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

Tonsillectomy is a commonly performed procedure in pediatric ENT departments worldwide. To comprehensively evaluate the morbidity associated with tonsillectomy techniques and potential factors that impact outcomes The present study examined the entirety of pediatric patients who underwent tonsillectomy or adenotonsillectomy at CUCH during the years 2021 and 2022. Comprehensive scrutiny was conducted on admissions and readmission data, which encompassed hospital episode statistics, operative notes, patient questionnaires, and electronic records. A total of 690 procedures were identified in our records, with 399 males and 291 females ranging in age from 1 to 13 years. The main indications for surgery included sleep-disordered breathing and recurrent tonsillitis. Among the patients, 233 underwent the surgery as a day case. Coblation intracapsular technique was used in 52% of cases, dissection method in 37%, and coblation extracapsular method in 10%. The incidence of post tonsillectomy bleeding (&infection) was 8.19%( 1.75%),14.89%(2.08%), 1.65%(1.65%) for dissection, coblation extracapsular and coblation intracapsular techniques respectively. Coblation intracapsular tonsillectomy has shown the lowest rate of postoperative hemorrhage compared to other techniques. Senior surgeons (consultants) had the lowest rate of post-tonsillectomy hemorrhage; however, this difference did not reach statistical significance.

This study aimed to establish normative data for cervical (cVEMP) and ocular (oVEMP) vestibular evoked myogenic potentials in the Indian population, with a focus on assessing demographic variations across different age groups and genders. A cross-sectional observational study was conducted from January 2023 to December 2023 at a tertiary care center, involving 40 participants with normal hearing thresholds. Standardized cVEMP and oVEMP tests were performed using 500 Hz tone bursts at 95-115 dB nHL. VEMP responses, including latency and amplitude, were statistically analyzed using descriptive statistics, ANOVA, and Kruskal-Wallis tests to determine normative ranges and assess the impact of age and gender. The study established normative VEMP thresholds at about 105 dB for cervical (cVEMP) and ocular (oVEMP) responses, notably higher than the global average of 70-100 dB, suggesting unique regional variations in the Indian demographic. Normative values ranged from 45.68 at the 5th percentile to 92.32 at the 95th percentile for cVEMPs, and 13.12 to 18.58 for oVEMPs. Data analysis showed exceptionally stable VEMP responses with minimal age-related decline-significantly less than typically seen in Western populations, and no significant gender differences, indicating consistent vestibular function across diverse demographic groups. This research significantly enhances the diagnostic framework for vestibular disorders in India by establishing tailored normative VEMP data. These benchmarks facilitate precise clinical assessments and support the development of customized treatment protocols, improving healthcare outcomes for vestibular dysfunctions.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-024-05043-6.

Otosclerosis is a common cause of hearing loss, yet diagnosing it remains a challenge. Wideband Tympanometry Absorbance (WTA) has been proposed as a potential tool for improving diagnostic accuracy. The aim of study was to investigate the diagnostic value of WTA in diagnosing otosclerosis by comparing its results in patients with clinically diagnosed otosclerosis and a normal control group. This prospective study was conducted in Mashhad, Iran, from 2022 to 2023, involving 64 participants including otosclerosis and control. Inclusion criteria for the otosclerosis group included a clinical diagnosis of otosclerosis confirmed by audiometric tests and conventional tympanometry, and eligibility for surgical intervention. The control group consisted of individuals with normal clinical audiometric and tympanometric results. Both groups underwent conventional and WTA tympanometric assessments. The evaluation of WTA involved 64 participants, divided evenly between otosclerosis a normal ears group. Conventional tympanometry at 226 Hz showed significant differences in compliance between otosclerosis and normal ears (p = 0.02). In contrast, at 1000 Hz did not demonstrate significant differences in compliance (p = 0.2). Also, WTA did not demonstrate significant differences in compliance (p > 0.9). Measurements of gradient and resonance across both 226 and 1000Hz frequencies showed no statistically significant differences. The sensitivity and specificity of WTA, evaluated through compliance, were 72% and 40%, respectively, with an area under the curve of 0.50. The study illustrates that while conventional tympanometry is effective in distinguishing otosclerosis from normal tympanic conditions, WTA shows limited diagnostic efficacy. The moderate sensitivity and specificity of WTA suggest that it should not be relied upon as the sole diagnostic tool.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-024-04876-5.

