International Journal of Otorhinolaryngology and Head and Neck Surgery

Proportions, five-year survival rates of hypopharyngeal cancer and its associated factors among head and neck cancer patients at a tertiary care hospital in Northern Tanzania

Mariam Fakhi — 2026-03-24

Background: Hypopharyngeal cancer is a rare, aggressive form of cancer of the hypopharynx. It is one of the public health problems with a high burden in low and middle-income countries (LMICs). Despite the advancement in cancer management, mortality associated with cancer continues to rise mostly in LMICs like Tanzania. Yet, the contribution of hypopharyngeal cancer to the observed outcome is not known.

Methods: A hospital based cohort study was conducted at a tertiary care hospital in northern Tanzania, Kilimanjaro Christian Medical Center (KCMC), from January 2015 to December 2019. Kaplan-Meier estimates were used to determine the survival rate. Cox regression analysis assessed factors associated with survival status. A p value <0.05 was considered statistically significant.

Results: A total of 1,259 participants with head and neck cancer were included in this study. Among them, 97 (7.7%) had hypopharyngeal cancer. Participants with hypopharyngeal cancer were followed for five years. The median survival time was 32.0 months at the end of follow-up, and 45 (46.4%) participants had died. Participants with stage IV cancer had a 3.82 times higher hazard of mortality compared to those with stage II. Additionally, those with distant metastasis had a 9.90 times higher hazard of death.

Conclusions: The study reported a poor survival rate with a five-year mortality rate of 46.4%. Participants with cancer at stage IV, and those with the presence of distant metastasis, had a higher hazard of mortality compared to their counterparts.

Survival outcomes of parotid carcinomas treated with surgery and adjuvant radiation therapy

Maliha Kazi — 2026-02-26

Background: Parotid cancers are a diverse histological group of cancers involving the parotid gland with varying effects of prognostic factors on treatment outcomes. The effect of adjuvant radiotherapy on the outcome in parotid cancers has always been debated in the past. The objective of current study was to measure the effect of prognostic factors and the survival outcomes of patients with primary parotid cancers treated with surgery and adjuvant radiotherapy.

Methods: From January 2010 to December 2023, a total of 61 patients treated at Freeman Hospital, were included in the analysis. Data was collected and stratified according to age, gender, tumour staging, surgical margins, lymphovascular invasion (LVI), peri-neural invasion (PNI), extra nodal extension (ENE) and recurrence rate. All patients treated with surgery and adjuvant radiotherapy were included in the study. Patients with incomplete data, distant metastasis or those lost to follow up were excluded. The OS, DSS and RFS rates based on surgical margins, LVI, PNI and ENE were calculated.

Results: The 5-year OS, DSS and RFS were 72.6%, 79.6% and 77.7%, respectively. Positive surgical margins did not influence the survival outcome in comparison to close or clear margins. Lower survival rates were noted for patients with ENE, although not reaching statistical significance.

Conclusion: Though retrospective in nature, our study provides valuable information that close or involved surgical margins do not adversely affect the outcome for parotid cancers treated with surgery and adjuvant radiotherapy and that surgical re-resection might not be indicated in this patient population.

Evaluating the predictive value of early postoperative parathyroid hormone levels for hypocalcemia in total thyroidectomy patients: a retrospective cohort study

Ahmed Al Omairin — 2026-03-24

Background: Hypocalcemia is a common complication following total thyroidectomy, often resulting from transient or permanent parathyroid gland dysfunction. Identifying early predictors is essential to prevent morbidity and guide timely supplementation. The retrospective single-center study evaluated the predictive value of immediate postoperative parathyroid hormone (PTH) levels for early hypocalcemia.

Methods: A total of 54 patients aged ≥18 years were included. PTH was measured within 1 hour postoperatively, while baseline serum calcium (Ca) levels were monitored every 8 hours for 24-48 hours. Patients were categorized by PTH level as low (<10 pg/ml), borderline (10-20 pg/ml), or normal (>20 pg/ml). Hypocalcemia was defined as Ca <8 mg/dl. Statistical analyses included the Kruskal-Wallis test with Tukey adjustment and Chi-square or Fisher’s exact test.

Results: Most patients had normal PTH levels (77.8%, n=42), and hypocalcemia occurred in 20.4% (n=11). A significant association was observed between low PTH levels and hypocalcemia, with 66.7% of patients with low PTH developing hypocalcemia compared to 9.5% in the normal group (p=0.0022). ROC curve analysis using a PTH cutoff of <20 pg/mL yielded an AUC of 0.76, with 58.3% sensitivity and 90.5% specificity. Pairwise comparisons showed that low PTH (Mdn=7.67, IQR=1.2, p<0.001) differed significantly from normal PTH but not from borderline low PTH (p=0.436). A significant difference was also observed between borderline low and normal PTH (p=0.0313).

Conclusions: Early postoperative PTH measurement is a valuable predictor of hypocalcemia after thyroidectomy. Patients with PTH ≤20 pg/ml should be closely monitored and managed proactively to ensure safe recovery and facilitate early discharge.

A two-step aABR regime in neonatal hearing screening: an efficient alternative for remote and poor geographic areas

Birkena Qirjazi — 2026-03-24

Background: Neonatal hearing screening is a standard of care for the neonatal population. Nevertheless, lost to follow-up (LTFU) cases remain an issue for many new and mature programs. This study aims to evaluate the impact of hearing screening using an aABR algorithm in a neonatal population, with a particular focus on its effect on LTFU rates.

