Ortner’s Syndrome-A Rare Cause of Hoarseness: Its Importance to an Otorhinolaryngologist

Introduction: Cardiovocal hoarseness (Ortner’s syndrome) is hoarseness of voice due to recurrent laryngeal nerve involvement secondary to cardiovascular disease. Recurrent laryngeal nerve in its course (especially the left side) follows a path that brings it in close proximity to numerous structures. These structures interfere with its function by pressure or by disruption of the nerve caused by disease invading the nerve. However painless asymptomatic intramural hematoma of the aortic arch, causing hoarseness as the only symptom, is a rare presentation as in this case.  Case Report: We report a case of silent aortic intramural hematoma which manifested as hoarseness as the only presenting symptom. A detailed history and thorough clinical examination could not reveal the pathology of hoarseness. The cause of hoarseness was diagnosed as aortic intramural hematoma on contrast computed tomography. Thus the patient was diagnosed as case of cardiovocal hoarseness (Ortner’s syndrome) secondary to aortic intramural hematoma.   Conclusion:  A silent aortic intramural hematoma with hoarseness as the only presenting symptom is very rare. This particular case report holds lot of significance to an otolaryngologist as he should be aware of this entity and should always consider it in the differential diagnosis of hoarseness

Audiological Outcome of Classical Adenoidectomy versus Endoscopically-Assisted Adenoidectomy using a Microdebrider

Introduction: The aim of this study was to evaluate audiological outcomes following adenoidectomy by the classical method and by endoscopically-assisted adenoidectomy using a powered instrument (microdebrider).   Materials and Methods: This study was conducted in a tertiary care center. It included 40 patients divided into two equal groups of 20 each. Group-A patients underwent classical adenoidectomy, while Group-B patients were subjected to endoscopically-assisted adenoidectomy using a microdebrider. Hearing outcome was measured by post-operative pure-tone audiometry and tympanometry.   Results: The post-operative average air-bone gap (ABG) was reduced from 19.6 dB to 11.8 dB in Group A and from 17.6 dB to 8.7 dB in Group B (P=0.010). There was reversal of tympanometric curves from type-B and type-C to type-A in 55% of the patients in Group A, while type-A curve was seen in 90% cases in Group B in the post-operative period.   Conclusion:  Audiological outcomes of endoscopically-assisted adenoidectomy using a microdebrider were superior compared with classical adenoidectomy

Role of Adenine and Guanine Sites in Hole Hopping in DNA Nanowire

Transfer integrals for oligos with different bases have been calculated using INDO/Koopman's approximation to unveil the charge transport mechanism in DNA. The sequences, G(A)nG, n = 1, 2, …, 10; G(A)xG(A)yG, x + y = 9; and G(A)xG(A)y G(A)zG, x + y + z = 8, were employed to interpret the Guanine (G) and Adenine(A) hopping. Adenine hopping is found to be faster in G(A)nG sequences with longer Adenine bridges (n ≥ 3). Inserting G-bases in between G(A)10G led to a decrease in the value of transfer integrals. Close analysis has revealed that bridge closer to 3′-end forms a hopping bottleneck; however, the presence of bridge at 5′-end enhances the charge transfer through A-hopping. Further insertion of single G sites in G(A)xG(A)yG (where x + y = 9) reduces the transfer integrals, thus explaining the hampering of A-hopping. Hence, sequences of the type G(A)nG, n > 3, are better suited for their application as molecular wire. Finally, studies on the effect of flipping of bases, i.e. flipping G:C to C:G on transfer integrals, have revealed that helical distortions and conformational changes due to sequence variations lead to changes in coupling, which is highly unpredictable