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International Journal of Otorhinolaryngology and Head and Neck Surgery
Number of Followers: 1  Open Access journalISSN (Print) 2454-5929 - ISSN (Online) 2454-5937 Published by Medip Academy  [12 journals]
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- Volumetric analysis of pharyngeal airway dimensions and hyoid bone
position following orthognathic surgery in skeletal class III patients: a
cross sectional cephalometric study
Authors: Amrit Thapa, I. D. Roy, B. Jayan, Saugat Ray, Andrews Navin Kumar, Amit Antil
Pages: 921 - 927
Abstract: Background: Objective of the study was to determine linear and volumetric changes in pharyngeal airway dimensions in class III patients treated by different modalities of orthognathic surgery and to compare the results of different orthognathic surgical modalities, and determine the change at the position of the hyoid bone. Methods: Pre and post-treatment lateral cephalogram of 53 class III adult patients who were treated by different modalities of orthognathic surgery studied to assess the changes in pharyngeal airway dimensions and hyoid bone position after orthognathic surgery. 28 patients were treated with mandibular set back, and 25 patients were treated with Bijaw surgery. Lateral cephalogram records were taken before treatment (T1), after surgery (T2), the end of the fixed treatment (T3) and 1 year after debonding (T4). Results: Interception of both surgical modalities has significant impact on various skeletal and pharyngeal parameters i.e., BMeH (0.00), PNS (0.009), MPS (0.13), GOP (0.001), IPS (0.007), SAS (0.006), and MAS (0.00). OJ (overjet) and OB (overbite) was significant especially after time interval of one year. In Bijaw groups, PPST4 parameter was significantly increased (0.0000), SPST4 (0.000), GOP (0.000), EPS (0.000) and IPS parameter was significantly decreased (0.045). Significant difference was observed in T4 time interval in superior pharyngeal airway space, posterior airway space and middle airway space with (p<0.05). Conclusions: Pharyngeal airway is significantly altered following orthognathic surgery in class III patients and it depends on the type of surgical modality employed were Bijaw surgery has significant impact on oropharyngeal and hypopharyngeal airway space.
PubDate: 2023-11-10
DOI: 10.18203/issn.2454-5929.ijohns20233536
Issue No: Vol. 9, No. 12 (2023)
- Comparative study of anatomical and functional results of butterfly
myringoplasty versus temporalis fascia underlay myringoplasty
Authors: Shaalini S., Jyothi Anand Chavadaki
Pages: 928 - 933
Abstract: Background: Myringoplasty is traditionally been done by using temporalis fascia graft material. But in recent years understanding of physiology and pathology of middle ear cleft is drastically improved with technical advancement in surgical methods. Various grafts have been tried for myringoplasty time to time with varying results. Methods: A case control study was conducted; where 52 patients underwent myringoplasty with butterfly graft and second group of 52 patients underwent myringoplasty with temporalis fascia graft under general anesthesia in major OT. All the patients were followed up for 3 months. The results of the procedure were assessed, with respect to closure of tympanic membrane perforations and improvement in the air bone gap post operatively. Results: Butterfly group had statistically significant number of healed patients and hearing improvement compared to temporalis fascia group at the end of one month and with no statistical significance at the end of three months. The age group less than 18 years showed better uptake with butterfly graft. The difference of mean pre-operative, 1 month and 3 months post-operative air bone gaps in butterfly graft were 35.57±2.87 dB, 27.86±2.53 dB, 24.65±2.66dB and in temporalis fascia were 35.97±2.6dB, 29.36±1.54dB, 25.12±1.73 dB respectively. Conclusions: Butterfly group had statistically significant hearing improvement in patients compared to temporalis fascia group at one month and with no statistical significance at three months post procedure. The age group less than 18 years showed better uptake with butterfly graft.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233577
Issue No: Vol. 9, No. 12 (2023)
- Study of the empirical role of proton pump inhibitor therapy on
laryngopharyngeal reflux
Authors: Nitin Chhabra, Ankita Aggarwal, Sanjeev Bhagat, Khushboo Goel
Pages: 934 - 938
