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

{"title":"Utilizing Narrow Band Imaging for Early Detection of Recurrence in Follow-Up Patients with Head and Neck Squamous Cell Carcinoma Treated with Curative Intent Using Radiotherapy/Chemo-Radiotherapy: Enhancing Detection and Patient Outcomes.","authors":"Vikas Gupta, V S Sreejith, S K Singh, Rajeev Chugh, Himanshu Swami, Abha Kumari, Varun Jerath","doi":"10.1007/s12070-024-05277-4","DOIUrl":"10.1007/s12070-024-05277-4","url":null,"abstract":"<p><p>Head and Neck squamous cell carcinoma (HNSCC) is one of the most common cancer in developing countries. Most of the patients present with advanced disease and requires rigorous treatment. Routine follow up of the patient is required to detect any recurrence which will substantially affect overall survival of the patient. Narrow Band Imaging is one of the advanced endoscopic modalities which can be used for assessment of the patients during follow-up along with White light examination (WLE) and WB PETCT. An observational study to determine the efficacy and diagnostic accuracy of NBI in early detection of recurrence in follow-up patients with HNSCC was conducted comparing it with WLE, WB-PETCT and HPE. 60 patients who received definitive radiotherapy /Chemoradiotherapy (RT/CRT) for HNSCC were followed up for a period of 12 months with WLE, NBI, WB PETCT and was compared with HPE. NBI demonstrated higher sensitivity (95.45%) and specificity (97.37%) compared to WLE, which had sensitivity and specificity of 77.27% and 92.11%, respectively. NBI also had superior diagnostic accuracy (96.67%) versus white light (86.67%).WB-PETCT had sensitivity of 95.45% and specificity of 92.11% with a diagnostic accuracy of 93.33% for detecting local recurrences. NBI is a more sensitive and accurate tool for detecting early recurrences in HNSCC post RT/CRT, improving patient outcomes through timely intervention. Proper training and standardized interpretation protocols are essential for maximizing its clinical utility.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"869-876"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Central Pathologies Imitating Peripheral Causes of Vertigo.","authors":"Divya Sethi, Uma Patnaik, Vikas Sharma","doi":"10.1007/s12070-024-05269-4","DOIUrl":"10.1007/s12070-024-05269-4","url":null,"abstract":"<p><p>To differentiate central vertigo mimicking peripheral vestibular diseases with proper history taking, examination and imaging to enable early diagnosis and management. This was an Observational Study carried out over two years and targeted patients across all age groups presenting with complaints of vertigo in ENT OPD of hospitals of the Armed Forces. All patients in all age groups for both genders were included, even those who had presented with recurring symptoms having been managed conservatively elsewhere. In the study population of 147, males were 72 and females were 75. The mean age of the study population was 54 years. The mean age for males and females was 56 years and 52 years respectively. Data were analysed using IBM Statistical Package for the Social Sciences (SPSS) Version 21. Out of 147 cases, 140 cases presented with typical symptoms of acute peripheral unilateral vestibular dysfunction and 7 presented with symptoms typical of peripheral dysfunction but with abnormal HINTS testing, and on further investigation by imaging, were diagnosed to have vertigo due to central pathologies like Cerebral Venous Thrombosis, Cerebello Pontine Angle Tumour, Posterior Circulation Stroke and Vascular Loops. The most common cause of positional vertigo is BPPV. However, clinicians must be aware that positional vertigo due to central lesions may mimic BPPV. In assessing a patient with positional vertigo, a careful clinical assessment without any preconceived notions of availability heuristic or confirmatory bias, is important to be able to identify the rare cases of CPPV. Features that we found most helpful in distinguishing CPPV and BPPV were the presence of additional neurological symptoms (including headache and vomiting) or signs (limb or gait ataxia), and a failed sustained response to repositioning manoeuvres. Furthermore, apogeotropic horizontal nystagmus on supine roll test and isolated positional downbeat nystagmus should also be considered red flags for CPPV.