bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of Diagnostic Criteria for AFRS: A Hospital Based Study
Authors: Chaitanya Krishna V , Kalavathi Lakshmi C 
Published: August 2020

Introduction
Bent and Kuhn criteria are the most commonly accepted diagnostic criteria for diagnosis of Allergic Fungal Rhinosinusitis. Other diagnostic criteria for the diagnosis of Allergic Fungal Rhinosinusitis include unilateral nasal disease, Charcot Leyden crystals, bony erosions which form the minor criteria in the diagnosis of Allergic Fungal Rhinosinusitis. Clinical and Laboratory features in Allergic fungal rhinosinusitis are variable. These variations in the diagnostic criteria in the diagnosis of Allergic Fungal Rhinosinusitis have been analysed in the present study.
Materials and Methods
Prospective study was performed on group of 46 patients of Allergic fungal Rhinosinusitis presenting in the Otorhinolaryngology OPD with symptoms of Allergic fungal rhinosinusitis as diagnosed and persisting for more than 3 months during September 2009 to August 2010.
Results
Absolute eosinophil count was elevated in 80.43%, total serum IgE elevated in 69.67%, skin prick test was positive in 63.05% of patients. CT scan revealed that most common paranasal sinus involved is ethmoid sinus as seen in 73.91% cases., Sphenoid sinus was least involved as seen in 17.40% cases. More than one paranasal sinus were involved in 65.21% of the cases.,Complete opacification of all sinuses with calcified deposits were seen in 4.76% cases. Mucosal thickening was seen bilaterally in 73.91% of the patients and bony erosion was noted in 6.52% of patients. Histopathology of nasal smears revealed Eosinophilia in 80.43% of patients. Inflammatory Charcot Leyden crystals were found in 15.21% of the patients45.65% showed goblet cell hyperplasia . Other types of inflammatory cells were seen in 56.52%of the study population and 23.91% patients showed positive fungal hyphae.
Discussion
The significance of absolute eosinophil count, skin prick test, histopathology, CT Scan features and nasal smear cytology have been discussed along with review of literature.
Conclusion
Although management of Allergic Fungal Rhinosinusitis has advanced tremendously with better understanding of underlying pathogenesis, diagnostic strategies are still far from clear and are still emerging. Lot of research work has to be carried out regarding relevant diagnostic criteria for the disease.
Comparison of Various Graft Materials in the Reconstruction of Ossicular Chain in Patients with Chronic Otitis Media: A Prospective Hospital Based Study
Authors: Fakhruddin Niaz , Gangaiah Chethan Kumar , KP Gopakumar , Thottan Geogin George , Noufal Mon 
Published: August 2020

Introduction
Ossicular chain reconstruction is the surgical procedure used to correct the hearing problems in patients with chronic otitis media (COM). In this era, where a large variety of innovative artificial prosthetic materials are being used to replace and reconstruct the ossicular chain, autografts still play a significant role.
Materials and Methods
The present study included 40 patients. Study population was selected based on inclusion and exclusion criteria. The ossicular reconstructive procedure was done under anesthesia and according to the status of the ossicular chain. Temporalis fascia was used to close the perforation. Mainly two procedures were performed: one is intact canal wall and the other is canal wall down.
Results
Most of the study population was middle aged and males were more compared to females. Thirty five patients had air bone gap above 30dB. In 38 patients, the incus had undergone necrosis. Most of the patients underwent short columella reconstruction. A closure of air bone gap with in 20 dB was achieved in 72.2% in patients with malleus stapes assembly. In short columella 22.2% of patients had closure of air bone gap within 20 dB. Incus remnant grafts gave better hearing gain.
Discussion
The published literature on the result of use of sculptured ossicle and cartilage in tympanoplasty have been reviewed
Conclusion
In the present study, cases with COM showed good hearing results patients implanted with autogenous cartilage and bone.
Role of Polidocanol as Sclerosant in Treatment of Hemangiomas of Head and Neck Region
Authors: Sangma Rupanjita , Patar Mukul 
Published: August 2020

