International Journal of Otorhinolaryngology and Head and Neck Surgery
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Published By Medip Academy

2454-5937, 2454-5929
Updated Saturday, 27 November 2021

Author(s):  
Sampath Kumar Singh ◽  
Gayathri K. ◽  
Mounika Reddy Y.

<p class="abstract">Coronavirus disease associated invasive fungal sinusitis has affected many and several have succumbed to the disease during the second wave of COVID-19 pandemic. Mucormycosis is a rare, opportunistic, fulminant, angioinvasive fungal infection caused by Rhizopus species of the order Mucorales. It mainly affects immunocompromised individuals, predisposed by diabetes mellitus, corticosteroids, immunosuppressive therapy, haematological malignancies and organ transplantation. We reported here a case of a 45 years old male with past history of Coronavirus disease, presenting with symptoms of invasive fungal sinusitis. With this case we emphasised on use of an alternate approach for bilateral total maxillectomy via midfacial degloving approach instead of a classical external Weber Ferguesen incision in extensive cases with several associated co-morbidities. Mid facial degloving approach is a combination of intraoral and intranasal incisions made to access the midface without any external incision. This approach is advantageous in comparatively having less complication rate, less morbidity and excellent cosmetic outcome.</p>


Author(s):  
Nithya Venkataramani ◽  
Ravi Sachidananda ◽  
Rajesh Karalumangala Nagarajaiah

<p class="abstract"><strong>Background:</strong> Vertigo is a complex symptom which can be present in multiple conditions, some of which are life threatening. Diagnosing a patient with vertigo could sometimes be challenging and there is a need for a comprehensive, yet easily reproducible diagnostic model with emphasis on the red flag signs. A simple way to achieve this is a checklist. The aim of the study was to propose a diagnostic checklist for patients presenting with vertigo to an ENT clinic to aid diagnosis and prevent diagnostic errors.</p><p class="abstract"><strong>Methods:</strong> A diagnostic checklist was used in all patients who presented with the symptom of vertigo, necessary tests were conducted and referrals were done when required.  </p><p class="abstract"><strong>Results:</strong> Out of eighty-five patients who presented with symptom of dizziness to ENT clinic, all patients received a definitive diagnosis treatment plan with the help of checklist.</p><p class="abstract"><strong>Conclusions:</strong> Checklist is an effective way to ensure elaborate assessment of the patient with emphasis on the red flag signs. It is a very important tool to arrive at diagnosis and formulate treatment plan.</p>


Author(s):  
Suman S. Penwal ◽  
Deepa A. Valame

<p><strong>Background:</strong> The disorder of the inner ear related to abnormally increased levels of endolymph in the membranous labyrinth is called Meniere’s disease.  It is well studied that the prevalence of Meniere’s disease varies widely across regions.  It was found to be 13% to 42% around the world in various places.  It is important to know the incidence in India to know the population suffering and to plan better treatment strategies to cater to rehabilitation strategies. Hence, the current study was planned to estimate a load of Meniere’s disease in a tertiary care hospital in Mumbai.</p><p><strong>Methods:</strong> A retrospective analysis of the case reports was undertaken.  As per American academy of otolaryngology-head and neck surgery (AAO-HNS, 2020), the patients were separated as definite and probable Meniere’s disease.</p><p><strong>Results:</strong> The descriptive analysis revealed that 6 in 1000 patients reporting for hearing evaluation in a tertiary care hospital are suffering from Meniere’s disease. There was a female preponderance found in the patients with a gender ratio of 1.85:1.</p><p><strong>Conclusions:</strong> The incidence of Meniere’s disease in a tertiary care hospital in Mumbai was found to be 0.61% of all the patients tested for hearing impairment.</p>


Author(s):  
Smita Soni ◽  
Anjali A. R. ◽  
Yashveer J. K.

