Journal of Otolaryngology and Head & Neck Surgery
The Annual Journal of Otolaryngology, Head & Neck Surgery is an open-access, peer-reviewed periodical dedicated to bridging the gap between clinical experience and global medical literature. It focuses on the understanding and management of various pathologies and diseases affecting the ear, nose, throat, head, and neck. The journal explores recent advancements and research in diseases, health, and medical science through robust, evidence-based clinical research studies. Positioned as a vital resource for postgraduate students, consultants, and healthcare professionals, the journal serves as a repository of clinical insights with an international perspective. Its readership includes otolaryngologists, head and neck surgeons, ENT nurses, as well as scholars and academicians across fields like medicine, trauma, and surgery. The journal aims to foster the analysis of clinical data from centers worldwide, utilizing standardized protocols to develop a globally accepted consensus on managing disorders within the field of otorhinolaryngology. As part of its evolving scope, sections such as "Case Reports," and "Original Research" have recently been introduced to further enhance its relevance and contribution to the field.
Bilateral COM with right sided sigmoid sinus thrombosis and left postaural fistula in a child
Chronic suppurative otitis media (COM) is a common pediatric condition that can occasionally lead to serious intracranial complications. Sigmoid sinus thrombosis is a rare but potentially life-threatening complication, often associated with cholesteatomatous disease. We report a case of a 10-year-old male presenting with bilateral ear discharge and progressive hearing loss for four years, associated with right-sided headache, neck pain, and intermittent fever. Otoscopic examination revealed advanced retraction changes with cholesteatoma in the left ear and a postaural fistula, while the right ear showed attic retraction with inflammation. Radiological evaluation with contrast-enhanced computed tomography of the brain and high-resolution computed tomography of the temporal bone demonstrated right sigmoid sinus thrombosis with involvement of the upper internal jugular vein, along with bilateral middle ear and mastoid disease. The patient was initially managed with intravenous antibiotics followed by right-sided modified radical mastoidectomy with type III tympanoplasty. The postoperative course was uneventful, with significant clinical improvement. This case highlights the aggressive nature of bilateral COM and underscores the importance of early diagnosis, appropriate imaging, and timely surgical intervention to prevent life-threatening intracranial complications. Keywords Chronic otitis media; Sigmoid sinus thrombosis; Cholesteatoma; Postaural fistula; Pediatric
Copyright (c) 2026 Upasana Saikia (Author) https://creativecommons.org/licenses/by-nc/4.0
OSTEOCUTANEOUS RADIAL FOREARM FREE FLAP FOR MAXILLA RECONSTRUCTION: SURGICAL TECHNIQUE
Osteocutaneous Radial Forearm free flap (OCRFF) is a composite flap comprised of a segment of the radial bone with the fasciocutaneous component and is based on Radial artery with Vena comitantes and cephalic vein as pedicle. It is used in midfacial reconstruction especially in the maxillary region involving bony defect. The advantage of this flap is that it is a thin, pliable flap with rich vascularity which provides a soft tissue covering along with a vascularized bone graft. In the recent studies, the flap survival rate is reported to be as high as 96-100% and the donor site complications are relatively low. The key to the success of this flap lies in meticulous pre-operative assessment including Allen’s test, proper imaging techniques which includes, USG doppler study of the donor site. Correct technique of flap harvest, radial osteotomy and plating (prophylactic fixation) ensures minimal chances of post-operative complications and flap failure. This article focuses on the pre-operative assessment, relevant anatomy and basic steps of flap harvest technique of OCRFF and aims to encourage the microvascular enthusiasts.
