Pub Date : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_54_21
M. Rashid, M. Zakaria, Maziah Romli, W. Mohamad, M. Awang
Auditory brainstem response (ABR) is an objective test typically carried out to estimate behavioral hearing thresholds among difficult-to-test children. The latencies of ABR waveforms are commonly used for hearing diagnosis. The available ABR normative data are utilized as guidelines by clinicians to identify the prominent peaks of ABR. In this paper, atypical ABR waveforms of a normal child were reported. Several useful points were highlighted from the present case report to guide clinicians to appropriately interpret the ABR results.
{"title":"The presence of atypical auditory brainstem response waveforms in a child with normal hearing","authors":"M. Rashid, M. Zakaria, Maziah Romli, W. Mohamad, M. Awang","doi":"10.4103/indianjotol.indianjotol_54_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_54_21","url":null,"abstract":"Auditory brainstem response (ABR) is an objective test typically carried out to estimate behavioral hearing thresholds among difficult-to-test children. The latencies of ABR waveforms are commonly used for hearing diagnosis. The available ABR normative data are utilized as guidelines by clinicians to identify the prominent peaks of ABR. In this paper, atypical ABR waveforms of a normal child were reported. Several useful points were highlighted from the present case report to guide clinicians to appropriately interpret the ABR results.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"167 - 170"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49203234","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_31_22
M. Vybhavi, V. Srinivas, V. Prashanth, Dechu Muddaiah, M. Lavanya
Otogenic brain abscesses are the second-most common intracranial complication observed in patients of chronic otitis media, more frequently occurring with cholesteatoma. Due to the availability of antibiotics and advanced imaging techniques, the incidence and mortality of otogenic brain abscesses has reduced. Nevertheless, we still come across cases of otogenic brain abscess in modern times. Here, we report a case of the left ear chronic otitis media, squamosal type with intracranial complication of the left cerebellar abscess in a 14-year-old girl. Magnetic resonance imaging of the brain showed a thick-walled cystic lesion in the left cerebellar hemisphere measuring 41 mm × 28 mm × 26 mm suggestive of brain abscess. High-resolution computed tomography of the temporal bone showed soft-tissue density in the left mastoid air cells, in epitympanum, and mesotympanum encasing the left middle ear ossicular chain, suggestive of chronic otomastoiditis with possible underlying cholesteatoma. The patient underwent left retromastoid suboccipital craniotomy and excision of brain abscess followed by the left modified radical mastoidectomy 1 month later. Follow-up scan at 6 months showed no recurrence or any residual disease. Hence, timely surgical intervention for complicated chronic otitis media gives satisfactory results.
{"title":"Otogenic cerebellar abscess with cholesteatoma","authors":"M. Vybhavi, V. Srinivas, V. Prashanth, Dechu Muddaiah, M. Lavanya","doi":"10.4103/indianjotol.indianjotol_31_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_31_22","url":null,"abstract":"Otogenic brain abscesses are the second-most common intracranial complication observed in patients of chronic otitis media, more frequently occurring with cholesteatoma. Due to the availability of antibiotics and advanced imaging techniques, the incidence and mortality of otogenic brain abscesses has reduced. Nevertheless, we still come across cases of otogenic brain abscess in modern times. Here, we report a case of the left ear chronic otitis media, squamosal type with intracranial complication of the left cerebellar abscess in a 14-year-old girl. Magnetic resonance imaging of the brain showed a thick-walled cystic lesion in the left cerebellar hemisphere measuring 41 mm × 28 mm × 26 mm suggestive of brain abscess. High-resolution computed tomography of the temporal bone showed soft-tissue density in the left mastoid air cells, in epitympanum, and mesotympanum encasing the left middle ear ossicular chain, suggestive of chronic otomastoiditis with possible underlying cholesteatoma. The patient underwent left retromastoid suboccipital craniotomy and excision of brain abscess followed by the left modified radical mastoidectomy 1 month later. Follow-up scan at 6 months showed no recurrence or any residual disease. Hence, timely surgical intervention for complicated chronic otitis media gives satisfactory results.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"181 - 185"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49648008","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_13_22
S. Goh, N. Hashim, F. Zaki, A. Abdullah
Bezold abscess (BZ) is defined as a deep neck abscess as the result of mastoiditis with mastoid tip erosion after otitis media (OM). Despite its rare occurrence due to the early intervention of ear infection with antibiotics, diligently looking for this complication is important, especially in the immunodeficient population. The utilization of radio imaging remains crucial in the management of acute OM with complications. The contrast-enhanced computed tomography facilitates the diagnosis and provides a glimpse of the disease extension. Early recognition and intervention are vital for a good outcome. The authors present a case report of a mastoiditis complicated with a BZ in the only hearing ear. The risk factors, presentations, and treatment options are discussed, along with the review of the literature.
