Showing papers in "Ear, nose, & throat journal in 2021"

Efficacy of Povidone-Iodine Nasal and Oral Antiseptic Preparations Against Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2).

Abstract: Introduction:Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the global pandemic of coronavirus disease 2019 (COVID-19). From the first reported cases i...

Dizziness and COVID-19.

Abstract: Coronavirus 2019 or COVID-19 is a novel entity which had led to many challenges among physicians due to its rapidly evolving nature. Vertigo or dizziness has recently been described as a clinical manifestation of COVID-19. Countless studies, emerging daily from various parts of the world, have revealed dizziness as one of the main clinical manifestation of COVID-19. This is not surprising as dizziness has historically been associated with viral infections. An earlier published study from China found dizziness to be the most common neurological manifestation of COVID-19. Dizziness was proposed to occur ensuing the neuroinvasive potential of severe acute respiratory syndrome coronavirus 2 or SARS-CoV-2 virus which causes COVID-19. Baig et al postulated that the virus enters the neural tissue from circulation and binds to the angiotensinconverting enzyme 2 receptors found in the capillary

Evolving Criteria for Adult and Pediatric Cochlear Implantation.

Abstract: The indications for cochlear implantation have gradually expanded as advancements in technology have evolved, resulting in improved audiologic outcomes for both adult and children. There remains a significant underutilization of cochlear implant technology in the United States, and recognition of the potential benefits of cochlear implantation for non-traditional indications is critical for encouraging the evolution of candidacy criteria. Adult cochlear implantation candidacy has progressed from patients with bilateral profound sensorineural hearing loss (SNHL) to include patients with greater degrees of residual hearing, single-sided deafness and asymmetric hearing, and atypical etiologies of hearing loss (eg, vestibular schwannoma, Meniere's disease, and otosclerosis). Indications for pediatric cochlear implantation have similarly evolved from children with bilateral severe to profound SNHL to implanting children at a younger age, including those with residual hearing, asymmetric hearing loss, inner ear malformations, as well as cochlear nerve deficiency. In this editorial, the literature investigating cochlear implantation for nontraditional indications is reviewed with an aim to use the best available evidence to encourage the evolution of candidacy criteria.

Hearing Loss in SARS-CoV-2: What Do We Know?

Abstract: Hearing loss following viral infection has been reiterated for years. Viral-induced hearing loss is known to cause from mild to profound hearing loss, either unilateral or bilateral, conductive or sensorineural type of hearing loss. Interestingly, the effects of hearing loss accruing viral infection differ greatly according to the type of virus. Accordingly, hearing loss may occur ensuing a few postulations including direct or indirect damage to inner ear structures as well as host immunemediated damage. Outcome of the hearing loss also varies greatly, as some viral infections are reversible with appropriate antiviral drugs. The recent pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has opened a Pandora’s box of novel intriguing clinical manifestations that are being unfolded perpetually. Although respiratory, cardiologic, and gastrointestinal symptoms are the main focus, recently olfactory and gustatory symptoms have successfully made it to the list. Recent studies have unveiled neurotrophic and neuroinvasive characteristics possessed by the novel coronavirus. The notion of SARS-CoV-2 infection as a precursor of hearing loss has recently been lauded. This has ignited the search on the evidence available on the prevalence of hearing loss among patients infected with SARS-CoV-2. Interestingly, a previous report on coronavirus discovered the involvement of brainstem, which could explain the auditory involvement. Myriad theories have been postulated on the mechanism of hearing loss following SARS-CoV-2 infection. Among them, hematogenic transmission posits the basis of hearing loss in these groups of patients. Severe acute respiratory syndrome coronavirus 2 attaches to the hemoglobin via b chain, gaining entry into erythrocytes, which acts as a transporter ergo, infecting all tissues by binding to the surface receptor, angiotensin-converting enzyme 2 (ACE2). As ACE2 has been reported to be abundant in the brain, medulla oblongata, and temporal lobe, the hearing center becomes affected, paving the way to hearing loss. Severe acute respiratory syndrome coronavirus 2 causes cytokine release once it binds to the surface receptor, ACE2. Therefore, the hearing center becomes affected by the inflammatory mediators released upon binding to the surface receptors in the temporal lobe. Additionally, as SARS-CoV-2 deoxygenates the erythrocytes, possibility of hypoxia of the hearing center may lead to permanent damage, causing permanent hearing loss. Another plausible hypothesis of hearing loss is ensuing reduced perfusion to the hearing organs due to ischemia. When ACE2 found in vascular smooth muscle becomes infected, and clot formation diminishes blood supply, thus causing ischemic damage, which may contribute to the hearing loss. The elderly group, which has been the main target population of severe SARS-CoV-2 infection, is prone to hearing loss, especially following the ischemia theory. We postulate that the reason behind scantily reported cases on hearing loss among patients infected with SARS-CoV-2 is that the infected patients with hearing loss present in grave conditions require urgent resuscitation. In the past, viral infection has been associated with sudden sensorineural hearing loss (SSNHL). Inflammation of the auditory pathway, including cochlear nerve, cochlea, and perilymphatic tissue, as well as cross-reaction between the antigens in the inner ear and virus have all been linked as the culprit in causing SSNHL. Additionally, indirect virus transmission from cerebrospinal fluid to the inner ear structures can also explain the cause behind SSNHL. Many reports have linked SARS-CoV-2 infection to a number of peripheral neuropathies; therefore, the possibility of impairment of transmission of auditory pathway is high among patients infected with SARS-CoV-2. Interestingly, recent

