COVID-19 Infection During Pregnancy and Hearing Loss in Infants: A Clinical Study.

Aims: To find the prevalence of hearing loss in children born to mothers who had COVID-19 infection during pregnancy. Materials and Methods: This was a prospective observational study conducted on 1960 babies born to mothers who were COVID positive during their pregnancy .All children born to RTPCR positive COVID-19 pregnant women were included in the study and babies who had any other risk factor for neonatal SNHL were excluded from the study. All the babies were subjected to OAE, and if it came pass, the test was repeated 2 weeks later. Those patients with repeat OAE also as refer were subjected to Brainstem Evoked Response Audiometry and findings correlated. Results: The study included 1960 neonates who were subjected to neonatal hearing screening by OAE. There were 1020 males (52.04%) and 940(47.96%) females and 80 cases of consanguinity. Fifty babies were excluded due to comorbidities. In the initial OAE test 380 neonates failed (19.9%) following which BERA was done and ten patients was found to Sensorineural hearing loss. Conclusion: The prevalence of hearing loss in our study on babies born to mothers with COVID-19 infection during pregnancy is 0.005. Although these primary results from our study does not indicate any immediate effect of SARS-COV-2 maternal infection on neonatal hearing. More children need to be tested and followed up over an extended period of time to detect any possible delayed auditory effects. Those patients who were identified to have hearing loss in our study will have to be on long term follow-up as we see long terms effects on cognition, memory, heart health, etc. in COVID survivors. Level of evidence: Level 1.

Benign Spindle Cell Lesion of the Nasal Cavity: A Rare Presentation of Solitary Fibrous Tumor.

Solitary fibrous tumors (SFTs) are rare neoplasms primarily found in the pleural region but have been documented in diverse extrapleural sites, including the nasal cavity and paranasal sinuses, albeit infrequently. Here, we present a case of a 48-year-old female who presented with a right-sided nasal mass and associated ophthalmologic symptoms, ultimately diagnosed with a benign spindle cell lesion localized to the nasal cavity. The patient underwent a comprehensive evaluation involving clinical examination, radiological imaging, and histopathological analysis, leading to the identification of a benign solitary fibrous tumor. Notably, diagnosing SFTs in the nasal cavity presents challenges due to their nonspecific clinical and imaging features, necessitating a multidisciplinary approach for accurate diagnosis and optimal management. Surgical excision, preferably via endoscopic techniques, remains the cornerstone of treatment based on tumor characteristics and extent. This case underscores the importance of recognizing uncommon presentations of sinonasal lesions, navigating diagnostic complexities, and emphasizing the critical role of multidisciplinary collaboration in achieving favorable treatment outcomes for patients with such nasal cavity tumors.

A Comparative Study of Treatment Outcomes of Music Therapy, Tinnitus Maskers and Pharmacotherpy in Chronic Subjective Tinnitus.

Tinnitus represents one of the most common and distressing otologic problems, and it causes various somatic and psychological disorders that interfere with the quality of life. This study aimed to compare the outcome of music therapy, tinnitus maskers and pharmacotherapy on patients with chronic tinnitus, to observe and analyse the etiological factors of tinnitus and to find out whether music can be used as an active listening mode by which tinnitus perception can be decreased. This was a comparative longitudinal study involving 90 patients with chronic tinnitus who were randomly assigned to 3 groups of 30 each: Group A (Music therapy), Group B (Pharmacotherapy) and Group C (Tinnitus masker). After a detailed clinical history and examination, Tinnitus Handicap Inventory and Visual Analogue Scores were recorded both prior to and following therapy, and patient were followed up monthly up to 2 months. There is a significant difference in the mean THI score (p = 0.002) and mean VAS(p = 0.0006) at 2 months follow up in patients treated with Music therapy and patients had a satisfactory outcome after music therapy and did not require any further treatment. Patients in pharmacotherapy and hearing aid group had a good clinical improvement but mean THI and mean VAS score was not statically significant. It was also noticed that loud noise exposure and hypertension were main etiological factors in 37.77% and 26% of patients respectively. Music therapy appears to be an effective and cost-efficient mode of therapy for chronic tinnitus and could be suitable for widespread implementation for patients with tinnitus of varying severity. Pharmacotherapy and hearing aid application in the treatment of tinnitus has good outcome in our study but requires long term treatment and follow up.

A Clinical Study of Smell Disorders in COVID-19 Patients in a Tertiary Care Hospital in Pondicherry: A Cross Sectional Study.

