dryness were also noted in patients with Sjögren's syndrome. A diagnosis of Sjögren's syndrome should be considered and investigated in smell deprivation and/or nasal septal perforation patients.
HIV (Human Immuno-deficiency Virus) infection has a multi system effect. some publications claimed deterioration of smell perception in HIV. In this study, we present our smell assessment in a group of HIV patients using market available tests. Methods: Cross sectional observational study of 19 patients recruited from a North Wales genito-urinary medicine (GUM) clinic. Inclusion and exclusion criteria were applied to HIV diagnosed patients. Patients who gave consent for the study were invited to an ENT clinic where smell and nasal assessment took place. Patients had anterior rhinoscoy. Smell Threshold test kit was used to assess smell sensation. Normal score smell threshold was considered if score was 5.5 or above. Results: 16 males and 3 females, age range 22-75 (mean 46 years old). 2 African and 17 Caucasian origin subjects. 14/19 (74%) had HIV diagnosis for less than five years. 11/19 (58%) had hyposmia (mean 4.40 while normal score is 5.50) when tested. 16/19 (84%) complained of no hyposmia prior to testing. 12/19 (63%) had highly active anti-retroviral therapy (HAART) treatment. 6/19 (32%) used recreational drugs (Cannabis). None of the patients had cognitive impairment. Conclusions: HIV patients had hyposmia although patients did not report it as a compalaint. Smell threshold is affected in HIV positive patients. This is important for patients health and safety. We recommend assessment of smell in HIV positive patients so they become aware of their reduced sense and its implication.
1 out of 9 (11%) repeat FNA reports were inadequate in the second cycle compared to 4 out of 13 (30%) in the first cycle (Figure 2).In both cycles, all of the patients with initial inadequate FNA reports (n = 17) were diagnosed with benign pathology on further investigation.
Learning Objectives:Purpose: There are specific frequency hearing losses such as c4-dip(2kHz loss) in otosclerosis and c5-dip(4kHz loss) in case of noise induced hearing loss. The c3-dip(1kHz loss), however, is seldom mentioned in clinical field. We found a group of patient with 1 kHz hearing loss fortuitiously and report it with review of literature.Method: Tertiary academic referral center-based retrospective chart review and review of audiogram was done. Otologic history, audiogram, diagnosis, occupation, history of noise exposure were reviewed with chart and telephone interview. We compared the c3-dip group with 98 patients of c5-dip group(4kHz hearing loss group).Results: Thirty one patients met the criteria of 1kHz audiometric notch. There are eleven males and 20 female with mean age of 40.6 years old. The pure tone threshold of 1kHz was 37.97 dB and the hearing threshold was 22.38 dB with other frequencies. Tinnitus was most the common complaints of c3-dip group compared with c5-dip group. The most common diagnoses of the c3-dip group were sudden sensorineural hearing loss(n = 8) and idiopathic tinnitus(n = 8). Female patients and unilateral cases were more common in c3-dip group than c5-dip group. Ear fullness was the more common symptom in c3-dip group than c5-dip group. The duration of occupation-related noise exposure was longer in c5-dip group than c3-dip group. The history of head or ear trauma was more frequent in c3-dip group than c5-dip group. Conclusion:We defined a new clinical entity of 1 kHz hearing loss group as c3-dip group. A 38-year-old woman visited our clinic with her left progressive hearing loss for 2 months. She had characteristic blue sclera and experienced frequent fractures from minor trauma in her teens. She looked normal in her appearance and stature. She did not have family history of hearing loss. Her ear drum was clear and pure tone audiogram showed left side 40 dB air-bone gap conductive hearing loss. Her right hearing was normal. Temporal bone CT revealed nothing special. Exploratory tympanotomy was performed to find stapes fixation and decided to do the stapedotomy. However, profuse perilymph gush developed when perforating the foot plate. Piston wire prosthesis was placed with struggling effort. Lumbar drain was placed right after finishing the operation. Although she had immediate postoperative dizziness, hearing loss, and tinnitus for 3 days, her hearing gradually improved and air-bone gap was closed 2 months after the surgery. Her good hearing was maintained for the 6 months on the follow-up audiogram. We present our experience of Ten cases of EAC cholesteatoma treated in a UK district general hospital (serving a population of approximately 275,000) between 2007 and 2014. We discuss the clinical presentation, appropriate investigation, and subsequent surgical management of these cases. Cholesteatoma of the external auditory canal is rare, but has potential for serious complications such as erosion into the temporo-mandibular joint, facial nerve, and skull base. The mos...
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