Assessment of the knowledge and attitudes about the management of dental trauma among ear, nose and throat physicians

PURPOSE

Ear, nose and throat physicians (ENTp) encounter dental trauma (DT) when patients refer to the emergency department, as well as during operations such as tonsillectomy and suspension laryngoscopy. This study aimed to investigate the attitudes and knowledge of ENTp about managing DT, and motivation for further education.

METHODS

This study was a cross-sectional observational survey on a sample of ENTp from 15 different private/public hospitals. A questionnaire of 22 questions was divided into three parts: the level of professional experience and the frequency of encountering DT; specific questions on the management of DT; self-assessment of educational approach and level of knowledge regarding DT.

RESULTS

A total of 128 surveys were accomplished and included in the evaluation. A larger percentage (96.9%) of the participants have experienced at least one case in the practice, and one-third (31.3%) have encountered more than ten DT cases. Although the duration of experience significantly affected the total number of correct responses to knowledge and attitudes regarding DT questions (p:0.028), more than half of the participants (44.38%) responded incorrectly to the questions. The majority of participants (97.7%) stated that they had no education on DT, and 90.6% were willing to receive DT training.

CONCLUSIONS

The results of this study emphasize the deficiency of ENTp' knowledge level about the management of DT. In addition, results demonstrated the enthusiasm of ENTp for further training, which can contribute to the requirement of education for providing appropriate management of DT cases.

Spectral resolution and speech perception after cochlear implantation using the round window versus cochleostomy technique

OBJECTIVE

To evaluate the spectral resolution achieved with a cochlear implant in users who were implanted using round window route electrode insertion versus a traditional cochleostomy technique.

METHODS

Twenty-six patients were classified into two groups according to the surgical approach: one group (n = 13) underwent cochlear implantation via the round window technique and the other group (n = 13) underwent surgery via cochleostomy.

RESULTS

A statistically significant difference was found in spectral ripple discrimination scores between the round window and cochleostomy groups. The round window group performed almost two times better than the cochleostomy group. Differences between Turkish matrix sentence test scores were not statistically significant.

CONCLUSION

The spectral ripple discrimination scores of patients who had undergone round window cochlear implant electrode insertion were superior to those of patients whose cochlear implants were inserted using a classical cochleostomy technique.

Oncologic outcomes in primary squamous cell carcinoma of the auricle: a retrospective cohort analysis

PURPOSE

The prognostic significance of auricular location in cutaneous squamous cell carcinoma (cSCC) is controversial. We aimed to characterize risk factors for, and evaluate the cumulative incidence of, locoregional recurrence in a cohort of patients with primary auricular cSCC.

METHODS

The study design was a single-institution retrospective cohort review from 1/2007 to 12/2016.

RESULTS

Among 851 potentially eligible individuals, 178 patients with primary auricular cSCC met strict criteria for inclusion. Median follow-up was 32 months, 93% were AJCC 8th edition (AJCC8) stage I and 6% were AJCC8 stage II. Most underwent Mohs micrographic surgery (MMS; 97%) and the remainder underwent wide local excision ± parotidectomy ± neck dissection ± adjuvant therapy (3%). Recurrences occurred in seven patients (4%): six were local and one was regional. The 3-year cumulative incidence of local and regional recurrence for AJCC8 stage I-II tumors were 1% (95% CI 0-5%) and 0%, respectively. Among ten patients upstaged to pT3 disease who underwent MMS alone, none recurred locoregionally. Compared to their respective counterparts, advanced stage, PNI, and LVI associated with a significantly increased risk of locoregional recurrence.

CONCLUSIONS

Our findings suggest that auricular location may not be a significant risk factor for cSCC staging systems. In the absence of other risk factors, unimodal therapy appears adequate for patients with primary, stage I-II auricular cSCC. The prognostic significance of pT3 auricular cSCC stage due to depth of invasion alone should be evaluated further.

Different Types of Auricular Keloids and Treatment by Intralesional Cryosurgery: Best Practice for Obtaining Long-Lasting Clinical Results

BACKGROUND

Auricular keloids belong to the most perplexing medical conditions, which have significant psychosocial impact on the patient's body image and quality of life.

SUMMARY

The article is purposed to provide dermatologists and plastic surgeons with the best proven practice using intralesional cryosurgery for the treatment of the different auricular keloid types in order to obtain superior clinical results by minimizing the probability of recurrence. In the past 20 years, the authors have developed novel procedures in order to increase the effectiveness of intralesional cryosurgery on auricular keloids, including hydrodissection, warm gauze technique, and excision of dangling skin. Long-lasting clinical results with a low recurrence rate and a satisfactory aesthetic outcome are achieved with no deformation of the ear framework.

