Journal of ENT and Allied Sciences

This article presents a rare and interesting case of isolated mucocoele of haller cell (Infraorbital ethmoid cell) presenting with extensive proptosis and visual disturbances in the absence of facial pain and symptoms of sinusitis. CT PNS with contrast revealed a heterogeneous non enhancing soft tissue lesion in the roof of the left maxillary sinus/floor of left orbit with severe thinning of the floor of the left orbit and not filling the maxillary sinus. This is the fourth reported case of isolated mucocoele of haller cell and the first case to present with significant proptosis and visual disturbances. Treatment opted was endonasal endoscopic surgical removal and restoring the appropriate orbital function and cosmesis. Early diagnosis and prompt surgical management can help avoid dangerous visual complications in these kind of rare presentations.

Keywords: Maxillary sinus mucocele; Proptosis; Haller cell mucocele; Infraorbital ethmoidal cell; Haller cell.

Hearing is one of the fundamental senses. It connects individual to the outside world, through communicate in a way that none of the other senses can achieve. Pure tone audiometry and auditory steady state response are audiological tests to evaluate hearing thresholds on an individual enabling in determination of the degree, type and configuration of hearing loss. At present, Pure tone audiometry (PTA) is the gold standard for the evaluation of hearing levels. Audiometers are used to make quantitative measurements of pure-tone air and bone conduction thresholds. However, it is not possible to obtain reliable thresholds with PTA in all patients.1,2

 Auditory steady state response (ASSR) testing is a newly developed measurement of auditory evoked potentials it can be used to objectively for predicting frequency specific hearing thresholds. ASSR measurements also detects automatic response and that feature is attractive in that it avoids problems associated with the experience and expertise of the observer3

Result: Among the 51 patients we found out very strong correlation between PTA and ASSR measurements at all the four frequencies were found between Normal and SNHL groups. However, in CHL group, there was no correlation between PTA and ASSR measurements at 500 Hz and 1000 Hz.

Conclusion: ASSR was able to detect thresholds at about 5 dB higher than that of PTA in both the ears in normal hearing patients at all frequencies.We conclude that ASSR testing can be an excellent complement to other diagnostic methods to serve as a valuable tool in the determination of hearing thresholds

Keywords: PTA; ASSR; Audiological Test; Hearing Loss; SNHL; CHL.

Tracheostomy is a tricky procedure but very crucial for ENT surgeons to master. Medical colleges use innovative tools to implement the teaching of anatomy to students and one such tool is the 3D Anatomage™ table which is a fully segmented touch interactive real human 3D anatomy platform that helps to visualize human anatomy just as it can be seen on a fresh cadaver. This study is based on advanced clinical skills program that was conducted for 26 ENT residents whose knowledge was assessed before and after the training and a feedback was taken to assess the usefulness of 3D Anatomage™. After the Module, an average of 23 students found it useful and superior to the old fashioned mannequin method of demonstration; 22 students showed significant improvement in knowledge and skills.

Keywords: 3D Anatomage™; Virtual Dissection; Tracheostomy.