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Article: Sudden Onset Auditory Neuropathy Spectrum Disorder: A Rare Case Report of Brown Vialetto Van Laere Syndrome.

Vishak, M S / Haritha, G H / Kalaiarasi, Raja

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

2023 Volume 76, Issue 1, Page(s) 1187–1190

Abstract: Brown Vialetto Van Laere syndrome is a rare disorder characterized by progressive pontobulbar palsy with bilateral sensorineural hearing loss and lower cranial nerve palsies. Fifty-eight cases have been reported in the last hundred years. As the most ... ...

Abstract	Brown Vialetto Van Laere syndrome is a rare disorder characterized by progressive pontobulbar palsy with bilateral sensorineural hearing loss and lower cranial nerve palsies. Fifty-eight cases have been reported in the last hundred years. As the most common presenting complaint of this disorder is hearing loss, audiological evaluation plays a vital role in pointing towards and narrowing its diagnosis. We present a case report of a 12-year male child affected by this disorder.
Language	English
Publishing date	2023-09-11
Publishing country	India
Document type	Journal Article
ZDB-ID	1471137-0
ISSN	0973-7707 ; 2231-3796 ; 0019-5421
ISSN (online)	0973-7707
ISSN	2231-3796 ; 0019-5421
DOI	10.1007/s12070-023-04207-0
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Article ; Online: Comparison of the Efficacy of Septoplasty with Nonsurgical Management in Improving Nasal Obstruction in Patients with Deviated Nasal Septum – A Randomized Clinical Trial

Dharanya Gopalakrishnan Srinivasan / Jyotirmay Hegde / Karthikeyan Ramasamy / Kalaiarasi Raja / Sathish Rajaa / Sivaraman Ganesan / Prabu Velayutham / Arun Alexander / Sunil Kumar Saxena

International Archives of Otorhinolaryngology, Vol 26, Iss 02, Pp e226-e

2022 Volume 232

Abstract: Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been ... ...

Abstract	Introduction In the current era, the major indication for septoplasty is nasal obstruction due to deviated nasal septum (DNS). Even though septoplasty is a commonly performed surgery, its effectiveness in relieving nasal obstruction in DNS has not been proven. Objective The present study involved the measurement of both objective (nasal patency) and subjective (quality of life measures) outcome measures for the evaluation of the efficacy of septoplasty as compared with medical management. Methods Patients with DNS presenting with nasal obstruction were included and randomized into a septoplasty group or into a nonsurgical management group, with 70 patients in each group. The improvement in nasal obstruction was assessed subjectively by the visual analogue scale (VAS), and the sino-nasal outcome test-22 (SNOT-22) and the nasal obstruction symptom evaluation (NOSE) questionnaires and was measured objectively by assessment of nasal patency by peak nasal inspiratory flow (PNIF) at 0, 1, 3, and 6 months of treatment in both groups. Results The average VAS, SNOT-22 and NOSE scores for the septoplasty versus the nonsurgical group before treatment were 6.28 versus 6.0, 19.5 versus 15, and 14 versus 12, respectively, and at 6 months post-treatment, the scores were 2.9 versus 5.26, 10 versus 12, and 8 versus 10 (p = 0.001), respectively. The average PNIF scores at 0 and 6 months were 60/50 l/min and 70/60 l/min, respectively, in the septoplasty group (p = 0.001); the scores at 0 and 6 months in the nonsurgical management group were 60/60 l/min and 70/70 l/min, respectively (p = 0.001). Conclusion Surgical correction of DNS by septoplasty improves nasal obstruction better than nonsurgical management at 6 months postsurgery.
Keywords	visual analogue scale ; pnif ; snot-22 ; nose score ; intranasal corticosteroids ; topical decongestants ; Medicine ; R ; Otorhinolaryngology ; RF1-547
Subject code	610
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Thieme Revinter Publicações Ltda.
Document type	Article ; Online
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Article ; Online: ‘Shifting from anxiety to the new normal’

Ganesan Sivaraman / Jijitha Lakshmanan / Britzer Paul / Mahalakshmy Thulasingam / Bitty Raghavan / Nipun Raghu / Kalaiarasi Raja / Sunil Kumar Saxena

Nigerian Postgraduate Medical Journal, Vol 29, Iss 2, Pp 110-

A qualitative exploration on personal protective equipment use by otorhinolaryngology health-care professionals during COVID-19 pandemic

2022 Volume 115

Abstract: Background: The novel coronavirus pandemic has influenced the working practice of health-care professionals who come across symptomatic and asymptomatic COVID patients in their day-to-day practice. Especially, among HCWs in otorhinolaryngology, with the ... ...