{"title":"A case of mastoiditis complicated with bezold abscess in the only hearing ear","authors":"S. Goh, N. Hashim, F. Zaki, A. Abdullah","doi":"10.4103/indianjotol.indianjotol_13_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_13_22","url":null,"abstract":"Bezold abscess (BZ) is defined as a deep neck abscess as the result of mastoiditis with mastoid tip erosion after otitis media (OM). Despite its rare occurrence due to the early intervention of ear infection with antibiotics, diligently looking for this complication is important, especially in the immunodeficient population. The utilization of radio imaging remains crucial in the management of acute OM with complications. The contrast-enhanced computed tomography facilitates the diagnosis and provides a glimpse of the disease extension. Early recognition and intervention are vital for a good outcome. The authors present a case report of a mastoiditis complicated with a BZ in the only hearing ear. The risk factors, presentations, and treatment options are discussed, along with the review of the literature.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"178 - 180"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46711027","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_71_21
Madhukar Upadhyay, S. Goyal
Conductive hearing loss due to ossicular anomalies is generally associated with external auditory canal dysplasia. Congenital ossicular anomalies in isolation are rare and often have a delayed diagnosis, particularly if unilateral. In such cases, the predominant symptom is conductive hearing loss and otosclerosis is usually the major differential diagnosis. We present a series of three cases of congenital ossicular chain anomaly. These patients were initially diagnosed as a case of otosclerosis. However, the diagnosis was revised based on intraoperative findings and managed accordingly.
{"title":"Absent Stapedius Muscle and other Rare Congenital Ossicular Anomalies: A Case Series","authors":"Madhukar Upadhyay, S. Goyal","doi":"10.4103/indianjotol.indianjotol_71_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_71_21","url":null,"abstract":"Conductive hearing loss due to ossicular anomalies is generally associated with external auditory canal dysplasia. Congenital ossicular anomalies in isolation are rare and often have a delayed diagnosis, particularly if unilateral. In such cases, the predominant symptom is conductive hearing loss and otosclerosis is usually the major differential diagnosis. We present a series of three cases of congenital ossicular chain anomaly. These patients were initially diagnosed as a case of otosclerosis. However, the diagnosis was revised based on intraoperative findings and managed accordingly.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"163 - 166"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47815522","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_112_21
G. Puttamadaiah, P. Bhanuprakash, B. Viswanatha, K. Patil, P. Menon
Introduction: Traumatic perforation of tympanic membrane (TM) is caused by increase in air pressure due to slapping, road traffic accident, blast injury, syringing, trauma by ear buds, etc., The incidence has been increased in recent times due to increased domestic violence and road traffic accidents. Hence, there is a need for early identification, evaluation, and management to reduce the morbidity. Objectives: The objective of the study was to describe etiologies of traumatic perforation of TM, to assess the findings of pure tone audiometry (PTA) among patients with traumatic perforation of TM, and to determine the outcome. Materials and Methods: This study was done between November 2017 and May 2019 in the department of ENT at Bangalore Medical College and Research Institute on 88 patients with traumatic perforation of TM who were subjected to otoscopic examination, tuning fork tests, and PTA. Patients were followed up on weekly basis. Results: Out of 88 patients, 33 patients (37.5%) were in the age group of 21–30 years. Fifty-four were males (61.36%) and 34 were females (38.63%). Slapping is the most common mode of injury with 50 (56.8%) patients. Left ear 55 (62.5%) was more commonly involved than right ear 33 (37.5%). Small perforation 55 (62.5%) was more common followed by medium-sized perforation 25 (28.4%) and large perforations were the least 8 (9.1%). Multiple quadrants were involved in 33 patients (37.5%). Posteroinferior quadrant was most commonly involved. Deafness (75%) was the most common symptom involving 66 patients. Average time taken for spontaneous healing was 37 days. Mean hearing improvement compared between hearing loss at the time of trauma and after 3 months was 13.18 ± 7.05 dB, which is statistically significant (P = 0.0001). Conclusion: Traumatic perforation of TM spontaneously healed in 80 participants (90.90%), whereas eight participants (9.09%) underwent surgery, i.e., tympanoplasty.
