The last several years have seen a considerable advancement in the treatment of sinonasal diseases. The advent of minimally invasive functional endoscopic sinus surgery has led to an increased understanding of the anatomy and function of the sinonasal region, making previously inaccessible areas safe to operate in. The advancement in imaging of the sinonasal tract has been associated with the evolution of endoscopic sinus surgery. The imaging of sinonasal pathology has progressed from conventional radiographs (plain films) to computed tomography (CT) and magnetic resonance imaging (MRI). Technological advancements in CT and MRI have given a precise differential diagnosis and greater detail about the anatomical extent of sinonasal pathologies. Because the high water content of the inflammatory state causes a markedly enhanced signal on T2-weighted scans, MRI can currently distinguish between retained secretions and inflammatory responses from the mass of the tumor. The invasive lesions affecting the soft tissues outside of the sinonasal region are more easily distinguished by MRI. MRI largely took the position of CT scan for malignant sinonasal lesions due to its superior capacity to distinguish between inflammation and tumor and its increased sensitivity for intracranial extension. MRI can be more useful than a CT scan in demonstrating the degree of soft tissue abnormalities and in identifying lesions that have returned after surgery.
{"title":"Role of magnetic resonance imaging in sinonasal pathology: a review","authors":"Santosh Kumar Swain, Prerna Barik, Pradosh Kumar Sarangi","doi":"10.18203/issn.2454-5929.ijohns20240082","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20240082","url":null,"abstract":"The last several years have seen a considerable advancement in the treatment of sinonasal diseases. The advent of minimally invasive functional endoscopic sinus surgery has led to an increased understanding of the anatomy and function of the sinonasal region, making previously inaccessible areas safe to operate in. The advancement in imaging of the sinonasal tract has been associated with the evolution of endoscopic sinus surgery. The imaging of sinonasal pathology has progressed from conventional radiographs (plain films) to computed tomography (CT) and magnetic resonance imaging (MRI). Technological advancements in CT and MRI have given a precise differential diagnosis and greater detail about the anatomical extent of sinonasal pathologies. Because the high water content of the inflammatory state causes a markedly enhanced signal on T2-weighted scans, MRI can currently distinguish between retained secretions and inflammatory responses from the mass of the tumor. The invasive lesions affecting the soft tissues outside of the sinonasal region are more easily distinguished by MRI. MRI largely took the position of CT scan for malignant sinonasal lesions due to its superior capacity to distinguish between inflammation and tumor and its increased sensitivity for intracranial extension. MRI can be more useful than a CT scan in demonstrating the degree of soft tissue abnormalities and in identifying lesions that have returned after surgery.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"116 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596567","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 : 2024-01-25DOI: 10.18203/issn.2454-5929.ijohns20240067
Nandini Gupta, Divyanshu Sharma, D. Parikh
In recent years extra pulmonary tuberculosis has more frequently been associated with mastoiditis in patients with immunodeficiency state. Although tuberculosis of the mastoid or otomastoiditis is a very rare complication of tuberculosis today, when occurs it may cause significant morbidity. Complications such as facial paralysis and permanent hearing loss may develop. Our purpose was to evaluate the differential findings of tuberculous otomastoiditis and evaluation of outcomes in patients undergoing surgery along with anti-tubercular therapy rather than patients receiving only anti-tubercular therapy. We reviewed 12 cases of TOM, all of which had been confirmed on sputum and pathological examination following middle ear mucosal biopsy. Neuroradiologists analyzed the typical findings of HRCT temporal bone. Tympanomastoid ear surgery was planned according to the extent of the disease involved. The soft tissue attenuation in the entire middle ear cavity and extension to the external auditory canal (EAC) or mucosal thickening of the bony EAC, erosion of the ossicles and scutum was clinically significant. Patients who underwent tympanomastoid surgery showed better prognosis than the patients receiving anti tubercular drugs alone. Patients with extra-pulmonary tuberculosis, especially otomastoiditis should get operated to remove the disease along with anti-tubercular treatment to prevent complications.
