bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comparative Study between ORIF and ORIF with Mandibulomaxillary Fixation in Unfavourable Mandible Fractures
Authors: Nath Kripamoy , Prakash Rudra , Devnath Bapan , Ghosh Avinava
Published: August 2020

Introduction 

This study aims to evaluate the efficacy of open reduction and the combination of open reduction with mandibulomaxillary fixation (MMF) in cases of unfavourable mandible fractures.

 

Materials and Methods  

This is a prospective study carried out from 2010 to 2015 on 60 patients with mandible fracture attending the Dept. of ENT.  The diagnosis and classification of mandible fracture into favourable and unfavourable types were done on the basis of clinical and CT faciomaxillary findings. The outcomes were assessed by comparing the preoperative and postoperative occlusion, mouth opening and symmetry of mandibular ramus. Patients with favourable mandible fractures were excluded from the study.

 

Results  

We found that out of 60 patients, 40 cases were of the unfavourable type. ORIF with MMF gave better outcome compared to ORIF alone. The data were statistically analysed using Z score and P value.

 

Conclusion 

Initial assessment of mandible fractures into favourable and unfavourable category plays a significant role in planning the management.  Management of unfavourable mandible fractures with ORIF and MMF gives functionally and aesthetically better results as compared to ORIF alone.
Aberrant Thyroid in the Parapharyngeal Space
Authors: Malipatil Sharanabasappa Rudragouda , George Ciju K , Vidisha Isha , Karadi Ravindrakumar Ningappa
Published: August 2020

Introduction

Aberrant thyroid is a mass of tissue having the structure of a normal or pathological thyroid gland and situated at some definite distance from normal thyroid, with which it has no connection. The prevalance of ectopic thyroid is 1 case per 100,000- 300,000 persons1 and the incidence of aberrant thyroid in parapharyngeal space is even rarer.

Materials and Methods

A rare case of aberrant thyroid in parapharyngeal space is reported, which presented as oropharyngeal mass and dysphagia. She also had   thyroid gland in the usual position.

Result

She was managed surgically with transcervical approach and was euthyroid postoperatively.

Conclusion

Aberrant thyroid should be one of the differential diagnoses for parapharyngeal space masses.
Near Complete Laryngopharyngeal Obstruction due to Vegetable Foreign Body in an Infant
Authors: Gupta Rahul , Gupta Ashok
Published: August 2020

Introduction

Impaction of foreign bodies and obstruction in the upper aero-digestive tract is a medical emergency.

Case Report

A 5-month-old male infant presented with impacted large vegetable foreign body lying in the hypopharynx of an infant causing almost complete laryngeal obstruction. Cardiopulmonary resuscitation was initiated and back blows were given between the blades of the scapula to assist in its removal. Only available curved artery forceps was gently passed beyond the foreign body; blades of the forceps were opened to engage it and foreign body was swept and rolled out. Patient was revived after intensive resuscitation.

Conclusion

Suspect foreign body in the upper aero-digestive tract in any child presenting with severe respiratory distress or apneic spells or choking. Foreign body may be removed with only available curved artery forceps by gently passing beyond it, followed by opening and engaging blades of the forceps to sweep and roll it out of the upper aero-digestive tract.
Nuchal Fibroma: An Uncommon Neck Mass
Authors: Das Soumyajit , Mukherjee Subhasish , Sharma Barun , Tamang Subash
Published: August 2020

Introduction

Nuchal fibroma or collagenosis nuchae is a rare benign tumour. It is a slow growing neoplasia of unknown etiogenesis, asymptomatic and of variegated histology. They are more common in males but our case was a female patient. The presentation may mimic sarcoma at times.

Case Report

An unusual case of a very large neck mass in a 62 years old female patient is reported. The growth involved the dorso-cervical region over a period of approximately 8  years but remained asymptomatic. The mass was excised and post excision histopathology was reported as nuchal fibroma.

Discussion

The case reported is large compared to the usual size of nuchal fibroma. Association with diabetes mellitus and Gardner’s syndrome has been reported in literature. MRI is the imaging of choice to establish the differential diagnosis.
A Study on Traumatic Faciomaxillary Fractures Encountered at a Tertiary Care Centre of North-Eastern India
Authors: Dutta Smrity Rupa Borah , Soni Sweta , Prakash Rudra
Published: August 2020

Introduction

Faciomaxillary fractures can present either as an isolated injury or as a part of polytrauma. The incidence of faciomaxillary injuries is on the incline with changing lifestyles in developing countries like India; thus posing as a major health burden. We conducted this study to aid in defining strategies to prevent and tackle the same.

Materials and Methods

A Prospective Observational study was conducted on all the patients admitted for traumatic faciomaxillary fractures in the Department of ENT for a period of three years. Aim of the study was to study the incidence, demography, pattern, management and postoperative complications in traumatic faciomaxillary fractures.

Result

Out of 499 cases who comprised our study group, the most common fracture encountered was of nasal bone(26.25%) with male predominance (86.37%), mostly scattered in the age group of 18-40 yrs (67.13%). RTA was found to be the most common cause (52.1%). Fractures of lateral third of face and mandible almost always needed an open reduction.

