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Objective Next to olfactory function, the nose can also perceive chemestetic sensations mediated by the trigeminal nerve. While olfactory dysfunction as a symptom of COVID-19 is well described, there has been little research on the limitation of other nasal sensory inputs due to SARS-CoV-2 infection. The aim of this study was to determine possible limitations of nasal chemesthesis after COVID-19 infection by a psychophysiological diagnostic tool. Methods In 65 patients with a PCR-confirmed, former COVID-19 disease, olfaction was tested by means of a sniffin' sticks test, tasting by taste sprays and chemesthesis with a menthol dilution series. The subjective self-assessment of the patients was recorded via a questionnaire. Results We found a restriction of nasal chemesthesis and the extent correlated with the loss of smell, as well as with the values of the taste score, but not with subjective self-assessment. Conclusion Not only the ability to smell and taste, but also nasal chemesthesis is affected by COVID-19.

Objective To alleviate pain after tonsillectomy (TE) with escalating gradual treatment protocols in a prospective trial. Materials & Methods Following TE, 83 consecutive adult patients were treated with two different four-staged escalating analgesic protocols. Metamizole served as basic medication in protocol 1 (PT1; n = 44), whereas with protocol 2 (PT2; n = 39) ibuprofen was applied as baseline analgesic. Both protocols were escalated according to the patient´s needs to metamizole and ibuprofen vice versa and additional weak to strong opioids. The primary efficacy endpoint was defined as the minimum and maximum pain as well as pain on ambulation (NRS, 0–10). Secondary endpoints comprised analgesic score, patient satisfaction and treatment-related side-effects. Results Both patient groups exhibited similar demographic characteristics (PT1: O 28.8 years; 64% ♀ and PT2: O 26.6 years; 56% ♀). Maximum pain (6.7 ± 1.9 vs. 7.6 ± 1.6, t(81) = −2.254, p = 0.027) and pain on ambulation (5.0 ± 1.8 vs. 5.8 ± 1.8, t(81) = -2.114, p = 0.038) were significantly higher with PT2. 68.2% of patients with PT1 needed an escalation of analgesic treatment compared to 100% with PT2 (p Conclusion Both treatment protocols yielded in a high degree of patient satisfaction but dissatisfactory pain relief following TE. Metamizole can be recommended as a basic medication allowing for improved pain relief. Reported pain intensities were independent of the amount of opioid intake. Further research is mandatory to standardize and improve analgesic treatment after TE.

Introduction: COVID-19 can be associated with a variety of longer-lasting impairments that can have a significant impact on patients’ quality of life (QoL). While this is well described in the literature for limitations in lung capacity or permanent headaches, there is little research on the impact of olfactory dysfunction in the context of COVID-19 on patients’ QoL. Methods: In 65 patients with a history of COVID-19, the present olfactory ability was assessed using the Sniffin’ Sticks test. In addition, olfactory QoL was assessed by the Questionnaire of Olfactory Disorders. Self-assessment was performed with visual analogue scales. The data were compared with the results obtained in healthy individuals and in patients with hyposmia due to other viral infections. Results: The QoL of COVID-19 patients was significantly lower compared to the healthy control group. Even recovered subjects whose olfaction had already returned to the normal range still had a reduced QoL. The severity of the olfactory impairment correlated with the reduction in QoL. However, the olfactory QoL of COVID-19 patients was not worse than that of patients’ olfactory loss due to other viral infections. Patients with parosmia had reduced QoL and rated their situation worse than patients without parosmia. Conclusion: QoL appears to be impaired in patients with long-lasting COVID-19 olfactory disorders several months after overcoming acute symptoms, even if olfaction has normalized. However, the impairment is not more pronounced than in patients with other postviral olfactory disorders of the same duration.

