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Auditory effects of noise pollution: Current research and future trends
Kiran Natarajan, S Sudhamaheswari, Sathiya Murali, Amarnath Devarasetty, Mohan Kameswaran
January-June 2017, 1(1):2-5
Noise pollution is increasingly being recognized as a major health problem in India. An increased incidence of noise-induced hearing loss (NIHL) has been observed in recent years. Several advances have taken place in the understanding of the molecular basis of NIHL. This can help in evolving preventive and treatment strategies. Research in genetics is progressing at a rapid pace, and several genes linked to NIHL have been identified. In the future, gene therapy may be available as a management modality. This paper will focus on the current research and future trends on the auditory effects of noise pollution.
  1,222 165 -
Tracheal mass: A management challenge
Gautam Khaund, Nayanjyoti Sarma, Biswajit Gogoi, Vivek Agarwal, Utpal Barman, Daizy Gogoi
January-June 2017, 1(1):15-16
A 58-year-old man presented with respiratory difficulty. He had a mass in the trachea arising from the left lateral wall and was totally obstructing the opening of the left main bronchus. This posed an anesthethic as well as a surgical challenge. The patient was managed, and the mass on Hewlett Packard Enterprise proved to be well-differentiated squamous cell carcinoma. He is doing well after 6 months following radiotherapy.
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Adenotonsillar surgeries in Kaduna, Nigeria
Musa Thomas Samdi, Musa Emmanuel, Abdullahi Musa Kirfi
January-June 2017, 1(1):6-8
Background: Adenotonsillar surgeries are the most common otolaryngology procedures in the pediatric age group worldwide. Aims: The aim is to evaluate the prevalence, indications, complications, and postoperative symptoms resolution after adenotonsillectomy in pediatric patients in our center. Settings and Design: A retrospective study was conducted in a tertiary health facility in Kaduna, Nigeria. Methodology: The medical records of all children that had surgical procedures from January 2009 to December 2012 were extracted. A total of 232 pediatric patients had adenotonsillectomy of a total of 312 who underwent surgical procedures over 4 years. Forty-eight patients did not meet criteria for inclusion in this study. Therefore, 184 patients satisfied the inclusion criteria for this study. Data were analyzed descriptively with Statistical Package for Social Sciences version 16. Results: The mean age at the time of surgery was 3.5 ± 2.43 years. There were 102 males and 82 females in a ratio of 1:0.8. The main indications were obstructive, pharyngeal, and otologic symptoms. The duration of follow-up after adenotonsillectomy range from 4 weeks to 6 months, 177 (96.19%) had complete resolution of symptoms after surgery, 7 (3.80%) had an additional treatment for rhinosinusitis. Four patients had immediate mild postoperative bleeding (reactionary hemorrhage). No deaths were recorded within the period under review. Conclusions: Adenotonsillar surgeries are common otolaryngology procedures in our hospital, mainly done on account of obstructive symptoms. They are rewarding procedures in terms of symptoms resolution and safety.
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Mobile phones for mobility or morbidity: Is there an evidence for morbidity?
Naresh K Panda, Karan Gupta, Sourabha K Patro, Roshan Verma, Sanjay Munjal, Jaimanti Bakshi, P. V. M. Laxmi
January-June 2017, 1(1):9-14
Objectives: Potential health risks are posed by long-term electromagnetic exposure due to mobiles. This study was undertaken to assess changes in the hearing at the level of the inner ear and central auditory pathway due to chronic exposure to the electromagnetic waves from mobile phones using both global system for mobile communication (GSM) and code division multiple access (CDMA) types of mobile technology. Study Design: Cross-sectional study. Materials and Methods: A total of 321 individuals who were long-term mobile users (more than 1 year, 238 GSM and 83 CDMA) and 46 individuals who had never used mobile phones underwent investigations including pure tone audiometry (500 Hz to 16 KHz), distortion product otoacoustic emissions (DPOAEs), auditory brain responses, and middle latency responses (MLR). The changes in the parameters were studied in mobile and nonmobile using ears of both GSM and CDMA individuals and corresponding ears of the controls to ascertain the effects of electromagnetic exposure. Results: GSM and CDMA users had a higher risk of having DPOAE absent as compared to controls (P = 0.000) more so if used longer during the day. They were found to have higher speech frequency thresholds and lower MLR wave Na amplitudes. More than 3 years of use emerged as a risk factor (P < 0.05). The damage was bilateral. Individuals using CDMA phones had more high-frequency loss than GSM user. The amplitudes of waves in MLR were lower in mobile phone users than nonusers. Conclusions: Long-term GSM and CDMA mobile phone use is associated with damage to the cochlea and auditory cortex.
