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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 retrospective case study of laryngeal edema causing airway obstruction
           immediately post COVID-19 vaccination

    • Authors: Kribananthan Lohanadan, Ahmad N. A., Avinash C.
      Pages: 1 - 4
      Abstract: Background: Laryngeal edema is defined as abnormal accumulation of fluid and swelling in the tissues of the larynx commonly associated with laryngeal injuries and allergic causes. The objective of this study is for the prompt recognition and management of laryngeal edema caused by an anaphylaxis reaction after receiving the COVID-19 vaccination from Pfizer-BioNTech, which is extremely important in view of its high morbidity and mortality rate.Methods: A retrospective case reviews was conducted for all health care workers in Sabah who were administered COVID-19 vaccination from Pfizer-BioNTech from February 2021-April 2021.Results: The mean age of study population in present study was found to be 33 years. Total of 42 patients were admitted during the period of 6 weeks out of 5000 health care workers who were vaccinated. Females constituted 64.3% of the study population while males constituted 35.7%. The clinical signs of laryngeal edema were dysphagia; the sensation of a lump in the throat; a feeling of tightness in the throat; voice changes, including hoarseness and roughness; and dyspnea within the period of 3 to 5 minutes post Pfizer COVID-19 vaccination. All patients received appropriate management using standard guidelines.Conclusions: The administration of the COVID-19 vaccination from Pfizer-BioNTech is life-threatening, however, its identification may aid in prompt emergency management in the future. Referral to an otorhinolaryngologist is necessary for patients who experience immediate or severe reactions.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214852
      Issue No: Vol. 8, No. 1 (2021)
  • An increase in cases of complicated chronic otitis media: an indirect
           impact of COVID pandemic

    • Authors: Faizah A. L. Deva
      Pages: 5 - 10
      Abstract: Background: Chronic otitis media is the most common disease dealt by an otologist, the cases of complication of which are remarkably low. The use of antibiotics and mastoidectomies have resulted in the fall of the fatal complications. COVID-19 pandemic called for restrictions which lead to medical care delay.Methods: This study was conducted in the department of otolaryngology of GMC and associated hospitals, Jammu from June 2020 and May 2021. The data was retrospectively collected the data from March 2018 to June 2020. The study group included the patients diagnosed with Chronic suppurative otitis media (CSOM) on otoscopy and the patients with complications of CSOM were evaluated for the symptoms of complication, type of complication, bacteriology, treatment and hospital stay.Results: The 38 (7.5%) patients among these were diagnosed with one or other complication, out of which 29 (76.3%) cases occurred during the COVID pandemic. The extra-cranial complications were more common and young to middle age group was more commonly involved.Conclusions: COM is a common otological disease, the occurrence of which should not be taken lightly. Without timely and accurate treatment, the complications ensue which are difficult to treat and require expertise.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214894
      Issue No: Vol. 8, No. 1 (2021)
  • Antibiotic sensitivity and bacteriology of chronic suppurative otitis
           media in department of ENT in tertiary care centre St. John’s Medical
           College and Hospital Bangalore

    • Authors: P. Chaitanya, Rahul Magar
      Pages: 11 - 13
      Abstract: Background: Chronic suppurative otitis media (CSOM) is a disease of middle ear. The aim of this study is to know the antibiotic sensitivity pattern in CSOM cases attending to ENT out patient department (OPD) in a tertiary care hospital and device an appropriate antibiotic protocol to treat CSOM cases.Methods: This is a prospective observational study. Fifty-eight patients of CSOM who present to the ENT OPD with ear discharge will be studied. Ear swabs of these patients will be collected and sent to microbiology to know the causative bacteria and their drug susceptibility.Results: Of the 58 patients studied 64% were males and 36% were females. Of the organisms isolated Stap aureus (53%) was most common followed by Pseudomonas (36%). All the gram-positive organisms were sensitive to cotimaxozole, amikacin and gentamycin and all gram-negative organisms were sensitive to ciprofloxacin, amikacin and netlimycin. Conclusions: It is better to collect an ear swab in all CSOM cases and then start antibiotics based upon the culture and sensitivity reports in order to improve the results and reduce the emergence of resistant strains, which can happen when antibiotics are prescribed randomly.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214869
      Issue No: Vol. 8, No. 1 (2021)
  • Endoscopic optic nerve decompression in traumatic optic neuropathy: our
           experience in a tertiary care centre