近年来，肺外结核越来越多地与免疫缺陷患者的乳突炎联系在一起。虽然乳突结核或耳乳突炎是当今非常罕见的结核病并发症，但一旦发生，可能会导致严重的发病率。可能会出现面瘫和永久性听力损失等并发症。我们的目的是评估结核性耳软骨炎的鉴别诊断结果，并评估在接受手术的同时接受抗结核治疗的患者比只接受抗结核治疗的患者的治疗效果。我们对 12 例 TOM 病例进行了复查，所有病例均在中耳粘膜活检后经痰液和病理检查证实。神经放射学专家分析了 HRCT颞骨的典型发现。根据病变的程度，计划进行鼓室成形术。整个中耳腔的软组织衰减并延伸至外耳道（EAC）或骨性外耳道粘膜增厚、听小骨和颅骨侵蚀具有临床意义。与只接受抗结核药物治疗的患者相比，接受鼓室成形术的患者预后较好。肺外结核病患者，尤其是耳乳突炎患者，应在接受抗结核治疗的同时进行手术切除病灶，以防止并发症的发生。
{"title":"Tuberculous otomastoiditis: analysis of otological tuberculosis with intact tympanic membrane","authors":"Nandini Gupta, Divyanshu Sharma, D. Parikh","doi":"10.18203/issn.2454-5929.ijohns20240067","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20240067","url":null,"abstract":"In recent years extra pulmonary tuberculosis has more frequently been associated with mastoiditis in patients with immunodeficiency state. Although tuberculosis of the mastoid or otomastoiditis is a very rare complication of tuberculosis today, when occurs it may cause significant morbidity. Complications such as facial paralysis and permanent hearing loss may develop. Our purpose was to evaluate the differential findings of tuberculous otomastoiditis and evaluation of outcomes in patients undergoing surgery along with anti-tubercular therapy rather than patients receiving only anti-tubercular therapy. We reviewed 12 cases of TOM, all of which had been confirmed on sputum and pathological examination following middle ear mucosal biopsy. Neuroradiologists analyzed the typical findings of HRCT temporal bone. Tympanomastoid ear surgery was planned according to the extent of the disease involved. The soft tissue attenuation in the entire middle ear cavity and extension to the external auditory canal (EAC) or mucosal thickening of the bony EAC, erosion of the ossicles and scutum was clinically significant. Patients who underwent tympanomastoid surgery showed better prognosis than the patients receiving anti tubercular drugs alone. Patients with extra-pulmonary tuberculosis, especially otomastoiditis should get operated to remove the disease along with anti-tubercular treatment to prevent complications.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"53 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598768","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: The main objective of this study was to observe the Indian clinical scenario and analyse the clinical and epidemiological profile of patients with vestibular migraine. Methods: This is a retrospective observational descriptive study. The outpatient records of the vertigo clinic at Department of Otorhinolaryngology of SGT medical college, Budhera, Gurgaon, Haryana was assessed from April 2023 to July 2023. Patients who were diagnosed with vestibular migraine based on ICD classification as follows was included in the study. Results: Study population predominantly comprised of 77% (17) females and 23% (5) of males. Almost 80% of the study population belonged to age group 31-40 years. Each episode of vertigo lasts for seconds in 50% of the patients and minutes in 45% of the patients. All patients had episodic vertigo.59% of patients described the vertigo as rotatory,18 % of the study population reported imbalance,18 % described swaying and 5% reported blackouts. Most of the examination was normal except 5 out of 22 patients reported giddiness on testing vertical saccades. Conclusions: Vestibular migraine is an underdiagnosed condition in India, there’s not much research and awareness, hence this study aims to overcome these limitations. Most of the patients were middle aged women. The physical and audiological examination of most patients were normal but showing abnormalities on testing saccades.
