Sudden sensorineural hearing loss after Covid-19 infection.

Covid-19 pandemic has taken the world by a storm, pushing the boundaries of human endurance and intellect. Caught at the horns of dilemma, humanity is still struggling with the management of the established symptoms not to mention the novel symptoms. In this regard, the novel symptoms must be highlighted to ensure proper and timely management. Viral aetiology has been an established entity for neurological deficits; hence, it would not be a huge leap to consider the correlation between Covid-19 and Sensorineural hearing loss (SNHL). Here, a case is being presented where the patient developed sudden sensorineural hearing loss after Covid-19 infection.

Castleman disease of the neck: A case report.

Castleman disease is a rare lymphoproliferative disorder with two distinctive presentations, namely Unicentric disease and Multicentric disease. Unicentric disease occurs as a solitary enlarged mass in the mediastinum and is rarely found in the head and the neck, whereas, Multicentric disease appears as a systemic disease with peripheral lymphadenopathy. Here we discuss an unusual case with characteristic clinical, radiologic and histologic findings of a 22-year-old male with Unicentric disease demonstrating a slow growing neck mass often times misdiagnosed as a lymphoma.

Changing paradigms in the surgical management of hyperparathyroidism at a tertiary care hospital in a developing country.

We report the presentation, management and outcomes of patients operated for hyperparathyroidism at our hospital. Patient sunder going surgery for hyper parathyroidism from 20 05 to 2 015 were retrospectively reviewed. Preoperative biochemistry, diagnostic scans and surgical procedures were studied. Follow up for cure rates, complications and histology were recorded. Out of 72 patients reviewed 54 (75%) were females and the rest males. The mean age was 48.04±15.5 years. Musculoskeletal complains were the most common (76.4%) among the cases reviewed. Asymptomatic hypercalcemia was seen in 13 (18.1%). The mean preoperative PTH level was 658.95 pg/ml and the mean preoperative calcium was 11.9 mg/dl. Bilateral neck exploration was done in 42 (58.3%) while focused unilateral approach was done in 27 (37.5%) cases. Solitary adenoma was the most frequent pathology in 58 (80.5%) patients. Asymptomatic hyperparathyroidism was less frequently detected in our population owing to lack of screening programme. Our patients are younger with a greater severity of the disease both symptomatically and biochemically compared to the West. In almost two decades, preoperative symptoms, calcium and PTH levels have changed marginally. Bilateral explorations are now giving way to focused less invasive procedures.

Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient?

OBJECTIVES: The aim of this study was to determine the incidence and characteristics of second primary malignancy (SPM) in patients with head and neck squamous cell carcinoma treated at a tertiary care hospital. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 221 patients who underwent surgery with or without adjuvant treatment for head and neck cancer from 2000 to 2002. Data of age, sex, risk factors, sites of primary and SPM, TNM stage of primary tumor, incidence of SPM, and survival were collected from medical charts. RESULTS: Eighteen patients developed SPM during a median follow-up of 67 months, with an overall incidence of 8.14%. In addition, 77.7% of SPMs occurred in the oral cavity, followed by 11% in the lungs. The 5-year overall survival after the diagnosis of SPM in the head or neck was 70%, compared to 30% for SPM in other body regions. CONCLUSION: Considering a high incidence of SPM, i.e., 8.14%, in a mean follow-up period of 67 months suggests the need for long-term follow-up. Since treatment of SPM has shown an acceptable survival rate, early detection and curative therapy should be emphasized.

Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient?

OBJECTIVES: The aim of this study was to determine the incidence and characteristics of second primary malignancy (SPM) in patients with head and neck squamous cell carcinoma treated at a tertiary care hospital. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 221 patients who underwent surgery with or without adjuvant treatment for head and neck cancer from 2000 to 2002. Data of age, sex, risk factors, sites of primary and SPM, TNM stage of primary tumor, incidence of SPM, and survival were collected from medical charts. RESULTS: Eighteen patients developed SPM during a median follow-up of 67 months, with an overall incidence of 8.14%. In addition, 77.7% of SPMs occurred in the oral cavity, followed by 11% in the lungs. The 5-year overall survival after the diagnosis of SPM in the head or neck was 70%, compared to 30% for SPM in other body regions. CONCLUSION: Considering a high incidence of SPM, i.e., 8.14%, in a mean follow-up period of 67 months suggests the need for long-term follow-up. Since treatment of SPM has shown an acceptable survival rate, early detection and curative therapy should be emphasized.

Harmonic scalpel versus electrocautery tonsillectomy: a comparative study in adult patients.

OBJECTIVE: To compare harmonic scalpel (HS) tonsillectomy with electrocautery (EC) tonsillectomy in terms of operating time, intra-operative blood loss, post-operative pain and secondary haemorrhage. METHODS: Sixty adult patients subjected to tonsillectomy only, were evaluated in this prospective study. The patients were stratified into 2 groups (30 each) based on the dissecting instrument used (HS vs. EC) at Aga Khan University Hospital Karachi Pakistan from June, 2006 to August, 2008. RESULTS: The mean operative time was less in electrocautery group (EC 3.57 +/- 0.85 minutes Vs HS 4.20 +/- 1.37 minutes; p<0.05). The mean intra operative blood loss was less in HS group (EC 3.43 +/- 3.42 ml Vs HS 2.40 +/- 2.74 ml; p =0.10). Post operative pain was significantly lower in harmonic scalpel group as compared to electrocautery group on 1st, 2nd and 3rd postoperative day (p < 0.05). From 3rd postoperative day onwards, although harmonic scalpel group was slightly better in terms of pain on visual analog scale but it was not statistically significant. Secondary haemorrhage after tonsillectomy was less in HS (EC 10% Vs HS 3%; p=0.61). CONCLUSION: Except lesser pain score in early postoperative period, the harmonic scalpel does not provide a major benefit over the more traditional method of electrocautery tonsillectomy.