Discussion

The age and gender distribution pattern as well as the cause of faciomaxillary fractures and complications have been compared with the published reports. The central third of the facial skeleton has been found to be affected most in traumatic fractures, whereas some other studies found fracture of the mandible to be the most common. Open reduction was needed in 44.9% of patients.

 

Conclusion

With increasing incidence of RTAs, there is a need to understand the pattern, review our management techniques and hence be able to provide appropriate and individualized management to those in need of it.
Evaluating Success of Surgery in Mucosal and Squamosal Chronic Otitis Media: A Retrospective Study
Authors: Saroha Nilank , Tomar Nitin
Published: August 2020

This study attempted to document success of surgery postoperatively, be it type I tympanoplasty or type III tympanoplasty with or without modified radical mastoidectomy.

Materials and Methods

This retrospective study involved 90 patients of Chronic Otitis Media who underwent surgery in the Department of Otorhinolaryngology in a tertiary care centre in the state of Uttar Pradesh.  

Results                               

At 3 week postoperatively, 83 patients (92.22%) had successful uptake of graft. Overall successful graft uptake was reduced to 87.78% (79 patients) after 3 months. Postoperatively, after 3 months, 90% of the patients (n=81) reported improvement in hearing. Preoperatively, 89.71 % patients of mucosal disease and 63.64% of squamosal disease had 21-40 dB hearing loss. Postoperatively, 88.24% patients with mucosal disease and 63.64% of squamosal disease had no conductive hearing loss. There was statistically significant gain in air conduction postoperatively. Average improvement in AB gap was also notably significant postoperatively in both subgroups.

Conclusion

Both type I and type III tympanoplasty give excellent response in term of graft uptake and postoperative hearing.

Abbreviations: COM-Chronic Otitis Media, AC-Air Conduction, AB-Air Bone, TP-Tympanoplasty, MRM-Modified Radical Mastoidectomy
Frontoethmoid Mucocele causing Unilateral Proptosis
Authors: Pathak Netra Aniruddha , Naik Chetana Shivdas , Rokade Vidya Vasant , Shinde Kiran Jayawant
Published: August 2020

Introduction

 Mucoceles occur most frequently in the frontal and ethmoidal sinuses, without gender prevalence. Presenting symptoms can include facial pain, headache, nasal obstruction, diplopia, decreased visual acuity, orbital globe displacement, facial swelling and meningitis, depending on the anatomic area involved. The gold standard in terms of diagnostic precision is computed tomography scan.

Case Report

The present study describes case of frontoethmoidal mucocele with orbital involvement that was treated by transnasal endoscopic approach obtaining good outcomes, demonstrating safety and efficacy of this surgical approach.

Conclusion 

Transnasal endoscopic management of mucoceles is preferred due to minimal trauma and less morbidity.
Primary Laryngeal Aspergillosis in an Immunocompetent Host
Authors: Biswas Kaustuv Das , Choudhary Ankit , Ghosh Swapan Kumar , Biswas Subhradev
Published: August 2020

Introduction

Aspergillosis of Larynx is very rare and may present with symptoms suspicious of malignancy. Prevention of dissemination warrants early diagnosis. It is found mainly in Immunocompromised patients and is usually necrotizing, invasive with disseminated systemic infection, associated with poor prognosis. In Immunocompetent patients it is extremely rare and may present as colonization associated with excellent prognosis.

Case Report

A 43 year old male patient presented with hoarseness of voice for about 3 months with whitish irregular lesion that involved the anterior 1/3 of both the vocal cords. A cheesy material was found covering indurated lesion of both the vocal cords, intraoperatively. Stripping of mucosa over vocal cords was done and cheesy material collected and sent for HPE which revealed Aspergillus hyphae overlying Mild dysplastic changes. Following diagnosis the patient was followed up with oral dosages of Itraconazole.

Discussion

The primary Aspergillosis of larynx is extremely rare. Involvement is always secondary to immunocompromised states like AIDS, malignancy, Diabetes, etc. This was a rare case in Immunocompetent patient.

Management constitute removal of the vocal cord lesions during biopsy. Amphotericin B is first-line agent for this infection, however aerosolised and liposomal amphotericin B offer effective dosing with less toxicity. Newer antifungal Itraconazole may produce more reliable results.
Effect of Topical Nasal Decongestants on Nasal Peak Flow Rates in Adults Suffering from Acute Sinusitis
Authors: Rajamani Santhosh Kumar
Published: August 2020

INTRODUCTION

In this research we study the effect of Nasal decongestant Xylometazoline 0.1% solution on Serial measurements of Nasal peak flow rates in a cohort of patients who were suffering from Acute Sinusitis.

CASE SERIES

A population of 90 patients were chosen from our regular Out-patient clinics who were suffering from Acute Sinusitis based on a Clinical diagnostic criterion. A baseline Nasal peak Flowmetry was done before and this was followed by common Decongestant Xylometazoline 0.1% solution spray application, followed by serial readings of Nasal peak Flowmetry done after 10 minutes, 25 minutes, 60 minutes, 120 minutes,240 minutes and 360 was taken then plotted and analysed.

 DISCUSSION

From the A.U.C Curves it can be inferred that Maximum decongestant action of Xylometazoline 0.1% solution is seen 1 hour after application and the raise in decongestant reaches a plateau by 2 hours. Readings remain elevated from baseline well 6 hours post decongestion.

