Post-Tracheostomy Steroid Nebulization: A Retrospective Analysis on Postoperative Complications.

The primary objective of this research was to meticulously evaluate the therapeutic potential of steroid nebulization, administered over a 2-week period post-tracheostomy, in attenuating postoperative complications with a concentrated emphasis on tracheal stenosis. The study spanned three years, commencing in 2019 and concluding in 2022, examining a patient cohort of 400 individuals. Utilizing a retrospective cohort methodology, the participants were systematically stratified into two cohorts: those subjected to steroid nebulization (n = 200) and a control group (n = 200). Adverse outcomes were bifurcated into minor complications, which encompass stomal infections and inflammations, and major complications, which include bleeding, tracheoesophageal fistula, and tracheal stenosis. These complications were evaluated at distinct post-operative junctures: 1 week, 1 month, 3 months, and 6 months. The primary outcome was deduced through a rigorous multivariate logistic regression model, incorporating variables such as age, sex, and the diagnosis of chronic obstructive pulmonary disease (COPD). Analytical data unveiled that the cohort administered with steroid nebulization manifested a statistically significant diminution in the incidence of complications when juxtaposed with the control group (25 vs. 38%). Predominantly, the incidence of tracheal stenosis was discernibly lower in the steroid nebulization group (10 vs. 22%). The multivariate analytical framework further corroborated the pivotal role of steroid nebulization in substantially reducing the propensity for tracheal stenosis. The therapeutic intervention of steroid nebulization in the aftermath of a tracheostomy procedure presents a commendable avenue in curtailing major complications, with an acute focus on tracheal stenosis. To fortify these preliminary findings, it is quintessential to undertake more exhaustive studies, such as randomized controlled trials, to ascertain the optimal regimen concerning nebulization's timing, dosage, and duration.

Effect of Educational Intervention on Psychological Well-Being in CRS: A Randomized Controlled Trial.

Chronic Rhinosinusitis (CRS) affects nearly 10% of the global population, leading to substantial economic and quality-of-life burdens. While patient education has improved outcomes in other chronic conditions, its impact on CRS remains understudied. The study aims to evaluate the effectiveness of a structured patient education program on the psychological well-being and symptom severity of individuals diagnosed with CRS. This was a prospective, randomized controlled trial conducted in a tertiary care centre from January 2021 to December 2022. We enrolled 200 adult patients diagnosed with CRS based on the European Position Paper on Rhinosinusitis and Nasal Polyps guidelines. Participants were randomized into two groups: the control group, receiving conventional CRS medical management, and the intervention group, receiving conventional treatment plus a structured patient education program. By the end of the study, 100 participants from each group completed the 2-year follow-up. The intervention group showed significant improvements in psychological well-being, with HADS scores decreasing from 10 ± 3.5 to 7 ± 3.0. CRS symptom severity, as measured by SNOT-22 scores, also significantly improved in the intervention group, dropping from 45 ± 10 to 35 ± 9. Additionally, the intervention group had fewer acute CRS flare-ups over two years compared to the control group. Adherence to nasal spray usage was higher in the intervention group, and feedback on the educational program was largely positive. A structured patient education program, when added to conventional CRS treatment, enhances psychological well-being, and reduces symptom severity. Given these promising results, there's need to integrate patient education into standard CRS management and explore its long-term benefits. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04407-8.

Tracheostomy Complications: Insights from a Two-Year, 15-Case Analysis at a Tertiary Care Facility.

The objective of this case series was to analyse the complications that arise from tracheostomy procedures conducted in a tertiary healthcare facility throughout a two-year timeframe. Fifteen occurrences of complications were observed out of the 100 tracheostomies that were studied, suggesting a prevalence rate of 15%. The detected complications included subcutaneous emphysema, misplacement of the tube, infection at the surgical site, and tracheal stenosis, among various others. Considerable indications of complication were identified, encompassing variables such as age and a history of head and neck cancer. The findings of this study highlight the significance of personalized patient care, vigilant monitoring, and proactive measures for individuals receiving tracheostomy. Further investigations are necessary to validate these findings and improve patient safety and outcomes in the realm of tracheostomy surgeries.

Management of Rhinosporidiosis: by Coblation.

