Background: Aspergillus niger and Aspergillus flavus are the most common causative agents of otomycosis with worldwide distribution. Extensive surgical debridement and systemic antifungal therapy are needed in cases of refractory otomycosis. Luliconazole is currently confirmed for the topical therapy of dermatophytosis. Moreover, it is found that luliconazole has in vitro activity against some molds and yeast species. Objectives: The aim of the present study was to evaluate the efficacy of luliconazole in comparison to routinely used triazole antifungals on Aspergillus isolates, obtained from otomycosis cases using microbroth dilution method. Materials and Methods: This study was carried out in the department of microbiology, from March 2020 to February 2022. A total of 55 strains of Aspergillus isolates obtained from otomycosis cases were confirmed based on macroscopic and microscopic identification. Antifungal susceptibility patterns of itraconazole, voriconazole, posaconazole and luliconazole were determined by broth microdilution method as per the Clinical Laboratory Standards Institute M38-A2 guidelines. Results: Among the azoles tested, the lowest minimum inhibitory concentration (MIC) geometric mean (0.00309 μg/ml), MIC50 (0.00098 μg/ml), and MIC90 (0.00781 μg/ml) values were attributed to luliconazole. Being the drug of choice for aspergillosis, voriconazole had a slightly higher MIC50 and MIC90 value of 1 μg/ml and 2 μg/ml, respectively. Even for the pan azole resistant isolates ( n = 3), luliconazole was found to be more effective with lower MIC values. Conclusion: The results of this study showed that luliconazole had an excellent in vitro activity with a lower MIC values than the triazoles tested. Hence, this novel imidazole antifungal agent can be considered an appropriate candidate for the treatment of otomycosis caused by A. niger and A. flavus strains. Furthermore, luliconazole showed better efficacy with lower MIC values for pan azole resistant isolates, suggesting that it could be a potential antifungal for treating aspergillosis caused by pan azole resistant isolates.
{"title":"Luliconazole: A Novel Potent Imidazole Activity against Aspergillus niger and Aspergillus flavus Causing Otomycosis","authors":"Bavadharani Sukumar, Thayanidhi Premamalini, Nivetha Shree Sasikumar, Somu Lakhmanan, Anupma Jyoti Kindo","doi":"10.4103/indianjotol.indianjotol_197_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_197_22","url":null,"abstract":"Background: Aspergillus niger and Aspergillus flavus are the most common causative agents of otomycosis with worldwide distribution. Extensive surgical debridement and systemic antifungal therapy are needed in cases of refractory otomycosis. Luliconazole is currently confirmed for the topical therapy of dermatophytosis. Moreover, it is found that luliconazole has in vitro activity against some molds and yeast species. Objectives: The aim of the present study was to evaluate the efficacy of luliconazole in comparison to routinely used triazole antifungals on Aspergillus isolates, obtained from otomycosis cases using microbroth dilution method. Materials and Methods: This study was carried out in the department of microbiology, from March 2020 to February 2022. A total of 55 strains of Aspergillus isolates obtained from otomycosis cases were confirmed based on macroscopic and microscopic identification. Antifungal susceptibility patterns of itraconazole, voriconazole, posaconazole and luliconazole were determined by broth microdilution method as per the Clinical Laboratory Standards Institute M38-A2 guidelines. Results: Among the azoles tested, the lowest minimum inhibitory concentration (MIC) geometric mean (0.00309 μg/ml), MIC50 (0.00098 μg/ml), and MIC90 (0.00781 μg/ml) values were attributed to luliconazole. Being the drug of choice for aspergillosis, voriconazole had a slightly higher MIC50 and MIC90 value of 1 μg/ml and 2 μg/ml, respectively. Even for the pan azole resistant isolates ( n = 3), luliconazole was found to be more effective with lower MIC values. Conclusion: The results of this study showed that luliconazole had an excellent in vitro activity with a lower MIC values than the triazoles tested. Hence, this novel imidazole antifungal agent can be considered an appropriate candidate for the treatment of otomycosis caused by A. niger and A. flavus strains. Furthermore, luliconazole showed better efficacy with lower MIC values for pan azole resistant isolates, suggesting that it could be a potential antifungal for treating aspergillosis caused by pan azole resistant isolates.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258079","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 : 2023-01-01DOI: 10.4103/indianjotol.indianjotol_173_22
Pradeep Kumar, Lakshmi Venkitaraman, T. Jayaraj
The study aimed to describe our experience with a case of tegmen defect that was approached transmastoid and was closed extradurally with titanium mesh. This was a retrospective review of surgical steps with cross reference to the clinical and radiological data collected. Two-year follow-up of the patient showed successful closure of the defect. Transmastoid approach can be considered even in a moderately large-sized tegmen defect and can thus avoid craniotomy which is a procedure with far superior morbidity.
