Background: Patients with facial trauma were analyzed to determine the clinical presentation of fractures of the naso-ethmoid, mid and lateral face. Methods: 61 patients in the trauma unit of Dayanand Medical College were prospectively analyzed during a period of two years (August 2013 to August 2015). Results: Road traffic accidents were the major cause of fractures (72.13%) followed by assaults (14.75%) and falls (8.19%). The age group commonly affected was 21-30 years (54.09%) followed by 31-40 years (13.11%). Facial fractures were more in males, the females being 5 times less at risk. Epistaxis, swelling, tenderness, nasal obstruction, external nasal deformity and crepitus were noted in almost all patients. Ecchymosis, telecanthus and CSF rhinorrhea were noted in 90.9%, 72.7%, and 18.18% respectively. 90% presented with circumorbital ecchymosis, facial edema and anterior open bite. Other symptoms were epistaxis (81%), infraorbital nerve anesthesia and surgical emphysema (47.6%) and lengthening of face (42.8%). The commonest presentation was circumorbital ecchymosis (95.5%), subconjuctival hemorrhage (85.7%), flattening of cheek and step deformity at the infraorbital margin (81%). Facial edema was seen in 76% and trismus in 42.9%. Conclusions: Common symptoms and signs of nasoethmoid fractures included epistaxis, swelling and tenderness, nasal obstruction, external nasal deformity and crepitus in all patients, circumorbital ecchymosis in 90% and telecanthus in 73%.
{"title":"Clinical manifestations of nasoethmoid-central midface and lateral mid midface trauma: an analytical study","authors":"Manish Munjal, Sonika Kanotra, Shubham Munjal, Parth Chopra, Vanshika Saggar, Hardeep Kaur, Lovleen Sandhu, Tejbir Singh Binepal, Anjana Pillai, Hemant Chopra, Sanjeev Uppal","doi":"10.18203/issn.2454-5929.ijohns20233213","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233213","url":null,"abstract":"Background: Patients with facial trauma were analyzed to determine the clinical presentation of fractures of the naso-ethmoid, mid and lateral face. Methods: 61 patients in the trauma unit of Dayanand Medical College were prospectively analyzed during a period of two years (August 2013 to August 2015). Results: Road traffic accidents were the major cause of fractures (72.13%) followed by assaults (14.75%) and falls (8.19%). The age group commonly affected was 21-30 years (54.09%) followed by 31-40 years (13.11%). Facial fractures were more in males, the females being 5 times less at risk. Epistaxis, swelling, tenderness, nasal obstruction, external nasal deformity and crepitus were noted in almost all patients. Ecchymosis, telecanthus and CSF rhinorrhea were noted in 90.9%, 72.7%, and 18.18% respectively. 90% presented with circumorbital ecchymosis, facial edema and anterior open bite. Other symptoms were epistaxis (81%), infraorbital nerve anesthesia and surgical emphysema (47.6%) and lengthening of face (42.8%). The commonest presentation was circumorbital ecchymosis (95.5%), subconjuctival hemorrhage (85.7%), flattening of cheek and step deformity at the infraorbital margin (81%). Facial edema was seen in 76% and trismus in 42.9%. Conclusions: Common symptoms and signs of nasoethmoid fractures included epistaxis, swelling and tenderness, nasal obstruction, external nasal deformity and crepitus in all patients, circumorbital ecchymosis in 90% and telecanthus in 73%.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"20 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135166896","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 : 2023-09-27DOI: 10.18203/issn.2454-5929.ijohns20232906
Stuti Shukla, Vivek K. Pathak, Himani Sharma, Kanika Arora, Sama Rizvi
A Schwannoma is a benign, locally aggressive tumor that occurs due to the proliferation of Schwann cells of the nerve sheath. These tumors may involve any cranial nerve and hence are routinely missed on diagnosis. We report a rare case of a young adult female with unilateral tonsillar fossa mass which was excised by transoral approach, and histopathology reported to be a tonsillar schwannoma. Hence, it is necessary to be aware of these rare benign tumors as they can mimic a tonsillar hypertrophy.
