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

Aim: This study aimed to investigate the presence and correlation of paranasal sinus pneumatization among patients with and without nasal septal deviations (NSD), to enhance clinical understanding of sinonasal anatomical variations.

Materials and methods: It is descriptive, retrospective study under a monocentric, utilizing institutional archives. 30 subjects with NSD and 30 without NSD were selected. Inclusion criteria required diagnostic quality Cone Beam Computed Tomography (CBCT) images, while exclusion criteria included developmental anomalies, central pathology, previous sinonasal surgery, fractures, and non-diagnostic images. The Assessment of Pneumatization of the Paranasal Sinuses (APPS) score was used to evaluate anatomical variations in paranasal sinuses based on CBCT scans. Statistical analysis was performed using the Chi-square test and independent t-test via SPSS version 23.

Results: A significant association between NSD and certain anatomical variations was observed. Notably, higher prevalence rates of variations such as pneumatization of the maxillary floor, middle turbinate concha bullosa, and superior frontal sinus wall were found in subjects with NSD. Statistical significance was confirmed in seven out of nine parameters, with p-values < 0.001 for most comparisons. The left side exhibited greater pneumatization than the right. The total APPS scores showed strong statistical significance between groups (p < 0.001).

Conclusion: The study reveals a significant relationship between nasal septal deviation and paranasal sinus pneumatization, suggesting that septal deviations may influence the extent of pneumatization in the sinonasal complex.

The aim of the present study was three folds; (i) to correlate clinical case history with objective findings of a client presented with sternal discomfort along with odynophagia; (ii) to evaluate the cause for retrosternal discomfort using Functional Esophagoscopy (FE); and (iii) to reaffirm the Cook's (2008) algorithm for clinical diagnosis of esophageal dysphagia in single sitting using Transnasal Esophagoscopy (TNE). A 72 years old male (named 'G') visited a tertiary health care hospital with a complaint of imbalance for past 2 months. Also, had a complaint of pain while swallowing for the past 15 days along with left arm weakness (for past 2 days) and got admitted for treatment. Pertaining to swallowing, a detailed case history was taken and Fiber-optic endoscopic evaluation of swallowing (FEES) was performed to evaluate swallowing safety functions using digital swallowing workstation (KAYPENTAX, New Jersy, USA). A large growth was noticed in the lower border of esophagous using TNE in this patient. The oral, oro-pharyngeal, and pharyngeal phase of swallowing was intact. Esophageal phase of swallowing revealed reduced peristaltic movement including a mass lesion observed in client 'G' from TNE procedure. Clinical correlation of objective findings in this client corroborated well with history. Visualization studies including TNE can be used safely, comfortably in OPD basis without any anesthesia would be few advantages of TNE procedure. Even lesions at lower end of esophagus can be detected using TNE and it is concluded that the symptom retro-sternal discomfort might be clinically correlated with history and objectively determined by TNE procedure as esophageal dysphagia due to structural lesion. Also, algorithm of Cook's (2008) guides the investigation procedure quickly in a single sitting. Therefore, clinical history about patient is imperative that accurately guides further in terms of patient's care for assessment and treatment.