{"title":"Transmastoid titanium mesh assisted extra dural layered closure of tegmen defect: Case report in a 10 year old","authors":"Pradeep Kumar, Lakshmi Venkitaraman, T. Jayaraj","doi":"10.4103/indianjotol.indianjotol_173_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_173_22","url":null,"abstract":"The study aimed to describe our experience with a case of tegmen defect that was approached transmastoid and was closed extradurally with titanium mesh. This was a retrospective review of surgical steps with cross reference to the clinical and radiological data collected. Two-year follow-up of the patient showed successful closure of the defect. Transmastoid approach can be considered even in a moderately large-sized tegmen defect and can thus avoid craniotomy which is a procedure with far superior morbidity.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"29 1","pages":"74 - 76"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45532721","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 : 2023-01-01DOI: 10.4103/indianjotol.indianjotol_237_20
Z. Naftali, Lina Lasminingrum, Meira Kusuma Astuti
Background: Benign Chronic Suppurative Otitis Media (CSOM) is a middle ear inflammation characterized by otorrhea with perforation in the central tympanic membrane. Topical ofloxacin as a standard therapy in this type of CSOM has limitations in reducing otorrhea score. Vitamin A supplementation could be given simultaneously with topical ofloxacin because of its property as a regulator of the local immune response in the middle ear. Objectives: This study aimed to analyse the effect of vitamin A supplementation on Tumor Necrosis Factor-α (TNF-α) and otorrhea score in benign CSOM patients. Materials and Methods: The pre-experimental method with post-test only control group approach was held from January to March 2020 at Rembang Regional Hospital, Central Java, Indonesia. The subjects of the study were benign CSOM patients aged 18-60 years who did not consume antibiotics or steroids for two weeks prior to the study. Subjects of the study were divided into two groups. The standard (control) group was given topical ofloxacin as standard therapy while the intervention group was given topical ofloxacin in combination with Vitamin A supplementation. The subjects consisted of 21 subjects in the standard group and 10 subjects in the intervention group. Results: The percentage of TNF-α expression in intervention group was 64.20 ± 36.18, while the percentage in the standard group was 91.10 ± 11.3. The result of the independent t-test showed that there was a significant difference between the two groups (P = 0.016; 95% CI = 9.41-44.37). There was a significant difference in the otorrhea score between the two groups (P = 0.003). Conclusion: There was a significant difference in TNF-α expression and the otorrhea score between the standard and the intervention group.
