Pub Date : 2023-11-27DOI: 10.18203/issn.2454-5929.ijohns20233578
N. Chhabra, Ankita Aggarwal, Sanjeev Bhagat, Khushboo Goel
Background: Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist’s office. Study to evaluate the presentation of different signs and symptoms of LPR along with evaluating the role of empiric PPI (proton pump inhibitor) in the management of LPR by observing its effect on RFS and RSI. Methods: A prospective observational study was conducted on 100 cases having different symptoms of LPR. Reflux symptom index (RSI) and Reflux finding score (RFS) were used to diagnose LPR. Patients were put on PPI (Pantoprazole 40 mg OD for 12 weeks) and followed up at 4,8 and 12 weeks and successive RSI and RFS scores were evaluated. The results were compiled and analyzed statistically. Results: Among all symptoms, most common presenting symptom of LPR was foreign body/sensation of something sticking in throat (80%). Upon pharmacological therapy with PPIs (Pantoprazole), the mean RSI score changed from 22.94±5.83 to 11.19±2.97 at 12 weeks of PPI therapy. The mean RFS score changed from 12.93±3.55 to 6.86±2.86 at 12 weeks of PPI therapy. The change in the RFS and RSI score was highly significant (p=0.001). Conclusions: LPR is a common condition presenting in ENT settings, the symptoms and signs of which may be complex. RFS and RSI score are valuable tools for diagnosing LPR. PPIs are proven to be effective therapy for LPR, more studies are encouraged to affirm the efficacy of PPIs over other management options.
{"title":"Study of the empirical role of proton pump inhibitor therapy on laryngopharyngeal reflux","authors":"N. Chhabra, Ankita Aggarwal, Sanjeev Bhagat, Khushboo Goel","doi":"10.18203/issn.2454-5929.ijohns20233578","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233578","url":null,"abstract":"Background: Laryngopharyngeal reflux (LPR) is a highly prevalent disease and commonly encountered in the otolaryngologist’s office. Study to evaluate the presentation of different signs and symptoms of LPR along with evaluating the role of empiric PPI (proton pump inhibitor) in the management of LPR by observing its effect on RFS and RSI. Methods: A prospective observational study was conducted on 100 cases having different symptoms of LPR. Reflux symptom index (RSI) and Reflux finding score (RFS) were used to diagnose LPR. Patients were put on PPI (Pantoprazole 40 mg OD for 12 weeks) and followed up at 4,8 and 12 weeks and successive RSI and RFS scores were evaluated. The results were compiled and analyzed statistically. Results: Among all symptoms, most common presenting symptom of LPR was foreign body/sensation of something sticking in throat (80%). Upon pharmacological therapy with PPIs (Pantoprazole), the mean RSI score changed from 22.94±5.83 to 11.19±2.97 at 12 weeks of PPI therapy. The mean RFS score changed from 12.93±3.55 to 6.86±2.86 at 12 weeks of PPI therapy. The change in the RFS and RSI score was highly significant (p=0.001). Conclusions: LPR is a common condition presenting in ENT settings, the symptoms and signs of which may be complex. RFS and RSI score are valuable tools for diagnosing LPR. PPIs are proven to be effective therapy for LPR, more studies are encouraged to affirm the efficacy of PPIs over other management options.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139229111","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}
Neck masses are one of the most common presentations in the ENT practice and they are a challenge in the diagnosis and management. The masses may be of congenital, inflammatory, or neoplastic origin. An accurate clinical assessment conducted while taking into account pertinent anatomical and developmental viewpoints, accompanied by well-planned investigative parameters, may aid in making an early diagnosis. Our is a series of three cases where in which we have described the finding of all the three cases in detail, first case is of 70 years female with right sided neck swelling which ultimately turned out to be right venous aneurysm. Second being a case of a young kid misdiagnosed as other infections and treated for long time, which ultimately responded with ATT. Lastly, a young kid presenting with multinodular goitre. We need to be ready for surprise and be ready to deal with unusual cases with different management options.
