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

Exploring the Role of Cap Grafts in tracheocutaneous fistula Closure. A tracheocutaneous fistula (TCF) is an abnormal connection that forms between the trachea (windpipe) and the skin of the neck. If spontaneous closure does not occur, fibrosis of the surrounding tissue may result in a persistent TCF and in some cases, iatrogenic laryngotracheal stenosis at the level of tracheostoma, the so-called A-frame deformity. In all 5 patients, Conchal cartilage was harvested. The new de-epithelialized stoma is measured, and the previously harvested graft is cut to match the defect. Passing through the centre of the tracheal cartilage and into the centre of the auricular cartilage graft, 3-0 PDS, horizontal mattress sutures are placed sequentially around the periphery of the graft, stabilised with Right SCM flap and skin was closed in layers. In each of the five cases, we achieved a resounding success by skilfully closing the fistulas and meticulously restoring the structural integrity. Equally noteworthy, all patients expressed contentment with the cosmetic outcomes at both the donor site and the neck region, deeming it as an acceptable aesthetic result.

Malignant nerve sheath tumors are rare and aggressive soft tissue sarcomas. They contribute to 5-10% of all soft tissue sarcomas. They can be sporadic, occur in patients with NF1 (neurofibromatosis 1) or can occur after radiation therapy. A high rate of recurrence and hematogenous metastasis is seen in these patients. They are also associated with poor prognosis. A case of malignant nerve sheath tumor seen in a 44-year-old male with pre-existing NF1 is being discussed here due to the unique nature of the disease and its rarity.

Primary cranial meningioma is extremely rare and only rarely described in clinical practice, as is primary sinus ectopic meningioma. We detailed the surgical management of a female patient, aged 83, who had a primary meningioma of the sphenoid sinus. This uncommon clinical entity was the subject of a study of the literature, and its prognosis was summarized.

Supplementary information: The online version contains supplementary material available at 10.1007/s12070-024-04722-8.

Although they are frequently benign tumors of mesenchymal origin, lipomas sporadically develop in the oral cavity. Intramuscular lipomas, which originate inside muscles, are a rare subtype. When found in the tongue, they are considerably more uncommon and its etiology remains unclear. Histological examination of the specimen shows mature adipocytes of uniform size with minimal vascularization and sometimes striated muscle fibers are to be seen in the periphery. A yellowish submucosal mass that is slowly expanding, painless, and asymptomatic, is typically seen based on a patient's history and clinical examination. Lipomas that occur in uncommon locations should be mentioned and should be considered in the differential diagnosis of an oral mass. The main treatment option is a complete surgical excision. The purpose of this report is to describe a case of a 43-year-old female patient with an atypical, well-defined intramuscular lipoma in her tongue that began to form around 10 months ago.

Owing to high global prevalence, incidence and associated mortality, cancer of head and neck particularly oral cancer remains a cardinal domain for research and trials. Immune-modulatory therapies that employ patients own immune system for therapeutic benefits in oral cancer seems promising. The aim of this review is to gauge the potential of immunotherapy as fourth domain of Oral cancer therapeutics. Articles were searched using suitable search terms in MEDLINE and Google Scholar database to include clinical trials, meta-analyses, and research in humans/animals/cell lines published in peer reviewed journals. A total of 97 articles were included in this review. Literature has several studies and trials where different types of immunotherapies has been attempted but it is crucial to identify precise biomarkers of genome based targeted agents and to find parameters to select patients who might benefit from immunotherapy. Also further research is required to estimate predictive value of tumor mutational burden and mutational signatures so as to aid in personalized prediction of oral cancer therapeutic response.

To assess the effectiveness of intraoperative facial nerve monitoring (IFNM) compared to non-monitoring in the prevention of post-operative facial nerve palsy during superficial parotidectomy. Patients treated with curative intent for parotid gland tumors between January 2020 and January 2022 were included. The study population has been divided in 2 groups, based on IFNM: the group A included patients operated with IFNM, whilst group B was the non-monitoring group. A further classification focused on the pathologies and the surgeons' experience. The study group included 58 patients, 27 female and 31 male. The mean age was 45.7 yr (range 36-78). No statistical difference has been found in post-operative HB grade between group A and B. The analysis of patients affected by pleomorphic surface lobe adenomas of the parotid did not show a statistical difference in HB outcome (p > 0.05). The analysis of the effect of surgeons' experience in IFNM advantage did not show statistical difference for superficial parotid tumors. The results of the present study suggest that the use of IFNM during parotid surgery is not mandatory to preserve the VII nerve function, both in case of primary tumor and in case of recurrence, and even when surgery is performed by less experienced surgeon compared to those cases treated by a more experienced surgeon.