Abstract: Background: Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist’s office. Study to evaluate the presentation of different signs and symptoms of LPR along with evaluating the role of empiric PPI (proton pump inhibitor) in the management of LPR by observing its effect on RFS and RSI. Methods: A prospective observational study was conducted on 100 cases having different symptoms of LPR. Reflux symptom index (RSI) and Reflux finding score (RFS) were used to diagnose LPR. Patients were put on PPI (Pantoprazole 40 mg OD for 12 weeks) and followed up at 4,8 and 12 weeks and successive RSI and RFS scores were evaluated. The results were compiled and analyzed statistically. Results: Among all symptoms, most common presenting symptom of LPR was foreign body/sensation of something sticking in throat (80%). Upon pharmacological therapy with PPIs (Pantoprazole), the mean RSI score changed from 22.94±5.83 to 11.19±2.97 at 12 weeks of PPI therapy. The mean RFS score changed from 12.93±3.55 to 6.86±2.86 at 12 weeks of PPI therapy. The change in the RFS and RSI score was highly significant (p=0.001). Conclusions: LPR is a common condition presenting in ENT settings, the symptoms and signs of which may be complex. RFS and RSI score are valuable tools for diagnosing LPR. PPIs are proven to be effective therapy for LPR, more studies are encouraged to affirm the efficacy of PPIs over other management options.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233578
Issue No: Vol. 9, No. 12 (2023)
- Surgical outcome of type I tympanoplasty in different types of mucosal
chronic otitis media: a prospective study
Authors: Vivek V. Harkare, Shiwani S. Pidurakar, Sonali P. Khadakkar, Nitin V. Deosthale, Priti R. Dhoke, Kanchan S. Dhote
Pages: 939 - 945
Abstract: Background: Chronic otitis media (COM) is a long-standing infection of middle ear cleft, causes severe destruction and leading to irreversible sequelae. The interval to convert discharging ear into dry is variable. Extensive counselling is required to keep these patients motivated for prolonged treatment duration. Hence, the study was conducted. Methods: A prospective study was carried out at NKP Salve and Lata Mangeshkar Hospital Nagpur, Maharashtra, between the age group of 16-60 years, who underwent type 1 tympanoplasty. Results were statistically analysed with respect to graft uptake, hearing improvement and size of perforation over a period of 2 years. Temporalis fascia was taken as a graft material. Results: Out of 70 cases, 38 cases had inactive ears and 32 cases had minimal, mucoid ear discharge (Active ear), which bacteriologically showed no organism. M:F ratio was 1.12:1. Graft uptake was successful in 92.11% of the cases in inactive group and 93.75% of the cases in active group. Graft uptake was 100% in small and moderate perforation. Hearing improvement was achieved in 71.05% of cases in the inactive group and 78.12% of cases in the active group, as measured by closure of the air-bone gap (ABG) and improvement in conductive hearing (significant >10 dB). We found no difference in the success rates. Conclusions: Presence of minimal discharge will not affect the surgical outcome of type 1 tympanoplasty in terms of graft uptake, hearing improvement and size of perforation.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233579
Issue No: Vol. 9, No. 12 (2023)
- Effects of radiotherapy for tumors of the larynx and hypopharynx in
hearing levels
Authors: Cristina Aguiar, Ana F. Carvalho, Ana R. Nobre, Francisco Branquinho
Pages: 946 - 950
Abstract: The head and neck oncological patients are susceptible, either because of tumor location or the treatments performed, to changes of their ear structures. Due to close proximity of radiation field to the ear, radiotherapy induces short and long-term toxicities to the external, middle and internal ear. The aim of this study was to evaluate the impact of radiotherapy on the inner ear. We conducted a cross-sectional retrospective study of patients with cancer of the larynx and hypopharynx undergoing radiotherapy alone or adjuvant to surgery. The follow-up period was 1 year. Relevant clinical and audiological variables were analyzed. We included 15 patients, mostly males, with a median age of 66 years. Average hearing threshold (AHT) deterioration was found in 13 ears, with a median of 8.1dB. Mean bone conduction threshold at 4000 Hz, air conduction threshold at 8000 Hz at 12 months and the median of the final air conduction threshold at 10,000 Hz was significantly higher than the pre-treatment. A correlation was observed between final AHT and dosage of radiation per fraction. Thus, for each increase of 1 Gy per fraction there was an increase of 22.13 dB in the final AHT. About half of the patients had deterioration of the final AHT, proving, on the one hand, the sensorineural hearing loss associated with radiotherapy, while emphasizing the need to perform long-term follow-up protocols for early auditory rehabilitation of these patients.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233580
