Endoscopic sinus surgery has been widely used for many years, but the Caldwell-Luc procedure remains valuable for ENT surgeons, particularly for accessing the maxillary sinus. [1] The Caldwell-Luc technique has well-documented indications, including severe midfacial injuries, oro-antral stulae, malignant exophthalmos, foreign body removal, and access to various areas such as the pterygomaxillary space, pterygopalatine fossa, orbital oor, infraorbital nerve infratemporal fossa, and nasopharynx. [2] However, the traditional Caldwell-Luc approach had drawbacks like numbness of the teeth, ap dehiscence, and recurrent sinusitis. Functional endoscopic sinus surgery has gained popularity due to its minimal invasiveness and physiological approach. This study aims to evaluate the indications and surgical procedure of Caldwell-Luc surgery, showcasing its versatility in an era dominated by endoscopic sinus surgery.

Nasal polyps are the end result of chronic inammatory disease of mucosa of the nose and mucosa of paranasal sinuses. According to the paranasal sinus of origin, those arising in the maxillary sinus are known as antrochoanal, those emerging from the sphenoid sinus as sphenochoanal, and those from the ethmoid sinus as ethmochoanal polyps. (1)(2) Sphenoid polyp though rare is often confused with Antrochoanal polyp because both are single, pedunculated and usually unilateral. (3) Nasal mass in sphenoethmoidal recess can be sometimes neoplastic like inverted papilloma.

Tracheostomy is one of the most common procedures done in intensive care unit (ICU) patients. Decannulation is the weaning off from tracheostomy to maintain spontaneous respiration and/or airway protection. However, this step needs a near perfect coordination of brain, swallowing, coughing, phonation, and respiratory muscles. However, despite its perceived importance, there is no universally accepted protocol for this vital transition. In this systematic review of decannulation we focus attention to this important aspect of tracheostomy care. To compare the two methods of decannulation, with gradual blocking of the tube and reducing the size of the tube and also study and compare the incidental complications associated with both methods. This longitudinal, open label, randomized, observational study of 50 patients who were tracheostomized for more than 7 days was carried out in a tertiary health care Centre in central India. Over the course of 2 years demographic data, clinical information was collected and patients divided into 2 groups according to the method of decannulation done by a simple randomization method. The outcomes and the complications associated with the two techniques in the study groups were also be noted down and then compared. Maximum number of patients in both the study groups were males (56

Perichondritis of the external ear is a frightening and disfiguring complication of the traumatized ear leading to residual deformity in cases. Here, we have 20 cases of posttraumatic perichondritis, out of which nine were diagnosed in the earliest stages and treated with oral antibiotics only, and seven were diagnosed after abscess formation and treated in the hospital setting with intravenous antibiotics. Four were diagnosed after abscess formation and treated with surgical intervention and intravenous antibiotics. The challenge lies in early diagnosis, proper analysis of the responsible aetiological factors, bacteriological agents involved, attempting to classify and stage this disease, and formulating a treatment protocol that should be advocated for the different disease stages.

Objective: This study compares two types of implants- a Teflon piston and a titanium piston, used in stapes surgery for otosclerosis. Study Design: A non-randomised prospective study conducted on 40 patients, in 2 groups of 20 each, undergoing stapedotomy in a tertiary care hospital. Pure tone audiometry results were noted preoperatively and 3 weeks post-operatively. Results: Both Teflon and titanium prostheses provided almost equal benefits to patients in terms of Air-Bone gap closure. Conclusion: While there is statistically no significant difference in the results observed, surgical skill of the operating surgeon plays an important role in hearing improvement and long-term results would require long term evaluation.

High resolution computed tomography (HRCT) of temporal bone helps in understanding the complex anatomy of temporal bone and in identifying disease in temporal bone. However, its role in diagnosing cholesteatoma and analyzing its extent and complications is not established unequivocally. Present study was undertaken to check sensitivity and specificity of HRCT in diagnosing cholesteatoma and assessing its extent and in identifying ossicular destruction and other complications. In this prospective study in 50 patients with clinical diagnosis of cholesteatoma, preoperative high-resolution temporal bone CT scans axial and coronal view were carried out and compared with intra-operative findings. Kappa statistics was used for radio-surgical correlation. Comparison of CT scan findings with intraoperative findings revealed perfect correlation for sigmoid plate erosion, mastoid cortex dehiscence and scutum erosion, strong correlation for erosion of malleus, posterior superior wall and peri labyrinthine cells, good for erosion of incus and stapes, labyrinthine fistula, tegmen erosion and extent of disease and moderate correlation for facial canal dehiscence. HRCT scan of the temporal bone is useful preoperative investigation for cholesteatoma surgery for identification and documentation of ossicular status, location and extent of disease, erosion of tegmen or sinus or labyrinthine dehiscence, with the exception of facial canal dehiscence. Although it serves as road map for surgery, it still has some false positives and false negatives and the importance of a skilful, aware and alert surgeon cannot be overemphasized.

Introduction: Although thyroglossal cysts are very common in children and young adults, their presentation in the elderly is very rare and often goes undiagnosed. This may lead to incomplete excision and recurrence of the cyst, thereby increasing the risk for a malignancy. Here we present a case in an elderly patient, who presented to us with a midline neck swelling, whereas the histopathology report confirmed a thyroglossal cyst. Keywords: Thyroglossal cyst, Elderly, Midline neck swelling, Malignancy, Incomplete.

Background and Objectives Functional endoscopic sinus surgery (FESS) is a well-established strategy for the treatment of rhinosinusitis. However, some patients do not respond to primary surgery and may require revision surgery. Anatomic alterations due to prior sinus surgery, scarring and adhesions as well as associated chronic mucosal inflammation can make revision procedures challenging. In order to shed more light on the difficulties faced by surgeons performing revision FESS, a study was performed to identify areas of recurrent disease on computed tomography in patients undergoing revision surgery, as well as to evaluate intraoperative findings during revision FESS. Materials and Method A hospital-based, interventional, non-randomized study was undertaken in 40 patients who underwent revision FESS. Multiple clinical parameters were recorded including number and type of previous surgeries, latest CT scans of the nose and paranasal sinuses, as well as intraoperative findings. Results Our findings demonstrated the diffuse nature of mucosal disease on CT in our patient population. Fibrosis and adhesion formation were the most common intraoperative findings on revision sinus surgery along with residual air cells, polypoid mucosal regrowth, and middle meatal antrostomy stenosis. Conclusion A careful evaluation of the patient is needed while contemplating revision surgery. A recent high-resolution CT scan is of paramount importance. The most common areas of disease recurrence are the ostiomeatal complex and residual ethmoids, and these areas should be given careful attention.

As an otorhinolaryngologist it is not an everyday occurrence to find a swelling in the nasolabial fold area. The challenge however lies in the diagnosis, proper and timed treatment of the existing pathology, especially in a non – infective case. There are various pathologies that can lead to a swelling in the nasolabial area. We here report a rare case of a female patient who presented to our outpatient department with a slowly progressive nasolabial swelling which radiologically pointed towards a Nasolabial cyst. However, the final diagnosis was an entity on the other end of spectrum, an Ameloblastoma, an odontogenic tumor.

Introduction- Foreign body is a substance that doesn’t belong to a location where it is found. Ear,nose and throat are common location for occurence of foreign bodies. It is a common problem encountered in both adults and children. Objective- 1) To analyse the different kinds of foreign bodies in ear ,nose and throat and their prevalence in different age groups. 2) To analyse the most prevalent site of foreign body among ear, nose and throat. Methods- A cross-sectional study was performed in our tertiary care hospital in Navi-mumbai. The study period was from august 2017 to august 2019. The study population were the patients who came to the out patient department and emergency room of this hospital. Result- A total of 100 patients as sample size with foreign bodies in ear, nose or throat were taken on first come basis. 62 were males and 38 were females. Of the 100 patients, 36 had foreign body in ear, 47 in nose and 17 in the throat. The foreign body was removed under local anaesthesia in 4% patients, with general anaesthesia in 30 % and with no anaesthesia at all in 66% patients. The most common age group affected was less than 10 years among both male and female patients. Conclusion- The most frequent site of foreign body occurrence was found to be nose. The most common site requiring general anaesthesia for foreign body removal was throat. Although most of the foreign bodies could be removed without any anaesthesia in the emergency room or outpatient department.

Marsupialization of stensen’s duct: Revisiting sialolith management - IJOAS- Print ISSN No: - 2582-4147 Online ISSN No:- 2582-421X Article DOI No:- 10.18231/j.ijoas.2019.006, IP Journal of Otorhinolaryngology and Allied Science-J Otorhinolaryngol Allied Sci

Rhinosporidiosis is a chronic granulomatous mucocutaneous infecion caused by Rhinosporidium seeberi.The infection is non-contagious and as the name suggests, it is primarily a disease of the nose.Here, we report a rare case of rhinosporidiosis affecting the nasopharynx in a 35 year old male patient.

Thyroid gland being at the receiving end of metastasis from a lung primary is an extremely unusual entity. The presentation is often subject to misdiagnosis and requires coordination on different departmental levels for proper and vigorous management. We report an uncommon clinical picture of a non- thyroid primary malignancy to shed light on importance of the same.

Purpose: Many studies have suggested Vitamin D to be a critical player in allergic rhinitis, however this association yet remains uncertain. In this study, the incidence of vitamin D deficiency in allergic rhinitis patients was compared to normal population and the role of Vitamin D in potentiating the action of a steroid spray in allergic rhinitis was evaluated. Methods: 200 subjects with allergic rhinitis were tested for serum vitamin D levels. A two arms study was carried out in allergic rhinitis patients with vitamin D deficiency wherein one group received treatment with steroid spray and vitamin D while the other group received treatment with steroid spray and placebo for a period of two weeks. The response in both the groups was compared by their total nasal symptom scores. The unpaired ‘t’test was used for comparison of the two groups. Results: There was a high prevalence (83%) of vitamin D deficiency in the allergic rhinitis patients. There was a significantly better response in the group which received vitamin D along with a steroid spray. Conclusion: There is higher prevalence of vitamin D in allergic rhinitis patients and that vitamin D supplementation in these patients potentiates the effect of steroid sprays.

Background: Schwannomas are benign and slow growing tumors that arise from the Schwann cells which ensheath the axons of peripheral nerve, cranial nerve and autonomic nervous system. A schwannoma of facial nerve may originate from extra or intra cranial segments of the nerve. Most of the facial nerve schwannomas originate from intra-tympanic region. In decreasing order of their frequency, schwannomas were found along the tympanic, mastoid (vertical), labrynthine and meatal segments of the facial nerve. It is an extremely rare entity as malignant degeneration of schwannomas is not frequent. A high level of clinical suspicion with detailed neuro-otological and radiological studies play important role in preoperative diagnosis of schwannomas. Case presentation: We reported a case of 35-year-old male with progressive right sided facial asymmetry, sudden onset hearing loss and non-pulsatile tinnitus in right ear. The patient’s presentation and diagnostic examinations helped us to reach a provisional diagnosis though final diagnosis was done on the basis of histopathological examination of the excised tumor which was suggestive of facial nerve schwannoma. Conclusion: The rare and inconsistent clinical presentation and radiological pattern of facial schwannoma often leads to a delayed and indefinite diagnosis. The critical step in management of diverse lesion is diagnosis for the management of facial schwannoma. This report is about a challenging case of facial nerve schwannoma in intra-tympanic region which was diagnosed and managed in our institution.

16 www.worldwidejournals.com PARIPEX INDIAN JOURNAL OF RESEARCH Volume-7 | Issue-12 | December-2018 | PRINT ISSN No 2250-1991

Objective: This study was designed to examine the co-incidence of acute otitis media and iron deficiency anemia in children below 12 years of age, and to evaluate the effect of restoring normal hemoglobin levels on the occurrence of attacks of acute otitis media. Materials and methods: A prospective study was conducted in a single tertiary center over a period of two years. A total of 100 children who were diagnosed with acute otitis media by otoscopic examination underwent evaluation of complete blood count and serum ferritin levels in their blood. The number of episodes of acute otitis media was recorded on follow-up. A statistically significant correlation between the iron deficiency anemia and episodes of otitis media was established. Results: In these 100 children, the episodes of acute otitis media pretreatment average were 1.01±0.91 whereas post treatment was 0.20±0.40. The average hemoglobin concentration before treatment was 9.624±1.71. Fifty five percent of the children had hemoglobin levels less than 9.5g/dL. It was observed that the frequency of acute otitis media was reduced by correction of iron deficiency anemia. Conclusion: It was concluded that iron deficiency anemia increases the susceptibility of children for recurrent episodes of ear infections and that it might be considered as a potential risk factor for such a common disease in infancy and childhood. Therefore, it is recommended to evaluate the hemoglobin level in every child who is diagnosed with episodes of acute otitis media. Correction of iron deficiency anemia proves to be an effective additional line of treatment for acute otitis media.

The WHO has designed a safe surgery checklist to enhance communication and awareness of patient safety during surgery and to minimise complications. WHO recommends that the check-list be evaluated and customised by end users as a tool to promote safe surgery. The aim of present study was to evaluate the impact of WHO safety checklist on patient safety awareness in otorhinolaryngology and to customise it for the speciality. A prospective structured questionnaire based study was done in ENT operating room for duration of 1 month each for cases, before and after implementation of safe surgery checklist. The feedback from respondents (surgeons, nurses and anaesthetists) was used to arrive at a customised checklist for otolaryngology as per WHO guidelines. The checklist significantly improved team member’s awareness of patient’s identity (from 17 to 86%) and each other’s identity and roles (from 46 to 94%) and improved team communication (from 73 to 92%) in operation theatre. There was a significant improvement in preoperative check of equipment and critical events were discussed more frequently. The checklist could be effectively customised to suit otolaryngology needs as per WHO guidelines. The modified checklist needs to be validated by otolaryngology associations. We conclude from our study that the WHO Surgical safety check-list has a favourable impact on patient safety awareness, team-work and communication of operating team and can be customised for otolaryngology setting.

Introduction: Pseudocyst of auricle is benign painless idiopathic cystic swelling on anterior surface of auricular cartilage with no definitive treatment and with a tendency to recur. We describe a novel modality of treatment for this condition. Methods: 14 patients treated by aspiration followed by pressure dressing with a silicone-based impression material used for hearing aid fitting. These patients were followed up over a six month period. Results: 13 patients had a successful outcome with complete resolution of swelling and without any recurrence. Only I patient (7.14%) showed recurrence after 2 weeks of treatment due to ineffective compression which was subsequently managed successfully by the same procedure. Conclusion: Complete aspiration and compression dressing using a silicone-based material (used to make hearing aid moulds) in our experience is a safe, inexpensive, non-invasive and effective method for management of the pseudocyst of the auricle.