  611 104 -
Quality of life of head-and-neck cancer patients – reliability and effectiveness of the european organization for research and treatment of cancer quality of life questionnaire-30 and European organization for research and treatment of cancer quality of life questionnaire-H and N35 questionnaires in patients in a tertiary care center in India
Vinay V Rao, Sadia M Shaikh, Mahesh Bhat, Anita Aramani, Veronica Lobo
July-December 2017, 1(2):22-25
Aims: To test the validation of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQs), the core module QLQ-C30, and the head and neck module QLQ-H and N35 in a tertiary care center. Materials and Methods: Forty head-and-neck cancer patients completed the QLQ-C30 and the QLQ-H and N35 during their treatment. Questionnaires given to them were translated into their regional language Kannada. Evaluation of the responsiveness, reliability, and validity of the questionnaire was undertaken. Results: The data support the reliability of the scales. Validity cannot be assessed. The questionnaire was responsive to change over a period of time; however, the applicability of the European questionnaire in Indian clinical setup is debatable. Summary: This data suggest that the EORTC QLQ-C30 and the QLQ-H and N35 are reliable and responsive when applied to a sample of head-and-neck cancer patients in India. Hence, it can be used as a platform to test validity at a multicentric level. Conclusion: Both the questionnaires are equally effective, the newer one providing more insight however few items maybe irrelevant in Indian context.
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D Dwarakanath Reddy, P. S. N. Murthy
January-June 2017, 1(1):1-1
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Clinico-cytoradiological correlation of thyroid surgery in patients with thyroid nodule
Harendra Kumar Gautam, Vinod Kumar, Surendra Kumar Kanaujia, Devendra Maurya, Shiromani Singh
July-December 2017, 1(2):17-21
Background: Thyroid swellings are commonly encountered in the surgical practice and accurate preoperative evaluation of thyroid disorder becomes mandatory for proper management of the patient. Aims and Objectives: To evaluate the clinical and radiological features of thyroid nodule with thyroid surgery. Materials and Methods: A total of 60 patients were included with more than 15 years of age presented with thyroid nodule. Results: Fifty three patients were females and seven were males with goitre duration of 6-60 months and presented with progressive increase in the size of the goitre. After clinical evaluation majority of patients were diagnosed as STN. According to ultrasonography, 58 patients were diagnosed as benign lesions while 2 patients were diagnosed with malignant lesions. According to FNAC, maximum number of patients i.e., 37 were diagnosed with colloid goitre while 2 patients had malignant lesions. On histopathological examination, 58 patients were diagnosed with benign lesions while 2 were diagnosed with malignant lesions. USG findings were correlated with thyroid surgery, Among 60 patients of thyroid nodule. 56 patients underwent hemi thyroidectomy.in which 34 were right thyroidectomy and 22 were left thyroidectomy and 4 patients underwent total thyroidectomy. One patient of total thyroidectomy was develop recurrent laryngeal nerve palsy. Conclusion: USG and FNAC has been shown to be more sensitive, specific and accurate than either technique alone but high resolution USG has important and cost effective investigation to decide the extent and type of surgery of thyroid nodules.
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Discharging sinus of neck after thyroid surgery:A rare case report
Kamlesh Kanwar Shekhawat, Vikram Singh Rathore
July-December 2017, 1(2):29-31
There are a number of complications after thyroid surgery such as compressing hematoma, tracheomalacia, wound infection, damage to the recurrent laryngeal nerve or superior laryngeal nerve, hypothyroidism, hypocalcemia, scar formation, and thyroid storm, but discharging skin sinus of the neck is a rare complication. We report a case of discharging pus sinus of the neck after hemithyroidectomy for 1 year; pus culture was positive for Pseudomonas aeruginosa. Thyroid function test was normal. Ultrasonography disclosed branching sinus tracts and right lobe thyroid nodule and the left lobe not visualized. Sinus tracts' excision surgery was done. Histopathology report revealed fibrocollagenous stroma with clusters of epithelioid cells, histiocytes, Langhans giant cells, and chronic inflammatory cells with foci of caseous necrosis. The diagnosis of thyroid tuberculosis (TB) was therefore made. Patient was put on isoniazid, rifampicin, ethambutol, and pyrazinamide. She responds well. Although seldom observed, TB should be kept in mind in the differential diagnosis of discharging sinus of neck.
