International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl <p>International Journal of Otorhinolaryngology and Head and Neck Surgery is an open access, international, peer-reviewed journal that publishes original research articles, review articles, and case reports in all areas of otorhinolaryngology. The journal's full text is available online at https://www.ijorl.com. The journal allows free access to its contents. International Journal of Otorhinolaryngology and Head and Neck Surgery is dedicated to bringing otorhinolaryngologists community around the world the best research and key information. The journal has a broad coverage of relevant topics in Otorhinolaryngology and various subspecialties such as Otology, Rhinology, Laryngology and Phonosurgery, Neurotology, Head and Neck Surgery etc. International Journal of Otorhinolaryngology and Head and Neck Surgery is one of the fastest communication journals and articles are published online within short time after acceptance of manuscripts. The types of articles accepted include original research articles, review articles, analytic reviews such as meta-analyses, insightful editorials, medical news, case reports, short communications, correspondence, images in medical practice, clinical problem solving, perspectives and new surgical techniques. It is published every <strong>two months</strong> and available in print and online version. International Journal of Otorhinolaryngology and Head and Neck Surgery complies with the uniform requirements for manuscripts submitted to biomedical journals, issued by the International Committee for Medical Journal Editors.</p> <p><strong>Issues: 6 per year</strong></p> <p><strong>Email:</strong> <a href="mailto:medipeditor@gmail.com" target="_blank" rel="noopener">medipeditor@gmail.com</a>, <a href="mailto:editor@ijorl.com" target="_blank" rel="noopener">editor@ijorl.com</a></p> <p><strong>Print ISSN:</strong> 2454-5929</p> <p><strong>Online ISSN:</strong> 2454-5937</p> <p><strong>Publisher:</strong> <a href="http://www.medipacademy.com" target="_blank" rel="noopener"><strong>Medip Academy</strong></a></p> <p><strong>DOI prefix: 10.18203</strong></p> <p>Medip Academy is a member of Publishers International Linking Association, Inc. 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We present a patient of Herpes zoster mismanagement with scarring of the right nasal cavity who was treated by placing a stent to achieve nasal patency. A 47-year-old male, previously diagnosed to have Herpes zoster, presented with complaints of right nasal obstruction, discolouration of skin and burning sensation over the right cheek and nose. He had applied an herbal paste given by quacks which led to scarring and hypopigmentation over the face. He tried peeling the scab off which resulted in a skin contracture and right nasal obstruction. Local examination revealed multiple erythematous hypopigmented plaques over the right maxillary region, scarring over the right lateral aspect of the dorsum, ala and tip and a skin contracture causing stenosis of the right anterior nares. The stenosed area was excised and diagnostic nasal endoscopy showed collapse of the ala and the vestibular region in the right nasal cavity. A red rubber catheter was used as a stent and sutured in place at the ala. Postoperatively, nasal cavity patency was maintained. Herpes zoster is usually self-limiting and treatment with analgesics suffices. Antiviral medication and corticosteroids may alleviate severe pain. However, mismanagement of the lesions by taking local herbal paste and medicines can lead to exacerbation of the lesions and complications like nasal stenosis.</p> <p> </p> Preeti S. Shetti, Manishaa E. V., Akash Rai Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4182 Tue, 26 Mar 2024 00:00:00 +0530 The anterior inferior cerebellar artery abutment: an uninvited guest in sudden sensorineural hearing loss https://www.ijorl.com/index.php/ijorl/article/view/4192 <p>Sudden sensorineural hearing loss (SSNHL) is an otological emergency and prompt recognition and management has been shown to improve hearing outcomes and quality of life. A 49-year-old female presented to the ENT OPD with complaints of sudden onset decreased hearing in the right ear since 3 days. Pure tone audiometry done in an outside hospital on day 2 of patient’s complaints showed right ear to have pure tone average of 90 dB (profound hearing loss) and left ear to have pure tone average of 21.66 dB (within normal limits). At presentation to the ENT OPD on day 3 of complaints, otoscopic examination revealed normal tympanic membrane. MRI inner ear and brain (plain and contrast) showed the right anterior inferior cerebellar artery to be abutting the posterior aspect of vestibulocochlear nerve. Patient received 2 doses of intratympanic injection of Dexamethasone followed by a course of oral steroids for 15 days. Serial repeat pure tone audiometry showed marked improvement of symptoms. Although most cases of SSNHL are idiopathic, a number of treatable conditions do exist. The relationship between vascular loops around the vestibulocochlear nerve and sudden sensorineural hearing loss have to be kept in mind while evaluating these patients. Prognosis for hearing recovery is based on several factors, including time since onset, degree of deafness, age, and vertigo. Although SSNHL will often spontaneously improve without treatment, directed therapy against treatable causes along with steroid therapy can aid in the improvement of symptoms.</p> Vishwanath Gowda, Akash Rai, Manishaa E. V., Rajesh Havaldar Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4192 Tue, 26 Mar 2024 00:00:00 +0530 Giant cell rich osteosarcoma of maxilla vs. giant cell granuloma: a diagnostic dilemma https://www.ijorl.com/index.php/ijorl/article/view/4201 <p>Giant cell-rich osteosarcoma is a rare histological variant of osteosarcoma, accounting for 3% of all primary osteosarcomas and rarely occurring in the head and neck region. GCRO poses a significant diagnostic challenge radiologically and histopathologically, as it often presents with a benign appearance despite being a clinically aggressive osteosarcoma with a high tendency for recurrence. Meticulous surgical planning, a radical surgical approach, and postoperative radiotherapy are essential to prevent recurrence. We are discussing the case of a 21-year-old male patient diagnosed with Giant Cell-Rich Osteosarcoma of the maxilla. This case highlights the diagnostic dilemma associated with GCRO, the surgical approach employed, and the subsequent reconstruction process.</p> <p> </p> Satish S. Satpute, Nidhin S. B., Nitin M. Nagarkar, Ashish Gupta, Ripudaman Arora Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4201 Tue, 26 Mar 2024 00:00:00 +0530 Unraveling a rare medical anomaly: a case report on the incidental discovery of a mixed fungal ball with parasitic elements https://www.ijorl.com/index.php/ijorl/article/view/4211 <p>Fungal ball is a type of fungal rhinosinusitis (FRS) that is chronic, non-invasive, and extramucosal. A fungal ball is a non-invasive accumulation of dense conglomeration of fungal hyphae in one sinus cavity Sinonasal fungal ball is known to be the most common form of fungal sinusiti. It typically affects immunocompetent individuals and appears as a unilateral lesion between the fourth and sixth decades of life. The most commonly involved sinus is the maxillary sinus. Patients are often asymptomatic, but some patients develop chronic mucopurulent rhinorrhea. Treatment is surgical, with removal of the fungal contents of the involved sinus, and no subsequent treatment is indicated, given the process is noninvasive. Here in we report the case of a 64-year-old gentleman diagnosed with fungal ball of maxillary sinus. Patient was asymptomatic and the fungal ball was identified as an incidental finding on imaging for stroke. The histopathological examination necrotizing lesion showing entangled septate, aseptate and pigmented fungal structures and non-viable parasitic structures noted. No viable tissue was seen. </p> <p> </p> Saud Ahmed, Ayisha Kunnumal, Prathima Koratagere, Vishakha Vijay Rane Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4211 Tue, 26 Mar 2024 00:00:00 +0530 Profiling of right internal jugular vein phlebectasia: a rare case study https://www.ijorl.com/index.php/ijorl/article/view/4203 <p>Internal jugular vein phlebectasia (IJP) is a congenital non-tortuous dilatation of the internal jugular vein that manifests as a soft, compressible mass in the neck under stress or while doing the Valsalva maneuver. As per a review of several articles, children are more likely to be impacted than adults. It is a benign disorder that often exhibits no symptoms. However, alterations in voice, paralysis of the vocal cords, and/or dysphagia are some symptoms that may be observed. The present case report is that of a 4.5-year-old male child with right IJP and cervical lymphadenopathy, who presented with symptoms of swelling in the neck on straining and pain while swallowing.