Otorhinolaryngological Manifestations Research Articles

Otorhinolaryngological manifestations in Traumatic brain injury in a tertiary care center of western Nepal

Introduction: Otorhinolaryngological injuries in head injury are something which are very common but yet are overlooked, missed and at times forgotten. In this study, we tried to see the epidemiological characteristics, clinical presentations and management of these associated injuries in cases of head injuries in a tertiary care center in western Nepal. Methods: An analytical study was done in all cases of head injury admitted to neurosurgical ward and ICU in between January 2019 to December 2019. Various clinical and epidemiological details were collected from the patient’s records obtained from Medical Records Department and charted in a preformed performa. All the continuous data were presented in terms of mean and standard deviation and categorical data in terms of percentage. Statistical analysis was done using SPSS 22.0 software. Results: Soft Tissue lacerations were the commonest findings in all head injuries; nose and face lacerations (29.5%), ear lacerations (23.5%) followed by facial bone fractures (19.2%). There were 41(52.6%) cases with mild head injury, 23 (29.5%) cases with moderate head Injury and 17 (17.9%) cases with severe head injury in patients those had associated ENT findings. There was no any statistically significant difference in outcome or hospital stay in between the head injuries with and without ENT manifestations (p=0.187) and (p=0.219) respectively. Conclusion: Skull base tumors are treated based on findings of diagnostic nasal endoscopy and imaging results. CT scans and MRIs are becoming more significant in the diagnosis of diseases. Endoscopic techniques to the skull base were beneficial in treating the malignancy. Chemotherapy can be used as a gold standard first-line treatment with radiation and surgery for significant types of head and neck tumors. immunotherapy-like checkpoint inhibitors targeting PD1 are the second-line treatments of advanced HNSCC. Prospective research and trials will be required in the future.

Otorhinolaryngological Manifestations in COVID-19: Review of Recent Evidence

Objectives: In this review we provide an updated concise review about the most common Otorhinolaryngological symptoms in COVID-19 patients.
 Methods: A searched strategy designed on published literature in different large medical databases and journals using various keywords to get the recent described manifestations.
 Results: 25 included studies that focused on ENT symptoms and involved the confirmed cases only. 6276 patients were accounted for the results which showed that the most prevalent ENT manifestation were cough in 3498 (56%) patients, headache in 2013 (32%) patients, sore throat in 1966 (31%) patients, anosmia in 1340 (21%) patients, loss of taste in 914 (15%) patients, and rhinorrhea in 196 (3%) patients.
 Conclusion: Cough was the commonest symptoms which should raise the suspicion to do COVID-19 swab especially if associated with smell and taste disorder.

A study on otorhinolaryngological manifestations in pregnant women

<p><strong>Background: </strong>Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions.<strong></strong></p><p><strong>Methods</strong>: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects.</p><p><strong>Results</strong>: 47.9% of the study cases had otological manifestations among which otitis media was the main finding.</p><p>16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3<sup>rd</sup> trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2<sup>nd</sup> and 3<sup>rd</sup> trimester.</p><p><strong>Conclusions: </strong>Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.</p>

Clinical Characteristics of COVID-19 from the Otorhinolaryngologist's Perspective: First Report from Oman, Middle East.

To study the otorhinolaryngological clinical characteristics of COVID-19 positive patients. A prospective cross sectional study on sixty five patients who were SARS-CoV-2 PCR positive, and completed 14 days of isolation period were surveyed with a questionnaire. The responses were evaluated and assessed. Sixty five SARS-Cov-2 PCR positive cases were included in the study. There were 57 (87.6%) males and 8 (12.3%) females. Thirty five (53.8%) were in home isolation, whereas, 30 (46.2%) were under institutional care. Forty five patients (72.6%) presented with mild symptoms, and 4 (6.4%) developed moderate symptoms. Thirteen (21%) were asymptomatic. Overall, 46 patients (70.7%) presented with upper airway symptoms with or without general symptoms. More than half of the patients experienced pharyngodynia or sorethroat, smell and taste dysfunction as common symptoms (66.7%, 61.4% and 50.7% respectively). Severe headache was noticed by eighteen (27.7%) patients. Other respiratory symptoms such as nasal congestion, rhinorrhoea, sneezing, facial pain, etc. were present with less frequency. In more than half of the patients (61.5%), all the symptoms recovered within 5 days, in 12 (18.5%) between 5 and 8 days, and in 9 (13.8%), between 9 and14 days. However, in four patients, symptoms lasted for 28–30 days. In seven patients (10.7%), symptoms recurred after the period of isolation, however, the retest was negative. Fever, cough and or shortness of breath are the commonly reported prominent symptoms of COVID-19, however, there is a changing trend of clinical presentation towards variable otorhinolaryngologic manifestations. Pharyngodynia, taste and smell dysfunctions are common in patients with COVID-19, and could represent potential characters.

