Assessment of anti-SARS-CoV-2 antibodies level in convalescents plasma.

Despite extensive vaccination, the quantity of patients infected with the SARS-CoV-2 virus and its variants continues to grow worldwide. Treating patients with a severe course of COVID-19 is a difficult challenge. One of the generally accepted and specific therapy methods is the use of plasma rich in anti-SARS-CoV-2 antibodies. On the other hand, assessing the antibodies level depending on the time after infection allows for vaccine-decision. The study marked the level of anti-SARS-CoV-2 IgG antibodies in 351 COVID-19 convalescent residents of one geographical region in Poland. The study group included blood donors. The studies were cross-sectional and extended to a questionnaire to determine infection severity. These data were compiled statistically. The study considered epidemiological factors, the time from the end of the infection, and infection severity. The fastest increase of the antibodies level was observed up to 59 days after COVID-19, and it was statistically significantly higher among men. Higher levels of antibodies were found among people above the average age in both men and women. There was an increase in the level of antibodies since the onset of the disease in men, while in women, it decreased. The antibodies level was also found to depend on the severity of the course of COVID-19 infection. The optimal group of plasma donors in the studied geographical region is men and women above 39 years old. after a more severe infection. The titer of antibodies increases with time from the disease.

[Can the SARS-CoV-2 virus damage human hearing and balance?] / Czy wirus SARS-CoV-2 moze uszkadzac sluch i równowage?

In 2019, COVID-19, the disease caused by the SARS-CoV-2 virus, evolved into a pandemic which is still going on. The basic clinical symptoms of the SARS-CoV-2 infection are: fever, dry cough, fatigue, muscle pain, respiratory problems, and the loss of smell or taste. Other symptoms, including those related to hearing and balance organs (hearing loss, tinnitus, dizziness), are reported less frequently by patients. They are especially rarely reported as the first symptoms of this infection. In order to answer the question of whether SARS-CoV-2 can cause hearing and balance damage, the authors reviewed the literature sources from 2019-2020 included in EMBASE and PubMed, entering the following words: "hearing loss," "COVID-19," "coronavirus," "sensorineural hearing loss," "vertigo," and "dizziness." Ultimately, 9 studies on the possible relationship between hearing impairment and SARS-CoV-2, and 4 studies on the possible relationship between damage to the balance and SARS-CoV-2, were qualified for the study. The results of the analysis suggest a possible relationship between COVID-19 and hearing loss, with no evidence of a similar relationship between this virus and the balance system. The possible existence of such a relationship should be especially remembered by hospital emergency room doctors, otolaryngologists and audiologists, especially as regards the possibility of a sudden sensironeural hearing loss as the first symptom of COVID-19. This also applies to doctors of other specialties. The authors indicate the need for further, intensive and multifaceted research on this issue. Med Pr. 2021;72(3):321-5.

[Patient in the otolaryngology office in the time of the COVID-19 pandemic in the light of current recommendations, legal regulations and authors' own experience]. / Pacjent w gabinecie otolaryngologicznym w dobie pandemii COVID-19 w swietle aktualnych wytycznych, przepisów prawnych i wlasnych doswiadczen.

Generally, COVID-19 is an acute contagious disease caused by the SARS­CoV-2 virus. The main route of human-to-human transmission is through contact with infectious secretions from the respiratory tract. Clinical manifestations vary from mild non-specific symptoms to life-threatening conditions. Since WHO declared COVID-19 a pandemic in March 2020, it has affected many medical, legal, social and economic aspects of everyday life in countries around the world. In this article, the authors present a summary of recommendations for taking care of otorhinolaryngology patients in outpatient settings and the legal basis referring to a risk of infection in doctor's office. In the selection of articles, the authors used English- and Polish-language online medical databases, typing the following keywords: SARS­CoV-2, COVID-19, otolaryngology, endoscopy, personal protective equipment, and legal responsibility of the physician. The mucosa of the upper respiratory tract is a potential site of virus replication. The specificity of an ear, nose and throat (ENT) examination and a direct patient-doctor contact favor the transmission of the infection. The authors discussed the elements of self-protection of medical personnel and the legal aspects a risk of the patient contracting the infection in the otolaryngology office. In the case of a direct contact with the patient, the following medical personal protective equipment is required: a cap, a mask with an FFP-2 filter, goggles, an apron and gloves. If, during the visit, exposure to secretions or aerosol from the respiratory tract is expected, the personnel should additionally wear a visor and a waterproof apron. The patient's visit in the clinic should be preceded by telemedicine consultation. Patients should be screened prior to having a direct contact with a physician, using a short patient questionnaire. The questionnaire may consist of simple questions about the characteristic symptoms of the SARS­CoV-2 infection and exposure to a sick person in the past 14 days. The question of staying in the areas of a high infection risk appears of little importance in view of the whole of Poland being perceived as constituting such an area. Due to the spread of the SARS­CoV-2 virus, new procedures for providing medical services have been introduced. In the case of claims on the part of the patient, the only protection the medical personnel or facility can provide is confirmation of scrupulous compliance with medical procedures . Med Pr. 2021;72(3):327-34.

