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   Table of Contents - Current issue
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January-March 2023
Volume 25 | Issue 1
Page Nos. 1-49

Online since Wednesday, March 29, 2023

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ORIGINAL ARTICLES  

Effect of vaccination on coronavirus disease 2019-related olfactory dysfunction p. 1
Abdulaziz Alhazmi, Hussam Darraj, Abdulrahman Aqeel, Ghadah Khormi, Alshomokh Hakami, Abdulaziz Kariri, Afnan Siddiq, Ali Sahli, Rahaf Othathi, Ibrahim Sumaily
DOI:10.4103/sjoh.sjoh_58_22  
Background: Hyposmia and anosmia are the reduced ability and inability to perceive odors, respectively. Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus that was first detected in late 2019 in China and has spread globally since mid-February 2020. Olfactory dysfunction (OD), such as anosmia or hyposmia, is an important early indicator of COVID-19. Objective: This study aimed to compare the incidence and duration of COVID-19-related hyposmia before and after vaccination. Design: This was cross-sectional study. Setting: Jazan region, February–July 2022. Patients and Methods: Data were collected from the adult population of the Jazan region using a self-administered questionnaire in the Arabic language. Data are presented as frequencies and percentages for categorical variables. Analysis of variance was used to compare means between groups while the Chi-square test was used for the comparison of categorical variables. Statistical significance was set at P < 0.05. Main Outcome Measures: The incidence and duration of COVID-19-related OD before and after vaccination. Sample Size: The sample size was 466. Results: Of the 510 respondents, 466 met the study criteria. OD just after receiving the vaccines was reported by 53 (12.2%) participants. COVID-19 was confirmed in 268 participants (52.5%; 118 men and 150 women); of these, 163 (60.8%) had OD and 144 (53.7%) reported taste dysfunction. OD was more frequent in women than in men (66.7% vs. 53.4%, P = 0.03) and was the only symptom in 10 respondents (3.7%). OD was less frequent in postvaccination infection (54.9% vs. 73.8%, P = 0.003). Moreover, the OD duration was significantly shorter in postvaccination COVID-19 infection (improvement in the 1st week, 66.3% vs. 33.9%, P = 0.001). Conclusions: Among patients with COVID-19, OD occurs less frequently in men and after vaccination, and the duration is shorter after vaccination. Limitations: This study was limited by the small sample size, cross-sectional design, and small number of respondents with common chronic diseases such as diabetes and hypertension.
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Evaluation of the effect of nasal septal deviation on the middle ear with wideband acoustic immitancemetry p. 7
Nilufer Bal, Yasin Kulaksiz, Alper Yenigun, Emre Polat, Orhan Ozturan, Ali Toprak, Selahattin Tugrul
DOI:10.4103/sjoh.sjoh_1_23  
Objectives: This study aimed to objectively reveal the effects of nasal septal deviation (NSD) and its subgroups on normal middle ear physiology by wideband acoustic immitancemetry (WAI), (it is also known as Wideband Tympanometry). Methods: Eighty-five participants with normal hearing were included in the study. Types of NSD finalized with the paranasal CT. The group without NSD was taken as the control group. Wideband absorbance and resonance frequency values were measured at ambient pressure and in the frequency range of 0.25–8.0 kHz. Results: Normal WAI results were obtained in 20 (31%) participants in the NSD group, compared to 13 (72%) in the Control group. The peak pressure values, resonance frequencies, and absorbance at ambient pressure were significantly different between the NSD and the control groups. Conclusion: WAI may be used as an objective method to evaluate middle ear involvement in patients with NSD problems.
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Olfactory dysfunction during the COVID-19 era: Prevalence and prognosis for recovery of sense of smell, Eastern region, Saudi Arabia p. 12
Khalid AlYahya, Abdullah Ahmed Alarfaj, Batool Zahar AlZahir, Fatema Mohammed Alhelal, Waroud Abdulaziz Al Sultan, Ibrahim Mohammed Almulhim, Abdullah Khalid Alhamam
DOI:10.4103/sjoh.sjoh_60_22  
Objective: There is a strong association between the onset of COVID-19 and olfactory dysfunction (OD) during infection or postinfection as a complication. This study is dedicated to measuring the prevalence of olfactory impairment and its clinical course among patients after COVID-19 infection. Methodology: A cross-sectional study was performed on patients with laboratory-confirmed COVID-19 infection. All participants had completed a validated questionnaire to evaluate the clinical course of OD. Results: Among the 305 participants, 138 reported sudden loss of smell. The mean time between the confirmation of COVID-19 and the onset of OD was 3.59 days. Olfactory impairment, accompanied by other symptoms prior to loss of smell, was reported in 67 participants and as an isolated disorder in 21 participants. Those affected reported nasal obstruction before loss of smell. A total of 138 participants complained of persistence of loss of smell even after the resolution of other symptoms. There is not a statistically significant relationship between the time of loss of smell relative to the confirmation of COVID-19 and the time of resolution of OD. In terms of gender, the prevalence of OD is equal among males and females, and results showed no significant relationship between them. Conclusions: The prevalence of OD is considered a complication among patients with COVID-19. The prognosis for spontaneous recovery from OD is favorable. Due to the lack of an objective measure for olfactory testing, further studies are needed to objectively measure the alteration of the smell.
