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International Journal of Otorhinolaryngology and Head and Neck Surgery
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2454-5929 - ISSN (Online) 2454-5937
Published by Medip Academy Homepage  [12 journals]
  • Prevention of hypoparathyroidism with the use of calcium-rich foods in the
           total thyroidectomy pre-operative period

    • Authors: Marcelo Jacques Segal, Jose Luis Braga De Aquino, Vania Aparecida Leandro Merhi, Jose Gonzaga Teixeira De Camargo, Paula Srebernich Pizzinato, Joao Paulo Zenun Ramos, Fernando De Almeida Delatti, Felipe Couto Ferreira Rocha, Aline Akel Ferruccio
      Pages: 1576 - 1582
      Abstract: Background: Transient hypocalcemia after total thyroidectomy (TT) is a common surgical complication.
      Authors used calcium supplements in different doses and periods, mainly after TT to try to avoid hypocalcemia. Indistinct use has been challenged due to complications. Currently, the risk of hypocalcemia was assessed by measuring parathormone (PTH) after TT; however, without a consensus on the best time and amount to consider. The objectives of this study were to evaluate the incidence of hypoparathyroidism with the use of calcium-rich foods in the pre-operative period of TT, followed by a measurement of PTH performed 12 hours after such procedureMethods: A preliminary study with 31 patients earmarked for TT. Patients were divided into two groups: (A) without calcium-rich foods intake in the TT pre-operative period; and (B) with the intake of calcium-rich foods, in the TT pre-operative period. These foods composing different menus have been suggested, based on the need for daily calcium intake, according to the age group and nutritional data of the Dietary reference intake (DRI). Beginning of the use of these foods has been standardized as being seven days before surgery, due to the slower calcium intestinal absorption process.  Results: Group B, when compared to A, showed a significant difference between PTH values, before and after surgery (p value <0.001).Conclusions: Calcium-rich foods intake in the conditions reported may be associated with lower rates of hypoparathyroidism.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213889
      Issue No: Vol. 7, No. 10 (2021)
  • Globus pharyngeus a diagnostic challenge for otolaryngologist

    • Authors: Tanvir Hussain, Aishan Patil, Amy Copperthwaite, Ronan Fahy, Emma Keane
      Pages: 1583 - 1588
      Abstract: Background: Globus pharyngeus, also known as globus sensation, can be defined as the sensation of a lump or foreign body in the absence of a mass on examination. The disorder is frequently linked to catarrh, hoarseness, chronic cough and persistent throat clearing. Globus pharyngeus accounts for 4 percent of ENT (ear, nose and throat) referrals. The exact cause of globus pharyngeus is unknown. The presence of lingual tonsil, cricopharyngeal spasm, hiatus hernia, cervical osteophytosis, sinusitis, gastro-oesophageal reflux, goiter post-nasal drip and anxiety have all been shown as associations in the literature. Digestive enzymes and regurgitation of stomach acid are thought to cause persistent inflammation, for example, of the laryngopharynx, which causes symptoms. Reflux has been depicted in 23-68 percent of patients with globus sensation. Notably, some studies claim that asymptomatic control patients have a similar rate.Methods: We presented our audit study of 50 subsets of patients. It was considered that gastro-oesophageal reflux was the reason; however, it cannot explain all the potential causes.Results: Barium swallow was found to be a very key diagnostic tool in this group of patients.Conclusions: Panendoscopy in globus sensation in the throat, looking through the possible causes of globus sensation, current trends and diagnosis as well as methods of treatment.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213890
      Issue No: Vol. 7, No. 10 (2021)
  • Asymptomatic hearing loss-a missed symptom of COVID-19

    • Authors: Choudhary Sathyanarayanan, Balaji Swaminathan, Ruta Shanmugam, V. U. Shanmugam, Prakash ., V. M. Lavanya, P. S. Divya
      Pages: 1589 - 1592
      Abstract: Background: COVID-19 pandemic is caused by SARS CoV2. The last reference of pandemic was Spanish flu in 1918 which caused hearing loss in many patients. The effect of COVID-19 is an interesting issue in audiology. Not much studies have been done; therefore, this kindled our interest to have a study on audiological profile of asymptomatic COVID-19 patients.Methods: The 20 cases in the age group of 20 and 50 years who were confirmed positive for COVID-19 formed the study group. 20 subjects who had normal hearing (Audiometric threshold at or better than 15 db HL) were used as control group. Pure-tone audiometry (PTA) was done for both the group on day 7 and 30. Air conduction and Bone conduction were measured. The audiometric thresholds were measured using the modified Hughson-Westlake method.Results: High frequency hearing impairment was found in 9 out of 20 patients in the study group on day 7. Out of the 9 affected patients 7 patients showed improvement upon further testing done on day 30.Conclusions: Like anosmia and ageusia, hearing loss can be considered as one of the clinical features in COVID-19 patients. This study was recorded to find a significant hearing loss in asymptomatic COVID-19 patients and thus sheds light on the auditory problem that people are experiencing during these difficult times and for future reference on pandemic research.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213691
      Issue No: Vol. 7, No. 10 (2021)
  • Endoscopic endonasal dacryocystorhinostomy-an experience in a tertiary
           care hospital

