Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery

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Facial nerve paralysis is the most severe form of cranial neuropathy that causes facial deformity. Late-onset or delayed facial nerve palsy is uncommon following tympanomastoid surgery, although it can occur up to 2 weeks following the procedure. Although pinpointing the specific reason for delayed facial nerve paralysis following tympanomastoid surgery is complex, several variables such as facial nerve injury and/or viral reactivation can play a role. Late facial nerve paralysis after tympanomastoid surgery is caused by exposure of the facial nerve and fallopian canal dehiscence. Late facial nerve paralysis may be produced by viral reactivation and damage to the chorda tympani nerve. This study aims to look at the prevalence, etiology, clinical signs, diagnosis, and current treatment options for delayed facial nerve paralysis following tympanomastoid surgery. The exact cause of delayed facial nerve paralysis after tympanomastoid surgery has significant consequences for therapy and prognosis. The use of steroid and antiviral drugs is helpful for the treatment of the delayed facial nerve paralysis due to viral reactivation. The overall prognosis of the delayed facial nerve paralysis following tympanomastoid operation is good. This article discusses the prevalence, etiopathogenesis, clinical features, diagnosis, and present treatment of late/delayed facial nerve palsy following the tympanomastoid operation.

Schwannoma is a benign nerve sheath tumor whose the most common site is the vestibulocochlear nerve. Sinonasal schwannoma is rare and septal schwannoma is even more rarer. We report a endonasal endoscopic-guided excision of the left nasal cavity mass attached at the nasal septum in a 59-year-old female which on histopathological examination was confirmed as schwannoma.

Introduction: The Sino-nasal outcome test-20 (SNOT-20) questionnaire contains 20 items provided with a 6-point Likert scale and are aimed at measuring rhino-sinusitis specific and general symptoms; however, no Bengali version is available. Aims and Objectives: We aimed to develop SNOT-20 Bengali version (SNOT-20-B) and examine its cross-cultural adaptability considering linguistic equivalence in patients suffering from chronic rhino-sinusitis. Materials and Methods: A cross-sectional study was conducted on 270 patients by consecutive sampling at the ear-nose-throat outpatient of National Institute of Homoeopathy, Kolkata. The SNOT-20-B was produced by standardized forward-backward translations. Construct validity was examined by the exploratory factor analysis (n = 150) using the principal component analysis (varimax rotation). Subsequently, confirmatory factor analysis (CFA; n = 120) was performed to verify model fit. Concurrent validity was checked by correlating SNOT-20-B score with simultaneously measured EQ-5D-5 L scores. Observations and Results: Internal consistency (Cronbach's α =0.860; 95% confidence interval 0.834, 0.883) and test-retest reliability (P > 0.05) both were satisfactory. Concurrent validity was agreeable (P = 0.007). In factor analysis, all the items loaded above pre-specified value of 0.4 and identified 6 components, explaining 67.8% of variation. The goodness-of-fit in the CFA model was acceptable (χ² = 517.396, P < 0.001; Comparative Fit Index = 0.634, Tucker Lewis Index = 0.551, root mean square error of approximation = 0.140, standardized root mean square residual = 0.298). Conclusions: SNOT-20-B, consisting of 20 items and framed within six components, appeared to be a valid and reliable questionnaire but measured different dimensions from the English version.

Objective: The salivary gland tumors or otherwise called the “unusual tumors” are aptly named. The aim of this study was to determine the types, frequency, distribution, and demographic characteristics and treatment–outcome aspects of salivary gland tumors in a large representative sample from southern peninsular India. Thereby, an attempt was made to understand to why are they actually called unusually presenting usual tumors. Materials and Methods: This original article is a retrospective study regarding a 17-year single institutional experience of these tumors with yet again unusual patterns of presentations. This work was harvested from an oncological unit in the southern part of India, the Royapettah Govt Hospital. Medical records from 2002 to 2019 of salivary gland tumor patients were compiled to derive the data and analyzed. Statistical Analysis Used: The data were grouped and analyzed using simple measures of central tendency, percentages, and represented in tables and graphs. Results: There are some similarities but more dissimilarities with respect to their presentation. Males outnumbered females. Malignant tumors outnumbered benign tumors. However, the most common benign and malignant tumors were similar to the rest of the world. Conclusion: A much confluent and in-depth analysis from other parts of India as well as other regions of the Asian subcontinent and world needs to be done to understand the behavior of these usual tumors presenting unusually.

Aims: Operating under personal protective equipment (PPE) has become the new norm. This study aims at assessing how the ear, nose, and throat surgeons coped with the changes, with tracheostomy as the procedure of interest. Materials and Methods: Chart review of 30 patients who underwent tracheostomy from March 23, 2020, to December 31, 2020, was done. A questionnaire was given to the senior residents in charge of the procedures after each tracheostomy and their experience on the various aspects of the procedure. The responses were compiled and various factors affecting the surgical experience and outcome were analyzed. Results: Vast majority of patients underwent tracheostomy for prolonged intubation (90%), which made preoperative assessment of cases difficult. The average time was 12.33 ± 2.54 min. Delay in procedures and difficulties of operating under PPEs made COVID-positive tracheostomy challenging. Conclusions: It is possible to perform aerosol-generating procedures safely with adequate protective gears. Tracheostomy in COVID-19 patients needs to be after careful considerations by intensive care specialists and streamlining of various logistical factors is very essential for effective utilization of Operation theatre and surgeons' time.

Online since 12^th Sep, 2016