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Purpose: A hypometabolic profile involving the limbic areas, brainstem and cerebellum has been identified in long COVID patients using [18F]fluorodeoxyglucose (FDG)-PET. This study was conducted to evaluate possible recovery of brain metabolism during the follow-up of patients with prolonged symptoms. Methods: Fifty-six adults with long COVID who underwent two brain [18F]FDG-PET scans in our department between May 2020 and October 2022 were retrospectively analysed, and compared to 51 healthy subjects. On average, PET1 was performed 7 months (range 3–17) after acute COVID-19 infection, and PET2 was performed 16 months (range 8–32) after acute infection, because of persistent severe or disabling symptoms, without significant clinical recovery. Whole-brain voxel-based analysis compared PET1 and PET2 from long COVID patients to scans from healthy subjects (p-voxel < 0.001 uncorrected, p-cluster < 0.05 FWE-corrected) and PET1 to PET2 (with the same threshold, and secondarily with a less constrained threshold of p-voxel < 0.005 uncorrected, p-cluster < 0.05 uncorrected). Additionally, a region-of-interest (ROI) semiquantitative anatomical approach was performed for the same comparisons (p < 0.05, corrected). Results: PET1 and PET2 revealed voxel-based hypometabolisms consistent with the previously reported profile in the literature. This between-group analysis comparing PET1 and PET2 showed minor improvements in the pons and cerebellum (8.4 and 5.2%, respectively, only significant under the less constrained uncorrected p-threshold); for the pons, this improvement was correlated with the PET1-PET2 interval (r = 0.21, p < 0.05). Of the 14,068 hypometabolic voxels identified on PET1, 6,503 were also hypometabolic on PET2 (46%). Of the 7,732 hypometabolic voxels identified on PET2, 6,094 were also hypometabolic on PET1 (78%). The anatomical ROI analysis confirmed the brain hypometabolism involving limbic region, the pons and cerebellum at PET1 and PET2, without significant changes between PET1 and PET2. Conclusion: Subjects with persistent symptoms of long COVID exhibit durable deficits in brain metabolism, without progressive worsening. [ABSTRACT FROM AUTHOR]

Key points: Chatbot Generative Pre‐trained Transformer (ChatGPT)‐4 indicated more than twice additional examinations than practitioners in the management of clinical cases in rhinology.The consistency between ChatGPT‐4 and practitioner in the indication of additional examinations may significantly vary from one examination to another.The ChatGPT‐4 proposed a plausible and correct primary diagnosis in 62.5% cases, while pertinent and necessary additional examinations and therapeutic regimen were indicated in 7.5%–30.0% and 7.5%–32.5% of cases, respectively.The stability of ChatGPT‐4 responses is moderate‐to‐high. The performance of ChatGPT‐4 was not influenced by the human‐reported level of difficulty of clinical cases. [ABSTRACT FROM AUTHOR]

Objective: Pediatric inferior turbinate hypertrophy (PedTH) is a frequent and often overlooked cause or associated cause of nasal breathing difficulties. This clinical consensus statement (CCS) aims to provide a diagnosis and management framework covering the lack of specific guidelines for this condition and addressing the existing controversies. Methods: A clinical consensus statement (CCS) was developed by a panel of 20 contributors from 7 different European and North American countries using the modified Delphi method. The aim of the CCS was to offer a multidisciplinary reference framework for the management of PedTH on the basis of shared clinical experience and analysis of the strongest evidence currently available. Results: A systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) criteria was performed. From the initial 96 items identified, 7 articles were selected based on higher‐evidence items such as randomized‐controlled trials, guidelines, and systematic reviews. A 34‐statement survey was developed, and after three rounds of voting, 2 items reached strong consensus, 17 reached consensus or near consensus, and 15 had no consensus. Conclusions: Until further prospective data are available, our CCS should provide a useful reference for PedTH management. PedTH should be considered a nasal obstructive disease not necessarily related to an adult condition but frequently associated with other nasal or craniofacial disorders. Diagnosis requires clinical examination and endoscopy, whereas rhinomanometry, nasal cytology, and questionnaires have little clinical role. Treatment choice should consider the specific indications and features of the available options, with a preference for less invasive procedures. Level of Evidence: 5 Laryngoscope, 134:1437–1444, 2024 [ABSTRACT FROM AUTHOR]

