Use of a rigid curved laryngoscope for observation and debridement of degenerated cricoid cartilage in nasogastric tube syndrome: A case report.

Nasogastric tube syndrome (NGTS) is a complication of NGT placement that can cause sore throat, bilateral vocal cord paralysis, and airway constriction. Although rare, this condition should be known by all physicians because it is sometimes fatal. We report a case of NGTS that was successfully diagnosed and debrided with a rigid curved laryngoscope. A 79-year-old man was referred to our department for evaluation of persistent pharyngeal pain and dysphagia after thoracic aortic aneurysm surgery. He had restricted bilateral vocal fold abduction, and the NGT had been placed for nearly 120 days. After induction of general anesthesia, the patient underwent laryngeal examination using a rigid curved laryngoscope, which revealed ossified cricoid cartilage in the postcricoid area, leading to confirmation of NGTS. The NGT was removed, and the protruding bony lesion was debrided. Subsequently, the patient underwent gastrostomy to improve his nutritional status. One month later, the postcricoid lesion improved, and the patient was able to tolerate an oral diet. The pathophysiology of NGTS is thought to involve ulceration of the postcricoid mucosa and injury of the posterior cricoarytenoid muscle by contact with the NGT. Although the treatment has not been established, early removal of the NGT is important. In the present case, the rigid curved laryngoscope was useful for resection of the bony lesion, which contributed to early epithelialization and symptom improvement.

A Nationwide survey of safety protocols and chemosensory assessments by Japanese clinicians pre- and post-COVID-19 pandemic.

OBJECTIVE: There has been an increase of attention and awareness of smell and taste loss due to the impact of COVID-19. However, little is known about the influence of COVID-19 on the number of psychophysical tests performed, the timing of these tests, or the protection protocols employed to protect against virus transmission. This study aimed to explore the changes in examination approaches, types of tests employed, and safety measures adopted by clinicians before and after the COVID-19 pandemic. METHODS: A survey was distributed to 404 institutes of the Oto-Rhino Laryngological Society of Japan, consisting of otolaryngologists working in university hospitals, general hospitals, and private clinics. The anonymous online survey contained questions related to safety measures and chemosensory assessments performed before and after the COVID-19 pandemic. Specifically, participants were queried on the number and types of examinations conducted, the type of examiners who performed them, the timing of tests in suspected and non-suspected COVID-19 cases, modifications made due to the pandemic, and the protective measures adopted during chemosensory examinations. RESULTS: Of the 201 respondents, representing a 50 % response rate, 49 % were from general hospitals, 48 % from university hospitals, and 3 % from private clinics. The study found a slight decrease in the overall number of chemosensory tests conducted post-COVID-19. In terms of who performed the test, there were no differences pre- and post- COVID-19. Most examinations (52-68 %) for suspected COVID-19 cases were performed 1-2 months after the onset of symptoms. Modifications in testing rooms and personal protective equipment (PPE) were reported by the majority of institutions post-pandemic. While different examination rooms or PPE were not commonly used based on a patient's previous COVID-19 diagnosis, changes were observed in testing practices. Most examinations were conducted in rooms with windows or fans, and PPE usage was high; surgical masks, eye visors or face shields, and disposable gloves being commonly used. Virus transmission from patient to examiner was reported in only one case during T&T olfactometer examination. CONCLUSION: We investigated the impact of the COVID-19 pandemic on the number of olfactory and gustatory tests performed, the type of examiner, the examination room, and the use of PPE and found no significant difference before and after the COVID-19 pandemic on these factors. Adherence to a protection protocol involving the proper use of PPE in controlled environments enabled the continuation of olfactory and gustatory tests during the pandemic.

q-Powders: a quick test for screening retronasal olfactory disorders with tasteless powders.

PURPOSE: To investigate the clinical utility of q-Powders-a retronasal identification screening test. METHODS: A total of 156 subjects (92 females, mean age: 54.5 years ± 17.3 years) completed a 3-item q-Powders retronasal identification test and a 16-items Sniffin' Sticks orthonasal identification test. We analyzed whether the q-Powders test could differentiate between subjects with normosmia and subjects with an olfactory disorder. RESULTS: Our data indicated that subjects with an olfactory disorder scored lower in the q-Powders test than subjects with normosmia. The analyses revealed q-Powders test sensitivity of 84% and a test specificity of 64.9% with a score of 2 points taken as a cutoff for olfactory disorders. CONCLUSION: The 3-item q-Powders retronasal test may be used for screening purposes in clinical research. LEVEL OF EVIDENCE: 4.

