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Abstract Introduction Acute upper respiratory infection (AURI) is the most common cause of postinfectious olfactory dysfunction (PIOD). Objective We investigated the prevalence of PIOD in a large group of patients reporting persistent smell impairment perception after the AURI resolution. Methods Olfactometry was performed within 1 month after the common cold resolution and after 1 year in 467 (299 males, mean age 41.7 years) outpatients. The Sniffin' Sticks olfactory test (Burghart instruments, Wedel, Germany) was used. Results Anosmia was documented in 28 (6%) patients, hyposmia in 33 (7%), and cacosmia in 55 (11.7%). After 1 year, PIOD improved in 82 (79.6%) patients re-tested. Conclusion The current study demonstrated that persistent olfactory dysfunction is a relevant symptom in patients with AURI, even though many patients had normal olfactometry. Thus, smell impairment deserves careful attention and requires objective documentation.

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Introduction Acute upper respiratory infection (AURI) is the most common cause of postinfectious olfactory dysfunction (PIOD). Objective We investigated the prevalence of PIOD in a large group of patients reporting persistent smell impairment perception after the AURI resolution. Methods Olfactometry was performed within 1 month after the common cold resolution and after 1 year in 467 (299 males, mean age 41.7 years) outpatients. The Sniffin' Sticks olfactory test (Burghart instruments, Wedel, Germany) was used. Results Anosmia was documented in 28 (6%) patients, hyposmia in 33 (7%), and cacosmia in 55 (11.7%). After 1 year, PIOD improved in 82 (79.6%) patients re-tested. Conclusion The current study demonstrated that persistent olfactory dysfunction is a relevant symptom in patients with AURI, even though many patients had normal olfactometry. Thus, smell impairment deserves careful attention and requires objective documentation.

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BACKGROUND: The fern test is a method for assessing the characteristics of the nasal section in the treatment of patients with mucous dysfunction of the airway. OBJECTIVE: The aim of this study was to investigate the role of the fern test in patients with rhinitis and to assess the classification of each type of rhinitis (types I-IV) in clinical practice. METHODS: A cross-sectional study, which included consecutive patients from a third level Rhinology Unit, worked with 182 patients with rhinitis and 30 healthy subjects as control. The patients were subdivided according to their type of rhinitis: allergic rhinitis (59), infectious rhinitis (32), polyps (31), NARES (Non-allergic rhinitis with eosinophilia syndrome) (30) and NARNE (non-allergic rhinitis with neutrophils) (30). RESULTS: The control subjects had only type I or II rhinitis, whereas patients with rhinitis usually showed type III or IV. Allergic rhinitis and nasal polyps had the most serious deterioration according to the fern test (type IV). CONCLUSIONS: The fern test is effective for assessing mucus alterations in patients with rhinitis and it could be included as a new parameter in the study of rhinitis as a potential biomarker of the function of damaged epithelial cells.

Antecedentes: La prueba de "helecho" es un método que sirve para evaluar las características de la secreción nasal en el tratamiento de pacientes con disfunción de la mocosa de la vía aérea. Objetivo: El objetivo del presente estudio fue investigar el papel de la prueba de helecho en pacientes con rinitis y evaluar la clasificación de cada tipo de rinitis (tipos I a IV) en la práctica clínica. Métodos: Estudio transversal en el que se incluyeron pacientes consecutivos de una unidad de rinología de tercer nivel. Se incluyeron 182 pacientes con rinitis y 30 sujetos sanos como controles. Los pacientes se subdividieron según el tipo de rinitis: alérgica (59), infecciosa (32), pólipos (31), rinitis eosinofílica no alérgica (30) y rinitis no alérgica con neutrófilos (30). Resultados: Los sujetos control solo presentaron rinitis tipo I o II, mientras que los pacientes con rinitis generalmente mostraban tipo III o IV. La rinitis alérgica y los pólipos nasales tuvieron el deterioro más grave según la prueba de helecho (tipo IV). Conclusiones: La prueba de helecho es efectiva para evaluar las alteraciones del moco en pacientes con rinitis y podría incluirse como un nuevo parámetro en el estudio de la rinitis como biomarcador potencial de la función de las células epiteliales dañadas.