    • Authors: Bincy Joseph, Sapna S. Nambiar, K. Ramachandran, Suma Radhakrishnan
      Pages: 14 - 20
      Abstract: Background: Traumatic optic neuropathy (TON) a vision threatening disorder requires early diagnosis and prompt treatment. High dose steroid injections, optic nerve decompression or combined therapy are the available current treatment options. This study aims to determine the visual outcome with transnasal endoscopic optic nerve decompression in patients with TON having no improvement in vision despite high dose steroids.Methods: A prospective study was conducted at the department of ENT, government medical college Kozhikode; on patients who presented with loss of vision following history of trauma. All patients suspected of compressive optic neuropathy received injection methyl prednisolone (30 mg/kg/day) with assessment of vision and HRCT scan. Patients with deterioration or no improvement in vision despite high steroid therapy were taken up for trans-nasal endoscopic optic nerve decompression.Results: In our study 19 patients with TON underwent trans-nasal endoscopic optic nerve decompression. 11(57.9%) patients had improvement of vision, 7 (36.8%) patients had no improvement of vision and 1 (5.3%) patient had worsening of vision. The visual improvement was seen in 8 (80%) patients when treatment was initiated within 7 days and in only 3(33.3%) patients when treatment was initiated after 7 days. The visual acuity at presentation and time interval between trauma and intervention are factors that determine better visual outcomes.Conclusions: The decreased visual acuity in TON requires prompt treatment. High dose steroid must be started at once when it is suspected or diagnosed. The timely surgical intervention with trans-nasal endoscopic optic nerve decompression is a relatively safe and effective technique enabling better visual prognosis.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214841
      Issue No: Vol. 8, No. 1 (2021)
  • A comparative study of endoscopic assisted versus conventional middle ear
           and mastoid surgery at a tertiary care teaching hospital

    • Authors: Jitendra Kumar Sharma, Sushma Mahich, Navneet Mathur
      Pages: 21 - 25
      Abstract: Background: Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.Methods: This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.Results: Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.Conclusions: The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214823
      Issue No: Vol. 8, No. 1 (2021)
  • Application of otoacoustic emissions and brainstem evoked response
           audiometry in newborn hearing screening

    • Authors: Gangadhara K. S., Amrutha V. Bhat, Sridhara S.
      Pages: 26 - 30
      Abstract: Background: Newborn hearing screening was conducted in a tertiary care hospital in a step by step manner using otoacoustic emissions (OAE) and brainstem evoked response audiometry (BERA) and details were recorded.Methods: A prospective institutional based study was conducted. All the newborns born in the hospital over a period of 18 months from December 2018 to May 2020 were considered in the study. Healthy newborns were screened bedside within 24 hours of delivery and NICU (Neonatal Intensive Care Unit) babies were screened in the NICU. Handheld OAE apparatus was used as the initial screening tool. A total of 3 OAEs were done for babies with a “refer” result in the OAEs, which were done 1 month apart. Babies with a “refer” in the third OAE were subjected for BERA.Results: A total of 14226 babies were screened at 24-48 hours of birth. Among them, 13,069 babies passed the first OAE screening in both ears. Remaining babies were referred for further follow-up. After subsequent follow-ups and successive testing, 11 babies were found to have hearing loss, which was diagnosed within 4-5 months of the child’s birth.Conclusions: Universal newborn hearing screening is the need of the day. OAE is an effective screening tool for newborn hearing loss. When complemented by BERA, majority of congenitally deaf babies can be diagnosed at a very early age. This helps in early intervention.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214895
      Issue No: Vol. 8, No. 1 (2021)
  • Association of sensorineural hearing loss in type 2 diabetes mellitus
           patients: an analytical cross sectional study