Methods: This retrospective study analyzed 2,072 infants selected from a total of 2,181 neonates born in the districts of Pogradec and Kukës, Albania, during 2018–2019. Two different newborn hearing screening algorithms were applied: a two-stage aABR protocol in Kukës and a three-stage TEOAE–TEOAE–aABR protocol in Pogradec. The “fail” rates and the proportion of infants LTFU were calculated and compared between the two screening approaches.

Results: LTFU rates were highest in Pogradec, where a traditional screening algorithm was used, increasing from 1.4% at the first test to 16.9% at the second. In Kukes, the corresponding rates were 0.7% and 15.5%. Fail rates ranged from 22.9% in Pogradec to 6.8% in Kukes. At both sites, fewer neonates failed the second screening than the first.

Conclusions: The algorithm based on two aABR stages appeared to produce a lower number of subjects who failed the first screening test and also a reduced number of LTFP cases. The ‘fail’ rates remained high in both sites, although lower in Kukes. Targeted strategies to reduce LTFU should be implemented to enhance the overall sensitivity and effectiveness of the hearing screening program.

Outcomes of endoscopic tympanoplasty in chronic suppurative otitis media: a prospective study from a tertiary care hospital

Riya M. Soby — 2026-03-20

Background: Chronic suppurative otitis media (CSOM) remains a significant public health issue in developing countries like India, contributing substantially to preventable hearing loss. Although microscopic tympanoplasty is widely practiced, endoscopic tympanoplasty (ET) with its minimally invasive transcanal approach, offers enhanced surgical visualization, reduced morbidity, comparable graft success rates and is particularly well-suited for high-volume tertiary centers where surgical efficiency and cost-effectiveness are critical. This study evaluates the outcomes of ET in terms of graft success, hearing improvement, and surgical efficacy.

Methods: A prospective study was conducted from August 2022 to August 2024, involving 70 patients diagnosed with tubotympanic type of CSOM. All patients underwent ET using a superiorly based tympanomeatal flap with an underlay grafting technique. Preoperative and postoperative audiological assessments were performed using pure tone audiometry at 1-month and 3-month intervals. The primary outcome measures included graft uptake rate, air-bone gap (ABG) closure, surgical duration, and postoperative complications.

Results: The study population had a male-to-female ratio of 1:2, with the majority (52%) aged between 10-30 years. The overall graft uptake success rate was 91.43% (64/70), with a statistically significant improvement in hearing outcomes. The mean preoperative ABG of 29.44 dB (95% CI: 28.10-30.78) improved to 13.60 dB at 3 months postoperatively (95% CI: 12.56-14.64 dB) at three months postoperatively (p<0.01). Surgical complications were minimal, and no major adverse events were noted.

Conclusions: ET demonstrates high success rates, substantial hearing improvement, and minimal complications, confirming its effectiveness in managing tubotympanic CSOM. The procedure offered the advantages of enhanced visualization provided by endoscopy facilitates precise graft placement and optimal surgical outcomes, shorter surgical time, faster postoperative recovery, and minimal complications. Its minimally invasive nature and favorable outcomes make it a reliable alternative to the microscopic approach, warranting its integration into routine clinical practice and otologic training programs for improved patient care.

Prescribing patterns and clinical perceptions of high-dose co-amoxiclav in upper respiratory tract infections: a nationwide study among otorhinolaryngologists

Amitrajit Pal — 2026-02-26

Background: Upper respiratory tract infections (URTIs) are a leading cause of outpatient visits and antibiotic use across age groups. Amoxicillin–clavulanate (co amoxiclav) is widely prescribed due to its activity against β lactamase–producing pathogens. High dose formulations (1 g) aim to enhance pharmacodynamic target attainment and clinical efficacy, particularly against less susceptible organisms. However, real world data on otorhinolaryngologists’ prescribing practices and perceptions of high dose co amoxiclav are limited.

Methods: A descriptive, questionnaire-based survey was conducted among otorhinolaryngologists attending the Annual National Conference of the Association of Otolaryngologists of India. A structured 10 item electronic questionnaire captured prescribing patterns, clinical indications, decision drivers, perceived effectiveness, safety, and patient compliance. Data was analysed using descriptive statistics.

Results: A total of 176 otorhinolaryngologists participated. Acute otitis media was the most common indication (52%), followed by acute tonsillitis (25%), sinusitis (16%), and pharyngitis (7%). Overall, 70% of respondents prescribed high dose (1g) co amoxiclav sometimes or often, with 59% using it as first line therapy. Clinical efficacy (52%) and once daily dosing convenience (21%) were the main drivers of use. Prescribing decisions were guided by clinical guidelines in 45% of cases. Satisfaction with outcomes was high (93%). Diarrhoea (66%) and nausea (21%) were the most frequently reported adverse effects. Dosing frequency was considered the key determinant of patient compliance (56%). High dose (1g) co amoxiclav was perceived as more effective than other antibiotics by 77% and safer by 87% of respondents.

Conclusion: High dose co amoxiclav (1 g) is widely accepted by otorhinolaryngologists for URTIs, supported by perceived efficacy, convenient dosing, favourable safety, and alignment with antimicrobial stewardship principles.

Role of fiberoptic endoscopic evaluation of swallowing in evaluating the pharyngeal phase of swallowing in patients with dysphagia: a cross-sectional study

Preetham Achoor Puthukudy — 2026-03-10

Background: Dysphagia or difficulty in swallowing, is a common symptom of various etiologies. The pharyngeal phase of swallowing is particularly critical for safe deglutition. FEES is a reliable, non-invasive diagnostic tool to evaluate this phase. The article’s main purpose is to estimate the prevalence and etiological profile of pharyngeal phase disorders using FEES in patients presenting with dysphagia and to analyze associated clinical and sociodemographic variables. The Associations were calculated by the Chi-square and Fisher's exact tests. Cramer’s coefficient calculates the strength of association. SPSS version 20 was used for statistical analysis.

Methods: In this descriptive cross-sectional study, 150 patients presenting with dysphagia were subjected to FEES using standard protocols. Data on demographics, clinical diagnoses and findings, including residue, whiteout, penetration, aspiration and sensation, were analyzed.

Results: In the study, the most common diagnosis was laryngopharyngeal reflux (20%), followed by carcinoma (16%). FEES findings revealed residues for solids in 29.3%, semisolids in 16% and liquids in 12.7%. Aspiration was observed in 4% for liquids and 2.7% each for semisolids and solids. Sensation was abnormal in 0.67% of the patients. A significant association was found between occupation and FEES findings (p=0.012) and between FEES and PAS scores (p=0.001).

Conclusions: FEES is an effective tool for evaluating pharyngeal dysphagia and identifying the risk of aspiration. It allows real-time assessment and supports tailored management strategies.

Post COVID assessment of hearing in a tertiary health care centre of India

Ekta Narang — 2026-03-24

Background: We have tried to find out the effects of COVID-19 on the audio vestibular system. We aim to study the type and severity of hearing loss in post COVID patients, if any. We also aim to find out the percentage of patients who have hearing loss following COVID-19 infection. This study also aims to find out the probable site of involvement of the audio vestibular system.

Methods: This study was conducted at a tertiary care hospital. 76 health care workers who had tested positive for COVID-19 were taken up for the study. All of them underwent Pure Tone Audiometry (PTA), Impedance Audiometry and Otoacoustic Emission Testing (OAE).

Results: Pure Tone Audiometry showed hearing loss in 14(18.4%) patients. It was mild in13 (92.9%), sensorineural in 12(85.7%) and bilateral in 11(78.6%). Impedance Audiometry showed Type A curve in 72 patients. On OAE testing 57 patients were pass and 16 were referred in both ears.

Conclusions: The percentage of hearing loss among COVID positive workers was 18.4%. Most of them (85.7%) had sensorineural hearing loss which was mild (92.9%). Hearing loss involved the higher frequencies more on PTA and OAE. OAE was referred in 23% of patients suggestive of cochlear outer hair cell as the possible site of involvement in the affected group. The study is registered under Clinical Trials Registry – India (www.ctri.nic.in) with registration number CTRI/2021/04/033078.

Position test with video Frenzel: does it have an added advantage compared to position test without video Frenzel?

Rajesh Raju George — 2026-03-24

Background: Benign paroxysmal positional vertigo (BPPV) is a common peripheral vestibular disorder that affects 2.4% of the population at any point in their lifetime. The diagnosis of this condition using positional tests has been a major milestone, largely due to the eminent work of Robert Bárány, Margaret Dix, and Charles Hallpike, who devised the positional test. As research and innovations progressed, Frenzel glasses—used to identify nystagmus clearly—and video-Frenzel system, which magnify and record nystagmus, became prevalent.

Methods: A prospective study was conducted on 118 patients with symptoms suggestive of BPPV. Initially, the positional test was performed without Frenzel glasses. After 15 minutes, the test was repeated with video-Frenzel.

Results: Results were analyzed using the chi-square test. A statistically significant increase in the detection rate of BPPV and multi-canal BPPV was observed when the positional test was performed with video-Frenzel.

Conclusions: Hence, we recommend performing the positional test with video-Frenzel in suspected BPPV cases.

Study of the association between computed tomography scan of paranasal sinuses and intraoperative findings in functional endoscopic sinus surgery

Anushree Prasad — 2026-03-24

Background: Functional endoscopic sinus surgery (FESS) has become the preferred surgical modality for managing sinonasal disorders. Preoperative computed tomography (CT) is considered the gold standard imaging tool, but variations exist in its correlation with intraoperative findings. Assessing this association is essential for improving diagnostic accuracy and surgical outcomes. Objectives of the study were to evaluate the association between CT scan findings of the paranasal sinuses and intraoperative observations during FESS, and to determine the role of the Lund-Mackay (LM) score in grading disease severity.

Methods: A prospective study was conducted on 40 patients who underwent CT imaging followed by FESS. Anatomical variations, extent of sinus involvement, and histopathological findings were analyzed. Disease severity was quantified using the LM scoring system.

Results: Maxillary sinuses were the most frequently involved (92.5%), followed by ethmoidal sinuses. Ethmoidal polyps were the predominant pathology (57.5%), with antrochoanal polyps accounting for 25% of cases. A strong correlation was noted between CT and FESS findings, particularly in cases of deviated nasal septum. The LM score showed progressive increases with the number of sinuses involved, indicating its reliability in disease severity assessment. Histopathological evaluation revealed diverse pathologies, guiding individualized management.

Conclusions: CT and FESS findings show significant association in evaluating sinonasal disease. CT reliably demonstrates anatomical variations and disease extent, while the LM score provides objective severity assessment. The combined use of CT and intraoperative findings enhances diagnostic precision and optimizes treatment strategies in paranasal sinus disorders.

