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1.
BMC Pediatr ; 21(1): 470, 2021 10 25.
Article in English | MEDLINE | ID: covidwho-1484305

ABSTRACT

BACKGROUND: COVID-19 is a disease of varying presentation and neurological sequelae of the disease are being studied. Following a cluster of paediatric facial nerve palsy (FNP) cases in an area of South Wales with a high prevalence of COVID-19, we conducted an opportunistic study to determine whether there has been an increase of incidence of FNP and if there is an association between the FNP and COVID-19 in children. METHODS: We performed a retrospective review of the incidence of FNP between 2015 and 2020 across two hospitals within the health board. The incidence was compared with that in 2020 including a cluster of six children in 14 weeks, presenting to Royal Glamorgan Hospital between June and October. RESULTS: There were 48 cases of children with FNP across both hospital within the study years. Seven (7) cases in 2020. The incidence was not statistically different in comparison to other years. Five out of six of these children in 2020 had antibody testing for COVID-19. All serology testing (100%) returned negative for SARS-CoV- 2 antibodies. CONCLUSIONS: In high prevalence area for COVID-19, cases of children with FNP have not shown a commensurate increase. we have found no causal link between COVID-19 and FNP in children. While this is a small study, larger cohort studies are needed to support this finding. As new strains of COVID-19 are being reported in UK, South Africa and Brazil, physicians need to continue to be vigilant for consistent pattern of signs and symptoms, especially in children.


Subject(s)
COVID-19 , Facial Paralysis , COVID-19 Testing , Child , Facial Nerve , Facial Paralysis/epidemiology , Facial Paralysis/etiology , Humans , Prevalence , Retrospective Studies , SARS-CoV-2
2.
J Laryngol Otol ; 135(10): 848-854, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1454702

ABSTRACT

OBJECTIVE: The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. METHOD: A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. RESULTS: A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. CONCLUSION: Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.


Subject(s)
Dissection/adverse effects , Facial Nerve/surgery , Hemostasis, Surgical/instrumentation , Parotid Gland/surgery , Blood Loss, Surgical/statistics & numerical data , Drainage/trends , Electrocoagulation/adverse effects , Facial Paralysis/epidemiology , Female , Humans , Length of Stay/statistics & numerical data , Male , Meta-Analysis as Topic , Middle Aged , Operative Time , Outcome Assessment, Health Care , Postoperative Period , Surgical Instruments/adverse effects
4.
Am J Otolaryngol ; 42(5): 103129, 2021.
Article in English | MEDLINE | ID: covidwho-1293531

ABSTRACT

OBJECTIVES: The symptoms of COVID-19 at the time of presentation mainly include fever, cough, respiratory distress and myalgia. On the other hand, as neurological symptoms, disruption of taste and smell and cerebrovascular pathologies are well-known, whereas other neurological symptoms and signs are being newly recognized. Sudden-onset sensorineural hearing loss (SSNHL) and idiopathic acute facial paralysis (Bell's palsy) are otologic emergencies that are frequently encountered by otorhinolaryngology specialists. Although there are many articles describing SSNHL and Bell's palsy in the literature, the literature describing their relationship to COVID-19 is limited. In our study, we aimed to present the neuro-otologic relationship of SSNHL and Bell's palsy with COVID-19. MATERIAL AND METHODS: The pretreatment real-time oronasopharyngeal PCR tests, COVID-19 symptomatology and COVID-19 infection statuses of patients who presented to our clinic with isolated SSNHL and Bell's palsy between April 2020 and April 2021 were questioned, and the data of the patients were collected. Throughout their treatment, the patients were followed-up in terms of COVID-19 infection. This is a prospective study. Moreover, to observe the change in the incidence, the data of patients visiting between January 2019 and January 2020 were also collected. The data of the patients were statistically analyzed using SPSS. RESULTS: The study included a total of 177 patients. The SSNHL group consisted of 91 patients, and the Bell's palsy group consisted of 86 patients. Neither group showed a statistically significant difference in comparison to the year without the pandemic in terms of the patient numbers (incidence), sex, age, morbidity, response to treatment or social habits. There was a statistically significant difference in age only in the Bell's palsy group, but this difference was not medically significant. CONCLUSION: As a result of our study, we did not observe a relationship between COVID-19 and cases of SSNHL and Bell's palsy. It is recommended to apply standard otologic treatment to isolated SSNHL and Bell's palsy patients whose association with COVID-19 is not determined.


Subject(s)
Bell Palsy/epidemiology , COVID-19/complications , Facial Paralysis/epidemiology , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sudden/epidemiology , Adult , Aged , Bell Palsy/diagnosis , Bell Palsy/virology , COVID-19/diagnosis , COVID-19/epidemiology , Facial Paralysis/diagnosis , Facial Paralysis/virology , Female , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/virology , Hearing Loss, Sudden/diagnosis , Hearing Loss, Sudden/virology , Humans , Incidence , Male , Middle Aged , Prospective Studies , Symptom Assessment , Turkey
5.
Fam Pract ; 39(1): 80-84, 2022 01 19.
Article in English | MEDLINE | ID: covidwho-1286563

