Chronic Otitis Media in Patients with Chronic Rhinosinusitis: A Systematic Review.

Introduction: Chronic otitis media (COM) and chronic rhinosinusitis (CRS) are two of the most common otolaryngological disorders. CRS and COM share pathophysiological mechanisms such as bacterial infection, biofilm, and the persistence of the obstruction state of ventilation routes. The purpose of this systematic review was to evaluate all available information on the association between COM and CRS. Methods: The protocol of this investigation was registered on PROSPERO in November 2022. Pubmed, Scopus, Web of Science, and Cochrane databases were systematically searched according to the PRISMA statement. Results: After the application of inclusion-exclusion criteria, four manuscripts with adequate relevance to this topic were included in the review. The study population consisted of 20,867 patients with a diagnosis of CRS, of whom 991 were also diagnosed with COM (4.75%). Conclusions: The included studies have shown that CRS has become significantly associated with COMas: a global inflammatory process that involves the epithelium in both the middle ear and upper airway. The identification of a relationship between CRS and COM may contribute to preventing chronic inflammatory conditions through the early management of the associated disease. Further, carefully designed studies are necessary to demonstrate the relationship between COM and CRS.

Age at Fitting Affected Unilateral Versus Bilateral Hearing Aids Choice in Asymmetric Hearing Loss.

BACKGROUND: Bilateral hearing aids are desirable to restore hearing in the most effective and natural way. The aim of the present study was to identify which type of hearing rehabilitation was preferred by our patients and which factors drove their choice. METHODS: One hundred eight patients with moderate-to-severe asymmetrical hearing loss before and after a 1-month trial with bilateral hearing aids were considered. RESULTS: As high as 58.3% of patients decided to continue with bilateral hearing aids (group BI), while 41.7% chose unilateral hearing aid (UNI group) in the best ear. Patients in the UNI group were significantly older than those in the BI group (P=.04); age > 77 years was an independent prognostic factor of unilateral hearing aid choice (odds ratio=6.26; P=.04). Matrix test scored significantly worse with a single hearing aid than with 2 hearing aids in both groups (UNI P=.03; BI P=.01). CONCLUSION: Patients with asymmetric hearing loss often prefer unilateral hearing aid, almost half in our experience. Nonetheless, bilateral hearing aids are desirable as unilateral hearing aid was associated with significantly poorer performance at a speech in noise hearing tests. Age at fitting could play a relevant role and is thus important in early diagnosis. Further studies are needed to confirm our results and investigate strategies to promote bilateral rehabilitation.

Magnetic Resonance Imaging Confirmed Olfactory Bulb Reduction in Long COVID-19: Literature Review and Case Series.

An altered sense of smell and taste was recognized as one of the most characteristic symptoms of coronavirus infection disease (COVID-19). Despite most patients experiencing a complete functional resolution, there is a 21.3% prevalence of persistent alteration at 12 months after infection. To date, magnetic resonance imaging (MRI) findings in these patients have been variable and not clearly defined. We aimed to clarify radiological alterations of olfactory pathways in patients with long COVID-19 characterized by olfactory dysfunction. A comprehensive review of the English literature was performed by analyzing relevant papers about this topic. A case series was presented: all patients underwent complete otorhinolaryngology evaluation including the Sniffin' Sticks battery test. A previous diagnosis of SARS-CoV-2 infection was confirmed by positive swabs. The MRIs were acquired using a 3.0T MR scanner with a standardized protocol for olfactory tract analysis. Images were first analysed by a dedicated neuroradiologist and subsequently reviewed and compared with the previous available MRIs. The review of the literature retrieved 25 studies; most cases of olfactory dysfunction more than 3 months after SARS-CoV-2 infection showed olfactory bulb (OB) reduction. Patients in the personal case series had asymmetry and a reduction in the volume of the OB. This evidence was strengthened by the comparison with a previous MRI, where the OBs were normal. The results preliminarily confirmed OB reduction in cases of long COVID-19 with an altered sense of smell. Further studies are needed to clarify the epidemiology, pathophysiology and prognosis.