Ear Nose Throat Research Articles

Hospitalizations for infections in primary Sjögren’s syndrome patients: a nationwide incidence study

Background Primary Sjögren’s syndrome (pSS) is an autoimmune disease with increased risk of infections. Here, we assessed whether pSS patients were at higher risk of hospitalization for community and opportunistic infections. Methods We selected newly hospitalized pSS patients between 2011 and 2018, through a nationwide population-based retrospective study using the French Health insurance database. We compared the incidence of hospitalization for several types of infections (according to International Classification for Disease codes, ICD-10) between pSS patients and an age- and sex-matched (1:10) hospitalized control group. We calculated adjusted Hazard Ratios (aHR, 95% CI) adjusted on socio-economic status, past cardiovascular or lung diseases and blood malignancies factors. Results We compared 25 661 pSS patients with 252 543 matched patients. The incidence of hospitalizations for a first community infection was increased in pSS patients [aHR of 1.29 (1.22–1.31), p < .001]. The incidence of hospitalization for bronchopulmonary infections was increased in pSS patients [aHR of 1.50 (1.34–1.69), p < .001, for pneumonia]. Hospitalizations for pyelonephritis and intestinal infections were increased [aHR of 1.55 (1.29–1.87), p < .001 and 1.18 (1.08–1.29), p < .001, respectively]. Among opportunistic infections, only zoster, and mycobacteria infections (tuberculosis and non-tuberculous) were at increased risk of hospitalization [aHR of 3.32 (1.78–6.18), p < .001; 4.35 (1.41–13.5), p = .011 and 2.54 (1.27–5.06), p = .008, respectively]. Conclusions pSS patients are at higher risk of hospitalization for infections. The increased risk of hospitalization for mycobacterial infections illustrates the potential bilateral relationship between the two conditions. Vaccination against respiratory pathogens and herpes zoster virus may help prevent some hospitalizations in pSS patients. KEY MESSAGES Primary Sjögren’s syndrome (pSS) increases hospitalization risk for community infections: bronchopulmonary, skin, dental, ear–nose–throat, intestinal infections and pyelonephritis. Hospitalizations for zoster and mycobacterial infections are also increased in this population. Dedicated preventive measures and vaccination campaigns could decrease the burden of infections in pSS patients.

A study of clinical and histopathological correlation of sinonasal masses

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Nasal masses are finding in an ENT (Ear, nose, throat) outpatient department. Most patient present with complaints of nasal obstruction.Other symptoms are nasal discharge, epistaxis and disturbances of smell. Sinonasal mass may be neoplastic (benign or malignant) or non-neoplastic (congenital, inflammatory) in nature. It is difficult to determine actual pathology underneath every nasal masses so, histopathological evaluation is mandatory for definitive diagnosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The present study is prospective observational study of symptomatology, demographic profile and histopathological correlation of sinonasal masses in samplw size 80, these are the total number of patients presenting at tertiary health care centre from 1&lt;sup&gt;st &lt;/sup&gt;Jan 2019 to 30&lt;sup&gt;th &lt;/sup&gt;June 2020 (18 months) the study include, patients of any age and sex presenting with nasal symptoms&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Majority of patients with sinonasal masses where in the age group 2&lt;sup&gt;nd&lt;/sup&gt; decade. Male female ratio was 1.28:1. Nasal obstruction was the most common presentation. Most common non neoplastic lesion was ethmoidal polyposis and most common benign lesion was hemangioma. Most common malignant lesion was squamous cell carcinoma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Presenting features of all sinonasal masses may be indistinguishable and post diagnostic dilemma. Correlation of clinical and histo-pathological modalities is of utmost importance for accurate diagnosis.&lt;/p&gt;

Prevalensi Anosmia dan Komorbiditas Pasien Covid-19 Sedang - Berat di RSUP Dr M Djamil Padang Tahun 2020

