Objective: To report a case of lingual thyroglossal duct cyst in an elderly man, excised via combined Trotter procedure and hyoid osteotomy.

Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Participant: An elderly retired male office worker with dysphagia

Results: The cyst was completely excised via median labiomandibular glossotomy, with hyoid osteotomy providing additional exposure. Our patient was discharged in two weeks after decannulation and remains asymptomatic.

Conclusion: The Trotter procedure with hyoid osteotomy may be a viable alternative to the Sistrunk procedure for large lingual TGDCs.

Objective: To determine the otorhinolaryngologic manifestations of long COVID-19 infection among patients consulting at the Quezon City General Hospital. : Methods Design: Cross-Sectional Study Setting: Tertiary Government Hospital Participants: Patients aged 18 years old and above, who previously tested positive for the SARS-COV-2 Test, and consulted with otolaryngologic problems at the Outpatient department, Emergency Room, or were dmitted, or referred from other services to the Department of Otorhinolaryngology Head and Neck Surgery, from October 2022 to January 2023 were considered for inclusion. Results: Out of 150 participants, 127 (84.67%) reported having otorhinolaryngologic symptoms. Five percent (5%) had ongoing symptomatic COVID-19 (4 to 12 weeks) and 11% had post COVID-19 syndrome (>12 weeks). Patients with long COVID-19 had rhinorrhea (54.51%), hyposmia (51.47%), dysgeusia (48.9%), anosmia (48.53%), sore throat (47.8%), ageusia (29.78%), tinnitus (23.53%), ear pain (23.53%), phantosmia (21.33%), and dizziness (11.76%). Out of 25 patients with long COVID, only 2 had pneumonia and 1 was hospitalized and eventually recovered. Conclusion This study showed a prevalence rate of 16% of long COVID-19 with rhinorrhea as the most prominent symptom. Long-term monitoring is essential and patients who had COVID should be advised to report any lingering illness which may subsequently develop. Physicians should be vigilant and aware of the clinical manifestations of long COVID in order to institute proper intervention.
COVID-19 ; SARS-CoV-2 ; Long COVID ; Post-Acute COVID-19 Syndrome ; Long Haul COVID-19 ; Post-Acute COVID-19 Syndrome ; Rhinorrhea

Simultaneously occurring malignancies may be detected in different organs or tissues at any given time. Patients diagnosed with a tumor may be found to have another tumor or second primary cancer. Second primary cancers (SPCs) may be further classified as synchronous or metachronous. Synchronous SPCs are lesions detected simultaneously or within 6 months after the diagnosis of the primary tumor while metachronous SPCs are tumors diagnosed 6 months after primary tumor diagnosis.1There is an increased risk of having second primary cancer in Head and Neck Squamous Cell Carcinoma (HNSCC) patients.1 In a study by Strojan et al. in 2013, among 2,106 head and neck cancer patients, 2.4% developed synchronous second primary cancers.2 A systematic review by Coco-Pelaz et al. in 2020, showed that second primary tumors most frequently occur in the head and neck area followed by the lungs and esophagus.3We present a case of follicular thyroid carcinoma with an incidental finding of cervical lymph-node metastatic squamous cell carcinoma from the tonsil and discuss the clinical presentation, ancillary procedures and management.
Adenocarcinoma, Follicular ; Positron-Emission Tomography

Objective: To determine the quality of life among SARS-CoV-2 (COVID-19) positive patients with anosmia using the Short Version Questionnaire of Olfactory Disorders - Negative Statements translated in Filipino (sQOD-NS Ph).

Methods: Design: Cross-Sectional Study

                 Setting: Tertiary Government Training Hospital

                 Participants: SARS-CoV-2 (COVID-19) RT-PCR positive patients aged 18 years old and above with COVID-19 symptoms and anosmia in a tertiary government hospital who consulted from March 2020 to August 2021 answered the short version of sQOD-NS Ph.

Results: Out of 108 participants with positive SARS-CoV-2 (COVID-19) RT-PCR test, 72 (66%) presented with anosmia, and sQOD-NS Ph scores ranged from 1 to 21 with a mean of 14.78. Thirty two (44%) encountered problems in eating while 21 (29%) had feelings of isolation due to loss of smell. There was an inverse correlation of -0.478 between recovery time of olfaction and QoL score, hence the longer the recovery time, the lower the QoL score, while the shorter the recovery time, the higher the QoL score (p < .0001).

