International Journal of Otolaryngology

Background. Pediatric benign fibro-osseous lesions of the nose and paranasal sinuses are considered rare neoplastic entities. These fibro-osseous lesions are difficult to accomplish owing to the multifaceted anatomy of the skull base in addition to the closeness to neurovascular configurations. Objective. The study aimed to study different clinical presentations, radiological manifestations, surgical management, and consequences of different benign fibro-osseous lesions in the pediatric age groups. Methods and Settings. This is a case series study of a single-center experience. Results. Four different cases were presented and discussed (osteoma, fibrous dysplasia, and ossifying fibroma. Conclusion. We reported four different cases of osteoma, ossifying fibroma, and fibrous dysplasia. All of these cases were managed endoscopically with no postoperative complications. Endoscopic management is considered highly effective with reduced morbidity. Preoperative radiographic studies are highly essential for diagnosis and operative planning.

Background. This study is designed to assess the variations of the ethmoid roof through the Keros, Gera, and Thailand-Malaysia-Singapore (TMS) classifications by means of Cone-Beam Computed Tomography (CBCT). Materials and Methods. 372 CBCT scans were reviewed. The depth of the olfactory fossa (OF) was defined by the height of the lateral lamella (LL). The degree of the angle formed by the LL and the continuation of the horizontal plane passing through the cribriform plate was calculated. The risk of injury to the skull base was assessed by TMS classification. Results. The distribution of Keros types 1, 2, and 3 was 20.43%, 66.26%, and 13.31%, respectively. No significant difference was seen in the Keros classification among males and females, and asymmetry in the depth of the cribriform plate was seen in 33.3% of patients. 29.57% of the cases had type I, 61.42% had type II, and 9.01% had type III of Gera classification. 33.9% of the patients had asymmetry in the Gera classification. There was not significant difference in the Gera classification among males and females. 95.43%, 4.17%, and 0.40% of patients were of types 1, 2, and 3 of TMS classification, respectively. Conclusion. The most prevalent variations of the ethmoid roof were Keros type II, Gera type II, and TMS type 1. Although the prevalence of the dangerous types (Keros type 3, Gera type III, and TMS type 3) was low, preoperative assessment is essential in reducing surgical complications. CBCT is beneficial in evaluating these variations due to its low radiation dose.

Background. Hearing impairment is a leading cause of disability worldwide. Early identification and early intervention of hearing loss can prevent further disability in the development of speech, language, cognition, and other developmental domains. This study aimed to determine the magnitude and factors associated with the refer results of newborn hearing screening at an academic tertiary hospital. Methods. An institution-based time series cross-sectional study was conducted with a calculated sample size of 368 newborns selected by systemic random sampling from a total of 2087 newborns born in SPHMMC during the study period. Two stage screening protocol was conducted using Transient Evoked Otoacoustic Emission (TEOAE) on the first, followed by TEOAE and Auditory Brainstem Reflex (ABR) as a second stage for newborns with refer results. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 26.0. Bivariate and multivariate analyses between dependent and independent variables were performed using binary logistic regression with a significance level of value <0.05. Result. Of the total sample size of 368 newborns, 62% (228) passed the first TEOAE and 38% (140) yielded refer results. From 121 who came for follow-up screening (6–28 days), 49.5% (60) passed the second TEOAE and 50.5% (61) had refer results. AABR screening of 61 newborns yielded pass in 11.5% (7) and refer result in 88.5% (54) newborns. Noise (AOR= 4.746, 95% CI 2.505–8.992, ), vernix caseosa (AOR= 19.745, 95% CI 9.057–43.043, ), and very low birth weight (AOR= 4.338, 95% CI 1.338–14.067, ) were found to be significantly associated with the refer rate of the first TEOAE test. Noise (AOR 39.445, 95% CI 5.974–260.467, ) and neonatal jaundice (AOR 21.633, 95% CI 1.540–303.994, ) were significantly associated with the follow-up screening refer result of TEOAE. Repeat TEOAE has decreased the refer rate from 38.0% (140/368) to 17.5% (61/349), 19 of which were lost to follow-up. AABR has decreased the overall refer rate from 17.5% to 15.5% (54/349). Conclusion. This study shows a significant number of newborns (15.5%) who need diagnostic audiologic work-up and may need intervention. Vernix caseosa and noise are avoidable factors, but newborns with jaundice and very low birth weight should be sent to ENT for screening.

Introduction. Unilateral Sensorineural Hearing Loss (USNHL) is an age-old known entity. Patients with USNHL lack the merits of binaural hearing, i.e., temporal summation, sound localization, and speech recognition in a noisy environment. The lack of binaural hearing affects such individuals’ quality of life (QOL). The present study is the most extensive Indian series related to QOL in USNHL patients. Objectives. This study aims to assess the impact of USNHL on the QOL of patients in the state of Uttarakhand. Methods. A cross-sectional study was carried out at a tertiary care center in Uttarakhand over a period of 18 months, from January 2018 to July 2019. A total of 115 patients with pure USNHL were evaluated using a validated questionnaire—Hearing Handicap Inventory for Adults-Hindi (HHIA-H). Results. In our study, patients with higher HHIA-H scores were male, young adults (age group 18–30 years), students, and laborers. Most of our patients (64%) had significant handicaps, followed by moderate handicaps in 25%. However, no significant correlation of degree of handicap was seen with age, duration, and degree of hearing loss. Conclusion. USNHL can lead to a significant handicap that can severely affect the emotional and social aspects of life. Thus, early diagnosis and rehabilitation are essential to prevent handicap and uplift QOL in patients with USNHL. This trial is registered with Clinical Trials Registry of India (CTRI reg. no. CTRI/2018/06/014396).

Background. Overall survival for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) has differed by sex, but little is known regarding cancer-specific outcomes. We assessed the independent association of sex with cancer-specific survival in patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). Methods. We identified 14,183 patients from the Surveillance, Epidemiology, and End Results (SEER) program with OPSCC and tumor HPV status. We used Kaplan–Meier methods to compare overall survival (OS) and OPSCC-specific survival (HNCSS) by patient sex and by tumor HPV status. We then separately fit multivariable survival and competing risk models evaluating the association of sex on these outcomes by tumor HPV status and stratified by the use of guideline-concordant OPSCC treatment. Results. A total of 10,210 persons with HPV-positive tumors (72.0%) and 3,973 with HPV-negative tumors (28.0%) were identified. A larger proportion of women had HPV-negative tumors (24.0%) versus HPV-positive tumors (13.2%; ). Women with HPV-positive tumors were less likely to receive guideline-concordant treatment compared to men. In unadjusted survival analyses, women did not differ in OS or HNCSS compared to men for HPV-positive tumors but had worse OS and HNCSS for HPV-negative tumors. After adjustment, men and women with HPV-positive OPSCC did not differ in OS or HNCSS. However, women with HPV-negative tumors faced worse overall survival (hazard ratio (HR) 1.15, 95% CI 1.02–1.29) that persisted even after stratifying for stage-appropriate treatment (HR 1.28, 95% CI 1.11–1.47). Conclusions. Women with HPV-positive OPSCC had similar survival outcomes compared to men, but those with HPV-negative tumors have worse overall and cancer-specific survival.

Background. Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. Aspergillus species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate. Objective. This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims to emphasize the importance of early diagnosis and treatment in such cases. Patients and Methods. A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019. Results. Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50%), six isolated maxillary fungal ball (38%), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6%), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6%). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball. Conclusion. Fungal ball may present with variety of symptoms but most commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities.