Biomedical subjects

T Hummel

Publications and source records attributed to T Hummel.

At least 37 records · Page 2Linked to original sources

PubMed2005

[Olfactory dysfunction due to nasal sinus disease. Causes, consequences, epidemiology, and therapy].

Olfaction not only contributes to our quality of life but, among other functions, it is also necessary for identifying potential dangers, e.g., fire or spoilt food. In general the value of olfaction is only recognized when the sense of smell is impaired or lost. Olfactory dysfunction is diagnosed according to its cause (e.g., sinonasal, post-traumatic, post-upper respiratory tract infection, neurodegenerative, and idiopathic). At present little is known about prognostic factors for predicting resolution of olfactory loss on an individual basis. In cases of impaired olfaction due to sinonasal disease, both conservative and operative treatments have been established. Corticoids are used both topically and systemically. In cases of severe mechanical obstructions or advanced stages of nasal polyposis, FESS (functional endoscopic sinus surgery) seems to be the state of the art.

Causality↗

PubMed2005

Gustatory function in chronic inflammatory middle ear diseases.

HYPOTHESIS: Changes of gustatory function after ear surgery have been studied extensively. However, little is known on the influence of repeated/chronic inflammation within the middle ear on taste. STUDY DESIGN: Prospective study. MATERIALS AND METHODS: Forty-six patients suffering from either cholesteatoma (n = 25) or chronic otitis media mesotympanalis (n = 21) received quantitative gustatory tests. None of these patients had been operated on before these investigations. RESULTS: Side by side comparison showed a significantly lower taste function on the anterior two thirds of the tongue ipsilateral to the site of inflammation, regardless of the diagnosis. Further analyses exhibited a trend toward greater impairment in relation to the severity of the inflammatory process. CONCLUSION: These data are proof that taste function changes in relation to chronic middle ear diseases. It further shows that many of these alterations go unnoticed by the patients.

Cholesteatoma, Middle Ear↗

PubMed2005

Zinc gluconate in the treatment of dysgeusia--a randomized clinical trial.

In the treatment of dysgeusia, the use of zinc has been frequently tried, with equivocal results. The aim of the present randomized clinical trial, which involved a sufficiently large sample, was therefore to determine the efficacy of zinc treatment. Fifty patients with idiopathic dysgeusia were carefully selected. Zinc gluconate (140 mg/day; n=26) or placebo (lactose; n=24) was randomly assigned to the patients. The patients on zinc improved in terms of gustatory function (p <0.001) and rated the dysgeusia as being less severe (p <0.05). Similarly, signs of depression in the zinc group were less severe (Beck Depression Inventory, p <0.05; mood scale, p <0.05). With the exception of the salivary calcium level, which was higher in the zinc patients (p <0.05), no other significant group differences were found. In conclusion, zinc appears to improve general gustatory function and, consequently, general mood scores in dysgeusia patients.

Adult↗

PubMed2004

Recording of the human electro-olfactogram.

Electro-olfactograms (EOG) are electrical potentials of the olfactory epithelium that occur in response to olfactory stimulation. The EOG represents the sum of generator potentials of olfactory receptor neurons. While this response has been used extensively in animal research, there are only a handful of papers describing the properties of the human EOG. In addition to a discussion of methodological issues related to the EOG, this review summarizes the characteristics and uses of these recordings. Among other results, EOGs have been used to provide evidence for the dominant role of the central nervous system in olfactory desensitization, for the functional characterization of the olfactory epithelium, the specific topographical distribution of olfactory receptors, or the expression of olfactory receptor neurons in response to exposure to odorants, and the characterization of certain odorants as olfactory receptor antagonists. In conclusion, in combination with nasal endoscopy and air-dilution olfactometry, the EOG is a unique part of a large array of techniques used to provide a complete picture of the processing of olfactory information in humans.

Animals↗

PubMed2004

Olfactory function in patients with idiopathic Parkinson's disease: effects of deep brain stimulation in the subthalamic nucleus.

