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

{"title":"Intra-Op Nerve Monitoring for Large Retrosternal Goitre - Anaesthetist's Dilemma.","authors":"Soumi Pathak, Mamta Dubey, Vishal Yadav","doi":"10.1007/s12070-025-05510-8","DOIUrl":"10.1007/s12070-025-05510-8","url":null,"abstract":"<p><p>In this report, we describe the successful anaesthetic management and intermittent intraoperative nerve monitoring (IONM) of a patient with a retrosternal goitre that caused severe tracheal compression (more than 70% occlusion) and tested positive for Pemberton's sign. While endotracheal tubes (ETT) with vocal cord surface electrodes are commonly used for IONM, they cannot be used in cases of distal tracheal compression, specifically when the compression occurs 5 cm or more below the vocal cords. In such situations, these neuromonitoring ETTS can get displaced and lose contact with the vocal cords, ultimately undermining their effectiveness. Electrodes attached to the thyroid cartilage can be used to monitor V1-R1-R2-V2 signals in such cases.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2421-2424"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152490","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":"Giant Concha Bullosa Containing Ethmoid Bulla Inside: A Case Report.","authors":"Onur Günaydın, Ayşe Çeçen, Gökhan Akgül, Doğukan Özdemir, Dursun Mehmet Mehel, Asude Ünal","doi":"10.1007/s12070-025-05454-z","DOIUrl":"10.1007/s12070-025-05454-z","url":null,"abstract":"<p><p>Paranasal sinus anatomy exhibits numerous variations, and preoperative awareness of these variations is essential for endoscopic sinus surgery. Concha bullosa, an air cell within the nasal turbinates, is most commonly seen in the middle turbinate, affecting 13 to 53.6% of patients. The ethmoid bulla, an air cell in the anterior ethmoid sinus, is anatomically close to the middle turbinate. We present a rare case of a giant concha bullosa containing an ethmoid bulla. A 52-year-old female presented with nasal obstruction and snoring. Examination revealed a slightly deviated septum and a giant concha bullosa in the left middle turbinate. CT scanning confirmed the concha bullosa with an ethmoid bulla inside, as well as a slightly deviated septum. Endoscopic surgery was performed to remove both the concha bullosa and ethmoid bulla. Postoperative recovery was successful, with resolution of her symptoms. Concha bullosa is classified into three types: bulbous, lamellar, and extensive, based on the extent of pneumatization. No classification currently describes a concha bullosa containing another nasal structure, such as an ethmoid bulla. Our case illustrates a unique variation. Paranasal sinus variations are common, and modern imaging allows for better preoperative planning. Recognizing both common and rare anatomical variations, such as the case presented, is crucial for safe and effective sinus surgery.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2391-2394"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152239","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":"Tirzepatide for Obstructive Sleep Apnea: A Novel Therapeutic Promise and the Perioperative Considerations.","authors":"Chandini Kukanti, Sumit Roy Chowdhury, Gyaninder Pal Singh","doi":"10.1007/s12070-025-05485-6","DOIUrl":"10.1007/s12070-025-05485-6","url":null,"abstract":"<p><p>Obstructive sleep apnea (OSA) is a prevalent global health issue, with recent advances in pharmacotherapy expanding treatment options. Tirzepatide, a dual GLP-1 and GIP receptor agonist, has been newly approved by the FDA for managing moderate to severe OSA, following promising results from major randomized trials. Initially indicated for type 2 diabetes mellitus, Tirzepatide promotes glycemic control and weight loss through incretin-mediated insulin secretion and appetite suppression. As its use becomes more widespread, perioperative physicians and head-neck surgeons must be familiar with its pharmacokinetics and associated risks. Notably, delayed gastric emptying, a dose-dependent side effect, raises concerns of pulmonary aspiration during general anesthesia. Preoperative gastric ultrasound, diet modification, and individualized glycemic management are recommended strategies. Given the limited high-quality data, a multidisciplinary, institution-specific approach remains essential in managing patients on Tirzepatide in the perioperative setting.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2430-2432"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152649","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":"When Epistaxis Tells a Story: A Case of Intranasal Haemangioma.","authors":"Aparna Das, P S Kishen Khanna, S Vijayasundaram, Madhangi Natarajan","doi":"10.1007/s12070-025-05502-8","DOIUrl":"10.1007/s12070-025-05502-8","url":null,"abstract":"<p><p>This is a case report of a 24-year-old female with spontaneous unilateral epistaxis due to a cavernous haemangioma beneath the right inferior turbinate. Surgical excision confirmed the diagnosis histopathologically. The patient had an uneventful recovery with no recurrence at three weeks follow-up.