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Publisher: Medip Academy   (Total: 12 journals)   [Sort by number of followers]

Showing 1 - 12 of 12 Journals sorted alphabetically
Intl. J. of Advances in Medicine     Open Access   (Followers: 1)
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: 3)
Intl. J. of Otorhinolaryngology and Head and Neck Surgery     Open Access  
Intl. J. of Reproduction, Contraception, Obstetrics and Gynecology     Open Access   (Followers: 9)
Intl. J. of Research in Dermatology     Open Access   (Followers: 1)
Intl. J. of Research in Medical Sciences     Open Access   (Followers: 2)
Intl. J. of Research in Orthopaedics     Open Access   (Followers: 1)
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
   Published by Medip Academy Homepage  [12 journals]
  • A comprehensive study on complications of endoscopic sinus surgery

    • Authors: Jude Anselm Shyras D., Mohana Karthikeyan S.
      Pages: 472 - 477
      Abstract: Background: In recent years, functional endoscopic sinus surgery has become the standard of care in the surgical management of chronic sinusitis and sino nasal polyposis. Because of highly variable anatomy and closely related vital structures, it has many potential complications. This study aims to evaluate the complications of FESS, factors influencing its occurrence and management of complications. Methods: This is a prospective study done in a tertiary care hospital over a period of one year. The first 100 patients diagnosed as chronic sinusitis or sino nasal polyposis, planned for FESS were included in the study and they were followed up for three months, post operatively. The occurrence of complications and factors associated with that were studied. Results: We had 1% of major complications and 12% of minor complications in this study. Major factors influencing the occurrence of complications are extension of the disease pathology and anatomical variations of the paranasal sinuses. Conclusions: FESS is one of the commonly performed surgeries in Rhinology, and the occurrence of major complications is less and extensive disease with altered anatomy is the major factor in the occurrence of complications.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A study on epistaxis in adults: a series of 120 cases

    • Authors: Nanmullai R., Vikram V. J.
      Pages: 478 - 481
      Abstract: Background: Epistaxis is a symptom of many diverse conditions. This study on epistaxis of 120 cases in adults, is to find out the most common causes for epistaxis, prevalence of epistaxis in either sex, age groups and for early identification of cause and management. Results were analysed. Methods: Prospective study of series 120 cases in adults.  Results: Results were analysed and idiopathic was most common cause of epistaxis, males were more affected than females, and the most common age group affected is 13 to 30 years. Most cases are treated by conservative measures. Conclusions: Idiopathic is the most common cause of epistaxis in this present study. Other causes are trauma, DNS with spurs, sinusitis and JNA in adolescent males. Males are commonly affected than females .The most common age group affected is 13 to 30 years and 41 to 60 years. Most cases are treated by conservative measures.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Concha bullosa: types and relationship with chronic sinusitis

    • Authors: Saarthak Wadhwa, Naveen Sharma, Uma Garg, Prishni Dutta
      Pages: 482 - 485
      Abstract: Background: The study was conducted with the objective to study the incidence of various types of concha bullosa as detected on computed tomography and to assess the relation between types of concha bullosa and sinusitis. Methods: Computed tomography of 70 patients who were having symptoms and signs of sinusitis and had concha bullosa were studied retrospectively. These scans were categorized into three types of concha: lamellar, bulbous and extensive type.  Results: There was no significant relation between ostium blockage and presence of concha bullosa (p>0.05). Also there was no significant relation between sinus disease and presence of concha bullosa on same side (p>0.05). Conclusions: There is no statistical significance of the type of concha bullosa with respect to sinusitis or ostio meatal complex blockage.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Outcome of ultrasound guided closed drainage of acute suppurative thyroid
           abscess as a definitive treatment modality

    • Authors: Ravi K. S., Vinay S. Bhat
      Pages: 486 - 490
      Abstract: Background: Thyroid abscess are relatively uncommon conditions in otolaryngology-head and neck surgery because of thyroid glands anatomical and physiological protective barrier. When it occurs it results in significant morbidity with potential mortality. Traditionally, surgical incision and drainage with antibiotics has been the mainstay of treatment. Some reports have suggested that ultrasound guided closed drainage is a less invasive and effective alternative in selected cases. The aim of our study is to evaluate the efficacy of ultrasound guided percutaneous closed drainage in the management of thyroid abscess. Methods: From January 2013 to December 2016, patients presenting with thyroid abscess to the department of otolaryngology at Adichunchanagiri hospital and who subsequently underwent ultrasound guided percutaneous closed drainage were included in the study.  Results: Five patients were recruited for the study. After the aspiration of pus under ultrasound guidance, all patients were symptomatically improved and no patients needed open surgical drainage afterwards. After treatment, all patients were cured of their disease completely without any complications and with reduced hospital stay. After discharge, no patient showed any signs of relapse on regular follow-up. Conclusions: Ultrasound guided percutaneous closed drainage of thyroid abscess is an effective and safe procedure because of good clinical outcome, patient satisfaction and reduced hospital stay. It is an effective alternative to open incision and drainage of thyroid abscess.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Efficacy of TEOAEs and BERA as screening tools for deafness in newborn

    • Authors: Dinesh Valse, H. K. Nagarathna
      Pages: 491 - 495
      Abstract: Background: Hearing during the first 6 months of life is also considered as crucial for normal acquisition of language. Hence, infants with permanent congenital and early hearing loss identified by 6 months of age and given appropriate and timely support are reported to achieve better language outcomes than those identified later than 6 months of age.Methods: The study group constituted of 200 ears of 100 neonates (0-28 days) that were randomly selected. The neonates were taken from immunization clinic, newborn nursery, neonatal ward and intensive care unit of our hospital and also those referred from other hospitals.  Results: There were 4 neonates (8 ears) with high risk factors of hyperbilirubinemia, prematurity and preterm born. These were subjected to Transient Evoked Oto-acoustic Emission (TEOAE) as well as BERA. Out of the 8 ears, 3 ears showed TEOAE fail, one had bilateral and the other had unilateral TEOAE fail. 5 ears passed TEOAE test.Conclusions: TEOAE cannot completely replace BERA as screening modality for hearing impairment in neonates, however can complement it. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Microbiological profile in chronic rhinosinusitis patients in a rural
           hospital of India

    • Authors: Ajay Kamble, Deepika Garg, Manish Puttewar, Prakash Nagpure
      Pages: 496 - 500
      Abstract: Background: Chronic rhinosinusitis is one of the most common health problem a detailed microbiological profile of which is necessary to guide its proper management. The aim of this study was to identify the microbial pattern present in chronic rhinosinusitis (CRS) patients undergoing functional endoscopic sinus surgery at a rural tertiary care hospital in India. Methods: A prospective study was done in ENT department of MGIMS, Sewagram over a period of 2 years. A total of 94 patients were included in the study. They were clinically diagnosed to have chronic sinusitis and confirmation was done by CT imaging of paranasal sinuses. During FESS, sinus secretions were aspirated and were subjected to bacterial and fungal culture. Bacterial and Fungal pathogens were identified according to the standard protocol.  Results: In the 94 patients, the mean age was 33.44 years and Male female ratio was 1.08: 1. Staphylococcus was the commonest organism isolated in 54 cases (57.4%) followed by Streptococcus pneumoniae in 5 cases (5.3%), Klebsiella in 1 case (1.1%), E.coli in 1 case (1.1%) and Pseudomonas aerogenosa in 1 case (1.1%).Fungus (Aspergillus niger) was isolated in 2 patients (2.1%) and no pathogens were found in 30 (31.9%) patients. Conclusions: In CRS bacterial etiology is the commonest.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Current trends of adenotonsillar hypertrophy presentation in a developing
           country, Nigeria

    • Authors: Waheed A. Adegbiji, Shuaib Kayode Aremu, Clement C. Nwawolo, Chinyere N. Asoegwu
      Pages: 501 - 505
      Abstract: Background: Adenotonsillar hypertrophy is a common paediatric disorder in Otorhinolaryngological practice worldwide. The prevalence, clinical manifestations and predisposing factors are well documented in developed countries. However, available data shows differences between the various studies. There is paucity of data from developing countries. Thus, this study is aimed at assessing the age group distribution, predisposing factors, clinical manifestation and complications of adenotonsillar hypertrophy in a developing country. Methods: It is a prospective study of children under 10 years over a period of 24 months. Interviewer assisted questionnaire was administered. Data obtained were statistically analysed using SPSS version 18.  Results: Two hundred and fifty three, 253 subjects were enrolled into the study. Adenotonsillar hypertrophy affected all age groups studied. A high incidence was noted among the under 2 year olds. The Male: Female ratio was 2:1. Chronic cases constituted 55.7% of our study population. Common predisposing factors were atopy (73.9%), familial history (67.3%) and recurrent upper respiratory tract infection (58.2%). The Commonest clinical features were snoring, noisy breathing, tonsillar enlargement and narrowing of postnasal space air column. Failure to thrive, otitis media and rhinosinusitis were the commonly associated complications observed. No death was recorded. Conclusions: Adenotonsillar hypertrophy is common in our environment. It is important for all primary health care physicians, paediatricians and otorhinolaryngologists to have a clear knowledge on this ailment. Prevention or reduction in incidence is possible.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Clinical profile of patients with atrophic rhinitis: descriptive study

    • Authors: Ratkal Kedarnath, Syed Mushtaq
      Pages: 506 - 509
      Abstract: Background: Atrophic rhinitis is a chronic nasal disease, characterized by a triad of symptoms, namely foul odour, atrophy of nasal mucosa and crusts formation. The understanding of the pathophysiology and the management of atrophic rhinitis has long been a vexing problem for the treating clinician. Hence some authors have recommended adopting a capsular dissection technique in order to avoid these complications. Methods: This present study was conducted in the Department of E.N.T, in which all the cases diagnosed as primary atrophic rhinitis and who were willing to undergo this surgery during the study period were taken for the study. Totally 20 patients were included for the study. Patients with secondary atrophic rhinitis were excluded.  Results: In our study foul smelling nasal discharge and falling of crusts were the most commonest presenting symptoms which were present in all 20 patients (100%). The other presenting complaints were loss of sense of smell in 19 patients (95%), nasal obstruction in 16 patients (80%), bleeding from nose in 9 patients (45%), headache in 9 patients (45%) and maggots in 2 patients (10%). Conclusions: The incidence of atrophic rhinitis is more in low, less in middle and nil in high socio economic status group of patients and smelling nasal discharge and falling of crusts were the most commonest presenting symptoms.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A study of occurrence of postoperative sensorineural hearing loss after
           middle ear surgeries

