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Vaira LA, Biglio A, Favro A, Salzano G, Abbate V, Lechien JR, De Riu G. Implant-prosthetic rehabilitation of the atrophic posterior mandible with additively manufactured custom-made subperiosteal implants: a cohort study. Int J Oral Maxillofac Surg 2024; 53:533-540. [PMID: 38272739 DOI: 10.1016/j.ijom.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 12/22/2023] [Accepted: 01/03/2024] [Indexed: 01/27/2024]
Abstract
The aim of this study was to retrospectively analyse a series of patients with posterior mandibular atrophy rehabilitated with custom-made subperiosteal implants. The study included patients with severe posterior mandibular atrophy who had undergone rehabilitation with subperiosteal implants between September 2018 and August 2022 in the Maxillofacial Surgery Operative Unit of the University Hospital of Sassari. Complications and the success rate were reviewed. Data from 30 implants placed in 17 patients were included and analysed. There were no major complications during the surgeries. The main postoperative sequela was oedema, which was reported as moderate by most patients and had completely regressed within 10 days of surgery. No partial or complete exposures, infections, or loss of the implants were detected during follow-up (average follow-up 22.5 months). Control computed tomography scans, performed at 6 months and then annually in all cases, did not show significant bone loss below the abutments, displacement of the implants, or loss or loosening of the osteosynthesis screws. Subperiosteal implants may represent a safe and reliable technique for the rehabilitation of severe atrophy of the posterior mandible. Prospective studies with a long follow-up will be needed to establish the long-term results of this type of implant-prosthetic rehabilitation.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy; School of Biomedical Science, Biomedical Sciences Department, University of Sassari, Sassari, Italy.
| | - A Biglio
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - A Favro
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
| | - G Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - V Abbate
- Maxillofacial Surgery Operative Unit, University Hospital of Naples "Federico II", Naples, Italy
| | - J R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
| | - G De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, Sassari, Italy
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Baudouin R, Hans S, Lisan Q, Morin B, Adimi Y, Martin J, Lechien JR, Tartour E, Badoual C. Prognostic Significance of the Microenvironment in Human Papillomavirus Oropharyngeal Carcinoma: A Systematic Review. Laryngoscope 2024; 134:1507-1516. [PMID: 37642393 DOI: 10.1002/lary.31010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/01/2023] [Accepted: 08/15/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE The immune microenvironment of HPV-associated (HPV+) oropharyngeal squamous cell carcinomas (OPSCCs) (HPV+OPSCCs) differs from that of HPV-independent oropharyngeal cancers (HPV-independent OPSCCs). The literature on the subject is very abundant, demanding an organized synthesis of this wealth of information to evaluate the hypothesis associating the favorable prognosis of HPV+OPSCC patients with a different immune microenvironment. A systematic review of the literature was conducted regarding the microenvironment of HPV+OPSCCs. DATA SOURCE MEDLINE/PubMed, Embase, and Cochrane Library databases. REVIEW METHODS A literature search was performed following PRISMA guidelines (Moher D. PLoS Med. 2009). The PEO (Population, Exposure, and Outcome) framework is detailed as follows: P: patients with oropharyngeal squamous cell carcinomas, E: human papillomavirus (HPV), and O: histological and immunological composition of the tumoral microenvironment (TME). No meta-analysis was performed. RESULTS From 1,202 studies that were screened, 58 studies were included (n = 6,474 patients; n = 3,581 (55%) HPV+OPSCCs and n = 2,861(45%) HPV-independent OPSCCs). The presence of tumor-infiltrating lymphocytes (TIL), CD3+ in 1,733 patients, CD4+ in 520 patients, and CD8+ (cytotoxic T lymphocytes (CTL)) in 3,104 patients, and high levels of PD-L1 expression in 1,222 patients is strongly correlated with an improved clinical outcome in HPV+OPSCCs. CONCLUSION This systematic review provides the most comprehensive information on the immune microenvironment of HPV+OPSCCs to date. Tumor-infiltrating lymphocytes and PD-L1 expression are associated with a favorable prognosis. B, CD8+ and resident memory cells densities are higher in HPV+OPSCCs. The importance of myeloid lineages is still a matter of debate and research. LEVEL OF EVIDENCE NA Laryngoscope, 134:1507-1516, 2024.
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Affiliation(s)
- R Baudouin
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - S Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - Q Lisan
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - B Morin
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - Y Adimi
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - J Martin
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - J R Lechien
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, Suresnes, France
- School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Montigny-le-Bretonneux, France
| | - E Tartour
- Department of Biological Immunology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
| | - C Badoual
- Department of Pathology, Hôpital Européen Georges Pompidou, Université Paris Cité, INSERM, PARCC, Paris, France
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Vaira LA, Lechien JR, Deiana G, Salzano G, Maglitto F, Piombino P, Mazzatenta A, Boscolo-Rizzo P, Hopkins C, De Riu G. Prevalence of olfactory dysfunction in D614G, alpha, delta and omicron waves: a psychophysical case-control study. Rhinology 2023; 61:32-38. [PMID: 36272169 DOI: 10.4193/rhin22.294] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND The purpose of this study was to compare the prevalence of olfactory dysfunction (OD) at different stages of the COVID-19 pandemic by evaluating subjects diagnosed with SARS-CoV-2 infection during the Omicron wave with psychophysical tests and comparing the results with those obtained from patients infected during the D614G, Alpha and Delta waves and with those of a control group. METHODOLOGY The study included adult patients diagnosed with SARS-CoV-2 infection. Depending on the time of diagnosis, the subjects were divided into four study groups: D614G; Alpha, Delta and Omicron variant groups. A group of uninfected individuals was used as control. All subjects underwent psychophysical evaluation of the olfactory function with the Connecticut Chemosensory Clinical Research Center olfactory test (D614G and Alpha groups) or the extended version of the Sniffin'Sticks test (Delta, Omicron and control groups). RESULTS 372 cases (134 D614G group, 118 Alpha group, 32 in Delta group and 88 Omicron group) were recruited and evaluated within 10 days of infection, alongside 80 controls. Patients self-reported olfactory loss in 72.4% of cases in the D614G group, in 75.4% of cases in the Alpha group, in 65.6% of cases in the Delta group and in 18.1% in the Omicron group. Psychophysical evaluation revealed a prevalence of OD: 80.6%, 83.0%, 65.6% and 36.3% in the D614G, Alpha, Delta and Omicron group respectively. The differences between the D614G, Alpha and Delta groups were not statistically significant. The Omicron group demonstrated a significantly lower prevalence of OD than the other variants but still significantly higher than the controls. CONCLUSIONS During the Omicron wave OD was less prevalent than during the D614G, Alpha and Delta periods. One-third of patients have reduced olfactory function on psychophysical evaluation during the Omicron wave. Our results should be considered with caution as the VOC has not been determined with certainty.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - J R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS. Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head Neck Surgery, Elsan Hospital, Paris, France
| | - G Deiana
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - G Salzano
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - F Maglitto
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - P Piombino
- Department of Maxillofacial Surgery, University of Naples Federico II, Naples, Italy
| | - A Mazzatenta
- Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, G. d Annunzio, University of Chieti-Pescara, Chieti Scalo, Italy
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - C Hopkins
- King's College, London, UK; British Rhinological Society (President), London, UK
| | - G De Riu
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
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Calvo-Henriquez C, Sandoval-Pacheco V, Chiesa-Estomba C, Lechien JR, Martins-Neves S, Esteller-More E, Kahn S, Suarez-Quintanilla D, Capasso R. Pediatric maxillary expansion has a positive impact on hearing? A systematic review and meta-analysis. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:31-38. [PMID: 36210326 DOI: 10.1016/j.anorl.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 05/15/2022] [Accepted: 07/26/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Hearing loss is a highly prevalent condition in the pediatric population. Pediatric maxillary expansion is a widespread treatment to address transverse maxillary deficiency. First reports describing an association between improvements for patients with HL and PME initiated in the 1960s. In this systematic review and meta-analysis we aim to review the role of maxillary expansion in reducing conductive hearing loss in pediatric population. REVIEW METHODS Pubmed (Medline), the Cochrane Library, EMBASE and Trip Database were checked. Main outcome was expressed as the difference between air-bone gap, compliance, ear volume and conductive hearing thresholds before and after treatment and the 95% confidence interval. RESULTS A total of 10 studies (218 patients) met inclusion criteria. The pooled data in the meta-analysis under a random effects model shows a statistically significant difference of 10.57dB mean reduction after palatal expansion. The air-bone gap was significantly reduced by 5.39dB (CI 95% 3.68, 7.10). Compliance and volume were assessed in three studies, with a non-significant positive difference in the compliance (0.14) and a statistically significant difference for volume (0.80) after palatal expansion. CONCLUSION This systematic review and meta-analysis found a positive effect of pediatric maxillary expansion in conductive hearing loss in well-select children. However, results cannot be extrapolated for children with conductive hearing loss without an accompanying orthodontic indication (maxillary constriction). It showed that the existing prospective studies exhibited qualitative pitfalls, limiting the ability to obtain conclusive evidence about the role of pediatric maxillary expansion on conductive hearing loss in children.
