bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection
Authors: Chaudhuri Gaurab Ranjan 
Published: August 2020

Introduction
Primary closure following oncosurgical resection of carcinoma tongue has been found to compromise tongue function in regards to speech and swallowing very badly. In contrast, reconstruction of tongue with free radial forearm flap following oncosurgical resection has shown promising functional outcome.
Materials and Methods
Thirteen patients (ten male and three female) with squamous cell carcinoma involving anterior 2/3rd of tongue had undergone either hemiglossectomy or subtotal glossectomy. Reconstruction was done with free radial forearm flap following oncosurgical resection and neck dissection. All of them received postoperative radiotherapy. Follow-up ranged from 2 months to 2 years. The age of the patients ranged between 32 and 65 years. Flap dimension ranged from 7x6 cm to 10x8 cm. Vascular anastomosis performed in an end-to-end manner with 8-0 Ethilon® under loupe magnifiacation.
Results
Venous congestion occurred in one patient after 48 hours postoperatively and the flap underwent complete necrosis on postoperative day 5. Postoperative hematoma was found in one patient within first 24 hours of reconstruction. Re-exploration was done immediately, blood clots were removed. No fresh bleeding point was seen and the flap survived. In this series, 12 out of 13 flaps survived completely (92%).
Conclusion
The free radial forearm flap has become a workhorse flap in head and reconstruction due to its lack of extra bulk, relative ease of dissection, long vascular pedicle, good calibre vessels, malleability and minimal donor site morbidity. Furthermore its low flap loss and complication rate offer the best choice for tongue reconstruction.
Endoscopic Cauterization of Sphenopalatine Artery in Posterior Epistaxis- Our Experience
Authors: Singh Mukesh Kumar , Das Chiranjib , Mukherjee Dwaipayan , Majumder Anirudhha , Hazra Tapan Kanti 
Published: August 2020

IntroductionEpistaxis is one of the commonest emergencies in Otorhinolaryngology. The management of intractable posterior epistaxis sometime becomes challenging to ENT surgeons. Over the last decade endoscopic cauterization of sphenopalatine artery has emerged as a viable and minimally invasive alternative.
Materials and MethodsThirty four patients with intractable posterior epistaxis were treated by endoscopic sphenopalatine artery cauterization between March 2010 & February 2013.
ResultsThere was no recurrence of epistaxis with an average follow-up of 12 months in 30 out of 34 patients. Only 4 patients had anterior epistaxis in follow up period, which were managed with anterior nasal packing. The success rate of endoscopic sphenopalatine artery cauterization, in this study was 88%.
ConclusionEndoscopic sphenopalatine artery cauterization is a safe & efficient method of controlling persistent posterior epistaxis with minimal complication.
Surgical approach to Parapharyngeal Tumours - Our Experience
Authors: Ghosh Shrestha Devjani , Majumdar Kinjal Shankar , Samanta Nirmalya , Jana Utpal 
Published: August 2020

IntroductionThe complex anatomy of the parapharyngeal space, the surrounding vital structures and late presentation of the tumours affecting this space pose difficult surgical challenge to every otolaryngologist. The study gives an overview of the experience in managing parapharyngeal tumours in a tertiary care setting.
Materials And MethodsFifteen patients with parapharyngeal tumours were treated surgically in a medical college hospital in Kolkata in the three year study period. Surgical approaches were chosen, considering the size, site, extent and histology of the tumours.
ResultsMost of the patients (33.33%) were from 20-30 years age group. 60% were females. The most common presenting feature was neck swelling. 80% of the cases were benign.The most common histologic variant was Schwannoma. The tumours were accessed through Trans-cervical, Trans-cervical Trans-parotid or Trans-cervical with Midline Mandibulotomy approaches. The most common post-operative complication was wound dehiscence.
DiscussionThe most common presentation of a parapharyngeal mass was neck swelling mainly behind the angle of mandible (86.67%). Younger patients in their third decade of life were found to be affected more. Gadolinium enhanced MRI was found to be the most important investigation in parapharyngeal tumours. Complications were minimal.
ConclusionA conservative trans-cervical approach was found to be feasible and effective in majority of the cases over radical ones, which may be required in malignancies and skull-base involvement.
Occult Foreign Bodies in ENT
Authors: Adhikary Bijan Kumar , Biswas Subhra Deb , Das Avick , Ghosh Swapan Kumar 
Published: August 2020

