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Intl. J. of Advances in Medicine     Open Access   (Followers: 2)
Intl. J. of Basic & Clinical Pharmacology     Open Access   (Followers: 2)
Intl. J. of Clinical Trials     Open Access   (Followers: 2)
Intl. J. of Community Medicine and Public Health     Open Access   (Followers: 5)
Intl. J. of Contemporary Pediatrics     Open Access   (Followers: 4)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 11)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 5)
Intl. J. of Research in Orthopaedics     Open Access  
Intl. J. of Scientific Reports     Open Access   (Followers: 1)
Intl. Surgery J.     Open Access   (Followers: 1)
Journal Cover International Journal of Otorhinolaryngology and Head and Neck Surgery
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   ISSN (Print) 2454-5929 - ISSN (Online) 2454-5937
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  • Comparative study of hearing level pre and post ossiculoplasty in Aseer
           Central Hospital, Saudi Arabia

    • Authors: Abdullah Assiri, Ali M. Al-Qannass, Tawfiq A. Khurayzi, Talat E. Alardi
      Pages: 312 - 316
      Abstract: Background: Achieving successful hearing outcomes following ossiculoplasty in patients with middle ear diseases depend on several factors. Unfortunately, the literature is confusing concerning the middle ear factors and types of pathologic process that are most important in predicting hearing outcome. The objective of the study was to investigate the improvement or deterioration of hearing after ossiculoplasty and identify the possible prognostic factors.Methods: Between January, 2012 and December, 2014, 30 ossiculoplasties were performed and followed up by the first author with the help of other authors in Otolaryngology department, Aseer Ceneral hospital, Abha, Kingdom of Saudi Arabia. The patients were followed up at 6 months, 9 months after the operation and then on a yearly basis. Postoperative hearing outcomes were considered successful if the postoperative air-bone gap was within 20 dB while it was considered not successful if it exceeds 20 dB.  Results: The study included 30patients. Their age ranged between 18 and 61 years with a mean of 37.4±10.7 years. Sixty percent of them (n=18) were females and forty percent (n=12) were males. Pre-operative PTA was 37.83±8.97 dB and it decreased to 23.0±12.57 dB postoperatively. This difference was statistically significant (p<0.001) with an average change in ABG of 150 dB across the 30 patients. The successful rate was 50%. the only factor proved to be significantly associated with successful ossiculoplasty was the male gender as 75% of makes compared to 33.3% of females patients reported postoperative air-bone gap within 20 dB, p=0.030. Conclusions: Successful rate of ossiculoplasty in Asser central hospital is within the globally reported rates. However, further larger prospective study is recommended for better understanding of predictive factors for hearing improvement after ossiculoplasty that may contribute to the surgeon’s judgment and the information given to patients.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Endonasal endoscopic dacryocystorhinostomy in Misrata central hospital,

    • Authors: Abdussalam M. Jahan, Yousef M. Eldanfur, Abdulhakim Ben Ghuzi
      Pages: 317 - 320
      Abstract: Background: Dacryocystorhinostomy (DCR) is a surgical procedure performed for the relief of nasolacrimal duct obstruction (NLDO). This procedure involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. It can be performed externally or endoscopically. The aim of this study is to evaluate the success rates and complications of endoscopic dacryocystorhinostomy in Misurata Central Hospital. Methods: Prospective study includes 30 patients admitted to the ENT-Department, Misrata Central Hospital over a period of one year, starting from April 2016 to March 2017. They underwent endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction.  Results: Thirty patients were included in the study. Their age ranged from 11-60 years, with mean age of 33 years. Most of the patients were in the age range of 31 to 50 years. There were 24 (80%) females and 6 (20%) males. The most common complaint of patients before surgery was epiphora. There was more obstruction on left side -21 (70%) than on the right side-9 (30%). Bilateral involvement was not seen. Three patients (10%) were required septoplasty during the endoscopic DCR procedure. Twenty four out of thirty (80%) patients had complete resolution. There were no any significant major complications observed in any patient in our study. Conclusions: Endoscopic DCR is safe, successful procedure for the treatment of nasolacrimal duct obstruction and has several advantages over conventional external approach.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Effect of nasal obstruction in the acoustic analysis of voice

    • Authors: Victor R. Sanchez-Balderas, María Fernández-Olvera, Rubén D. J. Ascencio-Padilla
      Pages: 321 - 325
      Abstract: Background: The voice is the main form of communication between humans and the nasal and sinusal cavity participates in the resonance process. An alteration in the nasal diameter can produce changes in the voice. The objective of this study was to relate the degree of nasal obstruction measured by the SNOT 20 questionnaire to the acoustic analysis of the voice. Methods: 58 non-smoker volunteers without laryngeal pathology where included, 25 women (43%) and 33 men (57%). The average age was 22.1 years (±1.7). The laryngopharyngeal reflux and SNOT20 questionnaires were applied together with an acoustic analysis, we measured fundamental frequency, Jitter and Shimmer. The analysis was done separating in groups by sex and by SNOT score (less than 20 points and equal or higher than 20).  Results: The average of SNOT questionnaire was 15.06 (±11.8), we found no relation between the scores of the SNOT20 questionnaire with Jitter, fundamental frequency, Shimmer or voice intensity (p≥0.01). When separated by groups, the analysis by sex or by scores (SNOT > or < than 20 groups) did not show a statistically significant relationship. Conclusions: In this study we did not find a relation between changes in acoustic analysis in Fundamental frequency, Jitter and Shimmer and the degree of nasal obstruction measured by SNOT 20. The groups of gender and severity of SNOT did not show relationship. More studies are necessary in order to evaluate the relation of nasal obstruction and the acoustic analysis of the voice. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Bacteriological profile of suppurative cervico-facial cellulitis of dental
           origin at the Lomé-CHU campus

    • Authors: Palakina P. Agoda, Saliou Adam, Hamza D. Sama, Harétfetéguina Bissa, Windpouiré P. Guiguimde, Pidem Hemou, Bina Betenora, Bathokedeou Amana, Eyawelohn Kpemissi
      Pages: 326 - 329
      Abstract: Background: Cervico facial cellulitis is mainly complications of oral infections. A better knowledge of the main germs involved and their susceptibility to antibiotics is necessary for their treatment. Methods: Three-year prospective study, carried out in the odontostomatology department of the CHU-Campus of Lome, fifty-five patients were included. The pus was taken by suction in a sterile single-use syringe and then directly seeded on agar. The incubation was carried out for 48 h.  Results: The sample consisted of 28 men and 27 women. Fifty-four point fifty percent of patients were between 14 and 40 years of age. Forty-four cultures (80%) were positive. The main germs isolated were Staphylococcus aureus, Streptococci, Escherichia coli, and Klebsiella pneumoniae. The study showed good susceptibility of staphylococcus to quinolones, from streptococcus to aminoglycosides, quinolones, and amoxicillin-clavulanic acid, and Enterobacteria to cephalosporins, aminoglycosides and quinolones. In the same way, the total resistance of all these germs to tetracyclines was proved. Conclusions: The resistance of Staphylococci and Streptococcus to betalactamins is a real public health problem.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Pure tone hearing threshold of patients with cleft palate anomaly in
           Kaduna, Nigeria

    • Authors: Emmanuel Musa, Aliyu Mohammed Kodiya, Abdullahi Musa Kirfi, Onyekwere George B. Nwaorgu
      Pages: 330 - 334
      Abstract: Background: Hearing loss is common in people with isolated cleft palate (ICP) or cleft lip and palate (CLP). There is renewed hope for surgical repair for people with cleft deformity in Nigeria today due to serious commitment in offering them free surgeries by Smile Train and other non-governmental organizations. While effort at corrective surgery is very commendable, the need for proper diagnosis and management of hearing loss among the cleft population cannot be overemphasized. The aim of this study was to assess the pure tone hearing threshold of patients with cleft palate anomaly at Smile Train Centre Kaduna, Nigeria. Methods: This was a prospective cross-sectional case controlled study to assess the pure tone hearing threshold of consecutive adults and children not less than 5 years of age with repaired or unrepaired cleft lip and cleft palate attending Etomie Smile Train Centre in Kaduna, Nigeria compared with a control group of non-cleft volunteers matched for age and sex. Ethical clearance and informed consent were obtained. History, ear examination and pure tone audiometry were performed. Data collected were analyzed using SPSS version 16. Simple statistical parameters, Chi - Square and paired-samples T-test were used as appropriate. The level of statistical significance was set at p<­­0.05.  Results: The prevalence of hearing loss was 59.4% in patients with CLP and ICP and 12% among the control group. Conclusions: There is high prevalence of conductive hearing loss among patients with cleft palate anomaly at Etomie Smile Train Centre Kaduna.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Ultrasonic cutting and coagulation device versus conventional diathermy
           dissection in thyroid surgery: prospective randomized trial

    • Authors: Aditya Singhal, Dharma Kant Baskota, Kunjan Acharya
      Pages: 335 - 338
      Abstract: Background: The objective of this study was to compare the operative time and postoperative outcomes in thyroid surgeries using the ultrasonic cutting and coagulation device with conventional diathermy dissection. Methods: This study was a prospective, interventional, cohort study. The patients   were randomized in two groups by lottery system. The patients operated with ultrasonic device were labeled as Group A: UCCD and by conventional diathermy as Group B: CDD. The operative time, postoperative drain volume, pain score on VAS and complications were assessed and compared in between the two techniques of surgery.  Results: Total of 18 males and 58 females underwent thyroid surgery with age ranging from 17 to 75 years. The operative time in UCCD group was less than CDD group (93.29 min vs. 106.59 min; p=0.06). The cumulative mean amount of drain was found to be less in UCCD group, this difference was statistically significant (77.86 ml vs. 138.05 ml; p=0.00018). The drain was removed earlier in UCCD group, this comparison was also statistically significant (2.49 days in UCCD group vs. 3.02 days in CDD group; p=0.000009). The mean pain score was found to be statistically significant on all the postoperative days in UCCD group. Conclusions: The patients experienced less pain and complication while using UCCD as technique for surgery.  Hence, ultrasonic device using both cutting and coagulating mode at the same time is efficient in hemostasis and lesser post-operative pain, and found to be advantageous.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Effect of partial inferior turbinectomy operation on pulmonary function

    • Authors: Saad Elzayat, Hany H. Moussa
      Pages: 339 - 342
      Abstract: Background: Nasal obstruction due to persistent hypertrophy of inferior turbinates is very common affecting respiration and daily activity. Partial inferior turbinectomy is a very safe and effective operation overcoming the nasal obstruction and nasal resistance caused by hypertrophied turbinates. Methods: In this prospective descriptive study, we tried to evaluate the effect of the operation on pulmonary functions and daily activity objectively by using spirometry and 6-minutes walking test before and after the operation. Thirty patients were included in this study.  Results: Significant improvement after the operation. Also, we use a subjective VAS score which revealed the same results, proving that, the pulmonary function tests improved significantly after partial inferior turbinectomy operation. Conclusions: Partial inferior turbinectomy is a very effective operation in the management of nasal obstruction caused by persistent hypertrophy of inferior turbinates resulting in improvement of the pulmonary function tests and daily activity after the operation without marked complications. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Clinicopathological study of pediatric neck masses

