COVID-19 in otolaryngologists: a cross-sectional multicenter study

Abstract Introduction: The nose and throat are areas of high viral load, which could place otolaryngologists at an even higher risk for COVID-19 than other health-care workers. Objective: To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. Methods: In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2 from August 1 to September 15, 2020. A questionnaire was also applied. Results: We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26-84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; p<0.001). From 23 seropositive participants, 14 were asymptomatic (60.9%; p< 0.001). There were no significant associations between seroconversion and age, sex, number of patient appointments and surgical procedures, workplace (hospital or private practice), patients with or without respiratory symptoms, or level of personal protective equipment used. The rate of COVID-19 in all health-care workers in the state was 7.69% at the end of the same period. Data from state government seroprevalence was 5.26 (risk ratio [RR]; 95% CI 3.27-8.45) and 4.66 (RR; 95% CI 2.93-7.43) times higher in otolaryngologists than in the general population in August and September, respectively. Conclusion: Otolaryngologists had a higher seroconversion rate than the general population. Using personal protective equipment, the level of occupational exposure did not result in higher rates of infection than other health-care workers, but the presence of infected household contacts was associated with higher rates of seroconversion.

COVID-19 in otolaryngologists: a cross-sectional multicenter study.

INTRODUCTION: The nose and throat are areas of high viral load, which could place otolaryngologists at an even higher risk for COVID-19 than other health-care workers. OBJECTIVE: To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. METHODS: In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2 from August 1 to September 15, 2020. A questionnaire was also applied. RESULTS: We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26-84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; p < 0.001). From 23 seropositive participants, 14 were asymptomatic (60.9%; p < 0.001). There were no significant associations between seroconversion and age, sex, number of patient appointments and surgical procedures, workplace (hospital or private practice), patients with or without respiratory symptoms, or level of personal protective equipment used. The rate of COVID-19 in all health-care workers in the state was 7.69% at the end of the same period. Data from state government seroprevalence was 5.26 (risk ratio [RR]; 95% CI 3.27-8.45) and 4.66 (RR; 95% CI 2.93-7.43) times higher in otolaryngologists than in the general population in August and September, respectively. CONCLUSION: Otolaryngologists had a higher seroconversion rate than the general population. Using personal protective equipment, the level of occupational exposure did not result in higher rates of infection than other health-care workers, but the presence of infected household contacts was associated with higher rates of seroconversion.

Tonsil size as a predictor of cardiac complications in children with sleep-disordered breathing.

OBJECTIVES/HYPOTHESIS: The primary objective was to evaluate the association of palatine (T/P) tonsil size determined by radiography with pulmonary artery pressure (PAP) measured by Doppler echocardiography in children with surgical indication for adenotonsillar hypertrophy. The secondary objective was to evaluate if tonsil size could help to identify children at higher risk of pulmonary artery hypertension (PAH). STUDY DESIGN: Cross-sectional study. METHODS: The study was conducted with a consecutive sample of children with indication of adenotonsillectomy for sleep-disordered breathing. T/P was measured by lateral neck radiography, PAP by echodopplercardiography, and symptoms and quality of life by the Obstructive Sleep Apnea (OSA)-18 questionnaire. T/P was plotted in a receiver operating characteristic (ROC) curve to determine the best cut-off point to identify children with PAH. RESULTS: A total of 45 children participated in the study. The mean age was 72.0 +/- 32.3 months, and six (13%) patients had PAH. Correlation between systolic PAP and T/P was strong (r = 0.624; P < .0001). T/P was significantly higher in patients with PAH (P < .001). OSA-18 score did not significantly correlate with the variables. The cut-off point identified in the ROC was 0.66, which was the minimum T/P where sensitivity was still 100%. Mean systolic pulmonary artery pressure in children with T/P >0.66 was significantly higher than in those with T/P <0.66 (P < .001). CONCLUSIONS: T/P showed a good correlation with PAP in children with adenotonsillar hypertrophy and surgical indication for sleep-disordered breathing. Children with T/P >0.66 can be at greater risk for cardiac complications and should be submitted to complementary studies with echodopplercardiography or given preference for surgery.

Endoscopic polipectomy with middle meatal antrostomy for antrochoanal polyp treatment.

