Pub Date : 2023-10-15DOI: 10.18231/j.ijashnb.2023.022
Rajkumari P. Khatri
Radiotherapy and chemotherapy are frequently employed in patients with head and neck cancer (HNC), causing significant side effects that impair life quality and prognosis by interfering with the cancer treatment regimen. There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), also known as Photobiomodulation (PBM), when used for the prevention and/or treatment of oral mucositis in patients undergoing radiotherapy for head and neck cancer or high-dose chemotherapy regimens. This could enhance patients’ quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care and hospitalization.
{"title":"The role of photobiomodulation therapy for supportive care during head and neck cancer treatment","authors":"Rajkumari P. Khatri","doi":"10.18231/j.ijashnb.2023.022","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.022","url":null,"abstract":"Radiotherapy and chemotherapy are frequently employed in patients with head and neck cancer (HNC), causing significant side effects that impair life quality and prognosis by interfering with the cancer treatment regimen. There is a large body of evidence supporting the efficacy of low-level laser therapy (LLLT), also known as Photobiomodulation (PBM), when used for the prevention and/or treatment of oral mucositis in patients undergoing radiotherapy for head and neck cancer or high-dose chemotherapy regimens. This could enhance patients’ quality of life, adherence to the prescribed cancer therapy, and treatment outcomes while reducing the cost of cancer care and hospitalization.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"234 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135760098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-15DOI: 10.18231/j.ijashnb.2023.019
Deepa Shivnani
Recurrent Respiratory Papillomatosis (RRP) is a benign condition which needs frequent surgical interventions for debulking of papillomatosis lesions for securing the airway. There is no definitive treatment for the management of RRP so far. Bevacizumab either intralesional or systemic has emerged as a promising solution for RRP patients undergoing repeated surgeries. We are reporting a case of a 6-year-old child with juvenile onset RRP who was treated by surgical excision of lesion with adjuvant systemic bevacizumab therapy.
{"title":"Use of adjuvant intravenous bevacizumab for aggressive recurrent respiratory papillomatosis- A case report","authors":"Deepa Shivnani","doi":"10.18231/j.ijashnb.2023.019","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.019","url":null,"abstract":"Recurrent Respiratory Papillomatosis (RRP) is a benign condition which needs frequent surgical interventions for debulking of papillomatosis lesions for securing the airway. There is no definitive treatment for the management of RRP so far. Bevacizumab either intralesional or systemic has emerged as a promising solution for RRP patients undergoing repeated surgeries. We are reporting a case of a 6-year-old child with juvenile onset RRP who was treated by surgical excision of lesion with adjuvant systemic bevacizumab therapy.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"234 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-15DOI: 10.18231/j.ijashnb.2023.016
S. Balaji, S. Venkatesan
As we all know 10% of all cerebral vascular anomalies are caused by a dural arteriovenous fistula (dAVF). While these lesions may be benign, the existence of retrograde venous drainage and cerebral venous reflux puts patients at risk of bleeding, neurological impairment, and death. Endovascular therapy is commonly utilized as the first-line treatment for dAVF. Both trans arterial and transvenous techniques are utilized to treat dAVF. The treatment strategy employed is dictated on the dAVF's angioarchitecture, location, and venous flow direction. Surgery and, to a lesser extent, stereotactic radiosurgery are used when endovascular procedures are ineffective or unsatisfactory, as well as when an AV fistula is associated with a ruptured aneurysm with cerebral bleeding.
{"title":"Occipital intracranial dural arteriovenous fistula with giant venous aneurysm and ruptured temporal arterial aneurysm with intra cerebral haemorrhage – a case report","authors":"S. Balaji, S. Venkatesan","doi":"10.18231/j.ijashnb.2023.016","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.016","url":null,"abstract":"As we all know 10% of all cerebral vascular anomalies are caused by a dural arteriovenous fistula (dAVF). While these lesions may be benign, the existence of retrograde venous drainage and cerebral venous reflux puts patients at risk of bleeding, neurological impairment, and death. Endovascular therapy is commonly utilized as the first-line treatment for dAVF. Both trans arterial and transvenous techniques are utilized to treat dAVF. The treatment strategy employed is dictated on the dAVF's angioarchitecture, location, and venous flow direction. Surgery and, to a lesser extent, stereotactic radiosurgery are used when endovascular procedures are ineffective or unsatisfactory, as well as when an AV fistula is associated with a ruptured aneurysm with cerebral bleeding.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-15DOI: 10.18231/j.ijashnb.2023.023
Alagappan Thiyagarajan
The biopsychosocial model is one of the most important models in physiotherapy practice. It has been proven to be particularly useful in treating behaviorally regulated diseases that have a wide range of risk factors, such as type 2 diabetes mellitus, osteoarthritis, obesity, hypertension, and cardiac issues. Physiotherapists should be aware of their modes of action in terms of the cultural environment in which they operate and the unique needs of the patients in order to refocus Physiotherapy practice toward the whole treatment of patients without compromising professional ethics. The purpose of this paper is to provide an overview of physiotherapists' methods of action and to highlight the importance of incorporating models of disablement, the idea of rehabilitation, the biomedical model, and the biopsychosocial model into patient management strategies.
