Tinnitus emerging in the context of a COVID-19 infection seems not to differ in its characteristics from tinnitus unrelated to COVID-19.

Background and aim: COVID-19 is a respiratory disease caused by the new coronavirus SARS-CoV-2, for which the first cases were reported in China, by December 2019. The spectrum of clinical presentations is wide, ranging from asymptomatic cases to a severe acute respiratory syndrome, sometimes with multiple systems involvement. Viral infections, including those related to respiratory virus, may cause hearing loss and, by extent, considering its pathophysiology, tinnitus. A systematic review on inner ear related symptoms in patients with COVID-19 reported 4.5% occurrence rate of tinnitus, with high variance of prevalence between the studies. Our aim is to further explore the relationship between COVID-19 and tinnitus. For this purpose we analyzed a sample of people who had suffered from a COVID-19 infection in the city of Volta Redonda, Brazil. In detail, we compared those with new onset tinnitus during or after the COVID-19 infection with those without tinnitus and those with tinnitus onset before the COVID-19 infection. Methods: Fifty-seven patients over 18 years old and previously diagnosed with COVID-19 confirmed by a RT-PCR test were included. Patients were subdivided in three groups: no tinnitus (NT), tinnitus that already existed before COVID-19 (chronic tinnitus, CT) and tinnitus that arose during or after COVID-19 (post-COVID-19 tinnitus, PCT). Data concerning COVID-19 symptoms, drugs prescribed for COVID-19, tinnitus characteristics, comorbidities and other otological symptoms were collected. For all the patients, tonal audiometry and otoacoustic emissions were performed. Tinnitus patients fulfilled the Tinnitus Handicap Inventory (THI) and visual-analog scales (VAS) for loudness and distress. Patients with CT answered a simple question about the worsening of their tinnitus after COVID-19. Results: PCT was reported by 19.3% of the patients, while 22.8% reported CT. No statistical difference was found between CT and PCT concerning hearing function, tinnitus characteristics and tinnitus distress. There was also no statistically significant difference between PCT and NT with respect to COVID-19 symptoms and pharmacological COVID-19 treatment. Patients with CT reported worsening of their tinnitus after COVID-19. Conclusion: As with other viral infections, inner ear symptoms may be associated with COVID-19. In our sample patients with tinnitus onset before COVID-19 and those with tinnitus onset during or after COVID-19 did not differ significantly in their clinical characteristics and their hearing function, suggesting that tinnitus occurring in the context of a COVID-19 infection is not related to a unique pathophysiological mechanism. The comparison of COVID-19 patients, who developed tinnitus with those who did not develop tinnitus did not reveal any differences in COVID-19 symptoms or COVID-19 treatment. Thus, there was no hint, that a specific expression of COVID-19 is closely related to post COVID-19 tinnitus onset. Although some drugs used to treat tinnitus are known to damage the inner ear cells (especially hydroxychloroquine), we did not see any relationship between the intake of these drugs and tinnitus onset, eventually due to the short prescription time and low doses. Among those patients who had tinnitus before COVID-19 30,8% reported worsening after COVID-19. Overall, tinnitus emerging in the context of a COVID-19 infection seems not to differ from tinnitus unrelated to COVID-19. For further exploring the relationship of tinnitus and COVID-19, large population based studies are warranted.

Nasal foreign bodies: description of types and complications in 420 cases.

UNLABELLED: Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To evaluate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS: We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05% of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION: Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05% of the cases, headed by epistaxis and nasal vestibulitis.

Corpos estranhos de fossas nasais: descrição de tipos e complicações em 420 casos / Nasal foreign bodies: description of types and complications in 420 cases

Corpos estranhos de fossas nasais são acidentes comuns em crianças, podendo, de acordo com a literatura, levar a complicações supurativas e bronco-aspiração do corpo estranho. O diagnóstico é feito quase sempre pela rinoscopia anterior, mas a nasofibroscopia e exames radiológicos podem ser úteis. OBJETIVO: Analisar um total de 420 casos de corpos estranhos de fossas nasais removidos no serviço de ORL-EPO do Hospital Municipal Souza Aguiar quanto a vários parâmetros como sexo, idade, tipo e complicações. MATERIAL E MÉTODO: 420 casos de corpos estranhos de fossas nasais removidos no serviço de Otorrinolaringologia e Endoscopia Per-oral (ORL-EPO) do Hospital Municipal Souza Aguiar, no período de dezembro de 1992 a dezembro de 1998, quanto aos parâmetros acima referidos. RESULTADOS: Foi encontrada uma maior incidência na faixa etária de 0 a 4 anos, sendo os mais comuns, pela ordem fragmentos de espuma, fragmentos de material plástico, grãos de feijão e fragmentos de papel. As complicações ocorreram em 9,05 por cento dos casos, sendo as mais comuns a epistaxe e a vestibulite. CONCLUSÃO: Os corpos estranhos de fossas nasais são acidentes encontrados principalmente na faixa etária de 0 a 4 anos, sendo os mais comuns, em nossa casuística, os fragmentos de espuma e pequenos artefatos de plástico. Complicações não são freqüentes, sendo as mais encontradas a epistaxe e vestibulite nasal.

