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

Surgical techniques for benign vocal cord lesions, such as vocal cord polyps, have witnessed rapid technological advancements. It is imperative for developing nations like India to keep pace with this evolving technology. Our study compares two recently introduced modalities of vocal cord polyp treatment, assessing both subjective and objective outcomes. A randomized controlled trial was conducted at a tertiary care centre in Northern India, enrolling 20 patients in the laser excision group and another 20 in the plasma ablation group for the treatment of benign vocal cord polyps. The study involved detailed subjective assessments using the GRBAS scale and VHI tools, along with objective measurements using Maximum Phonation Time (MPT). Additionally, Videostroboscopy was also performed for all patients both before and after the surgical procedure. Thorough assessment of the GRBAS score and VHI revealed substantial improvement postoperatively (p < 0.0001) in vocal cord polyp patients undergoing both laser and plasma ablation. Notably, laser ablation demonstrated superior subjective improvement compared to plasma. (p < 0.0001). Furthermore, aerodynamic evaluations, such as MPT, exhibited enhancement in both subgroups following the procedure. Videostroboscopic findings indicated comparable improvements in both subgroups. Our study concluded that both microlaryngeal plasma ablation and laser excision are effective surgical modalities for managing vocal cord polyps. Both procedures led to improvements in subjective and objective outcomes, with patients expressing higher satisfaction levels with laser excision.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05632-z.

Balloon sinuplasty is an innovative, minimally invasive technique for chronic rhinosinusitis in the field of endoscopic rhinology. Balloon sinuplasty has a good outcome and is an effective tool in the treatment of various sinus pathologies. The aim of the study is to assess the efficacy of balloon sinuplasty in chronic rhinosinusitis patients compared to Conventional Functional Endoscopic Sinus Surgery (FESS) with limited diseases based on our own experience. In our prospective comparative study, we included 75 patients with chronic maxillary sinusitis who did not respond to medical therapy. The selected 75 patients were randomly divided into two groups regardless of age and sex, labeled as Group A and Group B. The Group A patients underwent balloon sinuplasty and were compared with Group B patients who underwent Conventional FESS with the same surgery team. The study compared the outcomes of Balloon Sinuplasty and Conventional FESS. Results showed no significant difference in Lund Mackay scores or SNOT-22 scores between the two procedures. Balloon Sinuplasty took less time and showed less blood loss during surgery compared to Conventional FESS. Balloon Sinuplasty also showed better post-operative ostium status, fewer synechiae, and improved post-operative symptom scores. Balloon sinuplasty is a minimally invasive sinus surgery in rhinology compared to Conventional FESS. Despite its limitations, it is considered an effective method for opening blocked sinus ostia and restoring sinus drainage.

Schwannomas arising from the transverse cervical nerve is a rare entity, with no documented cases in the literature. These tumours pose diagnostic challenges requiring detailed clinicoradiological evaluation and histopathological confirmation. We present a successfully resected schwannoma of transverse cervical nerve schwannoma in a 44-year-old female.

Oral potentially malignant disorders (OPMD) are heterogeneous mucosal lesions of the oral cavity that have a higher chance of developing into malignancy, such as oral squamous cell carcinoma (OSCC), in contrast to their normal and other diseased counterparts. Information on diagnosed cases of OSCC and OPMDs at different grading stages was stored in the department's archives. The diagnosis was assessed and confirmed by two oral pathologists. They were sent for immunohistochemical examination after receiving their individual formalin-fixed, paraffin-embedded (FFPE) samples from the Department's archives. Accordingly, this study discovered that the BRCA2 gene, also known as the tumour suppression gene (TSG), was expressed in cases of OSCC and OPMDs. The results showed that when grade or severity increased, neither group's expression of this gene changed. We therefore conclude that a large number of studies with sample sizes would be necessary to confirm the findings, as well as to employ new tissue samples to confirm the expression of the BRCA2 gene and to incorporate methods like qPCR and Western blot (WB).

Solitary fibrous tumor (SFT) is a rare mesenchymal tissue neoplasm that can occur at all anatomic sites, commonly at the pleura. This uncommon mesenchymal tumor can arise in various soft tissues and organs throughout the body, primarily affecting adults and rarely seen in children. In the head & neck region, frequent sites involved are oral cavity, sinonasal tract and orbit. Histopathologically, these tumors are characterized by uniform, spindle-shaped to ovoid fibroblastic cells and a distinctive staghorn vascular pattern. Immunohistochemical analysis reveals that the tumor cells are consistently positive for CD34 and STAT6 in nearly all cases. In this article, we present a rare case of a solitary fibrous tumor located in the mandibular lingual gingiva of a 35-year-old female, with supporting immunohistochemical evidence.