Issue No: Vol. 9, No. 12 (2023)
- Unusual presentations of branchial cyst
Authors: Priti S. Hajare, Vinita V. Metgudmath, Izhak Mehadi, Neema K., Elsa Babu, Dhanush Nayak
Pages: 951 - 955
Abstract: Branchial cyst is a developmental cyst commonly presenting as a solitary, painless neck mass, typically located over lateral aspect of the neck. Most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck, it is very rare for a branchial cyst to manifest in other locations. Branchial cysts are believed to be derived from the branchial apparatus, mostly from the second branchial arch, although many theories have been proposed to explain the aetiology of branchial cysts. Congenital branchial cysts of the nasopharynx originate from the lateral nasopharynx with an inferior and medial extension. This rare and unusual occurrence of the cyst is characterised by its avid mucus secretion and unilateral presentation. Here we present four different presentations of branchial cyst - as a midline swelling, an unusually large presentation, nasopharyngeal presentation. Histopathology report showed cyst lined by stratified squamous epithelium and pseudo stratified ciliated columnar epithelium at places along with subepithelial lymphocytes suggesting branchial cyst. Hence, Branchial cyst should also be taken as one of the differential diagnoses in cystic lesions of the neck and lateral cystic lesions of nasopharynx.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233581
Issue No: Vol. 9, No. 12 (2023)
- Unusual neck masses encountered in remote areas of Sikkim
Authors: Santosh Kesari, Priyanko Chakraborty, Aseem Anand, Subhasish Mukherjee
Pages: 956 - 960
Abstract: Neck masses are one of the most common presentations in the ENT practice and they are a challenge in the diagnosis and management. The masses may be of congenital, inflammatory, or neoplastic origin. An accurate clinical assessment conducted while taking into account pertinent anatomical and developmental viewpoints, accompanied by well-planned investigative parameters, may aid in making an early diagnosis. Our is a series of three cases where in which we have described the finding of all the three cases in detail, first case is of 70 years female with right sided neck swelling which ultimately turned out to be right venous aneurysm. Second being a case of a young kid misdiagnosed as other infections and treated for long time, which ultimately responded with ATT. Lastly, a young kid presenting with multinodular goitre. We need to be ready for surprise and be ready to deal with unusual cases with different management options.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233582
Issue No: Vol. 9, No. 12 (2023)
- Amelanotic mucosal melanoma of the left sinonasal cavity: a case report
Authors: Yonanda Adi Pratama, I Komang Praba, Camelia Herdini, Sagung Rai Indrasari, Danu Yudistira, Yosephine Nina
Pages: 961 - 963
Abstract: Mucosal melanoma is rare type of melanoma accounted only 0.8-3.7% of melanoma. It defined as melanoma which occurs in mucous membrane, oral and nasal cavities, conjunctiva, genital sites, and rarely other mucosae. Head and neck melanoma accounted 50% among other sites. Recent studies, amelanotic subtype account 13.2% of all sino-nasal melanoma. Nasal cavity melanoma usually occurs on lateral nasal area especially in middle turbinate and inferior turbinate. Among other location, sino-nasal originated primary lesion was more deadly compared to other. We reported a case of amelanotic melanoma. 56 years old Asian Female presented with mass in left nose. The patient also complaint of recurring epistaxis, facial pain, epiphora, and blurred vision. After several follow up investigation, a diagnosis of amelanotic melanoma with orbit involvement was made. Subsequently patient underwent surgery for tumor removal. Although tumor has been removed, patient had to continue with adjuvant therapy for following month. Meticulous identifying and confirmation is an important factor which provide better understanding for the clinician in diagnosing.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233583
Issue No: Vol. 9, No. 12 (2023)
- An unusual case report of thyroid hemiagenesis with multinodular colloid
goitre
Authors: Shaalini S., Ravikeerti G.
