Intracranial complications of CSOM in pediatric patients: A persisting problem in developing countries.

BACKGROUND: Intracranial complications (ICC) of chronic suppurative otitis media (CSOM) occur even in the antibiotic area. These complications are commonly seen in pediatric patients due to poor hygiene and low immunity. They are more prevalent in developing countries due to illiteracy, low socioeconomic status and lack of access to health care facilities. OBJECTIVE: To study the incidence, clinical profile, treatment and outcome of pediatric patients presenting with intracranial complications of chronic suppurative otitis media. METHODS: A retrospective analysis of intracranial complications of CSOM in pediatric patients was conducted over a period of 15 years at a tertiary level institute. Data regarding age, sex, clinical presentation, laboratory and radiological investigations, management, duration of hospitalization, and outcomes were recorded. RESULTS: There were 142 patients, in the pediatric age group, diagnosed as having intracranial complications due to chronic otitis media during the study period. There was a decline in the incidence of ICC of CSOM. The most frequent intracranial complication seen was brain abscess (58.5%). All patients were administered intravenous antibiotics for 4-6 weeks and underwent canal wall down mastoidectomy. Neurosurgical intervention was considered in the required patients. The case fatality rate in our study was 2.8% (4 patients). CONCLUSION: Otogenic intracranial complications can be fatal if not managed appropriately and timely. Broad spectrum intravenous antibiotics are usually required for 4-6 weeks with or without neurosurgical intervention and mastoid exploration. A high index of suspicion is required in all patients presenting with danger symptoms.

Can HIV-infected patients undergo cochlear implantation?

OBJECTIVE: HIV-infected patients have an increased risk of developing sensorineural hearing loss. Cochlear implantation can be a mean of rehabilitating such patients. METHODS: A 36-year-old HIV-infected male with bilateral profound sensorineural hearing loss underwent cochlear implantation after exclusion of medical and radiological contraindications. The patient was followed up for 2 years to assess the audiological outcome. RESULTS: After a follow up of 2 years, the patient has attained good functional results not experienced any complications. Conculsion: Cochlear implantation can restore hearing to HIV-infected patients with profound hearing loss due to cochlear impairment. This helps in both social and vocational rehabilitation and can improve the quality of life of such patients.

True hamartoma of the tonsil.

An 18-year-old male patient presented with recurrent episodes of sore throat, fever, dysphagia, and foreign body sensation in throat of 3 years duration. An episode of acute tonsillitis was clinically documented and a polypoidal lesion was seen arising from the right tonsil. The patient underwent a tonsillectomy and the histopathological examination of the mass revealed it to be a true benign hamartoma of the tonsil.

Pilonidal sinus of the neck.

A pilonidal sinus is most commonly seen in the sacrococcygeal region. Here we describe a rare case of pilonidal sinus of the neck following trauma due to shaving. Excision of the sinus with primary repair resulted in complete healing of the lesion with no recurrence. The possible pathogenesis of this acquired condition is also discussed.

Sinonasal leiomyoma: report of 2 cases.

Leiomyomas are benign smooth-muscle tumors that are common in the alimentary tract, uterus, skin, and subcutaneous tissue. They are very uncommon in the upper respiratory tract and rare in the nasal cavity and paranasal sinuses. To the best of our knowledge, only 23 such cases have heretofore been published in the literature. We report 2 new cases of sinonasal leiomyoma that originated at different sites in the nasal cavity. We also discuss the various investigative and therapeutic modalities available.