    • Authors: Md. Shafiuddin Mazhar, Shrikrishna B. H.
      Pages: 510 - 516
      Abstract: Background: Chronic otitis media is the most common middle ear disease that is encountered in our hospital. There are various surgical procedures that are performed in cases of COM and other similar conditions of the middle ear. Any type of otosurgical procedure involves the risk of inner ear damage. As middle ear surgery is also performed for functional reasons this risk should be taken into consideration. There have been some studies mentioning many insults to the cochlea during middle ear surgeries. Some studies claim that sensorineural hearing loss post-surgery is not significant at all. In view of these contradictory studies, further study is essential on this subject. Methods: All patients undergoing middle ear surgeries are subjected to pure tone audiometry pre-operatively and tenth day, one month and three months postoperatively. Hearing assessment done with pure tone audiometer. The hearing threshold for pure tone audiometer was determined in a sound treated room at frequencies ranging from 125-8000 Hz for air conduction and 250-4000 Hz for bone conduction.  Results: Sensorineural hearing loss was not found in any of the patients postoperatively on 10th day 1st month and 3rd month. Conclusions: There was no significant variation between preoperative and postoperative bone conduction levels.  Therefore middle ear surgeries have not resulted in any SNHL. Duration of ear discharge, duration of surgery, type of surgery had no bearing on postoperative sensory neural hearing levels.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Retrospective audit of sinonasal inverted papilloma at a tertiary care
           centre

    • Authors: Somu L., Prasanna Kumar S., Urvashi Singh
      Pages: 517 - 521
      Abstract: Background: Inverted Papilloma of the sinonasal tract is a benign neoplasm with unique locally destructive capacity, tendency to recur and a propensity for malignant change. Despite varied studies, there seems to be a lack in consensus with regards to its etiology, predictors of recurrence and malignant transformation. The aim of our study is to analyse the clinical profile, management and outcome of histopathologically proven Inverted Papilloma of the nose and paranasal sinus at our institute. Methods: Retrospective chart review of 17 patients of histologically proven Sinonasal Inverted Papilloma over a period of 2 years from May 2013 to May 2015. Results: The majority were in their 5th and 6th decade of life (47%) with a male to female ratio of 15:2. All had been managed surgically with 10 patients undergoing endoscopic assisted polypectomy, 6 requiring partial maxillectomy & 1 requiring total maxillectomy for complete surgical clearance. All patients had been followed up for a minimum duration of 1 year and recurrence was found in 41%. 2 patients had been diagnosed with malignant transformation during follow-up, out of which 1 underwent right partial maxillectomy along with concurrent chemotherapy and other patient underwent left total maxillectomy with concurrent chemotherapy and intensity modulated radiation therapy. Conclusions: Inverted Papilloma of the sinonasal tract is a locally aggressive disease requiring careful endoscopic and radiological assessment. Adequate surgical management can ensure complete clearance of disease. A strict long term follow-up protocol will facilitate identifying recurrence and malignant transformation. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Incidence of complications of emergency tracheostomy in a rural medical
           college setting: a prospective study

    • Authors: Ajayan P. V., Anju Mariam Jacob, Nandakumar V. P.
      Pages: 522 - 527
      Abstract: Background: Tracheostomy done as an emergency procedure for the purpose of saving lives, is mostly associated with aerodigestive tract malignancies, though a few may be associated with foreign body aspiration. The incidences of complications intraoperatively as well as postoperatively are high in emergency tracheostomies. Few studies exist documenting the incidence of these complications .Thus this study was undertaken in a rural Medical College setting to find the incidence of complications associated with emergency tracheostomy.Methods: After Institutional ethical committee clearance, a prospective study was conducted over a period of 2 years which included 120 patients of all ages and both genders, who presented to the emergency room with stridor. All tracheostomies were performed, using standard techniques, in the emergency operation theatre under monitored anaesthesia care or general anaesthesia. Complications were noted during the procedure as well as in the postoperative period at regular intervals upto one year and were categorized as immediate, intermediate and late.Results: Though there was no case of mortality, the incidence of complications was 53.3%. The commonest immediate complication was haemorrhage (12.5%) followed by cardiopulmonary arrest (5%) and apnoea (3.3%). The commonest intermediate complications were infection (18.3%), crusting (12.5%), displacement of tube (8.3%) and bleeding (8.3%).Late complications noted were stomal stenosis (8.3%), keloid formation (5%) and tracheocutaneous fistula (3.3%).Conclusions: Some of these complications can be avoided by early intervention as a semi emergency procedure when you first think about it. This can avoid the hazzle of hurried tracheostomy in a struggling patient thus bringing down the incidence of complications.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A radiological study of anatomical variations in ostiomeatal complex in
           patients with chronic rhinosinusitis

    • Authors: Rajneesh ., Rahul S.
      Pages: 528 - 533
      Abstract: Background: In ancient times the paranasal sinuses, without any anatomical differentiation, were thought to be a system of hollow spaces through which mucus produced by the brain was drained. Leonardo da Vinci in Milano in 1489 was the first to prepare and draw anatomical specimens of the paranasal sinuses; the drawings, however, only became accessible to scientific evaluation as late as 1901.Methods: All adult patients (more than 20 years of age) attending the Outpatient department at ENT, diagnosed to have chronic rhinosinusitis, willing to undergoing Computed Tomographic evaluation were included in this study. Sample of 50 was selected using purposive sampling technique. All CT scans were obtained with GE Brightspeed scanner (16 slice MDCT scanner). Coronal sections were performed with the patients in prone position, with extended neck and the plane perpendicular to the infraorbitomeatal line.Results: Agger nasi was the most common variation seen in 72% cases followed by dwviated nasal septum in 66% patients. Other variations found were lateral attachment of uncinate process in 54%, uncinate attachment to skull base in 33%, concha bullosa in 32%, overpneumatized bulla ethmoidalis in 21%, medial attachment of unicinate process to middle turbinate in 13%, paradoxical bent middle turbinate in 11%, haller cell seen in 6%. 56% had type I frontoethmoidal cells, 29% had type II, and 15% had type III frontoethmoidal air cells.Conclusions: The presence of anatomical variants does not indicate a predisposition to sinus pathology but these variations may predispose patients to increased risk of intraoperative complications. The surgeon must pay close attention to anatomical variants in the preoperative evaluation avoid possible complications and improve success of management strategies. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Ear manifestations in head and neck injury

    • Authors: Siddaram Patil, Girish P. B.
      Pages: 534 - 538
      Abstract: Background: This study was done to study different types of trauma to the ear that occur in head and neck injury and methods which help in early diagnosis of such trauma to the ear. Methods: Data for the study were collected from patients who presented with ear, nose and throat manifestations in head and neck injury in the Department of Otorhinolaryngology at J. J. M. Medical College and Hospital, Davangere between November 2012 to October 2014. This is a prospective case study. 50 patients were included in the study. Once patient was presented to us detailed history and examination was done. Investigations were done wherever necessary.  Results: The incidence of head injuries is increasing in vehicular accidents (58%) due to increased use of vehicles, improper traffic control systems and increase in population. Males outnumbered the females. Males constituted 84%. Majority of the patients come under the age group of 21-40 constituting 60%. In the 50 cases, ear manifestations were seen in 22% patients. Conclusions: Microscopic examination and microsurgical techniques in the field of ENT have revolutionized the treatment methods of sequelae following head injury.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Descriptive study of endoscope assisted creation of neoturbinate by antral
           mucosal inversion in atrophic rhinitis

    • Authors: Ratkal Kedarnath, Syed Mushtaq
      Pages: 539 - 545
      Abstract: Background: As the exact etiology is not known, treatment is directed towards symptomatic relief. Medical treatment leads only to temporary remission of symptoms. Over the years, surgeons have attempted various techniques for long term relief of symptoms. Most of the techniques have been directed to the narrowing of the nasal cavity. Methods: All the cases diagnosed as primary atrophic rhinitis and who were willing to undergo this surgery were taken for the study. The cases diagnosed as primary atrophic rhinitis were subjected to detailed history and examination. Clinically following conditions were ruled out – tuberculosis, syphilis, rhinoscleroma, leprosy. A routine haemogram (Hb%, TC, DC, BT, CT), urine examination (albumin, sugar, microscopy), ESR serum VDRL was done for the patients.  Results: We were successful in creating a neoturbinate in 12 patients in our study. Of these, majority of the patients (6 patients) had their duration of symptoms between 2-4 years, the outcome in them are excellent in 4 patients, good in 2 patients. Conclusions: The results are encouraging with reduced crusting, healthier mucosa and some patients even regaining their sense of smell. All these above, with no nasal obstruction or pinched nostrils as may occur in young’s closure. But the effort involved is more in this surgical procedure.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Submental intubation in complex craniomaxillofacial trauma cases

    • Authors: A. Navin Kumar, P. K. Chattopadhaya, Gaurav Dua, Sandeep Mehta
      Pages: 546 - 550
      Abstract: Background: Airway management in patient with craniomaxillofacial trauma is challenging due to disruption of components of upper airway. In complex panfacial trauma cases, especially involving naso-orbito-ethmoidal complex, the airway is shared between the maxillofacial surgeon and anaesthesiologist. Often in such severe trauma cases, both nasotracheal and orotracheal intubation are contraindicated. Previously in such situation tracheostomy was the method of choice. Though tracheostomy is time tested it has its fair share of complications, some even life threatening. Other methods were used such as retromolar intubation as an alternative, but it may not be suitable for all such cases. Another approach is submental intubation but not so much in routine practice. A retrospective study was designed to evaluate clinical criteria’s airway management in complex craniomaxillofacial trauma cases using submental intubation.Methods: Datasheets of 14 craniomaxillofacial trauma cases who were intubated with submental intubation method were reviewed. The factors like: ease of anaesthesiologist for carrying out general anaesthesia, ease of surgeon for performing surgery and average time taken during the procedure, intraoperative and postoperative complications were evaluated and charted.  Results: Submental intubation provides intraoperative airway control, avoids use of both oral and nasal routes, and allows intraoperative manipulation of occlusion, intramaxillary and intermaxillary fixation. This technique has minimal complications and has better patient, anaesthetists and surgeons acceptability. The limitations of this technique include longer preparation time, inability to maintain long term postoperative ventilation and unfamiliarity of technique itself.Conclusions: This submental intubation can be used with little modifications in a variety of complicated panfacial trauma cases. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Inferior turbinectomy - outcome of various surgical modalities: a
           prospective study

    • Authors: Rajeev Reddy
      Pages: 551 - 554
      Abstract: Background: Inferior turbinate hypertrophy is one of the major causes of nasal airway obstruction. Medical treatment often produces insufficient improvement. In these circumstances, surgical reduction of inferior turbinate can be proposed. Many different techniques are currently available. The aim of our study is to prospectively evaluate the effectiveness of three techniques i.e., electrocautery, cryotherapy and radio frequency by comparing the response of patients to these surgical modalities of turbinate reduction.Methods: A total of 90 patients presenting with nasal obstruction with or without allergic symptoms, fulfilling the inclusion and exclusion criteria, attending ENT OPD are included in the study. A prospective study was conducted on three groups of thirty patients with symptoms and signs of nasal obstruction associated with inferior turbinate hypertrophy of more than 3 months duration. Then the percentage of subjective improvement in nasal airway is used to assess treatment outcomes 1 week, 1, 3, 6, 9 and 12 months after surgery.  Results: At the end of 12 months, 56.6% of patients treated with electrocautery and 56.6% of patients treated with cryotherapy showed 75% improvement in nasal obstruction whereas 59.99% of patients treated with radio frequency showed 100% improvement. No statistical difference in the amount of improvement in nasal obstruction was noted between the three treatment groups at the end of 12 months because of relatively small sample size.Conclusions: On this basis it is evident that clinically radio frequency showed better subjective improvement in nasal obstruction when compared to cryotherapy and electrocautery.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Nasal/maxillofacial manifestations of head and neck injury

    • Authors: Siddaram Patil, Girish P. B.
      Pages: 555 - 558
      Abstract: Background: A great deal of work has been directed toward using these symptoms to classify the severity of head injury. Loss of consciousness or coma and posttraumatic amnesia (difficulty in remembering new information after waking up from the coma) are the two most common symptoms used. A mild head injury is one in which the period of unconsciousness is less than twenty minutes and post traumatic amnesia lasts for less than one hour, while a head injury in which the person is unconscious for at least one day and experiences post traumatic amnesia for more than twenty four hours is considered severe. Methods: 50 Cases coming to O.P.D and casualty of Chigateri general hospital and Bapuji hospital attached to JJM Medical College, Davangere were studied.  Results: Evidence of C.S.F rhinorrhoea was noticed in 1(2%) case which managed conservatively. Maxillary fracture was noticed in 05 (10%) cases which were managed conservatively. Zygomatic fractures were noticed in 07 (14%) cases which were managed by open reduction and internal fixation with mini plates under general anesthesia. Conclusions: Mandibular fractures were noticed in 10 (20%) of cases which were managed by open reduction and internal fixation with mini plates under general anesthesia.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A study on risk factors of deafness in neonates: a descriptive study

    • Authors: Dinesh Valse, H. K. Nagarathna
      Pages: 559 - 561
      Abstract: Background: Identification of newborn hearing loss is addressed in the healthy people 2010 goals, stated as “increasing the proportions of newborn who are screened for hearing loss by age one month, have audiologic evaluation by age 3 months and are enrolled in appropriate intervention services by age 6 months. Methods: The study was conducted between October 2008 to October 2009 at Manipal Hospital, Bangalore. The study group constituted of 200 ears of 100 neonates (0-28 days) that were randomly selected. The neonates were taken from immunization clinic, newborn nursery, neonatal ward and intensive care unit of our hospital and also those referred from other hospitals.  Results: Out of 100 the neonates aged between 1-4 days were 67, 5-9 days were 24 and between 10-28 days were 9. Conclusions: There were no neonates with low Apgar score, no family history of hearing loss, no exposure to ototoxic drugs and no neonate on mechanical ventilator.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Outcome of ear surgeries in dry and wet ear

    • Authors: Shreyash C. S., Rajneesh ., Rahul S.
      Pages: 562 - 568
      Abstract: Background: Chronic suppurative otitis media (CSOM) can present with dry and wet ear (discharging ear). It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on wet ears is decidedly inferior. Hence the present dissertation is intended to find the outcome of ear surgeries in dry and wet ear.Methods: The present study comprises of 60 patients who have undergone type 1 tympanoplasty with cortical mastoidectomy, at Fr Muller’s Medical College, Mangalore. These patients were divided into two groups- Wet and Dry, based on the presence or absence of ear discharge at the time of surgery respectively. Inclusion Criteria: Patients of age group 16-60 years and both sexes, with mucosal type of chronic otitis media who underwent type 1 tympanoplasty with cortical mastoidectomy. Exclusion criteria: Patients with squamosal type of chronic otitis media or with ossicular chain erosion. A comparative analysis was done on the hearing improvement and incidence of the graft uptake postoperatively between the two groups.Results: In dry group, complete graft uptake was seen in 90% cases, whereas in wet group, a graft uptake rate of 86.7% was achieved. The graft take up rate is better in high x socio-economic status. Higher take up rates were seen in small and medium perforation compared to subtotal perforations. Hearing improvement, assessed by mean gain of PTA at the end of 6th month postoperatively, was achieved in 86% cases in Wet group and 90% cases in Dry group. There was an average hearing improvement of 13.08 db in speech frequencies in 88.3% cases. The difference between the two groups was statistically insignificant.Conclusions: In our study, we found no statistically significant differences between the success rates of Wet and Dry group, either in terms of graft uptake or the hearing improvement. Thus, from our study, we conclude that the presence of ear discharge at the time of surgery does not affect the success rate of type 1 tympanoplasty. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Significance of relationship between anatomical variants of middle
           turbinate and nasal septum in recurrent acute rhinosinusitis patients

    • Authors: Satya Sundar G. Mohapatra, Niranjan Sahu, Siba N. Rath, Mahesh C. Sahu, Rabindra N. Padhy
      Pages: 569 - 575
      Abstract: Background: Aim of the study was to evaluate the significance of relationship between anatomical variants of middle turbinate and nasal septum, and role for the causation of recurrent acute rhinosinusitis (RARS) in a tertiary care teaching hospital.Methods: Retrospective analysis of sinonasal computerized tomography (CT) images of 160 patients with history of RARS during August 2015 to December 2016 was done for evaluation of concha bullosa (CB) and paradoxical middle turbinate (PMT) associated with deviated nasal septum (DNS). Measurements of CB, PMT and septal deviation angles were recorded. Patients with acute and expansile paranasal sinus diseases were excluded.Results: Of the total 160 RARS cases with DNS, 120 cases had unilateral (contralateral and ipsilateral) and bilateral (dominant and similar sized) CB, and were distributed into group I (contralateral and dominant) and group II (ipsilateral and similar sized bilateral) basing on the direction of septal convexity. Maximum transverse diameter of CB (MTDCB) and septal deviation angle values were highly significant (p =0.0001) in group I CB cases. Direction of septal convexity had no significance (58 to right and 62 to left) in relation to CB pneumatization. Septal deviation severity in group I CB cases was highly significant (p =0.0001). The fraction of 40 unilateral and bilateral PMT cases revealed no significance (p =0.45) with severity of DNS.Conclusions: Anatomical variants of middle turbinate associated with DNS caused increased prevalence of OMC pattern RARS. Contralateral and dominant CBs had shown relationship in direct proportion to the severity of septal deviation contributing to recurrent rhinosinusitis.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Incidence of sinonasal anatomical variations associated with chronic
           sinusitis by CT scan in Karaikal, South India

    • Authors: Kranti Gouripur, Udaya Kumar M., Anand B. Janagond, S. Elangovan, V. Srinivasa
      Pages: 576 - 580
      Abstract: Background: Variations in sinonasal anatomy of adults are common and vary among different populations. Their role in development of pathological conditions such as sinusitis, epistaxis, etc is debated. Having clear picture of sinonasal anatomy of a person is essential in avoidance of complications during surgery. This study was done to analyze sinonasal anatomy in adults from Karaikal region having chronic sinusitis by nasal endoscopy and CT scan imaging.Methods: A total of 50 patients undergoing endoscopic sinus surgery were studied by preoperative nasal endoscopy, CT scanning and endoscopy at the time of definitive surgery and variations recorded and analyzed.  Results: The incidence of the sinonasal anatomical variations in CT scan study were – discharge in the frontal sinus (100%), agger nasi cells (96%), deviated nasal septum (70%), anterior ethmoidal cells (86%), posterior ethmoidal cells (58%), sinus lateralis (52%), frontal cells (50%), discharge in sphenoid sinus (50%), pneumatised superior turbinate (46%), INSA (34%), prominent bulla ethmoidalis (30%), supra orbital cells (26%), pneumatised septum(16%), medialised uncinate process (16%), paradoxical middle turbinate (16%), Haller cells (14%), supreme turbinate (14%), pneumatised inferior turbinate (12%), frontal recess obliteration (12%), absent pneumatisation of frontal sinus (12%), pneumatised middle turbinate (10%), Onodi cells (6%), pneumatised uncinate process (2%), maxillary sinus septation (2%).Conclusions: The high incidence of variations emphasises the need for proper preoperative assessment for safe and effective endoscopic sinus surgery. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Isotonic nasal spray versus fluticasone nasal spray in treatment of
           allergic rhinitis

    • Authors: Rachana Chowdary Gaddipatti, Suman P. Rao, Kalpana Rajiv, Manuj Jain
      Pages: 581 - 584
      Abstract: Background: Allergic rhinitis (AR) is a prevalent disease with great morbidity and causing significant societal and economic burden. Aims and objectives: To compare efficacy of fluticasone nasal spray and isotonic saline nasal spray in allergic rhinitis.Methods: This was a prospective randomized study conducted on patients of allergic rhinitis coming to ENT OPD a tertiary care teaching hospital. Sixty patients diagnosed with concomitant diagnosis of allergic rhinitis was randomly allocated to either Fluticasone propionate nasal spray (n= 30) and isotonic saline spray (n= 30). Results: The most common age group in fluticasone group was 21 to 30 years while in isotonic saline group 31 to 40 years was the most common age group. There was 52.8% of female and 47.2% in fluticasone group while in isotonic saline group, 52.5% of study population were female and 47.5% were male. There was significant improvement in VAS on day 15 and day 30 as compared to day 1 in fluticasone treated subjects as compared to isotonic saline group. After one month, Nasal blockage, nasal discharge, sneezing, nasal itching was improved to 71%, 69%, 81% and 78% in fluticasone treated subjects as compared to isotonic saline group in which improvement was up to 11%, 17%, 09% and 12% respectively and this difference was statistically significant. Conclusions: Fluticasone nasal spray has the potential to enhance patient satisfaction and compliance and reduce the need for polypharmacy in the management of seasonal allergic rhinitis.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Analysis of post implantation speech recognition abilities of children
           with hearing impairment using cochlear implants

    • Authors: Anjali R. Kant, Arun A. Banik
      Pages: 585 - 591
      Abstract: Background: As per census’2011, in India, there are 15, 94,249 children with hearing impairment below 18 years of age. A current method in treating children with hearing impairment is cochlear implantation. The use of cochlear implants aids in improving auditory detection, discrimination, identification and speech recognition. Although, speech recognition is a primary outcome measure in cochlear implantees, there is a paucity of word lists or tests to assess speech recognition abilities, both in local languages in general and Hindi in particular. Methods: In order to construct word lists comprising of monosyllabic and multisyllabic, easy and hard words, language samples from children (3 - 5 years of age, n = 120) were collected in order to create a database to select stimuli from. The frequency of occurrence and neighborhood density for the words selected from this database was then computed and word lists were constructed.  These newly constructed Hindi word lists were administered to 45 cochlear implantees (4.1 to 9 years of age); one year post implantation. Subjects were instructed to listen to the words and repeat them. Responses were scored as number of words correctly repeated.  Results: Cochlear implantees were able to show lexical effects of difficulty, i.e. they achieved higher scores for easy words than those for hard words. However, they were not able to show the same effect for word type. Conclusions: The newly constructed Hindi word lists appear to be valid lists in assessment of speech recognition abilities of children with hearing impairment using cochlear implants.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Traumatic perforation: determinants of conductive hearing loss

    • Authors: Ravi K. S., Ravishankar S. N.
      Pages: 592 - 595
      Abstract: Background: Traumatic perforations of the tympanic membrane are very common in day to day life and it may be due to direct or indirect source.  The aim of this study is to evaluate the various factors which determine the degree of hearing loss in patients with traumatic perforation of tympanic membrane. Methods: A retrospective review was performed in 50 patients seen at the ENT department in our rural tertiary center over a period of two years between January 2015 to December 2016. The patients with history of ear trauma from various causes and with absolutely no previous history of any ear disease were included in our study. The data retrieved included parameters such as age, sex, side, cause of injury and presenting complaints such as hearing loss, earache, tinnitus, and vertigo. A detailed clinical and otoscopic examination was done to determine the size and location of the perforation. Hearing was assessed using pure tone audiometry (PTA) to determine the degree of hearing loss and to correlate with frequency, size and location of perforation.  Results: A total of 50 patients with traumatic perforations of the tympanic membrane were enrolled for the study, comprising of 32 males and 18 females patients. Age of the patients ranged from12 to 65 years of age. The results showed that the most common mode of trauma was RTA (46%). Audiometry shows that the larger the tympanic membrane perforation, the larger the air–bone gap. Hearing loss was highest at the lowest frequencies and generally decreased as the frequency increased. The results also showed that there was no difference in air bone gap with relation to location of perforation (anterior vs. posterior). Conclusions: The conductive hearing loss resulting from a tympanic membrane perforation is frequency dependent, with the largest losses occurring at the lowest sound frequencies, hearing loss increases as size of the perforation increases and no relation with location of perforation.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Outcome of intact canal wall mastoidectomy in limited attic cholesteatoma

    • Authors: Rajeev Reddy
      Pages: 596 - 600
      Abstract: Background: Surgery for cholesteatoma has evolved over the years in terms of efficacy and patient compliance and better life. Intact canal wall technique is best in terms of normalization of the physiology of the ear along with eradication of disease. Hence this study is undertaken to evaluate a technique of intact canal wall mastoidectomy for limited attic cholesteatoma and to study practical considerations during surgery.Methods: Any person undergoing surgery for attic cholesteatoma has to be thoroughly examined during surgery and decision for doing a canal wall up (CWP) surgery will be taken on the operating table. The patients were regularly followed up and microscopic, otoendoscopic and audiological assessments done at regular intervals. Revision surgery was done only if there were signs of recidivism or if ossiculoplasty was planned for second stage or placement of prosthesis later was considered.  Results: Out of 100 cholesteatoma surgeries, 22 cases found suitable for the CWU technique. Only 1 out of 22 patients required revision surgery due to recurrence. Rest of the patients maintained healthy middle ear for more than a year. Prevention of medialization of attic cartilage piece was found to be a very important consideration.Conclusions: The CWU technique is a reliable method of management for limited attic cholesteatoma. Selection of subjects should be very meticulous. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Bacteriological profile of chronic suppurative otitis media in a tertiary
           care hospital

    • Authors: Sowmya Tumkur Rangaiah, Ravi Dudda, M. Hanumanth Prasad, Nagavara Kalegowda Balaji, Sumangala B., Madhuri Mruthyunjaya Gudikote
      Pages: 601 - 605
      Abstract: Background: Chronic suppurative otitis media is a disease affecting the middle ear and mastoid cavity, leading to considerable morbidity by causing hearing loss; and even life threatening complications in squamosal type of CSOM, if left untreated over long periods of time. Hence it is imperative to treat the persistent ear discharge in CSOM according to the antibiotic susceptibility of the organisms isolated. Methods: This is a prospective cross sectional study done in 135 patients of chronic suppurative otitis media presenting with active ear discharge. Sterile swabs were used to collect pus from discharging ear and sent for culture sensitivity.  Results: Staphylococcus and Pseudomonas aeruginosa were the most common organisms isolated in this study. Pseudomonas aeruginosa was most sensitive to Piperacillin-Tazobactam, followed by Meropenem and Ciprofloxacin. Staphylococcus aureus was most sensitive to Linezolid followed by Cefoxitin and Erythromycin. Conclusions: Treating active discharge of CSOM according to pus culture sensitivity pattern reduces the bacterial load in the middle ear and makes the ear more favourable for graft uptake. Keywords: Chronic suppurative otitis media, Aerobic bacterial culture, Antibiotic susceptibility, Pseudomonas aeruginosa, Staphylococcus aureus
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A CT and DNE study of osteomeatal complex variations and their correlation
           in chronic rhinosinusitis patients

    • Authors: Parul Sachdeva, Kuldeep S. Sachdeva, Baldev Singh, Manjit Singh, Manpreet Kaur, Isha Goyal, Gaurav Kataria
      Pages: 606 - 610
      Abstract: Background: CRS is a global burden reducing the productivity at work. This study was done to evaluate the occurrence of anatomical variations of osteomeatal complex (OMC) and to assess its relation in causation of chronic rhinosinusitis in the study population. Methods: A 100 patients diagnosed with CRS in the outdoor of Dept. Of ENT between November 2012 – November 2015 were subjected to CT Imaging and DNE and the frequency of anatomical variations and involvement of paranasal sinuses were evaluated. The correlation between them was established using chi-square test.  Results: Agger nasi cells were the most common variant seen in 73 (73%) patients with 12% being unilateral and 61% bilateral. Other variants seen were: deviated nasal septum in 68%, uncinate process variations in 58%, concha bullosa in 30%, enlarged bulla ethmoidalis in 25%, paradoxical middle turbinate in 18%, haller’s cells in 6% and accessory maxillary ostia in 2%. We could establish a correlation between a few of these variants and the affected sinuses. Conclusions: The importance of CT and nasal endoscopy is emphasized in patients with persistent symptoms to identify the anatomical variations that may contribute to the development of chronic sinus mucosal disease.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Solitary nodule thyroid: diagnosis and management

    • Authors: M. Deepthi, P. S. Sukthankar, K. Narsimloo
      Pages: 611 - 615
      Abstract: Background: Solitary nodule can be a true solitary nodule or a dominant nodule of multinodular goitre or ectopic thyroid or unilateral agenesis. Solitary nodule can be benign or malignant. Purpose of evaluation is to differentiate between the two. Methods: A prospective study of solitary nodule thyroid (STN) patients presenting to ENT outpatient department, for a period of 3 years from September 2012 to 2015.  Results: Out of 67 patients enrolled into study, 53 patients had benign true STN, 9 patients had multinodular goiter (MNG) presenting as solitary nodule and 5 had malignant nodule (7.46%). Among the benign nodules, 25 patients had small solitary nodule (<4 cm size). They were treated medically and followed-up for a period of 1 year. 28 patients with large benign solitary nodules (>4 cm size) were taken up for surgery directly. Hemithyroidectomy was done in benign STN patients (39 patients) and total thyroidectomy was done in malignant nodule and MNG patients and followed-up by lifelong L-T4 therapy. Conclusions: Small benign solitary nodules regress with medical therapy alone. In large solitary nodules, and in those nodules not regressing with medical therapy, hemithyroidectomy is adequate. In MNG and malignant nodules, total thyroidectomy is advocated. Hemithyroidectomy and total thyroidectomy patients were followed - up with suppression and supplementation therapy respectively.This area being fluorotic belt, there is an increased prevalence of goiter. This study gives a concise guideline in evaluation and management of STN for goiter endemic areas. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Clinical correlation between palpability of styloid process with its
           length on CT scan

    • Authors: Shibani V. Anchan, Arunkumar J. S., Raghunath Shanbag, Santosh S. Garag
      Pages: 616 - 620
      Abstract: Background: The aim of the study is to correlate the clinical palpability of the styloid process with its length which is determined by CT scan. Methods: A prospective study of 50 patients who presented to ENT OPD from January 2011 to January 2016 with cervicofacial pain and features of Eagle’s syndrome were clinically evaluated for elongated styloid process by palpating the tonsillar fossa. These patients were subjected to a detailed CT scan with coronal, axial and 3D cuts. The length of the styloid process in the CT scan was correlated with the clinical palpability of the styloid process.  Results: It was noticed that only styloid process of length greater than 28 mm was clinically palpable. Correlation between the clinical palpability and the minimum length required was established in this study. Conclusions: Patients with cervicofacial pain should be evaluated for styalgia by imaging and clinically by palpating the tonsillar fossa.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Vocal cord palsy and getting to know it better

    • Authors: Irene Gee Varghese, Goutham M. K.
      Pages: 621 - 623
      Abstract: Background: Vocal cord palsy is a challenging entity encountered by otolaryngologists in clinical practice. It is a sign of an underlying pathology. Vocal cord palsy requires thorough examination and needs to be investigated. We conducted a study to identify the various etiology of vocal cord palsy and the various modalities of treatment. Methods: A prospective study was conducted to study the various etiologies and modalities of treatment of vocal cord palsy. A total of 55 patients with vocal cord palsy were included in our study based on the inclusion and exclusion criteria. Patients diagnosed with vocal cord paralysis were followed up and the various modalities of treatment were studied.  Results: Males outnumbered females. Among patients of unilateral vocal cord paralysis left vocal cord was paralyzed in majority of the cases (30 patients). Vocal cord paralysis has a variable etiology. Neoplastic causes accounted for the largest number of patients followed by iatrogenic causes. The modality of treatment depends on the etiology. Patients with unilateral vocal cord palsy speech therapy were our modality of treatment. No surgical intervention was done for unilateral vocal cord palsy. Five patients with bilateral vocal cord palsy underwent Kashima’s operation. Conclusions: Vocal cord palsy is a symptom of an underlying disorder and not a disease. In our study malignancy is the commonest etiology for vocal cord palsy.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Hearing impairment in rural area of Himalaya: prevalence and etiology

    • Authors: Trilok C. Guleria, Shobha Mohindroo, Ramesh K. Azad, Narender K. Mohindroo
      Pages: 624 - 627
      Abstract: Background: Hearing impairment is most frequent sensory deficit in human population. The disease burden estimations based on sound epidemiological research provide the foundation for appropriate public policy focus and measures for effective management of disease conditions. Data regarding the magnitude of hearing impairment in our country is limited and the literature search revealed that no such studies have been conducted in this region. Methods: A community based cross sectional observational study was carried out among the 306 individuals in rural area of Shimla district, Himachal Pradesh. Information was obtained by a structured questionnaire, clinical ENT examination and audiological tests after obtaining informed consent.  Results: The study group had 52.6% males and 47.4% females. Maximum 26.5% of individuals were in the age group of 31-45 years. Mean age was 36.56±18.83. The prevalence of hearing impairment was 16.7%. Among individuals with hearing loss, maximum 52.9% were in the age group of ≥60 years. Sensorineural hearing loss was found in 68.6%, maximum 56.9% had mild hearing loss. Among majority of individuals with hearing loss cause was presbyacusis 52.9% followed by infectious ear disease 33.3%.Conclusions: In the present study, prevalence of hearing loss was found to be 16.7% and predominantly mild sensorineural or conductive type of hearing loss. An early intervention and quality patient education is necessary for prevention of hearing impairment in majority of cases.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Medical management of oral submucous fibrosis

    • Authors: Anjana Agrawal, Yashaswi Kaushal, Sudhakar Vaidya, Kriti Shrivastava
      Pages: 628 - 631
      Abstract: Background: In 1952 Schwartz coined the term “atrophica idiopathica mucosa oris” to describe an oral fibrosing disease he discovered in 5 Indian women from Kenya. Oral submucous fibrosis of oral cavity is a chronic progressive debilitating disease and premalignant condition of oral cavity. The condition is well recognized for its malignant potential and it is particularly associated with aracanut chewing. It is characterized by burning sensation in mouth particularly while eating spicy food and progressive development of inability to open mouth. Worldwide estimate of oral submucous fibrosis indicate that 2.5 million people are affected with a higher incidence in Indian subcontinent. Methods: This is an observational type of study of 100 patients with oral submucous fibrosis attending ENT OPD.  Results: We observed that with effective combination of treatment and avoiding predisposing factors and with long time follow-up we got markedly good results. Conclusions: Although medical management does not completely cure the disease but optimal doses of injection corticosteroid with injection hyaluronidase with avoidance of predisposing factors and improvement of dietary habit with prolong follow up is effective in some extent.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Listening skill progress in children with cochlear implants in the first
           three months after implantation

    • Authors: Aparna Nandurkar, Susmitha C. G.
      Pages: 632 - 638
      Abstract: Background: Development of auditory skills is triggered as soon as cochlear implantation is done. Very few studies have reported development of listening skills in cochlear implanted children in the immediate period following the implantation. The present study aims to profile the development of auditory skills in children with cochlear implants during the first three months following implantation. Methods: The tool used is Listening Progress Profile (LiP) which was used to collect information about listening skills one week prior to cochlear implantation, within a week of switch on and once every two weeks till the end of three months after implantation.  Twelve children in the age range of one year to five years with congenital bilateral profound hearing loss, who were scheduled for unilateral cochlear implantation were included as participants.  Results: Results indicate a statistically significant improvement in LiP scores at each test interval.  No significant difference was found in the listening skill progress for children implanted before and after three years of age. Younger male participants performed consistently better than older males and younger and older females. Conclusions: LiP can be used as a major tool for assessing the development of listening skills in young children during the immediate post implantation period as it provides detailed information regarding the auditory performance towards a variety of stimuli.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Clinical profile of cases of dysphagia presenting in ENT department: a
           study from rural tertiary care center

    • Authors: Ginni Datta, Manish Gupta, Naiya Rao
      Pages: 639 - 645
      Abstract: Background: Swallowing is a complex motor reflex requiring coordination among the neurologic system and muscles of the oropharynx and oesophagus. Disorders both benign and malignant may interfere with the process and cause dysphagia. We hereby undertake a study in a rural tertiary care centre to study the clinical profile of cases of dysphagia and to find the relative incidence of various etiologies of dysphagia.Methods: A prospective study was conducted upon both out and indoor patients coming to Department of Otorhinolaryngology from January 2016 to January 2017 with predominant symptom of difficulty in swallowing for both solids, liquids or either. Detailed history & examination was done. Further endoscopy, barium swallow, fine needle aspiration cytology (FNAC) & biopsies were done as required. A total of 140 cases were taken into consideration.  Results: The mean age was 52.5 years with 60% patients males and 40% females. The commonest etiology of dysphagia was Gastroesophageal reflux disease (GERD) occupying 28.57%of cases. Among them 65% werefemales majority in the age group of 45-55 years. The 2nd common cause of dysphagia was growth pharynx 18.5% of cases. Among them 19 cases were diagnosed as growth oropharynx and 7 cases as growth supraglottis extending to hypopharynx. 88.46% were males and all were smokers. The 3rd common etiology of dysphagia was obstructive oesophageal causes which included oesophageal malignancies, oesophageal webs, strictures and diverticula in the frequency of 16%, 3%, 3% and 6% respectively. Oesophageal malignancies were mainly adenocarcinoma, all males who were chronic smokers.Conclusions: Dysphagia is a commonly encountered clinical problem & limited studies exist regarding the prevalence of dysphagia etiologies. It is an alarm symptom, malignancy should be ruled out, and warrants early intervention. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Effect of myringotomy as an office procedure on the clinical course of
           acute otitis media: a retrospective study

    • Authors: Chakramakal Joseph Andrews, Raveendran Krishnan Rahul
      Pages: 646 - 649
      Abstract: Background: A retrospective study was conducted to find out the effect of office myringotomy on clinical course of acute otitis media (AOM). Methods: Patients with signs and symptoms of AOM who underwent office myringotomy were included in the study. The clinical course such as pain, blocked sensation, relief of blocked feeling, hearing improvement, fever, discharge and residual perforation (5 and 14 days) were evaluated after the office myringotomy and compared.  Results: Total 20 patients (10 females and 10 males of age between 5 to 30) were included in study. Among the total patients 12 were below <18 years age and remaining were above 18 years. The overall morbidity of these patients such as pain, blocked sensation and discharge was reduced after the office myringotomy. Furthermore, the residual perforation was absent during the end of 2nd week of post myringotomy. No discharge was found after the myringotomy. Conclusions: Simple myringotomy with five day course of antibiotic provides more symptomatic relief. The overall morbidity was less after the procedure. This indicates the requirement of myringotomy as an outpatient procedure in suitable patients.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A comprehensive study on cartilage tympanoplasty in adhesive otitis media

    • Authors: V. Saravana Selvan, C. Karuppasamy
      Pages: 650 - 655
      Abstract: Background: The surgical management of adhesive otitis media is debatable. Adhesive otitis media progressing to cholesteatoma cannot be predicted, and hearing remains normal until later in the disease course. Hence surgery is done only when there is hearing loss or frank cholesteatoma develops, where an extensive surgery may be needed. Earlier intervention is often avoided due to near normal hearing levels at this stage in some cases. Aim of the study was to hearing results and intactness of neotympanum who have undergone cartilage tympanoplasty with or without ossicular reconstruction are reported for patients with adhesive otitis mediaMethods: This is an open labelled randomised study conducted in Madras Medical College after getting approval from the Institutional Ethical Committee. The study was conducted during the period of November 2011 to April 2013. A total of thirty patients (thirty one ears) aged thirteen-forty eight years underwent cartilage tympanoplasty with or without ossicular reconstruction. Tympanotomy was followed by cartilage reconstruction of the tympanic membrane, with ossicular reconstruction if there is any ossicular discontinuityResults: The outcome measures were post-operative pure tone average, air-bone gap for three frequencies (five hundred, thousand, two thousand hertz) compared to pre-operative levels. There was a statistically significant improvement in hearing. Neotympanum was found to be stable significantly during follow up.Conclusions: Therefore cartilage tympanoplasty with or without ossiculoplasty is effective for adhesive otitis media.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Correlation of HRCT mastoid with clinical presentation and operative
           findings in ear diseases

