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Sanches AB, Sanfins MD, Skarzynski PH, Skarżyńska MB, Penatti HC, Donadon C, de Souza IP, da Silva IV, Colella-Santos MF. Wideband Tympanometry and Pressurized Otoacoustic Emissions in Children with Surgical Excision of Palatine and/or Pharyngeal Tonsils. Brain Sci 2024; 14:598. [PMID: 38928598 PMCID: PMC11201830 DOI: 10.3390/brainsci14060598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/03/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Palatine and pharyngeal tonsil hypertrophy may lead to dysfunction of the auditory tube due to a propensity for infection, potentially giving rise to otitis media. This is a quantitative and longitudinal study, developed from 2019 to 2021, at the State University of Campinas (UNICAMP). The studied sample comprised 15 participants aged 5 to 12 years (mean 7.9 years), 12 male and 3 female, arranged into two groups: children diagnosed with pharyngeal and/or palatine tonsil hypertrophy who were candidates for surgery (G1), and children who were later evaluated after surgery (G2). As part of the test, an otoscopy and measurements of logoaudiometry, pure-tone threshold audiometry, wideband tympanometry (ambient and peak pressure), and otoacoustic emissions (TEOAEs and DPOAEs, both at ambient and peak pressure) were all performed. There were statistically significant differences between phases in pure-tone audiometry, in terms of 226 Hz tympanometry, wideband tympanometry in peak pressure conditions, in the amplitude measurement TEOAEs in both pressure conditions, in DPOAEs in ambient pressure conditions, and in the signal/noise measurement in both pressures in DPOAEs. Overall, it was found that hearing tests were different for subjects with palatine and pharyngeal tonsil hypertrophy compared to the post-surgical group.
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Affiliation(s)
- Aline Buratti Sanches
- Faculty of Medical Sciences, State University of Campinas, Campinas 13083-887, São Paulo, Brazil; (A.B.S.); (C.D.); (I.P.d.S.); (I.V.d.S.); (M.F.C.-S.)
| | - Milaine Dominici Sanfins
- Speech-Hearing-Language Department, Audiology Discipline, Universidade Federal de São Paulo, São Paulo 04023-062, São Paulo, Brazil
- Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany/Warsaw, Poland;
| | - Piotr Henryk Skarzynski
- Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany/Warsaw, Poland;
- Department of Otorhinolaryngology Hearing, Center of Hearing and Speech Medincus, 05-830 Kajetany, Poland;
- Department of Clinical Trials, Institute of Sensory Organs, 05-830 Kajetany, Poland
| | - Magdalena Beata Skarżyńska
- Department of Otorhinolaryngology Hearing, Center of Hearing and Speech Medincus, 05-830 Kajetany, Poland;
- Department of Clinical Trials, Institute of Sensory Organs, 05-830 Kajetany, Poland
- Department of Hearing, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Kajetany, Poland
- Department of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, Poland
| | - Henrique Costa Penatti
- Department of Otolaryngology, Ambulatory of Medical Specialties, Santa Bárbara D’Oeste 13450-000, São Paulo, Brazil;
| | - Caroline Donadon
- Faculty of Medical Sciences, State University of Campinas, Campinas 13083-887, São Paulo, Brazil; (A.B.S.); (C.D.); (I.P.d.S.); (I.V.d.S.); (M.F.C.-S.)
| | - Ingrid Pereira de Souza
- Faculty of Medical Sciences, State University of Campinas, Campinas 13083-887, São Paulo, Brazil; (A.B.S.); (C.D.); (I.P.d.S.); (I.V.d.S.); (M.F.C.-S.)
| | - Ingridy Vitoria da Silva
- Faculty of Medical Sciences, State University of Campinas, Campinas 13083-887, São Paulo, Brazil; (A.B.S.); (C.D.); (I.P.d.S.); (I.V.d.S.); (M.F.C.-S.)
| | - Maria Francisca Colella-Santos
- Faculty of Medical Sciences, State University of Campinas, Campinas 13083-887, São Paulo, Brazil; (A.B.S.); (C.D.); (I.P.d.S.); (I.V.d.S.); (M.F.C.-S.)
