Objectives Functional problems, including nasal flow problems, are associated with specific skeletal and dental features. Further, maxillary expansion has been associated with nasal airway resistance alterations. This study aimed to investigate whether there is a correlation between skeletal features and nasal airflow‐ and olfaction‐related problems. Materials and methods This prospective study included 68 patients (30 boys, 38 girls; mean age 9 ± 2 years) examined at the Ohu University Hospital. We classified patients into three skeletal Classes (Class I, II, and III) based on the ANB angle. Olfactory disorder history was collected from the guardians. Maxillofacial measurements, nasal airflow assessments, and olfactory tests were performed using cephalometric analysis, rhinomanometry, and T&T olfactometer, respectively. Results Malocclusion, resulting from skeletal mandibular protrusion and smaller maxilla, was associated with reduced olfaction in children. The detection and recognition thresholds of skeletal Class III were significantly higher than those of Classes I (p = .01) and II (p = .01). Significant correlations were observed between SNA and the detection threshold (r = −.50) as well as between nasion perpendicular‐point A and the recognition threshold (r = −.53). The detection and recognition thresholds were significantly higher in Class III than in Classes I (r = .3) and II (r = −.1). Conclusions Maxillary growth and development may be associated with olfaction in children. Changing the maxillofacial morphology may improve olfactory function. In the future, we will investigate how malocclusion treatment affects olfactory function.
Recommendation for dental care during the COVID-19 pandemic was reported [1]. The authors present recommendations for (i) patient risk assessment, (ii) patient triage, and (iii) measures to prevent infection of health professionals and nosocomial transmission in dental clinics. With regard to patient triage, the authors classified dental treatments according to their emergency level. Their insistence consists of abscess drainage and tooth extraction due to acute pain as the "urgent level", extraction of teeth due to chronic pain, pain from broken ortho-appliance, and so on the "as soon as possible level", and finally, elective extraction
We read with interest the review "COVID-19 and the Otolaryngologist: Preliminary Evidence-Based Review" by Vukkadala et al. 1 In December 2019, the outbreak of coronavirus disease 2019 (COVID-19) infection, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, was reported in Wuhan, China. 2 During the COVID-19 pandemic, while the treatment for patients with non-urgent diseases is recommended to be postponed, diagnosis and treatment for the head and neck cancers (HNCs) must be continued as the same as before the pandemic, because the progress of HNCs is rapid and delay to the diagnosis and treatment can cause tumor progression and may negatively impact survival outcomes. Flexible fiberoptic endoscopy examination is considered to be a gold standard for workup of HNCs. However, during the COVID-19 pandemic, the examination is a high-risk procedure for HN surgical oncologists and otolaryngologists because of the high nasal viral loads in COVID-19 patients. Therefore, we think that Vukkadala et al. mentioned "Our institution has developed guidelines based on best available evidence including deferring all endoscopies unless considered necessary to reduce morbidity in the next 30 days (e.g., malignancy, airway risk)." 1 Indeed, in our institution endoscopy is performed only for initial diagnostic or staging purposes of symptomatic patients with hemoptysis, odynophagia limiting hydration and nutrition, or airway compromise and not for the follow-up of asymptomatic patients without those. Thus, we have concerns about overlooking asymptomatic HNC during the COVID-19 pandemic, because asymptomatic patients might sometimes develop HNC during the follow-up, and early HNCs cannot be detected by alternatives to endoscopy such as positron emission tomography/computed tomography (PET/CT) and ultrasound. Here, we propose the use of salivary biological markers in the early diagnosis of HNCs for follow-up of asymptomatic patients. Ideal biomarkers have high sensitivity and specificity, reversibility following proper treatment, and detectability before patients develop obvious clinical complaints of HNCs. Although various promising salivary biological markers were suggested, 3 a gain of both PMAIP1 and PTPN1 gene has been particularly hopeful, because the cohort-study accurately distinguishes HNCs individuals from non-HNCs individuals (100%). 4 Furthermore, reverse transcription-polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2 in saliva is a reliable diagnostic tool. 5 Thus, we hope that endoscopy will be performed for the patients with both negative COVID-19 and gain of PMAP1 and PTPN1 gene using saliva during the COVID-19 pandemic. Although clinical application of salivary diagnosis for HNCs needs further research, it will prevent overlooking asymptomatic patients with HNCs.
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