The effect of COVID-19 pandemic on laryngeal cancer in a tertiary referral center.

PURPOSE: This study aimed to evaluate whether there was a significant change in the laryngeal cancer stage before and after the COVID-19 pandemic. METHODS: This retrospective cohort study was conducted to evaluate the data of patients who operated due to laryngeal cancer in a tertiary referral hospital's ear, nose, and throat (ENT) department between June 2018 and 2021. The patients were included at the same period of the years to rule out any seasonal changes. The basic characteristic, tumor localization, and TNM stage of the patients were compared. RESULTS: 97 patients were operated due to laryngeal cancer during the time period reviewed. 57 (58.8%) patients were operated before and 40 (41.2%) after the COVID-19 pandemic. When comparing the patients before and after the COVID-19 pandemic period, the mean age significantly differed between the study groups that older age was observed in patients who admitted before the COVID-19 pandemic (62.8 ± 6.5 vs. 57.3 ± 6.8, p < 0.001). Regarding the TNM classification, the patients in the after COVID-19 pandemic group had higher rates of T4 stage laryngeal cancer compared to before COVID-19 pandemic group (12 (30%) vs. 4 (7%), p: 0.003). CONCLUSION: Younger patients have operated after the COVID-19 pandemic, and the patients were presented with larger tumor sizes. The pandemic may increase the time between diagnosis and surgery in laryngeal cancer patients.

Blood parameters as indicators of upper airway obstruction in children with adenoid or adenotonsillar hypertrophy.

UNLABELLED: Adenotonsillar hypertrophy (ATH) is the most common cause of obstructive sleep apnea in children. This study aimed to evaluate the blood parameters of children with ATH who underwent surgery. METHODS: The study included a review of the medical records of 130 children who underwent adenoidectomy or adenotonsillectomy with a diagnosis of adenoid hypertrophy and/or chronic tonsillitis. Patients were classified into 3 groups: group 1 (n=69) underwent adenoidectomy, group 2 (n=61) underwent adenotonsillectomy, and group 3 consisted of 82 healthy children. White blood cell count, platelet count, hemoglobin levels, mean platelet volume, and platelet distribution width values were the primary outcome measures. RESULTS: Mean platelet volume, platelet distribution width and hemoglobin values decreased in the groups that underwent surgery. Whereas the decrease in group 1 was insignificant, it was significant in group 2. White blood cell count values increased in both group 1 (adenoidectomy) and group 2 (adenotonsillectomy), but the increase in group 2 was significant. No significant difference in platelet count was detected before versus after the operation. CONCLUSIONS: Upper airway obstruction caused by ATH remarkably changes the blood parameters related to chronic hypoxia. Significant improvement can be achieved after adenotonsillectomy rather than adenoidectomy alone.

The role of allergic and nonallergic rhinitis on success of type 1 cartilage tympanoplasty.

OBJECTIVE: To investigate the role of allergic rhinitis (AR) and non-allergic rhinitis (NAR) on success of type 1 cartilage tympanoplasty. METHODS: This prospective study was conducted on 60 patients who had type 1 cartilage tympanoplasty. The patients were divided into three groups as no-rhinitis (n = 28), NAR (n = 18) and AR (n = 14) groups, based on their symptoms, skin prick tests and/or serum specific IgE levels. AR and NAR groups were treated for their rhinitis symptoms both pre- and postoperatively. The patients were followed up for a minimum of 6 months and compared for graft success rates and audiological outcomes. RESULTS: Three study groups were similar for age, gender distributions and preoperative air-bone gaps (p = 0.780, p = 0.167 and p = 0.676, respectively). Postoperative graft perforation rate was 0% in no-rhinitis and AR groups while it was 16.7% in NAR group, with a significant difference among three groups (p = 0.034). The comparison of three study groups for change in the postoperative air bone gaps in comparison with preoperative air bone gaps did not yield any statistically significant result (p = 0.729). CONCLUSION: Although AR does not result in failure of type 1 cartilage tympanoplasty in patients treated for rhinitis compared to the control group, NAR does. Pre- and postoperative treatment of patients for rhinitis and employment of cartilage graft may be the key factors for success of surgery in patients with AR. Further studies with a larger sample size are needed.

Effects of Anatolian Propolis and Hypertonic Saline Combination Nasal Spray on Allergic Rhinitis Symptoms: A Prospective, Multicenter Study.

Objectives: This study aimed to evaluate how Rhinapi nasal spray affects symptoms of allergic rhinitis. Methods: In this prospective, multicenter, observational study, 10,000 patients (comprising 5028 males and 4972 females) exhibiting symptoms of allergic rhinitis (namely, nasal discharge, sneezing, nasal itching, and nasal obstruction) from different centers in different regions of Turkey were enrolled in the study between March 2022 and March 2023. All the patients wanted to participate in the study and were administered Rhinapi one puff to each nostril three times a day, for a period of 3 weeks. Total symptom scores, quality of life (QoL) scores, and otolaryngological examination scores were evaluated before and 3 weeks after treatment. Results: The scores for discharge from the nose, sneezing, nasal pruritus, and blockage of the nose all indicated improvement when compared to pre-medication and post-medication. This difference achieved statistical significance (P < .001). The mean total symptom score fell following treatment (P < .001): whilst the score was 11.09 ± 3.41 before administering Rhinapi; after administration, the average score was 6.23 ± 2.41. The mean QoL scores also altered after medication (P < .001), improving from a mean value of 6.44 ± 1.55 to a mean of 7.31 ± 1.24. Significant improvement was also noted in the scores for conchal color and degree of edema after the treatment had been administered (P < .001). Conclusion: The study demonstrates that Rhinapi nasal spray decreases total symptom scores, and results in improved QoL and otolaryngological examination scores. Propolis spray may be recommended for patients with allergic rhinitis alongside other treatments.