Decrease of olfactory function in patients with Parkinson's disease (PD) is a well-investigated fact. The present study aimed to investigate olfaction in PD patients with a specific focus on the effects of deep brain stimulation in the subthalamic nucleus. Eleven patients (age 42-67 years) participated in this study. Using the "Sniffin' Sticks", olfactory function was assessed based on butanol odor thresholds and the patients' ability to discriminate odors. Measures were taken with the stimulator being switched ON and OFF, respectively. While deep brain stimulation had no effect on odor thresholds, in hyposmic PD patients odor discrimination was found to be significantly higher during the ON period. This may indicate that deep brain stimulation has a positive effect on the cognitive processing of olfactory information in PD patients.

Adult↗

PubMed2004

Laparoscopic needle catheter jejunostomy: modification of the technique and outcome results.

BACKGROUND: We describe a modification of the technique for laparoscopic jejunostomy in patients with stenosis of the upper gastrointestinal tract and assess the patients outcomes with this enteral access. METHODS: In a retrospective study of 80 patients, we evaluated the outcome of a modified technique for the laparoscopic placement of a jejunostomy catheter into the proximal jejunum. Standard laparoscopy equipment and ready-to-use jejunostomy catheters were used. After the creation of a pneumoperitoneum, the proximal jejunal loop was fixed to the parietal peritoneum. The jejunum was then punctured with a split needle, and the catheter (9F) was pushed into the jejunum. Finally, the catheter was secured with an additional purse-string suture. The external fixation was performed with nonabsorbable sutures. Enteral nutritional support with a polymeric enteral diet was initiated after fluoroscopic control on the first postoperative day at a rate of 20 ml/h. The flow rate was increased progressively until the nutritional goal of 60-80 ml/h was reached on the 3rd or 4th postoperative day. RESULTS: In all patients (n = 80), the placement site of the catheter was correct, and all patients were able to receive enteral nutrition on the 1st postoperative day. There were no intraoperative complications. The mean operating time was 51 min. Two patients developed a localized infection at the catheter site; one patient developed an abscess; and three patients had catheter obstructions. CONCLUSIONS: Patients in need of intermediate or long-term enteral nutrition may benefit from laparoscopic catheter jejunostomy. The technique described is safe, effective, and less invasive than alternative techniques of laparoscopic jejunostomy.

Aged↗

PubMed2004

[Olfactory dysfunctions. Epidemiology and therapy in Germany, Austria and Switzerland].

INTRODUCTION: Olfactory dysfunction has been reported to affect more than 200,000 patients a year in the USA. The aim of this survey was to obtain comparable epidemiological data and treatment information on olfactory dysfunction in German speaking countries. METHODS: Questionnaires were sent to all otorhinolaryngology departments in Germany, Austria and Switzerland; 52% of hospitals completed the survey. RESULTS: An average of 46 patients with olfactory dysfunction were treated per hospital every month. Hyp- and anosmia were most commonly caused by inflammatory diseases of the nose/paranasal sinuses (53%), respiratory dysfunction (19%), or postviral conditions (11%). Steroids were used most frequently for pharmacological treatment (topically 82%; orally 65%). Approximately one third of the clinics used B vitamins, or zinc; 80% of the hospitals performed surgery to treat underlying diseases. Acupuncture and smell training was used by approximately 20%. CONCLUSION: A total of 79,000 patients per year are treated for olfactory dysfunction in German hospitals. The vast majority of these disorders (72%) is caused by sinunasal diseases. The quality control of therapeutic strategies is urgently needed.

Austria↗

PubMed2004

[Olfactory dysfunction. Epidemiology, pathophsiological classification, diagnosis and therapy].

The present manuscript is the result of a collaborative effort within the framework of the Working Group of Olfactology and Gustology of the German Society for ENT, Head and Neck Surgery. It provides a comprehensive overview about the current views on the epidemiology, terminology, diagnostics, and therapy of olfactory dysfunction, and aims to offer a framework for the standardized procedures for the diagnosis and therapy of olfactory disorders.

