ENT Patients Research Articles

Multidisciplinary management of gastroesophageal reflux disease: an italian retrospective study

Abstract Background Millions of individuals are affected by gastroesophageal reflux disease (GERD) that causes significant discomfort negatively affecting patients’ overall quality of life. For a collaborative approach of continuous improvement in public health we wanted to know the real-world perspectives in the multidisciplinary and multimodal management pathway. Methods We aimed to interview a sample of gastroenterologists (GE), primary care physicians (GP), and otolaryngologists (ENT) to investigate the management of the intake and treatment of patients reporting symptoms of GERD. Symptoms were divided into typical and extraesophageal, and their severity and impact on quality of life was explored with the GERD Impact Scale (GSI) and Reflux Symptom Index (RSI). Results A total of 6211 patients were analyzed of whom with typical symptoms were 53.5%, while those with extraesophageal symptoms were 46.5%. The latter were more frequently reported by ENT patients (53.6%, p < 0.0001). GSI was highest in patients followed by GE (9 points) and GP (9 points) than ENT specialists (8 points), while the RSI was higher in the ENT group (14.3 ± 6.93) than in the groups of GP and GE, respectively (10.36 ± 6.36 and 10.81 ± 7.30, p < 0.0001). Chest pain had the greatest negative impact on quality of life (p < 0.0001). Of the 3,025 patients who used (proton pump inhibitors) PPIs, non-responders had a lower GSI when treated with a combination of adjunctive drug treatments and bioadhesive compounds, compared with single-component drugs. Conclusions The multidisciplinary and multimodal approach to the management pathway of GERD patients reveals variations in patient profiles by physician specialty, directing toward more appropriate and targeted treatments. In addition, the combination of adjunctive drug treatments and bioadhesive compounds appears to be effective in the management of patients refractory to PPIs. Key messages • The presentation of GERD symptoms is different in accordance with the physician’s speciality: the patients with GERD referred to a gastroenterologist had more severe disease and poorer quality of life. • The combination of adjunctive pharmacological treatments and bioadhesive compounds seems to be effective in the management of PPI refractory patients.

Analyzing Factors and Reasons Behind NonAttendance of ENT Patients: Clinical Audit.

Objective: This study analyzed the frequency of follow-up patients at the ENT clinic and identified different factors that are associated with nonattendance at follow-up appointments since nonattendance imposes significant stress on the system of healthcare. Methods: This study was an ambidirectional cohort study and conducted a telephonic survey with 104 ENT patients who missed their appointments. Results: The findings of the study revealed that patients missed their scheduled appointments because of transportation problems (46%), professional engagement (46%), family problems (44%), and financial problems (32.7%). However, patients didn't identify forgetfulness about the appointment, complete recovery, and health-related issues on the day of the appointment as the barrier to missing their scheduled appointment. The study assessed the relationship between socioeconomic status and the frequency of follow-up patients in an ENT clinic where transportation factor (P < .000), working commitments (P < .004) affecting the "Lower Middle and Middle Class" individuals, and financial problems (P < .005), family problems (P < .028), feeling sick (P < .037) were significantly affecting the "Middle-Upper Class" and "Middle Class." Meanwhile, forgetfulness was not associated with the socio-economic status of the ENT patients (P = .237). Conclusion: This study found transportation, family, financial issues, and professional commitments to be the key barriers to ENT appointment attendance, with Lower-Middle-Class patients particularly affected by forgetfulness. These missed appointments negatively impact patient health and strain the healthcare system.

