Search

Introducción: La enfermedad por el SARS CoV-2 (COVID-19) ha provocado millones de casos desde que se declarase el estado de pandemia por la Organización Mundial de la Salud (OMS) en marzo de 2020, cambiando las prácticas médicas y quirúrgicas habituales. Los sanitarios representan un importante porcentaje de la población general contagiada. Entre ellos, destaca el especial riesgo de infección en otorrinolaringólogos y cirujanos de cabeza y cuello (ORL), debido a la cercanía a la vía aérea superior y al riesgo de generación de bioaerosoles durante los procedimientos. Objetivo: El objetivo de este artículo es la elaboración de un documento de práctica otorrinolaringológica segura durante la pandemia COVID19. Método: Revisión bibliográfica. Resultados: Recopilación de la mejor evidencia adaptada al riesgo de trans misión, según la combinación de los resultados de los indicadores de riesgo establecidos por el Ministerio de Sanidad, Consumo y Bienestar Social (MSCBS). El presente documento es fruto de la colaboración de las comisiones científicas y del comité COVID-19 de la SEORLCCC. Introduction: The SARS CoV-2 (COVID-19) disease has caused millions of cases since the pandemic status was declared by the World Health Organization (WHO) in March 2020, changing the usual medical and surgical practices. Doctors and nurses represent a significant percentage of the general population infected. Among them, the special risk of infection in otorhinolaryngologists and head and neck surgeons (ENT) stands out, due to the proximity to the upper airway and the risk of generation of bioaerosols during procedures. Objective: The objective of this article is to prepare a document on safe otorhinolaryngological practice during the COVID19 pandemic. Results: Compilation of the best evidence adapted to the risk of transmission, according to the combination of the results of the risk indicators established by the Ministry of Health, Consumption and Social Welfare (MSCBS). This document is the result of the collaboration of the scientific commissions and the COVID-19 committee of the SEORLCCC.

Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has represented a major challenge for healthcare systems worldwide, changing the habits of physicians. A reorganization of healthcare activity has been necessary, limiting surgical activity to essential cases (emergencies and oncology), and improving the distribution of health resources. Objective To analyze the impact of the COVID-19 pandemic on head and neck cancer surgery management in Spain. Methods A cross-sectional study, through an anonymous and voluntary online survey distributed to 76 Spanish otorhinolaryngology departments. Results A total of 44 centers completed the survey, 65.9% of which were high-volume. A total of 45.5% of them had to stop high-priority surgery and 54.5% of head and neck surgeons were relocated outside their scope of practice. Surgeons reported not feeling safe during their usual practice, with a decrease to a 25% of airway procedures. A total of 29.5% were “forced” to deviate from the “standard of care” due to the epidemiological situation. Conclusions Approximately half of the departments decreased their activity, not treating their patients on a regular basis, and surgeons were reassigned to other tasks. It seems necessary that the head and neck surgeons balance infection risk with patient care. The consequences of the reported delays and changes in daily practice should be evaluated in the future in order to understand the real impact of the pandemic on the survival of head and neck cancer patients.

Traballo de Fin de Grao en Medicina. Curso 2019-2020. Introducción: La obstrucción nasal es un trastorno altamente asociado con frecuencia a un patrón de respiración oral, el cual origina diversas alteraciones de crecimiento y desarrollo, posturales, maloclusivas, entre otras. Objetivos: El objetivo principal de este trabajo es estudiar la correlación entre la resistencia nasal y la extensión de la columna cervical. Como objetivos secundarios, se estudian la relación entre la resistencia nasal y el centro corporal de gravedad (CDG), así como la relación entre la extensión de la columna cervical y el CDG. Métodos: se obtuvo una muestra de 60 participantes, con edades comprendidas entre los 18 y los 87 años, procedentes de las consultas de otorrinolaringología del Complejo Hospitalario Universitario de Santiago de Compostela. Para la evaluación de la resistencia nasal y del CDG, se emplearon la rinomanometría (Rhino-Base, Otopront®) y el Test de Organización Sensorial de la posturografía dinámica (Smart Equitest®), respectivamente. Se utilizaron proyecciones radiológicas anteroposteriores y laterales de la columna cervical para cuantificar su extensión. El análisis estadístico fue llevado a cabo con STATA para Macintosh v. 15.1 (StataCorp®). Resultados: La resistencia nasal presenta una relación estadísticamente significativa con el ángulo de Harrison C2-C4 (r = -0,318; p = 0,038) y con el CDG (r = -0,359; p = 0,018). No se ha evidenciado una relación estadísticamente significativa entre la extensión cervical y el CDG. Conclusiones: Cuando aumenta la resistencia nasal, tiene lugar una extensión de la columna cervical y un desplazamiento del CDG en sentido posterior. La magnitud de estos dos efectos se incrementa con la edad. Por ello, sería adecuada la colaboración entre los médicos especialistas en otorrinolaringología y aquellos profesionales encargados de la patología de la columna y las alteraciones posturales, abordando de un modo multidisciplinar la situación de los pacientes. Introduction: Nasal obstruction is very often associated with oral breathing, leading to several disorders such as growing alterations, postural imbalance, or malocclusions, among others. Objective: The current study aimed to determine the correlation between nasal resistance and cervical spine extension. Furthermore, relations of the corporal centre of gravity (CDG) with nasal resistance and cervical spine extension were studied. Methods: 60 subjects aged between 18 and 87 years old were recruited from the otorhinolaryngology consultations from Santiago de Compostela University Hospital Complex. The nasal resistance was evaluated using rhinomanometry (Rhino-Base, Otopront®), while CDG was determined by Sensorial Organisation Test from Dynamical Posturography (Smart Equitest®). Cervical extension was measured over lateral cervical spine radiographs. All the statistical analysis was carried out with STATA for Macintosh v. 15.1 (StataCorp®). Results: Nasal resistance showed a statistically significant relationship with C2-C4 Harrison angle (r = -0,318; p = 0,038) and CDG (r = -0,359; p = 0,018). No statistically significant correlation was found between cervical extension and CDG. Conclusions: When nasal resistance increases, an extension of the cervical spine and a posteriorly displacement of the CDG occurs. The magnitude of these two effects increases with age. For this reason, collaboration between otorhinolaryngology specialists and those professionals dealing with pathology of the spine and postural changes would be appropriate, addressing the situation of patients in a multidisciplinary way.