A systematic review of the primary squamous cell carcinoma of the external auditory canal: survival outcome based on T-staging and proposal of a new classification

OBJECTIVE

This study aimed to provide a systematic review on survival outcome based on Pittsburgh T-staging for patients with primary external auditory canal squamous cell carcinoma.

METHOD

This study was a systematic review in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines performed until January 2018; pertinent studies were screened. Quality of evidence was assessed using the grading of recommendation, assessment, development and evaluation working group system.

RESULTS

Eight articles were chosen that reported on 437 patients with external auditory carcinoma. The 5-year overall survival rate was 53.0 per cent. The pooled proportion of survivors at 5 years for T1 tumours was 88.4 per cent and for T2 tumours was 88.6 per cent. For the combined population of T1 and T2 cancer patients, it was 84.5 per cent. For T3 and T4 tumours, it was 53.3 per cent and 26.8 per cent, respectively, whereas for T3 and T4 tumours combined, it was 40.4 per cent. Individual analysis of 61 patients with presence of cervical nodes showed a poor survival rate.

CONCLUSION

From this review, there was not any significant difference found in the survival outcome between T1 and T2 tumours. A practical classification incorporating nodal status that accurately stratifies patients was proposed.

What are the limits on whale ear bone size? Non-isometric scaling of the cetacean bulla

The history of cetaceans demonstrates dramatic macroevolutionary changes that have aided their transformation from terrestrial to obligate aquatic mammals. Their fossil record shows extensive anatomical modifications that facilitate life in a marine environment. To better understand the constraints on this transition, we examined the physical dimensions of the bony auditory complex, in relation to body size, for both living and extinct cetaceans. We compared the dimensions of the tympanic bulla, a conch-shaped ear bone unique to cetaceans, with bizygomatic width—a proxy for cetacean body size. Our results demonstrate that cetacean ears scale non-isometrically with body size, with about 70% of variation explained by increases in bizygomatic width. Our results, which encompass the breadth of the whale fossil record, size diversity, and taxonomic distribution, suggest that functional auditory capacity is constrained by congruent factors related to cranial morphology, as opposed to allometrically scaling with body size.

Comparison of fetal and adult tympanic membrane sizes: a cadaveric study

OBJECTIVE

The work aimed to compare fetal and adult tympanic membrane (TM) sizes for understanding dimensional development from intrauterine life to adulthood.

METHODS

Fifty-six temporal bones (18 fetuses, 10 elderly adults, half male and half female in each group) were included in this study. Using a digital image software, the TM height, width and area were measured.

RESULTS

The mean area, height and width of the TM in adults were found as 58.84 ± 22.01 mm2, 9.06 ± 1.33 mm, and 8.10 ± 1.43 mm, respectively. Moreover, the mean area, height and width of the TM in fetuses were measured as 47.62 ± 12.57 mm2, 8.22 ± 1.12 mm, and 7.25 ± 1.15 mm, respectively. The TM dimensions were increasing in fetuses between 20-32 weeks of gestation. However, the TM dimension was statistically similar at the 7th month, the 8th month and adult periods. The TM height was greater than its width in fetuses and adults.

CONCLUSION

The calculated regression equations of the TM parameters in fetuses may be used to estimate its size. The TM size did not change from the 7th gestational month, and thus the membrane reached adult diameter in fetal life. The TM height and width showed a very wide range; therefore, we thought that the 12 mm (the height) × 10 mm (the width) graft might be ideal dimension during the repair of the TM perforations.

Eosinophilic chronic rhinosinusitis and concurrent Kimura's disease treated with mepolizumab

Kimura's disease is a rare, benign, chronic inflammatory disorder characterised by its eosinophilic infiltrate. Patients often present with one or more progressively enlarging subcutaneous lymph nodes in the head and neck region or enlarging salivary glands. We describe the case of a 26-year-old man presenting with severe peripheral eosinophilia and upper airway inflammatory symptoms, who later developed cervical lymphadenopathy and formally diagnosed with Kimura's disease. Based on our English-language MEDLINE literature search, to our knowledge this is the first case report describing treatment of Kimura's disease with mepolizumab.