Copyright (c) 2026 Lailyang T, Dr. Shunyu N. B., Dr. Lakshmanan J, Dr. Sarma G (Author) https://creativecommons.org/licenses/by-nc/4.0
Bilateral Antrochoanal Polyps :A rare variation of a common clinical entity
Introduction: Antrochoanal polyps (ACPs) are benign, typically unilateral lesions originating from the maxillary sinus mucosa. While they commonly extend into the nasopharynx, bilateral occurrence is exceedingly rare, and extension into the oropharynx represents an unusual clinical presentation that can lead to airway compromise and dysphagia. Case Presentation: An 18-year-old male presented with a 1.5-year history of progressive bilateral nasal blockage, headache, and hyponasal voice. Examination revealed pale polypoidal tissue completely obstructing both nasal cavities and extending inferiorly to obliterate the oropharynx. Contrast-enhanced computed tomography (CECT) confirmed bilateral soft tissue masses originating from both maxillary sinuses with significant oropharyngeal extension. The patient underwent Functional Endoscopic Sinus Surgery (FESS) utilizing a combined trans-oral and trans-nasal approach to safely deliver the massive 11 x 7 x 3 cm specimen. Histopathology confirmed a benign inflammatory antrochoanal polyp. Discussion and Conclusion: Bilateral ACPs with oropharyngeal involvement represent a severe "fourth stage" of growth that mimics oropharyngeal malignancy. Diagnosis relies on CECT to assess bony anatomy and the widening of the maxillary ostia. Surgical management via FESS is the treatment of choice, though massive polyps may require a combined approach to ensure complete clearance and prevent recurrence. Postoperatively, the patient experienced complete relief of symptoms.
Copyright (c) 2026 Anupam Mohanty, Dr Anuradha Deka, Dr Manu CB, Dr Zareen A Lynrah, Sr. Prof. Suvamoy Chakraborty (Author) https://creativecommons.org/licenses/by-nc/4.0
Implementing Neonatal OAE Screening in Resource-Limited Tertiary Care: Operational Challenges and Solutions
Aim: To evaluate the operational feasibility, technical performance, and efficiency of implementing neonatal otoacoustic emission (OAE) screening in a resource-limited tertiary care hospital and to identify practical solutions to common implementation challenges. Methods: A retrospective operational analysis was conducted of 339 consecutive neonates who underwent OAE screening at a tertiary care hospital over 14 months (October 2021–November 2022). Data were analyzed for screening modality utilization (distortion product OAE [DPOAE] vs. transient evoked OAE [TEOAE]), technical failure rates, pass/refer outcomes, temporal trends in screening performance, and operational efficiency metrics. Statistical comparisons included chi-square tests for proportional differences and seasonal decomposition analysis for temporal trends. Results: Of 339 screens performed, 313 (92.3%) yielded interpretable results with an 85.0% pass rate. DPOAE was utilized in 295 screens (87.0%), while TEOAE was used in 44 screens (13.0%). Technical failures included 5 "no seal" cases (1.5%), 4 "noisy" cases (1.2%), 3 "call again" cases (0.9%), and 1 "no result" case (0.3%). DPOAE demonstrated superior interpretability at 92.5% compared to TEOAE at 88.6% (p = 0.34). The program screened an average of 24.2 neonates per month. Seasonal analysis revealed significantly higher failure rates during monsoon months (14.6% vs. 5.2% during dry season, p = 0.012). Learning curve effects were evident with "no seal" failures decreasing from 9.1% in initial months to less than 0.5% by month 3. Conclusion: Neonatal OAE screening is operationally feasible and sustainable in resource-limited tertiary care settings with acceptable technical performance. DPOAE modality offers superior reliability. Identified challenges including inadequate probe seal, excessive ambient noise, and infant behavioral factors are remediable through targeted interventions including screener training, acoustic environment optimization, and scheduling coordination. Seasonal environmental factors significantly impact performance and require adaptive resource planning.
auditory screening; neonatal audiology; otoacoustic emissions; operational feasibility
Copyright (c) 2026 Collette Wanpli Nongsiej, Zareen Aliiana Lynrah, Suvamoy Chakraborty, Abhijeet bhatia, C.B Manu, Anuradha Deka, Larisa Kharmawphlang (Author) https://creativecommons.org/licenses/by-nc/4.0
Medial limit of Vagal Schwannoma; Parapharyngeal space: a case report
Introduction- Parapharyngeal space (PPS) tumour accounts for 0.5% of all head and neck tumours. PPS tumours have various origins- salivary gland tumours, schwannomas, neurofibromas and paragangliomas. They are usually asymptomatic. 50% of PPS schwannomas are originated from vagus nerve followed by sympathetic trunk. Case report- A 64-year-old male presented to us with hoarseness of voice for last 3 months. Tongue was deviated to left on protrusion. Bilateral tonsillar enlargement was there, left more than right with absent gag reflex. Contrast enhanced computed tomography (CECT) of neck showed tumor in left carotid sheath. Magnetic resonance imaging suggested vagal schwannoma. Patient was planned for excision of left vagal nerve schwannoma by mandibular swing approach. Discussion – Vagal schwannoma excision has risk of nerve paresis postoperatively. Conclusion- PPS tumors are rare, and they present with atypical clinical manifestations. The optimal procedure choice should be individualized based on availability, patient characteristics, and the surgeon’s experience.