Pages: 964 - 966
Abstract: Thyroid hemiagenesis is one of the rarest congenital anomaly of thyroid gland and found a total of 256 cases reported with female predominance. The left lobe is more commonly seen with thyroid hemi agenesis than the right lobe, with a ratio of 3.6: 1. We hereby reported a case of 50 years old female with the agenesis of the right lobe and isthmus of thyroid gland. Thyroid hemiagenesis can be associated with hyper or hypothyroidism. In our case patient had normal thyroid function tests. On ultrasonography of neck, a large heterogeneous lesion measuring 8.0×4.0×8.0 cm noted in the anterior aspect of neck, predominantly on the right side and seen crossing midline to the left. In our case we detected thyroid hemiagensis incidentally with the help of ultrasonography and confirmed it intra-operatively. Ultrasonography is the most cost-effective means of diagnosing thyroid hemiagenesis.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233584
Issue No: Vol. 9, No. 12 (2023)
- An alarming case of metallic sharp foreign body ingestion in an infant
Authors: Sonali Malhotra
Pages: 967 - 969
Abstract: Foreign body ingestion is a frequent challenge in the emergency room, with potential morbidity affecting around 1% of patients, often stemming from unintentional incidents. Accidents of this nature can result in severe complications leading to fatalities. Common complications involve lacerations, punctures, abscess formation, perforation, pneumomediastinum, mediastinitis, pneumothorax, pericarditis, tamponade, fistulas, and even vascular injuries to the aorta. The risk escalates significantly when the ingested object is sharp and narrow. Presenting an intriguing case, we report an instance of an infant ingesting a metallic, sharp foreign body. This particular case raises unique challenges given the vulnerability of the infant and the potential for severe complications associated with sharp objects. Immediate and precise medical intervention becomes paramount in such scenarios to prevent adverse outcomes. Vigilance in the emergency room is crucial, as the nature of foreign body ingestion can lead to diverse complications, emphasizing the need for a comprehensive understanding and swift response in managing these cases, particularly when involving infants who are at a heightened risk.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233585
Issue No: Vol. 9, No. 12 (2023)
- Cytomegalovirus esophagitis associated with arytenoid cyst in an
immunocompetent host
Authors: Shibani V. Anchan, Anjali Khialani, Athira Raj
Pages: 970 - 972
Abstract: CMV esophagitis is usually encountered in immunocompromised individuals and esophagus is rarely affected in immunocompetent individuals. CMV esophagitis associated with arytenoid cyst has not yet been reported in literature to the best of my knowledge and can be considered in case of recurrence of cyst following excision. The objective of this study is to report the unique presentation of CMV in an immunocompetent patient. A middle-aged immunocompetent lady presenting with dysphagia was diagnosed to have arytenoid cyst. Biopsy from upper esophagus revealed cytomegalovirus inclusion bodies and immunological test were performed to confirm the pathology. The cyst excision lead to recurrence. It was excised again followed by a course of intravenous ganciclovir. Currently, the role of antiviral in treatment of CMV esophagitis in immunocompetent individual is not well established. We have obtained good result in this patient with a course of Ganciclovir following excision of the cyst. The rarity of cytomegaloviral upper esophageal involvement, its association with arytenoid cyst and the utility of antivirus in treatment of an immunocompetent host makes this case report unique and interesting.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233586
Issue No: Vol. 9, No. 12 (2023)
- Low-grade myofibroblastic sarcoma of the head and neck region: a report of
Authors: Sashikanth Jonnalagadda, M. Abdul Amjad Khan, Kiranmayee Buddhavarapu, Prateek Raj Betham
Pages: 973 - 976
