Background The question of an optimal strategy and outcomes in COVID-19 tracheostomy has not been answered yet. The critical focus in our case study is to evaluate the outcomes of tracheostomy on intubated COVID-19 patients. Methods A multicentric prospective observational study of 1890 COVID-19 patients undergoing tracheostomy across 120 hospitals was conducted over 7 weeks in Spain (March 28 to May 15, 2020). Data were collected with an innovative approach: instant messaging via WhatsApp. Outcome measurements: complications, achieved weaning and decannulation and survival. Results We performed 1,461 surgical (81.3%) and 429 percutaneous tracheostomies. Median timing of tracheostomy was 12 days (4-42 days) since orotracheal intubation. A close follow-up of 1616/1890 (85.5%) patients at the cutoff time of 1-month follow-up showed that in 842 (52.1%) patients, weaning was achieved, while 391 (24.2%) were still under mechanical ventilation and 383 (23.7%) patients had died from COVID-19. Decannulation among those in whom weaning was successful (n = 842) was achieved in 683 (81%) patients. Conclusion To the best of our knowledge, this is the largest cohort of COVID-19 patients undergoing tracheostomy. The critical focus is the unprecedented amount of tracheostomies: 1890 in 7 weeks. Weaning could be achieved in over half of the patients with follow-up. Almost one out of four tracheotomized patients died from COVID-19.

Purpose The study aimed to determine the incidence and long-term evolution of COVID-related olfactory (OD) and gustatory (GD) dysfunction, the recovery timeline, and the association with other symptoms. The secondary objective was to identify the predictive clinical factors for the evolution of these symptoms. Methods A prospective case–control study was conducted from March 15 to October 15, 2020, in health workers with COVID-19 related symptoms in a tertiary care hospital. 320 patients were included after 6 months of follow-up: 195 in the case group and 125 in the control group. Olfactory dysfunction (OD), dysosmia, and gustatory dysfunction (GD) onset and recovery rate after 6 months follow-up are analyzed in both groups. Results There were 125 (64.1%) in case group patients with OD and 118 (60.5%) with GD. Total or partial recovery OD and GD was found in 89%, mainly in the first 2 months. In the control group, there were 14 (11.2%) patients with OD and 33 (26.4%) patients with GD, with 100% of total/partial recovery. Conclusion In both groups, OD and GD showed high-resolution rates during the first two months after the onset of symptoms. Nevertheless, 11% of the case group patients did not show any recovery, and the partial resolution was present in 30% of our patients, at the 6 months follow-up. We found a high correlation between OD and GD, both in the appearance of symptoms and in their recovery. Nasal obstruction and dyspnea have been identified as risk factors for the persistence of symptoms.

Persistence of residual symptoms 1 month after the acute BPPV can be associated with certain risk factors that should be taken into consideration (age, number of repositioning maneuvers needed, anxiety and/or depressive disorders). These patients could benefit of treatment with vestibular rehabilitation.

ResumenLas infecciones de la esfera otorrinolaringológica son la causa más común de prescripción de antibióticos y uno de los motivos más frecuentes de consulta en Atención Primaria. Entre ellas destacan la otitis media aguda y externa difusa, las faringitis agudas y las rinosinusitis agudas. Son de evolución autolimitada y generalmente de etiología vírica, por ello sus complicaciones son poco frecuentes. En la actualidad, el uso indiscriminado de antibióticos predispone a la aparición de resistencias bacterianas en la población. Debido a esto, la decisión de prescripción de antibióticos, hoy día, debe ser más prudente, para ello existen numerosas estrategias diagnósticas que se exponen a continuación. En la presente actualización, destacamos los factores etiológicos y fisiopatológicos de cada infección, así como la estrategia diagnóstica y terapéutica a aplicar en Atención Primaria. Las complicaciones de cada patología y las indicaciones de derivación para ser valoradas por especialistas del área ORL. Abstract Acute infectious disease of otolaryngology focusInfections are the most common cause of antibiotic prescription and one of the most frequent reasons for consultation in Primary Care. Among them, stand out acute media otitis and diffuse external otitis, acute pharyngitis and acute rhinosinusitis. Commonly they are viral and self-limited, so their complications are rare. Currently, the indiscriminate use of antibiotics have leaded to bacterial resistances; therefore antibiotic prescription should be more careful. Nowadays, several diagnostic strategies are available. In current updated etiological and pathophysiological factors of each infection, diagnostic and therapeutic strategy to be applied in Primary Care as well as the complications of each pathology and the referral indications to be assessed by specialists in the ENT area, will be reviewed. EtiopatogeniaLa patogénesis es multifactorial, desempeñando un papel primordial la ventilación de la trompa de Eustaquio, la madurez del sistema inmune del niño y los factores ambientales. *Correspondencia Correo electrónico: teresa.rivera@salud.madrid.org 5340 Medicine. 2019;12(91):5339-51 PATOLOGÍA OFTALMOLÓGICA Y OTORRINOLARINGOLÓGICA Los patógenos más frecuentes de la OMA son Streptococcus pneumoniae, Haemophilus influenzae y Moraxella catarrhalis, siendo los patógenos similares en los adultos y los niños. En total, S. pneumoniae y H. influenzae juntos son responsables del 50-60% de los casos pediátricos de OMA, mientras M. catarrhalis del 3-14% 3 . Otros patógenos menos implicados son: Streptococcus pyogenes grupo A (en OMA grave), Staphylococcus aureus (más frecuente en adultos), E. coli y Pseudomonas aeruginosa 4,5 .La infección vírica de vías respiratorias es un factor favorecedor de la OMA, aunque se considera la OMA como un proceso fundamentalmente bacteriano. Factores de riesgoLos factores de riesgo son los siguientes:1. Disfunción de la trompa de Eustaquio. Es el factor más importante en el desarrollo de la OMA tanto en el niño como en el adulto. Los ...