Chemosensory Dysfunction in COVID-19: Prevalences, Recovery Rates, and Clinical Associations on a Large Brazilian Sample.

OBJECTIVE: Our study aimed to measure the percentage of reported olfactory or taste losses and their severity, recovery time, and association with other features in a large cohort of patients with COVID-19. STUDY DESIGN: Prospective survey. SETTING: Quaternary medical center and online survey. METHODS: The perceived chemosensory capacities of 655 patients with confirmed COVID-19 were assessed with 11-point category rating scales (0, no function; 10, normal function). Patients were contacted in hospital, by phone calls, or by internet regarding their ability to smell or taste, and 143 were interviewed by phone 1 to 4 months later to assess the recovery of their chemosensory abilities. RESULTS: The prevalence of self-reported olfactory, general taste, and taste quality-specific disturbances (sweet, sour, bitter, and salty) in the patients with COVID-19 were 82.4% (95% CI, 79.5%-85.3%), 76.2% (95% CI, 72.9%-79.4%), and 52.2% (95% CI, 48.3%-56.1%), respectively. The majority reported anosmia (42.9%). The presence of chemosensory symptoms was not associated with COVID-19 severity. At a median time >2 months after the onset of symptoms, rates of total and partial olfaction recovery were 53.8% and 44.7%, while complete or partial return to previous taste function was 68.3% and 27.6%. Less than 5% of the patients reported no chemosensory function improvement at all. CONCLUSION: The prevalence of self-reported chemosensory dysfunction is high among patients with COVID-19. Almost all patients seem to recover a significant part of their smell and taste abilities in the first 4 months after the onset of symptoms.

Fixação funcionalmente estável no tratamento de sequela de fratura cominutiva de mandíbula por PAF / Functionally stable fixation in the treatment of comminuted jaw fracture by firearm projectile

Introdução: em traumas de alta energia por projéteis de arma de fogo (PAF), pode ocorrer a cominuição da mandíbula. Quando não identificadas ou tratadas de maneira equivocada, essas injúrias podem comprometer a saúde do indivíduo, com graves complicações estéticas e funcionais. Objetivo: o objetivo deste trabalho é relatar um caso de tratamento cirúrgico de sequela de ferimento por arma de fogo com fratura cominutiva em região de sínfise mandibular. Relato do caso: paciente procurou o serviço de cirurgia e traumatologia bucomaxilofacial após tratamento cirúrgico insatisfatório de fratura mandibular por PAF. Observou-se clinicamente mobilidade em manipulação, exposição óssea e drenagem purulenta. Na tomografia, observou-se gap ósseo, descontinuidade na base mandibular e material de osteossíntese inadequado. Foi proposta uma abordagem cirúrgica para instalação de placa de reconstrução do sistema 2.4 mm. Em acompanhamento pós-operatório, o paciente evoluiu com abertura bucal funcional e satisfatória, sem mobilidade nos fragmentos ósseos, arcabouço mandibular restabelecido e adequado posicionamento do material de fixação. Considerações finais: os casos de cominuição óssea apresentam características individuais que devem ser levadas em consideração em seu manejo. Nesses casos, a escolha do material de fixação é fundamental para o sucesso terapêutico e o uso de prototipagem soma para uma condução satisfatória do caso, garantindo menor tempo cirúrgico e melhor adaptação da placa. (AU)

Introduction: in high energy traumas caused by firearm projectiles may occur comminutive mandibular fractures. When it is not identified or inappropriately treated, these injuries can compromisse the individual's health, with serious aesthetics and funcional complications. Objective: the aim of this study is report a case of surgical treatment of sequelae from firearm injury with comminutive fracture in the region of mandibular symphysis. Case report: patient sought the service of Oral and Maxillofacial Surgery and Traumatology after 1 month of unsatisfactory surgical treatment of a mandibular fracture caused by firearm projectile. Clinical examination revealed mobility to manipulation and bone exposure with purulent drainage. Computed tomography of the face shows bad fracture consolidation in the anterior region of the mandible with bone gap and discontinuity in the mandibular base and inadequate and poorly positioned osteosynthesis material. It was then proposed a new surgical approach with instalation of the reconstruction plate of 2.4mm locking system. In postoperative follow-up, the patient evolved with a functional and satisfactory mouth opening, with no mobility in bone fragments, restored mandibular framework and adequate positioning of the fixation material. Final considerations: the cases of comminutive bone fractures show particular features that should be considered in their handling. In these cases, the choice of the fixation material is critical to therapeutic success and the use of prototyping sum for a satisfactory conduction of the case, ensuring shorter surgical time and better adaptation of the plate.(AU)

Tratamento conservador de ameloblastoma sólido recidivante em paciente jovem: relato de caso / Conservative treatment for recurrent solid ameloblastoma in young patient: case report

Introdução: O ameloblastoma é um tumor odontogênico benigno, embora seja localmente agressivo. As modalidades de tratamento para o ameloblastoma podem ser classificadas em radicais ou conservadoras, contudo a determinação da técnica de eleição permanece um tema controverso. Este trabalho tem como objetivo relatar e discutir um caso de ameloblastoma recorrente, tratado de forma conservadora, com enucleação e curetagem em um indivíduo adolescente. Relato do Caso: Paciente, sexo masculino, de 12 anos, foi encaminhado ao serviço de CTBMF do Hospital Universitário Oswaldo Cruz com aumento de volume assintomático em região de parassínfise mandibular direita. Foi realizada biópsia incisional e obtido o diagnóstico de ameloblastoma. Após dois anos de descompressão, foi realizada enucleação com curetagem da lesão. Cinco anos após a intervenção, o paciente apresentou recidiva do tumor, sendo realizada nova abordagem conservadora. Em acompanhamento de sete meses, ele evoluiu assintomático e sem sinais de recidiva. Considerações Finais: A abordagem conservadora é uma alternativa viável no tratamento de ameloblastomas, em especial quando se trata de indivíduos jovens, entretanto esta deve ser seguida de um rigoroso protocolo de acompanhamento clínico e radiográfico pós-operatório... (AU)

Introduction: The ameloblastoma is a benign but localy agressive odontogenic tumour. The modalities of treatment for ameloblastoma can be classified as radical or conservative, although the determination of the preferred technique remains a controversial field. The objective of this study is to report and discuss a case of recurrent ameloblastoma treated with a conservative approach with enucleation and curettage in a young patient. Case Report: 12-years old man, referred to the service of oral and maxillofacial surgery of Oswaldo Cruz University Hospital with an asymptomatic swelling in the right mandibular parasymphysis. Incisional biopsy was performed and the diagnosis of ameloblastoma was obtained. After two years of decompression, enucleation and curettage of the lesion were performed. Five years after the intervention, the patient presented with recurrence of the tumour and a new conservative approach was performed. In a seven month follow-up, the patient presents asymptomatic and without signs of recurrence. Final Considerations: The conservative approach is a viable option in the treatment of ameloblastomas, especially in young individuals. However, it should be followed by a strict protocol of clinical and radiographic postoperative follow-up... (AU)