Smell disorders persist in about half of the patients with other symptoms of COVID-19 disease, but the exact duration of the symptoms is yet unknown. Especially, only a few studies used validated olfactory tests for this.The aim of this study was to investigate how many patients with olfactory function impairment, which was detected in a validated olfactory test 3 months after COVID-19 disease, showed improvement in olfactory function after 6 months.About 26 patients with a PCR-confirmed, former COVID-19 disease, with an impaired olfactory function after three months, were included in the study. The olfactory function was evaluated with the sniffing sticks test, the taste function with taste sprays.Smelling function improved in all but one patient (96%). All measured subitems, i.e. olfactory threshold, identification and discrimination of odours significantly improved. In the whole mouth taste test all patients showed normal taste function.6 months after COVID-19 disease, olfactory function improves in just about all patients. Long-term measurements must investigate whether complete regeneration of the olfactory function will occur in all patients.

Smell and taste disorders occur in COVID-19 with a high prevalence, but little is known about the duration of the symptoms. In particular, studies using validated olfactory tests are very rare to date.The aim of this study was to determine the olfactory function of COVID-19 recoveries by a detailed olfactory test.91 patients with PCR-confirmed, past COVID-19 disease were included. Olfactory history was taken using a questionnaire. Olfactory function was evaluated with the sniffin' sticks test, tasting function with taste sprays.80 patients had experienced sudden olfactory loss during the course of disease and at the time of testing, 33 patients subjectively still had an impaired olfactory sense. Around 8 weeks had passed since the onset of symptoms. 45.1% of the tested individuals were still hyposmic according to the olfactory test while 53.8% showed an olfactory performance within the normal range. Patients' self-assessment correlated poorly with the measured olfactory performance.Half of the patients with an olfactory loss as a symptom of COVID-19 still have olfactory impairments after two months, although not all of these patients subjectively notice a restriction. Long-term measurements must confirm whether all affected patients will make full recovery.

Early reports of SARS-CoV-2 infections only rarely mentioned smell and taste disorders. Several studies, particularly from Europe and the USA, have now confirmed these symptoms as an early key feature of COVID-19. About 70 % of patients seem to experience a reduction of smell and taste in the course of the disease, with most of the studies published to date based on questionnaires and anamnestic data. Validated smell tests have so far only been used in a few studies. A distinction between taste and taste disorders, i. e. a distinction between retronasal aroma taste and the olfactory system from the dysfunction of taste capsules and the further cranial nerves, was mostly not made in the studies available to date. Some reports associate olfactory disorders with a milder clinical course. At the same time, the olfactory system via the olfactory bulb represents an entry point into the central nervous system, and an olfactory disorder could be a predisposing factor for central neurological symptoms. The clinical significance of smell and taste disorders in COVID-19 patients is currently still unclear. Further open questions concern the exact prevalence and the prognosis, so that overall higher quality studies with validated smell tests and larger numbers of patients are required.Nachdem anfängliche Berichte über die SARS-CoV-2-Infektion Riech- und Schmeckstörungen kaum erwähnten, haben mittlerweile mehrere Studien, insbesondere aus Europa und den USA, diese Symptome als Merkmal von COVID-19 bestätigt. Gut 2 Drittel der Erkrankten scheinen im Verlauf der Erkrankung eine Riech- und Schmeckminderung zu erleiden, wobei die meisten der bislang veröffentlichten Studien auf Fragebögen und anamnestischen Daten basieren. Validierte Riechtests wurden bislang nur in wenigen Studien eingesetzt. Eine Unterscheidung zwischen Schmeck- und Geschmacksstörungen, also eine Abgrenzung des retronasalen Aromaschmeckens über das olfaktorische System von der Dysfunktion von Geschmackspapillen und der weiterführenden Hirnnerven, erfolgte in den bisher verfügbaren Studien zumeist nicht. Einige Berichte assoziieren die Riechstörungen mit einem milderen klinischen Krankheitsverlauf. Gleichzeitig stellt das Riechsystem über den Bulbus olfactorius eine Eintrittspforte in das zentrale Nervensystem dar, und eine Riechstörung könnte ein prädisponierender Faktor für zentral-neurologische Symptome sein. Die klinische Bedeutung von Riech- und Schmeckstörungen bei COVID-19-Patienten ist aktuell noch unklar. Weitere offene Fragen betreffen die genaue Prävalenz und die Prognose, sodass insgesamt höherwertige Studien mit validierten Riechtests und größeren Patientenzahlen zu fordern sind.

