To study the effect of nasal packing on blood oxygen saturation.

Study was conducted on 30 patients of deviated nasal septum, who underwent septoplasty under local anesthesia followed by anterior nasal packing. The pulse oximetry was carried out three times on each patient to record the blood oxygen saturation (SpO₂) by using digital pulse oximeter. The first reading of SpO₂ was taken before nasal packing, second after 24 hours of nasal packing and third 3 weeks after surgery. Statistical analysis was done by Chi-square test and paired t-test.

A total of 33.3% patients were below 20 years of age, whereas 60% were between 20 and 30 years of age and 6.7% were above 30 years. Males were 80%. It was observed that preoperative mean SpO₂ was 98.3 ± 0.794%, after 24 hours of nasal packing was 97.17 ± 1.744% and 3 weeks after surgery was 98.87 ± 0.629%. On statistical analysis, the difference in SpO₂ was highly significant (p < 0.001).

The application of nasal packs can be risky in old patients, more so having cardiopulmonary disease. The use of packs with airflow is recommended in these patients who should ideally be monitored with pulse oximetry.

Singh S, Singh J, Kakkar V, Yadav SPS, Bishnoi A, Kathuria B, Gulati A, Sharma C. To Evaluate the Effect of Nasal Packing on Blood Oxygen Saturation. Int J Otorhinolaryngol Clin 2015;7(2):41-44.

To assess efficacy and safety of omeprazole in laryngitis due to laryngopharyngeal reflux disease (LPRD).

It was a prospective, randomized, open label study conducted in 90 patients with laryngitis due to LPRD. Group A (n = 45) received omeprazole and advice about life style modification, group B (n = 45) received only advice about life style modification. Reflux symptom index (RSI), reflux finding score (RFS), quality of life (QoL) and voice handicap index (VHI) were evaluated at 0, 4 and 8 weeks.

P ercentage r eduction i n R SI a nd R FS w as s ignificantly higher in group A after 8 weeks (37 vs 29%, 18 vs 13% respectively). Excess throat mucus, clearing of throat and erythema of posterior larynx improved considerably in group A compared to group B.

Omeprazole could be a significant addition to life style modification in LPRD patients particularly for signs and symptoms, such as excess throat mucus, clearing of throat and erythema of posterior larynx.

Doshi K, Varghese A, Badyal DK. Evaluation of Omeprazole in the Treatment of Laryngopharyngeal Reflux Disease: A Single Center, Prospective and Randomized Study. Int J Otorhinolaryngol Clin 2015;7(2):45-50.

Acquired benign laryngotracheal stenosis is often preventable. A majority of such patients have a history of some airway intervention, ranging from a planned endotracheal intubation for the purpose of anesthesia, to an emergency tracheotomy in the setting of stridor. The primary aim of the first treating clinician is to secure the airway, and often these patients already have a tracheotomy at the time of initial presentation.

We analyzed 80 patients that have been managed for varying grades and locations of acquired benign laryngotracheal stenosis presenting to a tertiary healthcare centre, and analyzed the impact of tracheotomy on the eventual outcome.

Tracheotomies performed in patients suffering from stenosis in the airway pose technical challenges. If planned even in the most urgent situations, they can play a vital role in determining the eventual outcome of the definitive treatment. The site, technique and care of the tracheotomy are key factors in determining the eventual outcome.

Hathiram BT, Khattar VS. The Impact of Tracheotomy on the Eventual Outcome of Surgery for Benign Laryngotracheal Stenosis in a Tertiary Health Care Setup. Int J Otorhinolaryngol Clin 2015;7(2):51-56.

Arora N, Jain K, Malhotra V, Bansal R. Nail Gun Injury: An Unusual Presentation as Tracheal Foreign Body. Int J Otorhinolaryngol Clin 2015;7(2):57-59.

Raman EV, Anand VT, Kumari AMA, Thaoroijam DD, Jose C. Management of Smoke Inhalational Laryngotracheal Injury: A Modest Experience. Int J Otorhinolaryngol Clin 2015;7(2):60-63.

Venous ectasia is rare causes of neck mass. Among neck veins, ectasia of the internal jugular vein (IJV) are extremely uncommon. However, this is to be kept in mind when considering differentials for laryngocele.

To recognize the similarities between laryngocele and ectasias of the IJV and the differences in their presentation and management.

Observational.

Tertiary care hospital, India.

Presenting a 7-year-old boy with a left-sided soft, non-tender neck mass that fluctuated in size with coughing and straining for the past 1 year, presentation classical of laryngocele. Computed tomography (CT) demonstrated marked asymmetrical dilatation of the left IJV in the neck. Color-flow Doppler ultrasonography revealed a solitary cystic lesion with evidence of high venous blood flow in the IJV area. The relevance of radiological evaluation in neck swelling is being highlighted.

Ashish G, Kurien M. Venous Ectasia: A Potential Mimicker for Laryngocele Radiology Covers the Road. Int J Otorhinolaryngol Clin 2015;7(2):64-67.

Ashish G, Sundereshan RS, Philip A. Transoral Laser Excision of Schwannoma in Base of Tongue: A Case Report with Review of Literature. Int J Otorhinolaryngol Clin 2015;7(2):68-71.

