Indian Journal of Otolaryngology and Head and Neck Surgery最新文献

This report highlights the case of a 13-year-old female diagnosed with late-onset auditory neuropathy spectrum disorder (ANSD). While newborn hearing screening programs are effective in early identification of hearing impairments, this case underscores the potential for late-onset ANSD that may be overlooked in such screenings. The case provides insights into possible pathophysiological mechanisms and emphasizes the need for continued monitoring of auditory health beyond the neonatal period. The child was born with neonatal jaundice and underwent phototherapy in the neonatal intensive care unit (NICU) for 10 days. Despite this medical history, she passed the newborn hearing screening and exhibited typical developmental milestones in auditory, speech, language, and motor domains during early childhood. At the age of 13, following a four-day episode of high fever caused by a foodborne infection, the child began experiencing difficulty hearing and understanding speech, particularly in noisy environments. Comprehensive audiological evaluation confirmed a diagnosis of auditory neuropathy spectrum disorder, suggesting a late-onset manifestation of the condition. The history of neonatal jaundice treated with phototherapy may have predisposed the child to auditory vulnerability, although the condition did not manifest during the early developmental years. The triggering role of the episode of fever suggests a potential interaction between predisposing factors and subsequent environmental or medical events. This case suggests a possible association between neonatal jaundice and late-onset ANSD, but other contributing factors cannot be ruled out. It highlights the need to address potential risk factors during counselling in newborn hearing screening programs and emphasizes the importance of periodic audiologic assessments in individuals with such risk factors.

Hearing loss is a significant but often under-recognized complication in pediatric HIV-positive patients. This study aimed to investigate the prevalence and types of hearing loss, their correlation with CD4 + counts, and the potential impact of antiretroviral therapy (ART) in this population. A cross-sectional study was conducted involving 50 pediatric HIV-positive patients aged 5-17 years attending a tertiary care hospital. Audiological assessments included Pure Tone Audiometry (PTA), Distortion Product Otoacoustic Emissions (DPOAE), and Impedance Audiometry. Data were analyzed to determine the prevalence and type of hearing loss, and correlations with CD4 + counts and ART regimens were explored. Hearing loss was identified in 21% of the ears examined (n = 14), predominantly sensorineural in nature (76.2%). Mild impairment hearing loss (26-40 dB) was the most common, affecting 80.95% of the ears. A significant association was found between lower CD4 + counts and the presence of hearing loss (333.62 ± 111.47 cells/mm³ compared to 671.75 ± 340.85 cells/mm³ in those without hearing loss, p = 0.001). There was no significant association of hearing loss with ART regime. Hearing loss as a morbidity was seen in 21% ears. A significant association was seen between hearing loss and lower CD4 + counts in pediatric HIV-positive patients, emphasizing the need for regular audiological monitoring.

Angioleiomyoma is a rare benign smooth muscle tumor that is uncommonly encountered within the nasal cavity and presents with non-specific symptoms. Biopsy with histopathology examination is required to establish the diagnosis. The primary therapy for nasal angioleiomyoma is total surgical excision and follow up is recommended to identify local recurrence. Here, we present a case of angioleiomyoma found in the inferior turbinate and provide an overview of the relevant literature.

Aim: To assess the role of various clinical and histological parameters in depicting recurrence in oral squamous cell carcinoma (OSCC).

Methodology: After seeking clearance from the institutional ethical clearance board, 171 excised cases of OSCC were included in the present study and divided into two groups (recurrent OSCC-rOSCC and non-recurrent OSCC- nOSCC). Data pertaining to the age, gender, site, laterality, histological grade, perineural invasion (PNI), lymphovascular emboli (LVE), bone invasion, depth of invasion, pathological tumor stage, nodal metastases, the status of surgical margins-intraoperatively, and recurrence were recorded and compared utilizing SPSS software.

Result: There was no statistically significant difference between the mean age of nOSCC (51.03±10.27 years) and rOSCC (51.87±10.39 years). Similary, no statistically significant differences were noted between the two study groups in the purview of the site (p-value: 0.505), laterality (p-value: 0.954), histological grade (p-value: 0.370), LVE (p value:0.109), bone involvement (p-value: 0.290), depth of invasion (p-value: 0.091) and pathological tumor stage (p-value: 0.174). However, there were significantly more instances of PNI (p-value: <0.001) and nodal metastasis in rOSCC (p-value: 0.019). Further, a statistically significant association was noted between the status of the margins at initial resection as compared to cases where clearance was achieved by subsequent revisions (p-value: <0.001).