    • Authors: Sambhaji G. Chintale, Vilas R. Kirdak, Sonali P. Jatale, Kaleem Shaikh
      Pages: 656 - 660
      Abstract: Background: HRCT is found to be extremely useful for evaluating the ear diseases involving the external auditory canal, middle ear cavity, vertical segment of facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint. Our main objective was to correlate the clinical presentation and operative findings of ear diseases with HRCT mastoid. Methods: This study is done in our institute otorhinolaryngology dept. from April 2014 to April 2016. This is prospective study involves 36 patient belonging to different age and sex groups with high suspicious of ear diseases. We have taken detail history of each patient with complete ear nose throat examination done and after that all patient were investigated with routine blood investigation, X-ray and HRCT mastoid to correlate clinical finding and subjected for operation to compare operative findings with HRCT finding.  Results: Determined using Pearson chi square test indicated a statistically significant correlation between HRCT temporal bone with clinical presentation and operative findings of ear diseases (p<0.05). Conclusions: With the advent of modern high-resolution CT scanners, detailed demonstration of temporal bone anatomy is practically possible now. We have been able to identify many significant structures not demonstrated by any of the known imaging modalities. The improved contrast and soft tissue a definition possible with HRCT has resulted in production of excellent images of soft tissue lesions in air spaces. Hence HRCT appears to be the diagnostic modality of choice for cholesteatomas and other soft tissue lesions in middle ear.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Study of benign oral lesions and serum vitamin levels in tobacco consumers

    • Authors: Reshma P. Chavan, Shivraj M. Ingole, Shubhangi M. Dalvi
      Pages: 661 - 665
      Abstract: Background: Oral mucosal lesions are seen commonly in tobacco consumers and some of them are precancerous. Study of various benign oral mucosal lesions has done in tobacco consumers. Comparison of serum Vitamin levels was done in patients with benign oral lesions in tobacco consumers and non- tobacco consumers. Methods: Retrospective study of 100 patients with benign oral lesion with tobacco addiction was done. Control group includes tobacco non-addicts. Detail history regarding tobacco consumption was noted. Tobacco consumption pattern was studied in patients with benign oral lesion. Ear, nose, throat examination was done in detail. Oral lesion was noted. Comparison between serum levels of vitamin A, C and vitamin E in benign oral lesion of patients with tobacco addiction and tobacco non-addicts were included in the study. The results were analysed statistically by student t-test.  Results: Patient with tobacco consumption with lime application was more prone to develop benign oral lesions. Gingivitis was most common lesion seen in study population followed by leukoplakia. Serum vitamin A, C and E were significantly decreased in tobacco consumers with benign oral lesions as compared to tobacco non-consumers. Decreased in serum vitamin levels were seen in all benign oral lesions irrespective of its malignant potential. Conclusions: Gingivitis was most common lesion seen in study population followed by leukoplakia. Serum level of non-enzymatic antioxidant vitamin such as vitamin A, C and E gets decreased significantly in all benign oral lesions irrespective of its malignant potential. Serum levels of the antioxidant vitamins indicate need of increased oral intake of these vitamins to protect from damage in all benign oral lesions.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Micro biological evaluation of aural swab culture and antibiotic
           sensitivity in 100 cases of tubotympanic and attico antral disease

    • Authors: Suneer R., Sivasankari L.
      Pages: 666 - 670
      Abstract: Background: Chronic suppurative otitis media and its complications is one of the commonest ENT problems in our country. The chronicity of the disease and poor response to routine treatment prompted us to isolate and identify the causative organisms and study the antimicrobial susceptibility pattern. Methods: About 50 patients with tubo tympanic disease and about 50 patients with attico-antral disease were selected, complete clinical ENT examination carried out, aural swabs were collected, culture was done and antibiotic sensitivity was studied.  Results: Culture of aural swab demonstrate the polymicrobial bacteriology consisting of both gram positive and negative pathogens, while gram negative pathogens form the majority of both tubotympanic and atticoantral disease. Mixed growth is more common in attico- antral disease. In our study, Ciprofloxacin and Cefotoxime has found out to be the drug of choice for both tubotympanic and atticoantral disease with high sensitivity. Conclusions: Periodical monitoring of microbiological profile is essential for making effective empirical protocol for the cases in a particular geographical location.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Clinical and audiological study of chronic suppurative otitis media
           tubotympanic type

    • Authors: Priyadarshini G., Sowmiya Murali, Febin James
      Pages: 671 - 675
      Abstract: Background: Chronic suppurative otitis media (CSOM), tubotymapanic type, despite a commonly encountered disease in otorhinolaryngology has many controversies involved. This study was aimed at bringing few of these aspects to limelight. Methods: The study was conducted in Otorhinolaryngology department, Aarupadai Veedu Medical College and Hospital, Pondicherry, India between September 2015 - August 2016. Total of 207 ears of 180 patients with CSOM tubotympanic type were included. Selected patients were subjected to ENT examination and pure tone audiometry after obtaining history.  Results: In this study 35.9% patients belonged to 4th decade and 29.4% to 3rd decade. Among patients with discharge for more than 30 years, 68.8% had moderately-severe hearing impairment and those with discharge for less than 10 years, 60.2% had mild hearing loss. Among patients with large central perforation, 51.4% had moderately-severe hearing loss and those with small central perforation, 68.4% had mild hearing loss. Hearing loss was nearly same in anterior and posterior perforations. On chi square test p value was 0.0874 i.e. >0.05, difference insignificant. Conclusions: In our study most patients were in 4th decade, incidence is equal in both genders. Hearing loss is directly proportional to disease duration and perforation size. Site of perforation does not influence hearing loss.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Parental perception of benefits from cochlear implantation in children
           with multiple impairments

    • Authors: Sumedha Chavan, Aparna Nandurkar
      Pages: 676 - 682
      Abstract: Background: Cochlear implantation (CI) in children with hearing impairment and an additional disability was not included in candidacy criteria earlier. With advances in technology and by taking into consideration the rehabilitation-pedagogic point of view, it is made possible to implant such children. In the Indian context, very few studies have documented benefits of CI in children with multiple impairments, whether measured or perceived by parents or families. Considering the number of children with additional impairments being implanted, it will be useful to conduct such a study, aimed at obtaining parents’ perceptions about benefits of cochlear implants in children with multiple impairments. Methods: The present study is a survey of 31 children (3-15 years) using CI and having multiple disabilities. An ICF based questionnaire was developed and used to record parents’ perception of benefits in terms of language development, speech perception, social interaction, communication skills (non-verbal and verbal), education, general tasks and demands, interpersonal interactions and relationships and family dynamics.  Results: Benefits were reported by all parents in all the domains i.e. listening, communication, learning and applying knowledge, interpersonal interactions and relationships and environmental factors. However, more parents reported consistent benefits in listening and interpersonal interactions. Most parents reported overall benefits from cochlear implantation in their children with multiple impairments. Conclusions: Results of this study can be helpful in estimating outcomes from CI in children with multiple impairments. Such information can be used during pre-CI counselling to facilitate development of realistic parental expectations about the benefits of CI in their children with multiple impairments. As results are based on parental reports, overestimation of perceived benefits may be present in some instances.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Our experience of 200 cases of thyroid surgery under local anaesthesia
           versus general anaesthesia

    • Authors: Sambhaji G. Chintale, Vilas R. Kirdak, Sonali P. Jatale, Kaleem Shaikh
      Pages: 683 - 686
      Abstract: Background: Local Anaesthesia is now being accepted universally as a safe alternative to general anaesthesia for thyroid surgery. This study was carried out to compare the outcomes of patients undergoing thyroid surgery under local and general anaesthesia. Methods: 200 patients who underwent thyroid surgery for benign and malignant diseases under local and general anaesthesia from March 2014 to march 2017 were analysed. Patient characteristics analysed were age, sex, pathology lesion size, operating time, length of stay, cost and post-operative complications.  Results: Mean lesion sizes were 4.5 cms and 6.5 cms in local and general anaesthesia group respectively. Mean operating time was 50, 5 minutes and 75.5 minutes in local anaesthesia and general anaesthesia group respectively. Mean cost incurred was Rs. 2500 in local anaesthesia and Rs. 5500 in general anaesthesia group. Mean length of hospital stay was 40, 25 hours and 75.06 hours in local anaesthesia and general anaesthesia group respectively. Conclusions: Local anaesthesia is a safe alternative to general anaesthesia for patients undergoing thyroid surgery. Use of local anaesthesiahas resulted in a decreased length of stay, cost and means operating time, hence useful in a setup with limited anaesthesia time and increased work load.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A prospective study of complications of tracheostomy and management in
           tertiary care hospital in rural area

    • Authors: Megha A. Kawale, Prashant N. Keche, Surendra H. Gawarle, Sneha V. Bhat, Aniket Buche
      Pages: 687 - 692
      Abstract: Background: The present study was carried out with an objective to study the various indications and prevalence of tracheostomy, appropriate time to perform it, and complications arising during and after the procedure and their modes of managements. Methods: A prospective and interventional study was carried out in ENT department during the period from Aug 2012 to May 2014. Total 124 patients (both pediatric and adult) undergoing tracheostomies for various indications were studied. The details of all participants such as demographic data, indications of tracheostomy, intra and postoperative complications were recorded and management of complications (if any) was done.  Results: The prevalence of tracheostomy was 0.253% for given study period and was performed more commonly in young adults (15-50 years). Males were more commonly subjected to tracheostomy as compared to females. Planned tracheostomies were more frequently performed, as most common indication of tracheostomy was assisted ventilation both in adult and children. The incidence of complications in intra and postoperative period was 29.81% (37 patients), the majority happening during the early postoperative period. Conclusions: The study concluded that the tracheostomy was more commonly perform in young adults with higher prevalence among male subjects. The main indication for tracheostomy in adult and children was assisted ventilation whereas most common complications were subcutaneous emphysema and peristomal infections. Most of the complications were managed conservatively.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Combined endoscopic endonasal and subciliary approach in revision DCR
           cases

    • Authors: Manjunatharao S. V., Rajshekar M. M.
      Pages: 693 - 698
      Abstract: Background: Study conducted to know surgical outcome of combined endoscopic endonasal and subciliary approach in revision DCR cases and complications associated with the procedure.Methods: Prospective, single-blinded, randomized, interventional study is carried out in Tertiary level center from August 2009 to April 2016. Totally 18 patients (11 female and 7 male) were involved in the study who has undergone previous DCR (11 external DCR and 7 endoscopic DCR). The results were analyzed at end of the 3rd and 6th month both subjectively and objectively.  Results: All the 18 patients who underwent combined approach were relived from epiphora. None of the patients developed any complications following surgery.Conclusions: The combination of endoscopic and external approach gives benefits of the both approaches giving huge advantages in revision cases. It gives excellent visualization of the surgical field, ability to correct internal nasal pathologies, make clear rhinostoma, workprecisely on fibrosed lacrimal sac and nearly no external scar. It provides good team work opportunity between otorhinologist and ophthalmologist.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Outcome of audiometric masking therapy on subjective tinnitus patients in
           different age groups