Copyright (c) 2026 Dr Anuradha Deka, Dr Neizekhotuo Brian Shunyu, Dr CB Manu (Author) https://creativecommons.org/licenses/by-nc/4.0
Atypical foreign bodies in ENT : A case series in a tertiary care hospital
Foreign bodies in ENT can be of varied types, presenting in different age groups, located at different sites. The ears are the most common foreign bodies followed by nose and throat. Most of the age group is below 10 years. They present with varying symptoms ranging from aural fulness to life threatening risk of aspiration or stridor in case of bronchial or esophageal location. Objects detected as foreign bodies in ear and nose have been bead, peanuts, paddy seeds, ball rings, paper, plastic. Coin, chicken bone and fish have been found in the esopghagus. They require skillful removal by trained ENT surgeon in the first attempt as more manipulation will lead to complications and need for general anaesthesia
Copyright (c) 2026 Aakriti Chandra (Author) https://creativecommons.org/licenses/by-nc/4.0
“Case Series of Transnasal endoscopic sphenopalatine artery ligation (TESPAL) for epistaxis and review of literature.”
Background: Epistaxis is a common condition, with about 6% of cases requiring medical intervention due to severe or recurrent bleeding. Posterior epistaxis often necessitates surgical management when conservative measures fail. Objective: To assess the effectiveness of transnasal endoscopic sphenopalatine artery ligation (TESPAL) in refractory epistaxis. Methods: A case series of six patients with severe or recurrent epistaxis unresponsive to conservative treatment was analyzed. All patients underwent TESPAL. performed with or without middle meatal antrostomy. Outcomes included bleeding control, complications, and hospital stay. Results: All patients achieved complete control of epistaxis following TESPAL. The procedure was associated with minimal complications, good patient tolerance, and reduced hospital stay. Conclusion: TESPAL is a safe, effective, and minimally invasive option for managing refractory epistaxis, offering high success rates with low morbidity and shorter hospitalization.
Copyright (c) 2026 RUUZENO AZENO, Jijitha Lakshmanan, Aswathi Kv, Dr Neizekhotuo Brian Shunyu, Hanifa Akhtar (Author) https://creativecommons.org/licenses/by-nc/4.0
Local Anaesthetics and regional nerve blocks in ENT
Background: Regional nerve blockade using local anaesthetics are useful for achieving anaesthesia to a specific area. The application of regional nerve blocks enables a lot of cases without the need for general anaesthesia (GA) in ENT (Ear, Nose & Throat) practice, thus minimising the side effects associated with GA. Objective: To give a brief overview of the pharmacology of local anaesthetics, the sites of regional blocks and the uses of local anaesthetics in ENT. Methods: Literature search has been carried out using PubMed, Google Scholar, and Cochrane database Results: Regional nerve blocks with various local anaesthetic agents usually achieves effective anesthesia with minimal complications. Conclusion: Local anaesthetics and regional blocks play a crucial role in ENT, enabling the surgeon to undertake a wide range of procedures under local anaesthesia without the need for general anaesthesia.
systemic complication of local anaesthetics.
Copyright (c) 2026 RUUZENO AZENO, Dr Neizekhotuo Brian Shunyu, Dr Jijitha Lakhsmanan Lakshmanan, Dr Hanifa Akhtar, Dr Aswathi KV, Dr Aakriti Chandra Chandra, Dr Nisha Kumari, Dr Paramesha Patra (Author) https://creativecommons.org/licenses/by-nc/4.0
Papillary Thyroid Carcinoma Presenting as Benign Thyroid Nodule Preoperatively in a Child: A Case Report
We report a case of papillary thyroid carcinoma in a 6-year-old male child who presented with a solitary midline thyroid nodule initially diagnosed as adenomatous goitre on fine needle aspiration cytology. Our case highlights the need for careful preoperative workup, management and follow-up of such cases in the paediatric age group.
