Lupine Publishers Journal of Otolaryngology: Journal of Otolaryngology impact factor

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Friday, October 6, 2023

Choanal Atresia Repair, A Comparison Between Transnasal Puncture With Dilatation And Stentless Endoscopic Transnasal Drilling

Abstract

Background: in this study we present the outcome of surgical repair of choanal atresia of 33 patients underwent the surgery at Tripoli University hospital and Tripoli central hospital
Objectives: The aim of this study to compare between two procedures used to repair choanal atresia. The first procedure is perforation and dilatation with stenting and the second procedure is endoscopic drilling without stenting. The comparison looked at the main complication which is restenosis of the choana.
Method: A review the medical notes of 33patients diagnosed with choanal atresia and subjected to surgical repair. Results: 8 patients out of 13 developed restenosis after treatment with perforation and dilatation (61.5%), While 4 patients out of 20 treated with trans-nasal endoscopic drilling without stenting (20 %)
Conclusion: The study showed that the risk of restenosis is significantly less in trans-nasal endoscopic drilling technique and the result of this procedure is comparable to the published data

Keywords: Choanal atresia; endoscopic repair; perforation and dilatation; restenosis

Friday, September 15, 2023

Unresolved Issues with Repeated MRI and CT Scan of the Brain in Vestibular Migraine and Recurrent Vestibulopathy: A Case Study

Abstract

Vertigo and vestibular disorder are on of common illness that still having multiple and unresolved issues especially in term of diagnosis and management. Limited awareness of the actual protocol for the vestibular disorder management lead to unnecessary investigation among the vertigo patients. Many clinicians in our set up focusing more on investigation such as repeated MRI and CT scan of the brain in order to rule out the cause of the problem. Due to this will lead to financial burden to patients and not an optimum management. Since after several investigation and undefined diagnosis patient will end up with the frustration and prolonged the problem without proper management. Recurrent vestibulopathy and Vestibular migraine is among the most common causes of recurrent vertigo in the general population. Despite its high prevalence and impact on healthcare management cost, it has remained an under-recognized condition and unknown pathophysiology. Recurrent vestibulopathy and vestibular migraine common illness that having unclear mode of therapy. In this case the optimum management is intensive vestibular Rehabilitation (VRT) needed and not a medication or injection that only symptomatic relieve. A 48-year-old lady, underlying migraine and hypertension was presented with spinning sensation for 1 year associated with left ear tinnitus. Improved almost 60% after intensive vestibular rehabilitation in ward for 4 days using BAL EX Quick balance module. Optimum and end solution able to achieve using proper diagnosis and management.

Keywords: Migraine; recurrent vestibulopathy; vestibular rehabilitation

Friday, September 8, 2023

Health vs Environment with a Focus on Otolaryngology: A Sociological Appraisal

Abstract

Sociologically speaking, environment, especially the built environment has highly affected the human health in particular in urban areas where population is more concentrated, merged with industries and the pollution diluted. The current urban life is exposed to many disorders and health issues. Under such circumstances, the developed countries have access to better means of treatment especially otolaryngological facilities, whereas the developing countries are generally in short of the necessary medical means. What the developing countries need to do is to invest more on their educational atmosphere, wide-spreading education in all corners of their countries regardless of race, gender, creed and color. That would be a good column for the next healthy generations. Environmental health includes neighborhood spaces, schools, and the places where we live. Based on environmental sociological perspectives, qualitative differences between different environments should be reduced to a minimum. However, population density and extensive and continuous migration have caused different geographical environments to have different environmental health. Environmental diseases largely reflect racial and class status such as habitat and climate which are interrelated, and also affect human health.

Keywords: Environmental effects; air pollution; urban environment; environmental justice; healthy generations

Friday, September 1, 2023

Negative Pathology Report Following Salivary Gland Surgery for Suspected Primary Tumor– What Went Wrong?

Abstract

Objective: For patients undergoing an oncologic surgery, postoperative pathological diagnosis negative for a tumor is a confusing outcome. Additionally, it may carry clinical and medicolegal consequences. The study defines the causes of such discrepancies in order to prevent such instances in the future.

