Variation in volumes and characteristics of ENT emergency visits during COVID-19 pandemic. Where are the patients?

The aim of this study is to analyze patterns and volumes of patients visiting ENT emergency departments during periods of community lockdowns given the newness of this situation and to assess the variation in numbers of visits and examine whether their reduction equally affects all categories of visit causation or whether it is limited to diseases not considered as emergencies. A retrospective descriptive study was conducted on prospectively collected registry data on patients of all age groups visited the emergency ENT department during the period of nationwide lockdown. Patients were grouped in 9 categories, according to the cause of visit the ENT emergency department. A total of 201 patients visited the ENT emergency department. The retrospective analysis of the data during the same period in the years 2013-2019 showed a reduction of 73% in total visits (mean total visits number between 2013 and 2019 was 745.29±20.0143). A statistically significant reduction in visitation was found in all categories studied with the exception of foreign body ingestion - aspiration. Patients with General ENT symptoms, mild epistaxis cases, otology cases, vertigo cases, uncomplicated infectious cases showed a statistically significant reduction in numbers and were treated empirically. Swallowing foreign body cases did not show statistically significant reduction. Limitation of movement and the lockdown itself, led to reduction of trauma cases. Surprisingly, there was also a reduction in oncology cases and an increase in numbers of these cases can be expected in the near future.

Variación de los volúmenes y las características de las visitas a urgencias de ORL durante la pandemia de COVID-19. ¿Dónde están los pacientes? / Variation in volumes and characteristics of ENT emergency visits during COVID-19 pandemic. Where are the patients?

The aim of this study is to analyze patterns and volumes of patients visiting ENT emergency departments during periods of community lockdowns given the newness of this situation and to assess the variation in numbers of visits and examine whether their reduction equally affects all categories of visit causation or whether it is limited to diseases not considered as emergencies. A retrospective descriptive study was conducted on prospectively collected registry data on patients of all age groups visited the emergency ENT department during the period of nationwide lockdown. Patients were grouped in 9 categories, according to the cause of visit the ENT emergency department. A total of 201 patients visited the ENT emergency department. The retrospective analysis of the data during the same period in the years 2013–2019 showed a reduction of 73% in total visits (mean total visits number between 2013 and 2019 was 745.29±20.0143). A statistically significant reduction in visitation was found in all categories studied with the exception of foreign body ingestion – aspiration. Patients with General ENT symptoms, mild epistaxis cases, otology cases, vertigo cases, uncomplicated infectious cases showed a statistically significant reduction in numbers and were treated empirically. Swallowing foreign body cases did not show statistically significant reduction. Limitation of movement and the lockdown itself, led to reduction of trauma cases. Surprisingly, there was also a reduction in oncology cases and an increase in numbers of these cases can be expected in the near future. (AU)

El objetivo de este estudio es analizar los patrones y los volúmenes de pacientes que visitan los servicios de urgencias de ORL durante los periodos de cierre de la comunidad, dada la novedad de esta situación, así como evaluar la variación en el número de visitas y examinar si su reducción afecta por igual a todas las categorías de visitas o si se limita a las enfermedades no consideradas como urgentes. Se realizó un estudio descriptivo retrospectivo a partir de los datos de registro recogidos prospectivamente sobre los pacientes de todos los grupos de edad que visitaron el servicio de urgencias de ORL durante el periodo de bloqueo nacional. Los pacientes se agruparon en 9 categorías, según la causa de visita al servicio de urgencias de ORL. Un total de 201 pacientes visitaron el servicio de urgencias de ORL. El análisis retrospectivo de los datos durante el mismo periodo en los años 2013 a 2019 mostró una reducción del 73% en el total de visitas (la media del número de visitas totales entre 2013 a 2019 fue de 745,29±20,0143). Se encontró una reducción estadísticamente significativa de las visitas en todas las categorías estudiadas con la excepción de la ingestión de cuerpos extraños/aspiración. Los pacientes con síntomas de ORL general, los casos de epistaxis leve, los casos de otología, los casos de vértigo, los casos infecciosos no complicados mostraron una reducción estadísticamente significativa en el número y fueron tratados empíricamente. Los casos de cuerpos extraños por ingestión no mostraron una reducción estadísticamente significativa. La limitación de los movimientos y el propio encierro permitieron reducir los casos de traumatismos. Sorprendentemente, también se redujeron los casos de oncología y cabe esperar un aumento del número de estos casos en un futuro próximo.

