Audiovestibular manifestations during pregnancy: a review

Pregnancy is nine-month duration physiological process with psychological, cardiovascular, and hormonal changes that affects different organs of the pregnant women. Any organs of the body can be affected during pregnancy due to hormonal changes so as in audiovestibular system. There are several audiovestibular manifestations occur during pregnancy such as hearing loss, otosclerosis, tinnitus, autophony, facial nerve palsy, and vertigo manifested as first time or get exacerbated during pregnancy. Majority of the changes during pregnancy are harmless to the mother and fetus, whereas some may cause pathological manifestations. The hormonal changes during pregnancy can cause alteration in the homeostasis of the inner ear fluids and hamper the inner ear functions. The changes of estrogen and progesterone levels during pregnancy can affect the audio-vestibular system. These changes in the inner ear may manifest with symptoms like vertigo, tinnitus, fullness in the ear, and hyperacusis. These symptoms in the pregnancy directly affects the quality of life both physically and emotionally. There are no standard guidelines for the management of audiovestibular manifestations. However, there are very little data available for audiovestibular manifestations during the pregnancy period. The objective of this review article is to discuss the prevalence, etiopathology, and clinical presentations, diagnosis and treatment of audiovestibular manifestations during pregnancy

Hearing loss and vertigo among COVID-19 patients: a review

The coronavirus disease 2019 (COVID-19) is an acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The clinical presentations of the COVID-9 patients vary from mild respiratory illness to fatal possible outcomes like death. SARS-CoV-2 infection can cause a wide range of extrapulmonary manifestations including sensory and neural complications like olfactory and/or gustatory dysfunction,otologic manifestations and long-term neurological complications. The association between the COVID-19 infection and hearing loss and vertigo make intuitive sense, give neuropathic manifestations of the inner ear resulting in cochleovestibular symptoms. Hearing loss and vertigo are interesting clinical outcomes associated with COVID-19 infections. Hearing loss and vertigo in COVID-19 patients have not received much attention from medical professionals. COVID-19 infection could have deleterious effects on the inner ear despite patients are asymptomatic. Hearing loss and vertigo play an important role for affecting routine activity and result in invisible handicap of the affected person and psychological solitary confinement. In current COVID-19 pandemic, some patients of COVID-19 are presenting with cochleovestibular symptoms such as hearing loss, vertigo and tinnitus. The proper understanding of the pathophysiology behind the hearing loss and vertigo in COVID-19 infections requires further research.This review article discusses the details of this epidemiology, etiopathology, assessment and management of the hearing loss and vertigo among COVID-19 patients

Role of vitamin D in controlling vertigo: a review

Vertigo is a disabling symptom that has a high recurrence rate and interferes with day-to-day functioning. Vertigo is frequently caused by Meniere's diseases and benign paroxysmal positional vertigo (BPPV). The most prevalent neuro-ontological condition causing vertigo is BPPV. Vertigo attacks that last only a few seconds and are brought on by changing the head's position with respect to gravity are the hallmark of BPPV. There is a suggestion that vitamin D deficiencies and BPPV and Meniere's diseases are positively correlated. However, there is not much awareness among clinicians about association between vitamin D deficiency and certain etiologies of vertigo. After taking vitamin D supplements, vertigo attacks stop happening. Supplementing with vitamin D may be beneficial for patients with low vitamin D levels who have BPPV and Meniere's disease. This review's goal is to discuss about how vitamin D helps to treat vertigo, especially BPPV and Meniere's disease

Premalignant lesions of the oral cavity: current perspectives

Premalignant lesions of the oral cavity are also called as potentially malignant disorders. The common premalignant lesions of the oral cavity include leukoplakia, oral submucous fibrosis (OSMF) and oral erythroplakia. These lesions have a very high malignant transformation rate. The exact etiological factors for development of the premalignant lesions of the oral cavity are not fully understood till date. Use of tobacco, alcohol drinking, chewing betel quid containing areca nut and solar rays are important etiological factors for resulting the premalignant lesions of the oral cavity. Early diagnosis is an important step for preventing the malignant transformations of these lesions and can be also life-saving. There are several treatment options including conservative to surgical for eliminating the premalignant lesions of the oral cavity. The aim of this study was to discuss the details of epidemiology, etiopathology, clinical presentations, diagnosis and current treatment of the premalignant lesions of the oral cavity.

