Dexamethasone eardrop with grommet placement vs intratympanic steroid injection for sudden sensorineural hearing loss: A randomized prospective clinical trial.

OBJECTIVES: The purpose of this study was to compare different means of intratympanic steroid delivery in the treatment of idiopathic sudden sensorineural hearing loss. DESIGN: Prospective, multicentered, randomized controlled trial. SETTING AND PARTICIPANTS: Fifty-six patients who fulfilled the inclusion criteria for idiopathic sudden sensorineural hearing loss who failed or were contraindicated for oral steroids were included in this study. Patients were randomly divided into 2 groups according to delivery methods: group A received 4 sections of intratympanic dexamethasone injection and group B received grommet placement with dexamethasone delivery followed by 3 sections of dexamethasone ear drop application. Self-administered paper-based questionnaires were filled out to measure subjective pain scores, vertigo, anxiety, and overall satisfaction immediately after each procedure. Hearing threshold was measured with pure tone audiogram in the follow-up. RESULTS: There was no statistical significance detected in hearing threshold improvement between both groups (P = 0.30). Grommet placement followed by dexamethasone eardrop application demonstrated a significant difference in shorter waiting time (24 min in grommet group vs 52 min in injection group; P < 0.01); and better overall satisfaction (1.6 in grommet group vs 2.5 in injection group; P < 0.05). CONCLUSIONS: Grommet placement followed by dexamethasone eardrop application is a good alternative for a patient indicated for intratympanic steroid, with less administrative cost, shorter waiting time, and more satisfaction.

Fingertip Injuries in Mask Factory Workers during the COVID-19 Pandemic.

Background: The COVID-19 pandemic has caused a dramatic increase in the demand of face masks. The aim of this study is to look into the demographics, clinical details, clinical outcome and the risk factors for fingertip injuries in mask manufacturing factory workers. Methods: This is a retrospective review of all patients admitted to a regional hospital following a fingertip injury sustained at a mask making factory over a 6-month period from March 2020 to August 2020. Data with regard to gender, age, hand dominance, job position, injured finger, type of injury, mechanism of injury, treatment, clinical outcome (time to return to work), as well as risk factors for injuries (training before work, duration of work before injury, previous experience on working on similar machines, protective measures and working hours) were collected and analysed. Results: There were seven patients in total (M:F = 6:1) with a mean age of 38.4 years. Four patients had injuries on their dominant hands. The most commonly injured finger was the middle finger (n = 3). The most common injury pattern was fingertip amputation (n = 5). Five patients required operative management. Only four patients received training before work and six patients were injured within the first month of work. No patient had previous experience in operating similar machines. Long working hours is also a related risk factor. Conclusions: Better occupational safety and training should be employed to prevent these injuries. Level of Evidence: Level IV (Therapeutic).