Algorithms↗

PubMed2004

[A rare case of a neuroendocrine carcinoma of the esophagus. Intermediate between a well-differentiated neuroendocrine carcinoma and a low-differentiated neuroendocrine carcinoma].

We report a rare case of a neuroendocrine carcinoma located in the esophagus of a 62-year-old male patient. The initial diagnosis of a "small-cell tumor" was based on biopsy. Our diagnosis was based on the histomorphological examination of the resected material. Diagnostic criteria were the characteristic solid or clustered growth patterns, monomorphic cell nuclei, lack of necrosis, immunohistochemical detection of neuroendocrine markers like chromogranin, synaptophysin and neuron-specific enolase (NSE) as well as detection of cytoplasmic neuroendocrine granules by electron microscopy. In addition, we found an increased prolific activity by staining with Ki67 antigen. 30% of the cell nuclei displayed a positive reaction. Focal invasion of blood vessels was also detected. With 17 different chromosomal imbalances, comparative genomic hybridization (CGH) revealed a malignant tumor stage that was not visible at the microscopic level. According to the new WHO classification of neuroendocrine tumors the described tumor was identified as an intermediate between a well-differentiated neuroendocrine carcinoma and a low-differentiated neuroendocrine carcinoma.

Biomarkers↗

PubMed2004

[Effects of systemic or topical administration of corticosteroids and vitamin B in patients with olfactory loss].

BACKGROUND: Aim of the present, unblinded, multicentric, open trial was to compare effects of 3 treatments in patients with olfactory dysfunction. METHODS: Treatments included administration of systemic corticosteroids (oral prednisolone), local corticosteroids (mometasone nasal spray), and systemic vitamin B, respectively. A total of 192 patients participated (95 women, 97 men; mean age 56 years). Duration of the smell loss ranged from 1 to 288 months (average 45 months). Olfactory dysfunction was due to infections of the upper respiratory tract (n = 72), sinunasal disease (n = 19), and posttraumatic olfactory loss (n = 10); the largest portion was classified as idiopathic (n = 85); other causes were rare (n = 6). RESULTS: Following systemic administration of corticosteroids improvement of olfactory function was observed (p < 0.001). Similarly, improvement of the sense of smell was found 2 (p = 0.03) and 6 months (p = 0.001) after local administration of mometasone, respectively. In contrast, after administration of vitamin B no significant change of olfactory function was seen after 2 months, while improvement was present after 6 months (p = 0.001). Duration of olfactory dysfunction had no effect on changes of smell function. CONCLUSIONS: These results indicate that improvement of olfactory function is found in olfactory dysfunction of different causes. Adequately controlled, blinded studies are needed to further explore potential effects of the various treatments.

Administration, Intranasal↗

PubMed2004

Olfactory sensitivity of subjects working in odorous environments.

The aim of the present study was to investigate whether people with a professional interest in odors also exhibit higher olfactory sensitivity. To this end, we investigated 58 subjects (age 33.6 +/- 11.0 years, mean +/- SD; 55 women) employed in perfume retail outlets and compared their olfactory sensitivity to 58 controls (age 34.6 +/- 9.9 years; 53 women) matched for age, gender and professional activities who did not work in such odorous environments. Olfactory function was assessed using the 'Sniffin' Sticks' test kit which includes tests for n-butanol odor threshold, odor discrimination and odor identification. Subjects working in perfume retail outlets scored higher in odor discrimination tests compared to controls. Working in an odorous environment for a full day had no major effect on general olfactory abilities, as indicated by measures performed at the beginning and end of a working day. Taken together, results from the present study do not support the idea that odorous environments are deleterious to general olfactory function.

Adult↗

PubMed2004

A study on the frequency of olfactory dysfunction.

