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INTRODUCTION: Although a COVID-19 nasopharyngeal swab is a safe procedure routinely performed by healthcare providers, it can lead to complications that can be life-threatening. We present seven cases of intractable epistaxis following a nasopharyngeal swab that required sphenopalatine artery ligation. We aim to shed light on this life-threatening condition, emphasizing the importance of recognizing and mitigating such complications. MATERIALS AND METHODS: This retrospective chart review involved cases of intractable epistaxis following a COVID-19 swab from January 2020 to June 2022. The patient's charts were reviewed for the location of the epistaxis and different intranasal and extranasal factors that could have led to it. RESULTS: Seven cases had intractable epistaxis following a nasopharyngeal COVID-19 swab. Six of the seven cases had a deviated nasal septum, and one case had an enlarged inferior turbinate. All patients had bleeding from the ipsilateral nasal structural abnormality. All patients underwent successful sphenopalatine artery ligation. CONCLUSION: Our study highlights the significance of recognizing the potential risk of intractable epistaxis post-COVID-19 swabs and emphasizes the importance of comprehensive training programs to ensure the safe and effective execution of nasopharyngeal swab procedures.
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Background Stapes surgery success depends on several factors, including the length of the prosthesis used. Whether to use a standard-size prosthesis or measure the length of the stapes prosthesis has been debated in the literature. This study aims to assess the surgical outcomes of a stapedotomy using the standard 4.5 mm prosthesis without custom measurements. Methodology This retrospective study involved patients with otosclerosis who underwent primary stapedotomy using a standardized 4.5 mm fixed-length prosthesis between January 2017 and February 2023 at a tertiary care center. Results Out of 111 charts reviewed, 99 ears (56 males and 43 females) were studied. The mean air-bone gap (ABG) significantly improved from 27.9 ± 9.12 dB preoperatively to 3.95 ± 3.54 dB post-operatively (p-value < 0.05). Hearing results showed that out of 99 ears, 96.96% had a postoperative ABG of ≤10 dB and 98.98% ≤20 dB. Only three patients showed postoperative mild transient dizziness that lasted a few days. None of the patients had persistent dizziness for more than one week. One patient developed postoperative reparative granuloma with tinnitus and sensory-neural hearing loss. None had a recurrence of the conductive hearing loss during the study period. Conclusion Our retrospective study on stapes surgery utilizing a standardized 4.5 mm prosthesis without custom measurements showed notable surgical success and safety. Using a standard-size prosthesis shortens the surgical time and eliminates the complexities associated with intraoperative measurements, potentially reducing the risk of complications.
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Multiple anatomical variations in the nasal cavity are well-described in the literature. We describe a rare case of pneumatization of the frontal sinus in the nasal septum that we term "Septo-Frontal Cell". To the best of our knowledge, this pattern of nasal septum pneumatization has not been described in the literature before. We have discussed the clinical and radiological findings and management of this patient.
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Metastatic laryngeal cancer is a rare entity, usually indicating an advanced disease once discovered. In this report, we are describing a case of a 60-year-old male patient with stage IV colorectal cancer (CRC), who presented to our clinic with dysphonia; further workups showed metastatic CRC.
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INTRODUCTION: The nasal mucosal contact points between the two opposing mucosal surfaces leading to the headache had been a point of debate for many years; the intermittent and fixed contact points and their relationship with headache have never been investigated before. We have studied the relationship of headache with a different type of contact points in our study. OBJECTIVES: The aim of our study was to study two different types of mucosal contact point between the lateral nasal wall and the nasal septum and to study their relationship with symptom of headache.There have been many papers published related to the mucosal contact points in the nose and their relationship with headache, most of the published data did not find any relation between the headache and the mucosal contact points. We conducted a retrospective study of 116 patients with deviated nasal septum and contact point with the lateral nasal wall. METHODS: A retrospective study done at a tertiary institute Included 116 CT scan of paranasal sinuses showing the deviated nasal septum with mucosal contact points, 64 CT scan showed severe deviated nasal septum with fixed contact points between the septum and the inferior turbinate, other 52 scans showed the intermittent mucosal contact point, that is, septum is coming in contact with inferior turbinate only when turbinate is enlarged. RESULTS: Thirteen patients out of 64 patients (20.31%) had a headache in the fixed contact point group as compared to 20 out of 52 (38.46%) patients in the intermittent mucosal contact points group; post-surgery, the 17/20 patients improved in the intermittent mucosal contact points group as compared to 5/13 in fixed contact points group. CONCLUSIONS: We conclude that the overall incidence of headache associated with mucosal contact points is low but the higher association is seen in the intermittent contact group. LEVEL OF EVIDENCE: 4.