{"title":"Importance of biopsychosocial model in Indian clinical physiotherapy practice","authors":"Alagappan Thiyagarajan","doi":"10.18231/j.ijashnb.2023.023","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.023","url":null,"abstract":"The biopsychosocial model is one of the most important models in physiotherapy practice. It has been proven to be particularly useful in treating behaviorally regulated diseases that have a wide range of risk factors, such as type 2 diabetes mellitus, osteoarthritis, obesity, hypertension, and cardiac issues. Physiotherapists should be aware of their modes of action in terms of the cultural environment in which they operate and the unique needs of the patients in order to refocus Physiotherapy practice toward the whole treatment of patients without compromising professional ethics. The purpose of this paper is to provide an overview of physiotherapists' methods of action and to highlight the importance of incorporating models of disablement, the idea of rehabilitation, the biomedical model, and the biopsychosocial model into patient management strategies.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-15DOI: 10.18231/j.ijashnb.2023.020
Premkumar Daivasikamani, Aung San Phyo
Carotid endarterectomy is common vascular procedure for atherosclerosis of carotid artery. Usually, it is done when the artery is narrowed more than 80% but it can be done even when it is narrowed 50 % if it produces symptoms. Carotid endarterectomy (CEA) is delayed 6 to 8 weeks after acute stoke, as the stroke can be progressive. Carotid endarterectomy (CEA) is done after optimal recovery from the stroke by the patient. The recovery depends on the preoperative size of the infarct and the neurological deficit. Emergency endarterectomy can be done when there is fluctuating neurological deficits due to acute carotid artery obstruction. CEA is contraindicated when the patient’s general condition is poor due to other serious illness which shorten life expectancy. It is not done in a case of major stroke as the recovery may not satisfactory.
{"title":"A case report of transient ischemic attack with carotid artery stenosis and discussion on the need for carotid endarterectomy","authors":"Premkumar Daivasikamani, Aung San Phyo","doi":"10.18231/j.ijashnb.2023.020","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.020","url":null,"abstract":"Carotid endarterectomy is common vascular procedure for atherosclerosis of carotid artery. Usually, it is done when the artery is narrowed more than 80% but it can be done even when it is narrowed 50 % if it produces symptoms. Carotid endarterectomy (CEA) is delayed 6 to 8 weeks after acute stoke, as the stroke can be progressive. Carotid endarterectomy (CEA) is done after optimal recovery from the stroke by the patient. The recovery depends on the preoperative size of the infarct and the neurological deficit. Emergency endarterectomy can be done when there is fluctuating neurological deficits due to acute carotid artery obstruction. CEA is contraindicated when the patient’s general condition is poor due to other serious illness which shorten life expectancy. It is not done in a case of major stroke as the recovery may not satisfactory.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135759776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-15DOI: 10.18231/j.ijashnb.2023.021
S. Balaji, S. Venkatesan
IHACs (interhemispheric arachnoid cysts) are a rare kind of congenital arachnoid cyst that account for5% of all occurrences. The best surgical treatment for symptomatic IHAC is still debatable, and there are no clear standards. At the time of presentation, the median age was 13 months. Macrocrania with rapidly increasing head size, seizures, infantile spasms, and developmental delay were the most common clinical manifestations.Endoscopic cyst fenestration and shunt surgery are both safe treatments for IHAC. We present an 11-month-old male infant born to non consanguineous parents who has had a steady rise in head size since 6 months of age and delayed mile stones.A magnetic resonance image of the brain revealed a massive interhemispheric arachnoid cyst, as well as corpus callosum agenesis and hypoplasia in both frontal lobes. Baby underwent endoscopic cyst fenestration and cystoperitoneal shunt.