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Impact of chronic rhinosinusitis on patients' quality of life in the western region, Saudi Arabia 2022 p. 18
Nisreen Ghazi Albouq, Majid A Albeladi, Layal Bakor Alyahyawi, Raghad Meteb Albalawi, Hajer Awadah Almutairi, Ma'ad Mohammed Aljohani
DOI:10.4103/sjoh.sjoh_3_23  
Background: Rhinosinusitis is distinguished by the simultaneous inflammation of the sinonasal mucosa. Chronic rhinosinusitis (CRS) has been demonstrated to have a negative influence on people's quality of life (QoL), as measured by a variety of standardized outcome instruments. We conducted this study to explore the impact of CRS on patients' QoL in the Western Region, Saudi Arabia. Subjects and Methods: This was an observational cross-sectional study carried out among population of the Western Region in Saudi Arabia in 2022. All males and females above the age of 18 years old were invited for participation. The data were collected by using a self-administered semi-structured questionnaire which was distributed via social media. SPSS version 23.0 was used for data analysis. Results: A total number of participants were 468. Most of them were females (76.9%), with males representing 23.1%. More than half of the respondents were from age between 18 and 28 years. In addition, our results revealed that during the past 8 weeks, a 1–2 week period was the most commonly reported duration of symptoms. Furthermore, the most commonly affected domain of rhinosinusitis disability index was the physical domain, followed by the emotional domain and functional domain. Conclusion: Our results suggested that CRS reduced QoL among people from the Western Region, Saudi Arabia. Further evaluation and research are needed to minimize the disability caused by CRS.
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Evaluation of eosinophil-to-lymphocyte ratio before and after immunotherapy in pediatric allergic rhinitis patients p. 24
Alper Yenigun, Nurtac Dagistanli, Emre Polat, Remzi Dogan, Mustafa Atilla Nursoy, Orhan Ozturan
DOI:10.4103/sjoh.sjoh_11_23  
Objective: The aim of this study is to calculate the eosinophil-to-lymphocyte ratio (ELR) before and after the treatment with subcutaneous immunotherapy (SCIT) and to investigate if ELR decreases after the treatment. The results will support our hypothesis of using the ELR as a diagnostic and prognostic parameter in allergic rhinitis (AR) patients. Study Design: This study was planned and performed as a case–control study. Materials and Methods: In this prospective study, we have collected the data from 68 pediatric patients (aged between 9 and 18 years) who have been treated with 4-year SCIT and whose skin prick test was negative after treatment of AR. ELRs were compared based on the hemogram results before SCIT and approximately 4 years later. Patients who have the inflammatory disease were eliminated from the study since lymphocytes were increased in the blood biochemistry tests. Results: When the eosinophil counts were compared before and after the immunotherapy, it was observed that the eosinophil ratios were decreased from 7.14 ± 4.63 to 4.55 ± 2.98; (P = 0.000) after treatment. Lymphocyte count also decreased from 34.8 ± 10.3 to 32.9 ± 8.3 (P = 0.091). After SCIT, ELRs were significantly lower (P < 0.001). While the mean ± standard deviation (SD) value of ELR was 0.18 (0–0.66) before the treatment, the mean ± SD value after SCIT was 0.11 (0.01–0.67). Total immunoglobulin E decreased from 96.9 ± 10 to 82 ± 11, which was not statistically significant (P = 0.058). Conclusion: A statistically significant decrease in ELR was observed in patients whose skin prick test was negative after immunotherapy. ELR would be as valuable as a skin prick test for diagnostic and prognostic purposes.