ZusammenfassungNachdem anfängliche Berichte über die SARS-CoV-2-Infektion Riech- und Schmeckstörungen kaum erwähnten, haben mittlerweile mehrere Studien, insbesondere aus Europa und den USA, diese Symptome als Merkmal von COVID-19 bestätigt. Gut 2 Drittel der Erkrankten scheinen im Verlauf der Erkrankung eine Riech- und Schmeckminderung zu erleiden, wobei die meisten der bislang veröffentlichten Studien auf Fragebögen und anamnestischen Daten basieren. Validierte Riechtests wurden bislang nur in wenigen Studien eingesetzt. Eine Unterscheidung zwischen Schmeck- und Geschmacksstörungen, also eine Abgrenzung des retronasalen Aromaschmeckens über das olfaktorische System von der Dysfunktion von Geschmackspapillen und der weiterführenden Hirnnerven, erfolgte in den bisher verfügbaren Studien zumeist nicht. Einige Berichte assoziieren die Riechstörungen mit einem milderen klinischen Krankheitsverlauf. Gleichzeitig stellt das Riechsystem über den Bulbus olfactorius eine Eintrittspforte in das zentrale Nervensystem dar, und eine Riechstörung könnte ein prädisponierender Faktor für zentral-neurologische Symptome sein. Die klinische Bedeutung von Riech- und Schmeckstörungen bei COVID-19-Patienten ist aktuell noch unklar. Weitere offene Fragen betreffen die genaue Prävalenz und die Prognose, sodass insgesamt höherwertige Studien mit validierten Riechtests und größeren Patientenzahlen zu fordern sind.

Hypothesis The vibration of the floating mass transducer (FMT) of a single active middle-ear implant (AMEI) is distinctly influenced by the properties of the material coupled to its back side. Background In round window vibroplasty, the FMT needs to be padded against the surrounding bone opposite from the round window membrane. This represents one factor influencing its performance as a round window driver. Therefore, we examined the effects of different materials linked to the back side of an FMT on its vibration range. Methods The back side of an FMT was glued to a silicone cylinder 1.0 mm in diameter and 1.0 mm – 1.5 mm in length and of 40A, 50A or 70A Shore hardness; to cartilage of equivalent size; or to a round window soft coupler (RWSC), all firmly fixed on a steel plate. The vibrations were determined by a laser Doppler vibrometer (LDV) measuring the velocity of the centre point on the front side of the FMT. Results The materials on the back side of the FMT significantly influenced the vibration range of the FMT. The RWSC and silicone of 40A Shore hardness allowed for the highest detected velocities, while cartilage led to a distinct reduction similarly to 70A silicone. Conclusion The coupling on the back side of an FMT distinctly affects its vibration range. In this regard, the RWSC and silicone of 40A Shore hardness yield the least impairment of vibration. Thus, the RWSC may be a feasible option in round window vibroplasty when additionally connected to the FMT opposite from the round window membrane. This article is protected by copyright. All rights reserved.

The NFκB transcription factor family facilitates the activation of dendritic cells (DCs) and CD4(+) T helper (Th) cells, which are important for protective adaptive immunity. Inappropriate activation of these immune cells may cause inflammatory disease, and NFκB inhibitors are promising anti-inflammatory drug candidates. Here, we investigated whether inhibiting the NFκB-inducing kinase IKK2 can attenuate crescentic GN, a severe DC- and Th cell-dependent kidney inflammatory disease. Prophylactic pharmacologic IKK2 inhibition reduced DC and Th cell activation and ameliorated nephrotoxic serum-induced GN in mice. However, therapeutic IKK2 inhibition during ongoing disease aggravated the nephritogenic immune response and disease symptoms. This effect resulted from the renal loss of regulatory T cells, which have been shown to protect against crescentic GN and which require IKK2. In conclusion, although IKK2 inhibition can suppress the induction of nephritogenic immune responses in vivo, it may aggravate such responses in clinically relevant situations, because it also impairs regulatory T cells and thereby, unleashes preexisting nephritogenic responses. Our findings argue against using IKK2 inhibitors in chronic GN and perhaps, other immune-mediated diseases.