Methods: A retrospective cohort study of patients who had undergone resection of a major salivary gland for a suspected or diagnosed primary tumor but had no tumor on surgical pathology.

Results: Eight patients (2.5%) had negative pathology. Causes for negative pathology were A) Surgical pathology error (n=3) B) Surgical management error (n=1) C) Surgery for definite diagnosis (n=2) D) Unexplained (n=2).

Conclusions: Negative pathology in salivary gland surgery is not rare. Negative pathology should raise the suspicions of both the surgeon and the pathologist. An immediate multidisciplinary review of all data will find the cause in most cases Keywords: Negative pathology; no tumor on pathology; salivary gland tumor; parotid gland tumor

Saturday, August 26, 2023

Changes in Allergy Pattern in Covid Pandemic

Introduction

In accordance to the above statement, both- the basic problem and the solution to this problem have been mentioned & that is- ‘stay home, stay safe and follow the Covid protocols’. In the last 2 years, the world has witnessed this century’s one of the most dreadful and contagious viral infection- Covid 19.

Friday, August 11, 2023

Meniere’s Disease: Its Possible Cause

Short Communication

There is a disease identified in the 19th Century that causes hearing loss beginning at age 30 -60. Not only is it associated with sensorineural hearing loss, but also dizziness and ringing in the ears. I propose that the cause of Meniere’s Disease is the result of a misalignment of the head relative to the spine.

Friday, August 4, 2023

Novel Personalized Biologic Driven Strategies in Head and Neck Cancers – Empirical Cancer Care Leaping Towards Precision Care

Abstract

Precision medicine is the targeted therapy with personalized approach to cancer treatment, ultimately Resulting in more precise targeting of tumor cells and spares the normal tissues and with minimal toxicities. The currently practised precision/targeted approaches in head and neck cancer are either based on the patient-specific or tumor-specific characteristics which includes the underlying etiology, tumor microenvironment or the genomics. The concept of precision medicine in oncology is focused on identifying therapies that are based on the genetic characterization of a patient’s tumor, thereby tailoring the cancer treatment to a specific gene mutation in an individual patient’s cancer. Though radiation oncology with the recent advancements with image guidance and functional imaging provides a more individualized treatment, it can be further optimized by the incorporation of novel biologic driven strategies, by consolidating the data obtained from genomics and radio genomics. This upgrades the treatment options with de-intensification or intensification based on the patient and tumor characteristics and etiology. This is currently achieved by various immunotherapeutic agents already in practice with monoclonal antibodies and signal transduction inhibitors and can be further expanded by identification of neoantigens for cancer vaccines and checkpoint inhibitor gene panels, with predictive and prognostic objective in addition to therapeutic benefits.

Friday, July 21, 2023

Ehlers-Danlos Syndrome (EDS) : A Common and often Disregarded Cause of Serious Gastrointestinal Complications in Children and Adults

Abstract

Ehlers-Danlos is a hereditary disease of the whole connective tissue initially described by dermatologists (Tscherchnogobov Moscow 1892, Ehlers, Copenhagen, 1900, Danlos, Paris, 1908). They emphasized the joint hyperlaxity and stretchiness of the skin which has long summed up the clinical expression of this entity. In recent decades, many other manifestations have been described and gradually identified, mainly by rheumatologists (Grahame, London, 1960). Several of them concern the digestive tract, mainly gastric reflux and constipation. They can be the cause of serious accidents: bronchial flooding by gastric reflux or aspiration, intestinal obstruction, hernial constriction, eventration, intestinal rupture, peritonitis of vesicular or appendicular origin, hemorrhages. It is important that gastroenterologists know how to link these manifestations to their etiology in order to adapt treatments, prevent iatrogenic accidents and direct the patients towards the treatment of other manifestations of Ehlers-Danlos disease. Nine clinical signs, including digestive manifestations, allow diagnosis by their significant grouping. The proof of hereditary origin is based on the identification of other identical cases in the family,, even if they are paucisymptomatic. A person affected by the disease systematically transmits the disease to all his children. We have verified this in all our patients.

