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Early Initiation of Voice Therapy After Microlaryngeal Surgery - A Randomized Control Study. J Voice 2024; 38:788-794. [PMID: 34986995 DOI: 10.1016/j.jvoice.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 12/02/2021] [Accepted: 12/06/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE A prospective single blinded randomized control trial was conducted to study if early initiation of voice therapy after microlaryngeal produces a better voice outcome in patients with benign vocal fold lesions. METHODS In this Patients undergoing microlaryngeal surgery for benign vocal fold lesions were recruited for the study and underwent voice evaluation and videostroboscopy preoperatively. Participants were randomised into two groups depending on the duration of voice rest-A (2 days voice rest) and B (5 days voice rest). Following the period of voice rest, voice therapy (tube phonation) was carried out for a month. Postoperative evaluation was done at 6 weeks (over telephone) and 3 months (in person visit) follow up. Outcome measures included the VHI-10, auditory-perceptual voice ratings, acoustic analysis and videostroboscopic vibratory ratings. RESULTS Of the 50 subjects, 35 completed the follow up evaluation. The overall compliance to absolute voice rest was 43%. Among the various parameters used for voice evaluation, there was no statistically significant difference between the two groups except for jitter, where the improvement in 5 day voice rest group compared to the 2 day voice rest group was statistically significant. CONCLUSION Prolonged voice rest after microlaryngeal surgery is difficult to comply with. As there was no significant difference between the two study groups, clinicians may prescribe a shorter duration of voice rest followed by early initiation of voice therapy after microlaryngeal surgery.
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Can There be a Biometric Parameter for Voice?-An Investigation Into the Vocal Cry of Twins. J Voice 2023:S0892-1997(23)00298-9. [PMID: 37867073 DOI: 10.1016/j.jvoice.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023]
Abstract
The voice of an individual is the result of interaction between the laryngeal and supra-laryngeal structures of a person. Since the laryngeal and supra-laryngeal structures differ from one person to another, the voice produced by each person becomes unique and recognizably different from another person. If this uniqueness in voice can be found in the acoustic parameters of the voice, it can contribute to the fields of forensic speaker identification and voice biometrics. The best methodology for such a study would be a comparison of the voices of twins who have a number of similar characteristics. OBJECTIVES OF THE STUDY To find out whether it is possible to perceptually differentiate the cry of identical twins from each other. To compare the acoustic parameters of cry among the twin pairs to find out the differentiating parameter. MATERIALS AND METHODS This was an observational longitudinal study. Nineteen pairs of twins less than 1 week old who had completed 34 months of gestation period with no major congenital abnormalities were included in the study. The PRAAT software was used for the analysis of the voice samples. RESULTS The present study on neonates could not identify one single differentiating acoustic parameter among the twins. We infer from the study that rather than an individual parameter, it could be a complex interaction of different parameters that could give individual identity to a person's voice. CONCLUSION The high similarity noticed in the acoustic parameters among the twin pairs, suggests that rather than individual parameters, it could be a complex interaction of different parameters that could give individual identity to a person's voice. The study can offer information to automatic speaker recognition, Forensic speaker identification, and voice biometry.
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Role of Narrow Band Imaging in Laryngeal Lesions: A Prospective Study from Southern India. Indian J Otolaryngol Head Neck Surg 2022; 74:5127-5133. [PMID: 36742616 PMCID: PMC9895569 DOI: 10.1007/s12070-021-02945-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 10/14/2021] [Indexed: 02/07/2023] Open
Abstract
To assess the utility of Narrow Band Imaging (NBI) as a diagnostic tool in evaluating laryngeal pathology in patients presenting with hoarseness. Study design: Prospective cross sectional diagnostic study. Methods: 200 patients with voice change were recruited and laryngeal findings documented with high definition flexible endoscopy with both white light and narrow band light and the representative still images recorded for analysis. The NBI intraepithelial papillary capillary loop (IPCL) patterns was compared with the histopathology report. Of the 200 patients evaluated, 84 lesions were biopsied which included both benign and malignant lesions. The sensitivity obtained was 73.3% [54.1-87.7% with 95% CI] and the specificity was 87% [75.1-94.6% with 95% CI] for detecting malignant lesions. NBI can be considered as a useful diagnostic tool in evaluating laryngeal pathology and can be used to detect early premalignant and malignant lesions.
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Laryngeal Dysplasia: To Biopsy or Not? Indian J Otolaryngol Head Neck Surg 2022; 74:2331-2333. [PMID: 36452722 PMCID: PMC9702373 DOI: 10.1007/s12070-020-02161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 09/21/2020] [Indexed: 10/23/2022] Open
Abstract
A renal transplant recipient with chronic hepatitis B underwent multiple laser excisions over 4 years for laryngeal keratosis. From the initial histopathology reports of mild to moderate dysplasia, a progression to squamous carcinoma was noted over 4 years. This case report highlights the possible role of immunosuppressants and hepatitis virus in the aetiopathogenesis of laryngeal carcinoma.
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Lack of Association of Helicobacter pylori in Laryngeal Pathologies. Indian J Otolaryngol Head Neck Surg 2022; 74:2636-2642. [PMID: 36452618 PMCID: PMC9702011 DOI: 10.1007/s12070-020-02361-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/28/2020] [Indexed: 02/07/2023] Open
Abstract
To study the association of Helicobacter pylori (H. pylori) in patients with laryngeal pathologies. Study design: prospective observational study. Tertiary care teaching hospital. One hundred consecutive patients with laryngeal lesions scheduled for microlaryngoscopy were enrolled in the study. Laryngopharyngeal reflux was assessed using the reflux symptom index and reflux finding score. Tissue samples from the laryngeal lesions were taken under general anaesthesia and were screened for the presence of H. pylori using real time polymerase chain reaction (PCR) for ureA genes and histopathological examination. Of the 100 patients, 14 had a significant reflux symptom index score and 35 had significant reflux finding score. The lesions in the study subjects included both benign and malignant laryngeal pathologies. Vocal cord polyps formed more than half of the laryngeal pathology (57%) studied. Our study could not detect H. pylori in any laryngeal lesions by PCR analysis and histopathological examination. H. pylori may not be associated with laryngeal pathologies.
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Unusual Cause of Neonatal Stertor. Indian J Otolaryngol Head Neck Surg 2022; 74:918-920. [PMID: 36452656 PMCID: PMC9702260 DOI: 10.1007/s12070-020-02010-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
Abstract
We report a case of neonatal respiratory distress caused by an epignathus. This rare tumour, arising from the basisphenoid and protruding from the mouth, is associated with high perinatal mortality. We highlight unique clinico-radiological findings and multidisciplinary approach for a successful outcome. We review oropharyngeal teratomas reported in the literature with current management approaches.
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A Comparative Study of Outcomes and Quality of Life in Canal Wall up Mastoidectomies and Canal Wall down Mastoidectomies. Indian J Otolaryngol Head Neck Surg 2022; 74:600-607. [PMID: 36032861 PMCID: PMC9411485 DOI: 10.1007/s12070-021-02424-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 01/25/2021] [Indexed: 10/22/2022] Open
Abstract
Abstract Chronic Otitis Media (COM) of the squamosal type was primarily managed by performing a canal wall down mastoidectomy; however, the latter era otolaryngologist envisioned benefits in preserving the posterior canal wall. Our primary objective was to assess the disease specific quality of life following canal wall up (CWU) mastoidectomy and canal wall down (CWD) mastoidectomy surgery after a 6 month post-operative period. A prospective observational study was done from September 2017 to August 2018 where the charts of 380 patients from Christian Medical College, Vellore were reviewed. Details of patients above 18 years who had undergone the above surgeries for COM active squamosal disease from the period of January 2014 to December 2016; and had their post-operative follow up (average of 16 months) during the period of study were looked at. The CWU group had a significantly better disease-specific quality of life in the symptoms subscale than the CWD group (p value < 0.01). The CWU group showed a significant air-bone gap closure to 23.3 dB as compared to 27.7 dB in CWD (p value = 0.005). The recurrence rates were 4.5% (9 cases) in the CWU group and 3.9% (7 cases) in the CWD group, which was not statistically significant. Both CWU and CWD methods of mastoidectomy for COM squamosal type give comparable outcomes in terms of recurrence with the CWU group having a better disease-specific quality of life after surgery. Level of Evidence 2a.