Pre-treatment role of FDG PET CT scan to evaluate- the extent of the primary lesion, nodal staging and distant metastasis in oral carcinoma in various TNM stages. Additionally, our study investigated the Correlation between SUVmax values on FDG-PET CT scans and histopathological proven positive nodes in patients undergoing surgery. In this study, all suspected cases of oral carcinoma in adults who visited the ENT clinic were examined and evaluated using various methods, including clinical examination, cytology, histopathology, and imaging tests like CECT scans, ultrasound, and CEMRI. Based on the results of these evaluations, the patients were staged. The patients were then given FDG-PET CT scans (done within 2 weeks of CECT/MRI scans), for restaging and treatment plans, such as surgery, chemotherapy, radiotherapy, or a combination of these methods, were developed. After surgery, the patients were restaged based on the histopathology report, and the results of the FDG-PET CT scans were compared to the histopathological findings and the histopathological positive nodes were compared to the SUV max value on the FDG PET CT scan and were correlated. In our study, the mean age of patients was found to be 50 years with a male: female ratio of 3.5:1. Maximum tumors presented at the buccal mucosa region. 92% of patients gave a history of tobacco addiction, and 18% were smokers. As per initial biopsy reports, maximum (62%) tumors were detected to be WDSCC, 2% were MDSCC and 6% were PDSCC. All 50 patients had normal findings on the chest x-ray and USG abdomen. 41 patients underwent CECT scans and 9 patients got CEMRI scans done. Staging after FDG PET CT scan was compared with that of radiological staging. It was found that in T staging there was upstaging in 36% of cases and downstaging in 14% of cases following the FDG PET CT scan. Likewise, N staging showed upstaging in 36% of cases and downstaging in 16% of cases after the FDG PET CT scan. In M staging, there was upstaging in 10% of cases after the FDG PET CT scan. In our study 15 cases got operated on. All 8 (53.3%) cases of postoperative histopathological positive lymph nodes had SUV max values greater than their reference value (> 2.5), and all negative histopathological lymph nodes had a low SUV max (< 2.5) value in the PET CT scan. The FDG PET CT scan is a highly effective tool for accurately diagnosing, staging, and predicting the outcome of oral cancers at all stages of the disease. The SUV max value (> 2.5) of the PET CT scan is positively correlated with the likelihood of nodal metastasis, as higher values were found to correspond with histopathological evidence of positive neck nodes.

[This corrects the article DOI: 10.1007/s12070-024-04770-0.].

The study delves into the distribution of cervical nodal metastasis among patients diagnosed with carcinoma of unknown primary who underwent definitive diagnostic surgical management in form of transoral robotic surgery assisted ipsilateral radical tonsillectomy and tongue base mucosal wedge biopsy with concurrent therapeutic open ipsilateral neck dissection. We conducted a prospective study at a tertiary care center over two-years, enrolling patients with unilateral neck swelling histopathologically confirmed as squamous cell carcinoma neck metastasis. For cases where the primary site remained undetected despite evaluation, patients underwent Transoral Robotic Surgery (TORS) assisted ipsilateral radical tonsillectomy and tongue base wedge biopsy, along with concurrent open ipsilateral neck dissection. The study examines the clinicopathological correlation of nodal metastasis in carcinoma of unknown primary and explores the concepts of Lymph node yield (LNY) and Lymph node density (LND). Clinicoradiologically, the majority of patients exhibited N2b disease (n = 10/18, 55.55%). However, histopathological examination of the neck dissection specimen revealed N3b disease in the majority (n = 5/17, 29.4%). Neck dissection was aborted for 1 patient with unresectable N3b nodal metastasis during the procedure. The most commonly affected lymph node level clinicoradiologically was level II (n = 18/18, 100%), which corresponded to level II pathologically in most cases (n = 15/18, 88.2%). Ipsilateral radical neck dissection was required in the majority of cases (n = 10/17, 58.82%). The median Lymph Node Yield (LNY) from ipsilateral neck dissection was 30.78 ± 3.52, with the highest Lymph Node Ratio (LNR) detected from level II (11.1 ± 1.56). In the context of carcinoma of unknown primary with secondary neck metastasis, exploring emerging concepts such as Lymph Node Ratio (LNR) and Lymph Node Density (LND) alongside other clinicopathological parameters is crucial. These concepts provide valuable insights into the metastatic burden and may aid in refining prognostication and treatment strategies for patients with this condition.

Polymorphous AdenoCarcinoma (PAC), a slow growing tumor primarily found in minor salivary glands, predominantly palate. Herein, we report a case of 52-year female with palatal swelling. This report highlights the recent updates on molecular and IHC findings of PAC and its sub variant CASG.

