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

Corona virus disease 2019 (COVID-19) pandemic saw a surge of invasive fungal sinusitis. This study prospectively followed up these cases to observe the long term sequelae and prognosis in these patients. A prospective, hospital based observational study was conducted at a tertiary referral center amongst 124 patients diagnosed with COVID- 19 associated invasive fungal sinusitis of the paranasal sinuses between April 2021 to September 2021. These patients were treated with surgery and or antifungals depending on the extend of the disease and surgical fitness of the patient and they were prospectively followed up till October 2023 by reviewing the clinical features, symptoms, serial nasal endoscopies and radiological imaging such as computed tomography and magnetic resonance imaging. The overall survival at the end of three months and eighteen months was 79.8% and 72.03% respectively. The most common presenting symptom in the outpatient department was facial pain in 67 patients (72.04%) which improved in only 17.91%. During the follow up period two patients developed progressive disease which required multiple surgeries.Covid-19 related invasive fungal sinusitis patients need judicious follow up for long term to minimise the possibility of progressive disease and associated complications.

Choanal atresia or stenosis (CA/S), whether congenital or acquired, is a rare but clinically significant condition characterized by the obstruction of the posterior nasal aperture. While congenital bilateral choanal atresia (CA) poses an immediate life-threatening risk in neonates due to obligate nasal breathing, unilateral CA may go unnoticed for several years. Acquired forms-particularly post-radiation-are increasingly recognized for their morbidity and impact on quality of life. We present five cases of CA having varied presentation from congenital non syndromic unilateral/bilateral CA to syndromic bilateral CA along with acquired cases of CA post radiotherapy for head and neck malignancies. This case series combines our experience with both congenital and acquired types of choanal atresia, offering a unique comparative perspective on their presentation, diagnosis, and surgical management.

Endoscopic Sinus Surgery & Endoscopic Septal Correction are among the most common surgeries done by an Otorhinolaryngologist. Crusting in the nose is basically dried mucus and is the most common complications post nasal surgeries. 213 individuals undergoing Endoscopic Septal Correction and Endoscopic Sinus Surgery were included in the study. The Nasal Crusting Score was used post-surgery to look for crusts which were blocking the airway, noted once a day at 6 am in the Post-Operative days. The Nasal Crusting Score was found to have a decreasing trend from post operative days 3 to 14. The p-value is found to be significant on comparing the crusting from the 2nd post operative days to the end of 14 days. This study presents a novel way of understanding airway problems caused by crusting after Endoscopic Septal Correction and Endoscopic Sinus Surgery by means of a Nasal Crusting Score. Quantitative assessment of the nasal airway has not been studied as date and all Quality of Life questionnaires also have a response bias. Older studies have proven that crusting is the hardest to manage and thus requires a protocol for treatment. This study presents a novel Nasal Crusting Score which can help assess the patency of the airway. It can prove to be a useful tool to quickly have a non-patient dependant scoring. The tool is simple and easy to use and can be done without using complex instruments.

To report a rare case of bilateral large sphenoid mucocele presenting with cranial neuropathies. A 77 year old female presented to ophthalmology OPD with chief complaints of headache since 4 months, double vision and restricted movements in the right eye since 4 months, on examination the patient was diagnosed to have bilateral lateral rectus palsy and underwent CECT PNS which showed the sphenoid sinus to be expanded and completely filled with non enhancing low attenuation material suggestive of mucocele and was impinging on bilateral optic canal with posterior displacement of pituitary gland. The patient was then referred to Oto-rhino-laryngology department for further management. Diagnostic nasal endoscopy did not reveal any positive findings. Ophthalmology examination revealed bilateral lateral rectus palsy and restriction of extraocular movements on abduction. The patient underwent FESS under GA and intra-operatively there was a bulge seen in the sphenoethmoidal recess on the left anterior wall of the sinus which was debrided, gush of purulent material was seen. The sinus was cleared. Similarly opposite side sphenoid sinus was opened and cleared. Wide sphenoidotomy and posterior septectomy was done. Dehiscent pituitary gland and lateral wall seen. Post operatively patient got relieved of headache, diplopia and showed improvement in lateral rectus paresis. Mucoceles of the sphenoid sinus are a very rare with variable clinical presentation. Imaging play a crucial role in diagnosis and early surgical intervention is vital to avoid complications. Endonasal endoscopic approach is the preferred line of management.

Objectives: Anthropometry, the study of human anatomy through dimensional analysis, is essential for standardizing human anatomy. This study aimed to measure external ear anthropometric variables in healthy pediatric Saudi individuals using a novel, photo-based technique. Methods: A cross-sectional study was conducted among children aged 1-17 years attending the otorhinolaryngology clinic at a tertiary hospital in Saudi Arabia. Data were collected between August 2022 and January 2023. We enrolled 76 participants (148 ears) who met our inclusion criteria. Patients with external ear deformities due to trauma, congenital malformations, previous surgery, or known congenital syndromes were excluded. This study used a software modality to measure the anthropometric variables which required a picture displaying the desired measurement area and a ruler to set the standard distance. Subsequently, all data were extracted using this method. Results: Of 76 enrolled participants, 52 (68.4%) were male and 24 (31.6%) female. The average age of the included participants was 7.71 ± 4.14 years. Significant differences were found in the right and left ear measurements between males and females. Right and left ear lengths, lobular lengths, concha lengths, and concha widths were significantly greater in males than in females. Conclusion: The study results suggest that male children tend to have larger ears than female children. Additionally, the anthropometric ear measurements in the Saudi pediatric population appear to be smaller than those of pediatric patients from other populations.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05633-y.