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Affiliation(s)
- C Calvo-Henriquez
- Rhinology study group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain.
| | - V Sandoval-Pacheco
- Rhinology study group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Service of Otolaryngology, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - C Chiesa-Estomba
- Rhinology study group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Service of Otolaryngology, Donostia University Hospital, San Sebastian, Spain
| | - J R Lechien
- Rhinology study group of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Foch Hospital, University of Paris Saclay, Paris, France
| | - S Martins-Neves
- Department of orthodontics, My Face Clinics and Academy, Lisbon, Portugal
| | - E Esteller-More
- Service of Otolaryngology, General University Hospital of Catalonia, Barcelona, Spain; Department of Otolaryngology, International University of Catalonia, Barcelona, Spain
| | - S Kahn
- Orthodontic private practice, San Francisco, CA, USA
| | - D Suarez-Quintanilla
- Orthodontic private practice, Santiago de Compostela, Spain; Department of Orthodontics, University of Santiago de Compostela, Santiago de compostela, Spain
| | - R Capasso
- Department of Otolaryngology - Head and Neck Surgery, Sleep Surgery Division, Stanford University Medical Center, Stanford, CA, USA
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Simon F, Peer S, Lechien JR, Couloigner V, Profant M, Fraysse B, Fakhry N. YO-IFOS educational video special issue, part 4: Rhinology and Plastics. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 4:105-106. [PMID: 34785025 DOI: 10.1016/j.anorl.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- F Simon
- Vice-chair of the YO-IFOS Education Committee. Department of Pediatric Otolaryngology, Hôpital Necker-Enfants Malades, AP-HP - Université de Paris, Paris, France.
| | - S Peer
- Chair of the YO-IFOS Education Committee. Division of Otolaryngology, University of Cape Town & Red Cross Children's Hospital, South Africa
| | - J R Lechien
- Vice-chair of the YO-IFOS Research Committee. Department of Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, Universite Libre de Bruxelles, Brussels, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital Paris Saclay University, Paris, France
| | - V Couloigner
- General Secretary of the French Society of Otorhinolaryngology (SFORL). Department of Pediatric Otolaryngology, Hôpital Necker-Enfants Malades, AP-HP - Université de Paris, Paris, France
| | - M Profant
- General Secretary of IFOS. Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine and University Hospital, Comenius University Bratislava, Slovakia
| | - B Fraysse
- President of IFOS. Service d'Otologie, Otoneurologie et ORL pédiatrique, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
| | - N Fakhry
- President of YO-IFOS. Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, Marseille, France
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6
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Fakhry N, Peer S, Lechien JR, Ayad T, Teissier N, Couloigner V, Profant M, Fraysse B, Simon F. YO-IFOS educational video special issue, part 2: Head and neck. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 2:37-38. [PMID: 34538361 DOI: 10.1016/j.anorl.2021.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- N Fakhry
- President of YO-IFOS, Department of Oto-Rhino-Laryngology Head and Neck Surgery, La Conception University Hospital, AP-HM, Aix Marseille Univ, Marseille, France.
| | - S Peer
- Chair of the YO-IFOS Education Committee, Division of Otolaryngology, University of Cape Town & Red Cross Children's Hospital, Cape Town, South Africa
| | - J R Lechien
- Vice-chair of the YO-IFOS Research Committee, Department of Anatomy and Experimental Oncology, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital Paris Saclay University, Paris, France
| | - T Ayad
- Chair of the YO-IFOS Research Committee, Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - N Teissier
- General Secretary of YO-IFOS, Pediatric ENT Department, Robert Debré Hospital, Paris 7 Denis Diderot University, 48, Bd Sérurier, 75019 Paris, France
| | - V Couloigner
- General Secretary of the French Society of Otorhinolaryngology (SFORL), Department of Paediatric Otolaryngology, Hôpital Necker-Enfants Malades, AP-HP - Université de Paris, Paris, France
| | - M Profant
- General Secretary of IFOS, Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine and University Hospital, Comenius University Bratislava, Bratislava, Slovakia
| | - B Fraysse
- President of IFOS, Service d'Otologie, Otoneurologie et ORL pédiatrique, Hôpital Pierre-Paul Riquet, CHU Purpan, Toulouse, France
| | - F Simon
- Vice-chair of the YO-IFOS Education Committee. Department of Paediatric Otolaryngology, Hôpital Necker-Enfants Malades, AP-HP - Université de Paris, Paris, France
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Lechien JR, Chiesa-Estomba CM, Hans S, Saussez S. Pathophysiological mechanisms and management of patients with long-time anosmia related to COVID-19. J Intern Med 2021; 290:464-465. [PMID: 33527593 PMCID: PMC8014317 DOI: 10.1111/joim.13257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 12/26/2022]
Affiliation(s)
- J R Lechien
- From the, Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - C M Chiesa-Estomba
- Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - S Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - S Saussez
- From the, Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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8
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Lechien JR, Chiesa-Estomba CM, Beckers E, Mustin V, Ducarme M, Journe F, Marchant A, Jouffe L, Barillari MR, Cammaroto G, Circiu MP, Hans S, Saussez S. Prevalence and 6-month recovery of olfactory dysfunction: a multicentre study of 1363 COVID-19 patients. J Intern Med 2021; 290:451-461. [PMID: 33403772 DOI: 10.1111/joim.13209] [Citation(s) in RCA: 126] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To investigate prevalence and recovery of olfactory dysfunction (OD) in COVID-19 patients according to the disease severity. METHODS From 22 March to 3 June 2020, 2581 COVID-19 patients were identified from 18 European hospitals. Epidemiological and clinical data were extracted at baseline and within the 2-month post-infection. RESULTS The prevalence of OD was significantly higher in mild form (85.9%) compared with moderate-to-critical forms (4.5-6.9%; P = 0.001). Of the 1916 patients with OD, 1363 completed the evaluations (71.1%). A total of 328 patients (24.1%) did not subjectively recover olfaction 60 days after the onset of the dysfunction. The mean duration of self-reported OD was 21.6 ± 17.9 days. Objective olfactory evaluations identified hyposmia/anosmia in 54.7% and 36.6% of mild and moderate-to-critical forms, respectively (P = 0.001). At 60 days and 6 months, 15.3% and 4.7% of anosmic/hyposmic patients did not objectively recover olfaction, respectively. The higher baseline severity of objective olfactory evaluations was strongly predictive of persistent OD (P < 0.001). CONCLUSION OD is more prevalent in mild COVID-19 forms than in moderate-to-critical forms. OD disappeared in 95% of patients regarding objective olfactory evaluations at 6 months.
