ABSTRACT
Congenital cholesteatoma (CC) is a whitish mass lesion found in the middle ear cleft behind the intact tympanic membrane in early life. It is a relatively uncommon disease and shows its growth and extension over a period of time. CC is evidenced with no prior history of tympanic membrane perforation, otorrhea, previous otologic procedures, normal pars tensa, and pars flaccida. The etiopathogenesis of CC is still controversial; however, the epithelial cell rest theory is the most commonly accepted one. The most common sites of CC are the anterior-superior and posterior-superior quadrants of the tympanic cavity. The most common clinical presentation of CC is conductive hearing loss. Early detection and intervention are needed to avoid the complications of CC. The treatment of choice in CC is still surgical. The frequency of recurrence seems to be lower in patients with CC than in acquired cholesteatoma. Rapid progression of the CC may occur in older children and the recurrence has been associated with advanced progression of the cholesteatoma. There are very few reports for CC available in the medical literatureThis objective of this review article is to discuss the prevalence, etiopathology, clinical manifestations, diagnosis, and treatment.
ABSTRACT
Background: Antrochoanal polyps (ACPs) are benign polypoidal mass originating from the maxillary sinus and they extend into the choana. The etiopathogenesis of ACP is not clear. These are found more commonly in children and young adults. ACP is almost always unilateral and common symptoms include nasal obstruction and nasal discharge. These lesions are extremely rare in the older adult age group. Materials and Methods: This is a retrospective study of 14 cases of ACPs managed between June 2017 and July 2022. Detailed clinical presentations, investigations, and treatment with surgical interventions for ACPs were studied. Results: Out of 14 cases of older adult patients with ACPs, there are 8 (57.14%) cases with a polyp on the left side and 6 (42.85%) cases on the right side of the nasal cavity. The most common symptom was constant and unilateral nasal obstruction in 12 (85.71%) patients, followed by purulent nasal discharge in 7 (50%) cases, clear rhinorrhea in 5 (35.71%) cases, facial pain in 4 (28.57%) cases, snoring in 3 (21.42%) cases, sneezing in 3 (21.42%) cases, and halitosis in 2 (14.28%) cases. Conclusion: ACPs are uncommon in the older adult age group. Diagnostic nasal endoscopy and computed tomography scans are important tools for the diagnosis of ACP. Functional endoscopic sinus surgery and power instrumentation are helpful for the complete removal of ACPs and are considered extremely safe procedures. Clinicians and otolaryngologists are often not aware of the prevalence of ACPs among the older adult age group.
ABSTRACT
Cochlear implantation is indicated in patients with severe to profound hearing loss that cannot be adequately treated by other auditory rehabilitation measures.The definitive indication of cochlear implantation is made on the basis of an extensive interdisciplinary clinical,audiological,radiological, and psychological diagnostic work-up.There are numerous changes are happening in cochlear implant candidacy.These have been associated with concomitant changes in surgical techniques,which enhanced the utility and safety of cochlear implantation.Currently, cochlear implants are approved for individuals with severe to profound unilateral hearing loss rather than previously needed for bilateral profound hearing loss.Studies have begun using the short electrode arrays for shallow insertion in patients with low-frequency residual hearing loss.The advancement in designs of thecochlear implant along with improvements in surgical techniques reduce the complications and result in the safety and efficacy of the cochlear implant which further encourages the use of these devices.This review article aims to discuss the new concepts in the candidacy of the cochlear implant,cochlear implant in younger children and hearing preservation,a cochlear implant for unilateral deafness,bilateral cochlear implant, and cochlear implant with neural plasticity and selection of patients for the cochlear implant.
ABSTRACT
Background: Hearing impairment and tinnitus are common otological manifestations found in the outpatient Department of Otorhinolaryngology. Hearing loss and tinnitus have been documented among coronavirus disease-2019 (COVID-19) patients. However, these clinical manifestations were rarely investigated among pediatric patients with COVID-19 infections. Objective: This study aims to evaluate the prevalence of hearing impairment and tinnitus among children with COVID-19 infection at a teaching hospital. Materials and Methods: This is a prospective and descriptive study where 192 children with COVID-19 infections were evaluated for hearing loss and tinnitus. There were 44 (22.91%) children with COVID-19 infections presenting with hearing loss and tinnitus. All of the children were confirmed as COVID-19 infection with the help of reverse transcription-polymerase chain reaction of the nasopharyngeal swab. Detailed history taking and clinical examination of the ear were done for the assessment of hearing loss and tinnitus and its outcome was analyzed. Results: Out of 44 children, 20 (45.45%) were presented with tinnitus, 16 (36.36%) were presented with hearing loss, and 8 (18.18%) were presented with both hearing loss and tinnitus. Out of 44 pediatric patients with hearing loss and/or tinnitus, 26 (59.09%) were males and 18 (40.90%) were females with a male child to female child ratio of 1.44:1. The mean age of the participants was 9.16 years with an age range from 5 to 18 years. The sporadic type of tinnitus is more common than any other type. Conclusion: This study showed that the presence of subjective neurological features like hearing loss and tinnitus can be found in children with COVID-19 infection. More studies are required to confirm the exact pathophysiology mechanism underlying this subjective symptom in pediatric patients with COVID-19 infection.