International Journal of Head and Neck Surgery

Register      Login

Table of Content

2021 | July-September | Volume 12 | Issue 3

Total Views


Joseph Chang, Katherine Yung

Gender Affirming Voice Care: A Literature Review

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:5] [Pages No:93 - 97]

Keywords: Gender dysphoria, Hormone replacement therapy, HRT, Laryngoplasty, Trans voice, Vocal fold shortening and retrodisplacement of the anterior commissure (VFSRAC), Voice surgery, Voice therapy, Wendler

   DOI: 10.5005/jp-journals-10001-1448  |  Open Access |  How to cite  | 


Aim and objective: Review recent advances and understanding of gender affirming voice care Background: Treatment for gender dysphoria is increasingly recognized as medically necessary. Voice care is similarly as important as treatments focused on physical change. Review results: This article reviews gender cues in communication as well as voice care options for voice masculinization and feminization. Voice masculinization techniques are poorly researched due to expectations that hormone replacement therapy (HRT) will result in adequate masculinization. HRT results are variable, however, and voice therapy and surgery are secondary options. Voice feminization has been better studied. While voice therapy and voice surgery are both options, voice therapy is often pursued first due to a low risk profile. Nonetheless, voice surgery techniques including Wendler glottoplasty (WG) and its variations are effective and safe. Conclusion: Gender affirming voice care is critical in the treatment of gender dysphoria. HRT is often inadequate for voice masculinization. Further research in voice therapy and surgery options is needed. In voice feminization, voice therapy and voice surgery, particularly WG, have been effective in improving not only vocal pitch but also quality of life. Clinical significance: Transgender individuals constitute a significant proportion of the population and frequently suffer from gender dysphoria. Gender affirming voice care is an essential component of treating gender dysphoria.



Shyam Sudhakar Sudarsan, Indu Rajkumar, K Revathi Shree, K Srinivasan

Is Nasal Polyp in Pediatric Cases Same as in Adult Population?

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:3] [Pages No:98 - 100]

Keywords: Adult polyps, Antrochoanal, Epistaxis, Ethmoidal, Functional endoscopic sinus surgery, Nasal polyposis, Pediatric polyps, Nasal obstruction, Osteomeatal complex

   DOI: 10.5005/jp-journals-10001-1451  |  Open Access |  How to cite  | 


Nasal polyposis is a chronic inflammatory disease affecting the nasal cavity and paranasal sinuses. Nasal polyps represent the end-stage local manifestation of chronic inflammatory disease of the sinonasal tract. Morphologically, nasal polyps are edematous grape-like protrusions most often originating in the upper part of the nose around the osteomeatal complex (OMC) on the lateral wall. Polyps can vary widely in size and should be considered a bilateral condition. Aim of our study was to evaluate the characteristics and clinical features of nasal polyps in pediatric and adult population. Medical records of 232 patients (11 children and 221 adults) evaluated nasal polyps between 2015 and 2018 were reviewed retrospectively. Demographic characteristics, clinical presentation, management and histological findings were compared of the 232 patients, 11 were children and 221 were adults. Nasal obstruction was the most common presenting symptom in both groups. The incidence of snoring was more common among the pediatric age group as compared to the adult group and was found to be statistically significant. Epistaxis was also found to be more common among the pediatric age group, while sinusitis was noted to be significantly more common among the adult group. On histologic examination, allergic nasal polyp was more common than inflammatory nasal polyp in children as compared to adults. Conclusion: Nasal polyps are more common in adults. Children have unique clinical features such as increased snoring and epistaxis and predominant allergic histology as compared to adults warranting special attention in devising management plan.