颈部肿块是耳鼻喉科最常见的病症之一，也是诊断和治疗的难题。肿块可能是先天性的，也可能是炎症性或肿瘤性的。在进行准确的临床评估的同时，考虑到相关的解剖和发育观点，并辅以精心策划的检查参数，可能有助于早期诊断。第一个病例是一名 70 岁女性，右侧颈部肿胀，最终被证实为右侧静脉瘤。第二个病例是一名被误诊为其他感染并接受了长期治疗的年轻儿童，最终在 ATT 治疗后好转。最后一个病例是一名患有多结节性甲状腺肿的年轻儿童。我们需要做好应对突发情况的准备，并随时准备以不同的治疗方案处理不寻常的病例。
{"title":"Unusual neck masses encountered in remote areas of Sikkim","authors":"Santosh Kesari, Priyanko Chakraborty, Aseem Anand, Subhasish Mukherjee","doi":"10.18203/issn.2454-5929.ijohns20233582","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233582","url":null,"abstract":"Neck masses are one of the most common presentations in the ENT practice and they are a challenge in the diagnosis and management. The masses may be of congenital, inflammatory, or neoplastic origin. An accurate clinical assessment conducted while taking into account pertinent anatomical and developmental viewpoints, accompanied by well-planned investigative parameters, may aid in making an early diagnosis. Our is a series of three cases where in which we have described the finding of all the three cases in detail, first case is of 70 years female with right sided neck swelling which ultimately turned out to be right venous aneurysm. Second being a case of a young kid misdiagnosed as other infections and treated for long time, which ultimately responded with ATT. Lastly, a young kid presenting with multinodular goitre. We need to be ready for surprise and be ready to deal with unusual cases with different management options.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139230325","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.ijohns20233583
Yonanda Adi Pratama, I. K. Praba, C. Herdini, S. R. Indrasari, Danu Yudistira, Yosephine Nina
Mucosal melanoma is rare type of melanoma accounted only 0.8-3.7% of melanoma. It defined as melanoma which occurs in mucous membrane, oral and nasal cavities, conjunctiva, genital sites, and rarely other mucosae. Head and neck melanoma accounted 50% among other sites. Recent studies, amelanotic subtype account 13.2% of all sino-nasal melanoma. Nasal cavity melanoma usually occurs on lateral nasal area especially in middle turbinate and inferior turbinate. Among other location, sino-nasal originated primary lesion was more deadly compared to other. We reported a case of amelanotic melanoma. 56 years old Asian Female presented with mass in left nose. The patient also complaint of recurring epistaxis, facial pain, epiphora, and blurred vision. After several follow up investigation, a diagnosis of amelanotic melanoma with orbit involvement was made. Subsequently patient underwent surgery for tumor removal. Although tumor has been removed, patient had to continue with adjuvant therapy for following month. Meticulous identifying and confirmation is an important factor which provide better understanding for the clinician in diagnosing.
{"title":"Amelanotic mucosal melanoma of the left sinonasal cavity: a case report","authors":"Yonanda Adi Pratama, I. K. Praba, C. Herdini, S. R. Indrasari, Danu Yudistira, Yosephine Nina","doi":"10.18203/issn.2454-5929.ijohns20233583","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233583","url":null,"abstract":"Mucosal melanoma is rare type of melanoma accounted only 0.8-3.7% of melanoma. It defined as melanoma which occurs in mucous membrane, oral and nasal cavities, conjunctiva, genital sites, and rarely other mucosae. Head and neck melanoma accounted 50% among other sites. Recent studies, amelanotic subtype account 13.2% of all sino-nasal melanoma. Nasal cavity melanoma usually occurs on lateral nasal area especially in middle turbinate and inferior turbinate. Among other location, sino-nasal originated primary lesion was more deadly compared to other. We reported a case of amelanotic melanoma. 56 years old Asian Female presented with mass in left nose. The patient also complaint of recurring epistaxis, facial pain, epiphora, and blurred vision. After several follow up investigation, a diagnosis of amelanotic melanoma with orbit involvement was made. Subsequently patient underwent surgery for tumor removal. Although tumor has been removed, patient had to continue with adjuvant therapy for following month. Meticulous identifying and confirmation is an important factor which provide better understanding for the clinician in diagnosing.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139233979","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.ijohns20233589
Manali Bhat, H. Vijayendra, V. Vijayendra, Nilesh H Mahajan
Several conditions are known to present as masses in the middle ear medial to an intact tympanic membrane. Reddish masses that blanch on seigelization are usually paragangliomas. Sometimes, a high rising jugular bulb or an aberrant carotid artery can also be seen. Whitish masses are usually congenital cholesteatomas, tympanosclerosis, cartilage grafts that have been surgically placed, and rarely middle ear adenomas (MEA). An elderly male presented with decreased hearing, which was revealed to be secondary to a pale mass in the middle ear, displacing the intact tympanic membrane laterally. He underwent biopsy followed by complete excision of the mass, with preservation of the intact ossicular chain. There no evidence of recurrence on follow-up. Histopathology revealed the mass to be a MEA, also known as middle ear neuroendocrine tumour (MeNET). Middle ear neuroendocrine tumours are rare tumours. We describe the clinical presentation and management of this tumour.