This study aimed to consolidate evidence linking vocal cord palsy (VCP) to hypoxic injury, and its pathophysiology, and explore related topographical representations along laryngeal innervation. PubMed, Embase, and Scopus were the databases used. This review adheres to PRISMA guidelines. We included case series or case reports published before December 6, 2023. These studies must document VCP, diagnosed via direct or indirect laryngoscopic evaluation, resulting from hypoxic injury with imaging documentation specifying the level of injury. Screening, review, quality assessment, and extraction were done using Covidence. Our search strategy yielded 380 articles, of which 11 papers met the inclusion criteria for final review. A total of 12 patients were included across the selected studies, evenly split between genders. The causes of hypoxic injury were stroke in 11 cases and perinatal asphyxia in one. The hypoxic injury affected the medulla, pons, basal ganglia, thalamus, internal capsule, cortex, and cerebellum. The distribution of hypoxic injuries was: left side (6), bilateral (2), right side (2), and not mentioned (2). Vocal cord involvement was unilateral in eight cases and bilateral in four cases. In five cases, the involvement was ipsilateral to the hypoxic injury, bilateral when the injury was bilateral, and contralateral in two cases. Our study provides insights into how hypoxic brain injury can cause VCP and correlates the level of lesions along the innervation pathway with the clinical presentation. VCP can be induced by hypoxic injuries to the neurons extending from the laryngeal motor cortex to the laryngeal motor neurons in the medulla.

A large keloid on the right earlobe that extended to the infraauricular region was the reason for the 42-year-old woman's referral for treatment. The entire thickness of the earlobe was implicated in the surgical defect that resulted from the severe keloid excision. We employed a straightforward technique to provide a pleasing appearance while repairing the entire lobe in a single stage without the need for grafts. In addition to being ornamental, ear lobules provide a crucial point of reference for facial symmetry while wearing earrings. It is obviously unnatural from an aesthetic standpoint to lose them. Numerous techniques created to reconstruct this deformity have offered a range of benefits and drawbacks. A case of big ear lobe keloid with whole ear lobe reconstruction employing a new, single-stage, superiorly based Preauricular flap technique that is easy to master and produces good results in terms of absence of recurrence or no any deformity even after a lengthy follow-up period has been presented.

Introduction: Epistaxis is commonly referred to as nosebleeds. The age range in which it most frequently manifests itself is three to eight years old. One of the primary settings for pediatric epistaxis is schools since kids can get accidental injuries while playing. The security and welfare of the pupils in school are the teacher's concerns. So, the teachers must be aware of the correct basic first-aid protocols. This study aims to assess the awareness of handling of epistaxis first aid in schools.

Methodology: The study participant's responses were gathered using a pre-tested semi-structured questionnaire. Statistical analysis was done and the significance of the results was assessed Results & Conclusion: The majority of participants felt confident when it came to managing epistaxis, despite the fact that they had not received any formal training and simply possessed only an average understanding of the subject, lacking detailed insights and intricacies related to its first aid treatment. This underscores the fact that they were overestimating their knowledge and expertise in this domain. Therefore, educators, who are typically the initial responders to pediatric epistaxis in schools, have a limited or inadequate understanding and familiarity with the appropriate first aid protocols. Further studies scaling larger populations and propagating awareness in institutes related to children especially through means of live demonstrations and workshops can advance first aid management during emergencies.

To analyze mortality from head and neck cancer (HNC) in the State of Santa Catarina from 1979 to 2023. Ecological study of data available in the Mortality Atlas of the National Cancer Institute and in the Mortality Information System. Approximately 13,309 deaths due to HNC were recorded in the Mortality Atlas, considering the period from 1979 to 2021 and 11,027 deaths recorded in SIM in the period from 1996 to 2023. The profile of these patients consisted predominantly of subjects aged 60-69 years old, male, white, married and with 1-3 years of education. Regarding types of cancer, most deaths occurred from laryngeal cancer, followed by oropharyngeal cancer. There is a need to improve health services, with an emphasis on diagnosis of the highest risk profiles, prevention and health promotion with publicity campaigns.