IntroductionForeign bodies are common ENT emergencies. Histories are usually forthcoming from the patient himself or the relatives . Three occult foreign bodies are reported here, which were missed even by treating doctors, with discussion about steps to avoid such errors in future.
Case SeriesCase 1: Though the history was apparent, the foreign body was removed only after 13 years from the Zygomatic region.Case 2: The parents were aware of the foreign body but inadequate investigations led to a delayed diagnosis.Case 3: The history clinched the diagnosis. Pre operative localization and separate incision to remove the foreign body saved the vital structures.
DiscussionA high index of suspicion, meticulous history and proper investigation like x-ray or CT scan or MRI of the diseased area may help in locating the hidden foreign bodies in the ENT region.
Migration of Ingested Fish Bone from Upper Aerodigestive Tract to the Skin of the Neck
Authors: Saha Mukulika , Chakrabarti Amit , Maity Amit Bikram , Mandal Satadal 
Published: August 2020

IntroductionIngested foreign bodies commonly get impacted in the upper aero digestive tract, but only a few of these foreign bodies have perforated the oesophagus and an even smaller number of these have migrated extraluminally.
Case reportA 43 year old male patient presented with history of accidental ingestion of fish bone (F.B) 3 weeks back. On examination a sharp pointed swelling was seen over right side of neck and on palpation a pointed object was felt beneath the intact skin. Digital X-ray, ultrasonography of the neck and CT scan neck showed a linear obliquely placed foreign body on right side of neck at the level of thyroid gland. The foreign body was easily removed by an incision over the skin and was confirmed to be a fish bone.
DiscussionHorizontally oriented foreign bodies are more likely to penetrate the lumen of a hollow viscus. The muscular contraction of the neck might account for this unusual event to some extent, one possible factor being that the presence of the foreign body in the soft tissue might have led to inflammation and oedema, which made the texture of the surrounding tissue loose and lax ; a sort of gel-sol interconversion.
Revisiting the Operating Room Basics
Authors: Chakravorty Tushar 
Published: August 2020

Young doctors walking into the operating room are eager to develop their skills to become efficient and knowledgeable professionals in future. But precious little is done to actively develop the basic practical skills of the budding doctors. They remain unaware about the layout of the operating room, the OR etiquette and often do not have sound scientific understanding and importance of meticulous execution of the basic operating room protocols.
This article stresses the need to develop the basics of OR protocol and to improve the confidence of the young doctor by strengthening his foundation by showing him that attention to the basics of medical care and empathy for the patient can really make a difference to the outcome of a treatment.
Idiopathic sialectasia of Stensen’s duct treated by marsupialisation of ectatic segment
Authors: Pal Indranil , Kumar Saumitra , Sinhababu Anindita , Chatterjee Kushal 
Published: August 2020

Introduction:Sialectasis of parotid duct is an uncommon condition characterised by abnormal dilatation of a part or whole of the Stensen's duct. It may lead to recurrent parotid infections as well as a cause of concern for the patient. Superficial parotidectomy is the accepted surgical treatment for this condition.
Case Report: A case of idiopathic dilatation of parotid duct is presented. It was treated by marsupialisation of the sialectatic segment.This procedure proved to be much simpler and safer than superficial parotidectomy whilst being equally effective.
Conclusion: In cases of Stensen's duct sialectasis without any abnormality of the parotid gland, marsupialisation of the ectatic segment should be the treatment of choice.
Effect of Canalplasty on Outcome of Results in Type I Tympanoplasty
Authors: Mallick Ajay , Bhalla Vijay , Roy Ravi 
Published: August 2020

Background: The aim of the surgical procedure of tympanoplasty is to strive to achieve an intact neo tympanum with normal hearing acuity. Widening of the external auditory canal, called canalplasty, helps in better visualization and hence better placement of the tympanic membrane graft. Aim of this study was to compare effect of canalplasty on the outcome of results of type I tympanoplasty.
Methods: 50 cases of patients diagnosed with chronic otitis media mucosal disease with a central dry perforation involving two or more quadrants of the tympanic membrane were included in the study. One group of 25 cases underwent tympanoplasty with canalplasty and was grouped under Group I while the other group of 25 cases underwent tympanoplasty without canalplasty and was called group II.
Results: Analysis was done for graft uptake, hearing improvement and time taken for the surgery. Group I achieved a success rate of 92% graft uptake as compared to group II, which achieved 84%. There was statistically significant improvement in post-operative hearing in cases with canalplasty. Time taken was between the two groups were not statistically significant.
Conclusion: Anatomical and technical factors diversely affect the functional outcome of tympanoplasties. Canalplasty helps in better visualization and placement of the graft. Time spent on drilling in canalplasty is compensated by the time gained in grafting of the neo tympanum. The procedure prevents lateralization of the graft due to the accurate exposure of the annulus. Post operative care is also easier in cases of tympanoplasty with canalplasty.
Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry
Authors: K Sharath Babu , Prabakaran Jayagar , Radhakrishnan Shankar 
Published: August 2020

Background :
Otitis Media with Effusion(OME) also known as Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy.
Aims and Objectives :
To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion.
Materials and Methods:
A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A), adenoidectomy with bilateral grommet insertion (Group B), bilateral grommet insertion (Group C), bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D).
Result :
The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures.