背景:良性慢性化脓性中耳炎(CSOM)是一种以耳漏伴中耳膜穿孔为特征的中耳炎症。局部氧氟沙星作为这类CSOM的标准治疗在降低耳漏评分方面存在局限性。维生素A的补充可与局部氧氟沙星同时给予，因为它具有调节中耳局部免疫反应的特性。目的:本研究旨在分析补充维生素A对良性CSOM患者肿瘤坏死因子-α (TNF-α)和耳漏评分的影响。材料和方法:2020年1月至3月在印度尼西亚中爪哇Rembang地区医院进行实验前方法和测试后仅对照组方法。研究对象为18-60岁的良性CSOM患者，在研究前两周未使用抗生素或类固醇。研究对象被分成两组。标准组(对照组)给予外用氧氟沙星作为标准治疗，干预组给予外用氧氟沙星联合补充维生素A。标准组21例，干预组10例。结果:干预组TNF-α表达率为64.20±36.18，标准组为91.10±11.3。独立t检验结果显示，两组间差异有统计学意义(P = 0.016;95% ci = 9.41-44.37)。两组患者耳漏评分差异有统计学意义(P = 0.003)。结论:标准组与干预组在TNF-α表达及耳漏评分方面存在显著差异。
{"title":"Vitamin A on tumor necrosis factor-alpha expression and otorrhea score in benign chronic suppurative otitis media","authors":"Z. Naftali, Lina Lasminingrum, Meira Kusuma Astuti","doi":"10.4103/indianjotol.indianjotol_237_20","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_237_20","url":null,"abstract":"Background: Benign Chronic Suppurative Otitis Media (CSOM) is a middle ear inflammation characterized by otorrhea with perforation in the central tympanic membrane. Topical ofloxacin as a standard therapy in this type of CSOM has limitations in reducing otorrhea score. Vitamin A supplementation could be given simultaneously with topical ofloxacin because of its property as a regulator of the local immune response in the middle ear. Objectives: This study aimed to analyse the effect of vitamin A supplementation on Tumor Necrosis Factor-α (TNF-α) and otorrhea score in benign CSOM patients. Materials and Methods: The pre-experimental method with post-test only control group approach was held from January to March 2020 at Rembang Regional Hospital, Central Java, Indonesia. The subjects of the study were benign CSOM patients aged 18-60 years who did not consume antibiotics or steroids for two weeks prior to the study. Subjects of the study were divided into two groups. The standard (control) group was given topical ofloxacin as standard therapy while the intervention group was given topical ofloxacin in combination with Vitamin A supplementation. The subjects consisted of 21 subjects in the standard group and 10 subjects in the intervention group. Results: The percentage of TNF-α expression in intervention group was 64.20 ± 36.18, while the percentage in the standard group was 91.10 ± 11.3. The result of the independent t-test showed that there was a significant difference between the two groups (P = 0.016; 95% CI = 9.41-44.37). There was a significant difference in the otorrhea score between the two groups (P = 0.003). Conclusion: There was a significant difference in TNF-α expression and the otorrhea score between the standard and the intervention group.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"29 1","pages":"6 - 9"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47813295","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 : 2023-01-01DOI: 10.4103/indianjotol.indianjotol_42_22
S. Parveen, Shraddha Jain, Ashish Disawal, Chandraveer Singh, P. Deshmukh, S. Gaurkar, Sameer Ashraf
Aim: The aim of this study was to create a three-dimensional model of the middle ear by finite element (FE) analysis, using measurements performed on human and cadaveric high-resolution computed tomography (HRCT) temporal bone, and to study the biomechanics in diseased conditions. Materials and Methods: This observational, cross-sectional study was conducted in Acharya Vinoba Bhave Rural Hospital, Sawangi, Meghe, Maharashtra, in the Department of Otorhinolaryngology. The first step of FE modeling approach comprised computer-aided geometric model incorporating the static dimensions from human and cadaveric temporal bones and dynamic dimensions from prepublished data. HRCT Scans of both sets of temporal bones were performed with 0.5 mm cuts, and measurements of the ossicles, middle ear, and tympanic membrane were taken. The cadaveric temporal bones were drilled, the ossicles dissected out and measured using HRCT as well as vernier calipers. This was followed by construction of the working FE model and application of this FE model for studying middle ear biomechanics in normal and diseased states. Results: The mean measurements of ossicles were calculated, and the movement of tympanic membrane was maximum at the site of umbo and stapes footplate, whereas minimum movement was within the ossicles. Larger peak-to-peak displacement was seen at 1000 Hz to 3000 Hz frequency. Our results suggest that FE model can prove beneficial in the study of middle ear biomechanics. Conclusion: The changes in the tympanic membrane movement in diseased state have been compared to normal ear and can be applied to reconstructed ears. FE analysis can be used to study the effect of material properties of various graft materials used in tympanomastoidectomy.
