Introduction: Mucormycosis is a rare clinical entity and often affects immunocompromised patients. It is caused by the fungus of the order Mucorales. Rhizopus species are the most common causative organism associated with mucormycosis. It is an emergency situation and has poor prognosis.Materials and Methods: A retrospective study included eight patients with head-and-neck mucormycosis diagnosed over a 3-year period from December 2016 to March 2019. Results: There are five male and three female patients, aged from 29 to 65 years. Out of eight patients, four were diabetic and the rest were with hematological disorders. There were five sinonasal mucormycosis and three nonsinonasal involvement. Diagnoses were confirmed by histopathological examination. Two cases were fatal due to cerebral involvement.Conclusion: Prompt diagnosis with tissue biopsy, local control of the disease by aggressive surgical debridement, and appropriate systemic antifungal treatment improve the prognosis and survival of the patients. Treatment of mucormycosis needs antifungal agents such as amphotericin B and wide surgical debridement. Early diagnosis and treatment is often needed for survival of the patients.

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Foreign body (FB) sensation in the throat is often a common symptom encountered in clinical practice. FB sensation in throat has numerous causes. Long-standing FB in the soft tissue of the neck is sometimes asymptomatic and presents only with throat irritation or FB sensation, although it is an extremely rare incidence. The diagnosis of this clinical event is based on the clinical presentations and imaging. The treatment is done by securing the airway, removal of FB, and antibiotic coverage. Here, we report the case of a 16-year-old boy presenting with chicken bone embedded in the soft tissue of the posterior pharyngeal wall and retropharyngeal space for 2 months in the throat without any major symptoms except FB sensation. Imaging confirmed the diagnosis of chicken bone in the retropharyngeal space with mild abscess formation, which was removed by transoral approach.

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Osteoclastoma or giant cell tumor is an uncommon neoplasm of the bone. Common sites for osteoclastomas are long bones. Osteoclastoma of the craniofacial bones is extremely rare clinical entity. Here, we are reporting a case of osteoclastoma originating from the left maxilla presenting with swelling at the left nasolabial area with nasal obstruction. He had undergone complete excision of the tumor under general anesthesia. During the postoperative period, the patient did well without any evidence of recurrence or metastasis for 1-year follow-up.

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Context and Aim: Complications related to maxillary sinuses are often related to their anatomic and pathologic variations and their close approximation to the tooth roots. It, thus, becomes important to study these sinuses even in situations when the patients reporting for dental complaints are asymptomatic for the sinuses. In the present scenario, cone-beam computed tomography (CBCT) has emerged as the standard imaging modality for bone and soft-tissue abnormalities offering multiple views with thin sectioning. The aim of the present study was to detect the prevalence of pathologic findings in maxillary sinuses in patients who were asymptomatic for the sinuses using CBCT. Materials and Methods: CBCT scans of 150 patients between the ages of 18 and 70 years reporting for routine dental complaints were analyzed for detecting pathologic findings in the maxillary sinuses. Statistical Analysis Used: The data were analyzed using the SPSS software version 15.0 (SPSS Inc., Chicago, IL, USA). Distribution of the overall prevalence of pathologic findings according to age and sex were calculated using the Chi-Square test whileP < 0.05 was considered to be statistically significant. Results: Overall prevalence of pathologic findings was found to be 58%, with the prevalence of mucosal thickening (MT) being 29.3%, polypoidal MT, 36.7%, partial opacification with liquid accumulation, 2%, complete opacification, 0.7%, and miscellaneous findings as 0.7%. Conclusion: The present study highlighted the clinical implications, dental pathologies might have, in relation to the maxillary sinuses underlying the significance of their accurate assessment in the perspective of dental and maxillofacial and ENT problems with a multidisciplinary approach of treatment for the successful treatment of chronic sinus pathoses.

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Plasma cell disorder spectrum ranges from the benign plasma cell granuloma to malignant multiple myeloma characterized by the monoclonal proliferation of plasma cells. Multiple myeloma with temporal bone involvement is a rare entity and may present with nonspecific otological symptoms similar to chronic ear disease leading to a diagnostic challenge. Suspicion of multiple myeloma involving temporal bone primarily is difficult, and most of the cases are diagnosed after initial surgical excision. The differential diagnosis includes temporal bone carcinoma and glomus tumor due to similar radiological features. The final diagnosis is, however, made by the histopathological and immunohistochemical analysis. The mainstay of treatment of multiple myeloma is chemotherapy; however, surgical excision of the lesion is warranted in cases of pressure symptoms and intracranial involvement. We present a case who presented with ear canal mass, facial palsy, and cerebellar symptoms and was diagnosed to be a case of multiple myeloma with temporal bone involvement and was treated successfully. He is on regular follow-up for 1 year and remains in complete remission.

