Objective Evidence of the Presence of Sars-Cov-2 in the Middle Ear- A Review of the Reported Cases Volume 7 - Issue 4

Waqas Jamil¹*, Farah Naz² and Mark Simmons³

• ¹ENT Department, Birmingham Children’s Hospital, Birmingham, UK
• ²Dow University of Health and Sciences, Pakistan
• ³Walsall Manor Hospital and University Hospital Birmingham NHS Foundation Trust, UK

Received: December 20, 2021;   Published: January 11, 2022

Corresponding author: Waqas Jamil, ENT Department, Birmingham Children’s Hospital, Birmingham, UK

DOI: 10.32474/SJO.2022.08.000276

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Abstract

Introduction: The presence of new coronavirus in middle ear cleft can have significant safety implications on ENT practice (e.g., viral shedding during ENT procedures including middle ear/mastoid surgery, ear micro-suction or intratympanic injections). Objective: This review aims to analyse all available studies providing objective evidence about the presence or absence of coronavirus (SARS-CoV-2) in the middle ear.
Methods: Standard search methodology was used to retrieve all studies dealing with the testing for the presence of coronavirus (SARS-CoV-2) in the middle ear. Databases searched were PubMed, CINAHL, Cochrane Library and Embase. Only articles providing objective evidence of SARS-CoV-2 in middle ear cleft were included i.e., where confirmation of viral presence was available through a diagnostic test. Studies merely reporting middle ear symptoms without a diagnostic test were excluded.
Results: A total of 167 articles were obtained during the literature search, out of which a final 6 studies were included and analysed. The presence of SARS-CoV-2 in the middle ear cleft was reported in 4 out of the 6 studies (10 out of a total of 20 patients tested). Surprisingly, in one patient SARS-COV-2 was identified in the middle ear by PCR testing with a negative oropharyngeal swab and no systemic features of SARS-CoV-2.
Conclusion: SARS CoV-2 was reported in the middle ear cleft of 50% (n=10/20) of patients included in our study. Based on our study findings, SARS-CoV-2 should be suspected in every patient undergoing ontological procedure during covid-19 until proven otherwise. The virus can be present in the middle ear in asymptomatic patients or/and patients with a negative oropharyngeal/ nasopharyngeal swab. Hence all necessary precautions must be undertaken during the otological procedures.

Keywords: SARS-CoV-2; middle ear; mastoid cleft; coronavirus; COVID-19

Abstract| Introduction| Methods| Results and Analysis| Discussion| Conclusion| Acknowledgement| Funding| Ethics and dissemination| References|