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There have been few investigations on the epidemiology, etiology, and medical management of acute unilateral vestibulopathy (AUV). Short-term pharmaceutical resolutions include vestibular symptomatic suppressants, anti-emetics, and some cause-based therapies. Anticholinergics, phenothiazines, antihistamines, antidopaminergics, benzodiazepines, and calcium channel antagonists are examples of vestibular suppressants. Some of these medications may show their effects through multiple mechanisms. In contrast, N-acetyl-L-leucine, Ginkgo biloba, and betahistine improve central vestibular compensation. Currently, AUV pathophysiology is poorly understood. Diverse hypotheses have previously been identified which have brought about some causal treatments presently used. According to some publications, acute administration of anti-inflammatory medications may have a deleterious impact on both post-lesional functional recovery and endogenous adaptive plasticity processes. Thus, some authors do not recommend the use of corticosteroids in AUV. Antivirals are even more contentious in the context of AUV treatment. Although vascular theories have been presented, no verified investigations employing anti-clotting or vasodilator medications have been conducted. There are no standardized treatment protocols for AUV to date, and the pharmacological treatment of AUV is still questionable. This review addresses the most current developments and controversies in AUV medical treatment. [ABSTRACT FROM AUTHOR]

Objective: So far, no original studies explored non-randomized, standardized protocols for COVID-19 associated olfactory dysfunction. The main objective was to determine the efficacy of a new protocol for post-COVID olfactopathy while assessing the benefit of adding adjuvant therapies to olfactory training. Methods: Patients suffering from long-lasting post-COVID-19 olfactory dysfunction were evaluated. A non-randomized protocol based on individual nasal endoscopy findings and patient's preferences was applied. Patients were assigned for olfactory training alone or olfactory training + adjuvant therapy. Participants performed olfactory objective and subjective evaluations at first consultation and 3 months after treatment, and results were compared. Results: A total of 47 patients were enrolled. All groups showed significant improvement in olfactory thresholds at 3-month follow-up suggesting protocol effectiveness (olfactory training group alone showed a mean threshold difference of 2.9, P <.001; Olfactory training + Topical Corticosteroid showed a mean threshold difference of 4, P =.006; Olfactory training + Topical Corticosteroid + Vitamin B complex showed a mean threshold difference of 4.4, P =.006; Olfactory training + Intranasal Vitamin A and E showed a mean threshold difference of 4.4, P <.001). Olfactory training alone showed lower mean olfactory threshold improvement, when compared to patients undergoing olfactory training + adjuvant therapy (olfactory training alone mean improvement 2.9 ± 2.3 vs olfactory training + adjuvants mean improvement 4.3 ± 2.458, P =.03). Conclusions: This is one of the first studies to demonstrate results in the treatment of post-COVID-19 persistent olfactory impairment. A customized approach based on endoscopy findings and patient's preferences may be a valid option for the management of persistent post-COVID-19 olfactory disorder. Adjuvant therapy could be considered in addition to olfactory training, but further studies are needed in order to confirm their effectiveness in this setting. Level of evidence: 2c (outcomes research). [ABSTRACT FROM AUTHOR]

