The COVID-19 pandemic has forced the introduction of rigorous actions to prevent the spread of the human coronavirus (SARS-CoV-2). This respiratory illness is generally spread by droplets, though it can also be transmitted through contact with hands or surfaces of contaminated objects. Therefore, keeping all frequently touched household surfaces, such as phones, faucets, door knobs, and fridge handles, germ-free has come to the forefront of everyone's mind more than ever before. This situation raises the question of whether these recommendations should also apply to hearing aids (HAs) and the external part of cochlear implants (CIs) since these are a potential reservoir for microorganisms. Behind-the-ear HAs, speech processors, external coils, and magnets are devices with relatively large surfaces that often face the interlocutor; therefore their casings may be easily contaminated by airborne droplets from the nose or mouth. In addition, these devices are frequently in contact with the hands of the owner, parent, or caregiver. Children may pull off the device in defiance or frustration or misplace hearing devices, e.g., while sitting in a car seat. Their devices are usually taken off during daily naps as well.Credit/Freepik, coronavirus, sanitization, infection control.Little is known about microbial flora on the external parts of CIs and HAs. Only one small study has demonstrated polymicrobial colonization in 70 percent of cases on the outer surfaces of HAs, but no viruses were included.1 It is also known from published data that SARS-CoV-2 could live the longest (even three to seven days) on plastic surfaces—the basic material of HA and CI casings.2 So the question is: How can these devices be disinfected? Device manufacturers recommend following the instructions in the user manuals and wiping HAs or speech processors using just a soft, dry cloth—not wipes with any type of alcohol or chemicals. However, simple mechanical cleaning with a dry cloth seems to be insufficient with the coronavirus pandemic. Today's need to disinfect hearing devices goes beyond the manufacturers' instructions. How can this be accomplished without soap or household detergents? UNDERSTANDING ANTIBACTERIAL ACTIVITIES It is worth mentioning the results of studies that compared four different cleaning procedures for eyeglass frames, which are contaminated in up to 90 percent of cases.3,4 The authors found that dry cleaning with tissues and microfiber cloths reduces bacterial counts significantly less than cleaning with impregnated wipes. At the same time, the efficacy of alcohol wipes (99% –100% median reduction in bacteria) is slightly higher than that of alcohol-free ones.4 Alcohol formulas, in the correct concentration, display antimicrobial activity against not only vegetative bacteria, mycoplasmas, and fungi but also viruses, including SARS-CoV-2. Although non-alcoholic wet wipes, which contain detergents or antiseptics, have antibacterial properties, they have limited or even no antiviral activity. Generally, many antibacterial agents cannot significantly affect the structure of a virus. Even if they are effective against the animal strains of coronaviruses, no evidence has yet been found that they are active against the human coronavirus. Thus, popular disinfecting wipes containing chlorhexidine gluconate may to some extent destroy SARS-CoV-2, but those that are saturated with triclosan or benzalkonium chloride will not. Since COVID-19 has only been around for a few months, many existing disinfectants have not yet been tested against the new strain of the virus. The U.S. Environmental Protection Agency (EPA) has compiled a constantly updated online list of products that—while not specifically tested on SARS-CoV-2—have been proven effective on similar or harder-to-kill viruses, such as the rhinovirus.5 Of note, many disinfectants that have alcohol in concentrations over 70 percent or contain chlorine, sodium hypochlorite, phenol, and ammonium can cause serious skin reactions, as well as functional or cosmetic damage to the surface of an object. For example, a 0.1 percent to 0.5 percent sodium hypochlorite solution (available in the form of wet wipes) effectively reduces coronaviral titer within one minute. This could help in disinfecting smartphones or CI remote controls, but not in wiping a speech processor, which comes in contact with the delicate skin behind the auricle.6 BALANCING SAFETY & INFECTION CONTROL To maintain a balance between successful disinfection and user