Unilateral, permanent hearing loss following severe COVID-19 infection.

Hearing loss following COVID-19 infection has been scarcely reported in the literature.A previously well middle-aged man presented to the emergency department with breathlessness and cough 8 days after testing positive for COVID-19 in the community. The patient was treated in the intensive care unit due to respiratory failure. Following extubation and step down to ward-level care 2 months later, the patient reported sudden left-sided hearing loss and tinnitus. Ear examination was unremarkable and pure tone audiometry revealed profound left sensorineural hearing loss. MRI of the internal acoustic meatus did not show any cerebellopontine lesions. Intravenous steroid therapy as well as oral steroids were not successful in improvement of hearing.A few cases of COVID-19-associated sensorineural hearing loss have been reported; the majority report irreversible loss. Awareness of this phenomenon and early referral for specialist review and audiological assessment to attempt salvage of hearing can reduce hearing disability.

Recording and evaluating affect and coping during COVID-19 in healthcare workers and outcomes (REACCH-Out): mental health implications for our junior doctor cohort.

The announcement of the COVID-19 pandemic in March 2020 had a huge impact on surgical practice in the UK. Many surgical trainees were redeployed to areas within the hospital to provide additional cover during this time. Providing adequate well-being and support to trainees is imperative during such times of hardship.18 plastic surgery junior doctors were redeployed to either intensive care units, emergency departments or medical wards during the period of intervention. A 2-3 weekly quantitative survey was completed by trainees which aimed to explore rates of anxiety, depression and coping during the first peak of the pandemic. A 'COVID-19 Care Package' was provided and regular interactions with the parent team was encouraged via the online platform of Zoom to support surgical junior doctors.The average anxiety score for trainees exceeded that regarded as 'normal' as predicted by the Hospital Anxiety and Depression Scale. Core surgical-level trainees were found to show higher scores of anxiety and depression throughout the course of project as compared with their senior specialty registrar counterparts. 43.8% of junior doctors reported greater levels of stress since the announcement of the pandemic. 81% of junior doctors stated they would value regular check-ins with work colleagues during difficult times.Providing a strong support system for trainees is vital to ensure doctors are not overwhelmed during potentially volatile times in their careers. The use of psychological monitoring tools to guide the implementation of appropriate levels of support for individuals could aid in enhanced junior doctor well-being and support. Feedback from surveys during this time of study suggests that surgical trainees agree that contact with their parent team and colleagues has a positive impact on their well-being and trainees value regular 'check-ins' with their colleagues on a monthly basis.

Primary thyroid squamous cell carcinoma presenting as a left-sided neck lump.

The elderly patient presenting with a neck lump often raises concerns regarding a malignancy. Thyroid gland malignancies are well recognised and subtype characteristics thoroughly researched, whereas rarer types of thyroid carcinoma are reported infrequently and often behave more aggressively. An 83-year-old woman was referred from the general practitioner (GP) to otolaryngology due to a 7-month history of an unexplained enlarging left-sided neck swelling. A fine-needle aspiration revealed cytology consistent with squamous cell carcinoma (SCC). Staging imaging failed to reveal evidence of a primary foci elsewhere. The definitive diagnosis was that of a primary thyroid SCC: a rare entity with limited citations in the literature. Surgical resection has been found to comprise the optimal treatment for this disease. Recognition of the possibility of primary thyroid SCC in elderly patients presenting with a neck lump, with prompt referral to a head and neck specialist permits a timely progression to potentially curative surgical management, a more promising prognosis and reduced mortality rates.