    • Authors: Atishkumar B. Gujrathi, Paritosh A. Kamble, Shashin Khadkekar, Nishikant Gadpayale, Yogesh Paikrao, Harshada Kurande, Indutai Rathod
      Pages: 1593 - 1598
      Abstract: Background: Dacryocystorhinostomy is a surgical procedure by which the lacrimal flow is diverted into the nasal cavity by making an opening in the lacrimal sac when the nasolacrimal duct gets blocked. The operation can be carried out using either an external or endonasal surgical approach.Methods: This is a clinical observational study done on 50 patients with chronic dacryocystitis with obstruction at the level of sac or nasolacrimal duct. This study was conducted at Dr. Shankarrao Chavan government medical college, Nanded, during the period of 2 years (2018-2020). Patients were evaluated and operated for endoscopic endonasal dacryocystorhinostomy.Results: The mean age of studied cases was 33.92±12.13 years. The M:F ratio was 0.78. Epiphora was the predominant complaint in all cases 100%. Swelling of lacrimal sac was present in 24% cases and Pain on affected side was present in 18% cases. 6% patients had fistula on the side of block. 12% patients had mucocele and 14% patients had pyocele on the affected side. Left and right side was involved in 54% and 40% cases respectively. The disease presented bilaterally in 06% cases. 80% patients had no complications after endonasal endoscopic dacryocystorhinostomy (EEDCR) surgery. Rate of surgical success was 92%.Conclusions: Nasolacrimal duct obstruction is more common among females and in middle aged persons. EEDCR is treatment which provides patients relief from the symptoms without any scar and also preserves nasolacrimal pump system with high success rate. It may prove better surgical technique in chronic dacryocystitis.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213891
      Issue No: Vol. 7, No. 10 (2021)
  • Comparative study on efficacy of SNOT 22 outcome in nasal surgery using
           teflon splinting for chronic rhinosinusitis

    • Authors: Sajitha K. B., Vibha B., Norma Thomas
      Pages: 1599 - 1603
      Abstract: Background: CRS is defined as inflammation in the nose and paranasal sinus and it is characterized by two or more cardinal symptoms. There is a growing need for a simple, reliable, system-specific standardized outcome measure that can help us explore CRS in a more uniform way and help us to take into account patients’ HRQoL. SNOT covers a broad range of health and health-related quality of life problems including physical problems, functional limitations, and emotional consequences.Methods: we report a case series of 60 patients, divided into 2 groups of 30 each. 1st group underwent FESS+septoturbinoplasty while the 2nd group underwent FESS+septoturbinoplasty with teflon splinting. Patients were asked to score their symptoms on SNOT 22 questionnaire pre-operatively and post-operatively.Results: Significant changes were noted in nasal related and quality of life domain and less significant changes noted in ear/facial related and psychological domains in group 2.Conclusions: patient-based outcome measures like SNOT 22, is helpful tool for quantifying changes in symptoms and useful for predicting post-operative improvement. It is both patient and researcher-friendly.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213892
      Issue No: Vol. 7, No. 10 (2021)
  • Comparative study of outcomes of type 1 tympanoplasty with and without
           anterior tucking

    • Authors: Sonee Thingujam, Jayita Poduval
      Pages: 1604 - 1610
      Abstract: Background: Type-1 tympanoplasty is the functional restoration of the normal middle ear by repairing the tympanic membrane (TM). Different techniques are still evolving to devise a way to give optimal graft uptake and hearing improvement with minimal instrumentation. Various studies have been done to assess the role of anterior tucking in type-1 tympanoplasty and to assess its superiority over other methods in repairing subtotal perforations and large perforations involving the anterior quadrant.Methods: This study was done to compare the outcomes of endoscopic type-1 tympanoplasty with and without anterior tucking. 60 cases of chronic otitis media (COM) mucosal type were divided into 2 groups of 30 patients each. Group 1 underwent endoscopic type-1 tympanoplasty with anterior tucking and group 2 underwent endoscopic type-1 tympanoplasty without anterior tucking. The outcomes were evaluated after 6 months and compared in terms of graft uptake and hearing gain.Results: The mean air-bone gap improvement was 13.16±2.65 in group 1 and 12.90±3.78 in group 2, which had statistically insignificant differences indicating similar hearing outcomes in both the groups. 96.7% successful graft uptake was achieved in group 1 and 90% in group 2, showing statistically insignificant differences indicating similar graft uptake rates in both the groups.Conclusions: Anterior tucking with endoscopic type-1 tympanoplasty could provide good graft support and efficient hearing improvement but cannot be labelled as a mandatory step in repairing subtotal perforations or large perforations involving anterior quadrant as the outcomes are comparable to the endoscopic type-1 tympanoplasty done without anterior tucking. 
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213893
      Issue No: Vol. 7, No. 10 (2021)
  • Impact of adenoidectomy on middle ear function in children between 5-12
           years of age with chronic adenoiditis