{"title":"Giant interhemispheric arachnoid cyst – A rare case report","authors":"S. Balaji, S. Venkatesan","doi":"10.18231/j.ijashnb.2023.021","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.021","url":null,"abstract":"IHACs (interhemispheric arachnoid cysts) are a rare kind of congenital arachnoid cyst that account for5% of all occurrences. The best surgical treatment for symptomatic IHAC is still debatable, and there are no clear standards. At the time of presentation, the median age was 13 months. Macrocrania with rapidly increasing head size, seizures, infantile spasms, and developmental delay were the most common clinical manifestations.Endoscopic cyst fenestration and shunt surgery are both safe treatments for IHAC. We present an 11-month-old male infant born to non consanguineous parents who has had a steady rise in head size since 6 months of age and delayed mile stones.A magnetic resonance image of the brain revealed a massive interhemispheric arachnoid cyst, as well as corpus callosum agenesis and hypoplasia in both frontal lobes. Baby underwent endoscopic cyst fenestration and cystoperitoneal shunt.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135759780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.18231/j.ijashnb.2023.012
Tejanjani Vathada, Rajashekar Alishala
: Seizures are characterized by abnormally excessive or synchronized neuronal activity in the brain. The purpose of the current study is to study etiology of partial seizure. To identify significant role of neuroimaging & EEG.: A cross sectional study involving a total 100 patients are recruited between 2-12 years. All the children aged 2 year to 12 years of age with partial seizures will undergo neuro imaging, plain and contrast (contrast where indicated). Out of 100 childrens 68% of the partial seizures in the age group 2 to 12 years occurred in younger children of 2-6 Years, while only 32% of the seizures occurred in 6 – 12 years of age group.. Among them, 75% of the cases revealed an identifiable cause in the CT brain and 63% of the cases showed abnormal EEG. Among the 75% with abnormal CT brain, 58 cases are identified as Neuroinfections, neurocysticercosis in 32 cases, Tuberculoma in 26 cases, 5 cases had infarct, 4 had Calcifications, 3 had Hydrocephalus, 2 had subdural effusion, 2 had AV malformations, 1 had brain tumour. Thus, partial seizures are the most prevalent neurological disorder in children, having a significant social and economic impact on developing country.. Frequently, even relatively benign, episodic spells are mistaken as seizures and even treated as such. Therefore, proper diagnosis and therapy should be emphasized more.
{"title":"Neuro radio logic diagnostic evaluation of partial seizure in children’s","authors":"Tejanjani Vathada, Rajashekar Alishala","doi":"10.18231/j.ijashnb.2023.012","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.012","url":null,"abstract":": Seizures are characterized by abnormally excessive or synchronized neuronal activity in the brain. The purpose of the current study is to study etiology of partial seizure. To identify significant role of neuroimaging & EEG.: A cross sectional study involving a total 100 patients are recruited between 2-12 years. All the children aged 2 year to 12 years of age with partial seizures will undergo neuro imaging, plain and contrast (contrast where indicated). Out of 100 childrens 68% of the partial seizures in the age group 2 to 12 years occurred in younger children of 2-6 Years, while only 32% of the seizures occurred in 6 – 12 years of age group.. Among them, 75% of the cases revealed an identifiable cause in the CT brain and 63% of the cases showed abnormal EEG. Among the 75% with abnormal CT brain, 58 cases are identified as Neuroinfections, neurocysticercosis in 32 cases, Tuberculoma in 26 cases, 5 cases had infarct, 4 had Calcifications, 3 had Hydrocephalus, 2 had subdural effusion, 2 had AV malformations, 1 had brain tumour. Thus, partial seizures are the most prevalent neurological disorder in children, having a significant social and economic impact on developing country.. Frequently, even relatively benign, episodic spells are mistaken as seizures and even treated as such. Therefore, proper diagnosis and therapy should be emphasized more.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"7 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82796456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.18231/j.ijashnb.2023.015
S. Balaji, S. Venkatesan
Multi-segment Facial Nerve Schwannoma (MFNS) is a very rare tumor, benign in nature and can arise anywhere along the course of the facial nerve from its origin in the cerebello-pontine angle to its extra cranial ramification in the parotid space of the extra cranial head and neck. It mimic like vestibular schwannoma and other cranial nerve schwannoma. The most common clinical presentation is facial palsy and depending upon the segment of the facial nerve involved. We report a rare case of multi-segment facial nerve schwannoma extending from cerebello-pontine angle to the parotid gland, presented with facial palsy, hearing loss, difficulty in swallowing and difficulty in walking. Radiological investigations was done and confirmed the diagnosis MFNS. Patient underwent near total excision of the tumor by combined approach and patient was improved clinically after the surgery.