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Affiliation(s)
- J R Lechien
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - C M Chiesa-Estomba
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - E Beckers
- Department of Otolaryngology-Head & Neck Surgery, Clinique de l'Europe, Brussels, Belgium
| | - V Mustin
- Department of Otolaryngology-Head & Neck Surgery, Clinique de l'Europe, Brussels, Belgium
| | - M Ducarme
- Department of Surgery, EpiCURA Hospital, Hornu, Belgium
| | - F Journe
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - A Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, Brussels, Belgium
| | | | - M R Barillari
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Division of Phoniatrics and Audiology, Department of Mental and Physical Health and Preventive Medicine, University of Naples SUN, Naples, Italy
| | - G Cammaroto
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology-Head & Neck, Forli Hospital, Forli, Italy
| | - M P Circiu
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - S Hans
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - S Saussez
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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Lechien JR, Chiesa‐Estomba CM, Radulesco T, Michel J, Vaira LA, Le Bon SD, Horoi M, Falanga C, Barillari MR, Hans S, Tucciarone M, Saussez S. Clinical features of patients who had two COVID-19 episodes: a European multicentre case series. J Intern Med 2021; 290:421-429. [PMID: 33527495 PMCID: PMC8013656 DOI: 10.1111/joim.13259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate the clinical features of patients who had two demonstrated coronavirus disease 2019 (COVID-19) episodes. METHODS Data of patients with both COVID-19 episodes were recruited from 22 March to 27 December 2020. The following outcomes were studied: epidemiological, comorbidities, prevalence and severity of general and otolaryngological symptom, olfactory, aroma, and gustatory dysfunctions. A comparison between first and second episodes was performed. RESULTS Forty-five patients reported having two confirmed COVID-19 episodes. The majority of patients had mild infections in both episodes. The second clinical episode was significantly similar to the first. The symptom duration of the second episode was shorter than the first. The occurrence of loss of smell was unpredictable from the first to the second episode. CONCLUSION The recurrence of COVID-19 symptoms is associated with a similar clinical picture than the first episode in patients with initial mild-to-moderate COVID episode. The pathophysiological mechanisms underlying the development of second episode remain uncertain and may involve either true reinfection or virus reactivation from sanctuaries.
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Affiliation(s)
- J. R. Lechien
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Human Anatomy and Experimental OncologyFaculty of MedicineUMONS Research Institute for Health Sciences and TechnologyUniversity of Mons (UMons)MonsBelgium
- Department of Otolaryngology‐Head & Neck SurgeryFoch HospitalSchool of MedicineUFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)ParisFrance
- Department of Otorhinolaryngology and Head and Neck SurgeryCHU de BruxellesCHU Saint‐PierreSchool of MedicineUniversité Libre de BruxellesBrusselsBelgium
| | - C. M. Chiesa‐Estomba
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Otorhinolaryngology— Head & Neck SurgeryHospital Universitario DonostiaSan SebastianSpain
| | - T. Radulesco
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Otorhinolaryngology‐Head & Neck SurgeryAP‐HM, Hopital La ConceptionMarseilleFrance
| | - J. Michel
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Otorhinolaryngology‐Head & Neck SurgeryAP‐HM, Hopital La ConceptionMarseilleFrance
| | - L. A. Vaira
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Maxillofacial Surgery UnitUniversity Hospital of SassariSassariItaly
| | - S. D. Le Bon
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Otorhinolaryngology and Head and Neck SurgeryCHU de BruxellesCHU Saint‐PierreSchool of MedicineUniversité Libre de BruxellesBrusselsBelgium
| | - M. Horoi
- Department of Otorhinolaryngology and Head and Neck SurgeryCHU de BruxellesCHU Saint‐PierreSchool of MedicineUniversité Libre de BruxellesBrusselsBelgium
| | - C. Falanga
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Division of Phoniatrics and AudiologyDepartment of Mental and Physical Health and Preventive MedicineUniversity of L. VanvitelliNaplesItaly
| | - M. R. Barillari
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Division of Phoniatrics and AudiologyDepartment of Mental and Physical Health and Preventive MedicineUniversity of L. VanvitelliNaplesItaly
| | - S. Hans
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Otolaryngology‐Head & Neck SurgeryFoch HospitalSchool of MedicineUFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)ParisFrance
| | - M. Tucciarone
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- ENT Department Hospital Universitario de JerezJerez de la FronteraSpain
| | - S. Saussez
- From theCOVID‐19 Task Force of the Young‐Otolaryngologists of the International Federations of Oto‐rhino‐laryngological Societies (YO‐IFOS)ParisFrance
- Department of Human Anatomy and Experimental OncologyFaculty of MedicineUMONS Research Institute for Health Sciences and TechnologyUniversity of Mons (UMons)MonsBelgium
- Department of Otolaryngology‐Head & Neck SurgeryFoch HospitalSchool of MedicineUFR Simone VeilUniversité Versailles Saint‐Quentin‐en‐Yvelines (Paris Saclay University)ParisFrance
- Department of Otorhinolaryngology and Head and Neck SurgeryCHU de BruxellesCHU Saint‐PierreSchool of MedicineUniversité Libre de BruxellesBrusselsBelgium
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10
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Saussez S, Hans S, Chiesa-Estomba CM, Lechien JR. Psychophysical evaluations are important, usefulness and usability approaches to study the smell disorder related to COVID-19. J Intern Med 2021; 290:468-469. [PMID: 33817882 PMCID: PMC8251326 DOI: 10.1111/joim.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 12/02/2022]
Abstract
Click here to view the Letter to the Editor by B. Arana‐Fernández et al
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Affiliation(s)
- S Saussez
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - S Hans
- Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris-Saclay University), Paris, France
| | - C M Chiesa-Estomba
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology-Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - J R Lechien
- From the, COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris-Saclay University), Paris, France
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11
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Lechien JR, Chiesa-Estomba CM, Calvo-Henriquez C, Ayad T, Simon F, Fakhry N. The YO-IFOS key points to write a good paper in otolaryngology. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 138 Suppl 1:2-5. [PMID: 34127408 DOI: 10.1016/j.anorl.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/28/2021] [Accepted: 03/07/2021] [Indexed: 01/05/2023]
Affiliation(s)
- J R Lechien
- Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otolaryngology-Head & Neck Surgery, Foch Hospital, UVSQ, Paris Saclay University, Paris, France; Department of human Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium; Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
| | - C M Chiesa-Estomba
- Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain
| | - C Calvo-Henriquez
- Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology - Head & Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - T Ayad
- Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Centre Hospitalier de l'Université de Montréal, Department of Otolaryngology-Head & Neck Surgery, Montreal, Quebec, Canada
| | - F Simon
- Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Pediatric Otolaryngology - Head and Neck Surgery Department, Necker-Enfants Malades Hospital, Paris, France
| | - N Fakhry
- Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France; Department of Otorhinolaryngology- Head and Neck Surgery, AP-HM, Aix Marseille University, La Conception University Hospital, Marseille, France
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12
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Petrocelli M, Cutrupi S, Salzano G, Maglitto F, Salzano FA, Lechien JR, Saussez S, Boscolo-Rizzo P, De Riu G, Vaira LA. Six-month smell and taste recovery rates in coronavirus disease 2019 patients: a prospective psychophysical study. J Laryngol Otol 2021; 135:436-441. [PMID: 33888166 PMCID: PMC8111201 DOI: 10.1017/s002221512100116x] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The long-term recovery rate for coronavirus disease 2019 related chemosensory disturbances has not yet been clarified. METHODS Olfactory and gustatory functions were assessed with psychophysical tests in patients in the first seven days from coronavirus disease 2019 onset and one, two, three and six months after the first evaluation. RESULTS A total of 300 patients completed the study. The improvement in olfactory function was significant at the two-month follow up. At the end of the observation period, 27 per cent of the patients still experienced a persistent olfactory disturbance, including anosmia in 5 per cent of cases. As for taste, the improvement in the psychophysical scores was significant only between the baseline and the 30-day control. At the 6-month evaluation, 10 per cent of the patients presented with a persistent gustatory disturbance with an incidence of complete ageusia of 1 per cent. CONCLUSION Six months after the onset of coronavirus disease 2019, about 6 per cent of patients still had a severe persistent olfactory or gustatory disturbance.
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Affiliation(s)
- M Petrocelli
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, Italy
| | - S Cutrupi
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Dentistry Operative Unit, Bellaria and Maggiore Hospital, AUSL of Bologna, Italy
| | - G Salzano
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Unit, University Hospital of Naples Federico II, Italy
| | - F Maglitto
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Unit, University Hospital of Naples Federico II, Italy
| | - F A Salzano
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitan, University of Salerno, Italy
| | - J R Lechien
- Covid-19 Task Force of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - S Saussez
- Covid-19 Task Force of the Young-Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies, Paris, France
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - P Boscolo-Rizzo
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Italy
| | - G De Riu
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Department of Medical, Surgical and Experimental Sciences, Italy
| | - L A Vaira
- Italian Research Group on Chemosensory Disorders in Covid-19 Patients, Italy
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Biomedical Science Department, Biomedical Science PhD School, University of Sassari, Italy
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13
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Maniaci A, Ferlito S, Bubbico L, Ledda C, Rapisarda V, Iannella G, La Mantia I, Grillo C, Vicini C, Privitera E, Coco S, Cammaroto G, Lechien JR, Magliulo G, Pace A, Meccariello G, Cocuzza S. Comfort rules for face masks among healthcare workers during COVID-19 spread. Ann Ig 2021; 33:615-627. [PMID: 33797548 DOI: 10.7416/ai.2021.2439] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background The outbreak of Coronavirus disease 2019 (COVID-19) made imperative the use of protective devices as a source control tool. As there is no definite antiviral treatment and effective vaccine, the only efficient means of protecting and mitigating infectious contagion has been the use of personal protective equipment, especially by healthcare workers. However, masks affect the humidification process of inhaled air, possibly leading to a basal inflammatory state of the upper airways. Study design This is a single-center observational study conducted at the University Hospital of Catania from April 1, 2020, to June 31, 2020. Methods We analyzed the role of protective masks on the elimination of upper airways complaints in healthcare workers of the University Hospital of Catania. We evaluated 277 subjects through a self-administered 17 item questionnaire based on respiratory, work performance and health-related quality of life domains. Results A higher prevalence of nasal and ocular symptoms, perceived reduced work performance, difficulty in concentrating, and sleep disorders were found. After two weeks adhering to a list of good practices that we recommended, significant reversibility of the symptoms investigated and work performance enhancement were observed. Conclusions Despite clinical complaints related to personal protective equipment, effective amelioration through usage rules is easily obtained. Given the essential use of protective masks, healthcare workers have to adhere to appropriate work and safety prevention rules.
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Affiliation(s)
- A Maniaci
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - S Ferlito
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - L Bubbico
- Department of Sensorineural Disability INAPP/Italian Institute of Social Medicine, Rome, Italy
| | - C Ledda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy
| | - V Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy
| | - G Iannella
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.,Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - I La Mantia
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - C Grillo
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - C Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.,Department ENT and Audiology, University of Ferrara, Ferrara, Italy
| | - E Privitera
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - S Coco
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
| | - G Cammaroto
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - J R Lechien
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - G Magliulo
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - A Pace
- Department of Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - G Meccariello
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - S Cocuzza
- Department of Medical and Surgical Sciences and Advanced Technologies "GF Ingrassia," ENT Section, University of Catania, Catania, Italy
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14
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Hopkins C, Surda P, Vaira LA, Lechien JR, Safarian M, Saussez S, Kumar N. Six month follow-up of self-reported loss of smell during the COVID-19 pandemic. Rhinology 2021; 59:26-31. [PMID: 33320115 DOI: 10.4193/rhin20.544] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Loss of smell and taste is now recognised as amongst the most common symptoms of COVID-19 and the best predictor of COVID-19 positivity. Long term outcomes are unknown. This study aims to investigate recovery of loss of smell and the prevalence of parosmia. METHODOLOGY 6-month follow-up of respondents to an online surgery who self-reported loss of smell at the onset of the CO- VID-19 pandemic in the UK. Information of additional symptoms, recovery of loss of smell and the development of parosmia was collected. RESULTS 44% of respondents reported at least one other ongoing symptom at 6 months, of which fatigue (n=106) was the most prevalent. There was a significant improvement in self-rating of severity of olfactory loss where 177 patients stated they had a normal smell of smell while 12 patients reported complete loss of smell. The prevalence of parosmia is 43.1% with median interval of 2.5 months (range 0-6) from the onset of loss of smell. CONCLUSIONS While many patients recover quickly, some experience long-term deficits with no self-reported improvement at 6 months. Furthermore, there is a high prevalence of parosmia even in those who report at least some recovery of olfactory func- tion. Longer term evaluation of recovery is required.