    • Authors: Jeevan Jyoti, Ihsan Ali, Syed Waseem Abbas
      Pages: 31 - 35
      Abstract: Background: The association of sensorineural hearing loss in diabetes mellitus patients is known since decades, yet there is no clear consensus among previous studies, with respect to the prevalence of SNHL in type 2 diabetes patients and the effect of duration and control of diabetes on hearing acuity. Hence the objectives of this study are to find the prevalence of SNHL in type 2 diabetes patients and to find the effect of duration and control of diabetes on hearing loss.Methods: The present study was conducted on 100 type 2 diabetes patients and age and gender matched 100 non- diabetic controls in the age group of <50 years, selected based on inclusion and exclusion criteria. After detailed history taking and clinical examination, all subjects underwent FBS, PPBS estimation and HbA1c evaluation was done for diabetic patients. All underwent pure tone audiometry, DPOAE and BERA and the findings were recorded and analyzed.Results: Diabetes patients had insidious onset, gradually progressive, bilaterally symmetrical SNHL. SNHL is prevalent in 73% of type 2 diabetes patients compared to 16% of controls. It is aggravated with the increasing age and duration of diabetes. Poor control of diabetes showed increased prevalence of SNHL compared to good control of diabetes.Conclusions: There is increased prevalence of SNHL in type 2 diabetes patients and it is more evident in patients with long duration of diabetes and more pronounced in patients with poor diabetic control.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214896
      Issue No: Vol. 8, No. 1 (2021)
  • Mycobacterial profile and antibiotic susceptibility pattern in chronic
           suppurative otitis media: a cross- sectional study

    • Authors: Basavaraj Hiremath, Subramanya B. T.
      Pages: 36 - 41
      Abstract: Background: Chronic suppurative otitis media (CSOM) is a disease of mucoperiosteal lining of the middle ear cleft. The poor compliance of patients to antibiotic treatment, Incomplete treatment, misuse/improper choice of antibiotics have resulted in changes in susceptibility to antibiotics and also development of resistant strains by microbes to commonly used antibiotics. This study aimed to identify the mycobacteriological profile and determine antibiotic susceptibility pattern in CSOM patients.Methods: This cross sectional study was conducted on 120 clinically diagnosed cases of CSOM attending otolaryngology department. Ear discharges obtained were processed for microbial culture (aerobic, anaerobic and fungi). Antimicrobial susceptibility testing was done by Kirby–Bauer disc diffusion method.  Results: Of total 120 cases, pathogens were isolated from 114 cases. The commonest aerobic organism isolated was Pseudomonas aeruginosa (34.5%) followed by Staphylococcus aureus (29.4%). Staphylococcus aureus showed maximum sensitivity to erythromycin (70%), followed by cotrimoxazole (62.5%) and ampicillin (55%). Maximum resistance was observed for ciprofloxacin (77.5%), followed by amoxiclave (55%). Pseudomonas aeruginosa showed maximum sensitivity to piperacillin (89.36%) followed by gentamicin (70.2%), amikacin (70.2%), moderate sensitivity to ceftazidime (51.06%); however resistance to carbpenicillin (60%). Ciprofloxacin which is the most prescribed topical antibiotic showing an increase in resistance to causative organisms of CSOM.Conclusions: Hence, it becomes essential to study each case of CSOM bacteriologically to formulate local antibiotic policy for appropriate use of antibiotics. This will certainly help in achieving a safe ear and to control the organisms developing resistance to prevalent antibiotics.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214897
      Issue No: Vol. 8, No. 1 (2021)
  • Central nervous system manifestations of mucormycosis

