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

Tongue hemangiomas, though benign, can lead to significant complications and discomfort in affected individuals. This case report details the management of a symptomatic tongue hemangioma using multiple injections of 3% boiling saline in a 13-year-old boy treated at a peripheral government hospital in India, emphasising the approach's efficacy and practicality within a financially constrained environment.

With conformal radiotherapy techniques, acute and late toxicities can be reduced because of significantly better dose conformity and reduced doses to normal tissue. With Intensity Modulated Radiation Therapy (IMRT) further dose escalation is possible. To evaluate clinical outcomes and patterns of failure after IMRT-SIB (Simultaneous integrated boost)/(Volumetric modulated arc therapy) VMAT technique in nasopharyngeal cancer patients. It is a retrospective analysis of 60 nasopharyngeal squamous cell carcinoma patients, treated with IMRT/VMAT radiotherapy and chemotherapy to primary and bilateral cervical nodes from March 2017 to December 2021. 60 patients received definitive treatment using IMRT-SIB. Patients were monitored during and after treatment for local and regional failure, distant metastasis, locoregional progression free and overall survival. Patient characteristics: median age 45; 75% male; 6.7% Stage I, 18.3% Stage II, 43.3% Stage III, 31.7% Stage IVA. The median follow up was 24.5 months (range 5.5-75.6). The 2-year local control, regional control, distant metastasis free, locoregional progression free and overall survival rates are 81.5, 82.9, 86.9, 77.7, 92.9%, respectively. 11 patients failed at the local site and 10 patients failed at regional sites, median time to failure was 12.2 months. The 5-year estimated regional control rate for N0 vs N + disease was 100% vs 74.2%(p-0.07). IMRT-SIB is a safe and acceptable treatment option for patients with carcinoma nasopharynx. The pattern of local failure within the target volume suggests locally advanced T stage disease may require a higher biologic dose to gross tumor.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05539-9.

This study aims to compare the microbial profiles and antibiotic resistance patterns in chronic otorrhea patients with and without surgical intervention, identifying key differences to guide personalized and evidence-based treatment strategies. A retrospective analysis of 120 patients diagnosed with chronic otitis media and otorrhea was conducted. Patients were divided into operated (n = 60) and non-operated (n = 60) groups. Microbial identification and antibiotic susceptibility testing were performed using standard microbiological methods. Statistical analyses assessed differences in microbial prevalence and resistance patterns between groups. Pseudomonas aeruginosa was the most common microorganism in both groups but was significantly more prevalent in the non-operated group (77.8% vs. 53.33%, p < 0.05). Escherichia coli was significantly higher in the operated group (17.78% vs. 3.7%, p < 0.05). Staphylococcus aureus showed no significant difference in prevalence but exhibited resistance exclusively in the operated group. Antibiotic resistance to Ciprofloxacin, Ceftazidime, and Ticarcillin-Clavulanate was high for Pseudomonas aeruginosa in both groups, with no significant differences. Escherichia coli displayed significantly higher resistance to Ampicillin-Sulbactam in the operated group (75.0% vs. 0%, p < 0.05). Operated and non-operated groups showed distinct microbial profiles and resistance patterns. Surgical interventions influence resistance development, particularly in Escherichia coli and Staphylococcus aureus. These findings underscore the importance of routine susceptibility testing to guide effective, individualized treatment and address multidrug-resistant pathogens.

