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

This study aimed to investigate patterns of recreational noise exposure among youth (15 to 24 years of age), inquire about early signs of hearing loss, and assess awareness and attitudes towards hearing protection. An observational cross-sectional study was conducted among individuals aged 15 to 24 years using a structured questionnaire. The survey included participant demographics, otological complaints, usage patterns of personal listening devices, engagement in recreational activities involving noise exposure, and awareness and attitudes towards hearing protection. Data were collated and analysed. Among the 792 participants, the mean age was 20.73 years, with 46% females and 54% males. Diagnosed chronic ear disease was reported by 5.1% of participants, while 8.6% had documented hearing loss. Tinnitus was experienced by 5.8%, and ear discharge by 4.8%. Nearly all participants (98.7%) used earphones daily, with a majority preferring in-ear devices. Active noise cancellation was used always by 20.2%, and sometimes by 20.7%. Regular use of audio speakers was reported by 47.47%. The mean loudness level for personal listening devices was 5.78 on a 10-point scale. Engagement in recreational activities involving noise exposure included music listening (89.90% participants), watching entertainment content (70.45% participants), academic engagements involving use of personal listening devices (66.16% participants), and watching instructional videos (57.07% participants). Additionally, 32.32% regularly engaged in activities involving exposure to loud noise bursts, and 60.1% encountered continuous disturbing environmental noise. Early indicators of hearing impairment were common, with 411 individuals (56.15%) frequently or consistently experiencing one or more symptoms suggesting the same. A majority of participants (89.6%) were aware of the hazards associated with loud sounds, yet only 25.8% used hearing protection in loud environments. After learning about the effects of loud sounds, 79.8% expressed willingness to use hearing protection. The study highlights significant non-occupational noise exposure and early symptoms of hearing loss among youth. Despite high awareness of noise hazards, the use of hearing protection remains low. Educational interventions are needed to emphasize the importance of safe listening practices and hearing conservation measures to mitigate the risk of noise-induced hearing loss in youth.

Despite a rise in the number of cochlear implant (CI) surgeries, limited data is available to date in the Indian settings, on the use of postoperative imaging to confirm intracochlear position of CI electrode array. The current study aims to evaluate the incidence of post-implantation complications related to surgical placement of CI electrode array, as identified on postoperative plain radiographs (X-rays). It also compares the occurrence of such complications amongst different CI manufacturers. The retrospective, observational study incorporated 469 patients (paediatric and adult), who underwent 478 primary cochlear implantations at a tertiary- care CI centre in India, between January 2006 and December 2023. Postoperative day one X-rays were evaluated to check the post-implantation intracochlear position of CI electrode. Angular insertion depths of electrode arrays were measured. Comparison of incidence of electrode related issues was performed amongst devices from four different CI manufacturers used in the study. Postoperative day one X-rays demonstrated normal intracochlear electrode array placement in 93.7 % (448) of the cochlear implantations; whereas electrode-related issues such as kink, incomplete insertion, tip fold-over, basal fold-over, migration and misplacement were identified in 6.3% (30) of the implantations. The percentages of postoperative X-ray abnormalities identified in CI electrodes from Cochlear™ Nucleus® (10.2%) and Oticon Medical (10.5%) were significantly higher than those identified in electrodes from MED-EL (3.8%) and Advanced Bionics (3.7%, p value < 0.05). Assessment of postoperative X-ray findings following CI surgeries conducted over the past 17 years, revealed a statistically significant decline in the overall percentage of electrode-related abnormalities from 12.9% in the years before 2010 to 5.7 % in the subsequent years after 2010 (p-value < 0.05). This study conducted in a large cohort of Indian patients, reiterates that postoperative plain radiography is a simple, reliable, cost-effective imaging technique that can be employed in the Indian settings, to ascertain the post-implantation intracochlear position of CI electrode. Postoperative imaging facilitates optimisation of CI surgery outcomes and leads to timely performance of revision surgeries for correction of electrode position; wherever indicated.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05555-9.

