Diagnostic and surgical innovations in otolaryngology for adult and paediatric patients during the COVID-19 era Innovazioni diagnostiche e chirurgiche in otorinolaringoiatria per i pazienti adulti e pediatrici durante l’era COVID-19

SUMMARY During the Coronavirus Disease 2019 (COVID-19) pandemic, otolaryngology has been shown to be a high-risk specialty due to the exposure to aerosol-generating physical examinations, procedures and surgical interventions on the head and neck area, both in adult and paediatric patients. This has prompted the issue of updating the guidelines by International Health Authorities in the Ear Nose and Throat (ENT) field and, at the same time, has stimulated engineers and healthcare professionals to develop new devices and technologies with the aim of reducing the risk of contamination for physicians, nurses and patients. Methods A review of the literature published on PubMed, Ovid/Medline and Scopus databases was performed from January 01, 2020 to December 31, 2021. Results 73 articles were eligible to be included, which were subdivided into 4 categories: (“Artificial Intelligence (AI)”;“Personal Protective Equipment (PPE)”;“Diagnostic tools”;“Surgical tools”). Conclusions All of the innovations that have been developed during the COVID-19 pandemic have laid the foundation for a radical technological change of society, not only in medicine but also from a social, political and economical points of view that will leave its mark in the coming decades.

Diagnostic and surgical innovations in otolaryngology for adult and paediatric patients during the COVID-19 era.

During the Coronavirus Disease 2019 (COVID-19) pandemic, otolaryngology has been shown to be a high-risk specialty due to the exposure to aerosol-generating physical examinations, procedures and surgical interventions on the head and neck area, both in adult and paediatric patients. This has prompted the issue of updating the guidelines by International Health Authorities in the Ear Nose and Throat (ENT) field and, at the same time, has stimulated engineers and healthcare professionals to develop new devices and technologies with the aim of reducing the risk of contamination for physicians, nurses and patients. Methods: A review of the literature published on PubMed, Ovid/Medline and Scopus databases was performed from January 01, 2020 to December 31, 2021. Results: 73 articles were eligible to be included, which were subdivided into 4 categories: ("Artificial Intelligence (AI)"; "Personal Protective Equipment (PPE)"; "Diagnostic tools"; "Surgical tools"). Conclusions: All of the innovations that have been developed during the COVID-19 pandemic have laid the foundation for a radical technological change of society, not only in medicine but also from a social, political and economical points of view that will leave its mark in the coming decades.

Voice Differences When Wearing and Not Wearing a Surgical Mask.

OBJECTIVE: The purpose of our study was to investigate the impact of surgical mask on some vocal parameters such as F0, vocal intensity, jitter, shimmer and harmonics-to-noise ratio in order to understand how surgical mask can affect voice and verbal communication in adults. METHODS: The study was carried out on a selected group of 60 healthy subjects. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. Voice samples were recorded directly in Praat. RESULTS: There were no statistically significant differences in any acoustic parameter between the masked and unmasked condition. There was a non-significant decrease in vocal intensity in 65% of the subjects while wearing a surgical mask. CONCLUSIONS: The statistical comparison carried out between all the acoustic voice parameters observed, extracted wearing and not wearing a surgical mask did not reveal any significant statistical difference. Most of the subjects, after wearing the surgical mask, presented a decrease in vocal intensity measured. Our conclusion was that wearing a mask is likely to induce the unconscious need to increase the vocal effort, resulting over time in a greater risk of developing functional dysphonia. The reduction of intensity can affect also social interaction and speech audibility, especially for individuals with hearing loss.

Acoustic voice analysis in the COVID-19 era.

OBJECTIVE: Among the different procedures used by the ENT, acoustic analysis of voice has become widely used for correct diagnosis of dysphonia. The instrumental measurements of acoustic parameters were limited during the COVID-19 pandemic by the common belief that a face mask affects the results of the analysis. The purpose of our study was to investigate the impact of surgical masks on F0, jitter, shimmer and harmonics-to-noise ratio (HNR) in adults. METHODS: The study was carried out on a selected group of 50 healthy subjects. Voice samples were recorded directly in Praat. All subjects were trained to voice a vocal sample of a sustained /a/, at a conversational voice intensity, with no intensity or frequency variation, for the Maximum Phonation Time (MPT), wearing the surgical mask and then without wearing the surgical mask. RESULTS: None of the variations in acoustic voice analysis detected wearing a surgical mask and not wearing a surgical mask were statistically significant. CONCLUSIONS: Our study demonstrates that the acoustic voice analysis procedure can continue to be performed with the use of a surgical mask for the patient, even during the COVID-19 pandemic.