{"title":"Application of finite element model of middle ear in the study of the middle ear biomechanics in normal and diseased states","authors":"S. Parveen, Shraddha Jain, Ashish Disawal, Chandraveer Singh, P. Deshmukh, S. Gaurkar, Sameer Ashraf","doi":"10.4103/indianjotol.indianjotol_42_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_42_22","url":null,"abstract":"Aim: The aim of this study was to create a three-dimensional model of the middle ear by finite element (FE) analysis, using measurements performed on human and cadaveric high-resolution computed tomography (HRCT) temporal bone, and to study the biomechanics in diseased conditions. Materials and Methods: This observational, cross-sectional study was conducted in Acharya Vinoba Bhave Rural Hospital, Sawangi, Meghe, Maharashtra, in the Department of Otorhinolaryngology. The first step of FE modeling approach comprised computer-aided geometric model incorporating the static dimensions from human and cadaveric temporal bones and dynamic dimensions from prepublished data. HRCT Scans of both sets of temporal bones were performed with 0.5 mm cuts, and measurements of the ossicles, middle ear, and tympanic membrane were taken. The cadaveric temporal bones were drilled, the ossicles dissected out and measured using HRCT as well as vernier calipers. This was followed by construction of the working FE model and application of this FE model for studying middle ear biomechanics in normal and diseased states. Results: The mean measurements of ossicles were calculated, and the movement of tympanic membrane was maximum at the site of umbo and stapes footplate, whereas minimum movement was within the ossicles. Larger peak-to-peak displacement was seen at 1000 Hz to 3000 Hz frequency. Our results suggest that FE model can prove beneficial in the study of middle ear biomechanics. Conclusion: The changes in the tympanic membrane movement in diseased state have been compared to normal ear and can be applied to reconstructed ears. FE analysis can be used to study the effect of material properties of various graft materials used in tympanomastoidectomy.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"29 1","pages":"10 - 16"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43905220","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 : 2023-01-01DOI: 10.4103/indianjotol.indianjotol_14_23
Srikar Vijayasarathy, H. Shetty
Introduction: Pseudo air–bone gaps (ABGs) in the audiogram can lead to a false diagnosis of middle ear pathology where none exists. While it is known that the magnitude of such false ABGs are frequency dependent, the effect on the severity of hearing loss on this relationship needs more clarity. Objective: The purpose of the study was to identify frequencies that are susceptible to pseudo-ABGs and investigate the effect of the degree of hearing loss on the magnitude of such air–bone gaps. Materials and Methods: A retrospective analysis of the ABG in three degrees of sensorineural hearing loss: mild (26–40 dB HL), moderate (41–55 dB HL), and moderately severe (56-70 dB HL) was carried out. One hundred and fifty samples were considered in each category (18–60 years). Differences across frequencies and degree of hearing loss were assessed. Results: Large ABGs were observed at 250 Hz and 4000 Hz, and the ABGs significantly increased with the degree of hearing loss at 250 Hz and 500 Hz. Conclusions: Caution needs to be exercised while interpreting the ABG at the low frequencies and 4000 Hz, especially when the degree of hearing loss is moderate and higher, to avoid the misdiagnosis of a conductive component in a sensorineural pathology.
