Otitis media is an inflammation of the middle ear & mastoid process, which could be acute purulent otitis media, otitis media with effusion and chronic suppurative otitis media (CSOM) (Berman, 1997). CSOM is a condition of non-healing perforation of the tympanic membrane associated with chronic inflammatory changes of the Mucoperiosteum of the middle ear cleft resulting in mucoid or mucopurulent otorrhea of a period of three months duration (Nwabuisi and Ologe, 2002; Sharma et al., 2004). CSOM is a major problem in developing countries like India. It is more common in children belonging to lower socioeconomic group (Lasisi et al., 2007). It is single most important cause of hearing impairment in our country (Srivastava et al., 2010). The study of microorganisms associated CSOM and their antibiotic sensitivity pattern is most significant for clinician to plan general outline of treatment of chronically discharging ear (Greval and Ram, 1996). The most common microorganisms found in CSOM are Pseudomonas aeruginosa, Staphylococcus aureus, Proteus mirabilis, Klebsiella species, E. coli, Aspergillus spp, and Candida Spp, but these organisms vary in various geographical areas (Anwar-us-Salam and Abdulla, 1997). Immediate and effective treatment supported the knowledge of causing microorganisms and their sensitivity ultimately leads to good clinical recovery and provides safety and complications caused by CSOM (Taneja, 1999). Antimicrobial therapy used to eradicate the bacterial agents causing otitis media but most of the microorganisms are acquiring antibiotic resistance. In developing countries, this problem is rapidly increasing due to misuse of antibiotics. The important factors associated with occurrence CSOM found to be a poor hospital hygiene, overcrowding, lack of resources for infection control and lack of personnel trained in controlling infections in hospital (Hart and Kariuki, 1998). Pseudomonas aeruginosa is the most predominant organism among the cases of CSOM reported by several workers in India and abroad with an incidence ranging from 21% to 52.14% (Gulati et al., 1969; Ayyagari et al., 1981; Rao and Bhaskaran, 1984). Pseudomonas aeruginosa possesses an intrinsic resistance to many antibiotics and has an ability to develop resistance through mutations in different loci or through the horizontal acquisition of resistant genes, which carried on plasmids, transposons or integrons (Bannerman et al., 2007). The changing flora of CSOM and emergence of strains resistant to the commonly employed antibiotics stimulated this study. The present work deals with the bacteriological study of CSOM to identify and categorize various organisms isolated and to evaluate their sensitivity pattern (Agrawal et al., 2013).
This is a case report of a 7 year old male child who presented with an unusual foreign body a glass marble in upper esophagus. The child was a case of global developmental delay, seizure disorder, patent ductus arteriosus, congenital hydrocephalus with VP shunt in situ. The case was a challenging one to the entire team of surgeons, anesthesiologist and pediatricians. Under general anesthesia the foreign body was removed using a foley’s catheter. Spherical foreign bodies like glass marbles are always challenging as the usual instruments cannot grasp such foreign bodies and there is always a chance of pushing the foreign body downwards during the attempt to remove. In this case foley’s catheter was used to retrieve the foreign body which is cheap, easily available and non-traumatic.
Laryngeal carcinomas account for about 2.4% of all malignant tumors and whose squamous cell carcinoma is the most frequent histological type (95%). Direct laryngoscopy and biopsy are the gold standard for the diagnosis of laryngeal cancer, but multiple imaging modalities exist and some are under development including spiral computed tomography (CT) and more recently multi-detector computed tomography which allowed neoplasm identification at an early stage. The endoscopy-computed tomography pair allows exploration of the anatomic zones (the para-glottic space, the subglottis, the cartilages and the hyo-thyro-epiglottic space…) whose impact modifies the therapeutic management (partial laryngectomy, total laryngectomy or even a surgical contraindication). The aim of this study is to compare the reliability of CT and endoscopy in evaluating the initial loco regional extension of laryngeal cancer by referring to histologic data.
There are limited psychophysical measurements on growth of loudness in early-deafened cochlear implant users as compared to postlinguallydeafened cochlear implants users. In this study, the “shape” of the loudness growth function was investigated for prelingually- and postlinguallydeafened subjects by measuring loudness growth within the electrical dynamic range on different bipolar electrode pairs using Absolute magnitude Estimation (AME) and Absolute magnitude Production (AMP). The shapes of the loudness functions were obtained and verified by comparing loudness growth models using the Akaike’s Information Criterion (AIC) method to get the best- fit functions. Results suggest that adult cochlear implant listeners can exhibit different loudness growth functions, counting on their acoustical experience before implantation. Eight subjects with considerable acoustic experience before implantation and comparatively late implantation demonstrated loudness functions that grew consistent with an expansive nonlinearity, in agreement with results from several previous studies. In contrast, the four early deafened subjects with little or no useful acoustic experience before implantation, had loudness functions that grew in proportion to stimulus current amplitude. These results suggest that the form of the loudness function is molded partially by the character and functionality of input to the central sensory system during auditory development.