Oral cavity lesions in COVID-19 patient- a neglected and morbid clinical entity in current pandemic

The novel coronavirus disease 2019 (COVID-19) is highly contagious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). COVID-19 infections are usually associated with acute respiratory symptoms along with fever, myalgia, fatigue, altered taste and smell sensation. However, some oral cavity manifestations have been found in COVID-19 patients. There is debate whether these oral cavity manifestations are due to SARS-CoV-2 infection or secondary to patient’s systemic condition. Currently research shows that SARS-CoV-2 affect the respiratory tract and other organs those have angiotensin converting enzyme 2 (ACE2) receptors. ACE2 receptors are abundantly present in the oral cavity tissues which prone for SARS-CoV-2 infection. The oral cavity lesions in COVID-19 patient ranges from ulcers in the oral cavity to candidiasis, recurrent herpes simplex, geographical tongue, mucositis and petechiae. COVID-19 infection significantly affects the oral cavity and salivary glands. Gustatory dysfunction or dysgeusia is a common oral cavity manifestation of COVID-19 patient. Clinicians should keep in mind about different lesions of the oral cavity and taste disturbances of the COVID-19 patients which will help the early diagnosis, treatment and avoid morbidity of the patient. There is still debate on exact cause for oral manifestations of the COVID-19 infections and its impact. This review article discusses the details of this neglected clinical entity such as oral cavity lesions in COVID-19 patients

Schwannoma of the pinna: a narrative review

Schwannomas are uncommon and benign neurogenic tumors that originate from the nerve sheath of the myelinated nerves. It can be found in any peripheral, cranial or autonomic nerves which contain Schwann cells. It is also called neuroma, nerve sheath tumor and neurilemmoma. Schwannomas in the head and neck region often present as painless swelling. The growth of schwannoma of the pinna causes an aesthetic alteration of the pinna. Schwannoma is a rare tumor of the pinna. The diagnosis of schwannoma is confirmed by histopathological study and immunohistochemistry. Histopathologically, it shows encapsulated, well-circumscribed lesions composed of different cellular patterns and arrangements. Histologically, the hallmark of schwannomas is the pattern of alternating Antoni A and Antoni B areas. The treatment of choice for schwannoma of the pinna is complete surgical excision. Recurrence following complete excision of the schwannoma is rare. Because of their rarity, these tumors are often not included in the differential diagnosis of the mass on the pinna. Preoperative suspicion and awareness are very important for schwannoma of the pinna to avoid delayed diagnosis and treatment. There is not much literature on the schwannoma of the pinna, indicating that this clinical entity is neglected. The objective of this article was to provide a comprehensive review of the schwannoma of the pinna including its epidemiology, etiopathology, clinical presentations, diagnosis and treatment

Vertigo following cochlear implantation: a review

Cochlear implantation may cause a detrimental effect on vestibular function and residual hearing. A significant number of patients with a cochlear implant present with vertigo. There are several mechanisms for dizziness following cochlear implantations. The causes may be surgical trauma, disruption of normal cochlear physiology, or ensuing endolymphatic hydrops. Vibratory trauma affecting the cochlea during cochleostomy plays a vital role in causing paroxysmal vertigo in patients with a cochlear implant. In addition, the vibrations affecting the cochlea are enough to dislodge otoconia particles. During cochlear implantation, it is necessary to insert an electrode array into the cochlea and thus the chance of damage to cochlear and function may happen. Dizziness or vertigo may develop after cochlear implantation. It usually occurs due to vestibular hypofunction. Vertigo following cochlear implantation has not frequently been documented in the literature previously. However, the increasing number of cochlear implantations in the current scenario is showing different postoperative complications like vestibular symptoms among patients with an implant. The vestibular symptoms following cochlear implantation range from a gradual sense of mild unsteadiness or lightheadedness to brief attacks of whirling vertigo. Vertigo following cochlear implantations affects the quality of life although vestibular therapy is often helpful to manage this condition. The article aims to provide a comprehensive review of vertigo following cochlear implantation