Abstract	Background: The novel coronavirus pandemic has influenced the working practice of health-care professionals who come across symptomatic and asymptomatic COVID patients in their day-to-day practice. Especially, among HCWs in otorhinolaryngology, with the risk of exposure being high, hence were mandated to use personal protective equipment (PPE). Materials and Methods: The change in perceptions and patterns of PPE use throughout the COVID-19 pandemic was studied in detail through interviews conducted among 15 key informants, and the data were analyzed using health belief model in our study. Results: A health belief model explains the trajectory of PPE use by otorhinolaryngology health care providers during the COVID-19 pandemic. The course of usage of PPE by otorhinolaryngology health-care professionals during the COVID-19 pandemic was explained through the health belief model. During the initial days of the COVID-19 pandemic, intense perceived severity and susceptibility to COVID infection led to PPE use, and otorhinolaryngology HCWs resorted to higher grade PPEs which gave optimal protection; but in course of time with a better understanding of the natural course of illness, minimal PPEs without compromising HCW safety were used with minimal discomfort. Perceived severity of COVID infection on self and family, health knowledge, influence of peers, and support from the institution encouraged them in using PPEs. Conclusion: We found that various aspects of health belief model such as the perceived susceptibility, perceived severity of the disease, perceived barriers and benefits in PPE use, self-efficacy, health-related knowledge, and the cues to action influence PPE use among otorhinolaryngology HCWs. The key findings can be applied in behavior change models to promote the use of PPE in the hospitals, especially during the time of pandemic.
Keywords	covid-19 ; health belief model ; pandemic ; personal protective equipment ; practise ; Medicine ; R
Subject code	360
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article: Factors Associated with Fracture and Migration of Tracheostomy Tube into Trachea in Children: A Case Series.

Parida, Pradipta-Kumar / Kalaiarasi, Raja / Alexander, Arun / Saxena, Sunil-Kumar

Iranian journal of otorhinolaryngology

2020 Volume 32, Issue 113, Page(s) 379–383

Abstract: Introduction: Tracheostomy is done to bypass the obstructed upper airway. Rare complication of this procedure is the fracture of the tube. Early identification and management of this condition is a great challenge to an otolaryngologist. To study the ... ...

Abstract	Introduction: Tracheostomy is done to bypass the obstructed upper airway. Rare complication of this procedure is the fracture of the tube. Early identification and management of this condition is a great challenge to an otolaryngologist. To study the factors associated with the fracture and migration of tracheostomy tube into tracheobronchial tree in paediatric age group. Materials and methods: This study is a case series study conducted on children with a diagnosis of fractured tracheostomy tube presenting as a foreign body airway over five years duration. Data regarding the possible patient and tube factors responsible for the condition were collected and analysed. Results: Total 11 patients (males-5 and females-6, average age-10.18 years, range 1-15 years) wearing tracheostomy tube for an average period of 2 years (range 3 months-8 years) were included in the study. Aspirated tubes were Jackson's metallic inner tube, Romson polyvinyl chloride plastic tube and Fuller's outer tube flange in 5 (45.5%), 4 (36.4%) and 2 (18.1%) patients respectively. The most common fracture site was at the junction between tube and neck plate (90.9%). The most common causes for fracture tube were prolonged use in 10 cases (90.9%), stomal narrowing in 9 cases (81.8%), and infection with peri-stomal granulation tissue in 9 cases (81.8%). Conclusion: A fractured tracheostomy tube is a rare but preventable late complication of tracheostomy. Appropriate training about proper tracheostomy care, timely check-up of tracheostomy tube for signs of wear and tear, scheduled replacement, regular follow up and awareness may prevention this complication.
Language	English
Publishing date	2020-09-28
Publishing country	Iran
Document type	Journal Article
ZDB-ID	3018470-8
ISSN	2251-726X ; 2251-7251
ISSN (online)	2251-726X
ISSN	2251-7251
DOI	10.22038/ijorl.2020.44797.2473
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Article: Pediatric Primary Tuberculous Osteomyelitis of the Mandible Mimicking Parotitis.