Tinnitus, a condition characterized by the perception of ringing or buzzing in the ears, affects millions of individuals worldwide, often leading to significant distress, impaired quality of life, and mental health concerns. Despite the widespread nature of tinnitus, effective treatment strategies remain limited, with few established guidelines for management. Recent studies suggest that Physical Activity may play a role in modulating tinnitus severity and perception, providing potential relief for sufferers. This scoping review aims to systematically explore the current body of evidence regarding the impact of physical activity on idiopathic tinnitus, specifically focusing on its effects on severity, perception, and related symptoms. Through an extensive search of databases such as PubMed, Scopus, and Web of Science, studies were examined on investigating various forms of physical activity, including aerobic exercises, resistance training, yoga and mind-body interventions. Key outcomes assessed include changes in tinnitus loudness, annoyance, and quality of life. The review also highlights potential physiological mechanisms underlying the observed effects, including the modulation of neuroplasticity, stress reduction and the improvement of cardiovascular and musculoskeletal health. Preliminary findings indicate that regular physical activity may offer a beneficial adjunctive approach to idiopathic tinnitus management, particularly for individuals with comorbid conditions such as anxiety, depression, and sleep disturbances. However, the current evidence is limited and heterogeneous, underscoring the need for further well-designed clinical trials to better define the optimal types, intensity, and duration of physical activity interventions.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05594-2.

COVID 19 pandemic has had its effect on the entire world population. The purpose of the study was to perform Epidemiological and Head Neck site wise assessment of Tuberculosis (TB) presentation and investigation during and immediately after the COVID 19 pandemic. The changing incidence and atypical presentations were documented. Institution based retrospective study was conducted and the data of Head Neck TB (HN- TB) was extracted from the patient registers of National Tuberculosis Elimination Programme (NTEP) of the same institute during the period of March 1st 2020 to 31st December 2022. Statistical analysis was done to satisfy the investigative purpose. In the study period 2118 patients were registered for TB. 279 patients were diagnosed with HN-TB as the primary site of involvement. Cervical Lymph node TB was the predominantly involved site followed by Head Neck Skin, Ear, Larynx, Ophthalmological structures, Facial bones, Oral cavity and Oropharynx, Neck sinus. The Incidence of TB as a whole and HN- TB saw uneven rise and fall with respect to its incidence during and after the pandemic. There were definite variations in the incidence of site specific involvement of HN- TB when compared to world literature. Changing disease dynamics comes as a challenge before NTEP amidst the prevailing pandemic. No particular investigation is full proof to detect tuberculosis and so, attempts should be made to maximise the number of detection options. Lessons should be learnt from the present situation to keep us prepared for the future.

Chronic otitis media is inflammation of mucoperiosteal lining of medial ear cleft which leads to bacterial colonization which inturn releases enzymes and toxins. Chorda tympani have an unprotected course in the middle ear running across the tympanic cavity from its posterior to anterior wall, supplying anterior two third of tongue making it easily amendable to the enzymes, cytokines and bacterial toxins released in the middle ear reflecting in its function. In this survey we have studied the impact of early surgical intervention on chorda tympani nerve's function in patients with chronic otitis media. In this study we included 90patients with COM fit for surgical intervention who were divided into 3groups based on the duration of the disease as < 5 years, 5-10 years and > 10 years. Each group were evaluated for 5different taste sensations over the anterior 2/3rd of tongue bilaterally by assigning a score of 0-15 preoperatively, 2 weeks postoperative and 8 weeks postoperatively and scores compared. It was noted that left side preponderance for the disease was more than right with a male predominance of 54.4%. Patients with history for < 5 years showed better improvement curve during postoperative follow-up when compared with the other two groups and least improvement noticed in the group with COM history for > 10 years.Similarly participants with more duration of dry ear showed better results. Early surgical intervention can prevent further deterioration of the nerve function and helps in achieving its complete recovery.

