A retrospective cohort study of telephone versus face-to-face clinics for the management of new otology referrals.

PURPOSE: To compare outcomes of telephone and face-to-face consultations for new otology referrals and discuss the wider use of telemedicine in otology. METHODS: Retrospective cohort study including new adult otology referrals to our unit, sampled consecutively between March 2021 and May 2021, seen in either a face-to-face or telephone clinic. Primary outcome measure was the proportion of patients with a definitive management outcome (discharged or added to waiting list for treatment) versus the proportion of patients requiring follow-up for further assessment or review. RESULTS: 150 new patients referred for a routine otology consultation (75 telephone, 75 face-to-face) were included. 53/75 patients (71%) undergoing a face-to-face consultation received a definitive outcome following initial review, versus 22/75 (29%) telephone patients (χ2 < 0.001, OR 5.8). 52/75 (69%) telephone patients were followed up face-to-face for examination. The mean (SD) number of appointments required to reach a definitive outcome was 1.22 (0.58) and 1.75 (0.73) in the face-to-face and telephone cohorts, respectively (p < 0.001). CONCLUSIONS: Telephone clinics in otology have played an important role as part of the COVID19 response. However, they are currently limited by a lack of clinical examination and audiometry. Remote assessment pathways in otology that incorporate asynchronous review of recorded examinations alongside audiometry, either conventional or boothless, may mitigate this problem; however, further research is required.

COVID-19 and tinnitus: an initiative to improve tinnitus care.

OBJECTIVE: To investigate the effects of COVID-19 on individuals with tinnitus and their views to guide future tinnitus care. DESIGN: A mixed-methods cross-sectional research design. STUDY SAMPLE: An online survey was completed by 365 individuals with tinnitus from Australia and other countries. RESULTS: Tinnitus was reported to be more bothersome during the pandemic by 36% of respondents, whereas 59% reported no change and 5% reported less bothersome tinnitus. Nearly half of the respondents had received COVID-19 vaccination(s) and 12% of them reported more bothersome tinnitus while 2% developed tinnitus post-vaccination. Australian respondents spent less time in self-isolation or quarantine and saw fewer change in in-person social contact than respondents from other countries. More than 70% of respondents thought that tinnitus care services were insufficient both before and during the pandemic. Regarding their opinions on how to improve tinnitus care in the future, five themes including alleviation of condition, government policies, reduced barriers, self- and public-awareness, and hearing devices were identified. CONCLUSIONS: A majority of respondents did not perceive any change in tinnitus perception and one-third of respondents had worsened tinnitus during the pandemic. To improve tinnitus care, better awareness and more accessible resources and management are crucial.

"I have cancer during COVID; that's a special category": a qualitative study of head and neck cancer patient and provider experiences during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic has drastically changed cancer care delivery strategies. Patients with locally advanced head and neck cancer (LA-HNC) may be particularly affected by the COVID-19 pandemic, as they often undergo treatments that require daily clinic visits (e.g., radiation therapy). The goal of this study was to characterize the lived experience of LA-HNC patients and their healthcare providers during the COVID-19 pandemic. METHODS: LA-HNC patients who completed a full course of chemotherapy and radiation therapy during the COVID19 pandemic (N = 20) and LA-HNC healthcare providers (N = 13) participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analyzed for qualitative themes. RESULTS: The COVID-19 pandemic had a significant impact on patients' overall quality of life and health care. Results were organized in four main themes: (1) increased psychological distress; (2) exacerbated social isolation; (3) added stress in clinic for patients and providers; and (4) delays in health care. CONCLUSIONS: Findings highlight myriad ways LA-HNC patients and providers have been affected by the COVID-19 pandemic. Results can inform the development of supportive interventions to assist LA-HNC in managing COVID-19-related stress and unmet needs related to social isolation and in-clinic support.

Catastrophic bilateral sudden sensorineural hearing loss following COVID-19.

Since December 2019, when it was first detected in Wuhan, the SARS-CoV-2 (COVID-19) has spread across the globe. The pandemic has had an unprecedented impact on the global population with >110 million confirmed cases and 2.5 million deaths. The most common initial symptoms of COVID-19 infection are cough, dyspnoea, fever, malaise and anosmia. Severe clinical manifestations include respiratory compromise, pneumonia, organ failure and death. There have been many other less common symptoms as a result of COVID-19 described in the literature, including significant rates of olfactory dysfunction. However, we believe there has been only one other previously documented cases of bilateral hearing loss.Sudden sensorineural hearing loss is a relatively common presentation seen by otolaryngologists. It is defined as rapid hearing loss, ≥30 dB occurring over 3 consecutive days in three contiguous sound frequencies. The exact pathological process is yet to be fully characterised, though it is most commonly unilateral and commonly develops shortly following viral infection. Treatment typically consists of glucocorticoid steroids administered orally, via intratympanic injection or a combination of both routes though there are currently no standardised management of these patients.Bilateral sudden sensorineural hearing loss (SSNHL) is rare, accounting for <2% of all cases. We describe a case of bilateral SSNHL in a 68-year-old patient who presented with profound hearing loss shortly after symptomatic infection with COVID-19, which at the time of publication is the first such case reported in the literature.