International Journal of Head and Neck Surgery

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2020 | January-March | Volume 11 | Issue 1

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Original Article

Himani Dhingra, Dinesh Madhur, Vikrant Kamboj, Sharad Hernot, Sachin Kadam, Rigved Nittala, Mohit Pareek

Epidemiological Study of Different Syndromes in 300 Deaf and Mute Children

[Year:2020] [Month:January-March] [Volume:11] [Number:1] [Pages:5] [Pages No:1 - 5]

Keywords: Childhood deafness, Deafness epidemiological profile, Syndromic hearing loss

   DOI: 10.5005/jp-journals-10001-1354  |  Open Access |  How to cite  | 


Objective: To study the epidemiological aspects of syndromic hearing loss (HL) in deaf and mute children below 15 years of age. Materials and methods: The study “Epidemiological study of different syndromes in 300 deaf and mute children” was conducted on 300 deaf and mute children below 15 years of age at Rohtak (Haryana) from August 2013 to July 2014. Three hundred deaf and mute candidates were included in the study from various schools for deaf and mute children in the Rohtak city and deaf and mute children attended the ENT outdoor at the Department of Otolaryngology and Head and Neck Surgery, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, for the evaluation of their deafness. Information regarding patient's age, sex, religion, age of presentation, residence, family history of deafness, consanguineous marriage in the family, socioeconomical status of the family, literacy and occupation of the parents, and developmental history of the candidate was recorded from the parents and guardians using a standard questionnaire. Audiological tests were done to determine the type and the degree of HL. Results: Out of 300 deaf and mute children, syndromic HL was found in 44 cases (14.66%). Most common systems involved in syndromic HL were ocular in eight patients (18.18%) followed by skeletal in four patients (9.09%) and craniofacial malformation in four cases (9.09%). Out of 300 deaf and mute cases, well-recognized syndromes were found in five cases (1.66%) and the most common syndrome found was Waardenburg's syndrome (2 cases). In the 44 syndromic HL cases, 36 patients were males (81.81%) and 8 patients were females (18.18%). Out of 44 syndromic HL cases, 42 (95.45%) were Hindu by religion and 2 (4.54%) were Muslim. Residence wise, 20 patients (45.45%) were from a rural area and 24 patients (54.54%) were from an urban area. Out of 44 syndromic HL cases, fathers were illiterate in 5 cases (11.36%), while mothers were illiterate in 23 cases (52.27%), while fathers were educated in 39 cases (88.63%) and mothers were educated in 21 cases (47.72%). By occupation, fathers were laborers in 25 cases (56.81%) and mothers were housewives in 38 cases (86.36%). Socioeconomically, 31 patients (70.45%) were from the lower–middle and middle socioeconomical status, while 11 cases (13.63%) were from the lower socioeconomical status. History of consanguineous marriage was present in two cases (4.54%). Both these cases were Hindu by religion. Family history (genetic etiology) of HL was present in six cases (13.63%) and acquired cases were found in nine cases (20.45%). In 29 cases (65.90%), no etiology was found. Conclusion: From the above results, we can see that syndromic HL is more common in the male urban child. Mothers who are illiterate and housewife are a risk factor for deafness. Syndromic HL is more common in the lower and lower–middle socioeconomical status families. Any newborn with ocular skeletal and craniofacial abnormalities should be urgently evaluated for deafness.


Original Article

Shahid Rasool, Rafiq A Pampori, Sabhiya Majid, Hilal Wani, Rabiya Farooq, Suhail Patigaroo

Comparison between ELISA and PCR for Detection of Epstein-Barr Virus in Head and Neck Malignancies

[Year:2020] [Month:January-March] [Volume:11] [Number:1] [Pages:6] [Pages No:6 - 11]

Keywords: ELISA for Epstein-Barr virus, Epstein-Barr virus, Head and neck carcinomas, Laryngeal carcinomas, Oral tumors, PCR for Epstein-Barr virus

   DOI: 10.5005/jp-journals-10001-1389  |  Open Access |  How to cite  | 


This is a comparative prospective study conducted for a period of 2 years from December 2012 to December 2014 in the Postgraduate Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College, Srinagar, in collaboration with the Department of Biochemistry. A total of 118 subjects were enrolled in the study design, which included 98 histopathologically confirmed head and neck malignant cases and 20 healthy controls. The aim of the study was to compare the ELISA with polymerase chain reaction (PCR) for detection of Epstein-Barr virus (EBV) in head and neck carcinoma cases and compare such results with controls. Results: Around 32.65 and 42.85% of patients were positive for EBV with PCR and ELISA, respectively. When these results were compared with controls, it showed statistically significant results; only 5% of subjects in controls were positive for EBV (p value = 0.015) with PCR while as many as 15% with ELISA (p value = 0.049). The sensitivity and specificity of ELISA are 100 and 84.85%, respectively, with diagnostic accuracy of the test 89.8% (Cohens κ value = 0.7853).