Otorhinolaryngological Manifestations in Pregnant Women

There are several physiological changes in the body of the pregnant women. Otological, rhinological, and laryngological changes are quite often seen in pregnancy. Most of the otorhinolaryngological manifestations during pregnancy are benign and reverse during the postpartum period and few do not. These changes in pregnancy are mainly due to alteration of the sex hormones in the female body which returns to a normal level once the pregnancy period over. There should be clear understanding between the otolaryngologists and obstetrician for improving the quality of life of the pregnant women by avoiding the drugs for controlling otorhinolaryngological symptoms, especially in the first trimester. It is important to have clinical knowledge in all clinicians regarding the manifestation of otorhinolaryngological manifestations and treatment options with precautions considering effects on the mother and fetus during pregnancy. Here, this review article discusses the alteration in body physiology, clinical manifestations, and current treatment practice of the ear, nose, and throat manifestations during pregnancy. Electronic search of the SCOPUS, Medline, and PubMed databases was done. The search items in the database included pregnancy, otorhinolaryngological manifestations, gravidarum, gestational epistaxis, gestational rhinitis, hearing loss, and vestibular manifestations in pregnancy. All literature was searched for and reviewed by two authors independently. Search results were then cross-examined, and any differences were settled by consensus.

Otorhinolaryngological manifestation in COVID-19

<p class="abstract"><strong>Background: </strong>Coronaviruses (CoV) disease caused by the seventh member of enveloped RNA coronavirusdisease. The COVID-19 is presented mainly by lower respiratory tract related symptoms such as fever, cough, dyspnea and chest tightness that could progress rapidly to acute respiratory distress syndrome (ARDS) whereas the different upper respiratory tract related symptoms include nasal congestion, sore throat and smell dysfunction. The aim of this study is to contribute to current knowledge about COVID-19 and to study about the otorhinolaryngological manifestations and its effects in COVID-19 patients.</p><p class="abstract"><strong>Methods:</strong> This prospective observational study was done on 644 patients who got admitted to COVID suspect ward of a tertiary care centre in middle India. The patients were assessed for the signs and symptoms and the findings were analysed.</p><p class="abstract"><strong>Results: </strong>Within the included 664 cases, 423 (64%) were males and 241(36%) were females. The maximum number of patients in 50 to 60 years of age ,128(19%). Among which 97% (646) from urban area and 3% (18) from rural area. 564 (85%) were symptomatic with 459 patients had symptoms for 1-4 days,112 patients for 5-10 days,4 patients between 11-15 days. The most common symptoms with which these patients presented were cough (68%), fever (62%), signs of breathlessness (61%). The most common ENT manifestations were sore throat 333 (59%), nasal discharge 120 (12%), anosmia 65 (12%), ear discharge 46 (8%).</p><p class="abstract"><strong>Conclusions: </strong>Even though the most common manifestations of COVID-19 were cough, fever, breathlessness significant proportions of patients do manifest with ENT symptoms like sorethroat, nasal discharge, anosmia, ear discharge which may go unnoticed. Recognizing the cases and addressing them properly is important for curbing the rapid spread of COVID-19 pandemic.</p>

COVID-19 and otorhinolaryngology: Returning to practice.

This article aims to focus on key points and provide an overview of the current knowledge of the Coronavirus Disease (COVID-19); the increased susceptibility of otorhinolaryngologists to the virus; its effects and impact on the ENT practice; disruption of specialist clinic services; as well as associated risks in ENT surgical procedures. Mitigation strategies that can be employed to efficiently return to practice and ensuring the highest level of safety to both the patient and the otorhinolaryngologist is emphasised whilst simultaneously adapting to the new normal. Attention was given to understanding of the virus, its effect on the ENT discipline and practice, counter measures to mitigate and minimise risk to allow for continuation of ENT services once restrictions and lockdowns are progressively lifted. Otorhinolaryngological manifestations are common symptoms of COVID-19. Evidence suggests that the highest rates of nosocomial spread were seen amongst otorhinolaryngologists. The COVID-19 pandemic unexpectedly halted a majority of the otorhinolaryngology activities, which impacted service provision in the ENT practice. As the pandemic evolves, and with its duration unpredictable, this may necessitate a fundamental shift in the way otorhinolaryngology is practiced as there may be further global viral pandemics in future and the ENT fraternity has to now adapt to the new normal. Continued vigilance is imperative and strategies optimally implemented to ensure safe return to both ENT specialist clinic services and surgeries is vital. There are currently no uniform best-practice recommendations for otorhinolaryngology in the COVID-19 setting, although key strategies to prevent the virus spread have become evident to be able to effectively ‘flatten the curve’ of COVID-19 infections over time.