Topical intranasal anesthesia impairs trigeminal function and airflow perception

Background: Impairment of airflow perception by the intranasal trigeminal system may explain chronic nasal obstruction (CNO), especially in cases where no major deformity or mucosal inflammation can explain reduced airflow. We aim to characterize the effect of topical intranasal anesthesia on intranasal trigeminal sensitivity and consequently the sensation of nasal obstruction. Methodology: We performed a crossover study of 16 healthy subjects, randomised for either treatment (topical intranasal anesthesia with 10% Xylocaine) or placebo (saline solution). We used the Trigeminal Lateralization Task (TLT) with eucalyptol to assess trigeminal sensitivity. We measured nasal patency objectively with Peak Nasal Inspiratory Flow (PNIF), and subjectively with a Visual Analog Scale (VAS), the Empty Nose Syndrome 6-Item Questionnaire (ENS6Q), and the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. Results: Topical intranasal anesthesia significantly reduced intranasal trigeminal sensitivity. Further, after topical intranasal anesthesia, reduced trigeminal sensitivity was associated with the subjectively reduced nasal patency, as highlighted by ENS6Q and NOSE scores. Conclusions: Topical intranasal anesthesia reduces intranasal trigeminal function resulting in subjectively reduced nasal patency. In future studies, the relation of reduced intranasal trigeminal function and subjective nasal obstruction needs to be addressed to open an avenue for potential interventions for an important portion of ENT patients.

Barriers to and enablers of the use of the Otology Questionnaire Amsterdam in clinical practice—a qualitative post-implementation study

BackgroundThe Otology Questionnaire Amsterdam (OQUA) is developed to evaluate multiple ear complaints and their impact on patients’ daily lives. The current clinical use of this questionnaire is below the potential utilization.AimTo identify the barriers and enablers of using the OQUA as perceived by ENT surgeons and patients and provide recommendations for an implementation strategy.MethodsProspective and qualitative analysis was performed using focus groups and interviews with ENT professionals (n = 15) and patients (n = 25) with ear complaints of one tertiary referral hospital and two regional hospitals. Barriers and enablers were identified and classified by using the Capability-Opportunity-Motivation-Behavior model and the Theoretical Domains Framework. Suggestions for an implementation strategy will be made accordingly.ResultsENT professionals’ barriers included lack of knowledge and skills to use the OQUA, inadequate technological support and perceived time constraints during consultation, uncertainty about the clinical relevance and lack of feedback on the outcomes of the OQUA. Enablers included beneficial consequences of the OQUA for the professional, organization and science. Patients’ barriers included lack of knowledge about the objective and usefulness of the OQUA, perceived burden, difficulties in completing the questionnaire and insufficient feedback during consultation. Patient enablers included beliefs about beneficial consequences of the OQUA for the patient, health care and society. Suggested interventions involved education, training, environmental restructuring and incentivisation.ConclusionBased on the findings, we propose an implementation strategy should focus on education and training about the objective, outcomes and relevance of the OQUA, environmental restructuring regarding the optimal use of the OQUA, and incentivisation with feedback on the valuable outcomes of the OQUA for the patient, professional and healthcare. Future research is needed to determine the feasibility of the implementation strategy.

Evaluation of the Effectiveness of Otorhinolaryngology Examination and Hearing Evaluation Training for Family Physicians

Objective: In our study, we aimed to investigate the level of knowledge of family physicians working in primary health care organizations about ENT diseases, to examine how they manage frequently admitted ENT patients, to identify the problems they experience during examination and to examine the effect of the training given. Method: Participants were first administered a 30-question pre-test created by the researcher based on the literature. Then, a collective training lasting 2 days and 1.5 hours per day was given by an ENT specialist from the researchers and a post-test was applied. Afterwards, the topics in which the researchers made the most mistakes or remained uninterpreted were recorded and a training program including these topics was created and training was given. Results: Of the 21 family physicians over 30 years of age, 2 (14.29%) were male and 18 (85.71%) were female. When the time of graduation from medical school of the family physicians in the study was analyzed, the number of family physicians with 5-10 years of medical school graduation was 4 (19.05%), 10 (47.62%) with 10-20 years of medical school graduation, and 7 (33.33%) with more than 20 years of medical school graduation. All of the family physicians who participated in the study think that ENT education is important for primary care medicine. Conclusion: ENT diseases are common in primary care. In order for family physicians to manage their patients more comfortably, we believe that rotations in the field of ENT diseases in the postgraduate period would be appropriate.