{"title":"Clinical-epidemiological profile of vestibular migraine patients: Indian scenario","authors":"Divya Joy, Ayushi Agarwal, Rohit K., Sumit Singh, Vikas Kakkar, Akriti Sharma, Khushboo Arora, Anusha Stani","doi":"10.18203/issn.2454-5929.ijohns20240064","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20240064","url":null,"abstract":"Background: The main objective of this study was to observe the Indian clinical scenario and analyse the clinical and epidemiological profile of patients with vestibular migraine.\u0000Methods: This is a retrospective observational descriptive study. The outpatient records of the vertigo clinic at Department of Otorhinolaryngology of SGT medical college, Budhera, Gurgaon, Haryana was assessed from April 2023 to July 2023. Patients who were diagnosed with vestibular migraine based on ICD classification as follows was included in the study. \u0000Results: Study population predominantly comprised of 77% (17) females and 23% (5) of males. Almost 80% of the study population belonged to age group 31-40 years. Each episode of vertigo lasts for seconds in 50% of the patients and minutes in 45% of the patients. All patients had episodic vertigo.59% of patients described the vertigo as rotatory,18 % of the study population reported imbalance,18 % described swaying and 5% reported blackouts. Most of the examination was normal except 5 out of 22 patients reported giddiness on testing vertical saccades.\u0000Conclusions: Vestibular migraine is an underdiagnosed condition in India, there’s not much research and awareness, hence this study aims to overcome these limitations. Most of the patients were middle aged women. The physical and audiological examination of most patients were normal but showing abnormalities on testing saccades.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"16 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596386","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 : 2024-01-25DOI: 10.18203/issn.2454-5929.ijohns20240078
Meenu Krishnan, Anitha Kumari, Ramani C. V.
Branchial cleft anomalies are rare, congenital lesions, that occur due to the maldevelopment of the branchial apparatus, during fetal maturation. Anomalies of the third and fourth arch contribute to a very small proportion of these. Most cases are detected in childhood, either as a cyst, sinus or fistula in the neck. Some of the common treatment approaches to third branchial cleft fistulas include endoscopic cauterization, open cervical fistulectomy and, in cases of recurrence, selective neck dissection. Here, we present a case of recurrent branchial fistula of the third arch, wherein we used a combined cervical and intraoral approach, conserving the thyroid cartilage, to achieve a complete excision of the fistula tract.
{"title":"Management of a recurrent third branchial arch fistula using combined endoscopic and open approach","authors":"Meenu Krishnan, Anitha Kumari, Ramani C. V.","doi":"10.18203/issn.2454-5929.ijohns20240078","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20240078","url":null,"abstract":"Branchial cleft anomalies are rare, congenital lesions, that occur due to the maldevelopment of the branchial apparatus, during fetal maturation. Anomalies of the third and fourth arch contribute to a very small proportion of these. Most cases are detected in childhood, either as a cyst, sinus or fistula in the neck. Some of the common treatment approaches to third branchial cleft fistulas include endoscopic cauterization, open cervical fistulectomy and, in cases of recurrence, selective neck dissection. Here, we present a case of recurrent branchial fistula of the third arch, wherein we used a combined cervical and intraoral approach, conserving the thyroid cartilage, to achieve a complete excision of the fistula tract.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"9 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595976","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 : 2024-01-25DOI: 10.18203/issn.2454-5929.ijohns20240066
S. Shanmugam, Aravind Shivakumar
Background: We conducted a study to compare the outcomes of upfront surgery and salvage surgery following definitive chemoradiation in locally advanced oral cavity squamous cell carcinoma. This study aims to compare the short-term outcomes (postoperative morbidity, recurrence) & long-term outcomes (overall survival, disease-free survival) between upfront surgery and salvage surgery following definitive chemoradiation in locally advanced oral cavity squamous cell carcinoma. Methods: A total of sixty patients with locally advanced oral cavity squamous cell carcinoma (T4a, N1-N2b) were retrospectively analyzed between January 2021 and August 2023. Thirty patients underwent upfront surgery followed by adjuvant radiation (group 1) while another thirty patients underwent salvage surgery following definitive chemoradiation (group 2) (radiation dose- 66-70 Gy) Results: Morbidity was found to be significantly higher in the salvage surgery group (group 2) when compared to the upfront surgery group (group 1) with a p value of 0.003. There was no statistical significance between the two groups in terms of disease-free survival and overall survival. Conclusions: This retrospective study shows that there are no significant differences in overall survival and disease-free survival amongst patients of locally advanced oral cavity squamous cell carcinoma treated with upfront surgery and salvage surgery following definitive chemoradiation. Morbidity is significantly higher in the salvage surgery group.
