Subjective Visual Vertical and Horizontal in Vestibular Migraine.

OBJECTIVE: To assess the functional status of the otolithic pathway in vestibular migraine by comparing the results of static and dynamic subjective visual vertical and horizontal [subjective visual vertical (SVV) and subjective visual horizontal (SVH)] testing in patients with vestibular migraine with that of normal individuals. MATERIALS AND METHODS: This hospital-based prospective study was conducted in 82 normal adults and 66 adults with vestibular migraine. The SVV and SVH angles were measured under static and dynamic conditions using a software-based test protocol. The arithmetic mean of six readings in each situation was considered. The results were further analyzed by stratifying cases and controls into two age groups 20-40 years and 41-60 years and into gender. RESULTS: The clinical profile of the patients with vestibular migraine was comparable to the available literature. The dynamic SVV and SVH in both age groups and the static SVH in the 41-60 years age group were significantly higher compared to normal individuals (p<0.05). The dynamic SVV and SVH were significantly higher in the cases compared to controls among both males and females (p<0.05). CONCLUSION: There is evidence of otolithic pathway abnormalities in individuals with vestibular migraine. The inclusion of SVV and SVH testing for the evaluation of patients with vestibular migraine may be useful in the interpretation and rehabilitation of symptoms in these patients.

Case Report of Youngest Successful Bilateral Cartilage Tympanoplasty in India.

Paediatric Chronic Suppurative Otitis Media (CSOM) remains a challenge for the treating otologists. Usually, concurrent foci of infection lie in the oropharynx or nasopharynx and treating these eventually leads to resolution of ear discharge. However, refractory cases can be threatening in view of complications secondary to CSOM. A two year and 10-month-old child presented with recurrent profuse mucopurulent ear discharge which had been refractory to multiple medical treatment. Recently she had recurrent otitis external episodes with excoriations of canal skin. Child underwent bilateral tympanoplasty with cartilage palisading technique. At eight months follow-up, the neotympanum is intact and the child had no further episodes of ear discharge. This case to our knowledge is the youngest child to undergo a bilateral successful cartilage tympanoplasty in Indian subcontinent. This case report is written with the aim to highlight the fact that cartilage tympanoplasty can be considered in treating refractory cases of paediatric CSOM.

Subjective visual vertical and horizontal abnormalities in a patient with lateral medullary syndrome-a case report.

INTRODUCTION: Evaluation of persistent vertigo in post infarct patients is very important as the management depends on whether the cause is purely of central origin or due to associated vestibular affliction. CASE REPORT: A patient with left sided dorsolateral medullary syndrome and persistent vestibular symptoms was evaluated. Vestibular test battery showed abnormal smooth pursuit, bilateral hyperactive caloric responses, and abnormal dynamic subjective visual vertical and dynamic subjective visual horizontal tests. CONCLUSION: Dorsolateral medullary infarctions (Wallenberg's syndrome) typically cause a central vestibular tonus imbalance in the roll plane with ipsilateral deviations of perceived vertical orientation. The SVV and SVH tests may have a role in localizing the pathology in a patient with lateral medullary syndrome.

Fibroepithelial Polyp of the Tonsil: Report of a Rare Case.

Pedunculated polyps of the palatine tonsil are rare benign tumours of tonsil. Most of the cases have been reported in adults with varying presenting symptoms. We report a 12-year-old male child who presented with 6 months history of difficulty in swallowing. There was no history of breathing difficulty, change in voice or history of trauma. Clinical examination revealed a 2x1 cm small pedunculated polyp arising from the superior pole of right tonsil which was excised under general anaesthesia. Left tonsil was normal. A diagnosis of fibroepithelial polyp of right palatine tonsil was made based on histopathological findings. An unusual presentation of a rare condition in a paediatric patient has been discussed along with the clinical and histopathological features of this lesion.

Solitary Fibrous Tumor of Nasal Cavity: A Case Report.

INTRODUCTION: Solitary fibrous tumours (SFTs) of the nose and paranasal sinuses are extremely rare. These were originally described as neoplasms of the pleura originating from spindle cells. It is further sub-classified as a benign type of mesothelial tumour. Its occurrence in many extra pleural sites have been reported earlier, mainly in the liver, parapharyngeal space, sublingual glands, tongue, parotid gland, thyroid, periorbital region, and very occasionally in the nose and paranasal sinus area. CASE REPORT: A 28-year-old man with a 6 month history of persistent progressive left nasal obstruction and watering of the left eye is reported. Further imaging by CT and MRI revealed a large, left-sided, highly vascular, nasal cavity mass (Figs.1-4) pushing laterally on the medial wall of the maxilla. The patient underwent a lateral rhinotomy, which proceeded with the excision of the mass. Histopathological analysis of the specimen was consistent with SFT. CONCLUSION: This case is reported to develop insights regarding diagnosis and management of such rare tumours.

A rare case of bilateral nasolabial cysts in a postpartum lady.

Nasolabial cyst, also known as Klestadt's cyst is an uncommon nonodontogenic cyst. Bilateral nasolabial cysts are rarer and less than 10 cases have been reported in the literature. Diagnosis is usually clinical and they present as slow-growing swellings in the nasolabial region causing cosmetic deformity and nasal obstruction. A postpartum lady presented with bilateral swelling of the cheeks. Excision was done via a sublabial approach. She is asymptomatic one year after surgery. Nasolabial cysts are developmental but usually noticed after a trauma. There is no data relating the cysts to pregnancy.