Solitary thyroid nodule, papillary thyroid carcinoma and paediatric age group
Copyright (c) 2026 Journal of Otolaryngology and Head & Neck Surgery https://creativecommons.org/licenses/by-nc/4.0
A Large Inflammatory Myofibroblastic Tumor Of The Cervical Region Mimicking Malignancy; A Case Report
Inflammatory myofibroblastic tumor is a rare soft tissue tumor characterized by proliferation of myofibroblast-differentiated spindle cell along with infiltration of various chronic inflammatory cells. WHO classified it as a low grade soft tissue tumor. though it is a benign disease it has locally destructive behavior, and propensity for recurrence and rarely metastasis. ALK gene rearrangement is the most common type of genetic abnormality noted. CT and MRI helps in extent of the disease where as histopathological examination is the gold standard for diagnosis, and surgery is the treatment of choice. Here we are presenting a case of 33 year female presented to us with a left sided neck swelling for 2 years, following histopathological examination and IHC staining diagnosed as a case of low grade myofibroblastic sarcoma underwent near total resection of the tumor and post operative histopathological diagnosis is made as inflammatory myofibroblastic tumor and she is in regular follow up without any recurrence till date. So though it is a rare disease we should always keep it in our differential diagnosis of cervical mass lesion and should be differentiated from other malignant and inflammatory condition for its better management.
Osteomas are rare mesenchymal tumours which can be canalicular or extracanalicular.In our case series we are presenting both the type of osteomas of temporal bone to highlight the difference in presentation and management. EAC is the most common site of osteoma and squamous part of temporal bone involvement is rarely encountered. Clinical presentation of osteomas may range from painless bony mass in extracanalicular involvement to one causing tinnitus and ear discharge if present in the external auditory canal.The differential diagnosis include paget’s disease, osteosarcoma, keratosis obturans. A high resolution computed tomography of the temporal bone is the investigation of choice.The diagnosis can only be confirmed by histopathology whereby we see mature lamellar and woven bone with harvesian canal.
Osteomas,Temporal Bone , Extra Canalicular,
Xanthogranulomatous Inflammation of the Maxilla Mimicking a Dentigerous Cyst: A Rare Case Report
Title Xanthogranulomatous Inflammation of the Maxilla Masquerading as a Dentigerous Cyst: A Rare Clinicopathological Entity Presenting Author Dr. Nongthombam Bidyananda Singh, Dr. Manu CB, Dr. Anuradha Deka, Dr. Nayana Sarma, Dr. S. Chakraborty Aim To describe an uncommon presentation of xanthogranulomatous inflammation involving the maxilla, radiologically simulating an odontogenic cyst, and to highlight the diagnostic challenges. Methodology A 33-year-old male presented with a 6-month history of insidious, progressive, painless left cheek swelling without history of trauma, infection, or difficulty in chewing food. FNAC revealed cystic macrophages and lipoproteinaceous debris, suggestive of a nonspecific cystic lesion. NCCT demonstrated a 3.7 × 3.6 × 3.7 cm well-defined hypodense lesion arising from the upper alveolar ridge of the left hemimaxilla with expansion and remodelling of maxillary walls, provisionally favouring a dentigerous cyst. The lesion was excised via a sublabial approach and submitted for histopathology and immunohistochemistry. Results Histopathological examination showed fibrocollagenous stroma with dense xanthomatous infiltrates, multinucleated giant cells, and sheets of CD68-positive histiocytes. Calretinin negativity excluded granular cell tumour. Findings were diagnostic of xanthogranulomatous inflammation, a rare non-neoplastic inflammatory process seldom reported in the maxillofacial skeleton. Conclusions Xanthogranulomatous inflammation of the maxilla is an exceptional entity that can closely mimic odontogenic cysts on imaging. Definitive diagnosis requires histopathology with immunohistochemical correlation. Complete surgical excision offers excellent prognosis and prevents recurrence.
