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Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients

Year 2021, Volume: 74 Issue: 1, 130 - 133, 30.04.2021

Abstract

Objectives: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is isolated as the cause of coronavirus disease-2019 (COVİD-19). Middle ear and mastoid air cells are covered with the airway mucosa. In COVİD-19, an involvement occurs in the airway mucosa; however, although the involvement of eustachian tube covered with this mucosa, middle ear, and mastoid is not known, there can be an intervention. The aim of the study is to investigate the findings of temporal tomography and evaluate the middle ear and mastoid in COVİD-19.

Materials and Methods: A retrospective observational study was planned. Patients with a positive polymerase chain reaction (PCR) test for SARSCoV- 2 and diagnosed with COVİD-19 were included in the study. COVİD-19 patients, who had temporal bone tomography scans (CT), were evaluated. One hundred twenty-nine COVİD-19 patients with positive PCR, who also had temporal bone scans, were included in the study. A grading system was used to evaluate the effusion in the middle ear and mastoid cells. According to this grading system, left and right middle ear and mastoid were evaluated separately. In the grading system, the scores were evaluated as 0=no effusion, 1=partial effusion, and 2=100% effusion. The maximum score was accepted as 8. Bilateral tympanic membranes of all the patients were normal.

Results: Involvement was observed in three patients. Bilateral partial effusion and middle ear involvement were observed in two patients. In one patient, bilateral partial mastoid and unilateral partial middle ear involvement was detected. Temporal CTs of other patients were normal.

Conclusion: No specific finding was found regarding temporal bone involvement from the temporal CT. Three patients had effusion in the middle ear and mastoid. SARS-CoV-2 generally does not affect the temporal bone; however, it rarely causes effusion in the mastoid and middle ear.

Key Words: COVİD-19, Temporal Bone, SARS-CoV-2, Mastoid, Middle Ear, Ear Effusion

Ethical Statement

Ethics Committee Approval: Ethical approval was obtained from Ankara City Hospital No.1 Clinical Research Board with number EI-20-726. Informed Consent: The study was a retrospective observational study. Peer-reviewed: Externally and internally peer-reviewed. Authorship Contributions Surgical and Medical Practices: Y.İ., M.A., S.B., Concept: S.B., R.G., B.K., Design: Y.İ., M.A., S.B., R.G., Data Collection o Processing: Y.İ., M.A., A.K.K., B.K., Analysis or Interpretation: Y.İ., M.A., A.K.K., B.K., Literature Search: Y.İ., M.A., S.B., A.K.K., B.K., R.G., Writing: Y.İ., M.A., S.B., R.G. Conflict of Interest: No conflict of interest was declared by the authors. Financial Disclosure: The authors declared that this study has received no financial support.

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References

  • 1. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382:1177-1179.
  • 2. Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382:1564-1567.
  • 3. Givi B, Schiff BA, Chinn SB, et al. Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg. 2020;146:579-584.
  • 4. Chen JX, Workman AD, Chari DA, et al. Demonstration and Mitigation of Aerosol and Particle Dispersion During Mastoidectomy Relevant to the COVID-19 Era. Otol Neurotol. 2020;41:1230-1239.
  • 5. Heikkinen T, Thint M, Chonmaitree T. Prevalence of various respiratory viruses in the middle ear during acute otitis media. N Engl J Med. 1999;340:260-264.
  • 6. Pitkäranta A, Virolainen A, Jero J, et al. Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction. Pediatrics. 1998;102:291-295.
  • 7. Brennan TE, Saadia-Redleaf MI. Occult middle ear and mastoid fluid in acute otitis externa. Laryngoscope. 2012;122:2067-2070.
  • 8. Adler SP. Congenital cytomegalovirus screening. Pediatr Infect Dis J. 2005;24:1105-1106.
  • 9. Al Muhaimeed H, Zakzouk SM. Hearing loss and herpes simplex. J Trop Pediatr. 1997;43:20-24.
  • 10. Chandrasekhar SS, Connelly PE, Brahmbhatt SS, et al. Otologic and audiologic evaluation of human immunodeficiency virus-infected patients. Am J Otolaryngol. 2000;21:1-9.
  • 11. Mustafa MWM. Audiological profile of asymptomatic Covid-19 PCRpositive cases. Am J Otolaryngol. 2020;41:102483.
  • 12. Huyett P, Raz Y, Hirsch BE, et al. Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects. Respir Care. 2017;62:350-356.
  • 13. Cetinkaya EA. COVID-19 Pandemic and Otologic Surgery. J Craniofac Surg. 28 May 2020.
  • 14. Saadi RA, Bann DV, Patel VA, et al. A Commentary on Safety Precautions for Otologic Surgery during the COVID-19 Pandemic. Otolaryngol Head Neck Surg. 2020;162:797-799.
  • 15. Chen N, Hou Q, Cui Z, et al. Effect of otitis media with effusion and its clinical intervention on the development of mastoid in children. Acta Otolaryngol. 2014;134:481-484.
  • 16. Frazier KM, Hooper JE, Mostafa HH, et al. SARS-CoV-2 Virus Isolated From the Mastoid and Middle Ear: Implications for COVID-19 Precautions During Ear Surgery. JAMA Otolaryngol Head Neck Surg. 2020;146:964-966.

