Incidence of Olfactory and Gustatory Dysfunctions in the Early Stages of COVID-19: An Objective Evaluation

Abstract Introduction Coronavirus disease 2019 (COVID-19) is a dangerous infectious disease caused by a newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has various clinical presentations. Numerable cases with non-specific olfactory and gustatory dysfunctions in COVID-19 have been reported from all over the globe. This is important as awareness will let people to self-isolate and help in limiting disease spread. Objective To objectively evaluate the frequency of olfactory and gustatory dysfunction, which may occur independently or with other symptoms, in laboratory confirmed COVID-19 patients at an early stage of the disease. Methods Objective evaluation of olfactory and gustatory function of 322 COVID-19 patients treated at our hospital, (SMGS, Government Medical College, Jammu), from August 2020 until November 2020. Results Our study population included 127 (39.4%) males and 195 (60.6%) females. Two hundred and twenty-six (70.2%) COVID-19 patients experienced olfactory and gustatory disorders. One hundred and sixty-five (51.2%) cases experienced both olfactory and gustatory disorders. Isolated olfactory dysfunction was reported in 34 (10.6%) patients, while 27 (8.4%) patients experienced only gustatory dysfunction. Conclusion The olfactory and gustatory dysfunctions, without any nasal obstruction or rhinorrhea, are significant symptoms in the clinical presentation of early COVID-19 patients. This presentation can be recognized at the earliest one, and it can reduce the high communicability of the COVID-19 disease.

Deep Neck Space Infections: A Profile of Fifty Nine Cases.

The present study was undertaken to analyse our experience with deep neck space infections and emphasize the importance of patient presentation, radiologic evaluation and early diagnosis and appropriate management. The records of 59 patients treated for deep neck space infections were evaluated. Odontogenic infections (35.59%) were found to be the most common cause of deep neck space infections followed by tonsillar infections (20.33%). Pain, fever, neck swelling and odynophgia were the most common clinical presentations. Radiological investigations were performed in all the patients (100%) while contrast enhanced CT - scan was performed in 35 patients (59.32%). The most commonly involved sites were the submandibular space and the parapharyngeal space, involving 14 patients and 11 patients respectively. All the patients (100%) were on intravenous antibiotics and fluids. Surgical intervention was done in 47 patients (79.66%) whereas 12 patients (20.33%) improved with conservative medical management alone. Despite the wide use of antibiotics, deep neck space infections are commonly seen. Early clinical and radiological diagnosis and appropriate management help to prevent the development of life threatening complications. Surgical drainage forms the mainstay of treatment, conservative medical therapy is also effective in selective cases.

Chondrosarcoma of the Maxilla-Recurrent.

An uncommon case of recurrent chondrosarcoma of the maxilla is presented. A brief discussion on the radiologic and histologic presentation of the tumor and the treatment modalities of this unusual tumor is discussed.

Sino-Nasal Hemangiopericytoma

Hemangiopericytoma is an uncommon vascular tumor derived from pericytes of Zimmermann, representing only a small portion of head and neck tumors, mostly occurring in the sino-nasal tract. A rare case of sinonasal hemangiopericytoma in a 52 year female presenting with symptoms of nasal abstruction and epistaxis and its treatment modalities are discussed in the present case report.

Foreign Body in the Wharton’s Duct

A case of unusual presentation of a vegetative foreign body in the Wharton’s duct is reported. The patient presented with history and clinical findings of recurrent left submandibular sialadenitis. Surgical excision of the submandibular gland was performed and during the ligation of the Wharton’s duct, a wooden splinter was found inside the lumen of the duct. Retrospectively, patient gave the history of ingestion of the same wooden splinter, lodging in the Wharton’s duct and subsequently causing recurrent attack of sialadenitis.

Prolonged Impacted Laryngeal Foreign Body

A unique presentation of laryngeal foreign body (meat bone) in a four year old girl is presented. She had prolonged impaction of meat bone in the larynx (22 days) and presented with sudden onset of hoarseness but was managed conservatively, outside, on the line of treatment of bronchial asthma. Foreign body was removed by direct laryngoscopy, under general anaesthesia, uneventfully. The presentation and management of airway foreign bodies are discussed in general.

A Study of Congenital and Early Acquired Impairment of Hearing

The present study included 261 patients (M:F=I.72: I) suffering from congenital and early acquired hearing loss. The aetiological breakup of the hearing loss was: genetic factors 47.5%. non-genetic factors 16.8%, congenital ear malfonnations 8.5% and cryptogenic factors in 27.2% cases. Autosomal recessive mode of inheritance was seen most commonly (62%) followed by autosomal dominant (20%) in the genetic group of hearing loss. Maternal Rubella was most common cause of prenatal group of hearing loss while perinataly birth anoxia and prematurity were common. Postnataly meningitis was most common aetiology ofhearing loss. Linkage analysis on SLINK 2 point autosomal data yielded LOD score of more than 3 in an autosomal dominant family.

Cervical Cystic Hygroma in an Adult

Cystic hygroma are benign tumors in the early childhood mainly manifesting in the head and neck region ..Cystic hygromas manifesting in elderly patients have not been reported in the literature so for. We report a rare presentation of cervical cystic hygroma in an adult male (58 yrs.), with sudden appearance and rapid progression to a relatively big size (10 cm x 12 cm) invloving superior mediastinum within a span of six months, giving a clue to malignant cystic pathology. Investigations proved the diagnosis of cystic hygroma. Transcervical excision was achieved with the help of cardiothoracic surgeons. The management of the cystic hygroma is being discussed.

Cranio-Facial Fibrous Dysplasia.

An unusual case offibrous dysplasia involving leftcranio-facial region in an adult male is reported. The clinical features, radiological findings and the treatment have been discussed.