Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population / 中华耳鼻咽喉头颈外科杂志

Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

Clinical analysis of vocal fold firbrous mass / 临床耳鼻咽喉头颈外科杂志

OBJECTIVES@#To explore the character of laryngoscopy finding, voice, and therapy of vocal fold fibrous mass.@*METHODS@#Clinical data, morphology, voice character, surgery and pathology of 15 cases with vocal fold fibrous mass were analyzed.@*RESULTS@#The morbidity of vocal fold fibrous mass might be related to overuse of voice and laryngopharyngeal reflex. Laryngoscopy revealed shuttle line appearance, smoothness and decreased mucosal wave of vocal fold. These patients were invalid for voice training and might be improved by surgery, but recovery is slow.@*CONCLUSIONS@#The morbidity of vocal fold fibrous mass might be related to overuse of voice and laryngopharyngeal reflex. Conservative treatment is ineffective for this disease, and surgery might improve.

Endoscopic transnasal prelacrimal recess-maxillary sinus approach for tumors in the pterygopalatine fossa / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the application of endoscopic transnasal prelacrimal recess-maxillary sinus approach in surgery for lesions in the pterygopalatine fossa.</p><p><b>METHODS</b>Five patients with tumors of pterygopalatine fossa were treated by endoscopic transnasal prelacrimal recess-maxillary sinus surgery between May 2008 and May 2011. The lesions treated included 4 schwannoma. and 1 neurofibroma. The operation began with endoscopic transnasal lateral nasal wall approach to maxillary sinus. Then after opening posterior wall of maxillary sinus, the pterygopalatine fossa was entered and the tumor was removed. The operation was performed under hypotension anaesthesia.</p><p><b>RESULTS</b>The tumors were removed totally in all 5 patients. No complication was found. After the surgery, all patients fully recovered and were discharged from the hospital in 5 to 12 days. No recurrence and death occurred during the follow up periods ranging from 5 to 28 months.</p><p><b>CONCLUSIONS</b>Endoscopic transnasal prelacrimal recess-maxillary sinus approach is safe and effective management for benign tumors in the pterygopalatine fossa. This approach reserved nasolacrimal duct and turbinate, maintained the structure and function of the nose, with decreased morbidity and shorter recovery periods.</p>

Significance of acoustic rhinometry and rhinomanometry in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To discuss the significance of acoustic rhinometry and rhinomanometry (RM) in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate, and the correlations between the subject symptoms and the object results by acoustic rhinometry and RM in patients before and after operation.</p><p><b>METHODS</b>A prospective study was conducted in forty-eight patients with nasal septal deviation and/or inferior turbinate hypertrophy. The patients were treated by submucous correction of nasal septum and/or submucous resection of inferior turbinate according to the patients' conditions. Visual analogue scale (VAS) was used to estimate the degree of nasal obstruction. Acoustic rhinometry and RM were used to obtain the data of nasal inspiratory effective resistance (IER), nasal expiratory effective resistance (EER), 0 - 5 cm nasal cavity volume (0 - 5 cm NCV), nasal minimal cross-sectional area (NMCA) and distance of the minimal cross-sectional area to the nostril (DCAN). The data were used to assess the airflow function of nasal cavity. Each patient was tested at the time both before and 4 weeks after surgery. The pre-and post operative data were used to calculate paired t-test by SPSS 17.0 and to disclose the Spearman rank correlation between VAS and IER, EER, 0 - 5 cm NCV, NMCA and DCAN individually.</p><p><b>RESULTS</b>The preoperative data showed that VAS was (3.44 ± 1.22), nasal IER was (0.66 ± 0.27) kPa×s×L(-1), nasal EER was (0.68 ± 0.29) kPa×s×L(-1), 0 - 5 cm NCV was (3.98 ± 1.30) cm(3), NMCA was (0.37 ± 0.23) cm(2) and DCAN was (2.42 ± 0.34) cm; and the postoperative data showed that VAS was (1.20 ± 0.80), nasal IER was (0.44 ± 0.21) kPa×s×L(-1), nasal EER was (0.46 ± 0.23) kPa×s×L(-1), 0 - 5 cm NCV was (4.85 ± 1.40) cm(3), NMCA was (0.53 ± 0.44) cm(2) and DCAN was (2.25 ± 0.49) cm. Significant differences existed in VAS, nasal IER, EER, 0 - 5 cm NCV, NMCA and DCAN between pre-and post operative data (t value were 9.163, 4.995, 4.508, -4.204, -2.203, 2.924, all P < 0.05). The correlation coefficient between VAS and IER, EER and 0 - 5 cm NMCA was 0.386, 0.343 and -0.307, respectively (all P < 0.05).</p><p><b>CONCLUSION</b>Both acoustic rhinometry and RM are appropriate methods to be used in the evaluation of submucous correction of nasal septum and submucous resection of inferior turbinate, however, the correlations between the subject symptoms and the object results by acoustic rhinometry and RM need further research.</p>

