No abstract

Foreign body (FB) ingestion is a common emergency managed by otorhinolaryngologists. The clinical manifestations and management vary as per the site of FB and its complications. The diagnosis of FB ingestion is often challenging and depends on its clinical presentations and imaging. One of the rare complications of FB ingestion is migration, which has the potential to result in morbidity and mortality. Migration of FB is said to have occurred in the presence of negative rigid esophagoscopy and positive radiography. Migration of FB to the neck requires neck exploration for its successful removal. Here, we report a case of sharp FB ingested, which penetrated through the hypopharyngeal wall by its sharp end and migrated into the deep space of the neck.

Actinomycosis is an uncommon infection caused by filamentous Actinomyces, which forms club-shaped filaments arranged in a radiating pattern and rarely infects palate. The clinical presentations are often non-specific, so it posed a challenging situation for clinicians to get diagnosis of actinomycosis. The histopathological study is often helpful for the diagnosis of actinomycosis. The patient needs clinical follow-up for complete healing of the lesion. This case report describes a case of palatal cyst, which was diagnosed as actinomycosis on the basis of histopathological examination. Surgical excision of the cyst with debridement of the granulation tissue is mandatory for such cystic presentation of actinomycosis. This case was undergoing complete excision, followed by amoxycillin and clavulanic administration for 3 months. The bony defect was reconstructed using mucoperiosteal flap of the palate.

Background: Headache is a common clinical entity seen among pediatric patients in routine clinical practice. The pressure of two opposing mucosa in the nasal cavity even in the absence of inflammation can be a cause of headache, which is called a rhinogenic contact point headache. Anatomical variations of the nose such as rhinogenic contact point headache may result in headache due to the contact of the nasal mucosa which often missed during the evaluation of the pediatric patients. Objective: The aim of this study is to assess the rhinogenic contact point headache in the pediatric age group. Materials and Methods: This is a prospective study and 112 children with rhinogenic contact point headache enrolled in this study. This study conducted at a tertiary care teaching hospital during September 2018–October 2021. The anatomical variations of the nose were evaluated with help of diagnostic nasal endoscopy and computed tomography (CT) scan. These anatomical variations in rhinogenic contact point headache were treated surgically. Results: Out of 112 children with rhinogenic contact point headache, 31 (27.67%) had deviated nasal septum, 28 (25%) had septal spur, 20 (17.85%) middle turbinate concha bullosa, 11 (9.82%) enlarged ethmoidal bullosa, 11 (9.82%) had hypertrophied inferior turbinate, 7 (6.25%) had hypertrophied super turbinate, and 4 (3.57%) had nasal septal bullosa. Treatment of each child with rhinogenic contact point was personalized for every patient. Conclusion: Headache is a common clinical symptom and is nearly universal in the life of a child. The contact between opposing mucosa in the nasal cavity in the absence of inflammation can result in headache and/or facial pain in the pediatric age group. Endoscopic excision of the contact points of nasal cavity is effective for the treatment of rhinogenic contact point headaches.

Background: Aspiration of an open safety pin in the airway is an extremely rare and critical condition that needs immediate and safe removal of the foreign body (FB). An open safety pin in the airway of the pediatric patient requires urgent recognition. Imaging will confirm the exact site of the open safety pin in the airway. Rigid bronchoscopy with optical forceps or grasping forceps is an ideal tool for the removal of the open safety pin from the airway. Objective: This study aims to evaluate the clinical details, management, and outcome of pediatric patients with an inhaled open safety pin in the laryngotracheal airway. Materials and Methods: This is a retrospective descriptive study done between November 2016 and December 2021. There were six children with inhaled open safety pins in the laryngotracheal airway. The diagnosis was done through proper history taking, clinical examination, and the X-ray of the neck and chest of the children. All children underwent rigid bronchoscopy with optical forceps to remove the open safety pin. Results: Out of the six children, four were boys and two were girls. Out of the six cases, four were in the proximal part of the airway and two were seen in the distal airway. The most common clinical presentation was coughing. In this study, open safety pins of the pediatric airway were removed successfully under general anesthesia with the help of a rigid bronchoscope. Conclusion: Open safety pin is rarely found in the laryngotracheal airway. Open safety pin may cause a life-threatening complication. During the removal of the open safety pin, the surgeon should maintain maximum care to not injure the surrounding structures by the sharp end of the open safety pin.