Otalgia Research Articles

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Ramsay Hunt syndrome (RHS) is a disease that is caused by the varicella-zoster virus and is characterized by severe ear pain, auricular vesicular eruptions, and peripheral facial paralysis. Objective: The aim of this case report is to provide information about the clinical findings and treatment process of RHS, which is a rare case and may have oral findings and stress the importance of early diagnosis. Case Report: A 60-year-old male patient had previously consulted an otolaryngologist and a family physician with complaints of vesicular eruptions in the right ear auricle and on the mandible. The patient in whom a diagnosis could not be established presented to the Department of Oral and Maxillofacial Radiology after exacerbated lesions. White plaque-like and ruptured vesicular lesions were observed in the intraoral examination. All vesicular lesions were on one side of the face, and the patient was referred to the dermatology clinic with the diagnosis of RHS. Facial paralysis fully recovered in a short time after early diagnosis and treatment. It should be kept in mind that there may also be oral findings in RHS, and a patient’s intraoral and extraoral examination findings should be evaluated together. Conclusion: Early diagnosis and treatment are highly important in preventing complications such as permanent facial paralysis, vestibulocochlear dysfunction, and hearing loss

Is there a difference in reduction of seizure frequency between transcutaneous and traditional VNS? (P5-1.009)

<h3>Objective:</h3> Our aim was to compare seizure frequency reduction between traditional and t-VNS <h3>Background:</h3> Transcutaneous vagus nerve stimulation (t-VNS) aims to overcome the disadvantages of surgical implantation of traditional VNS, yet little is known about whether these modalities are equally effective in seizure frequency reduction. <h3>Design/Methods:</h3> We conducted a systematic review following the PRISMA guidelines. Included were clinical and/or randomized trial articles indexed by Embase and Pubmed, with the keywords: “drug-resistant epilepsy” or “refractory epilepsy” and “vagus nerve stimulator”. We performed a meta-analysis, considering treatment success as ≥ 50% of seizure frequency reduction. Statistical analyses were weighted for population size. We performed Mann-Whitney test for between-group and Wilcoxon test for within-group analyses. <h3>Results:</h3> Eighteen studies were included (13 traditional, 5 t-VNS), with a total of 1383 patients, with a mean age of 31.27 ± 8.71 years and median follow-up assessment of 12 months (range, 3.5–36). The median success rate for the traditional and t-VNS groups were 49.2% (range, 28–100) and 28% (range, 0–54), respectively (P &lt; 0.0001), with adherence &gt;70% to t-VNS. High variability was observed within the traditional VNS studies (P=0.002), but not in t-VNS. The most common reported side effects from t-VNS were ear pain, dizziness, and headache while traditional VNS was most associated with cough and dysphonia. <h3>Conclusions:</h3> Although t-VNS presents as a more convenient alternative to its traditionally implanted counterpart, its efficacy seems to be relatively low for refractory epilepsy. Furthermore, t-VNS has been associated with more frequently reported side effects than traditional VNS. <b>Disclosure:</b> Mr. Costa has nothing to disclose. Mr. Dos Santos Silva has nothing to disclose. Henrique Januzzelli has nothing to disclose. Isabella D’Andrea has nothing to disclose.

Is the retroauricular region a suitable donor site for full-thickness skin grafting in the era of mask wearing?

During the coronavirus disease 2019 (COVID-19) pandemic, the everyday use of face masks massively increased to prevent the spread of infection. Many people complain of ear pain and erosion when wearing a mask for extended periods of time. If prolonged mask usage is uncomfortable for ordinary people, a question arises-how much more inconvenient must mask wearing be for patients with a full-thickness skin graft (FTSG) donor site in the retroauricular region? Herein, we evaluated complications related to face mask use in 27 patients with a retroauricular FTSG donor site, with the goal of clarifying whether the retroauricular region is still an appropriate FTSG donor site in the context of the COVID-19 pandemic. Complications in 27 patients treated by FTSGs harvested from the retroauricular region from 2019 to 2021 were investigated. A questionnaire comparing the normal and the operated sides was administered. Pain, itching, soreness, deformity, and symmetry were further investigated. Pain and itching were the only observed complications. The operated side was slightly more painful than the normal side in four patients (14.8%), and four patients (14.8%) reported itching on the operated side. However, all patients who experienced complications stated that the pain or itching did not interfere with mask wearing. Most symptomatic patients were older than 60 years of age (23.8%, p=0.185) and wore masks for longer periods of time (28.5%, p=0.326). Few retroauricular donor site-related complications occurred, and none of these complications caused inconvenience in daily life. Therefore, in the COVID-19 pandemic, the use of the retroauricular region as an FTSG donor site remains appropriate.