{"title":"Tonsillar Schwannoma: a rare case report","authors":"Stuti Shukla, Vivek K. Pathak, Himani Sharma, Kanika Arora, Sama Rizvi","doi":"10.18203/issn.2454-5929.ijohns20232906","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232906","url":null,"abstract":"A Schwannoma is a benign, locally aggressive tumor that occurs due to the proliferation of Schwann cells of the nerve sheath. These tumors may involve any cranial nerve and hence are routinely missed on diagnosis. We report a rare case of a young adult female with unilateral tonsillar fossa mass which was excised by transoral approach, and histopathology reported to be a tonsillar schwannoma. Hence, it is necessary to be aware of these rare benign tumors as they can mimic a tonsillar hypertrophy.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135582158","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 : 2023-09-27DOI: 10.18203/issn.2454-5929.ijohns20232899
Preetham A. Puthukudy, Musarrat Feshan, Devipriya Muthu
Background: Otomycosis is reported all over the world and it accounts for 5 to 20 percent of all cases of infective otitis externa during rainy seasons. The article's main purpose was to study the predisposing factors, most common symptoms, different species of fungi involved, and the treatment outcome of otomycosis. A Chi-square test was used to analyze the association of various factors. Statistical package for the social sciences (SPSS) version 20 was used for statistical analysis. Methods: In this prospective observational study, 100 patients with clinical evidence of otomycosis were evaluated and data regarding age, gender, risk factors, clinical appearance, fungal culture, and treatment modality received were taken. Response to treatment at the 1st follow-up (at 1 week), 2nd follow-up (at 2 weeks), and 3rd follow-up (at 3 weeks) were statistically analyzed. Results: In our study we found the disease to be more common among the 51 to 60 years age group. Males were affected more than females. The most common occupation was housewife. The most common predisposing factor was ear picking and the symptom was otalgia followed by itching. The disease was predominantly unilateral. Aspergillus niger was found to be the most common organism. Clotrimazole was the effective drug for otomycosis and significant responses were seen at the end of the 3rd week of treatment. Conclusions: Aspergillus niger was the most common organism causing otomycosis and responded well with clotrimazole ear drops.
{"title":"A prospective study of clinicopathological profile and outcome of otomycosis in patients presenting to a tertiary care center","authors":"Preetham A. Puthukudy, Musarrat Feshan, Devipriya Muthu","doi":"10.18203/issn.2454-5929.ijohns20232899","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232899","url":null,"abstract":"Background: Otomycosis is reported all over the world and it accounts for 5 to 20 percent of all cases of infective otitis externa during rainy seasons. The article's main purpose was to study the predisposing factors, most common symptoms, different species of fungi involved, and the treatment outcome of otomycosis. A Chi-square test was used to analyze the association of various factors. Statistical package for the social sciences (SPSS) version 20 was used for statistical analysis. Methods: In this prospective observational study, 100 patients with clinical evidence of otomycosis were evaluated and data regarding age, gender, risk factors, clinical appearance, fungal culture, and treatment modality received were taken. Response to treatment at the 1st follow-up (at 1 week), 2nd follow-up (at 2 weeks), and 3rd follow-up (at 3 weeks) were statistically analyzed. Results: In our study we found the disease to be more common among the 51 to 60 years age group. Males were affected more than females. The most common occupation was housewife. The most common predisposing factor was ear picking and the symptom was otalgia followed by itching. The disease was predominantly unilateral. Aspergillus niger was found to be the most common organism. Clotrimazole was the effective drug for otomycosis and significant responses were seen at the end of the 3rd week of treatment. Conclusions: Aspergillus niger was the most common organism causing otomycosis and responded well with clotrimazole ear drops.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135580177","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 : 2023-09-27DOI: 10.18203/issn.2454-5929.ijohns20232903
Sowmya S., Pavitra N., Sriranga Prasad
Dystrophic calcifications are pathological mineral precipitates which occur in degenerative or dead tissue, despite normal serum calcium and phosphate levels, mostly seen in subcutaneous tissues secondary to infection or trauma. Chronic inflammation of the tonsils may lead to the formation of calcifications called tonsilloliths. The prevalence amongst the population is 2% to 16%, in age groups ranging from 10 years to 77 years of age, with a male/female ratio of 1:1. These calcifications display radiopaque images that are single or multiple, round or irregular, unilateral or bilateral and are superimposed upon the mandibular ramus. Computed tomography (CT) can be the investigation of choice for definitive diagnosis. The treatment of tonsilloliths is dependent on the size and presence of symptoms. It’s preferable to remove a single, large tonsillolith, as they can cause recurrent episodes of tonsillitis. Usually manual compression, curettage or a simple incision to release the calcified body should suffice for the relief. In case of numerous tonsilloliths, an attempt to remove them individually is not a feasible approach. Hence, bilateral tonsillectomy is opted.