Rhinosporidiosis is a granulomatous disease commonly affecting the mucous membrane. It is caused by Rhinosporidium seeberi, an aquatic parasite & seen affecting the nose, paranasal sinuses most commonly. A retrospective study was conducted at a tertiary care hospital situated in Indian peninsula and five patients who were diagnosed and treated for rhinosporidiosis were analysed. Surgical excision by coblator along with medical management using Dapsone 100 mg once daily for 6 months given promising results in view of reducing recurrence. Combined approach of management including surgical excision using coblator and medical therapy with dapsone is effective in managing the rhinosporidiosis with no recurrence.

A Prospective Randomized Controlled Trial Comparing the Psychological Impact of Traditional Cold Steel Adenoidectomy and Endoscopic-Assisted Cold Steel Adenoidectomy.

Traditional Cold Steel Adenoidectomy (TCSA) and Endoscopic-Assisted Cold Steel Adenoidectomy (EACSA) frequently employ surgical adenoid removal methods. While these techniques effectively treat adenoid- related conditions, their influence on patients' psychological well-being still needs to be more adequately explored. With the increasing focus on the significance of mental well-being in surgical results, this study sought to explore and differentiate the psychological impacts of TCSA and EACSA. The primary objective was to examine and compare anxiety levels between TCSA and EACSA groups. Secondary objectives included evaluating surgical apprehension, post- surgery psychological well-being, procedural satisfaction, postoperative pain, duration until return to daily activities, and occurrence of postoperative complications. In a prospective, randomized controlled trial, 100 patients undergoing adenoidectomy were randomly allocated to the TCSA or EACSA group. The Hospital Anxiety and Depression Scale (HADS) was employed to evaluate anxiety levels at one week, one month, and three months following the surgery. Additional outcomes included surgical apprehension, post-surgery psychological well-being, procedural satisfaction, postoperative pain, time until return to daily activities, and postoperative complications. The EACSA group exhibited significantly lower HADS scores, surgical apprehension scores, and postoperative pain, alongside higher post-surgery psychological well-being scores and procedural satisfaction compared to the TCSA group (p < 0.05). Moreover, the EACSA group had a significantly shorter duration until the return to daily activities (p < 0.05). There were no significant variations found between the groups in terms of either the amount of bleeding during the procedure or the length of the operation. However, the EACSA group demonstrated a lower occurrence of postoperative complications, such as bleeding and infection. The results indicate that EACSA may provide benefits over TCSA in terms of reduced anxiety levels, surgical apprehension, postoperative pain, time until return to daily activities, and enhanced post-surgery psychological well-being and patient satisfaction. These findings could support clinicians in making informed decisions and offering patient counselling when choosing the most appropriate surgical technique based on patients' psychological health. Nevertheless, additional research is required to assess the enduring psychological consequences of these methods.

Hearing Aids and Quality of Life: A Psychological Perspective.

Objective: This research assessed the relationship between hearing aid usage and quality of life in individuals with hearing impairment, exploring associated demographic and clinical factors. Methodology: Data from 500 individuals at a tertiary care facility were collected over a year through medical records and an online questionnaire. Quality of life was gauged using WHOQOL-BREF and HHIE. Multiple linear regression analysed the correlation between hearing aid usage and quality of life, adjusting for age, gender, hearing loss severity, and socioeconomic factors. Results: Descriptive statistics showed varying degrees of hearing impairment, socioeconomic status, hearing aid usage, and quality-of-life scores. Bivariate analyses found significant correlations between hearing impairment level, socioeconomic status, hearing aid usage, and quality of life. Linear regression highlighted a positive relationship between daily hearing aid usage duration and quality-of-life scores, even after adjusting for covariates. Variations in quality-of-life ratings were observed between hearing aid users and non-users, spanning different hearing loss levels and socioeconomic statuses. Subgroup analysis showed a positive correlation between hearing aid use and quality of life across age groups. Conclusion: The study confirms the positive influence of hearing aids on the quality of life in hearing-impaired individuals, emphasizing the benefits of consistent use. Further studies should probe the specific domains and long-term adherence impacts. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04297-w.

Unraveling Bell's Palsy: Exploring HSV's Role and Facial Therapy's Impact on Aberrant Reinnervation and Synkinesis.