COVID-19 and Tinnitus.

Abstract: Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2, brings with it a plethora of health concerns. Although most people have mild symptoms, which are respiratory in nature, some experience neurological symptoms, central nervous system manifestations, peripheral nervous manifestations, and skeletal muscle manifestations. But the damaging impact of COVID-19 virus on the hearing organs in the inner ear is a new finding yet to be explored. Currently, there is little evidence published connecting novel coronavirus and tinnitus directly. But according to the American Tinnitus Association, preexisting behavioral conditions make it more likely for patients to experience tinnitus due to the stress and depression associated with social isolation and infection avoidance. Hearing loss and Tinnitus is a common pathology seen in otolaryngology and there are numerous papers in literature describing its associations with other infections. However, this is the first reported case of hearing loss and tinnitus in a COVID-19 patient, in the State of Qatar, and this case report strives to contribute to the ocean of literature highlighting the need for otorhinolaryngologists to be aware of its correlation with COVID-19 virus.

Diagnosis of SARS-CoV-2 by RT-PCR Using Different Sample Sources: Review of the Literature.

Abstract: Objective:The most widely used diagnostic technique for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is real-time reverse transcriptase-polymerase chain reaction (RT-PCR)....

The Role of Biologics in Chronic Rhinosinusitis With Nasal Polyps

Abstract: Biologic therapy is a new treatment option for patients with chronic rhinosinusitis with nasal polyps (CRSwNP). Currently, the only biologic with Food and Drug Administration-approval status for CRSwNP is dupilumab. Several other biologics are likely to be approved for CRSwNP, including mepolizumab and omalizumab, based on their promising phase 3 trial results. The role of biologics in the treatment paradigm requires consideration of multiple factors that have yet to be clearly established. This includes identifying patients most appropriate for biologic therapy while considering long-term safety and cost-effectiveness in the context of patient preferences and goals.

Evaluation of Olfactory Function With Objective Tests in COVID-19-Positive Patients: A Cross-Sectional Study.

Abstract: Objective:Olfactory dysfunction is relatively high in coronavirus disease 2019 (COVID-19) patients. The aim of this study is to investigate the incidence of olfactory disorder objectively in patien...

Vestibular Neuritis as Clinical Presentation of COVID-19.

Abstract: Coronavirus disease 2019 (COVID-19) may lead to many otolaryngological disorders such as loss of smell and taste, sudden sensorineural hearing loss (SSNHL), facial palsy, and parotitis The involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vestibular neuritis (VN) has been reported in 2 adult patients but not really confirmed through objective testings We present a case of a 13-year-old girl with left superior vestibular neuritis confirmed by Video Head Impulse Test during a proven COVID-19 infection To the best of our knowledge, this is the first case associating VN and COVID-19 that was demonstrated with an objective peripheral assessment Physicians may be aware about the occurrence of VN in patients with COVID-19, keeping in mind that this condition may develop not only in adults Early detection of SARS-CoV-2 in this pandemic is required to prevent its spread

COVID-19: Post-vaccine Smell and Taste Disorders: Report of 6 Cases.

