Introduction:Angina Bullosa Hemorrhagica (ABH) is a rare condition characterized by hemorrhagic blisters and is often asymptomatic. These lesions appear more commonly in the oral cavity and oropharynx and are often misdiagnosed. A retrospective cross-sectional study was performed in clinically confirmed cases of ABH to study its epidemiology, etiology and presentation in a tertiary care hospital in Southern Asia. Materials and Methods:Total of 8 patients of ABH were evaluated and included in the present study. All clinical data and track records were assessed by the medical records department. Cases were studied and results were interpreted. Results: Total of 8 cases were enrolled with male-to-female ratio of 0.6:1 and middle age as the most common age of presentation. Buccal mucosa was the most common site involved with average lesion size of 1.6 cm. Masticating trauma was the most common etiological risk factor. Majority patients were asymptomatic with spontaneous resolution of lesions in all the cases. Conclusion:Due to smaller number of studies reported, the lesions of ABH remained poorly understood with uncertain etiology. The knowledge of characteristic clinical features of the lesion and pattern of spontaneous healing is of utmost importance as a lesion of ABH can share some features with other serious disorders, thereby delaying the diagnosis. A thorough clinical history and examination of the lesion should always be done to establish an accurate diagnosis. Due to its completely benign nature, proper counseling of the patients must be ensured for better patient compliance.

Ewing’s sarcoma is a small round cell tumor commonly involving long bones. Head and neck involvement is seen less frequently with maxillary sinus being the rarest site. Here we report a case of a12-year-old female patient presented with left side facial swelling for 3 weeks duration which was diffuse and hard on palpation. CT and MRI of Nose para nasal sinus revealed a mass lesion in the left maxillary sinus infiltrating and eroding the orbital wall and extending intracranially. Biopsy from the lesion revealed Ewing’s sarcoma with strong positivity for CD-99 marker. Patient was referred to radiotherapy due to extensive disease at younger age. The CT and MRI along with HPE and IHC markers enables early diagnosis and prompt treatment that leads to better survival and prognosis, as unlike Ewing’s sarcoma of long bones, that metastasize early. The combined chemoradiotherapy is now the standard line of treatment along with close follow up for at least 2 years.

Background: The objective of the study was to evaluate and compare the results of endoscope assisted tympanoplasty with microscope assisted tympanoplasty. Methods: A prospective comparative study was conducted from January 2020 – September 2021 and included 60 patients of either sex in age group of 18-50 years having unilateral or bilateral inactive (mucosal) chronic otitis media with central perforation. Patients were randomly divided into 2 groups comprising of 30 patients each. Group-A (n=30) patients underwent endoscope assisted tympanoplasty while group-B (n=30) patients underwent microscope assisted tympanoplasty. Results: The overall graft take up rate in group-A and group-B was 93.33% and 96.67% respectively. In group-A, graft take-up was 90.90% in grade-IV perforations and 88.89% in grade-V perforations and graft take-up was 100% in grade-II and grade-III perforation. While in group-B, graft take-up was 91.67% for grade-III perforations, and 100% uptake was seen in grade-I, grade-IV and grade-V perforation. In group-A, pre-operative average air bone (AB) gap was 30.95 dB and post operatively it was 14.44 dB with an average hearing gain of 16.55dB while in group-B, the average pre-operative AB gap was 32.81dB and post-operative AB gap was 13.71dB with an average hearing gain of 19.11dB. Mean average time taken in group-A was 79.83±8.78 minutes, while in group-B it was 101.13±11.07 minutes. The average pain assessment score was 4.9 in group-A as compared to a score of 5.4 in group-B. Conclusions: The results of endoscope assisted and microscope assisted tympanoplasty are comparable. The operating microscope and endoscope should be employed as per the patient’s requirement and surgeon’s expertise.

Introduction:An unusual nasopharyngeal foreign body in a very young child with no clinical symptoms is a rare case presentation.Case Report:A nine-month-old child presented with a suspected history of foreign body ingestion without any clue to the parents about the nature of the foreign body. X-ray of the nasopharynx revealed a sharp unusual metallic "Louis Vuitton" shoe logo that the child had accidentally inserted into the nasopharynx via the oral cavity while playing. Foreign body was removed under general anesthesia without complications.Conclusion:X-ray nasopharynx should be included in the examination of a suspected case of foreign body ingestion, as an unusual shape of foreign body can even produce no clinical symptoms but still pose a potential life threat due to its dislodgement into the airway if missed or delayed.

Less than 1% of all head and neck neoplasms are juvenile nasopharyngeal angiofibromas, a cancer almost exclusively found in adolescent males. Here we present a case report of 14 year old male presented with neck swelling, nasal discharge mixed with blood, right sided proptosis and right sided palatal palsy where we performed CECT scan of the patient which showed homogenous opacity over nasopharynx extending to soft palate and posteriorly to C1 vertebra and DNE was performed. Later patient was planned for DNE along with biopsy which came out to be undifferentiated non-keratinized squamous cell carcinoma grade III. Further patient received external beam intensity modulated radiation therapy with complete response to treatment.

Carotidynia is transient perivascular inflammation of the carotid artery. It is a rare condition of head and neck associated with atypical neck pain, often unilateral. Patients with carotidynia often presents with atypical symptoms that makes the diagnosis of this rare entity difficult. In this article, we report a case series of 3 patients that presents with variable symptoms along with different investigative modalities and treatment approaches. Due to rare entity, this condition is often misdiagnosed or necessitates several visits to various specialties before a diagnosis is reached. Thorough clinical examination along with radiology is must to reach to a diagnosis. Patient should be counselled regarding the benign nature of the disease that can be easily controlled by low dose steroids.

To study the potential risk factors associated with mortality in patients with mucormycosis. A retrospective study of 490 patients with diagnosis of sinonasal mucormycosis was done. They were divided in two groups–Group A included 87 patients that expired during the study period and Group B included 403 control patients. All the demographic, clinical and outcome parameters were collected from the patient’s record files and noted in a structured case proforma and were analysed. During the mean hospital stay of 22 ± 6 days, 17.7

Sinonasal Organized hematoma (SOH) is a rare, benign condition that can mimic the malignancy of sinonasal region. It typically involves the maxillary sinuswith extra sinus involvement being a rare presentation. . We present two cases of SOH with unususal presentations, posing diagnostic challenges. One case had the organised hematoma over the hard palate, While the other case had an organised hematoma in the nasal cavity. Both the cases underwent thorough preoperative evaluation, including physical examination and radiology.. . Surgical management was employed in both cases. Early diagnosis and appropriate intervention are crucial for excellent prognosis. Preoperative diagnosis by clinical suspicion radiology is essential for adopting a more conservative approach.

Introduction:Primary hyperparathyroidism due to parathyroid adenoma commonly causes raised serum calcium and focal giant cell lytic lesions in bones known as Brown's tumors. It is more common in females in the post-menopausal age group.Case Report:We report a case of a 29-year-old female patient with Brown's tumor maxilla in a clinical setting of normocalcemic primary hyperparathyroidism. The patient presented to us with facial and palatal swelling for which FNAC was done. Cytology revealed hemosiderin-laden macrophages suspicious for Brown's tumor. On further imaging studies such as CT Neck, Tc99 Sestamibi scan, and other biochemical tests like parathyroid hormone assay and serum calcium level, the diagnosis of a hyperfunctioning parathyroid gland with normal calcium level was made. Parathyroidectomy was performed and parathyroid adenoma came out to be the primary pathology. On post-operative follow up there was regression of the swelling on the face and palate relieving the patient symptomatically.Conclusion:The diagnostic suspicion of primary hyperparathyroidism should be kept in mind whenever a young female presents with suspected Brown's tumor, even with normal serum calcium levels, for appropriate management. Ours was a highly uncommon case that was a diagnostic challenge and had a successful treatment outcome. Very few such cases have been reported in the literature to date to the best of our knowledge.

To compare results of inlay and overlay cartilage-perichondrium composite graft myringoplasty. The present study was conducted in the department of otorhinolaryngology, Pt. B. D. Sharma PGIMS, Rohtak. The study was conducted on 40 patients of either sex in age group of 15–50 years having unilateral or bilateral inactive (mucosal) chronic otitis media with dry ear over a period of at least 4 weeks without use of topical or systemic antibiotics after obtaining their informed and written consent. Mean age in group I was 25.25 ± 7.27 years and in group II was 25.95 ± 9.06 years. Maximum number of patients in both groups were in the age group 15–24 years. Out of the total patients, 60

BackgroundEsophageal foreign body impaction is one of the common reasons of referral to Ear Nose Throat clinic. It is a medical emergency requiring urgent evaluation and treatment. Esophageal foreign body in a very young child can be a diagnostic challenge.Case presentationIn this case, we report an unusual sharp foreign body in the upper aerodigestive tract of a 20-month-old female child. It was neglected and misdiagnosed in the initial phase and was treated as a case of upper respiratory tract infection. Chest X-ray done was suggestive of a radiopaque irregular sharp foreign body at the level of the 6(th) cervical vertebra. The patient underwent rigid esophagoscopy on an urgent basis, and the foreign body was removed without any complication.ConclusionEsophageal foreign body in a very young child can mimic upper respiratory tract infection due to atypical symptoms. Strong witness history along with X-rays of the neck, chest, and abdomen help in making the immediate diagnosis. Clinicians should always advise parents for supervision of their children during play.

Background: Covid-19 infection increases the risk of opportunistic infections like mucormycosis. Cutaneous mucormycosis can occur primarily by direct inoculation or secondary to involvement of the underlying structures. Cutaneous manifestations include tender, erythematous, indurated lesions and necrotic plaques. As the disease evolves, cutaneous features manifest progressively. Objectives: To study the manifestations of the cutaneous signs of sinonasal mucormycosis and management of such cases based on severity of involvement. Materials and methods: A retrospective analysis of 21 patients with diagnosis of cutaneous mucormycosis secondary to sinonasal involvement was done with assessment of their skin lesion, area involved and their clinical stage being noted at the time of admission and after 24 h. Treatment consisted of combination of surgical debridement, daily dressing and liposomal amphotericin B. Observations and Results: Out of total 21 patients, there were 10 males and 11 females. Among risk factors, 14 cases had history of covid 19 infection, 5 had history of steroid intake, 6 had history of ICU stay and all had deranged blood sugar levels. Among disease prognosis, excellent outcomes appeared in stage I and stage III showed worst outcome. Conclusion: Since initial clinical presentation is similar to cellulitis and other soft-tissue infections, early recognition is difficult. In this cohort, the prognosis of secondary cutaneous mucormycosis remained poor, especially in ICU patients and those with numerous predisposing factors. Such patients presented in late stages of the disease and mortality rate was very high in such group.

BackgroundIsolated frontal sinus involvement in mucormycosis is seen very infrequently. Recent technological advances including image guided navigation and angled endoscopes have shifted paradigm towards minimally invasive surgeries. Open approaches are still relevant for the disease of frontal sinus with lateral extension where effective clearance cannot be obtained if approached endoscopically.ObjectivesThe objective of this study was to describe the presentation and management of patients of mucormycosis with isolated frontal sinus involvement with help of external approaches.Materials and methodsThe available records of the patients were retrieved and analysed. The literature, the associated contributory clinical features and management techniques were reviewed.Results4 patients presented with isolated frontal sinus mucor involvement. 3 out of 4 patients had history of diabetes mellitus (75%). All patients had history of covid-19 infection (100%). 3 out of 4 patients had unilateral frontal sinus involvement and were operated by Lynch Howarth approach. Mean age of presentation was 46 years with male predominance. Bicoronal approach was used in one case with bilateral involvement.ConclusionAlthough conservative endoscopic surgeries are preferred nowadays for frontal sinus clearance but the extensive bony destruction with lateral extension in our series of patients with isolated frontal sinus mucormycosis warranted the need for open procedures.

Descending necrotizing mediastinitis is an uncommon, rapidly progressive pathology originating from odontogenic or cervical infections. It usually has a fulminant course, frequently leading to sepsis and mortality. A rare case of cervical necrotizing fasciitis and descending mediastinitis in a healthy young man, after an odontogenic infection with a successful outcome without aggressive surgical debridement, has been presented.

Rationale: Biphenotypic sinonasal sarcoma is a rare malignant tumour exclusively involving the sinonasal cavity. These tumours have variable and atypical presentations. Early approach and correct treatment modalities are key factors in the management of such cases. Patient Concern: A 48-year-old male patient presented with left-sided nasal obstruction and intermittent nasal bleeding for one year. Diagnosis: Biphenotypic sinonasal sarcoma confirmed on histopathological examination and immunohistochemistry. Treatment: The patient underwent surgical excision with left lateral rhinotomy and bifrontal craniotomy with skull base repair. The patient also received postoperative radiotherapy. Outcome: The patient is on regular follow-up with no similar complaints. Take-Away Lesson: Treating team should keep the diagnosis of biphenotypic sinonasal sarcoma in mind while investigating a patient with nasal mass. Surgical management is the treatment of choice, due to its local aggressive nature and proximity to the brain and eyes. Postoperative radiotherapy is vital to prevent tumour recurrence.