Frequency Of Anxiety in Pre-Operative Surgical Patients in the Tertiary Care Hospitals, Karachi

Background: Preoperative anxiety significantly impacts patient outcomes and healthcare delivery, with varying degrees of prevalence reported globally. Understanding and managing this anxiety are crucial for improving surgical experiences and patient recovery. This study focuses on tertiary care hospitals in Karachi, aiming to elucidate the frequency and determinants of preoperative anxiety among elective surgery patients. Objective: To ascertain the prevalence of preoperative anxiety among patients awaiting elective surgeries in various surgical units of tertiary care hospitals in Karachi and to identify significant contributing factors. Methods: In a prospective cross-sectional design, 400 patients scheduled for elective surgeries across six surgical units were assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). SPSS version 24 facilitated the analysis, focusing on global anxiety prevalence and its associations with demographic and clinical variables. Results: The study revealed a 62.0% prevalence of preoperative global anxiety. The APAIS scores indicated higher anxiety related to the surgery (mean = 7.27 ± 2.31) compared to anesthesia (mean = 5.14 ± 2.35). Significant associations were found between anxiety levels and age groups (p=0.002), surgical procedures (p&lt;0.001), and type of anesthesia (p&lt;0.001). ENT and urology patients exhibited notably higher anxiety, at 75.0% and 68.0% respectively. Multivariate analysis demonstrated a significant impact of gender on preoperative anxiety, with females showing increased vulnerability [aOR 1.91 (95% CI 1.13-3.21); p=0.015]. Conclusion: Preoperative anxiety remains a prevalent concern, with female patients exhibiting higher levels of anxiety than their male counterparts. The findings advocate for targeted counseling and informational support for patients, especially females, prior to surgery and anesthesia consultations, underscoring the need for healthcare professionals to address and mitigate preoperative anxiety effectively.

Current Rehabilitative Concepts in Ear Nose and Throat Department, University of Medical Sciences Teaching Hospital (UNIMEDTH): Challenges Encountered

Introduction: Unaddressed communication disorders are multidimensional, affecting individuals physiologically, psychologically and emotionally. The quality of life of these individuals can be improved with rehabilitative measures, justifying this study. The study therefore aims to assess the impact of rehabilitation on these patients, determine the challenges and proffer possible solutions. Methods: Eighteen months prospective study on audiological and speech disorders among ENT patients in the University of Medical Sciences Teaching Hospital, Ondo State, from April 2021 to September 2022 was carried out. History was taken, general examination and full E.N.T. examinations were done. Those with audiological disorders from canal blockage due to foreign bodies, debris and impacted wax had ear syringing. Others with persistent audiological condition were further evaluated and treated accordingly, with Hearing Aids trial and fitting inclusive. Patients with speech disorder had speech therapy after baseline audiological screening. Data were represented in tables and figures. P value &lt; 0.05 was statistically significant. Results: 930 patients presented at the ENT clinic. 537 (57.74%) females and 393 (42.26%) males. Of this, 405 (43.55%) patients had audiological conditions while 23 (2.47%) had speech disorders. Impacted wax, tinnitus, hearing loss, foreign body in the ear and delayed speech development were commonest. 297 had syringing while 105 patients were further evaluated. 369 of 405 patients were successfully rehabilitated. 3 stroke patients had good speech recovery. Predominant challenges encountered were unavailability of instruments and uncooperativeness of elderly patients. Weekly savings and incorporation of dedicated relatives for home therapy ensures solutions respectively. Conclusion: Rehabilitation in E.N.T., though gradually progressive, is beneficial. The guiding concept is patience.