{"title":"Traumatic perforation of tympanic membrane: A prospective study in a tertiary care institute","authors":"G. Puttamadaiah, P. Bhanuprakash, B. Viswanatha, K. Patil, P. Menon","doi":"10.4103/indianjotol.indianjotol_112_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_112_21","url":null,"abstract":"Introduction: Traumatic perforation of tympanic membrane (TM) is caused by increase in air pressure due to slapping, road traffic accident, blast injury, syringing, trauma by ear buds, etc., The incidence has been increased in recent times due to increased domestic violence and road traffic accidents. Hence, there is a need for early identification, evaluation, and management to reduce the morbidity. Objectives: The objective of the study was to describe etiologies of traumatic perforation of TM, to assess the findings of pure tone audiometry (PTA) among patients with traumatic perforation of TM, and to determine the outcome. Materials and Methods: This study was done between November 2017 and May 2019 in the department of ENT at Bangalore Medical College and Research Institute on 88 patients with traumatic perforation of TM who were subjected to otoscopic examination, tuning fork tests, and PTA. Patients were followed up on weekly basis. Results: Out of 88 patients, 33 patients (37.5%) were in the age group of 21–30 years. Fifty-four were males (61.36%) and 34 were females (38.63%). Slapping is the most common mode of injury with 50 (56.8%) patients. Left ear 55 (62.5%) was more commonly involved than right ear 33 (37.5%). Small perforation 55 (62.5%) was more common followed by medium-sized perforation 25 (28.4%) and large perforations were the least 8 (9.1%). Multiple quadrants were involved in 33 patients (37.5%). Posteroinferior quadrant was most commonly involved. Deafness (75%) was the most common symptom involving 66 patients. Average time taken for spontaneous healing was 37 days. Mean hearing improvement compared between hearing loss at the time of trauma and after 3 months was 13.18 ± 7.05 dB, which is statistically significant (P = 0.0001). Conclusion: Traumatic perforation of TM spontaneously healed in 80 participants (90.90%), whereas eight participants (9.09%) underwent surgery, i.e., tympanoplasty.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"111 - 115"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41878897","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_5_22
N. Devi, K. Sreeraj, S. Anuroopa, S. Ankitha, V. Namitha
Context: Cochlear plays a major role in providing fine-tuned frequency resolution of the sounds that were perceived. However, in the impaired auditory systems, this frequency resolution is affected, which indirectly leads to distortion in the perception of the sounds. However, the sharpness of tuning of a filter can be obtained from Q10 values and the shift in the tip frequencies of the psychophysical tuning curve can provide an estimate for the frequency resolution of the cochlea. Aim: This study aimed to estimate and compare the Q10 values and tip frequency between individuals with normal hearing and hearing loss. Subjects and Methods: A total of 92 ears were included for the study which was divided into two groups based on the hearing sensitivity. The psychophysical turning curves were obtained for 500 Hz, 1 kHz, 2 kHz, 4 kHz, and 6 kHz. The data on Q10 and the tip frequencies were statistically analyzed. Results: The results reveal that individuals with hearing loss have lesser Q10 values compared to individuals with normal hearing and this increased with increase in the test frequencies. Comparing the shift in the tip frequency between the two groups of individuals, the shift was toward the lower frequency which indicates it is an involvement of the outer hair cells. However, this study was limited only to those with mild flat sensory neural hearing loss. Conclusion: It could be concluded that Q10 and tip frequency measurement would be a valid measure for frequency resolution of the cochlea.
{"title":"Q10 and Tip Frequencies in Individuals with Normal-Hearing Sensitivity and Sensorineural Hearing Loss","authors":"N. Devi, K. Sreeraj, S. Anuroopa, S. Ankitha, V. Namitha","doi":"10.4103/indianjotol.indianjotol_5_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_5_22","url":null,"abstract":"Context: Cochlear plays a major role in providing fine-tuned frequency resolution of the sounds that were perceived. However, in the impaired auditory systems, this frequency resolution is affected, which indirectly leads to distortion in the perception of the sounds. However, the sharpness of tuning of a filter can be obtained from Q10 values and the shift in the tip frequencies of the psychophysical tuning curve can provide an estimate for the frequency resolution of the cochlea. Aim: This study aimed to estimate and compare the Q10 values and tip frequency between individuals with normal hearing and hearing loss. Subjects and Methods: A total of 92 ears were included for the study which was divided into two groups based on the hearing sensitivity. The psychophysical turning curves were obtained for 500 Hz, 1 kHz, 2 kHz, 4 kHz, and 6 kHz. The data on Q10 and the tip frequencies were statistically analyzed. Results: The results reveal that individuals with hearing loss have lesser Q10 values compared to individuals with normal hearing and this increased with increase in the test frequencies. Comparing the shift in the tip frequency between the two groups of individuals, the shift was toward the lower frequency which indicates it is an involvement of the outer hair cells. However, this study was limited only to those with mild flat sensory neural hearing loss. Conclusion: It could be concluded that Q10 and tip frequency measurement would be a valid measure for frequency resolution of the cochlea.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"126 - 129"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70771167","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_15_22
S. Patro, N. Panda, Ramya Rathod
Background: Long-term postsurgical follow-up in chronic otitis media (COM) is crucial in otologic practice for outcome assessment. Validated questionnaires for the same are robust alternatives when physical visits are not feasible such as the current COVID-19 pandemic and we present our findings of outcome assessment using COM outcome test (COMOT)-15 questionnaire through nonphysical mode. Materials and Methods: A retrospective analysis of a cohort of 112 patients of COM who underwent surgery by the single senior otology surgeon between 2009 and 2019 was done using COMOT 15 questionnaire through telephonic methods to circumvent the need of office visits. Results: Fifty out of 112 patients could be contacted and consented for the assessment and their COMOT-15 scores were obtained. The numbers of patients with any otologic symptoms and their need for consultations, except hearing loss were significantly less. One-third of the patients had mild to moderate residual hearing loss and its quality of life impacts, although the same neither was statistically significant nor required increased numbers of consultations. Conclusion: Bothering symptoms and the need for a frequent visit to the doctor is significantly less with adequate clearance of disease and mastoid obliteration in cases of canal wall down procedures. The residual mild-to-moderate hearing loss are not significant and manageable with day-to-day activities. Successful outcome of COM surgery needs long-term follow-up and evaluation by all practicing otologic departments and surgeons which can well be done through nonphysical modes in unprecedented situations like the current times.
{"title":"Patient-Related long-term outcome measures after mastoid surgery at a tertiary care center of North India: A retrospective analysis","authors":"S. Patro, N. Panda, Ramya Rathod","doi":"10.4103/indianjotol.indianjotol_15_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_15_22","url":null,"abstract":"Background: Long-term postsurgical follow-up in chronic otitis media (COM) is crucial in otologic practice for outcome assessment. Validated questionnaires for the same are robust alternatives when physical visits are not feasible such as the current COVID-19 pandemic and we present our findings of outcome assessment using COM outcome test (COMOT)-15 questionnaire through nonphysical mode. Materials and Methods: A retrospective analysis of a cohort of 112 patients of COM who underwent surgery by the single senior otology surgeon between 2009 and 2019 was done using COMOT 15 questionnaire through telephonic methods to circumvent the need of office visits. Results: Fifty out of 112 patients could be contacted and consented for the assessment and their COMOT-15 scores were obtained. The numbers of patients with any otologic symptoms and their need for consultations, except hearing loss were significantly less. One-third of the patients had mild to moderate residual hearing loss and its quality of life impacts, although the same neither was statistically significant nor required increased numbers of consultations. Conclusion: Bothering symptoms and the need for a frequent visit to the doctor is significantly less with adequate clearance of disease and mastoid obliteration in cases of canal wall down procedures. The residual mild-to-moderate hearing loss are not significant and manageable with day-to-day activities. Successful outcome of COM surgery needs long-term follow-up and evaluation by all practicing otologic departments and surgeons which can well be done through nonphysical modes in unprecedented situations like the current times.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"130 - 134"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49159822","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_8_22
T. Koento, S. Tamin, Syahrial Hutahuruk, A. Praborini, Ervin Amouzegar
Background: Ankyloglossia, or tongue-tie, is a condition in which the tongue is attached to the floor of the mouth through the frenulum, causing limited tongue movement. Short frenulum variations cause reduced anterior tongue movement resulting in breastfeeding, swallowing, articulation, and orthodontics problems. These abnormalities in infants cause breastfeeding problems that affect infants' weight gain, malocclusion, and speech disorders. Frenotomy in infant ankyloglossia is performed if there are problems with breastfeeding, poor sucking, slow weight gain, and recurrent mastitis. With this indication, we need to observed the efficacy of frenotomy done before the age of 1 month, and the frenotomy done at 1-3 months old in gaining weight of exclusively breastfed infants with ankyloglossia. Materials and Methods: A observational retrospective cohort method from patient medical records in a private hospital in Jakarta, Indonesia. The research subject is a total sampling patient medical records secondary data and collected 68 subjects. The Subjects are divided into two groups, the first group was patients whose frenotomy was done before the age of 1 month, and the second group was patients whose frenotomy was done at 1-3 months old. We assessed the weight gain between the two groups. The data were analyzed and compared the percentage of weight gain before and after frenotomy. Results: The percentage of weight gain before and after frenotomy shows that in the first group, there was a percentage gain of 11.4% in body weight of the subjects and during post-frenotomy control, the percentage of weight gain in this group increased to 111, 4%. In the second group, the percentage of weight gain before the frenotomy was 70.6%, while the post-frenotomy control was only 57.7%. Conclusion: The study demonstrated the efficacy of frenotomy in gaining weight of exclusively breastfed infants with ankyloglossia. There was a significant difference in the weight gain of infants with ankyloglossia who underwent frenotomy at the age of exclusive breastfeeding, before the age of 1 month and between the ages of 1 to 3 months.
{"title":"The frenotomy efficacy in gaining weight of exclusively breastfed infant with ankyloglossia","authors":"T. Koento, S. Tamin, Syahrial Hutahuruk, A. Praborini, Ervin Amouzegar","doi":"10.4103/indianjotol.indianjotol_8_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_8_22","url":null,"abstract":"Background: Ankyloglossia, or tongue-tie, is a condition in which the tongue is attached to the floor of the mouth through the frenulum, causing limited tongue movement. Short frenulum variations cause reduced anterior tongue movement resulting in breastfeeding, swallowing, articulation, and orthodontics problems. These abnormalities in infants cause breastfeeding problems that affect infants' weight gain, malocclusion, and speech disorders. Frenotomy in infant ankyloglossia is performed if there are problems with breastfeeding, poor sucking, slow weight gain, and recurrent mastitis. With this indication, we need to observed the efficacy of frenotomy done before the age of 1 month, and the frenotomy done at 1-3 months old in gaining weight of exclusively breastfed infants with ankyloglossia. Materials and Methods: A observational retrospective cohort method from patient medical records in a private hospital in Jakarta, Indonesia. The research subject is a total sampling patient medical records secondary data and collected 68 subjects. The Subjects are divided into two groups, the first group was patients whose frenotomy was done before the age of 1 month, and the second group was patients whose frenotomy was done at 1-3 months old. We assessed the weight gain between the two groups. The data were analyzed and compared the percentage of weight gain before and after frenotomy. Results: The percentage of weight gain before and after frenotomy shows that in the first group, there was a percentage gain of 11.4% in body weight of the subjects and during post-frenotomy control, the percentage of weight gain in this group increased to 111, 4%. In the second group, the percentage of weight gain before the frenotomy was 70.6%, while the post-frenotomy control was only 57.7%. Conclusion: The study demonstrated the efficacy of frenotomy in gaining weight of exclusively breastfed infants with ankyloglossia. There was a significant difference in the weight gain of infants with ankyloglossia who underwent frenotomy at the age of exclusive breastfeeding, before the age of 1 month and between the ages of 1 to 3 months.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"116 - 118"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49538927","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_98_21
N. Kumar, R. Sanji, Srirangaprasad Krishnaswamy
Palatal tremors including myoclonus are well-known causes of objective tinnitus. Essential palatal tremors and tic disorders are recognized but rarer causes of objective pulsatile tinnitus. An 8-year-old boy presented with a chief complaint of clicking sounds in both the ears for 1 month, intermittent, occurs frequently in episodes, wherein intraoral examination revealed bilateral rhythmic, low frequency, symmetrical contractions of the soft palate muscles accompanied by clicking sounds audible to physician as well (objective tinnitus). The child's mother stated that the clicking sounds were not present when he was asleep. When the child was distracted by tuning fork sound, the palatal movements stopped. CNS examination, developmental history, birth, and growth history were all normal. Magnetic resonance imaging study with contrast enhancement was normal. The child was started on clonazepam and clonidine and follow-up was done after 1st and 2nd months. The tinnitus reduced but did not resolve completely. Clinical features of a patient with palatal tremor should be carefully assessed with prior knowledge of possible etiopathologies to guide the investigations and management. We highlight a case of palatal tic disorder to bring the possibilities quickly to the reader's mind.
{"title":"Palatal tic disorder causing objective clicking tinnitus in an 8 years old","authors":"N. Kumar, R. Sanji, Srirangaprasad Krishnaswamy","doi":"10.4103/indianjotol.indianjotol_98_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_98_21","url":null,"abstract":"Palatal tremors including myoclonus are well-known causes of objective tinnitus. Essential palatal tremors and tic disorders are recognized but rarer causes of objective pulsatile tinnitus. An 8-year-old boy presented with a chief complaint of clicking sounds in both the ears for 1 month, intermittent, occurs frequently in episodes, wherein intraoral examination revealed bilateral rhythmic, low frequency, symmetrical contractions of the soft palate muscles accompanied by clicking sounds audible to physician as well (objective tinnitus). The child's mother stated that the clicking sounds were not present when he was asleep. When the child was distracted by tuning fork sound, the palatal movements stopped. CNS examination, developmental history, birth, and growth history were all normal. Magnetic resonance imaging study with contrast enhancement was normal. The child was started on clonazepam and clonidine and follow-up was done after 1st and 2nd months. The tinnitus reduced but did not resolve completely. Clinical features of a patient with palatal tremor should be carefully assessed with prior knowledge of possible etiopathologies to guide the investigations and management. We highlight a case of palatal tic disorder to bring the possibilities quickly to the reader's mind.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"156 - 159"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45336324","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 : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_172_21
T. Ojha, P. Gupta, V. Kataria, Kanika Sharma
Rhino-orbito-cerebral Mucormycosis is a rapidly aggressive disease having various clinical presentation like facial pain, nasal stuffiness, headache, retro-orbital pain, orbital swelling, ophthalmoplegia and visual loss. Multiple cranial nerves can be involved, however facial nerve palsy has been rarely reported. We aim to highlight the involvement of facial nerve as a presenting symptom. Mucormycosis should be kept as a differential in these cases for rapid diagnosis and treatment initiation to provide a good overall outcome.
{"title":"Facial nerve palsy - A rare and underrecognized neurological manifestation of rhino-orbito-cerebral mucormycosis with potential for misdiagnosis","authors":"T. Ojha, P. Gupta, V. Kataria, Kanika Sharma","doi":"10.4103/indianjotol.indianjotol_172_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_172_21","url":null,"abstract":"Rhino-orbito-cerebral Mucormycosis is a rapidly aggressive disease having various clinical presentation like facial pain, nasal stuffiness, headache, retro-orbital pain, orbital swelling, ophthalmoplegia and visual loss. Multiple cranial nerves can be involved, however facial nerve palsy has been rarely reported. We aim to highlight the involvement of facial nerve as a presenting symptom. Mucormycosis should be kept as a differential in these cases for rapid diagnosis and treatment initiation to provide a good overall outcome.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"174 - 177"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45031240","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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