safety based on off-label experiences, it seems reasonable to extend daily care procedures by cleaning speech processors or HAs with hand wipes or hygienic pads saturated with household hydrogen peroxide (3%). Such disinfection will be effective if the surfaces remain moist for at least one to two minutes. Although hydrogen peroxide deactivates many hard-to-kill viruses, it gradually loses its properties 30 to 45 days after the container has been opened.7,8 Therefore, the application of ethanol or isopropyl alcohol, which also destroys SARS-CoV-2, would be even more justified if we leave it on a surface for at least 30 seconds. The concentrations of those two disinfectants are crucial—less than 70 percent will not effectively kill SARS-CoV-2. Regardless of the cleaning agent used, the surface of a speech processor should be dried with a soft, clean cloth. Each type of speech processor is sensitive to a given disinfectant in a different way. If discoloration occurs on the case during cleaning, it must be stopped and the processor should be dried. Microphones are another part that can easily be damaged if cleaned in the manner described; thus, this practice is discouraged. Based on the bacteriological examinations of surgeons' eyeglasses, it can be concluded that the above recommendations should certainly be considered by health care professionals using HAs and CIs. It has been shown that the glasses of such people can be a source of surgical infection, suggesting that contamination can be caused not only by a surgeon's fingers but can also be spread through the air.9 Even the best disinfection of a speech processor or HA will bring limited results in the case of a person without sufficient personal hygiene. The most common way to transmit coronavirus is by our hands, which is why cleaning and disinfecting our hands with alcohol are very important. Hopefully, the current pandemic will strengthen the practice of proper personal hygiene habits in society.
To date, most studies on the relationship between chemosensory performance and quality of life have focused on orthonasal measures of olfactory function. In the current investigation, we examined the predictive value of orthonasal and flavor identification indices of olfactory function on a wide spectrum of health and sociopsychological factors, including quality of life, life satisfaction, overall health, and depressive symptoms. Participants were 178 ENT patients (Mage = 58 ± 1), representing various causes of olfactory loss: idiopathic smell loss (n = 51; Mage = 63 ± 2), sinunasal disease (n = 27; Mage = 56 ± 3), head trauma (n = 33; Mage = 51 ± 2), and infections of the upper respiratory tract (n = 67; Mage = 59 ± 2). They completed self-report questionnaires and underwent olfactory testing using Sniffin' Sticks (orthonasal olfactory testing) and "Taste Powder" (intraorally applied flavors for retronasal olfactory testing, additionally inducing taste sensation). Data were analyzed with hierarchical regression models wherein the first step included subjects' sex, age, and orthonasal olfaction score. In the second step, we included the "Taste Powder" score. Tested models revealed that the first step was not significantly predicting variables of interest; however, there was an improvement of the model's predictive value when the "Taste Powder" score was added. Results of this study suggest that flavor identification significantly improves predictions of health and sociopsychological functioning of ENT patients with various etiologies.
COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First observed at the end of 2019, COVID-19 was declared a pandemic in March 2020. Worldwide, many symptoms are caused by SARS-CoV-2. Otolaryngologic findings, such as voice disorders, and otologic disorders, such as tinnitus, hearing loss, and especially loss of smell, became pathognomic symptoms of COVID-19. Gastrointestinal tract manifestations and liver damage during SARS-CoV-2 infection are associated with a worse prognosis. In addition, virus affinity for the gastrointestinal tract suggests a potential fecal–oral transmission route. The pandemic also brought considerable challenges in maternity care and obstetric-gynecologic interventions. Uncertainties regarding risk for infection, possible vertical transmission, or post-COVID-19 complications have become a major issue in the everyday work of obstetricians and gynecologists. The effects of SARS-CoV-2 on the urinary system have manifested mostly as acute kidney injury.