导读:听图中的假气骨间隙(ABGs)可能导致中耳病理的错误诊断。虽然已知这种假ABGs的大小与频率有关，但这种关系对听力损失严重程度的影响需要更明确。目的:本研究的目的是确定易受伪abgs影响的频率，并探讨听力损失程度对这种气骨间隙大小的影响。材料与方法:回顾性分析轻度(26-40 dB HL)、中度(41-55 dB HL)和中重度(56-70 dB HL)三种感觉神经性听力损失患者的ABG。每个类别中有150个样本(18-60岁)。评估了不同频率和听力损失程度的差异。结果:250hz和4000hz时abg较大，250hz和500hz时abg随听力损失程度显著增加。结论:在解释低频和4000 Hz的ABG时需要谨慎，特别是当听力损失程度为中度和更高时，以避免在感觉神经病理中误诊传导成分。
{"title":"Pseudo air–bone gap in sensorineural hearing loss: Effect of signal frequency and degree of hearing loss – implications for clinical diagnosis","authors":"Srikar Vijayasarathy, H. Shetty","doi":"10.4103/indianjotol.indianjotol_14_23","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_14_23","url":null,"abstract":"Introduction: Pseudo air–bone gaps (ABGs) in the audiogram can lead to a false diagnosis of middle ear pathology where none exists. While it is known that the magnitude of such false ABGs are frequency dependent, the effect on the severity of hearing loss on this relationship needs more clarity. Objective: The purpose of the study was to identify frequencies that are susceptible to pseudo-ABGs and investigate the effect of the degree of hearing loss on the magnitude of such air–bone gaps. Materials and Methods: A retrospective analysis of the ABG in three degrees of sensorineural hearing loss: mild (26–40 dB HL), moderate (41–55 dB HL), and moderately severe (56-70 dB HL) was carried out. One hundred and fifty samples were considered in each category (18–60 years). Differences across frequencies and degree of hearing loss were assessed. Results: Large ABGs were observed at 250 Hz and 4000 Hz, and the ABGs significantly increased with the degree of hearing loss at 250 Hz and 500 Hz. Conclusions: Caution needs to be exercised while interpreting the ABG at the low frequencies and 4000 Hz, especially when the degree of hearing loss is moderate and higher, to avoid the misdiagnosis of a conductive component in a sensorineural pathology.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"29 1","pages":"57 - 60"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47678428","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}
The sensorineural acuity level (SAL) test is useful to determine the type of hearing loss if overmasking occurs in pure-tone audiometry (PTA) testing. In this article, we report two unilateral hearing loss cases to highlight the accuracy of the SAL test in predicting bone conduction (BC) thresholds in unilateral hearing loss cases, as well as the importance of using the appropriate SAL normative data. As found, the estimated BC thresholds (provided by the SAL test) were in good agreement with the actual BC thresholds (from the PTA) (i.e. within ± 5 dB) for both sensorineural hearing loss and conductive hearing loss cases. The accuracy of the SAL test is adequate to support the PTA results. Implementing inappropriate normative data may result in the misdiagnosis of the type of hearing loss.
{"title":"The Accuracy of Sensorineural Acuity Level Test in Predicting Bone Conduction Thresholds in Unilateral Hearing Loss Cases","authors":"Mahamad Almyzan Awang, Mohd. Normani Zakaria, Mohd. Fadzil Nor Rashid, Rosdan Salim, Nik Adilah Nik Othman","doi":"10.4103/indianjotol.indianjotol_187_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_187_22","url":null,"abstract":"The sensorineural acuity level (SAL) test is useful to determine the type of hearing loss if overmasking occurs in pure-tone audiometry (PTA) testing. In this article, we report two unilateral hearing loss cases to highlight the accuracy of the SAL test in predicting bone conduction (BC) thresholds in unilateral hearing loss cases, as well as the importance of using the appropriate SAL normative data. As found, the estimated BC thresholds (provided by the SAL test) were in good agreement with the actual BC thresholds (from the PTA) (i.e. within ± 5 dB) for both sensorineural hearing loss and conductive hearing loss cases. The accuracy of the SAL test is adequate to support the PTA results. Implementing inappropriate normative data may result in the misdiagnosis of the type of hearing loss.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258077","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 : 2023-01-01DOI: 10.4103/indianjotol.indianjotol_179_22
Siddhartha Basuroy, Leena Goel, Carnegie De Sa, Megha Goel, Kevin Mathew Varughese, Sunidhi Mohandas Vernekar, Rashmi Vijaykumar
