Skip to main content Accessibility help
×
Home
Hostname: page-component-55597f9d44-mm7gn Total loading time: 0.611 Render date: 2022-08-10T20:46:11.467Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "useRatesEcommerce": false, "useNewApi": true } hasContentIssue true

Long-term olfactory dysfunction following coronavirus disease 2019 infection, routine neck dissection at salvage laryngectomy, parotid incidentalomas, and prescribing intranasal steroids in HIV infection

Published online by Cambridge University Press:  27 August 2021

Rights & Permissions[Opens in a new window]

Abstract

Type
Editorial
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

A key theme throughout the coronavirus disease 2019 (Covid-19) pandemic has been olfactory and taste dysfunction as a cardinal symptom of infection.Reference Jain, Kumar, Kaur, Baisla, Goyal and Pandey1Reference Fuccillo, Saibene, Canevini and Felisati4 It is also becoming increasingly apparent that, in a small proportion of individuals, the olfactory disturbance becomes chronic and likely permanent, and evidence is accumulating to support this.Reference Vaira, Hopkins, Petrocelli, Lechien, Chiesa-Estomba and Salzano5Reference Capelli and Gatti8 In a study by Leedman et al. in this month's issue of The Journal, 7 per cent of individuals in a study population of 56 individuals went on to develop chronic, severe olfactory dysfunction six months following diagnosis.Reference Leedman, Sheeraz, Sanfilippo, Edgar, D'Aulerio and Robb9 These results are comparable with the findings of previous studies published in both this journal and elsewhere.Reference Vaira, Hopkins, Petrocelli, Lechien, Chiesa-Estomba and Salzano5Reference Capelli and Gatti8 While this finding is not unexpected given that other respiratory and common cold viruses can cause olfactory neuritis and permanent olfactory dysfunction, it does serve to illustrate that even though the proportion of individuals affected by chronic olfactory dysfunction is relatively small, the absolute number of individuals affected has the potential to be large given the considerable number of patients affected by Covid-19.Reference McNeill, Ramakrishnan and Carrie10 Further research is required in this area to identify the exact pathogenic mechanisms responsible, and determine why some patients exhibit temporary disturbance whereas others go on to develop chronic, debilitating olfactory dysfunction, with the accompanying detrimental effect on quality of life that ensues as a result.Reference Vaira, Hopkins, Sandison, Manca, Machouchas and Turilli11

Neck dissection at the time of salvage laryngectomy for the node-negative neck is controversial.Reference Gouzos, Dale, Sethi, Foreman, Krishnan and Hodge12 Proponents argue that it leads to better local disease control with more accurate pathological staging. However, this comes at the price of potentially increased surgical morbidity and a potentially low yield of positive nodes. Sharma et al., in this month's issue, serve to address this question further by studying the role of simultaneous neck dissection at salvage laryngectomy in 171 patients who underwent salvage laryngectomy between 2000 and 2015.Reference Sharma, Chaukar, Bal and D'Cruz13 The occult nodal metastasis rate was 10.5 per cent. In addition, initial node-positive disease prior to commencing radiotherapy was a predictor of occult metastasis, and the authors argue that this group should be offered elective neck dissection.

In a systematic review in this month's issue, Seymour et al. study the effects of prescribing intranasal steroids in human immunodeficiency virus (HIV)-positive patients; this is a nicely written review which publicises a little known interaction.Reference Seymour, Robinson, Richardson, Mohammed, Williams and McGilligan14 Beclomethasone does not interact, as the authors agree in their conclusions; therefore, it would seem more sensible to consider using Betnesol® drops for induction treatment for nasal polyps, despite its high systemic bioavailability, rather than to change HIV medication in the first instance.

Finally, Thompson et al. systematically review parotid incidentalomas on positron emission tomography (PET) imaging.Reference Thompson, Nolli and Bannister15 Their review revealed that the commonest aetiologies were Warthin's tumours (30.8 per cent), pleomorphic adenomas (14.1 per cent) and metastases (15.1 per cent), with an overall malignancy rate of 30.4 per cent. Parotid incidentalomas, like thyroid incidentalomas, identified through fluorodeoxyglucose F18 (18-FDG) PET therefore require further investigation.