    • Authors: Navneeta Gangwar, Pratibha Vyas, Saurabh Gakkar
      Pages: 343 - 347
      Abstract: Background: Pediatric neck masses are a reason for anxiety for both patients and doctor as there can be chances of malignancy. There are few established guidelines for evaluation. The etiology is varied so a thorough knowledge of clinical presentation is essential. Methods: A clinicopathological analysis of 150 cases of neck masses in children upto 12 years of age attending the outpatient clinic between Jan 2015 to June 2016 were included. Results: Maximum cases of reactive lymphadenopathy were found in our study 81 (20.7%), 23 (14.7%) thyroglossal cyst, 22 (14.7%) suppurative lymphadenopathy, mycobacterial lymphadenitis 20 (13.3%), dermoid cyst 17 (11.3%), branchial cyst 15 (10%), tubercular abscess 10 (6.7%), 3 cases (2%) each of Hodgkins lymphoma, lipoma, non-Hodgkins lymphoma were seen. FNAC was conclusive in 140 cases (93.4%). Conclusions: Percentage wise inflammatory etiology was the commonest (55.4%) followed by congenital (38.6%) and last was neoplastic (6 %). An orderly and sequential approach is needed to manage pediatric masses.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Prevalence and determinants of chronic suppurative otitis media in school
           going children in Bareilly (Uttar Pradesh)

    • Authors: Aditya Singhal, Pooja Agrawal, Vijender Kumar Agrawal
      Pages: 348 - 351
      Abstract: Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in the South East Asia having a prevalence of approximately 5.2% in the general population. The objective of the study was to find the prevalence of CSOM in school going children in urban field practice area of tertiary care hospital in Bareilly (UP). Methods: Cross-sectional study involving 495 schools going children in Bareilly district of Uttar Pradesh.  Results: The prevalence of CSOM was found to be 6.46%, with tubotympanic type constituting majority 81.25% trailed by atticoantral type 18.75%. Most patients presented with moderate hearing impairment (43.75%) and mild hearing impairment (31.25%). With respect to socioeconomic groups, upper lower, groups had 40.63%, and lower group had 34.37% prevalence. Conclusions: Improvement of health care facilities and awareness among health-care providers would definitely be helpful in reducing the prevalence of ear diseases in the developing countries like India.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A study on radio opaque foreign body in digestive tract of children

    • Authors: Bharathi Mohan M., Satish Kumar P., Vikram V. J., Kiruthiga M.
      Pages: 352 - 355
      Abstract: Background: An estimated 40 percent of foreign body ingestions in children are not witnessed, and in many cases, the child never develops symptoms. Sharp foreign body, button battery must be carefully removed and followed up for any complications. Foreign bodies that have passed the gastroesophageal junction should be assured that the foreign body will probably pass through the GI tract. Methods: A retrospective analysis of the records of the children below 12 years with foreign body ingestions were analysed and the radio-opaque foreign body were included in the study period between March 2012 to March 2015. The x-ray were analysed, type of foreign body, treatment and complications were noted.  Results: There were 45 children included in the study who had ingested foreign body and on radiological evaluation radio opaque foreign body was found. The coin topped the list with 30, button battery- 7 numbers, safety pin- 5 numbers. In 2 children who ingested button battery suffered cricopharyngeal stricture, which was treated with serial dilatation with bougies, while one child with open safety pin ingestion, developed pseudo- aneurysm of arch of aorta and one ear stud developed stridor with sub glottic stenosis. Conclusions: The radio opaque foreign though is easy to visualise, but in some case it can dangerous complications. Rigid oesophagoscopy and prompt removal of foreign body is the treatment of choice.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A descriptive study of aetiopathological evaluation of hoarseness: our

    • Authors: Sindhu B. S., Jayaprabha S.
      Pages: 356 - 361
      Abstract: Background: Hoarseness is a quality of voice that is rough, grating, harsh, more or less discordant and lower than normal in pitch for the individual. Besides affecting useful communication leading to tremendous alterations in daily living, voice problem may also signify the presence of more serious medical illnesses; such as malignancy or airway compromise. Hence this study is undertaken to determine the relative incidence of cases presented at a tertiary hospital, to analyse the hoarseness population based on age, sex, occupation etc, to find out the pathogenesis of hoarseness in the cases and to postulate the risk factors implicated in each. Methods: Descriptive cross sectional study was conducted on patients with hoarseness reported at Government Medical College, Trivandrum for a period of twelve months. Detailed history regarding duration, onset, nature of hoarseness, aggravating and relieving factors, voice fatiguability, diurnal variation, associated symptoms and history of upper respiratory infection were taken. Results: Being the tertiary hospital, the incidence was noted to be 0.7%. Majority of patients are in 4th to 7th decades and the most commonly affected age group was 50-59 years. Male preponderance with 4:1 ratio was observed in which manual labourers constitute the single largest group. Smoking, alcohol intake and vocal abuse are found to be the major etiological factors. Majority of lesions were malignant in nature, commonest being Carcinoma Glottis. In benign lesions, majority was vocal cord polyp. Conclusions: Early detection of pathology and awareness is very important in the management of hoarseness. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Comparative study between partial inferior turbinectomy and submucosal
           diathermy for treatment of inferior turbinate hypertrophy due to allergic

    • Authors: Datta R. K., Ramya B., Vinay S. R.
      Pages: 362 - 367
      Abstract: Background: Nasal obstruction due to inferior turbinate hypertrophy is one of the most common symptoms of Allergic rhinitis (AR) which causes significant debility. Surgery is one of the modalities of treatment to relieve patients of nasal obstruction. Objective of the study was to evaluate the efficacy of submucosal diathermy (SMD) and partial inferior turbinectomy (PIT) in the treatment of hypertrophied inferior turbinate.Methods: Sixty patients with allergic rhinitis and hypertrophied inferior turbinates were randomised into two groups with thirty patients each (group I underwent SMD and group II underwent PIT). They were assessed for relief of nasal obstruction by subjective and objective methods.  Results: Nasal obstruction due to hypertrophy of inferior turbinate was the main symptom with 45 (75%) patients having severe obstruction and 15 (25%) patients moderate obstruction. Both the surgical procedures were effective in reducing nasal obstruction & other symptoms of AR. Though the total symptom score was significantly reduced by both the methods (p=0.001) SMD was superior in relieving nasal obstruction at 3months follow up while PIT was more effective at 6 months follow up.Conclusions: SMD is an easier, less invasive method with lesser postoperative discomfort and complications as compared to PIT. Our study recommends SMD as an effective technique for relief of nasal obstruction in allergic rhinitis.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Lipomas of head and neck

    • Authors: Sathyaki D. C., Mereen Susan Roy
      Pages: 368 - 371
      Abstract: Background: Lipomas are rare in head and neck. In head and neck it is more common in posterior triangle. Methods: All patients with lipoma presenting to the OPD in a tertiary care centre.  Results: Lipomas were common in posterior triangle and was more common in males. Conclusions: Ultrasound and FNAC aid in diagnosis of Lipoma.  
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Economic aspect of tissue glue in thyroid surgeries

    • Authors: Harish M. O., Suresh Pillai
      Pages: 372 - 375
      Abstract: Background: Tissue glue or adhesives are the recent advances in closure of the skin wound. They have been used as an alternative to the sutures, staples and plasters. They have been found to be cosmetically better compared to other modes of wound closure. Whether the tissue glues are economically feasible for routine use has to be found out. The aims and objectives of this study is to find out the cost-effectiveness of tissue glue in comparison with traditional suture technique in thyroid surgeries.Methods: This is a prospective study to find out the economic aspect of tissue glue in comparison with silk suture in fifty three patients who underwent thyroidectomy at Kasturba Medical College, Manipal.  Results: The overall cost for tissue glue procedure was significantly less when compared to silk suture technique. Conclusions: Iso amyl-2-cyanoacrylate is excellent tissue glue. Though the initial cost of tissue glue is higher compared to silk sutures, the overall cost including the anaesthetic cost, hospital stay and reviews is considerably less. Thus we conclude that the tissue glue is economically cheaper compared to suture methods.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Management of advanced otosclerosis: experience in a tertiary care centre

    • Authors: Mohammed Iftekharul Alam, Kiran Natarajan, Takhellambam Biram Singh, Abha Kumari, Mohan Kameswaran
      Pages: 376 - 380
      Abstract: Background: Advanced otosclerosis affects approximately 10% of patients with otosclerosis. Ossification of the cochlea increases with the course of the disease and may cause sensori-neural or mixed hearing loss. Hearing aids, stapedotomy and cochlear implants are management options for hearing loss associated with advanced otosclerosis. Methods: A retrospective study of 153 patients with advanced otosclerosis was done in a tertiary ENT centre. 110 patients with advanced otosclerosis underwent stapedotomy and 43 patients with advanced otosclerosis underwent cochlear implantation (CI) from 1997 till date. Exclusion criteria included patients with profound hearing loss from causes other than otosclerosis. The aim was to study the indications, selection criteria, as well as surgical issues of stapedotomy and cochlear implantation in patients with advanced otosclerosis.  Results: Stapedotomy followed by use of hearing aid was found to give good outcomes in advanced otosclerosis. Patients with advanced otosclerosis who had poor pre-operative speech discrimination underwent CI. Complete insertion was possible in 39 patients and partial insertion was done in 4 patients. The outcomes of cochlear implantation were found to be satisfactory. Facial nerve stimulation was seen in 5 patients who underwent CI; however this was successfully managed by reprogramming or switching off the concerned electrodes. Conclusions: In our experience, stapedotomy or CI in advanced otosclerosis has proven successful, with a low complication rate. The selection criteria for stapedotomy versus CI have to be stringent for optimal outcomes.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Myringoplasty: underlay versus overlay techniques- a comparative study

    • Authors: Mahesh S. G., Vishwas K. Pai, Pallavi Pavithran, Nithin P. S.
      Pages: 381 - 386
      Abstract: Background: Chronic suppurative otitis media is an inflammation of the mucoperiosteal lining of the middle ear cleft. 10% of Indian population suffers from hearing impairment. Methods: The study comprises of 60 patients admitted in the department of ENT and head and neck surgery, AJIMS, Mangalore between June 2015 and May 2017. All patients suffered from CSOM, tubotympanic type. Selection criteria was patients with CSOM, TTD type with no or minimal SNHL, AB gap more than 20dB, absence of ossicular defects, no history of previous ear surgery and was operated on worse hearing ear. Exclusion criteria were atticoantral disease, ossicular defects, previous ear surgery, otomycosis and systemic diseases.  Results: The majority of the patients were between the age group of 20-40 years. Out of the 60 patients, 28 were male and 32 female. 8 patients with moderate size and 20 with large perforations underwent underlay myringoplasty. For onlay corresponding numbers were 17 and 13. 26 patients (86.7%) who underwent underlay and 27 patients (90%) who underwent overlay had good hearing improvement. 43.3% of the group had significant hearing improvement at 6 months follow up. 20 patients had pneumatised and 40 patients had sclerotic mastoids in the study. Graft take up was 90% for underlay and 96.6% for overlay. The hearing loss was more with larger perforations.18 patients with large perforations who underwent underlay had good hearing improvement versus 13 for overlay whereas for moderate perforations, only 8 patients had good hearing improvement for underlay versus 15 for overlay. Conclusions: The hearing improvement obtained with underlay and overlay myringoplasty are comparable. The cellularity of mastoid has no influence on the hearing improvement. The size of the perforation correlates well with the degree of hearing loss. Underlay myringoplasty seems to give better results for large perforations, overlay for moderate sized ones. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Clinical assessment of cervical node in head and neck malignancy: case

    • Authors: Leena Rajam K., Vikram V. J., Anjan Kumar Selvaraj, Saravana Babu P.
      Pages: 387 - 390
      Abstract: Background: Lymph node involvement is well established as an important prognostic factor for head and neck cancer, the spread of carcinoma of head and malignancy to the node levels is probably predictable according to the site of the primary. The appropriate staging of cervical lymph nodes is very important in the management of any head and neck primary carcinoma. Clinical palpation of cervical lymph nodes may yield false negative and false positive results. Methods: In a prospective study in patients of patients with primary malignancy from larynx, any sub site of pharynx (nasopharynx/oropharynx/hypopharynx) of histologically proven squamous cell carcinoma, the nodal status of primary tumour, the level of lymph node involved and the stage of presentation of the tumor and node were analysed clinically. Results: 61 cases included in our study, where males were 52 cases and females were 9 cases. The age incidence ranging from 35 years to 76 years noted. In the distribution of nodal secondary carcinoma of the nasopharynx was 100% nodal positive followed by hypopharynx, oropharynx, and larynx. 21% of patient presented in the N0 stage. The remaining 79% were node positive. In nodal secondary by size of primary most of the patients presented with T3 disease (52%) followed by T2 disease (26%), T1 disease (11%) and T4 disease (11%). Conclusions: In malignancy of larynx, pharynx, lymph node assessment clinically is an important prognostic factor to determine the staging of tumour. The clinical evaluation may also have false negative, so radiological evaluation will further give a detailed assessment of the nodes for better treatment outcomes to reduce the overall mortality. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Tympanometric changes following adenoidectomy in children with adenoid

    • Authors: Rashmi P. Rajashekhar, Vinod V. Shinde
      Pages: 391 - 396
      Abstract: Background: Adenoid Hypertrophy is the commonest disorder in children. The size of adenoids varies from child to child and also in the same individual as he grows and attains maximum size between age of 3 to 7 years. Adenoid hypertrophy plays a significant role in the pathogenesis of otitis media with effusion. Our objective was to study the tympanogram changes following adenoidectomy. i.e to find out the effect  of  adenoidectomy on Otitis Media with Effusion.Methods: Patients showing >50% of airway obstruction by the adenoids were included in the study. 20 patients with adenoid hypertrophy underwent adenoidectomy. Pre-operative and postoperative tympanograms of 40 ears were studied.  Results: Type A curve (normal) was found in 12 ears. Type B Flat tympanogram – 12 ears s/o Gross Serous Otitis Media. Type C tympanogram – 8 ears s/o uncomplicated eustachian tube obstruction. 5 ears showed tympanogram s/o Eustachian tube block without significant collection of middle ear fluid. 3 ears showed tympanogram s/o uncomplicated eustachian tube obstruction. Post adenoidectomy, 32 ears showed normal tympanogram. 8 ears showed tympanogram s/o negative middle ear pressure with normal compliance.Conclusions: Our study shows high prevalence of Otitis Media with Effusion in patients with adenoid hypertrophy. Otitis Media with Effusion is treated by adenoidectomy in most of the patients which is confirmed by post adenoidectomy tympanogram. Also, problem of decreased attention in school due to reduced hearing secondary to OME can be corrected by adenoidectomy. Hence, all patients should undergo pre and post-adenoidectomy tympanometry to know the compliance and pressure changes in the middle ear.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Tympanic membrane perforation: correlation of hearing loss with its site
           and size

    • Authors: Arvinder Singh Sood, Pooja Pal, Amit Kumar
      Pages: 397 - 402
      Abstract: Background: The objectives of the study were correlation of hearing loss with size and site of tympanic membrane perforation. Methods: A cross-sectional prospective study of 100 patients of both sex and age between 11-60 years with perforated tympanic membrane was conducted in the department of Otorhinolaryngology (ENT). Size and site of TM perforation was assessed using otoscope and otomicroscope. Size of perforation was measured with 1 mm thin wire loop and vernier caliper. Patients were divided into three groups according to size; Group I (0-9 mm), Group II (9-30 mm), Group III (>30 mm). The tympanic membrane was divided into five segments anterosuperior, posterosuperior, anteroinferior, posteroinferior and central for the localization of the site of perforation. Data thus collected was statistically analysed.  Results: Patients with Group I perforation had an average hearing loss of 31.42±7.15 decibel. Group II had an average hearing loss of 39.42±8.97 decibel. Group III had an average hearing loss of 48.91±7.38 decibel. Maximum hearing loss was noted in patients with central perforation with an average hearing loss of 39.34±9.47 decibel. Average hearing loss was found higher in posterior perforations than anterior quadrant perforations. This difference was however not statistically significant with ‘p’ value of ‘0.689’. Conclusions: Linear correlation was found between size of tympanic membrane perforation and degree of hearing loss. No linear correlation between site of tympanic membrane perforation and hearing loss was found. We found no correlation between duration of disease and size of tympanic membrane perforation with degree of hearing loss.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Conventional vs. endoscopic septoplasty: our experience

    • Authors: Visweswara Rao Suraneni, Suneel Kudamala, Srikanth K.
      Pages: 403 - 408
      Abstract: Background: A straight septum is the exception rather than the rule. A deviated septum can be asymptomatic or can cause functional and cosmetic abnormality. Different surgeries have been proposed for correction of deviated septum but septoplasty has been the procedure of choice. Septoplasty is a more conservative surgery with fewer complications and endoscopic septoplasty has become increasingly popular over the last few decades. Methods: This is a comparative study conducted at a tertiary care centre over a period of 1 year on 100 cases to compare the efficacy of endoscopic septoplasty with conventional septoplasty. 50 cases underwent conventional septoplasty while the other 50 cases underwent endoscopic septoplasty. Relief from pre-operative symptoms, anatomical correction of deformity and intraoperative/postoperative complications were studied.  Results: Patients belonging to endoscopic septoplasty group showed better symptomatic relief and lesser incidence of complications when compared to the conventional septoplasty group. Conclusions: Endoscopic septoplasty has better illumination and additional magnification which aid in accurate identification of pathology and precise excision of the deviated septal part. It is also useful for correction of posterior and high deviations of septum and for revision surgeries. Coventional septoplasty has got its own merits like dealing with situations in which septal damage is more and post trauma. Though better patient compliance, better relief from symptoms and lesser rate of complications give an edge for endoscopic over conventional septoplasty, both the procedures need to be done together in some situations to achieve optimal results.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Clinicopathological, microbiological and radiological evaluation of deep
           neck spaces infections

    • Authors: M. Santhosh Reddy, C. R. Vijay Bharath Reddy
      Pages: 409 - 412
      Abstract: Background: More and more use of antibiotics and development of new antibiotics have helped in reducing the morbidity associated with “deep neck infections”, but still their incidence is found in the general populations. Prompt diagnosis and early treatment are key. The objective of the study was to study deep neck infections regarding etiological factors, micro-biological features.Methods: A total of 24 patients were identified and diagnosed at S.V.S Medical College and Hospital Mahabubnagar over a period of 3 years, among them 12 patients were picked up at random basis for detailed study.  Results: It has been observed that the incidence of deep neck space infection was 3% till June 2010 and then it reduced to 1.76% by June 2011 and remained constant till October 2011. Sub-mandibular abscess was the most common in 58.3% of the cases. The most common source of infection of deep neck space infections was odontogenic in 45.8% of the cases. Airway obstruction was seen in 29% of the cases and mediastinitis was seen in only two patients. The most commonly observed organism involved in the deep neck space infections was streptococcus pyogenes in 75% of the cases. Conclusions: Deep neck space infections though rare, are associated with complications and most importantly antimicrobial resistance. Hence it is very important that these must not be neglected.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • An evaluation of preoperative high resolution computed tomography of
           temporal bone in cholesteatoma

    • Authors: Prabhu Khavasi, Santosh Malashetti, Chandrashekarayya S. H.
      Pages: 413 - 417
      Abstract: Background: Cholesteatoma is relatively common and potentially dangerous disease of the ear. It is characterised by local destruction and osseous erosion leading to complications. High resolution computed tomography (HRCT) is the imaging modality of choice for evaluation of middle ear structures and pathology. The aim of this study is to evaluate role of preoperative HRCT in the diagnosis of the disease, its extension and complications and plan for surgery.Methods: This prospective study was conducted at a tertiary referral teaching hospital and 40 cases of cholesteatoma were selected and their pre-operative HRCT temporal bone findings and intraoperative findings were correlated.  Results: This study showed good correlation between preoperative HRCT findings of cholesteatoma, and intraoperative findings. Conclusions: We conclude therefore the preoperative HRCT temporal bone is useful guide for the surgeon for the diagnosis and management of cholesteatoma.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Acquisition of voice onset time in Hindi speaking children with cochlear

    • Authors: Y. Kishore, Jaya Sahu, Ajay Basod, G. Obulesu, R. Salma Mahaboob
      Pages: 418 - 423
      Abstract: Background: The acquisition of voice onset time (VOT) in plosive consonants among hearing-impaired individuals has long been of interest to many researchers especially following the use of a hearing device such as the cochlear implant. The aim of the study was to study acquisition of voice onset time in Hindi speaking children with cochlear implant. Methods: A total of 15 CI subjects were chosen who were attending the speech and language therapy in Hindi and age matched 15 normal hearing children were selected for the study. Subjects were divided into 3 age groups according to hearing experience.  Results: The present study investigated the VOT values of voiced and voiceless plosives produced by Hindi-speaking prelingually deafened CI children with duration of CI experience ranged between 4 to 10 years. The results were then compared to a group of NH children with chronological age similar to the hearing experience of the CI children. Conclusions: A longitudinal study is recommended to continue monitoring the CI children acquisition of the voicing contrast to determine at what hearing age the difference would be insignificant between the CI and NH groups and whether similar developmental trend would continue.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Diagnosis and management of radio opaque nasal foreign bodies in children

    • Authors: Satish Kumar P., Vikram V. J., Mannarmannan N., Bhavani R.
      Pages: 424 - 427
      Abstract: Background: Nasal foreign body impaction is a common problem in paediatric population. Children are more affected because they have tendency to put anything in the nose or by their playmates. This study is about the various radio opaque nasal foreign bodies we encountered and their management. Methods: A retrospective study between January 2013 - January 2015, at Institute of child health/Madras Medical College, Chennai, was done in paediatric patients, who have accidently inserted the radio opaque foreign body in their nostrils. The case record were analysed for the nature of radio opaque nasal foreign body, the symptoms, complications encountered.  Results: There were 11 patients with radio opaque foreign body in our study. The most common age group was between 1 to 5 years 7 patients were in this age group. The type of foreign was button battery were 5 in number, safety pins 4, marble 1, bolt 1. All the patients were brought to hospital within 4 hours of insertion. We did not encounter any complications while removal of the nasal foreign bodies. Conclusions: Nasal foreign bodies are a common problem among children’s. The foreign body retrieval can be posing a great challenge to the otorhinolaryngologists. The radio opaque foreign body especially button battery, if not removed may lead to serious complications like septal perforation. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Anatomical variations in patients with chronic sinusitis

    • Authors: Pragadeeswaran Kumarasekaran, Rajprakash Dharmapuri Yadhava krishnan, Gurumani Sriraman
      Pages: 428 - 431
      Abstract: Background: Chronic sinusitis is repeated bouts of acute infection or persistent inflammation of the sinuses. The range of anatomic variants that can interfere with the mucociliary drainage of osteomeatal complex including concha bullosa, deviated nasal septum, uncinate process variations, ethmoid bulla, paradoxical middle turbinate, agger nasi and Haller cells. This is also important in surgeon point of view to know about detail knowledge of lateral nasal wall, paranasal sinuses, surrounding vital structures and anatomical variation. Methods: Observational case series study in which 90 cases of chronic rhinosinusitis patients attending the ENT outpatient department from November-2015 to November-2016 in Shri Sathya Sai Medical college and Hospital, who had chronic sinusitis for more than three months duration not responding to the medical line treatment and who are willing to undergo functional endoscopic sinus surgery are studied and statistically analysed.  Results: In our study we found anatomical variation in 93% of chronic sinusitis patients. In our study it was observed that 52% of patients with two anatomical variation, 41% patients presented with single anatomical variation and 7% patients presented with no anatomical variation. In our study deviated nasal septum was the most common anatomical variant noted followed by unilateral concha bullosa, medialized uncinate process, paradoxical middle turbinate, haller cell and agger nasi. Conclusions: In our study it was concluded that presence of anatomical variations is common in patients with chronic sinusitis. Presence of more than one anatomical variations significantly contributes to disease process. Deviated nasal septum is the most common anatomical variation in our study followed by concha bullosa, medialized uncinate process.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A comparative study of superiorly based circumferential tympanomeatal flap
           tympanoplasty with anteriorly anchoring flap tympanoplasty in large,
           subtotal, and anterior tympanic membrane central perforations in chronic
           suppurative otitis media of mucosal type

    • Authors: Amitkumar Rathi, Vinod Gite, Sameer Bhargava, Neeraj Shetty
      Pages: 432 - 439
      Abstract: Background: The main objective of the study was to assess and compare the graft uptake, hearing improvement, complications in large, subtotal, and anterior moderate perforations by each technique viz; superiorly based circumferential tympanomeatal flap tympanoplasty (STT)/full cuff and anterior anchoring flap tympanoplasty (AAT)/anterior tucking. Methods: In our study of 30 cases age group in the range of 10 years to 60 years. The mean air bone gap for the 8 patients with anterior moderate perforation was 31.75 db, for 17 patients with large central perforations was 38.75 db and for 5 patients with subtotal perforations was 41.4 db.  Results: Mean air bone gap closure after 3 months of surgery in the STT group was 21.4 db while that after 6months of the surgery for the same group was 22.06 db. Mean air bone gap closure after 3 months of surgery in the AAT group was 18.2 db while that after 6months of the surgery for the same group was 18.73 db. Conclusions: Comparing the air bone gap closure in patients who underwent surgery by AAT and STT technique we found that there is no statistical difference. Both techniques (viz: superiorly based circumferential tympanomeatal flap tympanoplasty and anteriorly anchoring flap tympanoplasty) can be used for the repair of large, subtotal, and anterior tympanic membrane central perforations in chronic suppurative otitis media of mucosal type.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Our experience of auricular hematoma treatment in wrestlers

    • Authors: Vilas R. Kirdak, Sambhaji G. Chintale, Kaleem Shaikh, Sonali Jatale
      Pages: 440 - 442
      Abstract: Background: Traditional Indian wrestlers, in contrast to wrestlers outside do not routinely wear protective head gear. So they are at increased risk of recurrent auricular hematoma, often resulting in sever auricular deformity like cauliflower ear or hematoma of ear. Methods: This is retrospective study of analysing 40 cases of auricular hematoma in Wrestlers evaluating treatment and outcome in all cases carried out in our institute at JIIUS IIMSR, Warudi, Badnapur, Jalna over period from September 2014 to September 2017 surgical technique used was incision drainage and mattress suture.  Results: The study material comprised of 40 cases all being wrestlers of auricular hematoma using the incision and drainage technique with mattress suture of pinna. All the wrestler were male as the game is predominantly played among men’s in India the average age of patient study was 26 yrs range between 16 to 35 yrs. 16 wrestlers had very bad cauliflowering of the both ear after earlier treatment while 4 patient had cauliflowering of one ear before being seen us for the new auricular hematoma. 8 patients develop second hematoma on the same ear at different location after receiving the treatment after six month while 6 of the patient developed hematoma on the opposite site ear after six month of treatment. Conclusions: In the management of auricular hematoma in sport person like wrestler’s simple incision and drainage followed by mattress suture without any pressure bandage with antibiotic application appears to be prompt treatment.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Incidence of accessory ostia in patients with chronic maxillary sinusitis

    • Authors: Puja Ghosh, Pragadeeswaran Kumarasekaran, Gurumani Sriraman
      Pages: 443 - 447
      Abstract: Background: Chronic maxillary sinusitisis is one of the most frequent diseases presenting in ENT out patient department seeking medical attention. Defects in the fontanelle region of the lateral nasal wall have been described as accessory ostia. The presence of AMO in both pre and post operated cases of chronic maxillary sinusitis can cause recirculation of mucus leading to recurrences. In the present study we will investigate the incidence of accessory ostia in patients with clinical and radiological signs of chronic maxillary sinusitis. Methods: The study included 100 patients visiting the out patient department of Shri Sathya Sai Medical College and Research Institute selected according to inclusion criteria with a clinical diagnosis of chronic rhino sinusitis which was confirmed by high resolution CT scan and those patients were subjected to diagnostic nasal endoscopy under local anesthesia.  Results: The study group consisted of total 100 patients among whom 56 were male patients and 44 were female patients. Accessory maxillary ostia were detected in 23% of the cases and in rest of the 77% cases it was absent. Among the 23 cases in 35% cases accessory ostia were found to be bilateral and in 65% cases it was found to be unilateral. Among the cases where accessory ostia were seen, in 39% cases only accessory ostia were found. Where as in 17.39% cases it was associated with concha bullosa, in 65.2% cases there was deviated nasal septum and in 8.7% cases paradoxical middle turbinate were found to be present. Conclusions: To conclude, the present study revealed close association of accessory ostia with chronic maxillary rhino sinusitis. It was also found that majority of the cases accessory ostia were found to be unilateral and were frequently found in the posterior fontanelle region.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Study of impact of surgical intervention (adenotonsillectomy) and
           conservative management on quality of life in patients with SDB

    • Authors: Arshed Ali, Jasif Nisar, Ihsan Ali, Rauf Ahmad
      Pages: 448 - 454
      Abstract: Background: SDB is an important cause of morbidity in children. SDB has been associated with decreased quality of life (QOL). In this study, we tried to determine The impact of surgical intervention (adenotonsillectomy) and conservative management on quality of life in patients with SDB. Methods: A total of 112 pediatric patients were included with SDB, who visited our OPD. Diagnostic methods include history and physical examination, audiotaping or videotaping, pulse oximetry. OSA 18 questionnaire was used to assess the quality of life with conservative treatment (pre and post-treatment) and after surgical intervention-before and after adenoidectomy or adenotonsillectomy.  Results: We had 112 patients with majority being males 69 (61.60%) and females 43 (38.30%), majority of patients were in the age group of 5-7 yrs (49.10%). In 47 patients (who underwent adenotonsillectomy/tonsillectomy), OSA-18 questionnaire was used pre-operatively, at 2 and 6 months. OSA-18 when used pre-operatively showed majority of patients 33 (70.21%) having score >80, and 14 (29.79%) patients having score between 60-80. No patient was below 60 score. Mean OSA-18 score pre-operatively was 84.15. OSA-18 score at 2 months and at 6 months were 30.06 and 26.40 respectively, which showed a lot of improvement in post-operative score and hence the post –operative quality of life. In 65 patients (conservative treatment) OSA-18 was used pre-conservative, at 2 and 6 months of treatment. OSA-18 when used before conservative treatment showed majority of patients 44 (67.6 9%) having score 60-80, and 21 (32.30%) patients having score between >80. No patient was below 60 score. OSA-18 score at 2 months showed improvement in 69.23% patients (<40), OSA-18 at 6 months showed recurrence in 12.33% patients. Conclusions: SDB substantially impact QOL in pediatric patients. QOL significantly improves following adenotonsillectomy. There is subset of patients 12.33% with SDB in whom there was recurrence of symptoms after conservative treatment. Thus showing that conservative management is inferior to surgical management in the treatment of SDB. SDB improved after an observation period. Thus, observation with close follow-up is another treatment option. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A study on chronic otitis media in tertiary care center

    • Authors: Leena Rajam K., Vikram V. J., Priyanka C., Indumathi R.
      Pages: 455 - 458
      Abstract: Background: Chronic otitis media (COM) is a serious healthcare concern worldwide, because of the distress and economic burden to the patient and their family. Temporal bone pneumatization plays an important role in etiology, behaviour, course and outcome of COM. Pneumatisation gets poorer with growing chronicity of the disease. Methods: A retrospective study was conducted between March 2015-March 2017 on female patients visiting with COM, at ENT department Kasturba Gandhi Hospital, Madras Medical College. The records were analysed of the age, duration of symptoms, associated complaints, pure tone audiogram, computerised tomography of temporal bone, mastoid surgery done according to the disease process affecting the ear.  Results: 35 female COM patients were analysed, most common age group is between 31-40 years in 14 patients. There hearing loss was mild category in 27. There were 27 cases of mucosal type of chronic otitis media and 8 cases of squamous type. The CT scan with sclerosis of mastoid was the common finding. Conclusions: In exclusive study on female patients with COM, the mucosal type of COM is common with mild hearing loss and sclerosed mastoid indicating the chronicity. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Unusual sites of dermoid cysts

    • Authors: Sathyaki D. C., Mereen Susan Roy, Razal Mohammed Sherif, Ashish Rao
      Pages: 459 - 461
      Abstract: Background: Epidermoids are ectoderm lined inclusion cysts which can be present anywhere in the body, but are rare in head and neck. Although only 7% of the dermoid cysts occur in head and neck region they are a part of differential diagnosis of neck swellings. They are more common in midline. This study presents to you the dermoids which present in unusual sites.Methods: It was a descriptive study. Cases which were proven as dermoid or epidermoid cysts by FNAC or by histopathology were included in this study.  Results: Male patients were more affected than female patients.Conclusions: Complete removal should be carried out to prevent recurrence. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Study of pathology of ossicles in non-cholesteatomatous chronic
           suppurative otitis media, its repair and outcome

    • Authors: C. R. Vijay Bharath Reddy, M. Santhosh Reddy
      Pages: 462 - 466
      Abstract: Background: If the ears have perforation of long standing durations, even without cholesteatomas, they remain infected. Three times as many operations were performed in the United States in 1978 for this disease as were performed for cholesteatoma. The objective of the study was to study of pathology of ossicles in non-cholesteatomatous chronic suppurative otitis media, its repair and outcome. Methods: This is a clinical study of patients presented to outpatient, department of Vijayanagar Institute of Medical Sciences, Bellary during the period of November 2004 to November 2005 with non-cholesteatomatous chronic suppurative otitis media. This study is aimed to study the various ossicular abnormalities encountered in non-cholesteatomatous chronic suppurative otitis media and their reconstruction techniques.  Results: 12 ears (40%) had central and 18 ears (60%) had subtotal perforation. The average hearing loss in patients with isolated erosion of lenticular process of incus was 50.72±6.95 dB. In our study, autologous incus was used for ossicular reconstruction in 14 (46.67%) patients and homologous septal cartilage in 10 (33.33%) cases. Twenty-nine of the 30 cases underwent myringostapediopexy (type IIIb tympanoplasty) with the ossicular graft as short columella between the tympanic membrane graft and the stapes superstructure. Conclusions: Excellent results were noted only with the autologous incus graft. 28.57% of the total patients with autologous incus graft showed excellent post-operative results. Good results were found for autologous incus, homologous septal cartilage and teflon PORP, with percentage of 28.57, 50 and 25% respectively.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Evaluation of efficacy of fixed dose combination of montelukast and
           levocetirizine compared to monotherapy of montelukast and levocetirizine
           in patients with seasonal allergic rhinitis

    • Authors: Kiran Bylappa, Wilma Delphine Silvia C. R.
      Pages: 467 - 472
      Abstract: Background: Allergic rhinitis (AR) is a global health problem. Almost 10%–25% of population worldwide is affected by AR. Seasonal allergic rhinitis (SAR) is caused by an IgE-mediated reaction to seasonal aeroallergens and is fairly easy to identify because of the rapid and reproducible onset and offset of symptoms in association with pollen exposure. SAR can result in hyperresponsiveness to allergens. Treatment of allergic rhinitis is aimed to achieve optimal symptom control and reduce nasal congestion, sneezing and rhinorrhea over the course of the entire day and night. Methods: Out of total 274 subjects, 92 subjects in the FDC of montelukast 10 mg and levocetrizine 5 mg group, 92 subjects in montelukast 10 mg group and 90 subjects in levocetrizine 5 mg group were enrolled in the study. The total study duration was 16 days. Criteria for evaluation of primary efficacy were mean change in daytime nasal symptoms score from baseline to end of treatment. Mean change in night time symptoms score from baseline to end of treatment. Mean change in daytime eye symptoms score from baseline to end of treatment. Patient's and physician's global evaluation of allergic rhinitis at the end of treatment. Mean change in rhinoconjunctivitis quality-of life score from baseline to end of treatment.  Results: Primary efficacy endpoint that fixed dose combination (FDC) of montelukast 10 mg and levocetirizine 5 mg was superior to montelukast 10 mg monotherapy or levocetirizine 5mg monotherapy in the treatment of patients with seasonal allergic rhinitis. Other secondary endpoints and global impression results are also supporting the therapeutic benefit of fixed dose combination over monotherapy. Conclusions: FDC of montelukast 10 mg and levocetirizine 5 mg was superior to montelukast 10 mg monotherapy or levocetirizine 5 mg monotherapy in the treatment of patients with seasonal allergic rhinitis.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Clinical findings and risk factors associated with oral cancer: a
           prospective study

    • Authors: Yashna Gupta, Parvinder Singh, Neeru Bedi, Pardeep Garg, Raja Paramjit Singh Banipal
      Pages: 473 - 476
      Abstract: Background: Oral cancer is associated with high morbidity and mortality and therefore it represents a grave health problem worldwide. However there is scarcity of the studies in the literature regarding the prognostic factors amongst the subjects. The aim of the present study is to determine the various risk factors and the most commonly affected sites by the oral squamous cell carcinoma amongst subjects of different age groups. Methods: The present prospective comparative study was conducted at the Department of Radiotherapy at Guru Gobind Singh Medical College and Hospital during a period of three months i.e. from April 2016 to June 2016. Patients were evaluated every week for a period of approximately 2 weeks. Examination of the oral cavity was done using probe and mouth mirror by trained personnel. TNM classification was used to classify tumour. Patient’s habits like alcohol and tobacco intake were also recorded. Complete demographic information was obtained from all the patients. All the data thus obtained was arranged in a tabulated form and analysed using SPSS software.  Results: The study included a total of 60 subjects. There were 11 females in the study and 49 males in the study. There were 18.3% (n=11) subjects having cancer of tongue. There were 23.3% (n=14) subjects having cancer of buccal mucosa. Alveolar ridge carcinoma was seen in 8.3% (n=5) subjects. There were 22 patients (30%) having stage III carcinoma. Majority of the subjects i.e. 70% (n= 38) were at stage IV A according to TNM classification. Conclusions: From the above study we can conclude that there is lack of awareness amongst the people about oral cancer. They mostly present during advanced stage of the disease. Most of the subjects are males, showing there predisposition towards harmful habits.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Phantom ringing syndrome: an Indian perspective

    • Authors: Ajeet Kumar Khilnani, Rekha Thaddanee, Gurudas Khilnani
      Pages: 477 - 480
      Abstract: Background: Use of smart phone, which has become an integral activity of daily life now, has begun to show subtle untoward effects on health. Various health related problems associated with electronic devices, especially smart phones, use are being studied. Phantom ringing syndrome (PRS) is one such adverse effect, which is an auditory hallucination seen in mobile phone users when they feel that their phone is ringing when it is actually not. To the best of our knowledge and literature search, we could not find any Indian study on PRS. This study was conducted to determine the prevalence of PRS and to find the factors associated with it.Methods: This was a prospective, cross-sectional online questionnaire based study, conducted in western Gujarat from July 2017 to October 2017. A 7-item validated questionnaire was sent to 800 participants, through e-mail or WhatsApp, and the responses received were analyzed using MS excel.  Results: Out of 319 respondents, 181 (67%) were males and 89 (33%) females. The mean age of males was 31.65 (9.65) years and females was 29.96 (11.19) years. PRS was present in 54.4% of respondents. There was no significant association between presence of PRS and age of participants (p=0.855), sex of participants (p=0.5232), profession (medical vs. non-medical) (p=0.498), physical location of mobile phone (p=0.829), mode of using mobile phone (p=0.718) and duration of mobile phone use (p=0.748). Conclusions: The prevalence rate of PRS in our study was 54.4%. PRS occurs irrespective of gender, age, profession, and physical location, duration and mode of phone use. It would be interesting to find exact site of involvement, in auditory circuit, by BERA studies.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Functional and anatomical results of inside out approach for cholesteatoma

    • Authors: Priyanka Chamoli, Chandra Veer Singh, Sheetal Radia, Anand K. Shah
      Pages: 481 - 489
      Abstract: Background: The objective of the study was to study the efficacy of inside-out approach in completely eradicating the cholesteatoma from middle ear and mastoid, preservation of hearing and quality of life post mastoidectomy with regards to recurrent discharge, wax, granulations. Methods: Non-randomizedprospective observational study performed at the Department of ENT in Bombay hospital Mumbai. The study involved 40 patients presenting with chronic suppurative otitis media with cholesteatoma. All of them underwent inside out mastoidectomy and were followed up till the end of the study to evaluate the efficacy of inside out mastoidectomy in eradicating the disease from the middle ear cleft, to assess preservation of hearing and to assess cavity problems.  Results: Of the 40 patients, 39 patients had a total clearance of disease by the inside out approach, and in 1 patient, we were doubtful of the clearance. All patients came for regular follow up and none of them had residual disease at the end of the study period. Thus, the overall success rate was 100% in this study. A significant improvement in the mean air conduction (p<0.01) and the mean air bone gap (p<0.01) postoperatively was seen in all in the postoperative 3rd month PTA. Only one patient had increased conductive hearing loss one and a half years postoperatively after initial improvement. A dry self-cleansing cavity was achieved in 95% of the patients and only 5% required regular cleaning of waxes the cavities. Conclusions: Inside out mastoidectomy is a better alternative in canal wall down procedures as it not only clears the disease from the middle ear cleft, but also leaves behind a small postoperative cavity, which will preserve the hearing, decrease the cavity problems and increase the quality of life of such patients.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Our experience of 30 cases of mucormycosis of nose and paranasal sinuses

    • Authors: Vilas R. Kirdak, Sambhaji G. Chintale, Sajit Shaikh, Kaleem Shaikh, Sonali Jatale
      Pages: 490 - 493
      Abstract: Background: Mucormycosis is life threatening fungal infection that occurs in immunocompromised patient. These infections are becoming increasingly common in yet survival remains very poor a great understanding of the pathogenesis of the disease may lead to future therapies.Methods: In present study we have made an attempt to evaluate a standard method of management of mucormycosis of nose and para nasal sinuses. Total 30 cases of mucormycosis of nose and Para nasal sinuses were studied JIIUS IIMSR Warudi, Badnapur, Jalna a tertiary center from June 2014 to June 2017 thoroughly on the basis of clinical behavior, histopathological report and radiological investigation, we have tried to formulate a standard method of treatment in the form of medical and surgical debridement or combination in order to achieve the best possible results.  Results: In this study male patient were 18 (50%) cases and female were 12 (40%). Most common predisposing factor was diabetes mellitus in 24 (80%) cases and other factors were tuberculosis 4 (13.33) and chronic renal failure 5 (16.66).Most commonly presented age group was 4th decade to 5th decade 11 (36.66) and 8 (26.66%) respectively. Most common symptom was nasal obstruction and sign was maxillary swelling 21 (70%). Most common radiological finding was cloudiness of sinuses 27 (90%) least common finding was intracranial extension 6 (20%). Most common used treatment modalities was amphotericin B24 (80%) and least used was surgical debridement by FESS 16 (53%).Conclusions: In the management of mucormycosis and its different pathological forms and most aggressive form like rhino cerebral mucormycosis prompt diagnosis based on clinical examination, reversal of predisposing condition and aggressive surgical debridement along with medical treatment remain corner stone of the therapy for this deadly disease. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Swallowing difficulties among healthy elderly: prevalence and aetiology