COVID-19 Hastalarının Orta Kulak ve Mastoid Hücrelerinin Değerlendirilmesi

Year 2021, Volume: 74 Issue: 1, 130 - 133, 30.04.2021

Abstract

Amaç: Şiddetli akut solunum yolu sendromu koronavirüsü-2 (SARS-CoV-2), koronavirüs hastalığı-2019 (COVID-19) hastalığının nedeni olarak izole edilmiştir. Orta kulak ve mastoid hücreler hava yolu mukozası ile örtülüdür. COVID-19’da hava yolu mukozasında tutulum meydana gelir, ancak BU mukoza ile örtülü östaki tüpü, orta kulak ve mastoid tutulumunun olduğu bilinmemekle birlikte etkilenme olabilir. Çalışmada amacımız COVID- 19’daki temporal kemik tomografisini inceleyerek orta kulak ile mastoid bölümün durumunu incelemektir.

Gereç ve Yöntem: Retrospektif gözlemsel bir çalışma planlandı. SARS-CoV-2 polimeraz zincir reaksiyonu (PCR) testi pozitif olup, COVID-19 tanısı olan hastalar çalışmaya dahil edildi. COVID-19 hastalarından temporal tomografisi (BT) olanlar değerlendirildi. Çalışmaya temporal BT’si olan 12 PCR pozitif COVID-19 hasta dahil edildi. Orta kulak ve mastoid hücrelerdeki efüzyonu değerlendirmek için bir evreleme sistemi kullanıldı. Bu evreleme sistemine göre sağ ve sol orta kulak ile mastoid ayrı ayrı değerlendirildi. Sıfır puan=efüzyon yok, 1 puan=parsiyel efüzyon ve 2 puan=%100efüzyon olarak değerlendirildi. Maksimum skor 8 olarak değerlendirildi. Hastaların iki taraflı kulak zarı normaldi.

Bulgular: Üç hastada tutulum izlendi. İki hastada bilateral parsiyel efüzyon ve orta kulak tutulumu izlendi. Bir hastada ise bilateral parsiyel mastoid ve tek taraflı parsiyel orta kulak tutulumu izlendi. Diğer hastaların temporal BT’leri normaldi.

Sonuç: Temporal kemik tutulumuna ait temporal tomografide spesifik bir bulgu saptanmadı. Üç hastada orta kulak ve mastoidde efüzyon saptandı. SARS-CoV-2 genellikle temporal kemiği etkilememektedir, ancak nadir olarak mastoid ve orta kulakta efüzyona neden olmaktadır.

Anahtar Kelimeler: COVID-19, Temporal Kemik, SARS-CoV-2, Mastoid, Ortak Kulak, Kulak Efüzyonu

