Assessment of olfactory recovery after COVID-19: cross-sectional study.

OBJECTIVE: This study aimed to evaluate recovery patterns of olfactory dysfunction among recovered COVID-19 patients, both subjective and objective, and correlate this recovery to the severity of the disease. METHODS: The study recruited 200 patients and assigned them to two equal groups, one of them was a control group. The olfactory function of the study group was assessed via subjective and objective methods at baseline and then monthly for three months, with changes in smell function reported at each visit. These patients underwent chemosensory testing using the Sniffin' Sticks test and completed the validated Arabic version of the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS). RESULTS: Olfactory dysfunction occurred on the first day of COVID-19 symptoms in 37% of participants. Subjective reports suggested smell recovery in 55% after 3 months, but Sniffin' Sticks showed only 1% with normal function, indicating persistent deficits in others. This study revealed smell recovery for 93% of participants (median 14 days), with most (58%) recovering within 2 weeks. No significant links were found between demographics, COVID-smell loss timing, and recovery speed. CONCLUSION: Three months after COVID-19, many patients perceive smell recovery, but objective tests reveal shockingly high rates of persistent dysfunction. Further follow-up with objective tests is vital to assess the true burden and potential long-term effects of smell loss.

Risk Factors for Recurrence of Nasal Polyps after Endoscopic Sinus Surgery in Patients with Allergic Chronic Rhino Sinusitis.

Rhino sinusitis, is a common inflammatory disease that affects the nasal cavity and paranasal sinuses in millions of individuals. Chronic sinusitis patients complain of a combination of nasal obstruction, rhinorrhea, post nasal drip and facial pain. To identify the risk factors of the recurrence of nasal polyps in chronic rhino sinusitis patients after endoscopic sinus surgery. After a review of 60 patients with chronic rhino sinusitis with failed medical treatment requiring FESS presenting in Kasr Alainy Hospital in Cairo University and October 6 University Hospital from May 2022 to March 2023. All patients were subjected to history taking, clinical examination including endoscopy, subjective evaluation of symptoms and CT-scan. Of our patients, six patients (15%) were diagnosed with recurrence of nasal polyps with chronic rhino sinusitis and needed revision surgery. There are multiple risk factors related to the recurrence of nasal polyps including smoking followed by having a history of an asthma, the presence of an allergy, septal deviation, prior sinus surgery, and turbinate hypertrophy. Other factors, as proper medical treatment such as topical steroids and treatment of allergy had a significant role in decreasing the recurrence rate. Risk factors related to the recurrence of nasal polyps should be avoided before surgery. The avoidance of risk factors protects the patients from the recurrence of nasal polyps, the hazards of anaesthesia on surgical treatment, and the financial cost of surgery. Follow up is important in the prevention of recurrence of nasal polyps and improves the symptoms.

Incidence of Post Total Laryngectomy Hypothyroidism: Effects of Thyroid Gland Surgery and Post-Operative Radiotherapy.

To record the incidence of hypothyroidism in patients after total laryngectomy, whether with or without postoperative radiation therapy and to analyze the effect of hemithyroidectomy for the development of hypothyroidism. A retrospective study included patients who underwent total laryngectomy (with or without hemithyroidectomy) between 2018 and 2021 for laryngeal carcinoma and/or received postoperative radiotherapy. Thirty-six (45%) of the 80 enrolled patients developed hypothyroidism after a median follow-up of 16 months. In this study, adjuvant radiation and central neck dissection were found to be significantly linked with developing post-operative hypothyroidism (p values: 0.001, 0.007, respectively). The incidence of hypothyroidism in patients treated for laryngeal carcinoma is high, especially after combination treatment of surgery and radiotherapy.

Objective Comparison Between Spreader Grafts and Flaps for Mid-Nasal Vault Reconstruction: A Randomized Controlled Trial.

OBJECTIVE: The goal of rhinoplasty is not exclusively aesthetic and the nasal function should always be considered. Several rhinoplasty techniques can participate in nasal valve dysfunction (eg, dorsal hump reductions). Therefore, mid-nasal vault reconstruction by spreader grafts or flaps is mandatory in these cases. To date, there is a literature gap in comparing both techniques objectively. This study shows an objective comparison between spreader grafts and flaps for mid-nasal vault reconstruction. MATERIAL AND METHODS: This study was a double-blind randomized controlled trial including 40 patients who were randomly divided into 2 groups. Group 1 (20 patients) underwent spreader grafts insertion, whereas group 2 (20 patients) underwent spreader flap placement technique. Pre-operative active anterior rhinomanometry measurements were compared to 6-month post-operative measurements. Data were summarized as mean (standard deviation) for the quantitative variables. Comparisons between the 2 groups were done using unpaired t test. RESULTS: In both groups, a significant decrease in nasal resistance was noted in both the right and left sides 6 months post-operatively (P < .001). However, the comparison between the 2 both groups showed no statistical significance. CONCLUSION: Both spreader grafts and flaps, which are used for the mid-nasal vault reconstruction, have comparable and effective results in reducing the nasal resistance as evidenced by active anterior rhinomanometry measurements.