References

Jain, A, Kumar, L, Kaur, J, Baisla, T, Goyal, P, Pandey, AK et al. Olfactory and taste dysfunction in coronavirus disease 2019 patients: its prevalence and outcomes. J Laryngol Otol 2020;134:987–91CrossRefGoogle Scholar
Petrocelli, M, Ruggiero, F, Baietti, AM, Pandolfi, P, Salzano, G, Salzano, FA et al. Remote psychophysical evaluation of olfactory and gustatory functions in early-stage coronavirus disease 2019 patients: the Bologna experience of 300 cases. J Laryngol Otol 2020;134:571–6CrossRefGoogle ScholarPubMed
Avci, H, Karabulut, B, Farasoglu, A, Boldaz, E, Evman, M. Relationship between anosmia and hospitalisation in patients with coronavirus disease 2019: an otolaryngological perspective. J Laryngol Otol 2020;134:710–16CrossRefGoogle ScholarPubMed
Fuccillo, E, Saibene, AM, Canevini, MP, Felisati, G. Olfactory disorders in coronavirus disease 2019 patients: a systematic literature review. J Laryngol Otol 2020;134:754–63CrossRefGoogle Scholar
Vaira, LA, Hopkins, C, Petrocelli, M, Lechien, JR, Chiesa-Estomba, CM, Salzano, G et al. Smell and taste recovery in coronavirus disease 2019 patients: a 60-day objective and prospective study. J Laryngol Otol 2020;134:703–9CrossRefGoogle ScholarPubMed
Petrocelli, M, Cutrupi, S, Salzano, G, Maglitto, F, Salzano, FA, Lechien, JR et al. Six-month smell and taste recovery rates in coronavirus disease 2019 patients: a prospective psychophysical study. J Laryngol Otol 2021;135:436–41CrossRefGoogle ScholarPubMed
Jalessi, M, Bagheri, SH, Azad, Z, Firouzabadi, FD, Amini, E, Alizadeh, R et al. The outcome of olfactory impairment in patients with otherwise paucisymptomatic coronavirus disease 2019 during the pandemic. J Laryngol Otol 2021;135:426–35CrossRefGoogle ScholarPubMed
Capelli, M, Gatti, P. Anosmia in the first coronavirus disease 2019 outbreak in Europe: functional recovery after eight months. J Laryngol Otol 2021;135:224–8CrossRefGoogle ScholarPubMed
Leedman, SR, Sheeraz, M, Sanfilippo, PG, Edgar, DW, D'Aulerio, GV, Robb, DM et al. Olfactory dysfunction at six months after coronavirus disease 2019 infection. J Laryngol Otol 2021;135:839–43CrossRefGoogle ScholarPubMed
McNeill, E, Ramakrishnan, Y, Carrie, S. Diagnosis and management of olfactory disorders: survey of UK-based consultants and literature review. J Laryngol Otol 2007;121:713–20CrossRefGoogle ScholarPubMed
Vaira, LA, Hopkins, C, Sandison, A, Manca, A, Machouchas, N, Turilli, D et al. Olfactory epithelium histopathological findings in long-term coronavirus disease 2019 related anosmia. J Laryngol Otol 2020;134:1123–7CrossRefGoogle ScholarPubMed
Gouzos, M, Dale, O, Sethi, N, Foreman, A, Krishnan, S, Hodge, JC. Elective neck dissection for the node-negative neck during salvage laryngectomy: an analysis of survival outcomes and complication rates. J Laryngol Otol 2019;133:788–91CrossRefGoogle ScholarPubMed
Sharma, S, Chaukar, DA, Bal, M, D'Cruz, AK. Is routine neck dissection warranted at salvage laryngectomy? J Laryngol Otol 2021;135:785–90CrossRefGoogle ScholarPubMed
Seymour, N, Robinson, M, Richardson, D, Mohammed, H, Williams, D, McGilligan, JA. Prescribing intranasal steroids in HIV-positive patients: systematic review of the literature. J Laryngol Otol 2021;135:755–58CrossRefGoogle ScholarPubMed
Thompson, C, Nolli, T, Bannister, M. Parotid incidentalomas: a systematic review. J Laryngol Otol 2021;135:765–69CrossRefGoogle ScholarPubMed
You have Access

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Long-term olfactory dysfunction following coronavirus disease 2019 infection, routine neck dissection at salvage laryngectomy, parotid incidentalomas, and prescribing intranasal steroids in HIV infection
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Long-term olfactory dysfunction following coronavirus disease 2019 infection, routine neck dissection at salvage laryngectomy, parotid incidentalomas, and prescribing intranasal steroids in HIV infection
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Long-term olfactory dysfunction following coronavirus disease 2019 infection, routine neck dissection at salvage laryngectomy, parotid incidentalomas, and prescribing intranasal steroids in HIV infection
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *