Cisplatin, a platinum-based chemotherapeutic agent, is widely used for its potent antineoplastic activity. Its cytotoxic effects are mediated through multiple mechanisms, including direct DNA damage, inhibition of DNA synthesis, mitotic arrest, and the induction of apoptosis via both intrinsic and extrinsic pathways. A key component of its mechanism involves the generation of reactive oxygen species (ROS) and lipid peroxidation. These mechanisms underpin its broad clinical utility in the treatment of various malignancies. However, despite its therapeutic efficacy, cisplatin is associated with a wide range of dose-limiting toxicities, most notably irreversible, bilateral sensorineural hearing loss (ototoxicity), nephrotoxicity, peripheral neuropathy, and myelosuppression. Other adverse effects include severe nausea and vomiting, ocular toxicity, and gonadotoxicity. This prospective cohort study aimed to evaluate the incidence and severity of sensorineural hearing loss (SNHL) in patients with head and neck cancers undergoing cisplatin-based chemotherapy. A total of 90 patients diagnosed with head and neck malignancies and receiving cisplatin chemotherapy were enrolled, all of whom underwent baseline audiometric assessment to exclude presbycusis. Following chemotherapy, 72.2
Epistaxis is common in otolaryngology practice and is usually attributed to local nasal causes. However, occult hematological disorders may remain undiagnosed when routine laboratory parameters appear normal. We report two cases in which ENT surgical intervention acted as a diagnostic stressor, unmasking previously unrecognized hematological abnormalities. A 33-year-old man with recurrent epistaxis and a history of previous transfusions underwent septoplasty with inferior turbinectomy after apparently acceptable preoperative investigations. Recurrent postoperative bleeding with fluctuating hemoglobin and platelet counts prompted hematological reassessment. Bone marrow evaluation showed hypercellular reactive marrow with increased megakaryopoiesis and erythroid hyperplasia, supporting peripheral platelet destruction rather than primary marrow failure. An 18-year-old man with lifelong intermittent epistaxis underwent adenoidectomy and subsequently FESS. Despite repeatedly normal routine coagulation profiles, he developed recurrent postoperative epistaxis. Platelet aggregometry demonstrated severely reduced aggregation responses to ADP, collagen, and arachidonic acid with preserved ristocetin response. Flow cytometry showed preserved GP IIb/IIIa and GP Ib/IX receptor expression, excluding Glanzmann thrombasthenia and Bernard–Soulier syndrome and supporting an inherited non-receptor qualitative platelet function disorder.These cases demonstrate that routine coagulation screening may fail to detect qualitative or dynamic hematological disorders. Recurrent or disproportionate postoperative bleeding should prompt review of serial blood counts, previous transfusion history, and advanced hematological testing when indicated. ENT surgeons may therefore play a critical role in recognizing atypical bleeding patterns and initiating multidisciplinary evaluation.
A substantial number of tympanic membrane perforation do not heal, it was proposed to use PRF to increase the healing rate. To evaluate the role of endoscopic management of traumatic tympanic membrane with platelet rich fibrin (PRF). The study included 120 adult patients. All patients underwent endoscopic guided application of PRF membrane over the approximated edges of perforated tympanic membrane under local anesthesia. The patients of traumatic TM perforation were of variable etiology. Left ear was affected more than right and grade II perforation was most common. At three weeks and six months follow up TM was normal in all cases. AB gap was significantly improved (p < 0.01). Autologous PRF healed all traumatic TM perforation and hearing was restored.
Oral squamous cell carcinoma (OSCC) represents a significant global health burden with a poor prognosis when diagnosed at advanced stages. Liquid biopsy offers a non-invasive approach for early detection and monitoring, utilizing various biomarkers including circulating tumor DNA (ctDNA), microRNAs (miRNAs), circulating tumor cells (CTCs), and extracellular vesicles. To systematically evaluate the diagnostic accuracy of liquid biopsy biomarkers in OSCC diagnosis through comprehensive meta-analysis. A systematic literature search identified 18 studies (2017–2025) encompassing 8,772 participants. Meta-analysis was performed using random-effects models to calculate pooled sensitivity, specificity, and area under the curve (AUC). Subgroup analyses examined performance by biomarker type and sample source. Pooled diagnostic accuracy showed sensitivity of 0.777 (95
Lymphatic filariasis is endemic in India and remains a significant public health problem. Although it commonly involves the lymphatics of the lower limbs and genitalia, isolated cervical lymph node involvement is rare and may mimic inflammatory or neoplastic neck lesions. We report a rare case of isolated submental filarial lymphadenopathy presenting as a diagnostic challenge. A 27-year-old man presented with a progressively enlarging swelling below the chin for 15 days. Clinical examination revealed a solitary, firm, freely mobile submental swelling without other cervical or systemic lymphadenopathy. Ultrasonography demonstrated features suggestive of a filarial worm, whereas fine-needle aspiration cytology suggested granulomatous inflammation, raising the possibility of tuberculosis. Owing to these discordant findings, an excision biopsy was performed, and histopathological examination confirmed filarial lymphadenopathy. The patient was treated with diethylcarbamazine and had an uneventful recovery. Isolated submental filarial lymphadenopathy is an uncommon presentation that can closely resemble other causes of cervical lymphadenopathy. This case emphasizes the importance of maintaining a high index of suspicion in endemic regions and correlating clinical, radiological, and pathological findings. Excision biopsy remains the definitive diagnostic modality when non-invasive investigations are inconclusive or conflicting.
