Upper respiratory tract and otolaryngological manifestations of coronavirus disease 2019 (COVID-19): A systemic review.

To detect, analyze, and discuss the different ear nose throat manifestations, those were reported in coronavirus disease-positive patients in the published and reviewed literature. Coronavirus disease has been reported to present with several symptoms. Common symptoms include new onset of fever, cough, fatigue, and myalgia. Other symptoms like sputum production, dyspnea, rhinorrhea, anosmia, nasal stuffiness, headache, and sore throat are less frequently reported, but the clinical presentation is highly variable among individuals. We review the otolaryngologic manifestations of coronavirus disease reported in the published literature to assess its importance in the early diagnosis of coronavirus disease. We searched PubMed database, MEDLINE, Web of Science, LILACS, SciELO, and Cochrane Library to find out relevant articles, using the following keywords: COVID-19, clinical features, characteristics, symptoms, clinical, manifestations, throat, cough, rhinorrhea, COVID-19 anosmia, headache, nasal, coronavirus, and coronavirus otolaryngologic. Article selection was based on their relevance to the research question. Totally, 14 articles and 2971 patients were recruited for our study. A wide variety of upper and lower airway manifestations were reported. Fever (34%-96.5%), cough (17.9%-83%), myalgia or fatigue (10%-31%), expectoration (20%-32.7%), dyspnea (7.6%-7.5%), rhinorrhea (1%-6.8%), sore throat (4%-61%), nasal congestion (3%-4.8%), and headache (3%-16.2%) were the most common symptoms reported. Our findings confirm that coronavirus disease infection presents with a wide spectrum of clinical presentation. The ear nose throat manifestations for coronavirus disease are not uncommon, but more attention should also be paid to patients with otolaryngologic symptoms which can appear early, as this could encourage an earlier diagnosis and treatment, which limits spread of the disease.

Clinical, pathological and molecular determinants in squamous cell carcinoma of the oral cavity.

Squamous cell carcinoma of the oral cavity (OCSCC) is the most frequently observed form of head-and-neck cancer in Southeast Asia and is the sixth most common cancer worldwide. Most cases of this preventable disease are caused by alcohol consumption, smoking and betel nut chewing. The survival rates of patients with advanced OCSCC have not increased significantly in recent years. While treatments for OCSCC are similar worldwide, survival rates differ by geographical area. The various genetic profiles and individual genetic susceptibility for carcinogens may account for this discrepancy. In some respects, molecular alteration or accumulation affects tumor progression and the clinical outcomes among patients with OCSCC. Clarifying the tumor behavior of oral cancer, with regard to pathological features or molecular aspects, could help clinicians to judge, tailor and adopt more effective therapeutic strategies to treat oral cancer.

Prognostic impact of p16, p53, epidermal growth factor receptor, and human papillomavirus in oropharyngeal cancer in a betel nut-chewing area.

OBJECTIVE: To evaluate the prevalence of human papillomavirus (HPV) and the prognostic significance of epidermal growth factor receptor (EGFR), p53, and p16 among patients with oropharyngeal carcinoma. DESIGN: Retrospective study. SETTING: Academic Institute of Otolaryngology, Kaohsiung, Taiwan. PATIENTS: Two hundred seventy-four patients who were diagnosed as having oropharyngeal carcinoma underwent testing for the presence of the HPV genome in the nuclei of their tumor cells from January 1, 1992, through March 31, 2008. INTERVENTIONS: The HPV genome was detected by performing polymerase chain reaction-based assays and in situ hybridization on tumor tissue from paraffin blocks. Immunohistochemistry staining for p16, p53, and EGFR was also performed. MAIN OUTCOME MEASURES: We used the Fisher exact test to evaluate the correlation between the clinicopathological variables and the presence of HPV in tumor cells. Survival analysis was based on the Kaplan-Meier method. RESULTS: We detected HPV in 45 of the 274 patients (16.4%); of these, HPV-16 and -18 were identified in 42 (93.3%) of the HPV-positive tumors. The HPV-positive oropharyngeal cancers were more likely to occur in females, nonsmoking individuals, and those who did not chew betel quid. The HPV-positive tumors significantly expressed p16 and were inversely associated with EGFR and p53 expression (all, P < .001). In addition, patients with tumor tissue that was positive for HPV (P = .008) and had negative expression of EGFR (P = .01), low expression of p53 (P = .01), and high expression of p16 (P = .04) had a better prognosis. CONCLUSION: Our results suggest that HPV, EGFR, p53, and p16 are useful biomarkers in predicting the clinical outcomes of oropharyngeal cancer.