OBJECTIVES/HYPOTHESIS: Goals of the study were to evaluate the frequency of olfactory dysfunction in a large representative population without sinonasal complaints and to investigate the extent to which general pathological conditions, medications, and aging influence olfaction. STUDY DESIGN: Prospective. METHODS: Results based on an odor identification test ("Sniffin' Sticks") were reported from 1240 subjects. The subjects presented themselves to an otorhinolaryngology outpatient clinic with relatively mild and transitory complaints unrelated to the upper airways. A detailed otorhinolaryngological examination in combination with a standardized interview further ascertained that these patients had no rhinological problems or symptoms relating to sinonasal disease. RESULTS: Apart from the confirmation of the effects of age, gender, and certain otorhinolaryngological diseases on the sense of smell, the study results revealed that certain general diseases (liver diseases, nonotolaryngological cancers) appear to influence olfactory function, whereas other diseases or disorders have little or no impact on olfaction (hypertension, cardiovascular problems). CONCLUSION: The data in the study revealed that olfactory dysfunction among subjects under 65 years of age is more frequent than previously reported.

Adolescent↗

PubMed2004

Assessment of olfactory function after septoplasty: a longitudinal study.

AIM: Aim of the study was to evaluate septoplasty-related changes of lateralised olfactory function during both early and late postoperative periods in comparison to the preoperative situation. MATERIAL/METHODS: Lateralised olfactory function was assessed in 30 patients using the "Sniffin' Sticks" test battery. Measurements were performed preoperatively, and 4 and 9 months postoperatively. RESULTS: Prior to septal surgery measurements revealed significantly higher odor thresholds for the obstructed nostril compared to contralateral thresholds. No such observations were made for suprathreshold measures. Postoperatively, a significant decline of odor discrimination was found in comparison to the preoperative situation. However, there was no significant change of odor thresholds and odor identification function during the 9-month postoperative follow up. On an individual basis, one of the initially normosmic patients became hyposmic following surgery. CONCLUSIONS: The present data indicate that odor thresholds, but not suprathreshold olfactory function, are related to nasal obstruction resulting from septal deviation. In contrast, postoperative changes were only seen for odor discrimination. Apart from psychological explanations of this finding, it may be hypothesized that these observations result from changes in intranasal airflow following surgery.

Adult↗

PubMed2003

Clinical presentation of qualitative olfactory dysfunction.

Many patients with olfactory dysfunction not only experience quantitative reduction of olfactory function, but also suffer from distorted olfactory sensations. This qualitative dysfunction is referred to as parosmia (also called "troposmia") or phantosmia, with the major difference that distorted olfactory sensations are experienced in the presence or absence of an odor, respectively. Our clinical observations corroborate the literature in terms of a general underestimation of the incidence of olfactory distortions. Based on selected cases we try to show that olfactory distortions exhibit a large variance in their clinical appearance. Further, emphasis is placed on the fact that only a detailed and directed history of the patient can provide cues to the correct diagnosis.

Adult↗

PubMed2003

[Central anticholinergic syndrome and apnea after general anaesthesia. A rare manifestation of the central anticholinergic syndrome].

The central anticholinergic syndrome (CAS) is a rarely observed condition after general anaesthesia. There are no definitive criteria to set the diagnosis of CAS. The syndrome may manifest in clinical neurological signs, such as hyperactive states or a depressed CNS state. The diagnosis usually depends on a process of exclusion of other conditions and is confirmed after rapid recovery following administration of physostigmine. We report on a 34-year-old patient who suddenly lost consciousness and developed respiratory arrest 1 h after general anesthesia and normal postoperative recovery. CAS was considered, although apnea has not been reported as a clinical symptom of this disease up to now and no peripheral signs of CAS were observed. After the administration of 1 mg physostigmine the symptoms resolved immediately and the patient started sufficient spontaneous breathing. However, corresponding to the plasma elimination half-life of the drug, further comatose episodes with apnea occurred. Therefore, the patient was admitted to the ICU and an infusion of physostigmin at a rate of up to 5 mg/h was started. Due to this therapy the patient's state became stable and 15 h after the first manifestation of CAS the infusion of physostigmin was discontinued. The following postoperative course was uneventful. In case of reduced vigilance with apnea after general anaesthesia, central anticholinergic syndrome should be considered. For diagnostic and therapeutic purposes the administration of physostigmine should be attempted.

