bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-operative predictors of ossicular necrosis in chronic otitis media-mucosal type
Authors: Rasheed Razim Abdul , . Mubeena , Gangadhara Somayaji K. S. 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media can cause a wide range of pathologies in the middle ear that include irreversible mucosal changes, granulation tissue formation, cholesteatoma, tympanosclerosis, and destruction of ossicles. Knowledge regarding ossicular discontinuity before surgery enables the surgeon to be prepared for ossiculoplasty. Objective was to study the pre-operative clinical, audiological and microscopic findings in chronic otitis media mucosal type and correlate preoperative findings with intra-operative ossicular necrosis. </p><p class="abstract"><strong>Methods:</strong> Study design was observational, descriptive and cross sectional study. All patients were subjected to detailed clinical, otoscopic and microscopic examination to assess the size and site of perforation, presence or absence of ear discharge, granulation tissue, tympanosclerosis in the middle ear, exposure of incudostapedeal joint and condition of middle ear mucosa. Pure tone audiogram was also done. All patients underwent tympanoplasty±cortical mastoidectomy and the intraoperative findings of ossicular necrosis were noted. </p><p class="abstract"><strong>Results:</strong> Of the 105 patients, 18(17.1%) had ossicular necrosis. Bivariate analysis showed positive correlation for long standing disease (p=0.004), presence of discharging ear (p=0.014), polypoidal middle ear mucosa (p=0.000) granulations in middle ear (p=0.000) and also when incudostapedeal joint was exposed (p=0.005). Mean Air bone gap was higher with 35 dB in ossicular necrosis and 22.7 dB in intact ossicular chain was also statistically significant (p=0.0001).</p><p class="abstract"><strong>Conclusions:</strong> Ossicular necrosis was best indicated by the presence of polypoidal mucosa, granulation in the middle ear and higher air-bone gap on audiometry. However longer duration of disease, persistent active stage of disease and exposure of incudostapedeal joint were also found to be significant.</p>
Outcome of conchal cartilage shield type I tympanoplasty: a prospective study of 70 patients
Authors: Kunnumal Ayisha , Priyadarshini G. 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Tympanoplasty is a surgical procedure performed to reconstruct hearing mechanism with or without reconstruction of tympanic membrane perforation. Cartilage shield tympanoplasty was first reported in literature by Duckert et al in 1995.The purpose of the present study was to prepare the cartilage shield graft and to evaluate its effect on the success rate of tympanoplasty.</p><p class="abstract"><strong>Methods:</strong> In this study 70 patients who presented to ENT OPD of Aarupadai Veedu medical college, Puducherry, with chronic otitis media (COM) mucosal type, who were treated during the period between December 2016 to April 2018 were enrolled. Patients with COM mucosal type, with mild to moderate conductive hearing loss, dry or moist ear were included in the study. Detailed history was taken in the selected patients including a thorough otological examination and blood investigations required for surgery. </p><p class="abstract"><strong>Results:</strong> In the present study male to female ratio was 1.6:1. 30% patients were in the age group between 20-24years. In our study 33% patients had pre-operative airbone gap in the range of 31-40 dB and post-operative improvement in airbone gap was in the range of 0-10 dB in 49% patients.</p><p class="abstract"><strong>Conclusions:</strong> Conchal cartilage shield tympanoplasty is an effective technique in tympanic membrane reconstruction and shows no detrimental effect to the hearing outcome. Conchal cartilage is preferred graft as it can be harvested from same incision. The graft uptake rates are excellent with this technique.</p>
Adenoid hypertrophy in adults
Authors: Thimmappa T. D. , Gangadhara K. S. 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Adenoid is a nasopharyngeal tonsil becomes active between 3 to 7 years of age. Starts involution by adolescence. Few of the occasions, the adenoid persists causing various symptoms including ear, nose, throat and facial deformities. It is also important while addressing the cause for nasal obstruction due to the co-existent adenoid tissue which may fail to diagnose pre-operatively becomes an on-table surprise.</p><p class="abstract"><strong>Methods:</strong> Adult patients above 16 years are subjected to study. Routine clinical examination done followed by diagnostic nasal endoscopy and the size of the adenoid tissue and other associated findings are recorded. </p><p class="abstract"><strong>Results:</strong> 100 patients were included in the study and gradings were done.</p><p class="abstract"><strong>Conclusions:</strong> We conclude the presence of adenoid tissue is due to persistence of a childhood problem, which is supported by presence of associated findings like high arched palate, supernumerary teeth.</p>