Correlation of auditory skills and verbal communication abilities in pediatric unilateral cochlear implants

Vidushi Verma — 2026-03-24

Background: Hearing is crucial for child’s speech and language development. The child's actions during the first few months and early years are reflexive; the child's hearing directly influences the development of language and speech abilities (Robbins et al, 2000). The Meaningful Auditory Integration Scale (MAIS) (Robbins et al, 1991) and the Meaningful Use of Speech Scale (MUSS) (Robbins and Osberger, 1991) are valid and reliable parent interviewed based questionnaires were performed. The aim of the study is to correlate the auditory skills and verbal communication abilities in pediatric unilateral cochlear implant recipients.

Methods: The cross-sectional study includes the 69 unilateral cochlear implant recipients chronological aged 4 to 8 years this further divided into three groups: Group I (Implant age of <1 year), Group II (Implant age of 1 to 2 years), Group III (Implant age of >2 years).

Results: There is a significant improvement in both auditory and verbal communication outcomes with increased cochlear implant use, particularly in all three groups shows statistically significant difference (p <0.05). A positive correlation between MAIS and MUSS was found in Groups I and II, but not in Group III. The correlation cannot be obtained, as there is limited verbal output present in >2 years cochlear implant recipients.

Conclusions: The study highlighted the correlation among the auditory skills and verbal communication skills in the unilateral cochlear implant recipients shows the continuum improvement with cochlear implant use.

Awake flexible endoscopy in supine position versus drug-induced sleep endoscopy: impact on surgical decision-making in obstructive sleep apnea: experience from a tertiary care centre in Pune, India

Seemab Shaikh — 2026-03-24

Background: Obstructive sleep apnoea (OSA), increasingly prevalent in India due to rising obesity and urbanisation, demands precise preoperative assessment for effective surgical management. This study compares awake flexible nasopharyngolaryngoscopy (FNPLS) and drug-induced sleep endoscopy (DISE) to evaluate their diagnostic contributions and impact on surgical decision-making in a resource-constrained setting.

Methods: A retrospective study at Inamdar Hospital included 177 patients (aged 18–65 years) with OSA (apnoea–hypopnoea index (AHI)>5) diagnosed via Level 2 or 3 polysomnography from January 2019 to July 2025. All underwent FNPLS and DISE to identify airway collapse sites. The study assessed whether DISE provided additional diagnostic information beyond FNPLS and influenced surgical planning. Data were analyzed using SPSS version 26 (p<0.05 for significance).

Results: All patients (100%) showed velar and oropharyngeal collapse on FNPLS and DISE. DISE revealed additional sites in 24.3% of cases, mainly tongue base (16.4%) and epiglottic collapse (2.2%), altering the primary diagnosis in 26.0% of patients. Surgical plans remained unchanged in 81.4% of cases. Mean AHI decreased significantly from 17.74±9.25 preoperatively to 9.37±5.91 post-surgery (p=0.001). No complications occurred during DISE or surgery.

Conclusions: FNPLS serves as an effective primary tool for OSA surgical planning. DISE offers valuable insights into dynamic airway collapse, enhancing diagnostic precision in select cases. Its role as a complementary investigation supports tailored surgical strategies while optimizing resource allocation.

A study of ENT symptoms in leprosy patients at a leprosy rehabilitation centre in Hyderabad, Telangana, India

Bhasmitha G. Reddy — 2026-03-24

Background: Hansen’s disease (leprosy) remains endemic in India. Otorhinolaryngologic (ENT) involvement, particularly of the nasal mucosa, may occur early but is often overlooked. Early recognition is vital for timely treatment and prevention of irreversible deformities. The objective was to describe the spectrum and frequency of ENT manifestations among multibacillary leprosy patients at a rehabilitation center in Hyderabad, India.

Methods: A cross-sectional observational study was conducted at Sivananda Rehabilitation Home from September 6-25, 2025. Forty-nine confirmed multibacillary patients (ages 12-70) underwent structured ENT evaluation, including anterior rhinoscopy, otoscopy, and oropharyngeal examination. For disease-type and bacteriological index (BI) correlations, an analytic cohort of 42 patients was used.

Results: In the analytic cohort (n=42), disease distribution was lepromatous (47.6%), borderline lepromatous (40.5%), and mid-borderline (11.9%). Overall, 16/49 (32.7%) reported nasal symptoms, with epistaxis being most common (62.5%). Clinical examination revealed nasal abnormalities in 28/49 (57.1%); turbinate atrophy was most frequent (36.7%), followed by hypertrophy (12.2%) and septal perforation (8.2%). Notably, 75% of patients with septal perforation had a BI>4. No participant reported ear or throat symptoms, though incidental otoscopic findings occurred in 12.2%.

Conclusions: ENT involvement is common in multibacillary leprosy, predominantly affecting the nose. Objective nasal findings significantly outpace reported symptoms. Routine ENT evaluation, specifically focused nasal examination, should be incorporated into standard leprosy assessments to support early recognition and reduce complications.

Flexible bronchoscopic management of high post-intubation tracheal stenosis: a case series

Manu Chopra — 2026-03-06

Post-intubation tracheal stenosis (PITS) affecting the upper 5 cm of the trachea, is difficult to manage because of its proximity to the vocal cords and the higher risks associated with surgery. Flexible bronchoscopic procedures provide a minimally invasive option for patients who are unsuitable for operative treatment. We describe a retrospective case series evaluating the outcomes of flexible bronchoscopic management in six patients with high PITS treated at a tertiary care chest centre of the Indian Armed Forces. Over a mean follow-up exceeding three years, all surviving patients remained symptom-free. This case series suggests that flexible bronchoscopic management is a safe and effective option for selected patients with high PITS and may represent a reasonable alternative when surgical treatment is not feasible.