    • Authors: G. Agaman, Jayita D. Poduval
      Pages: 1611 - 1616
      Abstract: Background: Otitis media with effusion (OME) is an inflammatory disorder of the middle ear that is characterised by the presence of endotympanic fluid without any sign or symptom of acute ear infection, which may lead to hearing loss or long-term sequelae and have a negative impact on speech development and behaviour. Aim of the study was to determine the influence of adenoidectomy on middle ear function in children with chronic adenoiditis and to correlate degree of adenoid hypertrophy with middle ear function.Methods: This cross-sectional study comprised 50 cases, who were 5-12 years of either sex presenting to ear, nose and throat outpatient department (ENT OPD) with grade 3, 4 adenoid hypertrophy. After detailed history and clinical examination, investigations such as pure tone audiogram, impedance audiometry, X-ray nasopharynx and diagnostic nasal endoscopy were carried out to confirm the diagnosis. All patients were posted for adenoidectomy by curettage. They were followed up at 1st, 3rd and 6th month for pure tone audiometry and impedance was done at 6th month of surgery.  Results: In this study, maximum number (82%) of cases belonged to more than 7 years age group. On otoscopy, dull, amber coloured tympanic membranes ™ was the most common finding in 78% of cases. 66% had adenoid hypertrophy grade three and 34% had adenoid hypertrophy grade four. Mean audiometry findings at preoperative, and one month and 3 months post-op intervals are 24.2, 13.28 and 12.2, and the p value is less than 0.0001, which is statistically significant.Conclusions: It may be concluded, that adenoidectomy completely eliminates the effusion in the middle ear cavity and exhibits significant postoperative hearing improvement.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213894
      Issue No: Vol. 7, No. 10 (2021)
  • Evaluation and management of ear itching: our experience

    • Authors: Srujan Vallur, Anil Raghavan, V. U. Jagdeeswaran, Pawan Kumar Gampa
      Pages: 1617 - 1623
      Abstract: Background: Itching of ear is a common presenting symptom in clinical practice. Ear itching has many underlying causes which needs detailed evaluation. The aim of the study was to determine the incidence of ear itch and the aetiological factors and various management options associated with ear itch.Methods: A retrospective observational cohort study was done in two centres over a period of one year in patients with ear itch in ENT outpatient were included. Sampling method used was systematic sampling. The details regarding the age, gender and co-morbidities of the patients were recorded. The ear was clinically examined.   Results: A total of 2143 patients presented to outpatient, 210 (9.8%) presented with ear itching. The mean age (SD) of the study patients were 46.8 years (15.6). The gender distribution showed a male:female of 1:1. Comorbidities included hypertension (27.14%), diabetes (8.57%) and combination of both in 8.1%. Mean±SD of duration of study subjects was 4.3±1.6 months. The common aetiologies were otomycosis (30%), wax deposition (25.24%) and otitis externa (14.29%). Diabetes was predominantly associated with otomycosis (68.57%, p<0.0001). In our study, prevalence of ear itching was 9.8% with common aetiologies were otomycosis, wax deposition and otitis externa. There was significant association of diabetes mellitus with otomycosis.Conclusions: Ear itching is a symptom that needs detailed history, careful clinical evaluation and management. Patient’s quality of life will largely improve if ear itching is dealt with all possible aetiologies and appropriate management.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213895
      Issue No: Vol. 7, No. 10 (2021)
  • Clinicopathological profile and treatment outcomes of patients presenting
           with epistaxis: a hospital-based cross-sectional study in Southern railway
           headquarters hospital, Chennai

