ABSTRACT
BACKGROUND: Various case reports have described sudden sensorineural hearing loss (SSNHL) in patients with the 2019 novel coronavirus disease (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our aim was to determine the incidence of COVID-19 in patients with SSNHL. METHODS: All consecutive patients with audiometric confirmed SSNHL between November 2020 and March 2021 in a Dutch large inner city teaching hospital were included. All patients were tested for COVID-19 by polymerase-chain-reaction (PCR) and awaited the results in quarantine. RESULTS: Out of 25 patients, zero (0%) tested positive for COVID-19. Two patients had previously tested positive for COVID-19: at three and eight months prior to the onset of hearing loss. CONCLUSIONS: This is the largest series to date investigating COVID-19 in SSNHL patients. In this series there is no apparent relationship between SSNHL and COVID-19.
Subject(s)
COVID-19 , Hearing Loss, Sensorineural , Hearing Loss, Sudden , Hearing Loss, Sensorineural/epidemiology , Hearing Loss, Sudden/epidemiology , Humans , SARS-CoV-2ABSTRACT
Although balloon packing appears to be efficient to control epistaxis, severe local complications can occur. We describe four patients with local lesions after balloon packing. Prolonged balloon packing can cause damage to nasal mucosa, septum and alar skin (nasal mucosa, the cartilaginous skeleton and the overlying soft-tissue envelope) and should, therefore, be avoided. We suggest early nasendoscopy in general anesthesia to identify and treat the bleeding focus, if bleeding cannot be controlled with regular packing.
Subject(s)
Epistaxis/therapy , Hemostatic Techniques , Nasal Cartilages , Nasal Mucosa , Tampons, Surgical/adverse effects , Aged, 80 and over , Female , Hemostatic Techniques/adverse effects , Hemostatic Techniques/instrumentation , Humans , Male , Middle Aged , Nasal Cartilages/injuries , Nasal Cartilages/pathology , Nasal Mucosa/injuries , Nasal Mucosa/pathology , Necrosis , Time Factors , Treatment Outcome , Wound HealingABSTRACT
Neurosarcoidosis is a rare identity and occurs in only 5% to 15% of patients with sarcoidosis. It can manifest in many different ways, and therefore, diagnosis may be complicated. We report a case presented in a very unusual manner with involvement of 3 cranial nerves; anosmia (NI), facial palsy (NVII), and hearing loss (NVIII). When cranial nerve dysfunction occurs, it is very important to take neurosarcoidosis into consideration.
Subject(s)
Central Nervous System Diseases/complications , Cranial Nerve Diseases/etiology , Facial Paralysis/etiology , Sarcoidosis/complications , Adrenal Cortex Hormones/therapeutic use , Adult , Audiometry , Central Nervous System Diseases/diagnosis , Central Nervous System Diseases/drug therapy , Cranial Nerve Diseases/diagnosis , Diagnosis, Differential , Facial Paralysis/diagnosis , Female , Hearing Loss/diagnosis , Hearing Loss/etiology , Humans , Magnetic Resonance Imaging , Olfaction Disorders/diagnosis , Olfaction Disorders/etiology , Sarcoidosis/diagnosis , Sarcoidosis/drug therapyABSTRACT
Los pacientes ancianos con neoplasias de cabeza y cuello a menudo no reciben el tratamiento adecuado. Muchos trabajos muestran que se puede realizar el tratamiento quirúrgico radical sin peligro en pacientes ancianos siempre que no existan otras enfermedades asociadas. La radioterapia es tolerada muy bien incluso por los muy ancianos. Los datos sobre quimioterapia combinada en esta población son muy escasos. La comorbilidad grave influye en la tasa de complicaciones posoperatoria y puede limitar la tolerancia a la quimioterapia. Una evaluación minuciosa del estado de salud del paciente previa al tratamiento y la optimización de su estado clínico son fundamentales en los ancianos. Sin embargo, en un análisis multivariado se demostró que incluso después de corregir la comorbilidad y otros factores, se mantenía el efecto de la edad sobre la elección del tratamiento. Las opiniones personales de los cirujanos de cabeza y cuello, los pacientes y sus familiares acerca de la tolerancia al tratamiento y la calidad de vida posterior pueden influir en la elección de la terapia. No obstante, el estudio de calidad de vida mostró que el impacto del tratamiento sobre la calidad de vida no difería entre los pacientes más jóvenes y más ancianos con cáncer de cabeza y cuello. Las presunciones erróneas de que "los ancianos son menos capaces de afrontar un tratamiento mayor" no deben jugar un papel en la elección terapéutica: Siempre se debe considerar el tratamiento estándar si no existen contraindicaciones graves.