{"title":"Recurrence of follicular dendritic cell sarcoma in tonsils after 7 years: a rare case report","authors":"Sowmya S., Pavitra N., Sriranga Prasad","doi":"10.18203/issn.2454-5929.ijohns20232903","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232903","url":null,"abstract":"Dystrophic calcifications are pathological mineral precipitates which occur in degenerative or dead tissue, despite normal serum calcium and phosphate levels, mostly seen in subcutaneous tissues secondary to infection or trauma. Chronic inflammation of the tonsils may lead to the formation of calcifications called tonsilloliths. The prevalence amongst the population is 2% to 16%, in age groups ranging from 10 years to 77 years of age, with a male/female ratio of 1:1. These calcifications display radiopaque images that are single or multiple, round or irregular, unilateral or bilateral and are superimposed upon the mandibular ramus. Computed tomography (CT) can be the investigation of choice for definitive diagnosis. The treatment of tonsilloliths is dependent on the size and presence of symptoms. It’s preferable to remove a single, large tonsillolith, as they can cause recurrent episodes of tonsillitis. Usually manual compression, curettage or a simple incision to release the calcified body should suffice for the relief. In case of numerous tonsilloliths, an attempt to remove them individually is not a feasible approach. Hence, bilateral tonsillectomy is opted.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135580461","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 : 2023-09-27DOI: 10.18203/issn.2454-5929.ijohns20232902
Amol Sulakhe, Sneha Save, Ravish Kumar
Schwannomas are benign, encapsulated, slow-growing, tumours deriving from the peri neural cells located in the nerve sheath. They can arise from any cranial, peripheral or autonomic nerves, and show a predilection for the head and neck region. They may produce secondary symptoms like nasal obstruction, dysphagia, and hoarseness of voice depending upon the location of the tumour. Preoperative diagnosis is difficult, relying on clinical suspicion, and confirmed by surgical pathology. Preoperative imaging or fine needle aspiration cytology may help to reveal diagnosis. The definitive diagnosis is made by histopathological examinations. A 28 years old female patient presented to the OPD with painless swelling on the left lateral side of the neck since 1 year. The swelling was mobile, non-tender, non-pulsatile firm in consistency measuring 4×3 cm with no bruit. MRI neck with contrast was done which revealed a moderately enhancing lesion of size 7×4×3 cm in the left carotid sheath. The tumour was approached by an anterior approach along the medial border of the sternocleidomastoid. Platysma and fascia were dissected followed by carotid sheath to reach the tumour. As the mass was seen arising from a branch of the ansa cervicalis, it had to be sacrificed.
{"title":"Cervical schwannoma: diagnosis and treatment","authors":"Amol Sulakhe, Sneha Save, Ravish Kumar","doi":"10.18203/issn.2454-5929.ijohns20232902","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232902","url":null,"abstract":"Schwannomas are benign, encapsulated, slow-growing, tumours deriving from the peri neural cells located in the nerve sheath. They can arise from any cranial, peripheral or autonomic nerves, and show a predilection for the head and neck region. They may produce secondary symptoms like nasal obstruction, dysphagia, and hoarseness of voice depending upon the location of the tumour. Preoperative diagnosis is difficult, relying on clinical suspicion, and confirmed by surgical pathology. Preoperative imaging or fine needle aspiration cytology may help to reveal diagnosis. The definitive diagnosis is made by histopathological examinations. A 28 years old female patient presented to the OPD with painless swelling on the left lateral side of the neck since 1 year. The swelling was mobile, non-tender, non-pulsatile firm in consistency measuring 4×3 cm with no bruit. MRI neck with contrast was done which revealed a moderately enhancing lesion of size 7×4×3 cm in the left carotid sheath. The tumour was approached by an anterior approach along the medial border of the sternocleidomastoid. Platysma and fascia were dissected followed by carotid sheath to reach the tumour. As the mass was seen arising from a branch of the ansa cervicalis, it had to be sacrificed.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135580777","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 : 2023-09-27DOI: 10.18203/issn.2454-5929.ijohns20232895
Katrina Zaballa, Geshani Jayasuriya, Karen Waters