Computer-aided endoscopic sinus surgery: a retrospective comparative study.

BACKGROUND AND OBJECTIVES: Endoscopic sinus surgery (ESS), markedly improved with the introduction of new preoperative imaging techniques, intraoperative visualization tools, and the use of surgical navigation systems. In this retrospective study we evaluated the usefulness of CT-guided endoscopic sinus surgery and studied its advantages over conventional endoscopic sinus surgery. METHODS: We retrospectively reviewed the records of 60 randomly chosen patients with chronic rhinosinusitis (CRS) and moderate-to-severe sinonasal polyposis, undergoing endoscopic sinus surgery with surgical navigation (n=30) and without navigation (n=30). Data on the operative note, time of surgery, complications, and recurrence rate were collected and analyzed. RESULTS: Of the 60 patients, 40 (66.7%) were diagnosed with CRS and 20 (33.3%) had allergic fungal sinusitis. Primary surgery was performed in 37 (61.7%) and revision surgery was performed in 23 (38.3%) cases. The computer-aided surgery (CAS) group included 28 (93.3%) patients with extensive disease and 12 (40%) with bone erosions, with intraorbital or extradural extension, while the non-CAS group included 24 (80%) patients with extensive disease and seven (23.3%) with bone erosions, with intraorbital or extradural extension. The average operative time was approximately 13 minutes greater in the navigation group, with significant improvement in the recurrence rate (n=11, 36.7% in the non-CAS group; n=5, 16.7% in the CAS group), and intraoperative complications were fewer in the CAS group (two exposures of orbital fat in the non-CAS group; no complications in the CAS group). CONCLUSION: Computer navigational systems appear to serve as a valuable adjunct in preoperative planning and safe intraoperative dissection.

Nasal packing in cosmetic and functional nasal surgery.

OBJECTIVE: To evaluate the routine use of nasal packing after cosmetic and functional nasal surgery. METHODS: Prospective collection from 2005 to 2006 at King Abdulaziz University Hospital in Riyadh for 54 patients post-septorhinoplasty with and without submucous diathermy or lateralization of inferior turbinate were evaluated for efficacy and complications of nasal packing which kept for different duration. RESULTS: All 54 patients had septoplasty, 21 with rhinoplasty, 12 with SMD, and 24 patients had inferior turbinate lateralization. Eight cm slim Merocel packed in 67 nasal cavity sides, 8 cm regular Merocel packed in 24 sides and 10 cm regular Merocel packed in 6 sides. Thirty-seven patients had the pack for 6 hours then removed and 17 patients had it for 24 hours. Forty-one patients with no significant discomfort, 13 patients with mild to moderate discomfort. CONCLUSION: Septorhinoplasty and SMD or lateralization of inferior turbinate can be managed without packing or any other hemostatic measures.

Allergic fungal sinusitis in children in Saudi Arabia.

OBJECTIVE: To report the allergic fungal sinusitis (AFS) in children in Saudi Arabia and to review the experience of King Abdul-Aziz University Hospital in diagnosis and management of AFS in children. METHODS: Hospital charts of 45 children reviewed retrospectively. Clinical presentation, radiological and operative findings, management and outcomes studied. Only 25 patients had =or> 4 diagnostic criteria, treated endoscopically between January 2000 and December 2005 and followed at least 2 years in KAUH, Riyadh, Kingdom of Saudi Arabia. RESULTS: Twenty-five patients had at least 4 criteria for AFS. All patients underwent functional endoscopic sinus surgery (FESS) with high recurrence rate, 44%. Twenty-eight percent needed revision surgery even with medical treatment post operatively. Moreover, no other complications were reported in this study. Aspergillus spp is the most common fungal type in our review. CONCLUSION: Allergic fungal sinusitis in children is underestimated and understudied associated with poor outcome and high recurrence rate because of difficulty in management. Therefore, the most effective approach of AFS management in children is to have a high index of suspicion, adequate preoperative evaluation, medical preparation preoperatively, meticulous surgery, medical management, postoperative including topical and systemic corticosteroids and close clinical follow-up with endoscopically guided debridement.