    • Authors: Ishita A. Shah, Niral R. Modi
      Pages: 42 - 46
      Abstract: Background: There has been an unprecedented increase in the number of mucormycosis cases post the second wave of COVID-19 in India, with a variety of clinical manifestations. The central nervous system manifestations have proven to be especially fatal, hence these require special attention. Aims and objectives of current investigation was to study the epidemiology, clinical features, risk factors, diagnostic modalities, management and complications of CNS manifestations of mucormycosis.Methods: This is a retrospective study, conducted on the mucormycosis patients admitted in G.G. hospital Jamnagar. Patients with clinically and radiologically evident central nervous system involvement were included in the study. The records of the patients were followed for 3 months post the diagnosis. 47 patients were included in the study.Results: The mean age of the patients was 51 years. 72.34% of patients were males, and 27.65%, were females. The most common clinical feature was headache 100% followed by fever 55%. Most of the patients (97.87%) had history of COVID 19 or had active infection. 63.96% had diabetes Mellitus. The most common radiological finding was cavernous sinus thrombosis (32.60%), 72.34% underwent surgical debridement, and all the patients were administered Amphotericin B. The outcome improved significantly with surgical debridement, with recovery seen in 51.06% patients.Conclusions: There has been a steep rise in the cases of mucormycosis following the COVID-19 pandemic. It is an extremely virulent infection which spreads rapidly, often causing the involvement of the central nervous system. However, early diagnosis and intervention have been found to alter the prognosis significantly.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214898
      Issue No: Vol. 8, No. 1 (2021)
  • The role of magnesium supplement in laryngopharyngeal reflux disease

    • Authors: Adhira Gobind
      Pages: 47 - 52
      Abstract: Background: Laryngopharyngeal reflux disease (LPRD) is one of the most prevalent upper gastrointestinal disorder encountered in clinical practice and its optimal treatment is not standardized. The role of magnesium in the human body functions is often underestimated. Since magnesium (Mg) plays a major role in the regulation of smooth muscle contractionby relaxing the pyloric sphincter and enhancing gastric emptying, thereby decreasing the pressure on the LES, it was hypothesized that adding magnesium supplements along with the regular treatment for LPRD, can improve LPRD symptoms. Magnesium has a neutralizing action on the gastric acid and therefore, it may be pertinent to achieve optimal Mg intakes in patients with LPRD.Methods: This is a prospective study done over a period of 1 year conducted in a tertiary care hospital in central India in patients presenting with LPRD of the age group 18-65 years.  Results: The study patients were divided into two groups-one treated with esmoprazole 40 mg capsules and alginate syrup and the other with esmoprazole capsules, alginate syrup and magnesium glycinate (250 mg) supplement. Both the groups showed appreciable improvement in their mean reflux symptom index (RSI) and reflux finding score (RFS) at 1 month and 3 months follow-up. Females showed a higher preponderance than males in the disease, symptoms and the mean RSI and RFS score.Conclusions: Addition of magnesium supplements along with the regular treatment for LPRD, can improve LPRD symptoms and should be considered in the treatment protocol of LPRD.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214899
      Issue No: Vol. 8, No. 1 (2021)
  • Comparative study of fine needle aspiration cytology and histopathology of
           thyroid swellings in tertiary health centre

    • Authors: Gangadhara K. S., Chaitanya Vadva, Sridhara S.
      Pages: 53 - 56
      Abstract: Background: Thyroid swelling being the most common presentation in ENT clinical practice, a prospective study was done to assess the role of Fine needle aspiration cytology in diagnosing the nature of thyroid swellings and comparing its results with histopathological examination findings.Methods: This is a prospective institutional based study comparing cytology and corresponding histopathology findings reported in 60 cases of thyroid swelling. The statistical analysis included sensitivity, specificity, positive predictive value, negative predictive value and accuracy in thyroid swelling.Results: Out of 60 cases, FNAC showed 93.3% and 6.6% of benign and malignant cases respectively whereas HPE showed 86.7% and 13.3% of benign and malignant cases respectively. On FNAC-HPE correlation using HPE as standard reference the diagnostic accuracy of present study is 91.66%.Conclusions: It was observed that FNAC is a reliable tool, safe and accurate method in evaluating thyroid swelling thus having great influences in treatment decision. Thus FNAC is the investigation of choice in thyroid swellings with excellent patient compliance, simple, safe and cost effective.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214900
      Issue No: Vol. 8, No. 1 (2021)
  • Clinicopathological study of non-malignant lesions of larynx: a
           prospective observational study