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Koizumi M, Ohbe H, Suzuki S, Hashimoto Y, Matsui H, Fushimi K, Yamasoba T, Yasunaga H. Impact of COVID-19 pandemic on the number of otolaryngologic surgeries in Japan. Auris Nasus Larynx 2024; 51:617-622. [PMID: 38564845 DOI: 10.1016/j.anl.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/30/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Previous studies show that the COVID-19 pandemic affected the number of surgeries performed. However, data on the association between the COVID-19 pandemic and otolaryngologic surgeries according to subspecialties are lacking. This study was performed to evaluate the impact of the COVID-19 pandemic on various types of otolaryngologic surgeries. METHODS We retrospectively identified patients who underwent otolaryngologic surgeries from April 2018 to February 2021 using a Japanese national inpatient database. We performed interrupted time-series analyses before and after April 2020 to evaluate the number of otolaryngologic surgeries performed. The Japanese government declared its first state of emergency during the COVID-19 pandemic in April 2020. RESULTS We obtained data on 348,351 otolaryngologic surgeries. Interrupted time-series analysis showed a significant decrease in the number of overall otolaryngologic surgeries in April 2020 (-3619 surgeries per month; 95% confidence interval, -5555 to -1683; p < 0.001). Removal of foreign bodies and head and neck cancer surgery were not affected by the COVID-19 pandemic. In the post-COVID-19 period, the number of otolaryngologic surgeries, except for ear and upper airway surgeries, increased significantly. The number of tracheostomies and peritonsillar abscess incisions did not significantly decrease during the COVID-19 pandemic. CONCLUSION The COVID-19 pandemic was associated with a decrease in the overall number of otolaryngologic surgeries, but the trend differed among subspecialties.
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Affiliation(s)
- Megumi Koizumi
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan; Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan; Department of Otolaryngology and Head and Neck Surgery, JR Tokyo general hospital, Tokyo, Japan.
| | - Hiroyuki Ohbe
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Sayaka Suzuki
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yohei Hashimoto
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Hiroki Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tatsuya Yamasoba
- Department of Otolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
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Trecca EM, Gaffuri M, Molinari G, Russo FY, Turri-Zanoni M, Albera A, Miriam di Lullo A, Russo G, Mannelli G, Ralli M. Impact of the COVID-19 pandemic on paediatric otolaryngology: a nationwide study. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2023; 43:352-359. [PMID: 37519138 PMCID: PMC10551727 DOI: 10.14639/0392-100x-n2452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/10/2023] [Indexed: 08/01/2023]
Abstract
Objective The COVID-19 pandemic profoundly modified the work routine in healthcare; however, its impact on the field of paediatric otorhinolaryngology (ORL) has been rarely investigated. The aim of this study was to assess the impact of COVID-19 on paediatric ORL. Methods A questionnaire was developed by the Young Otolaryngologists of the Italian Society of ORL-Head and Neck Surgery (GOS). The questionnaire consisted of 26 questions related to workplace and personal paediatric ORL activities. The link was advertised on the official social media platforms and sent by e-mail to 469 Italian otolaryngologists. Results The questionnaire was completed by 118 responders. During the pandemic, the main reduction was observed for surgical activity (78.8%), followed by outpatient service (16.9%). The conditions that were mostly impacted by a delayed diagnosis were respiratory infections in 45.8% of cases and sensorineural hearing loss in 37.3% of cases. Conclusions Paediatric ORL was highly impacted by the COVID-19 pandemic, with a significant reduction of surgical and outpatient activities and a delay in time-sensitive diagnosis. Therefore, the implementation of new strategies, such as telemedicine, is recommended.
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Affiliation(s)
- Eleonora M.C. Trecca
- Correspondence Eleonora Maria Consiglia Trecca IRCCS Casa Sollievo della Sofferenza, Department of Maxillofacial Surgery and Otolaryngology, viale Cappuccini 1, 71013 San Giovanni Rotondo (FG), Italy E-mail:
| | - Michele Gaffuri
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Department of Otolaryngology and Head and Neck Surgery, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Giulia Molinari
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Department of Otolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria of Bologna, Bologna, Italy
- Department of Experimental Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Francesca Yoshie Russo
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Department of Sense Organs, ENT Department, Sapienza University of Rome, Rome, Italy
| | - Mario Turri-Zanoni
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Andrea Albera
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Antonella Miriam di Lullo
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- ENT Unit- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Gennaro Russo
- Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Otolaryngology Unit, AORN dei Colli, V. Monaldi Hospital, Napoli, Italy
| | - Giuditta Mannelli
- Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Massimo Ralli
- Research group of Pediatric Otorhinolaryngology of the Task Force of the Young Otolaryngologists of the Italian Society of Otolaryngology-Head and Neck Surgery
- Department of Sense Organs, ENT Department, Sapienza University of Rome, Rome, Italy
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Hogg ES, Hampton T, Wright K, Sharma SD. The effect on the T-14 paediatric throat disorders outcome score of delaying adenotonsillectomy surgery due to COVID-19. Ann R Coll Surg Engl 2023; 105:S18-S21. [PMID: 35446154 PMCID: PMC10390237 DOI: 10.1308/rcsann.2021.0336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2021] [Indexed: 08/02/2023] Open
Abstract
INTRODUCTION Adenotonsillectomy is commonly performed for recurrent tonsillitis and obstructive sleep apnoea. These conditions may improve with age. The COVID-19 pandemic led to all UK elective surgery being suspended. This study aimed to determine whether delaying surgery had any effect on a patient's symptoms using the validated T-14 paediatric throat disorders outcome test. METHODS Patients completed a T-14 questionnaire when the child was listed for surgery; this was repeated on the revised surgery date and a paired t test was used to compare the responses. RESULTS Questionnaires were completed by 29 patients a mean of 6.4 months apart. There was a significant improvement in scores (p<0.02) for five domains: eating habits, visits to a doctor/A&E, antibiotics for less than 2 weeks, chronic infections and school missed due to sore throats. CONCLUSIONS This study demonstrates that following delays resulting from the COVID-19 pandemic, paediatric patients experienced an improvement in some aspects of their quality of life while awaiting tonsillectomy and/or adenoidectomy. This was most apparent in quality-of-life measures relating to recurrent tonsillitis, namely visits to a doctor/A&E, antibiotics for less than 2 weeks, chronic infections and school missed due to sore throats. Patients may experience an improvement in some of their individual symptoms, in particular their infective symptoms, during an observation period.
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Affiliation(s)
- ES Hogg
- Alder Hey Children’s NHS Foundation Trust, UK
| | - T Hampton
- Alder Hey Children’s NHS Foundation Trust, UK
| | - K Wright
- Alder Hey Children’s NHS Foundation Trust, UK
| | - SD Sharma
- Alder Hey Children’s NHS Foundation Trust, UK
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Gruescu ACS, Popoiu C, Levai MC, Tudor R, Fericean RM, Rivis M. A Cross-Sectional Assessment of Parental Concerns in the Pediatric Surgery Department during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11091330. [PMID: 37174873 PMCID: PMC10177879 DOI: 10.3390/healthcare11091330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 04/21/2023] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
The COVID-19 pandemic has impacted various aspects of healthcare, including pediatric surgery. This study aimed to assess parental concerns and stress levels in pediatric surgery during the COVID-19 pandemic, identify factors associated with increased parental anxiety or concern, and provide recommendations for healthcare providers. A cross-sectional study was conducted in a tertiary pediatric hospital in Timisoara, Romania, involving 174 parents of pediatric patients requiring elective or emergency surgery, with a mean age of 37.6 (25-47) years, out of which 89.1% of respondents were women. Parental concerns were assessed using the Parental Concerns Questionnaire (PCQ), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS-10). Parents of children undergoing emergency surgery (n = 108) reported higher levels on the practical impact domain of the PCQ scale (3.4 vs. 2.2, p < 0.001), emotional impact (2.7 vs. 2.2, p = 0.002), and total PCQ score (9.5 vs. 7.7, p < 0.001) compared to parents of children undergoing elective surgery (n = 66). Parents in the emergent surgery group also reported higher anxiety scores on the HADS questionnaire (7.9 vs. 6.5, p = 0.009) and higher perceived stress and total score on the PSS-10 survey (7.8 vs. 5.6, p = 0.046) (10.5 vs. 9.1, p = 0.047), respectively. A significantly higher proportion of parents in the emergent surgery group were concerned about restricted visitation policies (p = 0.013) and reported delaying or considering delaying their child's surgery due to the pandemic (p = 0.036). The results demonstrate heightened concerns, anxiety, and stress among parents of children undergoing emergency surgery during the COVID-19 pandemic. Healthcare providers should address parental concerns, provide clear communication, and ensure adequate support for families. Recommendations include enhancing information about COVID-19 precautions, reassuring parents about personal protective equipment availability, and facilitating family support within visitation restrictions.