    • Authors: Prabina Rashmi Mohanty, Basavaraj N. Walikar, Satish M. Rashinkar, Ashfak R. Kakeri, Milind V. Watwe, Wasifa S. Biradar
      Pages: 699 - 704
      Abstract: Background: Theoretical consideration suggests an impact of the age at tinnitus onset influencing tinnitus distress. The use of masking for tinnitus is a primary method of treatment of tinnitus. The objective was to study effectiveness of masking by introducing audiometric reference signal in treatment of subjective tinnitus.Methods: The 90 patients (45 males and 45 females) were assessed by pure tone audiometer. Patients were divided into 6 age group sets for evaluation. The reference signal (90 to 100 dB SPL for 2-3 minutes in tinnitus ear of frequency 1000 Hz) was used for masking therapy. Outcome of the study was measured by using the tinnitus handicap inventory (THI) score and awareness time (tinnitus perception) before and after audiometric reference signal masking therapy. Success rate was measured to measure therapeutic efficacy.  Results: Our results depict improvement in subjective tinnitus by 57.78% (in males), 55.56% (in females) and overall 56.67% success in patients aged between 21 to 60 years by using our audiometric reference signal masking therapy. Regarding gender, the finding of THI score, Awareness time and Success rate in our study showed females being affected more than males. Our study also evidenced a highest percentage of tinnitus after the age of 70 followed by the decades 61–70 and 51–60.Conclusions: Our new economically viable approach to subjective tinnitus patients by audiometric reference signal seems to be an effective in improv­ing the patient’s distress in age group 21 to 60 years. Before taking decision for selection of high cost hearing aids, we can use it for poor people.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Comparison of efficacy of myringoplasty in dry and wet ears in chronic
           otitis media of tubotympanic type

    • Authors: Yogeshwar Chandrashekar, Ravishankar Chandrashekar
      Pages: 705 - 709
      Abstract: Background: The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.Methods: This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  Results: Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688>0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582>0.05).Conclusions: The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A comparative study of smartphone based app with free field hearing for
           possible use as a screening test

    • Authors: Himanshu Swami, Aditya Bhargava, Sabarigirish K., Arvind B. M.
      Pages: 710 - 714
      Abstract: Background:Hearing loss is an invisible injury that has been viewed as an acceptable by-product of military service. It is imperative to detect hearing loss at early stage to take immediate remedial measures. In Indian armed forces the current method of assessment of hearing is primarily by Free Field Hearing which is obsolete and has numerous shortcomings. We contucted a study using free iOS application to detect hearing loss. The objectives of the study were to investigate the validity and reproducibility of app based hearing assement and free field hearing with clinical pure tone audiometer as gold standard. It is cross sectional intra-subject comparative studyMethods:The study was conducted at CHAF where 200 patients were accrued. Hearing assessment was carried out by Pure Tone Audiometry (PTA) which is gold standard. Thereafter these patients were subjected to hearing assessment by using windows application “freehearingtestsoftware.com” and by free field hearing (FFH).  Results:Hearing assessment by FFH and hearing check app was compared with PTA. Hearing check app was found to be more sensitive than FFH (98% and 73%). Both modalities had high specificity (95% and 99%). The test retest reproducibility measured with Pearson correlation coefficient was high (0.99) with hearing check app.Conclusions:Smart phone application like Hearing check app is a cheap and effective way to assess hearing with reasonable accuracy. It’s high sensitivity and high test retest reproducibility makes it an ideal tool for screening and early detection of hearing loss replacing out-dated free field hearing. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Study of clinical and demographic profile of patients diagnosed with
           secretory otitis media

    • Authors: Ajeet Kumar Khilnani, Viral Prajapati
      Pages: 715 - 720
      Abstract: Background:Secretory Otitis Media (SOM) is a common otological condition in children presenting most commonly with hearing loss. If untreated for long time, it can affect the language development of child. Its causes are multifactorial and treatment depends on the etiology. Various treatment modalities (medical and surgical) are available and they are administered in isolation or in combination. The objectives of the study were the present study was conducted with the objectives of knowing the most common age group affected by SOM, the common etiological factors of SOM and the outcome of various modalities of treatment of SOM.Methods:This prospective study was conducted at a tertiary care teaching hospital of North Gujarat. IEC approval and consent from the patients were taken. 40 patients diagnosed with SOM were included in the study and their clinical and demographic details and treatment outcomes were studied.  Results:Of the 40 patients, 65% were males. SOM was common in young children. Most of the cases (55%) were below 10 years of age. In 80% of cases SOM was bilateral. Deafness was the most common symptom (95%) with which patients presented with, followed by URTI and pain. All patients had impaired tympanic membrane mobility. Retraction of tympanic membrane was the next common otoscopic finding (85%). Initial management was medical and 18 patients required surgical intervention.Conclusions:SOM is a common ear disorder in children. Initial medical treatment has a definitive role and should be tried in all cases before surgical intervention is contemplated. A variety of surgical procedures are available which can be used depending on the indication. Complete recovery is expected to occur in most of the cases by a period of 3-6 months.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Granular cell tumor that originated in a posterior ethmoid sinus

    • Authors: Myung Woo Kim, Sun Hee Chang, Ick Soo Choi
      Pages: 721 - 724
      Abstract: A granular cell tumor (GCT) is a rare neoplasm. It grows slowly, presumably originates from a Schwann cell, and is typically benign. Histopathologically, GCTs are composed of loosely infiltrating sheets of large, pale, polyhedral cells with abundant granular eosinophilic cytoplasm and a pale, centrally situated nucleus. Immunohistochemically, GCTs express the S-100 protein and neuron-specific enolase. A GCT can occur anywhere in the body. Half of all GCTs occur in the head and neck regions, especially on the tongue, but they are rarely found in the nasal cavity. A GCT usually arises as a solitary tumor and can be confirmed only by a histologic examination. The appropriate treatment is excision of the lesion. Here, we present a rare case of a GCT originating in the right posterior ethmoid sinus in the nasal cavity. A GCT originating in a posterior ethmoid sinus has not been reported thus far. In our case, a simple nasal polyp was found in the left ethmoid sinus of the patient. Thus, we initially misjudged the GCT in the right nasal cavity as a simple nasal polyp.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Giant cell tumor of the frontal sinus: case report

    • Authors: Ali Alzarei, Majed Assiri, Rabab N. B., Wael Aljoraebi, Ibrahim Sumaily
      Pages: 725 - 727
      Abstract: Giant cell tumor (GCT) is an uncommon aggressive primary bone tumor usually affects long bones. It is rarely involving skull bones, and to less extent the frontal bone. Up to date only 3 adult cases reported of the frontal bone, only one of them was occupying the frontal sinus. Here, we present a 49 year old male presented with slowly growing left supraorbital swelling for 3 years. This swelling was a firm mass with destruction of anterior table of frontal bone. Diagnostic radiological work-up showed a mass in left frontal sinus, mass excised with external approach. Reporting this case with its clinical, radiological and histopathological images should add significant material to the literature for further studies of GCT of paranasal sinuses.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Sialolithiasis and deep neck infection after the submandibular gland
           excision

    • Authors: Metin Çeliker, Fatma Beyazal Çeliker, Suat Terzi, Engin Dursun
      Pages: 728 - 731
      Abstract: Sialolithiasis is a common disease and mainly affects the submandibular glands and the Wharton's duct. Recurrent sialolithiasis is a rare condition. Despite submandibular gland excision, sialolithiasis which requires recurrent sialolithectomy causing also deep neck infections is even rarer. Herein, a 57-year-old female patient, who had recurrent sialolithiasis in Wharton's duct despite submandibular gland excision and sialolithectomy performed 10 years ago and sialolithectomy for Wharton's duct calculi performed 2 years and one year ago via transoral approach, is presented. The patient had also deep neck infection requiring hospitalization and underwent transoral sialolithectomy and marsupialization of the duct after medical treatment. The present case study aimed to present with radiological modalities the recurrent sialolithiasis also causing deep neck infections despite submandibular gland excision, and to indicate the causes of recurrence and the points to be remembered for prevention.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A case report on localised laryngeal amyloidosis

    • Authors: Marija Agius, Tara Grima, Maja Cvorovic, Darko Babic, Charles Borg
      Pages: 732 - 734
      Abstract: Amyloidosis is a rare disease which involves deposition of amyloid in the tissues. Very rarely, amyloid can be deposited in a single organ giving rise to localised amyloidosis. In the present study, a rare case of localised amyloid deposition in the larynx in a young patient was presented. It is a slow progressive disease and often diagnosed late and is confirmed by biopsy results.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Angiosarcoma of the nasal cavity and paranasal sinuses: a rare case report

    • Authors: Jyoti Singh, Jai Lal Davessar, Sumit Prinja, Nitin Arora
      Pages: 735 - 736
      Abstract: Angiosarcomas are the malignant neoplasias of vascular phenotype whose constituent tumor cells have endothelial features. They account for less than 1% of all sinonasal tract malignancies. A case of 65 year old male with a 6 months history of spontaneous epistaxis and a nasal mass lesion presented to the OPD. On physical examination, a polypoidal purplish tumor of 6 × 5 cm was identified. A NCCT scan of nose and paranasal sinuses showed a nonenhanced tumor in the left nostril in maxillary, ethmoid, sphenoid and frontal sinus. An excisional biopsy revealed a poorly differentiated angiosarcoma. Surgical removal of the lesion was advised which was refused by the patient.Patient was put on the radiation therapy. Angiosarcoma of the nose and paranasal sinuses is an extremely rare tumor. Recurrences are common due to incomplete excision or mutiflocality.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Non-Hodgkin lymphoma of sinuses and nasal cavity: case series of two