This study aims to compare the efficacy of cartilage and temporalis fascia grafts in endoscopic tympanoplasty, focusing on graft uptake success rates and postoperative hearing outcomes. A prospective interventional randomized study was conducted from 2022 to 2024 in a tertiary care hospital, involving 60 patients aged 18-60 years with chronic otitis media (COM), tubotympanic type of disease. Patients were randomly divided into two groups: 30 underwent tympanoplasty with temporalis fascia grafts, and 30 received cartilage grafts. All surgeries were performed endoscopically using the transcanal approach. Graft uptake success was assessed postoperatively at 1, 3, and 12 weeks. Hearing outcomes were evaluated by comparing preoperative and postoperative air-bone gap (ABG) and pure-tone average (PTA) values at 500 Hz, 1 kHz, 2 kHz, and 3 kHz. Cartilage grafts provide superior structural stability and higher graft uptake success rates, while temporalis fascia grafts offer marginally better short-term hearing outcomes. Both materials significantly improve hearing, but cartilage exhibits greater resistance to re-perforation and long-term durability. The choice of graft material should be tailored to patient-specific factors for optimal surgical success and auditory restoration.

Intratonsillar abscess (ITA) is a rare infectious condition in both children and adults, with limited cases reported in the literature. It is often misdiagnosed due to its overlapping clinical features with peritonsillitis and peritonsillar abscess (PTA). Early recognition and appropriate management are crucial to prevent complications. We report a case of a 10-year-old boy with underlying allergic rhinitis and glucose-6-phosphate dehydrogenase (G6PD) deficiency who presented with a severe sore throat, fever, odynophagia, dysphagia, and right submandibular swelling. Examination revealed an asymmetrically enlarged right tonsil with trismus but no peritonsillar swelling. Laboratory findings showed elevated white blood cell count and C-reactive protein levels. A computed tomography (CT) scan confirmed a right intratonsillar hypodense lesion, suggestive of ITA. The patient was managed conservatively with intravenous antibiotics, analgesia, and hydration, resulting in clinical resolution without the need for surgical intervention. ITA shares clinical similarities with PTA, though trismus and voice changes are less frequent. While clinical examination is critical, imaging, particularly CT, is valuable in distinguishing ITA from other deep neck infections. Treatment primarily consists of intravenous antibiotics, needle aspiration and surgical interventions. Although rare, ITA should be considered in pediatric patients with persistent or severe tonsillitis symptoms. Prompt recognition and appropriate management, including the judicious use of imaging, can help avoid unnecessary surgical intervention while ensuring effective treatment.

Undergraduate curricula in medicine are by and large vast and may lead to early burnout. Meaningful engagement in skills training would go a long way towards not only making learning enjoyable, but also allowing the retention of basic knowledge of surgery. This study aimed to explore the sentiments among medical students regarding the learning of ENT as a subject. A principal element of this study explored the use of practical skills sessions in clinical skills labs to attain a mastery of an otherwise complex subject. A 21-point questionnaire created using Google Forms was circulated among medical students in years 3 through 5 of the MBBS course in both India and Malaysia. Demographic data as well as specific and closed questions regarding students' perception of the subject and skills training, were collated. There were also several open-ended questions about what students expect from skills training. 203 responses were recorded from India, and 103 from Malaysia, and the mean age of the participants was 23. An overwhelming majority (n = 293) felt skills training is useful, with only 2 students stating otherwise, and 10 divided on an opinion. 255 people felt that skills training should be made mandatory, while 13 stated otherwise, and 35 were not sure about this. Otoscopy emerged as the main skill to be learned in ENT. This study aimed to explore the sentiments among medical students regarding the learning of ENT as a subject. A principal element of this study explored the use of practical skills sessions in clinical skills labs to attain a mastery of an otherwise complex subject. Skills training is essential for the overall development of students.