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Affiliation(s)
- Ada Claudia Silvana Gruescu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Calin Popoiu
- Department of Pediatrics, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Mihaela Codrina Levai
- Research Center for Medical Communication, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
| | - Raluca Tudor
- Second Discipline of Neurology, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Doctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, Nr. 2, 300041 Timisoara, Romania
- Department of Infectious Diseases, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Mircea Rivis
- Department of Anesthesiology and Oral Surgery, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania
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Franchella S, Favaretto N, Frigo A, Franz L, Pilo S, Mularoni F, Marciani S, Nicolai P, Marioni G, Cazzador D. Does social distancing impact pediatric upper airway infections? An observational controlled study and a brief literature review. Am J Otolaryngol 2023; 44:103801. [PMID: 36893529 PMCID: PMC9974205 DOI: 10.1016/j.amjoto.2023.103801] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 01/18/2023] [Accepted: 02/19/2023] [Indexed: 03/04/2023]
Abstract
PURPOSE SARS-CoV-2 pandemic has reduced social interaction even among children. The objective of the study was to assess the role of social distancing in the course of common pediatric upper airway recurrent diseases. MATERIALS AND METHODS Patients aged ≤14 years with at least one ENT-related clinical condition were retrospectively recruited. All patients had two outpatient evaluations in the same period (April - September): the control group had the first evaluation in 2018 and second in 2019, whereas the case group had the first evaluation in 2019 and second in 2020. Patients of each group were individually compared between their two visits and deemed improved/unchanged/worsened for each specific ENT condition. The percentage of children improved/unchanged/worsened were then collectively compared between the two groups for each condition. RESULTS Patients who experienced social distancing presented a significantly higher improvement rate than controls for recurrent acute otitis media episodes (35.1 % vs. 10.8 %; Fisher's exact test p = 0.033) and for tympanogram type (54.5 % vs. 11.1 %, Fisher's exact test p = 0.009). CONCLUSIONS The anti-contagion social restrictions decreased the prevalence of middle ear infections and effusion in children. Further studies on larger cohorts are required to better elucidate these findings.
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Affiliation(s)
- Sebastiano Franchella
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Niccolò Favaretto
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy; Otorhinolaryngology Unit, AULSS5 Polesana, Rovigo, Italy
| | - Annachiara Frigo
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padova, Italy
| | - Leonardo Franz
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy; Department of Neuroscience DNS, Phoniatrics and Audiology Unit, University of Padova, Treviso, Italy; Guided Therapeutics (GTx) International Scholarship Program, Techna Institute, University Health Network (UHN), Toronto, ON M5G2C4, Canada; Artificial Intelligence in Medicine and Innovation in Clinical Research and Methodology (PhD Program), Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Simona Pilo
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Francesca Mularoni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Silvia Marciani
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Piero Nicolai
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
| | - Gino Marioni
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy.
| | - Diego Cazzador
- Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy
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Torres-García L, Acosta RM, Martínez AC, Alcañiz II, Velazquez AA, Carceller MA. Evolution in the incidence of infectious diseases in the pediatric ENT area during the COVID-19 pandemic. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022:S2173-5735(22)00121-1. [PMID: 36427791 PMCID: PMC9678834 DOI: 10.1016/j.otoeng.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/03/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION SARS COV-2 infection is an emerging disease that has become a global pandemic since the beginning of 2020. To reduce transmission, measures have been imposed by governments such as home confinement, the use of masks, social distancing or promotion of hand hygiene. The aim of this study is to determine if the measures adopted to reduce the COVID-19 pandemic have produced a decrease in the incidence of infectious diseases and their complications in the ENT area in our center. MATERIAL AND METHODS A retrospective descriptive study was carried out in a tertiary hospital of patients aged between 0 and 15 years who required admission due to deep cervical infections, complications derived from acute otitis media (mastoiditis or facial paralysis) or complicated acute sinusitis. RESULTS There is a notable decrease in the number of global admissions in the COVID period (9) compared to the average of the previous 5 years (20.1). Likewise, there are statistically significant differences in the number of admissions for cervical infections (p value = 0.027) and complications derived from acute otitis media (p value = 0.029). DISCUSSION/CONCLUSION A decrease in the number of admissions caused by complications of infections in the ENT area in paediatric patients has been observed after the start of the COVID-19 pandemic in our environment, this fact could be explained by a global decrease in the number of infections of the upper respiratory tract due to the hygienic measures taken by the COVID-19 pandemic.
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Affiliation(s)
- Lidia Torres-García
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, Spain.