The current coronavirus disease (COVID-19) pandemic anosmia and dysgeusia have been described as important symptoms of the disease. Clinical syndromes arising from infection with the SARS-CoV-2 virus can be of various kinds. Research by the American Academy of Otolaryngology shows anosmia occurs in 73% of patients and shows that anosmia is one of the important symptoms that arise from COVID-19 and to identify COVID-19 patients. To find out the description of anosmia in moderate-to-severe COVID-19 patients at RSUP Dr. M. Djamil Padang in 2020. The scope of the research is in the field of Ear Nose Throat Science. The research was conducted in the medical records section of Dr. RSUP. M. Djamil Padang. This research was conducted from August to September 2021. The type of research was descriptive categorical. The population in this study were all patients diagnosed with moderate-to-severe COVID-19 at RSUP Dr. M. Djamil Padang in 2020 as many as 106 samples with the Consecutive sampling technique. Univariate data analysis is presented in the form of frequency distribution and data processing using computerized SPSS program version IBM 24.0. Almost the same between male and female sexes with moderate-severe COVID-19, the mean age of moderate-severe COVID-19 patients was 49.68 (SD ± 12.63) years, which was dominated by the 52-53 age group. years with a total of 8 people, hypertension comorbid factor, as many as 35 people (33%), Diabetes Mellitus as many as 16 (15%) people, and cardiovascular disorders 8 people and 57 patients (53.8%) moderate-severe COVID-19 at RSUP Dr M Djamil Padang in 2020 does not suffer from anosmia. Conclusion: Almost the same between the sexes of women and men who suffer from moderate-severe COVID-19. The mean age of patients suffering from moderate-to-severe COVID-19 was 49 years and a standard deviation of 12.63. The most common comorbid disease suffered by patients was hypertension, followed by diabetes mellitus and cardiovascular disorders and complaints of anosmia were found in 49 patients.

Diagnostic efficacy of ultrasonography-guided fine needle aspiration cytology on thyroid swellings

IntroductionPatients presenting with a thyroid nodule, if malignant, may call for removal. A good screening tool with high diagnostic value for preoperative evaluation is preferred. Through real-time visualization of the needle to aspirate from the suspicious site, ultrasonography-guided fine-needle aspiration cytology could be an excellent screening tool.Materials and methodA cross-sectional descriptive study was conducted at Ganesh Man Singh Memorial Academy of Ear Nose Throat–Head and Neck Studies, Kathmandu, Nepal, from September 2018 to November 2019. We included 59 subjects of 15–72 years meeting the inclusion criteria. All study participants underwent preoperative ultrasonography-guided fine-needle aspiration cytological evaluation of thyroid nodule, which was correlated with their histopathological findings to determine diagnostic values.ResultThe sensitivity, specificity, and accuracy of ultrasonography-guided fine-needle aspiration cytology of thyroid nodule was 96.96%, 61.53%, and 81.35%, respectively. On stratification according to size, high sensitivity of 100% was observed in evaluating lesions of size < 2 cm and > 4 cm. There was a good inter-rater agreement between findings of ultrasonography-guided fine-needle aspiration cytology and histopathology with a kappa coefficient of 0.607.ConclusionUltrasonography-guided fine needle aspiration cytology is a reliable procedure to evaluate thyroid lesions with high diagnostic value. It is an excellent tool for evaluating small, non-palpable nodules.

Factors affecting the occurrence of otitis media with effusion in preschool and elementary school children: a comparative cross-sectional study

ObjectiveIdentify the risk factors for otitis media with effusion (OME), especially laryngopharyngeal reflux (LPR), adenoid hypertrophy and allergic rhinitis, that could be used to develop prevention strategies in children.DesignA comparative...

Evaluation of the relevance of interhospital transfer medicalization in the suspicion of foreign body aspiration in children

IntroductionForeign body aspiration in preschool children is a common and potentially fatal event. Diagnostic confirmation requires tracheobronchoscopy. The current medical care in West Provence Alpes Cote d'Azur (PACA) is based on an inter-hospital transfer via the emergency medical services (EMS) to the pediatric ear–nose–throat (ENT) reference center in Marseille as quickly as possible. However, the intensive care pediatric transport team has only one vehicle, which is not always available. The issue of the real risk for the suspected patient when they are asymptomatic therefore arises, questioning the presence of a physician during these transports. Main objectiveWe aimed to describe our practice regarding suspected foreign body aspiration (FBA) and assess the relevance of medical transport for children with suspected FBA regardless of their clinical and/or radiological presentation. Material and methodsThis was a retrospective, single-center study at the Timone Children's Hospital, from January 1, 2016, to December 31, 2017. Clinical and radiological data were collected from pediatric emergency files and endoscopy reports. ResultsA total of 178 children were suspected of having FBA upon arrival at the Pediatric Emergency Department of La Timone Children's Hospital; 96 children were transferred from another hospital on pediatric ENT advice. Of these 96 children, 63 were asymptomatic. Of these asymptomatic children who were transferred, 11 did not undergo tracheobronchoscopy and four children presented with a foreign body at tracheobronchoscopy (6%). When transport-related data were available, no deterioration of the clinical condition was described in these patients during transport. ConclusionIn our retrospective study of the medical care for suspected FBA in children in the West PACA region, less than 10% of children who were asymptomatic but suspected of having FBA presented with a foreign body on endoscopy, which questions the relevance of physician presence during transport of these patients.