Validation study of a novel approach for assessment of retronasal olfactory function with combination of odor thresholds and identification.

PURPOSE: The present study aimed to establish a test battery for the clinical assessment of retronasal odor thresholds and retronasal odor identification. STUDY DESIGN: Prospective case-control series. METHODS: Sixty participants (36 women, 24 men, mean age 37.6 ± 19.4 years) were enrolled in this study; 36 were healthy controls and 24 were patients with olfactory dysfunction. Orthonasal olfactory function was assessed with the "Sniffin' Sticks" test battery. Retronasal olfaction was assessed with oral odorant delivery using special containers for threshold function, and with oral tasteless powders for odor identification. RESULTS: Retronasal and orthonasal olfaction were significantly correlated for threshold scores, identification score, and the sum of threshold and identification score (TI score). Validity analyses showed that the retronasal TI score was able to discriminate between healthy controls and patients with olfactory dysfunction. CONCLUSIONS: Normosmic participants can be distinctly differentiated from patients with olfactory dysfunction using a valid test battery comprised of retronasal threshold and identification tests. Based on the current findings, we advocate a TI score of 16 as a cut-off between patients and controls. Therefore, TI scores of 17 and above would indicate retronasal normosmia.

A New Method for Assessment of Retronasal Olfactory Function.

OBJECTIVES/HYPOTHESIS: The aim of the study was to develop a test for the assessment of retronasal olfaction in healthy participants and patients with olfactory disorders using "tasteless" powders. STUDY DESIGN: Prospective case-control series. METHODS: A total of 150 participants (110 women, 40 men, mean age = 40 ± 16 years) were recruited for this study; 100 were healthy controls and 50 were patients with olfactory loss due to infections of the upper respiratory tract (n = 25), idiopathic causes (n = 12), sinonasal disease (n = 7), and head trauma (n = 6). Orthonasal olfactory function was evaluated using the Sniffin' Sticks test battery, and retronasal olfaction was evaluated using powders lacking distinctive tastes administered to the oral cavity. To establish test-retest reliability, healthy participants had their orthonasal and retronasal function tested twice. RESULTS: The validity analyses revealed that the selected 16 stimuli differentiated between normosmic participants and patients with olfactory loss, and that retronasal and orthonasal olfaction were highly correlated. CONCLUSIONS: The results of the present study indicate that patients with olfactory loss and controls can be clearly separated using a reliable test of retronasal olfaction based on 16 retronasal stimuli. LEVEL OF EVIDENCE: 2b Laryngoscope, 131:E324-E330, 2021.

A case of basaloid carcinoma of the esophagus with a solitary lung metastasis for which thoracoscopic partial lung resection was performed.

We experienced a case of basaloid carcinoma of the esophagus with a solitary lung metastasis for which thoracoscopic partial lung resection was performed. To the best of our knowledge, this is the first reported case of basaloid carcinoma of the esophagus with lung metastasis for which surgery was performed. There are no evidence-based treatment strategies for postoperative recurrence of basaloid carcinoma of the esophagus. Treatment strategies such as adjuvant therapy centered on chemotherapy and surgical indications should be established.

[Lung metastasis of basaloid-squamous cell carcinoma of the esophagus; report of a case].

A 69-year-old woman had undergone a subtotal esophagectomy for basaloid-squamous cell carcinoma of the esophagus 2 years before (pT3, ly1, v2, pN0, pStage II). Right lung metastasis was detected by follow up chest computed tomography( CT). A partial resection of the right lung was performed. Histopathological diagnosis was basaloid-squamous cell carcinoma. She is doing well 17 months after surgery for metastasis.To our knowledge, no case of radical surgery for the lung metastasis of basaloid-squamous cell carcinoma has not been reported in the Japanese literature to date.