Effect of Laryngopharyngeal Reflux Disease on Middle Ear Function: A Case-Control Study

Aims

To identify the effect of acid reflux on the middle ear function in patients with laryngopharyngeal reflux disease (LPRD) with no pre-existing otologic complaints.

Materials and Methods

Patients presenting with complaints suggestive of LPRD were identified and Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were calculated. 73 individuals with RSI ≥ 13 and RFS ≥ 7 was diagnosed with LPRD and chosen as cases. An equal number of healthy controls who had no symptoms of LPRD, matched for age and sex were chosen. Pure tone audiometry (PTA) and Impedance Audiometry were done in both the groups to assess middle ear function and the findings were compared.

Results

PTA values indicated hearing impairment among 61.64% of cases as compared to 17.81% controls (p value < 0.001). Result of Impedance Audiometry also revealed that 54.8% cases of LPRD had deranged middle ear function compared to 6.85% of controls (p value < 0.001).

Conclusion

Laryngopharyngeal reflux disease can have silent manifestations in the ear in the form of altered middle ear function. This can lead to a wide spectrum of dysfunctions in the form of serous otitis media, retraction pockets and squamosal variant of chronic otitis media, which has its own set of complications. Hence, early management of LPRD can reduce possibility of middle ear disease.

Mucocele Arising from the Submandibular Gland Presenting as Neck Swelling: A Rare Case Report

Mucoceles rarely involve major salivary glands. Very few cases involving the submandibular gland have been reported to date. A young male child presented with diffuse, soft, and painless swelling of the left submandibular region. Investigations suggested mucocele of the submandibular salivary gland. The mucocele was excised along with the left submandibular gland. Recovery was uneventful.

Study of patient profile of children with poor/delayed speech in a tertiary care centre in Western Uttar Pradesh, India

Background: Humans convey their emotions and information to one another through language. Delayed or poor speech can have a profound effect on the social and professional life of a person. Aim and Objectives: A study of children with poor/delayed speech in a tertiary care centre in western U.P. Objectives were as follows • To study the risk factors for congenital hearing loss in children with poor/no speech. • To screen them regarding their hearing status. • To analyze results in detail and compare with available literature. Materials and Methods: A hospital based prospective observational study was done from Jan - Dec 2019. One-hundred fifteen children were identified. Hearing screening was done in all of them by OAE testing followed by tympanometry and BERA wherever applicable. Results: Out of 115 children, 9 (7.8%) had normal hearing, 9 (7.8%) had central cause of deafness and 97 (84.4%) had congenital SNHL. 64% of subjects were male (p value- <0.001). 79% of them had an association with some risk factor during birth (p value- <0.001). 40.8% of them were first order in birth with a typical age group presentation of 2-3 yrs. 60.1% of the study population with SNHL had history of normal delivery at home. Conclusion: Improvement in the quality of antenatal care, obstetric services and postnatal care will reduce the number of cases of congenital sensorineural deafness significantly by reducing the number of high-risk babies. Moreover, the introduction of practice of universal hearing screening of newborns will help in identifying them early for proper rehabilitation.

Temporoparietal and Infratemporal fossa abscess as a complication of dental extraction – a rare and potentially lethal condition

Abscesses of the infratemporal fossa are rare in clinical practice. Usually it occurs as a complication of odontogenic infections, dental extraction, sinusitis and trauma. The initial signs & symptoms of this condition may be very non-specific in nature. If treatment is delayed, the abscess may extend superiorly to involve the temporoparietal region and only then it can be appreciated clinically. A middle aged male patient presented to us with the complaint of restricted mouth opening along with extensive swelling of the temporoparietal region. There was past history of tooth extraction. MRI scan confirmed it to be a case of temporoparietal & infratemporal fossa abscess with features of osteomyelitis of the ramus and adjacent body of the mandible on the right side. The patient was started on parenteral antibiotics and subsequently the abscess was drained by combined external and intraoral approach. The patient had an uneventful recovery. A thorough review of the literature has been done in relation to this condition and its management. A delay in diagnosis of this condition can lead to a number of potentially lethal complications. CT scan and MRI scan are the best modalities for confirming the diagnosis in suspected cases. Prompt drainage of the abscesses under antibiotic cover is the cornerstone of management. Isolated abscess of the infratemporal fossa may be drained intraorally or endoscopically by trans-maxillary approach. However if the temporoparietal region is also involved, a combined approach with a separate incision over the temporal region is indicated.Asian Journal of Medical Sciences Vol.9(4) 2018 57-60

The impact of maternal alcohol and illicit drug use on children's behavior problems: evidence from the children of the national longitudinal survey of youth

This study uses Children of the National Longitudinal Survey of Youth to test for evidence of a causal relationship between maternal alcohol, marijuana, and cocaine use, and children's behavior problems. Ordinary least squares (OLS) results provide strong evidence that substance use is associated with behavior problems. However, OLS estimation fails to account for unobserved factors that may be correlated with substance use and child behavior. To account for this problem, mother-child and family fixed-effects models are tested. The results suggest that maternal illicit drug use is positively associated with children's behavior problems, while alcohol use has a less consistent impact.

Applying cost analysis methods to school-based prevention programs

In order to efficiently allocate scarce prevention resources, policymakers need information about the economic costs of school-based substance use prevention programs. The objective of this paper is to outline economic cost analysis methods and demonstrate their applicability to school-based prevention programs. As an example, the paper focuses on estimating the economic cost of ALPHA, an intensive school-based substance use prevention program. The cost of ALPHA is compared to the costs of 3 elementary school programs that were alternatives to ALPHA. We collected cost information for 3 years, using a cost questionnaire that was completed by program and school budget officers and school principals. The program costs obtained from these sources were modified to conform to well-established economic cost analysis principles.

Marble bone disease in a child

A rare case of marble bone disease in a child is presented. The salient features of the disease are discussed in the light of available literaute.

Gustotoxicity of bleomycin

50 patients with advanced malignancy treated with bleomycin were assessed for taste abnormality. 5 (10%) cases were found to have some degree of taste impairment. Gustation sense returned to normal within 10-12 weeks following discontinuation of bleomycin therapy. The possible pathophysiology of gustotoxicity is discussed in the light of the available literature.

An unusual tumour mistaken as a lingual thyroid (a case report)

A rare case of benign mass with hypertrophic sero-mucinous gland presenting as a tumour at the junction of the anterior two-thirds and the posterior third of the middle of the tongue is reported, which is found to be of great academic interest because of its unique situation of that of a lingual thyroid and its characteristic histological picture. The salient features of the lesion are discussed.

Hansen's disease and olfaction

The sense of smell was assessed in a group of 50 leprosy patients. It was found that 40% of the patients showed a mild to complete impairment of the smell sense (anosmia) which was related to the systemic clinical state and to the severity of nasal lesions. Possible reasons for anosmia in leprosy patients are discussed. It has been observed that anosmia may be the presenting feature of leprosy. Most leprosy patients are not aware of olfactory disturbances, and anosmia may be missed unless specifically looked for. It is emphasized that leprosy should be considered an important cause of anosmia, at least in endemic areas, and in an anosmic patient leprosy should be always excluded.

A few points in the management of juvenile nasopharyngeal angiofibroma

A few points based on our experience on 100 cases of nasopharyngeal angiofibroma are described, which are found very useful in the successful removal of nasopharyngeal fibroma. A new technique for the control of haemorrhage by a muscle graft immediately after the removal of an angiofibroma is advocated.

Bilateral transitional-type inverted papilloma of the nose and paranasal sinuses

An uncommon bilateral transitional-type inverted papilloma of the nose and paranasal sinuses is presented, and the salient features of the lesion are discussed. The patient is well and without any signs of recurrence in either side of the nose more than two years after the first diagnosis and complete surgical excision of both tumours. Commonly unilateral, this tumour may occasionally be bilateral. In the present communication an uncommon case of bilateral inverted transitional-type papilloma, with a long history of allergy, is described with some comments on its pathogenesis.

Disturbance of taste in leprosy

The sense of taste was assessed in a group of 30 leprosy patients. The method used and the results are presented. Twelve patients (40 per cent) showed some degree of impairment of taste sensation and this was shown to be related to the severity of the disease. The possible reasons for the loss of taste are discussed.

Perforation of the Palate in Scleroma

A case of sclerotma with perforation of the palate is described. The patient presented a picture suggestive of syphilitic granuloma with perforation of the nasal septum and the palate. The diagnosis of scleroma was made on the basis of histopathology. The case was treated by surgical resection of the nasal mass and with antibiotics for a period of 3 months. The aetiopathogenesis of the clinical of the features in this case is discussed briefly in the light of available literature.

An Unusual -large Sized Rhinophyma

A case of rhinopttyma of dzfobulated type iated with is presented. The growth was big (I 5 x TO cm,) and showed dilated follicles andpits. Itwas surgically. The, relevant literature is reviewed.

A massive sublingual--cervical dermoid

An unusual case of a massive sublingual-cervical dermoid is presented. The salient features of the condition in relation to its incidence, embryology, pathology, symptomatology and management are discussed.