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共识声明。COVID-19 大流行背景下耳鼻喉科的皮质类固醇治疗。

Consensus statement. Corticosteroid therapy in ENT in the context of the COVID-19 pandemic.

机构信息

Department of otorhinolaryngology, head and neck surgery, Lariboisière university hospital, AP-HP, Paris, France.

Department of otorhinolaryngology, head and neck surgery, Lille university hospital, Lille, France.

出版信息

Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Sep;137(4):315-317. doi: 10.1016/j.anorl.2020.04.014. Epub 2020 May 4.

Abstract

This consensus statement about the indications and modalities of corticosteroid treatment in the context of the COVID-19 pandemic was jointly written by experts from the French Association of Otology and Oto-Neurology (AFON) and from the French Society of Otorhinolaryngology, Head and Neck Surgery (SFORL). There is currently not enough data in favour of danger or benefit from corticosteroids in COVID-19, so until this matter is resolved it is advisable to limit their indications to the most serious clinical pictures for which it is well established that this type of treatment has a positive impact on the progression of symptoms. In Grade V and VI Bell's palsy according to the House-Brackmann grading system, a week's course of oral corticosteroids is recommended. Corticosteroid therapy is also recommended in cases of sudden hearing loss of more than 60dB, either in the form of intratympanic injections or a week's course of oral medication. In rhinology, there is no indication for systemic corticosteroid therapy in the current situation. However, patients are advised to continue with their local corticosteroid therapy in the form of a nasal spray or by inhalation. Treatments with corticosteroid nasal sprays can still be prescribed if there is no alternative. Finally, systemic or local corticosteroid therapy is not indicated for bacterial ENT infections.

摘要

这份关于 COVID-19 大流行背景下皮质类固醇治疗的适应证和方式的共识声明,由法国耳科学和耳神经外科学会(AFON)以及法国耳鼻喉科学、头颈部外科学会(SFORL)的专家共同撰写。目前尚无足够数据表明 COVID-19 患者使用皮质类固醇有益或有害,因此在解决这个问题之前,建议将皮质类固醇的适应证限于病情最严重的临床情况,对于这些情况,已证实这种治疗方法对症状进展有积极影响。根据 House-Brackmann 分级系统,在 V 级和 VI 级贝尔面瘫中,推荐口服皮质类固醇治疗 1 周。对于超过 60dB 的突发性听力损失,无论是鼓室内注射还是口服药物治疗 1 周,都推荐皮质类固醇治疗。在鼻科学中,目前没有全身皮质类固醇治疗的适应证。但是,建议患者继续使用局部皮质类固醇治疗,如鼻喷雾剂或吸入剂。如果没有其他选择,仍可开皮质类固醇鼻喷雾剂治疗。最后,对于细菌 ENT 感染,不建议使用全身或局部皮质类固醇治疗。

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COVID-19 and rhinology, from the consultation room to the operating theatre.COVID-19 与鼻科学:从会诊室到手术室。
Eur Ann Otorhinolaryngol Head Neck Dis. 2020 Sep;137(4):309-314. doi: 10.1016/j.anorl.2020.04.013. Epub 2020 Apr 30.
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Smell and taste dysfunction in patients with COVID-19.新型冠状病毒肺炎患者的嗅觉和味觉功能障碍
Lancet Infect Dis. 2020 Sep;20(9):1015-1016. doi: 10.1016/S1473-3099(20)30293-0. Epub 2020 Apr 15.
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Antiviral treatment for Bell's palsy (idiopathic facial paralysis).贝尔氏面瘫(特发性面神经麻痹)的抗病毒治疗。
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