Tinnitus in COVID-19 Pandemic.

Tinnitus is a symptom that can significantly affect the quality of life of every patient. In patients with tinnitus, one of the most important diagnostic element is medical history data. Patients classify the pitch and loudness of tinnitus graphically using the visual analog scale (VAS). Visual analog scale and similar questionnaires constitute a valuable addendum of the clinical picture in patients with tinnitus. It seems essential, especially in the light of the information presented in the case report on the probability of correlation between tinnitus and stress and depression associated with social isolation infection avoidance. The knowledge about the patient's hearing condition before contracting COVID-19, the early symptoms of SARS-CoV-2 infection, the method of diagnosis of the infection, the time and method of isolation of the patient, and the time from the diagnosis of COVID-19 to the appearance of otolaryngological symptoms might enable the reader to gain more knowledge on the correlation between COVID-19 and tinnitus. New research reveals that tinnitus is being exacerbated by COVID-19.

Epidemiology of dizziness in northern Poland - The first Polish neurootologic survey of the general population.

INTRODUCTION: Dizziness is a common complaint among patients seen by primary care physicians, neurologist and otolaryngologist. It presents difficult clinical and diagnostic problems. OBJECTIVES: The purpose of this study was to determine the prevalence and incidence of dizziness in the general population of the town and district Bytów, northern Poland, and to describe its clinical characteristics. MATERIAL AND METHODS: Epidemiological questionnaires were completed by 4,799 inhabitants of the town and district of Bytów. All participants were randomly selected from the patients' list of the Family Health Centre 'Salus' in Bytów. The main variables studied were gender, age, school education, work situation, clinical characteristics of dizziness symptoms and circumstances provoking dizziness. RESULTS: Prevalence of dizziness was diagnosed among 16.4% of the inhabitants of the town and district of Bytów. Symptoms of dizziness appeared more often among the elderly and among women. Among young people, the condition shows as vertigo or presyncope, among people aged 50 or older, the condition showed as disequilibrium. The most common precipitant of dizziness was postural change. Dizziness was more likely to occur among those suffering from high blood pressure, diabetes, increased blood lipids, hypothyroidism, cardiac arrhythmia and depression. Dizziness was more likely to occur among women using OCS or HRT, and individuals taking anti-epileptic drugs. CONCLUSIONS: The authors present the first Polish neurootologic survey of epidemiology of dizziness in the general population. This condition is common in the general population, and this study indicates its prevalence in 16.4% of the inhabitants of the town and district of Bytów. It is recommendable that epidemiological studies should be carried out.

[Quality of life patients with sudden sensorineural hearing loss]. / Jakosc zycia chorych z naglym niedosluchem czuciowo-nerwowym.

AIM: The aim of this study was the assessment of the quality of life of patients suffering from SSNHL and treated in the Otolaryngology Ward of Regional Specialized Hospital in Slupsk between 2001 and 2010, who were interviewed at least one year after the end of treatment. MATERIAL AND METHODS: A test examination was carried out in the period between 1 September 2011 and 31 March 2012 in the group of patients previously treated for SSNHL in the Otolaryngology Ward of Regional Specialized Hospital in Slupsk. Sixty-one patients responded to an invitation in writing. Quality of life was measured using following questionnaires: WHOQOL-Bref and Cantril's ladder (questionnaire). RESULTS: A test carried out using a Cantril's questionnaire showed that the respondents assessed their quality of life as higher before they fell ill, compared to the period directly after they fell ill, in hope of improvement of their well being, although this hope was not as high as it was before they fell ill. These differences were statistically significant. As it was indicated by WHOQOL-Bref questionnaire, the condition did not influence the quality of life of the patients, however the patients reported a higher quality of life, when compared to the patients who did not observe hearing improvement (these differences were noticeable but considered statistically insignificant). CONCLUSIONS: The indicated ambiguous influence of the treatment of patients suffering from SSNHL on their quality of life demonstrates the need to continue such research.

