Role of Bleomycin Sclerotherapy as a Non-surgical Method for the Treatment of Cystic Hygroma of Head and Neck Region-an Institutional Study.

Cystic hygroma is a benign congenital tumor of lymphatic origin. Most common location is head and neck region. Bleomycin is an antineoplastic glycopeptide antibiotic agent with sclerosing property. In our present study, we used bleomycin for intralesional sclerotherapy for cystic hygromas of head neck region, as an alternative to surgical excision. We also statistically analyzed the pattern of cystic hygroma in head and neck region. Our present study was a prospective observational study of 40 patients. The study period was 18 months. All patients were given intralesional bleomycin at the dose of 0.5 mg /kg body weight, not exceeding 10 units at a time. The injection was repeated if required, at an interval of 4 weeks up to 4-5 times. Each patient was followed up at regular interval up to 1 year. Most common age group was found to be between 0-7 years (55%). Mean age was 6.9 years. Posterior triangle of neck was the commonest site (35%). Excellent response was noted in 24 patients (60%) while good response was noticed in 11 patients (27.5%). Poor response in 5 patients (12.5%). No major side effects noted with bleomycin sclerotherapy. No recurrence was noticed in our study. Intralesional bleomycin is a safe, simple, relatively cheaper and effective nonsurgical treatment method for cystic hygroma of head and neck region. It can be used as a first line treatment modality. Still, a lot of research is needed to establish it as a gold standard treatment modality for cystic hygroma.

Evaluation of Hearing Loss in Congenital Hypothyroid Children at a Tertiary Care Hospital in Central India.

Hearing loss has long been associated with congenital hypothyroidism and, if not noticed and treated early, may result in delayed language acquisition and difficulties in comprehension. In light of the implications of congenital hypothyroidism and its associated hearing loss, we decided to conduct this study. The aim of this study was to identify the prevalence of hearing loss in congenital hypothyroidism and its relation to the severity of the disease and age of initiation of treatment. This study was conducted from July 2016 to June 2021 at a tertiary care hospital in Bhopal. The hearing status of congenital hypothyroid children and matched controls was assessed by pure tone audiometry or free field audiometry and, in selected cases, with brainstem evoked response audiometry. Eight children (25%) with congenital hypothyroidism had hearing loss, compared to one (3.12%) in the control group (p < 0.05). No statistically significant difference has been found in the gender, mean age of diagnosis, mean age of initiation of levothyroxine treatment, mean screening FT4 levels, and mean screening TSH levels between congenital hypothyroid children with and without hearing loss. Due to the high prevalence of hearing loss in congenital hypothyroidism and its impact on language and cognitive development, it is critical to create awareness among healthcare professionals that children diagnosed with congenital hypothyroidism must undergo audiological evaluation at the time of diagnosis and periodically thereafter. Alternatively, children with unexplained hearing loss must be screened for congenital hypothyroidism.

Randomised Controlled Clinical Study of Injection Caroverine and Ginkgo Biloba Extract in Cochlear Synaptic Tinnitus.

Tinnitus, also known as phantom auditory perception, is an annoying symptom and 13-17% of population reports bothersome tinnitus. Cochlear synaptic tinnitus is the most common type. Many treatments have been tried but none is yet considered to be well established. To evaluate effect of Inj.Caroverine and Ginkgo Biloba extract in cochlear synaptic tinnitus in terms of improving tinnitus grading, tinnitus matching and quality of life of patient. It is Randomised controlled study, conducted in department of ENT, on 86 patients, who met inclusion criteria, divided into 4 groups. Gr1-Inj Caroverin, Gr2-Inj Placebo, Gr3-Ginkgo Biloba extract, Gr4-Placebo as extract. A single dose infusion of caroverine immediately improves tinnitus grading and matching and provides immediate relief in reducing severity of tinnitus in 54.54% cases but improvement was not sustained in caroverine group at 3 month and 6 month follow-up after infusion. Ginkgo biloba also is effective in improving tinnitus grading and matching in 31.8% cases and improvement was sustained in ginkgo biloba group even after 3 month of cessation of treatment i.e. at 6 month follow-up. It is suggested that Inj.Caroverine as intravenous infusion should be given in severe cases of tinnitus to reduce its severity immediately and then patient should be put on Tab.Ginkgo biloba for a period of 3 months to provide sustained and long lasting relief. Thus combination therapy of Inj.Caroverin and Tab.Ginkgo Biloba, appropriately tailored to the need of patient will provide better results in greater majority of patients.