Mundhe R, Tarte S, Patil P, Malik M, Bano S, Chinoy R. Chondrosarcoma of Larynx: A Case Report with Review of Literature. Int J Otorhinolaryngol Clin 2015;7(2): 72-74.

Mathews M, Paul RR, Mathew GA, Albert RR. A Case of Hidden Foreign Body: How We did It? Int J Otorhinolaryngol Clin 2015;7(2):75-77.

Tonsillectomy is one of the most common surgical procedures performed worldwide. However, it can potentially be associated with several complications. One of the very rare complications post-tonsillectomy in adults is subcutaneous emphysema, as in our case here. Although, most reported cases are resolved spontaneously, it may lead to fatal complications, like tension pneumothorax.

Tonsillectomy was performed on an adult patient with history of frequent tonsillitis. The patient developed facial subcutaneous emphysema 48 hours after the surgery (evident by clinical and radiological examination) that resolved within 2 days without further complications.

Tonsil should be removed along with tonsilar capsule. If tonsillectomy causes deeper than usual mucosal tear up to the level of the muscles, then air might pass into the subcutaneous tissue through the tonsillar fossa and superior constrictor muscle into fascial layers of neck. Emphysema can then spread to parapharyngeal, retropharyngeal spaces and mediastinum with its related morbidity. Though a rare complication, all otorhinolaryngologists must be aware of this complication and its management.

Abraham SS, Stephen V, Deve L, Kurien M. Subcutaneous Emphysema Secondary to Tonsillectomy. Int J Otorhinolaryngol Clin 2015;7(2):78-80.

Khatua RK. Fish in Hypopharynx: A Rare Case Report. Int J Otorhinolaryngol Clin 2015;7(2):81-82.

Chauhan A, Rajan S, Singh I. Tuberculous Pleural Effusion Presenting with Prevertebral and Cervical Emphysema: An Unusual Presentation. Int J Otorhinolaryngol Clin 2015;7(2):83-84.

Chalkiadakis V, Roukis G, Karatzias G, Androulakis M. Retropharyngeal Abscess related to Hematogenous Dissemination. Int J Otorhinolaryngol Clin 2015;7(2):85-87

Bhat SP, P Kamath SD, Rent NH, Shetty KC. Lymphangiomatous Polyp of the Tonsil: An Unusual Cause of Snoring. Int J Otorhinolaryngol Clin 2015;7(2):88-90.

Das DJ, Bhatia A, Debbarma R, Sarma K. Congenital Supraglottic Cyst with Stridor Immediately after Birth. Int J Otorhinolaryngol Clin 2015;7(2):91-92.

To discuss a case of spontaneous pneumomediastinum with pneumothorax with subcutaneous emphysema presenting with stridor due to laryngeal edema with relevant review of literature.

Spontaneous pneumomediastinum is a rare condition that has been described in healthy individuals following Valsalva manoeuvre, excessive and prolonged cough or emesis. Laryngeal involvement in these cases has not been reported so far.

We present an interesting case of spontaneous pneumomediastinum with pneumothorax with pneumopericardium and cervicofacial emphysema with suspected ingestion of foreign body. In view of stridor due to laryngeal edema tracheostomy was done. No obvious cause for the air leak was found on further investigations. The foreign body sensation could have led to oral provocative manoeuvres by the patient causing increased intra-alveolar pressures and air leak.

Spontaneous pneumomediastinum with cervicofacial emphysema with pneumopericardium with laryngeal involvement is very rare. Tracheostomy is essential in case of airway compromise. A thorough evaluation for the underlying condition is essential to prevent further air leak.

In a case of spontaneous pneumomediastinum with airway compromise due to involvement of the larynx, tracheostomy is essential to secure the airway and could also help in resolution of emphysema.

Pratibha CB, Satish D, Gopal S, Balasubramanya AM. An Interesting Case of Spontaneous Pneumomediastinum with Subcutaneous Emphysema following Oral Provocative Manoeuvre. Int J Otorhinolaryngol Clin 2015;7(2):93-96.

Trupthi MC, Syed KA, Sivaranjini R, Mukhopadhyay S, Varghese AM. Lipoid Proteinosis—A Pediatric Otolaryngologist's Perspective: A Case Report and Review of Literature. Int J Otorhinolaryngol Clin 2015;7(2):97-99.

Retropharyngeal abscess (RPA), is a deep tissue neck infection. It is a serious and occasionally life-threatening infection due to the anatomic location and the potential for obstruction of the upper airway. The retropharyngeal space is found posterior to the esophageal wall and anterior to the prevertebral fascia. Lymph nodes found in this space drain the nasopharynx, paranasal sinuses and middle ear. Often infections of these areas will lead to infection in the retropharyngeal space. Atrophy of these lymph nodes at or before puberty has been found as an explanation of the predominance of RPAs in young children. In fact, some believe that they atrophy after 4 years of age. Once almost exclusively a disease of children, is observed with increasing frequency in adults. Retropharyngeal abscess poses a diagnostic challenge for the ENT surgeon because of its infrequent occurrence and variable presentation.

Ten cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling.

Sore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication.

Most of the patients had history of trauma prior to the development of RPA. Computed tomography (CT) scan of neck and thorax has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space.

Tuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications.

Kumar N. Adult Retropharyngeal Abscess: A Retrospective Case Series. Int J Otorhinolaryngol Clin 2015;7(2):100-103.