Variation in volumes and characteristics of ENT emergency visits during COVID-19 pandemic. Where are the patients?

The aim of this study is to analyze patterns and volumes of patients visiting ENT emergency departments during periods of community lockdowns given the newness of this situation and to assess the variation in numbers of visits and examine whether their reduction equally affects all categories of visit causation or whether it is limited to diseases not considered as emergencies. A retrospective descriptive study was conducted on prospectively collected registry data on patients of all age groups visited the emergency ENT department during the period of nationwide lockdown. Patients were grouped in 9 categories, according to the cause of visit the ENT emergency department. A total of 201 patients visited the ENT emergency department. The retrospective analysis of the data during the same period in the years 2013-2019 showed a reduction of 73% in total visits (mean total visits number between 2013 and 2019 was 745.29±20.0143). A statistically significant reduction in visitation was found in all categories studied with the exception of foreign body ingestion - aspiration. Patients with General ENT symptoms, mild epistaxis cases, otology cases, vertigo cases, uncomplicated infectious cases showed a statistically significant reduction in numbers and were treated empirically. Swallowing foreign body cases did not show statistically significant reduction. Limitation of movement and the lockdown itself, led to reduction of trauma cases. Surprisingly, there was also a reduction in oncology cases and an increase in numbers of these cases can be expected in the near future.

Anomalous course of the sigmoid colon and the mesosigmoid encountered during colectomy. A case report of a redundant loop of sigmoid colon.

Introduction Sigmoid colon constitutes a part of the large intestine that presents several congenital anatomic variations. In particular, the presence of a redundant loop of sigmoid colon is of tremendous importance for surgeons, obstetricians and radiologists, since it is closely related to multiple pathological conditions and functional implications of the neighboring anatomical structures. PRESENTATION OF CASE: An unusual anatomic variation in position and length of the sigmoid colon and its mesocolon was unexpectedly detected during right hemicolectomy to a 67-year-old Caucasian male patient due to colon cancer. The operation was uneventful. A meticulous review of the literature was conducted as well. DISCUSSION: A redundant loop of sigmoid colon may go unnoticed or it might lead to urinary, digestive and vascular complications. Its presence is associated with acute and chronic pathological conditions, sigmoid volvulus and serious confusions in radiological diagnosis and instrumentation. CONCLUSION: Surgeons' thorough knowledge concerning this rare anatomic variation is fundamental and crucial in order to establish a correct diagnosis and assert the appropriate management when performing operations including pelvis and abdomen.

Abnormal distance of the extralaryngeal bifurcation point of the recurrent laryngeal nerve from the cricothyroid joint.

The extralaryngeal bifurcation point of the recurrent laryngeal nerve (RLN) is typically located in a mean distance of 0-2 cm from the cricothyroid joint (CTJ). In the presented case though, the left RLN was unexpectedly identified bifurcating in a mean distance of 7 cm from the left CTJ in a young woman with multinodular goiter during total thyroidectomy. The RLN was carefully exposed throughout its course for the avoidance of iatrogenic injury of the nerval structure. The operation was uneventful. The present manuscript aims to highlight a scarce anatomic variation and its implications for thyroidectomy. Rare anatomic variations of the RLN such as the presented one encumber thyroid surgery and represent a severe risk factor of RLN injury. Meticulous operative technique combined with surgeons' perpetual awareness concerning this peculiar anatomical aberration leads to an injury-free thyroid surgery.