Pinna keloids: any role of complete surgical excision as monotherapy?

Unmesh V. Warwantkar — 2026-03-24

Keloid is abnormal growth of scar tissue at the site of injury. External ear is one of the most common sites for keloids and most common reason being ear piercing. Many different treatment modalities such as surgery, intralesional steroids/ 5-FU, radiotherapy, silicone gel, cryotherapy, pressure earrings have been used for pinna keloids. Most of the studies suggest combination therapy of surgery and one of the above modalities gives better result and reduced recurrence compared to only surgery as monotherapy. At our institute we operated on 11 patients with 14 pinna keloids developed post ear piercing with aim not to leave behind any residue. None of the patients received any adjuvant therapy immediate post-surgery. Patients were followed up for 1 year. All the patients had good wound healing and acceptable scar post-surgery. Only 3 keloids out of 14 showed signs of recurrence and were treated with intralesional steroids. From this case series we would like to suggest complete surgical excision as primary mode of treatment (monotherapy) for pinna keloids developed post ear piercing without risk of recurrence and adjuvant therapy like intralesional steroids can be started at the onset of recurrence and not generally.

Distraction osteogenesis of mandible: our experience at RIMS, Ranchi

Astha Priya — 2026-03-24

Distraction osteogenesis has become an important modality in management of craniofacial deformities particularly in mandibular hypoplasia. This article describes extraoral distraction osteogenesis of mandible in management of mandibular deformities in 08 cases. Majority of patients presenting with mandibular deformities were secondary to TMJ ankylosis with a history of trauma. Body of mandible was primarily involved in 63% patients while in 37% patient’s ramus of mandible was involved. Bilateral distraction device placement was done in 05 (62%) cases and unilateral distraction device placed in 03 (38%) cases. Sliding genioplasty was performed additionally in severe mandibular hypoplasia (37.5% cases) to achieve a good profile. 63% patients were satisfied with the improved facial features both frontal and profile with functional harmonious occlusion noted while 37% patients were not satisfied as there was not significant improvement in facial symmetry. Distraction osteogenesis is a valuable tool for mandibular reconstruction, though individualized planning and careful execution are critical to minimize complications and optimize results. Multidisciplinary approach plays a key role in patient management and satisfaction assessment.

ENT problems of the general population: a health centre experience

Soumick Ranjan Sahoo — 2026-03-24

At present a lot of focus is being made in making healthcare accessible to all people. Many patients prefer to visit the health centre close to their homes. Among the clinical complaints for which a patient visits a health centre, ENT complaints constitute an important category. An attempt was made to get an idea of the otorhinolaryngology complaints/disorders for which patients visited the health centre attached to the main hospital and located near a residential area by spending few hours a day few days a week at the health centre. The most common diagnosis as per the study was upper respiratory tract infection. It is felt that health centre can be utilized to carry out otorhinolaryngology research, education and training of primary care providers on ENT pathology and for providing healthcare services to the people. This will bring uniformity in the level of ENT care and the services will reach those people who are unable to visit the main hospital especially senior citizens. This manuscript may also help the policymakers to implement the health centre model in different Primary Health Centre /Sub Centre/Urban Health Centre/Community Health Centre of India and promoting the concept of Community otorhinolaryngology.

Chronic suppurative otitis media and its association with sensorineural hearing loss: evidence from a systematic review

Ahmed Raquib — 2026-03-24

Chronic suppurative otitis media (CSOM) remains a major cause of preventable hearing impairment worldwide, yet its association with sensorineural hearing loss (SNHL) is often underestimated. The objective of this systematic review was to evaluate the prevalence, characteristics, and determinants of SNHL among patients with CSOM. A comprehensive literature search was performed across PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for studies published between January 2000 and February 2025. Eligible studies included patients diagnosed with CSOM who underwent pure-tone audiometry with bone conduction (BC) threshold assessment. Twelve studies met the inclusion criteria, representing 1,742 participants from Bangladesh, India, Pakistan, Iran, and Brazil. SNHL prevalence ranged from 18% to 31%, with significantly higher BC thresholds in diseased ears compared with contralateral normal ears. High-frequency hearing loss was most prominent. Longer disease duration, squamosal CSOM, and subtotal perforations were associated with greater SNHL in several studies, while findings on cholesteatoma were inconsistent. Overall, evidence demonstrates that CSOM contributes meaningfully to SNHL through chronic inflammation and cochlear involvement. Early diagnosis, routine audiological monitoring, and timely intervention are essential to prevent irreversible cochlear damage. Further longitudinal studies are needed to clarify risk factors and guide management.

Metastatic carotid body tumor: a rare condition

Salvador S. Yescas-Castellanos — 2026-03-24

Carotid body tumors (CBTs), or carotid glomus tumors, are rare, slow-growing benign neoplasms arising from the carotid body chemoreceptor. Metastatic disease is uncommon and poorly understood. We report the case of a 53-year-old male with a Shamblin type IIIB CBT, treated with a hybrid approach involving stent placement followed by en bloc resection. He remained disease-free for 116 months before developing regional recurrence along with pulmonary, bone, and brain metastases, which were managed with palliative radiotherapy. The patient died three years after the onset of the first metastases. This case highlights that CBT metastasis may arise more than a decade after initial treatment, underscoring the importance of long-term follow-up and multidisciplinary management.

