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OBJECTIVE: To ensure the safety and quality of vaccines, especially the newest RNA-vaccines against COVID-19, is one of the World Health Organization's current highest priorities. DESIGN: Case description. STUDY SAMPLE: We report three cases of sudden unilateral tinnitus following BNT162b2 mRNA-vaccine injection, which rapidly resolved in 2 out of 3 cases. RESULTS: The mechanism responsible for its development remains unclear. A hypersensitivity reaction with an abnormal autoimmune response or a vasculitic event may be implicated. CONCLUSIONS: Large-scale and well-designed studies are needed to improve surveillance of the COVID-19 vaccine and better define possible adverse reactions involving the cochleo-vestibular system and/or immunisation anxiety-related reactions.

BACKGROUND: It has become clear that healthcare workers are at high risk, and otolaryngology has been theorized to be among the highest risk specialties for coronavirus disease 2019 (COVID-19). The purpose of this study was to detail the international impact of COVID-19 among otolaryngologists, and to identify instructional cases. METHODS: Country representatives of the Young Otolaryngologists-International Federation of Otolaryngologic Societies (YO-IFOS) surveyed otolaryngologists through various channels. Nationwide surveys were distributed in 19 countries. The gray literature and social media channels were searched to identify reported deaths of otolaryngologists from COVID-19. RESULTS: A total of 361 otolaryngologists were identified to have had COVID-19, and data for 325 surgeons was available for analysis. The age range was 25 to 84 years, with one-half under the age of 44 years. There were 24 deaths in the study period, with 83% over age 55 years. Source of infection was likely clinical activity in 175 (54%) cases. Prolonged exposure to a colleague was the source for 37 (11%) surgeons. Six instructional cases were identified where infections occurred during the performance of aerosol-generating operations (tracheostomy, mastoidectomy, epistaxis control, dacryocystorhinostomy, and translabyrinthine resection). In 3 of these cases, multiple operating room attendees were infected, and in 2, the surgeon succumbed to complications of COVID-19. CONCLUSION: The etiology of reported cases within the otolaryngology community appear to stem equally from clinical activity and community spread. Multiple procedures performed by otolaryngologists are aerosol-generating procedures (AGPs) and great care should be taken to protect the surgical team before, during, and after these operations.

OBJECTIVE: To investigate the occurrence of olfactory and gustatory dysfunctions in patients with laboratory-confirmed COVID-19 infection. METHODS: Patients with laboratory-confirmed COVID-19 infection were recruited from 12 European hospitals. The following epidemiological and clinical outcomes have been studied: age, sex, ethnicity, comorbidities, and general and otolaryngological symptoms. Patients completed olfactory and gustatory questionnaires based on the smell and taste component of the National Health and Nutrition Examination Survey, and the short version of the Questionnaire of Olfactory Disorders-Negative Statements (sQOD-NS). RESULTS: A total of 417 mild-to-moderate COVID-19 patients completed the study (263 females). The most prevalent general symptoms consisted of cough, myalgia, and loss of appetite. Face pain and nasal obstruction were the most disease-related otolaryngological symptoms. 85.6% and 88.0% of patients reported olfactory and gustatory dysfunctions, respectively. There was a significant association between both disorders (p < 0.001). Olfactory dysfunction (OD) appeared before the other symptoms in 11.8% of cases. The sQO-NS scores were significantly lower in patients with anosmia compared with normosmic or hyposmic individuals (p = 0.001). Among the 18.2% of patients without nasal obstruction or rhinorrhea, 79.7% were hyposmic or anosmic. The early olfactory recovery rate was 44.0%. Females were significantly more affected by olfactory and gustatory dysfunctions than males (p = 0.001). CONCLUSION: Olfactory and gustatory disorders are prevalent symptoms in European COVID-19 patients, who may not have nasal symptoms. The sudden anosmia or ageusia need to be recognized by the international scientific community as important symptoms of the COVID-19 infection.

Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids.

DEAR EDITOR, On 11 March 2020, the WHO director declared the rapidly spreading COVID-19 a pandemic. The very next day, a group of Italian doctors working in Belgium, sensitised by personal contact with Italian clinicians in the forefront of the pandemic, decided to take action. Concerned about the imminent impact on the hospitals and the complex management of patients with COVID-19, they created a Facebook group in French to share information. It allowed clinicians from Belgium, France and Switzerland to efficiently communicate with each other, and exchange guidelines and research, as well as personal experiences. The group was named ‘Coronavirus/COVID-19 pour les médecins’ which translates from French to ‘Coronavirus/COVID-19 for doctors’. [...]