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Aspergillosis of the palatine tonsils is extremely rare. Immunodeficiency is an important risk factor for causing aspergillosis. The diagnosis of aspergillosis of the palatine tonsil may be overlooked in immunocompetent patients as it is often seen in immunocompromised. This lesion often mimics to the malignancy or premalignant lesion. Awareness of this lesion is required among the clinician for early treatment which depends on accurate diagnosis. Isolated aspergillosis of the palatine tonsils invariably responds well to antifungal therapy with the eradication of the risk factors. The definitive diagnosis is usually done by tissue biopsy and histopathological examination. Here, we reported a case of isolated aspergillosis of the palatine tonsil without involving the other parts of the pharynx and larynx and without any generalized immune deficits in a 42-year-old male. The patient was treated by antifungal agents.

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Context: Deep neck space infection is a potentially morbid condition characterized by pus collection in various potential and true spaces of the neck. With this study, we attempt to highlight, the changes in etiological factors in the current scenario, and management protocols for deep neck space infections. Furthermore, we studied the prevalence of antibiotic resistance in isolated microorganisms. Aims: To study the etiology, antibiotic sensitivity pattern, and management of deep neck space infections in adults and pediatric patients. Settings and Design: A retrospective analysis of patients undergoing surgical management of deep neck space infections at a tertiary care institute in India. Subjects and Methods: Analysis of records of 222 patients who underwent surgical management for deep neck space infections was done. All the patients received empirical antibiotic therapy within 30 min of hospital admission. The patients treated with conservative management were excluded from the study. Cultures and antibiotic sensitivities were obtained for patients undergoing surgical management. Results: Dental infection (52%) was the most common predisposing factor for deep neck space infections in adults followed by diabetes mellitus (28.2%). Multispace involvement was the most common presentation followed by parapharyngeal space involvement. The majority of the cultures were sterile (42.6%). The most common pathogen on cultures was Staphylococcus aureus (13.1% in adults and 47.4% in pediatric age group). The incidence of methicillin-resistant S. aureus (MRSA) was 22.7%, which was lower than what has been observed in the previous studies. Klebsiella pneumoniae isolates were found to have high incidence of resistance to cefotaxime (50%), cefepime (38.5%), and ceftazidime (75%). Complications were seen in 4.5% (n = 10) of patients with an overall mortality of 0.9% (n = 2). Conclusions: In view of comparatively lower incidence of MRSA, combination of amoxicillin-clavulanic acid along with clindamycin is a reasonable first-line antibiotic therapy for deep neck space infections. In patients with diabetes, amikacin or piperacillin-tazobactam can be added to the regime, as there is a higher incidence of infection by K. pneumoniae. Surgical management remains the mainstay of treatment and is associated with improved outcome.

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Background: Asymmetrical sensorineural hearing loss is usually idiopathic. Vascular loops are commonly implicated in compression disorders involving lower cranial nerves, which can be relieved on surgical decompression. However, the cause–effect relationship between vestibulocochlear symptoms and vascular loops is still controversial. Objective: The objective of this study is to look for an association between the presence of anteroinferior cerebellar artery (AICA) loops and asymmetrical sensorineural hearing loss of unknown etiology. Methods: Twenty-four patients with complaints of asymmetrical hearing loss of no discernible cause underwent a magnetic resonance imaging of the brain between August 2015 and August 2017. The AICA loops were graded using two classifications, namely Chavda classification and a grading system proposed by Adam Gorrie et al. (second classification). The vascular loops were correlated with the presence of hearing loss, tinnitus, and vertigo. Results: Hearing loss did not correlate significantly with the vascular loops on grading with either Chavda or the second classification. The presence of tinnitus or vertigo too did not correlate significantly with the grading of vascular loops. The caliber of AICA too did not correlate significantly with hearing loss. Conclusion: Vascular loops do not appear to be associated with asymmetrical hearing loss and other cochleovestibular symptoms.