    • Authors: Deepak Dalmia, Sanjaya Kumar Behera, Jas Simran Singh Bhatia
      Pages: 737 - 741
      Abstract: Non-Hodgkin lymphoma is a type of hematologic malignancy derived from lymphocytes, which varies significantly in their severity, from slow growing to very aggressive types. Incidence increases with age. Up to 45 years of age Non-Hodgkin lymphoma is more common among males than females. Various etiological factors includes infectious agents like Epstein-barr virus, Human T-cell leukemia virus, Helicobacter pylori, Human herpes virus-8, Hepatitis c virus, HIV etc. Exposure to chemical like polychlorinated biphenyls, phenoxy herbicides and medical treatments like radiation therapy and chemotherapy also act as etiological factors. Genetic diseases like Klinefelter’s syndrome, ataxia telangiectasia and autoimmune diseases like celiac sprue, rheumatoid arthritis and systemic lupus erythematosus can also act as causal factors. NHL in nose and nasal cavity is a rare finding. Ours is a case series of two rare case of non-Hodgkin lymphoma presented with a nasal mass with nasal obstruction. The first case is a sixty years old female patient who presented with a right nasal mass with nasal obstruction. The second case is a fifty years old male who presented with left side nasal mass with left proptosis.  We diagnosed these cases by taking biopsy from the nasal masses. These cases highlighted the importance of good clinical history and examination along with management according to definite protocols in regarding to avoid missing a rare.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Second branchial arch anomaly: case series of two

    • Authors: Sanjaya Kumar Behera, Deepak Dalmia, Ashay Amlekar
      Pages: 742 - 744
      Abstract: Branchial apparatus develop between the 3rd and 7th weeks of embryonic life. There are 5 mesodermal arches separated by invaginations of ectoderm and endoderm. During development the second arch grows caudally to cover the third and fourth arches and the second, third, and fourth pharyngeal clefts eventually fusing with the lower neck. The enclosed II, III, and IV clefts are called as the cervical sinus. If this process does not occur for some reason then it gives rise to branchial cyst, sinus or fistula. We are presenting two cases of second branchial arch anomaly. In first case there was bilateral branchial fistula with right side fistula associated with branchial cyst. In second case there was unilateral right side branchial fistula. We operated both the cases by giving step ladder incision. In second case we find fistulous track opening in the tonsillar bed. Both the patients recovered well with no recurrence since 1 year. Brachial cleft cyst is a common cause of soft tissue swelling in the neck of a young adult. They generally occur unilaterally and are typically seen in the lateral aspect of the neck. It is clinically apparent in late childhood or early adulthood. In older adults with this presentation, it is important to exclude metastatic lymphadenopathy, lymphoma or tuberculosis.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • A rare case of dysphonia in mitochondrial myopathy

    • Authors: Abha Kumari, Sunil Goyal, Virender Malik, Takhellambam Biram Singh, Vijay Krishnan Paramasivan, Mohan Kameswaran
      Pages: 745 - 748
      Abstract: The mitochondrial myopathy consists of diverse group of disorders which is characterized by primary dysfunction of mitochondrial respiratory chain leading to muscle disease. The involvement of larynx is very rare and only few cases have been reported in the literature. This study presents the fourth published case of dysphonia in the setting of mitochondrial myopathy. A patient with dysphonia with laryngeal involvement in mitochondrial myopathy is presented with literature review. A 43 year old man presented with progressive dysphonia and muscle weakness. Laryngeal examination showed bilateral adductor weakness of vocal cords and biopsy revealed findings typical of mitochondrial myopathy (MM). He underwent conservative trial for dysphonia with no relief and subsequently medalization thyroplasty showed some improvement in dysphonia. Mitochondrial myopathy should be considered in the differential diagnosis of dysphonia for early diagnosis and management. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Vestibular nerve compression: role of auditory brainstem response and
           cervical vestibular evoked myogenic potentials

    • Authors: Deepa A. Valame, Geeta B. Gore
      Pages: 749 - 754
      Abstract: The objective of the study was to evaluate the role of ABR and cVEMP in the diagnosis of vestibular compression syndrome (VCS) and to study the association of test results with the MRI findings. This is a case-report of four patients with VCS using case-study approach. Four patients with varying degrees of indentation of vestibulo-cochlear nerve by the anterior inferior cerebellar artery (AICA) loops were studied. Episodic rotatory vertigo was reported by three cases and two cases complained of tinnitus but the characteristic low-frequency ‘type-writer’ type of tinnitus was seen in only one. All cases showed evidence of retrocochlear pathology on ABR although two had normal peripheral hearing status. The cVEMP abnormalities noted were absence of cVEMP and reduced amplitude of cVEMP as compared to instrument-specific age-matched norms; only one case with no indentation of vestibulo-cochlear nerve had normal cVEMP tracings. Presence of AICA loops on the MRI by itself need not necessarily indicate vestibular compression syndrome. However when MRI excludes any other pathology in cases with symptoms such as unilateral sensorineural hearing loss, tinnitus, vertigo; vestibular compression could be the etiology. The likelihood of abnormal test findings is greater when the loop causes indentation of the nerve. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Rare case of chronic suppurative otitis media with gradenigo syndrome

    • Authors: Shiffali ., Priyanka ., Kulwinder Singh Sandhu, Jagdeepak Singh
      Pages: 755 - 757
      Abstract: We report a case of sixth nerve palsy as a rare complication of acute otitis media (apical petrositis). The clinical triad of symptoms consisting of retro-orbital unilateral pain related to trigeminal nerve involvement, diplopia due to sixth nerve palsy and persistent otorrhea is known as Gradenigo syndrome. The patient was treated with intravenous antibiotics along with modified radical mastoidectomy and had complete resolution of his symptoms.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Bimodal video laryngoscope assisted management of retropharyngeal abscess:
           a case report

    • Authors: Manish Munjal, Archana Arora, Amanjot Kaur, Gopika Talwar, Rupinder Mirley, Shubham Garg
      Pages: 758 - 760
      Abstract: A retropharyngeal abscess is a suppurative collection of the deep spaces of the neck. Mostly at presentation they are massive and are a dilemma for the surgeon and the anesthetist alike, vying for space, one for therapeutic intervention and the other for airway access. Video laryngoscopic assisted evacuation of such a collection, adopting the nasopharyngeal and the transoral route was undertaken in a middle aged individual which is being reported.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • An interesting case of fronto cutaneous fistula

    • Authors: Gurumani Sriraman, RajPrakash Dharmapuri Yaadhava Krishnan, Roopak Visakan Raja
      Pages: 761 - 763
      Abstract: Fronto cutaneous fistula is a very rare entity which usually occurs as a complication of long standing frontal sinusitis leading to frontal bone osteomyelitis. Its incidence has decreased due to the wide spread use of antibiotics. In this era we would like to report a rare case of fronto cutaneous fistula secondary to sino nasal malignancy. A 65 year old female presented to the ENT out patient service of our Hospital with complaints of discharging sinus in the left forehead for 2 months. There was blurring of vision in the right eye for one year .She was a known diabetic. General examination showed that there was a mild swelling around the right orbit and the right eye was significantly proptosed. Routine ENT examination revealed that there was a suspicious nasal mass in the right nasal cavity on anterior rhinoscopy later confirmed by diagnostic nasal endoscopy. Ear and Throat were normal. Neurology opinion was obtained which stated that the findings were suggestive of an intracranial Space occupying lesion extending into the right orbit. Urgent CT was ordered. Routine laboratory investigations were normal except the ESR value which was 60 mm at end of 1 hour. CT scan showed a sinonasal mass existed centered over the right nasal cavity extending into the surrounding sinuses, near complete erosion of lamina papyracea with extension into right orbit. Biopsy of was done. The biopsy showed squamous cell carcinoma with poorly to moderately differentiated cells. However as the patient was not willing for surgery, hence chemoradiation was advised.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Endoscopic trans-sphenoid excision of solid petrous apex lesion: a case
           report

    • Authors: Sai Spoorthi R. Nayak, Nishit J. Shah, Chandrashekhar E. Deopujari, Prashant V. Gunawat
      Pages: 764 - 767
      Abstract: Petrous apex lesions are highly challenging for surgical access as they lie in the most medial portion of the temporal bone, surrounded by vital structures. These lesions are traditionally tackled by labyrinthine approaches. Endoscopic endonasal approach has been described to drain cystic lesions like cholesterol granulomas. Intraosseous schwannomas of the petrous apex are a rare occurrence with only 3 cases being reported so far. We are the first to describe a transphenoidal route to completely excise a solid petrous apex lesion like a schwannoma.
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Sarcomatoid carcinoma a rare variant of squamous cell carcinoma of larynx:
           a case report

    • Authors: Trilok C. Guleria, Shobha Mohindroo, Narender K. Mohindroo, Ramesh K. Azad
      Pages: 768 - 770
      Abstract: Sarcomatoid (spindle cell) carcinoma is a rare variant of squamous cell carcinoma (SCC). It compromises of 2–3% of laryngeal cancers. Tumor arises from the oral cavity, tonsil, larynx and pharynx. Majority of these tumors are polypoid or pedunculated and tend to cause obstructive symptoms. These tumors are often detected at an early stage, removed by polypectomy during diagnosis and tend to have a very good prognosis. In this case report, 76 years male who presented with progressive hoarseness of his voice and pain in throat. The patient underwent direct laryngoscopy with excision of the malignant mass and received radiotherapy. 
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
  • Osteomyelitis of maxilla - a rare presentation: case report and review of
           literature

    • Authors: Vikas Gupta, Inderdeep Singh, Sunil Goyal, Manoj Kumar, Anubhav Singh, Gunjan Dwivedi
      Pages: 771 - 776
      Abstract: Osteomyelitis involving the maxillofacial skeleton is a rare entity today. In maxillofacial region mandible is more commonly involved as compared to maxilla. It continues to remain one of the most difficult to treat infections with considerable morbidity and costs to the healthcare system. Hallmark of osteomyelitis are progressive bony destruction and formation of sequestrum. When present, the possibility of underlying malignancy or granulomatous diseases should be kept in mind and ruled out. We present a rare case of osteomyelitis involving the maxilla in a 64 year old male diabetic. The patient was managed with sequestrectomy and debridement by infrastructure maxillectomy via a midfacial degloving approach, appropriate parentral antibiotic therapy and glycemic control. The patient had an uneventful recovery.  
      PubDate: 2017-06-24
      Issue No: Vol. 3, No. 3 (2017)
       
 
 
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