Background: Among all studies describing COVID-19 clinical features during the first wave of the pandemic, only a few retrospective studies have assessed the correlation between olfac-tory dysfunction (OD) and the evolution of disease severity. The main aim was to assess whether OD is a predictive factor of COVID-19 severity based on the patient's medical management (outpa-tient care, standard hospital admission, and ICU admission). Methods: A national, prospective, mul-ticenter cohort study was conducted in 20 public hospitals and a public center for COVID-19 screen-ing. During the first wave of the pandemic, from 6 April to 11 May 2020, all patients tested positive for COVID-19 confirmed by RT-PCR underwent two follow-up ENT consultations within 10 days of symptom onset. The main outcome measures were the evolution of medical management (out-patient care, standard hospital admission, and ICU admission) at diagnosis and along the clinical course of COVID-19 disease. Results: Among 481 patients included, the prevalence of OD was 60.7%, and it affected mostly female patients (74.3%) under 65 years old (92.5%), with fewer comor-bidities than patients with normal olfactory function. Here, 99.3% (290/292) of patients with OD presented with non-severe COVID-19 disease. Patients reporting OD were significantly less hospi-talized than the ones managed as outpatients, in either a standard medical unit or an ICU. Conclu-sions: As regards the clinical course of COVID-19 disease, OD could predict a decreased risk of hospitalization during the first wave of the pandemic. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effectiveness of platelet‐rich plasma (PRP) injection into the olfactory clefts of coronavirus disease 2019 (COVID‐19) patients with persistent olfactory dysfunction (OD). Study Design: Controlled study. Setting: Multicenter study. Methods: From March 2022 to November 2022, COVID‐19 patients with persistent OD were recruited from three European hospitals to undergo PRP injections into the olfactory clefts. Olfactory function was evaluated at baseline and 10 weeks postinjection with the Olfactory Disorder Questionnaire (ODQ) and threshold, discrimination, and identification (TDI) test. Data were compared with a control group of untreated patients. Results: Eighty‐one patients who underwent PRP injection and 78 controls were included. Sixty‐five PRP patients (80.3%) experienced subjective smell improvement after a mean duration of 3.4 ± 1.9 weeks. The parosmia, life quality statement, and ODQ sub‐ and total scores significantly decreased from pre‐ to 10‐week postinjection in the PRP group. The TDI sub‐ and total scores significantly increased 10 weeks postinjection. In controls, the ODQ score did not change over time, while the discrimination, identification, and total TDI scores significantly increase after 10 weeks of follow‐up. The 10‐week TDI and ODQ scores were significantly better in the PRP group compared with the controls. Conclusion: Patients who underwent PRP injection reported better 10‐week subjective and objective smell outcomes than controls. Future randomized‐controlled studies using saline injection into the olfactory cleft of controls are needed to determine the superiority of PRP over placebo. [ABSTRACT FROM AUTHOR]

Objective: The aim of our study was to describe the diagnostic performances of tubomanometry (TMM) and to determine tubomanometric parameter thresholds for the diagnosis of patulous eustachian tube (PET). Study Design: We performed a retrospective, monocentric study, including patients treated for PET vs control group. Setting: This study was performed at the Otolaryngology Department of a tertiary‐care hospital in the south of France. Methods: We collected epidemiologic and clinical data, as well as adjusted opening latency index ("R"‐index), rhinopharyngeal pressure threshold of tubal opening (Po), and velar contraction index (IVC) on TMM. Receiver operating characteristic (ROC) curves were used for determination of R index and Po thresholds. Results: Twenty‐one patients (26 patulous ears) and 14 controls (24 normal ears) were included. The R index values and Po values were significantly lower in the PET group vs controls (0.46 vs 0.80, respectively; P <.05 for R index and 13.89 vs 26.42 mbar, respectively; P <.05 for Po). No significant difference was reported between the 2 groups on IVC measurement (P =.784). After ROC curve analysis, R index was the most discriminating factor to classify PET patients with 89% specificity and 76% sensitivity with a threshold ≤0.6. Po value ≤10 mbar could support this diagnosis with more than 83% specificity. Conclusion: TMM is a reliable noninvasive method for positive diagnosis of PET. TMM could provide an accurate positive PET diagnosis and an objective evaluation for PET management. [ABSTRACT FROM AUTHOR]