Ethical Statement

-

Supporting Institution

-

Project Number

-

Thanks

-

References

  • 1. Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. N Engl J Med. 2020;382:1177-1179.
  • 2. Van Doremalen N, Bushmaker T, Morris DH, et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. N Engl J Med. 2020;382:1564-1567.
  • 3. Givi B, Schiff BA, Chinn SB, et al. Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic. JAMA Otolaryngol Head Neck Surg. 2020;146:579-584.
  • 4. Chen JX, Workman AD, Chari DA, et al. Demonstration and Mitigation of Aerosol and Particle Dispersion During Mastoidectomy Relevant to the COVID-19 Era. Otol Neurotol. 2020;41:1230-1239.
  • 5. Heikkinen T, Thint M, Chonmaitree T. Prevalence of various respiratory viruses in the middle ear during acute otitis media. N Engl J Med. 1999;340:260-264.
  • 6. Pitkäranta A, Virolainen A, Jero J, et al. Detection of rhinovirus, respiratory syncytial virus, and coronavirus infections in acute otitis media by reverse transcriptase polymerase chain reaction. Pediatrics. 1998;102:291-295.
  • 7. Brennan TE, Saadia-Redleaf MI. Occult middle ear and mastoid fluid in acute otitis externa. Laryngoscope. 2012;122:2067-2070.
  • 8. Adler SP. Congenital cytomegalovirus screening. Pediatr Infect Dis J. 2005;24:1105-1106.
  • 9. Al Muhaimeed H, Zakzouk SM. Hearing loss and herpes simplex. J Trop Pediatr. 1997;43:20-24.
  • 10. Chandrasekhar SS, Connelly PE, Brahmbhatt SS, et al. Otologic and audiologic evaluation of human immunodeficiency virus-infected patients. Am J Otolaryngol. 2000;21:1-9.
  • 11. Mustafa MWM. Audiological profile of asymptomatic Covid-19 PCRpositive cases. Am J Otolaryngol. 2020;41:102483.
  • 12. Huyett P, Raz Y, Hirsch BE, et al. Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects. Respir Care. 2017;62:350-356.
  • 13. Cetinkaya EA. COVID-19 Pandemic and Otologic Surgery. J Craniofac Surg. 28 May 2020.
  • 14. Saadi RA, Bann DV, Patel VA, et al. A Commentary on Safety Precautions for Otologic Surgery during the COVID-19 Pandemic. Otolaryngol Head Neck Surg. 2020;162:797-799.
  • 15. Chen N, Hou Q, Cui Z, et al. Effect of otitis media with effusion and its clinical intervention on the development of mastoid in children. Acta Otolaryngol. 2014;134:481-484.
  • 16. Frazier KM, Hooper JE, Mostafa HH, et al. SARS-CoV-2 Virus Isolated From the Mastoid and Middle Ear: Implications for COVID-19 Precautions During Ear Surgery. JAMA Otolaryngol Head Neck Surg. 2020;146:964-966.
There are 16 citations in total.

Details

Primary Language English
Subjects Otorhinolaryngology
Journal Section Research Article
Authors

Yuce İslamoglu 0000-0002-1294-7088

Müge Ayhan 0000-0002-4821-5559

Sami Bercin This is me 0000-0003-3626-5492

Ayşe Kaya Kalem 0000-0002-4759-0066

Bircan Kayaaslan 0000-0001-5225-8319

Rahmet Güner 0000-0002-1029-1185

Project Number -
Publication Date April 30, 2021
Published in Issue Year 2021 Volume: 74 Issue: 1

Cite

APA İslamoglu, Y., Ayhan, M., Bercin, S., … Kalem, A. K. (2021). Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 74(1), 130-133. https://doi.org/10.4274/atfm.galenos.2021.30306
AMA İslamoglu Y, Ayhan M, Bercin S, Kalem AK, Kayaaslan B, Güner R. Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. April 2021;74(1):130-133. doi:10.4274/atfm.galenos.2021.30306
Chicago İslamoglu, Yuce, Müge Ayhan, Sami Bercin, Ayşe Kaya Kalem, Bircan Kayaaslan, and Rahmet Güner. “Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74, no. 1 (April 2021): 130-33. https://doi.org/10.4274/atfm.galenos.2021.30306.
EndNote İslamoglu Y, Ayhan M, Bercin S, Kalem AK, Kayaaslan B, Güner R (April 1, 2021) Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74 1 130–133.
IEEE Y. İslamoglu, M. Ayhan, S. Bercin, A. K. Kalem, B. Kayaaslan, and R. Güner, “Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, pp. 130–133, 2021, doi: 10.4274/atfm.galenos.2021.30306.
ISNAD İslamoglu, Yuce et al. “Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 74/1 (April2021), 130-133. https://doi.org/10.4274/atfm.galenos.2021.30306.
JAMA İslamoglu Y, Ayhan M, Bercin S, Kalem AK, Kayaaslan B, Güner R. Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74:130–133.
MLA İslamoglu, Yuce et al. “Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 74, no. 1, 2021, pp. 130-3, doi:10.4274/atfm.galenos.2021.30306.
Vancouver İslamoglu Y, Ayhan M, Bercin S, Kalem AK, Kayaaslan B, Güner R. Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2021;74(1):130-3.