Olfactory Dysfunction in a Mexican Population Outside of COVID-19 Pandemic: Prevalence and Associated Factors (the OLFAMEX Study).

PURPOSE OF REVIEW: To study the prevalence of olfactory loss and its associated factors in a Mexican population a cross-sectional analytical study based on a population interviewed about health, epidemiologic aspects, and sense of smell (tested with four scents: rose, banana, perfume, and gas) was conducted to evaluate olfactory detection, memory, and identification. Levels of sense of smell perception were determined when the participants detected, recognized, or identified all (normosmia), 1-3 (hyposmia), or none (anosmia) of the odorants. Associated factors of olfactory dysfunction were identified by multivariate analysis (odds ratio, 95%CI). RECENT FINDINGS: Olfactory dysfunction is a prevalent disorder affecting up to 20% of the general population. In addition to viral infection, including COVID-19, a number of other causes and factors may also be involved. 1,956 surveys were conducted and 1,921 were analyzed. Most of the participants (62.1%) were women. The general prevalence of olfactory dysfunction, regarding detection, was 7.2% (7.1% hyposmia, 0.1% anosmia). Age-related olfactory deterioration was observed in both sexes from the 5th decade of life (OR 2.74, p = 0.0050). Women showed better olfactory identification (OR 0.73, p = 0.0010). Obesity (OR 1.97, p = 0.0070), low educational level, bad/very bad self-perceived olfactory function (OR 2.74, p = 0.0050), olfactory loss for less than one week (OR 1.35, p = 0.0030), exposure to toxics/irritants (OR 1.31, p = 0.0030), active smoking (OR 1.58, p < 0.0010), and type 2 diabetes mellitus (OR 2.68, 95%CI 1.74-4.10, p < 0.0001) were identified as factors associated with olfactory dysfunction. These results in a Mexican population suggest better olfactory identification (verbalization) in females. Age was a determining factor in the olfactory deterioration process and obesity and diabetes mellitus were also associated with olfactory disorders. Finally, these findings reinforce the differential diagnosis with other potential causes of sense of smell loss, during the COVID-19 outbreak.

3D printed ventilation tubes and their effect on biological models.

BACKGROUND: Acute otitis media (AOM) causes inflammation and hearing loss. Ventilation tubes are key in treatment. 3D printing improves prostheses in otorhinolaryngology, offering precision and greater adaptability. MATERIALS AND METHODS: An experimental study was conducted with Wistar rats from July to December 2020. 3D tympanostomy tube models were designed, with technical specifications and tests performed on inexpensive 3D printers. The tympanostomy tube was inserted endoscopically. RESULTS: Procedures were performed on five rats with implants in both ears. Pre-intervention pathologies, such as atical retraction and glue ear, were found. The PLA-printed tympanostomy tube showed improvement after adjustments. Histopathological results revealed significant middle and inner ear damage. CONCLUSION: In our study, the design and 3D printing of implants fulfilled the desired functions when modified, with a height of 5 mm. Complications included PLA degradation and ear damage. There were no adverse events during observation, highlighting the need for further research on 3D-printed implants.

[Time of care and its impact in the evolution of laryngeal cancer]. / El tiempo de atención y su impacto en la evolución del cáncer laríngeo.

Background: Laryngeal carcinoma is the 22nd most common cause of cancer in men worldwide and the second most common head and neck malignancy. The care of these patients is multidisciplinary. Factors such as tumor stage and initiation of treatment 60 days after diagnosis have been associated with worse survival. Objective: To know the overall time of care in laryngeal cancer and its impact on the outcome of patients in a tertiary health center. Material and methods: In July 2020, a retrospective study was carried out of 173 patients with laryngeal cancer diagnosed in the Department of Otorhinolaryngology from January 2014 to December 2018. Odds ratio and Fisher's exact test were calculated with a p value of 0.05. Results: 2 out of 77 patients started treatment at the recommended time. The total attention time (TAT) was 246 ± 159 days. 56% of the patients were still alive, 43% disease-free and 10% with progression. Control of the disease was achieved in 69% of early tumors and only 26% in advanced ones. Conclusions: The overall time of care impacts on the health status, affecting survival and control of disease. The stage of the tumor at the time of diagnosis is a decisive prognosis factor. Strategies towards multidisciplinary management and early detection in primary care should be created.

Introducción: el carcinoma de laringe es la vigésima segunda causa más común de cáncer en hombres a nivel mundial y la segunda malignidad más común en cabeza y cuello. La atención de estos pacientes es multidisciplinaria. Factores como el estadio del tumor y el inicio del tratamiento 60 días después del diagnóstico han sido asociados a una peor sobrevida. Objetivo: conocer el tiempo integrado de atención del cáncer de laringe y su impacto en el estado de salud de los pacientes en un centro terciario de atención. Material y métodos: en julio de 2020 se llevó a cabo un estudio retrospectivo de 173 pacientes con cáncer de laringe diagnosticados en el Servicio de Otorrinolaringología de enero de 2014 a diciembre de 2018. Se calculó la razón de momios y la prueba exacta de Fisher con valor de p = 0.05. Resultados: dos de 77 pacientes iniciaron tratamiento en tiempo recomendado. El tiempo total de atención fue de 246 +/- 159 días. El 56% de los pacientes continuaban con vida, 43% libres de enfermedad y 10% con progresión. El control de la enfermedad se logró en el 69% de los tumores tempranos y solo el 26% en los avanzados. Conclusiones: el tiempo integrado de atención impactó en el estado de salud, lo cual afectó en la sobrevida y el control de la enfermedad. El estadio de la enfermedad al momento del diagnóstico es un factor decisivo para el pronóstico. Deberán crearse estrategias para el manejo multidisciplinario y la detección temprana en la atención primaria.