Referred otalgia:evaluation of causes

Otalgia is the sensation of pain in the car, while referred otalgia Is pam felt in the ear but originating from non-otological source Lar pain is a diagnostic problem when examination of the ear shows no pathology. A prospective study was conducted in EN.T - private clinics in Kirkuk city from October 2007 to December 2008. Age , sex and causes of referred ofalgia were noted, During the study period 210 patients were evaluated , out of 210 patients 122 male "58%" and 88 females "42%", Tonsillitis,pharyngitis and post tonsillectomy were the commonest cause"S1 4%" Three patients had malignancy of upper aerodigestive tract and referred otalgia was one of its main symptoms. Referred ear pain is more commonly caused by tonsillitis , pharyngitis&#x0D; but it may be first symplom of head and neck malignancy,

COVID-19-induced headache in Boston and the vicinity

Headache is a common neurological symptom of Coronavirus disease 2019 (COVID-19) patients. However, the prevalence, comorbidities, and ethnic susceptibilities of COVID-19-induced headaches are not well-defined.We performed a retrospective chart review of patients who tested positive for SARS-CoV2 by reverse transcriptase-polymerase chain reaction (RT-PCR) in March and April 2020 at Massachusetts General Hospital, Boston, Massachusetts, USA.In the study, we identified 450 patients, 202 (44.9%) male, and 248 (55.1%) female, who tested positive for COVID-19. Headache is a significant painful symptom affecting 26% of patients. Female predominance is determined in sore throat, nasal congestion, hypogeusia, headache, and ear pain. In contrast, pneumonia and inpatient hospitalization were more prevalent in males. Younger patients (< 50) were more likely to develop sore throat, fatigue, anosmia, hypogeusia, ear pain, myalgia /arthralgia, and headache. In contrast, older (> 50) patients were prone to develop pneumonia and required hospitalization.Ethnic subgroup analysis suggests Hispanic patients were prone to headaches, nausea/vomiting, nasal congestion, fever, fatigue, anosmia, and myalgia/arthralgia compared to non-Hispanics. Headache risk factors include nausea/vomiting, sore throat, nasal congestion, fever, cough, fatigue, anosmia, hypogeusia, dizziness, ear pain, eye pain, and myalgia/arthralgia.Our study demonstrates regional gender, age, and ethnic variabilities in COVID symptomatology in Boston and the vicinity. It identifies mild viral, painful, and neurological symptoms are positive predictors of headache development in COVID-19.

Paediatric actinomycosis: A 16-year, single-institution retrospective review of cases.

Actinomycosis is a rare subacute to chronic granulomatous infection which can mimic other infectious or malignant diseases. This study examined the epidemiology and treatment outcome of actinomycosis in children. A retrospective study on children admitted for actinomycosis in a tertiary paediatric hospital in Singapore, from January 2004 to December 2020. Clinical profile, therapeutic interventions and outcomes were examined. A total of 10 patients were identified; 7 were female. The median age at first presentation was 9.8 years (range 4.7-15.7). The most common presenting symptom was fever (n = 6, 60%), followed by facial or neck swelling (n = 3, 30%) and ear pain (n = 3, 30%). Actinomycosis occurred predominantly in the orocervicofacial region (n = 6, 60%). Four patients (40%) had preceding dental infections in the form of dental caries or gingivitis. One patient had poorly controlled insulin-dependent diabetes mellitus. Actinomycosis was confirmed via culture in four patients, histopathology in four patients and both methods in two patients. All except one patient (n = 9, 90%) underwent surgical procedures. All patients received ampicillin or amoxicillin/clavulanate or other beta-lactams, for a median duration of 6.5 months (range 1.5-14). Complications included osteomyelitis (n = 4, 40%), mastoiditis (n = 2, 20%), brain abscess (n = 1, 10%) and recurrent neck abscess (n = 1, 10%). There was no mortality and all patients achieved complete resolution. Paediatric actinomycosis was rare in our 16-year review, but had a high complication rate. It can occur in immunocompetent patients, and dental infection was the predominant risk factor identified. Prognosis was excellent after surgical intervention and appropriate antimicrobial therapy.

