Lupine Publishers Journal of Otolaryngology: SJO

Showing posts with label SJO. Show all posts

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

Saturday, September 23, 2023

Efficacy of a Medical Device Based on Plant Extracts for the Symptomatic Treatment of Cough in Children and Adults. A Clinical Study

Abstract

Cough is one of the most common medical situations that leads to seek medical attention. The present study was carried out to evaluate the efficacy and tolerability in the treatment of cough in adults and children of a sugar-free syrup containing glycerol and extracts from roots of Althaea officinalis and from leaves of Plantago lanceolata (FTP 65 Cough syrup sugar free: Manufacturer Labomar SPA). One hundred and twenty subjects (60 children and 60 adults) were recruited. Participants received for 7 days one of the following dosage schedules:
a) Adult: “ Cough Syrup REF FTP 65” in single-dose containers of 10 ml, to be taken daily in 3 administrations
b) Children: “ Cough Syrup REF FTP 65” with a daily dosage of 10 ml/day for 2–6-year-old children, and of 20 ml/day, for 7–12-year-old children. The survey included three visits: a first visit (V0) of enrollment, a second visit (V1) after 3 days from the V0 and a third visit (V2) carried out after 7 days of therapy. The results of this study confirm the evidence that the medical device Cough Syrup REF FTP 65 may represent a valid choice as a treatment for coughing in adults and children

Keywords: Cough; mucociliary clearance; Althaea officinalis; Plantago lanceolata; moisturizing film

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 18, 2023

Orbital Ameloblastic Carcinoma – Unusual Presentation in A Non-Odontogenic Location

Abstract

Ameloblastic carcinoma has been described as an ameloblastoma in which there is histological evidence of carcinoma in a primary or recurrent ameloblastoma. The frequency of the lesion is estimated to be less than 1% of all ameloblastomas occurring in the mandible and maxilla.1 We present a case of a 30-year-old woman who presented with painless swelling of left upper face and recurrent upper respiratory tract infections. She was evaluated with CECT, MRI and PET-CT which showed 3.6 x 3.5 x 3.3 cm mass arising from the inferomedial wall of left orbit with sunburst periosteal reaction and cloudy osteoid matrix which was thought to be an osteosarcoma. She underwent a transorbital and trans nasal endoscopic wide local excision of the lesion which was then diagnosed as ameloblastic carcinoma on histopathology. Imaging features and pathological findings of the tumor along with novel treatment strategies and differential diagnosis are discussed in this case report.

Keywords: MRI; orbital tumor; ameloblastic carcinoma; osteosarcoma; CECT; PET

Abbreviations: 18F-FDG-PET: 18F-fluorodeoxyglucose–Positron Emission Tomography; CECT: Contrast Enhanced Computed Tomography; FLAIR: Fluid Attenuated Inversion Recovery; MRI: Magnetic Resonance Imaging; WHO: World Health Organization

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 28, 2023

Congenital Laryngeal Web in Adult Female: Impromptu & Incidental

Abstract

Congenital laryngeal web constitutes 5% of all congenital laryngeal anomalies. Most of them are either present at birth or in the first few months of life but very rarely at an older age group. It needs both meticulous evaluation and imperative management to the earliest as its presentation can range anywhere between perpetual dysphonia to permanent dyspnoea leading to devastating morbidity and mortality.

Keywords: Glottic web; congenital; dysphonia; dyspnoea; anterior laryngeal web

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 14, 2023

On Recurrence Detection of Squamous Cell Carcinoma of The Head and Neck; A Critical Survey

Abstract

Current follow-up protocols of squamous cell carcinoma of the head and neck (SCCHN) rely on detection of recurrence at an asymptomatic stage. The evidence supporting a survival benefit of asymptomatic recurrence detection is relatively weak. These protocols are entirely based on assumptions and tradition, not evidence. There is ample evidence supporting the notion that most recurrences are diagnosed through patient symptoms. The staggering preponderance of symptomatic recurrence suggests that patients lack knowledge concerning symptoms that signify recurrence. Patient education should therefore be regarded a key factor of follow-up. We strongly emphasize the need for an easily accessible and adequate description of red flag symptoms that might signify recurrence. Having proper information, patients are less likely to forget, withhold or disregard these symptoms. Adequate incorporation of symptomatic recurrence might prove beneficial in terms of survival. Improvement of surveillance protocols for patients treated for SCCHN is of great concern considering the lives at stake, expense of treatment and follow-up. Local recurrence is the most important prognostic factor in SCCHN and incomplete surgical margins the single most decisive factor concerning recurrence. Local recurrence can arise close to the site of the initial primary tumor, either from cells left behind after surgery (minimal residual disease/cancer) and further deterioration of premalignant epithelial changes left behind after an excision. Several techniques have been developed for securing resection margins and identification of premalignant epithelial changes, thereby replacing the need for frozen sections. Genetic studies have unravelled the difference between local recurrence and secondary malignant tumors (SMTs) that necessitate significant changes in the timing and duration of follow-up appointments and renewed listing of SMTs.

Conclusion: Today’s simple ‘one size fits all’ surveillance protocols for SCCHN are inadequate. Rethinking of today’s follow-up procedure is absolutely required.

Keywords: Cancer; head and neck; squamous cell carcinoma; recurrence; surveillance; second malignant tumours; treatment; survival, prognosis

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 26, 2023

Functional Preservation Resection Combined with Radiotherapy in the Treatment of Locally Advanced Malignant Maxillary Sinus Tumors: Our Experience in 6 Patients

Abstract

Objective: The aim of this study was to explore the feasibility and efficacy of functional preservation surgery combined with radiotherapy in the treatment of malignant tumors of maxillary sinus.

Materials and Methods: The authors retrospectively reviewed 6 cases of malignant tumors of maxillary sinus who had undergone functional preservation resection and were given radical radiotherapy 4 weeks after operation between January 2012 and May 2021. One case underwent radical maxillary sinus surgery, 4 cases lateral rhinotomy, and 1 case partial maxillectomy.

Results: The series included 6 male patients between 42 and 84 years old (average 58.7 years). Pathological types include squamous cell carcinomas (n=2; 1 case of well-differentiated squamous cell carcinomas), adenoid cystic carcinoma (n=2), small round cell malignant tumor with intrastriatal infiltration (n=1), and malignant transformation of inverted papilloma (n=1). Patients were clinically followed up for a median of 72 months (range 37-111 months), and all the 6 cases are alive with good quality of life.

Conclusions: In this single-center report from relatively small series of maxillary sinus malignant tumors, we demonstrate that functional preservative resection combined with radical radiotherapy is generally safe and effective for different types of maxillary sinus malignant lesions.

Keywords:Malignant tumor; radiotherapy; maxillary sinus; lateral rhinotomy; partial maxillectomy

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