{"title":"Middle ear neuroendocrine tumour-case report of a rare tumour of the temporal bone","authors":"Manali Bhat, H. Vijayendra, V. Vijayendra, Nilesh H Mahajan","doi":"10.18203/issn.2454-5929.ijohns20233589","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233589","url":null,"abstract":"Several conditions are known to present as masses in the middle ear medial to an intact tympanic membrane. Reddish masses that blanch on seigelization are usually paragangliomas. Sometimes, a high rising jugular bulb or an aberrant carotid artery can also be seen. Whitish masses are usually congenital cholesteatomas, tympanosclerosis, cartilage grafts that have been surgically placed, and rarely middle ear adenomas (MEA). An elderly male presented with decreased hearing, which was revealed to be secondary to a pale mass in the middle ear, displacing the intact tympanic membrane laterally. He underwent biopsy followed by complete excision of the mass, with preservation of the intact ossicular chain. There no evidence of recurrence on follow-up. Histopathology revealed the mass to be a MEA, also known as middle ear neuroendocrine tumour (MeNET). Middle ear neuroendocrine tumours are rare tumours. We describe the clinical presentation and management of this tumour.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139232868","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.ijohns20233579
V. Harkare, Shiwani S. Pidurakar, S. Khadakkar, Nitin V. Deosthale, Priti R. Dhoke, Kanchan S. Dhote
Background: Chronic otitis media (COM) is a long-standing infection of middle ear cleft, causes severe destruction and leading to irreversible sequelae. The interval to convert discharging ear into dry is variable. Extensive counselling is required to keep these patients motivated for prolonged treatment duration. Hence, the study was conducted. Methods: A prospective study was carried out at NKP Salve and Lata Mangeshkar Hospital Nagpur, Maharashtra, between the age group of 16-60 years, who underwent type 1 tympanoplasty. Results were statistically analysed with respect to graft uptake, hearing improvement and size of perforation over a period of 2 years. Temporalis fascia was taken as a graft material. Results: Out of 70 cases, 38 cases had inactive ears and 32 cases had minimal, mucoid ear discharge (Active ear), which bacteriologically showed no organism. M:F ratio was 1.12:1. Graft uptake was successful in 92.11% of the cases in inactive group and 93.75% of the cases in active group. Graft uptake was 100% in small and moderate perforation. Hearing improvement was achieved in 71.05% of cases in the inactive group and 78.12% of cases in the active group, as measured by closure of the air-bone gap (ABG) and improvement in conductive hearing (significant >10 dB). We found no difference in the success rates. Conclusions: Presence of minimal discharge will not affect the surgical outcome of type 1 tympanoplasty in terms of graft uptake, hearing improvement and size of perforation.
{"title":"Surgical outcome of type I tympanoplasty in different types of mucosal chronic otitis media: a prospective study","authors":"V. Harkare, Shiwani S. Pidurakar, S. Khadakkar, Nitin V. Deosthale, Priti R. Dhoke, Kanchan S. Dhote","doi":"10.18203/issn.2454-5929.ijohns20233579","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233579","url":null,"abstract":"Background: Chronic otitis media (COM) is a long-standing infection of middle ear cleft, causes severe destruction and leading to irreversible sequelae. The interval to convert discharging ear into dry is variable. Extensive counselling is required to keep these patients motivated for prolonged treatment duration. Hence, the study was conducted. Methods: A prospective study was carried out at NKP Salve and Lata Mangeshkar Hospital Nagpur, Maharashtra, between the age group of 16-60 years, who underwent type 1 tympanoplasty. Results were statistically analysed with respect to graft uptake, hearing improvement and size of perforation over a period of 2 years. Temporalis fascia was taken as a graft material. Results: Out of 70 cases, 38 cases had inactive ears and 32 cases had minimal, mucoid ear discharge (Active ear), which bacteriologically showed no organism. M:F ratio was 1.12:1. Graft uptake was successful in 92.11% of the cases in inactive group and 93.75% of the cases in active group. Graft uptake was 100% in small and moderate perforation. Hearing improvement was achieved in 71.05% of cases in the inactive group and 78.12% of cases in the active group, as measured by closure of the air-bone gap (ABG) and improvement in conductive hearing (significant >10 dB). We found no difference in the success rates. Conclusions: Presence of minimal discharge will not affect the surgical outcome of type 1 tympanoplasty in terms of graft uptake, hearing improvement and size of perforation.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228104","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.ijohns20233581
Priti S. Hajare, Vinita V. Metgudmath, Izhak Mehadi, Neema K., Elsa Babu, Dhanush Nayak
Branchial cyst is a developmental cyst commonly presenting as a solitary, painless neck mass, typically located over lateral aspect of the neck. Most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck, it is very rare for a branchial cyst to manifest in other locations. Branchial cysts are believed to be derived from the branchial apparatus, mostly from the second branchial arch, although many theories have been proposed to explain the aetiology of branchial cysts. Congenital branchial cysts of the nasopharynx originate from the lateral nasopharynx with an inferior and medial extension. This rare and unusual occurrence of the cyst is characterised by its avid mucus secretion and unilateral presentation. Here we present four different presentations of branchial cyst - as a midline swelling, an unusually large presentation, nasopharyngeal presentation. Histopathology report showed cyst lined by stratified squamous epithelium and pseudo stratified ciliated columnar epithelium at places along with subepithelial lymphocytes suggesting branchial cyst. Hence, Branchial cyst should also be taken as one of the differential diagnoses in cystic lesions of the neck and lateral cystic lesions of nasopharynx.
