Pub Date : 2022-04-01DOI: 10.4103/indianjotol.indianjotol_12_21
M. Zakaria
In pure-tone audiometry (PTA) testing, air conduction (AC) and bone conduction (BC) thresholds are documented accordingly to obtain complete information on the hearing status. Nevertheless, due to the cross-hearing phenomenon, a masking procedure is typically implemented in PTA as an effort to obtain the exact (masked) AC and BC thresholds. As indicated by the respective masking rules, the decision to carry out the masking procedure is based on the “suggested” minimum interaural attenuation (IAA), which is 40 dB (for headphones), regardless of frequency. In this case report, the importance of considering the minimum IAA value based on research findings is highlighted. In particular, to produce more reliable PTA results, the masking procedure can be conducted by considering a lower IAA value (<40 dB).
{"title":"The importance of considering the minimum interaural attenuation value in the masking procedure of pure-tone audiometry","authors":"M. Zakaria","doi":"10.4103/indianjotol.indianjotol_12_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_12_21","url":null,"abstract":"In pure-tone audiometry (PTA) testing, air conduction (AC) and bone conduction (BC) thresholds are documented accordingly to obtain complete information on the hearing status. Nevertheless, due to the cross-hearing phenomenon, a masking procedure is typically implemented in PTA as an effort to obtain the exact (masked) AC and BC thresholds. As indicated by the respective masking rules, the decision to carry out the masking procedure is based on the “suggested” minimum interaural attenuation (IAA), which is 40 dB (for headphones), regardless of frequency. In this case report, the importance of considering the minimum IAA value based on research findings is highlighted. In particular, to produce more reliable PTA results, the masking procedure can be conducted by considering a lower IAA value (<40 dB).","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"153 - 155"},"PeriodicalIF":0.1,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42591071","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_115_21
F. Azadegan-Dehkordi, Mahbobeh Koohiyan, M. Hoseini
Hearing plays an important role in human development and childhood speech learning for the proper functioning and development of people in society. Hearing loss (HL) is one of the most abnormal disabilities that affect the human senses. This disability may be due to genetic or environmental factors or both. Congenital HL is a disorder that occurs in at least 1 in 1000 births. At least 42 genetic loci are associated with syndromes, while more than 163 are associated with nonsyndromic HL (NSHL), and no specific gene therapy treatment has yet been proposed. Investigate the types of genes involved in regulating hair cell adhesion “and evaluate functions such as intracellular transport, the release of neurotransmitters, ion homeostasis, and hair cell cytoskeleton, and whether defects in them can impair cochlear and inner ear function.” Can help diagnose and treat the disease through various methods, including gene therapy. Given the complex internal and external structures of the ear, nervous system, and auditory mechanisms, it is not surprising that abnormalities in hundreds of different genes may lead to HL. In recent years, with the increasing number of studies on genes involved in congenital HL, counseling and treatment options with the help of gene therapy have increased. In this study, we aimed to describe genes and proteins and their functions in NSHL in the inner ear for screening and diagnostic programs of live birth and classify the genes involved in this model of deafness to open the door to gene therapy. It is on these genes. We hope to develop new molecular and gene therapies for autosomal recessive NSHL.