Friday, July 7, 2023

The Migration of a Fish Bone into Posterior Cervical Space

Abstract

Esophageal foreign bodies are commonly encountered in otolaryngology clinic. The most common esophageal foreign bodies are fish bones which are encountered in Southeast Asia and in Vietnam. The rare complication due to the ingested foreign body is its migration to the deep neck space and the formation of cervical abscess. This case depicts a patient with a fish bone in the esophagus that migrated extraluminally into the posterior cervical space. Moreover, the difficulties in removing the foreign body as well as the management of esophageal perforation are described in detail.

Keywords:Fish bone; Esophageal perforation; Migration; Posterior cervical space

Friday, June 30, 2023

A Giant Ranula: The Rima Oris Lantern – A Catch-All Approach

Abstract

Oral ranula is a retention cyst which arises from the sublingual salivary gland in the floor of the mouth due to ductal obstruction and fluid retention. Various surgical procedures have been quoted in the literature ranging from simple aspiration to complete or partial excision of the ranula. This paper highlights a case report of a huge impending plunging ranula in the floor of the mouth which has been successfully excised completely.

Keywords: Ranula; Marsupialisation; Pseudo-cyst

Friday, June 23, 2023

Lupine Publishers | Cervicofacial Herpes Zoster Complicating Ganglion- Pulmonary Tuberculosis: Case Report and Review of the Literature: A Case Report

Abstract

Tuberculosis is an infectious disease; it has a variable degree of presentation, most often pulmonary while the extrapulmonary location is dominated by lymph node involvement, especially cervical. On the other hand, herpes zoster results from the reactivation of the virus that causes varicella. Here, we report the case of cervicofacial herpes zoster complicating ganglion-pulmonary tuberculosis in a 19-year-old female patient with a history of varicella during childhood, who presents bilateral lymphadenopathy, the diagnosis of pulmonary and lymph node tuberculosis is confirmed by histology, she has treated with anti-tuberculosis drugs and the evolution was marked by the presence of lymphadenopathy and the appearance of cervicofacial herpes zoster.

Friday, June 16, 2023

Association Between Hearing Loss with Site and Size of Tympanic Membrane Perforation: A Retrospective Study

Abstract

Background: Perforation of tympanic membrane decreases surface area and allows the sound waves to pass through middle ear directly. Size of perforation and severity of the hearing loss are related.

Aim: The present study was aimed to evaluate association between hearing loss with site and size of tympanic membrane perforation.

Methods: All patients between 15-60 years of age with chronic otitis media safe type attending to outpatient clinic of ENT, Bangalore Medical College over the period of one year were included in this hospital-based retrospective study. The patients with unsafe CSOM, mixed hearing loss, and refusal to participate in the study, were excluded.

Results: 52% patients aged between 21 and 30 years. Male to female ratio was 1.7:1. 53% patients belonged to average socioeconomic class. The most common symptom on presentation was decreased hearing present in all the patients followed by otalgia (38%), and headache (31%). Unilateral ear was affected in 82 patients in our study. In 9 patients, both ears were affected. Among 50% ears, size of perforation was 10-30 mm2 followed by 0-9 mm2 in 40% ears, and >30 mm2 in 10% patients. We also observed that the patients with higher perforation have an increase in hearing loss on PTA examination (P<.0001). Among 100 ears, the most common perforation site was central (70%) followed by antero-superior (19%), antero-inferior (15%), postero-inferior (9%), and postero-superior (3%). We also observed that median PTA frequency on postero-superior site was significantly higher than antero-superior, anterosuperior, and central site (P<0.01).

Conclusion: Hearing loss is directly related to the size of TM perforation, as the size increases hearing loss also increases.

Keywords:Chronic otitis media; tympanic membrane; hearing loss

Friday, June 9, 2023

The Differences in Prosodic Features of Alaryngeal Speech after Laryngectomy

Abstract

Purpose: Defining the prosodic features of alaryngeal speech and determining their differences depending on the type of alternative speech.

Methods: The study included 60 laryngectomized subjects of both sexes with a mean age of 63 years. The subjects were divided into three groups depending on the type of alternative alaryngeal speech. Prosodic features were assessed using a four-component scale for the assessment of prosody of alaryngeal speech by three examiners. Statistical data processing was done using the SPSS statistical package.