</p> Kushali Shah, Pranali Chavan Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4203 Tue, 26 Mar 2024 00:00:00 +0530 Bilateral antrochoanal polyp: a rare entity https://www.ijorl.com/index.php/ijorl/article/view/4216 <p>Antrochoanal polyps (ACPs) are benign polyps that arises from inflamed and edematous mucosa of maxillary antrum. They arise most commonly from posterior wall of maxillary sinus. They occur more commonly in children and young adults without any sex predilection. The etiopathogenesis of ACPs is not clear but chronic sinusitis and allergy have been implicated. Patient usually present with nasal obstruction, may also have symptoms of epistaxis, rhinorrhoea, foreign body sensation. The diagnosis of the disease is done based on endoscopic examination of nasal cavities, computed tomography (CT) scan findings, and histopathologic results. ACPs are usually unilateral but can be bilateral in extremely rare cases. Based on adequate history and clinico-radiological examination misdiagnosis can be avoided which may lead to no improvement of symptoms and mandating revision surgery. Treatment of ACPs is always surgical. Functional endoscopic sinus surgery (FESS) and powered instrumentation during FESS is safe and effective method. Treating surgeon should focus on detecting the exact origin and extent of polyp to prevent recurrence. We herein presented extremely rare case of bilateral ACP in a 46 years female.</p> <p> </p> Nisha Kumari, Kathyayini N. Shivayogimath, Roohie Singh, Prashant Sengupta Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4216 Tue, 26 Mar 2024 00:00:00 +0530 Carbon dioxide laser: a novel approach for vallecular cyst excision in pediatric population https://www.ijorl.com/index.php/ijorl/article/view/4222 <p>In the pediatric population, vallecular cysts are most commonly found at the base of the tongue and the vallecula. They may present with sudden, life-threatening airway obstructions due to their anatomical position. A 4-year-old presented with a change in voice from the past 2 months and was diagnosed with a vallecular cyst. The patient was planned to undergo CO<sub>2</sub> laser micro-laryngeal surgery due to its precision and accuracy. In postoperative studies, the emerging CO<sub>2</sub> laser technology demonstrated superior results. In particular, in complex cases, this innovative approach has the potential to achieve the desired results.</p> Neha Anand Shendge, Shantanu Panja, Alokendu Bose, Suvojit Ghosh Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4222 Tue, 26 Mar 2024 00:00:00 +0530 Basal cell carcinoma at the pinna https://www.ijorl.com/index.php/ijorl/article/view/4217 <p>Basal cell carcinoma (BCC) is the most common type of non melanoma cutaneous malignancy BCC usually present on sun exposed area such as nose, mandibular, periocular region. A review of the literature revealed only a few reports of BCC on the auricle or conchal bowl. Objectives were to report a case of BCC of right pinna. A 62 year old man presented to ENT OPD with a painless blackish lesion in the right pinna appreciated since 6 months and progressively increased to the present size. On local examination of the pinna a blackish plaque with irregular margins was appreciated in the cocha, helical crus and incisura. It was soft to firm in consistency and tenderness absent. Wide excision of the lesion with healthy margin done under local anesthesia. Histopathology of excised specimen confirmed the lesion as BCC. BCC of pinna is an uncommon external ear pathology which should be kept as a differential diagnosis of lesions of the pinna by the otorhinolaryngologist.</p> Soumick Ranjan Sahoo, Pallavi Nayak, Nilanjan Datta Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4217 Tue, 26 Mar 2024 00:00:00 +0530 A giant dermoid cyst in the floor of the mouth: a case report https://www.ijorl.com/index.php/ijorl/article/view/4223 <p>Dermoid cysts are slow-growing cystic masses that are lined by stratified squamous epithelium and contain skin appendages. Dermoid cysts in the floor of the mouth account for less than 0.01% of all neck and oral cavity cysts. They can be either congenital or acquired. We report a case of a 25-year-old male, a final-year engineering student, who came to our outpatient department with complaints of swelling in the mouth and weight loss for 4 years. On examination, a large cystic swelling in the floor of the mouth, approx. 