  405 46 -
Head-and-neck rhabdomyosarcoma: Our experience
Reshmi Anna Alex, Dipak Ranjan Nayak, K Devaraja, N Apoorva Reddy, Rohit Singh, Shama Shetty
January-June 2018, 2(1):1-4
Background: Rhabdomyosarcoma (RMS) is not uncommon in the head-and-neck region. The nonspecific symptomology mimicking benign or inflammatory lesions result in delayed diagnosis, often in advanced stage, mandating multimodal therapy. Moreover, this delayed diagnosis may contribute to poor outcomes. Objective: The aim of this study is to share our experience in managing RMS affecting head-and-neck region. Materials and Methods: This was a retrospective review of six cases treated at a tertiary care institute. Results: Four cases diagnosed to have RMS of the paranasal sinus, one case involving the temporal bone, and one case with tumor presenting in the nasopharynx underwent treatment. Spinal metastasis was detected in two patients. A 5½-year-old child presenting with RMS temporal bone had the longest period of follow-up. Conclusion: This paper presents a series of six such cases that were treated by the senior author. Embryonal RMS of the temporal bone survived for more than 7 years and is on follow-up. Alveolar variant of RMS has a poor survival of >3 years in our series.
  305 58 -
Osteoclastoma at the maxillofacial region
Santosh Kumar Swain, Biplob Bhattacharyya, Mahesh Chandra Sahu
January-June 2018, 2(1):12-14
Osteoclastoma or giant cell tumor is an uncommon neoplasm of the bone. Common sites for osteoclastomas are long bones. Osteoclastoma of the craniofacial bones is extremely rare clinical entity. Here, we are reporting a case of osteoclastoma originating from the left maxilla presenting with swelling at the left nasolabial area with nasal obstruction. He had undergone complete excision of the tumor under general anesthesia. During the postoperative period, the patient did well without any evidence of recurrence or metastasis for 1-year follow-up.
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Diagnostic dilemma in a case of temporal bone carcinoma in a young man
Deepanava Jyoti Das, Abhijeet Bhatia, Pranjal Phukan, Chandralekha Baruah
July-December 2017, 1(2):26-28
Malignancy of temporal bone is a rare entity with an incidence of <0.2% of all head-and-neck cancer with an average age of occurrence at 60 years. We present here a case of a 21-year-old boy with temporal bone cancer who presented with clinical features of complicated chronic suppurative otitis media, radiologically as chronic osteomyelitis creating a diagnostic dilemma as there was no predisposing factor for osteomyelitis. The diagnosis was confirmed by open biopsy which revealed squamous cell carcinoma. The best survival rate is obtained with total temporal bone resection and post-operative radiotherapy.
  263 53 -
An unusual case of recurrent laryngeal nerve palsy presenting as hoarseness due to an aortic arch saccular aneurysm causing neurovascular conflict!
Santosh PV Rai, Vishak Acharya
July-December 2017, 1(2):32-33
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Vertigo among elderly people: Our experiences at a tertiary care teaching hospital of Eastern India
Santosh Kumar Swain, Diptiman Baliarsingh, Mahesh Chandra Sahu
January-June 2018, 2(1):5-8
Objective: This study aimed to evaluate the etiology, clinical profile, morbidity, diagnosis, and management of vertigo among elderly patients at a tertiary care teaching hospital of Eastern India. Materials and Methods: Seventy-two elderly patients were diagnosed as cases of peripheral vertigo above the age of 60 years enrolled in this study. The detailed etiology, clinical presentations, diagnostic methods, and treatment were assessed. Results: The most common peripheral vestibular disorders were benign peripheral paroxysmal positional vertigo (38.38%), idiopathic vestibulopathy (9.72%), migraine-related vertigo/migraine vestibulopathy (26.38%), Meniere's disease (5.55%), and acute vestibular neuritis (6.94%). Diabetes mellitus is a common systemic disorder associated with elderly vertigo patient. Mental disorders such as anxiety (18.05%), depression (15.27%), and phobia (12.5%) were seen in this study among elderly vertigo patients. Conclusion: This retrospective study revealed that 72 of elderly patients had been diagnosed with peripheral vertigo. The majority of vertigo patients are of benign paroxysmal positional vertigo with unilateral horizontal canal involvement among elderly patients in this study, followed by migrainous vestibulopathy, idiopathic vestibulopathy, and vestibular neuritis. Proper diagnosis and management help to make a better and quality life in elderly patients suffering with vertigo.
  211 57 -
Schwannoma of parapharyngeal space: Diagnosed by fine-needle aspiration cytology
Panduranga Chikkannaiah, Srinivasamurthy Venkataramanappa
January-June 2018, 2(1):9-11
Parapharyngeal space (PPS) tumors are rare constituting 0.5% of all head and neck tumors. Salivary gland tumors are common followed by neurogenic tumors. The initial diagnostic modality for these tumors is incisional biopsy which is hazardous at this site. Now, fine-needle aspiration cytology (FNAC) is gaining popularity as a prime diagnostic modality for parapharyngeal lesions. Here, we report a case of schwannoma of PPS in a 32-year-young lady, diagnosed by FNAC.