Panorama of foreign body in upper digestive tract in the population of Uttarakhand
Authors: Bansal Chetan , Bharti Prerana , Singh V. P. 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Foreign body aspiration is more common in children than adults because they explore the world with their hands and mouth and also have incomplete control and immature judgment. Foreign bodies in ENT are a medical emergency as their removal demands great skill due to unpredictability in the procedure and the complications associated with it.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted on 40 cases of digestive tract foreign bodies in relation to age, sex, type, site, clinical presentation, extraction and complications. </p><p class="abstract"><strong>Results: </strong>Youngest child was 5 months old. Most predisposed age group was 0-5 years (60% of cases). Cricopharynx (24 cases) was the most common site of impaction for foreign body. In the present study toys (22.5%) were most common foreign bodies followed by coins (15%) ingestion.</p><p class="abstract"><strong>Conclusions:</strong> Avoid carelessness. Avoid hasty drinking, eating, talking and running with anything in the mouth. Keep the things out of reach of the children. Be particular in sleep, anesthesia, coma or delirium. Avoid putting objects into mouth.</p>
Study and correlation of clinical, cytological and histopathological findings in diagnosis of parotid gland masses
Authors: Dutta Angshuman , Bhat Sweekritha , Dutta Debmita , Sharma Pragya , Gianchand Shikha 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Parotid masses comprise a variety of benign and malignant tumors and tumor-like conditions, which may present diagnostic challenges to the surgeon and pathologist as well. Fine needle aspiration cytology is considered to be a useful diagnostic tool used for preoperative evaluation of parotid masses. However its role may not be conclusive for evaluation. This study was aimed to evaluate fine-needle aspiration cytology in the diagnosis and management of parotid lesions.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective study done over a 3 year period included 38 patients with parotid gland lesions who underwent preoperative fine-needle aspiration cytology, MRI/USG followed by surgical procedure and histopathological examination. The clinical, cytological findings were compared with the final histological diagnosis and concordance assessed. </p><p class="abstract"><strong>Results:</strong> Of the 38 cases with parotid lesions 31(81.5%) were neoplasms and 7 (18.4%) were non-neoplastic lesions. Out of the neoplasms, 25 (80%) were benign and 6 (19%) were malignant parotid tumors. Deep lobe lesions were 9 (23.6%) and superficial lobe were 29 (76.31%). In this study correlation between FNAC and final histopathology was studied. In some situations cytological features could not provide correct tumor characterization. In our study the sensitivity of FNAC in diagnosing the lesion was 96.55% and specificity was 66.6%.</p><p class="abstract"><strong>Conclusions:</strong> FNAC is a simple and reliable technique for preoperative evaluation of parotid masses. Due to the minimally invasive nature of the technique, fine-needle aspiration cytology offers valuable information for planning of subsequent therapeutic management.</p>
A clinical study of endoscopic management of benign tumors of nasopharynx
Authors: Gupta Devang P. , Rai Shreya , Gupta Shalu , Ganvit Nikita , Makwana Jaydeep 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Benign tumors of nasopharynx are extremely rare; seen predominantly in children and young adults. Patients usually present with seemingly innocuous symptoms and an error in judgment can be catastrophic. Aim of our study is to analyse the incidence of these lesions, common presenting features and outcomes of endoscopic management.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective analysis of patients diagnosed to have benign tumours of nasopharynx by histopathological examination in our ENT department of civil hospital, B. J. Medical College, Ahmedabad. The period of study is from January 2016 to January 2018. Forty patients with complete clinical data were identified and included in the study. 