Introduction: Bell's Palsy, a disorder characterized by the abrupt onset of facial paralysis, has a significant impact on individuals globally. The precise contribution of the Herpes Simplex Virus (HSV) to its aetiology remains uncertain. The present study investigates the correlation between Herpes Simplex Virus (HSV) and Bell's Palsy, as well as evaluates the effectiveness of specialized facial therapy in its treatment. Methodology: A five-year longitudinal study was conducted at a tertiary care centre, with a sample of 100 patients diagnosed with Bell's Palsy, ranging in age from 18 to 65 years. The participants were divided into two groups: one receiving normal treatment and the other receiving specialized facial therapy. The assessments included HSV testing, the House-Brackmann scale for evaluating facial nerve function, the Facial Clinimetric Evaluation (FaCE) scale for assessing quality of life, and measures of patient satisfaction. Findings: The findings of the study revealed evidence supporting a robust association between HSV and the severity of Bell's Palsy. Significantly, individuals who underwent specialized facial therapy exhibited significant enhancements in facial nerve function, a decrease in synkinesis episodes, and better scores suggesting improved quality of life compared to those who received standard care. Additionally, this particular cohort also confirmed a noteworthy rise in patient satisfaction. Conclusion: This study indicates the potential association between HSV and Bell's Palsy while emphasizing the advantages of facial therapy. The above findings are of great significance; however, additional research is required in order to develop more precise ways of managing Bell's Palsy. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04275-2.

Sudden Spontaneous Neck Swelling Due to Thyroid Malignancy: A Case Report.

Sudden spontaneous swelling in the neck is an emergency condition required to be addressed immediately. It poses a diagnostic dilemma. It is extremely rare for a thyroid malignancy to present as a sudden onset neck swelling in a euthyroid young male with no obvious trauma to the neck. This is a rare case report of a follicular variant of papillary carcinoma thyroid presenting as sudden neck swelling to the extent of shifting trachea to other side in a young euthyroid male.

Endoscopic Assisted Cold Steel adenoidectomy - A Cost Effective Modification for Better Outcome.

Introduction: Adenoidectomy is most commonly performed in children to alleviate the symptoms pertaining to adenoid hypertrophy. The conventional cold steel method utilizing adenoid curette is the most commonly performed method in the world even after the invention of endoscopes & powered instruments like coblator & microdebrider due to the cost & time factors. The conventional method being a blind procedure, carries higher rate of recurrence due to remnant tissues. The visualization of the adenoid tissue in nasopharynx through the nasal endoscope helps in better engagement of adenoids into the curette & adequate tissue clearance with reduced recurrence of symptoms. Aim: To study the effect of visualization of adenoid tissue for better tissue clearance in conventional adenoidectomy. Objectives: To compare the duration of surgery, blood loss & recurrence rate following conventional cold steel adenoidectomy (CSA) & endoscope assisted cold steel adenoidectomy (EACSA). Method: 50 patients who underwent adenoidectomy with various indications were grouped into two groups with 25 patients each. Group A underwent (CSA)with or without tonsillectomy & Group B underwent (EACSA) with or without tonsillectomy were followed up for the duration of 3 months. The patients were evaluated for duration of surgery & post operatively for the recurrence at 3rd month of follow up. Results: In our study, it was found that the tissue clearance in Group A was significantly low. The recurrence rate of 48% was observed in CSA group compared to 0% in group B with EACSA. The duration of surgery in both the procedures were comparable. Conclusion: EACSA is an effective modification to CSA. It adds the benefits of endoscopic visualization of adenoid for the conventional curettage. The high recurrence rates of CA can be effectively reduced with no significant variation in duration of surgery.

Primary Non-Hodgkin's Lymphoma of the Nose: A Rare Case Report.

Extranodal NK/T-cell lymphoma, nasal type (ENKL) is a rare nasal pathology, which in the past was grouped with list of granulomatous diseases. It is an aggressive non-Hodgkin's lymphoma characterized clinically by a non-relenting destruction of the midline structures of the palate and nasal cavity. Despite the malignant clinical nature, tissue diagnosis may be difficult due to extensive tissue necrosis mandating multiple biopsies and has an ominous prognosis, as the average survival rate lying between 6 and 25 months as in large number of Asian studies. This is the case report of a 60-year-old female who presented with (L) nasal obstruction and recurrent episodes of rhinosinusitis for last 8 months, which had been treated with antibiotics, anti-inflammatory drugs and intranasal corticosteroids without success. After performing battery of tests, diagnosed histologically and confirmed by immunohistochemical analysis that the patient had an ENKL, nasal type (AKA angiocentric T-cell lymphoma).