Conclusion: Majority of COVID-19 patients with anosmia had mild or negligible impairment, while a small percentage had impaired quality of life. The low percentage may be due to high number of patients who may have recovered their sense of smell along the course of the disease.

Objective: To report a case of chronic suppurative otitis media with complications of lateral sinus thrombosis and otitic hydrocephalus and to discuss its clinical manifestations, clinical course, ancillary procedures and management. Methods: Study Design: Case Report. Setting: Tertiary Government Training Hospital. Patient: One. Results: A 35-year-old man was admitted due to intermittent right otorrhea for 20 years and headache for a month. The Glasgow Coma Scale (GCS) score was 12, and mastoidectomy performed on the second hospital day showed cholesteatoma with erosion of the bony covering of the sigmoid sinus with scanty purulent discharge. The GCS improved to 15 few hours post- operatively, however, 24 hours post-operatively, GCS decreased from 15 to 10 and a CT scan showed dilatation of cerebral ventricles and lateral sinus thrombosis which persisted on subsequent imaging studies. His condition deteriorated irreversibly despite a ventriculostomy, and he eventually expired after 3 weeks in the ward. Conclusion Otitic hydrocephalus due to lateral sinus thrombosis is a serious complication of chronic suppurative otitis media seldom encountered nowadays. In this case, otitic hydrocephalus developed and progressed despite broad spectrum antibiotics, mastoidectomy and a ventricular shunt. This case report underscores the importance of early recognition of warning signs of intracranial complications to institute prompt management.
Lateral Sinus Thrombosis ; Mastoidectomy ; Ventriculostomy

Objective: To determine the association of anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR test results among patients in a tertiary government hospital in Metro Manila. Methods: Design: Cross-Sectional Study. Setting: Tertiary Government Hospital. Participants: Patients aged 18 years old and above who consulted or were admitted with COVID-19 symptoms at the Quezon City General Hospital in the Philippines from July to September 2020 answered an offline version of the American Academy of Otolaryngology-Head and Neck Surgery AAO-HNS COVID-19 Anosmia Reporting Tool prior to undergoing (COVID-19) RT-PCR testing. Results: Out of 172 participants, 63 (36.6%) presented with anosmia. Sixty (95.2%) out of 63 of those with anosmia had a positive COVID-19 RT-PCR test result. Forty-one (65%) participants reported anosmia as the first symptom while the most common associated symptoms were fever (59%), cough (50%), and rhinorrhea (31%). There was a significant association between anosmia and positive SARS-CoV-2 (COVID-19) RT-PCR tests (X2 =33.85, df=1, p<.0001). Conclusion Anosmia was associated with a positive SARS-CoV-2 (COVID-19) RT-PCR test in more than 95% of those who reported the symptom. Anosmia should be considered as a red flag sign which should be included in the screening of persons suspected of being infected with COVID-19 to help mitigate further spread of the virus.
Anosmia ; Coronavirus ; SARS-CoV-2 ; Pandemics ; COVID-19

Objective: To determine the efficacy of carragelose® nasal spray versus mupirocin ointment impregnated nasal packs on postoperative mucosal healing among chronic rhinosinusitis with nasal polyposis (CRSwNP) patients after endoscopic sinus surgery (ESS). Methods: Design: Double-Blind, Non-Randomized, Right-Left Side Comparison Setting: Tertiary Government Training Hospital Participants: Fifteen (15) patients diagnosed with chronic rhinosinusitis with nasal polyposis (CRSwNP) who had ESS were included in the study. Nasal packs (Netcell®) impregnated with carragelose® nasal spray or mupirocin ointment were respectively applied in right and left nostrils. Postoperative mucosal healing was graded by a blinded consultant using the Lund-Kennedy Endoscopic Scoring System and Perioperative Sinus Endoscopy (POSE) scoring system. Results: Six patients (12 nasal sides) completed the study. Comparing nasal packs impregnated with carragelose® nasal spray mupirocin ointment, the carragelose® group had lower Lund- Kennedy median scores than the mupirocin group on the 7th post-operative day; and this was statistically significant (p = .027). There were no significant differences in Lund-Kennedy postoperative scores on days 4 (p = .217), 14 (p = .171) and 28 (p = .151). Conclusion: Carragelose® nasal spray impregnated nasal packs may be comparable with, and may be an alternative to mupirocin ointment impregnated nasal packs in terms of postoperative mucosal healing among ESS patients with CRSwNP.