    • Authors: Shivaram Gautaam N., Gopakumar K. P., Suresh Kumar M., Ragitha Binu Krishnan
      Pages: 57 - 63
      Abstract: Background: Non-malignant lesions of the larynx constitute an interesting array of lesions. The significance of non-malignant lesions lies in the fact that it cannot only cause change in voice but, at times, can lead to breathing difficulty or life-threatening stridor.Methods: This was a prospective observational study done between November 2019 - July 2020. All the details were filled up by the principal investigator in a structured study proforma. This proforma contains data regarding essential demographic details, clinical features, ENT examination, flexible video laryngoscopy findings, stroboscopy findings, voice handicap index, diagnosis and management. Statistical method and data analysis in this study we tried to describe the analysis process with appropriate methods and principles of statistics, using the data collected from the patients, participated in this study.  Results: The most common non-malignant lesion among the 50 patients studied was vocal cord polyp; second most common being the vocal cord cyst. The relation of hoarseness of voice, difficulty in breathing, smoking or alcohol intake with non-malignant lesions showed a statistically significant result. On interpreting the stroboscopic findings of various lesions, all cases of vocal nodule showed an hourglass-shaped glottic closure.Conclusions: These lesions can create a lot of mental and emotional tension in the patient and the family. Early diagnosis of the lesions can lead to effective management and functional recovery. Stroboscopy is valued for its excellent ability to examine the structure and the function of the glottis during phonation.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214901
      Issue No: Vol. 8, No. 1 (2021)
  • Open surgical approach to management of rhino-orbito-cerebral mucormycosis

    • Authors: Sunil K. C., Praveen Kumar B. Y., Ramesh Bhoomannavar, Rishabh Jain
      Pages: 64 - 68
      Abstract: Background: Since December 2019, when novel corona virus (COVID 19) was reported, it has spread widely to cause a pandemic. Rhino-orbito-cerebral Mucormycosis (ROCM), an opportunistic fungal infection caused by the order Mucorales and class Zygomycetes has led to an epidemic in our country.Methods: This prospective cross sectional study was conducted at a 1200 bed tertiary care teaching hospital in Mysore. All patients of ROCM who presented to us for treatment were selected for the study after informed consent. Only those patients who were operated via open approach were included.Results: Median age of the patients was 50 years (SD±10). 49 were male patients (67.1%). Diabetes mellitus was the most common underlying co-morbidity seen in 71 patients (97.3%). Facial pain (100%) and facial swelling (90.4%) were the most common presenting complaint. KOH positivity from nasal swab for Mucormycosis was positive in only 37 patients (50.7%). Traditional inaccessible areas to endoscope like the premaxilla, lateral orbit cavity, infra temporal fossa and hard palate were tackled by the open surgical approach route. Advantages of open surgical approach being the access to areas which are traditionally difficult to approach via the endoscope, aggressive debridement is possible which might be challenging endoscopically. Complications like wound dehiscence, oro-antral fistula, osteomyelitis and abscess were noted in our study.Conclusions: Open surgical approach offers a very viable, affordable and a very effective means for aggressive surgical debridement of infection and reduce mortality associated with ROCM. 
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214902
      Issue No: Vol. 8, No. 1 (2021)
  • A study to evaluate bone and cartilage ossiculoplasty in patients of
           ossicular disruption due to chronic suppurative otitis media

    • Authors: Hema Mehra, Sushma Mahich, Navneet Mathur, Mahima Singh
      Pages: 69 - 73
      Abstract: Background: Ossiculoplasty for ossicualar disruption in patients of chronic otitis media (COM) can be done by using either bone or cartilage. The present study was planned to compare bone and cartilage ossiculoplasty in patients of ossicular disruption due to COM.Methods: The prospective observational study was carried out in patients, who were admitted in the department of otorhinolaryngology of a tertiary care teaching hospital of Rajasthan during two years from November 2017 to November 2019. All patients with ossicular disruption due to COM and conductive hearing loss more than 40db were included in the study. Patients with sensorineural hearing loss were excluded from the study. Pure tone audiometry (PTA) was done before surgery. Hearing improvement was assessed 3, 6 and 12 months after surgery.  Results: In the present study 20 patients underwent bone ossiculoplasty using autologous incus and autologous cartilage was used in 80 patients for ossiculoplasty. Post-operative hearing gain was significantly more in autologous incus patients (22.7±4.2 db) compared to autologous cartilage (19.5±3.4 db) (p=0.002).Conclusions: The present study concluded that post-operative hearing gain was significantly better with autologous incus compared to autologous cartilage although both showed good results in terms of hearing gain. 
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214903
      Issue No: Vol. 8, No. 1 (2021)
  • Does gestational diabetes mellitus affect the hearing of the baby'

