Résumé
Abstract Introduction: The nose and throat are areas of high viral load, which could place otolaryngologists at an even higher risk for COVID-19 than other health-care workers. Objective: To investigate the prevalence of antibodies against SARS-CoV-2 in otorhinolaryngologists in southern Brazil, its relationship to demographic data, professional practice and reported symptoms of COVID-19, and compare it with official data on other health-care workers of the state and the general population in the same period. Methods: In this cross-sectional multicenter study, otolaryngologists actively practicing officially registered in Rio Grande do Sul were screened for IgM and IgG antibodies against SARS-CoV-2 from August 1 to September 15, 2020. A questionnaire was also applied. Results: We screened 358 (80.1%) of 447 actively practicing otolaryngologists (195 [54.5%] male; mean [SD] age, 47.77 [13.57] years; range, 26-84 years). Twenty-three were positive for IgM and/or IgG (6.4%). This result was significantly associated with reports of infected household contacts (19/315 negatives and 8/23 positives; p<0.001). From 23 seropositive participants, 14 were asymptomatic (60.9%; p< 0.001). There were no significant associations between seroconversion and age, sex, number of patient appointments and surgical procedures, workplace (hospital or private practice), patients with or without respiratory symptoms, or level of personal protective equipment used. The rate of COVID-19 in all health-care workers in the state was 7.69% at the end of the same period. Data from state government seroprevalence was 5.26 (risk ratio [RR]; 95% CI 3.27-8.45) and 4.66 (RR; 95% CI 2.93-7.43) times higher in otolaryngologists than in the general population in August and September, respectively. Conclusion: Otolaryngologists had a higher seroconversion rate than the general population. Using personal protective equipment, the level of occupational exposure did not result in higher rates of infection than other health-care workers, but the presence of infected household contacts was associated with higher rates of seroconversion.
Résumé
Introdução: Nas últimas décadas, a reconstrução da via aérea tornou-se o tratamento de escolha para estenose subglótica (ESG) na criança, realizada em único ou múltiplos estágios. Há indícios na literatura de que a cirurgia em um só tempo é mais efetiva. Objetivo: Avaliar o índice de sucesso da laringotraqueoplastia (LTP) e ressecção cricotraqueal (RCT) em único estágio nos pacientes tratados no nosso hospital. Método: Estudo retrospectivo de crianças submetidas à reconstrução laringotraqueal. Resultados: Foram incluídos 24 pacientes. As causas da ESG foram pós-intubação endotraqueal em 91,6% e congênita em 8,3%. Diagnosticamos ESG grau 4 em 1 paciente (4%), grau 3 em 16 (66,6%), grau 2 em 4 (16,6%), grau 3 associada com estenose glótica em 1 (4%), grau 3 associada com estenose traqueal em 1 (4%). Foram realizadas 26 LTP e 3 RCT. O índice de decanulação foi de 66% nos pacientes submetidos à RCT e de 85,7% nos pacientes submetidos à LTP; o índice total de decanulação foi de 83,3%. Todos apresentaram febre persistente no pós-operatório, que cessou após a extubação. Conclusão: Nossa série mostrou índice de decanulação de 83,3%...
Introduction: In recent decades, airway reconstruction has become the treatment of choice for subglottic stenosis (SGS) in children, which is performed in either single or multiple stages. However, there is evidence in the literature that single-stage surgery is more effective. Objective: To evaluate the success rate of single-stage laryngotracheoplasty (LTP) and cricotracheal resection (CTR) in patients that were treated in our hospital. Materials and Method: We performed a retrospective study of children undergoing laryngotracheal reconstruction. Results: Twenty-four children were included. The etiology of SGS was postintubation in 91.6% and congenital in 8.3%. One patient (4.2%) had grade 4 SGS, 17 (70.8%) presented with grade 3 SGS, 4 (16.6%) had grade 2 SGS, 1 (4.2%) had grade 3 SGS associated with glottic stenosis, and 1 (4.2%) had grade 3 SGS with tracheal stenosis. We performed 26 LTPs and 3 CTRs. Decannulation rates were 66% in the CTR procedures and 85.7% in the LTP procedures; the overall decannulation rate was 83.3%. All children presented with fever in the postoperative period, but were afebrile after the tube was removed. Conclusion: Our series showed a decannulation rate of 83.3%...