Yüce İSLAMOĞLU, Müge AYHAN, Sami BERCİN, Ayşe KAYA KALEM, Bircan KAYAASLAN, Rahmet GÜNER

COVID-19 Hastalarının Orta Kulak ve Mastoid Hücrelerinin Değerlendirilmesi

Amaç: Şiddetli akut solunum yolu sendromu koronavirüsü-2 (SARS-CoV-2), koronavirüs hastalığı-2019 (COVID-19) hastalığının nedeni olarak izole edilmiştir. Orta kulak ve mastoid hücreler hava yolu mukozası ile örtülüdür. COVID-19’da hava yolu mukozasında tutulum meydana gelir, ancak bu mukoza ile örtülü östaki tüpü, orta kulak ve mastoid tutulumunun olduğu bilinmemekle birlikte etkilenme olabilir. Çalışmada amacımız COVID- 19’daki temporal kemik tomografisini inceleyerek orta kulak ile mastoid bölümün durumunu incelemektir. Gereç ve Yöntem: Retrospektif gözlemsel bir çalışma planlandı. SARS-CoV-2 polimeraz zincir reaksiyonu (PCR) testi pozitif olup, COVID-19 tanısı olan hastalar çalışmaya dahil edildi. COVID-19 hastalarından temporal tomografisi (BT) olanlar değerlendirildi. Çalışmaya temporal BT’si olan 129 PCR pozitif COVID-19 hasta dahil edildi. Orta kulak ve mastoid hücrelerdeki efüzyonu değerlendirmek için bir evreleme sistemi kullanıldı. Bu evreleme sistemine göre sağ ve sol orta kulak ile mastoid ayrı ayrı değerlendirildi. Sıfır puan=efüzyon yok, 1 puan=parsiyel efüzyon ve 2 puan=%100 efüzyon olarak değerlendirildi. Maksimum skor 8 olarak değerlendirildi. Hastaların iki taraflı kulak zarı normaldi. Bulgular: Üç hastada tutulum izlendi. İki hastada bilateral parsiyel efüzyon ve orta kulak tutulumu izlendi. Bir hastada ise bilateral parsiyel mastoid ve tek taraflı parsiyel orta kulak tutulumu izlendi. Diğer hastaların temporal BT’leri normaldi. Sonuç: Temporal kemik tutulumuna ait temporal tomografide spesifik bir bulgu saptanmadı. Üç hastada orta kulak ve mastoidde efüzyon saptandı. SARS-CoV-2 genellikle temporal kemiği etkilememektedir, ancak nadir olarak mastoid ve orta kulakta efüzyona neden olmaktadır.

Evaluation of Middle Ear and Mastoid Cells of COVID-19 Patients

Objectives: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is isolated as the cause of coronavirus disease-2019 (COVİD-19). Middle ear and mastoid air cells are covered with the airway mucosa. In COVİD-19, an involvement occurs in the airway mucosa; however, although the involvement of eustachian tube covered with this mucosa, middle ear, and mastoid is not known, there can be an intervention. The aim of the study is to investigate the findings of temporal tomography and evaluate the middle ear and mastoid in COVİD-19. Materials and Methods: A retrospective observational study was planned. Patients with a positive polymerase chain reaction (PCR) test for SARSCoV- 2 and diagnosed with COVİD-19 were included in the study. COVİD-19 patients, who had temporal bone tomography scans (CT), were evaluated. One hundred twenty-nine COVİD-19 patients with positive PCR, who also had temporal bone scans, were included in the study. A grading system was used to evaluate the effusion in the middle ear and mastoid cells. According to this grading system, left and right middle ear and mastoid were evaluated separately. In the grading system, the scores were evaluated as 0=no effusion, 1=partial effusion, and 2=100% effusion. The maximum score was accepted as 8. Bilateral tympanic membranes of all the patients were normal. Results: Involvement was observed in three patients. Bilateral partial effusion and middle ear involvement were observed in two patients. In one patient, bilateral partial mastoid and unilateral partial middle ear involvement was detected. Temporal CTs of other patients were normal. Conclusion: No specific finding was found regarding temporal bone involvement from the temporal CT. Three patients had effusion in the middle ear and mastoid. SARS-CoV-2 generally does not affect the temporal bone; however, it rarely causes effusion in the mastoid and middle ear.

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