Objectives: To analyze the incidence of developing contralateral Ménière's disease (MD) in patients who undergo labyrinthectomy for vestibular dysfunction in unilateral MD. Study Design: Retrospective chart review. Participants and Methods: Adult patients with a diagnosis of MD who underwent surgical labyrinthectomy with minimum follow-up of 12 months were included. Patients who experienced chemical labyrinthectomy, surgical labyrinthectomy for a diagnosis other than MD, contralateral ear surgery, or bilateral MD before the labyrinthectomy were excluded. The key outcome measure is whether symptoms of MD developed in the contralateral ear post-labyrinthectomy. Statistical analysis was performed using w 2 (Fisher exact) test for discrete variables and the Student t test for continuous variables. A P value < .05 was considered significant. Results: Of the140 patients who underwent labyrinthectomy for intractable vertigo due to unilateral MD, 84 had at least 1 year follow-up appointments. Twelve percent (10/84) of these patients developed contralateral MD, which was diagnosed by a neuro-otologist based on symptoms consistent with MD, including low-frequency sensorineural hearing loss. Average age in years is 63.12 (10.83; mean [SD]) at time of surgery. Average follow-up was 35.57 (15.89) months (range: 12-69 months). Conclusion: The incidence of contralateral MD development in patients who underwent labyrinthectomy for unilateral MD is 12%. The current literature states that MD has a 30% bilateral involvement rate. Our incidence is significantly lower when compared to the current literature.
This study compares nasopharyngeal and tracheal samples for COVID-19 viral testing in patients with a tracheostomy. This was a prospective cohort study done at 2 academic hospitals between March and June 2020. Patients admitted through the emergency department who had a COVID-19 test and an existing tracheostomy or underwent a tracheostomy during the admission period were included. Patients with a positive initial nasopharyngeal swab were placed in the experimental group (n = 8), while those with a negative swab were the control group (n = 7). Nasopharyngeal and tracheal samples underwent COVID-19 testing using the Abbott RealTime SARS-CoV-2 RNA assay. Fourteen patients underwent tracheostomy, and 1 had an existing tracheostomy. The average duration of viral shedding in nasopharyngeal samples was 20.9 days. One patient (6.7%) tested positive in tracheal secretions after a negative nasopharyngeal swab. In the remaining patients (93.3%), the nasopharyngeal and tracheal specimens correlated.
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