Abstract: Post-vaccine olfactory and gustatory disorders are very rare and were reported in patients who received influenza vaccines. In this article, we report 6 cases of post-coronavirus disease 2019 (COVID-19) vaccine olfactory and gustatory disorders in patients with negative nasal swabs. Precisely, olfactory and gustatory dysfunctions were reported in 5 and 1 patients, respectively. Sense disorders occurred after the first injection of AstraZeneca (n = 4) or the second injection of Pfizer (n = 2) vaccines. In 4 cases, the olfactory or gustatory disorder was confirmed with psychophysical evaluations. The duration of chemosensory dysfunction ranged from 4 to 42 days. None of the patient reported mid- or long-term olfactory or gustatory disorder. The occurrence of olfactory and gustatory dysfunctions in adults benefiting from COVID-19 vaccines is still rare but has to be known by otolaryngologists.

The Role of Tracheotomy and Timing of Weaning and Decannulation in Patients Affected by Severe COVID-19.

Abstract: Objectives:Patients with acute respiratory failure due to coronavirus disease 2019 (COVID-19) have a high likelihood of needing prolonged intubation and may subsequently require tracheotomy. Indica...

Diversity in Academic Otolaryngology: An Update and Recommendations for Moving From Words to Action

Abstract: Objectives:(1) To investigate the state of diversity and inclusion initiatives in otolaryngology–head and neck surgery (OHNS) as compared to general surgery and (2) assess their effects on female r...

Mir-142-3p Regulates Inflammatory Response by Contributing to Increased TNF-α in Chronic Rhinosinusitis With Nasal Polyposis:

Abstract: Objective:Previous studies suggested that microRNAs played an important role in the progression of inflammation and remodeling of chronic rhinosinusitis with nasal polyposis. However, the abnormal ...

Taste and Smell Impairment in Critically Ill Patients With COVID-19: An Intensive Care Unit Study.

Abstract: Objective:To determine taste and smell impairment rates in patients with coronavirus disease 2019 (COVID-19) who were hospitalized in the intensive care unit (ICU).Methods:Between March 2020 and Ma...

Image-Guided Surgery and Intraoperative Imaging in Rhinology: Clinical Update and Current State of the Art.

Abstract: Introduction:Image-guided surgery (IGS) has gained widespread acceptance in otorhinolaryngology for its applications in sinus and skull base surgery. Although the core concepts of IGS have not chan...

Xerostomia and COVID-19: Unleashing Pandora's Box

Abstract: Ever since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was discovered, new findings are emerging linking to this deadly pandemic which causes coronavirus disease 2019 (COVID-19). Novel clinical manifestations are being unraveled on a daily basis although World Health Organization strongly supports acute respiratory illness, fever, and cough to be the most prominent clinical manifestation. Some symptoms may not be so blatant and are prone to be overlooked even by adept physicians. Recently, xerostomia or dry mouth syndrome has been linked with COVID-19 as xerostomia has been found largely amongst COVID-19 patients. Dry mouth or xerostomia is a sign of dehydration which could occur secondary to underlying illness such as COVID-19. We hypothesize that xerostomia occurs due to the neuroinvasive and neurotropism potential of SARS-CoV-2. Angiotensin-converting enzyme 2 (ACE2) has been reported to be the main site of entry of SARS-CoV-2 into the cell. Additionally, the pathway of entry of SARS-COV-2 into the peripheral nervous system and central nervous system through synaptic contact has been postulated. Dysgeusia, one of the newly discovered COVID-19 clinical manifestation, is thought to occur secondary to xerostomia. Alteration in the quantity and composition of saliva causing gustatory dysfunction supports the notion that xerostomia could cause gustatory dysfunction. In the same vein, reduction of proteins as well as antiviral properties within the saliva could be an indicator of COVID-19. Study by Biadsee et al found 72 of their COVID-19 patients complained of xerostomia which reported a strong association with gustatory dysfunction and burning mouth. Traditionally, mouth breathing which occurs secondary to viral-induced nasal obstruction and rhinorrhea has been considered the main culprit causing xerostomia. However, it is noteworthy that nasal obstruction and rhinorrhea are not the main presentation of COVID-19. Previous study has reported on angiotensin-converting enzyme (ACE2) receptor 2 in epithelial cells of the salivary gland as the primary site for coronavirus. Parallel to that, viralinduced infection and inflammation is a known cause of xerostomia. Hence, we would like to highlight that xerostomia ought to be considered as a possible clinical manifestation of COVID-19.

Postoperative Prescriptions and Corresponding Opioid Consumption After Septoplasty or Rhinoplasty.

Abstract: The objective of our study was to assess the relationship between postoperative opioid prescribing patterns and opioid consumption among patients who underwent septoplasty or rhinoplasty. A chart review of patients who underwent either septoplasty or rhinoplasty by 3 surgeons between July 2016 and June 2017 was performed, and pertinent clinical data were collected including the amount of narcotic pain medications prescribed. A telephone interview was then conducted to assess opioid usage and pain control regimen postoperatively. The number of opioid tablets prescribed and the number consumed were converted to total morphine milligram equivalent (MME) for uniform comparison. A total of 75 patients met the inclusion criteria, and 64 completed the telephone survey. Among these 64 patients, the mean (standard deviation [SD]) prescribed MME was 289.7 (101.3), and the mean (SD) consumed MME was 100.6 (109). Similarly, the mean (SD) number of opioid tablets prescribed was 42.4 (9.7), and the mean number of tablets consumed was 14.7 (16.3). Gender, procedure performed (septoplasty or rhinoplasty), use of Doyle splints, and surgeon were not associated with the amount of opioids prescribed or used. Subjective pain control was the only factor associated with an increase in opioid use (P = .0288). There was an overabundance of opioid pain medications prescribed compared to the amount consumed for pain control after septoplasty or rhinoplasty. Abuse of prescription opioids represents an important component of the nation's opioid crisis. Surgeons must be cognizant of the problem and adjust prescribing practices accordingly.

The Impact of the COVID-19 Pandemic on Follow-Ups for Vertigo/Dizziness Outpatients.

Abstract: Objectives:In the present report, we aimed to investigate the impact of the coronavirus disease (COVID-19) pandemic on vertigo/dizziness outpatient cancellations in Japan.Methods:We examined 265 ve...

The Factors Contributing to Efficiency in Surgical Management of Purulent Infections of Deep Neck Spaces.

Abstract: Deep neck infections (DNIs) are still emergency conditions in otorhinolaryngology. Due to rapid disease progression and life-threatening complications, the accurate surgical and medical treatment m...

Alteration of Smell and Taste in Asymptomatic and Symptomatic COVID-19 Patients in Sicily, Italy.

Abstract: Objectives:Alteration of smell and taste has been reported in patients with coronavirus disease 2019 (COVID-19). The incidence and clinical-symptomatic manifestation of COVID-19 is different betwee...

Applications of Office-Based 445 nm Blue Laser Transnasal Flexible Laser Surgery: A Case Series and Review of Practice

Abstract: Background:The recent introduction of 445 nm blue laser to office-based laryngology presents potential advantages. These include a desirable combination of cutting and photoangiolytic qualities and...

Is Regional Lymph Node Metastasis of Head and Neck Paraganglioma a Sign of Aggressive Clinical Behavior: A Clinical/Pathologic Review.

Abstract: Background:Head and neck paraganglioma is a rare neoplasm of the paraganglia. It accounts for <1% of all head and neck tumors. It usually has benign clinical course; however, malignant paragangliom...

Benign Paroxysmal Positional Vertigo: Comparison of Idiopathic BPPV and BPPV Secondary to Vestibular Neuritis.

Abstract: The aim of this study was to reveal clinical features of benign paroxysmal positional vertigo (BPPV) through comparing idiopathic BPPV and BPPV secondary to vestibular neuritis (VN). The clinical data of the 189 BPPV patients admitted to our tertiary care hospital including otolaryngological, audiological, vestibular, neurological, and radiological evaluations were reviewed. Patients diagnosed with idiopathic BPPV (n = 145) and BPPV secondary to VN (n = 44) were grouped as I and II, respectively. The clinical data of 2 groups were compared. The findings of the study showed that the patients with secondary BPPV due to VN are much younger, have symptoms of only posterior semicircular canal involvement, and require more treatments compared to patients with idiopathic BPPV. The clinical features of patients with BPPV secondary to VN and idiopathic BPPV differ on several aspects. More extensive studies are needed to investigate the underlying etiology in patients with BPPV encountered after VN.