Background: Objective of the study was to determine how the preoperative use of continuous positive airway pressure (CPAP) in children diagnosed with obstructive sleep apnea (OSA), and their compliance with the therapy, impact perioperative outcomes of adenotonsillectomy. Methods: A retrospective chart review was conducted on patients diagnosed with OSA on polysomnography, who underwent adenotonsillectomy between 2011-2017. Comparisons were made between patients who were not prescribed CPAP (N-CPAP), prescribed CPAP but non-compliant (NC-CPAP), and those compliant with their CPAP prescription (C-CPAP) therapy. OSA severity was categorized by total apnea-hypopnea index into mild <5, moderate 5-10, and severe >10. Results: A total of 55 of the 162 patients (34%) were recommended CPAP. For those recommended CPAP, 25 were NC-CPAP and 30 C-CPAP. Compared to N-CPAP, NC-CPAP had a 47% reduction in wait time to surgery (p=0.0008) but 59% increase in LOS (p=0.001), while C-CPAP had 24% reduction in wait time (p=0.12) but 34% increase in LOS (p=0.026). Risk for post-operative admission to pediatric intensive care unit (PICU) was highest in NC-CPAP (OR=12 CI 3-44) and increased in C-CPAP (OR=9 CI 2-33). Children with severe OSA had higher frequency of postoperative CPAP use, NC-CPAP 29% and C-CPAP 64% (p≤0.0001). However, use of CPAP did not prevent a requirement for post-operative oxygen. Conclusions: Amongst children prescribed pre-operative CPAP, compliance with therapy had a positive impact on the patient hospital experience following adenotonsillectomy.
背景:本研究旨在探讨阻塞性睡眠呼吸暂停(OSA)患儿术前使用持续气道正压通气(CPAP)及依从性对腺扁桃体切除术围手术期预后的影响。方法:对2011-2017年接受腺扁桃体切除术的多导睡眠图诊断为OSA的患者进行回顾性图表分析。比较未开CPAP (N-CPAP)、开CPAP但不遵医嘱(NC-CPAP)和遵医嘱(C-CPAP)治疗的患者。根据总呼吸暂停-低通气指数将OSA严重程度分为轻度(lt;5)、中度(5 ~ 10)和重度(gt;10)。结果:162例患者中55例(34%)推荐CPAP。NC-CPAP 25例，C-CPAP 30例。与N-CPAP相比，NC-CPAP手术等待时间减少了47% (p=0.0008)，但LOS增加了59% (p=0.001)，而C-CPAP手术等待时间减少了24% (p=0.12)，但LOS增加了34% (p=0.026)。NC-CPAP患者术后入院儿科重症监护病房(PICU)的风险最高(OR=12 CI 3-44)， C-CPAP患者术后入院风险增加(OR=9 CI 2-33)。重度OSA患儿术后使用CPAP的频率较高，NC-CPAP为29%，C-CPAP为64% (p≤0.0001)。然而，CPAP的使用并不能阻止术后对氧气的需求。结论:在接受术前CPAP治疗的儿童中，对治疗的依从性对腺扁桃体切除术后患者的住院经历有积极影响。
{"title":"Preoperative continuous positive airway pressure use improves the hospital experience of children undergoing adenotonsillectomy for obstructive sleep apnea","authors":"Katrina Zaballa, Geshani Jayasuriya, Karen Waters","doi":"10.18203/issn.2454-5929.ijohns20232895","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232895","url":null,"abstract":"Background: Objective of the study was to determine how the preoperative use of continuous positive airway pressure (CPAP) in children diagnosed with obstructive sleep apnea (OSA), and their compliance with the therapy, impact perioperative outcomes of adenotonsillectomy. Methods: A retrospective chart review was conducted on patients diagnosed with OSA on polysomnography, who underwent adenotonsillectomy between 2011-2017. Comparisons were made between patients who were not prescribed CPAP (N-CPAP), prescribed CPAP but non-compliant (NC-CPAP), and those compliant with their CPAP prescription (C-CPAP) therapy. OSA severity was categorized by total apnea-hypopnea index into mild <5, moderate 5-10, and severe >10. Results: A total of 55 of the 162 patients (34%) were recommended CPAP. For those recommended CPAP, 25 were NC-CPAP and 30 C-CPAP. Compared to N-CPAP, NC-CPAP had a 47% reduction in wait time to surgery (p=0.0008) but 59% increase in LOS (p=0.001), while C-CPAP had 24% reduction in wait time (p=0.12) but 34% increase in LOS (p=0.026). Risk for post-operative admission to pediatric intensive care unit (PICU) was highest in NC-CPAP (OR=12 CI 3-44) and increased in C-CPAP (OR=9 CI 2-33). Children with severe OSA had higher frequency of postoperative CPAP use, NC-CPAP 29% and C-CPAP 64% (p≤0.0001). However, use of CPAP did not prevent a requirement for post-operative oxygen. Conclusions: Amongst children prescribed pre-operative CPAP, compliance with therapy had a positive impact on the patient hospital experience following adenotonsillectomy.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"55 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581589","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 : 2023-09-27DOI: 10.18203/issn.2454-5929.ijohns20232908
Amol Sulakhe, Sneha Save, Ravish Kumar
Basal cell carcinoma (BCC) is the most common type of skin carcinoma. It is usually observed in older patients, especially in those frequently and intensively exposed to ultraviolet radiation during their lives. The most typical site is uncovered skin directly exposed to the sun. The lower eyelid is the most common site, other sites being head, face, neck and limbs. A standard surgical excision is considered a good treatment option for all BCCs arising on the face with 5 year recurrence rates of anything up to 10% providing adequate margins are taken. A 3 to 5 mm margin is recommended for standard surgical excision. Reconstruction can be done with the help of various flaps.
