{"title":"Management of intractable epistaxis in a tertiary care referral hospital: an observational study","authors":"Sanjeev Mohanty, Sudha Balasubramanian, Bulu Nahak, Chimay Sundaray, Sejal Mehta","doi":"10.18203/issn.2454-5929.ijohns20242041","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242041","url":null,"abstract":"Background: The aim of this study is to evaluate the effectiveness of sphenopalatine artery ligation/ cauterisation as a surgical intervention in control of refractory epistaxis and achieving haemostasis.\u0000Methods: The study was done with patients in the Department of ENT, Head and Neck surgery Health care hospital and out station referrals from institution’s outreach clinics, for a period of 2 years (May 2020-April 2022). Patients with recurrent epistaxis, not controlled by digital pressure, anterior packing (ribbon gauze/ merocele) or postnasal packing were taken up for emergency endoscopic sphenopalatine artery ligation/cauterisation under general anaesthesia. Effectiveness of this technique was established by routine endoscopic follow up of these patients over a period of 6 months post procedure. \u0000Results: Out of a total of 55 patients who presented with recurrent epistaxis, 8 patients settled down with conservative management (digital pressure/external ice pack application), 18 patients settled down with anterior nasal packing, 12 patients settled down with anterior and posterior nasal packing and 17 patients required sphenopalatine artery ligation/cauterization. None of these postop patients had any further episodes of nasal bleed.\u0000Conclusions: Sphenopalatine artery ligation has proven to be an effective measure in control of intractable refractory epistaxis when compared to therapeutic embolization or other procedures.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"6 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Palash Chandra Sarkar, M. A. Hanif, K. M. N. Alam, Mohammad Rafiqul Islam, M. S. Akram, S. A. Rahman, Raisa Enayet Badhan
{"title":"Functional outcome of carcinoma tongue after primary surgical treatment","authors":"Palash Chandra Sarkar, M. A. Hanif, K. M. N. Alam, Mohammad Rafiqul Islam, M. S. Akram, S. A. Rahman, Raisa Enayet Badhan","doi":"10.18203/issn.2454-5929.ijohns20242036","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242036","url":null,"abstract":"Background: Majority of patients with oral malignancies appear in a late stage, with a low survival rate, despite advancements in imaging and therapy choices. Surgery is a well-known option among the various therapeutic techniques. In order to evaluate the functional outcome of carcinoma tongue among patients receiving primary surgery, the study was designed.\u0000Methods: This cross-sectional observational study was conducted at the department of otolaryngology, national institute of ENT and central hospital (Pvt.) limited, Dhaka. All histopathologically diagnosed case of carcinoma tongue undergone primary surgical treatment were approached for including into the study. Informed written consent was taken from each subject. Total 30 patients were included. After surgical intervention, functional outcome was measured by the performance status scale (PSS) for head and neck cancer. Data analysis was done by SPSS 20.\u0000Results: Total 30 patients of carcinoma tongue were included in this study. Base of tongue (66.6%) and oral tongue (33.3%) were present as advanced and early stage respectively. Hemiglossectomy (43.3%) was the most commonly used methods. Improvement was seen in 'eating in public' score and 'understandability of speech score at 4th month after surgery, which was not steady over subsequent follow-ups. Normalcy of diet score also showed improvement at 4 months follow-up but slowly declined afterwards. Overall, improvement in 'eating in public' understandability of speech' and normalcy of diet score were not statistically significant.\u0000Conclusions: Improvement of functional status was not statistically significant following primary surgical intervention in carcinoma tongue.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"9 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141801193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Azevedo, João Vale Lino, M. Coutinho, Luís Meireles
{"title":"Misplaced cochlear implant into the superior semicircular canal","authors":"S. Azevedo, João Vale Lino, M. Coutinho, Luís Meireles","doi":"10.18203/issn.2454-5929.ijohns20242046","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242046","url":null,"abstract":"Cochlear implantation (CI) has become a routine surgery for the treatment of profound hearing-impaired patients all around the world. Surgical complications can occur and are an unexpected medical event related to the procedure itself and causing additional morbidity or a need for a revision surgery. Our goal was to describe a clinical case of a major complication of CI placement and the treatment performed. Our case is about a 68-year-old man proposed for unilateral CI placement. The electrode was placed in the vestibule and semicircular canal requiring surgical revision. This is a rare complication described in literature. Patient gave verbal consent to publish the case.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"30 17","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlos Navarro-Fernández, Zelik Luna-Peteuil, Agustin Guemes-Meza, Kuauhyama Luna Ortiz