{"title":"Comparison between upfront surgery vs salvage surgery following definitive chemoradiation in the treatment of potentially curable locally advanced oral cavity cancer: a retrospective study","authors":"S. Shanmugam, Aravind Shivakumar","doi":"10.18203/issn.2454-5929.ijohns20240066","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20240066","url":null,"abstract":"Background: We conducted a study to compare the outcomes of upfront surgery and salvage surgery following definitive chemoradiation in locally advanced oral cavity squamous cell carcinoma. This study aims to compare the short-term outcomes (postoperative morbidity, recurrence) & long-term outcomes (overall survival, disease-free survival) between upfront surgery and salvage surgery following definitive chemoradiation in locally advanced oral cavity squamous cell carcinoma.\u0000Methods: A total of sixty patients with locally advanced oral cavity squamous cell carcinoma (T4a, N1-N2b) were retrospectively analyzed between January 2021 and August 2023. Thirty patients underwent upfront surgery followed by adjuvant radiation (group 1) while another thirty patients underwent salvage surgery following definitive chemoradiation (group 2) (radiation dose- 66-70 Gy)\u0000Results: Morbidity was found to be significantly higher in the salvage surgery group (group 2) when compared to the upfront surgery group (group 1) with a p value of 0.003. There was no statistical significance between the two groups in terms of disease-free survival and overall survival.\u0000Conclusions: This retrospective study shows that there are no significant differences in overall survival and disease-free survival amongst patients of locally advanced oral cavity squamous cell carcinoma treated with upfront surgery and salvage surgery following definitive chemoradiation. Morbidity is significantly higher in the salvage surgery group.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"5 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596879","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 : 2024-01-10DOI: 10.18203/issn.2454-5929.ijohns20240013
Archisman Shubhadarshan, Uneza Gaiwale
Background: P300 is among the first auditory responses in a collection of event-related or endogenous evoked responses. Hearing loss has drastically reduced cognitive abilities in individual adults. P300 is used as an electrophysiological tool to assess cognitive functions. This study was framed to compare the effect of hearing loss in P300 amplitude and latencies in Indian population. As no such study was carried out in Indian population, this study will be helpful in evaluating the correlation between hearing loss and cognitive function. Methods: We recruited a total of 60 participants out of which 30 were in group 1 having normal hearing and other 30 were included in group 2 having hearing loss. P300 was obtained using a Neurosoft instrument using tone burst stimuli The acquisition of tonal stimuli was carried out in a sound-treated room. Results: The t test value (t=4.75, p<0.001) for P300 amplitude indicates that the difference between the mean among normal hearing and hearing-impaired adult was statistically significant. But the p=0.68 for P300 latency which indicates that the difference between the two groups is not statistically significant, which accepts hypothesis that There would not exist any relationship of P300 latency in normal hearing- and hearing-impaired adults. Pearson's correlation was found that hearing loss and amplitude of P300 has a strong negative correlation and latency of P300 has a poor positive correlation with hearing loss. Conclusions: Hearing loss affects the P300 measures. Due to hearing loss cognitive decline occurs which results in reduced amplitude and prolonged latency in P300.
{"title":"Effect of hearing loss on P300 measures","authors":"Archisman Shubhadarshan, Uneza Gaiwale","doi":"10.18203/issn.2454-5929.ijohns20240013","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20240013","url":null,"abstract":"Background: P300 is among the first auditory responses in a collection of event-related or endogenous evoked responses. Hearing loss has drastically reduced cognitive abilities in individual adults. P300 is used as an electrophysiological tool to assess cognitive functions. This study was framed to compare the effect of hearing loss in P300 amplitude and latencies in Indian population. As no such study was carried out in Indian population, this study will be helpful in evaluating the correlation between hearing loss and cognitive function.\u0000Methods: We recruited a total of 60 participants out of which 30 were in group 1 having normal hearing and other 30 were included in group 2 having hearing loss. P300 was obtained using a Neurosoft instrument using tone burst stimuli The acquisition of tonal stimuli was carried out in a sound-treated room. \u0000Results: The t test value (t=4.75, p<0.001) for P300 amplitude indicates that the difference between the mean among normal hearing and hearing-impaired adult was statistically significant. But the p=0.68 for P300 latency which indicates that the difference between the two groups is not statistically significant, which accepts hypothesis that There would not exist any relationship of P300 latency in normal hearing- and hearing-impaired adults. Pearson's correlation was found that hearing loss and amplitude of P300 has a strong negative correlation and latency of P300 has a poor positive correlation with hearing loss.\u0000Conclusions: Hearing loss affects the P300 measures. Due to hearing loss cognitive decline occurs which results in reduced amplitude and prolonged latency in P300.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":" 106","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139628140","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 : 2023-12-30DOI: 10.18203/issn.2454-5929.ijohns20234163
Deepika Eswari D., Sunil Pai, Ajay Kumar, Ramnath Shenoy, David Rosario, Hanock Nischal, Herison J.