Results: Significant differences were found between tracheoesophageal, esophageal, and electro laryngeal speech with respect to melody and accent performance, and variable rhythm, while the existing differences in the realization of pauses in speech were not significant. Most tracheoesophageal subjects have the appropriate melody, as well as the accent achieved during the speech, the logical pauses present, and in most cases the appropriate speech rhythm.

Conclusion: By evaluating prosody, vocal rehabilitation by the installation of a tracheoesophageal prosthesis has proven to be the most optimal rehabilitation method.

Keywords: Alaryngeal Speech; Assessment; Laryngectomy; Prosody

Friday, June 2, 2023

Prevalence of Abnormal Cervical Vestibular Evoked Myogenic Potential (CVEMP) Responses in Dizzy Patients Following Mild Traumatic Brain Injury

Abstract

Objective: We sought to assess the feasibility of cervical vestibular evoked myogenic potential (cVEMP) as a diagnostic tool for patients experiencing dizziness after mild traumatic brain injury (mTBI) in tertiary neurotology clinic. We used cVEMP to estimate the prevalence of saccular dysfunction after mTBI.

Design: This was a cross-sectional study of patients referred to a tertiary neurotology clinic for dizziness after mTBI. These patients were given a standard neurotology clinical examination and vestibular assessment in addition to a cVEMP test.

Results: 20 of 63 (31.7%) patients had an abnormal cVEMP response. 75% of these subjects showed no deficiency by clinical exam or VNG and 50% registered a deficiency by pure tone audiometry (PTA).

Conclusions: We found that abnormal cVEMP responses were common in dizzy patients post-mTBI and many had normal results in standard neurotological/vestibular tests. cVEMP may help identify those with vestibular dysfunction associated with saccular injury after mTBI.

Keywords: Vestibular evoked myogenic potential; TBI; cVEMP, saccule

Abbreviations: TBI: Traumatic Brain Injury; VEMP: Vestibular Evoked Myogenic Potential; SCM: Sternocleidomastoid; PTA: Pure Tone Audiometry; IAD: Interaural Amplitude Difference; PPPD: Persistent Postural Positional Dizziness

Friday, May 5, 2023

Ankyloglossia, A Case Report: Untying the Tongue Tie in the Family Tree

Abstract

Ankyloglossia or ‘Tongue-tie’ is a congenital oral anomaly characterized by the persistence of the lingual frenulum as an anatomical abnormality. It has a prevalence of 0.1 – 10.7 % as reported in the literature with affection more towards males. I hereby present a case report to have come across an Isolated Ankyloglossia in a family of 4 members, in whom 3 are affected with this condition.

Keywords:Ankyloglossia/Tongue tie; inheritance; familial; congenital; syndrome

Friday, April 28, 2023

Combined Surgical Approach Via Orbitozygomatic Craniotomy and Endoscopic Sinus Surgery for Giant Frontoethmoidal Osteoma Spreading into Orbit and Anterior Cranial Fossa

Abstract

Introduction: Osteoma is the most common benign paranasal sinus tumour. In majority of cases, it is asymptomatic and is diagnosed by chance. We report on a case of giant frontoethmoidal osteoma with intraorbital and intracranial spread. Combined surgical approach was chosen for management of this case. Immediate reconstruction of medial orbital wall and anterior skull base was performed.

Case Description: 25 years old man presented to otorhinolaryngology department due to incidental computed tomography finding. Giant osteoma of the right frontoetmoidal region spreading into an orbit and anterior cranial fossa was identified on computed tomography. The patient was absolute candidate for surgical treatment. Magnetic resonance imaging was performed to view possible involvement of adjacent intraorbital and intracranial anatomical structures. Right side orbitozygomatic craniotomy and endonasal endoscopic surgery were performed for removal of osteoma. On control computed tomography 12 months after surgery there were no pathological changes or reccurrence of osteoma.

Conclusion: Surgical approach for osteoma management should be chosen according to its size, localization and involvement of adjacent anatomical structures. For giant osteomas, spreading outside paranasal sinuses, endoscopic approach perspectives are limited. Multidisciplinary approach is of a vital importance to achieve the best treatment outcome.