Kalaiarasi, Raja / Vijayakumar, Chellappa / Archana, Ramalingam / Natarajan, Ramalingam

Cureus

2018 Volume 10, Issue 1, Page(s) e2071

Abstract: Tuberculosis (TB) is a worldwide public health problem; however, primary tuberculous osteomyelitis involving the mandible is extremely rare. Here, we report a 14-year-old boy who presented with a recurrent, generalized swelling of the cheek in the right ... ...

Abstract	Tuberculosis (TB) is a worldwide public health problem; however, primary tuberculous osteomyelitis involving the mandible is extremely rare. Here, we report a 14-year-old boy who presented with a recurrent, generalized swelling of the cheek in the right side, mimicking parotitis. Fine needle aspiration cytology (FNAC) from the swelling was inconclusive. Contrast-enhanced computed tomography (CECT) of the head and neck revealed an osteolytic lesion of the mandible with a surrounding abscess. An intraoral incisional biopsy of the tissue showed a granulomatous lesion. The patient was started on anti-tubercular therapy (ATT) for six months. Our patient's presentation underscores the clinical difficulty in establishing a diagnosis and considering tuberculous osteomyelitis in the differential diagnosis.
Language	English
Publishing date	2018-01-15
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.2071
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Article: Management of Laryngotracheal Trauma: A Five-Year Single Institution Experience.

Parida, Pradipta-Kumar / Kalaiarasi, Raja / Alexander, Arun

Iranian journal of otorhinolaryngology

2018 Volume 30, Issue 100, Page(s) 283–290

Abstract: Introduction: Laryngotracheal trauma is a rare life-threatening emergency that requires early identification and immediate intervention. Here, we present 26 patients with laryngotracheal trauma from a tertiary hospital in India. The aim was to describe ... ...

Abstract	Introduction: Laryngotracheal trauma is a rare life-threatening emergency that requires early identification and immediate intervention. Here, we present 26 patients with laryngotracheal trauma from a tertiary hospital in India. The aim was to describe the clinical presentation and management of laryngotracheal trauma patients. Materials and methods: This was a retrospective study of laryngotracheal trauma patients treated between January 2011 and March 2016. Patients who presented with a breach in the laryngotracheal framework were included, while those who had penetrating neck injuries superficial to strap muscles/platysma, burn injuries, caustic ingestion, or endotracheal injuries were excluded from the study. Results: Of 253 patients with neck injury, 26 (23 adults, three children; 21 males, five females; age range, 5-60 years) presented with a breach in the laryngotracheal framework (15 blunt neck-trauma patients and 11 penetrating neck-trauma patients). The most common cause of neck injury was road traffic accidents, seen in 12 patients (46.2%). Computed tomography (CT) was performed in all blunt trauma cases and in four patients with penetrating trauma. All penetrating trauma patients underwent neck exploration. Twelve blunt trauma patients (46.1%) were managed conservatively, while three (11.5%) required surgical intervention. The most common neck exploration finding noted in patients with a penetrating injury was fracture of the thyroid cartilage, which was seen in eight patients (30.8%). Twenty patients (76.9%) had a normal voice, five patients (19.2%) had a hoarse voice, and one patient (3.8%) had a breathy voice post treatment. Conclusion: Early intervention of laryngotracheal trauma is crucial. The role of a CT scan is essential in decision making in blunt trauma cases.
Language	English
Publishing date	2018-09-17
Publishing country	Iran
Document type	Journal Article
ZDB-ID	3018470-8
ISSN	2251-726X ; 2251-7251
ISSN (online)	2251-726X
ISSN	2251-7251
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Article: Anatomical Variations of the Middle Turbinate Concha Bullosa and its Relationship with Chronic Sinusitis: A Prospective Radiologic Study.