Epithelioid Sarcoma of the External Auditory Canal: An Uncommon Tumor at an Unusual Site and a Brief Overview of the Literature

We present a case (41 years old pregnant female) with epithelioid sarcoma arising in the left external auditory canal. On immunohistochemistry, the tumor cell diffusely expressed cytokeratins and showed patchy expression of ERG and CD34. The neoplastic cells demonstrated uniform loss of INI1-expression. Epithelioid sarcoma arising in the external auditory canal is rare. Awareness that ES may rarely arise at unusual sites is of critical importance in order to apply a broad enough panel in the immunohistochemical study, so a misdiagnosis of carcinoma can be avoided.

Evaluation of the relationship of chronic otitis media with the Körner's septum, auditory tube angle, and tubotympanic angle

PURPOSE

This study aimed to evaluate the relationships between chronic otitis media (COM) and the characteristics of Auditory tube (Eustachian) angle (ATa), tubotympanic angle (TTa), and Körner's septum (KS).

METHODS

A retrospective research was conducted between January 2019 and October 2019. The computed tomography (CT) results and medical files of 210 patients were evaluated. According to CT results and medical files, the patients were evaluated regarding the presence of COM, KS, ATa, and TTa.

RESULTS

There were 113 (53.81%) males and 97 (46.19%) females in the study group, and the mean age of the patients was 42.05 ± 10.77 years. The frequency of the KS was significantly higher in patients who were diagnosed with COM (35.66% vs. 7.41%, p < 0.001). The patients diagnosed with COM were found to have a narrower ATa and a wider TTa than the patients who were not diagnosed with COM. ATa was narrower and TTa was wider in patients with KS. The presence of KS and higher TTa value were considered as risk factors for COM (p < 0.001, p < 0.001, respectively) CONCLUSION:  Our findings indicate that ATa was narrower, TTa was wider and KS was more frequent in patients with COM. Analysis of risk factors demonstrated that increased TTa and the presence of KS were associated with increased risk for COM.

Melanoma metastatic to the hyoid bone

Metastatic melanoma may be included in the differential diagnosis of hyoid masses in patients with a history of melanoma. Hyoid resection is well tolerated and of diagnostic and therapeutic benefit in patients with tumors metastatic to the hyoid bone.

Ear melanoma: a four-case series

External ear melanoma is rare, and early diagnosis and treatment are paramount for the patient's survival. Four clinical cases are reported, emphasizing the importance of the routine clinical examination of the ears in the dermatological consultation. The study included male and female patients, aged 60 to 81 years old, with melanocytic lesions in the outer ear, evaluated with detailed physical and dermoscopic examination, leading to the identification of lesions suggestive of melanoma. The cases were treated surgically with excision of the lesion, and the diagnoses were confirmed by histopathological study. The therapeutic approach was instituted early as most cases were diagnosed at an early stage, which directly impacted global survival.

Clinical, ultrasonographic and histopathological diagnosis of ceruminous gland tumors in cats

Ceruminous gland tumor is the most common tumor of the ear canal in cats. Otoscopic examination of the ear tumor is so difficult due to narrowing of the external ear canal. The present study aimed to investigate clinical, ultrasonographic and histopathological characteristics of feline ceruminous gland neoplasm in cats. Ten cats with unilateral ear canal swelling were subjected to thorough physical and clinical investigations. Ultrasound of the ear canal and parotid gland was performed using 8.00 MHz linear probe. Tissue specimens were collected after surgical excision (total ear canal ablation) for histopathological examination. Clinical examination of the ceruminous tumors revealed firm pinkish mass obliterated the ear canal with purulent or bloody aural discharge. Ultrasound examination of the ear tumor was helpful in detecting the size, shape, echogenicity and extension of the tumors to the surrounding structures as well as the nature of the feline ceruminous tumor. Histopathological examination was the main diagnostic tool for detecting the nature of the ceruminous neoplasms.

Kcnb1 plays a role in development of the inner ear

The function of the inner ear depends on the maintenance of high concentrations of K⁺ ions. The slow-inactivating delayed rectifier Kv2.1/KCNB1 channel works in the inner ear in mammals. The kcnb1 gene is expressed in the otic vesicle of developing zebrafish, suggesting its role in development of the inner ear. In the present study, we found that a Kcnb1 loss-of-function mutation affected development of the inner ear at multiple levels, including otic vesicle expansion, otolith formation, and the proliferation and differentiation of mechanosensory cells. This resulted in defects of kinocilia and stereocilia and abnormal function of the inner ear detected by behavioral assays. The quantitative transcriptional analysis of 75 genes demonstrated that the kcnb1 mutation affected the transcription of genes that are involved in K⁺ metabolism, cell proliferation, cilia development, and intracellular protein trafficking. These results demonstrate a role for Kv2.1/Kcnb1 channels in development of the inner ear in zebrafish.