Otorhinolaryngological Manifestations and Its Management in COVID 19 Patients.

COVID 19 pandemic is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The first case was identified in December 2019, in Wuhan, China. It is an infectious disease and has led to the ongoing global pandemic. This pandemic has also started in Assam, with its first case reported on 31 March, 2020. A prospective study was conducted on 2000 laboratory confirmed coronavirus cases. Proper history were taken and clinical examinations were performed. They were also advised to do the necessary blood investigations, electrocardiogram and chest X- rays. Olfactory functions were assessed using substances like scented soap, mint toothpaste, vicks vaporub, etc. Gustatory functions were also assessed. In our study, we found that 83% (1650) patients presented with otorhinolaryngological or ENT (Ear, nose, throat) manifestations and 17% (350) did not have any otorhinolaryngological manifestations. The most common ENT symptoms with which the patients presented were sore throat (80%) and headache (76%). The other ENT symptoms were hyposmia (44%), dysgeusia (32%) and nasal congestion (28%). The most common non-ENT symptoms were fever (92%) and cough (85%). The other non-ENT symptoms with which the patient presented were malaise, generalized bodyache and abdominal symptoms (like diarrhea). This prospective study gives a view of the incidence of otorhinolaryngological manifestations in COVID 19 patients. But, no significant co-relation was seen between presence of ENT symptoms and the severity of the disease. However, further studies are required to know the pathogenesis of causing ENT symptoms properly and also for definitive treatment of these symptoms.

Otorhinolaryngological manifestations of coronavirus disease 2019: a prospective review of 600 patients.

To evaluate otorhinolaryngological manifestations of coronavirus disease 2019 infection and the time required for their resolution. A prospective analysis was conducted of coronavirus disease 2019 patients presenting from 1 April 2020 to 30 July 2020. The otorhinolaryngological manifestations were evaluated based on patient history. The time required for symptom resolution was evaluated separately for intensive care unit and non-intensive care unit patients. A total of 600 patients were included in the study; 13.3 per cent required the intensive care unit and 2.2 per cent expired. The otorhinolaryngological manifestations were: sore throat (88 per cent), fever (78.8 per cent), anosmia or hyposmia (63.6 per cent), ageusia or hypogeusia (63.5 per cent), rhinorrhoea (51.3 per cent), nasal obstruction (33.5 per cent), sneezing (30.3 per cent), and breathing difficulty (18.6 per cent). The time required for symptom resolution was longest for breathing difficulty (23.6 days for intensive care unit and 8.2 days for non-intensive care unit patients). Otorhinolaryngological symptoms are one of the main presentations of coronavirus disease 2019 infection. The increased prevalence of medical co-morbidities in patients requiring intensive care unit and in deceased patients is also highlighted.

Otorhinolaryngological Management in Taiwanese Patients with Mucopolysaccharidoses.

Background: Mucopolysaccharidoses (MPSs) are lysosomal storage disorders wherein glycosaminoglycans accumulate because the enzymes that degrade them are insufficient. The earliest symptoms, which are the main reasons for seeking consultation, are otorhinolaryngological and commonly occur in MPS I, II, IV, and VI. This retrospective study aimed to determine the occurrence of otorhinolaryngological manifestations in MPS patients in Taiwan and to analyze the prognosis of surgical intervention, including its effect on symptoms.Methods: We reviewed 42 patients (30 males and 12 females), with a median age of 20.5 years, who had MPS (16.7% type I, 35.7% type II, 19.0% type IIIB, 21.4% type IVA, and 7.2% type VI). The following otorhinolaryngological manifestations were collected: annual number of upper respiratory tract infections (URTIs) and otitis media with effusion (OME) episodes, adenoid size, tonsillar size, and apnea-hypopnea index (AHI).Results: Among 42 patients, we found recurrent otitis media in 42.9% of the patients, hearing loss in 83.3% (mixed: 52.4%, conductive: 21.4%, and sensorineural: 9.5%), frequent URTIs in 47.6%, and obstructive sleep apnea syndrome in 35.7%. Moreover, 76% of the patients underwent ear, nose, and throat (ENT) surgery, including adenoidectomy, tonsillectomy, tympanostomy with ventilation tube insertion, tracheotomy, and supraglottoplasty.Conclusions: MPS patients had a high incidence of ENT problems. ENT surgery reduced the severity of hearing loss, degree of symptoms related to upper airway obstruction, and severity of respiratory tract and otological infections of patients with MPS.