Subject(s)
Aged , Quality of Life , Comorbidity , Postoperative Complications , Head and Neck Neoplasms , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapyABSTRACT
Los pacientes ancianos con neoplasias de cabeza y cuello a menudo no reciben el tratamiento adecuado. Muchos trabajos muestran que se puede realizar el tratamiento quirúrgico radical sin peligro en pacientes ancianos siempre que no existan otras enfermedades asociadas. La radioterapia es tolerada muy bien incluso por los muy ancianos. Los datos sobre quimioterapia combinada en esta población son muy escasos. La comorbilidad grave influye en la tasa de complicaciones posoperatoria y puede limitar la tolerancia a la quimioterapia. Una evaluación minuciosa del estado de salud del paciente previa al tratamiento y la optimización de su estado clínico son fundamentales en los ancianos. Sin embargo, en un análisis multivariado se demostró que incluso después de corregir la comorbilidad y otros factores, se mantenía el efecto de la edad sobre la elección del tratamiento. Las opiniones personales de los cirujanos de cabeza y cuello, los pacientes y sus familiares acerca de la tolerancia al tratamiento y la calidad de vida posterior pueden influir en la elección de la terapia. No obstante, el estudio de calidad de vida mostró que el impacto del tratamiento sobre la calidad de vida no difería entre los pacientes más jóvenes y más ancianos con cáncer de cabeza y cuello. Las presunciones erróneas de que "los ancianos son menos capaces de afrontar un tratamiento mayor" no deben jugar un papel en la elección terapéutica: Siempre se debe considerar el tratamiento estándar si no existen contraindicaciones graves.(AU)
Subject(s)
Aged , Head and Neck Neoplasms , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/surgery , Comorbidity , Postoperative Complications , Quality of LifeABSTRACT
Little is known about long-term treatment outcome of elderly head and neck cancer patients and their quality of life (QOL). One hundred and eighteen older (>or=70 years) and 148 younger (45-60 years) patients with head and neck cancer were followed up for 3-6 years. In the long-term follow-up 33 younger and 24 older patients completed the EORTC QLQ-C30 and H&N35 and a questionnaire about depression. The survival rate after 3-6 years for younger patients was 36%, as compared to 31% in the older patient group. Higher tumour stages, more co-morbidity and non-standard treatment showed to be independent prognostic factors for mortality. No independent prognostic value of age could be found. The global QOL score remains roughly comparable. Even up to 6 years after treatment, we found no significant differences in survival or overall QOL between older and younger head and neck cancer patients.
Subject(s)
Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/psychology , Quality of Life/psychology , Age Factors , Aged , Female , Follow-Up Studies , Health Status , Humans , Male , Middle Aged , Neoplasm Staging , Prospective Studies , Surveys and Questionnaires , Survival Rate , Time FactorsABSTRACT
PURPOSE OF REVIEW: Comorbidity may be an important reason for head and neck surgeons to treat elderly patients less intensively. This article provides an overview of the influence of age and comorbidity on choice of therapy, postoperative complications, and survival. RECENT FINDINGS: Several retrospective studies show that elderly patients can undergo surgery if they do not have severe comorbid disorders. Severe comorbidity influences the rate of postoperative complications, and the higher complication rate in older patients reported in some studies is probably due to a higher level of comorbidity. Comorbidity also affects the survival of cancer patients, but several studies have failed to detect a relation between age and survival after correction for comorbidity. Thus, although severe comorbidity may influence the choice of treatment, patient age as such should not be a reason to exclude patients from intensive therapy. SUMMARY: If severe comorbidity is not present, elderly patients should receive standard treatment for head and neck cancer. Treatment choice should be based on medical findings and patient preference, not on chronologic age.
Subject(s)
Head and Neck Neoplasms/epidemiology , Age Factors , Aged , Comorbidity , Decision Making , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/therapy , Humans , Prognosis , Treatment OutcomeABSTRACT
BACKGROUND: Little is known about quality of life (QOL) in elderly patients. METHODS: Seventy-eight older (> or =70 years) and 105 younger patients (45-60 years) with carcinoma of the oral cavity, pharynx (stage > or =II), or larynx (stage > or =III) completed the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and EORTC Head and Neck Cancer Quality of Life Questionnaire before treatment. Fifty-one older and 70 younger patients completed all follow-up questionnaires at 3, 6, and 12 months. RESULTS: Before and after treatment, the physical functioning of the older patients was worse than that of younger patients. This difference remained relatively constant during follow-up and is probably related to normal aging. At baseline and 3 months, no other differences were found between both groups. At 6 months, younger patients reported more pain, but at 12 months no relevant differences were found. CONCLUSIONS: Treatment did not affect QOL differently in older and younger patients. Therefore, standard treatment should always be considered, irrespective of the patient's age.
Subject(s)
Carcinoma, Squamous Cell/psychology , Head and Neck Neoplasms/psychology , Quality of Life , Adaptation, Physiological , Adaptation, Psychological , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Cohort Studies , Combined Modality Therapy , Female , Follow-Up Studies , Geriatric Assessment , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/therapy , Humans , Male , Middle Aged , Neoplasm Staging , Probability , Retrospective Studies , Sickness Impact Profile , Surveys and Questionnaires , Time FactorsABSTRACT
OBJECTIVE: Elderly patients with head and neck cancer often receive non-standard treatment for reasons other than comorbidity. In this prospective study we investigated how elderly patients fare 1 year after treatment in comparison with their younger counterparts. MATERIAL AND METHODS: Seventy patients aged 45-60 years and 51 patients aged > or = 70 years with cancer of the oral cavity, pharynx (stage II-IV) or larynx (stage III-IV) participated in the study before treatment and 1 year later. Each patient was interviewed and given a questionnaire concerning physical functioning, social contacts, depressive symptoms, satisfaction with treatment and future expectations. RESULTS: At 12 months, patients in both age groups reported significantly more depressive symptoms and less social support than before treatment, and their Karnofsky Performance Score was lower. However, there were no differences between elderly and younger patients. Approximately 90% of those in both age groups said that they would choose the same treatment again, and there was no age difference regarding the impact of treatment or expectations for the future. CONCLUSION: This study shows that the impact of treatment on quality of life did not differ between elderly and younger patients with head and neck cancer. Therefore, standard treatment should be considered in elderly patients if no severe contraindications exist.