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2408-2410"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152654","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":"Multiple Black Carpenter Ants in Hypopharynx.","authors":"Sanjaya Kumar Behera, Ananya Aparoopa, Saroj Kumar Behera, Anita Manjari Jena, Smrutirekha Sahoo, Nisikant Pradhan, Elina Rout","doi":"10.1007/s12070-025-05495-4","DOIUrl":"10.1007/s12070-025-05495-4","url":null,"abstract":"<p><p>Foreign bodies in Otolaryngology are common chief complain in ENT emergency. Some foreign bodies are visible and can be removed easily where as some foreign bodies are difficult to visualise requires urgent medical intervention. We present a unusual case of 13 years old male child who visited our emergency room of District head hospital with odynophagia, drooling of saliva and pain in throat. On 70 degree scopy we found multiple black carpenter ants in the hypopharynx which were removed in OT under topical anesthesia. The patient was kept in observation in day care center then discharge with conservative management.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2398-2400"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152447","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":"Outcome Assessment of Conventional Vs. Endoscopic Nasal Septoplasty Using NOSE and SNOT-22 Questionnaires.","authors":"Arpit Saxena, Danish Ahmad Khan, Md Anas","doi":"10.1007/s12070-025-05492-7","DOIUrl":"10.1007/s12070-025-05492-7","url":null,"abstract":"<p><strong>Aims: </strong>Nasal septal deviation (NSD) is one of the most common structural abnormalities contributing to nasal obstruction, which significantly affects patients' quality of life. Septoplasty is the surgical procedure of choice to correct NSD. Traditionally performed via an open approach, endoscopic septoplasty has emerged as a minimally invasive alternative. However, there remains ongoing debate regarding the comparative effectiveness, patient satisfaction, and postoperative outcomes of these two techniques. This study aimed to compare the clinical and patient-reported outcomes of conventional versus endoscopic septoplasty using the Nasal Obstruction Symptom Evaluation (NOSE) and the 22-item Sino-Nasal Outcome Test (SNOT-22)questionnaires.</p><p><strong>Methods: </strong>A prospective, comparative study was conducted on 120 adult patients (60 undergoing conventional septoplasty and 60 undergoing endoscopic septoplasty) with symptomatic NSD. The NOSE and SNOT-22 questionnaires were administered preoperatively and at 1, 3, and 6 months postoperatively. Data analysis included comparisons of symptom scores, complication rates, and correlation with demographic factors.</p><p><strong>Results: </strong>Both groups demonstrated significant improvement in NOSE and SNOT-22 scores at all postoperative follow-up points compared to baseline (<i>p</i> < 0.001). However, patients undergoing endoscopic septoplasty had marginally better symptom relief (lower mean postoperative NOSE and SNOT-22 scores) and fewer postoperative complications compared to those undergoing conventional septoplasty. Operative time was shorter in the conventional group, but overall patient satisfaction at 6 months was higher in the endoscopic group.</p><p><strong>Conclusion: </strong>Both conventional and endoscopic septoplasty lead to significant improvements in nasal obstruction and related sinonasal symptoms as measured by NOSE and SNOT-22. Endoscopic septoplasty may offer additional benefits in terms of reduced complication rates and improved patient satisfaction, although conventional septoplasty remains a viable and effective option for correcting NSD. Further larger-scale, long-term studies are suggested to confirm these findings and optimize surgical decision-making.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2301-2308"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152589","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":"Unmasking Skull Base Phosphaturic Mesenchymal Tumors: A Rare and Treatable Cause of Tumor-Induced Osteomalacia.","authors":"Kalyana Sundaram Chithambaram, Amit Keshri, Chappity Preetam, Subhash Yadav, Nazrin Hameed, Mohit Sinha, Nidhin Das, Mohd Aqib, M S Arushi Kumar, Awadhesh Kumar Jaiswal, Sanjay Gambhir, Harrish Govindarajan, Ravi Sankar Manogaran","doi":"10.1007/s12070-025-05460-1","DOIUrl":"10.1007/s12070-025-05460-1","url":null,"abstract":"<p><p>Tumor-induced osteomalacia (TIO) is a rare syndrome caused by phosphaturic mesenchymal tumors that secrete substances, like FGF23, leading to phosphorus loss and osteomalacia. These tumors are often small and challenging to locate. Surgical excision is the primary treatment and usually results in symptomatic improvement. This report presents seven cases of skull base origin of these tumors to add to the existing literature. This retrospective study reviewed patients with phosphaturic mesenchymal tumors (PMT) who underwent surgical excision at a tertiary care institute from 2015 to 2023, focusing solely on tumors confined to the anterior or lateral skull base. The analysis included demographics, clinical features, biochemical and radiologic findings, tumor location, surgical details, and follow-up. The study included 7 patients (6 males, 1 female) with ages ranging from 40 to 65 years (mean age: 52 years). Common symptoms included lower back pain (70%), fractures (42%), difficulty walking (42%), and muscle weakness (28%). All patients showed hypophosphatemia, and elevated FGF23 levels were noted in 5 out of 7 patients (70%). Most tumors (86%) were in the anterior skull base, particularly in the ethmoid region. One patient had a tumor in the lateral skull base, confined to the mastoid. All patients underwent wide local excision via endoscopic and retromastoid approaches. Phosphaturic mesenchymal tumor-induced osteomalacia is a rare condition, with generalized nonspecific symptoms. Despite the challenging nature of the disease, surgical removal of the tumor can lead to a complete cure and significant symptom relief.