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

A 41year old male, with a diagnosis of diffuse subarachnoid haemorrhage and cerebral oedema following RTA, post 155 days of tracheostomy, came with complaints of ryles tube feed expectoration through tracheostoma, signs of aspiration and bilious vomiting. Patient was evaluated through rigid endoscopy and radiological CT imaging and was diagnosed to have Tracheoesophageal fistula.

Several different surgical techniques have been tried in the handling of nasal obstruction due to posterior nasal septal deviation and septal spur. This study aims to compare the outcomes of endoscopic versus conventional septoplasty (CS) for management of such issue. A retrospective randomized study was conducted on 112 individuals who had exclusive septoplasty and had either a posterior septal deviation or a septal spur. While 53 underwent endoscopic surgery (ES), 59 of them received conventional approach. The two groups were compared regarding the preoperative clinical presentation, intraoperative characteristics (duration of surgery, blood loss, nasal packing, and septal flap tear), early postoperative care (bleeding and pain), and complications three months after surgery such as synechia, numbness, septal perforation, incomplete correction, and septal hematoma. Subjective measurements (Nasal Obstruction Symptom Evaluation [NOSE] and pain scale) were used in the evaluation. Duration of surgery, intraoperative blood loss, and number of patients with nasal packing were significantly lower in ES (p < 0.001). NOSE score and pain scale were significantly lower in ES (p < 0.001). Postoperative numbness was significantly lower in ES (p < 0.001). Complications such as synechia, septal perforation, incomplete correction and septal hematoma were lower in ES with no statistical significance (p = 0.168, 0.245, 0.161, 0.497 respectively). With ES, septal spurs and posterior septal deviations are easier to treat with less duration of surgery and less blood loss. ES resulted in higher patient satisfaction regarding pain and an improvement of nasal obstruction. The complications associated with ES are lower.

Laryngeal sensory neuropathy (LSN) is an under-recognized cause of chronic laryngopharyngeal symptoms, including cough. This study aimed to investigate the role of superior laryngeal nerve (SLN) block in the management of LSN.A prospective interventional study was conducted at a tertiary care center over two years (January 2023 to December 2024). Adult patients presenting with unexplained chronic laryngopharyngeal symptoms were included in the study. LSN was diagnosed as a diagnosis of exclusion following a comprehensive evaluation to rule out other identifiable illnesses. SLN block was done with perineural infiltration of Triamcinolone and Lignocaine. Subjective improvement of symptoms and the cough severity index (CSI) were used for assessment at one- and four-months post-intervention.After the initial screening, 72 cases were enrolled, of which 30 (41.67%) were diagnosed with LSN. Of these, 22 patients opted for an SLN block. At one-month follow-up, 18 patients (81.8%) reported partial or complete symptomatic improvement, while four (18.2%) reported no symptomatic relief. The mean CSI score decreased significantly from 13.19 ± 8.13 (pre-intervention) to 7.63 ± 6.94 at one-month follow-up (p = 0.007). No adverse events were noted.SLN block appears to be an effective and safe treatment option for management of LSN. The high proportion of LSN (41.66%) among patients with unexplained chronic laryngopharyngeal symptoms suggests that it is more common than previously recognized. Further studies with comprehensive designs and greater number of participants are recommended to establish definitive treatment guidelines.

Richter transformation is the conversion of chronic lymphocytic leukemia into aggressive lymphoma, often diffuse large B-cell lymphoma, occurring in about 2-10% of chronic lymphocytic leukemia patients. Recognizing oral manifestations of this transformation is crucial for early diagnosis and management, as they can significantly affect treatment outcomes. A literature review was performed following PRISMA guidelines. We systematically searched the PubMed/MEDLINE database for case reports from 1980 to September 2024 using terms like "CLL," "Richter's Transformation," "oral manifestation," and "oral signs." Non-case reports and non-English studies were excluded for consistency and relevance. The literature review identified various oral manifestations linked to Richter transformation in chronic lymphocytic leukemia patients, including lymphomatous lesions, gingival hypertrophy, and ulcerative lesions in the head and neck. These findings underscore the need for careful patient monitoring for potential Richter transformation indicators. The literature review identified various oral manifestations linked to Richter transformation in chronic lymphocytic leukemia patients, including lymphomatous lesions, gingival hypertrophy, and ulcerative lesions in the head and neck. These findings underscore the need for careful patient monitoring for potential Richter transformation indicators.

Reconstructing oral cavity defects poses significant challenges due to the variability in defect size and location following tumor resection. Myomucosal flaps provide reliable options for medium-sized defects with reduced donor site morbidity, satisfactory functional and aesthetic outcomes. A retrospective observational study was conducted on 46 patients treated between 2016 and 2022 in two head and neck oncological centers. Inclusion criteria were oral cancer diagnosis, medium-sized surgical defects, and suitability for myomucosal flap reconstruction. Functional outcomes, including tongue mobility, oral opening, and aesthetic satisfaction, were assessed using standardized tools: EORTC QLQ-HN35, PSS-HN, FACT H&N questionnaires, and VAS scores. All flaps were successfully harvested and transposed, with minimal complications. The mean defect size was 4.41 × 3.38 cm. Functional assessment showed a mean oral opening of 3.43 cm and satisfactory tongue mobility (mean score: 6.38). Aesthetic outcomes were rated positively (mean VAS: 7.11). Complications included flap edema (n = 2), marginal necrosis (n = 1), and neck infection (n = 1). Patients reconstructed with FAMMIF flaps exhibited slightly higher House-Brackmann scores. Overall, the questionnaires highlighted the feasibility and versatility of myomucosal flaps, despite inherent limitations in achieving pre-surgical functionality. Myomucosal flaps represent a versatile and reliable option for medium-sized oral defect reconstruction, balancing functional recovery with aesthetic satisfaction. Future studies should explore prospective comparisons with free flaps and focus on enhancing post-operative rehabilitation protocols.

