Primary aspergillosis of the larynx: a case report.

Aspergillosis of larynx is very rare. Only a few cases have been reported in medical literature. Larynx is generally involved secondarily by aspergillosis. Only rarely the larynx happens to be the primary site of involvement. The lesions may be confined to the vocal folds or may involve various other sites of the larynx. There is, invariably, certain risk factors which may predispose for fungal infection like immune deficiency condition, use of inhaled or systemic steroids, long and continuous use of antibiotics etc. These lesions may mimic malignancy or a premalignant condition. Awareness of this entity is essential as the management depends on accurate diagnosis. These lesions invariably respond well to antifungal therapy with elimination of risk factors. Here we have reported a case of primary aspergillosis of the larynx without involvement of other part of the airway and without any generalized immune deficit in a 35 year old woman.

The potential risk factors and the identification of hearing loss in infants.

To identify potential risk factors for hearing loss from the infant with high risk criteria as guided by the Joint Committee on Infant Hearing (JCIH, 2000). 490 infants with age range of 2 days to 6 months who had undergone detailed audiological evaluation during for the period of 3 years at Gauhati Medical College Hospital were taken for the study. The hearing screening was performed on each infant using Distortion Product Otoacoustic Emission (DPOAE) testing. The infants who failed DPOAEs screening were followed up and Auditory Brainstem Response testing. Out of 490 high risk infants who had undergone detailed audiological evaluation 145 infants were found to be having hearing loss. Out of 145 infants 73 infants were male and 72 infants were female. The risk factor for hearing loss with the highest incidence was hyperbilirubenemia, Apgar scores of 0-4 at 1 min or 0-6 at 5 min was the second most prevalent risk factor, followed by TORCH infections. This study suggests the need for review of high risk register that is used along with the physiological and electrophysiological hearing test to screen the infants. The high risk register remains helpful in determining follow up plans so that children who may develop late onset of hearing loss will not be missed. Being aware of which risk factors are more likely to cause hearing loss in infants would be helpful to plan for follow up these children.

Use of intratympanic steroid as a primary treatment for sudden sensorineural hearing loss.

Dramatic nature of sudden sensorineural hearing loss sets it apart from most of the conditions, which the otologists face in their practice. It has a reported incidence of 5-20/1,00,000 of population with involvement of both sexes in any age group. Exact aetiology of the disease is not known and most of the cases are idiopathic. Treatment policy differs from centre to centre. This prospective study with intratympanic steroid injection as a primary treatment with or without oral corticosteried therapy results 64% success rate with average hearing gain of 25 dB.

Auricular trauma and its management.

Forty cases of external ear trauma have been studied during a period of three years from Jan '2001 to December 2004. It was observed that accidental trauma to the auricle may result in laceration, partial or complete loss of auricle. Injury of the tympanic membrane, temporal bone or facio maxillary region may be associated with auricular trauma. All wounds of auricle carry a risk of infection leading to perichondritis. Principles of successful treatment are conservation of tissue and prevention of infection.