Supportive Care Needs of Newly Diagnosed Cancer Patients in a Comprehensive Cancer Center: Identifying Care Profiles and Future Perspectives.

The prompt introduction of supportive care for patients with cancer leads to a better quality of life, potential survival benefits, and improvements in treatment safety. Considering that patients' needs vary, descriptive assessments could serve as a compass for an efficient and prompt healthcare response. The aim of this study was to identify supportive care needs in newly diagnosed patients according to cancer type. A retrospective study was conducted by collecting data from the case consultation and medical records of a comprehensive cancer center in France. Patients' needs were divided into twelve domains: nutrition, psychological support, psychiatric support, social care, physiotherapy, addictology, pain management, palliative care, pharmacology, complementary and alternative practice (CAM), sexual health, and speech therapy. Out of 6217 newly diagnosed patients of various cancer types who sought medical care at Gustave Roussy in 2021, 2541 (41%) required supportive cancer care (SCC), and of them, 1331 patients (52%) required two or more different SCC specialist interventions. The top five interventions were dietary (for 60% of patients), physiotherapy (33%), psychology (29%), social care (28%), and pain management (16%). Subgroup analysis according to cancer department highlighted additional specific needs: CAM for breast cancer patients (11%), speech specialist (27%) and addictologist (22%) interventions for ENT patients, psychiatry consultations for neurological patients (16%), and palliative care for dermatology patients (23%). The aforementioned data suggest that an early, multidisciplinary supportive care intervention should be required. Assembling human resources at the time of diagnosis within a dedicated day unit would be the next appropriate step in developing personalized care pathways related to the highlighted needs.

Epidemiological Profile of Ear, Nose, and Throat (ENT) Diseases in the Outpatient Department at Thung Song Hospital, a General Hospital in Southern Thailand, from 2016 to 2019.

The demand for ear, nose, and throat (ENT) care significantly contributes to the workload in outpatient departments (OPDs) worldwide, including Thailand. However, the epidemiology of ENT diseases in Thai OPDs has not been thoroughly reported. Therefore, this study aimed to assess and describe the epidemiology of these conditions among patients attending the ENT clinic at Thung Song Hospital, marking the first epidemiological report of southern Thailand. This retrospective, descriptive study spanned four years and observed the number of ENT patients. The comprehensive dataset revealed a total of 34,848 ENT visits and 12,712 new cases within the ENT clinic's OPD, averaging 3,178 case instances annually. Notably, over a quarter of the patients were classified as elderly, aged 60 years or older. Of significance, the prevalence of ENT diseases among females exceeded that of males by more than 15% each year. Specific age groups revealed distinct prevalent conditions: otitis externa was most common among children, benign tumors prevailed in adults, and sensorineural hearing loss was prominent among the elderly. This study endeavor aims to deepen the understanding of the epidemiology of these diseases. Such investigations could guide the refinement of healthcare approaches targeting ENT-related ailments.