| | - Raúl Mellidez Acosta
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - Isabel Ibáñez Alcañiz
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - Agustín Alamar Velazquez
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, Spain; Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain
| | - Miguel Armengot Carceller
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, Spain; Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, Spain
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Torres-García L, Acosta RM, Martínez AC, Alcañiz II, Velazquez AA, Carceller MA. [Evolution in the incidence of infectious diseases in the pediatric ENT area during the COVID-19 pandemic]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2022; 74:S0001-6519(22)00125-X. [PMID: 36339492 PMCID: PMC9626442 DOI: 10.1016/j.otorri.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/28/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION SARS COV-2 infection is an emerging disease that has become a global pandemic since the beginning of 2020. To reduce transmission, measures have been imposed by governments such as home confinement, the use of masks, social distancing or promotion of hand hygiene. The aim of this study is to determine if the measures adopted to reduce the COVID-19 pandemic have produced a decrease in the incidence of infectious diseases and their complications in the ENT area in our center. MATERIAL AND METHODS A retrospective descriptive study was carried out in a tertiary hospital of patients aged between 0 and 15 years who required admission due to deep cervical infections, complications derived from acute otitis media (mastoiditis or facial paralysis) or complicated acute sinusitis. RESULTS There is a notable decrease in the number of global admissions in the COVID period (9) compared to the average of the previous 5 years (20.1). Likewise, there are statistically significant differences in the number of admissions for cervical infections (p value= 0.027) and complications derived from acute otitis media (p value= 0.029). DISCUSSION/CONCLUSION A decrease in the number of admissions caused by complications of infections in the ENT area in paediatric patients has been observed after the start of the COVID-19 pandemic in our environment, this fact could be explained by a global decrease in the number of infections of the upper respiratory tract due to the hygienic measures taken by the COVID-19 pandemic.
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Affiliation(s)
- Lidia Torres-García
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - Raúl Mellidez Acosta
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | | | - Isabel Ibáñez Alcañiz
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, España
| | - Agustín Alamar Velazquez
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, España
- Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, España
| | - Miguel Armengot Carceller
- Servicio de Otorrinolaringología, Hospital Universitari i Politècnic La Fe, Valencia, España
- Facultad de Medicina y Odontología, Universidad de Valencia, Valencia, España
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Kourelis K, Angelopoulou M, Goulioumis A, Fouzas S, Kourelis T. Surgery for adenotonsillar hypertrophy and otitis media in children is less demanded in quarantine times. Int J Pediatr Otorhinolaryngol 2022; 158:111169. [PMID: 35552162 DOI: 10.1016/j.ijporl.2022.111169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 03/21/2022] [Accepted: 04/30/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In the COVID-19 era, extreme measures of social distancing have contained the spread of common viral respiratory infections, which are involved in the pathogenesis of Adenotonsillar Hypertrophy (ATH), and Chronic Otitis Media with Effusion (COME), the two commonest chronic ENT diseases of childhood. This study examines the lockdown effect on the number of procedures performed for these two conditions. METHODS The consecutive charts of 650 and 195 children being operated respectively for ATH and COME during the quarantine (05/2020-02/2021) and unrestrained (05/2019-02/2020) periods were retrospectively reviewed. Surgical treatment of ankyloglossia, performed in 103 patients during the same periods was employed as a control procedure. RESULTS Adenotonsillectomies and tympanostomies significantly decreased in the lockdown phase by 52% (P < 0.001) and 74% (P < 0.001), respectively, whereas control procedure counts increased by 25%. In terms of seasonal variation, ATH-related surgeries were significantly reduced during the winter season of the pandemic by 73% (P < 0.001), in comparison with the corresponding months of the unrestrained period. School-aged children received significantly fewer operations for ATH (-59%) than preschoolers (-42%), as a result of the lockdown (P = 0.044). CONCLUSION When the child's exposure to respiratory pathogens is minimal, as in the case of lockdown, a noticeable decline occurs in the incidence of ATH and COME indicated for surgical treatment. Chronic low-grade inflammation, boosted by repetitive viral infections seems to underlie both conditions. Timely, effective isolation measures might reverse the disease process and keep the child away from the Operating Room.
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Affiliation(s)
- Konstantinos Kourelis
- Department of Otolaryngology, Children's Hospital of Patras "Karamandaneio", 26331, Patras, Greece.