UNLABELLED: Antrochoanal polyp (ACP) or Killian polyp is a benign nonatopic lesion of the maxillary sinus. Patients usually present nasal obstruction. Many surgical options for the treatment of ACPs have been suggested to minimize postoperative recurrence. The endoscopic nasal approach is a surgical option for maxillary intrasinusal resection of the polyp implantation through the maxillary ostium or middle meatal antrostomy, with lower morbidity when compared to other surgical approaches. AIM: To evaluate the rate of endoscopic antrochoanal polypectomy with middle meatotomy in the treatment of ACP. MATERIALS AND METHODS: Were evaluated by means of a retrospective study, 29 patients, who were diagnosed based on history, physical examination, computed tomography, and histological findings, treated between 1997 and 2004. The surgical approach was endoscopic polypectomy with middle meatotomy. RESULTS: Twenty-nine patients with ACP, 17(58.6%) were females and 12(41.4%) males, age range, 7-75 years (average of 27.55 years) were included in this study. The main symptom were nasal obstruction 24(82%), oral breathing 11(37.9%), snoring nine (31%), rhinorrhea 5(17%), epistaxis 2(6.9%), headache 2(6.9%), and drip one (3.4%). The association with atopy was found in nine (31%). The mean follow-up period was 17 months (3-63 months). Only two patients (6.9%) presented recurrence. CONCLUSION: The rate of recurrence obtained in our study is no different from literature data, even when compared with former and gold standard procedures.

Polipectomia endoscópica com meatotomia média como tratamento de pólipo antrocoanal / Endoscopic polipectomy with middle meatal antrostomy for antrochoanal polyp treatment

Pólipo antrocoanal (PAC) ou pólipo de Killian é uma lesão benigna, não atópica, do seio maxilar. O sintoma predominante é a obstrução nasal. Diversas opções cirúrgicas para o tratamento dos PACs têm sido sugeridas para minimizar a recorrência pós-operatória. A endoscopia vem sendo utilizada como opção terapêutica na ressecção intra-sinusal maxilar da implantação do pólipo através do próprio óstio maxilar ou de uma antrostomia meatal média, com uma menor morbidade que as outras condutas cirúrgicas. OBJETIVO: Avaliar o índice de recidiva da polipectomia endoscópica com meatotomia média no tratamento do PAC. MATERIAL E MÉTODO: Foram avaliados, em estudo retrospectivo, 29 pacientes com o diagnóstico de PAC baseado na história, exame físico, tomografia computadorizada e exame anatomopatológico, tratados entre 1997 e 2004. O procedimento cirúrgico adotado foi polipectomia endoscópica com meatotomia média. RESULTADOS: 29 pacientes com pólipo antrocoanal, 17 (58,6 por cento) do sexo feminino e 12 (41,4 por cento) do masculino, com idades entre 7 e 75 (média 27,55 anos), foram incluídos nesse estudo. Os principais sintomas apresentados foram obstrução nasal, 24 (82 por cento), respiração oral, 11 (37,9 por cento), roncos, 9 (31 por cento), rinorréia, 5 (17 por cento), epistaxe, 2 (6,9 por cento), cefaléia, 2 (6,9 por cento) e gotejamento, 1(3,4 por cento). A associação com atopia foi de 9 (31 por cento). A média de seguimento foi de 17 meses (3-63 meses). Apenas 2 pacientes (6,9 por cento) apresentaram recidiva. CONCLUSÃO: O índice de recidiva obtido por nosso trabalho não difere dos dados da literatura, mesmo quando comparado com procedimentos longamente estabelecidos.

Antrochoanal polyp (ACP) or Killian polyp is a benign nonatopic lesion of the maxillary sinus. Patients usually present nasal obstruction. Many surgical options for the treatment of ACPs have been suggested to minimize postoperative recurrence. The endoscopic nasal approach is a surgical option for maxillary intrasinusal resection of the polyp implantation through the maxillary ostium or middle meatal antrostomy, with lower morbidity when compared to other surgical approaches. AIM: To evaluate the rate of endoscopic antrochoanal polypectomy with middle meatotomy in the treatment of ACP. MATERIALS AND METHODS: Were evaluated by means of a retrospective study, 29 patients, who were diagnosed based on history, physical examination, computed tomography, and histological findings, treated between 1997 and 2004. The surgical approach was endoscopic polypectomy with middle meatotomy. RESULTS: Twenty-nine patients with ACP, 17(58.6 percent) were females and 12(41.4 percent) males, age range, 7-75 years (average of 27.55years) were included in this study. The main symptom were nasal obstruction 24(82 percent), oral breathing 11(37.9 percent), snoring nine (31 percent), rhinorrhea 5(17 percent), epistaxis 2(6.9 percent), headache 2(6.9 percent), and drip one (3.4 percent). The association with atopy was found in nine (31 percent). The mean follow-up period was 17 months (3-63 months). Only two patients (6.9 percent) presented recurrence. CONCLUSION: The rate of recurrence obtained in our study is no different from literature data, even when compared with former and gold standard procedures.

Meningioma nasal / Nasal meningioma

Meningioma é responsável por aproximadamente 20 por cento de todas as neoplasias intracranianas, sendo o segundo tumor mais comum do sistema nervoso central (seguido dos gliomas). Entretanto, meningiomas primários dos seios paranasais são extremamente raros...

Meningiomas account for nearly 20 por cento of all intracranial neoplasms and are the second most common tumors of the central nervous system (following gliomas). However, primary meningiomas of the paranasal sinuses are extremely rare...