Automated hearing loss type classification based on pure tone audiometry data.

Hearing problems are commonly diagnosed with the use of tonal audiometry, which measures a patient's hearing threshold in both air and bone conduction at various frequencies. Results of audiometry tests, usually represented graphically in the form of an audiogram, need to be interpreted by a professional audiologist in order to determine the exact type of hearing loss and administer proper treatment. However, the small number of professionals in the field can severely delay proper diagnosis. The presented work proposes a neural network solution for classification of tonal audiometry data. The solution, based on the Bidirectional Long Short-Term Memory architecture, has been devised and evaluated for classifying audiometry results into four classes, representing normal hearing, conductive hearing loss, mixed hearing loss, and sensorineural hearing loss. The network was trained using 15,046 test results analysed and categorised by professional audiologists. The proposed model achieves 99.33% classification accuracy on datasets outside of training. In clinical application, the model allows general practitioners to independently classify tonal audiometry results for patient referral. In addition, the proposed solution provides audiologists and otolaryngologists with access to an AI decision support system that has the potential to reduce their burden, improve diagnostic accuracy, and minimise human error.

Numerical analysis of the ostiomeatal complex aeration using the CFD method.

We aimed to analyse ostiomeatal complex (OMC) aeration using the computational fluid dynamics (CFD) method of simulation based on human craniofacial computed tomography (CT) scans. The analysis was based on CT images of 2 patients: one with normal nose anatomy and one with nasal septal deviation (NSD). The Reynolds-Average Simulation approach and turbulence model based on linear eddy viscosity supplemented with the two-equation k-[Formula: see text] SST model were used for the CFD simulation. As a result, we found differences in airflow velocity through the ostiomeatal complex in patients with a normal nose and those with NSD. In a patient with NSD, the flow is turbulent in contrast to the normal nose (laminar flow). A faster (more intensive) airflow through the OMC was observed in the wider nasal cavity of the patient with NSD than on the narrower side. In addition, we want to emphasise the higher speed of airflow through the apex uncinate process area towards the ostiomeatal complex during exhalation, which, in the presence of secretions in the nose, predisposes to its easier penetration into the sinuses of the anterior group.

Proteomic analysis of sialoliths from calcified, lipid and mixed groups as a source of potential biomarkers of deposit formation in the salivary glands.

Salivary stones, also known as sialoliths, are formed in a pathological situation in the salivary glands. So far, neither the mechanism of their formation nor the factors predisposing to their formation are known despite several hypotheses. While they do not directly threaten human life, they significantly deteriorate the patient's quality of life. Although this is not a typical research material, attempts are made to apply various analytical tools to characterise sialoliths and search for the biomarkers in their proteomes. In this work, we used mass spectrometry and SWATH-MS qualitative and quantitative analysis to investigate the composition and select proteins that may contribute to solid deposits in the salivary glands. Twenty sialoliths, previously characterized spectroscopically and divided into the following groups: calcified (CAL), lipid (LIP) and mixed (MIX), were used for the study. Proteins unique for each of the groups were found, including: for the CAL group among them, e.g. proteins from the S100 group (S100 A8/A12 and P), mucin 7 (MUC7), keratins (KRT1/2/4/5/13), elastase (ELANE) or stomatin (STOM); proteins for the LIP group-transthyretin (TTR), lactotransferrin (LTF), matrix Gla protein (MPG), submandibular gland androgen-regulated protein 3 (SMR3A); mixed stones had the fewest unique proteins. Bacterial proteins present in sialoliths have also been identified. The analysis of the results indicates the possible role of bacterial infections, disturbances in calcium metabolism and neutrophil extracellular traps (NETs) in the formation of sialoliths.

Correlation of ENT Symptoms with Age, Sex, and Anti-SARS-CoV-2 Antibody Titer in Plasma.

Our objective is to evaluate the correlation between ENT symptom occurrence and antibody titer in convalescent plasma, as well as the influence of age and gender on ENT manifestations of COVID-19. We measured the levels of antibodies in 346 blood donors, who had PCR-confirmed previous infection and met the study inclusion criteria. We recorded otolaryngological symptoms during infection: dry cough, dyspnea, sore throat, smell/taste disturbances, vertigo, dizziness, nausea and vomiting, sudden unilateral loss of hearing, progressive loss of hearing, and tinnitus. In addition, we statistically analyzed the correlation between patients' antibody levels, symptoms, age, and gender using a chi-square test or Fisher exact test. A p-value less than 0.05 determined statistical significance. The mean age of the convalescents was 39.8 ± 9.56 SD and the median of the measured anti-SARS-CoV2 plasma antibodies was 1:368.5. The most common ENT symptoms were smell/taste disturbances (62.43%), dry cough (40.46%), sore throat (24.86%), and dyspnea (23.7%). Smell and taste disturbances were more frequent in younger patients and the marked antibody titer was lower, which was contrary to a higher antibody titer associated with dry cough, dyspnea, and dizziness. Occurrence of sore throat was not correlated with age, sex, or antibody level. There were no significant differences in otological symptoms in female patients. Gender does not affect the occurrence of ENT symptoms. The symptomatic course of SARS-CoV-2 infection is not always associated with higher levels of antibodies in the blood. The age of the infected patients, unlike gender, affects the occurrence of some ENT symptoms.