    • Authors: Thirupathi K., A. P. Preetham, Musarrat Feshan
      Pages: 1624 - 1629
      Abstract: Background: Epistaxis (nose-bleed) is one of the commonest emergencies presenting to an otolaryngological emergency that affects up to sixty per cent of the population in their lifetime; in this, six per cent needs medical care.Methods: Hospital-based cross-sectional study carried between October 2018 to January 2020 in the department of ENT at Southern Railway Headquarters Hospitals, Perambur, Chennai.Results: The mean age of the subjects was 47.76±23.01. Females were less affected compared to males with 1.68:1 male: female ratio. The results of ENT examination/anterior rhinoscopic examination revealed that all 153 (100%) subjects had anterior epistaxis and 5 (3.27%) had posterior epistaxis. 143 (93.46%) had deviated nasal septum. Diagnostic nasal endoscopy revealed that 90 (58.82%) had deviated nasal septum to the left, and 55 (35.94%) had to the right. The majority of subjects, i.e., 86 (56.21%), were managed conservatively, followed by 52 (33.99%), 5 (3.27%), and 1 (0.65%) patient were given treatment with anterior nasal packing, anterior and posterior nasal packing, and cauterization respectively. Whereas 9 (5.88%) subjects needed a surgical mode of treatment to manage their epistaxis.Conclusions: Findings revealed that the incidence was high in elderly individuals, with male preponderance over females. Anterior epistaxis more commonly occurred in comparison to posterior epistaxis. Our research supports the conservative management methods’ credibility in the epistaxis treatment. The practice of simple nasal packing is the commonest conservative approach that has a high rate of success. As a result, this method will be the best choice for epistaxis management.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213896
      Issue No: Vol. 7, No. 10 (2021)
  • Diagnosing chronic rhinosinusitis: a comparative study between diagnostic
           nasal endoscopy and computed tomographic scan paranasal sinuses

    • Authors: Dharmishtha H. Parmar, Hiten R. Maniyar, Hetna A. Patel
      Pages: 1630 - 1635
      Abstract: Background: The term ‘rhinosinusitis’ refers to a heterogenous group of disorders characterized by inflammation of mucosa of the nose and paranasal sinuses. The National Institute of Allergy and Infectious Diseases (NIAID) have recently mentioned that 136 million people of India suffer from chronic rhino sinusitis.Methods: A total 50 patients with symptoms of rhinosinusitis were investigated with both diagnostic nasal endoscopy and CT scan paranasal sinuses and their findings were scored with particular scoring system and compared with each other.  Results: Out of 50 patients, 90% patients were diagnosed on CT scan and 84% patients were diagnosed on nasal endoscopy. By considering CT scan as accurate procedure and correlating nasal endoscopy with CT scan, sensitivity was 88.88%, specificity was 60%, positive predictive value was 95.23%, negative predictive value was 37.5%, and p value was 0.004671, which was significant at p<0.05, indicates that CT paranasal sinuses is more accurate than diagnostic nasal endoscopy in diagnosing chronic rhinosinusitis.Conclusions: Both diagnostic nasal endoscopy and CT paranasal sinuses are important pre-operative evaluation tools in detecting pathology and both are complementary to each other. But CT paranasal sinuses are more convenient than endoscopy according to this study.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213897
      Issue No: Vol. 7, No. 10 (2021)
  • A systematic review of complications of attico-antral type of chronic
           suppurative otitis media in our region

    • Authors: Shashin Khadkekar, Libin Mathew Benny, Atishkumar B. Gujrathi, Nishikant Gadpayale, Yogesh Paikrao
      Pages: 1636 - 1643
      Abstract: Background: Chronic suppurative otitis media (CSOM) is a very common disease that should be carefully treated, as severe complications can develop. Despite the significantly decrease incidence of CSOM-related complications since the introduction of antibiotics, this clinical problem has not been eliminated.Methods: This was an observational study conducted including 60 cases of attico-antral type of CSOM and its complications. Detailed study of determinants of attico-antral type of CSOM and its complications were studied. The various options in the management of disease and its complications with their outcomes were studied.  Results: Majority of study participants belonged to lower socio-economic group. intra-temporal complications were most common complications and most of the patients required canal wall down surgery. Majority patients had complete recovery of the disease without recurrence during 3 months of follow-up.Conclusions: Our study concluded majority of the patients belonged to the low socioeconomic status. It was also clear from the study that timely intervention in the form of early diagnosis and administration of proper treatment resulted in complete recovery of majority of patients.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213898
      Issue No: Vol. 7, No. 10 (2021)
  • Mastoid cavity obliteration with bone dust: a retrospective study of 34