Childhood Ataxia with Central nervous system Hypomyelination, also known as leukoencephalopathy with Vanishing white matter, is a rare genetic disorder of autosomal recessive transmission, belonging to the hypomyelinating leukodystrophy family. It is characterized by progressive degradation of cerebral white matter, leading to cerebellar ataxia, various cognitive disorders, and muscle stiffness, as well as deafness. The diagnosis is made on the basis of a combination of clinical and radiological evidence, together with the identification of a mutation in the Eukaryotic Initiation Factor-2B gene. At present, there is no curative treatment, hence the importance of prevention of possible causes of cellular stress and early initiation of symptomatic treatment, with particular emphasis on rehabilitation of auditory function. In this case study, we report on a cochlear implant performed in a 6-year-old girl with this syndrome and profound bilateral sensorineural hearing loss, with the aim of assessing the results and impact on the patient's social and educational integration.

Background: Fishbone is a widespread foreign body accidentally swallowed, accounting for about 84% of ingested foreign bodies. Most of the patients do not present with any symptoms. The common sites where foreign bodies get embedded in the upper gastrointestinal tract involve the base of the tongue, the palatine tonsils, the pyriform sinus, and the vallecula.

Methods: The Department of Radiodiagnosis and Imaging, Kasturba Medical College Hospital, Mangalore, conducted a cross-sectional study involving CT examination of seven types of commonly consumed fish in the coastal Karnataka region, before and after cooking. After the scan, the ROI was drawn on the skull, hypural, spine, rib, upper jaw, and lower jaw to measure the HU unit for all seven fish.

Result: The study reported that the average HU unit of the skull, hypural, spine, rib, upper jaw, and lower jaw of fish before and after boiling. The mean value of skull bone showed 195.4 ± 141.7 and184.9 ± 123.2. The mean values of 284.1 ± 191.8 and 279.7 ± 105.7 for the spine. Similarly, for the hypural 242.1 ± 117.4 and 170.7 ± 100.8. For the ribs, the mean values were shown as 114.1 ± 59.8 and 99.4 ± 49.4. The average value of the upper jaw was 251 ± 198.9 and 116.6 ± 110.7.

Conclusion: The study provides an idea of the different ranges of HU value in the fish commonly consumed in the coastal Karnataka region. This information can aid in detecting the fish bone foreign bodies in patients with a suspected history of fishbone impaction.

Teratomas are perinatal neoplasias developed from primitive gonadal germ cells. There cervical location is very rare and presents any risks of diagnostic error. we report a case of an 18-year-old female patient without any pathological history received for an anterior cervical swelling that had been evolving about 12 months ago. The mass was mobile on palpation and swallowing evoking a nodular goiter both on clinical examination and neck CT scan. Lost sight, she reappeared 13 months later presenting a neck fistulization and pendulous pedicled cervical mass with a peri-pedicular oozing orifice, posing the indication of an enlarged total lumpectomy which was performed under general anesthesia. The evolution was marked by complete post-operative healing. teratomas are most often intragonadal. The cervical form of adult person is exceptional and can be confused with a thyroid tumor. That could be a source of diagnostic difficulties and therapeutic delay. cervical masses can be indicative of various types of pathology therefore we must think at all in front of this one.

[This corrects the article DOI: 10.1007/s12070-024-05226-1.].

Evaluating speech perception in hearing-impaired children is crucial for assessing their listening abilities and the effectiveness of hearing aids or cochlear implants. This provides clinicians with valuable information to optimize the implant settings and offer targeted support, thereby improving the children's communication outcomes in real-world environments the present study aimed to explore trisyllabic word recognition in noise in children using cochlear implant between the hearing age of 3-6 years. Trisyllabic word recognition in noise test and parental questionnaire was administered on the 33 children using cochlear implant in the hearing age range of 3-6 years which were divided into three groups (Group I: 3-4 years, Group II: 4-5 years, Group III: 5-6 years) with 11 participants in each group. Children using cochlear implant shows poor speech perception scores as compared to typically normally developing children across all age group. Also, as the signal-to-noise ratio (SNR) increases, children using cochlear implant across different age range show an improvement in their speech perception scores. Additionally, young children need a more favorable SNR than older children to effectively understand speech in noisy environments. The speech recognition in noise test will help in optimizing classroom acoustics for hearing-impaired children. SNR-based evaluation can provide guidance regarding interventions, habilitation, implant setting and auditory training, ensuring effective education and communication for children with hearing impairment. Also it can help in rehabilitative process of hearing impaired children in terms of selecting appropriate amplification systems, recommending assistive listening devices, and facilitating auditory training.