Conclusion: Perineural invasion, positive margins at the initial cut and positive nodal metastasis are associated with higher recurrence in oral squamous cell carcinoma.

Chronic static noise generated by wall-mounted humidifiers and suction systems during postoperative care poses a significant risk of sensorineural hearing loss (SNHL) among otolaryngology patients. This study aims to evaluate the intensity and duration of noise exposure and its impact on the prevalence of SNHL in postoperative patients. This prospective study included 27 postoperative head and neck surgery patients requiring tracheostomy, suctioning, Doppler monitoring, or humidified air. Participants were excluded if they had pre-existing hearing loss, prior chemoradiation therapy, or exposure to ototoxic medications. Noise levels were recorded using a sound dosimeter placed near patients' ears three times daily during the postoperative phase. The primary outcome was the prevalence of SNHL, expressed as a proportion with a 95% confidence interval (CI). During the first postoperative week, average noise levels were 87 dB at the wall mount and 69.3 dB at the head of the bed. Among the 24 patients who completed follow-up, 19 (80%) exhibited mild to moderate SNHL, while 5 (20%) had normal to mild SNHL. Three patients were lost to follow-up. Noise levels experienced by head and neck surgery patients during their postoperative hospital stay frequently exceed safe thresholds, posing a significant risk of hearing loss. These findings highlight the urgent need to revise care standards, develop noise mitigation strategies, and promote auditory health in hospital settings.

Hearing loss usually slopes towards the high-frequency regions of hearing in the elderly population. We assessed the speech perception performance in an elderly patient with high-frequency sloping hearing loss under different aided conditions as a function of speech stimuli and listening conditions. The participant was a 69-year-old male with symmetrical and post-lingually acquired bilateral high-frequency sloping sensorineural hearing loss. Speech recognition score testing was conducted under conventional and nonlinear frequency compression (NFC) settings of the hearing aids using conventional and high-frequency wordlists in quiet and + 5 dB SNR listening conditions. The participant outperformed speech perception for conventional wordlists compared to high-frequency wordlists in the conventional setting. Similarly, the participant outperformed speech perception for high-frequency wordlists in the NFC setting compared to the conventional setting. Finally, the participant underperformed speech perception in the noisy compared to quiet listening conditions, irrespective of hearing aid settings and wordlists. The conventional wordlists overestimated the performance of the conventional setting for speech perception. Other than evaluating the actual performance of the conventional setting, the high-frequency wordlists estimated some of the benefits of the NFC setting over the conventional setting for speech perception.

In this study, we examined anatomical variations in the anterior belly of the digastric muscle (ABDM) in two cadavers: a 68-year-old male and a 54-year-old female. Variations in the length, diameter, and origin-insertion relationships were measured and categorized. The results showed unilateral insertion and origin types, emphasizing their clinical relevance in head and neck surgery and radiological assessments.

Bilateral congenital dacryocystocele is a rare, congenital anomaly of the lacrimal drainage system in a newborn. Herein, we report a case of infected congenital bilateral dacryocystocele in a newborn. The case was determined to be a bilateral dacryocystocele after an endoscopic examination and confirmed by a magnetic resonance imaging (MRI) scan. Awareness of this entity is important, as it may cause a delay in referral to an otorhinolaryngology (ORL) specialist and subsequently, a delay in diagnosis. Therefore, it should be considered when there is unusual swelling present between the eyes of a newborn and it does not improve with medical treatment.

Permanent severe to profound hearing impairment in children can have a lifelong negative impact on the development of biological functions, such as speech and language, literacy, mental health, social and cognitive functioning and socioeconomic opportunity. However, by implementing efficient early detection and intervention initiatives, the effects of hearing loss can be reversed. In span of 8 years (2016-2023) of universal newborn hearing screening at Netaji Subhash Chandra Bose (NSCB) medical college, Jabalpur, total of 28025 newborns have been screened in a two-step process including one subjective test: Behavioural Observation Audiometry (BOA) and one objective screening tests: Otoacoustic Emissions (OAE). Auditory Brainstem Response (ABR) is used for conformation of hearing loss. 4806 newborns were under referred category and 350 newborns have been identified with hearing loss. The disease prevalence was 7.28% among the newborns under referred category. The sensitivity of screening test is 100% and specificity of 95.02% and accuracy of >95%. This paper presents a practical, affordable and accurate two-step process for early detection and treatment of hearing loss, highlighting the importance of Universal Newborn Hearing Screening and urging public health-care policymakers to implement this protocol nationwide.