Outcomes of an Advanced Speech and Language Therapist-Led Low-Risk 2-Week Wait Clinic for Suspected Head and Neck Cancer: A UK-Based Pilot Study

To describe outcomes of a pilot Speech and Language Therapist led (SLT-led) 2-week wait (2WW) assessment clinic for head and neck cancer (HNC). A prospective 3-month pilot clinic was conducted. All referrals were triaged by an otolaryngologist. Referrals for unilateral symptoms, palpable neck lumps and/or ear pain were excluded. SLTs performed initial assessment. All patients received oral and neck examinations, and a videolaryngoscopy, including therapy trials. All images and management plans were discussed with an otolaryngologist within one week of the clinic. Images of suspicious lesions were reviewed within 24 hours. Data were collected consecutively for all patients attending the clinic between December 2021 and March 2022. Data included demographics, smoking history, perceptual voice ratings (GRBAS), validated patient-reported outcome measures (PROMs), diagnoses, and clinical plans. Descriptive statistics were conducted within Excel and inferential statistics within SPSS. Over 3 months, 218 patients were seen, 62% were female and the mean age was 63 years. Most patients (54%) opted for "patient initiated follow-up" and 16% received further investigations. No patients required Ear, Nose and Throat (ENT) outpatient review for second opinion. Most (65%) received a functional diagnosis. The diagnostic yield of cancer was 5% (n=11) and high-grade dysplasia was 3% (n=6). At the time of writing, no patients had been re-referred to the service. There was a positive relationship between risk of diagnosis and mean GRBAS score (P < 0.01), and VHI-10 score (p=0.013). Patients with higher-risk diagnoses tended to be male, older, and had a history of smoking. PROMs suggested that laryngeal symptoms, regardless of underlying pathology, affect quality of life. Experienced SLTs working alongside otolaryngologists safely led assessment and directed treatment planning for patients referred to ENT on the 2WW pathway. The rate of high-risk diagnoses was low. Higher GRBAS and VHI-10 scores may be useful indicators for higher risk diagnoses.

Pain Relief With Peripheral Nerve Stimulation of Superficial Cervical Plexus: A Case Report and Literature Review

BACKGROUND: Neuropathic head and facial pain are relatively common and difficult to treat pain syndromes encountered in pain clinics throughout the world. Atypical syndromes with overlapping nerve distributions can be particularly frustrating for patients and providers. In recent years, as providers search for alternatives to medications, advances in neuromodulation technology, including spinal cord stimulation and peripheral nerve stimulation (PNS), have shown promise in treating neuropathic pain confined to specific nerve distributions, such as the greater and lesser occipital nerves. However, there is limited literature describing the use of PNS for atypical facial pain. We report the first known case of PNS to the superficial cervical plexus in a 45-year-old woman with bilateral ear and postauricular pain. CASE REPORT: A 45-year-old woman presented with over 6 years of bilateral ear and periauricular pain in the auriculotemporal and lesser occipital nerve distribution. Conservative management, including neuropathic pain agents, ketamine infusions, nasal sprays, opioids, nonsteroidal anti-inflammatory medications, ice, heat, and transcutaneous neurostimulation, provided limited relief. She had excellent pain control with a series of nerve blocks to the superficial cervical plexus; however, relief was short term. In an attempt for a more long-term solution, she underwent implantation of the SPRINT PNS (MicroLead, SPR Therapeutics, Cleveland, OH), which resulted in 100% pain relief, improved function at work, and improved sleep tolerance throughout the 60-day treatment. Unfortunately, her symptoms returned shortly after treatment course completion. CONCLUSIONS: To our knowledge, this is the first case utilizing PNS of the superficial cervical plexus to treat atypical facial pain. The 60-day trial resulted in 100% pain relief of previously debilitating and functionally limiting pain symptoms during the treatment phase suggesting that the superficial cervical plexus may be a reasonable target for permanent PNS implants. KEY WORDS: Peripheral nerve stimulator, peripheral nerve stimulation, superficial cervical plexus, atypical facial pain, anesthetic blockade, pain relief, neuropathic pain, neuromodulation, SPRINT