Recently artificial intelligence (AI) platforms have developed at a rapid pace. To date no studies have explored AI platform ChatGPT's ability to serve as an aid in research in the field of otolaryngology. The objective of our study is to evaluate the ability of ChatGPT to generate unique research ideas relevant to Otolaryngology. ChatGPT was tasked to generate novel research project ideas. Seven categories for all otolaryngology subspecialties were created: general otolaryngology, facial plastics and reconstructive surgery, rhinology and skull base surgery, pediatrics, head and neck oncology, laryngology, and otology/neurotology. Within each of the subspecialties, ChatGPT was prompted to provide research ideas for two specific research topics in order to gauge ChatGPT's ability to explore specific domains. Ten prompts were entered for general otolaryngology, and five prompts were entered for each subspecialty and subspecialty topic. ChatGPT was subsequently prompted with the same query to generate systematic review ideas for each category. Ideas were deemed novel if there were no similar systematic reviews retrieved during the literature review on PubMed, Scopus, or Web of Science. Ideas were graded for Clinical Relevance on a scale of 0 to 5, 5 being considered highly relevant/would contribute greatly to patient care and 0 being considered not relevant/not beneficial to patient care. Two reviewers graded each response. Out of 100 systematic review ideas generated by ChatGPT, we found that the artificial intelligence platform was incapable of creating unique systematic review research ideas. However, the ideas that it did generate were largely feasible and clinically relevant. Future studies should investigate the ability of ChatGPT to generate research inquiries with non-systematic review methodologies and in more specific otolaryngology topics.

Angina Bullosa Hemorrhagica is characterized with rapid appearance of soft, blood-filled blisters on the mucosa of oral cavity and oropharynx. It is a benign condition, and is not associated with any systemic hematological disorder. No etiological factors have been identified and there are no established guidelines for its management. The current case report describes the sudden appearance of large, bluish, soft lesion on the soft palate which was managed with incision and drainage, and healed completely over the next three weeks.

Introduction: In recent years, research on the effect of blood group on hearing function has gained more attention. Some blood groups show susceptibility to certain general health and auditory disorders like noise induced hearing loss, infections, coronary artery disease, gastric carcinoma and duodenal ulcer.

Aims: The present study aimed to determine the differences in middle ear and cochlear function among persons with different blood groups (AB, A, B, O).

Materials and methods: Sixty adults (18-24 years) with normal hearing sensitivity were included in the study. They were divided into four groups based on blood groups (A, B, AB, O) with 15 participants each. High-frequency thresholds, distortion product otoacoustic emissions (DPOAE) and resonance frequency were measured. High-frequency thresholds for both ears were measured at octave frequencies from 9 kHz to 16 kHz. Resonant frequency was determined using sweep frequency method.

Results: The findings demonstrated that individuals with blood group AB and O had considerably lower DPOAE amplitudes. Resonance frequency and extended high frequency thresholds did not, however, differ significantly between the blood groups.

Conclusion: The decrease in the amplitude of otoacoustic emissions (OAE) can be explained by a reduction in the quantity of robust outer hair cells and elevated protein levels, which in turn lead to a reduction in the cochlear blood flow in persons with blood type O and AB, respectively. More research with greater numbers of participants is necessary to improve the generalization of the findings.