Dysphagia-related mucositis in children undergoing chemotherapy: The COMEDY pattern.

Children undergoing chemotherapy can experience dysphagia due to non-erosive reflux disease (NERD). Oral mucositis (OM) associated with NERD-dysphagia in children with cancer has recently been defined with the acronym COMEDY (Clenching, Oral Mucositis, closed Eyes, DYsphagia). This study aims to identify the prevalence of the COMEDY pattern among chemotherapy-induced OM. Forty-two medical records of children undergoing chemotherapy for haemato-oncologic diseases and presenting OM were reviewed. The following data were collected: age, type of haemato-oncologic disease, presence of dysphagia, type of oral mucosal lesions (i.e. traditional oral mucositis or COMEDY pattern), site of oral lesions, ear-nose-throat (ENT) assessment for the indirect signs of NERD and paediatric neuro-psychiatric (PNP) assessment. Among 42 children with chemotherapy-related OM, 6 patients (14.2%) showed the COMEDY pattern. Besides the characteristic clinical aspect of the oral mucosa, initially classified as grade II OM, these children suffered from NERD-related dysphagia and PNP issues. A COMEDY pattern can occur in a number of cases of chemotherapy-induced OM; recognizing this pattern may improve the effectiveness of treatment.

Rational Drug Use by Patients Applying at Ear Nose Throat Polyclinic

Objective: This study was conducted to determine information, attitude, and behaviors of patients that apply at ear, nose, throat polyclinic regarding rational drug use.&#x0D; Method: The study that was planned as a descriptive, cross-sectional study was conducted with 273 patients that applied at ear nose throat polyclinic of a university hospital. Data was collected using Patient Information Form and Rational Drug Use Information Form and descriptive statistics were used in the analysis.&#x0D; Findings: Average age of patients were 40.71±15.21 year and 38.4% of the patients had higher education degree. It was found that 73.3% of the patients did not have knowledge about rational drug use, 59% received information about drugs they used from the doctor, 52.7% read the drug prospectus, 86.4% used the drugs prescribed by prescription, 75.8% used analgesics without consulting the doctor, 75.1% knew the storage conditions of drugs, 73.3% knew the purpose of use of drugs, and 82.4% knew the method of administration of the drug they used. Attitudes that were not in line with rational drug use were determined as taking nonprescription drug, increasing dosages used, abandoning drug when symptoms end, taking the same drug when symptoms repeat, seeking solutions by oneself in case of side effects, receiving and giving drug advices from relatives, and to acquaintances, and not investigating drug interactions.&#x0D; Conclusion and Recommendations: It was observed that the patients did not receive information about rational drug use. The results of the research showed that the patients had positive as well as negative attitudes about drug use. In line with these results, it is recommended that patients be educated on rational drug use.

Investigation of Reflux Characteristics in Outpatients of Otorhinolaryngology-Head and Neck Surgery by Age and Gender in the Chinese Population

