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Olfactory dysfunction in acute rhinosinusitis: intranasal sodium hyaluronate as adjuvant treatment

  • Rhinology
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Abstract

Acute rhinosinusitis (ARS) is defined as an inflammation of the mucosa of the nose and paranasal sinuses and affects 1–5 % of general population in Europe. Sinonasal diseases represent the main cause of smell alterations in adult patients and lead to mucosal congestion, increased quantity and density of secretions and altered mucociliary transport. For this reason the odorous molecules contained in the inspired air, cannot interact with the olfactory epithelium. Medical therapy of ARS has to reduce the severity and duration of symptoms and prevent complications. Recent studies have shown that Sodium hyaluronate modulate inflammation and has a reparative effect on the nasal mucosa. 48 patients affected by acute rhinosinusitis proven by CT scan, were enrolled. They were submitted to nasal endoscopy, olfactometric and mucociliary transport evaluation (MCTt), Visual Analogue Scale Questionnaire (VAS) at T0, after 14–18 days (T1) and after 30–35 days (T2). The patients were randomized into two treatment groups, A and B, and were treated for 30 days; each group was composed of 24 subjects. All patients received Levofloxacin (500 mg for 10 days) and Prednisone (50 mg for 8 days, 25 mg for 4 days and 12, 5 mg for 4 days). Moreover, Group A received twice a day for 30 days high molecular weight Sodium Hyaluronate (3 %) plus saline solution (3 mL sodium chloride-NaCl—0.9 %) using a nebulizer ampoule for nasal douche. Group B received twice a day for 30 days saline solution (6 mL sodium chloride-NaCl—0.9 %) using a nebulizer ampoule for nasal douche. At T1 Group A shown lower values in MCTt and threshold score was significantly higher than in Group B. VAS showed statistically significant differences between the two groups, in particular for smell, nasal obstruction and for nasal discharge. At T2 Group A MCTt was significantly lower than in Group B; odour threshold improved in both groups but in Group A was still significantly higher than in Group B. No statistical differences between two groups regarding odour discrimination and odour identification were confirmed at T1 and T2. VASy score showed statistically significant differences between the two groups only for nasal discharge.

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References

  1. Fokkens WJ, Lund VJ, Mullol J, Bachert C, Alobid I, Baroody F, et al. (2012) EPOS 2012: European position paper on rhinosinusitis and nasal polyps. Rhinology 1–229

  2. Cherry DK, Woodwell DA, Rechtsteiner EA (2007) National ambulatory medical care survey: 2005 summary. Adv Data 29(387):1–39

    Google Scholar 

  3. Sanchez-Vallecillo MV, Fraire ME, Baena-Cagnani C, Me Zernotti (2012) Olfactory dysfunction in patients with chronic rhinosinusitis. Int J Otolaryngol 2012:327206

    Article  PubMed  PubMed Central  Google Scholar 

  4. Mott AE, Leopold DA (1991) Disorders in taste and smell. Med Clin North Am 75(6):1321–1353

    Article  CAS  PubMed  Google Scholar 

  5. Rudmik L, Hoy M, Schlosser RJ, Harvey RJ, Welch KC, Lund V et Al (2013) Topical therapies in the management of chronic rhinosinusitis: an evidence-based review withrecommendations. Int Forum Allergy Rhinol 3(4):281–298

  6. Macchi A, Terranova P, Digilio E, Castelnuovo P (2013) Hyaluronan plus saline nasal washes in the treatment of rhino-sinusal symptoms in patients undergoing functional endoscopic sinus surgery for rhino-sinusal remodeling. Int J Immunopathol Pharmacol. Jan-Mar 26(1):137–145

    Article  CAS  Google Scholar 

  7. Casale M, Sabatino L, Frari V, Mazzola F, Dell’Aquila R, Baptista P et al (2014) The potential role of hyaluronan in minimizing symptoms and preventing exacerbations of chronic rhinosinusitis. Am J Rhinol Allergy 28(4):345–348

    Article  PubMed  Google Scholar 

  8. Gelardi M, Guglielmi AV, De Candia N, Maffezzoni E, Berardi P, Quaranta N (2013) Effect of sodium hyaluronate on mucociliary clearance after functional endoscopic sinus surgery. Eur Ann Allergy Clin Immunol 45(3):103-8

  9. Krasiński R, Tchórzewski H (2007) Hyaluronan-mediated regulation of inflammation Postepy Hig Med Dosw 19(61):683-9

  10. Hummel T, Sekinger B, Wolf SR, Pauli E, Kobal G (1997) ‘Sniffin’ sticks’: olfactory performance assessed by the combined testing of odor identification, odor discrimination and olfactory threshold. Chem Senses 22(1):39–52