Audio-Vestibular Manifestations in COVID-19; A Systematic Review and Meta-analysis

Introduction Audio-Vestibular (AV) presentation as a consequence of COVID-19 is a less ventured zone. The aim of the study was systematically review the literature (both studies and case reports) published up to August 2021, in order to provide evidence on audio-vestibular symptoms in SARS-CoV-2, COVID-19 patients. Systematic review and meta-analysis was performed for assessment of prevalence of AV symptoms among COVID-19 patients. Materials and Methods A search of existing literature using key words and MeSH (Medical Subject Headings) terms was done. The methods were developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. 36 qualitative studies were narratively synthesized. Meta-analysis was performed on 18 quantitative studies Results Hearing loss was most commonly reported AV manifestation among case series / case reports. In the quantitative studies, the pooled estimate of Hearing loss, Dizziness and Tinnitus was 4.558%, 4.226% and 5.513% respectively. Other reported AV symptoms included ear ache, aural fullness and facial paresis. Conclusion Prevalence of AV symptoms in COVID-19 differs from that of the published literature. This prevalence of hearing loss is less than that reported amongst the world population. Structured community-based studies with homogeneous working definitions have to be conducted to assess the true prevalence.

Paralisi del facciale, eruzione cutanea auricolare e otalgia: la sindrome di Ramsay Hunt

The Authors describe the case of an adolescent presenting with intense ear pain and facial palsy finally diagnosed with Ramsay Hunt syndrome.

Pentaclethra macroloba: A Review of the Biological, Pharmacological, Phytochemical, Cosmetic, Nutritional and Biofuel Potential of this Amazonian Plant.

Pracaxi (Penthaclethra macroloba (Willd.) Kuntze) is an Amazonian plant, traditionally used by the native population to treat health disorders such as inflammation, erysipelas, wound healing, muscle pain, ear pain, diarrhea, snake and insect bites as well as for cancer treatment. Other common uses include using the oil for frying, skin and hair beautification, and as an alternative source of energy. This review is focused on highlighting its taxonomy, occurrence and botanical origins, popular uses, pharmacology and biological activities, cytotoxicity, biofuel activity and phytochemistry in order to explore future therapeutic use and other applications. Pracaxi contains triterpene saponins, sterols, tannins, oleanolic acid, unsaturated fatty acids and long-chain fatty acids, with a high behenic acid value, which may serve for incorporation into drug delivery systems as well for the development of new drugs. These components are correlated with its anti-inflammatory, antimicrobial, healing, anti-hemolytic, anti-hemorrhagic, antiophidic, and larvicidal activities against Aedes aegypti and Helicorverpa zea, which ratify the popular/traditional uses. The species is nitrogen fixing; it is easy to propagate in floodplains and the terra firma, and it can be used for the reforestation of degraded areas. Additionally, the oil extracted from the seeds can leverage the bioeconomy of the region based on sustainable exploration.