To investigate the characteristics of patients with reflux diseases in the otorhinolaryngology-head and neck surgery clinics through the Reflux Symptom Scale-12 (RSS-12) and the Gastroesophageal Reflux Disease Questionnaire (GERD-Q). All included patients completed the RSS-12 and GERD-Q scales and were considered to have LPR with an RSS-12 score >11 and GERD with a GERD-Q score >7. Data were analyzed according to genders (male and female) and age (18-40, 41-60, and >60 years). A total of 977 patients were included. the mean RSS-12 and GERD-Q score were 11.32±21.34 and 6.31±1.21, and the positive rate of LPR and GERD were 28.76% and 8.90%, respectively. Males had a higher positive rate of LPR and GERD than females, and there were more males with LPR who also had GERD. Among those with both LPR and GERD, males had significantly higher ear-nose-throat (ENT) symptom scores such as hoarseness and excess throat mucus than females. However, females had significantly higher scores of gastrointestinal (GI) symptoms, mainly indigestion and abdominal pain, and elder patients (>60 years) had higher scores of ENT, GI, respiratory symptoms, as well as the impact of symptoms on quality of life than the young patients (18-40, and 41-60 years). Patients in the otorhinolaryngology-head and neck surgery clinics have different reflux characteristics by gender and age in the Chinese population. Males had more severe ENT-related symptoms of distress, while females had more complaints of GI symptoms. Older patients had higher scores for ENT, GI and respiratory symptoms.

The Pierre Robin sequence from an anesthesiologic perspective : Presentation of the procedure based on a retrospective analysis at a university hospital

As part of surgical interventions in pediatric patients, children with craniofacial malformations and syndromes are presented in the field of oral and maxillofacial surgery, anesthesia and also in all other clinical disciplines. In particular, the Pierre Robin sequence in the clinical context leads to asituation albeit arare one, which should be given high attention in preoperative, intraoperative and postoperative care. In aretrospective analysis from 1993 to 2020 in the Department of Oral and Maxillofacial Surgery at the University Hospital Halle (Saale), atotal of 54patients were identified with syndromic changes and aneed for surgical treatment. During this period, 12patients with aPierre Robin sequence were genetically confirmed, who received atotal of 20surgical interventions under general anesthesia at different times. Statistical analysis was performed using SPSS17.0. In 12patients with aPierre Robin sequence, 20surgical procedures were performed with the patient under general anesthesia. The youngest patients had an average age of 6months, the oldest 16years at the time of the operation. The average age was 5.7years. In addition to the genetic component, all children were assigned to the ASAI classification. The surgical indication was initially an isolated cleft palate in all patients, followed by further interventions such as dental restorations, corrective surgery in the area of the palate or ear nose throat (ENT) examinations. Drug induction of general anesthesia was weight-adapted using propofol 1%, fentanyl or remifentanil and rocuronium. In our study, out of 18orotracheal intubations, only 2patients had to be intubated by video laryngoscopy. One patient required nasal intubation and another was fitted with alaryngeal mask. The success rate of conventional intubation was 89.5%. Postoperatively, one infant had recurrent drops in saturation, so that reintubation was necessary.

Granulomatosis with polyangiitis in a patient with polydipsia, facial nerve paralysis, and severe otologic complaints: a case report and review of the literature

BackgroundGranulomatosis with polyangiitis, formerly known as Wegener granulomatosis, is a necrotizing vasculitis with granulomatous inflammation that belongs to the class of antineutrophil cytoplasmic antibodies-positive diseases. It occurs in a localized and a systemic form and may present with a variety of symptoms. Involvement of the upper respiratory tract is very common, while neurologic, endocrinological, and nephrological dysfunction may occur.Case presentationWe describe the case of a 29-year-old Central European male patient presenting with severe bilateral sensorineural hearing loss, otorrhea, and one-sided facial nerve paralysis. The patient was unsuccessfully treated with i.v. antibiotics at another hospital in Berlin, and tympanic tubes were inserted. After presentation to our emergency room, he was hospitalized and further diagnostics started. Increased fluid intake and 12 kg weight gain over the last months were reported. The patient was diagnosed with granulomatosis with polyangiitis and diabetes insipidus. The patient’s condition improved after treatment with rituximab.DiscussionA comprehensive PubMed search of all articles with granulomatosis with polyangiitis and diabetes insipidus was conducted to assess which combination of symptoms occurs simultaneously and whether other parts of the pituitary are commonly involved. The 39 selected articles, describing 61 patients, showed that ear–nose–throat involvement occurred most commonly, in 71% of cases. Of patients, 59% had involvement of the anterior pituitary gland, while true panhypopituitarism occurred in 13% of cases. Only one case report featured the same set of symptoms as described herein.ConclusionGranulomatosis with polyangiitis is a highly variable disease, commonly involving the upper airways, but that may present with symptoms solely related to the pituitary gland. Clinicians should have a low threshold to investigate for granulomatosis with polyangiitis in patients with therapy-resistant otorrhea. Patients may present with a complex set of symptoms, and integrating different specialists when additional symptoms occur may lead to faster diagnosis.