PR Beluregowda

Extracranial Head and Neck Schwannomas: An Institutional Experience

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:5] [Pages No:101 - 105]

Keywords: Extracranial, Nerve of origin (NOO), Schwannoma, Single institution

   DOI: 10.5005/jp-journals-10001-1443  |  Open Access |  How to cite  | 


Extracranial schwannomas of head and neck domain are rare neoplasms. Most of the times, these tumors occur as asymptomatic neck swellings which masquerade to cervical lymphadenopathy, carotid body tumors, bronchial cyst, vallecular cyst. We present ten cases of head and neck schwannomas who have been treated and followed up between June 2006 to march 2020 in the department of otorhinolaryngology of Hassan Institute of Medical Sciences, Hassan, Karnataka State, India. These patients have been retrospectively reviewed. The main aim of the study is to know the NOO(nerve of origin) preoperatively and on table. Also to know the unusual sites of schwannoma in head and neck domain. The age group is between 10yrs to 50ys and female predominance of 50% in our study. Seven patients presented with neck swelling and three patients with pressure symptoms. Pre-operative diagnosis is mainly on clinical suspicious. Radiological imaging like CT scan/MRI may be helpful in diagnosis. FNAC is adjunctive tool for diagnosis. Among 10 patients nerve of origin could make out in 7 patients. Three from sympathetic, three from vagus and one from Internal Laryngeal nerve. In three patients nerve of origin could not make out. Intracapsular dissection of the tumor with preservation of nerve of origin is most recent common modality of treatment. Neurological deficit after tumor excision is common in large tumor excision. Early recognition and treatment is best for preservation of the nerve of origin.



Anuar Kuri-Garcia, Alberto Guakil-Haber, Marlon Enrique Segovia-Forero, María Yazmín Olvera-Suárez

Cervical Accessory Nerve Schwannoma: A Case Report

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:5] [Pages No:106 - 110]

Keywords: Cervical mass, Head and neck, Head and neck surgery, Neck mass, Schwannoma

   DOI: 10.5005/jp-journals-10001-1440  |  Open Access |  How to cite  | 


Schwannomas are tumors derived from Schwann cells that produce the myelin sheath that covers peripheral nerves, uncommon in the head and neck area. These rare tumors can arise from cranial nerves in their extracranial pathways, from sympathetic chains and peripheral nerves. We report the case of a female patient with a cervical accessory nerve schwannoma and its computed tomography (CT) scan, magnetic resonance imaging (MRI), and histopathologic findings. Surgical excision avoiding nerve manipulation continues to be the first-line therapy in these cases, to avoid or minimize nerve-related complications.



Prashant Jain, Ashish Prasad, Sarika Jain

Recurrent Neck Abscess Secondary to Pyriform Sinus Fistula: A Diagnostic Challenge

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:3] [Pages No:111 - 113]

Keywords: Branchial arch anomaly, Pyriform sinus fistula, Recurrent neck abscess

   DOI: 10.5005/jp-journals-10001-1453  |  Open Access |  How to cite  | 


Pyriform sinus fistula are rare branchial anomalies which can present as recurrent suppurative neck infections. There diagnosis and management can be challenging. Ignorance about this rare entity can delay the diagnosis and can increase the challenges for surgeon to achieve recurrence free curative excision.



Anuja Santosh Kulkarni, Mrunal Kesari, Yoganand Patil

Antrochoanal Polyp in an Unusual Case of Follicular Ameloblastoma of Maxilla: A Case Report

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:5] [Pages No:114 - 118]

Keywords: Antrochoanal polyp, Follicular ameloblastoma, Maxilla, Maxillary antrum, Odontogenic tumor

   DOI: 10.5005/jp-journals-10001-1441  |  Open Access |  How to cite  | 


Follicular ameloblastoma of maxilla is a well-known rare clinical entity known to be originated from odontogenic cells. Although ameloblastoma is developed from dental epithelial remnants, the presence of ameloblastoma in maxilla with epicenter from maxillary antrum and not at all from alveolar process is a rare phenomenon. Here we report a rare presentation of this tumor as antrochoanal polyp with epicenter in maxillary antrum in a 45-year-old lady who presented with unusual complaints of dry cough with a history of 6 months along with hypothyroidism.