Otorhinolaryngological and Ophthalmological Manifestations of COVID-19 in the Pediatric Population.

Severe Acute Respiratory Syndrome Coronavirus 2 pandemic has affected several countries throughout the world. Being very contagious, it can affect any individual. So far, the prevalence of Severe Acute Respiratory Syndrome Coronavirus 2 in children amongst the total infected population is very low, ranging from 1-5%. Difficulty in diagnosing the disease clinically in the pediatric population owing to their inability to explain their symptoms often renders a possibility of overlooking this disease. Moreover, new modes of presentation are being reported apart from the classical tell-tale signs. In this scenario, medical professionals dealing with the children should be well aware of different modes of presentation of this disease in the pediatric population. This study thus aims to review otorhinolaryngological and ophthalmological manifestations in the pediatric population affected by Severe Acute Respiratory Syndrome Coronavirus 2.

Evaluation of hearing acuity in patients with chronic renal failure by pure tone audiometry

<p class="abstract"><strong>Background:</strong> Hearing loss is common in patients with chronic renal failure. It is well known that chronic renal failure (CRF) causes different systemic and otorhinolaryngologic manifestations due to the accumulation of nitrogenous waste products. The aim of the study was to evaluate hearing threshold and the severity of hearing loss at different frequencies in patients of chronic renal failure (CRF), and to analyse the role of duration of disease on hearing threshold in patients of CRF.</p><p class="abstract"><strong>Methods:</strong> Fifty two patients of CRF were included in the study. Pure tone audiometry was done in all cases.</p><p class="abstract"><strong>Results:</strong> Majority of the patients were in 21 to 40 year age group (mean: out of 52 patients, 38 patients (73.07%) had sensorineural hearing loss and 14 patients (26.93%) had normal hearing. Majority of the patients with hearing loss had mild (44.73%) or moderate (42.11%) sensorineural hearing loss. On comparison of the mean hearing threshold Group II (duration of disease more than five years- 17 patients) showed a statistically significant difference (P<0.05) in mean hearing threshold at 250 Hz.</p><p class="abstract"><strong>Conclusions:</strong> Hearing loss is present in majority of the patients of CRF. Most of the cases have mild to moderate sensorineural hearing loss. High frequency hearing loss in chronic renal failure is related to the duration of the disease, duration of haemodialysis’ and internal homeostasis, namely hyponatremia.</p>

Granulomatosis polyangitis: an otorhinolaryngological perspective

<p>Granulomatosis with polyangitis or Wegeners granulomatosis is a rare entity, however is known to have specific otorhinolaryngological manifestations. Initial clinical manifestations could be subtle but deteriorate rapidly with an underlying active autoimmune process which can be life threatening in severe subglottic stenosis. We report a case of Granulomatosis with polyangitis in an adolescent girl initially presented with otitis media refractory to treatment and epistaxis and rhinitis and eventually with the progression of disease presented with subglottic stenosis. Diagnosis was made by anti-neutrophil cytoplasmic antibody proteinase 3 (ANCA-PR3) positive status and histological confirmation by nasal biopsy, elevated C-reactive protein (CRP) levels and renal involvement with evidence of microalbuminuria. She underwent dilatation of the subglottic stenosis twice, with resection of the stenotic mass by coblation. The diagnostic and therapeutic challenges faced are emphasized in this report.</p>

Effect of Covid-19 in Otorhinolaryngology Practice: A Review.