Mild blast injury: vertigo complaints analysis

The data about vestibular disorders resulting from blast injury are contradictory. To disclose the problem of vestibular disorder as the consequence of blast injury, we have done present investigation. One hundred and nine patients were examined: 65 Anti-Terroristic Operation (ATO) participants, who survived mild and moderate blast injury without cranial trauma, and 44 non-ATO patients (rhinitis, pharyngitis, otitis). Questionnaire “Types of dizziness” has been used according to the International Clinical Protocol on Vestibular Disorders (Dizziness). Complaints of dizziness (distortion of perception of space, movement and time) have been revealed in 70.77 % (46) ATO and 43.18 % (19) non-ATO patients: F-test = 0.51, T-test = 0.004, thus, showing that this complaint is not specific for mild traumatic brain injury (mTBI). Objective vertigo (sensation of subjects moving around the patient) met in 26.15 % (17) ATO and 11.56 % (5) non-ATO patients: F-test = 0.027, T-test = 0.046. So, we have two different qualitative groups. Тhese complaints are specific for the patients, who survived blast injury. Complaints of vertigo are also typical for the patients, who survived blast injury. Complaints of giddiness are specific for the patients, who survived blast injury. Imbalance and drop attacks are not typical for ATO patients. Complaints of kinetosis are specific for the patients, who survived blast injury. Orthostatics (discomfort sensations that appear after sudden standing up) has been revealed in 76.92 % (50) ATO and 47.73 % (21) non-ATO patients, this complaint is not specific for mTBI. Vestibular system organizes space orientation tetrad: vestibular, somatosensory, visual and hearing information to percept, orient and interact with environment. Acro-, nycto- and ascendophobia have appeared to be of no importance. Agoraphobia (Greek αγωρα — market, supermarket syndrome, discomfort in open, public places or crowds) has been detected in 33.85 % (22) ATO and 15.91 % (7) non-ATO patients. This complaint is not specific for mTBI. Claustrophobia (discomfort appearing in small, closed spaces) is met in 20.00 % (13) ATO and 9.09 % (4) non-ATO patients: F-test = 0.024, T-test = 0.10. Thus, we have two different qualitative groups. This is also interesting case, when we reveal qualitative difference without quantitative one. This is the argument to use F-test in our study. So, complaints of claustrophobia are specific for the patients, who survived blast injury. The same situation is with descendophobia (discomfort during walking down the hill or descending the staircase, patients note the necessity of visual control. It has been shown that among other signs, there is a positive correlation with age, imbalance, ascendophobia and dyspnea). The results are discussed from the point of view of the severe vestibular impairment due to the blast injury. Conclusions. 1. MBTI from blast injury is accompanied by severe stress, objective and subjective vertigo, giddiness and kinetosis, which are considered to be the symptoms of vestibular damage. 2. Dizziness, orthostatics and agoraphobia are quantitatively significantly increased in mBTI, but it might not be considered specific for blast injury consequences. 3. Giddiness, claustrophobia and descendophobia in ATO patients have no quantitative changes compared to the ENT patients, but are specific for mBTI after blast injury. 4. It is important to use matrix Fisher test in statistical examinations.

139 “Never Event, Never Again” - a Closed Loop Audit on the Documentation of Nasogastric Tube Position Following X-Ray Confirmation

Abstract Aim Nasogastric feeding is common among ENT patients with dysphagia. CXRs are performed to confirm tube position before feeding. However, communication failure from poor documentation potentially leads to feeding through a misplaced tube into the lungs which is a "Never Event". This audit aims to reduce risk of patient harm by encouraging the use of nasogastric tube documentation sticker on clinical notes in Royal Victoria Hospital ENT ward. Method An initial study was conducted in June 2022 evaluating the quality of documentation of NGT position following CXR. Subsequently, several interventions were implemented including teaching doctors on utilising the documentation sticker that comes with each NGT pack, placing posters on the ward and reminding the nursing staff to check the documentation before starting feed. Further re-audit was carried out in August 2022 post-intervention. Results 58 CXRs were performed. Use of the documentation sticker rose from 42.1% to 85%. This led to verification of patient identity increasing from 39.5% to 100% and confirmation that the x-ray was most recent for the patient from 44.7% to 100%. 85% of the x-rays had time and date verified compared to 34.2% previously. Documentation of the position of NGT and instructions for feeding improved from 63.1% to 75% and 65.8% to 75% respectively. Record of the staff who confirmed tube position increased from 60.5% to 75%. Conclusions This audit demonstrated an increased use of the documentation sticker resulting in improvements in confirmation and documentation of NGT position. These positive changes reduce risks of significant patient harm thereby improving patient safety.