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Affiliation(s)
| | - P Surda
- Guy’s Hospital, London, UK
| | | | | | | | | | - N Kumar
- Wrightington, Wigan and Leigh Teaching NHS FT, UK
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15
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Vaira LA, Hopkins C, Petrocelli M, Lechien JR, Cutrupi S, Salzano G, Chiesa-Estomba CM, Saussez S, De Riu G. Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients. Rhinology 2021; 59:21-25. [PMID: 33290446 DOI: 10.4193/rhin20.515] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The growing number of COVID-19 patients with long-lasting olfactory disorders makes it necessary to identify ef- fective treatments that enhance the spontaneous recovery of olfactory function. METHODS Multicentre randomised case-control study that involved 18 patients with COVID-19 related anosmia or severe hyposmia for more than 30 days. Nine patients were prescribed systemic prednisone and nasal irrigation with betamethasone, ambroxol and rinazine for 15 days. The other 9, untreated, patients were used as controls. The olfactory function was evaluated with CCCRC test at 20 and 40 days from the first evaluation. RESULTS In the control group, a median olfactory score of 20 (IQR 30) was detected at baseline. At the 20-day control there was no significant improvement in olfactory function. The improvement in olfactory performance became significant at the 40-day follow-up compared to baseline scores [60 (IQR 60) versus 20 (IQR 30)]. In the treatment group, patients had a mean olfactory score of 10 (IQR 15) at initial control. At the 20-day control, a significant im-provement in the olfactory scores, compared to the baseline, was detected [70 (IQR 40) versus 10 (IQR 15)]. Olfactory function further improved at 40 days [median score 90 (IQR 50)]. Patients in the treatment group reported significantly higher improvements of the olfactory scores than the controls at both the 20-day [40 (IQR 45) versus 10 (IQR 15)] and 40-day [60 (IQR 40) versus 30 (IQR 25)] evaluations. CONCLUSIONS Based on the results of this study, the mix of drugs including steroids could represent a useful specific therapy to reduce the prevalence of this long-term morbidity.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Sassari, Italy; Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - C Hopkins
- King's College, London, United Kingdom
| | - M Petrocelli
- Maxillofacial Surgery Operative Unit; Bellaria and Maggiore Hospital, AUSL Bologna, Italy
| | - J R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO- IFOS); Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - S Cutrupi
- Dentistry Operative Unit of Bellaria Hospital - AUSL of Bologna, Italy
| | - G Salzano
- Maxillofacial Surgery Unit, University Hospital of Naples "Federico II" Naples, Italy
| | - C M Chiesa-Estomba
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO- IFOS); Osakidetza, Donostia University Hospital, Department of Otorhinolaryngology. Biodonostia Health Research Institute, San Sebastian, Spain
| | - S Saussez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO- IFOS); Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - G De Riu
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Sassari, Italy
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16
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Vaira LA, Hopkins C, Sandison A, Manca A, Machouchas N, Turilli D, Lechien JR, Barillari MR, Salzano G, Cossu A, Saussez S, De Riu G. Olfactory epithelium histopathological findings in long-term coronavirus disease 2019 related anosmia. J Laryngol Otol 2020; 134:1123-1127. [PMID: 33190655 PMCID: PMC7729153 DOI: 10.1017/s0022215120002455] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Olfactory dysfunction represents one of the most frequent symptoms of coronavirus disease 2019, affecting about 70 per cent of patients. However, the pathogenesis of the olfactory dysfunction in coronavirus disease 2019 has not yet been elucidated. CASE REPORT This report presents the radiological and histopathological findings of a patient who presented with anosmia persisting for more than three months after infection with severe acute respiratory syndrome coronavirus-2. CONCLUSION The biopsy demonstrated significant disruption of the olfactory epithelium. This shifts the focus away from invasion of the olfactory bulb and encourages further studies of treatments targeted at the surface epithelium.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
- Biomedical Science Department, University of Sassari, Italy
| | - C Hopkins
- Department of ENT, King's College, London, UK
| | - A Sandison
- Department of Histopathology, Charing Cross Hospital and Imperial College Healthcare NHS Trust, London, UK
| | - A Manca
- Histopathology Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - N Machouchas
- Otorhinolaryngology Operative Unit, University Hospital of Sassari, Italy
| | - D Turilli
- Radiology Operative Unit, University Hospital of Sassari, Italy
| | - J R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (‘YO-IFOS’), Belgium
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (‘UMons’), Belgium
| | - M R Barillari
- Department of Mental and Physical Health and Preventive Medicine, Luigi Vanvitelli University, Naples, Italy
| | - G Salzano
- Maxillofacial Surgery Unit, University Hospital of Naples ‘Federico II’, Italy
| | - A Cossu
- Histopathology Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Italy
| | - S Saussez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (‘YO-IFOS’), Belgium
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (‘UMons’), Belgium
| | - G De Riu
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
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17
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Lechien JR, Hopkins C, Saussez S. Sniffing out the evidence; It's now time for public health bodies recognize the link between COVID-19 and smell and taste disturbance. Rhinology 2020; 58:402-403. [PMID: 32352450 DOI: 10.4193/rhin20.159] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Since the outbreak of the pandemic, anecdotal observations have been accumulating rapidly that sudden anosmia and dysgeusia are peculiar symptoms associated with the COVID-19 infection. Prof C. Hopkins, as President of British Rhinological Society, published a letter describing "the loss of sense of smell as a marker of COVID-19 infection" and proposed that adults presenting with anosmia but no other symptoms should self-isolate for seven days. The Hopkins team published the first case report and case series as well as other evidence that isolated sudden onset anosmia (ISOA), should be considered highly suspicious for SARS-CoV-2(1). Subsequently, a larger series of 2428 patients presenting with new onset anosmia during the COVID-19 pandemic has been reported, of whom 16% report loss of sense of smell as an isolated symptom. Only 51% reported the recognized symptoms of cough or fever. A major limitation of this series however, was a lack of access to testing to confirm the COVID-19 status of the patients(2); in the 80 who had been tested 74% were positive. In the same way, the American Academy of Otolaryngology-head and neck surgery (AA0-HNS) proposed "that anosmia could be added to the list of screening tools for possible COVID-19 infection. More, they warrant serious consideration for self-isolation and testing those patients".
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Affiliation(s)
- J R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS); Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - C Hopkins
- Guys and St Thomas NHS Foundation Trust, London, UK
| | - S Saussez
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Universite Libre de Bruxelles, Brussels, Belgium
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18
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Chiesa-Estomba CM, Lechien JR, Radulesco T, Michel J, Sowerby LJ, Hopkins C, Saussez S. Patterns of smell recovery in 751 patients affected by the COVID-19 outbreak. Eur J Neurol 2020; 27:2318-2321. [PMID: 32677329 PMCID: PMC7405216 DOI: 10.1111/ene.14440] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 07/10/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Post-viral olfactory dysfunction is well established and has been shown to be a key symptom of COVID-19 with more than 66% of European and US patients reporting some degree of loss of smell. Persistent olfactory dysfunction appears to be commonplace and will drive the demand for general practitioner, otolaryngology or neurology consultation in the next few months - evidence regarding recovery will be essential in counselling our patients. METHODS This was a prospective survey-based data collection and telemedicine follow-up. RESULTS In total, 751 patients completed the study, of whom 477 were females and 274 males. The mean age of the patients was 41 ± 13 years (range 18-60). There were 621 patients (83%) who subjectively reported a total loss of smell and 130 (17%) a partial loss. After a mean follow-up of 47 ± 7 days (range 30-71) from the first consultation, 277 (37%) patients still reported a persistent subjective loss of smell, 107 (14%) reported partial recovery and 367 (49%) reported complete recovery. The mean duration of the olfactory dysfunction was 10 ± 6 days (range 3-31) in those patients who completely recovered and 12 ± 8 days (range 7-35) in those patients who partially recovered. CONCLUSIONS According to our results, at this relatively early point in the pandemic, subjective patterns of recovery of olfactory dysfunction in COVID-19 patients are valuable for our patients, for hypothesis generation and for treatment development.