5x6 cm, obscuring the oropharynx, was seen. USG and CECT of the neck suggested ranula and plunging ranula in the right submandibular space, respectively. He underwent a combined (debulking and enucleation) submandibular cystic swelling excision through a transoral approach under general anesthesia guided by awake fiber optic nasal intubation. The intraoperative and postoperative periods were uneventful. Histopathologic examination of the resected tissue specimen suggested a dermoid cyst. The patient recovered well during the 1-month follow-up, and he gained weight up to 2.5 kg in a month of treatment. Dermoid cysts are very rare cystic lesions on the floor of the mouth. Surgery is the most curable method of treatment. A proper clinical examination with imaging guidance is necessary for accurate delineation of the cyst. Large submandibular cystic lesions can be excised by combining debulking and enucleation through a transoral approach, with a good cosmetic and functional outcome.</p> Yuvaraj Thirunavukarasu, Biswanath Roy, Ajaykumar Arya, Vishnupriya Pari Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4223 Tue, 26 Mar 2024 00:00:00 +0530 The role of virtual endoscopy in surgical practice of otolaryngology head and neck surgery: a review article https://www.ijorl.com/index.php/ijorl/article/view/4183 <p>Virtual endoscopy involves the acquisition of data to generate a three-dimensional view of hollow anatomical structures. This interface would allow for the realistic integration of anatomical structures in complex cavities involving sinuses, larynx, and ears. Current literature lacks updated review on the role virtual endoscopy in otolaryngological practice. This paper serves to highlight the use of virtual endoscopy in amongst three main domains: otology, rhinology and laryngology. Review of literature were conducted using various databases including, Pubmed, Scopus, Embase, Web of Science, google scholar. Only papers in full text, English language, and relevant to our objectives were included. A critical descriptive review of the papers were performed to illustrate the strength and weakness on the utilization of virtual endoscopy as a surgical planning tool in otorhinolaryngology practice. The advantages of applying VE in our practice serves two folds; as an educational tool for novice trainees mainly for surgical skill acquisition and as a pre-op planning to understand complex anatomical narrow operative fields. Our paper is the first to demonstrate the most updated commentary review article of the application of virtual endoscopy in sinus surgery, laryngeal airway evaluation and the assessment of ear surgery.</p> <p> </p> Ali Jafar, Bader Alali Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4183 Tue, 26 Mar 2024 00:00:00 +0530 Study on anatomical variations of nose and paranasal sinuses in patients with sinonasal polyposis https://www.ijorl.com/index.php/ijorl/article/view/4212 <p><strong>Background: </strong>Knowledge regarding the sinonasal variations plays an important role in the management of sinonasal diseases. Despite being postulated as one of the risk factors for sinonasal diseases, its role in the pathogenesis of nasal polyp is still unclear. This study was done to determine the prevalence of sinonasal anatomical variations by CT imaging and examine its association with sinonasal polyposis (SNP).</p> <p><strong>Method: </strong>A descriptive cross-sectional study was conducted from January, 2019 to January, 2020 at a tertiary care center after receiving ethical approval from the institutional review committee of the hospital. Patients above 17 years of age having sinonasal polyp and not responding to 3-4 weeks of medical treatment were included in the study. Convenience sampling was done. Data were collected and entered in Microsoft excel and analyzed using statistical package for the social sciences version 24.0.</p> <p><strong>Results: </strong>Among 72 patients, 86.11% of the patients were found to have anatomical variations of nose and paranasal sinuses with Agger nasi (79.09%) and deviated nasal septum (DNS) (72.5%) being the most common variations noted, 29% of patients were found to have a single variation while multiple variations were seen 70.9% of patients.</p> <p><strong>Conclusions: </strong>Our study showed that patients with sinonasal polyps have a higher prevalence of sinonasal anatomical variations and severity of polyp increased with the presence of more than one variation in a patient.</p> Akriti Shrestha, Kolaj Kattel, Sabi Rana, Sagar Devkota, Astika Shrestha, Pronin Piya Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4212 Tue, 26 Mar 2024 00:00:00 +0530 Role of flexible fiberoptic nasopharyngolaryngoscopy and indirect laryngoscopy in the diagnosis of laryngopharyngeal pathologies https://www.ijorl.com/index.php/ijorl/article/view/4188 <p><strong>Background:</strong> Visualization of the larynx and pharynx is essential to diagnose and treat pathologies, and to prognosticate. This can be done by using indirect laryngoscopy, rigid and flexible endoscopy, and direct laryngoscopy. The main purpose of the article was to assess the profile of laryngopharyngeal pathologies diagnosed by flexible fiberoptic nasopharyngolaryngoscopy and indirect laryngoscopy in patients with laryngopharyngeal symptoms and to estimate the level of agreement between flexible fiberoptic nasopharyngolaryngoscopy and indirect laryngoscopy for selected laryngopharyngeal conditions like vocal nodule, vocal cord polyp, Reinke’s edema, hypopharyngeal growth, vocal cord palsy, vocal cord growth. An Independent t-test and chi-square test were used to analyze the results. Statistical package for the social sciences (SPSS) version 20 was used for statistical analysis.