{"title":"An update on autosomal recessive hearing loss and loci involved in it","authors":"F. Azadegan-Dehkordi, Mahbobeh Koohiyan, M. Hoseini","doi":"10.4103/indianjotol.indianjotol_115_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_115_21","url":null,"abstract":"Hearing plays an important role in human development and childhood speech learning for the proper functioning and development of people in society. Hearing loss (HL) is one of the most abnormal disabilities that affect the human senses. This disability may be due to genetic or environmental factors or both. Congenital HL is a disorder that occurs in at least 1 in 1000 births. At least 42 genetic loci are associated with syndromes, while more than 163 are associated with nonsyndromic HL (NSHL), and no specific gene therapy treatment has yet been proposed. Investigate the types of genes involved in regulating hair cell adhesion “and evaluate functions such as intracellular transport, the release of neurotransmitters, ion homeostasis, and hair cell cytoskeleton, and whether defects in them can impair cochlear and inner ear function.” Can help diagnose and treat the disease through various methods, including gene therapy. Given the complex internal and external structures of the ear, nervous system, and auditory mechanisms, it is not surprising that abnormalities in hundreds of different genes may lead to HL. In recent years, with the increasing number of studies on genes involved in congenital HL, counseling and treatment options with the help of gene therapy have increased. In this study, we aimed to describe genes and proteins and their functions in NSHL in the inner ear for screening and diagnostic programs of live birth and classify the genes involved in this model of deafness to open the door to gene therapy. It is on these genes. We hope to develop new molecular and gene therapies for autosomal recessive NSHL.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"6 - 17"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48560054","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_247_20
B. Barati, M. Ghazizadeh
Introduction: Many scientists have worked on microbial flora of the ear canal or middle ear in nonoperated patients, but it is not clear that what changes would be occurred in the flora of the mastoid cavity postoperatively. It can help the surgeons to choose the appropriate drugs in the perioperative period. The study was designed to investigate the microbial flora of the middle ear and mastoid cavities after canal wall down (CWD) mastoidectomy. Materials and Methods: The survey was designed as a prospective cross-sectional study. All patients with chronic otitis media who had undergone CWD mastoidectomy in a public university hospital from 2014 to 2017 were enrolled in the study. They were periodically followed up postoperatively at least for 6 months. Swab sampling from ear cavity was performed, and the samples were sent for culture and antibiogram. Each specimen was sent for bacterial and fungal analysis. If bacterial culture result was positive, the sensitivity of the cultured organisms to common antibiotics was also assessed. Results: Seventy-four patients entered into the survey. Twenty-six (35%) of samples were positive for bacteria, and 11 (14.5%) were positive for fungi. Furthermore, 3 (4%) of the studied ears were positive simultaneously for both bacterial and fungal culture. Among cultured bacteria, Staphylococcus epidermidis was the most common species (29%). Candida species was the most common fungal species (8%). Conclusions: Microbial infection is a common finding after CWD mastoidectomy. S. epidermidis and Candida species should be considered as the primary targets of treatment.
{"title":"Microbial flora of mastoid cavity after canal wall down (CWD) mastoidectomy","authors":"B. Barati, M. Ghazizadeh","doi":"10.4103/indianjotol.indianjotol_247_20","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_247_20","url":null,"abstract":"Introduction: Many scientists have worked on microbial flora of the ear canal or middle ear in nonoperated patients, but it is not clear that what changes would be occurred in the flora of the mastoid cavity postoperatively. It can help the surgeons to choose the appropriate drugs in the perioperative period. The study was designed to investigate the microbial flora of the middle ear and mastoid cavities after canal wall down (CWD) mastoidectomy. Materials and Methods: The survey was designed as a prospective cross-sectional study. All patients with chronic otitis media who had undergone CWD mastoidectomy in a public university hospital from 2014 to 2017 were enrolled in the study. They were periodically followed up postoperatively at least for 6 months. Swab sampling from ear cavity was performed, and the samples were sent for culture and antibiogram. Each specimen was sent for bacterial and fungal analysis. If bacterial culture result was positive, the sensitivity of the cultured organisms to common antibiotics was also assessed. Results: Seventy-four patients entered into the survey. Twenty-six (35%) of samples were positive for bacteria, and 11 (14.5%) were positive for fungi. Furthermore, 3 (4%) of the studied ears were positive simultaneously for both bacterial and fungal culture. Among cultured bacteria, Staphylococcus epidermidis was the most common species (29%). Candida species was the most common fungal species (8%). Conclusions: Microbial infection is a common finding after CWD mastoidectomy. S. epidermidis and Candida species should be considered as the primary targets of treatment.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"23 - 25"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43585610","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_99_21
A. Baki, Wan Draman, Z. Salahuddin, Nik Adilah Nik Othman
The cerebellopontine angle (CPA) is a cerebrospinal fluid-filled space, found at the junction between the cerebellum and pons. Vestibular schwannoma (VS) is the most common CPA tumor. Typical initial symptoms are unilateral or asymmetrical hearing impairment, tinnitus in the affected ear, or imbalance or vertigo. We report an unusual case of the patient who presented with right sensorineural hearing loss but was found to have left VS in the normal hearing ear.
{"title":"Atypical manifestation in vestibular schwannoma","authors":"A. Baki, Wan Draman, Z. Salahuddin, Nik Adilah Nik Othman","doi":"10.4103/indianjotol.indianjotol_99_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_99_21","url":null,"abstract":"The cerebellopontine angle (CPA) is a cerebrospinal fluid-filled space, found at the junction between the cerebellum and pons. Vestibular schwannoma (VS) is the most common CPA tumor. Typical initial symptoms are unilateral or asymmetrical hearing impairment, tinnitus in the affected ear, or imbalance or vertigo. We report an unusual case of the patient who presented with right sensorineural hearing loss but was found to have left VS in the normal hearing ear.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"74 - 76"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47694426","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_151_21
Isha Shah, S. Malukar, Jayesh Singh, Ankita Parikh, U. Kunikullaya
Rhabdomyosarcoma (RMS) is one of the most commonly encountered soft-tissue sarcomas in childhood. The most common location is in the head-and-neck region, followed by the urogenital system, extremities, and torso. Head and neck is a common site though the temporal bone is an extremely rare site with only a few reported cases in the literature till now. Herein, we report a case of a sclerosing type of temporal bone RMS in an 8-year-old young girl. We discuss clinical, pathological, radiological findings and management of temporal bone RMS. Misdiagnosis is common because of this aggressive temporal bone lesion's similarity to more common benign diseases. Clinicians should maintain suspicion for RMS in patients with chronic otitis media not responsive to medical therapy and should refer a specialist multidisciplinary team in a timely manner as an early diagnosis will optimize the chance of survival. Clinical features, radiologic findings, and histopathological examination using immunohistochemistry are all important for the correct diagnosis of temporal bone RMS. It is important to be aware of and to know how to deal with such rare cases.
{"title":"Temporal bone rhabdomyosarcoma mimicking chronic suppurative otitis media","authors":"Isha Shah, S. Malukar, Jayesh Singh, Ankita Parikh, U. Kunikullaya","doi":"10.4103/indianjotol.indianjotol_151_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_151_21","url":null,"abstract":"Rhabdomyosarcoma (RMS) is one of the most commonly encountered soft-tissue sarcomas in childhood. The most common location is in the head-and-neck region, followed by the urogenital system, extremities, and torso. Head and neck is a common site though the temporal bone is an extremely rare site with only a few reported cases in the literature till now. Herein, we report a case of a sclerosing type of temporal bone RMS in an 8-year-old young girl. We discuss clinical, pathological, radiological findings and management of temporal bone RMS. Misdiagnosis is common because of this aggressive temporal bone lesion's similarity to more common benign diseases. Clinicians should maintain suspicion for RMS in patients with chronic otitis media not responsive to medical therapy and should refer a specialist multidisciplinary team in a timely manner as an early diagnosis will optimize the chance of survival. Clinical features, radiologic findings, and histopathological examination using immunohistochemistry are all important for the correct diagnosis of temporal bone RMS. It is important to be aware of and to know how to deal with such rare cases.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"88 - 90"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47511767","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_149_21
C. Teh, Salim Iffah, N. Prepageran
Objectives: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder which is also the most common cause of chronic dizziness. Effective treatment is dependent on the awareness of the provider's knowledge of PPPD and correct provision of treatment. This study was aimed to assess the awareness of PPPD and practice patterns among a diverse group of providers who care for patients with chronic dizziness in the outpatient clinics. Materials and Methods: A 12-question web-based survey was distributed to a cross-sectional convenience sample of medical providers from primary care including general practitioners, otorhinolaryngology (ORL) and internal medicine all over Malaysia. We analyzed the responses using multivariate logistic regression. Results: Of the 186 included responses, only 46.7% (85 respondents) replied they have heard of PPPD and 158 (84.9%) have actually encountered patients with symptoms describing PPPD. Those in primary care had less odds of having heard of PPPD (adjusted odds ratio [aOR] 0.37 confidence interval [CI] 0.18–0.76) nor treated patients with PPPD symptoms (aOR 0.18 CI 0.07–0.49) when compared to the General Medical and ORL providers. In terms of treatment of PPPD, gender, level of training, and practice setting predicted the provision of therapy. Conclusion: PPPD awareness is still lacking among our providers and the current practices reflect that the management of chronic dizziness is focused on ruling out systemic causes. Now is the time to invest in health communication strategies to improve the awareness and knowledge of managing chronic dizziness especially PPPD.
目的：持续性体位性知觉性眩晕（PPPD）是一种慢性功能性前庭障碍，也是引起慢性眩晕的最常见原因。有效的治疗取决于提供者对PPPD知识的认识和正确的治疗。本研究旨在评估门诊护理慢性头晕患者的不同提供者对PPPD的认识和实践模式。材料和方法：将一项12个问题的网络调查分发给来自马来西亚各地初级保健医疗提供者的横断面便利样本，包括全科医生、耳鼻喉科医生和内科医生。我们使用多元逻辑回归分析了反应。结果：在186份回复中，只有46.7%（85名受访者）回答他们听说过PPPD，158名（84.9%）实际遇到过有PPPD症状的患者。与普通医疗和ORL提供者相比，初级保健提供者听说过PPPD的几率较小（调整后的比值比[aOR]0.37置信区间[CI]0.18-0.76），也没有治疗过PPPD症状的患者（aOR 0.18 CI 0.07-0.49）。在PPPD的治疗方面，性别、训练水平和实践环境预测了治疗的提供。结论：我们的提供者仍然缺乏PPPD意识，目前的做法反映出慢性头晕的管理侧重于排除系统性原因。现在是时候投资于健康沟通策略，以提高管理慢性头晕（尤其是PPPD）的意识和知识了。
{"title":"Persistent postural-perceptual dizziness: A multispecialty survey of clinician awareness and practices in Malaysia","authors":"C. Teh, Salim Iffah, N. Prepageran","doi":"10.4103/indianjotol.indianjotol_149_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_149_21","url":null,"abstract":"Objectives: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder which is also the most common cause of chronic dizziness. Effective treatment is dependent on the awareness of the provider's knowledge of PPPD and correct provision of treatment. This study was aimed to assess the awareness of PPPD and practice patterns among a diverse group of providers who care for patients with chronic dizziness in the outpatient clinics. Materials and Methods: A 12-question web-based survey was distributed to a cross-sectional convenience sample of medical providers from primary care including general practitioners, otorhinolaryngology (ORL) and internal medicine all over Malaysia. We analyzed the responses using multivariate logistic regression. Results: Of the 186 included responses, only 46.7% (85 respondents) replied they have heard of PPPD and 158 (84.9%) have actually encountered patients with symptoms describing PPPD. Those in primary care had less odds of having heard of PPPD (adjusted odds ratio [aOR] 0.37 confidence interval [CI] 0.18–0.76) nor treated patients with PPPD symptoms (aOR 0.18 CI 0.07–0.49) when compared to the General Medical and ORL providers. In terms of treatment of PPPD, gender, level of training, and practice setting predicted the provision of therapy. Conclusion: PPPD awareness is still lacking among our providers and the current practices reflect that the management of chronic dizziness is focused on ruling out systemic causes. Now is the time to invest in health communication strategies to improve the awareness and knowledge of managing chronic dizziness especially PPPD.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"32 - 40"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41652281","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_51_22
G. Malzanni, Caterina Lerda, R. Battista, Chiara Canova, O. Gatti, M. Bussi, L. Piccioni
Objective: The objective of this study was to examine improvement in speech recognition and “the Speech, Spatial and Qualities of Hearing Scale” (SSQ) scores in monolateral cochlear implant (CI) users and its correlations to data logging statistics. Materials and Methods: A prospective observational, nonrandomized, study was conducted analyzing speech tracking with shielded mouth in noise (SMn), speech audiometry, and SSQ questionnaire (Italian version) at 1, 3, and 6 months postactivation of CI of 31 patients. The overall data of average daily use and acoustic scene analyses were extracted from data logging system. Data of 6-month cumulative speech in quiet-, speech-in-noise-, and noise-listening time of 19 patients were correlated to speech perception scores and SSQ scores. Results: An improvement was observed in all outcomes (speech tracking with SMn, speech audiometry, and SSQ scores). Listeners used their device on for a mean time of 13.45 h per day. Quiet scene was the most represented listening environment. A significant positive correlation was found between noise exposition (in hours) and hearing quality score of SSQ and between exposition to 60–69 dB noise and scores resulted from each part of SSQ. Discussion: The analysis failed to demonstrate a correlation between auditory performances and both exposition to speech scene and total exposition. However, time spent in noise using the device correlated with SSQ scores. Conclusion: Cochlear implantation ensures good results in speech recognition and quality of life, with progressive scores' improvement after activation. A predominant use in quiet was observed together with a correlation between hearing performance and exposition to noise.
