Magnetic Resonance Imaging Confirmed Olfactory Bulb Reduction in Long COVID-19: Literature Review and Case Series

An altered sense of smell and taste was recognized as one of the most characteristic symptoms of coronavirus infection disease (COVID-19). Despite most patients experiencing a complete functional resolution, there is a 21.3% prevalence of persistent alteration at 12 months after infection. To date, magnetic resonance imaging (MRI) findings in these patients have been variable and not clearly defined. We aimed to clarify radiological alterations of olfactory pathways in patients with long COVID-19 characterized by olfactory dysfunction. A comprehensive review of the English literature was performed by analyzing relevant papers about this topic. A case series was presented: all patients underwent complete otorhinolaryngology evaluation including the Sniffin’ Sticks battery test. A previous diagnosis of SARS-CoV-2 infection was confirmed by positive swabs. The MRIs were acquired using a 3.0T MR scanner with a standardized protocol for olfactory tract analysis. Images were first analysed by a dedicated neuroradiologist and subsequently reviewed and compared with the previous available MRIs. The review of the literature retrieved 25 studies; most cases of olfactory dysfunction more than 3 months after SARS-CoV-2 infection showed olfactory bulb (OB) reduction. Patients in the personal case series had asymmetry and a reduction in the volume of the OB. This evidence was strengthened by the comparison with a previous MRI, where the OBs were normal. The results preliminarily confirmed OB reduction in cases of long COVID-19 with an altered sense of smell. Further studies are needed to clarify the epidemiology, pathophysiology and prognosis

Rilevanza della diagnostica per immagini nella diagnosi delle ipoacusie neurosensoriali fluttuanti e progressive.

Scopo dello studio: L\u2019acquedotto vestibolare largo \ue8 una delle malformazione pi\uf9 comuni dell\u2019orecchio interno radiologicamente identificata. La caratteristica clinica audiologica pi\uf9 rilevante di tale malformazione \ue8 l\u2019ipoacusia neurosensoriale fluttuante progressiva. Nel presente lavoro verranno esposte le caratteristiche audiologiche di paziente affetti da ipoacusia neurosensoriale fluttuante con evidenza neuroradiologica di acquedotto vestibolare largo. Materiali e metodi: I 17 pazienti riportati in questo studio sono stati selezionati tra quelli che sono giunti per il nostro Servizio per ipoacusia neurosensoriale bilaterale, fluttuante e progressiva negli ultimi cinque anni. Ai fini di stabilire la diagnosi eziologica sono stati sottoposti allo studio per immagini della capsula otica mediante tomografia computerizzata (TC) e risonanza magnetica nucleare (RMN) per la ricerca di malformazioni e/o displasie cocleari. Risultati: lo studio neuroradiologico ha evidenziato in quattro pazienti oltre alla presenza dell\u2019acquedotto vestibolare largo anche malformazioni del vestibolo labirintico, del labirinto posteriore e del condotto uditivo interno. Nel corso del follow-up in due casi la progressione dell\u2019ipoacusia fluttuante ha determinato un\u2019anacusia; in quattro casi l\u2019entit\ue0 della malformazione si correlava con l\u2019asimmetria di soglia audiometrica. Discussione: la ricerca di malformazioni della capsula otica ed in particolare dell\u2019acquedotto vestibolare largo mediante studio neuro radiologico (TC e RMN) rimane l\u2019indagine di scelta per la diagnosi eziologica delle ipoacusie neurosensoriali non genetiche, fluttuanti e progressive

Sudden hearing loss in sarcoidosis: otoneurological study and neuroradiological correlates

Sarcoidosis is an inflammatory multisystem disorder of unknown cause. Approximately 5-7% of patients manifest symptoms of central nervous system involvement, or neurosarcoidosis. Cranial neuropathy usually entails facial nerve palsy and optic neuritis. Sudden hearing loss has been reported in fewer than 20 cases. Herewith, two new cases of sudden hearing loss due to probable neurosarcoidosis are reported, each having a quite different clinical course. In one case, unilateral sudden hearing loss and facial palsy were the presenting symptoms of systemic sarcoidosis, while in the second, unilateral sudden deafness occurred despite ongoing immunosuppressive treatment for systemic sarcoidosis

Rilevanza del neuroimaging in bambini con riscontro di ipoacusia neurosensoriale monolaterale: diagnosi eziologica e management.

Poste

Retropharyngeal abscess: An unusual presentation of Kawasaki disease. Case report and review of the literature

We report the case of a patient with Kawasaki disease whose initial presentation mimicked a retropharyngeal abscess and review the literature of this topic (16 cases reported). Fever and deep neck infection like symptoms were the only clinical findings at admission in 87.5% children. All children had a neck CT scan performed showing findings suggestive of retropharyngeal abscess. All children were started antibiotic therapy without clinical improvement and 31% of patients underwent unproductive surgical drainage of the retropharyngeal space. Otolaryngologist should be aware of atypical presentation of Kawasaki disease presentation mimicking retropharyngeal abscess. Early diagnosis is pivotal for preventing cardiac complications and avoiding the risk associated to unnecessary surgical intervention

Temporal Bone High-Resolution Computed Tomography in Non-Syndromic Unilateral Hearing Loss in Children

Objective: The aim of this study was to disclose possible inner ear abnormalities/pathologies by means of high-resolution computed tomography (HRCT) of the temporal bone (TBHRCT) in children with unilateral hearing loss (UHL). Methods: Retrospective review of audiological evaluation and TBHRCT in 22 children with UHL. Results: Two thirds of the children showed profound hearing loss. Review of HRCT scans identified inner ear malformations/pathologies in 9 (41%) cases and a high jugular bulb (HJB), always dehiscent with the vestibular aqueduct, in another 5 (22%). Inner ear malformations included enlarged vestibular aqueduct, common cavity and cochleovestibular hypoplasia, while labyrinthine ossification was the detected pathology. In 1 child, the common cavity of the right ear was associated with congenital melanocytic naevus of the left eyelid and lipomeningocele. To the best of our knowledge, this condition has never been described. Conclusions: The aetiology of UHL may be revealed in more than half of patients by means of TBHRCT. Besides common inner ear abnormalities, TBHRCT should be evaluated carefully to rule out HJB, dehiscences, diverticulum or erosion of inner ear structures

Osteoma del condotto uditivo interno.

Poste

Analisi di mutazione in soggetti con sospetta sindrome di Pendred

Comunicazione oral