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2252-2259"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152652","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 Case Report on Chronic Suppurative Otitis Media and its Devastating Complications: A Persistent Challenge in Developing Countries.","authors":"Zainab Rasheed, Muhammad Roshan, Muhammad Azeem Aslam","doi":"10.1007/s12070-025-05500-w","DOIUrl":"10.1007/s12070-025-05500-w","url":null,"abstract":"<p><p>This case report highlights a severe presentation of chronic suppurative otitis media (CSOM) in a resource-limited setting, complicated by dural sinus thrombosis, meningitis, and neck abscess. It underscores the life-threatening potential of untreated CSOM and the urgent need for early intervention and awareness in developing countries.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2404-2407"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152658","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":"Association of Markers of iron Metabolism with Mucormycosis: A Case Control Study.","authors":"Ankita Semwal, Amit Kumar Tyagi, Prasan Kumar Panda, Amit Kumar, Bhinyaram, Kalyani Sridharan, Bela Goyal, Ashok Kumar, Gaurav Dhingra, Sharon Kandari, Mahendra Singh","doi":"10.1007/s12070-025-05506-4","DOIUrl":"10.1007/s12070-025-05506-4","url":null,"abstract":"<p><strong>Aim and objective: </strong>To estimate the association of mucormycosis with markers of iron metabolism and to correlate levels of serum ferritin with stage of mucormycosis.</p><p><strong>Materials and methods: </strong>We conducted a case control study in hundred (50 cases and 50 controls) patients. Biopsy proven mucormycosis patients were taken as cases. Controls were selected from the same study population as the cases, and they were representative of the population at risk. Controls were matched for the age, gender, and all known risk factors of mucormycosis, and for each case, one control was taken.</p><p><strong>Result: </strong>We enrolled 50 cases and 50 controls. Rhino-orbital mucormycosis (50%) was the most encountered clinical presentation among cases followed by rhino-orbital-cerebral mucormycosis (36%). Diabetes mellitus was the most commonly encountered risk factor (96%). The mean serum iron (ug/dl) value (41.5 vs. 72, <i>p</i> < 0.001) and transferrin saturation (%) value (14.1 vs. 19.86, < 0.001) were significantly lower in cases than in controls. The mean serum ferritin (ng/ml) value (2087.6 vs. 174.5, < 0.001) was higher in cases as compared to controls.</p><p><strong>Conclusion: </strong>Higher serum ferritin values seem to be an indicator of the severity of disease in the present study. Individuals with elevated serum ferritin levels must be carefully managed with anticipation of severe outcomes, especially in those who have concurrent risk factors.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2344-2351"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152692","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":"Predictors of Surgical Success and Hearing Outcomes in Endoscopic Cartilage Tympanoplasty: A Ten-Year Retrospective Study.","authors":"Abdulmjeed Alnosair, Noor Binsanad, Rashed Aldoseri, Mai Nasser, Amal AlAbdulla, Gowri Sivaramakrishnan, Mohamed Alshehabi","doi":"10.1007/s12070-025-05512-6","DOIUrl":"10.1007/s12070-025-05512-6","url":null,"abstract":"<p><p>Endoscopic tympanoplasty provides superior surgical capabilities compared with microscopic technique. We aimed to investigate the surgical and functional success rates of endoscopic cartilage tympanoplasty and identify the predictors of poor outcomes. We analyzed the data for all patients who underwent endoscopic cartilage tympanoplasty at Bahrain Defence Force Royal Medical Services, Military hospital between March 2014 and April 2024. Patient demographics, clinical characteristics were analyzed. Inclusion criteria included patients with chronic otitis media and dry, stable TM perforations. Exclusions were active otitis media, perforations caused by trauma or cholesteatoma, and cases requiring mastoidectomy. Surgical success was defined as TM graft closure six months postoperatively, and functional hearing success was determined by achieving postoperative ABG ≤ 20 dB. A total of 132 patients (72 males, 60 females; mean age: 34.77 ± 16.2 years) were included. The overall surgical success rate was 81.8%, with variations across age groups. Central perforations were the most common (51.5%) and had an 81% success rates. Audiological outcomes showed significant ABG closure, with a mean pre-operative ABG of 16.34 ± 9.4 dB reducing to 9.15 ± 10.0 dB post-operatively (<i>p</i> < 0.001), resulting in an average ABG reduction of 7.19 ± 9.8 dB. Social hearing (ABG ≤ 20 dB) was achieved in 91% of cases. Binary logistic regression identified smoking, granulation tissue, and age < 12 years as significant predictors of graft failure. Endoscopic technique demonstrates high surgical and functional success rates. Smoking, granulation tissue, and younger age negatively impacted outcomes emphasizing the importance of patient selection in optimizing results.</p>","PeriodicalId":49190,"journal":{"name":"Indian Journal of Otolaryngology and Head and Neck Surgery","volume":"77 6","pages":"2363-2369"},"PeriodicalIF":0.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152611","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}