Correction of neonatal auricular deformities with DuoDERM: A simple technique

Ear moulding in neonates has been shown to successfully correct congenital auricular anomalies. There are several available moulding techniques. However, commercially available moulding devices (e.g., EarWell and Ear Buddy) can be costly, and their alternatives have limited customizability. We present a technique using cost-effective and customizable materials for moulding common anomalies (Stahl's ear, constricted ear, and prominent ear). DuoDERM Extra-thin, Steri-strips, and 3M Kind Removal Silicone tape are used to splint the ear in a preferred position. The DuoDERM is rolled into a putty, placed in the ear, and secured with tapes. This treatment is initiated in the clinic, with weekly splint changes carried out at home by caregivers, and intermittent follow-up appointments. DuoDERM moulding is a safe, inexpensive, highly customizable, and simple way to correct auricular deformities. Primary physicians/paediatricians should embed moulding into their practice, starting treatment as early as possible in the neonatal period.

Temporal bone carcinoma: testing the prognostic value of a novel clinical and histological scoring system

PURPOSE

Our group recently proposed the novel Padova prognostic scoring system for temporal bone carcinoma (TBSCC) that considers: the revised Pittsburgh staging system; radiological dura mater involvement; non-anterior spread (medial, inferior or posterior into the temporal bone and skull base) of T4 tumors; and histological grade. The aim of the present study was to validate this prognostic TBSCC scoring system in a case series selected from the literature.

METHODS

A search was run to identify studies on TBSCC reporting the variables included in our score for each patient. Then our system was applied to the data extracted.

RESULTS

Only two published investigations reported all the clinical and pathological data required for our scoring system. In one series from the Gruppo Otologico in Piacenza (Italy), a significantly higher recurrence rate (p = 0.008), shorter disease-free survival (DFS) (p = 0.001), higher disease-specific mortality (DSM) (p = 0.006), and shorter disease-specific survival (DSS) (p = 0.004) were associated with scores ≥ 5. Receiver operating curve (ROC) analysis showed an AUC of 0.804 for TBSCC recurrence, and 0.832 for DSM. In a series from Kyushu University Hospital (Japan), a significantly higher DSM (p = 0.018) and shorter DSS (p = 0.021) were associated with scores ≥ 5. ROC analysis showed an AUC of 0.812 for tumor relapse and 0.790 for DSM.

CONCLUSION

Our TBSCC Padova scoring system confirmed its validity when applied to the only two international TBSCC series providing the required data. These preliminary results need to be confirmed in a multi-center prospective setting.

Arterio-venous malformations of the ear: Description of distinct anatomical presentation and multidisciplinary management approach

BACKGROUND

Arterio-venous malformations (AVMs) of the ear are a rare entity and their management should be decided in a dedicated multidisciplinary team (MDT) setting. The aim of this study is to describe the distinct anatomical patterns of the auricular AVMs in our unit and propose a combined interventional radiological and surgical approach.

MATERIALS AND METHODS

All consecutive patients presenting with AVMs of the ear and reviewed by the Vascular Anomalies MDT between 2014 and 2019 were included in this study. Signs, symptoms, diagnostic investigations and operative findings were collected prospectively.

RESULTS

After reviewing our nine patients, we identified four anatomical patterns of auricular AVMs: I: involves just a component of the ear and should undergo embolization followed by excision and reconstruction without significant loss of form; II: affects the superior two-thirds of the ear, sparing the lobule and part of the conchal bowl; these patients should undergo embolization, excision and monitoring before formal reconstruction of the ear is offered; III: involves the entire ear and should undergo embolization and pinnectomy; if there is no recurrence, the patients can be offered either a carved-rib cartilage reconstruction or a prosthesis, depending on the quality of the surrounding soft-tissues; IV: involves the ear and surrounding tissue, making surgical management and subsequent reconstruction extensive.

CONCLUSION

The management of auricular AVMs is based on the extent of the ear involved. We feel that our combined interventional radiological and surgical approach will aid the management of these complex patients.

A retrospective analysis of complications and surgical outcome of 1380 ears: Experience review of paediatric otoplasty

AIM OF THE STUDY

The psychological benefits of successful surgery for prominent ears have been emphasised. However, there are few comprehensive reports in the literature on the incidence of complications. The aim of this retrospective study is to present the postoperative outcome and possible recurrence of prominent ears after otoplasty in a University Hospital Center.