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Introduction: Nasal septal deviation is a common diagnosis made by an otorhinolaryngologist, and septoplasty or submucous resection is among the most common daycare procedures practiced in the clinic. Aims and Objectives: The aim of this study was to assess clinically if at all, there is any change in the symptoms of a person post an isolated septal surgery without dealing with the external contour and cosmetic appeal. Materials and Methods: One hundred patients with complaints of nasal obstruction, trouble breathing through the nose, and headache were selected for the study. The initial preoperative assessment was done based on a symptomatic score (Nasal Obstruction Symptom Evaluation Scale [NOSE]). The presence of a septal deviation (cartilaginous or bony) was confirmed with a computed tomography of the paranasal sinuses and a diagnostic nasal endoscopy. Surgery was then performed to correct the pathology based on the location of the deviation. The postoperative assessment was done after 12 weeks based on the NOSE Scale. The results were analyzed and documented. Observations and Results: It was found that the symptomatic picture was better post surgery. Conclusion: The conclusion obtained from the study was that septoplasty and submucous resection as isolated surgical procedures are still relevant in today's world for symptomatic betterment and a healthier lifestyle.

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Objective: This study aimed to evaluate the etiology, clinical profile, morbidity, diagnosis, and management of vertigo among elderly patients at a tertiary care teaching hospital of Eastern India. Materials and Methods: Seventy-two elderly patients were diagnosed as cases of peripheral vertigo above the age of 60 years enrolled in this study. The detailed etiology, clinical presentations, diagnostic methods, and treatment were assessed. Results: The most common peripheral vestibular disorders were benign peripheral paroxysmal positional vertigo (38.38%), idiopathic vestibulopathy (9.72%), migraine-related vertigo/migraine vestibulopathy (26.38%), Meniere's disease (5.55%), and acute vestibular neuritis (6.94%). Diabetes mellitus is a common systemic disorder associated with elderly vertigo patient. Mental disorders such as anxiety (18.05%), depression (15.27%), and phobia (12.5%) were seen in this study among elderly vertigo patients. Conclusion: This retrospective study revealed that 72 of elderly patients had been diagnosed with peripheral vertigo. The majority of vertigo patients are of benign paroxysmal positional vertigo with unilateral horizontal canal involvement among elderly patients in this study, followed by migrainous vestibulopathy, idiopathic vestibulopathy, and vestibular neuritis. Proper diagnosis and management help to make a better and quality life in elderly patients suffering with vertigo.

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Background: Thyroid swellings are commonly encountered in the surgical practice and accurate preoperative evaluation of thyroid disorder becomes mandatory for proper management of the patient. Aims and Objectives: To evaluate the clinical and radiological features of thyroid nodule with thyroid surgery. Materials and Methods: A total of 60 patients were included with more than 15 years of age presented with thyroid nodule. Results: Fifty three patients were females and seven were males with goitre duration of 6-60 months and presented with progressive increase in the size of the goitre. After clinical evaluation majority of patients were diagnosed as STN. According to ultrasonography, 58 patients were diagnosed as benign lesions while 2 patients were diagnosed with malignant lesions. According to FNAC, maximum number of patients i.e., 37 were diagnosed with colloid goitre while 2 patients had malignant lesions. On histopathological examination, 58 patients were diagnosed with benign lesions while 2 were diagnosed with malignant lesions. USG findings were correlated with thyroid surgery, Among 60 patients of thyroid nodule. 56 patients underwent hemi thyroidectomy.in which 34 were right thyroidectomy and 22 were left thyroidectomy and 4 patients underwent total thyroidectomy. One patient of total thyroidectomy was develop recurrent laryngeal nerve palsy. Conclusion: USG and FNAC has been shown to be more sensitive, specific and accurate than either technique alone but high resolution USG has important and cost effective investigation to decide the extent and type of surgery of thyroid nodules.

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Aims: To test the validation of the European Organization for Research and Treatment of Cancer (EORTC) quality of life questionnaires (QLQs), the core module QLQ-C30, and the head and neck module QLQ-H and N35 in a tertiary care center. Materials and Methods: Forty head-and-neck cancer patients completed the QLQ-C30 and the QLQ-H and N35 during their treatment. Questionnaires given to them were translated into their regional language Kannada. Evaluation of the responsiveness, reliability, and validity of the questionnaire was undertaken. Results: The data support the reliability of the scales. Validity cannot be assessed. The questionnaire was responsive to change over a period of time; however, the applicability of the European questionnaire in Indian clinical setup is debatable. Summary: This data suggest that the EORTC QLQ-C30 and the QLQ-H and N35 are reliable and responsive when applied to a sample of head-and-neck cancer patients in India. Hence, it can be used as a platform to test validity at a multicentric level. Conclusion: Both the questionnaires are equally effective, the newer one providing more insight however few items maybe irrelevant in Indian context.

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