ENT management of children with adenotonsillar disease during COVID-19 pandemic. Ready to start again?

Torretta, Sara; Capaccio, Pasquale; Gaffuri, Michele; Gaini, Lorenzo; Borin, Marco; Maruca, Antonella; Battilocchi, Ludovica; Nitro, Letizia; Marchisio, Paola

doi:10.1016/j.ijporl.2020.110145

Cited by 7 publications

(6 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The stunning diffusion of COVID-19 from our region placed at the epicentre of the Italian epidemic at the end of February 2020 brought us to stop any elective medical activities except for those related to emergency [1]. Periodic outpatient assessment of otitis-prone children (OPC) (i.e.…”

Section: Introductionmentioning

confidence: 99%

Incidental lowering of otitis-media complaints in otitis-prone children during COVID-19 pandemic: not all evil comes to hurt

et al. 2020

Self Cite

View full text Add to dashboard Cite

Given COVID-19 pandemic periodic outpatient assessment of otitis-prone children regularly followed at our tertiary outpatient clinic of upper respiratory tract infections was discontinued since 9 March. In order to avoid leaving the patients to themselves just during the winter months, which are the most critical ones for these children, we kept in touch with the families of 102 children (mean age 41.4 ± 14.0 months) who had had a follow-up visit scheduled during the lockdown, and compensated with telemedicine assessment. This incidentally leads to the unexpected but not at all negative finding that a consistent clinical improvement had been occurred in most (82.3%) of children. A statistically significant reduction in the mean number of documented acute otitis media episodes, otorrhea episodes, and systemic antibiotic treatments during the February-April 2020 period compared with February-April 2019 was attested. Clinical evaluation performed in 27.4% cases revealed normal middle ear findings in all but three (89.3%) children. Conclusion: Our data document a global improvement of otitis-prone children in Milan during the Italian lockdown, as a fortuitous and incidental positive effect of the national lockdown. Keywords Otitis media. Children. Otitis-prone. COVID-19. Infection Abbreviations COVID-19 Coronavirus 2019 disease OPC Otitis-prone children RAOM Recurrent acute otitis media CURTI Outpatient clinic of upper respiratory tract infections What is Know: • During COVID-19 pandemic in Italy any non-urgent medical activity including periodic outpatient assessment of otitis-prone children was discontinued. • Otitis-prone children experience acute infectious exacerbations mainly in winter. What is New: • Most of children reached by means of a telemedicine assessment during lockdown experienced a subjective clinical improvement; clinical assessment at the end of the lockdown revealed normal otoscopic findings in most cases. • Exceptional circumstances during COVID-19 pandemic had a fortuitous positive effect on otitis-prone children's clinical conditions.

show abstract

Section: Introductionmentioning

confidence: 99%

Incidental lowering of otitis-media complaints in otitis-prone children during COVID-19 pandemic: not all evil comes to hurt

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…The measures adopted to contain the COVID-19 pandemic also resulted in a decrease of airborne-mediated respiratory infections other than COVID-19, including URTI, bronchiolitis, and AOM (Kuitunen et al, 2020;Lin et al, 2020;Torretta et al, 2020;Alde et al, 2021;Angoulvant et al, 2021;. In addition, the number of children presenting to healthcare facilities for non-urgent complaints, such as AOM or otitis media with effusion (OME), was also affected by the fear of contracting COVID-19 at the hospital or the outpatient clinics.…”

Section: Reduction In Pediatric Aom/ome Casesmentioning

confidence: 99%

“…Another report from Milan addressed the clinical activities pertinent to pediatric OM and modifications of surgical waiting lists during the COVID-19 pandemic, with patient selection based upon the priority of certain conditions, as defined by the Italian Society of Otorhinolaryngology-Head and Neck Surgery (Torretta et al, 2020). Priority for VTI surgery was granted to candidates with persistent OME, causing a negative impact on language development.…”

Section: Changes In Ventilating Tube Surgerymentioning

confidence: 99%

Otitis Media Practice During the COVID-19 Pandemic

Marom¹,

Pitaro

Shah

et al. 2022

Front. Cell. Infect. Microbiol.