{"title":"Recurrence due to dissemination of tumor cells after transoral endoscopic thyroidectomy vestibular approach","authors":"Carlos Navarro-Fernández, Zelik Luna-Peteuil, Agustin Guemes-Meza, Kuauhyama Luna Ortiz","doi":"10.18203/issn.2454-5929.ijohns20242048","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242048","url":null,"abstract":"The present report aims to document a case of recurrence attributed to residual tumor in a patient with papillary thyroid cancer who underwent Transoral endoscopic thyroidectomy vestibular approach (TOETVA). A 48-year-old female presented with a mass in the central part of the neck. On ultrasound, the lesion was classified as TIRADS 4b. Fine-needle aspiration biopsy revealed papillary carcinoma (cT1b cN0 cM0, stage I). The patient underwent transoral thyroidectomy without complications. The pathology report showed conventional papillary thyroid carcinoma in both lobes, with the predominant lobe measuring 2×1×0.5 cm. Three years later, the patient presented with elevated thyroglobulin levels (1.92) despite adequate TSH suppression. Six months later, a repeat ultrasound showed continued persistence of the lesion at level VI, prompting resection under local anesthesia, which revealed invasive papillary thyroid carcinoma involving soft tissues. TOETVA remains a safe procedure for cancer cases. However, its oncological outcomes have not yet been fully demonstrated, particularly regarding the impact of possible recurrences stemming from residual tumor fragments or cells during the procedure.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"34 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. K. Behera, Ananya Aparoopa, Saroj Kumar Behera, Anita Manjari Jena
{"title":"Foreign bodies in unusual sites in ENT: two case report","authors":"S. K. Behera, Ananya Aparoopa, Saroj Kumar Behera, Anita Manjari Jena","doi":"10.18203/issn.2454-5929.ijohns20242049","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242049","url":null,"abstract":"In otorhinolaryngology practice, foreign body impaction in the ear, nose, and throat areas and in the head and neck are emergencies. Here we present two unusual cases that we treated at our District Headquarter Hospital. First case involved a metallic foreign body a key ring in the oropharynx extending into the nasopharynx and laryngopharynx in a child, and the second case involved a foreign body wooden stick accidentally penetrating the postauricular region across the cheek to the zygomatic arch near lateral margin of periorbital area causing grade III facial nerve paresis in a female. We successfully removed both the foreign bodies. In first case after the removal of metallic foreign body from throat we kept patient for nasogastric feeding for 48 hours followed by normal liquid diet. In Second case after removal of foreign body the residual facial nerve paresis was resolved with tapering dosage of steroid.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"118 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonal Kala, Madhuri Kaintura, T. Maithani, Arvind Varma, Rishabh Dogra
{"title":"Comparative study of sutureless thyroidectomy using harmonic scalpel versus vessel ligation thyroidectomy","authors":"Sonal Kala, Madhuri Kaintura, T. Maithani, Arvind Varma, Rishabh Dogra","doi":"10.18203/issn.2454-5929.ijohns20242040","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242040","url":null,"abstract":"Background: Hemostasis is crucial for thyroidectomy surgery. Traditional methods used for hemostasis like suture ligation has a risk of knot slipping hence new methods of ligation became need of the hour. Harmonic scalpel is one such newer method of vessel ligation providing faster and precise ligation of vessels. The objective was to compare effectiveness of sutureless technique using harmonic scalpel in thyroid surgery with conventional suture ligation technique.\u0000Methods: The 50 patients undergoing thyroid surgery were divided into two groups of 25 each. Group A underwent thyroid surgery using conventional suture ligation and group B underwent thyroid surgery using harmonic scalpel.\u0000Results: Our results showed that in group B, none of the patients had change of voice and only 1 had transient hypocalcemia while 2 in group A had recurrent laryngeal paresis and 4 had transient hypocalcemia (not statistically significant). The average blood loss was less in group B as compared to group A (p=0.014), as was the post op drain collection 12.60 ml (p=0.034) as compared to 17.80 ml in group A, and the operative time 34.60 minutes (p=0.00) as compared to 45.44 minutes in group A. The overall cost was thus conspicuously reduced as compared to group A.\u0000Conclusion: Sutureless thyroidectomy using harmonic scalpel is safe, fast and cost-effective technique to perform thyroidectomies.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"51 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Metgudmath, Pallavi Kallur, Virupaxi V. Hattiholi
{"title":"Horse collar: a rare case report of Madelung disorder with review of literature","authors":"R. Metgudmath, Pallavi Kallur, Virupaxi V. Hattiholi","doi":"10.18203/issn.2454-5929.ijohns20242050","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242050","url":null,"abstract":"Multiple symmetric lipomatosis is a rare disorder of fat metabolism which is characterized with bilateral symmetric and usually painless masses at various anatomical sites. Generally, the patient with this disease presents with cosmetic deformities. Extensive masses are known to have compressive symptoms like breathing difficulty and dysphagia. Imaging plays a pivotal role diagnosing this condition. Treatment options include both surgical and non-surgical modalities along with management of other metabolic disorders like diabetes and abstaining from alcohol intake. Recurrence is common. Given the uncommon nature of this illness and the debates surrounding its management, we report a case of multiple symmetric lipomatosis.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"33 23","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stella Nabawanga, Rym Hidour, Henry Kajumbula, Justine Namwagala, Sedrack Matsiko, Brian Muhereza, Michael Tumuhimbise