Subacute thyroiditis-an unusual endocrine cause of pyrexia of unknown origin: Case report with review of literature

We report a case of a 58-year-old male who presented with high grade fever of 45 days duration. He had presented with a dry cough and right ear pain. His initial clinical evaluation and diagnostic tests were unremarkable. During the hospital stay, he developed palpitation for which tests for thyroid functions were done which revealed subacute thyroiditis. He recovered fully with the treatment. Subacute thyroiditis is one of the rarely mentioned causes of Pyrexia of Unknown origin. A high index of suspicion and appropriate imaging is required for early diagnosis and management.

Intrapulmonary Metastasis from Adenoid Cystic Carcinoma of the External Auditory Canal: A Case Report.

External auditory canal adenoid cystic carcinoma (EAC) is rare and is associated with nonspecific clinical manifestations such as early ear pain. We report a patient with advanced lung metastases from adenoid cystic carcinoma (ACC) of the EAC, which is difficult to diagnose. Under general anesthesia, lengthened right temporal bone resection, parotidectomy, facial nerve resection, cervical lymph node dissection (I-III), partial mandibular resection, tumor resection in the inferior temporal fossa and lateral femoral flap repair were performed, followed by regular radiotherapy and chemotherapy. During 2years of postsurgical follow-up, there was no recurrence. The combination of early detection, resection, postoperative radiotherapy, and chemotherapy can result in a good therapeutic effect.

Local therapy of acute otitis media in children

Acute otitis media (AOM), one of the most common infectious and inflammatory diseases in infants, toddlers and young children, is defined as an infectious inflammation of the middle ear, usually bacterial, often with earache, fever, and possibly otorrhea. Almost all children suffer from otitis media, 80–90% – at preschool age. The frequency of acute otitis media in children in a megapolis is more than 4 000 cases per 100 000 population, however, given the large proportion of asymptomatic variants against the background of acute respiratory infections, insufficient equipment of pediatricians with otoscopes, registration of acute otitis media almost exclusively by ENT doctors, the frequency of acute otitis media may be significantly higher. The clinical picture may be nonspecific. Ear pain and otoscopy are decisive for the diagnosis. The severity of inflammation correlates well with the scale of visual assessment of pain according to the child’s facial expressions. The aims of treatment are to relieve pain using topical or systemic analgesics, decide together with an ENT specialist on the need for antibiotic therapy, avoid not indicated antibiotic therapy, prevent complications (tympanic membrane perforation, acute mastoiditis, meningitis). With unexpressed otitis media, it is advisable to use symptomatic therapy and drops. A complex of compounds (lidocaine, phenazone) provides a quick therapeutic effect. Topical anaesthetics block the transmission of the pain signal from the receptor to the central nervous system through the inhibition of voltage-gated sodium channels. The symptomatic treatment (analgesics, antipyretics, topical therapy) results in improvement in 60% of patients within the next 24 hours, and in 80% within the next 3 days.For prophylaxis of otitis, it is necessary to prevent acute respiratory infections, do vaccination against influenza and pneumococcal infections, avoid exposure to tobacco smoke, and keep babies breastfeeding.

Snot-22 a Predictive and Assessment Tool for Subjective Improvement After Fess in Patients of Chronic Rhinosinusitis.

Chronic Rhinosinusitis (CRS) is a common health problem with an estimated prevalence of 6.8% in Asia. The treatment of CRS involves an initial course of maximal medical therapy followed by Functional Endoscopic Sinus Surgery (FESS). Here, we are assessing the outcomes of FESS on CRS using most recent Sino Nasal Outcome Test (SNOT-22) questionnaire, for quantifying changes in symptoms and predicting extent of postoperative improvement. 75 patients who reported in the tertiary health care centre in Department of ENT, MGM Medical College & M.Y. Hospital, Indore and were diagnosed with CRS that did not relieve on medication were selected on the basis of inclusion and exclusion criteria. The selected cases were asked to answer the SNOT-22 questionnaire before the surgery. FESS was done and after three months, the patients were again subjected to the SNOT-22 questionnaire. There was 83.67% overall improvement in postsurgical SNOT-22 evaluations, which was statistically significant (p value < 0.00001). Most common SNOT-22 symptom was the need to blow nose, which was seen in 28 (93.34%) cases, while ear pain was found in 10 (50%) patients and was the least common SNOT-22 symptom. FESS seems to be effective treatment of CRS patients. We observed SNOT-22 to be very effective and reliable in assessing the Quality of Life in CRS patients and to measure the improvement after FESS.