Background: Deviated nasal septum (DNS) has been reported to jeopardizing the nasal aerodynamics. This in turn may affect the pressure dynamics in the nasopharynx and eventually affect the development and pneumatization of mastoid air cells. Few studies done previously have shown a positive correlation between nasal pathologies and mastoid pneumatization. Objectives: This study was undertaken to see for the possible association of mastoid cell pneumatization, with DNS. Materials and Methods: Limited high-resolution computed tomography temporal bone and computed tomography nose and paranasal sinuses were used to calculate the mastoid air cell volume and angle of septal deviation. The degree of septal deviation was graded into mild, moderate, and severe. The mastoid air cell system volume was calculated on the side of the convexity of the septal deviation and the other side. Results: It was found that there is a statistically significant difference in the mastoid volume on the affected side of the DNS vis a vis the unaffected side. Further, the degree of reduction of the volume was not a linear function of the degree of septal deviation. Conclusions: Septal deviation significantly reduces the mastoid air cell volume on the affected side Thus, early correction of pathological DNS in adults, irrespective of the etiology, is important, so as to avoid the chances of developing chronic ear pathologies in later life.
{"title":"Association of Mastoid Pneumatization with Deviated Nasal Septum: A Clinicoradiological Study","authors":"Siddhartha Basuroy, Leena Goel, Carnegie De Sa, Megha Goel, Kevin Mathew Varughese, Sunidhi Mohandas Vernekar, Rashmi Vijaykumar","doi":"10.4103/indianjotol.indianjotol_179_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_179_22","url":null,"abstract":"Background: Deviated nasal septum (DNS) has been reported to jeopardizing the nasal aerodynamics. This in turn may affect the pressure dynamics in the nasopharynx and eventually affect the development and pneumatization of mastoid air cells. Few studies done previously have shown a positive correlation between nasal pathologies and mastoid pneumatization. Objectives: This study was undertaken to see for the possible association of mastoid cell pneumatization, with DNS. Materials and Methods: Limited high-resolution computed tomography temporal bone and computed tomography nose and paranasal sinuses were used to calculate the mastoid air cell volume and angle of septal deviation. The degree of septal deviation was graded into mild, moderate, and severe. The mastoid air cell system volume was calculated on the side of the convexity of the septal deviation and the other side. Results: It was found that there is a statistically significant difference in the mastoid volume on the affected side of the DNS vis a vis the unaffected side. Further, the degree of reduction of the volume was not a linear function of the degree of septal deviation. Conclusions: Septal deviation significantly reduces the mastoid air cell volume on the affected side Thus, early correction of pathological DNS in adults, irrespective of the etiology, is important, so as to avoid the chances of developing chronic ear pathologies in later life.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"114 10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136257755","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}
Context: The development and maturation of the hearing process begin in the fetal stage and progresses up to 6 months of age. Neonatal screening is therefore an essential method to screen for hearing loss at an early age. As there is a paucity of literature on the use of otoacoustic emissions (OAEs) and brainstem evoked response (BERA) tests for screening, hence we conducted a prospective observational study to screen the high-risk neonates admitted to neonatal intensive care unit (NICU) using OAE and further BERA (wherever indicated). Aims: The primary objective was to estimate the incidence of hearing loss in high-risk neonates admitted to NICU using OAEs as a screening tool. A secondary objective was to determine the risk factors predictive of hearing impairment in these neonates. Settings and Design: It was a prospective observational study conducted in a tertiary care hospital. Subjects and Methods: The study was conducted over a period of 1 year from April 1, 2021, to March 31, 2022. Fifty neonates with high-risk factors who fulfilled the inclusion criteria were enrolled and subjected to a two-staged OAE screening test and further BERA (in neonates where overall OAE result was REFER). Statistical Analysis Used: Continuous data variables were presented as means and standard deviations. Categorical data were presented as percentages and Chi-square test was used to derive comparisons. For all statistical testing, P < 0.05 was considered statistically significant. Results: Of 50 neonates enrolled in the study, 22 (44%) passed the Stage I OAE. The remaining 28 (56%) underwent Stage II OAE, out of which 17 (34%) passed the Stage II screening. Eleven neonates with overall OAE results as REFER were taken up for BERA. Three neonates (6%) had a hearing loss on BERA while in 8 (16%) BERA was normal. The overall incidence of hearing loss was 6%. The variables with a statistically significant correlation with the results of OAE were - APGAR score and perinatal asphyxia at a low APGAR score. Conclusions: The incidence of hearing loss in this study was 6%. APGAR score and perinatal asphyxia at a low APGAR score at 1 and 5 min had statistically significant correlation with the outcomes of OAE screening.
