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

Maxillary antral mucoceles are rare complications of chronic inflammation of the sinus mucosa due to infection or trauma that leads to an obstructed sinus outflow, such as allergic fungal rhinosinusitis. Treatment of choice of AFRS is medical therapy associated with functional endonasal endoscopic surgery; surgical evacuation (preferentially using endoscopic approach) of mucocele is resolutive in most cases. We think that in cases of giant maxillary mucocele Caldwell Luc approach should be avoided even in case of facial soft tissues (including the orbit) or pterygomaxillary fossa involvement, since endoscopic approach can provide adequate surgical field reducing complication rate and sequaelae.

Psychophysical measurements of T and C-levels are difficult in children. Electrically evoked Stapedial Reflex (eSRT) and Neural Response Telemetry (NRT) is an objective method to measure the same. This study aims to correlate intraoperative eSRT and NRT levels with Maximum Comfort Level (MCL) in children and ascertain its usefulness in programming a cochlear implant. Thirty children undergoing cochlear implant surgery were included. Intra-operative eSRT and NRT was measured using single electrode stimulation on third electrode. After three weeks, implant was switched on and MCL were documented. We observed a statistically significant positive correlation of eSRT (r²-0.755) and NRT (r²-0.698) with maximum comfort level. Intra-operative eSRT and NRT testing can reliably predict the behavioural MCL, and can be useful for evaluating patients who are difficult to test.

This study aims to evaluate reliability of Manekar et al. system in clinical settings by comparing and correlating it with widely used Lund & Mackay (L-M) system to quantify the severity of rhinomaxillary mucormycosis (RMM). Objectives are (a) To assess the severity of maxillary sinus disease using L-M system. (b) To assess the severity of maxillary sinus disease using Manekar et al. system. (c) To assess the severity of maxillary osteomyelitis using Manekar et al. system (d) To compare the scores of L-M and Manekar et al. system. This retrospective analytical study involved three experts reviewing CT scans of 38 RMM patients. Both Manekar et al. and L-M systems were used to grade the cases. Mean observations were calculated, and the systems were compared using Pearson's chi-squared test and Pearson correlation coefficient (PCC). The Kappa coefficient determined inter-rater reliability and variability. Kappa reliability test for Manekar et al. system showed values of k = 0.92 (left) and k = 0.94 (right), indicating perfect agreement. The correlation between Manekar et al. system and L-M system showed strong positive correlations, with PCC values of r = 0.832 (left) and r = 0.839 (right). A highly significant statistical difference was found between the two systems, as the L-M system assessed maxillary sinus involvement as a single unit, while the Manekar et al. system provided a detailed evaluation. The Manekar et al. system is reliable for evaluating maxillary sinus disease and osteomyelitis. Further research is needed to monitor disease progression and postoperative recovery using Manekar et al. system.

Thyroid surgery once referred to as "horrid butchery" due to its high risk and complexity, has transformed dramatically over the centuries. Advances in surgical techniques, along with improvements in hemostasis and nerve identification technologies, have significantly reduced the mortality associated with thyroidectomy. The advent of intraoperative nerve monitoring and visual identification using reliable anatomical landmarks has made the identification and preservation of the recurrent laryngeal nerve almost routine. However, despite these advancements, the intricate design, variable anatomy, and crucial functionality of the parathyroid glands continue to pose significant challenges, even for the most experienced and high-volume surgeons. The aim of our retrospective study is to investigate the association between thyroiditis (histopathologically diagnosed) and the occurrence of hypocalcemia in our patients who have undergone total thyroidectomy. A total of 223 patients were analyzed, divided into two groups: 102 patients without thyroiditis and 121 patients with thyroiditis. The incidence of the postoperative hypocalcemia was compared between these two groups. We have performed the statistical analysis to determine if there were any significant differences noted in the occurrence of hypocalcemia between the two groups. In the non-thyroiditis group, hypocalcemia developed in 50 of 102 patients (49.0%). In the thyroiditis group, hypocalcemia occurred in 67 of 121 patients (55.4%). Chi-square test was used to analyze the data, yielding a p-value of 0.417, which indicates no statistically significant difference in the post operative hypocalcemia incidence between patients with and without thyroiditis. Patients with thyroiditis exhibit a higher incidence of hypocalcemia, though not statistically significant compared to non-thyroiditis cases. Preoperative identification of thyroiditis, expert surgical guidance, and emphasis on tactile feedback while tissue handling reduce the risks of post-thyroidectomy hypoparathyroidism, ensure patient safety and optimal surgical outcomes.