Preparatory endonasal surgical modification to create a functional corridor for effective photoimmunotherapy in residual nasopharyngeal carcinoma: a case report

Yoshiya Ishida — 2026-03-24

Delivering effective photoimmunotherapy (PIT) in the anatomically constrained nasopharynx is technically challenging. Optimizing laser access is essential for achieving complete tumor illumination and maximizing treatment efficacy. A man in his fifties with refractory residual nasopharyngeal carcinoma (NPC) underwent preparatory endonasal surgical modification consisting of endoscopic resection of the posterior nasal septum and inferior turbinates. This procedure created a straight transnasal functional corridor and provided an adequate standoff distance for frontal diffuser placement. PIT was subsequently administered using intravenous cetuximab sarotalocan sodium, according to the standard protocol. The newly established functional corridor enabled stable and uniform laser illumination of the nasopharyngeal lesion. The procedure was completed without intraoperative or postoperative complications. Endoscopy and biopsy performed seven weeks after PIT confirmed a complete response, and the patient remained disease-free at 12 months of follow-up. Preparatory endonasal surgical modification can overcome anatomical barriers and facilitate safe and effective PIT delivery for residual NPC. By simplifying laser access and reducing technical demands, this minimally invasive approach may facilitate broader clinical use of PIT in anatomically constrained nasopharyngeal regions.

Empty nose syndrome case study

Iris Zhorov — 2026-03-24

Empty nose syndrome (ENS) is a rare rhinological disorder secondary to excessive loss of nasal turbinate tissue. This case study presents a 33-year-old male who developed ENS following functional endoscopic sinus surgery (FESS). Despite significant improvement of rhinosinusitis severity and incidence, the patient experienced severe facial pain and suffocation sensation during nasal breathing starting several months postoperatively. Diagnosis was confirmed using the ENS6Q and a positive cotton test. An in-office intervention was successful in temporarily alleviating symptoms and improving quality of life. This intervention was placement of intranasal dissolvable packing (Nova Pack). After three weeks, the symptoms did recur. However, the patient was extremely grateful for temporary relief from his symptoms. This case highlights an in-office short-term remedy for ENS severe symptoms, which may be extremely helpful for these difficult-to-treat patients.

Lumbar drain associated radiculoplexopathy in a patient with spontaneous cerebrospinal fluid rhinorrhea: a proposed checklist

Stuti Chowdhary — 2026-03-10

Continuous lumbar drainage (LD) is often performed along with endoscopic cerebrospinal fluid (CSF) rhinorrhoea repair. They serve various functions, such as offsetting the pressure over the repair site, decreasing the CSF pressure gradient across the repair site, and facilitating graft adhesion. However, their insertion may cause neurological sequelae due to displacement, breakage, or dural trauma at the site. The authors present a case of a rare complication of LD insertion where the patient developed lumbar plexus neuropathy due to an epidural CSF collection. Imaging and neurological assessment helped with the diagnosis, while device removal with bed rest resolved the symptoms. There is a paucity of literature on this complication in adults, and this report describes the presentation, management, and treatment of this problem along with a suggested checklist.

Sinonasal angiosarcoma: a rare case of recurrent vascular malignancy managed with endoscopic excision and radiotherapy

Aswathi Krishna — 2026-03-24

Angiosarcoma is an aggressive endothelial malignancy that is rarely found in the nasal cavity. Objectives of the study were to present a rare case of sinonasal angiosarcoma, treated via endoscopy and radiotherapy A 50-year-old hypertensive woman presented with one month of recurrent left epistaxis and nasal obstruction. Endoscopy revealed a firm, bleeding reddish-black mass medial to the middle turbinate. CT imaging showed a heterogeneously enhancing lesion extending into the nasopharynx and ethmoidal cells. Endoscopic excision revealed a 5×2.5×1.5 cm lesion; histopathology showed retiform and capillary vascular channels with endothelial hob nailing and focal necrosis. Immunohistochemistry was positive for CD34, BCL2, CD99; Ki 67 was ~25% with possibility of hemangioen-thothelioma. Recurrence appeared at three months and was excised, confirming angiosarcoma. The patient underwent 30 cycles of radiotherapy. Sinonasal angiosarcoma is aggressive with high recurrence risk. Thorough histopathological evaluation, combined treatment, and close follow-up are essential.

Unexpected histology – ectopic salivary gland in the false vocal cord

V. Ravisankar — 2026-03-24

An ectopic salivary gland is an anomaly where salivary gland tissue is located outside its normal anatomical boundaries. We present a case of a 57-year-old man with no known co-morbidities presenting with the sole symptom of persistent throat pain for six months. Clinical examination revealed a cystic lesion in the vallecula and a smooth mass in the anterior third of the right vocal cord. Contrast enhanced computed tomography (CECT) confirmed the findings. Patient underwent microlaryngeal excision and histopathological examination was suggestive of seromucinous salivary gland tissue. We diagnosed the patient as ectopic salivary gland. To date, only nine cases of ectopic salivary glands in the larynx have been identified, with just three occurring in the false cords, making this patient the fourth reported case. This case highlights the need to consider ectopic salivary glands in falsel cords as a differential diagnosis during evaluation of submucosal masses in the larynx.

A rare case of capillary hemangioma mimicking glomus tympanicum in a 38 years old male

Huidrom Anand Singh — 2026-03-24

Capillary hemangiomas of the middle ear are rare benign vascular neoplasms characterized by abnormal proliferation of small blood vessels. We report a case of a 38-year-old male who presented with episodes of otorrhea, aural fullness, otalgia, and hearing loss in the left ear. Otoscopic examination revealed a thickened, reddish, non-pulsatile tympanic membrane. Pure tone audiometry demonstrated mild conductive hearing loss, and CT imaging of the temporal bone showed a soft tissue mass in the mesotympanum and epitympanum. Surgical exploration and histopathology confirmed the diagnosis of a capillary hemangioma. Surgical excision remains the mainstay of treatment, with histopathology as the definitive diagnostic tool. Long-term follow-up is recommended due to the risk of recurrence.