{"title":"Unusual presentations of branchial cyst","authors":"Priti S. Hajare, Vinita V. Metgudmath, Izhak Mehadi, Neema K., Elsa Babu, Dhanush Nayak","doi":"10.18203/issn.2454-5929.ijohns20233581","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233581","url":null,"abstract":"Branchial cyst is a developmental cyst commonly presenting as a solitary, painless neck mass, typically located over lateral aspect of the neck. Most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck, it is very rare for a branchial cyst to manifest in other locations. Branchial cysts are believed to be derived from the branchial apparatus, mostly from the second branchial arch, although many theories have been proposed to explain the aetiology of branchial cysts. Congenital branchial cysts of the nasopharynx originate from the lateral nasopharynx with an inferior and medial extension. This rare and unusual occurrence of the cyst is characterised by its avid mucus secretion and unilateral presentation. Here we present four different presentations of branchial cyst - as a midline swelling, an unusually large presentation, nasopharyngeal presentation. Histopathology report showed cyst lined by stratified squamous epithelium and pseudo stratified ciliated columnar epithelium at places along with subepithelial lymphocytes suggesting branchial cyst. Hence, Branchial cyst should also be taken as one of the differential diagnoses in cystic lesions of the neck and lateral cystic lesions of nasopharynx.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139234014","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.ijohns20233588
Solikin, Muhammad A. Darmawan, Monik Alamanda, Agus Surono
Megaesophagus is a largely dilated esophagus, an uncommon condition that could be the end-stage of preceding esophageal achalasia. Chronic food stasis such as in achalasia and megaesophagus could cause fungi infection in the esophagus. This report aimed to raise awareness of these rare cases. A 68-year-old male with two decades of swallowing difficulty was referred to Sardjito Hospital. Computed tomography esophagography showed megaesophagus and bird beak sign suggesting achalasia. Both esophagoscopy and esophageal tissue biopsy showed consistent results of severe esophageal candidiasis (EC). The patient was also suspected to have a mass at the distal part of the esophagus and gastric cardia, which could also contribute to the esophageal obstruction. We consulted the gastroenterologist for gastrostomy feeding and exploration of the suspected tumor. EC is known mainly in patients with immunodeficiency, while food stasis is a lesser-known cause. End-stage achalasia not only could lead to megaesophagus, but chronic food stasis is the perfect environment for fungi growth. Other causes of food stasis such as distal esophageal and gastric cardia tumors could also be the predisposition of EC. We reported a rare case of a patient with EC as a complication of megaesophagus and esophageal achalasia.
