Potential Risks for Healthcare Disparities Among Individuals With Voice and Upper Airway Disorders: A Systematic Review

Aim: Pharyngodynia, nasal congestion, rhinorrhea, smell, and taste dysfunctions could be the presenting symptoms of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2. The aim was to perform a systematic review of current evidences on clinical presentation of COVID-19, focusing on upper airway symptoms in order to help otolaryngologists identifying suspected cases. Methods: We searched PubMed and Web of Science electronic databases. Results: We included 5 retrospective clinical studies for a total of 1556 hospitalized patients with COVID-19, 57.5% were male and mean age was 49.1 years. Pooled data revealed that pharyngodynia was present in 12.4% of patients, nasal congestion in 3.7%, and rhinorrhea was rare. No reports on COVID-19 and olfactory/gustative disorders matched inclusion criteria but preliminary evidences suggested they could be present. Common symptoms were fever (85.6%), cough (68.7%), and fatigue (39.4%). Frequent comorbidities were hypertension (17.4%), diabetes (3.8%), and coronary heart disease (3.8%); 83% of patients had alterations on chest computed tomography that were bilateral in 89.5% of cases. Ground-glass opacity was the most common finding (50%). Lymphopenia (77.2%) and leucopenia (30.1%) were common. Critical cases with complications were 9%, intensive care unit admission was required in 7.3%, invasive ventilation in 3.4%, and mortality was 2.4%. Conclusion: Otolaryngologists should know that pharyngodynia, nasal congestion, olfactory, and gustative disorders could be the presenting symptoms of COVID-19. Clinical presentation together with radiological and laboratory findings could help to identify suspected cases.

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Rhinological interventions for obstructive sleep apnoea – a systematic review and descriptive meta-analysis

The Journal of Laryngology & Otology ◽

10.1017/s0022215119000240 ◽

2019 ◽

Vol 133 (03) ◽

pp. 168-176 ◽

Cited By ~ 4

Author(s):

S Sharma ◽

J C R Wormald ◽

J M Fishman ◽

P Andrews ◽

B T Kotecha

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnoea ◽

Surgical Intervention ◽

Meta Analysis ◽

Upper Airway ◽

Sleep Apnoea ◽

Current Evidence ◽

Nasal Surgery ◽

Surgical Interventions ◽

Obstructive Sleep

AbstractObjectivesObstructive sleep apnoea is a common chronic sleep disorder characterised by collapse of the upper airway during sleep. The nasal airway forms a significant part of the upper airway and any obstruction is thought to have an impact on obstructive sleep apnoea. A systematic review was performed to determine the role of rhinological surgical interventions in the management of obstructive sleep apnoea.MethodsA systematic review of current literature was undertaken; studies were included if they involved comparison of a non-surgical and/or non-rhinological surgical intervention with a rhinological surgical intervention for treatment of obstructive sleep apnoea.ResultsSixteen studies met the selection criteria. The pooled data suggest that there are reductions in the apnoea/hypopnea index and respiratory disturbance index following nasal surgery. However, the current body of studies is too heterogeneous for statistically significant meta-analysis to be conducted.ConclusionNasal surgery may have limited benefit for a subset of patients based on current evidence.

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Peer review report 1 on “Impact on the upper airway space of different types of orthognathic surgery for the correction of skeletal class III malocclusion: A systematic review and meta-analysis”

International Journal of Surgery ◽

10.1016/j.ijsu.2017.01.050 ◽

2017 ◽

Vol 37 ◽

pp. 161-162

Keyword(s):

Systematic Review ◽

Peer Review ◽

Orthognathic Surgery ◽

Meta Analysis ◽

Upper Airway ◽

Class Iii ◽

Class Iii Malocclusion ◽

Skeletal Class ◽

Different Types

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Hyaluronic acid and upper airway inflammation in pediatric population: A systematic review

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2016.03.015 ◽

2016 ◽

Vol 85 ◽

pp. 22-26 ◽

Cited By ~ 9

Author(s):

Manuele Casale ◽

Paola Vella ◽

Antonio Moffa ◽

Giuseppe Oliveto ◽

Lorenzo Sabatino ◽

...

Keyword(s):

Systematic Review ◽

Hyaluronic Acid ◽

Airway Inflammation ◽

Pediatric Population ◽

Upper Airway

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Efficacy and Co-morbidity of Oral Appliances in the Treatment of Obstructive Sleep Apnea-Hypopnea: a Systematic Review

Critical Reviews in Oral Biology & Medicine ◽

10.1177/154411130401500303 ◽

2004 ◽

Vol 15 (3) ◽

pp. 137-155 ◽

Cited By ~ 111

Author(s):

A. Hoekema ◽

B. Stegenga ◽

L.G.M. de Bont

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

Primary Outcome ◽

Upper Airway ◽

Effect Sizes ◽

Obstructive Sleep ◽

Co Morbidity ◽

Airway Obstructions ◽

Craniofacial Complex

The Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a common sleep-related breathing disorder characterized by repetitive obstructions of the upper airway during sleep. Modification of pharyngeal patency by Oral Appliance (OA) therapy has been suggested as an alternative to various treatment modalities for OSAHS. To determine the evidence base with respect to the efficacy and co-morbidity of OA therapy in OSAHS, we conducted a systematic review of the available literature. Primary outcome measures were the reduction in number of upper-airway obstructions and co-morbidity related to the craniomandibular or craniofacial complex, respectively. Eligible studies regarding efficacy were independently assessed by two assessors using a quality assessment scale. Effect sizes of methodologically sound studies were calculated. In identical interventions, effect sizes were pooled with the use of a random-effects model. Given the scarcity of controlled studies related to co-morbidity, appraisal was confined to a description of eligible studies. Sixteen controlled trials related to efficacy were identified. With respect to the primary outcome measure, OA therapy was clearly more effective than control therapy (pooled effect size, −0.96; 95% confidence interval [CI], −1.49 to −0.42) and possibly more effective than uvulopalatopharyngoplasty. Although patients generally preferred OA therapy, improvement of respiratory variables, such as the number of upper-airway obstructions, was usually better in Continuous Positive Airway Pressure (CPAP) therapy (pooled effect size, 0.83; 95% CI, 0.59 to 1.06). Moreover, specific aspects related to OA design may influence patient-perceived efficacy and preference. Twelve patient-series and one controlled trial related to co-morbidity were identified. Analysis of the data suggests that OA therapy may have adverse effects on the craniomandibular and craniofacial complex. Although CPAP is apparently more effective and adverse effects of OA treatment have been described, it can be concluded that OA therapy is a viable treatment for, especially, mild to moderate OSAHS. Controlled studies addressing the specific indication and co-morbidity of OA therapy are warranted.

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