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The use of photograph editing applications among patients underwent cosmetic rhinoplasty surgery: A cross-sectional study p. 29
Faisal M Obeid, Hatan Mortada, Fatimah Al Mazrou, Nawaf Alhindi, Khalid Arab
DOI:10.4103/sjoh.sjoh_38_22  
Rhinoplasty is a type of plastic surgery that might be motivated by the desire to change nose appearance, improve breathing, or both. Social media is considered nowadays one of the major aspects of the internet. It is not deniable that we depend on using social media on a daily basis to enhance our communication and represent ourselves. Recently, the demand on editing applications like Snapchat has increased, and studies have shown the association between developing low self-esteem and the usage of editing applications. The aim of this study was to assess the relationship between self-esteem and photograph edits on social media applications in young women who underwent rhinoplasty. A single-centered retrospective cross-sectional study was conducted at Ajmal clinic, Riyadh, Saudi Arabia. Data were obtained through a self-structured online questionnaire distributed online to patients who underwent rhinoplasty between 2020 and 2021. The study included 205 participants aged above 18 years old with a predominance of female gender (91.2%). Editing was performed frequently by 33.2% of the participants. However, 40.0% of respondents claimed that they rarely edited their photographs before posting online. Factors associated with using Snapchat as the most editing application have been assessed. Snapchat use was significantly associated with age and female gender. The extensive usage of editing applications was significantly associated with most of the demographic data including age, female gender, low to middle income, single relationship status, and employment status.
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CASE REPORTS Top

Acute mastoiditis in a young child p. 34
Salmah M Alharbi, Ahmed Saeed Alasiri, Khalid Talat Ardi, Yahya Dhafer Alahmari
DOI:10.4103/sjoh.sjoh_39_22  
Acute mastoiditis is a serious complication of acute otitis media. It is a destructive inflammatory disease of the mastoid bone. There is no consensus on the management of acute mastoiditis in children. Proper choice of the treatment regimen according to the presentation of the patient and the patient's response to therapy is critical to prevent further complications. We report the case of a 3-month-old child with acute otomastoiditis complicated by subperiosteal and subcutaneous abscesses. He was successfully managed with intravenous antibiotics, incision and drainage of the abscesses, and myringotomy tube insertion without the need for mastoidectomy.
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Synovial sarcoma of the pyriform sinus: An extremely rare case and literature review p. 38
Emre Polat, Huseyin Toprak, Yagmur Basak Polat, Sahande Elagoz, Fadlullah Aksoy, Orhan Ozturan
DOI:10.4103/sjoh.sjoh_54_22  
Synovial sarcoma (SS) is a malignant mesenchymal tumor usually seen in young adults. Most cases occur in the extremities, especially the lower extremities. It is rarely seen in the head-and-neck region, and localization in the larynx and hypopharynx is even rarer. Approximately 20 immunohistochemically defined cases of laryngeal and hypopharyngeal SSs have been reported so far in the literature. We outline the case of a patient with primary hypopharyngeal SS who presented with hoarseness.
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Bleeding septal polyp, a rarity becoming common – A report of four cases p. 42
Ahmad Rufai Tukur, Ahmad M Aldhafeeri, Faisal Hazaa Abohelaibah, Rania G Roshdy, Yousif Ali Aldhafeeri, Fahad Salih Aldhafeeri, Madallah Mutlaq Alanazi
DOI:10.4103/sjoh.sjoh_50_22  
Bleeding septal polyp is a benign, previously assumed very rare lesion that usually presents as unilateral epistaxis, nasal blockage, and intranasal mass. It can occur spontaneously or posttraumatic. We report four cases of three young adult females and one pediatric male. All of them presented with recurrent, spontaneous, torrential, unilateral epistaxis with progressive unilateral nasal blockage of varied durations. Anterior rhinoscopy was done in all cases, and it revealed a polypoidal mass in the cartilaginous septum and ulcerated mucosa in some cases that easily bleeds on contact. A clinical diagnosis of a bleeding septal polyp was made. Patients were evaluated and underwent excisional biopsy using the transnasal endoscopic resection technique. Histology revealed hemangiomatous lesions for the females and angiofibroma for the male. They were followed up for 6 months, with complete healing of the excision site and without any complaint. Bleeding septal polyp is becoming a common cause of spontaneous, recurrent unilateral epistaxis. This case report is an addition to the literature to increase awareness in clinical practice.
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Bleeding post radiofrequency ablation of inferior turbinate: A case study p. 47
Fatemah S AlTheyab, Ebraheem A AlNofal
DOI:10.4103/sjoh.sjoh_57_22  
Nasal obstruction is a troublesome condition and negatively impacts the quality of life. One of the most important causes is inferior turbinate hypertrophy. Radiofrequency submucosal tissue ablation is an effective technique used to reduce inferior turbinate volume. It is considered a safe, minimally invasive procedure with a low risk of complications. Most of the complications reported were minor such as pain, edema, sneezing, crustation, and bleeding. This study demonstrates a case of major bleeding as a complication of radiofrequency ablation of inferior turbinate aiming to reduce the incidence of such complication. The patient had major bleeding resulting in a drop in hemoglobin level, however, no surgical intervention was required, and he was managed conservatively.
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