CONCLUSION

Patients who are prescribed Xylometazoline 0.1% solution are advised that maximum relief from congestion would be obtained around 1 to 2 hours after application and hence effect would decrease. Surgeons who use Xylometazoline 0.1% solution for nasal packing must proceed with the Surgery within 1 hour of application of the pack to obtain maximum hemostatic and decongestant benefit of this drug.
The Contralateral Ear in Unilateral Chronic Otitis Media - Does it Need Reckoning ?
Authors: Narayanaswamy Ramakrishnan , Awasthi Gaurav
Published: August 2020

Introduction

    This comparative study aims to analyze findings and their significance in the contralateral ears of patients with unilateral Chronic Otitis Media (COM) and compare it with a control group of healthy subjects.

Materials and Methods

     One hundred patients of unilateral COM and 100 healthy individuals were included in this study from Jan 2015 to July 2016. The findings were noted in the contralateral ears of patients with unilateral COM and 100 control subjects. The changes found in the contralateral ears were assessed statistically for significance.

Results

In 100 cases of unilateral COM, 58 patients had some abnormality in the contralateral ear. Myringosclerosis patches being the most common finding were seen in 29 patients followed by TM retractions seen in 28 patients. Prevalence of abnormal findings was found to be significantly higher in the squamous group as compared to the mucosal group.  In 100 ears in the control group, only 11 % had positive findings. TM retractions were seen in 5 subjects (3 Attic and 2 Pars tensa retractions). 

Conclusion

            It can be statistically concluded that the disease of COM in one ear affects the contralateral ear slowly and silently. Hence both ears are affected as pairs and a slow pathological process continues behind an intact TM and kept hidden from the view unless it is actively sought for. Contralateral ears should also be actively followed up, in cases of unilateral COM in order to pick up disease harboring silently.
Epidemiological Profile of Foreign Body in Upper Aero-digestive Tract in a Peripheral Tertiary-Care Hospital
Authors: Maiti Amit Bikram , Hembrom Rabi , Sinha Rupam , Mandal Satadal , Nair Mayur M , Patra Somnath
Published: August 2020

Introduction

Foreign body in upper aero-digestive tract leads to many complications including life-threatening ones to the patients. Its management depends upon type of foreign body and site of lodgement.

Materials and Methods

A descriptive study was conducted from March 2013 to February 2017 to determine the different components of the epidemiological profile of the cases of Foreign body in upper Aero-digestive Tract (UADT) and its management principle. Total 192 patients were selected for this study. These patients underwent different procedures for foreign body removal and post-operative notes were taken for data analysis to note the epidemiological pattern.

Results

A total of 192 patients were included in the study. Epidemiological data were derived and analyzed comprehensively to present the different profiles.

Conclusion

Fish bone was found to be the commonest foreign body in upper aero-digestive tract, followed by coin and meat bone. Foreign bodies are commonly removed by Tilley's forceps followed by Hypopharyngoscopy.
Assessment of the Utilization Pattern and Related Knowledge about Topical Nasal Decongestants among the Users
Authors: Rajasekaran Valli , Ghosh Puja
Published: August 2020

Introduction

Nasal decongestants are one of the drugs commonly prescribed by otorhinolaryngologists in their day to day practice. The excessive or inappropriate use of nasal decongestant due to rapid symptomatic relief leads to drug misuse or abuse. Inadequate knowledge about the drug usage leads to inappropriate drug usage.

Materials and Methods

A cross sectional study was done among 90 patients who were using topical nasal decongestants. A pre tested, pre validated questionnaire was used to assess the patient’s knowledge, the utilization pattern and the attitude towards the drug usage.

Results                                  

The mean age of presentation in our study was 38.4 years. Only 14.4% of the people knew the appropriate duration of drug usage. Only 33.3% knew about the probable side effects of prolonged drug usage. There was a significant correlation between knowledge and utilisation pattern of topical nasal decongestants usage and the literacy level. Though most of the people (46.7%) started using the drug after being prescribed by a doctor, only 14.3% among them strictly  adhered to doctor’s instructions.82% of the users were not much worried about the prolonged usage as 73.3% believed that prolonged use may or will surely improve their symptoms. Though 66.7% users wanted to stop prolonged usage of the drug, 76.9% had varying difficulties in stopping the drug. 

 

Conclusion

The knowledge and the utilization pattern regarding the drug usage were very low. The same was found to be better with increase in literacy level. Health professionals should play a major role in establishing a rational drug usage.
A Study on Hospital Acquired Infections among Patients in a Tertiary Care Hospital of Darjeeling District, West Bengal
Authors: De Maumita , Mukherjee Diptanshu
Published: August 2020

Introduction

Hospital Acquired Infections (HAI), also called ‘Nosocomial Infections’ are identified at least 48-72 hours following admission to health institution. In many hospitals, HAI appears to be a hidden, cross-cutting problem. Thus a continuous surveillance is imperative for determining the extent of the problem and its effective prevention and control. Present study determines the incidence and different types of hospital acquired infections and the bacterial pathogens responsible for those.

Materials and Methods

An observational longitudinal study was undertaken during January to June 2014, among 107 patients admitted in ENT wards of North Bengal Medical College and Hospital (NBMCH), selected by consecutive inclusion technique. Information was taken using a predesigned, pretested semi-structured schedule. The collected data were analyzed as frequencies, percentages and means ± standard deviations.