    • Authors: Fathima Abdul Khader, Gangadhara Somayaji K. S., Mubeena .
      Pages: 494 - 498
      Abstract: Background: Dysphagia is a common problem among elderly individuals. Very few studies have been done to know the prevalence of dysphagia among healthy elderly individuals. So a study was done to assess the prevalence of swallowing difficulties among healthy elderly individuals and to find out the various causes for it in them. Methods: 259 elderly individuals were screened using the swallowing disturbance questionnaire to assess the prevalence of swallowing disorders. Those individuals with swallowing disorders were further subjected to modified Barium swallow to know the aetiology.  Results: Of the 259 elderly individuals screened, 85 were females and 174 were males. The mean age and standard deviation was 66.16±6.233. The prevalence of swallowing difficulties was 20.1%, with no significant difference in the gender wise distribution or age wise distribution. Among the various aetiologies diagnosed, idiopathic cause is the commonest, followed by oesophageal neoplasm (21.1%), and then the achalasia cardia (9.6%). Among oesophageal neoplasm, mid-thoracic esophageal neoplasm (9.6%) is the commonest. Conclusions: Considering the time and cost involved, it is not feasible to subject all elderly for instrumental swallowing evaluation like videofluoroscopy. Hence it would be beneficial to screen the elderly individuals for dysphagia and educate them regarding its importance, as dysphagia can also be associated with serious underlying pathology and complications such as aspiration. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Sensorineural hearing loss and type II diabetes mellitus

    • Authors: Kavita Sachdeva, Saima Azim
      Pages: 499 - 507
      Abstract: Background: The association between Hearing loss and diabetes, first mentioned by Jardao in 1857, had been under continuous research since then; giving both positive and negative results. This study aims to explore the relationship of hearing loss with type II DM and also to evaluate the impact of glycemic control over degree of hearing loss. Methods: 92 patients with type II DM were enrolled in this study, audiometrically evaluated and compared with equal number of age and sex matched non-diabetic controls. Apart from audiological tests, haematological tests like FBS, PPBS, HbA1c, serum creatinine and cholesterol were carried out to assess glycemic control.  Results: It was observed that 31 (34%) of the diabetic patients had mild to moderate sensorineural hearing loss, while only 12 (13%) of the control group suffered from the same, which is statistically significant (p<0.05). Among these 31 patients, 19 (61%) patients had uncontrolled diabetes (HbA1c >8.5) and 12 (39%) had higher creatinine levels (>2.5 mg/dl). Higher frequencies (4 and 8 kHz) were found to be affected more, both in case and control groups. Low stapedial reflex thresholds were observed in 14% patients of case group and 5.4% of the controls. Speech discrimination scores were not significantly different. Otoacoustic emission showed outer hair cell dysfunction in 85% cases and 66% controls. Conclusions: There is a strong correlation between diabetes mellitus and hearing threshold levels especially at higher frequencies. Long duration and uncontrolled diabetes has more implications over hearing threshold. Since the pattern of hearing loss in diabetes and presbycusis is similar, it may be said that hearing level with ageing is significantly impaired earlier in diabetic patients as compared to general population.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Rhinolith a forgotten entity: our experience in remote hilly population of

    • Authors: Chetan Bansal, V. P. Singh, Deeksha Nautiyal
      Pages: 508 - 511
      Abstract: Background: Rhinoliths are mineralized foreign bodies in the nasal cavity and are diagnosed based on the presenting illness and clinical examination. Giant nasal stones are very rare in occurrence, since improved diagnostic techniques now make it possible to identify foreign bodies at an early stage of disease. The aim of the study was to revisit this rare and forgotten clinical entity with the variations in presentation in the hilly population of uttarakhand and treatment revisited.Methods: We report a case series of 33 patients with rhinoliths who presented to our institute over a period of 10 years, from January 2007 to January 2017.  Results: Average age was 25.48 years (range: 5 years to 60 years). 19 were female and 14 male. The incident was reported by a family member/attendant in 12.1% of cases (4 cases), discovered following nasal symptoms in 84.84% (28 cases) and was incidentally discovered in 3.03% (1 case). Symptoms comprised rhinorrhea associated with unpleasant nasal odor in 30.3% of cases (10 cases), epistaxis in 15.1% (5 cases), symptoms of sinusitis in 18.12% (6 cases), ozena in 6% (2 cases)and nasal obstruction in 84.84% (28 cases). There was one case of massive bilateral rhinolith presenting with bilateral symptoms which required an open approach in today’s era whereas all other cases were managed endoscopically. Conclusions: Although rhinoliths are a rare occurrence, attending doctors should be aware of this entity and should have a high index of suspicion in cases with progressive unilateral nasal obstruction, unilateral rhinorrhea, unilateral nasal bleeding. In rare cases, rhinolith should be kept in mind as a differential diagnosis and also in bilateral nasal symptoms also specially if the symptoms are long standing.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Analysis of type of tympanograms across different age groups in a tertiary
           care hospital: a retrospective study

    • Authors: Hanumantha Prasad M., Ravi D., Balaji N. K., Sowmya T. R., Sahana Puttaraju, Nirmala Jagadish
      Pages: 512 - 516
      Abstract: Background: Tympanometry is a non-invasive test clinical test for the assessment of middle ear status/functioning. Several studies over the past few years have produced conflicting results regarding changes in the middle ear function with advancing age. Hence, the present study is aimed to give evidences on distributions of type of tympanograms in males and females under various age groups.Methods: The study followed retrospective design, where data collected from January 2017 to October 2017 were used. A total of 2,292 tympanograms of the 1146 patients were analysed. Descriptive statistics and Wilcoxon’s signed rank test were used. A p-value <0.05 was considered as significant.  Results: It was documented that higher occurrence of ‘B’ type and ‘Ad’ type of tympanogram in paediatric group and geriatric group respectively. As it is expected, ‘A’ type of tympanogram is predominant in adult and older adult group. Also, there was no gender difference seen in type of tympanograms.Conclusions: Higher occurrence of ‘B’ type of tympanogram in paediatric group warrants medical line of treatment and educating on ear-hygiene in them.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Effectiveness of minimally invasive endoscopic sinus surgery in
           alleviating the symptom complex in chronic rhino-sinusitis

    • Authors: M. Santhosh Reddy, C. R. Vijay Bharath Reddy
      Pages: 517 - 521
      Abstract: Background: Early surgical intervention has been found to be better in terms of patient satisfaction compared even with the medical management. The objective of the study was to study effectiveness of minimally invasive endoscopic sinus surgery in alleviating the symptom complex in chronic rhino-sinusitis.Methods: Retrospective review of the chronic rhino-sinusitis data of 164 patients done, who undergone functional endoscopic sinus surgery with or without septoplasty between 2005 and 2013. Any recurrence of symptoms and radiological evidence recorded in the patient notes. The number of patients who undergone revision surgery also recorded.  Results: The recurrence rate of symptoms and sinus disease was 20% (33 patients). There was no relation between the severity of the symptoms and the amount of disease seen in the CT scans. The two patients, who had purulent sinusitis, WERE completely relieved of their headaches and resumed their routine work soon after the operation. About 90% patients improved regarding nasal obstruction, 75% patients improved of nasal discharge, 60% patients showed improvement for sneezing. There were adhesions in about 6% patients and polyps recurred in 30% of patients. The recurrence of symptoms improved with medication in majority of patients.Conclusions: The meticulously performed functional endoscopic surgery effectively improved symptom complex. If properly performed it is effective in alleviating all the symptoms and decrease recurrence rate and complications can be kept at negligible levels. Hence it offers a clear advantage in reducing complications and recurrence rates in sinus disease. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Brainstem auditory responses in type-2 diabetes mellitus

    • Authors: Siddharth Suresh, Sharwak Ramlan, Gangadhara Somayaji, Nimalka Sequeira
      Pages: 522 - 525
      Abstract: Background: Diabetes mellitus causes pathophysiological changes at multiple organs. Brainstem Evoked Response Auditory (BERA) represents a non-invasive tool to detect diabetes related sensorineural hearing loss. The aim was to assess diabetes related central auditory pathway involvement using BERA.Methods: The study comprises two groups, (i) Diabetic group (n=15), (ii) Control group (n=15). The controls were matched for age and sex with the study group. BERA was done for all these patients after detailed clinical examination and relevant blood investigations.  Results: There was significant latency differences found in wave III, V and interpeak latencies I-III, III-V and I-V between control and study groups at 70 dBnHL and 80 dBnHL. At 90 dBnHL the diabetic group demonstrated significant latency differences in waves I, III and V and interpeak I-III, III-V and I-V compared to controls. The duration of DM was 5-10 years in 8 patients (53.3%) out of which 7 subjects (87.5%) had prolonged BERA. 7 patients (46.6%) were diabetic for more than 10 years of which all patients (100%) had prolonged latencies.Conclusions: The wave I latency was found non significant which suggests that the pathway from 8th nerve to cochlear nucleus is not affected in diabetic patients. The delay in latencies III and V and interpeak latencies I-III, III-V and I-V in diabetic patients compared to the controls suggests brainstem and midbrain involvement. So the study suggests that BERA helps in early detection of central neuronal axis involvement in type-2 diabetes mellitus. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Role of PETCT in the management of untreated advanced squamous cell
           carcinoma of the oral cavity, oropharynx and hypopharynx

    • Authors: Angshuman Dutta, B. G. Chaithra, Harkirat Singh
      Pages: 526 - 531
      Abstract: Background: Advanced stage cancers of the oral cavity, oropharynx and hypopharynx have the worst prognosis owing to higher incidence of regional and distant metastases. PET/CT scan can detect distant metastases and can therefore be done at the initial presentation in advanced stage head and neck cancers to facilitate the chalking out of an appropriate treatment plan.Methods: The study included 41 patients having stage III & IV of oral cavity, oropharyngeal and hypopharyngeal squamous cancer. The patients underwent clinical examination, an initial imaging with CT/MRI of the disease site and conventional metastatic workup. An initial TNM staging and treatment plan was formulated. The patients then underwent PET/CT. Tumor restaging was done and the treatment plan was altered if required after the PETCT.  Results: There was change in management of 4(9%) owing to upstaging of disease following PETCT.Conclusions: PETCT scan had a significant impact on the staging of disease affecting change in the treatment protocols. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A randomized control trail on the effectiveness of (Tricyclic
           antidepressant) Amitriptyline 10 mg bedtime in patients suffering from
           Meniere’s disease