Introduction
Haemangiomas are common presentation in head and neck, prevalence being 60% followed by 25% and 15% respectively in trunk and limbs. This report studies the efficacy of Polidocanol as sclerosant in the treatment of heamangiomas in head and neck.
Materials and Methods
The two year prospective study conducted from January 2015 to December 2016 with Polidocanol as sclerosant on 55 patients attending the department of ENT. Intralesional injections of 3 % polidocanol were given at 2 week intervals.
Results
Out of 55 patients 15 cases did not follow up after the first dose, so results were calculated out of 40 patients. 12 patients showed complete regression & 15 showed regression to half the size. Thus 67.5 % patients showed acceptable results. There were no side effects except hyperpigmentation in 2 patients. There were no cases of recurrence during our study period.
Conclusion
Sclerotherapy is a promising method of treatment for haemangiomas of head and neck that may obviate the need for surgical intervention.
Midline Nasal Dermoid - A Series of Thirteen Cases and Review of Literature
Authors: Saha Vedula Padmini , Ghosh Debangshu , Dutta Santanu , Saha Somnath , Basu Sumit Kumar 
Published: August 2020

Introduction
Congenital midline nasal masses include nasal dermoid sinus cysts, encephaloceles and gliomas. They are rare malformations, of which dermoid cyst is a relatively common congenital abnormality. A systematic review of the clinical feature and management outcome of congenital midline nasal dermoids would help in predicting the outcome of such cases.
Materials and Methods
A prospective observation was made on a series of patients with nasal dermoids with or without sinus tract for a period of three years. Altogether thirteen patients were evaluated. Age of the patients ranged from two to twenty seven years. There were seven males and six females. Intracranial extension was ruled out radiologically. Excision of the dermoid cyst with or without sinus tract was undertaken under general anesthesia and followed up for one year.
Conclusion
Surgery is the gold standard treatment for nasal dermoids and complete excision and cosmetically good repair is mandatory for good results.
Congenital Midline Nasal Mass: Four Cases with Review of Literature
Authors: Chintale Sambhaji Govind , Jatale Sonali Prafull , Kirdak Vilas Rambhahu , Shaikh Kaleem Azeem 
Published: August 2020

Introduction
Congenital midline nasal masses include nasal dermoids, gliomas, encephaloceles. Although rare, these disorders are clinically important because of their potential for connection to the central nervous system. Preoperative knowledge of an intracranial connection is a necessity to allow for neurosurgical consultation and possible planning for craniotomy. This study discusses the clinical presentation of congenital midline nasal mass and the role of imaging modalities like CT scan and MRI in diagnosis and the surgical management.
Materials and Methods
This prospective study is carried from March 2014 to March 2016, during which 4 cases presented to the Otorhinolaryngology department. Pre-operative evaluation of the patients included endoscopic evaluation along with haematological investigations, CT Scan and MRI. The masses were removed with nasal endoscopic sinus surgery or by external approaches and neurosurgical intervention.
Result
The age of the patients ranged from 3 years to 25 years. Three of them were male and one female. There was one case of nasoethmoidal encephalocele and the other three were dermoids (intranasal dermoid cyst, nasal dermoid cyst and nasal dermoid sinus cyst).
Conclusion
Congenital midline nasal masses are rare. These disorders are clinically important because of their intracranial connection which require proper evaluation with radiological imaging like CT scan and/or MRI before FNAC and any surgical intervention.
Skull Base Langerhans Cell Histiocytosis with Diabetes Insipidus and Panhypopituitarism- A Rare Clinical Entity
Authors: Ghosh Anirban , Chaudhury Mithun , Mukherjee Abhishek 
Published: August 2020

Introduction
A case of Langerhans cell histiocytosis (LGH) involving extensive area of base of skull resulting in panhypopituitarism and diabetes insipidus (DI) is reported.
Case Report
A 16 year old male presented with diminished vision, bilateral ptosis, left sided lateral rectus palsy, hypoesthesia of trigeminal nerve with nasal obstruction for last 5 months. There was polypoidal, bleeding mass in both nasal cavities. Contrast enhanced CT Scan showed a large homogenous mass arising from sphenoid extending into cavernous sinus and the suprasellar region. Endoscopic nasal biopsy revealed abundant Langerhans cell histiocytes, macrophages, neutrophils. Chemotherapy and radiotherapy were administered. But within 2 months the patient presented with Cushingoid features and further diminution of vision. Detailed work-up revealed Hypogonadotrophic hypogonadism and diabetes insipidus. Debulking of the tumour was done and left optic nerve decompression was done. PET scan was performed and showed large, well defined mass with increased FDG uptake in the skull base with suprasellar extension, reaching upto petrous temporal bone and causing bony erosion of ethmoid and sphenoid sinuses. Patient was then advised adjuvant chemotherapy.