Adult↗

PubMed2003

[Secondary decompression trepanation in progressive post-traumatic brain edema after primary decompressive craniotomy].

Besides evacuation of epidural or subdural hematoma, early decompressive craniectomy with duraplasty has to be performed in the neurotraumatological care of patients with moderate [Glasgow Coma Scale (GCS) score 9-12 points] or severe traumatic brain injury (TBI; GCS score </=8 points) and threatening herniation. The efficacy of secondary decompressive craniectomy and duraplasty after primary trepanation is under debate due to missing evidence of improved outcome. The objectives of this study were to register the incidence of increasing brain edema after isolated TBI and primary craniectomy, to identify possible decision criteria for secondary decompressive trepanation, and to evaluate the neurological performance 6 months after discharge with the Glasgow Outcome Score (GOS). Of 131 patients who suffered from isolated TBI and had to be primarily operated between January 1997 and December 2001, 58 (male:female = 48:10; median age of 50.9 years) were included in this analysis. In 11 patients (male:female = 9:2; median age of 40.0 years) a secondary unilateral extensive or contralateral decompressive craniectomy had to be performed in the clinical course. Four of the 11 patients (36.4%) did not survive TBI; they died at a median of 1 day after revision or 6 days after TBI, respectively. In the group of secondary decompressive craniectomy we recorded admission (80.0 min after TBI) 35 min later ( p=0.009) than in the group of primary trepanation. Prehospital otorrhagia was observed more frequently ( p=0.036). In univariate analysis, arterial hypotension ( p=0.018) and otorrhagia at admission ( p=0.035), intracranial pressure (ICP) immediately after primary operation ( p=0.024), and decrease of maximal postoperative cerebral perfusion pressure (CPP; p=0.031) below the median cutoff value of 70 mmHg correlated with the event of secondary decompression craniectomy. Multivariate analysis identified decreased maximal CPP after primary trepanation as the only independent prognostic parameter (score 10.496; df=1; p=0.043) for the necessity of secondary trepanation and unfavorable GOS 6 months after discharge. In patients with isolated moderate or severe TBI, prehospital arterial hypotension as well as otorrhagia negatively influenced the mortality and morbidity. Therefore, early adjustment of arterial hypotension and the rapid transport into a neurotraumatological center are to be required for prehospital management of TBI patients. The decrease of maximal CPP below 70 mmHg despite administration of catecholamines representing the only independent prognostic parameter during monitoring in the intensive care unit seems to indicate the necessity of an operative revision as well as an unfavorable GOS 6 months after discharge.

Adult↗

PubMed2003

[The human vomeronasal organ].

Odors influence human behavior. The perception of so-called pheromones is frequently mentioned in the context of a functional vomeronasal organ. Vomeronasal ducts can be detected in approximately half of the population. Its functionality, still a matter of debate, seems to be unlikely, at least after birth. It is easily conceivable that pheromone-induced changes in behavior are mediated through receptors in the human olfactory epithelium.

Adult↗

PubMed2003

Effects of the form of glasses on the perception of wine flavors: a study in untrained subjects.

Many wine connoisseur claim that the glass shape has a direct impact on wine aroma. This hypothesis was investigated in healthy volunteers (85 m, 96 f; age 19-73 years); 89 subjects received red wine, 92 subjects white wine. Subjects compared three glasses with a white wine and three glasses with a red. Glasses were of different shape but of the same height and of comparable opening diameter. All glasses had elegant stems; two glasses of 'tulip' and 'beaker'-like shapes were used in sessions with red and white wines. Different bulbous glasses were used in either red or white wine sessions. Subjects were blinded whether they received one or more wines. Intensity, hedonic tone, and quality of the wines were rated repeatedly before and after drinking. Ratings of wine odors from different glasses were influenced by glass shape. Importantly, this appeared not to relate to the esthetic impression the glasses made. Thus, the present data indicate that the shape of glasses seems to influence the perception of wine odors.

Cooking and Eating Utensils↗