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

We present a case of a woman with epiphora secondary to complete nasolacrimal duct obstruction due to granulomatous inflammation around pigmented, birefringent foreign bodies, consistent with cosmetics. History is critical when evaluating epiphora to differentiate an innate melanocytic process, such as melanoma, from exogenous sources such as cosmetics on histopathology.

Persistent tracheocutaneous fistulas though uncommon often lead to persistent air leaks and infections.The surgical scar too mars the psyche of the individual.This necessitate a robust repair. We utilized the versatile Limberg flap to repair a non healing fistula in a 45-year-old male.

Endoscopic push-through cartilage myringoplasty is a minimally invasive procedure for repairing tympanic membrane perforations that eliminates the requirement for canal wall incision and tympanomeatal flap elevation. The study aims to evaluate hearing improvement, graft uptake rate, operative time, and the need for postoperative analgesia in cartilage myringoplasty using push-through technique. This case series study included twenty-eight patients with different sizes of tympanic membrane perforations who underwent cartilage myringoplasty by push-through technique. Successful graft uptake rate was (96.4%). There is an improvement in air conduction from 32.13 ± 5.063 dB to 22,023 ± 3.306 dB and a significant improvement in the average air-bone gape from 19.47 ± 5.342 dB to 10.39 ± 3.462 dB (P-value < 0.05). Twenty-four (85.7%) patients had mild post-operative pain (according to visual analogue score) and the rest (14.3%) had moderate pain. The mean operative time is 33.15 ± 7.2 min. Endoscopic push-through cartilage myringoplasty is an effective method of repairing tympanic membrane perforations. It has a graft uptake comparable to other methods, with less operative time and significant improvement of hearing.

Nasal septal perforation is an uncommon condition caused by several aetiologies. The recent trend in the increased use of Tapentadol intra-nasal analgesic spray has led to various systemic and local complications. This is one of the first few case reports on Tapentadol-induced nasal septal perforation. A 34-year-old female presented to the Otorhinolaryngology clinic with a two-week history of a painful non-healing ulcer in the palate associated with pus discharge.She also had bilateral nasal obstruction and foul-smelling discharge. The patient had used Tapentadol nasal spray (22.5 mg/spray) 4-5 times daily for two years to manage her lumbar disc prolapse pain.Oral cavity examination showed a 0.5 × 0.5 cm fistula at the junction of the hard and soft palate. Diagnostic nasal endoscopy exhibited extensive dried crusting and pus discharge, along with a perforation in the cartilaginous part of the septum, and eroded bilateral inferior turbinates. Patient was worked up for granulomatous disease of nose / malignancy. Biopsy showed acute on chronic inflammation with necrotic tissue.Bood investigations included cANCA, pANCA, and Rheumatoid factor, which was negative. Treatment involved the cessation of the Tapendalol nasal spray, local debridement, and a regiment of antibiotics and steroids. Upon follow-up, endoscopy demonstrated improved symptoms and the regeneration of normal mucosa. Drug-induced septal perforation is recognized as a rare condition, but it should be taken into account in all cases of septal perforation. Meticulous history and clinical examination is essential for accurate diagnosis.

This study aims at finding different branching patterns of facial nerve during parotid surgeries and the relationship of the nerve to tragal pointer (TP) and stylomastoidforamen (SMF). The facial nerve enters the body of the parotid gland with varying branching patterns, establishing unique relationship requiring close care while doing parotidectomies. A Hospital Based Prospective Observational, descriptive study, conducted among the participants in a tertiary care centre for a period of 18 months who underwent superficial parotidectomy. In the present study 50% patients had type 2 branching pattern, 24% patients had type 3 branching pattern, 15% had type 4 branching pattern and 10% had type 1 branching pattern. Mean Distance between main trunk and tragal pointer is 7.5 mm and standard deviation is 1.5. Mean Distance between main facial nerve trunk (FNT) and stylomastoid foramen is 1.54 mm and standard deviation is 0.2. Type 2 is the commonest branching pattern of facial nerve inside the parotid gland. This study will provide a road map for the surgeons to anticipate the variations in branching patterns and the knowledge of result of our study might help in decreasing the iatrogenic injury of facial nerve during parotid surgeries.

Stickler syndrome type 1 (STL1) is an autosomal dominant genetic disorder that affects connective tissue with highly heterogeneous clinical manifestations, primarily at the ocular, orofacial, skeletal, and auditory levels. The aim of our study was to determine the variability of the auditory phenotype associated with pathogenic variants of the COL2A1 gene and its impact on long-term treatment and follow-up. A retrospective observational study was conducted on patients with a confirmed diagnosis of STL1 treated between 2018 and 2024 at the Otorhinolaryngology Department of the Marqués de Valdecilla University Hospital. The electronic medical records of the patients included in the study were reviewed to gather the following information: family history, age, sex, genetic variant of STL1, audiological test data, associated clinical manifestations, radiological tests, and treatment. Among the 8 patients included in the study, 6 (75%) exhibited hearing loss, with severity ranging from mild to profound. Of these, 4 (66.7%) had sensorineural hearing loss, 1 (16.7%) had conductive hearing loss, and 1 (16.7%) had a mixed type. The 4 patients with sensorineural hearing loss required hearing aid fitting, and one of them also needed a cochlear implant, showing significant improvement in language comprehension. Another patient required a mastoidectomy due to a cholesteatoma. The results of our study suggest that hearing loss in patients with STL1 is a common finding, predominantly sensorineural in nature and of variable intensity.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05638-7.