    • Authors: Meenesh Juvekar, Baisali Sarkar
      Pages: 1644 - 1648
      Abstract: Background: Chronic suppurative otitis media leads to ear discharge with hearing loss with squamosal type often presents with cholesteatoma and mainstay of treatment is surgical. Modified radical mastoidectomy is the ideal surgical option in these cases but it results in open mastoid cavity formation with certain common cavity problems. This study done to find the results of mastoid cavity obliteration with autologous bone dust and how this technique is effective in avoiding long term cavity problems and assists in ossiculoplasty.Methods: This is a retrospective observational study done in a tertiary care hospital. Patients presented with squamosal type of chronic otitis media were operated for a canal wall down modified radical mastoidectomy.The mastoid cavity was obliterated using bone dust. A follow up of the patients was done and the healing of the cavity with the hearing result assessed.Results: The study includes total of 34 patients. 58.82% were male and 41.18% were female. All patients underwent canal wall down modified radical mastoidectomy and obliteration of the mastoid cavity was done with bone dust. The common cavity problems of discharge, debris were markedly reduced in an obliterated cavity with better healing of the cavity. The middle ear aeration was maintained assisting the ossicular reconstruction.Conclusions: This study showed that mastoid cavity obliteration with bone dust offers significant long term benefits in providing dry, well epithelized cavity at the same time assisting in ossicular reconstruction.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213899
      Issue No: Vol. 7, No. 10 (2021)
  • Our comprehensive experience with tracheostomy in tertiary
           multi-speciality hospital over four years

    • Authors: Parth B. Kapadia, Manit M. Mandal, Ajay J. Panchal, Rakesh Kumar, Neel Parmar, Vidhi Shah
      Pages: 1649 - 1652
      Abstract: Background: Tracheostomy is a common surgical procedure used to achieve a secure airway in patients in elective as well as emergency conditions. Our study accounts for our first-hand experience with the procedure in our tertiary multi-speciality hospital.Methods: It is a four year (January 2017 to February 2021) retrospective study in which all the 246 cases of tracheostomies were taken into account which were performed during this study period in the department of otorhinolaryngology (ENT), Surat Municipal Institute of Medical Education and Research (SMIMER), Surat (India). The patients were thoroughly followed up until the final outcome of the tracheostomy was established.  Results: A total of 246 tracheostomies were performed, 63.82% of which were in men. The mean patient age was 42 years. The majority (76%) were elective, performed for various indications, while the remaining 24% were emergency tracheostomies. All tracheostomies were performed by otorhinolaryngologists. Complications relating to tracheostomy were documented in 40 patients (16%) intra-operatively and/or post-operatively which included bleeding, surgical emphysema, granulations along the stomal site and rarely shock. The mean time to decannulation was 13.48 days.Conclusions: Our study takes into account and discusses the findings of all the 246 tracheostomies which were performed during the study period of 4 years. Elective cases form the majority although there is a significant case series of emergency tracheostomies performed for a range of pathologies. 
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213900
      Issue No: Vol. 7, No. 10 (2021)
  • Challenges in managing complex chronic middle ear disease: MERF experience

    • Authors: Kiran Natarajan, Aruna Devaraju S., Anubhav Shrivastava, Swathi Ramasamy, Raghunandhan Sampathkumar, Mohan Kameswaran
      Pages: 1653 - 1659
      Abstract: Background: Chronic otitis media is one of the commonest conditions managed in otolaryngology practice. In developing countries such as India, advanced disease presentation is often seen mostly owing to lack of awareness of the disease and its potential complications, long distance between the patient’s home and the treatment centre, causing delay in treatment. Surgical management is the mainstay of treatment of chronic otitis media.Methods: The aim of this study was to retrospectively analyze the patients with complex chronic middle ear disease, who underwent tympanomastoid surgery. Forty-seven patients (4.9%) out of a total of 968 patients with chronic otitis media presented with complex advanced disease and challenging intra-operative situations at our tertiary referral centre between January 2016 to December 2020. The extent of disease, associated complications, challenges in surgical management, and the eventual outcomes were studied in detail.Results: Among these forty-seven patients, there were 24 males and 23 females. Of the 47 patients, 8 were children (17%). Extensive cholesteatoma causing facial palsy, labyrinthine fistula, dural involvement, internal auditory meatus involvement, extensive granulations extending into the inner ear through the oval or round window, extensive tympanosclerosis was noted in these patients. All patients underwent surgical management, and achieved satisfactory outcomes.Conclusions: Advanced chronic otitis media has the potential to pose various challenges during tympanomastoid surgery. Appropriate planning for surgery aiming at complete disease clearance, meticulous after-care and long-term surveillance result in favorable outcomes.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213901
      Issue No: Vol. 7, No. 10 (2021)
  • Challenges in treating patients with foreign bodies in hypopharynx and
           esophagus: our experience in a tertiary care hospital