Purpose: The evaluation of peripheral hearing organ function is vital for determining the pathophysiology of tinnitus and for establishing appropriate treatment strategies. This research seeks to investigate cochlear functions in tinnitus patients, irrespective of whether they have hearing loss.

Methods: In this study, participants suffering from tinnitus were divided into two groups: the first study group (SG-I) consisted of 20 individuals who had associated hearing loss (HL). In contrast, the second group (SG-II) included 20 individuals without hearing loss. A control group (CG) was formed with 20 normal-hearing participants who did not have tinnitus. The tinnitus-related discomfort levels were evaluated using the Tinnitus Handicap Inventory (THI). Alongside pure-tone audiometry, Otoacoustic Emissions (OAE) were conducted to assess cochlear functions and to identify any dead regions (DR). Additionally, Threshold Equalizing Noise (TEN) was employed in the evaluation.

Results: The analysis revealed a threshold shift in subjects from SG-I when evaluated using Transient Evoked Otoacoustic Emissions (TEN), with these levels showing statistically significant differences from both SG-I and the control group (CG). Furthermore, SG-I exhibited both threshold shifts and distortion responses (DR) as indicated by TEN. In contrast, Transient Otoacoustic Emissions (TEOAE) did not present any significant differences between SG-II and CG. The findings for Distortion Product Otoacoustic Emissions (DPOAE) in SG-II demonstrated significant decreases in emission amplitudes at 6 and 8 kHz.

Conclusion: Conventional testing methods are suitable for evaluating tinnitus patients with hearing loss. Nevertheless, for patients with normal hearing experiencing tinnitus, the use of additional assessments such as Otoacoustic Emissions (OAE) and Tone-Evoked Noise (TEN) enables a more precise evaluation of the peripheral hearing mechanisms. The limited or absent otoacoustic emissions (OAEs) observed in the SG-I group indicate a potential reduction or loss of functionality in the outer hair cells (OHC) at the tested frequency. In contrast, an increase in the thresholds of the tone-equalizing noise (TEN) test points to a possible dysfunction in the inner hair cells (IHC).

This study aimed to explore the potential causal relationship between anxiety-depression and tinnitus using a bidirectional mendelian randomization (MR) approach. Utilizing genetic data from five UKB datasets, one IEU dataset, one EBI dataset encompassing traits linked to anxiety and depressive states, and tinnitus data sourced from the FinnGen project, we conducted two-sample MR analyses. Instrumental variables were selected based on stringent criteria, including genome-wide significance, clumping to ensure independence, and the exclusion of palindromic Single Nucleotide Polymorphisms and those associated with confounders. The primary MR analysis employed the Inverse Variance Weighted method, supplemented by sensitivity analyses using the Weighted Median and MR-Egger methods, to address potential pleiotropy. MR analyses suggested a genetic correlation between anxiety-depression and an increased risk of tinnitus. These findings were robust across various sensitivity analyses, including MR-Egger and MR-PRESSO, which supported the absence of pleiotropy and outliers. No evidence of reverse causality was found, strengthening the argument regarding the unidirectional influence of psychological factors on tinnitus. Our results indicate that a genetic predisposition to anxiety and depression can significantly enhance the risk of developing tinnitus. This finding the integration of psychological assessments and interventions in the management of tinnitus, highlighting the importance of addressing mental health components in auditory conditions. Further studies are required to explore these associations in more diverse populations and refine the mechanisms underlying these relationships.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05618-x.