Abstract: Sarcoma of the head and neck are rare and account of less than 1% of all tumors in head and neck region. Low grade myofibroblastic sarcomas (LGMFS) are even rare with only handful of cases ever reported in head and neck. We review 2 cases with LGMFS of maxilla and mandible. Retrospectively reviewed 2 patients who carried histological diagnosis of LGFMS. Previous clinic, operative and referral notes were reviewed along with histopathology slides and radiological studies. A 37-year-old female presented with recurrent right maxillary sinusitis and on CT scan was found to have an expanding mass in right maxillary sinusitis. Biopsy revealed it to be a LGMFS. She underwent total maxillectomy with orbital floor reconstruction, post operative radiation and is disease free for 18 months. A 49-year-old female presented with radiolucent mass on routine radiological examination. Initial enucleation and biopsy revealed it to be a LGMFS and was later treated with segmental mandibulectomy and fibular free graft reconstruction and post-operative radiotherapy. LGMFS of the bone is extremely rare tumor with only 8 cases being reported earlier from the skeletal system in entire body. Most common mode of presentation is asymptomatic mass found incidentally. These tumors are malignant with a rare propensity to metastasize distally. Hence prompt and accurate histological diagnosis followed by wide surgical excision with adjuvant therapy form important tenets of management.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233587
Issue No: Vol. 9, No. 12 (2023)
- Severe esophageal candidiasis in a megaesophagus patient: a rare case
Authors: Solikin, Muhammad A. Darmawan, Monik Alamanda, Agus Surono
Pages: 977 - 980
Abstract: Megaesophagus is a largely dilated esophagus, an uncommon condition that could be the end-stage of preceding esophageal achalasia. Chronic food stasis such as in achalasia and megaesophagus could cause fungi infection in the esophagus. This report aimed to raise awareness of these rare cases. A 68-year-old male with two decades of swallowing difficulty was referred to Sardjito Hospital. Computed tomography esophagography showed megaesophagus and bird beak sign suggesting achalasia. Both esophagoscopy and esophageal tissue biopsy showed consistent results of severe esophageal candidiasis (EC). The patient was also suspected to have a mass at the distal part of the esophagus and gastric cardia, which could also contribute to the esophageal obstruction. We consulted the gastroenterologist for gastrostomy feeding and exploration of the suspected tumor. EC is known mainly in patients with immunodeficiency, while food stasis is a lesser-known cause. End-stage achalasia not only could lead to megaesophagus, but chronic food stasis is the perfect environment for fungi growth. Other causes of food stasis such as distal esophageal and gastric cardia tumors could also be the predisposition of EC. We reported a rare case of a patient with EC as a complication of megaesophagus and esophageal achalasia.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233588
Issue No: Vol. 9, No. 12 (2023)
- Middle ear neuroendocrine tumour-case report of a rare tumour of the
temporal bone
Authors: Manali Bhat, H. Vijayendra, Vinay Kumar Vijayendra, Nilesh Mahajan
Pages: 981 - 983
Abstract: Several conditions are known to present as masses in the middle ear medial to an intact tympanic membrane. Reddish masses that blanch on seigelization are usually paragangliomas. Sometimes, a high rising jugular bulb or an aberrant carotid artery can also be seen. Whitish masses are usually congenital cholesteatomas, tympanosclerosis, cartilage grafts that have been surgically placed, and rarely middle ear adenomas (MEA). An elderly male presented with decreased hearing, which was revealed to be secondary to a pale mass in the middle ear, displacing the intact tympanic membrane laterally. He underwent biopsy followed by complete excision of the mass, with preservation of the intact ossicular chain. There no evidence of recurrence on follow-up. Histopathology revealed the mass to be a MEA, also known as middle ear neuroendocrine tumour (MeNET). Middle ear neuroendocrine tumours are rare tumours. We describe the clinical presentation and management of this tumour.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233589
Issue No: Vol. 9, No. 12 (2023)
- Synchronous presentation of giant anterior neck lipoma and interarytenoid
hamartoma
Authors: Roshan Ali, Arun Maran Sattien, Liano Lucy, Sudhiranjan Thingbaijam
Pages: 984 - 987
