Modern psychophysical tests to assess olfactory function.

The sense of smell significantly contributes to quality of life. In recent years much progress has been made in understanding the biochemistry, physiology and pathology of the human olfactory system. Olfactory disorders may arise not only from upper airway phlogosis but also from neurodegenerative disease. Hyposmia may precede motor signs in Parkinson's disease and cognitive deficit in Alzheimer's disease. These findings suggest the complementary role of olfactory tests in the diagnosis and management of neurodegenerative diseases. In this report we present a review of modern olfactory tests and their clinical applications. Although rarely employed in routine clinical practice, the olfactory test evaluates the ability of odour identification and is a useful diagnostic tool for olfaction evaluation. Olfactory screening tests are also available. In this work we strongly recommend the importance of an ENT evaluation before the test administration and dissuade from a self-administration of an olfactory test.

Olfactory screening test in mild cognitive impairment.

Mild cognitive impairment (MCI) is a transient status between physiologic ageing and dementia. Each year more than 12% of subjects with MCI develop Alzheimer's disease. This study evaluated the presence of an olfactory deficit in amnesic MCI (aMCI) patients. Twenty-nine patients diagnosed with aMCI and a homogeneous control group of 29 subjects were enrolled in the study. Olfactory function was assessed by the Sniffin' Sticks Screening Test (SSST) and the Mini Mental State Examination, the Clinical Dementia Rating, the Geriatric Depression Scale and the Mental Deterioration Battery were used to evaluate the neurocognitive status. aMCI patients showed a significant impairment of their olfactory identification compared to controls (SSST score: 8.3+/-2.1 vs. 10.8+/-0.9; p<0.001). These results suggest that olfactory tests should be part of the diagnostic armamentarium of pre-clinical dementia. A long-term follow up might confirm the olfactory identification function as an early and reliable marker in the diagnosis of pre-clinical dementia.

Olfactory screening test: experience in 102 Italian subjects.

Development of the olfactory screening test has given the physician a fast and easy instrument to assess olfactory function. This study evaluated the odour identifiability and familiarity of the 12 items of the Sniffin' Sticks Screening test in 102 normal Italian subjects (54 female, 48 male), age range 13-88 years (mean 46.4), classified as normosmics. The Sniffin' Sticks Screening test is an olfactory identification multiple-forced-choice test widely used in Europe. The Italian subjects showed a high familiarity for the odorants of the Sniffin' Sticks Screening test, except for cloves, even if 89.3% of the subjects correctly identified cloves in the multiple (four) choice of answers. On the basis of the results obtained, it is suggested that the Sniffin' Sticks Screening test should be used in routine clinical practice to assess olfactory function in the Italian population.

Myxoid liposarcoma of the oral cavity: case report and review of the literature.

Liposarcomas very rarely affect the oral cavity; in such cases the cheek is typically involved. Differential diagnosis between lipoma and other sarcomas is sometimes challenging because the macroscopic and histological features may be difficult to distinguish. Neoplasms with the morphology of lipoma should always receive a careful postoperative histopathologic evaluation. Complete surgical excision is the most effective treatment. We present a case of myxoid liposarcoma of the cheek, together with a literature review of intraoral liposarcomas reported during the last 60 years.

Isolated oropharyngeal Kaposi's sarcoma in non AIDS patient: differences and similarities with spindle-cell haemangioendothelioma.

Vascular tumours rarely affect the oropharynx and overall they can represent a diagnostic challenge since their clinico-histopathological patterns are not always clear. This case report, of an isolated pharyngeal vascular proliferation, allowed the authors to analyse the similarities and differences between Kaposi's sarcoma and spindle-cell haemangioendothelioma. Moreover, it emphasizes the importance of diagnostic tools, such as the human herpesvirus 8 (HHV8) marker, that sometimes may represent the only reliable test for clearly establishing the diagnosis.

[Mefloquine and ototoxicity: a report of 3 cases]. / Meflochina ed ototossicità: descrizione di tre casi.

We report these cases of high-frequency sensorineural hearing loss and tinnitus, following malaria prophylaxis with mefloquine (Lariam). Only one patient had partial remission of hearing loss after suspension of the treatment. In the remaining two cases the symptomatology remained unchanged. None of the patients reported improvement of tinnitus. Our experience suggests that a routine audiologic evaluation, before and after prophylactic use of antimalarial drugs, is important to monitor potential hearing deficit.

[3 cases of post-stapedectomy labyrinthine fistula]. / Su tre casi di fistola labirintica post-stapedectomia.

Three cases are presented of labyrinthine fistula which suddenly arose in patients who had undergone stapedectomy interposing a vein graft from the back of the hand. These patients had all enjoyed 12-15 years apparently problem free period before the fistula occurred. In all three cases the fistula was accompanied by objective dizziness and varying degrees of sensorineural or mixed hearing loss. The patients underwent revision surgery which identified the fistula and the endolymph oozing out of the graft from the previously installed prosthesis. The authors present the cases, describe how the symptoms arose and the results obtained with revision surgery. Finally, they discuss the need to first perform stapedotomy with a platinar hole; they indicate that the number of cases of total or partial stapedectomy should be limited only to those cases characterized by anatomical variations and/or whenever complications arise during surgery.

[A case of Kaposi sarcoma of the pharynx as a primary manifestation of the acquired immunodeficiency syndrome]. / Su di un caso di kaposi faringeo come prima manifestazione della sindrome da immunodeficienza acquisita.

Unusual infectious and neoplastic complications regularly represent the first manifestation of the acquired immunodeficiency syndrome. Otorhinolaryngologists have to be aware of AIDS manifestations in as much as head and neck findings are frequent and are sometimes the initial presentation of HIV infection. The Authors report the case of a patient with a pharyngeal Kaposi in sarcoma, then point out the importance of otorhinolaryngological evaluation complete diagnosis of the syndrome.