Smell Status in Children Infected with SARS-CoV-2.

OBJECTIVES/HYPOTHESIS: This study aimed to evaluate the olfactory status in children with laboratory confirmed SARS-CoV-2 using subjective and psychophysical methods. STUDY DESIGN: Prospective clinical cross-sectional study. METHODS: This is a prospective clinical cross-sectional study of 79 children with COVID-19. The 21st item of SNOT-22 questionnaire and odor identification test were used for smell assessment. Children were examined twice during the hospitalization, and a telephone survey was conducted 60 days after hospital discharge. RESULTS: Immediately after confirmation of COVID-19, smell impairment was detected in 86.1% of children by means of the Identification test and in 68.4% of children by means of the survey (P = .010). After 5 days survey revealed a statistically significant decrease in the number of patients with hyposmia (41 out of 79, 51.9%). On the first visit, the mean Identification test score corresponded to "hyposmia" (9.5 ± 2.7), while on the second visit, the average value was 13.1 ± 1.9, which corresponded to "normosmia." According to the telephone survey, recovery of the olfactory function occurred within 10 days in 37 of 52 patients (71.2%), 11 to 29 days - in 12 children (23.1%), and later than 30 days - in three cases (5.7%). CONCLUSIONS: In the pediatric population, olfactory dysfunction is an early and common symptom of COVID-19. There is a trend to quick recovery of olfactory function in children with COVID-19. The overwhelming majority of patients (94.3%) had no subjective olfactory complaints by the end of the first month. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E2475-E2480, 2021.

Endoscopic repair of septal perforation in children.

OBJECTIVE: Being increasingly faced with the problem of pediatric nasal septal perforations, we have found that the surgical management of nasal septal perforations in children is not widely described in the litrature. The objective of our study was to demonstrate the results of different surgical techniques, including two original endoscopic techniques, in the septal perforation repair in children. METHODS: 24 children, ranging between 6 and 17 years of age, with nasal septal perforations were operated using different endoscopic techniques from February 2015 to May 2019 at the special tertiary referral clinic. Apart from well-known techniques, such as anterior ethmoidal artery flap, intranasal bipedicled advancement flap, sublabial flap, free temporal fascia graft, we used two original techniques - inverted edges technique and cross-septal returned flap. RESULTS: The total rate of complete perforation closure was 79% (19 of 24 patients). Regarding the reduction of symptoms, the efficacy of surgery was approaching 100%. The combination of inverted edges technique and anterior ethmoidal artery septal flap demonstrated the best results with no reperforations in all 10 cases. Using cross-septal returned flap, we achieved complete closure of perforation in 5 (83%) of 6 patients. The remaining techniques were performed rare and showed relatively low rates of success. There were 2 cases of complications (oronasal fistula), both developed in patients with sublabial mucosal flap. CONCLUSION: Use of endoscopic assistance, vascularized mucoperichondrial flaps and bilateral closure demonstrates high effectiveness in septal perforation surgical repair in children. LEVEL OF EVIDENCE: 4.