[Clinical-pathological characterization of laryngeal cancer in the Mexican population]. / Caracterización clínico-patológica del cáncer de laringe en la población mexicana.

Background: Cancer of the larynx occupies the first frequency site of cancer of the upper digestive tract and represents 42% of malignant neoplasms of the upper aero-digestive tract. It is a potentially curable entity if it is diagnosed in early stages. Objective: Characterize the clinical pathological features of patients with laryngeal cancer, which can serve as a guide for diagnostic suspicion in primary and secondary care. Method: Descriptive study. All the records of patients with an initial diagnosis of primary laryngeal carcinoma undergoing direct micro-laryngoscopy plus biopsy from January 1, 2014 to December 31, 2018 were analyzed. Results: 173 new cases of laryngeal carcinoma were diagnosed, the male sex predominated (86%). With an average age of presentation of 65 ± 11 years and a history of smoking in 78.6% (n 136). Dysphonia was the initial symptom in 81% (140) of the patients. Conclusions: The profile of the patient with laryngeal cancer corresponds to a patient older than 60 years, male, a history of smoking and a history of dysphonia greater than 30 days. Clinically, we will find an epithelial epidermoid moderately differentiated tumor limited to the glottis.

Introducción: El cáncer de laringe ocupa el primer lugar en frecuencia entre los cánceres del tracto aéreo-digestivo superior, y representa el 42% de las neoplasias malignas de las vías aéreo-digestivas superiores. Es una enfermedad potencialmente curable si se diagnostica en estadios tempranos. Objetivo: Conocer las características clínico-patológicas de los pacientes con cáncer de laringe, mismas que puedan ayudar como guía para la sospecha diagnóstica en el primer y el segundo niveles de atención. Método: Estudio descriptivo en el que se analizaron todos los expedientes de pacientes con diagnóstico inicial de carcinoma primario de laringe intervenidos con microlaringoscopia directa más biopsia del 1 de enero de 2014 al 31 de diciembre de 2018. Resultados: Se diagnosticaron 173 casos nuevos de carcinoma de laringe. Predominó el sexo masculino (86%). La edad promedio de presentación fue de 65 ± 11 años. Hubo antecedente de tabaquismo en el 78.6% (136). La disfonía fue el síntoma inicial en el 81% (140) de los pacientes. Conclusiones: El perfil del paciente con cáncer de laringe corresponderá a un paciente mayor de 60 años, de sexo masculino, con antecedente de tabaquismo y disfonía de más de 30 días. Clínicamente se encontrará un tumor epitelial del tipo epidermoide moderadamente diferenciado confinado en la glotis.

[Imploding antrum syndrome: three cases with different management approaches]. / Síndrome de implosión maxilar: tres casos y sus diferentes abordajes de tratamiento.

BACKGROUND: Silent sinus or imploding antrum syndrome is a very rare condition, consisting of a usually asymptomatic spontaneous collapse of the sinus walls and floor of the orbit. It is associated with negative pressures, and when this occurs, it presents with manifestations such as enophthalmos, hypoglobus, and tilt flow orbital floor. As its incidence is very low, it is frequently missed as a diagnosis, and in fact there are currently fewer than 150 cases reported in the literature. CLINICAL CASES: Three patients have been identified in our practice over a period of two years, with different symptoms that influenced the decision of the treatment modality, which were: watch and wait, endoscopic sinus surgery, or endoscopic sinus surgery plus orbitoplasty. CONCLUSIONS: Despite being a rare entity, it stills catches the attention of the ENT, OMF surgery and Ophthalmologist. The diagnosis is mainly radiological, due to the late clinical manifestations and symptomatology. The treatment should be individualised and based on the symptoms and the individual decision of each patient, firstly by Functional Endoscopic sinus surgery, and once sinus permeability is restored, it may require augmentation surgery of the orbital floor, either with autologous bone implant, titanium or other material. It is important to be aware of this pathology, to know and to suspect it, avoiding misdiagnosis.

[Post-traumatic cholesteatoma with posterior fossa invasion]. / Colesteatoma postraumático con invasión a fosa posterior.

Post-traumatic cholesteatomas are an extremely rare variety of secondary cholesteatomas. We present a case of a 51-year-old male with post-traumatic cholesteatoma with posterior fossa invasion of 30-year evolution that initially manifested as acute otomastoiditis and headache. Its physiopathology and clinical manifestations are discussed.

Colesteatoma postraumático con invasión a fosa posterior / Post-traumatic cholesteatoma with posterior fossa invasion

Los colesteatomas postraumáticos son una variedad extremadamente rara de colesteatomas secundarios. Presentamos el caso de un varón de 51 años con un colesteatoma postraumático de 30 años de evolución que invade hacia fosa posterior y se manifiesta inicialmente como una otomastoiditis aguda y cefalea. Se discute su fisiopatología y sus manifestaciones clínicas (AU)

Post-traumatic cholesteatomas are an extremely rare variety of secondary cholesteatomas. We present a case of a 51-year-old male with post-traumatic cholesteatoma with posterior fossa invasion of 30-year evolution that initially manifested as acute otomastoiditis and headache. Its physiopathology and clinical manifestations are discussed (AU)