Conclusion :
Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis Media with Effusion who is at risk for speech/language/hearing loss.
An Arrow Penetrating the Globe and the Sinonasal Complex
Authors: Narjinary Richard , Samaddar Saikat , Ghosh Sanjoy , Bandopadhyay Saumendra Nath 
Published: August 2020

Introduction:
Foreign bodies represent on average 11% of all ENT emergencies. Associated eye trauma represents 5% of all cases of blindness in developing countries. Accidental and homicidal arrow injuries presenting to an otorhinolaryngologist are still a stark reality in this modern era.
Case report:
A 22 year-old female presented with an accidental arrow injury in her left eye; extending into the nose. On examination, she had no light perception in left eye and a penetrating injury of the sclera. CT scan showed extensive injury to ipsilateral nasal cavity, floor of left orbit and the maxillary sinus and anterior ethmoid cells. Multidisciplinary approach ensured removal of the unusual foreign body from the orbit, nose and paranasal sinuses.
Discussion:
Accidental injury in ear, nose or throat with sharp projectiles presents a challenge. Arrowhead may be poisoned and thus exploration is delayed until the systemic effect of the poisoned is reduced. An injury such as this involves a multidisciplinary approach. As ENT surgeons we must be aware such challenges and equip ourselves with the knowledge to tackle them.
Endoscopic Solution to Rhinogenic Contact Headaches
Authors: Segana Hasan Abdul Cader , Nair Reghunandanan , Ahmed Shah Fahim 
Published: August 2020

Introduction
Headache is a common complaint that brings patients to multidisciplinary clinics. It is utmost important to have meticulous clinical diagnosis of patients with rhinogenic and non sinusogenic headaches. The diagnosis has become easier with the advent of modern endoscopy and endoscopic sinus surgical techniques. This study aims to investigate the role of some anatomical nasal abnormalities in rhinogenic contact headache and to evaluate response to endoscopic surgery.

Materials and Method
A prospective study was conducted at a secondary level regional referral Hospital in the Sultanate of Oman. Patients with long-lasting, frequent, severe headaches not amenable to medical treatment, above 20 years of age were taken into consideration. Routine nasal endoscopy, Computerized tomography scan of the paranasal sinuses, Nasal decongestion and various surgical techniques to correct the anatomical abnormalities were included in our study and results were correlated statistically.

Result
There was a male predominance in our study with duration of headache ranging from 2 weeks to 5 years. There was a preponderance of headache in frontal region in our study group. Diagnostic nasal endoscopy and CT scan of PNS revealed Deviated nasal septum / septal spur, concha bullosa, Haller cell, pneumatised uncinate process and agar nasi cells. The overall success rate of the surgery in relieving headaches, measured by the MIDAS- VAS score, was approximately 75 %. The non-parametric Wilcoxon signed rank test, Chi square and paired T tests shows that the following study has rejected the null hypothesis as statistically significant where the P value <0.05.

Discussion
Researchers have examined the contact points as a source of rhinogenic / contact headache. Intranasal mucosal contact released substance P, causing pain and headache, Substance P has a potent vasodilator effect. Vasodilatation and perivascular inflammation are the final common pathways in pain. Surgical treatment for contact point-induced headaches has had good success.

Conclusion
The etiology of rhinogenic headache is multifactorial. Complete history taking, scrupulous preoperative evaluations, multidisciplinary consultations, Initial medical controls, long observation, and diligent postoperative follow-ups are mandatory for not only accurate diagnosis but also for promising surgical outcomes of non-sinusitis related rhinogenic headache. Our experience reveals that patients with rhinogenic contact headaches can benefit significantly from meticulous endoscopic decompression
A Comparative Study on Laryngeal Aerodynamics in Dysarthrophonic versus Normophonic Male Subjects
Authors: Chatterjee Indranil , Dhara Sovon , Chatterjee Somsubhra , Chaterjee Shahi Arpita 
Published: August 2020

Introduction
Dysarthria is a motor speech disorder. It occurs due to paralysis, weakness, or incoordination of the speech musculature. The authors with this study want to enrich clinical understanding of the difference of the aerodynamic characteristics in normophonic and dysarthric population.
Materials and method
The aerodynamic characteristics in normophonics and in dysarthric population were compared and documented using Voice Function Analyzer (Aerophone II®). Forty male individuals within the age range of thirty five to fifty five years participated in this study. The control group had twenty normophonic cases with no history of neurological disorder. The second group had twenty cases with dysarthria.
Result
Significant difference was found between the two groups in peak flow, forced volume and duration, vital capacity and fast adduction-abduction measurements.
Discussion
The difference in results from both the groups and their implications are discussed based on these findings.
Conclusion
The present study has assessed the parameters of speech and voice disorder in male dysarthric individuals. It suggests inclusion of aerodynamic measurement in test protocol and for evidence based research and prognosis documentation. Measurement of laryngeal or vocal tract resistance may be useful in documenting a variety of the perceptual voice characteristics.
Clinicopathological Study of Thyroid Swellings with Some Emphasis on Geographical and Community Distribution: A Hospital Based Analysis
Authors: Borsaikia Kusum , Patar Mukul 
Published: August 2020