1251 A Project Aimed at Improving the Completeness and Quality of Admission Clerking in the ENT Department

Abstract Aim Admissions notes are essential in communicating information regarding patients. The project aimed to improve the proportion of completed admission clerking and the quality of the recorded data for the ENT patients admitted to the ward. Method We have included emergency presentations and elective admissions for moderate and major head and neck surgery. Patients were identified from handover lists. Baseline data were collected across a period of six weeks, and 103 admission notes were included. Following the intervention, the data collection lasted another six weeks, and 93 documents were identified. Documents were compared against The Royal College of Surgeons of England Guidelines for Clinicians on Medical Records and Notes. Interventions to improve the standard of admission clerking included: a short departmental presentation, educational posters, and an introduction of the electronic clerking proforma. Results Following the intervention, the proportion of completed admission clerking has increased and the quality of recorded data has improved.The proportion of completed admission clerking increased from 95.4% to 100% for emergency presentations, and from 2.6% to 68.2%for elective admissions. Data completeness has improved across all documentation domains. For emergency presentations, the most notable improvement was recorded for the medication history (76.9% vs 93.0%) and allergy status (73.9% vs 87.3%). For elective admissions, the greatest improvement was noted for past medical history (2.6% vs 65.6%) and social history (0% vs. 56.5%). Conclusions In conclusion, the use of clerking proforma alongside educational presentation and posters increased the completeness and quality of admission clerking, for both emergency and elective presentations in the ENT department.

Organization of children's otorhinolaryngological care in conditions of biological risks: international experience

The COVID-19 pandemic has spurred the introduction of new devices and technologies into the organization of otorhinolaryngological care, the development of safety measures and clinical work protocols in order to increase the safety of doctors and patients. Virtual outpatient clinics have been integrated into the pediatric and basic outpatient services, the potential of which for pediatric otolaryngology is considered quite significant. In otorhinolaryngological practice, the transition to the expanded use of telemedicine technologies (individual gadgets for examining ENT patients, including a direct access otoscope connected to an otolaryngologist's computer) was especially significant. The practice of pediatric ENT services tends to combine virtual and face-to-face visits, even after the acute phase of the COVID-19 pandemic. When organizing otorhinolaryngological care, it is necessary to pay special attention to dialogic consensus - an inclusive and reflective dialogue between a doctor and a patient.

Study of blood group and platelet counts in ER and ENT patients with epistaxis

Background: Epistaxis is one of the most common emergencies and a very difficult problem to tackle especially in Primary Health Centers or Health Posts in rural areas of Nepal. The objective of the study was to identify blood group and platelet count with the occurrence of nasal bleeding. Materials and Methods: A prospective study was carried out among 96 patients visiting Kathmandu Medical College and Teaching Hospital in Emergency Department and ENT Department with epistaxis from October 2021 to October 2022. Ethical clearance was obtained from IRC Kathmandu Medical College Teaching Hospital (reference no: 0609202105). A blood sample was sent for blood groups and platelet count. Convenience sampling was used. Data were entered in Microsoft Excel 2016 and analyzed in Statistical Package for Social Sciences version. Results: The age group of 20-29 years was found to be the commonest age group presented with epistaxis. The commonest blood group with epistaxis was found to be O+ve and platelet count was found to be within the normal range in the majority of the cases. Conclusions: Epistaxis was found to be more common among patients with O+ve than non ‘O’ blood groups. Patients with Blood group O+ve need to be investigated further for coagulation profile before any kind of procedure.

Is High-Risk Sexual Behavior a Risk Factor for Oropharyngeal Cancer?