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"843-853"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chondro Osseous Respiratory Epithelial Hamartoma-a Rare Entity.","authors":"Amitha A Asharaf, Nitty Mathew, Prateek P Nayak, Priya T Rajan, Bidisha","doi":"10.1007/s12070-024-05260-z","DOIUrl":"10.1007/s12070-024-05260-z","url":null,"abstract":"<p><p>Chondro-osseous respiratory epithelial adenomatoid hamartomas (COREAHs) are benign hamartomas very rarely seen in the nasal cavity. We are presenting a case of COREAH in a 39-year-old female that was managed surgically. As the clinical history and gross and radiological features of COREAH resemble those of other aggressive diseases, this case report puts emphasis on considering COREAH as a differential diagnosis to avoid unnecessary surgical interventions.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"1055-1058"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Lateral Semicircular Canal Dysfunction in Chronic Otitis Media Patients using Air Caloric Test and Video Head Impulse Test.","authors":"Selavarajan Gopal, M Sivaranjani, Raghunath Shalini, Malarvizhi Ravisankar","doi":"10.1007/s12070-024-05264-9","DOIUrl":"10.1007/s12070-024-05264-9","url":null,"abstract":"<p><p>In developing nations like India, chronic otitis media (COM) is a common middle ear ailment that has serious ramifications for both hearing and quality of life. Long-term inflammation of middle ear cavity and tympanic membrane are the hallmarks of COM, which can result in consequences like facial paralysis, labyrinthitis, hearing loss, and potentially fatal cerebral abscesses. The effect of COM on vestibular function is still unknown. Studies reveal a positive correlation between the severity of COM and vestibular impairment, which may point to a cause-and-effect link. Using air caloric testing and video head impulse testing (VHIT), this study seeks to explore the link between vestibular symptoms, particularly lateral semicircular involvement with COM. To quantify the involvement of lateral semicircular canal using air caloric test and video head impulse test, compare the results of both tests in patients with chronic otitis media and to detect early labyrinthine dysfunction using air caloric test and Video head impulse test. A cross-sectional study was conducted over a period of 2 years to investigate the involvement of the lateral semicircular canal in patients aged 18 years and above with symptoms suggestive of chronic otitis media. All patients underwent air caloric and video head impulse tests, to evaluate canal paresis and horizontal vestibulo-ocular reflex (VOR). The outcomes of both tests were compared to investigate their correlation and diagnostic value. A total of 145 patients were enrolled in this study, with a median age range of 30-39 years and the gender distribution was nearly equal. The majority of patients (85.5%) presented with mucosal type chronic otitis media (COM), while 14.5% had squamosal type COM.Video head impulse test (VHIT) revealed abnormalities in 45.5% of patients, whereas the air caloric test (ACT) showed abnormalities in 21%. A positive head impulse test was observed in 11 patients (14.5%). Patients with medium and large-sized central perforations were more prone to giddiness. Labyrinthine fistula was detected in one patient with active squamosal disease. 56.1% of patients with abnormal VHIT had normal canal paresis and only 29 patients (43.9%) showed both abnormal VHIT and Air caloric test. VHIT is found to be more sensitive compared to air caloric test. The study highlights the significance of utilising both VHIT and ACT in the comprehensive evaluation of vestibular function in patients with COM. For individuals with vestibular deficits due to COM, a combined approach can improve diagnostic accuracy and guide targeted therapy and rehabilitation options.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"832-836"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Smoking on Electron Microscopic Structure of Nasal Mucosa.","authors":"Ranjan Kumar Sahoo, Achal Gulati, Vineeta Vijay Batra, Jeevanjyoti Sahoo, Ditixaben J Patel, Avinav Gupta, Rinchen Angmo","doi":"10.1007/s12070-024-05302-6","DOIUrl":"10.1007/s12070-024-05302-6","url":null,"abstract":"<p><p>The present study aimed to assess and compare the effect of smoking on ultrastructure morphology of nasal mucosa between smokers and nonsmokers. The study included 50 subjects aged 25-62 years who were planned for rhinological surgical procedures. Subjects were divided into 3 groups- group 1 (nonsmoker), group 2 (smokers taking 1 pack/day or less), group 3 (smokers taking 2 pack/day or more). During surgery, two 1-mm³ biopsies of nasal mucosa were taken from inferior turbinate, 1 cm behind its anterior end. Specimens were examined with compound and transmission electron microscope. There were significant mucosal changes like squamous metaplasia, goblet cell hyperplasia, increase in basement membrane thickness seen in smokers. Ciliary changes like loss of cilia, decrease in length of cilia and significantly affected in smokers. But no significant changes seen in width of cilia and microtubular defect. Chronic inflammation, fibrosis, venous congestion and submucosal gland hypotrophy changes seen significantly in smokers as compared to nonsmokers. Smoking has a deleterious effect on the nasal respiratory mucosa. The severity of structural changes increased with duration of smoke exposure.