</p> <p><strong>Methods:</strong> In this descriptive cross-sectional study, 101 patients with laryngopharyngeal symptoms were subjected to both indirect laryngoscopy and flexible fiberoptic nasopharyngolaryngoscopy. The structures visualized, pathologies detected, time taken and discomfort levels were statistically analyzed. </p> <p><strong>Results:</strong> In our study, we found that laryngopharyngeal symptoms were more common among the 61 to 70 years age group. The majority of them were males. The majority of them were retired employees. The most common presenting complaint was difficulty in swallowing, followed by globus sensation and voice change. All structures were visualized by flexible fiberoptic nasopharyngolaryngoscopy. Whereas, in indirect laryngoscopy, some structures were visualized and some were not. Pyriform fossa apex and post-cricoid region were not visualized for all patients with indirect laryngoscopy. Laryngopharyngeal reflux was the most common pathology detected. There is no significant difference between IDL and FOL in site, subsite, and clinical appearance of the pathology detected. There is a significant difference between IDL and FOL in time taken (FOL has a higher mean) and discomfort levels (IDL has a higher mean).</p> <p><strong>Conclusions:</strong> Though indirect laryngoscopy is cost-effective in terms of investment, the time taken for the procedure is also less, flexible fiberoptic laryngoscopy is considered superior because it can visualize all structures and can detect pathologies early in their stage so that the patient gets treatment early which can alter the prognosis.</p> Musarrat Feshan, Preetham A. Puthukudy, Alagammai Odayappan Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4188 Fri, 01 Mar 2024 00:00:00 +0530 Role of nasal endoscopy in evaluation and management of epistaxis https://www.ijorl.com/index.php/ijorl/article/view/4209 <p><strong>Background:</strong> Epistaxis is the most common ENT emergency. The localization of bleeding site and its control in profuse epistaxis is of major concern for the ENT surgeon. Nasal endoscope has proved to be a boon for the otolaryngologist and is an important tool in diagnosing these bleeding points and their immediate management which reduces the incidence of nasal packing either anterior or posterior. Aim was to study the importance of nasal endoscopy in diagnosing the cause and site of epistaxis and managing them appropriately.</p> <p><strong>Methods:</strong> It was a prospective study conducted in 187 patients of epistaxis visiting ENT emergency at SMGSH, Jammu after getting IEC clearance. </p> <p><strong>Results:</strong> 139 (73.8%) had anterior and 48 (26.2%) posterior epistaxis. Dry nasal septum and mass lesions were the common local causes followed by deviated nasal septum. Anterior part of septum (little’s area) was the common site of bleeding followed by woodruff’s area. The overall success rate of diagnosing the local cause and site of epistaxis was 99% with nasal endoscopy and only 47% with combined anterior and posterior rhinoscopy. Thus, eliciting the importance of nasal endoscopy over conventional anterior and posterior rhinoscopy.</p> <p><strong>Conclusions:</strong> Nasal endoscopy helps in detecting the site and cause of epistaxis and also aids in its appropriate management. It helps in endoscopic guided direct pressure packing, bipolar electrocautery, endoscopy assisted mass excision and endoscopic guided foreign body removal. However, nasal endoscopy is not a substitute for nasal packing.</p> <p> </p> Hardeep Singh, Preeti Sharma, Sonika Kanotra, Kshitij Gupta, Sunil Kotwal, Divya Gupta Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4209 Mon, 19 Feb 2024 00:00:00 +0530 A retrospective study of posterior canal benign paroxysmal positional vertigo cases in a tertiary care industrial hospital https://www.ijorl.com/index.php/ijorl/article/view/4193 <p><strong>Background:</strong> Balance disorders form a significant proportion of the patients attending ENT OPD. Among the various otologic causes responsible for balance disturbances, BPPV is one of the important causes. The etiological mechanism responsible for BPPV are canalithiasis and cupulolithiasis. Positional maneuver such as Epleys maneuver are used for treating posterior canal BPPV along with medications.