Nasal cavities foreign bodies are common accidents in children, sometimes leading, in accordance with the literature, to complications such as epistaxis and bronchoaspiration. Diagnosis is often made with anterior rhinoscopy, but sometimes nasal fibroendoscopy and imaging may be useful. AIM: To evaluate 420 cases of nasal foreign bodies removed in ENT Service of Souza Aguiar Hospital, Rio de Janeiro, as related to sex, age, type of foreign body and complications. MATERIALS AND METHOD: 420 cases of nasal foreign bodies removed in the ENT service of Souza Aguiar Hospital between December 1992 and December 1998 were evaluated according to the parameters related above. RESULTS: We found higher incidence between 0 and 4 years of age, and the most frequently found foreign bodies were foam fragments, plastic pieces of little toys, beans and paper fragments. Complications occurred in 9.05 percent of the cases, epistaxis and vestibulitis being the commonest. CONCLUSION: Nasal foreign bodies are especially found between the ages of 0 and 4 years. In our study, foam fragments and small plastic objects were the most frequent foreign bodies found. Complications were found in 9.05 percent of the cases, headed by epistaxis and nasal vestibulitis.

Uso do acamprosato no tratamento do zumbido: um estudo duplo-cego / Tinnitus treatment with acamprosate: double-blind study

O tratamento do zumbido é, ainda nos dias de hoje, um grande desafio para os otorrinolaringologistas. Várias lacunas persistem em sua fisiopatologia, tendo como resultado vários tipos de tratamento, com resultados muito irregulares. O acamprosato é uma droga utilizada no tratamento do alcoolismo, devido à sua ação reguladora da transmissão glutamatérgica e GABA-érgica, nunca tendo sido empregado no tratamento do zumbido. OBJETIVO: Avaliar a segurança e eficácia do uso do acamprosato, no tratamento do zumbido de causa neurossensorial. FORMA DE ESTUDO: ensaio clinico randomizado. MATERIAL E MÉTODO: 50 pacientes com zumbido de causa neurossensorial foram divididos em 2 grupos, 25 recebendo acamprosato e 25 placebo por 3 meses, em um estudo prospectivo duplo-cego, sendo analisados os efeitos terapêuticos e efeitos colaterais, de acordo com escala (nota) de 1 a 10, atribuída pelo próprio paciente. RESULTADOS: Foi observado algum grau de melhora sintomatológica em 86,9 por cento dos pacientes, sendo que em 47,8 por cento dos casos observamos melhora superior a 50 por cento, dados estatisticamente significativos em relação ao placebo. A incidência de efeitos colaterais encontrada foi baixa (12 por cento) e de intensidade leve, com boa tolerabilidade geral. CONCLUSÃO: O acamprosato, medicação utilizada no tratamento do alcoolismo, é eficaz e seguro para o tratamento do zumbido de causa neurossensorial, com percentual de melhora superior à maioria das medicações utilizadas para o tratamento do zumbido, constituindo uma excelente alternativa terapêutica.

Tinnitus treatment with acamprosate: double-blind study.

UNLABELLED: Nowadays, the treatment of tinnitus is still a great challenge for the otolaryngologists. Many facts remain unknown in its pathophysiology, leading to many different therapies, with irregular results. Acamprosate is a drug used in alcoholism treatment, due to its regulating effects in glutamatergic and GABA neurotransmission, and has never been used before in the treatment of tinnitus AIM: To evaluate efficacy and safety of the acamprosate in the treatment of sensorineural tinnitus. STUDY DESIGN: Randomized clinical trial. MATERIAL AND METHOD: 50 patients with sensorineural tinnitus were divided into two groups: 25 received acamprosate and 25 placebo, for a period of 3 months, in a prospective double-blind study, being analyzed for its efficacy and safety by the subjective score from 1 to 10 given by the patient. RESULTS: We found a high index of success in the relief of tinnitus, about 86.9%. In 47.8% of the cases we found more than 50% relief. The incidence of side effects was low, 12%, all of them mild. CONCLUSION: Acamprosate, a drug used in the treatment of alcoholism, is a safe and successful alternative for sensorineural tinnitus' treatment.

Corpos estranhos animados em otorrinolaringologia / Strange animated bodies in othorinolaringology

Forma de estudo: Clínico retrospectivo. Material e método: Foram reportados 56 casos de corpos estranhos animados em orelhas (55 insetos e 1 aracnídeo) e 1 caso (inseto) em fossas nasais. O material foi coletado no setor de Emergência do serviço de ORL do Hospital Municipal Souza Aguiar, no centro do Rio de Janeiro, entre os anos de 1998 e 2000, e identificado por zoólogos do Museu Nacional, Rio de Janeiro. A maior parte dos casos ocorreu em Nova Iguaçu e Campo Grande, sendo analisados os quadros clínicos e as complicaçöes ocorridas. Resultado: Os insetos säo: 30,35 por cento Blattaria (baratas); 25 por cento Diptera (moscas e mosquitos); 12,5 por cento Lepidoptera (borboletas e mariposas); 10,7 por cento Coleoptera (besouros); 7,15 por cento Hemiptera (percevejos, cigarras, afídeos, etc.), 5,35 por cento Hymenoptera (vespas, abelhas, formigas, marimbondos) e 5,31 por cento outros