Results

The present study found incidence rate of hospital acquired infections as 19.6% and incidence density as 26.35 per 1000 patient days. Surgical site infection was commonest type (57.2%) followed by urinary tract infection (23.8%) and blood stream infection (19.0%) respectively. 15.4% of blood cultures, 100.0% of surgical wound swab cultures and 21.7% of urine cultures were positive and gram negative bacteria were most frequently occurring organisms. Most commonly found bacteria were Pseudomonas and Klebsiella.

Discussion

Background characteristics of the study population; incidence rate, the different types of hospital acquired infections among those admitted patients and the bacterial pathogens responsible for those infections have been discussed along with review of literature.

Conclusion

Even if in a tertiary health care facility, hospital acquired infection rate could not be brought down into <10%. So implementation of stringent guidelines on prevention of HAI and continuous surveillance and monitoring system can help to diminish this problem in future.
Chondroid Syringoma of Dorsum of the Nose
Authors: Pathak Netra Aniruddha , Rokade Vidya Vasant , Shinde Kiran Jayawant
Published: August 2020

IntroductionChondroid syrigomas are rare, usually benign tumors occurring predominantly in the head and neck area. These are also known as mixed tumors of skin. Preoperative diagnosis is difficult and generally histopathology examination confirms the diagnosis.  The usual presentation is that of a slowly growing mass.Case ReportA rare case of chondroid syringoma on dorsum of external nose in 30 year old female patient   is presented.DiscussionChondroid syringoma presents as slow‐growing, painless, subcutaneous or intracutaneous nodule in middle‐aged adult males. The tumor is often initially confused with more common dermatologic skin disorders such as sebaceous cysts, dermoid cysts, neurofibromas, dermatofibromas, basal cell carcinoma, histiocytoma and seborrheic keratosis. The treatment of choice is surgical excision with negative margins with follow-up to detect recurrences.
An Interesting Case of a Butcher Who Attempted to Cut His Neck
Authors: Ankale N R , Mudhol R S , Havaldar Rajesh Radhakrishna , Singh Anju
Published: August 2020

Introduction

Cut throat injuries are well recognized in homicide but less recognized in suicides. The incidence of suicide is increasing worldwide owing to the more stressful strenuous lifestyle and other risk factors like substance abuse. Suicide by incising one’s own throat is associated with hesitation marks whereas homicidal wounds are not.

Case Report

We present an interesting case of a suicidal cut throat of the victim being a butcher who was on alcohol abstinence since 3 days with severe injuries of supraglottic larynx and cricopharynx, surprisingly without any evidence of hesitation marks. He underwent immediate neck exploration and suturing of the injured structures without the need of a tracheostomy.

Discussion

A multidisciplinary approach by Otolaryngologists, Psychiatrists, Intensivists, and Anaesthetists is required in the effective management of these victims. A thorough proper early assessment can totally avoid the need of tracheostomy which is recommended in practice, hence preventing complications arising out of this unnecessary but advocated procedure.
Myxoid Chondrosarcoma of the Hyoid Bone
Authors: Majumdar Kinjal , Samanta Nirmalya , Shrestha Devjani Ghosh , Mondal Kasturi , Jana Utpal
Published: August 2020

Introduction

Chondrosarcoma of hyoid bone is very rare with only 19 cases still reported. We, therefore, present this case report for the interest of medical literature to make clinicians aware of the disease.

Case Report

They usually present as a slow growing upper neck mass. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful radiologic investigations. The tumour was resected through a trans-cervical approach. Definite diagnosis was made by postoperative histopathology and immunohistochemistry.

Discussion

Surgical excision is the treatment of choice for local control. Incomplete removal is a risk factor for recurrence and possible dedifferentiation. Long term follow up is necessary.
Isolated Sphenoid Sinus Disease- A Unique Case of Sphenoidal Mucocoele
Authors: Ghosh Tushar Kanti , Gupta Srijoy , Devineni Pradeep
Published: August 2020

Introduction

Isolated Sphenoid Sinusitis and sinus lesions is a rare entity accounting for just 1-3% of all Sinus afflictions. Most have occurred in men between the ages of 30 and 40 years.

Case Report

A case of right sphenoid sinus mucocele is reported in a male patient aged 68 years, with size of the lesion (35 x 34 mm) detected by CT & MRI scans. The patient presented with a 3 weeks history of unilateral ptosis, diplopia, and photophobia. He also complained of bilateral nasal obstruction, nasal stuffiness, and a mucoid nasal discharge. Endoscopic decompression of the right sphenoid sinus was performed, and approximately 160 ml of thick, sterile mucoid secretion was aspirated. Despite the size of the mucocele, no significant destruction of the sphenoid walls was evident. Postoperatively within 15 days the patient's symptoms improved significantly.