Background: Vascular anomalies are broadly classified into vascular tumors and vascular malformations, as per the classification by the international society for the study of vascular anomalies (Kunimoto et al. Int J Mol Sci 23(1):388, 2022) (ISSVA). Vascular tumors arise due to abnormal endothelial proliferation, with infantile hemangiomas (IHs) being the most prevalent benign type, occurring in approximately 5-10% of infants (Wildgruber et al. Insights Imaging 10(1):30, 2019). These tumors demonstrate a predilection for the head and neck region and are more commonly observed in females (George et al. J Oral Maxillofac Pathol 18(Suppl 1):S117-S120, 2014). In contrast, vascular malformations represent congenital structural anomalies of blood or lymphatic vessels, resulting from errors in embryonic vascular development.

Methods: This prospective observational study was conducted over one year at a tertiary referral center, focusing on patients diagnosed with vascular Anomalies. The objective was to evaluate the clinical presentation, management strategies, and outcomes, with an emphasis on aligning treatment approaches with current literature and evidence-based protocols.

Results: A total of 45 patients were included in the study, comprising 24 males (53.33%) and 21 females (46.67%). The age of presentation ranged from infancy to 70 years. Two patients (4.44%) were infants (0-1 year), 10 patients (22.22%) were in the age group of (1-18 years), and the majority, 33 patients (73.33%), were adults (> 18 years). The most frequently involved anatomical sites were the face (46.67%) followed by the oral cavity and oropharynx (44.44%), with symptomatology varying according to lesion size, site, and extent. Surgical intervention was the most commonly employed treatment modality (44.44%), demonstrating favorable outcomes with low recurrence rates. Sclerotherapy was utilized in 35% of cases and was particularly effective for select lesion types. In the pediatric cohort, oral propranolol was administered with positive therapeutic response. Combined approaches, particularly surgery following embolization, yielded enhanced outcomes in complex or extensive lesions.

Conclusion: Surgical management remains the cornerstone of treatment for vascular malformations, offering the most definitive results and lowest recurrence rates. In selected cases, adjunctive therapies such as preoperative embolization or sclerotherapy can optimize surgical outcomes. A multidisciplinary, individualized treatment approach based on lesion type, location, and patient age is essential for optimal management of vascular anomalies.

Introduction: Laryngopharyngeal reflux (LPR) is a common disease in the outpatient department of otolaryngology and is characterised by backflow of stomach contents into the pharynx and larynx resulting in significant negative impact on the quality of life of patients. The aim of study was to assess the effect of proton pump inhibitor (PPI) on quality of life in patients with LPR.

Method: 110 patients diagnosed with LPR were enrolled in study and prescribed omeprazole (20 mg) twice daily for 12 weeks. The Reflux Symptom Index (RSI), Reflux Finding Score (RFS) and LPR-health-related quality of life (HRQOL) were recorded for each patient at the initial visit and at 4th, 8th and 12th week follow-up visits.

Results: Mean RSI, RFS, HRQOL was 15.28 ± 1.19, 12.65 ± 1.16 and 77.77 ± 11.80 respectively at baseline. Significant improvement was observed in RSI and RFS scores after treatment. The HRQOL score also showed gradual improvement after PPI treatment.

Conclusion: PPI treatment brought about a significant improvement in signs, symptoms and quality of life of LPR patients.

Telerehabilitation has developed as one of the important aspects of health care delivery in the current era. Hence the present study aimed to systematically review the literature and understand the effectiveness of teletherapy in the management of voice disorders. A comprehensive search was performed in the PUBMED, CINAHL, and Scopus databases using Boolean operators, adhering to the PRISMA. The methodological quality of the selected studies was assessed using the ROBINS-I tool. The review included 12 articles meeting the inclusion criteria, featuring various study designs. All studies reported positive outcomes from televoice therapy intervention across multiple voice outcome measures, irrespective of whether participants received direct or indirect or a combination of voice therapy techniques. Studies comparing teletherapy with face-to-face therapy indicated that teletherapy is as effective as in-person therapy. However, the overall risk of bias assessment for the included studies, using the ROBINS-I tool, ranged from moderate to serious. This systematic review revealed that teletherapy is a feasible alternative to in-person therapy for voice disorders. However, there is a need to understand the effectiveness of teletherapy in demonstrating different voice therapy techniques. Further studies are needed to understand the application of various/particular voice therapy techniques via telepractice.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-025-05775-z.

The frequently overlooked Infrahyoid flap is robust, pliable and an extremely versatile option for reconstruction of small-medium size oral cavity defects. Precarious venous drainage and slightly higher rates of congestion followed by flap loss have led to this flap being side-lined and underutilized. We review our experience of using the infrahyoid flap to reconstruct 18 patients with oral cavity defects following ablative resections for cancers of the oral cavity. In this retrospective analysis, outcomes and complications of 18 patients reconstructed with an Infrahyoid flap for defects created after ablative resection of cancers of oral cavity between June 2019 and May 2022 were studied. 18 patients (14 men and 4 women) were reconstructed with an infrahyoid flap for defects created after resection of cancers of the tongue, floor of mouth and buccal mucosa. Mean age of the study population was 48.33 years. Overall major/minor complications were seen in 38.88% patients. The most common complication recorded was that of partial flap loss seen in 22.22%. Complete flap loss was seen in 2 patients (11.11%) of which one patient developed an Oro-cutaneous fistula. Three patients were assessed to have a partially intelligible speech and one patient presented with restricted tongue protrusion in the post operative period. The easy to harvest infrahyoid flap is a reliable method of reconstructing small-medium sized oral cavity defects. Excellent functional outcomes along with minimal donor site morbidity and acceptable flap related complications makes it a worthy option for reconstructing such defects.