Recent Updates and Future Directions in Nasopharyngeal Carcinoma: A Literature Review
Nasopharyngeal carcinoma (NPC) is an epithelial malignancy with distinct epidemiology, high association with Epstein Barr virus (EBV), and very high sensitivity to radiotherapy and chemotherapy. Advances in radiology, radiotherapy, systemic chemotherapy, surgical salvage techniques for early recurrent cases, incorporation of immunotherapy have all significantly improved disease control and survival outcomes, making accurate staging increasingly important. In view of increasing good prognosis, the 9th version of the AJCC/UICC staging system introduces modifications to better align with modern treatment approaches and prognostic stratification. This review summarises highlights the recent updates in NPC staging and throw light on the advances in the management of locoregionally advanced, recurrent, and metastatic disease, with particular emphasis on immunotherapy. Emerging evidence supports plasma EBV-DNA as a useful biomarker in patients receiving anti–PD-1 therapy for prognosis and early detection of disease progression, although it is not yet incorporated into staging systems. New therapies such as antibody–drug conjugates and bispecific antibodies show promise but require further validation.
Incidence of Unilateral Sensorineural Hearing Loss in a Tertiary Hospital in Northeastern India: A Retrospective Study
Background: Unilateral Sensorineural Hearing Loss (USNHL) poses a significant yet under-recognized health burden, impairing spatial sound localization and speech discrimination. While commonly overshadowed by bilateral hearing loss, its psychosocial and functional impacts warrant dedicated investigation. Objective: To determine the incidence and severity of USNHL among patients. Methods: A retrospective analysis of pure tone audiometry (PTA) data was conducted over 18 months (January 2024–June 2025) at AIIMS Guwahati. A total of 4000 patients were assessed for hearing complaints, and 269 were identified with USNHL. Results: Unilateral Sensorineural Hearing Loss accounted for 6.7% of all hearing loss cases reviewed. A male predominance (63.1%) was observed. The most affected age group was 41–50 years (21.5%), and the majority (36.4%) presented with profound hearing loss. Mild hearing loss was also noted (31.5%), that is indicates functional limitations even in early stages. Conclusion: Unilateral Sensorineural Hearing Loss is often overlooked with considerable functional implications. Early identification through PTA and community awareness is essential. The study highlights the need for early identification and auditory rehabilitation tailored to unilateral hearing loss patients.
Nasa Shareera: Review of Anatomy of Nose in Ayurveda
Shalakya Tantra is the branch of Ayurveda which deals with the diseases of Otolaryngology along with Ophthalmology and Oro-dentistry. Ayurvedic equivalent of modern anatomy is Rachana Shareera, anatomy of nose in Ayurveda is termed as Nasa Shareera. Historical review, embryology, anatomical parts, characteristics of ideal nose, as well as the concept of Nose as the Gateway to the structures of head and neck region, as per Ayurveda have been dealt with.
Demographic profile of Head and Neck Malignancy in Northeast India: A Retrospective study.
Introduction: head and neck cancer are the sixth most common malignancy worldwide, with 57.5% of the global burden occuring in Asia, particularly India, particularly in Northeast where genetic, environmental and lifestyle related risk factors are significant contributor Method: retrospective study done in AIIMS Guwahati for a period of one and half year. Results: total 552 patients data were collected, among which male are more common than female, Malignant diseases are more common than benign conditions with elderly people of age 45-60 years were more effected by cancers. the majority of patients were from assam78.6% followed by Nagaland 16.8%. oral cavity carcinoma25.5% being the most common malignancy followed by hypopharyngeal cancer10.1%,oropharyngeal cancers 8.9%, laryngeal cancer 7.8%, and nasopharyngeal cancers7.4%. Among benign diseases multinodular goiter, lipoma and pleomorphic adenoma are predominant. Miscellaneous tumours accounted for 18.5% of cases. discussion: this one and half year study highlights that the head and neck cancer in North east India mostly effect males in their late adulthood, with oral cavity carcinoma being the most prevalent subtype. assam and Nagaland contribute to the highest case buirden. conclusion: High number of malignancy with wide verities of disease rises concern and needs targeted awareness, early screening, region-specific cancer control policies.