(1) Background: Several lines of evidence established a link between high-risk (HR) sexual behavior (SB), the persistence of human papillomavirus (HPV) DNA in saliva, and the presence of oncogenic HR-HPV subtypes in oropharyngeal squamous cell carcinoma (OPSCC). A highly influential case-control study by D'Souza et al. comparing OPSCC patients and ENT patients with benign diseases (hospital controls) established HR-SB as a putative etiological risk factor for OPSCC. Aiming to replicate their findings in a nested case-control study of OPSCC patients and propensity score (PS)-matched unaffected controls from a large population-based German cohort study, we here demonstrate discrepant findings regarding HR-SB in OPSCC. (2) Methods: According to the main risk factors for HNSCC (age, sex, tobacco smoking, and alcohol consumption) PS-matched healthy controls invited from the population-based cohort study LIFE and HNSCC (including OPSCC) patients underwent interviews, using AUDIT and Fagerström, as well as questionnaires asking for SB categories as published. Afterwards, by newly calculating PSs for the same four risk factors, we matched each OPSCC patient with two healthy controls and compared responses utilizing chi-squared tests and logistic regression. (3) Results: The HNSCC patients and controls showed significant differences in sex distribution, chronologic age, tobacco-smoking history (pack years), and alcohol dependence (based on AUDIT score). However, PS-matching decreased the differences between OPSCC patients and controls substantially. Despite confirming that OPSCC patients were more likely to self-report their first sexual intercourse before age 18, we found no association between OPSCC and HR-SB, neither for practicing oral-sex, having an increased number of oral- or vaginal-sex partners, nor for having casual sex or having any sexually transmitted disease. (4) Conclusions: Our data, by showing a low prevalence of HR-SB in OPSCC patients, confirm findings from other European studies that differ substantially from North American case-control studies. HR-SB alone may not add excess risk for developing OPSCC.

Insomnia, depression and anxiety in patients urgently referred with suspicion of head and neck cancer.

To determine differences in insomnia, depression and anxiety between ENT patients with benign and malignant conditions prior to and after an urgent suspicion of cancer appointment. Out-patients with urgent suspicion of cancer completed three psychometric questionnaires prior to their appointment and at two to four weeks post-diagnosis. There was no significant difference in questionnaire scores between malignant and benign patients prior to the patients' appointments (p > 0.05 for all questionnaires). In benign patients, there was significant improvement in scores for all questionnaires (p < 0.01) and in malignant patients there was significant worsening of scores for all questionnaires (p < 0.01) at follow-up appointments. Prior to appointments, patients with benign and malignant conditions experienced similar levels of insomnia, depression and anxiety. Following diagnosis, cancer patients had significantly poorer scores, indicating worsening of these symptoms. In patients with benign diagnoses, all questionnaire scores improved, indicating resolution of their symptoms and possible association between the appointment and their baseline scores.

RADIOLOGICAL EVALUATION OF PEDIATRIC SENSORINEURAL HEARING LOSS AT A TERTIARY CARE CENTER IN CENTRAL INDIA

Objective: Hearing dysfunction is the most common sensory deficit in children. If hearing is lost, especially in children's, it may have a huge impact on life, interfering with the acquisition of spoken language and social development. It is therefore important to detect any abnormalities at an early age. Patients with complaint of inability to hear since birth attending ENT OPD, M.Y.H Hospital, Indore and patients referred to M.Y.H hospital from district hospitals with inability to hear since birth were evaluated clinically and audiometry was done. Patients with SNHL fulfilling the inclusion criteria were considered and their radiological evaluation was done. High resolution computed tomography scan (HRCT) of temporal bone were used in radiological evaluation of patients with congenital sensorineural. SUBJECTS AND METHODS: The study was conducted at a tertiary care centre Maharaja Yashwantrao Holkar (MYH) hospital and Mahatma Gandhi Memorial Medical College (MGMMC), Indore in the Department of otorhinolaryngology and head &amp; neck surgery. Cases with hearing loss from 1 to 16 years of age were selected. A detailed medical history with primary focus on inability to hear was obtained with emphasis on previous hospital stays, developmental delay, maternal history, family history. Complete ENT examination was done. Our study included a total 30 children. All chil Results: dren were between 1-16 years of age with sensorineural hearing loss. Majority 11(36.67%) of the participated in the study were between 5-8 years of age. Cochlear anomaly was found in 03(10%) patients. Cochlea was found normal in 27(90%) on both the ears, 03(10%) child had hypoplastic cochlea bilaterally, none were with aplastic cochlea. Vestibular anomaly was seen normal in 28(93.33%) patients on bilateral side. 02(6.67%) patients were present with dysplastic vestibule. SSC was found dysplastic/malformed in 04(13.33%) patients who had dysplastic/malformed semicircular canal. Conclusion: The selection of candidates for hearing aid trials and cochlear implantation requires consideration of a variety of clinical, audiological and radiological factors. Imaging is a fundamental part of the preoperative workup, it provides the surgeon with details which will lead him to a successful cochlear implantation with no or minimal complications. HRCT temporal bone provided us the information about the presence of various inner ear malformations including cochlea, vestibule, SCC, IAC. Mastoid, pneumatization, variations in vascular anatomy which included forward lying sigmoid sinus and high riding jugular bulb. All these findings are important for a detection of cause of SNHL in patients.

The role of telephone clinics in ENT.

This quality improvement project assessed the outcomes of telephone consultations for ENT patients in order to identify areas where telephone consultations may be useful in the long term. New ENT patient appointments in May 2019 and May 2020 were reviewed. Total outcomes as well as subspecialty-specific and presentation-specific outcomes were compared for telephone versus face-to-face consultations. There were 638 consultations in total (465 in 2019 and 173 in 2020). Following telephone consultations, more patients were followed up and fewer patients were listed for surgery or discharged. Overall outcomes for subspecialties followed the general trend, albeit with a few variations. Lack of clinical examination in telephone consultations likely affects confidence in making a diagnosis and therefore discharging or listing patients for surgery. Nevertheless, looking at specialty-specific and presentation-specific data, there may be a role for telephone consultations in selected patients.

Prevalence of Hypovitaminosis D among ENT Patients in Nigeria – A Multi-center, Multi-regional study

Prevalence of Hypovitaminosis D among ENT Patients in Nigeria – A Multi-center, Multi-regional study

LARGE-SCALE SCREENING FOR SARS-COV-2 INFECTION IN ENT PATIENTS DURING THE COVID-19 PANDEMIC

IntroductionBased of the authors’ own material, the results of screening tests for SARS-CoV-2 infection were analysed in ENT patients scheduled for a diagnostic procedure or elective surgery in our hospital during 10 months of the COVID-19 pandemic.Material and methodsThe study was carried out on 546 women, aged 18–94 years and 696 men, aged 18–87 years, who were scheduled for hospitalisation between 1 May 2020 and 28 February 2021. PCR and antigen tests for the SARS-CoV-2 virus were performed in all patients. A negative result was a prerequisite for admission in order to undergo a diagnostic procedure or surgery.ResultsSARS-CoV-2 virus testing was performed in 1242 patients, 44% of whom were female and 56% male. In terms of age distribution, the peak for women was either 51–60 years (7.3%) or 61–70 years (10.5%), while for males the peak age was lower, at 18–30 years (10.5%) or 31–40 years (12.1%). In each month, a similar number of tests were performed, which was related to our contract with the Polish National Health Fund. To allow for a patient scheduled for a procedure being COVID-19 positive and unable to attend, the department asked us to qualify more patients for surgery in each week so as to keep up the standard number of surgical treatments. Our data showed that 1.5% of women and 2.5% of men became COVID-19 positive. The number of infected patients increased gradually from October 2020 to January 2021, related to an increase in morbidity.ConclusionsOf the 1242 patients, 236 (19.0%) women and 231 (18.6%) men were scheduled for a diagnostic procedure, while 310 (25.0%) women and 465 (37.4%) men were tested for elective surgery. Screening tests for SARS-CoV-2 infection in all these patients allowed us to disqualify patients from hospitalization if they had a positive result, thereby limiting the transmission of the virus while allowing us to fulfill our contract.