Bengal Journal of Otolaryngology and Head Neck Surgery

Number 23(1), 2015

5
Adult Retropharyngeal Abscess

Authors: Saumendra Nath Bandyopadhyay, Dwaipayan Mukherjee, Diptanshu Mukherjee, Swagatam Banerjee, Shubhra Kanti Sen

Abstract

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Introduction The proportion of adults suffering from retropharyngeal abscess (RPA) has increased in comparison to children. Materials and methods Eight cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling. Results Sore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication. Discussion Most of the patients had history of trauma prior to the development of RPA. CT scan has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space. Conclusion Tuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications. Keywords Retropharyngeal abscess, Deglutition disorders, Esophagus/Radiography

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Universal Neonatal Hearing Screening - a Necessity and not a Choice

Authors: Saikat Samaddar, Swagatam Banerjee, Sanjoy Kumar Ghosh, Subhra Bhattacharya, Diptanshu Mukherjee, Sirshak Dutta

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ABSTRACT Introduction Congenital deafness in a child is often missed. Several distraction tests have evolved over time to diagnose congenital deafness. However, these are of limited value in the era of Evoked Response Audiometry. The study was conducted to compare the result of universal neonatal hearing screening (UNHS) in high risk and non-high risk neonates using Otoacoustic Emission (OAE) and Brainstem Evoked Response Audiometry (BERA). Materials And Methods A study was conducted over a time period of three months at a tertiary care institute to screen all live neonates for congenital hearing impairment using OAE, followed up by BERA, if required. Result 1182 neonates were screened for hearing impairment. 336 were in high risk group and the rest in non-high risk group. Nine neonates turned out to have abnormal BERA results (absence of wave V). Six of them were high risk babies and the rest three were non-high risk ones. Discussion 33.33% of congenital deaf population detected by UNHS belong to the Non High Risk group. Studies across the world suggest at least 50% chance of missing out a congenital deaf child if Universal Neonatal Hearing Screening is not practiced. Conclusion In order to ensure that early detection and effective intervention are possible for all neonates with hearing impairment, UNHS should be performed. Three stage UNHS protocol using OAE and BERA showed that the implementation of UNHS for congenital childhood hearing loss for all neonates in India would be beneficial. Keywords Deafness; Infant, Newborn; Hearing Tests; Evoked Potentials, Auditory, Brain Stem; Audiometry, Evoked Response; Otoacoustic Emissions, Spontaneous