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The aim of this study is to analyze patterns and volumes of patients visiting ENT emergency departments during periods of community lockdowns given the newness of this situation and to assess the variation in numbers of visits and examine whether their reduction equally affects all categories of visit causation or whether it is limited to diseases not considered as emergencies. Methods: A retrospective descriptive study was conducted on prospectively collected registry data on patients of all age groups visited the emergency ENT department during the period of nationwide lockdown. Patients were grouped in 9 categories, according to the cause of visit the ENT emergency department. Results: A total of 201 patients visited the ENT emergency department. The retrospective analysis of the data during the same period in the years 2013 to 2019 showed a reduction of 73% in total visits (mean total visits number between 2013 to 2019 was 745.29 ± 20.0143). A statistically signi cant reduction in visitation was found in all categories studied with the exception of foreign body ingestion-aspiration. Conclusion: Patients with General ENT symptoms, mild epistaxis cases, otology cases, vertigo cases, uncomplicated infectious cases showed a statistically signi cant reduction in numbers and were treated empirically. Swallowing foreign body cases did not show statistically signi cant reduction. Limitation of movement and the lockdown itself, led to reduction of trauma cases. Surprisingly, there was also a reduction in oncology cases and an increase in numbers of these cases can be expected in the near future.

To investigate the possible correlation between benign paroxysmal positional vertigo (BPPV), seasonality, and climatic variations as indicators of vitamin D deficiency, since otoconia are calcium carbonate crystals. MethodsThis is a study of patients who received the diagnosis of BPPV from September 2015 to August 2019. Gender, age, and month of diagnosis were factors recorded and analyzed. The cut-off age of 50 years is used to include osteoporotic patients and postmenopausal women. Meteorological and climatic data of latitude, temperature, sunshine hours, humidity, precipitation, wind force, atmospheric pressure, and horizontal solar irradiance were collected. ResultsFour hundred and eighty-five patients were included in the study; 206 were male (42%) and 279 were female (58%). The mean age was 57.8±15.4 and 54.9±13.9, respectively; 192 patients were ≤50 years old (121 female and 71 male) and 293 patients were over 50 years old (135 male and 158 female). A statistical significance in seasonal variation during autumn months was demonstrated (p-value= 5.2 e-05, z-statistic: 9.8164). There was no statistical correlation between the median number of BPPV patients and the median sunshine hours per month, horizontal solar irradiance, or other climatic variables. ConclusionsOur study demonstrates seasonality in BPPV patients in Greece but no correlation between BPPV and climatic variations as a proxy for Vitamin-D levels was documented.

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Fibrous dysplasia is a rare non-malignant condition where fibrous tissue replaces the normal bone architecture. Involvement of temporal and occipital bones is exceptionally rare and is associated with unique complications. A 10-year-old boy presented with right retroauricular enlargement and pain. Imaging studies and biopsy revealed fibrous dysplasia of the temporal and occipital bones. There was no hearing loss or sequelae arising from posterior fossa compression. The patient was discharged with follow-up instructions. Only 10 cases of occipital bone fibrous dysplasia have been reported in the medical literature. Occipital bone fibrous dysplasia can be complicated with Chiari malformation and syringomyelia while temporal bone involvement is associated with hearing loss. These potential developments require close follow-up that includes detailed neurologic examination, imaging and audiology.