Peri and post-operative complications after carbon dioxide laser surgery of the larynx

To analyze the complications of transoral laser surgery [TLS] for larynx tumors in a single center institution, and to highlight its possible risks. This is a retrospective study of the peri- and post-operative complications of 500 patients who underwent TLS from November 2001 to July 2008 in the Department of Otolaryngology, Head and Neck Surgery, Anhui Provincial Hospital, Anhui Medical University, Hefei, China. The total rate of complications was 10.2%. The major complications accounted for 0.8%, including one ignition, one post-operative bleeding, one dyspnea, and one laryngeal web; and the minor ones were found in 47 of 500 patients [9.4%], including 30 patients with suspension laryngoscopy related complications. A higher incidence of complications was observed in patients with larynx carcinoma than those with benign/precancerous lesions [p=0.00]. Peri- and post-operative complications after TLS for benign larynx tumors are relatively rare events, but are relatively frequent for larynx cancers. Every surgeon who performs laser surgery should have a clear concept of management for these complications, and strategies to avoid these complications should be performed

Prevention of anterior glottic stenosis after CO2 laser cordectomy with chitosan / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To observe the effect of immediate topical application of chitosan on preventing anterior glottic stenosis (AGS) after microsurgical resection of both vocal fold with CO2 laser, including the anterior commissure, in a canine model.</p><p><b>METHODS</b>Sixteen canine larynges were injured by microresecting procedure of both vocal folds with CO2 laser. The dogs were randomly divided into two groups, chitosan group and control group. The chitosan and isotonic sodium chloride solution (control) were used for 5 minutes immediately after surgery. One week after the initial surgery, three dogs in each group were randomly selected , ultrastructure of fibroblast were examined with transmission electronic microscope and expression of basic fibroblast growth factor (bFGF) and transforming growth factor beta1 (TGF-beta1) were evaluated by enzyme-linked immunosorbent assay (ELISA). Three weeks after surgery, the rest dogs' glottic web were lysed and repeatedly treated with chitosan and isotonic sodium chloride solution respectively. The glottic wound healing and AGS formation were examined every week, and all larynges were harvested and examined histologically six weeks after the initial surgery.</p><p><b>RESULTS</b>Transmission electronic microscope examination of the ultrastructure of fibroblast indicated that chitosan inhibited the proliferation of fibroblast. Chitosan increased the expression of bFGF and TGF-beta1, and bFGF and TGF-beta1 in chitosan group, which was significantly higher than that in control group (z=-2.887 and -2.005, P=0.002 and 0.041). Chitosan decreased the extent of AGS formation. Three weeks after the surgery, the AGS lesion in the control group affected mean 49% of the length of the vocal folds from the anterior commissure to the vocal process, while chitosan group affected mean 7%, which was significantly less than the extent of web formation in the control group, (z=-2.619, P=0.008). The grade of collagen content in chitosan group was significantly lower than that in control group (P=0.003).</p><p><b>CONCLUSION</b>Chitosan is effective in preventing AGS after CO2 laser cordectomy.</p>

Transoral endoscopic CO2 laser surgery for hypopharynx in experimental animals / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the substantial resection limits of CO2 laser surgery for hypopharynx and the course of wound healing in animals, for the purpose of evaluating the clinic usefulness of transoral CO2 laser surgery in the treatment of selected hypopharyngeal carcinomas.</p><p><b>METHODS</b>Twenty-three dogs were randomly assigned to two groups. Group one (11 dogs) received left piriform sinus resection, group two (12 dogs) received the resection of posterior wall of the hypopharynx. Six dogs in group one were killed immediately or 4, 8, 12, 16, 20 d post-operatively. Seven dogs in group two were killed immediately or 7, 14, 21, 28, 35, 42 d post-operatively. The whole larynx and hypopharynx were taken out and the specimens were examined by naked eyes and under microscope. The other 5 dogs in each group were fed until the wound healed, the duration were observed.</p><p><b>RESULTS</b>All the operations were successful and the results were satisfactory. In group one, the dogs could take food the day after operation; two dogs had slight cough during eating and recovered after five days. In group two, the dogs could take food the next day after operation, eight dogs had slight cough during eating and recovered after ten days. The excision dimension was satisfactory. In group one (resection of the lateral wall of piriform sinus), the size of raw surface was (7.5 +/- 0.8) cm2 (x +/- s) and the healing time was (18.4 +/- 1.5) d. In group two (resection of the posterior wall of the hypopharynx), the wound surface was (7.0 +/- 0.5) cm2 and the healing time was (39.8 +/- 1.9) d. The healing time in group two was significantly longer than that in group one (t = 19.535, P <0. 01). The post-operative healing process were observed, including cellulose membrane coverage, granulation filling and epithelization.</p><p><b>CONCLUSIONS</b>Transoral CO2 laser was suitable for partial hypopharynx resection. Animals can recuperate well with little complications. Although the course of wound healing was delayed, wound surface can recover with good laryngeal and deglutition functions.</p>