Julian Anthony Gaskin

The effect of female hormone manipulation on nasal physiology.

Background This study was performed to establish whether the ovarian hormone beta-estradiol has any influence on nasal physiology when manipulated during in vitro fertilization treatment. Methods Women undergoing in vitro fertilization (IVF) treatment at the Assisted Conception Unit, Leicester Royal Infirmary, were recruited. Nasal peak inspiratory flow rate, acoustic rhinometry, anterior rhinomanometry, mucociliary clearance, olfactory thresholds, quality of life, and serum 17-beta-estradiol levels were measured at each visit. Subjects were studied at the beginning of their IVF treatment and then at one or two additional occasions while they received synthetic follicule-stimulating hormone with a final set of results taken at the end of their treatment. Results Results were analyzed using paired t-tests. There was no statistical difference between any of the data sets for any of the variables during the process of IVF treatment. Conclusion Increasing levels of beta-estradiol that occur in IVF treatment cause no significant effect on nasal physiology in contrast to the effects seen during pregnancy.

What is the short term effect of perfumes on olfactory thresholds

OBJECTIVES Body sprays and perfumes are commonly worn by patients attending ENT out-patients clinics. Their effect on performance in olfactory testing is unknown. The aim of this study was to determine whether olfactory thresholds are altered by the presence of such fragrances. MATERIALS AND METHODS One hundred and sixty healthy volunteers, aged 18 to 65 years, underwent olfactory thresholds testing. Each was then exposed to one of four strong perfumes, applied in a facemask for two minutes, and the thresholds were retested. RESULTS AND ANALYSIS All olfactory thresholds worsened after being exposed to the strong perfumes of Lynx and Impulse body sprays, with the strongest effect being on olfactory detection of phenylethyl alcohol (p<0.001). CONCLUSIONS Strong perfumes can have a negative effect on olfactory thresholds. SIGNIFICANCE Patients attending olfactory threshold testing need to be advised not to wear body sprays or perfumes.

Experience and Outcomes of New Developments in Bone Conduction Hearing Technologies in Children

Objectives: (1) Recognize that percutaneous implant stability in children can be measured using radio frequency analysis (RFA) to generate Implant Stability Quotients (ISQs) and guide sound processor loading. (2) Discuss sound processor loading of the Cochlear BahaÒ (BIA300, BA400) transcutaneous implants at 4-6 weeks in selected children and potential advantages of the transcutaneous ATTRACT implant. Methods: We collected data prospectively on all children undergoing implantable BC implants at surgery and follow up appointments. We aimed to assess implant stability over time in children undergoing 1-stage surgery using RFA measurements and investigate the possible implications for earlier loading following surgery. Our experience and outcomes with the ATTRACT transcutaneous device as part of the controlled market release (3+ cases) will also be reviewed. Results: Nine children underwent 10 BI300 implants with a mean age of 9 years 4 months. 7 children received the BA400 percutaneous device without soft tissue reduction, with a mean age of 7 years 11 months. Using RFA the mean ISQ at surgery for BI300 implants was 60 and the corresponding unadjusted value for BA400 implants was 50. Changes in ISQs over time are discussed, showing the potential for processor loading at 4-6 weeks. Conclusions: Greater implant stability has been demonstrated using the BI300 and BA400 implants, which would subsequently enable early Baha loading. The transcutaneous ATTRACT system potentially offers further improvement in cosmesis and skin inflammation and is likely to have greater acceptance in children with microtia and canal atresia and those who would have previously declined Baha.

The Effects of Sensory Deprivation on Olfactory Thresholds

PROBLEM: The aim of this study was to determine if olfactory thresholds are influenced by removal of other sensory inputs, namely hearing and sight. METHODS: A prospective study was conducted whereby 50 consecutive olfactory threshold tests in total where performed on four subjects (mean age of 38 years; range 29 years to 60 years) over a three-month period in 2006. Each subject underwent threshold testing with the odor phenethyl alcohol using a computer-driven olfactometer device. Subjects were tested both with a blindfold and ear-defenders, and then without, and this order was randomised. These olfactory thresholds were compared and analysed for a statistical difference. RESULTS: There was no significant difference between the olfactory thresholds performed with visual and auditory deprivation, and the olfactory thresholds without visual and auditory deprivation (p 0.01). CONCLUSION: Olfactory thresholds are not significantly influenced by visual or auditory deprivation. SIGNIFICANCE: Olfactory testing in the office can therefore be undertaken accurately without the need to address these factors.

P172: Can Strong Perfumes Affect Our Olfactory Thresholds

oculomotor nerve palsy caused by paranasal-sinus desease. Clinical course and computed tomography (CT) image are documented, and pathogenesis relating to local anatomy is discussed. METHODS: Retrospective case report and review of pertinent literature. RESULTS: Report of three cases of isolated oculomotor nerve palsy caused by paranasal-sinus desease. All the patients complained of double vision and had unilateral disturbance of ocular movement and ptosis, but no visual impairment in opthalmologic examination. In two cases, CT demonstrated soft tissue density (STD) in the posterior ethmoid and the sphenoid sinuses and also inside the ipsilateral anterior clinoid precess (ACP) of sphenoid bone. In the remaining case, CT showed STD in the ethmoid sinus and pneumatization in the ACP. Endoscopic sphenoidectomy was performed on the former two cases, and the last case was treated conservatively with steroid and antibiotics. Their ocular movement returned to normal approximately one month later. In all the cases, CT demonstrated a bony defect at the inferior wall in ACP, which is adjacent to the superior orbital fissure. CONCLUSIONS: Since the oculomotor nerve runs just under the ACP, the authors speculate that compression and/or inflammation through the pneumatized ACP might easily cause isolated oculomotor nerve palsy as in the present cases.

11:14 AM: Effect of Female Hormone Manipulation on Nasal Physiology

delayed spontaneous CSF rhinorrhoea and thereby establishing that transnasal endoscopic repair is a minimally invasive and efficient approach. METHODS: This is a retrospective study conducted at a 1,800 bed tertiary university hospital where approximately 200 patients visit the ENT outpatient department daily. RESULTS: Between 1999 and 2005, 76 patients (34 traumatic immediate onset, 28 spontaneous delayed onset) with CSF rhinorrhoea were treated. Fourteen patients had undergone neurosurgical intervention for an anterior skull base lesion. A remote history of head and nose trauma was illustrated in 57.1% of patients with late onset leaks; 14.2% of patients had varying episodes of meningitis before diagnosis of CSF rhinorrhoea. Investigations included CT, MRI, and immunofixation of beta 2 transferrin. Transnasal endoscopic repair using fat as a plugging material, fascia lata as an overlay graft, and finally fibrin glue was used in all cases. 92.8% of patients had no further episodes of CSF leak. Two patients underwent revision external surgery for closure. There were no major complications, though olfaction was lost in all patients except those with sphenoid leaks. CONCLUSIONS: The results of transnasal endoscopic repair now make it the treatment of choice for most anterior cranial and sphenoid CSF leaks, with the exception of some defects in the frontal sinus. We lay down an algorithm for managing CSF rhinorrhoea in which endoscopic repair should be the initial surgical treatment in the majority of cases. A neurosurgical approach should be reserved for revision cases.