    • Authors: Gangadhara K. S., Amrutha V. Bhat, Nagaraj M.
      Pages: 74 - 76
      Abstract: Background: Hearing screening results of babies born to mothers with and without gestational diabetes mellitus done within 24-48 hours of delivery using otoacoustic emissions was compared. Babies who failed the screening were recalled for further testing.Methods: A prospective institutional based study was conducted between December 2018 and May 2020. All the babies were screened for hearing impairment using handheld OAE apparatus within 24-48 hours of delivery. History of gestational diabetes mellitus in the mother was enquired. Any baby with a “refer” result in the OAE study was recalled for a repeat OAE testing after a month. This was repeated two more times if the baby failed the test every time. In case of failing the test for the third time, the baby was sent for brainstem evoked response audiometry for confirmation of hearing loss.Results: Screening was done for 14226 babies. Among them, 44 babies were born to mothers with gestational diabetes mellitus. The hearing screening results did not show a significant association between gestational diabetes mellitus and hearing impairment in the baby.Conclusions: Gestational diabetes is considered as one of the risk factors for deafness in the baby. This study could not establish such a relationship.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214904
      Issue No: Vol. 8, No. 1 (2021)
  • Primary laryngeal lymphoma: a diagnostic challenge

    • Authors: Catarina Lombo, Carlos Matos, Rui Fonseca
      Pages: 77 - 80
      Abstract: Lymphomas of head and neck constitute 5-15% of malignancies in this region. However, its primary occurrence at the larynx is exceedingly rare due to the paucity of lymphoid tissue. Here, we reported a case of a 41 year old male who presented with a 1 month history of hoarseness and odynophagia. The examination revealed right vocal cord palsy and an ipsilateral subglottic exudate, that was misdiagnosed as infectious disease. The lesion quickly progressed to airway obstruction, requiring a tracheotomy. Multiple biopsies under general anesthesia were needed before reaching the final diagnosis of diffuse large B-cell lymphoma, Epstein-Barr positive. Selected treatment modality included 3 cycles of chemotherapy followed by radiotherapy in moderate dose with complete remission after 2 years of follow up. The tracheotomy was removed, however, the patient did not recover vocal quality. This case highlighted the heterogeneous presentation of extra-nodal head and neck lymphomas and emphasized the need for suspicion of neoplasm when an infection doesn’t respond to maximal medical therapy.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214853
      Issue No: Vol. 8, No. 1 (2021)
  • Giant cell tumor of the tenosynovial type in the prevertebral space with a
           cervical approach

    • Authors: Daniel A. Rappoport, Lucas Fuenzalida, Patricio I. Sepulveda, Patricio J. Gac
      Pages: 81 - 84
      Abstract: The complex anatomy of the neck makes surgical interventions of cervical neoplasms a very complex process. The aforementioned challenges the surgeon to find a surgical approach with the least morbidity and cosmetic sequelae. This is particularly true in tumoral occupation of the prevertebral space (PVS), most frequently due to the extension of neoplasms from naso and oropharynx; whereas primary tumors of the PVS are extremely rare. There are a number of surgical approaches to access the skull base and the anterior region of the upper cervical spine, such as the transcervical-transtemporal approach, retraction and dissection of the soft palate, mandibular osteotomy, medial glossotomy, among others. The following article presents a case report in which a less invasive combined transcervical-transoral approach was performed on a tenosynovial giant cell tumor of the PVS. As an alternative in the treatment of these type of lesions, it is in our opinion equally effective and less morbid.
      PubDate: 2021-12-23
      DOI: 10.18203/issn.2454-5929.ijohns20214905
      Issue No: Vol. 8, No. 1 (2021)
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