Introduction: To date, little is known about predisposing factors for persistent COVID-19-induced olfactory dysfunction (pCIOD). The objective was to determine whether olfactory cleft (OC) measurements associate with pCIOD risk.Material and Methods: Three subgroups were recruited: group A included patients with pCIOD, group B included patients without olfactory dysfunction following SARS-CoV-2 infection (ntCIOD), and group C consisted in controls without past history of SARS-CoV-2 infection (noCOVID-19). Olfactory perception threshold (OPT) and visual analog scale for olfactory impairment (VAS-olf) were obtained. OC measurements were obtained through computed tomography scans. Results were subsequently compared.Results: A total of 55 patients with a mean age of 39 ± 10 years were included. OPT was significantly lower in pCIOD patients (group A: 4.2 ± 2.1 vs. group B: 12.3 ± 1.8 and group C: 12.2 ± 1.5, p < 0.001). VAS-olf was significantly higher in pCIOD (group A: 6 ± 2.6 vs. group B: 1.7 ± 1.6 and group C: 1.6 ± 1.5, p < 0.001). OC length was significantly higher in group A (42.8 ± 4.6) compared to group B (39.7 ± 3.4, p = 0.047) and C (39.8 ± 4, p = 0.037). The odd of pCIOD occurring after COVID-19 infection increased by 21% (95% CI [0.981, 1.495]) for a one unit (mm) increase in OC length. The odd of pCIOD occurring was 6.9 times higher when OC length >40 mm.Conclusion: Longer OC may be a predisposing factor for pCIOD. This study is expected to encourage further research on OC morphology and its impact on olfactory disorders. [ABSTRACT FROM AUTHOR]

Objective: Mucosal melanomas are rare neoplasms having their own pathogenesis, epidemiology, and clinical characteristics. Most patients will develop metastatic disease regardless of surgical resection, which is the preferred treatment in the early stages. However, there are few data published in the literature and there are no well-defined therapeutic guidelines. This work aims to present 3 cases of mucosal melanoma of the head and neck and, considering the particularities and rarity of this type of tumor, carry out a review of its characteristics, staging, and treatment. Methods: Data regarding clinical records were reviewed maintaining anonymity. The study was performed according to the Helsinki Committee requirements. Patients have given their informed consent for participation in the research study. Results: We present 3 cases of nasosinusal malignant melanoma that were observed at our center. All underwent endoscopic sinus surgery. The conditions of these patients were discussed in light of literature guidelines. Conclusions: Nasosinusal malignant melanoma of the nose is a rare tumor. Considering the high probability of recurrence of this type of tumor and the associated poor prognosis, even after aggressive surgical treatment, more studies are needed to establish the use of systemic complementary immunotherapy to improve the prognosis. The endoscopic surgical approach is our preferential approach since it allows us to obtain an apparently similar local control regarding open surgery, with less associated morbidity. Checkpoint inhibitor immunotherapy, established as the first line for metastatic cutaneous melanoma, appears to be the primary systemic treatment with the most promising role for nasosinusal melanoma progression-free survival. The rarity of this lesion reinforces the consideration of nasosinusal melanoma among the differential diagnosis of tumors of nose and paranasal sinuses. [ABSTRACT FROM AUTHOR]

Objective: The study aimed to assess a possible association between allergic rhinitis and asthma and surgical management of chronic rhinosinusitis. Methods: A retrospective study was carried out to review the clinical charts of adult patients who underwent functional endoscopic sinus surgery as a surgical treatment for chronic rhinosinusitis. Data regarding clinical symptoms, endoscopic findings, and radiological findings were considered. Results: The studied population included 74 patients. An average Lund-Mackay score of 10.59 ± 5.427 was identified with no statistically significant difference between the presence or absence of allergic rhinitis or asthma. There was a statistically significant association between the presence of sneezing attacks, nasal itching, and hyposmia before surgery and the presence of asthma previously diagnosed. There is no statistically significant difference between the Lund-Mackay score before the surgery or the presence of nasal polyposis, asthma, or allergic rhinitis. Overall, we verified a reduced prevalence of symptoms after functional endoscopic sinus surgery with no difference between the groups with and without allergic rhinitis or asthma. Conclusions: There was a statistically significant association between the presence of sneezing attacks, nasal itching, and hyposmia before surgery and the presence of asthma previously diagnosed. We did not find a statistical difference between the degree of regression of nasal polyposis in the sub-samples of patients with allergic rhinitis or asthma. Our findings are also in line with the literature which shows that symptoms improved significantly in both asthmatics and non-asthmatics postoperatively. [ABSTRACT FROM AUTHOR]