    • Authors: Santhosh Kumar Rajamani, Pritikanta Sahu
      Pages: 532 - 536
      Abstract: Background: Meniere’s disease is one of the most common causes of chronic recurrent vertigo in general population. Meniere’s disease is closely associated with migraine and migrainous vertigo/ vestibular migraine. Amitriptyline has been classically used in management of Vestibular migraine. This randomized control trail examines the effectiveness of (Tricyclic antidepressant) Amitriptyline 10mg bedtime in patients suffering from Meniere’s disease using a Randomized control trial. This was a randomized, double-blinded, placebo-controlled trial, cross over type with a power of 80% at 5% significance level.Methods: One hundred five patients with definite Meniere’s disease were randomized and assigned to either placebo or trial arm. Trial arm were given Amitriptyline 10 mg bedtime and placebo arm were given a generic Vitamin B-complex tablet. Visual analogue score and standard questionnaires were used to assess the improvements in vertigo, imbalance, dizziness and disease-specific quality of life before and after use of Amitriptyline vs. placebo for period of 10 days each.  Results: Amitriptyline 10mg at bedtime (10mg H.S), produces significant improvement in the vertigo in patients suffering from Meniere’s disease compared to placebo. Chronic imbalance and hearing levels are not affected by the use of the above drug regime. Daytime sedation and weight gain are the most troublesome adverse effects of Amitriptyline at 10mg per day dose. No other serious adverse effects were observed in this research.Conclusions: Low dose bedtime Amitriptyline 10mg appears to be safe and produces improvement in vertigo and disease-specific quality of life in Meniere’s disease patients. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Correlation between degree of hearing loss and intraoperative findings in
           tubotympanic type of chronic suppurative otitis media

    • Authors: Ravi Dudda, Sowmya Tumkur Rangaiah, M. Hanumantha Prasad, Nagavara Kalegowda Balaji
      Pages: 537 - 541
      Abstract: Background: The aim of tympanoplasty done for tubotympanic type of chronic suppurative otitis media (CSOM) should not only be to achieve a dry ear, but also to give hearing improvement to the patient. Aim of this study was to determine the correlation between size and site of tympanic membrane perforation with degree of hearing loss and correlation between ossicular chain status and degree of hearing loss on pure tone audiometry.Methods: Patients with tubotympanic CSOM with hearing loss upto 60 dBHL undergoing tympanoplasty were examined to know the site and size of tympanic membrane(TM) perforation. Intraoperative findings pertaining to middle ear and ossicles were noted.  Results: Out of 52 patients of tubotympanic type of CSOM, hearing loss was least (31.18±7.46 dBHL) in small perforations of the TM and highest in subtotal perforations (48.74±7.83 dBHL) which was statistically significant. Hearing loss was significantly more in posterior perforation (46.61±7.02 dBHL) than in anterior perforation of TM (32.65±8.77 dBHL). There was a statistically significant difference in pure tone average hearing loss between intact ossicle group (32.87±9.77 dBHL) and eroded ossicle group (43.39±9.60dBHL). Difference in air bone gap was also significant between intact ossicle group (24.09±9.56 dB) and eroded ossicle group (31.02±9.83 dB). Multiple ossicles were eroded in nineteen patients with incus being the most commonly eroded ossicle.Conclusions: In this study, hearing loss increased with increased size of TM perforation and also with posterior perforation. Incus was found to be the most commonly eroded ossicle. Multiple ossicles were seen eroded most commonly when hearing loss was moderate. The surgeon will be better equipped to do ossiculoplasty in view of these preoperative findings and also to counsel the patient better about their expectation of hearing improvement following surgery. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Dyadic wavelet analysis and detection of sinusitis using near infrared

    • Authors: S. Kamatchi, M. Sundararajan
      Pages: 542 - 549
      Abstract: Background: Sinusitis is a chronic infection or inflammation which affects the paranasal sinus cavities and the associated nasal cavities. As the symptoms of sinusitis greatly resemble upper respiratory infections, diagnosing sinusitis clinically is a major issue. Though imaging techniques serves as a standard in confirming the diagnosis of chronic sinusitis, the availability at the primary care settings, affordability and diagnosing acute cases calls upon an alternative technique in practice. Recent researches confirming the diagnosis of sinusitis using Near-infrared imaging gives us hope in taking up the research using optical sensing. The objective of the study was to successfully diagnose sinusitis using NIR-LED optical sensor and to signal process the data obtained from the patients using Dyadic Wavelet Transform (DyWT) to confirm and to validate diagnosis using regression analysis. The study also correlates the plain radiographic findings with the NIR device sensing to make the device feasible.Methods: This was a one year pilot study (June 2014–May 2015) conducted with forty patients suspected of sinusitis and with clinical history along with ten healthy individuals as controls.  Results: Patients age ranged from 18-65 years were included in the study. Results from NIR sensing device well correlate with the radiographic examination of the registered candidates. The regression result perfectly matches with the dyadic wavelet results of the patients, confirming the diagnosing of sinusitis using near- infrared sensor. Radiographic examination well correlates with the results from the NIR diagnostic device providing a valuable evidence of the hardware.Conclusions: NIR-LED sensor device can provide qualitative evidence in differentiating the mild and severe patients based on air-fluid level present in the sinus. The results strongly recommend that NIR sensing device can be a best alternative in case of frequently sinus affected patients and for the unaffordable patients without the risk of radiation.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Comparison of stacked tone-ABR and chirp ABR in individual with normal
           hearing and sensorineural hearing loss

    • Authors: C. R. Vijay Bharath Reddy, M. Santhosh Reddy, K. Suresh
      Pages: 550 - 554
      Abstract: Background: There are no published studies that compared amplitude of stacked-Tone ABR and Chirp ABR in hearing impaired individuals with sensorineural hearing loss, which need to be investigated. Objective of the study was to know whether amplitude of standard chirp evoked ABR is same as tone burst evoked stacked ABR in individuals with normal hearing listeners and individuals with sensorineural hearing loss.Methods: Present hospital based cross sectional study was carried out at Malla Reddy Institute of Medical Sciences, from January 2016 to December 2016. Two groups of subjects were taken. Group I consisted of 20 ears (14 males and 6 females) with normal hearing. Group II consisted of 20 ears (11 females and 9 males) with cochlear hearing loss.  Results: Wave V Amplitude of stacked tone ABR was higher than Chirp stimuli evoked ABR wave V in both the groups. Amplitude of stacked tone ABR and chirp was smaller for individuals with sensorineural hearing loss than normal hearing. Between the 2 chirp stimuli, standard Chirp ABR amplitude was higher than modified Chirp in normal hearing listeners and individual with sensorineural hearing loss. For modified chirp in individuals with normal hearing and cochlear hearing loss. Latency obtained by standard chirp was longer compared to latency obtained by modified chirp, which is seen in both the groups.Conclusions: Chirp ABR may be opted over stacked tone ABR in neurological investigations due to its lesser variability in amplitude and shorter duration of testing. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A clinical study of epistaxis

    • Authors: Sawanth Sampigethya, Elizabeth Cherian, Deepika Pratap, Ivan Mani, Vadisha Srinivas Bhat
      Pages: 555 - 558
      Abstract: Background: Epistaxis is one the common emergencies in Oto-rhino-laryngology. It may occur in any age and in either gender. Cause of epistaxis range from simple self-limiting condition to more sinister malignancy which needs a radical approach. Hence, one should evaluate these patients appropriately and identify the cause to treat them accordingly. The present work was undertaken with the aim of studying the demographic profile of patients with epistaxis, its causes and management.Methods: The present study consisted of 60 patients who came with complaint of epistaxis. The patient’s detailed history was obtained. Detailed systemic examination and ENT examination was performed on patients in the study. Patients were investigated and treated as per the standard hospital protocol.  Results: Out of the total 60 cases of epistaxis, 65% were males and 35% were females. Most of our cases were aged more than 50 years (31.7%) with mean age of 38.56 years. Most common etiology of epistaxis in present study was hypertension (20%), followed by acute rhino-sinusitis (15%). Commonest cause in children was deviated nasal septum and acute rhinosinusitis while in young adults, trauma was the common cause. Most common cause in elderly was hypertension. Medical management was done in most of the cases (65%) while anterior and posterior packing was done in 20% and 10% cases respectively. Three cases underwent electro-cauterization of bleeding point.Conclusions: Epistaxis can be seen in anyage. However the etiology of this condition varies with age. Understanding of the etiology helps in better evaluation and treatment of the case. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Comparing endoscopic microdebrider assisted adenoidectomy with curettage

    • Authors: C. Ravishakar, Shambulinga Killera
      Pages: 559 - 564
      Abstract: Background: Adenoid is a mass of lymphatic tissue situated posterior to the nasal cavity, in the roof of the nasopharynx, forming a part of the Waldeyer's ring, was initially described in 1868 by Meyer. Adenoidectomy is one of the commonest operations done on children. It is done alone or along with tonsillectomy or with ventilation tube insertion for otitis media with effusion. Objective of the study was to compare the results of endoscopic microdebrider assisted adenoidectomy with that of conventional curettage adenoidectomy.Methods: A prospective randomized study of 60 patients with clinical features of adenoid hypertrophy. These patients were randomly divided into two groups, 30 each using the table of random numbers. Group I, underwent endoscopic microdebrider assisted adenoidectomy and group II underwent adenoidectomy by curettage. All the patients were followed up for a period of 3 months. Parameters such as operating time, blood loss, intra-operative/post-operative complications and residual adenoid tissue were assessed.  Results: In this study mean age of patients in group I (EAA) was 9±0.50 years (range 6–15 years) and group II (CA) was 9.86 ± 2.31 years (range 6-15 years). The mean operating time was 20.79 minutes for the group I (range: 12 to 35 minutes) and 14.42 minutes for group II (range: 10 to 22 minutes, p=0.001). Blood loss was around 31.06 ml (range: 21 to 46 ml) in group I and 22.26 ml (range: 10 to 60 ml) in group II. Adenoidectomy by curette group showed more residual nasopharyngeal adenoid tissue (43.33%) than by endoscopic microdebrider assisted adenoidectomy (20%).Conclusions: Endoscopic microdebrider assisted adenoidectomy is a safe and more effective compared to curettage method, with very minimal chances of injury to the surrounding structures during the procedure.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Comparative study between result of temporalis muscle fascia and tragal
           cartilage perichondrium as a graft material in type 1 tympanoplasty

