Loss of Vision Outcome for Allergic Fungal Sinusitis: Case Report and Literature Review.

Visual loss is a rare manifestation of allergic fungal rhinosinusitis (AFRS). We report a case of an adult male who was diagnosed with AFRS and who presented during the COVID-19 pandemic lockdown with sudden-onset complete vision loss and a lack of recovery after surgical and medical management. We reviewed the literature on reported cases of AFRS complicated by visual loss to identify factors associated with visual outcomes. We found 50 patients who were diagnosed with acute visual loss due to AFRS, with an average age of 28 ± 14 years. Complete and partial recovery after surgical intervention were reported in 17 and 10 cases, respectively. However, the absence of vision improvement was reported in 14 of the cases. Early diagnosis and prompt intervention can return vision back to normal. However, delayed presentation, complete loss of vision, and acute onset of visual loss are associated with worse outcomes.

Efficacy of chlorin dioxide wipes in disinfecting airway devices contaminated with Covid-19.

Background: Reprocessing and disinfecting endoscopes is a routine practice in otolaryngology. An effective, safe, and rapid disinfection technique is essential during the COVID-19 pandemic. Objective: To validate the efficacy of chlorine dioxide wipes in disinfecting three types of airway endoscopes contaminated with COVID-19-positive patient secretions. Methods: Chlorine dioxide wipes were tested on rigid nasal endoscopes, laryngoscope blades, and flexible bronchoscopes. The endoscopes were disinfected using the wipes after exposure to COVID-19-positive patients. The tested scope was included in the study if the post procedure pre disinfection swab was positive for COVID-19 virus using RT-PCR. We analyzed 38 samples for 19 subjects (scopes) pre and post disinfection with chlorine dioxide wipes from July 2021 to February 2022. Results: A total of four rigid endoscopes, four flexible bronchoscopes, and four laryngoscopes were included in the study which represent 24 pre and post disinfection swabs. The others were excluded because of negative pre disinfection swab. All the post disinfection PCR swab results were negative. Conclusion: Chlorine dioxide is a convenient, fast, and effective disinfection technique for COVID-19-contaminated airway endoscopes.

Screening for Olfactory Dysfunction in COVID-19 Patients Using Quick Smell Identification Test.

OBJECTIVE: To determine the prevalence of OD in the confirmed case with COVID-19 among our population using quick smell identification test (Q-SIT) as screening tool. METHODS: Cross- sectional study carried out in Qatif area-Saudi Arabia among adult hospitalized patient with confirm COVID-19 during the period between May and July, 2020. All adults confirmed COVID-19 patients were interviewed for history of current disease and associated symptoms as well as performing Q-SIT. Participants who had history of olfactory dysfunction, and critical cases required ICU admission were excluded. RESULTS: The prevalence of OD among COVID-19 cases was (16.3%) in our population using Q-SIT compared to (27.4%) for self-reported symptom. Females were having higher prevalence in compare to males (30.5% and 11.1%) respectively; which was statistically significant (P < 0.001). The patients reported higher prevalence of ageusia (31.9%) with significant association with OD (P < 0.001). Q-SIT showed high positive and negative predictive value in detecting OD among patients with COVID-19 (84% and 93% respectively). CONCLUSION: Q-SIT is a useful, validated and easy to apply tool for screening OD among patients with COVID-19. Some patients presented solely with this symptom which can occurs unnoticed in COVID-19 patients, and there for required objective test for detection.

Utilization of telemedicine in rhinologic practice during COVID-19 pandemic.

BACKGROUND: The only two preventive interventions available for COVID-19 have been social distancing and quarantine. These preventive measures challenge health care providers by causing cancelations of elective in-person outpatient clinic visits in many hospitals, particularly in otolaryngology clinics. OBJECTIVES: To assess the applicability and feasibility of telemedicine in rhinology cases with a study of outcomes to guide rhinologists on indications of in-office visits. Assessment of patient satisfaction with telemedicine in the rhinology clinic was also investigated. METHODS: A retrospective review of electronic charts of all adult patients (>18 years) who were scheduled in the rhinology clinics of King Abdulaziz University Hospital, Riyadh, Saudi Arabia, and received a phone call as a part of telemedicine care from April through June 2020. Demographics (including age and gender), diagnosis, plan of treatment, and status of the visit (either new or follow-up) were collected. In addition, we used a special questionnaire to measure the satisfaction rate among patients who received telemedicine services. RESULTS: A total of 339 patients were included. The mean age was 41 years with 60.2% males. Only 5 cases (1.48%) were asked to attend to the clinic. The vast majority of cases were given a follow-up (n = 311, 91.7%). The most common diagnosis among the follow-up cases was chronic rhinosinusitis with nasal polyposis (n = 130, 38.3%). The satisfaction telephone survey had a total of 41 respondents out of 80 cases selected randomly. Most respondents (83.3%) were satisfied with telemedicine services. CONCLUSION: We conclude that telemedicine proved its effectiveness in the efficient management and screening of rhinology cases during public health emergencies while providing sufficient protection for patients and medical practitioners. Telemedicine as a modality of care during the pandemic faced minor or no opposition given patients' understanding of the importance of social distancing.