Kalaiarasi, Raja / Ramakrishnan, Venkataramanan / Poyyamoli, Santhosh

International archives of otorhinolaryngology

2018 Volume 22, Issue 3, Page(s) 297–302

Abstract: ... ...

Abstract	Introduction
Language	English
Publishing date	2018-03-13
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2578584-9
ISSN	1809-4864 ; 1809-9777
ISSN (online)	1809-4864
ISSN	1809-9777
DOI	10.1055/s-0038-1625978
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Article ; Online: Otogenic Lateral Sinus Thrombosis

Kalaiarasi Raja / Pradipta Kumar Parida / Arun Alexander / Gopalakrishnan Surianarayanan

International Archives of Otorhinolaryngology, Vol 22, Iss 03, Pp 208-

A Review of Fifteen Patients and Changing Trends in the Management

2017 Volume 213

Abstract: Abstract Introduction Otogenic lateral sinus thrombosis is a rare intracranial complication of otitis media in the modern age of antibiotic treatment, but it is potentially a dangerous complication. Objectives The aim of this study is to focus on the ... ...

Abstract	Abstract Introduction Otogenic lateral sinus thrombosis is a rare intracranial complication of otitis media in the modern age of antibiotic treatment, but it is potentially a dangerous complication. Objectives The aim of this study is to focus on the various clinical presentations, management options and sequelae in a series of fifteen patients with otogenic lateral sinus thrombosis. Methods Retrospective chart review of inpatients treated for otogenic lateral sinus thrombosis at our tertiary care institution between 2010 and 2015. Results A total of 15 patients (11 males and 4 females) with ages ranging from 9 to 60 years were diagnosed with otogenic lateral sinus thrombosis. The most commonly reported symptoms were headache, ear discharge and hard of hearing, which were experienced by all 15 (100%) patients. In contrast to previous studies found in the literature, 7 (47%) patients in our series presented with neck pain and neck abscess. Imaging studies and microbiological cultures were performed for all patients, who also underwent a mastoidectomy procedure. Internal jugular vein ligation was performed on 5 (33%) patients. Incision and drainage of the neck abscess was performed on 7 (47%) patients. All patients had a satisfactory resolution of their symptoms, and the mortality rate was of 0%. Conclusions Otogenic lateral sinus thrombosis, though a rare complication, can still occur; therefore, keeping a high level of suspicion is important, especially in developing countries. We also describe the patients with neck abscess associated with this rare condition. Combining parenteral antibiotics with surgical intervention is the treatment of choice.
Keywords	lateral sinus thrombosis ; otitis media ; cholesteatoma ; Medicine ; R ; Otorhinolaryngology ; RF1-547
Subject code	616 ; 610
Language	English
Publishing date	2017-07-01T00:00:00Z
Publisher	Thieme Revinter Publicações Ltda.
Document type	Article ; Online
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Article: Microbiological Profile of Chronic Tonsillitis in the Pediatric Age Group.

Kalaiarasi, Raja / Subramanian, Kalaivani S / Vijayakumar, Chellappa / Venkataramanan, Ramakrishnan

Cureus

2018 Volume 10, Issue 9, Page(s) e3343

Abstract: Introduction Tonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar ... ...