{"title":"Rare case of Multi-segment facial nerve schwannoma (MFNS) - A case report","authors":"S. Balaji, S. Venkatesan","doi":"10.18231/j.ijashnb.2023.015","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.015","url":null,"abstract":"Multi-segment Facial Nerve Schwannoma (MFNS) is a very rare tumor, benign in nature and can arise anywhere along the course of the facial nerve from its origin in the cerebello-pontine angle to its extra cranial ramification in the parotid space of the extra cranial head and neck. It mimic like vestibular schwannoma and other cranial nerve schwannoma. The most common clinical presentation is facial palsy and depending upon the segment of the facial nerve involved. We report a rare case of multi-segment facial nerve schwannoma extending from cerebello-pontine angle to the parotid gland, presented with facial palsy, hearing loss, difficulty in swallowing and difficulty in walking. Radiological investigations was done and confirmed the diagnosis MFNS. Patient underwent near total excision of the tumor by combined approach and patient was improved clinically after the surgery.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87827095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-15DOI: 10.18231/j.ijashnb.2023.010
Tshetiz Dahal, Dhiraj Prasad Shah, Aman Kumar Yadav
According to earlier research, tumour response, Lymphocytopenia, and a system-wide immune-inflammatory indexes all affect the clinical results of Stage III NSCLC. We postulated that the tumour response to CRT would be related to hematologic parameters and could perhaps anticipate clinical results.Retrospective evaluation of stage III NSCLC patients treated at a single facility between 2015 and 2020 was done. After receiving CRT, the pre-treatment gross tumour volume (GTV) was measured again. Full blood counts were taken before, during, and after treatment. Neutrophil platelet lymphocyte was used to define the systemic immune-inflammation index (SII). Kaplan-Meier estimates were used to compute overall survival (OS) and prognosis-free survival (PFS), which were then compared using Wilcoxon tests. Then, taking into account additional baseline parameters, pseudovalue regression was used to provide a multivariate study of hematopoietic factors affecting controlled average duration.There were 110 patients in total. The median PFS and OS were 20 and 35 months, respectively, after a median follow-up of 24 months. Baseline SII was correlated with OS (p = 0.039) but not PFS (p = 0.10), and baseline ALC was correlated with both PFS and OS (p = 0.13 and p = 0.06, respectively) in the multivariate model. The recovery SII, nadir ALC, and nadir SII were not connected to PFS or OS.: Baseline hematologic variables, such as baseline ALC, baseline SII, and recovery ALC, were related to clinical outcomes in this cohort of patients with stage III NSCLC. The relationship between disease response and hematologic variables or clinical outcomes was not strong.
{"title":"Lymphocytopenia repercussions on stage III Non-small cell lung cancer (NSCLC) patients' tumour progression and their clinical results after chemoradiation","authors":"Tshetiz Dahal, Dhiraj Prasad Shah, Aman Kumar Yadav","doi":"10.18231/j.ijashnb.2023.010","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.010","url":null,"abstract":"According to earlier research, tumour response, Lymphocytopenia, and a system-wide immune-inflammatory indexes all affect the clinical results of Stage III NSCLC. We postulated that the tumour response to CRT would be related to hematologic parameters and could perhaps anticipate clinical results.Retrospective evaluation of stage III NSCLC patients treated at a single facility between 2015 and 2020 was done. After receiving CRT, the pre-treatment gross tumour volume (GTV) was measured again. Full blood counts were taken before, during, and after treatment. Neutrophil platelet lymphocyte was used to define the systemic immune-inflammation index (SII). Kaplan-Meier estimates were used to compute overall survival (OS) and prognosis-free survival (PFS), which were then compared using Wilcoxon tests. Then, taking into account additional baseline parameters, pseudovalue regression was used to provide a multivariate study of hematopoietic factors affecting controlled average duration.There were 110 patients in total. The median PFS and OS were 20 and 35 months, respectively, after a median follow-up of 24 months. Baseline SII was correlated with OS (p = 0.039) but not PFS (p = 0.10), and baseline ALC was correlated with both PFS and OS (p = 0.13 and p = 0.06, respectively) in the multivariate model. The recovery SII, nadir ALC, and nadir SII were not connected to PFS or OS.: Baseline hematologic variables, such as baseline ALC, baseline SII, and recovery ALC, were related to clinical outcomes in this cohort of patients with stage III NSCLC. The relationship between disease response and hematologic variables or clinical outcomes was not strong.