Conclusion

The Nasal Endoscope has revolutionised sphenoid sinus mucocele treatment. An adequate sphenoidotomy and drainage give excellent results.
Radiological Analysis of Frontal Cells and its Association with Frontal Sinus Mucosal Disease: A Tertiary Care Hospital Based Study
Authors: Shrestha Bikash Lal , Karmacharya Sameer
Published: August 2020

Introduction

The frontal sinus and frontal recess both have complex anatomy causing difficulty during endoscopic sinus surgeries. The term frontal cells is currently used to describe a group of anterior ethmoidal cells classified by Kuhn et al into 4 types. Though there are precise descriptions, the frequency of frontal sinus cells (FSCs) varies widely in the literature. The presence of FSCs is responsible for a narrowing of the frontal sinus outflow tract which subsequently causes a partial obstruction of drainage and aeration of the frontal sinus. Our main aim is to the see the distribution of different frontal cells in Nepali population and relation with frontal sinus mucosal disease.

 

Materials and Methods

This prospective, longitudinal study performed in 110 consecutive patients who underwent CT scan of nose and paranasal sinuses. The frontal cells and agger nasi cells were identified and association between the frontal cells and agger nasi cells with frontal sinus mucosal disease was analyzed with chi square test.

 

Results

The agger nasi was present in 83.63% CT scans whereas frontal cells were distributed in 61.82% CT (computed tomogram) scans. There was not statistical significance and any association between the frontal cells and agger nasi cells with frontal sinus mucosal disease.

 

Conclusion

The frontal cells and agger nasi cells distribution in Nepalese population, even though in small sample size, is similar with other studies in the literature. There is also non association of either frontal cells or agger nasi cells with frontal sinus mucosal disease.
A Study of Aetiological Profile of Unilateral Sensorineural Hearing Loss
Authors: Gangopadhyay Prasenjit , Prasad Bipin Kishore
Published: August 2020

Introduction: It is necessary to identify the aetiology of sudden sensorineural hearing loss for proper management. Despite advancement in the field of diagnostic radiology, immunochemistry and genetic studies, there are still many cases of USNHL where a definite cause cannot be identified. In this study, an attempt has been made to identify the aetiological factors responsible for unilateral sensorineural hearing loss (USNHL)..                               

Materials and Methods: Seventyfive patients with acquired unilateral sensorineural hearing loss without chronic otitis media were included in the study. Hearing was assessed by tuning fork test and pure tone audiometry. Special tests were done to differentiate between cochlear and retrocochlear pathology, to objectively assess hearing loss and to diagnose nonorganic hearing loss. Radio-imaging was done to diagnose skull bone fractures, space occupying lesions in internal auditory meatus and cerebellopontine angle or intracranial pathologies. Biochemical analysis of blood, immunoglobulin and serological assay were done to rule out specific causes.

Results: Majority of patients were within 21-30 years of age. 37 patients presented with sudden and remaining with progressive hearing loss. Majority (57.3%) were found to have idiopathic cochlear pathology. Amongst the remaining, there were 8 cases of acoustic trauma, 4 each of Meniere’s disease and cerebellopontine angle tumour and 3 each of Noise-induced hearing loss, labyrinthitis and Non-organic hearing loss. There were 2 cases of meningitis and 1 each of barotrauma, connective tissue disorder, iatrogenic trauma, fracture of petrous bone and cerebrovascular accident. 

Conclusion: Most of the studies have been done on sudden sensorineural hearing loss. Current study, including sudden and progressive cases, is hence an attempt to ascertain aetiological profile of unilateral SNHL.
Demographic Profile of Hearing Deficiency in a peripheral referral hospital- A Five Year Study
Authors: Chakrabarti Amit , Sen Indranil , Sinha Rupam , Kumar Manish , Hembrom Rabi , Mandal Satadal , Maiti Amit Bikram
Published: August 2020

Introduction: This present study is an attempt to study the demographic characteristics of individuals presenting with hearing loss in a peripheral tertiary care hospital using the available database of pure tone audiometry results.

Materials and methods: A retrospective, observational, descriptive study was conducted over a period of 5 years in the Department of ENT of a peripheral tertiary care hospital wherein all subjects having a pure tone audiometry were included in the study. The records of PTA done were analyzed followed by systematic analysis.

Results: A total of 9790 individuals inclusive of 5566 males and 4224 females were studied. Maximum no of individuals belonged to the age group of 21-30 years. Nearly 63% of total subjects suffered from Bilateral hearing loss. Sensorineural hearing loss was most prevalent type of loss. Mild degree of loss was most prevalent. Adolescents and young adults comprised the bulk of the study population. Sensorineural hearing is the most common type. Bilateral hearing loss is more frequent. Mild degree of loss is most frequent.

Conclusion: This study emphasized the ‘Composite parameter distribution’ in addition to the classical single parameter demographic profile of deafness in a remote tertiary care hospital. Adolescents and young adults comprised the bulk of the study population. Sensorineural hearing is the most common type. Bilateral hearing loss is more frequent. Mild degree of loss is most frequent.
Clinical Study to Determine Occult Vestibular Dysfunction in Patients of Chronic Otitis Media using Computerized Static Posturography
Authors: Singh D K , Gupta Salil Kumar , Bhalla Vijay , Raina Sheetal , Kumari Abha
Published: August 2020

Introduction

Various studies have shown high incidence of subjective vestibular dysfunction in cases of chronic otitis media (COM). Evaluation of vestibular dysfunction in chronic otitis media patients is becoming an integral part of comprehensive management of COM. In our study, we have evaluated vestibular dysfunction in patients with COM, using computerized static posturography, an objective technique in contrast to other subjective tests of vestibular dysfunction.

