<p class="abstract"><strong>Background:</strong> The sinus tympani is a deep pocket of varying dimensions and shape situated in the retrotympanum. The sinus tympani lies medial to the facial nerve. Hence surgical access is difficult. This area is frequently involved in chronic otitis media attico antral type. Removal of disease from this area is difficult leading to cholesteatoma recidivism. The anatomy has been well described in literature. Its dimensions and morphology has not been described in the Indian population. Knowledge of the endoscopic anatomy of this area will help to eradicate disease leading to better results.</p><p class="abstract"><strong>Methods:</strong> A canal wall down mastoidectomy was performed on twenty wet temporal bones. A zero degree endoscope was introduced into the middle ear to view the sinus tympani. Using a graduated millimetre scale. The dimensions and morphology of the sinus tympani was studied. </p><p class="abstract"><strong>Results:</strong> Twenty wet bones were dissected. The mean height of the sinus tympani was 3.55 mm. The mean width was 2.22 mm and mean depth was 1.72 mm. The morphology was as follows: 13 bones had a type A morphology (classical type), 6 had a type B morphology (confluent), 1 bone had a type D morphology (restricted type). We did not encounter a type C sinus tympani in our study.</p><p class="abstract"><strong>Conclusions:</strong> The morphology and dimensions of the sinus tympani are variable. The otologist must have a complete knowledge of the anatomy of this area to successfully eradicate disease from this area.</p>
<p class="abstract">Choanal atresia is an uncommon congenital abnormality of nasal airway characterised by the complete obliteration of choana. Unilateral choanal atresia is more common as compared to bilateral choanal atresia. A case of unilateral nasal obstruction in an adult which was initially diagnosed as chronic rhinosinusitis and was posted for endoscopic sinus surgery at a secondary referral hospital. Increased nasal bleeding during the surgery led to the surgeon abandoning the procedure and was referred to Mysore Medical College and Research Institute. On detailed evaluation, unilateral choanal atresia of right sided was noted. It was subsequently managed by endoscopic recanalization of the posterior choana. This case of unilateral choanal atresia in an adult is being reported here for the rarity of its presentation. A high level of clinical suspicion is necessary to diagnose such cases and to prevent avoidable complications during routine endoscopic surgeries. Resection of posterior part of nasal septum to create uni-choana negates the need for stenting post-operatively.</p>
<p class="abstract">Small cell carcinoma is an uncommon type of malignant epithelial neuroendocrine neoplasm. It is most commonly of pulmonary origin and only less than five percent of all tumours are extrapulmonary. Esophagus, stomach, colon and rectum, gall bladder, head and neck, urinary bladder, prostate, skin and cervix are the most common extrapulmonary sites. Small cell carcinoma of larynx accounts for less than one percent of all laryngeal neoplasms. It is a highly aggressive neoplasm with poor prognosis. It most commonly affects supraglottis in males who are heavy smokers in their sixth and seventh decades. Various paraneoplastic syndromes can also be associated with the neoplasm. More than 90% of small cell laryngeal neoplasms present with metastatic disease. Surgery is not considered the initial treatment of choice; concurrent chemo radiotherapy is proven to provide longer survival. We report the rare case of extrapulmonary small cell neuroendocrine tumour in subglottis in a non-smoker female patient.</p>
Six hundred patients who attended outpatient department (OPD) in the Department of Otorhinolaryngology, with sensorineural hearing loss following inclusion criteria, are included in the study. Detailed history was taken followed by clinical examination. All patients were subjected to complete ENT examination, pure tone audiometric examination was done in all cases (MAICO MA42 audiometer). Height, body weight, and waist circumference (WC) were measured. Results The correlation between obesity and SNHL was found to be more significant in females than males. Obese and diabetic patients of both sexes were found to have higher degree of hearing loss for both high and low frequencies as compared with nonobese patients. Good correlation was found between BMI and degree of hearing loss. Abrupt high tone loss type of audiometric configuration was the commonest finding in both male and females. Conclusion There is a correlation between ages related to sensory neural hearing loss with central obesity and its comorbidities, with waist circumference as the most important indicator. Clinical Significance A careful understanding of the modifiable risk factors for age-related sensory neural hearing loss help in its early detection and prevention.
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