| | - Maria Angelopoulou
- Department of Otolaryngology, Children's Hospital of Patras "Karamandaneio", 26331, Patras, Greece
| | - Anastasios Goulioumis
- Department of Otolaryngology, Children's Hospital of Patras "Karamandaneio", 26331, Patras, Greece
| | - Sotirios Fouzas
- Department of Pediatrics, University Hospital of Patras, 26504, Patras, Greece
| | - Theodoros Kourelis
- Department of Medical Oncology, "Olympian" General Hospital, 26443, Patras, Greece
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10
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Windfuhr JP, Günster C. Impact of the COVID-pandemic on the incidence of tonsil surgery and sore throat in Germany. Eur Arch Otorhinolaryngol 2022; 279:4157-4166. [PMID: 35218385 PMCID: PMC8881894 DOI: 10.1007/s00405-022-07308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/07/2022] [Indexed: 11/21/2022]
Abstract
Purpose To longitudinally evaluate the impact of the COVID-19-pandemic on the incidence of inpatient tonsil surgery and outpatient primary care of sore throat in Germany. Methods A retrospective interrupted time-series analysis was conducted. The national database of the Hospital Remuneration System was used to retrieve the number of operations performed between January 2019 and September 2021 including elective and non-elective cases with the exception of malign diseases. Three episodes were compared on a weekly basis: before, during, and after the first national lockdown (March 16–May 3, 2020). We also analysed the number of outpatient doctor contacts of sore throat patients in 2019 and 2020. Results Overall, 144,069 surgical cases were included in the analysis. The first lockdown resulted in an abrupt and significant decrease of all types of tonsil surgery (p < 0.01). The incidence of tonsillectomy decreased from 556 (before) to 111 (during) and 326 (after) cases per week (relative risk 0.24; 95% CI 0.19–0.30, and 0.82; 95% CI 0.73–0.92). After the lockdown, the incidence persisted on a lower level compared to 2019. The number of doctor contacts decreased from 2,967,322 in 2019 to 1,976,617 in 2020 (− 33.4%). Conclusions The first lockdown was associated with a significant decrease of all types of tonsil surgery. A return to pre-pandemic surgical activity was not identified. The findings were accompanied by a significant decrease of outpatient doctor contacts of sore throat patients in primary care, particularly in the subgroup of children and adolescents. The impact of the second lockdown, starting in December 2020, was by far not comparable. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-022-07308-8.
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Affiliation(s)
- Jochen P Windfuhr
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, Kliniken Maria Hilf, Viersener Str. 450, 41063, Mönchengladbach, Germany.
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11
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Kuitunen I, Artama M, Haapanen M, Renko M. Urinary tract infections decreased in Finnish children during the COVID-19 pandemic. Eur J Pediatr 2022; 181:1979-1984. [PMID: 35098402 PMCID: PMC8801286 DOI: 10.1007/s00431-022-04389-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/01/2021] [Accepted: 01/22/2022] [Indexed: 11/05/2022]
Abstract
UNLABELLED Social restrictions reduced the rates of respiratory infections in 2020, but studies on the rates of urinary tract infections (UTIs) during lockdown have had conflicting results. This study aimed to report UTI incidence during the first and second waves of COVID-19 pandemic in Finland. We conducted a retrospective register-based cohort study. The whole Finnish pediatric population (children under the age of 15 years, N = 860,000) was included. The yearly and monthly incidences of UTIs per 100,000 children in 2020 were compared to that of three previous years (2017-2019) by incidence rate ratios (IRRs) with 95% confidence intervals (CIs). A total of 10,757 cystitis and 4873 pyelonephritis cases were included. The yearly incidence of cystitis was 12% lower (IRR 0.88, CI 0.83-0.94) among children aged 1-6 in 2020 and 11% (IRR 0.89, CI 0.83-0.95) lower among children aged 7-14 in 2020 compared with previous years. The yearly incidence of pyelonephritis was 16% lower (IRR 0.84, CI 0.76-0.94) among children aged 1-6. No significant decrease were observed among children aged < 1 and 7-14. CONCLUSION The incidence of cystitis and pyelonephritis during a period of social restrictions was lower than during 2017-2019, especially in children aged 1-6 years. These results raise the possibility of reducing the occurrence of urinary tract infections in children by improving hygiene measures. WHAT IS KNOWN • Social restrictions have reduced the rate of common respiratory infections globally. • Previous studies have presented a decreased or unchanged incidence of urinary tract infections during the COVID-19 pandemic. WHAT IS NEW • During the pandemic, there was a decrease in the incidence of urinary tract infections in Finnish children and the most prominent decrease was in daycare-aged children. • Improved hygiene measures and social restrictions may have influenced the transmission of uropathogens.
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Affiliation(s)
- Ilari Kuitunen
- Institute of Clinical Medicine, Department of Pediatrics, University of Eastern Finland, Kuopio, Finland. .,Department of Pediatrics, Mikkeli Central Hospital, Porrassalmenkatu 35-37, 50100, Mikkeli, Finland.