<p><strong>Background:</strong> Chronic otitis media (COM) is a long-standing disease of middle ear cleft and mastoid cavity having a permanent perforation in the tympanic membrane with or without discharge. It’s a worldwide health problem and it is still predominant in the modern antibiotic era. Aim<strong> </strong>was to determine the prevalence and types of ossicular chain defect in mucosal and squamosal type of COM. Also, to evaluate the hearing loss in relation to ossicular chain defect.</p><p><strong>Methods:</strong> The study was prospective observational study conducted in Bhopal over the duration of one year (January 2019 to June 2020). Patient aged 11-70 years reporting with COM were included in the study. Details regarding sociodemographic profile and extensive examination were recorded. Data was entered into MS excel 2007, analysis was done.</p><p><strong>Results:</strong> It was more prevalent in the age groups of 21-30years (39%) with female (53%) preponderance. Right sided ear was commonly involved (58%). Majority of the patients had tubo-tympanic disease (62%) whereas 38% had attico-antral disease. Ossicular chain was found intact in 33% cases. Average hearing loss was maximum (67.6 dBHL) when all ossicles are eroded. Hearing loss was minimum (33.6 dBHL) with isolated handle of malleus involvement.</p><p><strong>Conclusions:</strong> COM is one of the commonest causes of preventable hearing impairment in our society, hence early diagnosis and timely intervention is needed. Awareness among patients and doctors regarding the need for better ear hygiene is necessary.</p>


Author(s):  
Santosh Kumar Swain

<p>Tinnitus is the perception of a sound without any external auditory input and patient experiences as a ringing or buzzing sound in the ear or head. Tinnitus is a common and troublesome clinical entity that has existed for centuries. However, the exact etiology for tinnitus is not known. Electrical suppression of the tinnitus by cochlear implant is a secondary benefit to many cochlear implant recipients. Cochlear implants are often helpful to improve speech perception for those suffered with severe to profound hearing loss where hearing aids are no longer beneficial. There is high prevalence of tinnitus among patients with profound hearing loss which often reduced after cochlear implant. Although only few cochlear implant recipients show complete elimination of tinnitus after implantation and many uses result in improvement or stabilization. Cochlear implant causes appearance of homolateral tinnitus in small percentage of the cases. However, none of the cases of tinnitus which appear after cochlear implantation are thought to be severe to the patient. All literatures of cochlear implant and tinnitus were identified via Scopus, Google scholar, Medline and PubMed and analysed individually. Articles of cochlear implant and tinnitus included according to specified eligibility criteria. The review article analysed case series, case reports and original research on cochlear implant and tinnitus published in the English language. The aim of this review article is to provide a comprehensive review of the cochlear implant and its role in tinnitus.</p>


Author(s):  
Varunkumar Jayakumar ◽  
Jaiswal Shubhalaxmi Atmaram

<p class="abstract"><strong>Background:</strong> The aim of the study was to (a) determine the incidence and distribution of cases according to age, sex, etiology etc; (b) to know common etiology for the different diseases; (c) to understand pathophysiology of the disease; (d) to know various presentations of the disease; (e) to determine various diagnostic tools; and (f) to know modalities of treatment available.</p><p class="abstract"><strong>Methods:</strong> Prospective observational study, method of sampling: non-random, purposive. department of ENT, Government medical college and tertiary care centre. Fifty-one patients with benign and malignant lesion of larynx were analysed. Only cases with persistent hoarseness for more than three weeks were selected. Benign lesions included neoplastic and non-neoplastic lesions. All cases underwent a thorough ENT examination. Once suspected the cases were examined under direct laryngoscope, fibreoptic laryngoscope and if needed microlaryngeal examination was also done.   </p><p class="abstract"><strong>Results:</strong> The study showed 86.6% benign lesions and 41.1% malignant lesions of larynx with male preponderance. It was observed that vocal polyp was the commonest benign non-neoplastic lesion and papilloma was the commonest neoplastic lesion. Squamous cell carcinoma accounted predominantly in malignant lesions and was commonly found in glottis.</p><p class="abstract"><strong>Conclusions:</strong> Thus, this study reflects there is an urge to raise awareness and educate people regarding detrimental effects of vocal abuse, alcohol and tobacco consumption, preventive measures, early symptoms and availability of diagnostic tools, so that early diagnosis and appropriate treatment can be executed to reduce the morbidity and mortality.</p>