Sensitivity caused by Dermatophagoides pteronyssinus and D. farinae (Astigmata: Pyroglyphidae) in subjects with allergic rhinitis

The house dust mites (HDMs), defined here as members of the family Pyroglyphidae, are present just about everywhere in human dwellings and act as an important risk factor for allergic rhinitis (AR). They are a major perennial allergen source that causes AR. In the present study, 160 subjects clinically diagnosed with AR from the Department of Ear Nose Throat (ENT), Government Rajindra Medical College and Hospital, Patiala, India, and 30 non-allergic healthy, control individuals were selected. Blood samples were taken from all these study subjects for serological testing and ImmunoCAP™ Phadia™ 100 was used for the detection of total and HDM specific immunoglobulin E (IgE) levels. To detect total IgE levels, a mixture of 14 different allergens was used and, for HDM specific IgE, a mixture of Dermatophagoides pteronyssinus (Trouessart) and D. farinae Hughes allergens. Dust samples were taken from mattresses used by the study subjects with the help of a vacuum cleaner. A floatation method was used for the extraction of mites. Hoyer’s medium was used for the preparation of slides for microscopy. Total IgE levels were elevated in all AR subjects and HDM specific IgE levels were found to be positive in 54.38% of them. Analysis of dust samples showed that 72.50% of samples from the mattresses of AR subjects were found to be positive for the HDMs D. pteronyssinus and D. farinae and 33.33% of those from the control group. Total and HDM specific IgE levels of AR subjects showed statistically significant correlation with each other, but in the control group no such correlation was found. Moreover, a significant result was found between the positive HDM specific IgE levels and the number of D. pteronyssinus and D. farinae found in their respective dust samples. In conclusion, the total IgE and positive HDM specific IgE levels showed that there was a chance of allergic reaction in rhinitis subjects. Furthermore, the significant statistical analysis between positive HDM specific IgE levels against D. pteronyssinus and D. farinae, and the higher prevalence of these two species in the houses sampled provided support for these mites being the major allergen sources for the symptoms of AR in the study area.

Evaluation of the Impact of Dentoalveolar Trauma Management Training Course on Physicians and Dentists' Education in Multiple Hospitals in Mashhad, Iran.

Background: Dental trauma injuries are the second most common traumatic injuries among children and adolescents. An incorrect diagnosis or a delayed treatment of traumatic injuries may lead to irreparable damages. Thus, proper management provided by physicians and dentists is crucial for patients affected by these injuries.This study aimed to evaluate the impact of dentoalveolar trauma management training on improving physicians' and dentists' knowledge in different emergency wards in Mashhad, Iran. Methods: In this educational interventional study, a total number of 60 residents and interns selected from the following categories: maxillofacial surgery residents, emergency medicine residents, ear-nose-throat (ENT) residents, and medical interns were included, who were randomly selected. We gathered information using a valid and reliable questionnaire. Afterward, we provided the participants with booklets about dental traumas. By passing one month, the above-mentioned questionnaire was used to re-evaluate the target groups' knowledge. The results were statistically analyzed using Chi-square, One-way ANOVA and paired sample T-test with statistically significant differences defined for p < 0.05. Results: Prior to the training, the interns had the lowest knowledge, while the maxillofacial surgery residents had the highest level of knowledge in comparison to interns, ENT residents, and emergency medicine residents, respectively (p < 0.001). After completing the course, the maxillofacial surgery residents once again represented the highest knowledge, followed by emergency medicine residents, ENT residents, and medical interns, respectively. A statistically significant difference was noticed in pre- and post-course knowledge evaluation. Conclusion: A comparison of the results before and after the training course demonstrates a significant lack of knowledge on dentoalveolar traumas among physicians and also reveals that providing this education is necessary because it significantly increases their knowledge in this regard.