  11. Dalton P (2004) Olfaction and anosmia in rhinosinusitis. Curr Allergy Asthma Rep 4:230–236

    Article  PubMed  Google Scholar 

  12. Doty RL, Mishra A (2001) Olfaction and its alteration by nasal obstruction, rhinitis, and rhinosinusitis. Laryngoscope 111:409–423

    Article  CAS  PubMed  Google Scholar 

  13. Kelle A, Malaspina D (2013) Hidden consequences of olfactory dysfunction: a patient report series. BMC Ear Nose Throat Disord 13(1):8

    Article  Google Scholar 

  14. Ciofalo A, Filiaci F, Romeo R, Zambetti G, Vestri AR (2006) Epidemiological aspects of olfactory dysfunction. Rhinology 44(1):78–82

    PubMed  Google Scholar 

  15. Kern RC (2000) Chronic sinusitis and anosmia: pathologic changes in the olfactory mucosa. Laryngoscope 110(7):1071–1077

    Article  CAS  PubMed  Google Scholar 

  16. Ialenti A, Di Rosa M (1994) Hyaluronic acid modulates acute and chronic inflammation. Agents Actions 43(1–2):44–47

    Article  CAS  PubMed  Google Scholar 

  17. Chen WY, Abatangelo G (1999) Functions of hyaluronan in wound repair. Wound Repair Regen 7(2):79–89 (review)

    Article  CAS  PubMed  Google Scholar 

  18. Partsch G, Schwarzer C, Neumüller J, Dunky A, Petera P, Bröll H et al (1989) Modulation of the migration and chemotaxis of PMN cells by hyaluronic acid. Z Rheumatol 48(3):123–128

    CAS  PubMed  Google Scholar 

  19. Manzanares D, Monzon ME, Savani RC, Salathe M (2007) Apical oxidative hyaluronan degradation stimulates airway ciliary beating via RHAMM and RON. Am J Respir Cell Mol Biol 37(2):160–168

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Tanaka Y, Makiyama Y, Mitsui Y (2000) Endothelin-1 is involved in the growth promotion of vascular smooth muscle cells by hyaluronic acid. Int J Cardiol 76:39–47

    Article  CAS  PubMed  Google Scholar 

  21. Forteza R, Lieb T, Aoki T, Savani RC, Conner GE, Salathe M (2001) Hyaluronan serves a novel role in airway mucosal host defense. FASEB J 15:2179–2186

    Article  CAS  PubMed  Google Scholar 

  22. Gouteva I, Shah-Hosseini K, Meiser P (2014) Clinical efficacy of a spray containing hyaluronic Acid and dexpanthenol after surgery in the nasal cavity (septoplasty, simple ethmoid sinus surgery, and turbinate surgery). J Allergy (Cairo):635490

  23. Casale M, Ciglia G, Frari V, Incammisa A, Mazzola F, Baptista P et al (2013) The potential role of hyaluronic acid in postoperative radiofrequency surgery for chronic inferior turbinate hypertrophy. Am J Rhinol Allergy. May-Jun 27(3):234–236

    Article  Google Scholar 

  24. Cantone E, Castagna G, Sicignano S, Ferranti I, Rega F, Di Rubbo V et al (2014) Impact of intranasal sodium hyaluronate on the short-term quality of life of patients undergoing functional endoscopic sinus surgery for chronic rhinosinusitis. Int Forum Allergy Rhinol 4(6):484–487

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Organi di Senso Department, “Sapienza” University of Rome, via Gregorio VII 80, 00165, Rome, Italy

    Andrea Ciofalo, Marco de Vincentiis, Giampietro Zambetti, Giancarlo Altissimi, Massimo Fusconi, Antonio Greco & Giuseppe Magliulo

  2. ENT Section, Department of Neurosciences DNS, University of Padova, Padua, Italy

    Giancarlo Ottaviano

Authors
  1. Andrea Ciofalo
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  2. Marco de Vincentiis
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  3. Giampietro Zambetti
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  4. Giancarlo Altissimi
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  5. Massimo Fusconi
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  6. Antonio Greco
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  7. Giancarlo Ottaviano
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  8. Giuseppe Magliulo
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Correspondence to Giuseppe Magliulo.

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This study was not funded

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Ciofalo, A., de Vincentiis, M., Zambetti, G. et al. Olfactory dysfunction in acute rhinosinusitis: intranasal sodium hyaluronate as adjuvant treatment. Eur Arch Otorhinolaryngol 274, 803–808 (2017). https://doi.org/10.1007/s00405-016-4277-x

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  • DOI: https://doi.org/10.1007/s00405-016-4277-x

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