{"title":"Deep neck space infections among patients attending a tertiary Ugandan hospital: clinical presentation, bacterial etiology and antimicrobial susceptibility","authors":"Stella Nabawanga, Rym Hidour, Henry Kajumbula, Justine Namwagala, Sedrack Matsiko, Brian Muhereza, Michael Tumuhimbise","doi":"10.18203/issn.2454-5929.ijohns20242035","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242035","url":null,"abstract":"Background: Deep neck space infection (DNSI) is inflammation often with abscess collection within the potential fascial spaces in the head and neck region. There is limited data on this disease in Uganda. This study sought to determine the clinical presentation and bacterial etiology with antimicrobial susceptibility of bacterial pathogens causing DNSIs among patients at a tertiary hospital.\u0000Methods: A cross-sectional study design was used. The study population comprised 66 patients of all age groups with DNSIs. An interviewer-administered questionnaire was filled. A pus sample was taken off for culture and sensitivity. Data was entered using Epidata, validated and transferred to Stata version 16 for analysis.\u0000Results: The majority of patients with DNSI were males (59.1%) with a mean age of 21.6 years. Neck swelling (100%) and pain (95.5%) were the most common presentation. The study participants were divided into two major groups; 29 patients belonged to the pediatric group, while 37 patients belonged to the adult group. Odontogenic sources were the most common predisposing factor in the adult group and nonodontogenic sources for the pediatric group. In both groups, the submandibular space (48.4%) was the most common site of presentation. Staphylococcus aureus (34.5%) was the most common isolated organism in the pediatric group, and MRSA were 46.1% overall Viridans streptococci (37.8%) was most common in the adult group with no resistance to clindamycin.\u0000Conclusions: Susceptibility pattern varied, and highlights the necessity of doing antimicrobial sensitivity for all patients.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"51 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141799902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ho Yi Yuan, Vivian Lau Zhi Han, Mohammad Nasyatmuddin Yahya, Chew Shiun Chuen, M. R. Mohamad Yunos
{"title":"Eagle’s syndrome: mimicker of submandibular and temporomandibular joint pathology","authors":"Ho Yi Yuan, Vivian Lau Zhi Han, Mohammad Nasyatmuddin Yahya, Chew Shiun Chuen, M. R. Mohamad Yunos","doi":"10.18203/issn.2454-5929.ijohns20242047","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20242047","url":null,"abstract":"Eagle’s syndrome is characterized by recurrent pain in the oropharynx and face due to an elongated styloid process or calcified stylohyoid ligament. Various theories existed to explain about development of Eagle’s syndrome. Symptoms are variable and non-specific, thus making it a challenge and dilemma to recognize and diagnose it clinically, and sometimes it can be missed out. A good history taking is important to recognize the disease with proper physical examination. Radiological intervention has been an important tool to diagnose Eagle’s syndrome. A 31 years old lady with presentation of right submandibular pain for one week, radiating to right preauricular region, associated with odynophagia, trismus and reduced oral intake. She was initially misdiagnosed as submandibular sialadenitis and lymphadenitis, and later was referred to dental for temporomandibular joint arthritis. She was treated with antibiotic initially however symptoms were not improved. CT neck done and revealed elongated right styloid process. Excision of right styloid process provided complete pain relief. Even though Eagle’s syndrome is not a common disease, in cases of unexplained complain of pain over head and neck region, it should be considered as one of the differential diagnosis. Eagle’s syndrome can be managed medically by symptomatic treatment/by surgical intervention.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"34 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141800625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aswini A., Swati Mishra, Devanshi Modi, Sanjay Udupi
{"title":"Association of apnea-hypopnea index and lateral cephalometry pre- and post-surgery in obstructive sleep apnea patients","authors":"Aswini A., Swati Mishra, Devanshi Modi, Sanjay Udupi","doi":"10.18203/issn.2454-5929.ijohns20241297","DOIUrl":"https://doi.org/10.18203/issn.2454-5929.ijohns20241297","url":null,"abstract":"Background: Snoring and obstructive sleep apnea are new emerging medical entity and require early diagnosis and treatment because of their increasing implication on physical, mental, social and emotional health. Aim of this study is to assess severity of OSHAS and co-relate efficacy of various post-surgical parameter on objective and subjective improvement in patients.\u0000Methods: 43 patients having the symptoms were included in the study and followed over a period of three months and during their post operative visit their lateral cephalometric findings, ESS were recorded and compared to pre operative values to see if any association exists between them.\u0000Results: it was seen that various surgical interventions did bring about subjective and objective improvement in patients and these were statistically significant.\u0000Conclusions: OSHAS is a spectrum of disorders and has great impact on persons physical, mental and emotional well-being. Early diagnose and treatment eliminated the future risks. Surgical intervention helps improve symptoms of OSHAS and should be undertaken without delay wherever indicated.","PeriodicalId":14350,"journal":{"name":"International Journal of Otorhinolaryngology and Head and Neck Surgery","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}