O-263 Sperm parameters in cancer patients: the role of cancer and cancer diagnoses

Abstract Study question How do sperm parameters compare in various oncologic conditions when compared with controls? Is there an association between severity of the disease and sperm parameters? Summary answer Most cancer types appear to affect sperm parameters. Motility is reduced in all cancers, while sperm concentration is strongly diminished in testicular cancer. What is known already There is no actual consensus whether cancer is negatively associated with semen quality. Some studies have reported poorer sperm parameters in men with cancer, especially testicular cancer. Others have reported no differences in semen parameters of cancer patients when compared with patients with benign diseases. Furthermore, small studies have shown conflicting differences in sperm parameters when comparing across different cancer types. Study design, size, duration Academic single-centered, retrospective cohort study with men banking sperm for fertility preservation prior to undergoing chemotherapy. A total 965 patients with various cancer types, recently diagnosed, produced at least one sample for sperm cryopreservation between 2004 and 2020. Concentration and progressive motility were analyzed for each sample at the time of cryopreservation, before beginning the chemotherapy treatments. Participants/materials, setting, methods The first sample of each patient was kept for data analysis (n = 965). The control group were unselected homosexual male couples planning parenthood, without any known fertility impairment (n = 39). Cancers were grouped as: testis (n = 297), lymphoma (n = 285), leukemia (n = 79), sarcoma (n = 85), brain (n = 61), gastro-intestinal (GI) (n = 73), ear-nose-throat (ENT) (n = 24), and other (n = 52). The last group included cancers of such as kidney, prostate, melanoma, or lung cancer. T-test and Fisher-test were used for statistical analyses. Main results and the role of chance Patients with testicular cancer had significantly lower mean sperm concentration when compared to controls (30.5 vs 69.9 M/ml; p &amp;lt; 0.01). Other groups showed similar concentration values when compared to controls. Furthermore 47% testicular cancer patients had oligospermia (as determined by WHO criteria) compared with 10% unselected controls (p &amp;lt; 0.001) However, sperm from patients with almost all types of cancer showed lower motility rates when compared to controls (31.5 to 35.0% vs 49.0%; p &amp;lt; 0.001). The only group showing similar motility with controls was ENT cancers (41.1% vs 49%, p = 0.2). Similarly, sperm samples from all cancer groups showed higher proportions with asthenospermia (as determined by WHO criteria) when compared with controls (39.1%-54.7% vs 18%, p &amp;lt; 0.01) For individual cancer groups, comparing sperm parameters between patients who survived and those who died, there were no significant differences, suggesting the severity or stage does not modulate the effect of the cancer itself on the sperm. Patients in the testis, lymphoma, leukemia, sarcoma and brain cancer groups were significantly younger than controls (25.3-29.1 vs 37.3 years old), while GI and ENT groups were similar to controls (37.4 and 36.5 vs 37.3). In the “other cancers” group, patients were significantly older than controls (44.4 vs 37.3). Limitations, reasons for caution The interpretation of the findings of this study is limited by the retrospective nature of the analysis and the potential for unmeasured confounding variables. Wider implications of the findings There is an association between abnormal sperm parameters in samples for pre-chemotherapy cryopreservation and all cancer types. This may affect the future likelihood of pregnancy. Young men with cancer need to be counselled that ICSI may be recommended should they need or choose to use their cryopreserved sperm. Trial registration number Not applicable

Anatomical variation of nose and paranasal sinuses among patients with chronic rhinosinusitis on computer tomography

Introduction: Chronic rhinosinusitis is one of the commonest diseases of sinonasal cavity seen in Ear nose throat clinic. Although chronic rhinosinusitis is a clinical diagnosis, CT scan imaging studies helps in accessing the disease and gives a clear anatomy of sinonasal cavity. Chronic rhinosinusitis is a group of disorders that is characterized by inflammation of the mucosa of the nose and paranasal sinuses of at least 12 consecutive weeks duration. There are number of factors that play role in the development of rhinosinusitis, including both host and environmental factors. CRS is a more persistent problem that requires a specific treatment approach.&#x0D; Methodology: This is a prospective comparative study which was conducted in Department of otorhinolaryngology of Birat Medical College and Teaching Hospital from 1st August 2020-31st Dec 2020. This study was approved by Institutional Review Committee of Birat Medical College and Teaching Hospital. 124 patients were taken in the study. The primary objective of the study was to determine the anatomical variation of nose and paranasal sinuses among patients with chronic rhinosinusitis on computer tomography. Informed and written consent was taken from all the subjects participating in the study.&#x0D; Result: A total of 124 patients was included in the study. Out of which 68 (54.76%) were men and 56 (45.24%) were female. The age of patients with CRS ranged from 15-75 years. Highest number of patients with CRS was in the range of 35- 44 years. Mucosal thickening was more common in maxillary sinus (91.12%) followed by ethmoidal (67.74%), spheniod (55.64%) and frontal (54.03%).&#x0D; Conclusion: CT scan is the most common tool to know the anatomical variations of the nose and para nasal sinuses. Moreover it is highly recommended for the patients suffering from chronic rhinosinusitis. CT scan provides all the sinonasal variations and then it becomes easier for the treating physician for better surgical planning and overall management of chronic rhinosinusitis.