Using HRCT Temporal bone in all cases of COM Squamous type, would act as a guide map and would lead to a better outcome for the patient as removal of the disease without preoperative high resolution radiological evaluation could lead to the destruction of various vital structures situated in and around the temporal bone. In earlier days HRCT temporal bone was not indicated in all cases of COM Squamous type, it was considered only in cases of complications, recurrence and pediatric population. This study compares the intraoperative findings in COM Squamous type cases with that of HRCT Temporal Bone, in all cases of COM Squamous disease before surgery to emphasize the importance of doing HRCT temporal bone prior to every case of COM Squamous type. After institutional ethical clearance, (IEC No: AIIMSRPR/IEC/2020/688) we conducted a prospective cross-sectional observational study on 112 patients over a time period of 12 months in age group between 5-65 years diagnosed with COM Squamous type with/without complication. They underwent surgery and intraoperative findings were correlated with the radiological findings keeping various parameters into consideration. This study discovered a strong relationship between HRCT of the temporal bone and intraoperative results. HRCT temporal bone, despite its drawbacks such as increased exposure to radiation and the inability to differentiate types of soft tissue densities, should be performed in all cases of COM Squamous type prior to surgery.

Isolated nasolacrimal duct rhinosporidiosis is a rare manifestation of this chronic granulomatous disease. This reports the first known case in Mumbai, highlighting the need to consider rhinosporidiosis in differential diagnosis of intermittently presenting nasal mass. Appropriate diagnosis, endoscopic surgical management and oral dapsone therapy, prevented recurrence in this case.

Introducing powered instrumentation causes drastically changes regarding the endoscopic sinus surgery performance. Such technology has a particular usage in treating different forms of CRS with nasal polyposis. In the therapy of sinonasal polyposis, we report the accuracy of surgery with a microdebrider to typical endoscopic sinus surgery instruments. A prospective randomized comparative investigation has been carried out at Al Azhar University Hospital-ENT department, involving 80 patients who were radiologically and clinically diagnosed with bilateral sinonasal polyposis. These patients had not exhibited improvement with previous medical treatments. The diagnosed cases were equally allocated into two groups, Group A (microdebrider group), who underwent microdebrider, and Group B (conventional Group), who underwent surgery with traditional equipment (Messerklinger approach). The intraoperative blood loss differs significantly among the two groups. In Group A, intraoperative blood loss seems to be much lower in individuals who had FESS with the use of a Microdebrider. Group A had mean surgery duration of 130 min, while Group B had a mean surgery time of 163 min. In the treatment of sinonasal polyposis, a microdebrider has some advantages over Conventional endoscopic sinus surgery. For people with sinonasal polyposis, powerful endoscopic sinus surgery is a preferable therapy option. It creates a dry operating field allowing better visualization and cuts down on operative duration. The current study shows that while these tools may be beneficial, they are not required for successful Functional Endoscopic Sinus Surgery (FESS) outcomes.

The study aims to compare the laryngeal aerodynamic parameters of male smokers and non-smokers. It primarily investigates the aerodynamic parameters of voice using AerophoneII, in smokers and non-smokers, compares the results and examines whether the influence of smoking would have any influence on the aerodynamic parameters of voice. We took 60 male subjects of age range 20-45 years who were divided into two groups: smokers and non-smokers. Five parameters were taken to assess: Peakflow, Vitalcapacity, Maximum sustained phonation, Fast adduction abduction Rate and Vocal Efficiency. A significant difference was found for all the aerodynamic parameters between smokers and non-smokers. The pathological changes found in smokers include: (1) airway epithelial damage, (2) chronic airway inflammation; (3) structural changes in the airway wall; and (4) loss of alveolar attachments (Saetta et al. in Eur Respir J 7:1505-1515, 1994).

Vocal fold paralysis, a condition caused by nerve damage, leads to impaired vocal fold movement, impacting speech, breathing, and swallowing. Diagnosing this condition is challenging as conventional methods are invasive. Even after requiring specialized equipment, the diagnosis often fails to confidently distinguish it from similar disorders. This results in treatment delay, affecting the patient's quality of life. Artificial intelligence can be trained on datasets to identify patterns in data that humans can miss, especially in cases where the disease incidence is not common. This narrative review consolidates recent research on the application of artificial intelligence on vocal fold paralysis diagnosis in the last five years. All research papers that have aimed to diagnose unilateral or bilateral vocal fold paralysis using artificial intelligence have been reviewed in this work. Datasets, performance, and challenges have been showcased, along with research gaps and areas for improvement. Artificial intelligence models have demonstrated significant diagnostic potential. Artificial intelligence applied to acoustic analysis successfully identified subtle voice changes linked to impaired vocal fold function with high accuracy. Application to imaging-based approaches offered reliable and detailed motion assessments of vocal folds. Computational approaches provide promising supplements if not alternatives to traditional diagnostic tools, enabling earlier identification and personalized treatment. Dataset diversity, model bias, and reliance on high-quality data are consistent challenges. Future research should focus on expanding the pool of available public datasets, refining algorithms, and ensuring usability in clinical settings to maximize the impact of these technologies on patient outcomes.