ABSTRACT

Introduction: A very well-known fact which is always in mind of clinician before using higher dose of steroid or for longer duration is the adverse effect of it and direct steroid delivery to the inner ear using intratympanic injection would not only achieve higher concentration of steroid in inner ear but also at the same time, it limits systemic side effects at a relatively much lesser dose. The study has been done to evaluate the role of intratympanic dexamethasone for the treatment of tinnitus in SNHL not responding to oral medications.
Materials and Methods: This prospective interventional study has been done in the Department of Otorhinolaryngology, Government Medical College and Susheela Tiwari Government Hospital, Haldwani, Nainital, Uttarakhand. The study included 50 patients SNHL with tinnitus not responded to oral medication for at least 6 weeks. All patients were divided into two groups. The first group received intratympanic dexamethasone and the second group did not receive it.
Results: There was a significant improvement seen in 52% of patients after treatment with intratympanic dexamethasone, whereas only 12% improvement was seen in the other group.
Conclusion: Intratympanic dexamethasone treatment is a simple officebased procedure with satisfying results in cases of sudden sensorineural hearing loss with tinnitus.

KEY WORDS: Dexamethasone, intratympanic injection, sudden sensorineural hearing loss, tinnitus
How to cite this article: Ahmad S. Role of intratympanic dexamethasone in patients presenting with sensorineural hearing loss and tinnitus not responding to oral medications. Int J Adv Integ Med Sci 2019;4(1):1-3.

Source of Support: Nil,

Conflicts of Interest: None declared.

Received: 14-03-2019

Accepted: 22-04-2019

ABSTRACT

Introduction: Rhinogenic contact point headache (RCPH) is due to contact between adjacent nasal mucosa causing mechanical and chemical changes leading to referred headache. It generally remains undiagnosed and is commonly mistreated with selfmedication chronically without substantial benefit. Such a headache is generally refractory to medical management and causes a chronic agony to the patient and the treating clinician.
Aim: The aim of the study was to find out the most common mucosal contact points in the nose and to evaluate the usefulness of surgical outcome in patients with RCPH which is unrelated to active inflammatory or allergic pathology
Materials and Methods: A total of 120 patients were selected after clinical and radiological evaluations having a headache due to rhinogenic mucosal contact points. Headache parameters were recorded in terms of intensity, duration, and frequency and then correlated at 1, 6, and 12 months after surgery. The outcome of surgery was then evaluated statistically.
Observation and Results: The patients with septal spur and concha bullosa had a more severe headache than in deviated nasal septum and other conditions. Overall, 89.16% of patients showed improvement in headache after surgery while 10.84% could not appreciate any benefit. There was substantial relief in symptoms soon after surgery but the complete effect of surgical outcome was evident at a longer follow-up of 1 year.
Conclusion: Our results suggested that surgical correction of nasal mucosal contact points can be very helpful in a headache which is not usually diagnosed or treated by medical management.

KEY WORDS: Anatomical variation, concha bullosa, endoscopy, paradoxical turbinate, rhinogenic contact point headache, rhinogenic headache, septal spur
How to cite this article: Chandra S, Rana AK, Srivastava A, Sharma CM. Refractory rhinogenic contact point headache: Causes and role of surgical management. Int J Adv Integ Med Sci 2019;4(1):4-10.

Source of Support: Nil,

Conflicts of Interest: None declared.

Received: 22-03-2019

Accepted: 11-04-2019

ABSTRACT

Introduction: Actinomycosis is a slowly progressive infection Gram-positive, nonspore forming, non-acid-fast, anaerobic, or microaerophilic endogenous bacterium of genus Actinomyces. They are commonly found in the saliva and dental plaque. Actinomyces israelii is the most frequently isolated species.
Case Report: A 60-year-old male patient presented in the head-and-neck oncology clinic with a history of non-healing lesion in oral cavity for the past 1 month. On examination, he was partially edentulous and an ulcerative lesion was present on the hard palate. On digital palpation, the hard palate detached itself and came out of the oral cavity spontaneously. Histopathological examination of the specimen showed filament-like structures which were positive with periodic acid-Schiff and pointed to a diagnosis of actinomycosis.
Discussion: It is very rare to find actinomycosis involving hard palate and limited number of literature is available. The bacteria are a common commensal of the oral cavity and seldom known to cause any active infection. Antibiotic of penicillin group is the main line of the treatment of actinomycosis.
Conclusion: In clinical practice, one should always propose a differential diagnosis in any case and final diagnosis should be made only after histopathological report. The treatment of actinomycosis is long-term antibiotic with regular follow-up.

KEY WORDS: Actinomyces, hard palate, microaerophilic bacteria
How to cite this article: Sharma S, Agarwal A, Garg C, Gupta S, Mohan C, Srivastava A. Actinomycosis of the hard palate – A rare presentation. Int J Adv Integ Med Sci 2019;4(1):11-13.