Comparison of endoscopic and microscopic methods in stapedotomy: a retrospective analysis.

The goal of the present study was to compare the audiologic results, complications, and advantages/disadvantages of endoscopic and microscopic stapedotomy. Patients who experienced stapedotomy surgery in the Ear Nose Throat Clinic (ENT) of Selcuk University Faculty of Medicine between September 2011 and January 2018 were included in the study. The data of all patients were analyzed and divided into two groups. Those who underwent endoscopic stapedotomy were included in group I, and patients who underwent microscopic stapedotomy formed group II. Surgical findings, complications, and operation times were compared for the two groups. Air and bone conduction thresholds were evaluated at the frequencies of 500, 1000, 2000, and 4000Hz pre- and postoperatively at 1, 3, and 6months, and the mean (± SD) air-bone gap value was recorded. While the mean pre- and postoperative air-bone gaps were 34.38 ± 7.47dB (23-53dB) and 9.69 ± 4.43dB (0-19dB), respectively, in group I, 34.32 ± 7.57dB (23-6dB) and 9.62 ± 4.25dB (2-23dB) were the respective means calculated in group II (p < 0.05). When the mean postoperative air-bone gap was compared, there was no statistically significant difference between the two groups (p = 0.774). The mean operative times for groups I and II were 57.22 ± 4.37min and 63.70 ± 7.34min, respectively (p < 0.001). The requirement for chorda tympani nerve manipulation and scutum curettage was significantly less in group I compared to group II (p = 0.003). Postoperative dysgeusia and postoperative pain were found to be higher in group II than group I, but they were not statistically significant (p > 0.05). Endoscopic stapedotomy displayed similar audiological results, shorter operation times, and similar complication rates, as well as being a less invasive surgery, compared to the microscopic approach.

Assessment of hearing loss in patients with rosacea.

Rosacea is not only a skin condition but a systemic inflammatory disease that includes chronic inflammation, vascular alterations, and autoimmunity in pathogenesis. We aimed to evaluate the presence of a sensorineural hearing loss in the patients with rosacea in comparison with the healthy control group and, also to compare the audiometric results according to the severity of disease among the patient group. Fifty-three patients with erythematelangiectatic or papulopustular type of rosacea and 105 age- and sex-matched healthy controls were included. Each participant had audiometric measurements after a complete ear-nose-throat examination by the same otorhinolaryngologist. The results of air and bone conduction thresholds showed statistically significant differences in particularly high frequencies between the groups in both the right and left ear (for all p < 0.05), but there was no correlation between audiometric measurements and the severity or the type of rosacea (p > 0.05). Regardless of disease severity or type, rosacea patients are likely to have sensorineural hearing loss, and it is important to refer these patients in the early period.

Emergencies in the COVID-19 Era: Less Attendances, More Admissions.