    • Authors: Nambiar Sapna S., Swathilal S. A., Sunilkumar K. P., Soumya Aravind M. V.
      Pages: 1660 - 1667
      Abstract: Background: Foreign bodies (FBs) of the hypopharynx and esophagus are among the common otolaryngologic emergencies. Every new case poses a clinical challenge with need for optimal treatment strategy. The objective of our study is to highlight a few of the challenges faced while treating these patients.Methods:  A prospective study was done on all patients who reported to the ENT casualty, Government Medical College Kozhikode with history or suspicion of foreign body throat from January 2020 to January 2021. A total of 160 patients reported of which 48 (30%) patients required further evaluation with rigid endoscopy and foreign body removal in the operative room. A few challenges like migration of foreign bodies, dilemma in diagnosis with FB mimicking ossified cartilages on X-ray, FB removal in mentally challenged patients and treatment of esophageal perforation post rigid endoscopy are discussed.Results: Only 48 (30%) patients of the total 160 patients required rigid endoscopy and foreign body removal in the operating room. The foreign body was obtained in 42 (87.5%) patients while 6 (12.5%) patients improved post rigid endoscopy though foreign body was not obtained. One patient with denture in the esophagus developed esophageal perforation requiring prolonged hospital stay.Conclusions: A high index of suspicion among patients presenting with dysphagia, neck pain and sudden decrease in food intake is warranted. Early diagnosis with appropriate imaging modalities is essential for confirmation of diagnosis. Dentures are among FBs that necessitate more caution. Esophageal perforation, a rare but life-threatening complication must be diagnosed timely with appropriate surgical intervention.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213902
      Issue No: Vol. 7, No. 10 (2021)
  • A clinical study of traumatic tympanic membrane perforation

    • Authors: Fida Harish A. T., Raghavendra Prasad K. U.
      Pages: 1668 - 1672
      Abstract: Background: Tympanic membrane (TM) which forms the partition between external auditory canal and middle ear may be ruptured by trauma. Traumatic TM perforation is a commonly observed condition. Though, several therapeutic interventions have been described, conservative follow-up until spontaneous complete recovery is the most common choice.Methods: It was a prospective cohort study conducted during a period of 10 months from July 2020 to April 2021, carried out in 30 patients who presented to outpatient department of ENT and casualty of Hassan institute of medical sciences hospital with traumatic TM perforation.  After taking informed consent, detailed history was taken, thorough examination of ear was performed and characteristics of perforation were noted. Pure tone audiometry (PTA) was conducted, data was statistically analysed.Results: Mean age group was 33.1 years and 73.3% were males. Ear pain was the commonest symptom with accidental trauma being the most common cause. 70% of them had left TM perforation and posteroinferior quadrant was mostly involved.Conclusions: Traumatic TM perforation is commonly seen in young adults following accidental trauma and assault. Earache, sudden hearing loss and tinnitus are the common symptoms. Most of the cases heal spontaneously with conservative management.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213903
      Issue No: Vol. 7, No. 10 (2021)
  • Diagnostic value of tonsillectomy in positron emission tomography and
           computerised tomography negative carcinoma of unknown primary

    • Authors: Meenu Induchoodan, Rajeev Kumar Madhavan, Shibu George
      Pages: 1673 - 1678
      Abstract: Carcinoma of unknown primary (CUP) represents a heterogeneous group of malignancy metastasis unique biology of which remains poorly understood. Even after a complete diagnostic workup including positron emission tomography and computerised tomography (PET-CT) scans the primary site of origin may remain unclear. This case series analysed the diagnostic value of bilateral palatine tonsillectomy in evaluating PET-CT negative head and neck squamous cell CUP. From retrospective analysis of cluster of 68 cases with metastatic cervical nodes with no obvious primary referred for ENT evaluation during a period of 20 months, we identified 5 cases where pan endoscopy and radiological evaluation including PET-CT were negative in detecting the primary. All 5 patients underwent bilateral palatine tonsillectomy along with biopsies from base of tongue and nasopharynx as a part of completion of diagnostic work-up. Tonsillar squamous cell carcinoma was revealed by subsequent histopathology examination in 4 out of 5 patients despite negative PET-CT evaluation. Blind biopsies from other sites like nasopharynx and base of tongue were unfruitful. Our experience strongly emphasises the fact that bilateral palatine tonsillectomy has a high yield in detecting primary even in PET negative CUP, though it needs a larger evidence base.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213904
      Issue No: Vol. 7, No. 10 (2021)
  • Rare cases of nasal mass with bleeding: case series