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Affiliation(s)
- C M Chiesa-Estomba
- COVID-19 Task Force of the Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology - Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain
| | - J R Lechien
- COVID-19 Task Force of the Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otolaryngology - Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - T Radulesco
- COVID-19 Task Force of the Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Oto-Rhino-Laryngology Head and Neck Surgery, Aix Marseille Univ, APHM, IUSTI, La Conception University Hospital, Marseille, France
| | - J Michel
- COVID-19 Task Force of the Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | - L J Sowerby
- COVID-19 Task Force of the Young Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otolaryngology - Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada
| | | | - S Saussez
- Department of Otorhinolaryngology - Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain.,Department of Otolaryngology - Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Head and Neck Surgery, EpiCURA Hospital, Hornu, Belgium
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19
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Vaira LA, Hopkins C, Petrocelli M, Lechien JR, Chiesa-Estomba CM, Salzano G, Cucurullo M, Salzano FA, Saussez S, Boscolo-Rizzo P, Biglioli F, De Riu G. Smell and taste recovery in coronavirus disease 2019 patients: a 60-day objective and prospective study. J Laryngol Otol 2020; 134:703-709. [PMID: 32782030 PMCID: PMC7471571 DOI: 10.1017/s0022215120001826] [Citation(s) in RCA: 127] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND The long-term recovery rate of chemosensitive functions in coronavirus disease 2019 patients has not yet been determined. METHOD A multicentre prospective study on 138 coronavirus disease 2019 patients was conducted. Olfactory and gustatory functions were prospectively evaluated for 60 days. RESULTS Within the first 4 days of coronavirus disease 2019, 84.8 per cent of patients had chemosensitive dysfunction that gradually improved over the observation period. The most significant increase in chemosensitive scores occurred in the first 10 days for taste and between 10 and 20 days for smell. At the end of the observation period (60 days after symptom onset), 7.2 per cent of the patients still had severe dysfunctions. The risk of developing a long-lasting disorder becomes significant at 10 days for taste (odds ratio = 40.2, 95 per cent confidence interval = 2.204-733.2, p = 0.013) and 20 days for smell (odds ratio = 58.5, 95 per cent confidence interval = 3.278-1043.5, p = 0.005). CONCLUSION Chemosensitive disturbances persisted in 7.2 per cent of patients 60 days after clinical onset. Specific therapies should be initiated in patients with severe olfactory and gustatory disturbances 20 days after disease onset.
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Affiliation(s)
- L A Vaira
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
| | - C Hopkins
- ENT Department, King's College, London, UK
| | - M Petrocelli
- Maxillofacial Surgery Operative Unit, Bellaria-Maggiore Hospital, Un'azienda Sanitaria Locale (‘AUSL’) Bologna, Italy
| | - J R Lechien
- COVID-19 Task Force of the Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (‘YO-IFOS’)
- Department of Human and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (‘UMons’), Belgium
| | - C M Chiesa-Estomba
- COVID-19 Task Force of the Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (‘YO-IFOS’)
- Department of Otorhinolaryngology, Osakidetza, Donostia University Hospital, Biodonostia Health Research Institute, San Sebastian, Spain
| | - G Salzano
- Maxillofacial Surgery Unit, University Hospital of Naples ‘Federico II’, Italy
| | - M Cucurullo
- Maxillofacial Surgery Department, San Paolo Hospital, Azienda Socio Sanitaria Territoriale (‘ASST’) Santi Paolo e Carlo, University of Milan, Italy
| | - F A Salzano
- Otolaryngology Operative Unit, Department of Medicine, Surgery and Dentistry, ‘Scuola Medica Salernitana’, University of Salerno, Italy
| | - S Saussez
- COVID-19 Task Force of the Young Otolaryngologists of the International Federation of Oto-rhino-laryngological Societies (‘YO-IFOS’)
| | - P Boscolo-Rizzo
- Department of Neurosciences, Section of Otolaryngology, University of Padua, Treviso, Italy
| | - F Biglioli
- Maxillofacial Surgery Department, San Paolo Hospital, Azienda Socio Sanitaria Territoriale (‘ASST’) Santi Paolo e Carlo, University of Milan, Italy
| | - G De Riu
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Italy
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20
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Lechien JR, Hopkins C, Saussez S. Letter to the Editor about the Beltrán-Corbellini et al. publication: 'Acute-onset smell and taste disorders in the context of Covid-19: a pilot multicenter PCR-based case-control study' (Eur J Neurol 2020. doi: 10.1111/ene.14273). Eur J Neurol 2020; 27:e33. [PMID: 32443166 PMCID: PMC7280577 DOI: 10.1111/ene.14357] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 05/07/2020] [Indexed: 12/24/2022]
Affiliation(s)
- J R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,Department of Surgery, School of Medicine, UFR Simone Veil, Foch Hospital, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - C Hopkins
- Guy's and St Thomas NHS Foundation Trust, London, UK
| | - S Saussez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS), Paris, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
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21
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Coppée F, Lechien JR, Declèves AE, Tafforeau L, Saussez S. Severe acute respiratory syndrome coronavirus 2: virus mutations in specific European populations. New Microbes New Infect 2020; 36:100696. [PMID: 32509310 PMCID: PMC7238997 DOI: 10.1016/j.nmni.2020.100696] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 12/28/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is being intensively studied, particularly its evolution, in the increasingly available sequences between countries/continents with classical phylogenetic tree representation. More recently, certain protein mutations have been correlated with specific functional impacts. Our clinical data from patients suggest that clinical symptoms differ between European countries. Among other factors, SARS-CoV-2 mutations could explain these disparities. Our analyses point to an association of diverse mutations, including co-evolving ones, in a few SARS-CoV-2 proteins within specific countries. We therefore suggest combining clinical information from patients and the determination of the associated SARS-CoV-2 genome to better understand the specific symptoms.
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Affiliation(s)
- F Coppée
- Department of Metabolic and Molecular Biochemistry, Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - J R Lechien
- Department of Human Anatomy and Experimental Oncology, Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - A-E Declèves
- Department of Metabolic and Molecular Biochemistry, Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - L Tafforeau
- Department of Cell Biology, Research Institute for Health Sciences and Technology, University of Mons, Belgium
| | - S Saussez
- Department of Human Anatomy and Experimental Oncology, Research Institute for Health Sciences and Technology, University of Mons, Belgium
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22
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Yanni A, Dequanter D, Lechien JR, Loeb I, Rodriguez A, Javadian R, Van Gossum M. Malnutrition in head and neck cancer patients: Impacts and indications of a prophylactic percutaneous endoscopic gastrostomy. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:S27-S33. [PMID: 30846293 DOI: 10.1016/j.anorl.2019.01.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 11/12/2018] [Accepted: 01/11/2019] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Head and neck cancer (HNC) patients often experience malnutrition before and during treatment. Prophylactic gastrostomy has emerged as an efficient tool for ensuring adequate nutrition. However, there is no suitable algorithm able to identify patients at high risk of malnutrition. The aim of this study was to describe the nutritional management, to assess the impact of prophylactic gastrostomy, and to identify predictors of malnutrition. METHODS This retrospective study included 152 patients treated with surgery, radiotherapy, or chemotherapy for HNC. The patients were classified according to their gastrostomy status (prophylactic or non-prophylactic). Nutritional, tumoral and treatment characteristics were reported. Clinical and nutritional outcomes were measured 6 weeks after the beginning of treatment. In order to describe the nutritional management and the impact of prophylactic gastrostomy on patients, univariate analysis was generated using chi-square test and Mann-Whitney test or Student's t-test. Logistic regression was performed to identify factors associated with malnutrition. RESULTS Forty-one patients received prophylactic gastrostomy whereas 111 patients had no nutritional support. Prophylactic gastrostomy placement was associated with a lower initial body mass index, with severe malnutrition, and with initial oral intake disorder. Patients who did not experienced prophylactic gastrostomy had much worse outcomes such as hospital readmissions (P=0.042), relative weight loss at 6 weeks (P<0.0001), dysphagia, severe malnutrition, and poor state of health (P=0.001). Our complication rates (4.9%) were lower than the usual range (5.9-9.3%) and no life-threatening complication was reported. Positive N status, oral intake disorder, concomitant radiochemotherapy, nasopharyngeal, and hypopharyngeal tumor site were significant predictive factors for malnutrition. CONCLUSIONS Prophylactic percutaneous endoscopic gastrostomy showed advantages in terms of hospital readmissions, relative weight loss at 6 weeks, dysphagia, severe malnutrition, and poor state of health. Tumoral, nutritional and treatment characteristics seem to be predictors for malnutrition. Hence, physicians should integrate these factors in their nutrition algorithm approach.