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OBJECTIVES: To evaluate the reliability of high-resolution CT scans (HRCT scans) in the diagnosis of tympanosclerosis and to determine its benefit to predict the post-surgical hearing outcome based on comparing radiological and surgical findings. METHODS: A retrospective study at a tertiary institute included 940 ears that underwent tyampanoplasty for chronic suppurative otitis media (CSOM) between January 2013 and March 2017. Preoperative temporal bone HRCT scans were analyzed to check for the prediction of tympanosclerosis and ossicular fixation. Intraoperatively, ossicular chain integrity was checked. Preoperative and postoperative audiometric evaluations using air-bone gap (ABG) were compared. A postoperative pure-tone ABG of 20 dB or less was considered as a successful hearing result. Results are compared with historical control groups, the study has been reviewed and approved by the IRB at the medical research center in Hamad Medical Corporation; however, it is a retrospective study so no informed consent was obtained from the patients. RESULTS: The study included 940 ears that underwent tympanoplasties due to CSOM, where 238 out of 940 (25.3%) of ears showed tympanosclerosis during tympanoplasty, intraoperatively, tympanosclerosis was localized to the eardrum in 174 of the 238 involved ears (73.1%), A 64 out of 238 (26.9%) of the ears with tympanosclerosis showed ossicular fixation, divided as 45 ears with Incudo-malleal fixation, 14 ears with stapes fixation, and 5 ears with triple ossicular fixation. HRCT scan of the temporal bone was suggestive of ossicular chain fixation in 79 cases distributed as 55 incudo-malleal fixations, 19 stapes fixation, and 5 complete ossicular fixations, with a sensitivity of 96.8%, and specificity of 98%. The audiological results were analyzed, with a patient follow-up after 6 months. CONCLUSIONS: Our study showed that CT scans when combined with the clinical findings can be an informative guide to otolaryngologists for preoperative evaluation and counseling of tympanosclerosis surgeries.
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Given the overlapping clinical features of sino-nasal immunoglobulin 4-related disease (IgG4-RD) to rhinitis or rhinosinusitis, this paper aims to delineate this rare, isolated manifestation significant to physicians for their daily practice and researchers contributing to this field.
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Invasive aspergillosis is commonly encountered in immunosuppressed patients either primarily through direct inoculation or secondary from blood dissemination. This report describes a case of 53 years old immunocompromised female patient who was diagnosed with frontotemporal anaplastic astrocytoma and developed nasal skin lesion turned to be invasive cutaneous aspergillosis.
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Pleomorphic sarcoma of the larynx is a rare variant of laryngeal cancer. We present the case of a 59-year-old male patient who has been smoking for 40 years. He presented with signs and symptoms of an obstructive glottic mass. The diagnostic workup pointed to a malignant pathology; the histopathology report confirmed the diagnosis of glottic undifferentiated pleomorphic sarcoma (malignant fibrous histiocytoma).
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We report the first case of spontaneous infarction occurring in pleomorphic adenoma located in infratemporal fossa mimicking parapharyngeal abscess, including clinical presentation, workups, and surgical approach. The final diagnosis was confirmed on a histological basis. The combination of CT scan and MRI might be helpful in distinguishing neoplasia from abscess collection in this area. Surgical intervention is the treatment of choice.