{"title":"Screening for Hearing Loss in High-Risk Neonates Using Otoacoustic Emissions","authors":"Deeksha Chawla, Rohit Verma, Siddharth Bhargava, Manish Munjal, Anshuman Dhawan, Udeyana Singh","doi":"10.4103/indianjotol.indianjotol_55_23","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_55_23","url":null,"abstract":"Context: The development and maturation of the hearing process begin in the fetal stage and progresses up to 6 months of age. Neonatal screening is therefore an essential method to screen for hearing loss at an early age. As there is a paucity of literature on the use of otoacoustic emissions (OAEs) and brainstem evoked response (BERA) tests for screening, hence we conducted a prospective observational study to screen the high-risk neonates admitted to neonatal intensive care unit (NICU) using OAE and further BERA (wherever indicated). Aims: The primary objective was to estimate the incidence of hearing loss in high-risk neonates admitted to NICU using OAEs as a screening tool. A secondary objective was to determine the risk factors predictive of hearing impairment in these neonates. Settings and Design: It was a prospective observational study conducted in a tertiary care hospital. Subjects and Methods: The study was conducted over a period of 1 year from April 1, 2021, to March 31, 2022. Fifty neonates with high-risk factors who fulfilled the inclusion criteria were enrolled and subjected to a two-staged OAE screening test and further BERA (in neonates where overall OAE result was REFER). Statistical Analysis Used: Continuous data variables were presented as means and standard deviations. Categorical data were presented as percentages and Chi-square test was used to derive comparisons. For all statistical testing, P < 0.05 was considered statistically significant. Results: Of 50 neonates enrolled in the study, 22 (44%) passed the Stage I OAE. The remaining 28 (56%) underwent Stage II OAE, out of which 17 (34%) passed the Stage II screening. Eleven neonates with overall OAE results as REFER were taken up for BERA. Three neonates (6%) had a hearing loss on BERA while in 8 (16%) BERA was normal. The overall incidence of hearing loss was 6%. The variables with a statistically significant correlation with the results of OAE were - APGAR score and perinatal asphyxia at a low APGAR score. Conclusions: The incidence of hearing loss in this study was 6%. APGAR score and perinatal asphyxia at a low APGAR score at 1 and 5 min had statistically significant correlation with the outcomes of OAE screening.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258080","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 : 2023-01-01DOI: 10.4103/indianjotol.indianjotol_156_22
Eunike Deborah Phoebe, Nyilo Purnami, Margarita Maria Maramis, Lilik Djuari
Backgrounds: Hearing loss occurs in a third of the elderly population worldwide but is often overlooked. Studies have shown that hearing loss increases the risk of depression in the elderly population and reduces the quality of life. Objective: The objective of this study is to prove the relationship between hearing loss and depression in geriatrics and to assess the effect of physical illness in geriatric patients that may cause depression. Methods: This type of research is observational-analytic with a cross-sectional approach. The study was conducted at the geriatrics polyclinic, Dr. Soetomo Hospital. Results: There are 47 participants in this study who are outpatients of the geriatrics polyclinic that carried out by consecutive sampling. Data are retrieved from medical records and Geriatric Depression Scale (GDS) questionnaire interviews. The effect of physical illness was assessed as a confounding variable in this study. Data analysis used multiple linear regression, one-sample Kolmogorov–Smirnov test, and Spearman correlation test. Conclusion: This research found hearing loss in most geriatric patients, but the prevalence of depression in the study participants was low. The degree of hearing loss was not related to the GDS questionnaire score. Diabetes is a confounding factor in the onset of depression in study participants.