Abstract PD8-05: Effectiveness of Electroacupuncture Versus Auricular Acupuncture in Reducing Pain and Improving Quality of Life in Breast Cancer Survivors with Chronic Musculoskeletal Pain

Abstract Introduction: Chronic musculoskeletal pain is common and debilitating among breast cancer survivors. Recently, the Personalized Electroacupuncture (EA) versus Auricular Acupuncture (AA) Comparative Effectiveness (PEACE) trial demonstrated that both acupuncture methods reduced pain more than usual care (UC) in cancer survivors. However, the comparative effectiveness between EA and AA among breast cancer survivors is unknown. Here, we report the results of subgroup analysis of breast cancer survivors enrolled in the PEACE trial. Methods: PEACE is a three-arm, parallel, single center randomized trial investigating the effectiveness of EA and AA versus UC for chronic musculoskeletal pain in 360 cancer survivors. Patients in both EA and AA received ten weekly treatments. Patients in UC could receive ten EA treatments after week 12. The primary endpoint was the change in mean Brief Pain Inventory (BPI) pain intensity from baseline to week 12; change from baseline to week 24 and change in quality of life were secondary endpoints. We analyzed the subset of 46% of trial participants with a primary diagnosis of breast cancer. We conducted constrained linear mixed model analyses, which constrained all arms to have a common pre-randomization baseline mean. Model-based mean estimates at weeks 12 and 24 were compared between arms using model contrasts. Results: Among 165 breast cancer survivors, the baseline mean pain severity was 5.35 (95% Confidence Interval [CI]: 5.04, 5.66). At week 12, the BPI pain severity score was 2.69 (2.26. 3.13) in EA, 3.60 (3.17, 4.02) in AA, and 5.06 (4.47, 5.65) in UC. At week 24, the mean BPI pain severity was 2.84 (95% CI: 2.40, 3.28) in EA and 3.67 (95% CI: 3.23, 4.10) in AA. EA reduced pain severity significantly more than AA at both week 12, (-0.90 [-1.45, -0.36], p=0.001) and week 24 (-0.82, [-1.38, -0.27], p=0.004). There were no differences between EA and AA in improvements in PROMIS physical health or mental health component scores, but both EA and AA significantly improved both PROMIS scores at week 12 compared to UC. Mild toxicities were reported, more patients dropped out of the AA arm due to ear pain. Conclusions: EA was more effective than AA at reducing pain severity, but both similarly improved physical and mental health scores. Breast cancer survivors with chronic musculoskeletal pain may consider EA before AA. Citation Format: Ting Bao, W. Iris Zhi, Raymond Baser, Qing Li, Jun Mao. Effectiveness of Electroacupuncture Versus Auricular Acupuncture in Reducing Pain and Improving Quality of Life in Breast Cancer Survivors with Chronic Musculoskeletal Pain [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr PD8-05.

Unusual Presentation of Anca Vasculitis with Otitis Media and CVA

A 42-year-old African female (Kenyan in origin), known to have hypertension that was diagnosed during gestation and persisted; presented with a history of dysphagia for four years. Before her admission, she had presented to the surgical clinic with ear fullness and ear pain with throbbing headaches, and she was diagnosed with bilateral oto-mastoditis. Her symptoms subsequently, progressed to a multisystemic disease involving the lungs, brain, kidneys, and peripheral nerves. ANCA vasculitis is a rare disease, the main target organs in granulomatous polyangiitis include the ear, nose throat, and upper respiratory tract, and glomerulonephritis of the kidney and the lungs. Localized disease manifestation can include the nose (rhinorrhea, nasal crusts, septal perforation) and ear (otitis media, hearing loss, sensorineural deficits). The diagnosis of vasculitis from localized disease manifestation can be difficult to diagnose.