Discussion
Langerhans cell histiocytosis is a rare group of disorders characterised by abnormal clonal proliferation and accumulation of abnormal dendritic cells. Involvement of base of skull is even rarer. Though diabetes insipidus has been reported in Langerhans cell histiocytosis involving pituitary, panhypopituitarism is rare. These combinations of extensive Langerhans cell histiocytosis of base skull with clinical features of Diabetes insipidus and panhypopituitarism makes this case a rare clinical entity.
Venous Malformation in the Neck
Authors: Adhikary Bijan Kumar , Kundu Sohag , Ghosh Bhaskar , Sinha Ramanuj 
Published: August 2020

Introduction
Venous malformation is a benign vascular lesion. Approximately 40% of such cases occur in head and neck.
Case Report
Venous malformation in a 19 year old man is reported, which presented as a lateral neck swelling.
Discussion
The venous malformation in the head and neck region may confuse the surgeon in distinguishing it from its other common congeners e.g. hemangioma, lymphangioma etc. and may also cause dilemma regarding its treatment modality. Treatment options include surgery, laser therapy, sclerotherapy or a combination depending upon the complexity of the lesion.
Do Socio-Economic Factors Play a Role in Delayed Presentation of Complicated Chronic Otitis Media (Squamous)?
Authors: Maggon Nidhi Vohra , Sethi Ashwani , RWR Harikesh , Pimparkar Surendra Vishwasrao 
Published: August 2020

Introduction
The influence of Socioeconomic (SE) status on delayed reporting and consequent complications in cases of Chronic Otitis Media-squamous (COMS) has been investigated.
Materials and Methods
This prospective observational study included 34 patients with complicated COMS who presented to Otolaryngology Department at a tertiary care teaching hospital between December 2012 and December 2016. The patients were classified into 5 classes namely upper, upper middle, lower middle, upper lower, and lower based on a standardised real-time Kuppuswamy’s SE status scale (KS) taking an average of consumer price indices for Industrial workers over 4 years (Jan ‘12 to Dec ‘16) as 267 and calculating their incomes. Level of education and occupation of the head of the family were the other components of KS which was calculated for each presenting patient.
Results
Of the 34 patients, 15 were males (44%) and 19 females (56%) with their ages ranging from 18 months to 61 years (Mean-24.1 years, SD-17.3). 15 of the 34 patients (44.1%) were in the Upper-lower SE class as per KS Scale, 13 were in lower-middle class (38.23%), 5 were in Upper-middle class ( 14.70%) and 1 patient belonged to Upper class (2.9%). Though the literacy levels are integral to KS Scale a differential analysis showed 23 of the 34 patients/guardians had education level poorer or equal to Intermediate high school (67.64%). The time gap between onset of symptoms of COMS and presentation with complications of COMS ranged from 9 months to 8 years with a mean time gap of 3.48 years (SD-2.01). There were 24 Extra-cranial complications and 21 Intra-cranial complications with 10 patients having more than one complications. There was a strong inverse correlation between Time gap and composite KS (-0.51). A differential analysis showed that Time gap most strongly correlated with Education level of the head of the family (-0.615), followed by total family income (-0.403) and occupation of the head of the family (-0.329).
Conclusion
There is a strong association between the SE status of the family and the occurrence of complications in COMS that is otherwise highly amenable to successful management. Level of education, nature of employment and family income that constitute KS scale have significant inverse correlation with delayed reporting and consequent complications of COMS. Level of Education is the greatest influence on the time gap.
Juvenile Nasopharyngeal Angiofibroma: Changing Paradigms in Management
Authors: Bhalla Vijay , Narayanaswamy Ramakrishnan 
Published: August 2020

Introduction
Juvenile Nasopharyngeal Angiofibroma (JNA) is a tumor of young and adolescent males. It is a benign vascular tumor arising from the spheno-palatine foramen. It is best managed surgically at present by endoscopic methods with or without pre-operative embolization. Tumor attributes like intracranial extent and residual vascularity after embolization need to be assessed pre-operatively before undertaking endoscopic surgery, in order to reduce surgical blood loss and morbidity.
Materials and Methods
Twenty-three cases of JNA (n=23) were operated endoscopically at a tertiary level military hospital. They were staged with the Snyderman staging system. Demographic variables including stage wise management were brought out with intraoperative time and blood loss recorded for different stages.
Results
The intraoperative surgical time, intra-operative blood loss and recurrence/residual rates were compared with similar studies in existing literature and correlated well.
Conclusion
Endoscopic Endonasal approach to JNA is now a well-established technique. With improvements in embolization techniques and better instrumentation like HD camera systems, endo-bipolar cautery, Coblation and endo-liga clips and neuro-navigation, better visualization and better haemostatis can be achieved, resulting in significant reduction in the morbidity and improvement in surgical results.
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.