Introduction: Thyroid swellings/goiter are still prevalent in north east part of India. Apart from its sub-Himalayan location the areas along the river Brahmaputra suffer from flooding every year and there is also frequent changing of river course, thought to be another reason for iodine depletion in soil of this region(3).
Aim: To determine the incidence of thyroid swellings and distribution among different sections of society and geographical areas, and to evaluate the role of FNAC in the diagnosis and management and find out its accuracy by comparing with histopathology.
Materials and methods: In the present study, total 212 patients with thyroid swellings attending department of ENT of a state medical college during the period from January 2013 to December 2015 and undergone FNAC at department of Pathology were taken into consideration.
Results: Out of 212 cases major fraction (52.83%) were hailed from areas along the Brahmaputra river followed by patients (33.96%) from tea gardens and adjacent areas. Patients belonging to tribal communities constituted 45.28%, whereas patients from tea workers section of society formed the second majority (34.9%). Female male ratio of cases was 5:1. Majority of patients were from 21-40 years age group with mean age of 37.2 years. Cytology results of 212 cases showed colloid goiter 73.58%, adenomatous goiter 8.49%, thyroiditis 9.9%, hurthle cell neoplasm 1.41%, follicular neoplasm 4.24%, papillary carcinoma 1.41%, papillary carcinoma of follicular variant 0.47% and medullary carcinoma in 0.47% cases. Histopathology was possible in 65 cases and compared with FNAC results with accuracy rate of 89.23%.
Conclusion: Frequent flooding and changes of river course may be one of the reasons for high prevalence of thyroid swellings and goiter along the Brahmaputra valley apart from its sub-Himalayan location. Consumption polluted drinking water and goitergenous food stuffs may be another reason of high incidence. FNAC is an easy, rapid, reliable, less invasive, low cost technique for diagnosis of thyroid swellings.
Intratemporal Facial Nerve Paralysis- A Three Year Study
Authors: Ghosh Anirban , Bera Sankar Prasad , Saha Somnath 
Published: August 2020

Introduction
This study on intratemporal facial paralysis is an attempt to understand the aetiology of facial nerve paralysis, effect of different management protocols and the outcome after long-term follow-up.
Materials and Methods
A prospective longitudinal study was conducted from September 2005 to August 2008 at the Department of Otorhinolaryngology of a medical college in Kolkata comprising 50 patients of intratemporal facial palsy. All cases were periodically followed up for at least 6 months and their prognostic outcome along with different treatment options were analyzed.
Result
Among different causes of facial palsy, Bell’s palsy is the commonest cause; whereas cholesteatoma and granulation were common findings in otogenic facial palsy. Traumatic facial palsies were exclusively due to longitudinal fracture of temporal bone running through geniculate ganglion. Herpes zoster oticus and neoplasia related facial palsies had significantly poorer outcome.
Discussion
Otogenic facial palsy showed excellent outcome after mastoid exploration and facial decompression. Transcanal decompression was performed in traumatic facial palsies showing inadequate recovery. Complete removal of cholesteatoma over dehiscent facial nerve gave better postoperative recovery.
Conclusion
The stapedial reflex test is the most objective and reproducible of all topodiagnostic tests. Return of the stapedial reflex within 3 weeks of injury indicates good prognosis. Bell’s palsy responded well to conservative measures. All traumatic facial palsies were due to longitudinal fracture and 2/3rd of these patients showed favourable outcome with medical therapy.
Unilateral Acquired Posterior Maxillary Mandibular Syngnathia
Authors: Sahu Abhishek Vijay , Roy Kamalika Purkayastha , Kashyap Niva 
Published: August 2020

Introduction: Congenital bony fusion of the maxilla and mandible, especially as an isolated occurrence, is a rare condition while acquired fusion being even rarer.
Case report: A rare case of a 32 year old female patient with acquired unilateral bony fusion between the zygomatic arch of maxilla and ramus of mandible is reported.
Discussion: Forty one cases of syngnathia has been reported in the international literature from 1936 to 2009, of which 39 cases are congenital and two were acquired, case 1 probably as a result of a fibrotic tubed pedicle and in case 2 from myositis ossificans. According to several case series, bony ankylosis of the mandible and maxilla has also been found to occur in 30%-43% of cases of NOMA.