Source of Support: Nil,

Conflicts of Interest: None declared.

Received: 17-03-2019

Accepted: 29-04-2019

ABSTRACT

Thyroglossal duct cysts are the most common cystic midline lesion in children and young adults. The location of the lesion and its cystic appearance easily lead to the diagnosis on ultrasonography in most of the cases. Uncommon presentations include infection, hemorrhage or neoplastic change. In cases presenting with uncommon features, cross sectional imaging modalities like CECT / CEMRI are needed for diagnosis.

KEY WORDS: CECT, cyst, midline, Thyroglossal duct, ultrasound
How to cite this article: Kushagra, Kumar M, Singh SK, Sharma H, Kumar L. Thyroglossal duct cyst: Common and uncommon presentations. Int J Adv Integ Med Sci 2019;4(1):14-17.

Source of Support: Nil,

Conflicts of Interest: None

Received: 24-03-2019

Accepted: 07-04-2019

ABSTRACT

Leiomyomas of the extremities are very rare and more so deep leiomyomas of the upper limbs. The literature mentions very few cases of deep soft-tissue leiomyomas of the upper limb. Leiomyomas represent 4.4% of all benign soft-tissue tumors. These are mainly of four types: Cutaneous, vascular, and those arising from deep soft-tissues. A case of soft-tissue leiomyoma of the forearm eroding midshaft of ulna is presented here and its radiological and histopathological correlations are discussed. A young female presented with a soft-tissue swelling of 1 year duration on the right forearm which turned out to be leiomyoma. The case is being presented for its extreme rarity and probability of misdiagnosing such tumors.

KEY WORDS: Immunohistochemistry, leiomyoma, soft-tissue tumor, wide excision
How to cite this article: Abbey RK, Mittal K, Goyal K, Kalia S. Leiomyoma of the upper extremity: A very rare presentation and review of literature. Int J Adv Integ Med Sci 2019;4(1):18-21.

Source of Support: Nil,

Conflicts of Interest: None declared.

Received: 04-04-2019

Accepted: 14-04-2019

ABSTRACT

Sturge–Weber syndrome is a rare congenital neurocutaneous disease. The incidence of Sturge–Weber syndrome is 1 in 50,000 live birth with somatic single nucleotide variant mutation in the GNAQ gene. It is commonly associated with port-wine stains of the face, glaucoma, convulsions, intellectual disability, headache, and hemiparesis. Sturge–Weber syndrome has features such as facial capillary malformation, ipsilateral leptomeningeal angioma, and calcifications on CT head. It carries a poor prognosis and needs a multidisciplinary approach for the management.

KEY WORDS: Capillary malformation, neurocutaneous disorder, port-wine stain, Sturge–Weber syndrome
How to cite this article: Ahuja A, Bhambri A, Ahmed SM. A rare case of Sturge–Weber syndrome: A Case report. Int J Adv Integ Med Sci 2019;4(1):22-24.

Source of Support: Nil,

Conflicts of Interest: None

Received: 26-03-2019

Accepted: 09-04-2019

ABSTRACT

Introduction: Chronic giant cell granulomata represent the typical response of the body to a varied range of noxious or irritant agents acting at a low level of toxicity. Surprising that two substances made by the organism itself, keratin and sebum, are among the most potent granuloma producers. Oleo-keratin granulomatosis of the peritoneum represents the typical response of the body (peritoneum) to the sebum.
Case Study: A young nulliparous female with complaints of abdominal distention and fever. On examination, the patient was conscious, well oriented with stable vitals. Mild pallor was present. On P/A, there was distention with a suprapubic bulge of 12 × 10 cm in the lower abdomen extending up to the umbilicus. The mass had restricted mobility, non-tender, variegated in consistency, with ill-defined margins. On P/S examination, thick mucoid discharge was present. P/V examination showed normal size retroverted uterus. On p/R examination, rectal mucosa was free.
Conclusion: Dermoid cyst is the most common benign tumor of the ovary, occurring in the reproductive age group. The malignant change in this benign tumor is very rare (approx. 1%) and the usual malignancy is squamous cell carcinoma and sarcoma if at all. The clinical picture of leaked/ruptured dermoid cyst produces a clinical picture of malignancy. The prognosis of this condition is otherwise quiet good, but the presentation is unique and occurrence quite rare.

KEY WORDS: Adhesions, oleo-keratin granulomatosis, ovary, peritoneum
How to cite this article: Dhawan S, Gupta R, Aparajeeta K, Gupta S, Dalmia K. Oleo-keratin granulomatosis of the peritoneum: A rare case. Int J Adv Integ Med Sci 2019;4(1):25-27.

Source of Support: Nil,

Conflicts of Interest: None declared.

Received: 16-03-2019

Accepted: 28-03-2019