</p> <p><strong>Methods:</strong> We are retrospectively studying the posterior canal BPPV cases seen in our hospital from January 2022 to January 2024. There were total 192 vertigo cases seen in the vertigo clinic of ENT Department after taking into account inclusion and exclusion criteria. Diagnosed cases of posterior canal BPPV were treated by Epleys maneuver along with pharmacological treatment.</p> <p><strong>Results:</strong> Total 50 cases of posterior canal BPPV were diagnosed which constituted 26.04% of the total no of vertigo cases. Regarding the etiology of posterior canal BPPV, 2 cases were posttraumatic while 48 cases were idiopathic. The success rate of Epleys maneuver along with Betahistine was 78% in treating such cases.</p> <p><strong>Conclusions:</strong> This retrospective study shows that most of the posterior canal BPPV cases were idiopathic. Epleys maneuver along with Betahistine was effective in the management of BPPV patients in our setup.</p> Soumick Ranjan Sahoo, Pallavi Nayak, Nilanjan Datta Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4193 Tue, 26 Mar 2024 00:00:00 +0530 Sensorineural hearing loss in patients with type 2 diabetes mellitus: a hospital based cross sectional study https://www.ijorl.com/index.php/ijorl/article/view/4180 <p><strong>Background:</strong> One of the most important of the five senses in human beings is hearing. It plays an important role in the development of speech, cognitive and communication skills. The decrease in length, quality of life and depletion of social networks can be caused by hearing impairment. Therefore, the sense of hearing, perception of sound and its biological purposes, can’t be lightly dismissed. Diabetes mellitus is a common metabolic disorder that causes impairment in various systems of the body. One of the complications of diabetes mellitus is hearing impairment and tinnitus which in turn leads to decreased quality of life in affected individuals.</p> <p><strong>Methods:</strong> 75 type 2 diabetes mellitus patients age group of 35 -55 yrs with or without aural symptoms (deafness, tinnitus) were taken into the study.</p> <p><strong>Results:</strong> prevalence of sensorineural hearing loss (SNHL) was found 60%. Prevalence of SNHL is lowest among 35-40 age group (12.5%) and highest among 51-55 age group (80.5%). Prevalence of SNHL among the diabetic patients was calculated and it was noted to be 36.8%, 60% and 74% with the duration of diabetes ≤5 yrs, 6-10 yrs, ≥11 yrs. respectively.</p> <p><strong>Conclusions:</strong> SNHL is prevalent in 60% of type II diabetic patients.</p> Karishma, Varanasi Swetha, Chandra Mouli Sileveru Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4180 Tue, 26 Mar 2024 00:00:00 +0530 Expert opinion on the clinical use of a combination of antihistamines with leukotriene receptor antagonists in the management of allergic rhinitis in Indian settings https://www.ijorl.com/index.php/ijorl/article/view/4190 <p><strong>Background: </strong>Various clinical studies have reported that the combination of montelukast and levocetirizine was effective in alleviating residual symptoms and the improvement of quality of life associated with allergic rhinitis. However, there was a dearth of data regarding the prescription practice among clinical practitioners. So, this study aims to gather clinicians' opinion regarding the use of antihistamines, with a special focus on the combined use of antihistamines with leukotriene receptor antagonists for the management of AR in Indian settings.</p> <p><strong>Methods:</strong> The multiple-response questionnaire-based survey involving 19 questions gathered information on current recommendations, clinical observations, clinical experience of specialists in AR management, and the use of montelukast with levocetirizine in routine settings.</p> <p><strong>Results: </strong>Out of 388 participants, approximately 84% of respondents preferred a combination of antihistamines and leukotriene receptor antagonists for managing AR. Additionally, 36% stated that 26 to 50% of patients presenting to routine practice may require montelukast and antihistamine combination as treatment. Around 61% endorsed the combination of antihistamines with leukotriene receptor antagonists as the preferred AR treatment strategy. In long-term AR management, 65% of clinicians rated montelukast with levocetirizine as excellent, and 78% of respondents reported montelukast confers additive benefits when combined with antihistamines.