Laryngopharyngeal Reflux Patient Changes during the COVID-19 Quarantine.

Background and Objective: To examine the effects of the lockdown on diet adherence and stress levels in patients with laryngopharyngeal reflux (LPR). Materials and Methods: Patients with a positive LPR diagnosis at the hypopharyngeal-esophageal impedance-pH monitoring were treated from a pre- to lockdown period with a 3-month high-protein, low-fat, alkaline, plant-based diet, with behavioral changes, and an association of pantoprazole (20 MG/d) and alginate (Gaviscon 3/d). The following patient-reported outcomes questionnaire and findings instrument were used: Reflux Symptom Score-12 (RSS-12) and Reflux Sign Assessment (RSA). At the posttreatment time, patients were invited to evaluate the impact of lockdown on diet adherence and stress management with a predefined grid of foods and beverages and the perceived stress scale (PSS), respectively. Results: Thirty-two patients completed the evaluations. RSS-12 and RSA significantly improved from baseline to 3-month posttreatment. Most patients experienced mild-to-severe stress levels at the end of the lockdown. The level of stress substantially increased in 11 patients (34%) due to the lockdown, while it did not change in 11 patients (44%). In 11 cases (34%), patients reported that the adherence to the anti-reflux diet was better than initially presumed thanks to the lockdown period, while 44% (N = 14) reported that the lockdown did not impact the adherence to a diet. PSS and RSS-12 were significantly correlated at the end of the pandemic (rs = 0.681; p < 0.001). The increase in stress level was positively associated with the lack of adherence to diet (rs = 0.367; p = 0.039). Conclusions: During the lockdown, the diet habits of LPR patients were improved in one-third and unchanged in 44% of cases. The stress level was increased in one-third of patients, which was associated with an increase in symptom scores.

Impact of COVID-19 Lockdown on Stress and Diet Adherence in Patients with Laryngopharyngeal Reflux.

Objectives:To study the impact of lockdown on diet adherence and stress in patients treated for laryngopharyngeal reflux (LPR). Methods:Patients with a positive LPR diagnosis at the hypopharyngeal-esophageal impedance-pH monitoring were treated from the pre- to lockdown period with diet, behavioral changes and an association of proton pump inhibitors and alginate. The following outcomes were used to assess the clinical features of patients: reflux symptom score-12 (RSS-12) and reflux sign assessment (RSA). At post-treatment time, patients were invited to evaluate the impact of lockdown on diet adherence and stress management with a predefined grid of foods and beverages and perceived stress scale (PSS), respectively. Results:Thirty-two patients completed the evaluations. RSS-12 and RSA significantly improved from baseline to three-month post-treatment. Most patients experienced mild-to-severe stress level at the end of the lockdown. The level of stress substantially increased in 34% of patients due to lockdown, while it did not change in 44%. In 34% of cases, patients reported that adherence to antireflux diet was better than initially presumed thanks to the lockdown period, while 44% believed that the lockdown did not impact their adherence to diet. PSS and RSS-12 were significantly correlated at the end of the pandemic (p<0.001). The increase of stress level was positively associated with the lack of adherence to diet (p=0.039). Conclusion:During the lockdown, diet habits were improved or unchanged in most LPR cases, while stress level was increased in one-third of patients.

Papillary Thyroid Carcinoma Metastatic to the Frontal Sinus and Frontal Recess: Case Report.

We describe an extremely rare papillary thyroid carcinoma metastasic to the paranasal sinuses and our surgical management. A 39-year-old patient with a history of papillary thyroid carcinoma diagnosed five years earlier who presented with symptoms of chronic sinusitis. Medical imaging demonstrated opacification of the frontal sinuses and the anterior ethmoid sinus without signs of angiogenesis, bone destruction or calcification. Biopsy under general anesthesia revealed presence of papillary thyroid carcinoma cells. Treatment consisted in sinus endoscopic surgery with Draf III procedure followed by 131I therapy. To our best knowledge, this is the first described case of papillary thyroid carcinoma metastatic to the frontal sinus and frontal recess.

Platelet-Rich Plasma, an Innovative and Noninvasive Technique for Closure of Tracheoesophageal Fistula After Laryngectomy, Report of 2 Cases.

An innovative and noninvasive technique for closure of persistent tracheoesophageal fistula after total laryngectomy is described. In our preliminary study, two patients were included. No clinical and radiological signs of locoregional recurrence prior to treatment were diagnosed. We performed local injections of autologous platelet-rich plasma (PRP) according to our protocol. Complete closure of the fistula was observed in both patients who were able to take normal feeding. No side effects associated with the procedure were observed. These preliminary results are encouraging to consider PRP injection before more invasive surgical techniques in the treatment of persistent tracheoesophageal fistulas after total laryngectomy.

Effectiveness and safety of PRP on persistent olfactory dysfunction related to COVID-19.

INTRODUCTION: Olfactory dysfunction (OD) is a well know symptom of coronavirus disease 2019 (COVID-19), accounting for 48 to 85% of patients. In 1 to 10% of cases, patients develop a chronic olfactory dysfunction (COD), lasting more than 6 months. Recently, platelet-rich plasma (PRP) was used in patients with non-COVID-19 COD and authors reported encouraging results. METHODS: In the present study, we investigated the usefulness and safety of PRP injection in 56 patients with COVID-19 COD by the Sniffing Stick test (TDI score) and a linker-scale from 0 (none) to 3 (strong) and we compare the result to a control group. RESULTS: At 1 month post-PRP injection, the mean TDI scores significantly improved by 6.7 points in the PRP group (p < 0,001), the mean self-assessment of improvement in smell function was 1.8 (mild-to-moderate) in the PRP group, which was significantly higher than the score (0.3) in the control group (p < 0,001). CONCLUSION: Our results showed that PRP in the olfactory cleft can increase the olfactory threshold 1 month after the injection. Moreover, our results suggest that timing of treatment may be an important factor and that PRP is a safe treatment, because no adverse effects were reported throughout the study. TRIAL REGISTRATION NUMBER: NCT05226546.

First case of Ethmoid Metastasis From an Induced Oropharyngeal Squamous Cell Carcinoma HPV, Interest of the P16 as a Diagnosis Aid.

We describe the first case of ethmoid metastasis from an oropharyngeal human papillomavirus-induced squamous cell carcinoma using the anti-P16 immunohistochemistry. The p16 overexpression can be a valuable aid in the differential diagnosis.

Prevalence of Persistent Olfactory Disorders in Patients With COVID-19: A Psychophysical Case-Control Study With 1-Year Follow-up.

The purpose of this multicenter case-control study was to evaluate a group of patients at least 1 year after coronavirus disease 2019 (COVID-19) with Sniffin' Sticks tests and to compare the results with a control population to quantify the potential bias introduced by the underlying prevalence of olfactory dysfunction (OD) in the general population. The study included 170 cases and 170 controls. In the COVID-19 group, 26.5% of cases had OD (anosmia in 4.7%, hyposmia in 21.8%) versus 3.5% in the control group (6 cases of hyposmia). The TDI score (threshold, discrimination, and identification) in the COVID-19 group was significantly lower than in the control group (32.5 [interquartile range, 29-36.5] vs 36.75 [34-39.5], P < .001). The prevalence of OD was significantly higher in the COVID-19 group, confirming that this result is not due to the underlying prevalence of OD in the general population.