RESUMEN
Adenoid cystic carcinomas (ADCC) are distinctive salivary gland neoplasms with characteristic histomorphology. The diagnosis of dedifferentiation/high-grade transformation (HGT) indicates poor prognosis and is most often made on histopathology. We present a case of ADCC arising from a minor salivary gland tumor exhibiting HGT, reaching up to the submandibular gland and having lymph node metastases, suspected on fine-needle aspiration cytology. The index case highlights the awareness of the entity of the HGT of salivary gland tumors and raises suspicion for cytological diagnosis.
RESUMEN
Acoustic analysis of voice provides objective values which can be used for treatment follow-up, comparison, and analysis. There are a variety of programs available for this purpose, but none of these provide a normative value. The reason being that the acoustic parameters vary with age, gender, and ethnicity. The study was done to create standardized values of acoustic parameters in north Indian Hindi speakers for clinical use. OBJECTIVE: To evaluate the characteristics of voice of the north Indian Hindi speakers across the adult population based on acoustic measures of fundamental frequency (F0), jitter, shimmer, and harmonic-to-noise ratio and to observe the gender differences in these measures. METHODS: A total of 62 (39 men and 23 women) voice samples from healthy normal voiced adults aged 18-40 years were included. RESULTS: Mean fundamental frequency in males and females in the age group 18-25 is 156 and 262, respectively. Similarly mean fundamental frequency in males and females in the age group 26-40 is 141 and 253, respectively. Shimmer in the women (18-25) group and jitter in the men (26-40) group is not normally distributed. Rest all parameters were normally distributed across all groups. Fundamental frequency showed statistically significant gender differences in both the age groups. Jitter and shimmer variables were statistically significant when compared between the two genders in the age group 26-40. Harmonic-to-noise ratio showed a statistically significant difference in the age group 18-25 among both genders. There exists statistically significant negative correlation between smoothed cepstral peak prominence and fundamental frequency, Pearson's r -0.479 (P-value <0.001). CONCLUSION: All acoustic parameters except intensity show a significant gender difference; however, the participants across each gender revealed no difference in acoustic parameters when segregated into age groups.
RESUMEN
To study the prevalence of Laryngopharyngeal reflux in individuals having throat complaints by applying the Reflux Symptom Index and Reflux finding score as a prognostic tool after anti reflux therapy. Materials and Methods: A Cross-sectional study of 75 patients of age 18 years and above with clinical diagnosis of Laryngopharyngeal reflux was conducted in ENT. Cases were examined with detailed history and thorough examination with indirect laryngoscopy and Hopkins 70 degree endoscope. Symptoms and findings of patients were assessed by Belafsky Reflux Symptom Index and Reflux Finding Score. Patients presenting Belafsky Reflux Symptom Index > 13 and also Reflux Finding Score > 7 were classified as having Laryngopharyngeal reflux. After 6 weeks of treatment, patients were reassessed and Reflux Symptom Index and Reflux finding score were calculated. Results: The mean age of the study subjects was 37.12 ± 12.39 years. Most common symptom reported based on RSI questionnaire was excessive throat mucus (81.33%) followed by clearing of throat (75%) and coughing on lying down and heartburn. Based on the Laryngoscopy, about 57.33% had thick endolarygeal mucus, 56% had diffuse erythema, 45.33% had granulations and 29.33% had subglottic edema. Based on the reflux symptom scores, we found 53.33% and 80% of patients based on reflux findings score to have Laryngopharyngeal Reflux. The mean Reflux Symptom Index scores were 16.25 ± 5.53 and 10.73 ± 4.40 and also the mean Reflux Finding scores were 13.81 ± 2.42 and 6.61 ± 2.16 respectively before and after the treatment which was statistically significant.
RESUMEN
The purpose of this study is to aggregate and summarize the complication rates among various modified techniques of pectoralis major myocutaneous flap harvesting. Various databases were searched from its inception to September 2020. Studies describing surgical management of head and neck oncologic reconstruction using pectoralis major myocutaneous flap and its surgical modifications were included in study. All included studies: (1) described a pectoralis major flap harvesting technique categorized by author as conventional technique, bipaddle or bilobed flap, segmental flap, flap transfer using subclavicular route, skin paddle over Pectoralis Major, Flap with Multiple vascular supply, U shaped skin paddle, modified short incision technique; and (2) reported the number of postoperative complications in participants. Meta-analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total 183 studies were included. Segmental flap (0.20%), flap with multiple vascular supply (5.18%) and parasternal skin flap (6.38%) had the highest rates of total complications and were the only techniques to show a statistically significant increase in odds ratio compared with conventional technique (odds ratio 1.89, 9.05 and 7.26, respectively, P < 0.05). Bipaddle flap (57.48%) and u shaped skin flap (78.05%) show statistically significant decrease in odds ratio as compared to conventional technique. Among all the modifications in surgical technique of pectoralis major myocutaneous flap harvesting bipaddle flap and u shaped skin flap show least total complication rates. But on the contrary rates of partial flap necrosis and fistula are significantly higher in bipaddle flap as compared to conventional technique. As such, the choice of surgical technique should primarily be made based on the defect size, patient selection and surgeons' discretion rather than the presumed complication rate.
RESUMEN
Tinnitus often described as sound in the ear in absence of any external stimulus. It poses a challenge to the psychological and mental wellbeing of the patient and professional unsatisfaction to the clinician. The patient often an old aged individual usually approaches the outpatient department with various sounds in the ear, making him feel ill or unable to have a sound sleep. The middle-aged patient often complains of professional incapability and lack of concentration due to tinnitus. Despite vast academic research and advances, the efficiency of available treatment is debatable, often compelling the clinician to convey the message that "you may have to learn to live with it". In the present overview of reviews, we tend to look into the management of tinnitus and present a comprehensive outlook of various evidence-based reviews from Cochrane and augmented with various studies from PubMed.
RESUMEN
(1) To study the BERA changes in neonates with unconjugated hyperbilirubinemia. (2) To compare the BERA changes in the neonates with unconjugated hyperbilirubinemia before and after therapy. Thirty consecutive term appropriate for gestational age (AGA) neonates presenting to NICU with total serum bilirubin requiring intervention (using the American Academy of Pediatrics guidelines) were included in the study as cases and thirty normal term AGA neonates with uneventful peri-natal period and a maximum measured serum bilirubin <12 mg/dl in case of term baby were included as controls after obtaining informed consent. Initial BERA was done within 3-24 h of hospitalization after obtaining informed consent from parents, at the time of discharge and at 3 month followup. Machine used for recording BERA was intelligent hearing system version 3.3. In our study out of the 30 cases 10 (33.3 %) cases were found to have BERA changes in the form of absent wave forms, raised threshold, prolonged latencies or prolonged inter peak latencies. In our study, it was observed that there was statistically significant correlation (p value < 0.005) between increasing bilirubin level and BERA changes. Correlation of the findings of this study with previous few studies indicates that BERA can be used as a useful non invasive tool to determine auditory functions in the neonate especially changes of early bilirubin toxicity.