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Affiliation(s)
- A Yanni
- Department of Stomatology and maxillofacial surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
| | - D Dequanter
- Department of Stomatology and maxillofacial surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium; Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
| | - J R Lechien
- Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium; Laboratory of Anatomy and Cell Biology, Department of Anatomy and Experimental Oncology, Faculty of Medicine, Mons School of Medicine, University of Mons (UMons), UMONS Research Institute for Health Sciences and Technology, Avenue du Champ-de-Mars, 6, 7000 Mons, Belgium.
| | - I Loeb
- Department of Stomatology and maxillofacial surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
| | - A Rodriguez
- Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
| | - R Javadian
- Department of Stomatology and maxillofacial surgery, School of Medicine, Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
| | - M Van Gossum
- Department of gastroenterology, School of Medicine, université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
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23
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Ayad T, Stephenson K, A L Smit D, Ben-Ari O, Késmárszky R, Lechien JR, Sobol S, Meller C, Sargi Z, Maunsell R, De Siati RD, Jia H, Krishnan V, North H, Eter EG, Metwaly O, Peer S, Teissier N, Sowerby L, Hong P, Fakhry N. Young Otolaryngologists of International Federation of Oto-rhino-laryngological Societies (YO-IFOS) committees. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S61-S65. [PMID: 30174261 DOI: 10.1016/j.anorl.2018.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- T Ayad
- Centre Hospitalier de l'Université de Montréal, Montreal, Canada.
| | - K Stephenson
- Birmingham Children's Hospital, Birmingham, United Kingdom
| | - D A L Smit
- University Medical Centre Utrecht, Utrecht, The Netherlands
| | - O Ben-Ari
- Tel Aviv Sourasky Medical Center, affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - J R Lechien
- Centre Hospitalier Universitaire de Bruxelles, Site Saint-Pierre, Bruxelles, Belgium
| | - S Sobol
- University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA
| | - C Meller
- Prince of Wales and Sydney Hospitals, Sydney, Australia
| | - Z Sargi
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, Fl, USA
| | - R Maunsell
- Setor de Otorrinolaringologia Pediátrica, FCM-UNICAMP, Campinas, Brazil
| | - R D De Siati
- Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - H Jia
- Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - V Krishnan
- Madras ENT Research Foundation, Raja Annamalaipuram, Chennai, India
| | - H North
- Westmead Hospital, Sydney, Australia
| | - E G Eter
- Saint joseph University, School of Medecine, Beirut, Lebanon
| | - O Metwaly
- Kasr Alainy School of Medicine, Cairo University, Cairo, Egypt
| | - S Peer
- Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | | | - L Sowerby
- St. Joseph's Healthcare, Western University, London, Canada
| | - P Hong
- IWK Health Centre, Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, Nova Scotia
| | - N Fakhry
- Hôpital de la Conception, Marseille, France
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24
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Fournier I, Fakhry N, Kennel T, Tessier N, Bahgat A, Lechien JR, Ayad T. Challenges faced by young otolaryngologists-head & neck surgeons around the world. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:S67-S73. [PMID: 30170973 DOI: 10.1016/j.anorl.2018.06.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/16/2018] [Accepted: 06/22/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To document work-related stressors and to identify coping strategies employed by young board-certified otolaryngologists-head & neck surgeons (OTL-HNS) around the world. The second objective is to evaluate demographic and professional characteristics associated with a higher level of work-related stress. METHODS A survey was sent to all OTL-HNS under 45 years old from the 2017 IFOS meeting. This survey was conducted by the YO-IFOS group (Young Otolaryngologists of the International Federation of Otolaryngological Societies). Data were collected for a period of 1 month. Demographic characteristics and information concerning challenges encountered by OTL-HNS during the early years of their career were collected. RESULTS Among the 2787 attendees, 928 responded to the survey (response rate=33.3%). The three most frequent challenges faced by OTL-HNS in the early years of their career were related to administrative workload (45%), high patient quota (42%) and desire to achieve adequate work-life balance (42%). Practices used by OTL-HNS to cope with stress were physical activity (37%), recreational activities (35%) and self-organization (32%). Higher levels of stress were frequently found in participants who possessed five to ten years of experience (P=0.007) and who were employed by an academic institution (P=0.020). On the other hand, lower levels of stress were often encountered in participants who had 5 years or less of experience (P=0.002). CONCLUSION This study provides insight on characteristics that are associated with various levels of stress. Moreover, it demonstrates the work-related stressors and the resilience techniques employed by OTL-HNS in early years of their career. Stress will always be present during the surgeon's career. Therefore, knowing how to recognize it and how to deal with it is key. More resources should be made available for OTL-HNS needing aid. Because surgeons must be in control of their stress if they want to provide high quality health care.
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Affiliation(s)
- I Fournier
- School of medicine, université de Montréal, Montreal, Canada
| | - N Fakhry
- Hôpital de la Conception, 13005 Marseille, France
| | - T Kennel
- Hôpital universitaire Gui-de-Chauliac, université de Montpellier, CHRU de Montpellier, 34295 Montpellier, France
| | - N Tessier
- Hôpital Robert-Debré, 75019 Paris, France
| | - A Bahgat
- Lecturer of otorhinolaryngology and consultant of sleep surgery, Alexandria university, Alexandria, Egypt
| | - J R Lechien
- School of medicine, université de Mons, Mons, Belgium
| | - T Ayad
- Centre hospitalier de l'université de Montréal, Montreal, Canada.