Maxillary sinus aeration analysis using computational fluid dynamics.

The maxillary sinus aeration using the computational fluid dynamics (CFD) method based on individual adult patients' computed tomography (CT) scans were analyzed. The analysis was based on CT images of 4 patients: one with normal nose anatomy and three with nasal septal deviation (NSD) and concha bullosa (CB). The CFD simulation was performed using the Reynolds-Average Simulation approach and turbulence closure based on linear eddy viscosity supplemented with the two-equation k-[Formula: see text] SST model. As a result, it was found that the lower part of NSD has the most significant impact on the airflow change within the maxillary sinuses compared to CB and the upper part of NSD. In a healthy nose, the airflow in the sinuses is continuous, while NSD and CB change this flow into pulsatile. Multiple changes in the direction of flow during one respiratory phase were observed. The flow intensity within the maxillary sinus opening is lower on the NSD side. The concept of vorticity measure is introduced to evaluate and compare various patients qualitatively. Typically, the lowest values of such measures are obtained for healthy airways and the highest for pathological changes in the nasal cavity.

The Role of 3D Printing in Planning Complex Medical Procedures and Training of Medical Professionals-Cross-Sectional Multispecialty Review.

Medicine is a rapidly-evolving discipline, with progress picking up pace with each passing decade. This constant evolution results in the introduction of new tools and methods, which in turn occasionally leads to paradigm shifts across the affected medical fields. The following review attempts to showcase how 3D printing has begun to reshape and improve processes across various medical specialties and where it has the potential to make a significant impact. The current state-of-the-art, as well as real-life clinical applications of 3D printing, are reflected in the perspectives of specialists practicing in the selected disciplines, with a focus on pre-procedural planning, simulation (rehearsal) of non-routine procedures, and on medical education and training. A review of the latest multidisciplinary literature on the subject offers a general summary of the advances enabled by 3D printing. Numerous advantages and applications were found, such as gaining better insight into patient-specific anatomy, better pre-operative planning, mock simulated surgeries, simulation-based training and education, development of surgical guides and other tools, patient-specific implants, bioprinted organs or structures, and counseling of patients. It was evident that pre-procedural planning and rehearsing of unusual or difficult procedures and training of medical professionals in these procedures are extremely useful and transformative.

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.

Trial Proteomic Qualitative and Quantitative Analysis of the Protein Matrix of Submandibular Sialoliths.

Our studies aimed to explore the protein components of the matrix of human submandibular gland sialoliths. A qualitative analysis was carried out based on the filter aided sample preparation (FASP) methodology. In the protein extraction process, we evaluated the applicability of the standard demineralization step and the use of a lysis buffer containing sodium dodecyl sulfate (SDS) and dithiothreitol (DTT). The analysis of fragmentation spectra based on the human database allowed for the identification of 254 human proteins present in the deposits. In addition, the use of multi-round search in the PEAKS Studio program against the bacterial base allowed for the identification of 393 proteins of bacterial origin present in the extract obtained from sialolith, which so far has not been carried out for this biological material. Furthermore, we successfully applied the SWATH methodology, allowing for a relative quantitative analysis of human proteins present in deposits. The obtained results correlate with the classification of sialoliths proposed by Tretiakow. The performed functional analysis allowed for the first time the selection of proteins, the levels of which differ between the tested samples, which may suggest the role of these proteins in the calcification process in different types of sialoliths. These are preliminary studies, and drawing specific conclusions requires research on a larger group, but it provides us the basis for the continuation of the work that has already begun.

Mitigation effect of face shield to reduce SARS-CoV-2 airborne transmission risk: Preliminary simulations based on computed tomography.

We aimed to develop a model to quantitatively assess the potential effectiveness of face shield (visor) in reducing airborne transmission risk of the novel coronavirus SARS-CoV-2 during the current COVID-19 pandemic using the computational fluid dynamics (CFD) method. The studies with and without face shield in both an infected and healthy person have been considered in indoor environment simulation. In addition to the influence of the face shield and the synchronization of the breathing process while using the device, we also simulated the effect of small air movements on the SARS-CoV-2 infection rate (outdoor environment simulation). The contact with infectious particles in the case without a face shield was 12-20 s (s), in the presence of at least one person who was positive for SARS-CoV-2. If the infected person wore a face shield, no contact with contaminated air was observed during the entire simulation time (80 s). The time of contact with contaminated air (infection time) decreases to about 11 s when the surrounding air is still and begins to move at a low speed. Qualitative differences between simulations performed on the patients with and without the face shield are clearly visible. The maximum prevention of contagion is probably a consequence of wearing a face shield by an infected person. Our results suggest that it is possible to determine contact with air contaminated by SARS-CoV-2 using the CFD method under realistic conditions for virtually any situation and configuration. The proposed method is probably the fastest and most reliable among those based on CFD-based techniques.

[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.