Cystic hygroma presenting as paediatric stridor

Prasun Mishra — 2026-03-24

Cystic hygroma, a fluid-filled lymphatic lesion, commonly presents in the head and neck but can occur anywhere. Paediatric stridor is a critical emergency demanding precise diagnosis and immediate airway intervention. We report the case of a 2-year-old male child presenting with a 7-day history of dysphagia and stridor, accompanied by high-grade fever, left neck swelling, and torticollis. Examination revealed a posterior pharyngeal wall bulge. Initial impression was retropharyngeal abscess, necessitating emergency tracheostomy for airway compromise. Midline aspiration yielded straw-coloured fluid, and histopathological examination confirmed cystic hygroma. Postoperative MRI revealed a large (9.6 x 7.7 x 3.4 cm) hyperintense cystic lesion with septations, extending from the oropharynx to the upper mediastinum, encasing vital structures. The patient subsequently underwent four cycles of sclerotherapy with intra-lesional bleomycin. This case highlights the challenges in diagnosing atypical causes of paediatric stridor. Sclerotherapy with bleomycin proved to be a highly effective treatment for this extensive cystic hygroma, demonstrating its superiority over surgical options due to lower associated risks and favourable outcomes.

A rare case of non-functioning parathyroid carcinoma masquerading as euthyroid neck mass

Subasri Shanmugam — 2026-03-24

Parathyroid carcinoma is an exceptionally rare endocrine malignancy, often functional, manifesting with hypercalcemia and elevated parathyroid hormone (PTH) levels. Non-functional parathyroid carcinoma lacks classical biochemical features, making its diagnosis particularly challenging. Here, we present a case of 60-year-old male with swelling in the anterior aspect of right side of neck. Ultrasound of the neck showed complex cystic nodule suggesting fine needle aspiration cytology (FNAC) to rule out papillary neoplasm. FNAC results were suggestive of hyperplastic colloid nodule. Then the routine blood tests, including serum calcium and thyroid function, were within normal limits and the patient was taken up for total thyroidectomy. Histopathology of the specimen revealed features suggestive of medullary thyroid carcinoma, necessitating IHC. Tumor cells stained strongly positive for GATA3 and PTH, while being negative for calcitonin, MCEA, TTF1, and S100. Focal capsular and lymphovascular invasion was noted and the final diagnosis of parathyroid carcinoma was made. Parathyroid carcinoma is a rare and aggressive tumor that may clinically and radiologically mimic a thyroid nodule, especially in its non-functional form. Diagnosis is extremely difficult and is best confirmed with immunohistochemistry.

A rare case report of unilateral giant sphenochoanal polyp with sphenoidal mucocele

Shaikh Rahila — 2026-03-24

Sphenochoanal polyp is a rare benign tumour arising from sphenoid sinus. The most common presenting complaint is gradually progressing nasal obstruction. Clinically, it mimics antrochoanal polyp and differentiated using nasal endoscopy, computer tomography and magnetic resonance imaging of the paranasal sinuses. Functional endoscopic sinus surgery (FESS) is the treatment of choice. Whereas mucous retention cyst of sphenoid is one of the rarer conditions. It develops due to obstruction of seromucinous gland of sinus mucosa, resulting in accumulation of mucus causing dilatation of the gland. Retention cysts and polyposis are infrequent in sphenoid sinus compared to other paranasal sinuses. Main clinical presentation of sphenoid mucocele is due to its pressure effects on surrounding structures, causing headache, diminished vision, ophthalmoplegia or intracranial complications. Sometimes, it remains undiagnosed and comes out as an accidental finding during surgery as occurred in our case. Patients with complaints must go under surgical removal of cyst and polypoidal mass. We report a case of a 23-year-old male presenting with unilateral nasal obstruction, headache, periorbital swelling, and a history of recurrent paranasal sinus infections. He was diagnosed with a sphenochoanal polyp based on investigations but underwent FESS, during which a sphenoid mucocele was discovered as an incidental finding.

Extended radical parotidectomy with mastoidectomy and facial nerve resection for advanced parotid malignancy: a case report

Gopu G. — 2026-03-24

Advanced parotid malignancies with perineural spread pose significant surgical challenges and often require aggressive multidisciplinary management. We report a case of a 52-year-old male who presented with a progressively enlarging right parotid swelling for 1.5 years associated with right lower motor neuron facial nerve palsy for one year. Patient was evaluated clinically and radiologically. Fine needle aspiration cytology initially suggested mucoepidermoid carcinoma. The patient underwent radical parotidectomy with extended radiacal neck dissection, intact canal wall mastoidectomy, facial nerve resection through a combined surgical approach involving ENT and surgical oncology teams. Intraoperatively, tumour infiltration into the sternocleidomastoid muscle, internal jugular vein, spinal accessory nerve and posterior belly of digastric was noted, necessitating an extended radical resection. Final histopathology revealed salivary duct carcinoma with lymphovascular and perineural invasion and nodal metastasis. Postoperative radiotherapy was planned as adjuvant therapy. This case highlights the importance of aggressive surgical management with skull base exposure in advanced parotid malignancies with perineural spread to achieve optimal oncological clearance.