Author(s):  
Nitish Baisakhiya ◽  
Sujata Maini ◽  
Kartikey Pandey

<p class="abstract">Cysticercosis is a major public health problem especially in developing countries like ours. Disease can be prevented by increasing the public awareness about personal hygiene and sanitation. The disease commonly affects the central nervous system and the condition is referred to as neurocysticercosis. Neurocysticercosis is probably is the commonest parasitic infestation of the central nervous system (CNS). Although the extracranial involvement is exceedingly rare. The head and neck regions commonly affected are tongue, sternocleidomastoid muscle, masseter muscle and strap muscles of the neck. Isolated cases of cysticercosis have been reported in the literature in head and neck region. We are reporting the case series of seven cases of extracranial cysticercosis presenting in different parts of head neck region. Two cases presented with a tongue nodule, two cases in the region of masseter muscle, one case in the pre-maxillary region and one in the sternocleidomastiod muscle in the neck. All cases were dealt with a clinical suspicion of cysticercosis as the condition is endemic in our region. The empirical treatment was started in all the cases after demonstration of cyst on ultrasonography. The cases responded to the oral albendazole combined with corticosteroid therapy. As the disease is a common entity in our country all cases presenting with firm, long standing, single swelling in the head neck region should be dealt with suspicion of cysticercosis. Early diagnosis and treatment can prevent the hazardous intracranial complications and mortality.</p>


Author(s):  
Shallu Jamwal ◽  
Gopika Kalsotra ◽  
Monica Manhas ◽  
Apurva Raina ◽  
Parmod Kalsotra ◽  
...  

<p><strong>Background: </strong>Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions.<strong></strong></p><p><strong>Methods</strong>: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects.</p><p><strong>Results</strong>: 47.9% of the study cases had otological manifestations among which otitis media was the main finding.</p><p>16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3<sup>rd</sup> trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2<sup>nd</sup> and 3<sup>rd</sup> trimester.</p><p><strong>Conclusions: </strong>Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.</p>


Author(s):  
C. A. Swapna ◽  
E. Siva Kumar ◽  
Lavanya Karanam

<p>Congenital muscular torticollis usually results from the shortening or excessive contraction of sternocleidomastoid muscle. Delay in diagnosis and appropriate early therapeutic evaluation can lead to permanent disability. We would like to report two rare cases with congenital muscular torticollis who underwent surgery followed by aggressive physiotherapy. We would like to emphasise the need of an early diagnosis and intervention which leads to best outcome. This can prevent progressive physical deformity. Surgeons should offer the patient with option of release and repair of sternocleidomastoid muscle as it gives excellent result in view of mobility and appearance for child.</p>


Author(s):  
Rachna Dhingra ◽  
Gurbax Singh ◽  
Kuldeep Kumar ◽  
Vignesh A. K. ◽  
Pavail Singh ◽  
...  

<p class="abstract">Lingual thyroid is defined as an ectopic thyroid gland tissue located in the midline of the tongue base. Patients with lingual thyroid tissue usually present with symptoms such as dysphagia, choking, haemorrhage, dyspnea and occasionally life threatening airway obstruction. Lingual thyroid is a rare anomaly with an incidence of 1 in 3000 of the thyroid cases seen, with overall prevalence of 1 in 100,000. Here we presented a case with complaint of difficulty in swallowing and foreign body sensation throat. The intraoral examination showed spherical mass with 2 cm of diameter, covered with intact mucosa, located midline at base of tongue. She was diagnosed clinically as lingual thyroid and evaluated further. By proper transdisciplinary approach correct diagnosis can be made and patient can be managed. In present case, thyroid profile, USG neck and thyroid scintigraphy helped in diagnosis. Patient was managed medically with tablet levothyroxine which relieved her symptoms. Surgical management was not considered as patient improved with levothyroxine and surgical excision would have made patient further hypothyroid as there was no thyroid gland in neck.</p>


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