Keywords:Frontoethmoidal osteoma; giant osteoma; bicoronal incision; orbitozygomatic craniotomy; FESS

Friday, April 21, 2023

A Systematic Literature Review of Music Induced Hearing loss

Abstract

Music induced hearing loss is caused by listening to loud music on Personal Music Players (PMP) or attending discotheques regularly over a period of time. Exposure to loud music causes physiological changes and damage in the Basilar Membrane especially to the Outer Hair Cells, Inner Hair Cells, and the Auditory Nerve. Damage includes loss of sensitivity to soft sounds, presence of recruitment, tinnitus, reduced frequency selectivity and reduced flow of synapses and information to the auditory cortex. This leads to poor auditory discrimination and reduced temporal fine structure of sounds and poor pitch perception. Hearing loss acquired due to exposure to intense loud music, is typically greatest over the frequency range 3–6 kHz, hence the high frequency hearing loss. Numerous studies done on threshold changes, temporary threshold shift and permanent threshold shift using Pure Tone Audiometry and Oto-Acoustic Emission have indicated high frequency hearing loss in young adults after exposure to loud music at discotheques, overuse of Personal Music Players (PMP) in teenagers and children. Pure Tone Audiometry (PTA) changes weren’t noted, however Oto-Acoustic Emissions (OAE) showed changes and indication of high frequency hearing loss and tinnitus was noted as a symptom after loud music exposure.

Keywords:PTA: Pure Tone Audiometry; OAE: Oto-Acoustic Emissions; PMP: Personal Music Players; MIHL: Music Induced Hearing Loss; TM: Tympanic Membrane

Tuesday, April 18, 2023

Effectiveness of Current Physiotherapy in Osteoarthritis of the Knee

Abstract

Osteoarthritis (OA) of the knee is a multifactorial disease that develops with many causes such as aging, obesity, genetic factors, and mechanical load. The main symptoms of OA are the initial degeneration and destruction of knee articular cartilage, and the mechanical load and accumulation of abnormal bone turnover (bone resorption and formation) that occurs in the subchondral bone. Until now, physiotherapy approaches for knee OA have been focused on as the main pathological conditions of articular cartilage destruction and bone changes around the joints. However, in recent years, it has been perceived as a regression change in all joint components, including the meniscus, joint capsule, ligaments, and muscles. The purpose of this review is to explain current physiotherapy methods applied to knee OA patients and the findings of research on this subject.

Keywords:After knee osteoarthritis; physiotherapy; rehabilitation; conservative therapy; total knee arthroplasty

Friday, March 24, 2023

Use of Temporoparietal Flap and Split Skin Grafting of Donor Area to Salvage Cochlear Implant – Novel Experience from A Tertiary Hospital in India

Abstract

The management of cochlear implant exposure can be very challenging especially in the pediatric population where reconstructive options are limited. Various techniques comprising conservative and surgical methods have been used to prevent explanation with variable success rates. We describe the use of the temporoparietal fascial flap (TPFF) for this purpose due to its wide coverage and tension-free closure. We present the case of a child who had implant exposure 3 months after the surgery. He was managed conservatively initially. When this failed restoring of the wound was done. However, this also was not successful. Then we tried coverage with TPFF and split-thickness skin grafting of the TPFF donor site which succeeded. Our experience provides evidence that TPFF can be used for the coverage of post aural wound in cases of implant exposure and when combined with a splitthickness skin graft (STSG) of the donor site, it can further increase the success rates. The STSG of the donor site ensures a tensionfree closure in comparison with primary closure which would put further pressure on the TPFF.

Keywords:TPFF: Temporoparietal Fascial Flap; STSG: Split-Thickness Skin Graft

Friday, March 17, 2023

Digestive Problems & Autofellatio

Abstract

In this paper, we consider the injuries incurred from autofellatio that cause digestive problems. The esophagus is put on a mathematical basis and the force necessary to allow for the bolus to enter the stomach.

Keywords:Digestion; autofellatio; spine; Bernoulli’s equation