Correlation Between Adenoid Hypertrophy, Tympanometry Findings, and Viscosity of Middle Ear Fluid in Chronic Otitis Media With Effusion, Southern Oman

Abstract: Otitis media with effusion is a common cause of diminished hearing in children younger than 12 years. Hypertrophy of adenoids is one of the commonest etiologies of this condition. It has been mentioned that with increased size of the adenoid tissue, the more likely the incidence of fluid in the middle ear. The aim of this study was to find whether there is a correlation between adenoid size, tympanometric findings, and type of fluid in the middle ear irrespective of disease duration. This is a prospective study done on 100 pediatric patients (12 years and less) presented with chronic otitis media with effusion (COME) and adenoid hypertrophy from July 2015 till July 2017. Cases with tympanometry evidence of COME (B, Cs) and adenoid hypertrophy seen by nasal endoscopy were included. Adenoid size was graded and correlated with the type of tympanometry and type of fluid in the middle ear. Sixty male children and 40 female children were involved. Age ranged from 3 to 12 years with a mean of 7.19 ± 2.489 years. Highly significant relation existed between grade 4 adenoid hypertrophy and mucoid nature of middle ear fluid (P value = .000). There is a highly significant relation between adenoid hypertrophy grade Ⅳ and type B tympanometry. There is a highly significant relation between adenoid size and nature of middle ear fluid irrespective of the duration of complaints, where grade Ⅳ adenoid hypertrophy showed more increase in middle ear effusion viscosity making adenoid size a very important predictor for the tympanometry type and the nature of the fluid in the middle ear.

The Role of Comorbidities in Benign Paroxysmal Positional Vertigo.

Abstract: Purpose:To assess the correlation between the comorbidities, such as hypertension, diabetes, thyroid disorders, hearing loss, hyperlipidemia, and vitamin D deficiency and benign paroxysmal position...

Investigation of Astaxanthin Effect on Cisplatin Ototoxicity in Rats by Using Otoacoustic Emission, Total Antioxidant Capacity, and Histopathological Methods:

Abstract: Background:Cisplatin-induced ototoxicity is related to oxidative stress. Astaxanthin is one of the most powerful antioxidants in nature.Aims/objectives:To investigate the protective effect of astax...

Endoscopic Stapedotomy: Overcoming Limitations of Operating Microscope:

Abstract: The study is aimed to assess the scope of endoscopic stapedotomy in overcoming technical challenges faced during conventional stapedotomy using operating microscope. Sixty-four patients with clinical and audiological diagnosis of otosclerosis were randomly assigned into one of the 2 groups-one underwent conventional stapedotomy using operating microscope, while the other group underwent endoscopic stapedotomy, the operating surgeon being the same for both groups, for all cases. The 2 groups were observed in terms of extent of the postero-superior canal bone curettage/drilling, chorda tympani repositioning, visualization of footplate area, surgical time from first incision to ear packing, post-operative morbidity in terms of post-operative pain, vertigo, hearing outcome, and changes in taste sensation. It was observed that irrespective of the width of the external auditory canal, endoscopic approach offered better access to the footplate area requiring lesser bone removal and chorda tympani repositioning. The operating time, post-operative pain, and changes in taste sensation were significantly less in the endoscopic group. However, no difference was noted in terms of the post-operative hearing outcome and incidence of vertigo. Endoscopic stapedotomy has clear advantages in terms of the technicality and accessibility to the working area as well as faster recovery.

Risk Factors for Mortality in 220 Patients With COVID-19 in Wuhan, China: A Single-Center, Retrospective Study

Abstract: Background:An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 infection occurred in Wuhan, China, in December 2019. To date, the analysis o...

COVID-19 and anosmia: The story so far.

Abstract: ObjectivesThe pandemic has affected over 182 million coronavirus disease 2019 (COVID-19) cases worldwide. Accumulated evidence indicates that anosmia is one of the significant characteristics of CO...