    • Authors: Deepalakshmi Tanthry, Panchami Shridhar Perdoor, Mahesh Santhraya, Devan Poothatta Pannen, Rukma Bhandary, Vishwas Pai
      Pages: 1679 - 1682
      Abstract: A thorough evaluation of nasal masses along with early management of the disease can prevent complications and further deterioration of the disease to a larger extent. Nasal mass occurring in the nose with symptoms of epistaxis is a sign of suspicion of malignancy. Patients can have variable presentations according to the site and extent of the infection. This article comprises of study done on 3 patients who presented to the ear, nose, and throat (ENT) out patient department with nasal mass with bleed. All three of the patients were subjected to clinical examination, diagnostic nasal endoscopy, radiological evaluation, surgical intervention and histopathological assessment. Thorough evaluation helps the operating surgeon to come to a specific diagnosis so that the chances of diagnosing rare cases does not get ruled out and helps the further deterioration of the disease.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213905
      Issue No: Vol. 7, No. 10 (2021)
  • Multidetector computed tomography imaging of squamous cell carcinoma of
           buccal mucosa

    • Authors: Ashwini Sankhe, Neha Rahatekar, Diksha Mankar
      Pages: 1683 - 1688
      Abstract: This study aims at describing the role of multidetector computed tomography (MDCT) and CT imaging findings in evaluation of squamous cell carcinoma of buccal mucosa and its staging. Retrospective study of 40 patients who underwent MDCT and were histopathogically proven case of squamous cell carcinoma (SCC) of buccal mucosa patients were included in the study. Plain, arterial, venous phase and puff cheek CT cuts were taken from base of skull till clavicle. The imaging findings in squamous cell carcinoma (SCC) of the oral cavity allow the radiologist to accurately determine the extent and staging of disease thereby help clinicians plan appropriate treatment. 40 such patients were done in which majority of them are male patients-27 as compared to female patients-13. Among these 40 patients, 20 patients had stage IVB cancer, 13 patients had stage IVA, 5 patients had stage II and 2 patients had stage I cancer. No patient included in our study had stage III.  Patients’ recovery will depend on how early the cancer is found and staging gives an idea of patients’ possible outcomes. MDCT is non-invasive and cost-effective investigation which helps in evaluating squamous cell carcinoma of buccal mucosa and determines its stage of buccal cancer and guide the therapy accordingly.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213906
      Issue No: Vol. 7, No. 10 (2021)
  • Multicranial neuropathy secondary to endolymphatic sac tumor

    • Authors: Tanvir Hussain, Thomas J. Crotty, Eoin F. Cleere, Mel Corbett, Aishan Patil, Marcus Choo
      Pages: 1689 - 1692
      Abstract: Endolymphatic sac tumors (ELST) are rare neuroectodermal neoplasms arising from the epithelium of the endolymphatic sac or duct. Despite their benign histopathological features, ELSTs frequently demonstrate a locally destructive growth pattern with involvement of the skull base and cranial nerves. While ELSTs may arise sporadically, the majority of cases occur in association with Von Hippel-Lindau (VHL) syndrome. ELSTs are commonly diagnosed late due to their slow growing nature and non-specific symptomatology. Surgical resection is the treatment of choice. However, due to the location of these tumors in the lateral skull base surgical intervention carries a high risk of injury to critical neurovascular structures in close proximity. We presented the case of a 51 years old gentleman with a three-months history of hearing loss and otalgia. He subsequently developed multiple cranial neuropathies and was diagnosed with a sporadic ELST. He underwent a complete surgical resection and received adjuvant radiotherapy.  
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213657
      Issue No: Vol. 7, No. 10 (2021)
  • Thyroglossal cyst in elderly: a rare cause of inspiratory stridor

    • Authors: Animesh Agrawal, Nitish Baisakhiya, Harshita Sharma
      Pages: 1693 - 1695
      Abstract: Thyroglossal cyst is the most common congenital anterior neck swelling in childhood. Commonly present as painless swelling in the 2nd decade of life but the cases are reported in the elderly age group also. It represents the persistent epithelial tract from the foramen cecum to the thyroid gland. Clinically can be diagnosed and can be differentiated with other mid-line swelling by movement with the protusion of tongue. It is usually related to the hyoid bone and may be supra-hyoid, infra-hyoid, lower part of the midline or rarely lingual in position. Ultrasonography is the investigation of choice for this cystic condition. It is safe, economical and easily available investigation among all the radiological study. MRI is helpful to diagnose cervical extension and lingual cyst. Inspite of close relation to the laryngeal structure it rarely present as laryngeal mass and causes stridor or sleep apnea as in our case. Classic Sistrunk procedure is the treatment of choice for the condition. Endoscopic CO2 Laser is useful in situation where only intraoral cyst present without cervical extension. Marsupialization is reserved for lingual cyst especially in Neonate. We are reporting this case which was present in the elderly and reported with long standing anterior neck swelling with inspiratory stridor on lying down position.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213907
      Issue No: Vol. 7, No. 10 (2021)
  • Giant unicystic ameloblastoma of maxilla-successful endoscopic management