Genuine concerns are being increased regarding potential health risks associated with the radiation exposure while using mobile devices. To study the effects of mobile phone usage on auditory functions. The detailed history of the patient was obtained with special emphasis on total cumulative usage [in years], average daily use [in minutes]. According to the years of exposure, subjects were divided into Group A (< 5 years of exposure) and Group B (> 5 years of exposure) and according to the average daily usage of mobile phones, subjects were divided into Group 1 (< 60 min daily usage) and Group 2 (> 60 min of daily usage). After that systemic examination was done. Audiological testing included pure tone audiometry (PTA) with extended high frequencies (0.250-12 kHz), Otoacoustic emissions (OAE) and Auditory Brainstem response (ABR) testing and middle latency response (MLR) were performed. Out of 100 subjects, maximum subjects (38%) in the present study were in the age group of 21-30 years with male: female ratio of 1.6:1. The main associated complaints in the subjects at the time of enrolment in the study included ear warmth (34%) followed by aural fullness (20%) and tinnitus (17%). In Group A, mild SNHL was seen in 3 (11.54%) subjects in whom 2 had > 60 min average daily use and 1 had < 60 min daily use. In Group B 19 (25.68%) subjects had mild SNHL out of which 6 were in Group 2 and 13 were in Group 1. In group B 2 (2.7%) subjects had moderate SNHL. Increase in latencies of Na and Pa were noted with prolonged and frequent exposure to mobile phones in MLR. It is advised to limit the usage of mobile phones so as to reduce the damage caused by EMRs to the auditory system.

Head and neck malignancies presenting with a neck abscess as the primary symptom are uncommon and may result in a misdiagnosis or delay in diagnosis and appropriate treatment. Here we report on a rare case where a young adult presented with signs and symptoms of a retropharyngeal abscess, which was later identified as an esophageal malignancy.

Introduction: The prevalence of thyroid carcinoma (TC) among pediatric and adolescent populations is infrequent, yet its global occurrence is escalating. Insufficient information pertaining to TC in the pediatric populace of Indonesia presents issues in the identification and management of patients with this condition. The objective of this study is to provide a detailed account of a collection of pediatric TC cases that were recorded at a tertiary care center throughout an extended interval of eight years.

Presentation of cases: The present study conducted a retrospective data analysis of ten patients who received a diagnosis of TC during the period spanning from 2014 to 2022. The present study focused on analyzing the clinical manifestation, diagnostic measures, treatment modalities, and immediate postoperative consequences of TC. All patients diagnosed with thyroid cancer exhibited the presence of neck lump. Nine patients underwent total thyroidectomy, while one patient underwent isthmolobectomy. The histopathologic evaluation confirmed the diagnosis of thyroid cancer in every individual. There were a significant number of patients, up to 50%, who encountered complications after undergoing surgery. Two patients reported the hoarseness of voice, whereas two other patients experienced the signs of hypocalcemia. Only one patient exhibited both these symptoms simultaneously.

Discussion: The implementation of total thyroidectomy as a surgical intervention in pediatric patients poses a notable challenge. Postoperative monitoring for potential complications following surgery for total thyroidectomy is imperative.

Conclusions: The current study provides evidence that the utilization of total thyroidectomy in combination with lymph node dissection as indicated in patients with lymph node metastases in pediatric patients with thyroid carcinoma leads to a significant reduction in the probability of recurrence of lymph node enlargement. During the performance of surgical procedures, meticulous observation plays a key role in mitigating the risk of postoperative complications, such as hypoparathyroidism, hypocalcemia, and injury to the recurrent laryngeal nerve. Thus, it is imperative to conduct follow-up procedures for post-surgical interventions among pediatric patients diagnosed with TC.

Of all the head and neck tumors, salivary gland tumors account to 3%. Pleomorphic adenomas are one of the most common benign tumors arising from major salivary glands, although it could also develop from minor salivary glands situated at accessory sites like nasal cavity, pharynx, parapharyngeal space, lacrimal glands etc. Tumors of infratemporal fossa are quite unusual, mainly because of its hidden location in retromaxillary region. We report an unusual case of 65 years old male presenting with complaint of progressive left cheek swelling for 4 years. FNAC revealed pleomorphic adenoma of minor salivary gland tumor. Intraoperatively a giant lobulated tumor was seen occupying almost whole space of infratemporal fossa, which was removed in-toto via open approach. Patient was kept on regular follow up with no evidence of recurrence reported till date.