Most of malign tumors of head and neck region often occur at the nose. Surgical methods like primary closure, skin grafts, local flaps and free tissue transfer are often used for reconstruction of those defects. Nasal dorsum, nasal tip, sidewalls, alar regions, columella and soft triangles are described as nine subunits of the nose and various reconstruction methods are described for every subunit. Local flaps are often advanced on the pivot point by rotating or advancing. The most commonly used local flaps in nasal reconstruction; bilobed, rhomboid, advancement, dorsal nasal and transposition flaps. Nasal dorsum skin is thin and mobile. Dorsal nasal flap, glabellar flap, forehead and full thickness skin could also be preferred for reconstruction of this region. Nasolabial flaps are the foremost preferred method for reconstruction of the nasal sidewall. Bilobed flap, dorsal nasal flap and forehead flap are the foremost preferred flap techniques within the nasal tip. Bilobed flap, nasolabial flap, paramedian forehead flap and Millard’s “gull-wing” flap are the well-liked methods to form reconstruction of alar region. The dimensions of the defect, its relation with neighboring structures, comorbid diseases of the patient, smoking and alcohol use are other important factors.
To increase awareness and the index of suspicion regarding Grisel's syndrome among otolaryngologists after otolaryngology procedures. We conducted a search of MEDLINE/PubMed for articles published through January 2020 utilizing the following terms: Grisel's syndrome, Grisel syndrome, and atlantoaxial subluxation alone and in combination with other terms like ENT, otolaryngology, head & neck, tonsillectomy, adenoidectomy, adenotonsillectomy, mastoidectomy, tympanoplasty, and tympanomastoidectomy. We included English-language cases that occurred after surgical procedures and contained the following data: age, onset, common presenting symptoms, diagnostic approach, management options, and the presence of complications. We found 39 papers that met our criteria. Most cases occurred after adenotonsillectomy with or without ventilation tube insertion (55.6%). The majority of the affected population was the pediatric age group, and the main presenting symptom was torticollis that presents as early-onset. In regard to management, most of the cases were treated with medical therapy with or without adjunctive measures (e.g., a cervical collar). No neurological complications were recorded except in one case that was treated with no long term sequel. Grisel's syndrome is a rare complication that occurs after otolaryngology procedures and can result in serious neurological complications and death. A high index of suspicion is an important factor for early diagnosis and management to prevent such complications. In most cases, conservative management is successful with a good prognosis.
Background: The present study was undertaken to compare the efficacy of toendoscopic removal with conventional techniques in aural myiasis patients. Methods: The 338, aural myiasis patients in study group were treated using Hopkine rigid toendoscope, the visible crawling caudal end of maggots was grasped with forceps & removed. Rests were identified from crawling movements or the visible caudal end buried in EAC and middle ear cavity and removed. Complete maggots clearance of ear cavity from EAC to middle ear cavity was done and same was repeated on other side if needed. Equal number of patients was treated using head light. Results: The mean age in two groups was 55.5 years (range 02-68) in aural myiasis patients. There were 56.5% males and 43.5% females. Mean duration of aural symptom in both groups was 2 days. Endoscopically mean number of 42 maggots (range-10- 62) were removed in first sitting as compared to conventional technique where mean of 28 (range 10-48) maggots were removed (p<0.001). The mean duration of endoscopic treatment was 2days whereas in control group it was 6days. The difference was statistically significant (p<0.001). Conclusion: Otoendoscopic procedure is superior to the conventional extraction method for removal of aural maggots. The larvae located in deep and inaccessible areas can be identified and removed easily. The disease was controlled in shorter time and ensures less damage to the middle ear structures.
Adenoid cystic carcinomas have specific pathologic features that correlate with prognosis. In general, adenoid cystic carcinomas are aggressive tumours with poor prognosis. Treatment most commonly includes surgery with or without radiation and chemotherapy. We describe a patient who presented with right periorbital swelling and CT Face contrast showing well defined soft tissue dense heterogeneously enhancing mass lesion seen along medial wall of right orbital region. The tumour was excised, and pathologic analysis showed an adenoid cystic carcinoma of the lacrimal gland. We review the clinical, radiographic, and pathologic features of these rare malignant tumours as well as treatment options.
Introduction: In the present work, a review is conducted on hearing loss, its origin, the consequences of the lack of a timely treatment, the possibilities and benefits provided by the access to a cochlear implant and the corresponding auditory rehabilitation. Materials and Methods: The methods used in the present work were Ling Test, Vowel Recognition, Consonant Recognition, Two-syllable Word Test, and Open-set Sentence Recognition. Results: By means of a descriptive study of a population that received a cochlear implant and after one year of use, we can observe high rates of auditory discrimination in all the variables presented and their levels of requirement and complexity, showing a close relationship between an appropriate and timely approach and a successful auditory rehabilitation. Conclusion: In all of the cases in this sample, the cochlear implant led to an improved quality of life for both the patients and their family members, allowing children to develop the language and improve their performance in school activities, and adults to appropriately reintegrate into society.
In adults, electric and acoustic stimulation (EAS) with intact hearing in the implanted ear improves speech comprehension, spatial hearing, and overall quality of life. However, there is a scarcity of research on the effects of EAS in children. The aims of this study was to evaluate the degree of EAS-related speech understanding benefit in children with retained acoustic hearing, as well as what role acoustic interaural time difference (ITD) sensitivity may have in that benefit. Six children with acoustic hearing loss and twenty children with normal hearing (NH) were chosen to take part in the study. An eight-loudspeaker array was used to test voice recognition, with speech coming from one loudspeaker at 0 degrees and restaurant noise coming from the other loudspeakers (45–315 degrees). The ITD thresholds for a 250-Hz stimulus presented acoustically via insert earphones were measured.