This case report presents the diagnostic challenges encountered in identifying nasopharyngeal Burkitt lymphoma (BL) in an 18- year-old male initially misdiagnosed with adenoid hypertrophy. BL, a rare and aggressive B-cell non-Hodgkin’s lymphoma (NHL), typically manifests in cervical lymphnodes or facial bones, making nasopharyngeal involvement unusual. The patient's symptoms progressed from nasal blockage to oropharyngeal dysphagia and neck swelling, prompting further investigation. Radiological assessments, including a CT scan, were inconclusive, leading to a diagnosis through excisional biopsy and immunohistochemistry, confirming BL with CD20, CD10, and Bcl-6 expression. Successful treatment involved six cycles of chemotherapy, resulting in complete remission. This case underscores the importance of considering rare malignancies in atypical presentations and highlights the role of comprehensive diagnostic approaches in achieving accurate and timely management.
{"title":"Nasopharyngeal Burkitt lymphoma masquerading as adenoid hypertrophy in an adult: a diagnostic challenge","authors":"Deepika Eswari D., Sunil Pai, Ajay Kumar, Ramnath Shenoy, David Rosario, Hanock Nischal, Herison J.","doi":"10.18203/issn.2454-5929.ijohns20234163","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20234163","url":null,"abstract":"This case report presents the diagnostic challenges encountered in identifying nasopharyngeal Burkitt lymphoma (BL) in an 18- year-old male initially misdiagnosed with adenoid hypertrophy. BL, a rare and aggressive B-cell non-Hodgkin’s lymphoma (NHL), typically manifests in cervical lymphnodes or facial bones, making nasopharyngeal involvement unusual. The patient's symptoms progressed from nasal blockage to oropharyngeal dysphagia and neck swelling, prompting further investigation. Radiological assessments, including a CT scan, were inconclusive, leading to a diagnosis through excisional biopsy and immunohistochemistry, confirming BL with CD20, CD10, and Bcl-6 expression. Successful treatment involved six cycles of chemotherapy, resulting in complete remission. This case underscores the importance of considering rare malignancies in atypical presentations and highlights the role of comprehensive diagnostic approaches in achieving accurate and timely management.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140906","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 : 2023-11-27DOI: 10.18203/issn.2454-5929.ijohns20233594
V. Paramasivan, Jas Simran Singh Bhatia, Kamal Pandyan
Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial obstruction of upper airway during sleep. Various pathophysiological phenotypes contributing for the repetitive events of apnea and hypopnea have been identified in the recent studies. Consequently, various new modalities of treatment are being introduced to be implemented either independently or in conjunction with the previously available treatment modalities. This article imparts a thorough knowledge of various modes of treatment available for the non-surgical treatment of OSA. Many studies conducted in the past had emphasized the importance and effectiveness of lots of non-surgical modes of treating OSA. Our article includes a concluding description of all those studies including those on CPAP and myofunctional therapy. Thorough knowledge of both i.e., the pathophysiological phenotypes and available modes of treatment is necessary for the successful treatment of obstructive sleep apnoea. Recent advances, both in terms of causative factors as well as corresponding treatment options, should be laid down in the form of management guidelines as a part of evidence-based medicine.