ABSTRACT

BACKGROUND: Vaccinations are a cornerstone of preventative medicine in the USA. However, growing concerns regarding facial nerve palsy following vaccination exist. OBJECTIVE: This study aims to assess the occurrence of facial palsy as reported by the Vaccine Adverse Event Reporting System (VAERS) database. METHODS: A retrospective analysis of the VAERS database was performed for cases of 'Facial Palsy', 'Bell's Palsy', 'Facial Paralysis' and 'Ramsay Hunt Syndrome' between 2009 and 2018. Subgroup analysis was performed to determine gender, age, history of facial palsy, type of vaccine used, number of days until onset of symptoms and overall facial palsy rate. RESULTS: Nine hundred and forty-four entries met our inclusion criteria with 961 vaccine administrations resulting in facial paralysis. Facial palsy following vaccinations was evenly distributed across all age cohorts with two peaks between 60 and 74 years old and between 0 and 14 years old. Most patients were female (N = 526, 55.7%) without a reported history of facial palsy (N = 923, 97.8%). In 2009, reported incidence rate was 0.53%, as compared with 0.23% in 2018. The influenza vaccine had the greatest number of cases (N = 166, 17.3%), followed by the varicella (N = 87, 9.1%) and human papillomavirus vaccines (N = 47, 4.9%). CONCLUSIONS: With the SARS-CoV-2 pandemic and recent approvals of the vaccinations, there is growing concern of facial palsy following vaccination. Although it is a known adverse event following vaccination, the likelihood of facial palsy following vaccination is low, with only 0.26% of overall reported cases over a 10-year span.


Subject(s)
Bell Palsy , COVID-19 , Facial Paralysis , Influenza Vaccines , Bell Palsy/epidemiology , Bell Palsy/etiology , Child, Preschool , Facial Paralysis/epidemiology , Facial Paralysis/etiology , Female , Humans , Retrospective Studies , SARS-CoV-2 , Vaccination/adverse effects
6.
Am J Otolaryngol ; 42(5): 103032, 2021.
Article in English | MEDLINE | ID: covidwho-1171724

ABSTRACT

PURPOSE: Publications about increased number of peripheral facial paralysis in the COVID-19 pandemic emerged in the literature. However, these studies comprised of an estimate rather than a broad analysis of exact numbers. In this study, we planned to investigate whether the pandemic really resulted in an increase in facial paralysis cases admitted to the hospital by evaluating the cases who applied to our hospital due to facial paralysis in the COVID-19 pandemic year and in the previous 4 years. MATERIALS AND METHODS: Patients who applied to our hospital due to facial paralysis between March 2016-February 2017 (Group 1), between March 2017-February 2018 (Group 2), between March 2018-February 2019 (Group 3), between March 2019-February 2020 (Group 4), and between March 2020-February 2021 (Group 5) were investigated and detailed data were noted. RESULTS: 156, 164, 149, 172 and 157 patients were admitted to the hospital due to peripheral facial paralysis in Group 1, 2, 3, 4, and 5, respectively. Of these patients, 155, 164, 145, 169, and 153 were Bell's palsy, respectively. SARS-CoV-2 RT-PCR test was positive in only 2 of the 153 patients who were diagnosed in the year of the pandemic. CONCLUSIONS: This study showed that the number of peripheral facial paralysis detected during the COVID-19 pandemic was similar to previous years. Very few number of positive SARS-CoV-2 RT-PCR test results may have been found incidentally in Bell's palsy patients. Theses stating that SARS-CoV-2 causes peripheral facial paralysis should be supported by laboratory studies and postmortem research.


Subject(s)
Bell Palsy/epidemiology , COVID-19/complications , Facial Paralysis/epidemiology , Bell Palsy/diagnosis , Bell Palsy/virology , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Nucleic Acid Testing , Facial Paralysis/diagnosis , Facial Paralysis/virology , Hospitalization , Humans , Incidence , Real-Time Polymerase Chain Reaction , Retrospective Studies , Turkey
8.
Brain Behav ; 11(1): e01939, 2021 01.
Article in English | MEDLINE | ID: covidwho-911627

ABSTRACT

OBJECTIVE: To compare the incidence and clinical features of individuals presenting in emergency rooms (ER) with facial palsy during the Italian COVID-19 outbreak and in the same period of 2019. METHODS: We retrospectively reviewed the medical records for all accesses to the six ER in the province of Reggio Emilia, Italy, during the first phase of the COVID-19 pandemic (27 February-3 May 2020) to identify all cases of diagnosed facial palsy. Clinical information was retrieved for each patient and compared with that of facial palsy cases presenting in 2019. RESULT: Between 27 February and 3 May 2020, 38 patients presented to provincial ERs for facial palsy; in 2019, there were 22 cases, for an incidence rate ratio of 1.73 (95% CI 1.02-2.92) for the 2020 cohort. Of the 2020 cohort, eight patients (21%) presented with active or recent symptoms consistent with COVID-19 infection, compared with 2 (9%) in 2019 (p = .299); one was tested and resulted positive for SARS-CoV-2. Moreover, patients were younger (-11 years, p = .037) than those of the previous year and manifested a longer lag (+1.1 days, p = .001) between symptoms onset and ER presentation. CONCLUSION: We observed a higher occurrence of facial palsy during the COVID-19 outbreak compared to the same period of the previous year; 21% of patients presenting with facial palsy had active or recent symptoms consistent with SARS-CoV-2 infection, suggesting an excess risk of facial palsy during or after COVID-19. These patients searched for medical attention later, probably because of the fear of contracting COVID-19 during assistance.


Subject(s)
COVID-19/epidemiology , Facial Paralysis/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Comorbidity , Female , Humans , Italy/epidemiology , Male , Middle Aged , Pandemics , Retrospective Studies , SARS-CoV-2 , Young Adult
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