Allergic rhinitis, olfactory disorders and secretory IgA.

The authors point out the possible relationship between the biochemical and immunological components of nasal mucus in subjects affected by allergic rhinitis and/or olfactory disorders. Fifty seven subjects (33 F, 24 M) aged between 19 and 73 years, (median age 65 SD 14.60) were studied. Twenty seven of them were normosmic affected by allergic rhinitis and taken as control group, (14 were positive to allergometric tests and/or RAST, while the other 13 were negative), 30 were dysosmic, and subdivided into parosmic (n = 6), anosmic (n = 15) and hyposmic (n = 9) (only one was negative both to allergometric tests and to RAST). In all patients we assessed: nasal mucus (it was analysed for: mucus quantity, pH, protein concentration, K+ concentration and the SIgA antibodies, tested both by radian immunodiffusion and by ELISA), allergometric tests, PRIST, RAST, anterior rhinomanometry, evoked olfactory potential. As regard to allergometric tests, we have no observed statistically significant differences between the control and the dysosmic group, although all the dysosmic patients (except one) were positive both to allergometric tests and to RAST. Total (PRIST) and specific (RAST) IgE values (except for the anosmic subjects who had IgE values moderately higher) were similar to the results obtained by allergometric tests. As regards to nasal secretion quantity, it was reduced (p: n.s.), like the pH (p: n.s.), in the parosmic subjects. On the other hand, proteins concentration of nasal secretion was lowered in hyposmic (p: n.s.) and anosmic (p = 0.05) subjects, while there were no differences between parosmic subjects and control group. The values of SIgA in controls and hyposmic subjects were not too different and similar to those observed by other authors; however they were slightly increased in controls affected by allergic rhinitis with positivity both to RAST and/or allergometric tests (p: n.s.), while they were reduced in the parosmic and significantly in the anosmic patients (p < 0.01). On the basis of that data, the authors conclude that, (though related to a limited case reports) being the secretory IgA values inversely proportional to the gravity of olfactory pathology, a their protective role (if the anatomic-functional substratum is efficient), in the pathologies examined, can be easily hypothesized. Besides, that data highlight that their concentration is slightly decreased in those patients affected by allergic rhinitis, without olfactory disorders (p: n.s.).

[Otomycosis: a microbiological study of 147 cases of otitis externa]. / Otomicosis: estudio microbiologico sobre 147 casos de otitis externa.

An accurate and systematic myco- and bacteriological appraisal of each case, should comport the lowering of wrong diagnosis and also therapeutic failures in those patients. The target of the AA. is to verify the frequency and the identification as well, of bacteria and/or fungi, unique or in association, responsible for the otitis. And the objective is to start with the most appropriate treatment in spite of the laboratory answer and also to schedule a laboratory protocol to follow in suspected cases of otomycosis.

[Secretory otitis media: current aspects and therapeutic role of adenoidectomy]. / Otite media secretoria: aspetti attuali e ruolo terapeutico della adenoidectomia.

The prognostic influence of adenoidectomy on the clinical course of secretory otitis media (S.O.M.) was evaluated in 46 children with abnormal tympanometry, i.e. a flat curve (type B tympanogram) or a middle ear pressure less than 100 mm H2O (type C tympanogram). The children were divided by randomized, blind allocation into one group of 22 subjected to myringotomy with adenoidectomy and another group of 24 subjected to myringotomy without adenoidectomy. All 46 children were followed up by impedance audiometry, pure tone audiometry and otomicroscopy 1, 3, 6 and 15 months after surgery. No significant differences were found between the two groups. Possible pathogenetic mechanisms leading to the development of S.O.M. in the presence of large adenoids are discussed.