Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery

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Context: Deep neck space infections (DNSIs) are unique among infectious diseases for potential life-threatening complications. Its early recognition is therefore challenging and a high index of suspicion is necessary to avoid any delay in treatment. Aims: This study aims to analyze the age, sex, source, nature, associated systemic conditions, neck spaces involved, and the bacteria isolated in patients with DNSIs. Settings and Design: A prospective, descriptive study was conducted in the Department of ENT and HNS, B.P. Koirala Institute of Health Sciences, Dharan, Nepal for a period of 2 years from August 2014 to July 2016. Subjects and Methods: All patients with DNSI who required hospitalization were included, whereas those with superficial skin soft-tissue infections, infections due to traumatic or surgical wounds or tumors were excluded. Statistical Analysis Used: The data were recorded on a pro forma and analyzed using Microsoft Excel 2007 (Microsoft, WA, USA). Results: Out of the 76 patients, 25 patients were >50 years of age (32.89%). Male: female ratio was 1:1.17. The most common source was dental infection occurring in 32 cases (42%). Diabetes mellitus was the most common associated systemic condition (4 cases). Submandibular and peritonsillar spaces were most commonly involved. A sterile culture was seen in the majority (18/32). Staphylococcus aureus and Escheria coli were the predominant bacteria isolated. Conclusions: DNSI is a common condition in the elderly populations. Odontogenic infection and diabetes mellitus are the predisposing factors. S. aureus and E. coli are the common causative agents.

Inherited systemic hyalinosis is a rare autosomal recessive disorder affecting the mutation in gene ANTXR2. Since this entity was first described in 1978, many authors tried to differentiate two distinct entities: severe form as infantile systemic hyalinosis and milder form as juvenile hyaline fibromatosis. As more cases beginning to appear, it was recognized that these two entities are two ends of the spectrum of the same disease process. Now, there is a general consensus of grouping these entities together under the term inherited systemic hyalinosis. In this genetic disorder, the role of the surgery is limited to improve the quality of life only. We report a case of inherited systemic hyalinosis who presented to us at the age of 3 years and had surgery at the age of 7 years and 8 years, with a follow-up of 2 years postsurgery.

Mondini deformity accounts for majority of cochlear malformations. These children can be given a near-normal lifestyle by performing cochlear implant (CI) surgery. The results of standard incision cochlear implantation (SICI) in these children are very encouraging. However, there are very few centers in world which offer the minimal incision cochlear implantation (MICI) in these patients. We report a case of 2-year-old child suffering from Mondini deformity who underwent CI with MICI. MICI reduces the impact of surgery drastically in these children as it can be performed without shaving of hairs with a 2-cm incision. The complication rate of MICI is comparable to SICI. Apart from better cosmesis, another advantage is early switch on of the device. We are of the opinion that MICI is safe and can be successfully performed in cases of Mondini deformity without any fear.

Choristoma is a tumour like mass which is an island of normal cells or tissues in abnormal locations due to defects during embryological development. Choristoma is most frequently seen in the tongue and presence of choristoma in the tonsil is extremely rare. On histopathological examination, an island of mature cartilage with normal appearing chondrocytes amidst the lymphoid follicles were seen. We present here a case of cartilaginous choristoma with the complaint of chronic tonsillitis.

Online since 12^th Sep, 2016