[Malignant and non-malignant cartilaginous tumours of the larynx]. / Zlosliwe i niezlosliwe guzy chrzestne krtani.

INTRODUCTION: Cartilaginous tumours of the larynx are rare. They usually involve cricoid cartilage, less frequently thyroid cartilage and other cartilages. The most significant clinical manifestations are hoarseness, dyspnea, dysphagia or a neck mass. On physical examination, tumour is found as a bulge with intact mucosa or a tumour situated in a part of the larynx also with fixation. CT scanning is the mainstay of radiographic imaging. The histopathologic diagnosis is made after the surgical excision. Prognosis for survival is good. The recurrences occur very often, also with malignant transformation and require laryngectomy. MATERIAL: We presented 11 patients (including symptoms, involved cartilage, laryngoscopy examination, histopathologic diagnosis, treatment and the follow-up). RESULTS: 6 patients manifested hoarseness, 5 dyspnea, 3 dysphagia, 1 neck mass as the first symptom. In laryngoscopy a tumour with intact mucosa was situated in subglottis - 5 patients, in supraglottis - 2 patients and in half of the larynx with fixation - 4 patients. The majority of tumours involved the cricoid cartilage - in 9 cases, the rest arytenoid and epiglottic cartilage. The histopathology diagnosis were given after surgery, only in one case after biopsy. There were 7 patients with chondrosarcoma and four with chondroma. We did not observe lymph node or distant metastases. All patients were treated surgically. Follow-up of patients with chondrosarcoma were 5 to 17 years without recurrence. However, two recurrences of chondroma appeared to be chondrosarcomas and required laryngectomy.

[Surgical treatment results of acquired external auditory canal atresia]. / Wyniki leczenia chirurgicznego nabytego zarosniecia przewodu sluchowego zewnetrznego.

UNLABELLED: Acquired post inflammatory external auditory canal atresia is a rear complication of external ear disease. It is presented as a connective tissue scar in bony part of external auditory canal. The aim of this study is clinical and epidemiological analysis and presentation of diagnostics and treatment results of patients with atresia treated in the Otolaryngology Department of Medical University of Gdansk. MATERIAL AND METHODS: In the period of 3 years (2008-11) 10 patients (8 women and 2 men) aged 30 to 70-years-old (medium 53 years) were treated for acquired atresia. All of these patients had medial closure of EAC with thick connective tissue scar and tympanic membrane involvement. Intrameatal access was performed in 5 patients, intraural access in 3 patients and retroaurical access in 2 patients. In all cases canaloplasty with meato-tympanic angle enlargement was performed, skin defect was replaced with free epidermal flap, silicon foil with fibrinous sponge was used for coverage. RESULTS: In all of our patients external auditory canal widening and hearing improvement was achieved. Due to increasing EAC narrowing four patients underwent second surgery with another free epidermal flap grafting. CONCLUSION: The selection of surgical access in patients with acquired atresia should comply with the etiology of the disease and the shape of EAC. During surgery we aim at maximal broadening of the bony part of EAC. The success of the treatment depends on meato-tympanic angle enlargement and free epidermal flap grafting.

[Epidural abscess as a complication of acute mastoiditis in a 7-year-old child]. / Ropien nadtwardówkowy jako powiklanie ostrego zapalenia wyrostka sutkowatego u 7-letniego dziecka.

INTRODUCTION: Epidural abscess is the commonest intracranial complication of acute mastoiditis. In some cases this entity may pose a diagnostic problem. MATERIALS AND METHODS: We report a case of acute mastoiditis followed by an epidural abscess in the middle cranial fossa and a bone fistula to subtemporal fossa. Localization of the abscess was revealed by means of computed tomography and magnetic resonance imaging of the head in early stage of the disease. RESULTS: The treatment of choice was mastoidectomy with epitymanotomy, myringostomy, revision of zygomatic area to ensure drainage of the epidural abscess and intravenous antibiotics. After two years of observation the child is in a good condition with normal hearing. CONCLUSIONS: Osteolysis visualized on CT scan may suggest an intracranial complication occurrence. MRI should be performed to determine the precise localization of the abscess.