33 patients out of 40 (83%) were males and 7 were females (17%). Following surgical excision patients were followed up for a mean period of 2 years. The Clinical profile, investigation modalities, treatment options are being analysed here. </p><p class="abstract"><strong>Results:</strong> Forty patients had undergone surgical excision for tumours arising from the nasopharynx. The mean age was 21.37 years (range 10–43). Thirty three patients were males and seven were females. Indications for resection were juvenile nasopharyngeal angiofibroma in thirty cases, lobular capillary hemangioma in four cases, paraganglioma in two cases, hemangiopericytoma in two cases, and neurofibroma in two cases. There were no significant post-operative complications. Recurrence due to residual lesion was seen in three cases. The mean follow up period was 2 years (range 1-3 years).</p><p class="abstract"><strong>Conclusions:</strong> It is important to note that patients with similar symptoms have varied pathology and thus need for radiological evaluation, JNA is commonest benign nasopharyngeal tumor and surgical approach<strong> </strong>depends on size and extent of tumor.</p>
A cross sectional study of hearing thresholds in medical students
Authors: Katiyar V. M. Hemlata , Elango D. , Prasanna Vincent 
Published: February 2019

<p class="abstract"><strong>Background:</strong> The hearing thresholds of young adults with no known hearing loss or noise exposure is expected to be closer to 0 dB HL, though with the increasing usage of recreational noise through personal amplification devices there is shift in thresholds noted. Some studies have highlighted the effect of these devices on the hearing thresholds and a general shift of thresholds towards 25 dB. Objective was to determine the audiometric thresholds of a screened sample of medical students with presumed normal hearing.</p><p class="abstract"><strong>Methods:</strong> A total of 103 medical students in the age group of 20 to 23 years were screened and subjected to PTA. The Pure tone average was calculated for air conduction (AC) and bone conduction (BC) separately and also for high frequencies (HF). The average for the female students was compared with that of male students. The right ear average was compared with that of left ear. </p><p class="abstract"><strong>Results:</strong> There was a statistically significant difference with higher thresholds for males in BC and HF, however the difference in AC was not significant. Between the right and left ears, there was statistically significant elevation observed in BC average in the right ear, but no significant difference was found in the HF and AC thresholds.</p><p class="abstract"><strong>Conclusions:</strong> There is evidence of thresholds especially BC, shifting more towards 25 dB HL in young adults considered to have normal hearing. Early screening will help in identifying this and prevent further elevation by judicious use of mobile phones, personal music players and personal listening devices.</p>
Aetiological profile of non-traumatic epistaxis: a two-year retrospective analysis in a tertiary care hospital
Authors: Manappattu Najmudheen , Bashir N. K. , Raj Girish 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Epistaxis is one of the commonest rhinological emergencies. Studies from different parts of the world show wide variation in aetiological profile. Idiopathic epistaxis is the most common form in most western studies while in many developing countries trauma is the predominant factor. Rhinosporidiosis is an important cause for epistaxis in certain parts of Malappuram district of Kerala. Hence this study was designed to analyze the non-traumatic causes for epistaxis in study location with a special emphasis on age and sex distribution and the role of rhinosporidium in epistaxis.</p><p class="abstract"><strong>Methods:</strong> Retrospective analysis of case records of epistaxis patients was done in a tertiary care teaching hospital in Malappuram district of Kerala, India. Patients with epistaxis reported through OP, IP and referrals from other departments were included as the study population. Age and sex distribution of idiopathic epistaxis and systemic and local cause of epistaxis with its age and sex distribution were analysed. </p><p class="abstract"><strong>Results:</strong> Total of 110 patients were studied, 74 males and 36 females, between the ages of 4 and 80. Predominant age group was 11-20 years followed by 21-30, with male dominance in almost all age ranges. Right side predominance was noted in unilateral cases. Thirty-six patients had primary epistaxis. Among the systemic causes, 15 had hypertension, four platelet dysfunction and three altered coagulation. Local causes were found in 51 cases; rhinosporidiosis being the commonest followed by infection.</p><p class="abstract"><strong>Conclusions:</strong> Non-traumatic epistaxis is more common among young males. Nasal rhinosporidiosis and infection are the two prominent local causes for epistaxis.</p>