Septorhinoplasty (SRP) is one of the most commonly performed procedures worldwide. There is a recognized debate about the impact of nasal surgery on olfactory function (OF). The study's objective was to assess the effect of SRP on late postoperative OF. A comprehensive review and meta-analysis were employed to assess OF after SRP. All the integrated studies used objective instruments to quantify OF before and after surgery. A literature search was conducted, and the selected works were evaluated, computed, and finally included in a meta-analysis. The risk of bias was assessed using the NIH Guidance for Evaluating the Quality of Before-After (Pre-Post) Studies with No Control Group. Only the latest follow-up OF measurements provided by each research were considered in the analysis. The 95% confidence interval of the effect magnitude for each study was calculated to elucidate effect sizes. Eleven studies were included in the analysis. Five studies reported late OF improvement (45.5%), five reported no alteration in OF (45.5%), and only one study reported OF impairment after SRP (9%). Some works described a transitory decline in OF shortly following surgery, followed by postoperative improvement. A pooled meta-analysis showed that OF was not significantly altered after SRP (p = 0.10) in the late follow-up. SRP surgery seems to constitute a safe procedure concerning OF in the long term. According to research, OF may deteriorate temporarily after surgery with later improvement, sometimes to higher values than baseline. The anticipated evolution of OF after intervention could be discussed during the preoperative consultation for SRP. [ABSTRACT FROM AUTHOR]

Oculo-auriculo-vertebral spectrum (OAVS) is aetiologically/pathogenetically a heterogeneous disorder. This study focuses on investigating of maternal drug intake during pregnancy in OAVS cases. Our sample was composed of 114 paediatric cases of OAVS. For each patient, an evaluation form seeking identity, medical history, pregnancy and family data, physical/dysmorphological findings and results from complementary tests was applied. Through the analysis of all the forms applied, the history of drug exposure/maternal diseases were retrospectively studied. The age of the population studied ranged between 1 month and 18 years, the majority being male. Regarding otological features, most had pinna involvement: microtia (86.6%); preauricular appendices (41.6%) and preauricular sinus (15.7%). External auditory canal atresia/stenosis was observed in 61.0% of the cases. Most had conductive hearing loss (75.5%) and imaging study revealed middle/inner ear malformations in 21.1% of the cases. Regarding nonotological characteristics, ophthalmological, osteoarticular and cardiac involvement were the 3 most frequently observed. Most cases had no evident cause for the development of anomalies (68.4%). However, in 16.7% a positive family history was identified. A history of drug intake has been elicited in 14.9% of the participants. The drugs intake during pregnancy found in our study were: isotretinoin, fluoxetine, oral contraceptives, levothyroxine, domperidone, enalapril, acyclovir and pseudoephedrine/triprolidine and gestational diabetes in need of treatment. Some drugs are unquestionably associated with the development of malformation, such as isotretinoin, however, the other drugs cannot be underestimated, since their synergistic effect with other environmental agents and genetic background may be in the origin of OAVS. [ABSTRACT FROM AUTHOR]

Background: The objective of this work was to describe a simple, economical, and reproducible method for taste evaluation. Methods: A new protocol called Taste Assessment Protocol was created using different concentrations of sweet, salty, bitter, and sour solutions. The test was applied to participants complaining of persistent olfactory-gustatory complaints after coronavirus disease 2019 diagnosis. Results: Ten participants were included. The mean Taste Assessment Protocol score was 10.75 ± 1.2, with a recorded minimum of 8 and a recorded maximum of 12. Ninety percent of the patients had a Taste Assessment Protocol score ≥ 10. The mean olfactory threshold of the observed patients was 3.5 ± 1.7, with a registered minimum of 2 and a maximum of 6. Conclusion: Tests like this may persuade researchers and clinicians to assess taste more regularly. Validation of this method could bring light to a standardized and easily applicable taste test, with a well-defined score. Taste assessment by this method suggests that gustatory dysfunction after coronavirus disease 2019 may be due to retronasal olfactory dysfunction. [ABSTRACT FROM AUTHOR]