</p> <p><strong>Conclusions:</strong> The significant preference for the combined use of antihistamines and leukotriene receptor antagonists underscores their perceived efficacy in AR treatment. The combination of antihistamines with leukotriene receptor antagonists emerges as the favored strategy for managing AR.</p> Manjula S., Krishna Kumar M. Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4190 Tue, 26 Mar 2024 00:00:00 +0530 Standardizing the size of pistons in both sexes and comparing the outcome of reverse stapedotomy: our experience https://www.ijorl.com/index.php/ijorl/article/view/4200 <p><strong>Background:</strong> Stapedotomy is one of the most fascinating surgery in otology. Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patients' quality of life.</p> <p><strong>Methods:</strong> Prospective observational study conducted at Ghosh ENT foundation, Kolkata from May 2021 to May 2023 to study the outcome of reverse stapedotomy with microscope and the length of the piston used.</p> <p><strong>Results:</strong> Our study comprised of 192 ears operated for otosclerosis, 101 were males and 91 were females. 37 patients were misdiagnosed and prescribed hearing aids without being suggested stapedotomy. The most common associated complaint was tinnitus in both the sexes and only 1 patient complained of vertigo. The most common post op complication was vertigo followed by dysgeusia, Tympanomeatal flap tear was observed in a handful cases and repaired by a tympanoplasty. Our method creates minimal complication and reduces the duration of surgery. We noticed that the average length of the piston required is 4.25 mm in females while for males it is 4.5 mm. only 3 female patients were fitted with 4.5 mm piston. Patients operated by our stapedotomy technique showed that the ABG closure within 10 dB could be achieved in 87% and within 20 dB in 97% of cases without any otologic complications.</p> <p><strong>Conclusions:</strong> A good and favourable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and an appropriate surgical technique. This will ultimately lead to less post-operative complications and the need for revision surgery.</p> Tushar K. Ghosh, Debayan Dey Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4200 Tue, 26 Mar 2024 00:00:00 +0530 Study of outcome of type 1 interlay tympanoplasty https://www.ijorl.com/index.php/ijorl/article/view/4205 <p><strong>Background: </strong>The aim of this study is to assess the success rate of interlay tympanoplasty and its related complications.</p> <p><strong>Methods: </strong>This study was carried out in the department of otorhinolaryngology and head and neck surgery, GMERS medical college and hospital, Sola, Ahmedabad, Gujarat. In this observational study, 50 patients aged between 20-58 years with chronic otitis media were selected. Tuning fork test, pure tone audiogram, HRCT temporal bone, hemogram, anaesthesia fitness was done in all patients.</p> <p><strong>Results: </strong>All patients underwent type 1 interlay tympanoplasty with success rate of 96 % (48 cases out of 50).</p> <p><strong>Conclusions:</strong> Patients were followed up for a period of 2 months at which point they were assessed both endoscopically and from an audiological point of view.</p> Shailee Mehta, Nifla Bhastekar Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4205 Tue, 26 Mar 2024 00:00:00 +0530 Survival and clinical outcomes of salvage surgery in recurrent oral cavity cancer: a single institutional experience https://www.ijorl.com/index.php/ijorl/article/view/4207 <p><strong>Background:</strong> Oral cavity is the most common site of head and neck squamous cell carcinoma in India with more than 70% presenting in locally advanced stage. Recurrence in all stages of OCSCC occurs in up to 50% of patients, with most failures being local and/or regional relapses. The present study was done to analyze clinical outcomes of patients undergoing salvage surgery (SS) following recurrent OCSCC.</p> <p><strong>Methods:</strong> A retrospective analysis of prospectively collected data of 82 patients with recurrent OCSCC was done in the department of head and neck surgery.