{"title":"Severe esophageal candidiasis in a megaesophagus patient: a rare case","authors":"Solikin, Muhammad A. Darmawan, Monik Alamanda, Agus Surono","doi":"10.18203/issn.2454-5929.ijohns20233588","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233588","url":null,"abstract":"Megaesophagus is a largely dilated esophagus, an uncommon condition that could be the end-stage of preceding esophageal achalasia. Chronic food stasis such as in achalasia and megaesophagus could cause fungi infection in the esophagus. This report aimed to raise awareness of these rare cases. A 68-year-old male with two decades of swallowing difficulty was referred to Sardjito Hospital. Computed tomography esophagography showed megaesophagus and bird beak sign suggesting achalasia. Both esophagoscopy and esophageal tissue biopsy showed consistent results of severe esophageal candidiasis (EC). The patient was also suspected to have a mass at the distal part of the esophagus and gastric cardia, which could also contribute to the esophageal obstruction. We consulted the gastroenterologist for gastrostomy feeding and exploration of the suspected tumor. EC is known mainly in patients with immunodeficiency, while food stasis is a lesser-known cause. End-stage achalasia not only could lead to megaesophagus, but chronic food stasis is the perfect environment for fungi growth. Other causes of food stasis such as distal esophageal and gastric cardia tumors could also be the predisposition of EC. We reported a rare case of a patient with EC as a complication of megaesophagus and esophageal achalasia.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139228896","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.ijohns20233587
S. Jonnalagadda, M. A. A. Khan, Kiranmayee Buddhavarapu, Prateek Raj Betham
Sarcoma of the head and neck are rare and account of less than 1% of all tumors in head and neck region. Low grade myofibroblastic sarcomas (LGMFS) are even rare with only handful of cases ever reported in head and neck. We review 2 cases with LGMFS of maxilla and mandible. Retrospectively reviewed 2 patients who carried histological diagnosis of LGFMS. Previous clinic, operative and referral notes were reviewed along with histopathology slides and radiological studies. A 37-year-old female presented with recurrent right maxillary sinusitis and on CT scan was found to have an expanding mass in right maxillary sinusitis. Biopsy revealed it to be a LGMFS. She underwent total maxillectomy with orbital floor reconstruction, post operative radiation and is disease free for 18 months. A 49-year-old female presented with radiolucent mass on routine radiological examination. Initial enucleation and biopsy revealed it to be a LGMFS and was later treated with segmental mandibulectomy and fibular free graft reconstruction and post-operative radiotherapy. LGMFS of the bone is extremely rare tumor with only 8 cases being reported earlier from the skeletal system in entire body. Most common mode of presentation is asymptomatic mass found incidentally. These tumors are malignant with a rare propensity to metastasize distally. Hence prompt and accurate histological diagnosis followed by wide surgical excision with adjuvant therapy form important tenets of management.
{"title":"Low-grade myofibroblastic sarcoma of the head and neck region: a report of two cases of this extremely rare type of sarcoma and review of literature","authors":"S. Jonnalagadda, M. A. A. Khan, Kiranmayee Buddhavarapu, Prateek Raj Betham","doi":"10.18203/issn.2454-5929.ijohns20233587","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233587","url":null,"abstract":"Sarcoma of the head and neck are rare and account of less than 1% of all tumors in head and neck region. Low grade myofibroblastic sarcomas (LGMFS) are even rare with only handful of cases ever reported in head and neck. We review 2 cases with LGMFS of maxilla and mandible. Retrospectively reviewed 2 patients who carried histological diagnosis of LGFMS. Previous clinic, operative and referral notes were reviewed along with histopathology slides and radiological studies. A 37-year-old female presented with recurrent right maxillary sinusitis and on CT scan was found to have an expanding mass in right maxillary sinusitis. Biopsy revealed it to be a LGMFS. She underwent total maxillectomy with orbital floor reconstruction, post operative radiation and is disease free for 18 months. A 49-year-old female presented with radiolucent mass on routine radiological examination. Initial enucleation and biopsy revealed it to be a LGMFS and was later treated with segmental mandibulectomy and fibular free graft reconstruction and post-operative radiotherapy. LGMFS of the bone is extremely rare tumor with only 8 cases being reported earlier from the skeletal system in entire body. Most common mode of presentation is asymptomatic mass found incidentally. These tumors are malignant with a rare propensity to metastasize distally. Hence prompt and accurate histological diagnosis followed by wide surgical excision with adjuvant therapy form important tenets of management.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139231127","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.ijohns20233577
S. S., J. Chavadaki
Background: Myringoplasty is traditionally been done by using temporalis fascia graft material. But in recent years understanding of physiology and pathology of middle ear cleft is drastically improved with technical advancement in surgical methods. Various grafts have been tried for myringoplasty time to time with varying results. Methods: A case control study was conducted; where 52 patients underwent myringoplasty with butterfly graft and second group of 52 patients underwent myringoplasty with temporalis fascia graft under general anesthesia in major OT. All the patients were followed up for 3 months. The results of the procedure were assessed, with respect to closure of tympanic membrane perforations and improvement in the air bone gap post operatively. Results: Butterfly group had statistically significant number of healed patients and hearing improvement compared to temporalis fascia group at the end of one month and with no statistical significance at the end of three months. The age group less than 18 years showed better uptake with butterfly graft. The difference of mean pre-operative, 1 month and 3 months post-operative air bone gaps in butterfly graft were 35.57±2.87 dB, 27.86±2.53 dB, 24.65±2.66dB and in temporalis fascia were 35.97±2.6dB, 29.36±1.54dB, 25.12±1.73 dB respectively. Conclusions: Butterfly group had statistically significant hearing improvement in patients compared to temporalis fascia group at one month and with no statistical significance at three months post procedure. The age group less than 18 years showed better uptake with butterfly graft.