    • Authors: Abhay Kumar, Prabhu Narayan, Prem Narain, Jaypal Singh, Prateek Kumar Porwal, Sanjay Sharma, Daya Shankar
      Pages: 565 - 568
      Abstract: Background: Leading cause of deafness in India is chronic suppurative otitis media. Most common cause of TM perforation is chronic suppurative otitis media. With this background this study was to compare hearing results, as well as graft takes for commonly preferred reconstruction techniques of the TM (i.e., temporalis fascia vs. cartilage) in tympanoplasty.Methods: The present study consists of 60 cases of C.S.O.M (TTD) which was divided into two groups with 30 cases in each group. In first group type1 tympanoplasty was done by Temporalis fascia technique. In second group type 1 tympanoplasty done by tragal cartilage with perichondrium technique. History and otoscopic examination along with pure tone audiometry was performed preoperatively. Postoperative hearing results and graft uptake were compared between two groups, all surgeries were performed through the post aural approach.  Results: Graft uptake results are better with tragal cartilage with perichondrium technique. Hearing improved significantly in both groups. Though this was slightly better in TFT, but not significant statistically.Conclusions: Graft uptake rates are better with the tragal cartilage with perichondrium technique in comparison of TFT and hearing results are almost equivalent with both techniques.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • A retrospective study comparing treatment outcomes of spontaneous healing,
           scaffolding with silastic sheet and gelfoam in patients with traumatic
           tympanic membrane perforations

    • Authors: Monika Patel, Maitri Kaushik, Arun Dehadaray, Viraj Gaikwad
      Pages: 569 - 574
      Abstract: Background: Objective of the study was to compare the treatment outcome of conservative management, intervention with silastic sheet and gelfoam mixed with autologous blood in traumatic perforations of tympanic membrane.Methods: A retrospective study was conducted on 69 patients; with traumatic ear perforation were treated by conservative management, silastic sheet placement and gelfoam with autologous blood. Patients data every week and minimum of 4 visits was documented. On follow up data was reassessed in terms of symptom improvement, healing of perforation, duration for healing and development of secondary infection. Statistical analysis was done using Fischer’s exact test.  Results: Out of the 69 patients group1 consisted of 38 patients, group2 had 19 and group3 had 12 patients. The age ranged from 02-72 years, with greater incidence in females. In group 1 though the healing rate was very good symptom improvement was gradual. The symptom improvement in both group 2 and 3 were satisfactory and highly significant p<0.001. The difference in healing outcome of three modality of treatments was found significant p<0.05 but the occurrence of infection and local reaction did not affect the healing outcome at the end p<0.05.Conclusions: Traumatic TM perforations have a high chance of healing. Treatment outcome should not consider only healing status as a sole measure but symptom relief from distressing symptoms like ear buzzing or tinnitus and hearing loss should also be considered. Use of scaffolding method can be useful in such cases. Hence selection of proper treatment modality should be considered based on patient complaints.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Foreign bodies in adult upper digestive tract: a series of 30 cases

    • Authors: Nirmal Kumar Jayaraman, Vikram V. J., Kalaiselvi M., Sudha M.
      Pages: 575 - 578
      Abstract: Background: Rigid endoscopy under general anaesthesia has traditionally been used by otolaryngologist for diagnosis and management of variety of disorders affecting the upper digestive tract including the removal of foreign body. Smooth foreign bodies does not pose much threat but may cause airway obstruction. Sharp foreign bodies, if not removed the earliest may penetrate oesophageal wall and cause complications.Methods: A Retrospective analysis was done for patients who underwent rigid oesophaghoscopy under general anaesthesia for 30 patients of foreign body ingestion at Upgraded Institute of Otorhinolaryngology, Madras Medical College, Chennai, between November 2016 – November 2017. The records of age, sex, co-morbidities, X-ray finding, complications were recorded.  Results: Majority of adults in this group belonged to 40-50 years age. The most common foreign body impacted was chicken bone totalling 16. 2 patients of denture ingestion were referred for flexible endoscopy after failed attempt, 1 developed oesophageal perforation.Conclusions: Rigid endoscopy is the gold standard for removal of sharp foreign body as the sharp ends can be clasped and brought in to the endoscope there by preventing damage to the mucosa. Foreign body with multiple sharp ends which cannot be negotiated into rigid endoscope, should be pushed into the stomach and attempted removal by cutting sharp ends of foreign body or by gastrostomy, as pulling such foreign body will lead to full length tear of oesophagus leading to morbidity and mortality. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Bilateral cervical accessory tragus: a rare pediatric neck mas

    • Authors: Suha Ertugrul, Goksen Ertugrul
      Pages: 579 - 581
      Abstract: An accessory tragus is a small elevation of skin that contains a bar of elastic cartilage and is usually found along an imaginary line drawn from the tragus to the angle of the mouth or, uncommonly, along the anterior margin of the sternocleidomastoid muscle. These malformations are present at birth. It is usually located unilaterally in the preauricular region. Accessory tragi may occur along the migratory line, as the auricle ascends from the neck area and their origin is the mandibular branchial arch. Other auricular abnormalities are not usually associated with accessory tragus, since the majority of the external ear evolves from the second branchial arch. To the best of our knowledge this is the first accessory tragus case that seen on the lateral cervical region bilaterally.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Rosai Dorfman disease: a case report

    • Authors: Yazid Bin Pol Ong, Loong Siow Ping, Khor Foo Kiang, Gan Soon Ching, Angeline Bt Madatang, Ahmad Toha Bin Samsudin
      Pages: 582 - 584
      Abstract: Rosai Dorfman disease (RDD) is a rare granulomatous disease that typically presents with massive lymphadenopathy. To our knowledge, there have only been 650 cases reported worldwide. It is more common among adults and has characteristic clinical, radiological and histopathological findings. Here, we present a case of RDD in a 51 year-old man with massive submental lymphadenopathy which was not responding to antibiotics. Computerized Tomographic Scan showed ill-defined non-enhancing soft tissue density while fine needle aspiration for cytology displayed emperipolesis which is seen in patients with RDD. The swelling followed a benign course and reduced in size progressively without further intervention. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Benign cemento-ossifying fibroma: a rare case report

    • Authors: Gurbax Singh, Jasmine Kaur, Jai Lal Davessar, Latika Kansal, Ajay Singh
      Pages: 585 - 587
      Abstract: Cemento-ossifying fibroma (COF) is a benign fibro-osseous lesion commonly seen in the head and neck regions. It is considered as a benign, locally aggressive neoplasm that requires surgical excision. COF has traditionally been considered to be slow growing. We report a case of 11 year-old girl who presented to the ENT Department of our hospital with 7 months history of nasal obstruction, proptosis and headache. Computed Tomography scan images showed a mass in the right nasal cavity. This case is notable because involvement of the sphenoid sinus is rare. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Migratory fish bone complicating as neck abscess

    • Authors: Prawahar Chiluveru, Ajay Kumar, Jyothi Chavadaki
      Pages: 588 - 590
      Abstract: Accidental ingestion of fish bone is usually uncomfortable, some cases it may be dangerous to a patient, a challenging diagnosis. A retained fish bone may have potentially disastrous complications which may affect the morbidity or mortality. Fish bone may even penetrate extra-luminally and reside in the soft tissue of the neck. Computed tomography (CT) of the neck is of great assistance in diagnosing a migrating fish bone. Surgical exploration is mandatory.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Primary nasal tuberculosis: diagnostic dilemma: a case report with role of

    • Authors: Mahender Singh, Trilok C. Guleria, Ramesh K. Azad, Narender K. Mohindroo
      Pages: 591 - 593
      Abstract: Tuberculosis of the nose is so rare that it has become a forgotten entity among the clinicians. The clinicians fail to diagnose primary nasal TB as symptoms and signs of this specific nasal inflammation mimic other nonspecific nasal inflammatory conditions and therefore, its diagnosis and treatment is often delayed. We came across a case of primary nasal TB in a 65 years old female presented with complaints of nasal obstruction, epistaxis and anosmia since past 3 years. Anterior rhinoscopy showed friable nasal mass in both nasal cavities. Computed tomography scan showed heterogeneously enhancing soft tissue in nasal cavity with destruction of the nasal septum and hard palate. Histopathological examination and GeneXpert confirmed mycobacterium tuberculosis. The patient was put on antituberculous therapy.Nasal endoscopy and tissue biopsy play important role in diagnosis of the disease. GeneXpert test not only has good sensitivity and specificity for the diagnosis of EPTB but also perfectly fits the requirements of the Indian health care setting.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Temporal bone carcinoma in a 25 year old patient

    • Authors: Shibani V. Anchan, Aneel Myageri
      Pages: 594 - 596
      Abstract: A 25 year old female patient presented to us earache and ear discharge. She was diagnosed with moderately differentiated carcinoma of the temporal bone. The patient was treated with radical mastoidectomy and postoperative radiotherapy. A review of literature has been done.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Classical presentation of Ackerman’s tumour of tongue: a case report

    • Authors: Ravi D., Hanumanth Prasad M., Madhuri M. Gudikote, Balaji N. K., Sowmya T. R.
      Pages: 597 - 599
      Abstract: Ackerman’s tumour also called verrucous carcinoma (VC) is a controversial manifestation of well differentiated squamous cell carcinoma (SCC). It manifests as proliferative cauliflower like growth which is characteristic. Histologically it has a deceptively benign microscopic appearance. Hence it requires expertize for diagnosis. Although VC is illustrated as a benign lesion with minimum aggressive potential, over a period of time it can evolve into SCC. We report here a case of verrucous carcinoma of tongue in a young male with a history of tobacco chewing. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Pill in the left bronchus-pediatric foreign body aspiration: a case report

    • Authors: Raghul Sekar, Karthikeyan Ramasamy, Hegde Jyotirmay, Arun Alexander, Sunil Kumar Saxena
      Pages: 600 - 603
      Abstract: Pediatric population is more prone for accidents such as foreign body aspiration. It is an important and preventable cause of mortality and morbidity in children. Pill aspiration is one of the rare causes foreign body aspiration in both children and adults. History is crucial and can guide treatment in case of foreign body aspiration. We present a 5 year old child who had history and examination suggestive of pneumonia which turned out to be a foreign body in left bronchus on computed tomography. The foreign body was a half broken tablet of Co-trimoxazole removed by rigid bronchoscopy without any complication. The child’s symptoms improved satisfactorily following removal. 
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
  • Gradinego’s syndrome: atypical presentation

    • Authors: Sumana C. V., Suhel Hasan
      Pages: 604 - 607
      Abstract: Gradenigo’s syndrome was first described by Giuseppe Gradenigo in 1907 when he reported a triad of symptoms consisting of unilateral periorbital pain related to trigeminal nerve involvement, diplopia due to sixth cranial nerve palsy and persistent otorrhoea, associated with otitis media with petrositis. The classical syndrome related to otitis media has become very rare after the antibiotic era. Incomplete and atypical clinical features of Gradenigo’s syndrome have been described and non infectious causes may mimic this condition. We report a case of acute petrositis in a 19 year old boy with unilateral periorbital pain, diplopia (lateral rectus palsy) in the absence of ear discharge. Careful clinical history, physical examination, including neuroimaging, is necessary to make a differential diagnosis. Appropriate management requires antibiotic treatment and possible surgical intervention.
      PubDate: 2018-02-23
      Issue No: Vol. 4, No. 2 (2018)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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