{"title":"The Relationship between Degree of Hearing Loss and Geriatric Depression Scale Scores in Geriatric Patients","authors":"Eunike Deborah Phoebe, Nyilo Purnami, Margarita Maria Maramis, Lilik Djuari","doi":"10.4103/indianjotol.indianjotol_156_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_156_22","url":null,"abstract":"Backgrounds: Hearing loss occurs in a third of the elderly population worldwide but is often overlooked. Studies have shown that hearing loss increases the risk of depression in the elderly population and reduces the quality of life. Objective: The objective of this study is to prove the relationship between hearing loss and depression in geriatrics and to assess the effect of physical illness in geriatric patients that may cause depression. Methods: This type of research is observational-analytic with a cross-sectional approach. The study was conducted at the geriatrics polyclinic, Dr. Soetomo Hospital. Results: There are 47 participants in this study who are outpatients of the geriatrics polyclinic that carried out by consecutive sampling. Data are retrieved from medical records and Geriatric Depression Scale (GDS) questionnaire interviews. The effect of physical illness was assessed as a confounding variable in this study. Data analysis used multiple linear regression, one-sample Kolmogorov–Smirnov test, and Spearman correlation test. Conclusion: This research found hearing loss in most geriatric patients, but the prevalence of depression in the study participants was low. The degree of hearing loss was not related to the GDS questionnaire score. Diabetes is a confounding factor in the onset of depression in study participants.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"72 10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258074","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}
Temporal bone paragangliomas arise from the paraganglion cells that are located in the middle ear and the lateral skull base. We present a 46-year-old man with undisturbed right intermittent pulsatile tinnitus, ear fullness, and progressively reduced hearing for 1 year. Clinically, the right tympanic membrane is bulging, and there is a pulsatile reddish mass in the middle ear. Computed tomography reveals soft tissue at the right mastoid air cell that extends inferiorly to the jugular foramen and laterally to the ear canal. The mass has an epicenter at the right jugular fossa and is obliterating the internal auditory meatus in magnetic resonance imaging. The diagnosis of advanced right nonsecreting jugulotympanicum paraganglioma Glasscock-Jackson type IV was established from imaging and a normal 24-h urine metanephrine level result. After extensive multidisciplinary deliberations, radiation treatment was determined to be the patient’s best course of treatment.
{"title":"A Case of Jugulotympanicum Paraganglioma: A Treatment Dilemma","authors":"Nurul Najwa Mohd Zakir, Izny Hafiz Zainon, Nik Adilah Nik Othman","doi":"10.4103/indianjotol.indianjotol_67_23","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_67_23","url":null,"abstract":"Temporal bone paragangliomas arise from the paraganglion cells that are located in the middle ear and the lateral skull base. We present a 46-year-old man with undisturbed right intermittent pulsatile tinnitus, ear fullness, and progressively reduced hearing for 1 year. Clinically, the right tympanic membrane is bulging, and there is a pulsatile reddish mass in the middle ear. Computed tomography reveals soft tissue at the right mastoid air cell that extends inferiorly to the jugular foramen and laterally to the ear canal. The mass has an epicenter at the right jugular fossa and is obliterating the internal auditory meatus in magnetic resonance imaging. The diagnosis of advanced right nonsecreting jugulotympanicum paraganglioma Glasscock-Jackson type IV was established from imaging and a normal 24-h urine metanephrine level result. After extensive multidisciplinary deliberations, radiation treatment was determined to be the patient’s best course of treatment.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136258068","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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