DESCRIPTION OF THE UNDERSTANDING AND CONCERN OF CHILDREN WITH SPECIAL NEEDS FOR EAR HYGIENE, EAR INFECTION AND HEARING HEALTH AT GOVERNMENT SPECIAL SCHOOL II BANJARMASIN

Children with special needs often lack good knowledge about health. In addition, ear and hearing health is often neglected by society. Ear and hearing disorders can cause disability or limitations in socializing and can also cause serious complications. The aim of this study is to provide an overview of the level of understanding and concern for ear health and hearing health. The number of samples was 37 people with an age range of 11-18 years with a cross-sectional study. The research was conducted descriptively by using a questionnaire containing 18 questions. The results of this study showed that all research subjects did not understand the correct habit of cleaning their ears. Most of the subjects did not understand the causes of ear infections. The most commonly recognized symptom of an ear infection is ear pain (54%). Almost all participants understand that ear infections can have complications in the brain. The use of earphones (40%) is not a habit for the subject. More than 50% of subjects have an understanding that hearing loss can be cured. Almost all (97%) of respondents felt the need to get more information about ear and hearing health. Understanding of ear and hearing health in children in special needs is still relatively low. The level of children in special needs 's concern for ear and hearing health is also still low. Government Special School II Banjarmasin students feel they need information related to ear and hearing health.

The impact of screen exposure among school-aged children in South India during the COVID-19 pandemic: an online survey

BackgroundThe impact of excessive screen time with personal listening devices (PLDs) on vision, hearing, balance, and overall health among adults has been reported in the literature. However, its impact on children is not well documented. A survey was undertaken to highlight the possible effects of screen time combined with transducers on vision, hearing, balance, and overall health complaints in children via parental proxy. This cross-sectional survey consisted of questions divided into four domains: vision, hearing, balance, and overall health. It was conducted online using social media to avail total maximum responses.ResultsA total of 136 responses were obtained from the parents of children studying from grade 1 to 8 through the survey conducted in south India. Increased negative impact on vision was observed in more than 50% of children. Similarly, the hearing and balance domain reported 16% ear pain, 4.4% tinnitus, 9.6% dizziness, 8.8% nausea, and 2.2% imbalance while walking. Likewise, the overall stress domain reported 26.5% general body discomfort, 37.5% neck pain and stiffness, 29.4% headaches, 43.4% lack of concentration, 39.7% overall changes in child’s health and 46.3% behavioral issues with various severity markings (slight to severe).ConclusionsLonger periods of screen exposure have various negative impacts on vision, hearing, balance system, and overall health. These effects have to be managed for the health of our children.

Female with Fibromuscular Dysplasia

Fibromuscular dysplasia (FMD) is a noninflammatory, nonatherosclerotic disorder that cause arterials steno- sis, occlusion, aneurysm, dissection, and artery tortuosity. The etiology of FMD remains unknown. The most frequently involved arteries are the renal, internal carotid, vertebral arteries and visceral. Among adults, FMD is more common in females. Most common symptoms are renovascular hypertension, headache, pulsatile tinnitus, neck pain, and abdominal pain. We present a 62-year old female patient who was diagnosed with grade 3 arterial hypertension at the age of twenty -nine. During diagnostic treatment, narrowing of the right renal artery was determined and percutaneous transcutaneous angioplasty of the right renal artery was performed. Diagnosis of fibromuscular dysplasia was suspected. After this procedure, the value of blood pressure was normalized. At the age of forty, the patient was re-introduced with antihypertensive, and CT angiography showed 50 % lumen stenosis of the right renal artery. She was referred to a neurologist. The patient has been complaining about frequent headaches, pulsatile tinnitus in the right ear, increased fatigue, and occasional abdominal pain for many years. Neurosonological testing showed partially wall thickening in the left common carotid artery and multiple stenosis and dilatation of the left internal carotid artery. The left vertebral artery has multiple stenoses and dilatations in the distal V1 segment. The findings indicated changes in fibromuscular dysplasia and the diagnosis of FMD was confirmed.