  191 36 -
Brother Mujeeb's technique to fix the hair away from the surgical site
Jay Prakash, Natesh S Rao, J Prashanth Prabhu, Shagun Sareen
January-June 2018, 2(1):15-15
  143 38 -
Deep neck space infection: Are we overlooking the elderly?
Shankar P Shah, Shyam Thapa Chetri, Bajrang P Sah, Sudip Mishra, Amit K Singh, Swotantra Gautam
July-December 2018, 2(2):17-20
Context: Deep neck space infections (DNSIs) are unique among infectious diseases for potential life-threatening complications. Its early recognition is therefore challenging and a high index of suspicion is necessary to avoid any delay in treatment. Aims: This study aims to analyze the age, sex, source, nature, associated systemic conditions, neck spaces involved, and the bacteria isolated in patients with DNSIs. Settings and Design: A prospective, descriptive study was conducted in the Department of ENT and HNS, B.P. Koirala Institute of Health Sciences, Dharan, Nepal for a period of 2 years from August 2014 to July 2016. Subjects and Methods: All patients with DNSI who required hospitalization were included, whereas those with superficial skin soft-tissue infections, infections due to traumatic or surgical wounds or tumors were excluded. Statistical Analysis Used: The data were recorded on a pro forma and analyzed using Microsoft Excel 2007 (Microsoft, WA, USA). Results: Out of the 76 patients, 25 patients were >50 years of age (32.89%). Male: female ratio was 1:1.17. The most common source was dental infection occurring in 32 cases (42%). Diabetes mellitus was the most common associated systemic condition (4 cases). Submandibular and peritonsillar spaces were most commonly involved. A sterile culture was seen in the majority (18/32). Staphylococcus aureus and Escheria coli were the predominant bacteria isolated. Conclusions: DNSI is a common condition in the elderly populations. Odontogenic infection and diabetes mellitus are the predisposing factors. S. aureus and E. coli are the common causative agents.
  99 27 -
Tonsillar cartilaginous choristoma: A rare entity
Khushboo Saran, Shashikala Vinayakamurthy, K Vidya, Jay Prakash
July-December 2018, 2(2):21-22
Choristoma is a tumour like mass which is an island of normal cells or tissues in abnormal locations due to defects during embryological development. Choristoma is most frequently seen in the tongue and presence of choristoma in the tonsil is extremely rare. On histopathological examination, an island of mature cartilage with normal appearing chondrocytes amidst the lymphoid follicles were seen. We present here a case of cartilaginous choristoma with the complaint of chronic tonsillitis.
  82 23 -
Inherited systemic hyalinosis: Role of surgery
Saad Al Shammari, Swathi Velagapudi, Thomas Varghese Mannil, Sarvani Davuluri, Suresh Velagapudi
July-December 2018, 2(2):23-26
Inherited systemic hyalinosis is a rare autosomal recessive disorder affecting the mutation in gene ANTXR2. Since this entity was first described in 1978, many authors tried to differentiate two distinct entities: severe form as infantile systemic hyalinosis and milder form as juvenile hyaline fibromatosis. As more cases beginning to appear, it was recognized that these two entities are two ends of the spectrum of the same disease process. Now, there is a general consensus of grouping these entities together under the term inherited systemic hyalinosis. In this genetic disorder, the role of the surgery is limited to improve the quality of life only. We report a case of inherited systemic hyalinosis who presented to us at the age of 3 years and had surgery at the age of 7 years and 8 years, with a follow-up of 2 years postsurgery.
  75 19 -
Undetected mass in vallecula: Failure of airway management
Jay Prakash, Natesh S Rao, J Prashanth Prabhu, Shagun Sareen
July-December 2018, 2(2):30-31
  73 14 -
Mondini deformity implanted with minimal incision
Munish Saroch, Amit Saini, Gaveshna Gargi
July-December 2018, 2(2):27-29
Mondini deformity accounts for majority of cochlear malformations. These children can be given a near-normal lifestyle by performing cochlear implant (CI) surgery. The results of standard incision cochlear implantation (SICI) in these children are very encouraging. However, there are very few centers in world which offer the minimal incision cochlear implantation (MICI) in these patients. We report a case of 2-year-old child suffering from Mondini deformity who underwent CI with MICI. MICI reduces the impact of surgery drastically in these children as it can be performed without shaving of hairs with a 2-cm incision. The complication rate of MICI is comparable to SICI. Apart from better cosmesis, another advantage is early switch on of the device. We are of the opinion that MICI is safe and can be successfully performed in cases of Mondini deformity without any fear.
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