HISTORIQUE: La rhinoplastie n'a pas seulement un objectif esthétique. En effet, il faut toujours tenir compte de la fonction nasale. Plusieurs techniques de rhinoplastie peuvent entraîner une dysfonction de la valve nasale, par exemple en cas de réduction de la bosse dorsale. Dans ces situations, il faut absolument procéder à une reconstruction de la voûte nasale par greffes ou lambeaux d'extension. Jusqu'à présent, les publications scientifiques n'ont pas comparé pas objectivement les deux techniques. La présente étude contient une comparaison objective entre des greffes et des lambeaux d'extension lors de la reconstruction de la voûte nasale. OBJECTIF: La présente étude présente une comparaison objective entre les greffes et les lambeaux d'extension lors de la reconstruction de la voûte nasale. MÉTHODOLOGIE: La présente étude aléatoire et contrôlée à double insu comptait 40 patients répartis au hasard entre deux groupes. Le groupe 1 (20 patients) a subi l'insertion de greffes d'extension et le groupe 2 (20 patients), la technique d'installation de lambeaux d'extension. Les chercheurs ont comparé les mesures de rhinamométrie antérieure active obtenues avant l'opération à celles obtenues six mois après l'opération. Ils ont résumé les données relatives aux variables quantitatives à l'aide de l'écart-type moyen et standard. Ils ont comparé les deux groupes à l'aide du test de Student non apparié. RÉSULTATS: Dans les deux groupes, la résistance nasale latérale droite et gauche avait diminué considérablement six mois après l'opération (P < 0,001). Cependant, d'après la comparaison entre les deux groupes, cette différence n'était pas statistiquement significative. CONCLUSION: Les greffes et les lambeaux d'extension utilisés pour la reconstruction de la voûte nasale, donnent des résultats comparables et efficaces pour réduire la résistance nasale, tel que le démontrent les mesures de rhinamométrie antérieure active.

The Impact of Velopharyngeal Surgery on the Polysomnographic Parameters After Cleft Palate Repair.

Velopharyngeal surgical procedures may have adverse effect on the airway of the patients with velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the polysomnographic parameters (PSG) in patients who underwent corrective surgery for treatment of VPI. The study included 39 patients who underwent 1 of 3 velopharyngeal surgical techniques; Furlow palatoplasty (12 patients), pharyngeal flap (18 patients), and sphincter pharyngoplasty (9 patients). The patients were subjected to PSG, and they were considered to have obstructive sleep apnea (OSA) with apnea-hypoapnea index (AHI) >1.Comparison of PSG parameters of patients showed insignificant difference regarding the total sleep time, sleep efficiency, arousal index, desaturation index, and minimum oxygen saturation. Significant difference was detected regarding peak end-tidal CO2 and AHI. Pharyngeal flap was detected as the most surgical technique that worsened the PSG parameters with OSA in 78% of patients, followed by sphincter pharyngoplasty with OSA in 56% of patients. Furlow palatoplasty was detected as the least impacting technique on the airway in 25% of patients who demonstrated OSA. In conclusion, velopharyngeal surgery has a variable impact on the PSG; pharyngeal flap has the most worsening effect followed by sphincter pharyngoplasty, while Furlow palatoplasty has the least adverse effect.

The effect of adenotonsillectomy on obstructive sleep apnea in children with Down syndrome.

OBJECTIVE: Children with Down syndrome (DS) are liable to develop obstructive sleep apnea (OSA) due to many anatomical airway abnormalities. The tonsils and adenoid occupy part of the airway space, and their removal may be helpful in relieving airway obstruction. The aim of this study was to assess the effectiveness of adenotonsillectomy in the treatment of OSA in those children. METHODS: Fifty DS children with difficult breathing were recruited, and they were subjected to polysomnographic examination (PSG). Patients with apnea-hypopnea index (AHI) > 1 were considered to have OSA. Adenotonsillectomy was performed for patients who had OSA and adenotonsillar hypertrophy, and after 3 months PSG was done for them with recording of the same preoperative parameters. RESULTS: Forty-three children demonstrated OSA on PSG, and they were included in the study. The preoperative mean AHI was 9.18 (± 6.17) that improved postoperatively to 2.72 (± 3.80) with its normalization in 72% of patients. Also, significant improvement of arousal index, minimum oxygen saturation, desaturation index, and peak end-tidal CO2 was achieved postoperatively. CONCLUSION: Adenotonsillectomy is an effective method for the treatment of OSA in children with DS. However, the condition may persist in some children who usually have airway narrowing at multiple levels.

Maxillary sinus mucocele: predisposing factors, clinical presentations, and treatment.

PURPOSE: Maxillary sinus mucocele (MSM) is uncommon lesion and has many presenting features. The aim of this study was to detect the possible predisposing factors, clinical characteristics, and to assess the efficacy of trans-nasal endoscopic treatment of this lesion. METHODS: This retrospective multicenter study was conducted on 36 patients with MSM, the diagnosis of the disease was based on computed tomographic criteria. The patients' history, presenting features, and surgical management were reviewed. All patients were followed up postoperatively for at least 3 years. RESULTS: Chronic sinusitis, previous surgery, allergic rhinitis, and nasal trauma may be implicated as predisposing factors for the disease. However, in some patients (56%) the cause may remain uncertain. MSM may present with unilateral cheek pain, heaviness, swelling, numbness, hemifacial pain, nasal obstruction, nasal discharge, and/or proptosis. All patients were treated with trans-nasal endoscopic marsupialization through the middle meatus, patients with large MSM showed bulged medial maxillary wall, and they needed to empty the fluid through inferior antrostomy to facilitate introduction of the instruments to the middle meatus. All patients reported resolution of their symptoms, and none required revision surgery through the follow-up period. CONCLUSIONS: MSM has several predisposing factors such as chronic sinusitis, previous surgery, allergic rhinitis and nasal trauma. However, some patients have no identifiable cause. The disease can present with a variety of symptoms which are usually related to their expansion and subsequent pressure on the surrounding structures. Trans-nasal endoscopic approach is an effective and safe method for treatment of the lesion.