Le syndrome CAPOS, acronyme d’ataxie cérébelleuse, aréflexie, pes cavus, atrophie optique et surdité neurosensorielle, est une affection neurologique rare, associée à la mutation spécifique c.2452G>A dans le gène ATP1A3. Les patients présentent typiquement, dans l’enfance, un ou plusieurs épisodes de dégradation neurologique aigüe comportant ataxie, aréflexie, léthargie et/ou ophtalmoplégie. Ce tableau initial peut être évocateur d’un syndrome de Guillain-Barré, de Miller-Fischer ou d’une encéphalite. Toutefois, l’électromyographie et l’analyse du liquide céphalo-rachidien sont normales. Les déficits neurosensoriels apparaissent généralement dans le décours, dans un délai variable qui rend souvent peu clair leur lien avec l’épisode initial. La surdité neurosensorielle acquise est, en particulier, un signe constant de la maladie. Nous rapportons l’histoire d’une enfant ayant développé une surdité neurosensorielle rapidement progressive 3 ans après un épisode encéphalitique survenu à l’âge de 15 mois. Le diagnostic de syndrome CAPOS fut évoqué et confirmé à l’âge de 6 ans, alors qu’elle présentait une atrophie optique depuis l’âge de 4 ans. Le syndrome CAPOS devrait être considéré dans le diagnostic différentiel des surdités neurosensorielles acquises de l’enfant, en particulier en cas d’antécédent de dégradation neurologique aigüe.

CAPOS syndrome (cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss) is a rare neurological disorder, recently associated with the c.2452G > A hotspot mutation in the ATP1A3 gene, with sensorineural hearing loss as a prominent feature. We herein report on a girl who has experienced hearing loss for three years following an initial encephalitic episode when aged 15 months old. CAPOS was diagnosed only when she was six years old by targeted testing whilst she displayed optic atrophy, cerebellar signs and areflexia. CAPOS syndrome should be considered in the differential diagnosis of acquired childhood deafness, prompting clinicians to search for associated neurological features.

Background : the aim of this multicenter study is to investigate the effect of chronological age and gender and postural control. Methods : to approach an ecological model, we used a multicenter posturography assessment. We analyzed postural control with surface, mean velocity of center pressure (CoP)and temporal analysis, with Postural Instability Index (PII) being a more sensitive parameter in postural evaluation. A large sample of 156 age -and gender- matched heathly children recruited in several pediatrics hospitals, participed. Results : our current results showed au significant decrease of all postural parameters (surface, mean velocity of CoP and PII)with age, and only on stable support condition. Our study additionally described a gender effect in conditions where all sensory inputs are most challenged with an mean velocity of CoP being significantly smaller in girls with respect to boys. Conclusion : we concluded that a postural control improves with age linked with maturation process. Moreover, this maturation process seems not yet achieved at 16.08 years and still ongoing beyond. Interestingly, our results reported specificities linked with gender effect. Indeed, girls and boys do not proceed in the same way to maintain their postural control. We could make hypothesis that more children maintain their postural control efficiently; with a low energy cost, the more they allocate attention to learning during childhood.

Le médecin généraliste contacté par/pour un patient présentant des vertiges aigus a besoin d’outils lui permettant un dépistage rapide et fiable d’un problème vestibulaire central urgent et vital. Certaines plaintes subjectives sont des feux rouges qui indiquent un examen médical urgent avant envoi éventuel dans une unité d’urgence neurologique. L’utilisation de la batterie de tests HINTS doit être encouragée car elle a été rapportée comme étant assez sensible et spécifique dans la détection de problèmes vestibulaires centraux. Après un rappel des symptômes subjectifs et des signes cliniques qui évoquent des troubles centraux, les causes vestibulaires périphériques fréquentes seront présentées., [Doctor, my head is spinning…] When contacted by a patient suffering from acute vertigo or dizziness, the general practitioner needs easy clinical tools enabling him to screen for urgent and life-threatening central vestibular disorders in a timely and reliable manner. Some subjective complaints are red flags that indicate the need for a rapid medical examination before a possible referral to a neurology emergency unit. Using the HINTS tool must be further promoted, given that it proved to be specific and sensitive in detecting central vestibular disorders. After a review of the subjective symptoms and clinical signs that evoke central vestibular disorders, the article presents the most frequent peripheral vestibular disorders.

Young Otolaryngologists (YO) can face many challenges early in their careers. YO in the developing world might lack access to high quality and inexpensive educational material, although open access resources are increasing [1]. YO practicing in geographically isolated countries or modest academic hospitals might struggle to get opportunities for high-quality clinical or research fellowships [2]. Young surgeons who are active in research sometimes lack the opportunity to shine in international meetings because they have limited access to otolaryngology networks, associations and societies.