Post-COVID-19 airway stenosis treated by tracheal resection and anastomosis: a bicentric experience.

Objective: The COVID-19 pandemic was an extraordinary challenge for the global healthcare system not only for the number of patients affected by pulmonary disease, but also for the incidence of long-term sequalae. In this regard, laryngo-tracheal stenosis (LTS) represents one of the most common complications of invasive ventilation. Methods: A case series of patients who underwent tracheal resection and anastomosis (TRA) for post-COVID-19 LTS was collected from June 2020 to September 2021. Results: Among 14 patients included, 50% had diabetes and 64.3% were obese. During intensive care unit stay, mean duration of orotracheal intubation (OTI) was 15.2 days and 10 patients (71.4%) underwent tracheostomy, which was maintained in 7 for an average of 31 days. According to the European Laryngological Society classification, 13 patients (92.9%) had a grade IIIa LTS and one a grade IIIa+. All patients underwent Type A TRA, according to the authors' classification. No major perioperative complications were reported and at the last follow-up all patients were asymptomatic. Conclusions: With the appropriate indications, TRA represents an effective treatment in post-COVID-19 LTS patients. Short OTI times and careful tracheostomy are required in order to reduce the incidence of airway injury.

Olfactory and Gustatory Outcomes in COVID-19: A Prospective Evaluation in Nonhospitalized Subjects.

OBJECTIVE: To prospectively assess the rate and timing of recovery of olfactory (OD) and gustatory (GD) dysfunction in patients affected by COVID-19. STUDY DESIGN: Cohort study. SETTING: Population-based evaluation in a COVID-19 high-prevalence region. SUBJECTS AND METHODS: We analyzed the clinical course of OD and GD in a cohort of home-quarantined SARS-CoV-2-positive patients from Northern Italy. Physicians administered a survey-based questionnaire at recruitment (T0). During follow-up, patients responded to online dedicated surveys modulated according to symptoms at T0. RESULTS: A total of 151 patients completed the follow-up survey. OD and/or GD were observed in 83% and 89% of subjects, respectively. Resolution rates of OD and GD at 30 days from onset were 87% and 82%, respectively. Risk factors for late resolution were grade of dysfunction at onset (total vs partial), gender, and presence of nasal congestion. Three (2%) patients previously reporting complete resolution of symptoms complained of subsequent recurrence of OD and/or GD after a mean of 19 days from resolution of the previous episode. CONCLUSION: COVID-19-related OD and GD had high rate of resolution in the first month from onset of symptoms. However, in 10% to 15% of patients, these symptoms showed only partial improvement after this period.

SARS-CoV-2 Infection in Health Care Workers: Cross-sectional Analysis of an Otolaryngology Unit.

The restart of routine in- and outpatient activity in the COVID-19 postepidemic peak needs to be carefully planned in light of specific patterns of viral diffusion. We evaluated SARS-CoV-2 serology in the entire personnel of a COVID-19-free otolaryngology department in a highly affected area. The aim was to determine the prevalence of SARS-CoV-2 positivity among staff to clarify the impact of different risk factors for infection. The entire staff of the otolaryngology unit was tested for SARS-CoV-2 serology. Symptomatic staff members were tested with nasal/pharyngeal swabs. All answered a survey focused on the number of in- and extrahospital positive contacts and type of activities in the unit. Five (9%) were positive for SARS-CoV-2 infection. The only variable associated with a higher risk of infection was the number of extrahospital contacts without personal protective equipment (P = .008). Our study shows that in non-COVID-19 departments, the use of adequate personal protective equipment leads to low rates of infection among health care workers. The prevalent risk of infection was related to extrahospital contact.

COVID-19 and Total Laryngectomy-A Report of Two Cases.

OBJECTIVE: To date, no cases have been reported on the effects of COVID-19 in laryngectomees. CASE PRESENTATION: We herein presented two clinical cases of laryngectomized patients affected by COVID-19, detailing their clinical course and complications. DISCUSSION: In our experience, permanent tracheostomy did not significantly affect the choice of treatment. However, dedicated devices and repeated tracheal toilettes may be needed to deal with oxygen-therapy-related tracheal crusting. CONCLUSION: In conclusion, laryngectomees should be considered a vulnerable population that may be at risk for worse outcomes of COVID-19 due to anatomical changes in their airways. The role of the ENT specialist is to guide airway management and inform the support-staff regarding specific needs of these patients.