{"title":"Basal cell carcinoma of nose","authors":"Amol Sulakhe, Sneha Save, Ravish Kumar","doi":"10.18203/issn.2454-5929.ijohns20232908","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232908","url":null,"abstract":"Basal cell carcinoma (BCC) is the most common type of skin carcinoma. It is usually observed in older patients, especially in those frequently and intensively exposed to ultraviolet radiation during their lives. The most typical site is uncovered skin directly exposed to the sun. The lower eyelid is the most common site, other sites being head, face, neck and limbs. A standard surgical excision is considered a good treatment option for all BCCs arising on the face with 5 year recurrence rates of anything up to 10% providing adequate margins are taken. A 3 to 5 mm margin is recommended for standard surgical excision. Reconstruction can be done with the help of various flaps.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581600","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}
Background: Mucormycosis is a deadly disease that mostly affects the immunocompromised. Steroid therapy following COVID-19 infection has led to an alarming rise in the rates of this rare infection. Key to management of this disease is early diagnosis. The most common modalities used for diagnosis are KOH mount and histopathological examination. In our study we compare the efficacy of these two diagnostic modalities. Methods: Nasal endoscopy was done in all suspected cases of the disease. Nasal discharge, crusts were collected in a sterile manner and sent for KOH mount examination. Specimens collected following surgical debridement was sent for HPR examination. The results of both are compared. Results: In our study, HPR was positive in 82.2% cases while KOH mount showed positive results in 43.5% cases only. Conclusions: Histopathology helps in confirming the diagnosis of mucormycosis. It also helps to demonstrate tissue invasion and identification of species of fungus. But it is time consuming. KOH mount examination is rapid and inexpensive but the test shows high false negative values. Thus, KOH mount examination can be used as a screening tool while histopathological examination can be used as a confirmation test for post covid mucormycosis.
{"title":"A study on the utility of KOH mount and HPR in the diagnosis of post COVID mucormycosis","authors":"Anjalikrishna B., Kavita Sachdeva, Soumya Saini, Mayur Kabade","doi":"10.18203/issn.2454-5929.ijohns20232901","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232901","url":null,"abstract":"Background: Mucormycosis is a deadly disease that mostly affects the immunocompromised. Steroid therapy following COVID-19 infection has led to an alarming rise in the rates of this rare infection. Key to management of this disease is early diagnosis. The most common modalities used for diagnosis are KOH mount and histopathological examination. In our study we compare the efficacy of these two diagnostic modalities. Methods: Nasal endoscopy was done in all suspected cases of the disease. Nasal discharge, crusts were collected in a sterile manner and sent for KOH mount examination. Specimens collected following surgical debridement was sent for HPR examination. The results of both are compared. Results: In our study, HPR was positive in 82.2% cases while KOH mount showed positive results in 43.5% cases only. Conclusions: Histopathology helps in confirming the diagnosis of mucormycosis. It also helps to demonstrate tissue invasion and identification of species of fungus. But it is time consuming. KOH mount examination is rapid and inexpensive but the test shows high false negative values. Thus, KOH mount examination can be used as a screening tool while histopathological examination can be used as a confirmation test for post covid mucormycosis.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581606","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}
Follicular dendritic cell sarcoma (FDCS) is a rare mesenchymal neoplasm. It arises from not only from lymph nodes but also from extra nodal tissues, either as acquired lymphoid tissue or as part of the organized constitutive lymphoid tissue. We here report this rare entity which developed again after 7 years post tonsillectomy in a 5-year old male patient. Patient underwent radical tonsillectomy and adjuvant treatment is awaited. Differential diagnosis includes large cell lymphoma, peripheral nerve sheath tumor, extracranial meningioma, malignant melanoma, metastatic carcinoma, ectopic thymoma, malignant fibrous histiocytoma, and interstitial reticulum cell sarcoma. Currently, the management of FDCS includes the therapeutic guidelines similar to that of high-grade soft tissue sarcomas that is complete surgical resection of the lesion with possibility of adjuvant radiotherapy and/or chemotherapy. The ideal combination of management of FDCS has yet to be defined.