Objectives: This study aims to compare the clinical profiles, outcomes, and mortality-related risk factors of COVID-19-associated mucormycosis (CAM) with cases identified before the pandemic. Additionally, it seeks to evaluate the impact of the COVID-19 pandemic on the epidemiology and severity of mucormycosis infections.

Study design: Retrospective, observational study.

Setting: The study was conducted across multiple medical centers in Shiraz, Iran.

Methods: We reviewed clinical data of patients diagnosed with mucormycosis before and during the COVID-19 pandemic. The study included a detailed analysis of demographic profiles, clinical characteristics, risk factors, treatment outcomes, and mortality. Mortality-related risk factors were specifically analyzed through logistic regression models to identify predictors of poor outcomes in CAM patients.

Results: The study included 122 cases of mucormycosis, with 85 cases associated with COVID-19. Patients with CAM showed higher prevalences of diabetes mellitus and hypertension compared to pre-pandemic cases, while malignancies were higher in peri-pandemic cases than in CAM cases (p < 0.05). CAM cases also demonstrated significantly higher in-hospital mortality (23.1%) compared to pre-pandemic cases (7.7%). Elevated platelet counts and the presence of periorbital edema were more commonly observed in CAM patients. Mortality-based analysis indicated that malignancies and high platelet counts were significant predictors of mortality in CAM patients.

Conclusion: COVID-19 has markedly affected the severity and mortality of mucormycosis, with CAM cases showing worse outcomes than pre-pandemic incidences. Our study emphasizes the need for aggressive management and increased awareness of risk factors to enhance survival rates in CAM patients during the pandemic.

Melanocytic nevus (MN) is a common skin lesion; however, its presence in the external auditory canal (EAC) is uncommon. Following previous reports on various treatment approaches, we share our experience with endoscopic resection in managing a case of MN in EAC. A 44-year-old woman presented with prolonged ear blockage with intermittent whitish ear discharge for the past year. Single-handed endoscopic resection is effective in treating a rare external auditory canal melanocytic nevus. This report also illustrates the benefits of endoscopy in early diagnosis and management.

The lateral periodontal cyst (LPC) is a relatively rare odontogenic non-inflammatory cyst that arises in the alveolar process in close proximity to the roots of vital teeth. LPC is considered to be an odontogenic cyst of developmental origin that arise in close proximity to the periodontal space of teeth, with the exclusion of an inflammatory pathogenesis. LPC is most frequently observed in the premolar region of the mandible, followed by the maxillary incisor region. It is preferentially diagnosed in individuals aged between 40 and 70 years, although it may be occasionally diagnosed in patients outside this age range. LPC is usually asymptomatic and it is usually found by a combination of a clinical finding of a gingival swelling in the facial or lingual aspect of a tooth and of a radiographic finding. The involved teeth are usually vital. The radiographic feature of LPC is a well circumscribed ovoid-round radiolucent area, usually with a less than 1 cm diameter. The aim of the present article is to present an unusual case of LPC in the molar region in a 10-year-old child, and to discuss its diagnosis and management.

Total parotidectomy poses significant challenges due to the dissection and preservation of the facial nerve. The branching pattern of the facial nerve varies, making identification of the facial nerve trunk a crucial step in surgery. The average length of the facial nerve trunk is 14.1 mm. This case highlights the encounter with an unusually long facial nerve trunk during parotidectomy and its management.

Oral cancer is the most common type of cancer in Indian males. Recurrent disease occurs in 17-40% of patients after primary treatment. Out of these around 20-30% recur at primary site and 10-15% at loco-regional nodal area with greater than 90% of recurrences occurring in first 2 years Survival rate is less even after advancement in management strategies. Most of the patients present at an advanced stage of the disease when the lymph node metastasis has already occurred which determines the outcome and leads to poor prognosis. Even if meticulous treatment, the risk of regional recurrence cannot be eliminated. We undertook to study and compare the factors responsible for locoregional control rate, distant control rate, disease free survival rate, recurrence free survival time and overall survival time. All patients enrolled in Department of Otorhinolaryngology, GTBH and DSCI, Delhi with surgery as integral part of treatment and upto 2 year of follow up were included and studied. Bony invasion (p = 0.001) and positive margins (p = 0.006) were found to be significant predictor of recurrence. LVI and Lymph node staging decreased RFS time (p < 0.05). LVI and ECE was associated decreased OS. 2 year overall survival rate with and without recurrence were 36% and 68% respectively. Mortality rates after recurrence was found to be 62%, RFS was 51%. Histopathologically, advanced diseases are associated with high recurrence rate, Bone involvement, margin status, LVI, ECE, advanced N-Stage being important predictors. Recurrence is always associated with poor outcome.