R Lakshmi Menon, M Muniraju

A Rare Case of a Giant Congenital Multinodular Goiter with Intrathyroidal Parathyroid Adenoma

[Year:2020] [Month:January-March] [Volume:11] [Number:1] [Pages:4] [Pages No:12 - 15]

Keywords: Congenital goiter, Huge goiter, Intrathyroid adenoma, Parathyroid adenoma, Thyroid

   DOI: 10.5005/jp-journals-10001-1387  |  Open Access |  How to cite  | 


Aim: To highlight the management of huge multinodular goiters and report a rare case of intrathyroidal parathyroid adenoma. Background: Goiter is an abnormal enlargement of thyroid gland. Huge goiters are a surgical challenge due to possible difficulty in intubation, tracheomalacia, retrosternal extension and distorted anatomy. Goiters associated with congenital hypothyroidism undetected at birth leads to permanent neurological deficits. This case report highlights a case of huge multinodular goiter with a rare intrathyroidal parathyroid adenoma detected on histopathology. Case description: This case report deals with a 27-year-old male patient, presenting with huge hypothyroid multinodular goiter weighing 750 g with no compression symptoms. He had low IQ probably due to undetected hypothyroidism at birth. His postoperative histopathology report showed an intrathyroidal parathyroid adenoma which is an extremely rare tumor. Conclusion: This report aims to emphasize the existence of congenital hypothyroidism and also that huge goiters when dissected meticulously may be removed without any major complications. We also report an incidental finding of rare intrathyroidal parathyroid adenoma. Clinical significance: Neonatal screening of hypothyroidism and its subsequent treatment can prevent mental retardation. We would also like to emphasize the importance of preoperative serum parathormone and calcium levels in all patients undergoing thyroidectomy to detect asymptomatic parathyroid adenomas.



Manas R Rout

Kuttner's Tumor of Submandibular Gland: A Case Report

[Year:2020] [Month:January-March] [Volume:11] [Number:1] [Pages:3] [Pages No:16 - 18]

Keywords: Salivary gland, Sialoadenitis, Sialometaplasia

   DOI: 10.5005/jp-journals-10001-1357  |  Open Access |  How to cite  | 


Kuttner's tumor is called chronic sclerosing sialadenitis is a chronic inflammatory condition affecting the salivary glands. This is relatively rare in occurrence, and more important is that it is under-recognized and under-reported. A 71-year-old male patient came to our ENT outpatient department with complaints of swelling in the right submandibular region for 2 months, which was painless and insidious in onset growing slowly to attend the present size. The patient was hypertensive and nondiabetic. On local examination, there was a swelling of size 4 cm × 4 cm confined to the right submandibular triangle. The mass was firm in consistency, nontender with irregular surface, and not fixed to the skin or underlying structures. The mass was palpable bimanually. Skin over the swelling was normal. Clinically, the patient was diagnosed as “chronic submandibular adenitis” and sent for fine needle aspiration cytology (FNAC) and ultrasonogram (USG) of the neck. FNAC came as chronic adenitis of submandibular gland (right). USG neck came as submandibular adenitis (right). So the right submandibular gland was excised under general anesthesia and sent for the histopathological study. The microscopic study reported as Kuttner's tumor (chronic sialadenitis with sialometaplasia). This is a rare benign condition of the submandibular gland simulating a tumor and is because of chronic inflammation. This case is presented here because of its rare occurrence.



KG Somashekara, Lakshmi Shantharam, GM Bilkhis Mahjabeen

Metastatic Hepatocellular Carcinoma Presenting as Maxillary Sinus Lesion

[Year:2020] [Month:January-March] [Volume:11] [Number:1] [Pages:3] [Pages No:19 - 21]

Keywords: Hepatocellular carcinoma, Maxillary sinus, Metastasis

   DOI: 10.5005/jp-journals-10001-1345  |  Open Access |  How to cite  | 


Metastasis of malignant tumors to the sinonasal area is an infrequent occurrence and usually indicates the late stage of the primary disease. We report a rare case of previously undiagnosed metastatic hepatocellular carcinoma presenting solely as a maxillary sinus lesion. We have also reviewed literature on hepatocellular carcinoma metastasizing to the sinonasal area and discussed the pathogenesis of the possible routes of metastatic spread.


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