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Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD). Our aim was to provide an evidence-based practical guide to the management of PIOD (including post–coronavirus 2019 cases) for both primary care practitioners and hospital specialists. A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD. The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction. The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options. [ABSTRACT FROM AUTHOR]

The "Sniffin' Sticks" test is widely used in Europe as a standard test to assess olfaction. Several culturally-adapted versions have been developed. However, no version adapted to Sub-Saharan African populations exists. The aims of the present study were (1) to assess the applicability of the Sniffin' Sticks test in the population of South Kivu (DR Congo), and (2) to develop a culturally adapted version with normative values. In a first study, 157 volunteers were tested with the original Sniffin' Sticks test. Based on these results, we selected odors that were poorly recognized in the identification test and replaced them by culturally adapted odors. In a second study, we assessed the modified version of the Sniffin' Sticks test in 150 volunteers and defined normative values. In the first study, we found that olfactory function (threshold-discrimination-identification: TDI score) significantly decreased with age and was better in females. Five odors were poorly recognized and were replaced by culturally adapted odors. In the second study, we found that this adapted version led to a higher rate of correctly identified odors. We defined normative values for the South-Kivu population (TDI score: 18–35 years: 30.4 ± 6.0; 36–55 years: 26.2 ± 5.3; > 55 years: 25.6 ± 5.0). This culturally adapted version of the Sniffin' Sticks test is culturally adapted to the South Kivu population. The normative values will provide the basis for clinical evaluation of pathologic subjects. [ABSTRACT FROM AUTHOR]

Abstract: Introduction and aim: There is a high prevalence of olfactory dysfunction in the general population. Several causes of olfactory dysfunction have been reported and this disorder is classically divided into sinonasal and non-sinonasal-related olfactory dysfunction. The aims of this study were firstly, to evaluate the frequency of the various aetiologies of olfactory dysfunction in a population of patients with non-sinonasal-related olfactory dysfunction and secondly, to evaluate the degree of olfactory impairment associated with these various aetiologies. Material and methods: We retrospectively reviewed a cohort of 496 patients with non-sinonasal-related olfactory dysfunction. The aetiology of the olfactory dysfunction was recorded for each patient. The aetiology was determined by a complete clinical assessment, including medical history, complete otorhinolaryngological examination, psychophysical testing of olfactory function, recording of olfactory event-related potentials and brain magnetic resonance imaging. Six groups of patients were defined on the basis of the aetiology of the disease and orthonasal and retronasal psychophysical olfactory performances were evaluated in each group. Results: Post-infectious and post-traumatic aetiologies were the most common causes, representing 37.9% and 33.1% of patients, respectively, followed by idiopathic (16.3%), congenital (5.9%), toxic (3.4%) and neurological (3.4%) olfactory dysfunction. Anosmia was significantly more frequent in congenital (93.1%) and post-traumatic (62.8%) olfactory dysfunction, whereas hyposmia was more frequent in the post-infectious group (59.6%). Orthonasal and retronasal olfactory function tests were significantly correlated in all groups except for the congenital group. Conclusions: The data of this study confirm that the most common causes of non-sinonasal-related olfactory dysfunction are post-infectious and post-traumatic. Post-infectious olfactory dysfunction is mainly observed in middle-aged women and is mainly associated with hyposmia, whereas post-traumatic olfactory dysfunction is mainly observed in young men and is associated with a high rate of anosmia. [Copyright &y& Elsevier]

Abstract: We report the case of an 18-month-old boy with a large heterogeneous and lobulated soft-tissue mass, filling completely the right nasal cavity and anterior ethmoid, displacing the nasal septum, eroding the lamina papyracea, compressing the orbit and extending to the endocranium. There were multiple intralesional foci of calcification. The tumor was completely removed via an endonasal endoscopic approach. The definitive histopathologic diagnosis was that of a nasal chondromesenchymal hamartoma (NCMH). This is an exceedingly rare benign tumor of the upper respiratory tract that shares similarities to the mesenchymal hamartoma arising from the chest wall in neonates. Moreover as some NCMHs are associated with a “pleuropulmonary blastoma”, they can be part of the heredofamilial disease complex associated with PPB and linked to mutations of gene DICER1. [Copyright &y& Elsevier]

Summary: Soft tissue has been recently recognized as a primary site for myoepithelial tumour and only a small number has been reported to occur in the head and neck. Although the majority of myoepithelial tumours of the soft tissue are benign, some can be aggressive and develop distant metastases. We describe a patient with malignant myoepithelial tumour occurring in the soft tissue of the head and neck and rapid metastatic progression. In contrast to previous publications warning for overtreatment of patients with myoepithelial tumours, our report suggests that early and correct diagnosis followed by a radical therapeutic approach is required when there is evidence of malignancy. [Copyright &y& Elsevier]

: BackgroundIncomplete symptomatic relief of pharyngoesophageal (Zenker’s) diverticulum after endoscopic stapling or laser division has been reported by some authors. The clinical relevance of cricomyotomy, although supported by experimental data, remains controversial.: MethodsOperative procedures consisted of transcervical resection (n = 34, group I), transcervical resection plus cricomyotomy (n = 12, group II), transcervical cricomyotomy (n = 8, group III), transcervical cricomyotomy plus diverticulopexy (n = 47, group IV), endoscopic stapling division (n = 31, group V), and endoscopic laser division (n = 55; group VI).: ResultsThe percentage of totally asymptomatic patients was significantly (p < 0.004) higher after open procedures (combined groups I to IV) than after endoscopic treatment (combined groups V and VI) regardless of the size of the pouch (<3 cm, 85% versus 25%; ≥3 cm, 86% versus 50%). The percentage of patients with no or occasional (ie, fewer than twice a week) symptoms was significantly (p < 0.001) higher after open procedures (98%) than after endoscopic treatment (57%) for less than 3-cm diverticula whereas it was not higher (p = 0.409) for 3-cm or greater pouches (open, 97%; endoscopic, 88%). Furthermore, this percentage was similar (p > 0.286) after endoscopic stapling division and after endoscopic laser division (<3 cm, 50% versus 58%; ≥3 cm, 96% versus 80%). It was also similar (p > 0.197) after resection alone (group I) and after open operations including myotomy (combined groups II to IV) (<3 cm, 100% versus 98%; ≥3cm, 92% versus 100%). Unlike endoscopic stapling and division, laser division was complicated by mediastinitis (2 patients), and 1 patient was referred because of cervical esophageal disruption during laser division. Five of six postoperative fistulas after resection occurred in patients who did not have myotomy, and 4 patients were referred 12 to 49 years after resection without myotomy for true recurrence of the pouch.: ConclusionsOpen techniques afford better symptomatic relief than endoscopic techniques, especially in patients with small diverticula. Endoscopic stapling and division is safer than laser division. Although very effective at midterm, resection without myotomy predisposes to the development of postoperative fistula and to recurrence of the pouch after many years. [Copyright &y& Elsevier]