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Covid 19 Pandemic-Training of Healthcare Workers in Obtaining a Nasopharyngeal Swab: Our Experience. Indian J Otolaryngol Head Neck Surg 2021; 74:3126-3130. [PMID: 34540649 PMCID: PMC8442653 DOI: 10.1007/s12070-021-02849-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022] Open
Abstract
To describe the training of healthcare workers (HCW) in nasopharyngeal swabbing during the COVID 19 pandemic. Study design: Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: One hundred and seventy eight health care workers were trained from May 2020 to January 2021. Three modules were designed to train the health care workers in the technique of obtaining a nasopharyngeal swab specimen.Training consisted of an instructional video on how to perform nasopharyngeal swabs and live demonstration followed by hands-on supervised training. The trainees included 30 doctors, 101 nurses, 31 respiratory therapists, 3 physiotherapists, 9 interns and 4 lab technicians. There were 39 male and 139 female trainees. After attending all 3 modules of training, they were confident and efficient in taking a non-traumatic nasopharyngeal swab. Good knowledge and adequate training is key to a good nasopharyngeal sampling for SARS CoV-2 testing.
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Impact of tonsillectomy on dysphagia symptoms and body weight in children. Am J Otolaryngol 2020; 41:102682. [PMID: 32829057 DOI: 10.1016/j.amjoto.2020.102682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/28/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
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Transnasal Flexible Laryngoscopy Using Different Topical Preparations and Methods of Application-A Randomized Study. J Voice 2020; 36:847-852. [PMID: 33092947 DOI: 10.1016/j.jvoice.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 10/07/2020] [Accepted: 10/09/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The field of laryngology has grown exponentially since the advent of the transnasal flexible laryngoscopy. Flexible laryngoscopy when performed skillfully using the proper technique, facilitates a good view of the hidden areas of the larynx. OBJECTIVE To compare the effectiveness of the topical agents in providing a more comfortable experience for the patient, allowing the practitioner to advance the endoscope with less friction, pain and discomfort for the patient using 10% lidocaine spray, 2% lidocaine gel, 4% lidocaine with xylometazoline (1:1) soaked pledgets, or aqueous gel. MATERIALS AND METHODS A prospective randomized single-blinded clinical trial was conducted in a tertiary care teaching hospital in South India where 376 patients were recruited and allocated into four groups based on the topical preparation used. Following endoscopy, each subject filled a questionnaire grading their experience on a visual analogue scale. The clinician also then answered a questionnaire on aspects of the endoscopy performed. RESULTS The pain score and the ease of performing the procedure among the different groups were comparable. Those in the 10% lidocaine arm experienced significant burning sensation (P = 0.0001). The other variables such as throat pain (P = 0.783), gag reflex (P = 0.318), unpleasant taste (P = 0.092), globus (P = 0.190), swallowing difficulty after the procedure (P = 0.273), difficulty in breathing (P = 0.744) and willingness to have a repeat procedure (P = 0.883) were also comparable. CONCLUSION Aqueous gel can be used topically during a flexible nasopharyngolaryngoscopy instead of an anesthetic agent alone or one combined with a nasal decongestant.
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Isolated Aspergillus Laryngitis: Spectrum, Management, and Review of Literature. J Voice 2020; 36:880.e13-880.e19. [PMID: 33004228 DOI: 10.1016/j.jvoice.2020.09.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Isolated aspergillus laryngitis is rare and often diagnosed after surgical excision or biopsy for a suspected premalignant or malignant pathology. Unlike other systemic or localized aspergillosis, there are no specific guidelines for isolated laryngeal aspergillosis. Our experience of dealing with a wide variety of isolated laryngeal aspergillosis showed that this entity is very responsive to medical therapy, making extensive debridement (as often carried out in surgically accessible aspergillosis) unnecessary as it would invariably lead to long-term dysphonia. MATERIALS AND METHODS A retrospective analysis of all cases of isolated aspergillus laryngitis that presented to our hospital over the past 5 years was carried out. All patients with confirmed histopathological diagnosis of aspergillus infection were included. RESULTS Twelve patients (five males and seven females) aged 28-54 years, who were diagnosed with aspergillus laryngitis presented with dysphonia. The most common involved site was the true vocal cords. All patients underwent cautious biopsies either in the operating theatre or in-office using a channeled fiber-optic laryngoscope. On histopathological examination, eight had invasive aspergillus infection while others showed variety of noninvasive involvement including colonization of cysts and carcinoma in situ. The most common species isolated was Aspergillus fumigatus. Appropriate antifungal chemotherapy was prescribed after ruling out systemic involvement. None of the patients showed recurrence or residual lesions on follow-up and reported significantly improved voice. CONCLUSIONS This study highlights the wide spectrum of presentation of isolated aspergillus laryngitis with Aspergillus fumigatus being the most common organism isolated. Even the invasive variant is a medically treatable condition with voriconazole being the drug of choice. The importance of cautious biopsies and resections for voice preservation is also emphasized. To our knowledge, this is the largest report on isolated aspergillus laryngitis.
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Hairy Polyp of the Nasopharynx Associated With Hypoplastic Soft Palate, Low Eustachian Tube Orifice, and Tonsil. EAR, NOSE & THROAT JOURNAL 2020; 101:NP68-NP70. [PMID: 32720810 DOI: 10.1177/0145561320944115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Deep head and neck infections: outcome following empirical therapy with early generation antibiotics. Trop Doct 2018; 48:179-182. [PMID: 29759037 DOI: 10.1177/0049475518774472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In order to study the bacteriological profile, antibiotic sensitivity and outcome following empirical therapy with early generation antibiotics in patients with deep head and neck infection, a retrospective review of 42 patients admitted for drainage and intravenous antibiotic therapy was performed. Ludwig's angina was the commonest infection, with the most common organisms isolated being Group F ß-haemolytic (15%) and non-haemolytic (12.5%) streptococcus. All streptococci and anaerobic gram-positive cocci were susceptible to penicillin. S. aureus isolates were oxacillin-sensitive and enterococcus isolates were ampicillin-sensitive. All 42 patients received empirical therapy with either intravenous penicillin or its derivatives. In only three patients was a change of antibiotic required based on culture and sensitivity results. Early generation antibiotics appear ideal as empirical therapy for deep head and neck infection.
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Endocrine Glands and Hearing: Auditory Manifestations of Various Endocrine and Metabolic Conditions. Indian J Endocrinol Metab 2017; 21:464-469. [PMID: 28553606 PMCID: PMC5434734 DOI: 10.4103/ijem.ijem_10_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
The aetiology of hearing loss in humans is multifactorial. Besides genetic, environmental and infectious causes, several endocrine and metabolic abnormalities are associated with varying degrees of hearing impairment. The pattern of hearing loss may be conductive, sensori-neural or mixed. The neurophysiology of hearing as well as the anatomical structure of the auditory system may be influenced by changes in the hormonal and metabolic milieu. Optimal management of these conditions requires the integrated efforts of the otolaryngologist and the endocrinologist. The presence of hearing loss especially in the young age group should prompt the clinician to explore the possibility of an associated endocrine or metabolic disorder for timely referral and early initiation of treatment.
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Abstract
Sublingual dermoids are uncommon lesions in the floor of mouth. The most common age of presentation is early adulthood, but presentation in infancy has also been reported. This report highlights the clinical presentation and treatment challenges in infants. An 8-month-old infant presented with inability to close mouth, intermittent stertor and snoring. MRI suggested a sublingual dermoid which was confirmed on histopathology of the surgically enucleated specimen. Sublingual dermoids are uncommon lesions of the floor of mouth. The age of presentation of a sublingual dermoid depends on the initial size of the lesion. Large sublingual dermoids in neonates can present with respiratory embarrassment and need early surgical intervention. Surgical enucleation via an intraoral approach is the treatment of choice with external approach reserved for very large cysts below the mylohyoid. Large sublingual cysts can present with anaesthetic challenges and may need fibreoptic intubation.
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Abstract
BACKGROUND The treatment of chronic granulomatous fungal sinusitis (CGFS), a rare form of invasive fungal sinusitis, is controversial. AIM To assess the response to postoperative antifungal therapy in patients with CGFS and suggest an effective treatment protocol. METHODOLOGY Clinical records of patients with CGFS who had undergone excisive surgery followed by antifungal therapy were reviewed to assess current disease status. RESULTS Fourteen male and 4 female patients were diagnosed with CGFS, based on typical histopathological and fungal smear/ culture results. Aspergillus flavus was isolated from 88.9% cases. Stage 1 patients had resectable sinonasal disease, stage 2 had additional spread to orbit/palate and stage 3 had extensive disease. Follow-up ranged from 6 months to 8 years. Residual disease was seen in all but one patient who received amphotericin B as first line therapy and in none of those who received itraconazole or voriconazole. Even those who received azoles as second line therapy were disease free at last follow-up. CONCLUSION Surgery followed by itraconazole or voriconazole for Stage 1 and 2 disease and voriconazole for stage 3 disease is recommended for a good outcome. Amphotericin B is not recommended as first line therapy for CGFS.
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Robotic Pelvic Lymphadenectomy in Pregnancy. J Minim Invasive Gynecol 2015; 22:S116. [DOI: 10.1016/j.jmig.2015.08.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
INTRODUCTION Schwannoma of the infraorbital nerve is a rare entity, with lesser than a dozen cases reported in literature and only one from India. REPORT This article reports a 23-year-old male presenting with a painless swelling in the cheek, which was eventually diagnosed as infraorbital nerve schwannoma. He underwent a complete excision of the tumor via a Caldwell Luc approach and continues to be disease free on 3 year follow-up. CONCLUSION Despite its rarity, infraorbital nerve schwannomas should be considered in the differential diagnosis, of upper jaw swelling. We recommend the Caldwell Luc approach as safe, effective and cosmetically acceptable, for anteriorly based infraorbital schwannomas, and review literature on this unusual entity.
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Abstract
Paget's disease of bone (PDB) is a chronic disorder characterised by focal areas of excessive osteoclastic bone resorption with a secondary increase in osteoblastic bone formation. First-degree relatives of patients with PDB are at seven times higher risk of developing this disorder, with a tendency towards earlier age at onset. We report two siblings who presented with features of polyostotic Paget's disease. They presented with features of non-inflammatory back pain. Biochemical evaluation was unremarkable except for elevated serum alkaline phosphatase. Subsequently, radiology and bone scans were diagnostic of polyostotic PDB. They were treated with bisphosphonates with which they improved.
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Chronic Pharyngitis: Role of Atypical Organisms. Otolaryngol Head Neck Surg 2012; 147:894-9. [DOI: 10.1177/0194599812457344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Bacteria including Chlamydophila pneumoniae, Mycoplasma pneumoniae, and anaerobic bacteria such as Fusobacterium necrophorum have been implicated as etiological agents of chronic pharyngitis in Western literature. Because there are no data regarding this from India, the authors undertook this study. Study Design Prospective case-control study. Setting Tertiary-level medical college and hospital. Method In total, 343 consecutive adults with persistent throat pain and/or irritation (duration ≥3 months) were screened for known causes of pharyngitis by a thorough clinical and endoscopic examination. In 71 patients, the evaluation performed was unable to determine any cause, and these were considered cases. An enzyme-linked immunosorbent assay test to detect IgA and IgG antibodies to C pneumoniae and M pneumoniae was performed on 66 of these cases and 62 controls. The posterior pharyngeal swabs taken from both the cases and controls were subjected to aerobic and anaerobic culture. Results Individuals with chronic pharyngitis had a 3.43 times odds of being seropositive for C pneumoniae as compared with controls ( P = .001; odds ratio = 3.43). Aerobic organisms and M pneumoniae did not seem to be significant etiological agents for chronic pharyngitis. On the contrary, isolation of Fusobacterium spp was found to be significantly more in controls as compared with cases. Conclusion This study suggests an association between IgA antibodies to C pneumoniae and chronic pharyngitis. Further studies using more specific tests combined with long-term follow-up are needed to confirm these findings.
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Audio-vestibular function in human immunodeficiency virus infected patients in India. Indian J Sex Transm Dis AIDS 2012; 33:98-101. [PMID: 23188933 PMCID: PMC3505303 DOI: 10.4103/0253-7184.102115] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE As the acquired immunodeficiency syndrome (AIDS) epidemic shows no signs of abating, the impact of AIDS is felt more in the developing countries due to socioeconomic reasons. The possibility of drug-induced ototoxicity also adds to the risk of audio vestibular dysfunction. We sought to determine if there was a difference between the audio-vestibular function in the asymptomatic human immunodeficiency virus (HIV) infected patients and patients with AIDS. STUDY DESIGN A prospective, cross-sectional study SETTING A tertiary care center in South India MATERIALS AND METHODS The audio-vestibular system of 30 asymptomatic HIV positive subjects (group 1) and 30 subjects with AIDS (group 2), and age-matched 30 healthy controls (group 3) were assessed using pure tone audiometry and cold caloric test. RESULTS Sixteen patients each, in group 1 and group 2 and four subjects in the control group were detected to have a hearing loss indicating significantly more HIV infected individuals (group 1 and 2) were having hearing loss (P=0.001). Kobrak's (modified) test showed 27% of patients in group 1 and 33% of patients in group 2 and none in the group 3 had a hypofunctioning labyrinth (P=0.001). CONCLUSION It seems that the human immunodeficiency virus does affect the audio-vestibular pathway. There was a significant incidence of audio-vestibular dysfunction among the HIV infected patients, as compared to the control population (P=0.001) and no significant difference between the asymptomatic HIV seropositive patients and AIDS patients. Majority of the patients had no otological symptoms.
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Audio-vestibular function in human immunodeficiency virus infected patients in India. Indian J Sex Transm Dis AIDS 2012. [PMID: 23188933 PMCID: PMC3505303 DOI: 10.4103/2589-0557.102115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE As the acquired immunodeficiency syndrome (AIDS) epidemic shows no signs of abating, the impact of AIDS is felt more in the developing countries due to socioeconomic reasons. The possibility of drug-induced ototoxicity also adds to the risk of audio vestibular dysfunction. We sought to determine if there was a difference between the audio-vestibular function in the asymptomatic human immunodeficiency virus (HIV) infected patients and patients with AIDS. STUDY DESIGN A prospective, cross-sectional study SETTING A tertiary care center in South India MATERIALS AND METHODS The audio-vestibular system of 30 asymptomatic HIV positive subjects (group 1) and 30 subjects with AIDS (group 2), and age-matched 30 healthy controls (group 3) were assessed using pure tone audiometry and cold caloric test. RESULTS Sixteen patients each, in group 1 and group 2 and four subjects in the control group were detected to have a hearing loss indicating significantly more HIV infected individuals (group 1 and 2) were having hearing loss (P=0.001). Kobrak's (modified) test showed 27% of patients in group 1 and 33% of patients in group 2 and none in the group 3 had a hypofunctioning labyrinth (P=0.001). CONCLUSION It seems that the human immunodeficiency virus does affect the audio-vestibular pathway. There was a significant incidence of audio-vestibular dysfunction among the HIV infected patients, as compared to the control population (P=0.001) and no significant difference between the asymptomatic HIV seropositive patients and AIDS patients. Majority of the patients had no otological symptoms.
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Iatrogenic pseudoaneurysm: a rare complication of sinonasal surgery. Am J Otolaryngol 2011; 32:607-10. [PMID: 21035916 DOI: 10.1016/j.amjoto.2010.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 08/11/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE We report 2 patients with iatrogenic pseudoaneurysms, which developed following sinus surgery. METHOD Case reports and a review of literature of the management of iatrogenic pseudoaneurysm. RESULTS For one patient who presented with massive epistaxis, the only lifesaving option available was to perform an urgent angiogram followed by selective embolization of the feeding vessel. In the second patient who presented with persistent nasal obstruction and discharge and no epistaxis, a traumatic aneurysm of the internal carotid artery was demonstrated on magnetic resonance imaging scan that was later confirmed by angiography; he, however, declined further treatment. CONCLUSION Iatrogenic pseudoaneurysms that develop following a vascular injury, though rare, can cause life-threatening epistaxis or a thromboembolism. In this report, we describe 2 different manifestations of iatrogenic vascular malformations following sinus surgery. The role of angiography and subsequent endovascular therapy in the management of these lesions is emphasized.