IntroductionHealthcare systems suffered a significant hit by the COVID-19 pandemic since the spring of 2020, and a need for major reorganization emerged. Along with the constant increase in COVID-19 cases, a significant drop in emergency attendances for non-COVID-19-related conditions was noted worldwide. We decided to document attendances in our hospital's emergency department during the first lockdown period in order to monitor this trend, compare it to data from other countries, and start monitoring the effects of this reduction in the years to come.Materials and methodsEmergency department attendances at AHEPA University Hospital, Thessaloniki, Greece, from March 10, 2020, to May 31, 2020, were documented and compared to the corresponding period in 2019. The data collected included the number of patients per specialty, severity upon admission, as well as the need for admission.ResultsWe found a 58% reduction in emergency department attendance during the studied period compared to the corresponding period in 2019 (p<0.0001). The reduction was more noticeable in ears, nose, throat (ENT), and ophthalmology attendances (75.7% and 78.1% reductions, respectively, p<0.001), but other specialties, such as cardiology and general surgery, were also significantly affected (60% and 63% reductions, respectively, p<0.001). However, the percentage of attendances that required admission increased significantly by 25-33% (p<0.001) during the lockdown, reflecting the higher severity of cases reaching the hospital.ConclusionDespite the obvious reduction in attendances during the COVID-19 pandemic, patients still suffer from serious conditions that require hospital admission. Therefore, hospitals need to be supported to also care for these patients. The long-term effects of avoiding hospital attendance need to be closely monitored.

Prognostic values of LDH and Hematological factors in Patients with Sudden Hearing Loss

Objective: In our study, we aimed to evaluate the relationship between Lactate Dehydrogenase and hematological parameters, neutrophil, Neutrophil lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume serum levels in patients with Sudden sensorineural hearing loss prognosis. Methods: 60 patients were hospitalized and treated for Sudden Hearing Loss at Dicle University Hospital Ear Nose Throat Clinic between May 2013 and April 2020, and 60 healthy individuals without any health problems were included in the study. Pretreatment peripheral blood was drawn from all subjects, followed by routine blood cell analysis. The absolute numbers of neutrophils, lymphocytes, and platelets in peripheral blood were obtained, and the Neutrophil lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume of each case were calculated. Results: A total of 120 participants, including 60 Sudden sensorineural hearing loss patients case group and 60 healthy individuals in the control group, were included in the study. The median age of the case group was 46.0 (29.0-55.0), and the control group was 48.0 (33.5-58.5), and no statistically significant difference was found between the groups in terms of age (p = 0.191). The median Lactate Dehydrogenase, Neutrophil, and Neutrophil lymphocyte ratio of the case group was significantly higher than the control group (p &lt;0.05). There was no significant difference between the groups in terms of thrombocyte, mean platelet volume, lymphocyte, platelet lymphocyte ratio, body mass index, and gender (p&gt; 0.05). Conclusion: We think that the increase in Lactate Dehydrogenase level may be a poor prognostic factor in patients with sudden hearing loss that does not improve. In addition, we believe that the increase in neutrophil count and Neutrophil lymphocyte ratio is quite significant but cannot be considered a poor prognostic factor.

Risk factors of anxiety during anesthesia induction in children undergoing eye and ear-nose-throat surgery

Objective: To explore the risk factors of anxiety during anesthesia induction in children undergoing eye and ear-nose-throat (ENT) surgeries. Methods: The clinical data of 930 children who underwent eye and ENT surgeries in the Eye & ENT Hospital of Fudan University from January to December 2019 were collected. The outcome variable was the degree of anxiety during anesthesia induction. Demographic information about the children and their family members, anxiety scores and the usage of preoperative sedative drugs were collected as the exposure factors. The risk factors of anxiety during anesthesia induction were determined by logistic regression analysis. Results: A total of 930 children were included in the study, of which 56(6.0%) cases developed anxiety during the induction period. Univariate logistic regression analysis showed that age (OR=0.72, 95%CI:0.61-0.86, P<0.001), anxiety grading of children by medical evaluation method (mild as the reference, moderate OR=5.42, 95%CI:2.92-10.07, P<0.001; severe OR=7.53, 95%CI: 2.54-22.29, P<0.001), Modified Yale Preoperative Anxiety Scale (mYPAS) score at arrival in the preoperative waiting room (OR=1.05, 95%CI:1.02-1.07, P<0.001) and sedation score (OR=0.48, 95%CI: 0.30-0.76, P<0.001) were risk factors for the development of anxiety during the induction period. Multivariate logistic regression analysis revealed that anxiety grading of children by medical evaluation method was a risk factor for affecting anxiety in the induction period (mild as the reference, moderate OR=4.08, 95%CI:1.81-9.18, P<0.01; severe OR=4.95, 95%CI:1.26-19.44, P=0.022). Conclusion: Anxiety grading of children by medical evaluation method is an essential risk factor for predicting anxiety during induction period.