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"922-928"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890844/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective Study on Anemia in Hypothyroidism and Hyperthyroidism.","authors":"U P Santosh, Priyanka Rajesh, Ajay S Kumar, Ima Chandra, Veena Prabhakaran, Arfan Nasser","doi":"10.1007/s12070-024-05249-8","DOIUrl":"10.1007/s12070-024-05249-8","url":null,"abstract":"<p><p>Anemia is a common condition associated with thyroid diseases but the causal relationship between these disorders remains unclear. Thyroid hormones play a crucial role in erythropoiesis by stimulating the expression of the erythropoietin gene and erythropoietin production. An excess of thyroid hormones is also linked to altered iron metabolism or oxidative stress. The significance of the study lies in understanding the relationship between thyroid function and anemia, correlation of thyroid hormone levels and anemia and its improvement on correction of the hormonal imbalance. To evaluate the influence of thyroid hormones on hemoglobin and its improvement on correction of the hormonal imbalance. 150 patients of either sex diagnosed as hypothyroid/hyperthyroid and anemic as per WHO guidelines were selected between September 2019 and October 2023. They were the treated with appropriate doses of Levothyroxine/carbimazole for hypothyroidism/hyperthyroidism respectively. Follow-up assessments done at 1 month and 3 months, with hemoglobin, T3, T4, TSH levels and analyzed. We observed that participants with either hypothyroidism or hyperthyroidism exhibited lower hemoglobin concentrations regardless of gender. Following correction of thyroid dysfunction there was significant improvement in the hemoglobin values and improvement of non-specific complaints at the end of the 3 months follow up. Our study showed that thyroid dysfunction affects hemoglobin and it is essential to know its association for better management of both conditions. The correction of thyroid dysfunction also improved the hemoglobin status. Hence, routine follow-up of patients with thyroid disorders should involve complete blood count assessments, and patients diagnosed with anemia screened for thyroid disorders.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"779-783"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exceptional Case of Garcin Syndrome Mimicking Bell's Palsy in Advanced Non-Small Cell Lung Carcinoma.","authors":"Nur Faseeha Mohamed Idrus, Noraimi Khamalrudin, Salwa Zainal, Wan Nabila Wan Mansor","doi":"10.1007/s12070-024-05258-7","DOIUrl":"10.1007/s12070-024-05258-7","url":null,"abstract":"<p><p>Garcin syndrome is an exceptional clinical condition characterized by progressive multiple ipsilateral cranial nerve involvement which is caused by malignant osteoclastic lesion at skull base. We report a rare case of Garcin syndrome which was misdiagnosed as Bell's palsy. A 69-year-old lady, presented with generalized headache and right facial nerve palsy in which progressively worsened even after treatment with corticosteroid. Computed tomography (CT) brain showed skull base erosion suggesting tuberculosis or metastatic lesion. Mass at the left hilar region was seen from her chest x-ray which raise suspicion of lung malignancy after tuberculosis has been ruled out. A month later, she developed worsening right facial nerve palsy followed by multiple cranial nerve involvement on the ipsilateral side. CT staging revealed features of lung malignancy with loco-regional and distant metastases to liver and spine. Histopathological diagnosis of non-small cell lung carcinoma was established after biopsy during bronchoscopy.