Self Cite

View full text Add to dashboard Cite

The global coronavirus disease-2019 (COVID-19) pandemic has changed the prevalence and management of many pediatric infectious diseases, including acute otitis media (AOM). Coronaviruses are a group of RNA viruses that cause respiratory tract infections in humans. Before the COVID-19 pandemic, coronavirus serotypes OC43, 229E, HKU1, and NL63 were infrequently detected in middle ear fluid (MEF) specimens and nasopharyngeal aspirates in children with AOM during the 1990s and 2000s and were associated with a mild course of the disease. At times when CoV was detected in OM cases, the overall viral load was relatively low. The new severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative pathogen responsible for the eruption of the COVID-19 global pandemic. Following the pandemic declaration in many countries and by the World Health Organization in March 2020, preventive proactive measures were imposed to limit COVID-19. These included social distancing; lockdowns; closure of workplaces; kindergartens and schools; increased hygiene; use of antiseptics and alcohol-based gels; frequent temperature measurements and wearing masks. These measures were not the only ones taken, as hospitals and clinics tried to minimize treating non-urgent medical referrals such as OM, and elective surgical procedures were canceled, such as ventilating tube insertion (VTI). These changes and regulations altered the way OM is practiced during the COVID-19 pandemic. Advents in technology allowed a vast use of telemedicine technologies for OM, however, the accuracy of AOM diagnosis in those encounters was in doubt, and antibiotic prescription rates were still reported to be high. There was an overall decrease in AOM episodes and admissions rates and with high spontaneous resolution rates of MEF in children, and a reduction in VTI surgeries. Despite an initial fear regarding viral shedding during myringotomy, the procedure was shown to be safe. Special draping techniques for otologic surgery were suggested. Other aspects of OM practice included the presentation of adult patients with AOM who tested positive for SARS-2-CoV and its detection in MEF samples in living patients and in the mucosa of the middle ear and mastoid in post-mortem specimens.

show abstract

“…Proper education and training are needed to enable the sample collection teams to reliably and safely perform sample collection in the proper section of the nasopharynx [18]. With this objective, any effort toward standardization and control of the sampling procedure is valuable, especially when dealing with children, whose reduced compliance with the unpleasant maneuver of swab penetration may further burden the technique sensitivity of the test [25]. Effective sampling is also particularly critical with children due to the purportedly high and still probably underestimated rate of asymptomatic carriers.…”

Section: Discussionmentioning

confidence: 99%

Cross-Sectional Study on Lateral Skull Radiographs to Design a New Nasopharyngeal Swab for Simplified COVID-19 and Respiratory Infections Diagnostic Testing in Children

Goracci

Volpe

Salerni

et al. 2022

JCM

View full text Add to dashboard Cite

Nasopharyngeal swab sample collection is the first-line testing method for diagnosing COVID-19 infection and other respiratory infections. Current information on how to properly perform nasopharyngeal swabbing in children is largely defective. This study aimed at collecting nostril to nasopharynx distance measurements on lateral skull radiographs of children and adolescents to design a nasopharyngeal swab meant to standardize and facilitate the sample collection procedure. A total of 323 cephalograms of 152 male and 171 female children aged 4–14 years taken for orthodontic reasons were selected. On each cephalogram, the shortest distance between the most anterosuperior point of the nostril contour and the nasopharynx outline was measured in mm parallel to the palatal plane. Descriptive statistics of the measurements were calculated for each age group. The lower limit of the 95% confidence intervals of the measurements was taken as a reference to design a swab shaft with marks that, at each age, delimitate a safety boundary for swab progression up to the posterior nasopharyngeal wall. The simplification of the procedure enabled by the newly designed nasopharyngeal swab is valuable to help healthcare providers perform specimen collection on children in a safe and effective way, perhaps under the less-than-ideal conditions possibly occurring in ‘point-of-need’ contexts.

show abstract

ENT management of children with adenotonsillar disease during COVID-19 pandemic. Ready to start again?

Cited by 7 publications

References 5 publications

Incidental lowering of otitis-media complaints in otitis-prone children during COVID-19 pandemic: not all evil comes to hurt

Incidental lowering of otitis-media complaints in otitis-prone children during COVID-19 pandemic: not all evil comes to hurt

Otitis Media Practice During the COVID-19 Pandemic

Cross-Sectional Study on Lateral Skull Radiographs to Design a New Nasopharyngeal Swab for Simplified COVID-19 and Respiratory Infections Diagnostic Testing in Children

Contact Info

Product

Resources

About