阻塞性睡眠呼吸暂停（OSA）的特点是在睡眠过程中反复出现上气道完全或部分阻塞。最近的研究发现了导致呼吸暂停和低通气反复发作的各种病理生理表型。因此，各种新的治疗模式被引入，可单独使用，也可与之前可用的治疗模式结合使用。本文全面介绍了非手术治疗 OSA 的各种治疗模式。过去进行的许多研究都强调了许多非手术治疗 OSA 方式的重要性和有效性。我们的文章对所有这些研究进行了总结性描述，包括有关 CPAP 和肌功能疗法的研究。要成功治疗阻塞性睡眠呼吸暂停，就必须充分了解两者，即病理生理学表型和可用的治疗模式。作为循证医学的一部分，应以管理指南的形式介绍在致病因素和相应治疗方案方面的最新进展。
{"title":"Medical management of obstructive sleep apnea: a review article","authors":"V. Paramasivan, Jas Simran Singh Bhatia, Kamal Pandyan","doi":"10.18203/issn.2454-5929.ijohns20233594","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233594","url":null,"abstract":"Obstructive sleep apnea (OSA) is characterized by repetitive episodes of complete or partial obstruction of upper airway during sleep. Various pathophysiological phenotypes contributing for the repetitive events of apnea and hypopnea have been identified in the recent studies. Consequently, various new modalities of treatment are being introduced to be implemented either independently or in conjunction with the previously available treatment modalities. This article imparts a thorough knowledge of various modes of treatment available for the non-surgical treatment of OSA. Many studies conducted in the past had emphasized the importance and effectiveness of lots of non-surgical modes of treating OSA. Our article includes a concluding description of all those studies including those on CPAP and myofunctional therapy. Thorough knowledge of both i.e., the pathophysiological phenotypes and available modes of treatment is necessary for the successful treatment of obstructive sleep apnoea. Recent advances, both in terms of causative factors as well as corresponding treatment options, should be laid down in the form of management guidelines as a part of evidence-based medicine.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228711","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 : 2023-11-27DOI: 10.18203/issn.2454-5929.ijohns20233592
Nur Setyo N. O. V., Yonanda Adi Pratama, I. K. Praba, C. Herdini, S. R. Indrasari, Danu Yudistira
Ossifying fibroma (OF) is a rare non-malignant fibro-osseous lesion of the craniofacial area with the characteristic of slow-growing and locally aggressive. The incidence rate in paediatric patients is still not clear. The management is varied from observation and serial radiologic imaging to radical resection of the tumour. To provide knowledge and information about diagnosing and managing a rare case of craniofacial ossifying fibroma. A-5-year-old boy diagnosed with orbito-inferonasal region ossifying fibroma underwent extirpation of the mass with the lateral rhinotomy- Webber Ferguson approach, anterior orbitotomy by the ophthalmologist, and obturator placement by the prosthodontist. OF remains a rare disease, particularly in paediatric patients, which is locally aggressive although it’s benign characteristic. Definitive excision is the treatment of choice for OF. Successful surgical outcome was due to a multidisciplinary team and surgical incision technique. We found that lateral rhinotomy Weber Ferguson incision showed excellent exposure. Vision and facial nerve function were preserved as well as good facial symmetry and aesthetics and recurrence prevention. Regular follow-up is necessary for young OF patients.
骨化纤维瘤（Ossifying fibroma，OF）是一种罕见的颅面部非恶性纤维骨病变，具有生长缓慢和局部侵袭性的特点。儿科患者的发病率尚不明确。治疗方法多种多样，从观察和连续放射成像到肿瘤根治性切除术。旨在提供有关诊断和处理一例罕见颅面骨化性纤维瘤的知识和信息。一名5岁男孩被诊断为眶内骨化性纤维瘤，他接受了鼻外侧-韦伯-弗格森法肿块切除术，眼科医生进行了前眶切开术，口腔修复科医生进行了钝器置入术。OF仍然是一种罕见的疾病，尤其是在儿童患者中，虽然具有良性特征，但在局部具有侵袭性。确定性切除是治疗 OF 的首选方法。手术的成功归功于多学科团队和手术切口技术。我们发现，鼻外侧切口韦伯-弗格森（Weber Ferguson）切口显示了良好的暴露效果。视力和面部神经功能得以保留，面部对称性和美观性良好，并可预防复发。对于年轻的 OF 患者，有必要进行定期随访。
{"title":"A successful surgical management of pediatric ossifying fibroma in peripheral limited setting: a rare case report","authors":"Nur Setyo N. O. V., Yonanda Adi Pratama, I. K. Praba, C. Herdini, S. R. Indrasari, Danu Yudistira","doi":"10.18203/issn.2454-5929.ijohns20233592","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233592","url":null,"abstract":"Ossifying fibroma (OF) is a rare non-malignant fibro-osseous lesion of the craniofacial area with the characteristic of slow-growing and locally aggressive. The incidence rate in paediatric patients is still not clear. The management is varied from observation and serial radiologic imaging to radical resection of the tumour. To provide knowledge and information about diagnosing and managing a rare case of craniofacial ossifying fibroma. A-5-year-old boy