Demography, head and neck cancer, Northeast
Free Fibula osteocutaneous repair – A novel approach to mandibular defects
Head and neck cancers are managed by multimodality approach.However after oncologic resection, reconstruction should focus on restoring form and function.Herein we report a series of 04 cases who underwent resection of oral cavity tumors followed by reconstruction with free fibula osteocutaneous flap and its functional outcome
A Rare case of Unusually Big Adenomatoid Odontogenic tumor.
Of all odontogenic tumors, adenomatoid odontogenic tumors (AOT) are extremely rare, making for about 3% of cases. It is a benign, slowly developing, encapsulated, non-invasive, and non-aggressive odontogenic lesion connected to an impacted tooth. For years, these lesions could go undetected. The lesion does not return after the standard course of treatment of enucleation and curettage. Here, we report an uncommon case of an unusually large AOT in a 16-year-old female patient from northeastern India, who presented with complaints of a swelling over her left side of face for past 5 years associated with bilateral nasal blockage. Clinical examination and investigations revealed a hard swelling with some cystic regions of size 7.6 (CC) x 7.2 (AP) x 6.6 (TR) cm. The patient underwent staged removal of the tumour and the histopathological examination of the cyst wall showed features suggestive of adenomatoid odontogenic tumor. The patient remains symptom free on a follow up period of 18 months.
Angiomyolipoma of the Parotid Gland: A Rare Presentation
Angiomyolipomas are non-cancerous growths consisting of smooth muscle, blood vessels, and mature fatty tissue. They typically develop in the kidney but can occasionally be found in the head and neck area. While extremely uncommon in the parotid gland, with only very few reported cases to date, we present here the case of a 17-year-old female who had a slowly enlarging mass in her parotid gland over the past four years. Upon examination, a soft, rubbery mass measuring 2 x 1 cm was discovered in front of her right ear. Histological analysis confirmed the presence of an angiomyolipoma in the parotid gland. In conclusion, when encountering rubbery masses in the parotid gland, considering angiomyolipoma in the differential diagnosis is prudent.
Complex Retained Ballistic Foreign Bodies of the Nasopharynx and Ethmoid Sinus: A Two-Case Series and Review
Background: Retained ballistic foreign bodies in anatomically intricate regions such as the nasopharynx or paranasal sinuses are exceptionally rare and pose diagnostic and therapeutic challenges. Cases: We present two cases in 49‑year‑old males: Case 1 involved a bullet lodged in the posterior nasopharyngeal wall with multiple tooth fragments embedded in the tongue following intraoral gunshot trauma; Case 2 featured a metallic fragment retained in the left posterior ethmoid sinus after a self‑inflicted nasal gunshot wound. Management and Outcome: Both patients underwent emergency surgical intervention—open retrieval and tracheostomy for Case 1, endoscopic sinus surgery with septoplasty for Case 2—and recovered uneventfully. Conclusion: These cases underscore the critical role of high‑resolution computed tomography, multidisciplinary planning, and tailored surgical approaches in successfully managing rare upper aerodigestive ballistic injuries.
Cervical Osteophyte-Induced Dysphagia: A Case Report
Anterior cervical osteophytes are a rare but important cause of dysphagia, especially in elderly patients with comorbidities such as cervical spondylosis, diabetes, and hypertension. A 65-year-old male presented with progressive dysphagia to solids and a throat discomfort. Video laryngoscopy revealed a posterior pharyngeal wall bulge, and cervical spine X-ray showed a prominent anterior osteophyte at the C5 level causing pharyngeal compression. The patient improved with conservative treatment and was informed about the possible need for surgery if symptoms progressed, emphasizing patient awareness. This case highlights the importance of considering cervical osteophytes in dysphagia evaluation and the role of imaging in diagnosis.