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25
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Fournier I, Stephenson K, Fakhry N, Jia H, Sampathkumar R, Lechien JR, Melkane AE, Bahgat AY, De Carvalho Lopes K, Kennel T, Teissier N, Ayad T. Barriers to research among residents in Otolaryngology - Head & Neck Surgery around the world. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 136:S3-S7. [PMID: 30143399 DOI: 10.1016/j.anorl.2018.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/16/2018] [Accepted: 06/22/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To document the challenges faced by residents in Otolaryngology - Head & Neck Surgery (OTL-HNS) around the world to successfully complete research projects. The second objective is to assess if the challenges are uniform worldwide. METHODS A survey was sent to all OTL-HNS under 45 years old from the 2017 IFOS meeting. This survey was conducted by the YO-IFOS group (Young Otolaryngologists of the International Federation of Otolaryngological Societies). Data was collected for a period of 1 month. Demographic characteristics, information regarding research projects conducted and data concerning perceived barriers to completion of research projects were collected. RESULTS Among the 2787 attendees, 928 responded to the survey (response rate=33.3%). Of these 928 answers, 267 responses were from residents/interns in OTL-HNS, while 635 responses were from certified otolaryngologists. The three most frequent obstacles to conducting research projects for trainees were limited dedicated time (64%), insufficient financial resources (55%) and lack of education in research (45%). There was no statistical difference in these barriers among the different countries (P>0.05). CONCLUSION This is the first international study that provides insight on trainee's challenges to conduct research projects during residency. Despite the notion that research is essential for generating new knowledge to guide patient care, many residents fail to successfully incorporate research in their surgical curriculum. These obstacles must be addressed by Otolaryngology - Head & Neck Surgery programs in order to facilitate and support resident's research.
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Affiliation(s)
- I Fournier
- School of medecine, Université de Montréal, Montreal, Canada
| | - K Stephenson
- Birmingham Children's Hospital, Birmingham, United Kingdom
| | - N Fakhry
- Hôpital de la Conception, Marseille, France
| | - H Jia
- Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | | | - J R Lechien
- CHU de Bruxelles, site CHU Saint-Pierre, Brusells, Belgium
| | - A E Melkane
- Hotel-Dieu de France Hospital, Saint-Joseph University, Beirut, Lebanon
| | - A Y Bahgat
- Lecturer of Otorhinolaryngology and consultant of sleep Surgery, Alexandria University, Egypt
| | | | - T Kennel
- Université de Montpellier, hôpital universitaire Gui-de-Chauliac, CHRU de Montpellier, Montpellier, France
| | | | - T Ayad
- Centre hospitalier de l'université de Montréal, Montreal, Canada.
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Lechien JR, Doyen J, Deleuze M, Khalife M, Saussez S. Giant metastasis invading pharyngeal wall, pterygomaxillary space, submaxillary and parotid glands. Rev Laryngol Otol Rhinol (Bord) 2015; 136:167-168. [PMID: 29400040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
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27
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Lechien JR, Brotchi J, Van Maldergem L, Costa de Araujo P, Bruninx G, Hilbert P, Nubourgh Y. Li-Fraumeni syndrome: multiple distinct brain tumours in two brothers. Neurochirurgie 2014; 60:51-4. [PMID: 24636404 DOI: 10.1016/j.neuchi.2013.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/21/2013] [Accepted: 11/13/2013] [Indexed: 11/16/2022]
Abstract
Li-Fraumeni syndrome is a rare autosomal dominant cancer-prone condition characterized by the occurrence of a large set of different types of cancer in a patient and their family. A germline disease-causing mutation of the gene encoding the p53 protein is associated with the syndrome. We report on a family in which segregation of a TP53 mutation in two generations was associated with two brain tumours, a leiomyosarcoma and a thyroid carcinoma in four male patients. The main patient presented with seizures revealing several primary brain tumours. We review recent views on its molecular basis and discuss management of the condition as well as a review of the literature.
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Affiliation(s)
- J R Lechien
- Department of Anatomy, Faculty of Medicine, University of Mons, avenue du Champ-de-Mars, 6, 7000 Mons, Belgium.
| | - J Brotchi
- Department of Neurosurgery, Erasme Hospital, Université Libre de Bruxelles, Bruxelles, Belgium
| | | | - P Costa de Araujo
- Department of Anatomy, Faculty of Medicine, University of Mons, avenue du Champ-de-Mars, 6, 7000 Mons, Belgium
| | - G Bruninx
- Department of Radiology, CHU Charleroi, Université Libre de Bruxelles, Bruxelles, Belgium
| | - P Hilbert
- Institute of Pathology and Genetics, avenue Georges-Lemaître, 25, 6041 Gosselies, Belgium
| | - Y Nubourgh
- Department of Neurosurgery, CHU Charleroi, Université Libre de Bruxelles, Bruxelles, Belgium
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Lechien JR, Khalife M, Delvaux V, Huet K, Piccaluga M, Costa de Araujo P, Harmegnies B, Saussez S. [Pathophysiology, assessment and treatment of laryngopharyngeal reflux]. Rev Laryngol Otol Rhinol (Bord) 2014; 135:163-170. [PMID: 26521362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Laryngopharyngeal reflux is a prevalent, yet incompletely understood, ENT disorder accounting for 8 to 10% of patients consulting ENT. This clinical entity, increasingly considered as different from gastroesophageal reflux disease, may greatly affect the quality of life of patients through vocal and digestive symptoms. Debate persists concerning pathophysiology, diagnosis, and treatment. The aim of this review is to study the current literature about the pathophysiology, diagnosis, treatment, and the outcomes in the follow-up.
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Lechien JR, Delvaux V, Huet K, Khalife M, Piccaluga M, Harmegnies B, Saussez S. [Transgender voice and communication treatment: Review of the literature]. Rev Laryngol Otol Rhinol (Bord) 2014; 135:97-103. [PMID: 26521349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Transgender persons constitute a small but growing population in ENT department: as a matter of fact, many voice parameters significantly contribute to the perception of gender (fundamental frequency, supraglottic resonance patterns, etc.). The persons involved in transition processes may therefore aim at changing their own voice properties, either by means of speech therapy or by medical intervention (hormonotherapy and/or surgery). The current voice assessment and outcome measures for this population before and after treatment are nevertheless still lacking validity. A well-accepted general framework including self-perception, subjective assessment of the practitioner and objective measures is not well documented. This review is therefore meant as a contribution to the development of a state of the art in the field.
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Lechien JR, Kindt N, Costa PDA, Chantrain G, Preillon J, Laurent G, Saussez S. [MIF in head and neck cancer: a new therapeutic target ?]. Rev Laryngol Otol Rhinol (Bord) 2013; 134:67-74. [PMID: 24683815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Macrophage migration inhibitory factor is a critical proinflammatory cytokine produced by cells of innate and adaptive immune system. MIF plays a key role in cell cycle regulation and in the pathogenesis of many cancers. Recently, MIF has been studied in the upper aerodigestive tract cancer for its involvement in tumor progression, invasion, proliferation and cell motility. In addition, MIF appears to be a mediator in angiogenesis and in the development of metastasis and locoregional lymph node, which are often associated with a poor prognosis. The mechanisms of action responsible for MIF involvement in tumor progression are not completely elucidated. However, the main effects of MIF are mediated by the CD74 receptor. MIF binding to its receptor is responsible for the activation of several signaling pathways (ERK1/2 - MAPK, JAB1 - CSN5, PI3K - Akt), the inhibition of p53 and the stimulation of angiogenic factors including VEGF and IL-8. The overexpression of MIF also causes a reduction of the anti-tumor activity of the immune system. Finally, MIF could be an interesting biomarker in the diagnosis and monitoring of upper aerodigestive tract cancers. In this paper, we assess the state of knowledge of MIF involvement in upper aero-digestive tract cancers and we analyze the therapeutic perspectives.
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