{"title":"Speech recognition, quality of hearing, and data logging statistics over time in adult cochlear implant users","authors":"G. Malzanni, Caterina Lerda, R. Battista, Chiara Canova, O. Gatti, M. Bussi, L. Piccioni","doi":"10.4103/indianjotol.indianjotol_51_22","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_51_22","url":null,"abstract":"Objective: The objective of this study was to examine improvement in speech recognition and “the Speech, Spatial and Qualities of Hearing Scale” (SSQ) scores in monolateral cochlear implant (CI) users and its correlations to data logging statistics. Materials and Methods: A prospective observational, nonrandomized, study was conducted analyzing speech tracking with shielded mouth in noise (SMn), speech audiometry, and SSQ questionnaire (Italian version) at 1, 3, and 6 months postactivation of CI of 31 patients. The overall data of average daily use and acoustic scene analyses were extracted from data logging system. Data of 6-month cumulative speech in quiet-, speech-in-noise-, and noise-listening time of 19 patients were correlated to speech perception scores and SSQ scores. Results: An improvement was observed in all outcomes (speech tracking with SMn, speech audiometry, and SSQ scores). Listeners used their device on for a mean time of 13.45 h per day. Quiet scene was the most represented listening environment. A significant positive correlation was found between noise exposition (in hours) and hearing quality score of SSQ and between exposition to 60–69 dB noise and scores resulted from each part of SSQ. Discussion: The analysis failed to demonstrate a correlation between auditory performances and both exposition to speech scene and total exposition. However, time spent in noise using the device correlated with SSQ scores. Conclusion: Cochlear implantation ensures good results in speech recognition and quality of life, with progressive scores' improvement after activation. A predominant use in quiet was observed together with a correlation between hearing performance and exposition to noise.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"45 - 51"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45455581","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_104_21
Jayesh Singh, Aastha Shah, Ankita Parikh, Isha Shah, D. Anand, Himanshi Jain, U. Suryanarayan
Squamous cell carcinoma of the external ear is rare and the combination of external beam radiotherapy and brachytherapy has been beneficial for tumors in this location due to the advantage of organ preservation and thereby cosmesis. The incorporation of brachytherapy allows the delivery of doses large enough for the eradication of tumor and the advantage of rapid dose fall off due to brachytherapy minimizes the radiation damage to the nearby organs at risk. Herein we report a case of elderly male with early stage squamous cell carcinoma of external ear treated with a combination of external beam radiation with brachytherapy. An eighty nine year old male reported to our hospital with the complaints of left sided ear ache the presence of some mass in the left external ear. A diagnostic Contrast enhanced Computed Tomography (CECT) scan of head and neck showed a 1.6*1.5*1.4 cm mass lesion (maximum diameter) involving anterior cartilaginous part of left external auditory canal and preauricular soft tissue,thereby staged as T2N0,stage II. Patient was planned for External Beam Radiotherapy (EBRT) using 3D CRT(Conformal Radiotherapy) technique by 6 MV photon beam to a dose of 50 Gy in 25 fractions (2 Gy/#) and following this,a gap of seven days was given and after that four fractions of HDR brachytherapy using Iridium 192 of 3 Gy/# keeping a gap of six hours between two fractions on a single day,Two flexible plastic tubes were used for radiation delivery. The size of the catheter used for radiation delivery was 6 French. Planning CT scan was taken and target volume defined as PTV and a dose of 3 Gy per fraction to a total of 4 fractions was prescribed to the target volume. The spike of intravenous site was used for fixing the plastic tube in the mould. The tumor responded ver well to radiotherapy. Brachytherapy is an effective modality to boost high risk areas without significant damage to the surrounding area. External Beam Radiotherapy in case of early stage carcinoma external auditory canal combined with brachytherapy boost can be considered as a better modality with less severe side effects and better cosmesis.
{"title":"High-dose-rate brachytherapy boost following external radiotherapy in a case of carcinoma external ear","authors":"Jayesh Singh, Aastha Shah, Ankita Parikh, Isha Shah, D. Anand, Himanshi Jain, U. Suryanarayan","doi":"10.4103/indianjotol.indianjotol_104_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_104_21","url":null,"abstract":"Squamous cell carcinoma of the external ear is rare and the combination of external beam radiotherapy and brachytherapy has been beneficial for tumors in this location due to the advantage of organ preservation and thereby cosmesis. The incorporation of brachytherapy allows the delivery of doses large enough for the eradication of tumor and the advantage of rapid dose fall off due to brachytherapy minimizes the radiation damage to the nearby organs at risk. Herein we report a case of elderly male with early stage squamous cell carcinoma of external ear treated with a combination of external beam radiation with brachytherapy. An eighty nine year old male reported to our hospital with the complaints of left sided ear ache the presence of some mass in the left external ear. A diagnostic Contrast enhanced Computed Tomography (CECT) scan of head and neck showed a 1.6*1.5*1.4 cm mass lesion (maximum diameter) involving anterior cartilaginous part of left external auditory canal and preauricular soft tissue,thereby staged as T2N0,stage II. Patient was planned for External Beam Radiotherapy (EBRT) using 3D CRT(Conformal Radiotherapy) technique by 6 MV photon beam to a dose of 50 Gy in 25 fractions (2 Gy/#) and following this,a gap of seven days was given and after that four fractions of HDR brachytherapy using Iridium 192 of 3 Gy/# keeping a gap of six hours between two fractions on a single day,Two flexible plastic tubes were used for radiation delivery. The size of the catheter used for radiation delivery was 6 French. Planning CT scan was taken and target volume defined as PTV and a dose of 3 Gy per fraction to a total of 4 fractions was prescribed to the target volume. The spike of intravenous site was used for fixing the plastic tube in the mould. The tumor responded ver well to radiotherapy. Brachytherapy is an effective modality to boost high risk areas without significant damage to the surrounding area. External Beam Radiotherapy in case of early stage carcinoma external auditory canal combined with brachytherapy boost can be considered as a better modality with less severe side effects and better cosmesis.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"80 - 83"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44966703","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 : 2022-01-01DOI: 10.4103/indianjotol.indianjotol_146_21
A. Dahlan, I. Zainon, Z. Yeoh, Mohd Khairi Md Daud
Bone anchored hearing aid (BAHA) is a device that combines a sound processor with a small titanium fixture implanted at the mastoid area. It is indicated for those having conductive hearing loss, especially in those not suitable for hearing aids. Emissary veins are residual connections between intracerebral veins and their extracranial drainage. The vein may be injured at the time of drilling procedure such as during insertion of implant at the mastoid area. We report a case of difficult BAHA surgery after encounter with cortical emissary vein. Mastoid emissary vein is a rare but definite entity which if not diagnosed preoperatively could be a cause of severe hemorrhage intraoperatively.
{"title":"Cortical emissary vein: An important vessel to look for before bone anchored hearing aid implantation","authors":"A. Dahlan, I. Zainon, Z. Yeoh, Mohd Khairi Md Daud","doi":"10.4103/indianjotol.indianjotol_146_21","DOIUrl":"https://doi.org/10.4103/indianjotol.indianjotol_146_21","url":null,"abstract":"Bone anchored hearing aid (BAHA) is a device that combines a sound processor with a small titanium fixture implanted at the mastoid area. It is indicated for those having conductive hearing loss, especially in those not suitable for hearing aids. Emissary veins are residual connections between intracerebral veins and their extracranial drainage. The vein may be injured at the time of drilling procedure such as during insertion of implant at the mastoid area. We report a case of difficult BAHA surgery after encounter with cortical emissary vein. Mastoid emissary vein is a rare but definite entity which if not diagnosed preoperatively could be a cause of severe hemorrhage intraoperatively.","PeriodicalId":44304,"journal":{"name":"Indian Journal of Otology","volume":"28 1","pages":"91 - 93"},"PeriodicalIF":0.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42360700","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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