| | - Miia Artama
- grid.502801.e0000 0001 2314 6254Faculty of Social Sciences, Department of Epidemiology, Tampere University, Tampere, Finland ,grid.14758.3f0000 0001 1013 0499Finnish Institute of Health and Welfare, Tampere, Finland
| | - Marjut Haapanen
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine, Department of Pediatrics, University of Eastern Finland, Kuopio, Finland
| | - Marjo Renko
- grid.9668.10000 0001 0726 2490Institute of Clinical Medicine, Department of Pediatrics, University of Eastern Finland, Kuopio, Finland ,grid.410705.70000 0004 0628 207XDepartment of Pediatrics, Kuopio University Hospital, Kuopio, Finland ,grid.10858.340000 0001 0941 4873PEDEGO Research Unit, University of Oulu, Oulu, Finland
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12
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Breinig S, Mortamet G, Brossier D, Amadieu R, Claudet I, Javouhey E, Angoulvant F, Arnaud C. Impact of the French National Lockdown on Admissions to 14 Pediatric Intensive Care Units During the 2020 COVID-19 Pandemic-A Retrospective Multicenter Study. Front Pediatr 2021; 9:764583. [PMID: 34956977 PMCID: PMC8709570 DOI: 10.3389/fped.2021.764583] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 11/17/2021] [Indexed: 01/18/2023] Open
Abstract
Background: After the COVID-19 pandemic reached France in January 2020, a national lockdown including school closures was officially imposed from March 17, 2020, to May 10, 2020. Pediatric intensive care units (PICUs) admit critically ill infants, children and teenagers with severe acute conditions, in particular infectious and traumatic diseases. We hypothesized that PICU admissions would be considerably modified by the lockdown. Aims: The objectives of the study were to describe the type of admissions to French PICUs and to compare the occupation of PICU beds according to local epidemic conditions during the French national lockdown period, compared with the same period the previous year. Methods: We conducted a retrospective multicenter study in 14 French PICUs. All children aged from 7 days to 18 years admitted to one of the 14 participating PICUs over two 3-month period (March 1, 2020, to May 31, 2020 and March 1, 2019, to May 31, 2019) were included. Analysis was based on data extracted from the medicalized information systems program (a national database used in all French hospitals, into which all admissions and their diagnoses are coded for the purpose of calculating hospital funding). Each main diagnosis was reclassified in 13 categories, corresponding to normal PICU admissions. Results: We analyzed a total of 3,040 admissions, 1,323 during the 2020 study period and 1,717 during the same period in 2019. Total admissions decreased by 23% [incidence rate ratio (IRR) 0.77, 95% CI 0.71-0.83, p < 0.001], in particular for viral respiratory infections (-36%, IRR 0.64, 95% CI 0.44-0.94, p = 0.001). Admissions for almost all other diagnostic categories decreased, except intoxications and diabetes which increased, while admissions for cardiac and hemodynamic disorders were stable. Patient age and the sex ratio did not differ between the two periods. Median length of stay in the PICU was longer in 2020 [4 (IQR 2-9) vs. 3 (IQR 1-8) days, p = 0.002] in 2019. Mortality remained stable. Conclusions: In this large national study, we showed a decrease in the number of PICU admissions. The most severe patients were still admitted to intensive care and overall mortality remained stable.
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Affiliation(s)
- Sophie Breinig
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital, Toulouse, France
- Center for Epidemiology and Research in Population Health (CERPOP), UMR1295, Toulouse University, INSERM, Toulouse, France
| | - Guillaume Mortamet
- Pediatric Intensive Care Unit, Grenoble-Alpes University Hospital, Grenoble, France
| | - David Brossier
- Pediatric Intensive Care Unit, CHU de Caen, Caen, France
- Université Caen Normandie, School of Medicine, Caen, France
- Université Caen Normandie, GREYC, Caen, France
| | - Romain Amadieu
- Neonatal and Pediatric Intensive Care Unit, Children's Hospital, Toulouse, France
| | - Isabelle Claudet
- Pediatric Emergency Department, Children's Hospital, Toulouse, France
| | - Etienne Javouhey
- Pediatric Intensive Care Unit, Hospices Civils de Lyon, Bron, France
| | - François Angoulvant
- Assistance Publique-Hôpitaux de Paris, Department of General Pediatrics, Pediatric Infectious Disease and Internal Medicine, Robert Debré University Hospital, Université de Paris, Paris, France
- INSERM, Centre de Recherche des Cordeliers, UMRS 1138, Sorbonne Université, Université de Paris, Paris, France
| | - Catherine Arnaud
- Center for Epidemiology and Research in Population Health (CERPOP), UMR1295, Toulouse University, INSERM, Toulouse, France
- Clinical Epidemiology Unit, University Hospital Toulouse, Toulouse, France
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13
