Ishwar Chandra Behera’s research while affiliated with Siksha O Anusandhan University and other places

Vertigo is a morbid symptom in the pediatric age group. It is not an uncommon clinical presentation in children. The etiopathology of vertigo in children is different from that of the adult age group. It is often not easy to evaluate this symptom in pediatric age group. In most cases, the children do not express their symptoms in detail and so clinicians cannot obtain adequate history and determine their exact etiology for vertigo. The benign paroxysmal vertigo is a common etiology in younger children, whereas the vestibular migraine is responsible for vertigo in majority of older children. Hence, pediatricians, otorhinolaryngologists, physicians, and neurologists often face difficulty in establishing the appropriate diagnosis of vertigo in children. The diagnosis of vertigo in children includes a detailed history, clinical examination, complete neurological examination, and audiological assessment. The treatment of vertigo in children includes the treatment of appropriate etiology. The prognosis of vestibular function recovery in children is often variable and unpredictable. Imaging such as computed tomography scans or magnetic resonance imaging is done in selected cases. The objective of this review article is to familiarize the readers with these complex disorders of children and with the current protocols in their management.

The majority of cases of actinomycosis are of odontogenic origin and related to the perimandibular region with other sites of primary actinomycosis in the head and neck region include the tongue, paranasal sinuses, middle ear, larynx, lacrimal passage, and thyroid gland. Actinomycosis is an uncommon infection caused by Actinomyces species, facultative anaerobic bacteria that are part of the normal flora in the oropharynx, gastrointestinal tract, and female genital tract. The risk factors for actinomycosis in the pediatric age group are dental caries, trauma, debilitation, and poorly controlled diabetes mellitus. The pathogenesis of the actinomycosis in the head and neck region is often unclear. The hallmark of actinomycosis is the spread of infection which fails to respect the tissue or fascial planes. The organism causing actinomycosis is often difficult to isolate from culture and the differential diagnosis is extensive which prompts clinicians to name the actinomycosis the masquerader of the head and neck area. This clinical entity in pediatric patients may mimic malignancy or granulomatous disease in the head and neck region. Clinicians must be aware of typical presentations of actinomycosis in the head and neck region. Bacterial cultures and histopathological study are the cornerstones of the diagnosis of actinomycosis, however, particular conditions are needed to find the exact diagnosis. The treatment of actinomycosis includes a combination of surgery and antibiotic therapy. Surgery is an important adjunctive to medical therapy in patients with extensive lesions of actinomycosis. Actinomyces species are uniformly susceptible to penicillin. This review article discusses the etiopathology, epidemiology, clinical manifestations, diagnosis, and current treatment of the actinomycosis in the head and neck region of pediatric patients.

Coronavirus disease 2019 (COVID-19) is a highly contagious infection caused by a novel strain of coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The severity of the COVID-19 infection of the pediatric patient varies broadly between a mild cough and fever to severe form of diseases such as acute respiratory distress syndrome (ARDS) for which some may need intubation and followed by mechanical ventilation through tracheostomy in case of prolonged ventilation. Performing tracheostomy in pediatric patient pose a challenge for health care professional as there is high chance of spread of the disease in COVID-19 pandemic. Surgical tracheostomy is an aerosol generating procedure which causes high chance of spread of infections. There is increasing concern for high transmissibility of the virus to the operating surgeon with their assisting staff and other nearby patients. Pediatric tracheostomy should be performed with close association with pediatric otolaryngologists, anesthesiologists and pediatric intensive care physicians along with adequate personal protective equipment (PPE) for smooth and safe execution of the procedure.

The novel coronavirus disease (COVID-19) pandemic is posing unprecedented challenges among the otolaryngologists during managing the pediatric patients. COVID-19 infection is caused by novel coronavirus called severe acute respiratory syndrome coronavirus-2. This infection is transmitted primarily through human contact and by droplet route. The pediatric otolaryngologists have a critical role for managing nose, paranasal sinus, ears, oral cavity, pharynx, and larynx, which are important sites for generating aerosols and virus transmission. Asymptomatic pediatric patients have high risk for viral shedding. In COVID-19 pandemic, the surgical procedure by pediatric otolaryngologists should be limited to the emergency condition. The surgical interventions should limit the viral dissemination. This review article provides an overview of common methods to limit the viral transmission to the otolaryngologists and assisting health-care staffs from COVID-19 infections during the management of the pediatric patients.

p class="abstract"> Background: Otitis media with effusion (OME) is one of the commonest diseases causing hearing impairment in children. Hearing loss in early childhood may lead to risk of speech and language problems and psychosocial abnormalities. Aim of this study is to evaluate the role of topical intranasal steroids (Mometasone furoate) in pediatric hearing loss due to otitis media with adenoid hypertrophy. Methods: A prospective study carried out at a tertiary care teaching hospital of eastern India where 104 children participated with diagnosis of otitis media with effusion and hearing loss between 2017 to 2019. These participants were divided into study group and control group. The age group of the children was between 5 to 10 years. Detail otoscopic examination, pure tone audiometry, tympanometry and nasopharyngeal endoscopy were done for assessing the hearing loss, fluid in the middle ear and adenoid hypertrophy. Results: There is improvement of hearing in the study group as compared to control group. A significant improvement in hearing was seen in the study group (p=0.0001). In the study group, 37 (77.08%) out of the 48 children OME resolved over a period of 12 weeks after treatment in comparison to 18 (37.50%) in the control group (p=0.0004). Conclusions: Intranasal topical steroids can be a treatment option alternative to surgery in OME. As it is short term follow up in this study, long term follow up is required. Intranasal mometasone furoate treatment can be considered as a good treatment option for OME.</p