Orbital involvement in Sinonasal tumours most commonly present as proptosis, epiphora and/or visual symptoms. We aimed to enumerate the orbital manifestations of Sino nasal tumours, to describe strategies employed to manage orbit and vision, to evaluate outcomes, vision preservation and survival rates. This retrospective study spanning ten years identified 147 Sino nasal pathologies with clinic-radiological involvement of the orbit. Of the 147 cases, 35 were diagnosed as Sino nasal tumours with orbital involvement. Patients with sinonasal symptoms without clinical involvement of orbit and those with primary orbital pathology were excluded. Of the 35 patients, histopathology revealed benign and malignant tumours in 17(48.6%) and 18(51.4%) patients respectively. Inverted papilloma and squamous carcinoma were the most common benign and malignant diagnoses, respectively. Proptosis was the most common orbital symptom (42.9%) and reduced ocular motility were noted in 22.8%. Orbit preservation was achieved in all 17 cases with benign disease. Among those with malignant disease, 15 (83%) underwent globe-sparing surgeries and 3(17%) underwent orbital exenteration. Normal orbital function was retained in 6(33%) of the 15 patients. Orbital involvement in sinonasal tumours can be indicators of either chronicity or aggressive disease course. Compressive symptoms were common in benign aetiologies. In our series, orbital preservation was obtained in resection of all benign tumours. Orbital preservation was achieved in most patients with malignant disease. Histology, extent of surgery and follow up determined overall outcome in these patients.

Malleus has a catenary lever mechanism in sound transmission in a normal ear leading to better acoustic signal at the footplate. However, the literature is rife with controversy regarding its role in ears where hearing has been restored using a prosthesis. Though the presence of malleus has prevented lateralization of graft in reconstructed middle ear, consensus on role of malleus on outcomes of ossiculoplasty malleus is still unclear. It's a prospective longitudinal study with 60 patients randomised into two groups. Both the groups had reconstruction done with TORP. In one group malleus was preserved (M +)and placed over the TORP using malleus relocation technique while in another group malleus was intentionally removed(M -). Both the groups were compared for Improvement in hearing, AB gap and stability of the implant. Age group more than 40 years was most affected in both groups followed by age group between 15 and 30 years. There was equal incidence of males and females in (M -) group and Incidence of Females was 60 percent versus 40 percent males in (M +) group. Preoperative PTA of moderate conductive hearing loss (40-55db) was most found followed by severe conductive hearing loss (> 55db) with standard deviation of 7.155 and mean hearing loss was 46.30db in (M +) group. Post operative pure tone averages improved to mild hearing loss (26-30db) in about 90percent of patients with mean of 32db and standard deviation of 7.06 in (M +) group Preoperative PTA of severe conductive hearing loss (> 55 db.) was most found followed by moderate conductive hearing loss (45-55db)with standard deviation of 6.471 and mean hearing loss was 47 db in (M-)group.Post operative pure tone averages improved to mild hearing loss (26-30 db.) in about 90 percent of patients with mean of 33 db and standard deviation of 5.431 in (M -) group. The average reduction in AB gap in (M +) was 22.61db with std deviation of 0.08 while in (M-) it was 17.61 with std deviation of 2.0.). The difference for improvement in hearing between both the groups was not statistically significant. The intergroup reduction in AB gap was also statistically insignificant. The extrusion was seen in 1 case in (M +) and 6 cases in (M-). This difference between both the groups was statistically significant. If malleus is used by an otologist to stabilize the implant its role becomes significant in long term outcomes of ossiculoplasty, however it doesn't contribute as far as hearing improvement or reduction AB gap is concerned.

Audiologists are hearing healthcare specialists dedicated to the rehabilitation of individuals with hearing loss by prescribing the appropriate amplification devices. The process of choosing and fitting hearing aids involves several steps for which standardized guidelines have been issued. The aim of the present investigation was to evaluate the patterns of practice employed by Indian audiologists in the evaluation and fitting of hearing aids for adults. The survey was conducted using an Online questionnaire and distributed to Audiologists practicing in different parts of India via Google form link between April-August 2020. In all, 158 Audiologists participated in the study. The questionnaire consisted of 48 questions distributed over seven domains which included Respondent's Profile, Hearing aid fitting experience with Adults, Assessment protocols, Hearing aid selection, Hearing aid fitting, Hearing aid verification, and Skills and Confidence levels of Audiologists. The findings of the study revealed varying practice trends, particularly during the stages of hearing aid verification and validation. There were also differences in the Audiologists' proficiency and confidence in carrying out the various stages of fitting hearing aids.