TITLE- EPISTAXIS: PATTERNS OF PRESENTATION AND MANAGEMENT – A RETROSPECTIVE STUDY FROM A TERTIARY INSTITUTION
Epistaxis is a common ENT emergency, with varied presentations ranging from minor nasal bleeding to life-threatening haemorrhage. This study aims at evaluating the varying presentations, aetiologies, and management outcomes of epistaxis in a tertiary care centre in Northeast India. Methods: A retrospective review was conducted over one year (April 2024–April 2025) at a tertiary hospital in Northeast India. Data from 114 patients presenting with epistaxis were analysed for demographics, bleeding site, aetiology, comorbidities, and treatment methods. Results: Of 114 patients, 62.2% were male, with a mean age of 41.3 years. Anterior epistaxis accounted for 95.5% of cases. The leading causes were hypertension (35.8%) and nasal trauma (20.9%). Most cases were managed conservatively with nasal compression, topical agents, and cautery. Anterior nasal packing was needed in 35.8% of patients, while 6 patients required surgical or radiological intervention. Conclusion: Anterior epistaxis was the most frequent presentation, primarily due to hypertension and trauma. Conservative measures were effective in most cases. Surgical or interventional procedures were reserved for refractory cases, supporting a stepwise management approach.
endoscopic sphenopalatine artery ligation
Plexiform Neurofibroma- a rare tumor of submandibular salivary gland
Plexiform neurofibroma is more commonly seen in the orbit, neck , back and inguinal region. It is extremely rare in submandibular gland. This lesion rarely transforms into malignancy, but are locally infiltrative and can lead to haemorrhage. Therefore Plexiform neurofibroma should always be considered during differential diagnosis while excising a submandibular gland mass. We present here case of plexiform neurofibroma in the submandbular gland and diffused neurofibroma in the floor of mouth in a 15 yr old male not associated with Neurofiromatosis - 1.
An anterior neck lipoma mimicking thyroid swelling: a case report.
ABSTRACT Introduction Lipoma arises from adipose cells which are benign, mesenchymal tumor. They can be present all over the body and around 13% are located in head and neck region, but rarely occurs in the anterior aspect of the neck. Case report 25-year-old woman presented with swelling in the anterior part of neck. The swelling clinically resembled a thyroid swelling. But on evaluation, turned out to be a lipoma. Surgical excision of the swelling was done. Conclusion Lipoma presenting in the anterior part of neck is rare. It usually mimics a thyroid swelling Evaluation with imaging and Fine needle aspiration cytology (FNAC) leads to proper diagnosis and helps in appropriate intervention.
APPROACH TO A CASE OF OTOGENIC CEREBELLAR ABSCESS
Chronic otitis media (COM) is a common ear infection leading to multiple intracranial and extracranial complications. But with advent of antibiotics, the rate of complications has reduced. Intracranial complications are a dreaded result of such infections, and the rarity of such complications has made their treatment an exotic case report. Here we would like to discuss a case of a 20 year old male with cerebellar abscess due to Chronic Otitis Media (COM), along with postauricular abscess and post aural discharge which was treated surgically with mastoid exploration along with concurrent neurosurgical intervention followed by medical management with antibiotic and anticoagulant coverage with complete recovery of the patient. It was observed that patient had full recovery with no residual abscess. 3 month postoperative follow up of the patient revealed a healed mastoid cavity with an intact neotympanum. Even though rare and moribund, when treated properly, patient' recover completely.
Angina Bullosa Haemorrhagica- A rare mucosal condition of oral cavity
Introduction Angina Bullosa Haemorrhagica is a benign, rare condition of oral cavity, characterized by a sudden onset blood filled blisters in mucosa of oral cavity which rupture and heals spontaneously without scarring, considered to present in 0.05% of cases of oral ulcer. It resolve spontaneously but in 30% cases it has tendency to reoccur. case report A 48 year female presented with sudden onset, self resolving oral ulcer clinically diagnosed as Angina Bullosa Haemorrhagica following Ordioni et al. criteria for diagnosis. Conclusion Angina Bullosa Haemorrhagica is a rare, benign disease of oral cavity that rupture and heals spontaneously without scarring, often triggered by trauma or associated with systemic factors such as hypertension, diabetes or prolonged use of corticosteroid. Diagnosis is mainly clinical. Differentiation from vesicobullous, hematological disorder is essential to avoid misdiagnosis and unnecessary interventions.
