Giant arterio venous malformation (AVM) of the tongue and floor of mouth are rare. They become life threatening when ignored by the patients. Treatment protocols are not well established. This report describes the treatment of a 35 years old female who presented to us with complains of swelling of tongue, floor of mouth and left sub mandibular region since 15 years causing dysphagia, and oral bleed since one day. Magnetic resonance Angiography revealed a giant AVM at the above site with dilated left external carotid artery (ECA) and left lingual artery. Patient underwent ECA ligation under general anaesthesia and serial injection sclerotherapy at the local site. After 3 months and 6 cycles of sclerotherapy, the patient had a satisfactory outcome. A detailed report with review of literature is presented.

Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objectives Chronic rhinosinusitis (CRS) is a complex disease that incorporates many different conditions. Our aim is to determine the role of environmental risk factors in chronic rhinosinusitis. Methods This was a case-control study where forty cases of CRS in the age group of 18-62 years were recruited from the ENT-OPD of UCMS and GTB Hospital, Delhi, a tertiary care hospital, along with 40 age-appropriate healthy controls. Informed and written consent was obtained from all the subjects. Detailed history and examination along with routine blood and radiological investigations were done. Subjective assessment of disease was done using visual analog scales of SNOT 22 questionnaire, environmental questionnaire, and saccharine test. Objective assessment was done using endoscopic grading according to Lund and Kennedy scoring. CT scores were also obtained using Lund and Mackay staging system. Passive air sampling was done by the settle plate method and Anderson six-stage cascade impactor was used for active air sampling. Blood agar and Sabouraud dextrose agar plates were inserted on the six stages of the cascade impactor, which were later incubated at 35°C and 25°C respectively, for 18-24 hours. Bioaerosol concentrations were calculated and MicroScan WalkAway system was used to identify bacterial and fungal growth. The correlation between total bioaerosol concentration and the symptom score was done by spearman's correlation coefficient; a comparison of mean total bioaerosol concentration between the case and control groups was done by Mann-Whitney U-test. Results The mean total bio-aerosol concentration from active air sampling in the case group was 458.52 CFU/m3 and 437.63 CFU/m3 in control, which was not significant. It was found to be negatively correlated, but not significant with various parameters in case groups like SNOT 22 score, environmental exposure score, saccharine test, smoking, and endoscopic score. A positive but insignificant correlation was found between total bioaerosol concentration and absolute eosinophilic count and CT score. The mean CFU/100 mm3 counted after passive air sampling between case and control group was 34.03 and 30.88 CFU/100mm3 which was not significant. Fungal growths were mostly Aspergillus flavus and A. Niger followed by Cladosporium spp. Conclusion The fungal burden was high in all the households of the case as well as control groups, although, a significant correlation could not be established. The environmental conditions found in this study were found to be conducive to future risk of exacerbation of preexisting fungal infections for which, indoor air quality needs to be monitored.

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Schwannoma also known as neurinomas of verocay is a benign, slow growing, nerve sheath tumor arising from the Schwann cells of the nerve. Around 25-40% of the schwannoma arises from the soft tissues of head and neck areas. Out of which, only <1% arises from the oral cavity. The most common intra-oral site is the tongue and the least common site being the lips. Moreover, Schwannoma in the lower lip are excessively rare during childhood and adolescence. Due to its rarity in lower lip, it’s diagnosis is usually overlooked during the primary examination. Complete surgical excision of the tumor is the treatment of choice. Recurrence cases and malignant degeneration are extremely rare. Here, we reported a case of a 17 year old female with peripheral Schwannoma of the lower lip, presented to the Otorhinolaryngology department, Indira Gandhi Hospital, Dwarka, Delhi with complaints of painless swelling in the lower lip causing cosmetic deformity for the patient. She underwent complete enucleation of the mass and is being follow-up in the outpatient department.