A rare case of abnormal epithelial migration in the external auditory canal secondary to cotton bud abuse.

The outer third of external auditory canal is cartilaginous and contains pilosebaceous glands and hair follicles. The medial two third is bony, and the skin is devoid of these skin appendages and its secretions. It also has outward migratory property which makes the ear self-cleansing. Here we present an exceeding rare case of hair in the tympanic membrane causing distressing symptom of scratchy sensation, tinnitus, and otalgia. We hypothesize, it is the distortion of migratory pattern medially due to repeated otitis externa caused by abuse of cotton bud that led to presence of hair in the tympanic membrane.

Special Sensory Function Deficit among Patients with Post-COVID-19 Visiting a Tertiary Care Centre.

Introduction: Several patients who recover from COVID-19 infection continue to have persistent symptoms even after recovery from the disease. The special sensory functions such as taste, smell and hearing are affected by COVID-19 infection even after recovery from the illness. The aim of the study was to find out the prevalence of special sensory deficits among patients with post-COVID-19 visiting a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among adult patients who recovered from COVID-19 visiting a tertiary care centre from 1 January 2022 to 31 December 2022. After obtaining ethical approval from the Research Ethics Board of Health, data on patients who were diagnosed with COVID-19 one year ago was obtained from the surveillance register from the Ministry of Health. They were contacted by phone call and invited to the centre to participate in the study. Appropriate clinical examination and tests were carried out to assess the special sensory deficits. A convenience sampling technique was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 271 patients, the prevalence of sensory function deficit was 39 (14.39%) (10.21-18.57, 95% Confidence Interval). Conclusions: The prevalence of special sensory deficits after recovery from COVID-19 infections was found to be similar to the findings of other studies. Keywords: anosmia; COVID-19; hearing loss.

Diagnostic and therapeutic dilemma in orofacial pain: A rare case of bilateral Eagle syndrome.

Eagle's syndrome is a collection of symptoms due to abnormal and/or elongated styloid process. This can irritate the various neurovascular structures that lie in its close proximity, mainly the glossopharyngeal nerve, leading to odynophagia, dysphagia, foreign body sensation, cervicofacial pain, and headache. It is a diagnosis of exclusion and needs high degree of clinical suspicion. It is a rare condition with no reported incidence in the Bhutanese population so far. In this article, we present a case of elongated styloid process that was causing persistent and troublesome orofacial pain in a patient, which was not relieved by medication. The patient underwent trans-oral styloidectomy, which helped cure his symptoms.

Recurrent ear bleed with profound bilateral sensorineural hearing loss: A case of Munchausen syndrome.

Factitious disorders and Munchausen syndromes present with history and physical symptoms to all specialties, and they are often extensively evaluated. Diagnosis of Munchausen syndrome is a challenge and patients often do not receive the correct diagnosis and appropriate care especially in settings where access to mental health professionals is difficult. We present a case of recurrent bleed from the right ear, bilateral profound hearing loss and jerky movement of limbs that was extensively evaluated and followed up for 4 years until a diagnosis of Munchausen syndrome was reached. This case reports the risk of harm to the patient and wastage of healthcare resources unless physicians begin to actively evaluate for factitious disorders.