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October-December 2011 Volume 17 | Issue 4
Page Nos. 145-182
Online since Thursday, March 29, 2012
Accessed 98,631 times.
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ORIGINAL ARTICLES |
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Connexin 26 mutations in congenital SNHL in Indian population |
p. 145 |
SS Nayyar, S Mukherjee, N Moorchung, E James, MD Venkatesh, PS Sukthankar, K Sabarigirish, RB Batra DOI:10.4103/0971-7749.94491 Introduction: Hearing impairment is a sensory disability that affects millions of people all over the world. Fifty percent of these cases are hereditary. Two genes have been localized to DFNB locus (GJB2 & GJB6) on chromosome 13 which have been commonly implicated in autosomal recessive causes of deafness among which the Connexin 26 mutation is the most common. Materials and Methods: Twenty-seven unrelated Indian patients between the ages of 1 and 23 years with nonsyndromic congenital sensorineural hearing loss for GJB2 mutations, specifically for W24X. Analysis was done by the polymerase chain reaction (PCR) Restriction fragment length polymorphism RFLP and sequencing methods. Results: Seven out of these 27 subjects were found to have the W24X mutation, implying a frequency of 26% (7/27). Conclusion: Our results are in concordance with what has been reported in world literature. We also showed a 100% concordance between the PCR RFLP and sequencing methods. |
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Evaluation of the cytotoxicity of ventilation tube, nasal packing, and spongostan used in ear-nose-throat surgeries |
p. 149 |
Emine Elif Altuntas, Zeynep Sümer DOI:10.4103/0971-7749.94492 Purpose: The aim of this study was to determine biocompatibility of spongostan, merocell, and ventilation tube using agar diffusion and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide tests in cell culture and to evaluate the results in terms of clinical practices. Materials and Methods: The experimental procedures involved in this study were approved by the Animal Ethics Committee of Cumhuriyet University (B.30.2.CUM.0.01.00-50/4), and the study was conducted following accepted guidelines for the care and use of laboratory animals for research. The present study was supported by Cumhuriyet University Scientific Research Projects (CÜBAP) Project no T-408. L929 mouse fibroblast cell culture was used in the present study. In this study, indirect toxic effects of the leakage products from the materials were tested with the agar overlay test, and also direct toxic effects of leakage materials occurring at different time and leakage products from the materials were tested with the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide test. Results: As a result of evaluating the 21 days' leakage material of the ventilation tube a moderate (+2), 24 and 48 h of leakage material of the merocell low degree and 24-hour leakage material of the spongostan limited cytotoxicity were found. Conclusion: Many biomaterials cytotoxicity study were found in the literature as well as in our study shown by MTT and agar diffusion tests they were not toxic. |
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Transmastoid approach to otogenic brain abscess: 14 years experience |
p. 155 |
VR Borade, SA Jaiswal, HO Nemade DOI:10.4103/0971-7749.94493 Objectives: Objectives of this study were to review our experience in on otogenic brain abscess and its management by transmastoid drainage and compare the results. Materials and Methods: All patients with brain abscess secondary to CSOM presenting to our department from January 1997 to December 2010 were included in this study. All patients subjected to clinical, neurological, opthalmological examination and CT scan was done as an imaging modality. All patients managed by radical mastoidectomy or modified radical mastoidectomy and transmastoid drainage of brain abscess as neurosurgical facility not available. Results: Seventy-two patients in whom brain abscess secondary to chronic suppurative otitis media was diagnosed and has been treated since 1997 are presented. 85% of patients were below 20 years of age. More than 50% patients presented with more than one complication of chronic suppurative otitis media. 85% of patients were having extensive cholesteatoma and 15% patients were having extensive granulations in middle ear and mastoid air cells. 83% patients were having cerebellar abscess while 17% patients were having temporal lobe abscess. 80% of the pus culture was sterile while in 20% patients various microorganisms such as Proteus spp., Escherichia coli, Pseudomonas aeruginosa, Staphylococcus spp., and Streptococcus spp were cultured. Overall mortality in this series was 4.4%. Conclusion: In diagnosis of otogenic brain abscess CT scan with constrast is of immense help. Transmastoid drainage of brain abscess is a safe and effective method that can be performed by otologists in cases of otogenic brain abscess. |
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Effect of mobile phone usage on hearing threshold: A pilot study |
p. 159 |
CS Ramya, Kutty Karthiyanee, Shankar Vinutha DOI:10.4103/0971-7749.94494 Introduction: Mobile phones use electromagnetic radiation in the microwave range, which can be harmful to hearing. Earlier studies have showed an increase in hearing threshold with more than 30 minutes usage of mobile phones per day. Objective: To evaluate the relationship between the duration of usage of mobile phones per day and the change in auditory threshold. Materials and Methods: After obtaining institutional ethical committee clearance, 50 subjects, aged between 15 and 40 years, from institutional campus using mobile phones for more than 5 years were selected for this study. 25 subjects who used mobile phones for <30 min/day formed the control group, while 25 subjects who used their mobile phones for >30 min/day formed the test group. Pure-tone audiometry was done on all the subjects. Results: There was a significant increase in the hearing thresholds at all frequencies in air conduction and bone conduction in right ear in test group compared with the control group. Similarly, there was a significant increase in the hearing thresholds at all frequencies in air conduction and bone conduction in left ear also except for bone conduction at frequency 4 and 6 kHz. Conclusions: There is a significant increase in the hearing threshold in mobile phone users associated with duration of usage. |
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Etiological factors for pediatric sensorineural hearing loss |
p. 162 |
Sanjay Kumar, Prachi Gautam, Ravinder Sharma, Vivek Taneja DOI:10.4103/0971-7749.94495 Introduction: The prevalence of sensorineural hearing loss (SNHL) is 2-3 per 1000 live births in India. The present study was carried out to identify and diagnose children with SNHL and study their etiological profile. Materials and Methods: The study was conducted at tertiary care hospital. A total of 150 cases were evaluated. Data on epidemiological factors were collected. Detailed clinical and audiological assessment of patients was performed by conducting audiological tests like free field audiometry, pure tone audiometry (PTA), oto-acoustic emissions (OAE) and brainstem-evoked response audiometry (BERA). Results: Majority of cases were diagnosed between 0 and 5 years of age; male:female ratio was almost equal. Out of 150 cases, the maximum number of cases [24 (16%)] were having genetic etiology, 15 (10%) were having history of prenatal complications, 18 (12%) cases were having perinatal complications and 39 (26%) presented with acquired factors responsible for SNHL, while in 54 (36%) cases, the etiological factors remained undetermined. Conclusions: In most cases of SNHL, the cause is undetermined. The maximum number of cases in which the cause is determined are of genetic etiology. 12% cases have perinatal insult as cause. |
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CASE REPORTS |
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Unexpected cause of malignant otitis externa: A rare case report |
p. 165 |
Abdulla Al-otaibi, Bandar Mohammed Al-qahtani, Zaid Al-dhawi DOI:10.4103/0971-7749.94496 Malignant otitis externa is an uncommon infection affecting the ear canal and temporal bone. The most common causative organism is Pseudomonas aeruginosa. In this article, we report a malignant otitis externa caused by actinomycosis, a case never been reported before in the literature. |
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Otitic hydrocephalus |
p. 167 |
Urmila Gurung, Anurag , KS Ullah, RP Shrivastav, H Bhattarai DOI:10.4103/0971-7749.94497 Otitic hydrocephalus is a rare intracranial complication of middle ear infection. It presents with features of raised intracranial pressure without any neurological deficits. Its exact pathogenesis is still not known but most associate it with lateral sinus thrombosis. Magnetic resonance imaging and Magnetic resonance venography are useful in diagnosis. We present a case of otitic hydrocephalus and discuss its clinical findings, pathogenesis, diagnostic tools, and treatment modalities. |
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Iatrogenic facial nerve palsy "Prevention is better than cure": Analysis of four cases |
p. 170 |
