Purpose. This paper aims to report the impact of COVID-19 outbreak on Emergency Ear nose and Throat (ENT) activity, in Lombardy (Italy), during COVID-19 pandemic.Methods. The number of accesses to Emergency Department requiring ENT consultations between February 21st and May 7th, 2020, was retrospectively collected, along with the conditions treated. Data were stratified in one-week time spans, in order to evaluate the evolving trends during the on-going epidemic and a comparison with the two previous years was performed. Results. A significant reduction in the number of consultations performed during the pandemic was observed, as high as - 91% compared to the same period of 2018. Conclusion. Multiple reasons can explain such a reduction of Emergency ENT consultations, not least the fear of potentially being infected by SARS-Cov-2 by while accessing the hospital. The analysis performed might be useful as a starting point for a future reorganization of first aid consultations once the epidemic will be resolved.

Purpose This paper aims to report the impact of COVID-19 outbreak on Emergency Ear nose and Throat (ENT) activity, in Lombardy (Italy), during COVID-19 pandemic. Methods The number of accesses to Emergency Department requiring ENT consultations between February 21st and May 7th, 2020, was retrospectively collected, along with the conditions treated. Data were stratified in 1-week time spans, to evaluate the evolving trends during the ongoing epidemic and a comparison with the two previous years was performed. Results A significant reduction in the number of consultations performed during the pandemic was observed, as high as − 91% compared to the same period of 2018. Conclusion Multiple reasons can explain such a reduction of Emergency ENT consultations, not least the fear of potentially being infected by SARS-CoV-2 by while accessing the hospital. The analysis performed might be useful as a starting point for a future reorganization of first aid consultations once the epidemic will be resolved.

Laryngeal tuberculosis (LTB) is a rare manifestation of tuberculosis (TB), accounting for 1% of all TB cases. Despite its rarity it is the most frequent laryngeal granulomatous disease. We performed a systematic literature review of the last 20 years on LTB and also present a case from our hospital with special focus on voice assessment. The literature review includes a total of 308 cases, involving studies from seven countries. In all, 64.3% of patients were males. At the time of diagnosis, the mean age range was 44.6-56.5 years. Odynophagia, hoarseness and dysphonia were the most frequent presenting symptoms. In 64 cases, the initial suspicion was laryngeal cancer. Most cases involved the true vocal folds. In about a third of cases a primary LTB with normal chest radiographic was found. Although it can be treated successfully, LTB may cause significant changes in voice quality. Nowadays, LTB is rarely diagnosed and may be confused with laryngeal cancer, it should also be included in the differential diagnosis with all other chronic benign inflammatory and non-inflammatory diseases of the larynx.

Madelung’s Disease (MD), also known as benign multiple symmetric lipomatosis or Launois-Bensaude syndrome, is a rare condition. The characteristic feature is the presence of numerous diffuse lipomas at the level of the neck or upper limbs. The etiology is unknown, but a close association with ethyl abuse has been observed. The use of radiological examinations such as ultrasound, computed tomography and magnetic resonance imaging is helpful for the differential diagnosis. There are two classifications mainly used: The Enzi classification and the Donhauser classification. In this article we present a case of MD with laryngeal localization. A 50-year-old man was referred to our department complaining of dysphonia for about 6 months. An abnormal and diffuse enlargement of the anterior part of the neck was noticed, compatible with “Madelung’s Collar”. Fiberoptic examination of the larynx revealed the presence of a lipomatous-like neoformation of the left false vocal cord. The patient underwent surgical removal of the laryngeal neoformation with transoral laser microsurgery. With this article we suggest a possible diagnostic and therapeutic procedure for the treatment of laryngeal lipomatosis. Keywords: Lipoma; TML; Larynx; Dysphonia; ENT

Centrifuged autologous fat injection is a safe, feasible and effective phonosurgical technique for the treatment of chordal paralysis and its use dates back to 1991. This procedure allows to correct glottic incompetence by medialization of one or both vocal cords. Expecting fat resorption, which occurs postoperatively, the surgeon injects at least 30-40% more fat than needed to achieve glottic closure. The procedure is minimally invasive, with minimal morbidity and complications. In this article, we present a rare case of iatrogenic lipoma secondary to excessive lipoinjection due to the increase of the vocal cords, causing severe dysphonia.