Incidence and prognosis of olfactory and gustatory dysfunctions related to SARS-CoV-2 Omicron strain infection in China: A national multicenter survey of 35,566 individuals.

Objective: This cross-sectional study aimed to determine the epidemiology of olfactory and gustatory dysfunctions related to COVID-19 in China. Methods: This study was conducted by 45 tertiary Grade-A hospitals in China. Online and offline questionnaire data were obtained from patients infected with COVID-19 between December 28, 2022, and February 21, 2023. The collected information included basic demographics, medical history, smoking and drinking history, vaccination history, changes in olfactory and gustatory functions before and after infection, and other postinfection symptoms, as well as the duration and improvement status of olfactory and gustatory disorders. Results: Complete questionnaires were obtained from 35,566 subjects. The overall incidence of olfactory and taste dysfunction was 67.75%. Being female or being a cigarette smoker increased the likelihood of developing olfactory and taste dysfunction. Having received four doses of the vaccine or having good oral health or being a alcohol drinker decreased the risk of such dysfunction. Before infection, the average olfactory and taste VAS scores were 8.41 and 8.51, respectively; after infection, they decreased to 3.69 and 4.29 and recovered to 5.83 and 6.55 by the time of the survey. The median duration of dysosmia and dysgeusia was 15 and 12 days, respectively, with 0.5% of patients having symptoms lasting for more than 28 days. The overall self-reported improvement rate was 59.16%. Recovery was higher in males, never smokers, those who received two or three vaccine doses, and those that had never experienced dental health issues, or chronic accompanying symptoms. Conclusions: The incidence of dysosmia and dysgeusia following infection with the SARS-CoV-2 virus is high in China. Incidence and prognosis are influenced by several factors, including sex, SARS-CoV-2 vaccination, history of head-facial trauma, nasal and oral health status, smoking and drinking history, and the persistence of accompanying symptoms.

[Comparison of the efficacy of 2 types of mandibular advancement device in severe obstructive sleep apnea hypopnea syndrome].

PURPOSE: To evaluate the efficacy of 2 mandibular advancement devices in 6-week treatment of patient with severe obstructive sleep apnea hypopnea syndrome (OSAHS) who refused to CPAP or CPAP therapy. METHODS: A randomized cross-over study was designed and conducted. Twenty-two male patients with severe OSAHS were included for treatment. Rod type and controllable type mandibular advancement devices (MADs) were used respectively in 6 weeks with 2-week interval, while the whole experimental duration was 14 weeks. The differences of the indexes of the polysomnography (PSG) were analyzed, which were gained before the intervention and 6 weeks after use of 2 types of MADs. Questionnaires with Epworth sleep and SCL-90 symptoms self evaluation scales were proceeded. Meanwhile, the parameters such as the stability of the MAD, the adverse reaction and the subjective symptom relief were assessed. The result was statistically analyzed by SPSS19.0 software package. RESULTS: Compared with the apnea hypopnea index (AHI) before the intervention (48.16±13.99 times/hr), both the AHI of the rod type (19.16±2.74 times/hr) and the controllable type (18.93±2.57 times/hr) were reduced by 50%. The remaining parameters showed that both types of MADs had a significant effect on mandibular advancement. There was significant different decrease in each index of the SCL-90 (P<0.01), while significant differences were found in somatization, interpersonal sensitivity and anxiety compared with those before intervention(P<0.05). At the same time, there were significant differences in the indexes of stability and results occlusive comfort between the rod type and the controllable MADs (P<0.05). CONCLUSIONS: The objective results and the patients' physical and mental health are improved obviously by using the 2 types of MADs. Controllable MADs have more advantages in compliance; however, further research should be conducted for long-time outcome.

[Swallowing and laryngeal function preserving in surgical treatment of the head and neck tumors involving the tongue root].

OBJECTIVE: To investigate the surgical technique which could preserve the swallowing and laryngeal function effectively in the malignant head and neck tumors involving the tongue root. METHODS: From January 2003 to December 2008, 31 cases of malignant head and neck tumors involving the tongue base had been treated in this hospital were retrospectively analyzed. There were 27 males and 4 females in which 9 cases of primary malignant tumor were from the base of tongue; 3 cases were from the tonsil, 11 cases were from supraglottic laryngeal carcinoma and 8 cases were from hypopharyngeal carcinoma. Preserved the lingual artery of the reserved side and the normal tissue of the root of tongue according to the clinical anatomy of lingual artery during the operation. If preoperative CT had indicated that bilateral lingual arteries were involved, total glossectomy should have been done. The epiglottis, vocal cords and the ventricular band of larynx was preserved as much as possible for the mechanisms of laryngeal function. RESULTS: In this group, residual tongue necrosis did not occurred. One case with total glossectomy didn't remove the trachea cannula. Five had total laryngectomy. The other 25 cases decannulated from 14th days to 90th days postoperatively. The time of oral feeding was started from 10th days to 31st days postoperatively. Two cases with hypopharyngeal carcinoma developed fistula, which were cured by dressing change. Two with root of tongue cancer and 1 with tonsil cancer had postoperative infection and healed in 2 weeks. The median follow-up time was 36 months, and the Kaplan-Meier 3-years and 5-years survival rates were 79.5% and 69.6% respectively. CONCLUSIONS: In the surgical treatments of the malignant head and neck tumors involving the base of tongue, the excisions and reconstructions of the primary tumor and the involved tongue base according to the clinical anatomy of lingual artery and the protection mechanisms of laryngeal function during the operation was one of the most effective technique to preserve the swallowing and laryngeal function.