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Abstract
Objective: The impact of HIV/AIDS is felt more in developing countries because of socioeconomic reasons. There is risk of audio vestibular dysfunction with the use of anti-retroviral therapy, which may be ototoxic. This study was to determine the difference between audio-vestibular function in asymptomatic HIV infected and AIDS patients. Method: In this prospective cross sectional study conducted in a tertiary care hospital in South India, the audio-vestibular system of 30 AIDS subjects (group 1) and 30 asymptomatic HIV positive subjects (group 2) and age-matched 30 healthy controls (group 3) were assessed using pure tone audiometry and cold caloric test. Results: Sixteen patients each, in group 1 and group 2, were detected to have hearing loss. In the control group, 4 were detected to have hearing loss. Comparing patient groups 1 and 2 with that of group 3, the p-value was significant ( P = .001). Kobrak’s (modified) test showed 27% of patients in group 1 and 33% of patients in group 2 had a hypofunctioning labyrinth. Conclusion: It was found that the human immunodeficiency virus does affect the audio-vestibular pathway. There was a significant incidence of audio-vestibular dysfunction in both study groups compared to the controls. There was no significant difference between the HIV seropositive asymptomatic patients and patients with AIDS. The majority of the patients had no otological symptoms.
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A case of Turner syndrome with hyperparathyroidism in an adult. EAR, NOSE & THROAT JOURNAL 2008; 87:110-112. [PMID: 18437933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
Turner syndrome is a hereditary chromosomal anomaly that affects girls and women. A result of gonadal dysgenesis, its primary characteristics are short stature, osteoporosis, neck webbing, and cardiac defects. Turner syndrome may also involve the auditory system and kidneys. We report the case of a woman with Turner syndrome who presented late in adulthood with severe osteoporosis and hypercalcemia. She was subsequently diagnosed with primary hyperparathyroidism secondary to a parathyroid adenoma. After excision of the adenoma, the woman's serum calcium level normalized. To the best of our knowledge, only 4 other cases of Turner syndrome with hyperparathyroidism have been reported in the literature.
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Abstract
Turner syndrome is a hereditary chromosomal anomaly that affects girls and women. A result of gonadal dysgenesis, its primary characteristics are short stature, osteoporosis, neck webbing, and cardiac defects. Turner syndrome may also involve the auditory system and kidneys. We report the case of a woman with Turner syndrome who presented late in adulthood with severe osteoporosis and hypercalcemia. She was subsequently diagnosed with primary hyperparathyroidism secondary to a parathyroid adenoma. After excision of the adenoma, the woman's serum calcium level normalized. To the best of our knowledge, only 4 other cases of Turner syndrome with hyperparathyroidism have been reported in the literature.
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Reconstruction of the conchal bowl and external auditory canal. EAR, NOSE & THROAT JOURNAL 2006; 85:425. [PMID: 16909809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
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Complications of acute infective rhinosinusitis: experience from a developing country. Singapore Med J 2005; 46:540-4. [PMID: 16172774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Complications of acute infective sinusitis are a therapeutic emergency. The purpose of this study was to determine the clinical presentation, microbiological pattern, treatment modalities and outcome of patients diagnosed to have acute rhinogenic orbital, intra- and extra-cranial complications from a developing country in Asia. METHODS A retrospective chart review from October 1999 to January 2004 was conducted. RESULTS Among 247 ENT surgical emergencies documented, 13 patients (5.3 percent) were diagnosed to have acute sinusitis with various complications either as in solitary or multiple forms. Orbital complications were the most common (61.5 percent) followed by acute subdural empyema (23.1 percent) and meningitis (15.2 percent). Subdural empyema was the most common intracranial complication. Staphylococcus was reported to be the most common offending organism (45.5 percent). Majority of the patients (84.6 percent) had surgical drainage of the affected sinuses, 38.5 percent being endoscopic drainage while external approach was done for those with coexisting osteomyelitis (30.8 percent). Two patients had combined approach, and one patient had post-operative facial paresis. There was no mortality in our series. CONCLUSION Early detection, aggressive medical and prompt surgical treatment by multidisciplinary approach involving ophthalmological, neurosurgical and rhinological procedures, can successfully treat the complications with a significant reduction in the morbidity and no mortality.
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THE TREATMENT OF ACUTE HEMATOGENOUS OSTEOMYELITIS WITH PENICILLIN AND SULFONAMIDES COMBINED. Calif Med 1947; 67:84-87. [PMID: 18731278 PMCID: PMC1642995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Fractures of the Forearm: A Simple Method of Handling by Means of Wire Traction. CALIFORNIA AND WESTERN MEDICINE 1933; 39:177-181. [PMID: 18742623 PMCID: PMC1658784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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