Cochlear deformities and its implication in cochlear implantation: a review

Hearing loss is one of the world’s leading causes of chronic health conditions. Cochlea plays a vital role in the hearing mechanisms and it converts sound energy into electrical stimuli which are transmitted to the brain through the neural pathway. The human cochlea is difficult to explore because of its vulnerability and bordering bony capsule. Congenital malformation of the inner ear or cochlea is an important cause of congenital sensorineural hearing loss. The deformity of the cochlea may result from arrested development of cochlea at different stages of fetal life or from abnormal development due to genetic abnormalities. There are hair cells responsible for converting sound energy into electrical impulses. These hair cells are easily damaged, which results in permanent hearing loss. Cochlear implants are surgically implantable biomedical devices that bypass the sensory hair cells and directly stimulate the remaining fibers of the auditory nerve with an electric current. Cochlear implantation is capable of restoring a surprisingly large degree of auditory perception to patient that is suffering from severe to profoundly deaf. Children with cochlear anomalies are thought to have poorer outcomes with cochlear implantations, therefore would be poorer candidates due to their diminished ability to interpolate and use auditory information provided through a cochlear implant. Parents should be counselled to establish realistic post-implant expectations in case of children with cochlear deformity. So, patient selection has emerged as one of the most vital determinants of successful outcomes after pediatric cochlear implantation

Greater superficial petrosal nerve and its surgical importance: a review

The greater superficial petrosal nerve (GSPN) is an important but often underappreciated branch of the facial nerve. The GSPN is a mixed nerve which contains both sensory and parasympathetic fibers. It serves as the motor root of the pterygopalatine (sphenopalatine) ganglion. GSPN has a long course which passes across the middle skull base between the petrous bone and dura mater and running through the foramen lacerum. It then incorporates to the deep petrosal nerve and crosses along the pterygoid canal to the pterygopalatine ganglion. The postganglionic nerve fibers innervates the lacrimal glands, nasal mucosa and palatal mucosal glands via branches of the zygomatic nerve/zygomaticotemporal branch, sphenopalatine, greater palatine, lesser palatine nerves and pharyngeal nerve. Surgical anatomy of the GSPN nerve is often unfamiliar to many clinicians. As this nerve is usually unrecognized without use of high resolution microscope or endoscope, its anatomical knowledge is essential for surgeons basically otologists and other head and neck surgeon to minimize the risk of injury during surgical intervention. This review article surely increases the precise knowledge of the GSPN including its embryology, surgical anatomy, blood supply, relations with other structures and imaging

Current treatment options for allergic rhinitis: a review

Allergic rhinitis (AR) is an immunoglobulin E-mediated inflammatory reaction in the nasal mucosa caused by inhaled allergens such as dust, pollen, mold, or animal dander. AR is a common chronic disease that is often ignored, misdiagnosed, and/or mistreated. Clinically, AR is characterized by four major symptoms such as rhinorrhea, sneezing, nasal itching, and nasal congestion. It can be associated with certain co-morbid conditions like asthma and nasal polyposis. AR is diagnosed by taking proper history taking, nasal examination, and allergy tests. A proper understanding of the pathophysiology of AR can lead to improved treatment of this disorder. The treatment for AR should target symptoms to improve the quality of life for patients. Undertreatment of AR often impairs quality of life. The important concern in the treatment of AR is the patient’s adherence to the treatment. Novel treatments are needed for cheaper, early, better, and more permanent symptom resolution in AR. Evidence-based guidelines for AR treatment are helpful to improve disease control. The treatment of AR includes avoidance of relevant allergens, appropriate pharmacotherapy, immunotherapy, patient education, and follow-up. Intranasal corticosteroids are the most effective modality of treatment for AR. This review article discusses details of current treatment options for AR