Cross sectional study of prevalence of LPRD at tertiary care hospital
Authors: Gaur Raghvendra Singh , Patra Paromita 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Reflux means return or regurgitation of fluid. When symptoms arise due to reflux of stomach contents into the pharynx and larynx it is termed as laryngopharyngeal reflux disease (LPRD). GERD and LPRD are two different entities and the management principle of GERD doesn’t apply to LPRD. We designed a cross sectional study to evaluate the prevalence of laryngopharyngeal reflux among the patients visiting the ENT outpatient department over a duration of one year.</p><p class="abstract"><strong>Methods:</strong> Patients presenting with throat and voice symptoms for more than a month were included in the study. The reflux symptom index (RSI) put forward by Belafsky et al was used to assess the symptoms of reflux. A diagnosis of reflux was made if the patient had an RSI score &gt;13. </p><p class="abstract"><strong>Results:</strong> A total of 2669 patients included in study period, out of which 1316 (49.3%) were males and 1353 (50.7%) were females. Out of the 2669, 1938 (72.6%) patients were found to have a RSI of &gt;13. Out of the 1938 patients subjected to 70 laryngoscopy 1842 patients (95%) were found to have a RFS &gt;7. Of the 1842 patients with RFS &gt;7, 1234 were males (67%) and 608 were females (33%).</p><p class="abstract"><strong>Conclusions:</strong> In a developing country like India, where resources and man power are limited, symptoms of laryngopharyngeal reflux might often be overlooked. The diagnosis and treatment protocol for LPRD needs to be standardized through more long term studies in the manner it has been done for GERD.</p>
Development of multiple choice question bank in otorhinolaryngology by item analysis: a cross-sectional study
Authors: Khilnani Ajeet Kumar , Thaddanee Rekha , Khilnani Gurudas 
Published: February 2019

<p class="abstract"><strong>Background:</strong> Multiple choice questions (MCQs) are routinely used for formative and summative assessment in medical education. Item analysis is a process of post validation of MCQ tests, whereby items are analyzed for difficulty index, discrimination index and distractor efficiency, to obtain a range of items of varying difficulty and discrimination indices. This study was done to understand the process of item analysis and analyze MCQ test so that a valid and reliable MCQ bank in otorhinolaryngology is developed.</p><p class="abstract"><strong>Methods:</strong> 158 students of 7<sup>th</sup> Semester were given an 8 item MCQ test. Based on the marks achieved, the high achievers (top 33%, 52 students) and low achievers (bottom 33%, 52 students) were included in the study. The responses were tabulated in Microsoft Excel Sheet and analyzed for difficulty index, discrimination index and distractor efficiency. </p><p class="abstract"><strong>Results:</strong> The mean (SD) difficulty index (Diff-I) of 8 item test was 61.41% (11.81%). 5 items had a very good difficulty index (41% to 60%), while 3 items were easy (Diff-I &gt;60%). There was no item with Diff-I &lt;30%, i.e. a difficult item, in this test. The mean (SD) discrimination index (DI) of the test was 0.48 (0.15), and all items had very good discrimination indices of more than 0.25. Out of 24 distractors, 6 (25%) were non-functional distractors (NFDs). The mean (SD) distractor efficiency (DE) of the test was 74.62% (23.79%).</p><p class="abstract"><strong>Conclusions:</strong> Item analysis should be an integral and regular activity in each department so that a valid and reliable MCQ question bank is developed.</p>
Evaluation of the benefits of functional endoscopic sinus surgery on bronchial asthma in patients with concomitant nasal polyposis
Authors: Gupta Vijay , Gupta Arindam 
Published: February 2019

<p class="abstract"><strong>Background:</strong> It is important to understand the relationship between diseases of the upper and lower respiratory tracts because of the prevalence of nasal polyp and asthma, their impact on patients’ lives, the resultant burden on the health care system, and the potential benefits of functional endoscopic sinus surgery. Objective of the study was to evaluate the benefits of functional endoscopic sinus surgery (FESS) on bronchial asthma in patients with concomitant nasal polyposis.</p><p class="abstract"><strong>Methods:</strong> A total of 30 patients having nasal polyposis with asthma were taken up in the study. Patients were evaluated in reference to radiographic study of nose and PNS, pulmonary function by spirometry and asthma symptoms by ACT score. FESS was performed in all patients. Post-surgery spirometry and ACT score was done at 3 and 6 months. </p><p class="abstract"><strong>Results:</strong> Maximum patients belonged to the age group of 35-49 years. When compared pre and post-operative ACT score, we observed a mean of 15.7 (pre-operative), 13.6 (at 3 months) and 19.8 (at 6 months). FEV1% score was 74.6 pre-operatively, which was 90.2% at 3 months and 95.5% at 6 months of follow up.