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Haapanen M, Renko M, Artama M, Manninen I, Mattila VM, Uimonen M, Ponkilainen V, Kuitunen I. Tympanostomies and tonsillar surgery in children during the COVID-19 pandemic in Finland. Laryngoscope Investig Otolaryngol 2021; 6:878-884. [PMID: 34401516 PMCID: PMC8356882 DOI: 10.1002/lio2.622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/31/2021] [Accepted: 07/03/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To assess the impact of social restrictions due to COVID-19 on the number of tympanostomies and tonsillar surgeries in children. METHODS Incidences were calculated per 100 000 children for tonsillar surgery and tympanostomies in 2020 and compared to the mean incidence of referral years 2017 to 2019 by incidence rate ratios (IRR) with 95% confidence intervals (CIs). Median waiting times were also compared. RESULTS Before the lockdown, tonsillar surgery incidence was 33.4/100000 (IRR 1.14, CI 0.76-1.71) in February 2020. After the lockdown began, the incidence of tonsillar surgery was 1.4/100000 (IRR 0.04, CI 0.01-0.15) in April. In June, tonsillar operation incidence started to increase (20.4 per 100 000). The incidence of tympanostomies was 81% lower (IRR 0.19, CI 0.09-0.39) in April 2020 and 61% lower (IRR 0.39, CI 0.22-0.69) in August 2020 than in 2017-2019. These incidence rates remained lower all year (December 2020 IRR 0.13, CI 0.05-0.33). Median waiting time for tonsillar surgery was 3.3 months in 2020 and 1.6 months in 2017 to 2019; P <.001, and for tympanostomies 1.3 months in 2020 and 1.0 months in 2017 to 2019, P <.001. The referral rate to otorhinolaryngology during the severest restrictions was 35% lower in April and May 2020 compared with the reference years. CONCLUSION This study suggests that the restrictions against COVID-19 reduced the incidence rates of tonsil surgery and tympanostomies in children. Also, the lockdown and cancellations of elective operations in spring 2020 led to increased waiting times. These findings may help in preparing for future pandemics.Level of evidence: Level 3.
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Affiliation(s)
- Marjut Haapanen
- School of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Marjo Renko
- School of MedicineUniversity of Eastern FinlandKuopioFinland
- Department of PediatricsKuopio University HospitalKuopioFinland
- PEDEGO Research UnitUniversity of OuluOuluFinland
| | - Miia Artama
- Faculty of Social SciencesTampere UniversityTampereFinland
- Finnish Institute of Health and WelfareTampereFinland
| | | | - Ville M. Mattila
- Department of Orthopaedics and TraumatologyTampere University HospitalTampereFinland
- Faculty of Medicine and Health TechnologiesTampere UniversityTampereFinland
| | - Mikko Uimonen
- Department of SurgeryCentral Finland Hospital NovaJyväskyläFinland
| | | | - Ilari Kuitunen
- School of MedicineUniversity of Eastern FinlandKuopioFinland
- Department of PediatricsMikkeli Central HospitalMikkeliFinland
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14
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Aldè M, Di Berardino F, Marchisio P, Cantarella G, Ambrosetti U, Consonni D, Zanetti D. Effects of COVID-19 Lockdown on Otitis Media With Effusion in Children: Future Therapeutic Implications. Otolaryngol Head Neck Surg 2021; 165:710-715. [PMID: 33494659 PMCID: PMC7841252 DOI: 10.1177/0194599820987458] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objective To evaluate the role of social isolation during the lockdown due to the
SARS-CoV-2 outbreak (severe acute respiratory syndrome coronavirus 2) in
modifying the prevalence of otitis media with effusion (OME) and the natural
history of chronic OME. Study Design Retrospective study. Setting Tertiary level referral audiologic center. Methods We assessed the prevalence of OME among children aged 6 months to 12 years
who attended the outpatient clinic for hearing or vestibular disorders
during 2 periods before the lockdown, May-June 2019 (n = 350) and
January-February 2020 (n = 366), and the period immediately after the
lockdown, May-June 2020 (n = 216). We also compared the disease resolution
rates between a subgroup of children with chronic OME (n = 30) who were
diagnosed in summer 2019 and reevaluated in May-June 2020 and a similar
subgroup (n = 29) assessed in 2018-2019. Results The prevalence of OME in this clinic population was 40.6% in May-June 2019,
52.2% in January-February 2020, and 2.3% in May-June 2020. Children with
chronic OME had a higher rate of disease resolution in May-June 2020 (93.3%)
than those examined in May-June 2019 (20.7%, P <
.001). Conclusion Closure of schools and the physical distancing rules were correlated with a
reduction in the prevalence of OME and favored the resolution of its chronic
forms among children who attended the outpatient clinic. These data could
suggest that in the presence of chronic OME, keeping young children out of
group care settings for a period might be beneficial to allow for OME
resolution.
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Affiliation(s)
- Mirko Aldè
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Di Berardino
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paola Marchisio
- Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giovanna Cantarella
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Otolaryngology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Ital
| | - Umberto Ambrosetti
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.,Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Diego Zanetti
- Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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