{"title":"Recurrence of follicular dendritic cell sarcoma in tonsils after 7 years: a rare case report","authors":"Pratiksha Pawar, Shubhanshi Kangloo, Ameya Bihani, Kunal Gupta, Soma Yadav","doi":"10.18203/issn.2454-5929.ijohns20232907","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232907","url":null,"abstract":"Follicular dendritic cell sarcoma (FDCS) is a rare mesenchymal neoplasm. It arises from not only from lymph nodes but also from extra nodal tissues, either as acquired lymphoid tissue or as part of the organized constitutive lymphoid tissue. We here report this rare entity which developed again after 7 years post tonsillectomy in a 5-year old male patient. Patient underwent radical tonsillectomy and adjuvant treatment is awaited. Differential diagnosis includes large cell lymphoma, peripheral nerve sheath tumor, extracranial meningioma, malignant melanoma, metastatic carcinoma, ectopic thymoma, malignant fibrous histiocytoma, and interstitial reticulum cell sarcoma. Currently, the management of FDCS includes the therapeutic guidelines similar to that of high-grade soft tissue sarcomas that is complete surgical resection of the lesion with possibility of adjuvant radiotherapy and/or chemotherapy. The ideal combination of management of FDCS has yet to be defined.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135580454","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}
Actinomyces are saprophytic, filamentous branched bacteria, living as commensal organisms in the oral cavity. They become invasive when they gain access to the subcutaneous tissue, through a mucosal lesion. The common predisposing conditions are having dental caries, dental manipulations and maxillo facial trauma. Actinomycosis of the tonsil is usually related to obstructive tonsillar hypertrophy rather than recurrent tonsillitis. Since actinomyces is a normal inhabitant of the human body, it will be found in every anatomical site of the body. But tonsillar actinomycosis results from reduction of oxidation- reduction potential caused by pyogenic and anaerobic infections. Mucosal trauma plays a major role in the entry of the organisms. These organisms produce toxins and proteolytic enzymes to cause pathology within the tonsil. Dilated cystic spaces and neutrophilic infiltration are the unusual features highlighted in this report. Antibiotic therapy along with tonsillectomy is suggested as the preventive and curative treatment for tonsillar actinomycosis.
{"title":"Eclipsed sunray in the tonsil: mystery unfolded","authors":"Saranya Thangavel, Charisha David, Magesh Kuppusami, Rajarajeswari Nalamate, Manjari Phansalkar, Mary Kurien","doi":"10.18203/issn.2454-5929.ijohns20232905","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20232905","url":null,"abstract":"Actinomyces are saprophytic, filamentous branched bacteria, living as commensal organisms in the oral cavity. They become invasive when they gain access to the subcutaneous tissue, through a mucosal lesion. The common predisposing conditions are having dental caries, dental manipulations and maxillo facial trauma. Actinomycosis of the tonsil is usually related to obstructive tonsillar hypertrophy rather than recurrent tonsillitis. Since actinomyces is a normal inhabitant of the human body, it will be found in every anatomical site of the body. But tonsillar actinomycosis results from reduction of oxidation- reduction potential caused by pyogenic and anaerobic infections. Mucosal trauma plays a major role in the entry of the organisms. These organisms produce toxins and proteolytic enzymes to cause pathology within the tonsil. Dilated cystic spaces and neutrophilic infiltration are the unusual features highlighted in this report. Antibiotic therapy along with tonsillectomy is suggested as the preventive and curative treatment for tonsillar actinomycosis.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135581592","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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