Anosmia and ageusia are the first and maybe the only symptom in patients affected with COVID-19 especially if the patient is paucisymptomatic. This aim of this study was to determine the demographic details of patients with anosmia, prevalence of anosmia and the time taken for it to resolve in patients who are positive for COVID-19 and took treatment in our hospital. Cross Sectional Study. Patients with real time polymerase chain reaction (RTPCR) positive nasopharyngeal and oropharyngeal swabs, who met the inclusion and exclusion criteria were included in the study. The study group was interviewed through telephonic calls and a questionnaire filled to see the development and regression of their symptoms. Of the study population of 1000, 742 patients had some sort of a smell disturbance. There was a positive correlation between the severity of the disease and history of smoking. The prevalence of smell disturbances among COVID-19 patients in our study was 74.2%. One important finding that we found out was that majority of the smokers had moderate disease. Most of the patients had complete recovery form smell disturbance in the due course of time. The mean time for resolution of smell disturbance was found to be 9.89 days. Anosmia and ageusia can represent the only symptomatology present in patients with COVID-19 and they are completely reversible and hence they can be used as early predictors of infection. Level of Evidence: Level 2.

Virtual Telephonic Follow-Up for Patients Undergone Septoplasty Amid the COVID Pandemic.

Septoplasty is a common procedure in ENT practice with fewer complication rates. Long term follow-up is usually not necessary. The aim of our study is to evaluate the feasibility of virtual telephonic consultation to follow-up the patients in the immediate postoperative period. After excluding the patients based on the criteria, twenty-four patients were telephonically followed up by a resident using structured NOSE questionnaires and the responses were noted. All the patients had improvement in symptoms with 14 patients completely asymptomatic (NOSE score of < 5). Two patients had moderate symptoms (NOSE score 30-50) and 8 patients had mild symptoms (nose score 5-25). Majority of the patients interviewed were satisfied with the telephonic follow up and were willing to accept such patient-friendly services in the future. Virtual Telephonic follow-up of patient undergone uncomplicated septoplasty is a feasible, cost-effective model with a high rate of patient satisfaction.

Proficiency of virtual follow-up amongst tinnitus patients who underwent intratympanic steroid therapy amidst COVID 19 pandemic.

AIM: The aim of this study was to assess the efficacy and feasibility of virtual follow-up in patients who have undergone intratympanic steroid injection for treatment of tinnitus during COVID-19 pandemic. MATERIALS & METHODS: Twenty-five patients having long-term tinnitus undergoing intratympanic steroid course, were followed up virtually via video calling & telephonic methods and evaluated using Tinnitus handicap inventory scoring over the period of 68 days. RESULTS: 20 out of 25 patients expressed improvement from symptoms (80%) and 5 of the remaining (20%) showed no improvement. However, most of them were inarguably satisfied with this virtual method of follow up and had no reservation in following the similar method of observation in future. CONCLUSION: Virtual follow-up using video calling applications and telephonic call is an efficacious, cost effective and user-friendly method, which can provide accurate post procedural observation while keeping in account the nationwide lockdown during COVID 19 pandemic.

Design and Implementation of Competency Based Postgraduate Medical Education in Otorhinolaryngology: The Pilot Experience in India.

The worldwide call for a shift towards competency based postgraduate medical education has until recently gone largely unheeded in India, despite the Medical Council of India enshrining the principle in its regulations for postgraduate institutions. This paper details the first concrete attempt at establishing a CBME curriculum in Otorhinolaryngology in India. The design and implementation of the CBME curriculum was carried out in four phases, in a time-bound manner over a period of 6 months. Phase I consisted of an extensive literature review and a clarification of the major objectives of the program. Phase II involved the listing out of 20-30 entrustable professional activities (EPAs) for each specialty and the 13 core EPAs common to all incoming residents and the subsequent mapping of these EPAs to their respective domains of competence and year-wise levels of competence. This was followed by the development of milestones for each EPA and appropriate clinical vignettes. Phase III focused on development of 360° assessment strategies, including the in-house development of an e-portfolio. Phase IV was dedicated to the implementation of the CBME curriculum, and involved various sensitization and orientation programs for faculty and the new residents. This exercise in designing and implementing a CBME program showed the important role that intra-departmental and inter-institutional cross-communication and exchange of ideas vies-a-vie workshops and personal communication play in bridging the lapses in knowledge in this emerging area, reaching consensus to achieve project goals and for finding relevant solutions to common problems. Medical education in India presents its own peculiar set of logistical and cultural challenges. Keeping in line with the recommendations of the Medical Council of India regarding Postgraduate Medical Education, it is essential that medical colleges in India not fall behind the international paradigm shift towards CBME.