Materials and Methods

In this prospective case control study done over a period of 1.5 years, 50 cases of COM and 50 healthy controls were included and they underwent Computerized Static Posturography. Parameters taken were Somaesthetic, visual and vestibular scores in both antero-posterior (AP) and medio-lateral (ML) axis; and in combined axis (Antero-posterior +Medio-lateral) and these scores were compared with those of healthy controls.

Results

Total 50 cases of COM (average disease period - 5.7 years), of both sexes, with age range of 15-60 years and mean age of 31.58 years were taken. On analyzing above mentioned parameters using SPSS software, we found no significant difference in vestibular function in cases of COM as compared with healthy individuals. 

Discussion

The outcome of computerized static posturography can be quantified with respect to changes in center-of-force sway amplitude, distance, or velocity, which, by virtue of not being burdened by subjective interpretation, its results can be, documented both graphically and numerically.

Conclusion

This study, further solidified with objective evidence, raises a question on COM without complications being directly responsible for vestibular dysfunction.
Maxillary Dentigerous Cyst Associated With Supernumerary Tooth
Authors: Nanwani Prashant
Published: August 2020

Introduction

Dentigerous cysts are caused by a developmental abnormality derived from the reduced enamel epithelium of the tooth-forming organ. Dentigerous cyst rarely involve impacted supernumerary tooth in anterior maxilla while commonly involve third molar tooth.  

Case Report

A case of dentigerous cyst in association with supernumerary tooth in a 15-year-old male patient is reported causing right nasal cavity obstruction. The present case report describes the management of a dentigerous cyst by surgical enucleation.
Fibrolipoma of the Hypopharynx
Authors: Bhutia Kunzang Doma , Bose Anandabrata , Debnath Anjon
Published: August 2020

Introduction:  Hypopharyngeal  lipomas  are  rare  tumors  of  head  and  neck  which  present  with  vague  symptoms  like  dysphagia,  foreign  body  sensation  in  throat,  feeling  of  something  coming  to  the  throat  or mouth,  choking  sensations  or  with  symptoms of  obstructive  sleep  apnea.  These   tumors  can  cause  upper  airway  obstruction  and  even  asphyxial   deaths  presenting  as  medical   emergency. 

Case report:  We  report  one  such  case  of  a  38  year  old  female  with  hypopharyngeal  lipoma  who  had  presented  to  us  with symptoms  of  dysphagia,  choking  episodes  and  foreign  body  sensation  in  throat.

Discussion:   Laryngoscopic  examination   in  these  cases  is  diagnostic  to  assess   its  size  and  site  of  attachment.  Imaging  studies  like  CT scan  or  MRI  help  in  diagnosis.
Endoscopic Stapedotomy: A New Dimension to the Conventional Microscopic Procedure
Authors: Ghosh Bhaskar , Adhikary Bijan Kumar
Published: August 2020

Introduction

Endoscopes are not only complementing microscopic ear surgery but are also establishing their independent role in recent years.

Materials and Methods

This observational study was conducted from February 2018 to February 2019. Thirteen patients with clinical and audio-tympanometric features suggestive of stapedial otosclerosis underwent unilateral endoscopic stapedotomy from February to July 2018. They were followed up for a minimum of 6 months, till February 2019. Zero degree naso-endoscopes were exclusively used. Details of the surgical technique, its usefulness and subjective drawbacks are described.

Results

Two patients with sequel of otitis media with effusion evident at surgery were excluded. With a female predilection, the average age of the subjects was 31 years (range: 17-56 years). Curettage of the posterosuperior wall was needed in 7 patients; significant canalplasty was performed in 2 of them where the endoscope was difficult to negotiate. The chorda tympani required mobilization in only 3 patients, including those requiring significant canalplasty. Per-operative complications included injury to the chorda, tearing of tympanomeatal flap, and instability of the long process of incus in 1 patient each. One patient was lost to follow up. Average pre-operative bone conduction was 10±5dB with an air-bone gap at 35±5dB. At 6 months follow up, air-bone gap of <10dB was achieved in 5 patients, and that at10-20dB in 4. One patient developed moderate sensorineural component. Otherwise, there was no significant complication at 6 months following surgery.

Conclusion

Endoscopic stapedotomy is a safe and effective approach towards stapes surgery, with better surgical field of view and minimal tissue trauma
Use of Voice Handicap Index (VHI) as Predictor of Outcome of Non-surgical Treatment in Vocal Nodules
Authors: Hazra Sayan , Dubey Arya Brata , Das Arindam , Janweja Mridul
Published: August 2020

Introduction

Vocal Nodule is commonest benign vocal cord lesion which causes varying degree of dysphonia having serious impact on personal and professional well being. Voice Handicap Index (VHI) is a psychometrically validated tool for measuring pshycosocial handicapping effect of voice disorder.

 

Materials and Methods

From data available since last 18 months, patients who had undergone treatment for vocal nodule were selected as study population. In Group A, 50 patients were selected who required surgery and Group B, 50 patients who responded to medical treatment. Patients filled in VHI-30 form at time of diagnosis and subjected to voice therapy and adjunctive medical treatment for 1 month and reassessed using VHI-30. Successful treatment consisted of absence of pathology by laryngoscopy and decrease of VHI total score ≥18.