The aim of this study is to identify, localize, and document the relationship between the AICA loop (Anterior Inferior Cerebellar Artery loop) and VII and VIII nerve complexes, and its symptomatic correlation. 50 patients with MRI Brain with 3D T2 Drive were studied from Sep 2018 to Dec 2018. Symptomatic correlation of 100 sides of the AICA loop over the VII-VIII nerve complex was analyzed prospectively. The presence of a vascular loop on MRI was correlated with the presence of neuro-otological symptoms such as sensorineural hearing loss, tinnitus, facial palsy, and vertigo. Vascular loops were present in 25 of the 100 sides, of which 24% were associated with neuro-otological symptoms whereas 76% sides were not associated with any symptoms. The 24% sides with symptoms were further investigated and were then proven to be not because of the presence of vascular loops. The presence of vascular loops in the internal auditory canal may be an incidental finding in MRIs and may not always be a causative factor for any unexplained neuro-otologic symptoms. Specific investigations are mandatory to avoid any unnecessary surgical intervention. Further studies involving a larger number of patients are required to accurately evaluate the association between these symptoms and vascular loop.

The incidence of otosclerosis is lower in yellow and black populations compared to white populations. Preoperative diagnosis and surgical indications are based on clinical features and audiological evaluations. To summarize the clinical features and analyze audiological characteristics of otosclerosis in China, aiming to improve the diagnosis and determination of surgery given its low incidence in the country. A retrospective analysis was conducted involving 80 ears (48 patients) who underwent surgery for otosclerosis from 2003 to 2023. Among the patients, 88.8% experienced tinnitus, only 2.5% had Willis paracusis, Schwarz sign was all absent, and Gellé test was negative in 98.7%. Furthermore, 31.2% of the patients did not exhibit a Carhart notch, while 63.6% had a Carhart notch at 2 kHz, and 5.2% at 1 kHz. Tinnitus is the main accompanying symptom of otosclerosis. Willis Paracusis and Schwarz sign are relatively rare in otosclerosis. The Gellé test provides reliable diagnostic criteria for otosclerosis. The presence of a Carhart notch is not definitive for diagnosing otosclerosis and does not appear exclusively at 2 kHz. Significance: P < 0.05.

To share our experience of sinonasal cancer management as a tertiary center.This is a retrospective study from a single tertiary center. The staging was performed according to the AJCC, 8th edition.A total of twenty-six patients were included in the study. The majority of the patients were male (76.9%), with the maxillary sinus as the primary tumor being predominant (80.8%), as was squamous cell histology (65.5%). T4 tumors at diagnosis accounted for 61.5% of the patients. The local recurrence rate was 23.1%. Induction chemotherapy was the initial treatment choice for 11.5% (n = 3) of the patients. Primary surgery was selected for 7.7% of the patients, and chemoradiotherapy was the treatment choice for 53.8%. The median follow-up duration was 56 months (95%CI: 29.8-82.1). The median overall survival (OS) was not reached, with 61.5% of patients remaining alive. The median disease-free survival (DFS) was not reached. Additionally, 61.5% of patients did not experience local recurrence or metastasis. Local recurrence was identified as an adverse prognostic factor for OS (NR vs 30 months, 95%CI 0.543-59.457, p = 0.037). Intracranial extension was identified as an adverse prognostic factor for DFS (NR vs. 7 months, 95%CI 0-14.321, p = 0.019).SNCs are rare and heterogeneous cancers that require a multidisciplinary management approach. Due to nonspecific symptoms, most patients are diagnosed at advanced stages. More prospective data are needed to optimize patient care.

Filariasis continues to be a significant public health problem and its parasites affect the lives of millions of people, especially those living in tropical countries, like India. It is caused primarily by Wuchereria bancrofti (90%) and in some cases by Brugia malayi and timori (10%). Even though filariasis is highly prevalent in the endemic regions, it is rarely reported from the extra lymphatic sites. Here, we are reporting the case of a 20 year-old male who presented with a left-sided post-auricular subcutaneous nodular swelling of size 3 cm × 2 cm for the past 6 months. Routine blood investigations and peripheral blood smear examinations were reported as normal. Fine needle aspiration cytology from the lesion revealed microfilaria of Wuchereria bancrofti. This case report highlights the chances of finding microfilaria from an unusual site. In the differential diagnosis of subcutaneous nodular swellings, the possibility of filariasis must be kept in mind, and a careful search should be done for microfilaria in the aspiration smears done for an accurate diagnosis.