Otorhinolaryngological manifestations are common among patients suffering from COVID-19. This study provides a brief and precise review of the current knowledge regarding COVID-19 including disease transmission and clinical characteristics. This article aims to review the otolaryngologist experience treating patients in the cities where COVID 19 impact is most, and to propose appropriate protective measures while managing ENT patients. This is a retrospective study conducted in the Department of Otorhinolaryngology, Hind Institute of Medical Sciences, Ataria, Sitapur from 10 March 2020 to 4 May 2020. The most common otolaryngological symptoms of COVID-19 were cough, sore throat, and dyspnea. Rhinorrhea, nasal congestion and dizziness also seen in some of the patients. COVID-19 could also manifest as an isolated sudden hyposmia/anosmia. Upper respiratory tract (URT) symptoms were commonly observed in younger patients and usually appeared initially. They could be present even before the molecular confirmation of SARS-CoV-2. Otolaryngologists are at higher risk for SARS-CoV-2 infection as they cope with URT symptoms in OPD and while performing surgery in COVID-19 positive patients. Patients with cough, sore throat, dyspnea, hyposmia/anosmia and a history of travel to the region with confirmed COVID-19 patients, should be considered as potential COVID-19 cases. An otolaryngologist should wear FFP3/N95 mask, glasses, disposable and fluid resistant gloves and gown while examining such individuals. ENT surgeries should be postponed if not urgent.

As disfunções olfativas e gustativas como apresentação clínica da COVID-19

O objetivo desse estudo é elucidar sobre as evidências das alterações olfativas e gustativas e suas características em sujeitos diagnosticados com COVID-19. Pesquisa qualitativa, descritiva, baseada em uma revisão integrativa da literatura, realizada no Portal de Periódicos da Capes considerando toda a coleção de bases de dados. A busca ocorreu no período de maio de 2020, por acesso remoto, com os descritores: “Sars-cov2” OR “Covid-19” OR “Coronavirus” AND “Olfactory” OR “Smell” OR “Anosmia” OR “Hyposmia” OR “Dysosmia” OR “Dysgeusia”. Após triagem e elegibilidade foram selecionadas 15 publicações.Os estudos identificaram: hiposmia de leve à severa, anosmia, fantosmia e parosmia, associadas ou não à hipogeusia e ageusia, em prevalências entre 22,7 a 88,8% no geral. Os sintomas, geralmente, ocorrem no início da doença (dentro de cinco dias). As principais comorbidades foram febre, mialgias, fadiga, tosse e diarreia.Os sintomas olfativos e gustativos, principalmente na ausência de outras manifestações otorrinolaringológicas, foram fortemente associadas ao diagnóstico de COVID-19, destacando seu papel como critério de triagem em pacientes com suspeita da doença.

Review of practical recommendations for otolaryngologists and head and neck surgeons during the COVID-19 pandemic

IntroductionOtolaryngologists are at very high risk of COVID-19 infection while performing examination or surgery. Strict guidelines for these specialists have not already been provided, while currently available recommendations could presumably change in course of COVID-19 pandemic as the new data increases. ObjectivesThis study aimed to synthesize evidence concerning otolaryngology during COVID‐19 pandemic. It presents a review of currently existing guidelines and recommendations concerning otolaryngological procedures and surgeries during COVID-19 pandemic, and provides a collective summary of all crucial information for otolaryngologists. It summarizes data concerning COVID-19 transmission, diagnosis, and clinical presentation highlighting the information significant for otolaryngologists. MethodsThe Medline and Web of Science databases were searched without time limit using terms ‘‘COVID-19”, “SARS-CoV-2” in conjunction with “head and neck surgery”, “otorhinolaryngological manifestations”. ResultsPatients in stable condition should be consulted using telemedicine options. Only emergency consultations and procedures should be performed during COVID-19 pandemic. Mucosa-involving otolaryngologic procedures are considered high risk procedures and should be performed using enhanced PPE (N95 respirator and full face shield or powered air-purifying respirator, disposable gloves, surgical cap, gown, shoe covers). Urgent surgeries for which there is not enough time for SARS-CoV-2 screening are also considered high risk procedures. These operations should be performed in a negative pressure operating room with high-efficiency particulate air filtration. Less urgent cases should be tested for COVID-19 twice, 48 h preoperatively in 24 h interval. ConclusionsThis review serves as a collection of current recommendations for otolaryngologists for how to deal with their patients during COVID-19 pandemic.