Pediatric lingual Schwannoma: case report on an atypical localisation of a benign nerve sheath tumour

Bijiraj V. Veetil — 2026-03-24

Schwannomas of the tongue are rare tumours, and their occurrence in the paediatric population is exceptionally uncommon. We present the case of a 9-year-old boy with a nodular mass on the tongue, present for two years. Complete surgical excision was performed with preservation of both motor function and overall tongue mobility. Histopathological examination confirmed the diagnosis of Schwannoma. This case is reported to highlight the rarity of paediatric lingual Schwannomas and the favourable functional outcomes achievable with meticulous surgical management.

Giant slow flow vascular malformation of the posterior pharyngeal wall: a rare entity

Nitish Baisakhiya — 2026-03-24

Arteriovenous malformations (AVMs) involving the posterior pharyngeal wall are sporadic and pose significant clinical and surgical challenges due to their proximity to vital airway and vascular structures. We report a case of a large posterior pharyngeal AVM in a 52-year-old male, presenting with stertor, progressive dysphonia, dysphagia, and oropharyngeal swelling. Imaging revealed a non-infiltrative vascular lesion occupying the oropharynx and extending from the lower nasopharynx up to the valleculae level. The lesion was successfully excised via microscope-assisted intraoral surgery following elective tracheostomy. Postoperative follow-up showed complete recovery without recurrence. It is the largest size of slow-flowing AVM in the posterior pharyngeal wall reported in the English literature till date. This case underscores the importance of early recognition, imaging, and a multidisciplinary approach for managing complex vascular lesions of the upper aerodigestive tract (posterior pharyngeal wall).

Masson's hemangioma of the larynx: a rare benign vascular lesion in an adult male

K. Karthikeyan — 2026-03-24

Masson’s hemangioma, also known as intravascular papillary endothelial hyperplasia (IPEH), is a rare benign vascular lesion. IPEH accounts for approximately 2% of vascular tumors and is most frequently reported in the skin and subcutaneous tissues of the head and neck, extremities, and trunk. Although laryngeal hemangiomas are predominantly observed in infants and typically involve the subglottic region, adult laryngeal hemangiomas are uncommon and more often arise in the supraglottic and glottic areas. We report a case of a 50-year-old male who presented primarily with respiratory distress. A tracheostomy had been performed previously to secure the airway. On examination a smooth nodular mass was observed in the medial part of the left aryepiglottic fold, extending to the arytenoid cartilage and post-cricoid region. Radiological evaluation confirmed findings. The patient underwent microlaryngeal excision of the mass. Histopathological examination was suggestive of hemangioma with papillary endothelial hyperplasia (Masson’s hemangioma). This case emphasizes the importance of accurate histopathological evaluation to distinguish this benign entity from malignant vascular tumors. Complete surgical excision remains the treatment of choice and is associated with an excellent prognosis.

Thyroglossal duct cyst carcinoma in a young female: reassessing the need for total thyroidectomy after Sistrunk operation

Suhas S. S. — 2026-03-24

Thyroglossal duct cyst carcinoma (TGDCCa) is a rare malignancy, accounting for approximately 1% of thyroglossal duct cysts. Preoperative diagnosis is challenging because clinical and imaging findings often mimic benign lesions. Papillary thyroid carcinoma is the most common histological subtype, and optimal management, particularly the role of total thyroidectomy remains controversial. A 24-year-old female presented with a slowly progressive midline neck swelling of three years’ duration. Ultrasonography and computed tomography (CT) revealed a cystic infra-hyoid lesion with a small solid component and microcalcifications. She underwent a Sistrunk procedure. Histopathological examination demonstrated a 4 mm focus of papillary carcinoma confined to the cyst wall with tumour-free margins, no hyoid bone invasion, and a normal thyroid gland. After counselling, she opted for surveillance rather than thyroidectomy. Postoperative thyroglobulin levels and serial imaging remained normal. This case highlights the indolent nature of low-risk TGDCCa and supports individualized management, with Sistrunk alone being adequate in select patients.

The role of bamboo shoots derived flavonoids as Epstein-Barr virus inhibitors in nasopharyngeal carcinoma

Ida Ayu Alit Widiantari — 2026-02-26

Epstein-Barr virus (EBV) is a ubiquitous oncogenic virus that infects humans and is strongly associated with various malignancies, including nasopharyngeal carcinoma (NPC), Hodgkin lymphoma, and B-cell lymphomas. One of the major challenges in the management of EBV-associated diseases is the virus’s ability to establish latency and evade host immune surveillance. Conventional treatments such as chemotherapy and radiotherapy are often unable to specifically target latent EBV reservoirs, highlighting the need for complementary therapeutic approaches. Bamboo shoots, a traditional dietary component, contain a variety of flavonoid compounds that have been shown to possess diverse biological activities, including antiviral and anticancer effects. This article aims to review the potential of flavonoid compounds found in bamboo shoots as anti-EBV agents in NPC based on evidence from previous studies. The review methodology involved a comprehensive search of scientific publications from reputable databases. The findings indicate that flavonoids such as luteolin, apigenin, and quercetin present in bamboo shoots exert inhibitory effects on the EBV life cycle by suppressing viral reactivation from the latent to the lytic phase, downregulating the expression of EBV latent proteins (LMP1 and LMP2A), and inducing apoptosis in EBV-infected cells. In conclusion, flavonoids derived from bamboo shoots demonstrate potential for development as adjuvant therapeutic agents in NPC by targeting EBV infection; however, further studies are required to establish their clinical efficacy.