METHODS

A total of 705 patients were followed after otoplasty. We carried out a retrospective review of the file that included all children who had been treated for prominent ears following the same surgical technique from January 01, 1993 to December 31, 2017, and made a descriptive analysis of the data.

MAIN RESULTS

Our study confirmed the prevalence of females in operative treatment of PE, as well as the predominance of the bilateral form of this anomaly. Postoperative complications were recorded in 3.7% of the children (n = 26). 16 patients (2.2%) developed hypertrophic scar complications that required surgical revision in all cases, classifying them as 3b according to the Clavien-Dindo classification. Nine patients (1.3%) required surgical revision for recurrence (Clavien-Dindo 3b). Recurrence, unlike scarring complications, seems to be dependent on the surgeon's experience. A family history was noted in 20% of cases.

CONCLUSIONS

The otoplasty technique showed here is safe and has a low rate of the complications commonly described in the literature. A prospective study with a survey of complications and degree of satisfaction with the results will follow.

Pediatric foreign bodies of the ear: A 10-year national analysis

OBJECTIVES

To estimate the incidence of emergency department visits for pediatric ear foreign bodies. To identify the most common items and their trends.

METHODS

The Nationwide Electronic Injury Surveillance System (NEISS) was queried for emergency department visits involving the diagnosis of foreign bodies in the ear including pinna and canal in children over the most recent 10-year span available. National incidence estimates and demographic data were extracted from the same database.

RESULTS

Ear foreign bodies in children made up an estimated total 446,819 ED visits nationwide over the past 10 years. The mean age was 7.2 ± 4.3 years old. The majority (55.6%, n = 248,531) of cases were female. The most common class of objects found was jewelry, primarily embedded earrings and beads, accounting for 55.5% visits, followed by paper products at 7.1%, pens and pencils at 4.1%, desk supplies (erasers) at 3.7%, BBs or pellets at 3.5%, and earplugs and earphones at 3%. Females were significantly more likely to have jewelry foreign bodies, and males were significantly more likely to have foreign bodies from all other categories other than first-aid supplies.

CONCLUSION

Foreign bodies of the ear are a common reason for emergency department visits in children, primarily jewelry, paper products, and desk supplies. Recognition of commonly encountered objects can aid in both speedier recognition of unknown objects, as well as guide patient counseling.

Perichondritis: inspect the lobule

Case presentation

This is a brief report of a 57-year-old Caucasian female presented with a 4-day history of worsening left ear pain. Her symptoms began with left otalgia and otorrhea which progressed to helical erythema, prompting a visit to the emergency department. She was noted to have erythema of the left auricle and swelling of the left auditory meatus. Our otolaryngology service observed erythema of the auricle with sparing of the lobule.

Diagnosis

The diagnosis to be otitis externa with perichondritis was established, and we recommended otic ciprofloxacin-hydrocortisone, IV vancomycin, and ciprofloxacin. The patient had marked improvement and was discharged on an oral and otic fluoroquinolone. In this case, the diagnosis of perichondritis was made by a classic physical examination finding: erythema and edema with sparing of the fatty lobule. This key finding helps to distinguish perichondritis from otitis externa.

How I do it: a simulator of the ear for developing otomicroscopy skills during the coronavirus disease 2019 pandemic

OBJECTIVE

To develop a simulator of the external auditory canal and tympanic membrane that enables surgical trainees to practise their otomicroscopy skills, which is particularly valuable at a time where there is limited patient contact because of the coronavirus disease 2019 lockdown.

METHODS

A simulator of the external auditory canal and tympanic membrane was made using a cardboard bowl, a 2 ml syringe and a latex glove. The simulator was used to practise otomicroscopy skills, including microsuction, foreign body removal, myringotomy and grommet insertion. Five doctors in the ENT department participated, ranging from core surgical training year two doctor to specialty doctor.

RESULTS

The simulator provides an effective tool on which surgical trainees can practise, develop and maintain a variety of otomicroscopy skills.

CONCLUSION

This inexpensive, easy and quick-to-make simulator enables trainees to practise their otomicroscopy skills on an approximately accurate model during a time when there is minimal clinical opportunity to develop these skills, particularly because of the coronavirus disease 2019 pandemic.

