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      Proficiency of virtual follow-up amongst tinnitus patients who underwent intratympanic steroid therapy amidst COVID 19 pandemic

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          Abstract

          Aim

          The aim of this study was to assess the efficacy and feasibility of virtual follow-up in patients who have undergone intratympanic steroid injection for treatment of tinnitus during COVID-19 pandemic.

          Materials & methods

          Twenty-five patients having long-term tinnitus undergoing intratympanic steroid course, were followed up virtually via video calling & telephonic methods and evaluated using Tinnitus handicap inventory scoring over the period of 68 days.

          Results

          20 out of 25 patients expressed improvement from symptoms (80%) and 5 of the remaining (20%) showed no improvement.

          However, most of them were inarguably satisfied with this virtual method of follow up and had no reservation in following the similar method of observation in future.

          Conclusion

          Virtual follow-up using video calling applications and telephonic call is an efficacious, cost effective and user-friendly method, which can provide accurate post procedural observation while keeping in account the nationwide lockdown during COVID 19 pandemic.

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          Development of the Tinnitus Handicap Inventory.

          Wolfgang Spitzer, Gale W. Newman, Samuel G. Jacobson (1996)
          To develop a self-report tinnitus handicap measure that is brief, easy to administer and interpret, broad in scope, and psychometrically robust. A standardization study of a self-report tinnitus handicap measure was conducted to determine its internal consistency reliability and convergent and construct validity. Audiology clinics in tertiary care centers in two sites. In the first investigation, 84 patients reporting tinnitus as their primary complaint or secondary to hearing loss completed the 45-item alpha version of the Tinnitus Handicap Inventory (THI). In the second investigation, 66 subjects also reporting tinnitus completed the 25-item beta version. Convergent validity was assessed using another measure of perceived tinnitus handicap (Tinnitus Handicap Questionnaire). Construct validity was assessed using the Beck Depression Inventory, Modified Somatic Perception Questionnaire, symptom rating scales (annoyance, sleep disruption, depression, and concentration), and perceived tinnitus pitch and loudness judgments. From the alpha version of the THI, we derived a 25-item beta version with the items grouped into functional, emotional, and catastrophic subscales. The total scale yielded excellent internal consistency reliability (Cronbach's alpha = .93). No significant age or gender effects were seen. Weak correlations were observed between the THI and the Beck Depression Inventory, Modified Somatic Perception Questionnaire, and pitch and loudness judgments. Significant correlations were found between the THI and the symptom rating scales. The THI is a self-report measure that can be used in a busy clinical practice to quantify the impact of tinnitus on daily living.
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            Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the COVID-19 pandemic: a literature review

            Paul Mick, Russell Murphy (2020)
            Background Adequate personal protective equipment is needed to reduce the rate of transmission of COVID-19 to health care workers. Otolaryngology groups are recommending a higher level of personal protective equipment for aerosol-generating procedures than public health agencies. The objective of the review was to provide evidence that a.) demonstrates which otolaryngology procedures are aerosol-generating, and that b.) clarifies whether the higher level of PPE advocated by otolaryngology groups is justified. Main body Health care workers in China who performed tracheotomy during the SARS-CoV-1 epidemic had 4.15 times greater odds of contracting the virus than controls who did not perform tracheotomy (95% CI 2.75–7.54). No other studies provide direct epidemiological evidence of increased aerosolized transmission of viruses during otolaryngology procedures. Experimental evidence has shown that electrocautery, advanced energy devices, open suctioning, and drilling can create aerosolized biological particles. The viral load of COVID-19 is highest in the upper aerodigestive tract, increasing the likelihood that aerosols generated during procedures of the upper aerodigestive tract of infected patients would carry viral material. Cough and normal breathing create aerosols which may increase the risk of transmission during outpatient procedures. A significant proportion of individuals infected with COVID-19 may not have symptoms, raising the likelihood of transmission of the disease to inadequately protected health care workers from patients who do not have probable or confirmed infection. Powered air purifying respirators, if used properly, provide a greater level of filtration than N95 masks and thus may reduce the risk of transmission. Conclusion Direct and indirect evidence suggests that a large number of otolaryngology-head and neck surgery procedures are aerosol generating. Otolaryngologists are likely at high risk of contracting COVID-19 during aerosol generating procedures because they are likely exposed to high viral loads in patients infected with the virus. Based on the precautionary principle, even though the evidence is not definitive, adopting enhanced personal protective equipment protocols is reasonable based on the evidence. Further research is needed to clarify the risk associated with performing various procedures during the COVID-19 pandemic, and the degree to which various personal protective equipment reduces the risk.
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              Tinnitus: Characteristics, Causes, Mechanisms, and Treatments

              Byung In Han, Ho Won Lee, Tae-You Kim … (2009)
              Tinnitus-the perception of sound in the absence of an actual external sound-represents a symptom of an underlying condition rather than a single disease. Several theories have been proposed to explain the mechanisms underlying tinnitus. Tinnitus generators are theoretically located in the auditory pathway, and such generators and various mechanisms occurring in the peripheral auditory system have been explained in terms of spontaneous otoacoustic emissions, edge theory, and discordant theory. Those present in the central auditory system have been explained in terms of the dorsal cochlear nucleus, the auditory plasticity theory, the crosstalk theory, the somatosensory system, and the limbic and autonomic nervous systems. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. This paper reviews the characteristics, causes, mechanisms, and treatments of tinnitus.
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                Author and article information

                Contributors
                Shashwat Datt Mehta
                Journal
                Journal ID (nlm-ta): Am J Otolaryngol
                Journal ID (iso-abbrev): Am J Otolaryngol
                Title: American Journal of Otolaryngology
                Publisher: Elsevier Inc.
                ISSN (Print): 0196-0709
                ISSN (Electronic): 1532-818X
                Publication date PMC-release: 15 August 2020
                Publication date (Electronic): 15 August 2020
                Electronic Location Identifier: 102680
                Affiliations
                Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Pondicherry, India
                Author notes
                [* ]Corresponding author at: Mahatma Gandhi Medical College and Research Institute, Pillaiyarkuppam, Pondicherry 607402, India. shashwatdmehta@ 123456gmail.com
                Article
                Publisher ID: S0196-0709(20)30374-4 Publisher ID: 102680
                DOI: 10.1016/j.amjoto.2020.102680
                PMC ID: 7428771
                PubMed ID: 32861124
                SO-VID: 8018a7dc-9c35-4c40-9727-dbbdc8682132
                Copyright © © 2020 Elsevier Inc. All rights reserved.
                License:

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                Date received : 17 July 2020
                Categories
                Subject: Article

                Keywords: virtual,video-calling,telephonic,follow-up,intratympanic steroid,covid 19,tinnitus
                Data availability:
                Keywords: virtual, video-calling, telephonic, follow-up, intratympanic steroid, covid 19, tinnitus

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