{"title":"Comparative study of anatomical and functional results of butterfly myringoplasty versus temporalis fascia underlay myringoplasty","authors":"S. S., J. Chavadaki","doi":"10.18203/issn.2454-5929.ijohns20233577","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233577","url":null,"abstract":"Background: Myringoplasty is traditionally been done by using temporalis fascia graft material. But in recent years understanding of physiology and pathology of middle ear cleft is drastically improved with technical advancement in surgical methods. Various grafts have been tried for myringoplasty time to time with varying results. Methods: A case control study was conducted; where 52 patients underwent myringoplasty with butterfly graft and second group of 52 patients underwent myringoplasty with temporalis fascia graft under general anesthesia in major OT. All the patients were followed up for 3 months. The results of the procedure were assessed, with respect to closure of tympanic membrane perforations and improvement in the air bone gap post operatively. Results: Butterfly group had statistically significant number of healed patients and hearing improvement compared to temporalis fascia group at the end of one month and with no statistical significance at the end of three months. The age group less than 18 years showed better uptake with butterfly graft. The difference of mean pre-operative, 1 month and 3 months post-operative air bone gaps in butterfly graft were 35.57±2.87 dB, 27.86±2.53 dB, 24.65±2.66dB and in temporalis fascia were 35.97±2.6dB, 29.36±1.54dB, 25.12±1.73 dB respectively. Conclusions: Butterfly group had statistically significant hearing improvement in patients compared to temporalis fascia group at one month and with no statistical significance at three months post procedure. The age group less than 18 years showed better uptake with butterfly graft.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139231109","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.ijohns20233585
Sonali Malhotra
Foreign body ingestion is a frequent challenge in the emergency room, with potential morbidity affecting around 1% of patients, often stemming from unintentional incidents. Accidents of this nature can result in severe complications leading to fatalities. Common complications involve lacerations, punctures, abscess formation, perforation, pneumomediastinum, mediastinitis, pneumothorax, pericarditis, tamponade, fistulas, and even vascular injuries to the aorta. The risk escalates significantly when the ingested object is sharp and narrow. Presenting an intriguing case, we report an instance of an infant ingesting a metallic, sharp foreign body. This particular case raises unique challenges given the vulnerability of the infant and the potential for severe complications associated with sharp objects. Immediate and precise medical intervention becomes paramount in such scenarios to prevent adverse outcomes. Vigilance in the emergency room is crucial, as the nature of foreign body ingestion can lead to diverse complications, emphasizing the need for a comprehensive understanding and swift response in managing these cases, particularly when involving infants who are at a heightened risk.
{"title":"An alarming case of metallic sharp foreign body ingestion in an infant","authors":"Sonali Malhotra","doi":"10.18203/issn.2454-5929.ijohns20233585","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20233585","url":null,"abstract":"Foreign body ingestion is a frequent challenge in the emergency room, with potential morbidity affecting around 1% of patients, often stemming from unintentional incidents. Accidents of this nature can result in severe complications leading to fatalities. Common complications involve lacerations, punctures, abscess formation, perforation, pneumomediastinum, mediastinitis, pneumothorax, pericarditis, tamponade, fistulas, and even vascular injuries to the aorta. The risk escalates significantly when the ingested object is sharp and narrow. Presenting an intriguing case, we report an instance of an infant ingesting a metallic, sharp foreign body. This particular case raises unique challenges given the vulnerability of the infant and the potential for severe complications associated with sharp objects. Immediate and precise medical intervention becomes paramount in such scenarios to prevent adverse outcomes. Vigilance in the emergency room is crucial, as the nature of foreign body ingestion can lead to diverse complications, emphasizing the need for a comprehensive understanding and swift response in managing these cases, particularly when involving infants who are at a heightened risk.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139232485","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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