 

Results

The cut-off score was calculated using Receiver Operating Characteristics (ROC). VHI cut-off of total score was 45 (Sensitivity 94%, Specificity76%). The cut-off score for functional, physical and emotional domains are 14(Sensitivity 94%, Specificity 64%) , 15(Sensitivity 92%, Specificity 60%) and 15(Sensitivity 90%, Specificity 66%) respectively.

 

Discussion

Hard consistency of nodules can explain refractoriness to speech therapy and higher VHI score. The physical subscale of VHI was higher among both groups indicating patients’ perceptions of laryngeal discomfort and voice output affected them more. According to our study patients with higher VHI score should be counselled for MLS at earliest instead of speech therapy for one month which would not have given good outcome.

 

Conclusion

These scores give a good idea about categories of patients who will not benefit by non-surgical treatment and hence early surgical intervention will obviate the duration of handicap and delay in appropriate treatment.
Effect of Intratympanic Dexamethasone in Idiopathic Sudden Sensorineural Hearing Loss
Authors: Hembrom Rabi , Sen Indranil , Tamang Bina , Mandal Satadal , Chakrabarti Amit
Published: August 2020

Introduction

Oral steroids currently represent the standard treatment for idiopathic sudden sensorineural hearing loss The aim of this study is to assess the effectiveness of intratympanic dexamethasone injection for treating ‘Idiopathic sudden sensori-neural hearing loss’ (ISSNHL) not improved with conventional oral steroid.

Materials and Methods

A prospective study was conducted on 30 patients refractory to oral steroid therapy between June 2017 to May 2018. ‘Intratympanic dexamethasone injection’ (ITDI) was given every week for 3 consecutive weeks. Hearing was assessed by performing pure tone audiogram before every ITDI and also 1 week after the completion of treatment.

Results

Hearing improvement was found in 19 out of the 30 cases (63.3%).

 

Conclusions

Intratympanic dexamethasone significantly improves the prognosis of ISSNHL and is a safe, inexpensive and effective treatment.
Perichondrium - An Autologous Substitute for Temporalis Fascia in Type I Tympanoplasty: A Comparative Study
Authors: Kayet Bahnisikha , Dubey Aryabrata
Published: August 2020

Introduction 

Temporalis fascia is the commonly used graft material for tympanic membrane reconstruction. Tragal perichondrium share with the fascia the quality of being mesenchymal tissue. In our study we compared perichondrium and temporalis fascia in terms of graft uptake and hearing improvement.

Materials and Methods

All patients presenting with discharge from ear and decreased hearing were subjected to clinical examination and investigation. Patients satisfying inclusion criteria were included in study with total of 40 patients. Twenty underwent type1 tympanoplasty with temporalis fascia (TF) and another 20 patients with tragal perichondrium (TP). To evaluate success patients are evaluated at end of 6 months for graft uptake and 3 months for hearing results in audiological gain of 10 dB in two consecutive frequencies.

Results

Mean Pre-op AC Threshold in TF group was 30.75 dB±5.16 and Post-op AC Threshold was 14.15 dB±8.05. Mean Pre-op AC Threshold in TP group was 32.2 dB±4.81 and Post-op AC Threshold was 20.95 dB±7.14. Mean post-op AC Threshold, Mean Post-Op AB Gap and Mean Audiological Gain was statistically significant among 2 groups p=0.0075, p=0.0013, p=0.0294 respectively.  Temporalis fascia was better than Tragal Perichondrium. Graft uptake in 2 groups was not significant (p=0.6325).

Conclusion

From the present study we may conclude that temporalis fascia, tragal perichondrium free grafts provide viable autograft material for tympanoplasty. Both achieve good hearing restoration but the improvement in hearing or audiological gain is better in temporalis fascia graft than in tragal perichondrium graft.
Efficacy and Safety of Duckbill Valve Voice Prosthesis in Comparison to Provox
Authors: Mukherjee Monoj , Das Siddhartha
Published: August 2020

Introduction

Voice rehabilitation is the most important issue after total laryngectomy as source of vibration is removed. Three options are there like esophageal voice, electrolarynx and surgical prosthetic voice. Best is the prosthetic speech as voice is generated by lung powered air column. Provox prosthesis is the standard on and most commonly used. But it is costly for the class of patients presenting to our government hospitals. Duckbill prosthesis is very economical and may be helpful for them. There is very limited number of studies with duckbill prosthesis.

Materials and Methods

Twenty two  post-laryngectomy patients  was selected for this study. Proper counselling was done regarding cost, pros and cons of Provox and Duckbill prosthesis. Fifteen patient selected Duckbill where as seven patient have chosen Provox prosthasis. Voice analysis was done after one month of speech therapy by perceptual voice analysis protocol. Safety and complications arising from prosthesis were also noted.

Results

There was no significant difference in quality of voice.Both prosthesis are safe if prolong use is avoided.