Abstract: Giant lipomas are benign soft tissue tumor found rarely in the neck and are still rarer in the anterior part of neck. Laryngeal hamartoma (LH) is a very rare lesions and the number of reported cases is limited. Herein, we report a case of 68 years old male with a history of painless, slow growing swelling on anterior neck for past 8 years and also complaints of dyspnoea and stridor for past 6 months. FNAC from anterior neck swelling was suggestive of lipoma. USG and CT findings were suggestive of soft tissue lesions. Indirect and flexible laryngoscopy shows a large pedunculated, globular mass in interarytenoid region. A complete surgical excision of the anterior neck mass and interarytenoid polyp was done. Diagnosis of lipoma and hamartoma was confirmed on histopathology. Patient was followed up for 2 years with no evidence of recurrence.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233590
Issue No: Vol. 9, No. 12 (2023)
- Itraconazole versus steroids in post operative cases of allergic fungal
rhinosinusitis: a randomized controlled trial
Authors: Ankit Aggarwal, Khushboo Goel, Sanjeev Bhagat, Dimple Sahni, Dinesh Kumar Sharma, Vishav Yadav
Pages: 988 - 994
Abstract: This study was aimed to compare the effect of oral steroids and itraconazole in reducing the recurrence in allergic fungal rhinosinusitis (AFRS) patients undergoing ESS. In this randomized controlled trial, 50 patients of both sexes aged between 15-60 years with AFRS were subjected to functional endoscopic sinus surgery (ESS). In the post-operative period, patients were randomly divided into 2 groups containing 25 patients each. Group A received systemic steroid followed by topical steroid. Group B received oral itraconazole. Patients were followed at the end of 6, 10 and 14 weeks after surgery. Sinonasal outcome test 22 (SNOT-22) Lund Kennedy endoscopic score (LKES), AEC and serum total IgE were repeated at each post-operative visit and compared with the preoperative values. Repeat NCCT nose and PNS was done at 14th week to look for recurrence. Statistically significant difference was seen between the two groups in AEC, LKES and SNOT-22 with group A showing more significant improvement than group B, but not in serum IgE and Lund Mackay computed tomography (LMCT) score. The group A had 24% (n=6) recurrence rate, while group B had 44% (n=11) recurrence rate. The difference in the two groups in recurrence was not statistically significant. We evaluated multiple parameters including radiological and endoscopic scores to find the difference between the two drugs and found steroid to be superior than itraconazole.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233591
Issue No: Vol. 9, No. 12 (2023)
- A successful surgical management of pediatric ossifying fibroma in
peripheral limited setting: a rare case report
Authors: Nur Setyo N. O. V., Yonanda Adi Pratama, I. Komang Praba, Camelia Herdini, Sagung Rai Indrasari, Danu Yudistira
Pages: 995 - 999
Abstract: Ossifying fibroma (OF) is a rare non-malignant fibro-osseous lesion of the craniofacial area with the characteristic of slow-growing and locally aggressive. The incidence rate in paediatric patients is still not clear. The management is varied from observation and serial radiologic imaging to radical resection of the tumour. To provide knowledge and information about diagnosing and managing a rare case of craniofacial ossifying fibroma. A-5-year-old boy diagnosed with orbito-inferonasal region ossifying fibroma underwent extirpation of the mass with the lateral rhinotomy- Webber Ferguson approach, anterior orbitotomy by the ophthalmologist, and obturator placement by the prosthodontist. OF remains a rare disease, particularly in paediatric patients, which is locally aggressive although it’s benign characteristic. Definitive excision is the treatment of choice for OF. Successful surgical outcome was due to a multidisciplinary team and surgical incision technique. We found that lateral rhinotomy Weber Ferguson incision showed excellent exposure. Vision and facial nerve function were preserved as well as good facial symmetry and aesthetics and recurrence prevention. Regular follow-up is necessary for young OF patients.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233592
Issue No: Vol. 9, No. 12 (2023)
- Double coin ingestion in a child: a rare occurrence
Authors: Sonali Malhotra
Pages: 1000 - 1002