</p><p class="abstract"><strong>Conclusions:</strong> FESS has a positive influence in the lower airways function of asthmatic patients. Recorded improvement of the subjective and objective parameters measured, should not only be attributed to alleviation of upper airway symptoms and to concomitant improvement of a patient's quality of life, but also to the positive influence of FESS on the intrinsic mechanisms.</p>
Efficacy of local and systemic corticosteroid and hyaluronidase therapy in oral submucous fibrosis: a histopathological study
Authors: Bansal Mohan 
Published: February 2019

<p class="abstract"><strong>Background:</strong> As the etiopathogenesis of OSMF is not well established, a myriad of different medical and surgical modalities of treatment are reported however studies on histopatholgical changes after treatment are very sparse. There are reports on various regimens of steroids using different molecules, doses and routes of administration and their combination with other drugs. These were the driving factors to conduct this study. This histopathological study was conducted to know the efficacy of various forms of steroid therapy in various combinations.</p><p class="abstract"><strong>Methods:</strong> This prospective randomized single blinded outcome based study was conducted in the department of Otorhinolaryngology (ENT) and Pathology in a tertiary care medical college hospital. The 150 clinically diagnosed patients were divided into 5 groups: A, B, C, D and E. Each group was treated differently with different modes of administration of steroids with and without combinations of other medicines. To study histopathological changes before and after treatment, biopsy was taken in 100 patients who gave their consent for the same. </p><p class="abstract"><strong>Results:</strong> The various histopathological changes observed in the tissues taken after the treatment in 100 patients, were in terms of changes in the epithelium towards normalisation, decrease in fibrous tissue in the submucosa, decrease in the cellular infiltration, appearance of new capillaries, restoration of glandular activity and decrease in the fibrosis of muscles. The calculated Chi square value (p&gt;0.05) was found less than table value.</p><p class="abstract"><strong>Conclusions: </strong>Local and systemic corticosteroid and hyaluronidase therapy<strong> </strong>in patients with OSMF<strong> </strong>were found effective. However, histopathologically, it was not found statistically significant whether corticosteroids are given locally and/or systemic with or without injection hyaluronidase.</p>
A rare case of direct cervical skin involvement from metastatic cervical lymph node in carcinoma of oral cavity
Authors: Lakshmi Narayana M. , Swetha V. , Kumarguru B. N. 
Published: February 2019

<p class="BodyA">Carcinoma of the oral cavity is becoming more prevalent in India owing to increased betel nut chewing, beedi smoking, consumption of hans, gutka and other tobacco products. In the tumor spread, first it metastasizes to cervical nodes and then to distant sites. We report a rare case of direct skin involvement from metastatic cervical lymphadenopathy. A 60 years old lady came with the complaints of swelling on the left side of the neck since 3 years. She was a betel nut chewer since childhood. On examination, the swelling was tender, firm, fungating with erythema over the swelling. Oral cavity examination showed a 2×3 cm ulcerative growth in the left gingivobuccal sulcus with grade III trismus. CECT scan showed irregular heterogeneously enhancing necrotic mass of size 5.1×4.2×3.7 cm, in the submandibular region showing skin infiltration. There was an irregular heterogeneously enhancing lesion in the left gingivobuccal sulcus. Biopsy from the growth showed features of well-differentiated squamous cell carcinoma. The patient underwent composite resection and left modified radical neck dissection with complete excision of the fungating tumor with tumor-free margins. The defect in the oral cavity and neck was closed with pectoralis major myocutaneous flap and deltopectoral flap. Histopathology showed pT2N3bM0 with stage IVb and patient was advised adjuvant chemo-radiation. In conclusion, cervical skin involvement from cervical metastasis is rare compared to facial skin involvement from the tumor. Patients with N3b nodal staging should be planned in a multidisciplinary setting for a better treatment outcome.</p>