OBJECTIVE: To report a case of acute bilateral facial nerve palsy in a 24-year-old woman and to present the differential diagnoses, pathophysiology, management and prognosis.

METHODS:

Design: Case study

Setting: Tertiary Private Hospital

Patient: One (1)

RESULT: A 24-year-old woman with fever, joint pains, cough, chest pain, difficulty ambulating and progressive facial muscle weakness was diagnosed with rheumatic fever. Bilateral facial nerve paralysis was noted, and Electromyography-Nerve Conduction Velocity (EMG-NCV) testing with special facial nerve study revealed abnormal facial nerve and blink reflex studies while EMG-NCV of the upper and lower limbs were normal. Audiometry and MRI of the brain and facial nerve were normal while Schirmer's Test showed decreased tearing in both eyes. The rheumatic fever resolved within 5 days of antibiotics, while Prednisone and physiotherapy resulted in improvement of facial paralysis from House Brackmann V to House Brackmann II-III over a period of 6 months.

CONCLUSION: Idiopathic facial paralysis or Bell's Palsy is the most common cause of acute unilateral facial paralysis while bilateral facial nerve paralysis is a rare condition. Patients with facial palsy should undergo appropriate diagnostics to determine the underlying condition and to facilitate prompt management.

OBJECTIVE: To determine the association of thyroid malignancy and the following ultrasonographic findings: presence of solid hypoechoic nodule, irregular margins (infiltrative, microlobulated, or speculated), microcalcifications or disrupted rim calcifications with small extrusive hypoechoic soft tissue component, taller than wide shape of the thyroid nodule, and evidence of extrathyroidal extension.

METHODS:

Design:           Cross-Sectional Study

Setting:           Tertiary Government Training Hospital

Participants: Records of patients admitted to the Otorhinolaryngology- Head and Neck Surgery ward with a diagnosis of nodular non-toxic goiter, multinodular non-toxic goiter, and thyroid malignancy who underwent thyroid surgery between January 2017 and June 2018 were considered for inclusion.

RESULTS: A total of 33 patients, 7 males and 26 females, were included in this study. Patients' age ranged from 26 to 69 years with an average of 46 years. Thirteen (39.4%) had malignant while 20 (60.6%) had benign histopathologic results. There was a significant association between presence of solid hypoechoic nodule (Fisher exact, n = 33, p = .0047), irregular margins and microcalcifications with malignant histopathology results (X2 (df = 1, N = 33) = 8.57, p = .003). No significant difference was noted in the proportion of subjects with malignancy according to taller than wide nodules (Fisher exact, n = 33, p = 1.000) or presence of extrathyroidal extension nodules or presence of extrathyroidal extension (Fisher exact, n = 33, p = .276). On multivariate analysis using logistic regression, only microcalcification was found to be a significant predictor of malignancy (OR = 8.96, 95% CI:  1.02 - 87.19, p = .05).

Conclusion: There was a significant association between presence of solid hypoechoic nodule, margins and microcalcifications with thyroid carcinoma. Only microcalcification was found to be a significant predictor of thyroid malignancy on ultrasound, although our confidence interval was broad.

KEYWORDS: calcifications; thyroid; thyroid carcinoma; thyroid nodule; ultrasonography

OBJECTIVE: To present a case of progressive hemifacial atrophy in a young woman with Parry-Romberg Syndrome and the role of autologous fat transfer to improve her aesthetic appearance and lessen facial asymmetry.

METHODS:

Design:           Case Report

Setting:           Tertiary Government Training Hospital

Patient:           One

RESULTS: A 20-year old woman consulted because of drooping of the right eyelid and gradual thinning of right cheek muscles since age 16.  On examination, the right facial muscles were hypoplastic with prominent facial bony ridges. An MRI scan showed atrophy of the right medial pterygoid and masseter. She underwent autologous fat transfer on the right side of the face to augment the cheek, improve cosmetic appearance and lessen facial asymmetry.  

Conclusion: Our patient is satisfied and happy with the outcome and cosmetic appearance of her autologous fat transfer and is ready to undergo the same procedure if the need arises in the future. Although no definite cure exists for Parry Romberg syndrome, our report illustrates the role of autologous fat transfer as an inexpensive, easily harvested and biocompatible material to improve facial asymmetry. The procedure yielded encouraging results, although long-term benefits remain uncertain.

Keywords: Parry-Romberg syndrome; progressive hemifacial atrophy; autologous transplantation