Abstract: Foreign bodies in the esophagus pose a common ENT emergency, often involving a single coin that typically passes without harm. However, the occurrence of paired coin foreign bodies is exceptionally rare. A notable case involves a 3-year-old child who presented to the ENT emergency department with sudden dysphagia and vomiting. A plain X-ray of the soft tissue in the neck and chest revealed a unique finding-a double circular opacity in the cervical esophagus, indicating the ingestion of two foreign bodies in perfect radiological alignment. Given the rarity of such cases, coupled with the challenges in diagnosis when a comprehensive history is unavailable, this instance stands out. The child underwent a rigid esophagoscopy under general anesthesia to address the situation. This case underscores the importance of considering uncommon scenarios in clinical practice and the necessity for thorough diagnostic approaches, especially in the absence of a detailed patient history. The presentation of dual foreign bodies in precise radiological alignment adds a layer of complexity to the diagnosis, highlighting the need for a nuanced and vigilant approach in managing such infrequent but potentially serious cases in the ENT emergency setting.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233593
Issue No: Vol. 9, No. 12 (2023)
- Vestibular migraine and its management in Indian clinical setting: a
narrative review
Authors: Ilambarathi M., Avinash Bijlani, Dhrubo Roy
Pages: 1003 - 1010
Abstract: Vestibular migraine (VM) is a disorder connecting two clinical conditions, migraine and vertigo. A high prevalence of VM (~30%) is reported among Indians suffering from dizziness. Yet, there is no gold standard for diagnosis and treatment. Trials specifically for patients with VM are scarce. This review provides an overview on VM and its management in the Indian clinical setting. An evidence-based discussion and review of literature on VM was performed by expert panelists, and opinions were gathered. Experts opined that in vertigo clinics, around 50% of patients are diagnosed with VM, with a higher predominance in females aged 30-50 years, while in children, the age of manifestation is 12-14 years. The most common presenting symptoms of VM among adults are spontaneous vertigo, followed by positional vertigo with headache, nausea, vomiting, photophobia and phonophobia, while intolerance to loud sounds and sudden falls are common symptoms in children with VM. Common comorbidities associated with VM are benign paroxysmal positional vertigo (BPPV) and Meniere’s disease (MD). Experts opined that there are currently no approved standardized treatment protocols for VM. The steps in the management of VM include diet and lifestyle modification, along with medicines for symptomatic relief (abortive) and prophylaxis and vestibular rehabilitation. Globally, prochlorperazine, a vestibular suppressant, is widely used for the management of vertigo and its associated symptoms. According to experts, prochlorperazine 5 mg twice or thrice daily for 5-7 days can play a significant role as an abortive treatment in the management of various patient profiles of VM.
PubDate: 2023-11-06
DOI: 10.18203/issn.2454-5929.ijohns20233517
Issue No: Vol. 9, No. 12 (2023)
- Medical management of obstructive sleep apnea: a review article
Authors: Vijaya Krishnan Paramasivan, Jas Simran Singh Bhatia, Kamal Pandyan
Pages: 1011 - 1018
Abstract: Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial obstruction of upper airway during sleep. Various pathophysiological phenotypes contributing for the repetitive events of apnea and hypopnea have been identified in the recent studies. Consequently, various new modalities of treatment are being introduced to be implemented either independently or in conjunction with the previously available treatment modalities. This article imparts a thorough knowledge of various modes of treatment available for the non-surgical treatment of OSA. Many studies conducted in the past had emphasized the importance and effectiveness of lots of non-surgical modes of treating OSA. Our article includes a concluding description of all those studies including those on CPAP and myofunctional therapy. Thorough knowledge of both i.e., the pathophysiological phenotypes and available modes of treatment is necessary for the successful treatment of obstructive sleep apnoea. Recent advances, both in terms of causative factors as well as corresponding treatment options, should be laid down in the form of management guidelines as a part of evidence-based medicine.
PubDate: 2023-11-27
DOI: 10.18203/issn.2454-5929.ijohns20233594
Issue No: Vol. 9, No. 12 (2023)