Tissue engineering: from the bedside to the bench and back to the bedside

The field of Tissue Engineering and Regenerative Medicine has evolved rapidly over the past thirty years. This review will summarize its history, current status and direction through the lens of clinical need, its progress through science in the laboratory and application back into patients. We can take pride in the fact that much effort and progress began with the surgical problems of children and that many surgeons in the pediatric surgical specialties have become pioneers and investigators in this new field of science, engineering, and medicine. Although the field has yet to fulfill its great promise, there have been several examples where a therapy has progressed from the first idea to human application within a short span of time and, in many cases, it has been applied in the surgical care of children.

3D Finite Element Modeling of Blast Wave Transmission from the External Ear to Cochlea

As an organ that is sensitive to pressure changes, the ear is often damaged when a person is subjected to blast exposures resulting in hearing loss due to tissue damage in the middle ear and cochlea. While observation of middle ear damage is non-invasive, examining the damage to the cochlea is difficult to quantify. Previous works have modeled the cochlear response often when subjected to an acoustic pressure input, but the inner ear mechanics have rarely been studied when the ear is exposed to a blast wave. In this study we aim to develop a finite element (FE) model of the entire ear, particularly the cochlea, for predicting the blast wave transmission from the ear canal to cochlea. We utilized a FE model of the ear, which includes the ear canal, middle ear, and uncoiled two-chambered cochlea, to simulate the cochlear response to blast overpressure (BOP) at the entrance of the ear canal with ANSYS Mechanical and Fluent in a fluid-structure interface coupled analysis in the time domain. This model was developed based on previous middle and inner ear models, and the cochlea was remeshed to improve BOP simulation performance. The FE model was validated using experimentally measured blast pressure transduction from the ear canal to the middle ear and cochlea in human cadaveric temporal bones. Results from the FE model showed significant displacements of the tympanic membrane, middle ear ossicles, and basilar membrane (BM). The stapes footplate displacement was observed to be as high as 60 µm, far exceeding the displacement during normal acoustic stimulation, when the 30 kPa (4.35 psi, 183 dB (SPL), Sound Pressure Level) of BOP was applied at the ear canal entrance. The large stapes movement caused pressures in the cochlea to exceed the physiological pressure level [< 10 Pa, 120 dB (SPL)] at a peak of 49.9 kPa, and the BM displacement was on the order of microns with a maximum displacement of 26.4 µm. The FE model of the entire human ear developed in this study provides a computational tool for prediction of blast wave transmission from the ear canal to cochlea and the future applications for assisting the prevention, diagnosis, and treatment of blast-induced hearing loss.

Lassa virus antigen distribution and inflammation in the ear of infected strain 13/N Guinea pigs

Sudden-onset sensorineuronal hearing loss (SNHL) is reported in approximately one-third of survivors of Lassa fever (LF) and remains the most prominent cause of Lassa virus (LASV)-associated morbidity in convalescence. Using a guinea pig model of LF, and incorporating animals from LASV vaccine trials, we investigated viral antigen distribution and histopathology in the ear of infected animals to elucidate the pathogenesis of hearing loss associated with LASV infection. Antigen was detected only in animals that succumbed to disease and was found within structures of the inner ear that are intimately associated with neural detection and/or translation of auditory stimuli and in adjacent vasculature. No inflammation or viral cytopathic changes were observed in the inner ear or surrounding structures in these animals. In contrast, no viral antigen was detected in the ear of surviving animals. However, all survivors that exhibited clinical signs of disease during the course of infection developed perivascular mononuclear inflammation within and adjacent to the ear, indicating an ongoing inflammatory response in these animals that may contribute to hearing loss. These data contribute to the knowledge of LASV pathogenesis in the auditory system, support an immune-mediated process resulting in LASV-associated hearing loss, and demonstrate that vaccination protecting animals from clinical disease can also prevent infection-associated auditory pathology.

COVID-19 and ear endoscopy in otologic practices

Purpose

Otolaryngologists have had to postpone the majority of surgical procedures in the current COVID-19 pandemic. Airborne transmission, beyond the projection of droplets from upper airways, expose healthcare workers to a risk of viral infection. Aerosol generating procedures (AGP) increase the risk of viral transmission to staff within the operating room.

Methods

Surgery of middle ear and mastoid is also considered an AGP, particularly mastoidectomy performed using a high-speed drill. The authors report their experience in endoscopic ear surgery as an alternative technique to reduce AGP in otologic procedures.

Results

Transcanal endoscopic ear surgery is a reliable technique used to manage many otologic conditions.

Conclusion

The endoscopic approach may reduce the risk of viral transmission to operating room staff by reducing the need for mastoidectomy.