    • Authors: Sanjeev Mohanty, Manu Vergis, Devipriya V., Haripriya G., Lakshmi Shree Nallapaneni, Pravilika Parachur Nallapaneni
      Pages: 1696 - 1699
      Abstract: This 32-year-old male patient presented with complaints of restricted mouth opening and gross facial asymmetry owing to the massive jaw swelling on the right side. After a thorough examination, a diagnosis of unicystic ameloblastoma of maxilla. Although, the standard of care surgical approach was through Weber-Fergusson incision, a concerted attempt to excise the tumour with the minimally invasive endoscopic route was made successfully. The patient was symptom free now with complete resolution of swelling on a regular follow up post operatively. This case report highlighted the modern day protocol of organ preservation concepts in surgical management of a rare tumour in otolaryngology practice
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213908
      Issue No: Vol. 7, No. 10 (2021)
  • Teratoma of larynx: case report

    • Authors: Rakesh Srivastava, Vini Tandon
      Pages: 1700 - 1703
      Abstract: Teratomas are embryonal neoplasm arises from totipotent germ cells. They are having tissues from all the three blastodermic layers. There are various locations of congenital teratoma. Naso-oropharyngeal site teratoma are either sessile or pedunculated. We describe a rare case of laryngeal teratoma in a five years old patient presented with change in voice and breathing difficulty. On flexible laryngoscopy, it appeared like supraglottic cyst but on CT scan it was confirmed as teratoma. Pre-operative tracheostomy and transoral carbon dioxide laser assisted excision done. Histopathological examination showed osteoid trabeculae, chondroid tissue with loose myxoid islands and adipose tissue. No recurrence of tumor on 18 months follow-up. This is the first case report of pediatric larynx teratoma reported in present century.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213909
      Issue No: Vol. 7, No. 10 (2021)
  • External auditory canal osteoma: a case report

    • Authors: Sneha S., Sowmya Gajapathy, Srikanth G., Ramesh V., Jayita Das Poduval
      Pages: 1704 - 1707
      Abstract: External auditory canal (EAC) osteomas are rare, solitary benign unilateral lesion. Small lesions are incidentally diagnosed and larger lesions produce symptoms of pain, ear discharge and defective hearing. Diagnosis is made based on a combination of clinical history and examination, radiographic imaging, and histopathology. They are usually confused with exostosis which are multiple, bilateral, smooth-bordered, broad-based lesions without deep extension. We present a case of 21-year-old male patient who came to our outpatient department, with complaints of left ear blocking sensation for past 6 months. On evaluation, it was diagnosed as left EAC osteoma and the same was excised via post-auricular approach. This case is being presented for its rarity
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213910
      Issue No: Vol. 7, No. 10 (2021)
  • Current treatment of post-tonsillectomy pain: a review

    • Authors: Santosh Kumar Swain
      Pages: 1708 - 1714
      Abstract: Tonsillectomy is one of the most common surgical procedures performed by an otorhinolaryngologist. This surgery is done more in the pediatric age group. Although tonsillectomy is safe and effective surgery, it is usually associated with significant post-operative pain. Analgesics used for post-tonsillectomy pain is often inadequate. Severe throat pain following tonsillectomy has been documented for decades. Patients or parents/caretakers often worry about such severe pain in the home. The pain following tonsillectomy is usually intense and long-lasting. The severe post-tonsillectomy pain often overstrains the patient, family, and hospital staff. Regular changes in the analgesic armamentarium, particularly in pediatric patients are making the treatment of post-tonsillectomy pain more challenging. Pain following the tonsillectomy period continues to be a highly debated issue and an area of active research. Throat pain in the post-tonsillectomy period can result in significant morbidity among patients. There are different analgesics available; each one has its risk profile and side effects when used for controlling post-tonsillectomy pain. This review article discusses on recent management of post-tonsillectomy pain. This article reviews the epidemiology, pathophysiology, impact of post-tonsillectomy pain, and details of medications used for controlling post-tonsillectomy pain.
      PubDate: 2021-09-27
      DOI: 10.18203/issn.2454-5929.ijohns20213911
      Issue No: Vol. 7, No. 10 (2021)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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