Hearing assessment in chronic kidney disease patients: a cross-sectional study

<p class="abstract"><strong>Background:</strong> It is well known that chronic kidney disease (CKD) causes different systemic and otorhinolaryngologic manifestations due to the accumulation of waste products, osmotic alteration, and antigenic similarity between basement membrane of the glomerulus and stria vascularis of the inner ear. </p><p class="abstract"><strong>Methods:</strong> The study subjects were divided into two groups, 50 CKD patients and 50 healthy volunteers in age group 15-60 years. All CKD patients and controls were subjected to hearing assessment using standard pure tone audiometry. </p><p class="abstract"><strong>Results:</strong> For low frequency hearing loss increased from stage 2 and 3 to stage 4 and 5, and for high frequency hearing loss among stage 2 and 3 CKD patients was mild to moderate (65.22%) in nature and hearing loss increased in intensity (i.e. severe to profound) in stage 4 and 5 of CKD patients. Dialysis patients were having more severe hearing loss in comparison to non dialysis patients. Hearing loss was negatively correlated with the eGFR. And positively correlated with the duration of the disease (CKD).</p><p class="abstract"><strong>Conclusions:</strong> Our study highlights the pattern of hearing loss in people suffering from chronic kidney disease who were either on dialysis or not on dialysis. Early identification can prevent further deterioration of hearing in patients suffering from chronic kidney disease.</p>

A study on otorhinolaryngologic manifestations in human immunodeficiency virus infected patients

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>The main aim of this study was to find out the ear, nose, and throat (ENT) manifestations in a selected regional population of 100 HIV infected patients, to identify the commoner ENT manifestations among them and to make these manifestations, a guide for regional ENT surgeons, to diagnose HIV/AIDS patients early and to treat them accordingly.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>The study was a prospective study which was conducted for a period of five years which included 100 HIV seropositive patients, among the patients attending the Outpatient Department of the Otorhinolaryngology and anti-retroviral therapy centre across Government Hospitals in Tamil Nadu according to our inclusion or exclusion criteria. Detailed ENT clinical examination as well as laboratory investigations were carried out to evaluate the nature of ENT presentations of HIV infection. </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>Out of the 100 HIV positive patients, who had some form of ENT symptoms, the most common ENT manifestation in HIV/AIDS was oral candidiasis (40%) followed by cervical lymphadenopathy (30%). Other common manifestations are oral herpes simplex and sensorineural hearing loss. Less common manifestations are chronic sinusitis, tuberculous laryngitis, chronic otitis media, oral hairy leukoplakia, nasal polyps and Kaposi’s sarcoma. Oral candidiasis, chronic/recurrent mucocutaneous herpes simplex, oral hairy leukoplakia and Kaposi’s sarcoma are the AIDS defining illnesses. Oral hairy leukoplakia, is pathognomonic of HIV infection.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>These manifestations help ENT surgeons, to recognize HIV/AIDS patients from the specific ENT lesions occurring in them, for early diagnosis and subsequent treatment.</p>

Otorhinolaryngological manifestations in COVID-19 infections: An early indicator for isolating the positive cases

COVID-19 is an infectious respiratory disease caused by a novel virus severe acute respiratory syndrome corona virus 2. Clinical manifestations of COVID-19 range from asymptomatic or flue such as symptoms to severe dyspnea or breathlessness. The combination of the symptoms such as anosmia, persistent cough, fever, fatigue, diarrhea, abdominal pain, and lack of appetite are commonly found in CVOID-19 patients. The symptomatology due to otorhinolaryngological manifestations is often by respiratory tract infections and predominantly found for consultation at otorhinolaryngology clinic. Otorhinolaryngological manifestations are usually associated with aerosol producing symptoms and so highly contagious in very short period. It is need to identify the patient with symptoms and rightly pinpoint to infect individuals. This review article focuses on the otorhinolaryngological manifestations and its implications in early transmission of the COVID-19 along with the preventions. This article will surely increase awareness among the frontliner clinicians and help them to protect themselves along with early suspicion of cases before spreading the diseases to community.

Giant Cell Arteritis (GCA): Pathogenesis, Clinical Aspects and Treatment Approaches.

Giant Cell Arteritis (GCA), or Horton's Arteritis, is a chronic form of vasculitis of the large and medium vessels, especially involving the extracranial branches of the carotid arteries, in particular, the temporal artery, with the involvement of the axillary, femoral and iliac arteries too. Arterial wall inflammation leads to luminal occlusion and tissue ischemia, which is responsible for the clinical manifestations of the disease. A substantial number of patients affected by GCA present head and neck symptoms, including ocular, neurological and otorhinolaryngological manifestations. The aim of this article is to present pathogenesis, clinical aspects and treatment approaches of GCA manifestations.