diagnosed with orbito-inferonasal region ossifying fibroma underwent extirpation of the mass with the lateral rhinotomy- Webber Ferguson approach, anterior orbitotomy by the ophthalmologist, and obturator placement by the prosthodontist. OF remains a rare disease, particularly in paediatric patients, which is locally aggressive although it’s benign characteristic. Definitive excision is the treatment of choice for OF. Successful surgical outcome was due to a multidisciplinary team and surgical incision technique. We found that lateral rhinotomy Weber Ferguson incision showed excellent exposure. Vision and facial nerve function were preserved as well as good facial symmetry and aesthetics and recurrence prevention. Regular follow-up is necessary for young OF patients.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"357 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139232626","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 : 2023-11-27DOI: 10.18203/issn.2454-5929.ijohns20233580
Cristina Aguiar, Ana F. Carvalho, Ana R. Nobre, Francisco Branquinho
The head and neck oncological patients are susceptible, either because of tumor location or the treatments performed, to changes of their ear structures. Due to close proximity of radiation field to the ear, radiotherapy induces short and long-term toxicities to the external, middle and internal ear. The aim of this study was to evaluate the impact of radiotherapy on the inner ear. We conducted a cross-sectional retrospective study of patients with cancer of the larynx and hypopharynx undergoing radiotherapy alone or adjuvant to surgery. The follow-up period was 1 year. Relevant clinical and audiological variables were analyzed. We included 15 patients, mostly males, with a median age of 66 years. Average hearing threshold (AHT) deterioration was found in 13 ears, with a median of 8.1dB. Mean bone conduction threshold at 4000 Hz, air conduction threshold at 8000 Hz at 12 months and the median of the final air conduction threshold at 10,000 Hz was significantly higher than the pre-treatment. A correlation was observed between final AHT and dosage of radiation per fraction. Thus, for each increase of 1 Gy per fraction there was an increase of 22.13 dB in the final AHT. About half of the patients had deterioration of the final AHT, proving, on the one hand, the sensorineural hearing loss associated with radiotherapy, while emphasizing the need to perform long-term follow-up protocols for early auditory rehabilitation of these patients.
{"title":"Effects of radiotherapy for tumors of the larynx and hypopharynx in hearing levels","authors":"Cristina Aguiar, Ana F. Carvalho, Ana R. Nobre, Francisco Branquinho","doi":"10.18203/issn.2454-5929.ijohns20233580","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233580","url":null,"abstract":"The head and neck oncological patients are susceptible, either because of tumor location or the treatments performed, to changes of their ear structures. Due to close proximity of radiation field to the ear, radiotherapy induces short and long-term toxicities to the external, middle and internal ear. The aim of this study was to evaluate the impact of radiotherapy on the inner ear. We conducted a cross-sectional retrospective study of patients with cancer of the larynx and hypopharynx undergoing radiotherapy alone or adjuvant to surgery. The follow-up period was 1 year. Relevant clinical and audiological variables were analyzed. We included 15 patients, mostly males, with a median age of 66 years. Average hearing threshold (AHT) deterioration was found in 13 ears, with a median of 8.1dB. Mean bone conduction threshold at 4000 Hz, air conduction threshold at 8000 Hz at 12 months and the median of the final air conduction threshold at 10,000 Hz was significantly higher than the pre-treatment. A correlation was observed between final AHT and dosage of radiation per fraction. Thus, for each increase of 1 Gy per fraction there was an increase of 22.13 dB in the final AHT. About half of the patients had deterioration of the final AHT, proving, on the one hand, the sensorineural hearing loss associated with radiotherapy, while emphasizing the need to perform long-term follow-up protocols for early auditory rehabilitation of these patients.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139231552","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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