Tinnitus, defined as the perception of sound without an external acoustic stimulus, has a multifactorial etiology, including metabolic, vascular, and neuro-otological factors. Microvascular dysfunction has been proposed as a possible mechanism in its pathogenesis. This study aimed to investigate whether changes in hematological parameters-specifically mean platelet volume (MPV), neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR)-are associated with tinnitus. In this retrospective case-control study, 100 patients aged 18-59 with tinnitus and 100 age- and sex-matched healthy controls were included. Controls underwent hearing screening during the same period. Subjects with hearing loss, anatomical ear abnormalities, or systemic diseases were excluded. Hematological values including hemoglobin, neutrophil, lymphocyte, platelet counts, MPV, NLR, and PLR were recorded and compared between groups. Neutrophil and lymphocyte counts were significantly higher in the tinnitus group. However, both NLR and PLR values were significantly lower in these patients compared to controls (p < 0.05). The tinnitus group also had a significantly higher mean age and a greater proportion of female participants. Elevated neutrophil and lymphocyte levels may suggest an inflammatory or vascular role in tinnitus. However, the lower NLR and PLR findings complicate this interpretation, implying that other mechanisms may also be involved. Hematological markers such as NLR and PLR may contribute to understanding the underlying pathophysiology of tinnitus and warrant further investigation.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05556-8.

The main aim of this study is to evaluate the hearing health of car wash and auto detailing workers. Audiologic findings of car cash and auto detailing workers in indoor and outdoor environments will be compared with normal hearing individuals. The study included 26 car wash and auto detailing workers working indoors (I-CD), 25 car wash and auto detailing workers working outdoors (O-CD) and a control group of 29 participants. All participants performed a hearing evaluation including Tympanometry, Pure Tone Audiometry (PTA), Transient Evoked Otoacoustic Emission (TEOAE) tests. Tympanometry results, a significant difference was obtained between the groups for left ear canal volume (p<0.05). Significant differences were obtained between the groups for PTA at 250 Hz, 500 Hz and 1000 Hz in the right and 500 Hz in the left ear; for TEOAE at 1000 Hz and 1500 Hz in the right and 1000 Hz in the left ear (p<0.05). Positive significant correlations were obtained between the duration of experience of I-CD workers and PTA at 500 Hz, 1000 Hz and 6000 Hz in the right and 125 Hz in the left ear; and between the duration of experience of O-CD workers and PTA at 2000 Hz in the right, 2000 Hz and 6000 Hz in the left ear (p<0.05).The synergistic effect of noise, chemical components and vibration threatens the hearing health of car wash and auto detailing workers.

Radiotherapy is commonly used in the curative treatment of head and neck cancers, serving both definitive and adjuvant roles. As oncologic outcomes improve, there is a rising occurrence of second malignancies among long-term survivors of these cancers. Radiation-induced osteosarcoma (RIOS) is an uncommon malignancy that emerges as a late consequence of radiotherapy. It usually develops within the irradiated area with a latency period of 5 to 20 years after treatment completion. However, cases of RIOS manifesting within a much shorter latency period, such as 2 years, are sporadic and highly atypical. This report presents a case of RIOS, highlighting the clinical course, diagnostic challenges, and management strategies of this aggressive secondary malignancy.

Chronic otitis media (COM) often leads to ossicular chain damage, necessitating ossiculoplasty for hearing restoration. Various prosthetic materials are available, including autologous grafts and synthetic materials like titanium, hydroxyapatite, and teflon. However, the comparative efficacy of these materials in ossiculoplasty remains unclear. This study aims to evaluate and compare the efficacy of different prosthetic materials used in ossiculoplasty. A systematic review and network meta-analysis were conducted, adhering to PRISMA guidelines. Studies comparing at least two different prosthetic materials in ossiculoplasty were included. Postoperative hearing outcomes were the primary focus measured at long-term follow-up (6-12 months). A Bayesian framework was used for the statistical analysis, incorporating both direct and indirect comparisons through a random-effects model. Seventeen studies with a total of 1,273 patients were included. Titanium and hydroxyapatite prostheses showed similar air-bone gap (ABG) outcomes, with mean effects of 16.00 dB but varying confidence intervals. Autologous and teflon showed the best air conduction (AC) outcomes with 31.00 and 32.00 dB respectively. In terms of bone conduction (BC) autologous and hydroxyapatite demonstrated similar results (18.00 dB). This network meta-analysis provides the first comprehensive comparison of prosthetic materials used in ossiculoplasty, demonstrating that autologous offers superior outcomes in AC and BC, while hydroxyapatite and titanium perform similarly in ABG closure. Despite these findings, no single prosthesis emerged as definitively superior across all outcomes, emphasizing the need for individualized prosthesis selection based on patient-specific factors. Further research with head-to-head trials and long-term follow-up is needed to optimize ossiculoplasty outcomes.