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BACKGROUND: Precision medicine is an up-to-date strategy aimed at individualizing precise pathophysiological mechanisms. Thus, precision medicine is the basis for personalized medicine, inasmuch as it seeks to define the most appropriate treatment for each patient. Nasal cytology requires only an optical microscope, stains, glasses, and nasal cytology curettes. The procedure may last very few minutes using quick staining and, therefore, it can be considered a reliable point-of-care test in the office setting. METHODS: Cross-sectional study that included 5030 outpatients with nasal disorders: 2612 males and 2418 females, with a mean age of 36.8 ± 17.1 years, who were attended to within a 5-year period. The patients were subdivided according to skin prick-test and nasal cytology results into subjects with allergic rhinitis or non-allergic rhinitis. Cellular forms were further subdivided based on their cytotype: NARNE (> 50% of neutrophils with absence of spores and bacteria); NARES (> 20% of eosinophils); NARMA (> 10% of mast cells); and NARESMA (> 20% of eosinophils and > 10% of mast cells). RESULTS: 453 subjects (9%) had negative nasal cytology, 1056 (21%) had allergic rhinitis, 538 (10.7%) had NARES, 493 (9.8%) had nasal polyposis, 251 (5%) had rhinosinusitis, 221 (4.4%) had NARESMA 201 (4%) had infectious rhinitis, 131 (2.6%) had NARMA, 89 (1.8%) had NARNE, with the remaining subjects having a miscellaneous inflammatory/infectious profile. CONCLUSIONS: Nasal cytology provides quick information about phenotype and endotype and can be repeated during follow-up to assess post-treatment changes.

Antecedentes: La medicina de precisión es una estrategia actualizada que apunta a individualizar los mecanismos fisiopatológicos precisos. Entonces, la medicina de precisión es la base de la medicina personalizada, como definir el tratamiento apropiado en cada paciente. La citología nasal solo necesita un microscopio óptico, tinturas, gafas y curetas. El procedimiento puede durar muy pocos minutos usando tinción rápida, por lo tanto, se puede considerar una prueba confiable en el punto de atención en el consultorio. Métodos: Estudio transversal que incluyó 5030 pacientes ambulatorios con trastornos nasales: 2612 hombres y 2418 mujeres, edad promedio de 36.8 ± 17.1 años, quienes fueron atendidos en un periodo de cinco años. Los pacientes se subdividieron conforme a la prueba cutánea y la citología nasal en sujetos con rinitis alérgica y con rinitis no alérgica. Las formas celulares se subdividieron en función del citotipo: rinitis no alérgica con predominio de infiltración eosinofílica (NARNE, neutrófilos > 50 % con esporas y bacterias ausentes); rinitis no alérgica con eosinófilos (NARES, eosinófilos > 20%); rinitis no alérgica con predominio de infiltrado de mastocitos (NARMA, mastocitos > 10 %) y rinitis no alérgica con eosinófilos y mastocitos (NARESMA, eosinófilos > 20 % y mastocitos > 10 %). Resultados: 453 (9 %) sujetos tuvieron citología negativa a nasal, 1056 (21 %) rinitis alérgica, 538 (10.7%) NARES, 493 (9.8%) poliposis nasal, 251 (5%) rinosinusitis, 221 (4.4%) NARESMA, 201 (4%) rinitis infecciosa; 131 (2.6%) NARMA y 89 (1.8%) NARNE; los sujetos restantes tenían un perfil inflamatorio-infeccioso misceláneo. Conclusiones: La citología nasal proporciona información rápida sobre el fenotipo y endotipo y puede repetirse en el seguimiento para evaluar los cambios posteriores al tratamiento.

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