Rakesh Kumar, CV Karthikeyan, Chirom Amit Singh, C Preetam, Kapil Sikka DOI:10.4103/0971-7749.94498 Iatrogenic facial nerve palsy in mastoid surgery is considered a crime or a taboo in the present scenario of medical science. But one has to accept the fact that every otologist encounters this entity at some point in his/her career. Hence it is of prime importance to be equipped to detect and to manage these cases. The obvious and disfiguring facial deformity it causes makes this a dreaded complication. Our article here discusses our experience in managing four cases of iatrogenic facial palsy. The etiology in all the cases was mastoidectomy for cholesteatoma. The detection of the site and repair was performed by the same surgeon in all cases. The facial nerve was transected completely in three cases, and in one case there was partial loss (>50%) of fibers. Cable nerve grafting was utilized in three patients. There was grade 4 improvement in three patients who underwent cable nerve grafting, and one patient had grade 2 recovery after end-to-end anastomosis. A good anatomical knowledge and experience with temporal bone dissection is of great importance in preventing facial nerve injury. If facial nerve injury is detected, it should be managed as early as possible. An end-to-end anastomosis provides better results in final recovery as opposed to cable nerve grafting for facial nerve repair. |
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Myxoma of the temporal bone: A rare neoplasm |
p. 173 |
Kapil Sikka, Rajeev Kumar, Rakesh Kumar, Prem Sagar, Lavleen Singh DOI:10.4103/0971-7749.94499 Myxomas of the temporal bone are rare mesenchymal tumors. We present a case of a 16-year-old girl who presented with complaint of mass lesion protruding from the right ear canal and from behind the ear for last 2 years. Biopsy of the mass was suggestive of benign mesenchymal lesion with prominent myxoid changes. Radiology of the temporal bone showed soft tissue density involving right side external auditory canal, middle ear, mastoid antrum and both lobes of the parotid gland. Tumour excision along with total parotidectomy was performed. Postoperative histopatholgy was consistent with myxoma. The patient is on regular follow-up for last 5months with no recurrence till date. Temporal bone myxomas are rare neoplasms which are surgically treatable but have a strong tendency to recur, necessiating long-term follow-up. |
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Branchio-oto-renal syndrome: A case report and review of literature |
p. 176 |
Jagannath Bisanna, Smitha S Gangaraj DOI:10.4103/0971-7749.94500 Branchio-oto-renal (BOR) syndrome is an autosomal dominant disorder characterized by branchial arch anomalies, hearing impairment, and renal anomalies. Very few articles on this syndrome have been published in journals related to otorhinolaryngology. We present a case of BOR syndrome, with review of literature, in an attempt to familiarize this syndrome for early detection and prevention of its long-term adverse effects. |
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Lateral sinus thrombosis: A diagnosis still persisting |
p. 178 |
U Venkatesh, S Vinaya Babu, KV Shivaprakash, M S Thomas Prasanna Raj DOI:10.4103/0971-7749.94501 Lateral sinus thrombosis is a potentially life-threatening complication, if any delay in its diagnosis and management. The altered clinical picture in the era of antibiotics may be misleading. Therefore, early diagnosis, aggressive medical and surgical management are required for successful outcome. Here, we present a pediatric case which was presented with lateral sinus thrombosis secondary to chronic otomastoiditis with successful outcome. A brief review of literature regarding clinical signs, symptoms, and treatment option are discussed. |
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Auricular pleomorphic adenoma: Case report and review of literature |
p. 181 |
Rajeev Kumar, Prem Sagar, SC Sharma, Sandeep Mathur, Ranajoy Ghosh DOI:10.4103/0971-7749.94502 To report the first case of pleomorphic adenoma (PA) arising in the ear lobule, and overall, the sixth case of PA in the auricle in medical history. A 28-year-old young male presented to us in the outpatient department with a small, painless, firm, freely mobile swelling in the left ear lobule for past 3 months. The patient wanted excision of the swelling for cosmetic purposes. Fine-needle aspiration of the swelling suggested features consistent with PA. The tumor was excised under local anaesthesia. Postoperative histopathological examination confirmed the findings of cytology. There was no recurrence during the 8-month follow-up. PA can rarely arise in the ear lobule, which is to be treated by complete surgical excision. |
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