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"14 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80619457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cholesteatoma is a well-demarcated sac of keratinizing squamous epithelium in the temporal bone, which is commonly characterized as “skin in the wrong place. The major goal of surgery for cholesteatoma is to make the ear safe and dry with increasing concern of the hearing outcome of patients. Two main surgical techniques employed are Canal Wall down (CWD) and Canal Wall up Mastoidectomy (CWU). In the current study, an attempt would be made to evaluate which technique would be better for achieving disease clearance with favorable hearing outcome and dry ear.1. To evaluate the hearing results following CWU and CWD surgery in patient with cholesteatoma.2. To decide surgical approach according to extension of disease.Materials and Methods:This is a prospective study involving 100 patients with cholesteatoma who had undergone CWD and CWU surgery over the period of 3 years.The choice of mastoidectomy, CWD or CWU, was the decision of the surgeon, after completely evaluating the patient, preoperatively and intraoperatively. All cases were followed up & assessed by autoscopic examination & PTA for minimum of 3 months. In the CWD group, mean hearing gain, in 3 months was 12±1.73dB. In the CWU group, hearing gain in 3 month postoperative period was 18±2.06 dB. Also the hearing gain between the two groups was compared and it was found to be statistically significant for the 3 months (p=0.0002) postoperatively; signifying that there was a comparable difference for CWU over CWD mastoidectomy in the matter of Hearing Gain. SNHL was also seen post operatively in both group. Total 3 (6%) patient in CWU had SNHL post operatively in comparison to 7(14%) patients in CWD. From our study results, we think that CWU is superior to the CWD surgery in cases of cholesteatoma because of good post-operative hearing outcome as well as less complication and law morbidity. CWD surgery should be used in cases of extensive cholesteatoma, mental retardation, not sure about follow up and inadequate middle ear space cases.
{"title":"A comparative study of hearing outcome in cholesteatoma surgery canal wall up versus canal wall downmastoidectomy in 100 patients","authors":"Trupti Savariya Rameshbhai, Alpesh Fefar Damjibhai","doi":"10.18231/j.ijashnb.2023.008","DOIUrl":"https://doi.org/10.18231/j.ijashnb.2023.008","url":null,"abstract":"Cholesteatoma is a well-demarcated sac of keratinizing squamous epithelium in the temporal bone, which is commonly characterized as “skin in the wrong place. The major goal of surgery for cholesteatoma is to make the ear safe and dry with increasing concern of the hearing outcome of patients. Two main surgical techniques employed are Canal Wall down (CWD) and Canal Wall up Mastoidectomy (CWU). In the current study, an attempt would be made to evaluate which technique would be better for achieving disease clearance with favorable hearing outcome and dry ear.1. To evaluate the hearing results following CWU and CWD surgery in patient with cholesteatoma.2. To decide surgical approach according to extension of disease.Materials and Methods:This is a prospective study involving 100 patients with cholesteatoma who had undergone CWD and CWU surgery over the period of 3 years.The choice of mastoidectomy, CWD or CWU, was the decision of the surgeon, after completely evaluating the patient, preoperatively and intraoperatively. All cases were followed up & assessed by autoscopic examination & PTA for minimum of 3 months. In the CWD group, mean hearing gain, in 3 months was 12±1.73dB. In the CWU group, hearing gain in 3 month postoperative period was 18±2.06 dB. Also the hearing gain between the two groups was compared and it was found to be statistically significant for the 3 months (p=0.0002) postoperatively; signifying that there was a comparable difference for CWU over CWD mastoidectomy in the matter of Hearing Gain. SNHL was also seen post operatively in both group. Total 3 (6%) patient in CWU had SNHL post operatively in comparison to 7(14%) patients in CWD. From our study results, we think that CWU is superior to the CWD surgery in cases of cholesteatoma because of good post-operative hearing outcome as well as less complication and law morbidity. CWD surgery should be used in cases of extensive cholesteatoma, mental retardation, not sure about follow up and inadequate middle ear space cases.","PeriodicalId":13287,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"14 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85495032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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