SARS-CoV-2 is not found in the sweat of COVID-19 positive patients.

BACKGROUND: As the SARS-CoV-2 virus made a pandemic all over the world, its transmission routes became significant. Transmission from human to human is known, but other possible routes are not determined well. AIMS: This study aimed to reveal the presence of SARS-CoV-2 virus in sweat. METHODS: This prospective study was conducted in a tertiary care education and training hospital. Fifty patients were included in this study. Skin disinfection was done with an alcohol-based solution. Swabs for RT-PCR (real-time reverse transcriptase polymerase chain reaction) were taken from forehead and axilla skin after sweating patients for 30 min. After collection of sweat, swabs were placed into 2 ml of sterile viral transport medium, then transported quickly to the microbiology laboratory. RESULTS: No SARS-CoV-2 virus was detected in RT-PCR of forehead and axilla swabs. CONCLUSION: This study showed that there is no transmission of SARS-CoV-2 virus via sweat. However, general precautions must be taken while doing interventional procedures.

Unexpected difficult airway with hypogonadotropic hypogonadism.

BACKGROUND: A critical aspect of safe general anesthesia is providing adequate ventilation and oxygenation. Failed endotracheal intubation and inadequate ventilation with insufficient oxygenation may lead to serious complications, even death. Anesthesiologists rarely encounter unexpected difficult airway problems in daily routine. Management of an unexpectedly difficult airway consists of laryngeal mask ventilation, gum-elastic bougie and video laryngoscopy-assisted intubation. Gum-elastic bougie is the easiest and cheapest tool used in case of an unexpected difficult intubation occurring in the operating room. CASE: A 53-year-old male patient with hypogonadotropic hypogonadism presented as an unexpected difficult intubation after the induction of anesthesia. No pathological finding or predictor of difficult intubation was present. In addition, bag-mask ventilation was poor and inadequate. The patient was finally successfully intubated with a gum-elastic bougie. CONCLUSION: A difficult airway has been described in patients with a variety of endocrine disorders, including pituitary diseases, but not with hypogonadism. There may be an unrevealed relationship between hypogonadism and difficult airway. Gum-elastic bougie is still the most attainable and effective tool in the operation room in this situation.

The role of allergic and nonallergic rhinitis on success of type 1 cartilage tympanoplasty / El papel de la rinitis alérgica y no alérgica en el éxito de la timpanoplastia de cartílago tipo 1

Objective: To investigate the role of allergic rhinitis (AR) and non-allergic rhinitis (NAR) on success of type 1 cartilage tympanoplasty. Methods: This prospective study was conducted on 60 patients who had type 1 cartilage tympanoplasty. The patients were divided into three groups as no-rhinitis (n = 28), NAR (n = 18) and AR (n = 14) groups, based on their symptoms, skin prick tests and/or serum specific IgE levels. AR and NAR groups were treated for their rhinitis symptoms both pre- and postoperatively. The patients were followed up for a minimum of 6 months and compared for graft success rates and audiological outcomes. Results: Three study groups were similar for age, gender distributions and preoperative air-bone gaps (p = 0.780, p = 0.167 and p = 0.676, respectively). Postoperative graft perforation rate was 0% in no-rhinitis and AR groups while it was 16.7% in NAR group, with a significant difference among three groups (p = 0.034). The comparison of three study groups for change in the postoperative air bone gaps in comparison with preoperative air bone gaps did not yield any statistically significant result (p = 0.729). Conclusion: Although AR does not result in failure of type 1 cartilage tympanoplasty in patients treated for rhinitis compared to the control group, NAR does. Pre- and postoperative treatment of patients for rhinitis and employment of cartilage graft may be the key factors for success of surgery in patients with AR. Further studies with a larger sample size are needed.(AU)

Objetivo: Investigar el papel de la rinitis alérgica (AR) y la rinitis no alérgica (NAR) en el éxito de la timpanoplastia de cartílago tipo 1. Métodos: Este estudio prospectivo se realizó en 60 pacientes con timpanoplastia de cartílago tipo 1. Los pacientes se dividieron en tres grupos como libres de rinitis (n = 28), NAR (n = 18) y AR (n = 14) según sus síntomas, pruebas cutáneas y/o niveles de IgE específica en suero. Los grupos AR y NAR fueron tratados antes y después de la operación por síntomas de rinitis. Los pacientes fueron seguidos durante al menos 6 meses y se compararon las tasas de éxito del injerto y los resultados audiológicos. Resultados: Los tres grupos de estudio fueron similares en cuanto a la edad, la distribución por sexos y el espacio entre el aire y el hueso preoperatorio (p = 0,780, p = 0,167 y p = 0,676, respectivamente). Mientras que la tasa de perforación del injerto postoperatorio fue del 0 % en el grupo sin rinitis y AR, fue del 16,7 % en el grupo NAR, y hubo una diferencia significativa entre los tres grupos (p = 0,034). La comparación de los tres grupos de estudio con los espacios óseos aéreos preoperatorios para el cambio en los espacios óseos aéreos posoperatorios no arrojó un resultado estadísticamente significativo (p = 0,729). Conclusión: Aunque AR no falla en la timpanoplastia de cartílago tipo 1 en pacientes tratados por rinitis en comparación con el grupo control, NAR sí lo hace. El tratamiento pre y postoperatorio de pacientes con rinitis y el uso de injertos de cartílago pueden ser factores clave para el éxito de la cirugía en pacientes con RA. Se necesitan más estudios con tamaños de muestra más grandes.(AU)