</p> <p><strong>Results:</strong> At the end of 1 year post SS for OCSCC 62 out of 82 (75.6%) patients were alive without disease. At the end of 2 year after SS 22 out of 45 patients were alive of which 21 were alive without disease and 1 was alive with disease (48.8%). At the end of 3 years, 10 out of 25 of which 9 were alive without disease and 1 patient was alive with disease (40%). Median disease-free survival (DFS) post SS was 13.50 months (0-47 months). DFS and overall survival (OS) post SS showed significantly better results in patients treated with surgery along with RT as primary treatment, patients with late recurrence, patients with early recurrent T stage, patients with free margins at SS and in patients who received adjuvant radiation therapy post SS.</p> <p><strong>Conclusions:</strong> Salvage Surgery is one of the best treatment options for recurrent OCSCC with acceptable survival rates.</p> Akansha A. Kandoi, Rajesh A. Kantharia, Shehnaz R. Kantharia, Zahoor Ahmad Teli Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4207 Tue, 26 Mar 2024 00:00:00 +0530 The impact of adenotonsillectomy on the acoustic parameters of voice https://www.ijorl.com/index.php/ijorl/article/view/4215 <p><strong>Background:</strong> The aim of the study was to evaluate and compare the changes in the acoustic parameters of voice and nasalance in individuals with chronic adenotonsillitis, before and after surgery. </p> <p><strong>Methods:</strong> A pospective case-control study conducted in the department of ENT and HNS of a tertiary care centre from September 2014 to June 2016 with 120 patients aged between 5 to 16 years. 60 cases and 60 controls were assessed aged between 5 to 16 years. Cases included patients who underwent adenotonsillectomy in the inpatient department of ENT at Father Muller Medical College, Mangalore, India. Acoustic analysis of 5 parameters (fundamental frequency, jitter, shimmer, noise harmonic ratio and nasalance) was done 1day pre-operatively and at 4 weeks post-operatively by means of a VAGMI, Voice and Speech Systems, Bangalore, India, providing normative data for analysed measures. </p> <p><strong>Results:</strong> The results of the study showed that pre-operative cases exhibited significant alterations in Jitter, Shimmer and NHR, compared to the control group. No significant differences were observed in the F0. Nasalance significantly reduced post-operatively and were almost normalized after the surgery. </p> <p><strong>Conclusions:</strong> Chronic adenotonsillar hypertrophy causes transient changes in acoustic parameter of voice, which makes the voice disharmonic and harsh. Adenotonsillectomy eliminates the nasalance. Hence, parents should be warned for changes in voice after surgery. </p> Preeti S. Shetti, Mahesh Bhat T., Jacqueline B. Fernandes, Tanishtha Saxena Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4215 Tue, 26 Mar 2024 00:00:00 +0530 A clinical study to compare the efficacy of crushing of middle turbinate with lateral partial turbinectomy for concha bullosa https://www.ijorl.com/index.php/ijorl/article/view/4242 <p><strong>Background:</strong> Concha bullosa (CB), a pneumatized middle turbinate is most common variations of sino-nasal anatomy. Identified in approximately ~35% (range 14-53%) of patients, a large CB cause nasal obstruction, recurrent sinus infections and headache, may develop into mucocele or mucopyocele or affect olfaction. Endoscopic lateral partial turbinectomy (LPT) is the standard procedure for the treatment of CB. However, the recurrence of contact points and postoperative synechiae with subsequent frontal recess obstruction are common complications of this technique. Crushing of a pneumatized turbinate preserves the mucosa, less time consuming and carry less risk of complications. The aim of the study was to compare the efficacy of crushing with LPT for the treatment of CB.</p> <p><strong>Methods:</strong> This was a prospective cohort study conducted by convenient sampling in the Department of ENT, KIMS, Hubli, Karnataka, India. In 53 patients, 43 with unilateral and 10 with bilateral CB satisfying the inclusion and exclusion criteria were subjected to either crushing (group A) or LPT (group B). The success of both techniques were compared based on the relief of symptoms assessed by the visual analogue scale, nasal endoscopy and computed tomography (CT) scan after 6 months of surgery. </p> <p><strong>Results:</strong> The overall success rate of the outcome was equal between the two groups, with no statistical (p&gt;0.05) difference.</p> <p><strong>Conclusions:</strong> Crushing the CB is as efficient as LPT for the treatment of pneumatized middle turbinate. However, surgically crushed CB can get re-pneumatization in some patients.</p> Savita Z. Ninnekar, Raveendra P. Gadag, Venkatesh Doreyawar, Kadeeja P. Jasmine Copyright (c) 2024 International Journal of Otorhinolaryngology and Head and Neck Surgery https://www.ijorl.com/index.php/ijorl/article/view/4242 Tue, 26 Mar 2024 00:00:00 +0530