Abstract	Introduction Tonsillitis is a very common disease in children. Understanding the microbiology and pathology of chronic tonsillitis is an important step in its management. The aim of the study was to describe the microbiological profile of core tonsillar tissue in chronic tonsillitis in children. Materials and methods Children under 16 years of age with chronic tonsillitis were recruited in the descriptive study. Children with recurrent tonsillitis and recurrent tonsillitis with obstructive symptoms were included. Children who underwent tonsillectomy for obstructive symptoms alone and those who received antibiotics for at least one month prior to surgery were excluded from the study. Dissection and the snare method of tonsillectomy were done on all children. The operated specimen was cut into two halves in a sterile container. The core of the tonsillar tissue was swabbed with two sterile cotton-tipped swabs and sent for the microbiological evaluation of aerobes and anaerobes. The tonsillar tissue was sent for a histopathological examination. Results A total of 106 children were operated for chronic tonsillitis in one year. The mean age of children included in this study was 9.4 years. The duration of symptoms due to tonsillar disease ranged from four weeks to 28 months. There were 48 males and 58 females. Recurrent tonsillitis was the most common indication for tonsillectomy in all children. A total of 301 aerobes and 171 anaerobic microorganisms were isolated from 106 children with chronic tonsillitis. The aerobic bacterial species most often isolated was Streptococcus viridans, which was present in 83 children followed by Group A, β-hemolytic Streptococci in 67 children. The anaerobic bacterial most often isolated was Peptococcus species in 49 children. Polymicrobial aerobic and anaerobic flora were present in all tonsillar specimens, yielding an average of 4.1 isolates per specimen. The histopathological examination revealed chronic tonsillitis with reactive follicular hyperplasia in all (100%) children. Actinomycosis was associated with non-specific reactive follicular hyperplasia in four specimens. Conclusion Polymicrobial aerobic and anaerobic flora are identified in deep tonsillar tissue in children with tonsillitis. The identification of bacterial isolates from the core tissue in recurrent tonsillitis could dictate the management of chronic tonsillitis. The histopathological examination of the core tissues of the tonsils helps in an accurate identification of organisms that are difficult to culture.
Language	English
Publishing date	2018-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.3343
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Article ; Online: Diode Laser Stapedotomy vs Conventional Stapedotomy in Otosclerosis: A Double-Blinded Randomized Clinical Trial.

Parida, Pradipta Kumar / Kalaiarasi, Raja / Gopalakrishnan, Surianarayana

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2016 Volume 154, Issue 6, Page(s) 1099–1105

Abstract: Objectives: To assess and compare the efficacy of diode laser stapedotomy (DLS) and conventional manual stapedotomy (CMS) in the treatment of otosclerosis.: Study design: Randomized clinical trial.: Setting: Tertiary health center.: Subjects and ...

Abstract	Objectives: To assess and compare the efficacy of diode laser stapedotomy (DLS) and conventional manual stapedotomy (CMS) in the treatment of otosclerosis. Study design: Randomized clinical trial. Setting: Tertiary health center. Subjects and methods: We randomly assigned 60 patients with otosclerosis planned for primary stapedotomy to receive either DLS or CMS. Primary outcome measure was hearing gain measured by pure-tone audiometry (PTA) performed preoperatively and postoperatively. Hearing gain was compared within and between the groups. Secondary outcome measures were the incidence of intraoperative (bleeding and fractured footplate) and postoperative (vomiting, vertigo, sensorineural hearing loss, tinnitus, facial nerve paralysis, and hospital stay) morbidities. Results: Sixty primary stapedotomies (30 in the CMS group and 30 in the DLS group) done for 60 patients (male, n = 42; female, n = 18) were included in the analysis. Preoperative mean air-bone (AB) gap in the DLS and CMS groups was 38.51 ± 8.643 dB and 36.42 ± 8.678 dB, respectively. Mean AB gap at 6 month was 10.86 ± 5.383 dB and 11.05 ± 5.236 dB in the CMS and DLS groups, respectively. Air conduction was improved by 24.98 ± 5.348 dB in the DLS group and 24.08 ± 5.911 dB in the CMS group at 6 months. No statistically significant differences were found in hearing gain between the 2 groups at 6 months (P > .05). A decreased rate and severity of intraoperative bleeding, postoperative vertigo, and vomiting were observed with the diode laser (0%, 6.6%, and 10%) compared with the conventional technique (16.7%, 16.7%, and 16.7%), but these differences were not statistically significant (P > .05). Conclusion: Hearing outcomes and complications of DLS were similar to CMS. These study findings confirm the efficacy of the diode laser in stapedotomy, but DLS offers no advantages over CMS for otosclerosis surgery.
MeSH term(s)	Acoustic Impedance Tests ; Adolescent ; Adult ; Audiometry, Pure-Tone ; Bone Conduction ; Double-Blind Method ; Female ; Humans ; Laser Therapy/methods ; Lasers, Semiconductor ; Male ; Middle Aged ; Otosclerosis/surgery ; Postoperative Complications ; Prospective Studies ; Stapes Surgery/methods ; Treatment Outcome
Language	English
Publishing date	2016-06
Publishing country	England
Document type	Comparative Study ; Journal Article ; Randomized Controlled Trial
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1177/0194599816635132
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