Conclusion

There is no significant difference in the quality and safety of both the prosthesis, but huge difference in cost is present. More over it is recurrent cost as it should be changed every year or earlier. One Provox costs around rupees fifty thousand whereas a duckbill prosthesis costs rupees one thousand approximately in Indian market.
Determining the Association of Benign and Malignant Salivary Gland Tumours with ABO-Rh Blood Groups
Authors: Oroei Mahbobeh
Published: August 2020

Introduction

Various studies have proposed that some ABO blood groups may be associated with increased risk of cancer. Hence, we decided to conduct this study to investigate the relationship between ABO-Rh blood group and risk of salivary gland tumor.

Materials and Methods

In this study, 190 patients with salivary gland tumor and 400 healthy persons were investigated. Demographical information including ABO blood group of both groups were collected and analyzed using the SPSS 18 version. Binary logistic regression (univariate and multivariate model) were applied with 95% confidence interval.

Results

The most common blood group in patients with salivary gland tumor was blood group O. There was no significant relationship between the ABO blood group and salivary gland tumor risk (All; p>0.05). The blood group O and A were the most abundant blood groups in patients with the malignant and benign salivary gland tumor respectively (46.6%, 35.7%).The risk of malignancy of tumor in the patients with blood group O was marginal (1.84; 95%CI: 0.96-3.53, p: 0.06). 

Conclusion

This study shows no relationship between ABO-Rh blood groups and salivary gland tumor risk. However, to reach a definitive conclusion about the risk of malignancy in blood group O, stronger studies are needed in the future.
An Innovative Technique to Repair Cervical Oesophageal Perforation using Oro-oesophageal Tube and AMBU
Authors: Gupta Manish , Datta Ginni
Published: August 2020

Introduction

Oesophageal perforation is a rare condition and has high morbidity and mortality. Both the morbidity and mortality are directly related to the delay in diagnosis and start of treatment. Primary closure with drainage is recommended if perforation is detected in less than 24 hours. Treatment for delayed or missed rupture of oesophagus is not very clear and is controversial.

Case Report

We hereby report a case of delayed diagnosed cervical oesophagus rupture following gunshot, which was primarily repaired. Special emphasis is on newer technique of fistula localization using oro-oesophageal tube and AMBU for better closure. The fistula closure was successful and no there were no post-operative complications.

Discussion

The symptoms and signs on presentation of patient of cervical oesophagus perforation are discussed along with the differing treatment paradigms for early versus late presentation. Surgical repair with primary closure may be undertaken, even in late presentation of oesophagus rupture. This technique of oro-oesophageal tube used along with AMBU, may be useful in cases of both cervical and upper thoracic oesophagus rupture.
Cornu cutaneum of Pinna
Authors: C Satish Kumar , K V Bharathi , Colbert Kumaran Ramesh , A Sophia
Published: August 2020

Introduction

Cornu cutaneum is a nodule of dense keratin, resembling the horn of animals, an uncommon clinical condition predominantly seen in elderly men, and even rare to be seen on the pinna.

 

Case Report

A 70 year old man, presented with a horn like swelling on the left pinna for 2 years. The lesion was excised and histopathological examination did not show any underlying or associated conditions. 

Discussion

The cause of worry here is not the disfigurement, but the probability of underlying premalignant or malignant condition. Exposure to sunlight is considered as the etiology. Ours being a tropical country where exposure to sunlight could not be avoided, a high clinical vigil and early intervention is recommended to reduce the mortality and morbidity from the spectrum of diseases resembling this condition.
Clinical and Experimental Study on Thermoregulatory System and its Relation with Vasomotor Rhinitis
Authors: Saha Somnath , Majumder Nirmalya Kumar , Thombre D P
Published: August 2020

Introduction

Much of the perennial cold are of vasomotor origin still a less appreciated phenomenon even among the medical personnel, much of which is dubbed in a cursorily in the clinical analogue of a west paper wrap as ‘allergic rhinitis’.  This study was attempted to find out the role of thermoregulatory system with causation of vasomotor rhinitis and assessing role of hypothalamus in causation of vasomotor rhinitis.

Materials and Methods

In this study conducted during the period of July 1987 to August 1988, 20 normal adult individuals were taken as control and thermoregulatory study was done on them. The results were compared with cases of vasomotor rhinitis/non-allergic rhinopathy cases. In experimental study thermoregulatory study was done on albino rats before and after stereotaxis of anterior and posterior hypothalamic nuclei and the result were compared before stereotaxis and post stereotaxis.

Results

Among human study in clinical subjects, patient suffering from vasomotor rhinitis showed a definite shift towards thermoregulatory imbalance both for generalized body caloric fluctuation and particularly on the nasal mucosa. Post-vidian neurectomy results for thermoregulation test was highly significant. In animal study post-hypothalamic stereotaxis temperature measurement showed minimal depression. Dorsal anterior hypothalamic lesion ablation showed significant derangement in the thermoregulatory tolerance profile of the rats’ belly temperature. Posterior hypothalamic lesion showed that there may be some amount of derangements in the thermoregulatory tolerance, which however is not statistically conclusive. Thermoregulatory control is done at hypothalamus, particularly at anterior hypothalamic nuclei level and posterior hypothalamic nuclei in the brain. Thermoregulatory study proves a close correlation between non allergic rhinitis with imbalance in central thermal regulation by hypothalamus.

Conclusion

Thermoregulatory study in control and clinical subjects proves a close correlation between vasomotor rhinitis and sympathetic, parasympathetic system.