Prajakta M Bapat, Uma P Chaturvedi, Sujaya Mazumder, Raji Naidu, Susan Cherian

Ectopic Sebaceous Glands over Buccal Mucosa: A Case Report on Fordyce Spot

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:2] [Pages No:119 - 120]

Keywords: Ectopic sebaceous glands, Fordyce granules, Hereditary nonpolyposis colorectal cancer

   DOI: 10.5005/jp-journals-10001-1444  |  Open Access |  How to cite  | 


Aim and objective: To highlight the importance of histopathological diagnosis to identify Fordyce spots. Background: These are normal variants in which sebaceous glands are ectopically located over the mucosal surfaces and are not in association with hair follicles. Fordyce spots, or Fordyce granules, can be found on the genital mucosa (glans penis and labia minor), esophagus, gastroesophageal junction, uterine cervix, sole of the foot, thymus, and tongue. Case description: The following two cases are included in our case report: (1) A 30-year-old male patient with a lesion of size 2 mm in diameter, located over right buccal mucosa. This was a painless white patch, clinically suggestive of lichen planus. This was histopathologically confirmed as Fordyce spots. (2) This case was an incidental finding along with erythroplakic patch in a 60-year-old man. Conclusion: Histopathology is the gold standard of diagnosis in this condition; it is imperative for the pathologist to identify the presence of Fordyce spots. Clinical significance: Fordyce spots over the oral mucosa are reported rarely and is known to have an array of clinical mimics such as malignancies of oral mucosa.



Shital Patel, Deval Mehta, Taher Rupawala, Naiya Shah, Zenish Bhatti, Kruna Bhimani

Role of Orthopantomogram as an Invaluable Diagnostic Aid for Satisfactory Evaluation of Elongated Styloid Process: A Review of Literature

[Year:2021] [Month:July-September] [Volume:12] [Number:3] [Pages:4] [Pages No:121 - 124]

Keywords: Elongated styloid process, Oral submucous fibrosis, Orthopantomogram, Pain, Trismus

   DOI: 10.5005/jp-journals-10001-1442  |  Open Access |  How to cite  | 


Aim and objective: To scrutinize and conduct a review of the scientific literature describing the visualization of elongated styloid process (ESP) using an orthopantomogram in general population as well as in patients having oral submucous fibrosis (OSMF). Background: The styloid process, arising from the temporal bone and extending up to 25–30 mm in length, can be a cause of chronic pain and suffering. Similarly, OSMF is rapidly emerging as a widespread, debilitating collagen metabolic disorder affecting the younger population, owing to addiction to tobacco and areca nut chewing. The surgical protocol for the treatment of submucous fibrosis demands thorough postoperative physiotherapy, failure of which will lead to reoccurrence of trismus. The physiotherapeutic exercises become particularly challenging if the styloid process exhibits abnormal elongation, due to chronic inflammation and irritation. An ESP, thus, may become an impediment for patients being surgically treated for OSMF. Review results: The review was designed based on the 58 relevant articles obtained after inserting the terms “Elongated Styloid Process and Oral submucous Fibrosis” and “Elongated Styloid Process and Orthopantomogram” in the databases of PubMed and ScienceDirect, respectively during the period of September 2017 till September 2020. Conclusion: Orthopantomogram was widely used as a primary imaging investigation to evaluate the styloid process. An ESP, measuring more than 30 mm, was commonly observed in the older population and in men. The use of cone beam computed tomography and three-dimensional computed tomography was highly limited yet universally advocated in long-term studies for a more detailed scientific explanation of the occurrence and angulation of an ESP both in general population and in patients exhibiting OSMF. Clinical significance: The co-incidental finding of an ESP and OSMF must be carefully diagnosed before planning the surgical intervention in patients having submucous fibrosis. Such cases must be managed with multidisciplinary setting using single-stage procedure to maximize treatment outcome and ensure patient wellbeing.


© Jaypee Brothers Medical Publishers (P) LTD.