The therapeutic approach for buccosinusal fistula (BSF) requires careful consideration of factors such as infection status, bone defect size, and epithelialization. The literature describes three primary treatment options: vestibular flap, buccal fat pad, and palatal flap. This study aims to report a clinical case of recurrent BSF after five surgical interventions and review current literature on treatment modalities. A 42-year-old female patient underwent extraction of the upper left first molar, followed by alveolar bone grafting, evolving into buccosinusal communication (BSC). Over 45 days, she underwent five surgical interventions using the vestibular flap technique, which failed to prevent epithelialization and led to aesthetic and functional complications, such as facial asymmetry and displacement of the parotid papilla. As an alternative, a rotated split palatal flap was employed. After six months of follow-up, complete closure of the BSC was observed, with no signs of sinus pathology or raw areas at the donor site, indicating satisfactory healing and successful treatment. Literature shows that while vestibular flaps are commonly used, they often fail in large or recurrent defects due to tension and limited vascularization. Buccal fat pads offer good coverage but may not suffice for extensive areas. Palatal flaps stand out for their robust blood supply from the greater palatine artery, thicker tissue, and high success rates, particularly in previously treated cases. Thus, they are strongly indicated for refractory BSF cases. The palatal flap is an effective, reliable alternative for BSF management, especially in complex cases.

Introduction: Tinnitus, defined as the perception of sound without an external stimulus, affects approximately 10-15% of the world population, often resulting in significant emotional and functional impairments. Despite advancements in diagnostic approaches, the relationship between subjective tinnitus severity and objective auditory brainstem response (ABR) findings remains poorly understood. This study evaluates these associations to enhance understanding of tinnitus pathophysiology and formulate clinical practice.

Methodology: This prospective, observational study included 50 adults (aged 18-65 years) with chronic tinnitus lasting six months or longer and normal, mild, or moderate hearing loss (hearing thresholds ≤ 55 dB HL), as determined by pure-tone audiometry. Tinnitus severity was assessed using the Tinnitus Functional Index (TFI), evaluating domains such as intrusiveness, emotional distress, and quality of life. Auditory brainstem response (ABR) testing analysed wave latencies (I, III, V) and inter-peak intervals (I-III, III-V, I-V). Correlations between TFI scores, ABR parameters, and demographic factors, including age and tinnitus duration, were examined.

Results: TFI scores demonstrated severe impacts on quality of life, intrusiveness, and emotional distress. ABR testing revealed abnormalities in 25% of participants, particularly prolonged Wave V latency and I-V interval. Significant correlations were observed between Intrusiveness and Wave V latency (r = 0.35, p = 0.018) and between Emotional Distress and the I-V interval (r = 0.40, p = 0.010). Older participants and those with longer tinnitus duration exhibited higher severity and more pronounced ABR abnormalities.

Conclusion: This study establishes a significant association between subjective tinnitus severity and objective auditory brainstem dysfunction, emphasizing the neural basis of tinnitus. The findings highlight the importance of integrating subjective and objective assessments in clinical evaluation to guide personalized therapeutic strategies.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05616-z.

Trigemino-abducens synkinesis is a rare neurological condition scarcely discussed in the current bibliography. The few cases are related to synkinesis involving the masticatory muscles, but there are no reports associated to the malleolar muscle. We report a 56 years old woman with annoying feeling inside the right ear when she looks to the same side. Examining this ear, we can identify some eardrum movements when the patient looks to the right. We diagnose this synkinesis and we offer a surgical solution after the poor efficacy of the neurological treatment.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05584-4.

Sinonasal tumors are an uncommon pathological entity, often presenting with overlapping clinical and radiological features, which makes their diagnosis particularly challenging. Less than 2% of these are vascular tumors, with their diagnoses ranging from benign to malignant conditions. Even with advanced imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), which provide a near-accurate picture of the extent of the disease, distinguishing them between benign and malignant vascular tumors remains difficult. We present the case of a 42-year-old female who experienced a year-long history of nasal obstruction, severe headache, and intermittent unilateral nasal bleeding. Imaging revealed a highly vascular sinonasal tumor, raising the possibility of benign vascular neoplasms, though malignant tumors were also considered a rare differential. Subsequent surgical excision and frozen section analysis revealed a poorly differentiated sinonasal squamous cell carcinoma. However, postoperative histopathology confirmed the diagnosis of Olfactory Neuroblastoma. The patient underwent combined surgical resection followed by postoperative chemotherapy. This case report highlights the challenges associated with the diagnosis of sinonasal tumors and the significance of histopathological evaluation as the key to unveil the final diagnosis.