Variability in human olfactory sensitivity has been attributed to individual-level factors such as genetics, age, sex, medical history of infections and trauma, neurogenerative diseases, and emotional disorders. Scarce evidence exists on the cross-cultural variation in olfactory sensitivity. Hence, we performed 2 studies to estimate the variability in olfactory threshold as a function of location and environment. Study 1 involved 11 laboratories from 4 continents (N = 802). In each location, in a designated laboratory, approximately 80 subjects underwent olfactory sensitivity testing with custom-made tests with eucalyptol and phenylethanol (PEA) odors. Tests were based on the Threshold subtest of the Sniffin' Sticks battery. In Study 2, we compared olfactory sensitivity and suprathreshold perception of PEA and eucalyptol in 2 Chinese (N = 160) and 2 Indian (N = 92) populations-one based in their native country and the other in Germany. Both studies present large-scale evidence that olfactory sensitivity varies as a function of geographical location and suggest that environmental factors play an important role in shaping olfactory sensitivity and suprathreshold olfactory perception. We delineate further steps necessary to identify specific factors underlying uncovered variability and the relationship between olfactory sensitivity and suprathreshold odor perception. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
• Children with severe nasopharyngeal obstruction are diagnosed relatively early. • Early diagnosis of adenotonsillar hypertrophy is crucial for normal facial development. • Adenotonsillar hypertrophy at young age predispose to vertical facial growth.
Introduction The effect of SARS-CoV-2 on hearing has not been thoroughly examined. Factors limiting hearing tests in COVID-19 patients are hygiene requirements and the need to use specialized equipment. The objective of the study was to assess changes in hearing thresholds between diagnosis of COVID-19 and convalescence using a mobile app. Material and methods Patients with mild to moderate COVID-19 symptoms, who were isolating at home were enrolled in the study between 1 September 2020 and 31 January 2021. Subjects answered an online medical survey and self-assessed hearing thresholds using the Hearing Test<sup>TM</sup> mobile app (e-audiologia.pl). These procedures were done twice, once at the time of diagnosis and again 2 weeks after convalescence. Results A total of 67 subjects were found eligible for the study. At most frequencies the patients’ hearing did not differ between the first and second examinations; however, for 4 kHz, a statistically significant improvement in the hearing threshold was found (<i>p</i> = 0.05). Survey review revealed noticeable improvement (<i>p</i> = 0.001) over time in smell, taste, and nasal congestion. Conclusions It seems that SARS-CoV-2 infection caused a transient and selective (at 4 kHz) hearing impairment in patients who had had mild to moderate infection. The results suggest that as olfactory function returns after COVID-19, an improvement in hearing can be expected. Solutions based on mobile technology are useful for monitoring the hearing of patients in a pandemic.
Fibrous dysplasia is an uncommon bone disorder affecting various parts of the skeleton, often affecting facial and cranial bones. In this case, a 10-year-old patient was diagnosed with fibrous dysplasia of the ethmoid sinus at an early age. The patient has experienced nasal congestion, snores, and worsening nasal patency since 2019. A CT scan revealed an expansive proliferative lesion, likely from the frontal or ethmoid bone, protruding into the nasal cavity, ethmoid sinus, and right orbit. The tumor causes bone defects in the area of the nasal bone, leading to fluid retention in the peripheral parts of the right maxillary sinus. The patient's parents decided not to undergo surgery to remove the diseased tissue and reconstruct the area, as it would be very extensive, risky, and disfiguring. The patient is being treated conservatively with an MRI, with a contrast performed approximately every six months and infusions of bisphosphonates. Despite the lesion's size, the patient does not experience pain characteristic of dysplasia, and functions typically. Fibrous dysplasia of bone is a rare condition that presents with the most visually apparent manifestations, often mistaken for other bone conditions. Advanced diagnostic tools, like CT and MRI, are used to identify conditions affecting the ethmoid sinus more frequently. However, diagnostic errors often occur in imaging studies, leading to confusion. The most common period for clinical manifestations and diagnosis is around 10 years of age. The preferred approach in managing fibrous dysplasia involves symptomatic treatment, which can alleviate airway obstruction, restore normal globe position and visual function, and address physical deformities. Surgical intervention is recommended only for patients with severe functional impairment, progressive deformities, or malignant transformation.
