The toll of noninfected CRS patients to the COVID-19 pandemic.

Social distancing with the aim of avoiding infections and pre-serve critical care capacities during the COVID-19 pandemic has been implemented in Germany according to World Health Organization (WHO) recommendations from early March onwards. Limitations of physical contacts to reduce exposure to SARS-CoV-2 infected individuals were handled strictly, particularly in medical centers dealing with airway diseases, like rhinology and pneumology clinics. Such measures and reluctance to visit out- and inpatient services resulted in a 82% decrease in consultations to the 12 German oto-rhino-laryngological (ORL) centres forming our database during the 50 days following March 09 in 2020 if compared to the same period in 2019. Our data on CRS care underline reports on undertreatment of non-COVID-19 individuals with several different diseases during the current pandemic. We should try to reduce the toll these patients have to pay as much as possible. We established telemedicine, e-Health and artificial intelligence-supported triage for selecting the right patients for onsite-consultations and to advise patients in several demands.

[Local allergic rhinitis to Alternaria alternata : Evidence for local IgE production exclusively in the nasal mucosa]. / Lokale allergische Rhinitis auf Alternaria alternata : Nachweis bei Patienten mit persistierender nasaler Symptomatik.

In a subgroup of patients with symptoms of allergic rhinitis (AR), no systemic sensitization can be detected in skin tests or serum. These patients are considered to be afflicted with so-called "local allergic rhinitis" (LAR) with IgE-production exclusively at the site of the nasal mucosa. Patients without any positive allergy test results but seasonal (intermittent) or perennial (persistent) allergic symptoms were often misdiagnosed as having "non-allergic rhinitis" (NAR) in the past.However, there is evidence for a specific IgE-production in the nasal mucosa in these patients without systemic sensitization. The diagnosis of LAR is confirmed by clinical symptoms, the detection of specific IgE production in the nasal mucosa and/or nasal provocation tests.We report on two cases of LAR to Alternaria alternata with symptoms of persistent allergic rhinitis that have been diagnosed by positive allergenspecific nasal challenge tests and specific IgE determinations in nasal secretions.According to an actual literature research, this is the second report published on LAR caused by Alternaria alternata.

Treatment of hypertrophic palatine tonsils using bipolar radiofrequency-induced thermotherapy (RFITT.).

CONCLUSION: Radiofrequency volume reduction of palatine tonsils is a gentle and safe treatment method in selected patients, which should carefully be considered as an alternative to tonsillectomy or tonsillotomy. OBJECTIVES: The aim of this study was the evaluation of bipolar radiofrequency-induced thermotherapy (RFITT) compared to standard blunt dissection tonsillectomy (TE) for the volume reduction of palatine tonsils in chronic tonsillar hypertrophy. PATIENTS AND METHODS: A total of 137 patients (98 children) were treated in two groups in a prospective controlled, randomized clinical trial. The TE group underwent standard tonsillectomy using blunt dissection. The RFITT group underwent interstitial RF ablation. Perioperative blood loss and duration of surgery were monitored. Tonsil volume reduction in the RFITT group was measured by sonography. Postoperative pain, as well as difficulty in swallowing and speaking, were evaluated using visual analog scales. RESULTS: In the RFITT group, we found an average tonsil volume reduction of 40%, at about 3 weeks after treatment. Postoperative pain, swallowing and speaking difficulties, and perioperative blood loss were significantly lower, and the duration of surgery was significantly shorter (all p<0.05) in the RFITT group. Preservation of the treatment results was monitored until 6 months after treatment, with no after effects during this time period.

[Bronchial asthma--what is of importance for the ENT-specialist?]. / Asthma bronchiale--Was sollte der HNO-Arzt über die Erkrankung wissen?

In Germany the prevalence of bronchial asthma in adults is 5 % and up to 10 % in children. This explains its enormous medical and economic importance. Bronchial asthma is not only the most-frequent allergic lung disease; it is the most prevalent chronic illness of the childhood. Alongside with other atopic diseases--allergic rhinitis and atopic dermatitis--in the last decades the incidence increased significantly. Allergic and non allergic rhinitis and sinusitis are strongly correlated with asthma. This explains why ENT-specialists are often consulted first by patients with chronic inflammations of both the upper and lower airways. Hence, the ENT-specialist should clearly understand the pathophysiologic mechanisms of the disease, become familiar with the typical clinical findings and get a broader knowledge of the standard diagnostic methods and therapeutic issues. This article gives a detailed overview on these topics and the current guidelines.