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"1062-1066"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sinonasal and Laryngeal Presentations of Pituitary Adenoma.","authors":"Juhi Irfana Basheer, Balakrishnan Ramaswamy, Aseem Pradhan, Girish Menon, Deepak M Nayak","doi":"10.1007/s12070-024-05201-w","DOIUrl":"10.1007/s12070-024-05201-w","url":null,"abstract":"<p><p>Pituitary adenomas, the second most common intracranial pathology, often exhibit symptoms beyond the classic triad of headache, visual disturbances, and hormonal imbalances. Unusual presentations involve sinonasal pathology, cranial nerve involvement, and mass effects on adjacent structures like the skull base. Secretory adenomas may manifest hormonal changes and their effects. A 43-year-old hypertensive male presented with progressive nasal obstruction. Nasal endoscopy revealed a mass in the left nasal cavity. MRI and histopathology confirmed a pituitary adenoma diagnosis. A 58-year-old male with hoarseness and inspiratory stridor exhibited acromegalic features and vocal cord palsy. Imaging revealed a pituitary adenoma. ENT specialists must recognize varied presentations of pituitary adenomas, which may include sino-nasal issues, cranial nerve deficits or even voice/airway disorders. Early detection allows for effective management, emphasizing interdisciplinary collaboration and prioritizing airway protection in severe cases.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"1170-1175"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Vessels Color Doppler Ultrasound Findings in Sudden Sensorineural Hearing Loss: A Comparative Analytical Study.","authors":"Shadman Nemati, Alia Saberi, Sima Fallah Arzpeyma, Maliheh Akbarpour, Ali Faghih Habibi, Ali Darini, Maryam Dourandeesh","doi":"10.1007/s12070-024-05309-z","DOIUrl":"10.1007/s12070-024-05309-z","url":null,"abstract":"<p><p>The main etiology of sudden sensorineural hearing loss (SSNHL) is uncertain and vascular problems have been proposed as one of the underlying factors in this disease. Patients with SSNHL and people without any hearing or ear disorders as the control group were included in the study (aged 18-65 years). Clinical examination, pure tone audiometry, and color doppler ultrasound of the neck vessels were performed for all patients and control subjects, on both sides, to check blood flow, peak systolic velocity (PSV), vascular diameter, and intima-media thickness (IMT) in the common carotid (CCA), vertebral (VA), and internal carotid arteries (ICA). Thirty-three patients and 33 control subjects enrolled in the study. Comparing ultrasonography findings in the involved and non-involved side in the patients' group, blood flow in the VA and CCA was 85.66 (33.52), 113.42 (40.26) and 390 (431.5-358.0), 405 (437.0-339.0), respectively, and IMT in the ICA and CCA was 0.7 (0.6-0.8), 0/6 (0.5-0.7), and the differences were statistically significant (<i>P</i> < 0.05). On the other hand, comparing the results between the case and control groups, blood flow in the VA, the IMT in the CCA, and the PSV in the VA in the involved ear were significantly different (<i>P</i> < 0.05). Vascular indices, like blood flow in the VA and the IMT in the CCA, are different in SSNHL cases.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"943-948"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Lingering Threat: A Migratory Fish Bone Causing Delayed Cervical Foreign Body Granuloma.","authors":"Xian Ming Woo, Kuganathan Ramasamy, Senthilraj Retinasekharan","doi":"10.1007/s12070-024-05254-x","DOIUrl":"10.1007/s12070-024-05254-x","url":null,"abstract":"<p><p>Fish bone ingestion is a common presenting complaint to the Otorhinolaryngology clinic. In majority of the cases, the removal of visualised impacted fish bones is fairly straightforward. However, diagnostic dilemma may arise in cases of migratory fish bones as initial examination may be unsuspecting. Computed tomography (CT) of the neck has proven to be a valuable tool in identifying the presence of such foreign bodies. However, there is also a subset of patients who are asymptomatic as the fish bone migrated extra-pharyngeally and they may only present late with potentially grave consequences. Herein, we present a case of elderly female with history of fish bone ingestion who presented to us eight months later with primary complaint of huge swelling in the left side of the neck. Subsequent investigation unravelled the diagnosis of migratory fish bone causing an extensive foreign body reaction resulting in a huge granuloma. The fish bone was successfully removed with subsequent resolution of the neck swelling.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 2","pages":"1085-1087"},"PeriodicalIF":0.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}