Atypical BPPV an often confusing entity: Review of literature
Benign Paroxysmal Positional Vertigo (BPPV) is not an uncommon disorder involving the vestibular system which is associated with recurrent attacks of vertigo and nystagmus and aggravated by positional change of head. As per the “Barany Society diagnostic criteria for BPPV” it includes vertigo or dizziness associated with change in position along with positional nystagmus, and if these features are absent we classify them as atypical BPPV. Lately, various forms of atypical BPPV have emerged, including cases with no nystagmus in typical positions, intense short lasting nystagmus in different head positions. The phenomenon of "canal switch," where otolith from one semicircular canal shifts into another, has been proposed to explain the occurrence of paradoxical nystagmus. This review aims to provide a comprehensive overview of the possible origins of eye movements in all three semicircular canals and explore the different forms of atypical BPPV, contributing to a deeper understanding of this enigmatic condition.
Submental flap in small but reconstructive mandated oral cavity lesions
In this era of microvascular reconstruction, where the practise of microvascular surgery is widely practised by many surgeons, reconstruction with free flap has become mandatory in most of the head and neck oncological procedures. However, due to its difficult learning curve and time-consuming nature, free flaps are not routine surgery for many surgeons. The success of free tissue transfer surgery is not solely determined by the surgeon’s skills alone. Age and operative time can cause medical complications, if not surgical complications, and hence can lead to free flap failure. There are some lesions where local and regional flaps still hold their value as a good substitute for free flaps. The submental flap is one such flap. Though the utility and safety of the submental flap in oncological surgery has been questioned by many, with proper case selection and proper technique, the submental flap is still good and safe in oral cavity reconstruction. The purpose of this paper is to present a series of 13 patients who had undergone reconstruction with submental flaps after resection of their primary tumours in the oral cavity.
Identifying Inverted Papilloma: An Important consideration in Nasal Polyposis
Inverted papillomas comprises of only 0.4% to 7% among all sinonasal tumors and commonly presents as red, bulky, unilateral, vascular mass and sometimes associated with the presence of polyps. Though benign it is given special attention because of its increased incidence of recurrence, with a property to cause destruction locally and in long-standing cases its association with carcinoma. Its presentation can be very similar to chronic rhinosinusitis with nasal polyposis or an antro-choanal polyp therefore, it can be misdiagnosed if high clinical suspicion is not kept in mind. Out of the three cases in this series, one case was initially diagnosed as chronic rhinosinusitis with nasal polyposis, second case was diagnosed as antro-choanal polyp based on clinical, radiological and pre-operative biopsy reports and the third case was diagnosed as inverted papilloma with synchronous squamous cell carcinoma after the preoperative biopsy report. The need to bear in mind the possibility of inverted papilloma although rare in differential diagnosis of nasal polyposis is stressed because it necessitates a more complete surgical procedure to avoid recurrence and achieve better outcome.
Evaluating the Diagnostic Accuracy of Tympanometry and High-Resolution Compute Tomography (HRCT) in Otosclerosis: A Retrospective Comparative Study
Background: Otosclerosis is a progressive disease causing stapes fixation and conductive hearing loss. While tympanometry and high-resolution computed tomography (HRCT) are commonly used for diagnosis, their accuracy varies. This study evaluates the diagnostic performance of these modalities individually and in combination, using intraoperative findings as the reference standard. Methods: A retrospective analysis of 40 patients who underwent exploratory tympanotomy for suspected otosclerosis was conducted. Preoperative tympanometry and HRCT findings were compared to intraoperative confirmation. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. McNemar’s test assessed statistical significance. Results: Tympanometry had high sensitivity (78.13%) but low specificity (50%), whereas HRCT had lower sensitivity (43.75%) but higher specificity (62.6%). Combining both improved specificity (75%) but reduced sensitivity (37.5%). PPV remained high (85.7% for the combined test), indicating strong predictive value when both tests were positive. However, NPV was consistently low, limiting their reliability in ruling out otosclerosis. Statistical analysis showed no significant change in diagnostic accuracy when combining tests. Conclusion: Tympanometry is useful for screening, while HRCT aids in confirmation. However, neither test alone nor in combination reliably excludes otosclerosis due to low NPV. Preoperative HRCT interpretation should involve experienced radiologists, and emerging imaging techniques may enhance diagnostic accuracy.