Agenesis of the thyroid isthmus is a rare entity with a incidence rate of 0.5 and 10%. Thyroid isthmus agenesis could be associated with ectopic thyroid tissue or agenesis of the thyroid lobes. We discuss a case of a multinodular goitre which presented with morphological variations which was not detected on ultrasonography of the neck.

Keywords
Thyroid; Head and neck; Isthmus.

Everyday all of us use rechargeable solutions either its smartphones, televisions, or any other electronic devices. Faster streaming of these electronic devices to other external devices may be facilitated through wireless connectivity. Wireless streaming demands much more battery backup. With advancement of hearing aid technology many features exists in hearing aids which may facilitate better spectral information, improved speech understanding in presence of background noise and thus improving communication and quality of life of the users. The use of these advanced features often requires continuous uninterrupted power supply. Traditional disposable hearing aid batteries cannot be assured of their performance due to their inopportune time discharge. Recently rechargeable solutions in hearing aids have been discovered that can support long-lasting wireless streaming. Modern day rechargeable batteries are expected to be easy to charge which can last for longer duration with more reliability and durability. Rechargeable as a feature is added on over and boon. Rechargeable battery solutions based on its various benefits may support as boon for environment, hearing aid users and professionals (better counseling and more satisfied users). The aim of this article is to highlight the awareness of these different rechargeable solutions for the users and professionals. In addition mentioning in brief the superiority of Lithium ion battery which is widely accepted in rechargeable hearing aids.

Keywords
Rechargeable hearing aids; Wireless streaming; Batteries for hearing aids; Li-ion batteries.

Introduction
Previous literature has reported ill-effect of ototoxic drug on hearing and balance. Present study investigated awareness among medical doctors for the same.
Method
A total of 55-medical doctors of multiple specialties from Assam, India participated in the present study. A total of 14 questions with Likert Scale based scoring pattern were framed and validated for the present study.
Results
Outcome of the present study showed high awareness percentage about side effect ototoxic drugs was obtained, which was a satisfying outcome.
Conclusion
While low audiological referral and consultation awareness was identified as an area of concern.

Keywords
Ototoxicity; Doctors; Assam; Awareness.

Introduction

Pleomorphic adenomas are the most common benign parotid tumours in all populations. Management always consists of a curative superficial parotidectomy. However, rare cases described, in which these histological benign tumors metastasize to distant sites. We present an example of a recurrent parotid pleomorphic adenoma with a contralateral supraclavicular lymph node metastasis after several surgical interventions.

Case report

In this case, we reported reported a case of 29-years male with extensive metastasis in submandibular, submental and also very rarely seen contralateral supraclavicular lymph node metastasis. Parotidectomy with preservation of facial nerve and radiotherapy was given to the patient since the lesions were very aggressive.

Conclusion

The patient had several surgical interventions, so it is essential to do meticulous resection in the first surgery to prevent local recurrence and distant metastasis.

Keywords

Pleomorphic adenoma; Metastasizing pleomorphic adenoma; Salivary gland benign neoplasia.

Objectives
Cardiovascular surgery is increasingly performed in children for congenital malformations of the heart and great vessels. Observed as vocal fold immobility, recurrent laryngeal nerve injury is a well-described complication. As overall outcomes improve and patients live longer, the sequelae of vocal fold immobility amplify insignificance. Families are often unaware of the longterm issues related to vocal fold immobility especially with regard to need for alternative alimentation routes. We report on the incidence of use of feeding tubes, the timing of vocal fold function return and need for additional aerodigestive interventions.
Methods
We reviewed 65 patients <2-years who underwent cardiovascular surgery at a tertiary center from 2008-2013 and were diagnosed post-operatively with vocal fold immobility by fiberoptic examination.
Results
Patent ductus arteriosus and hypoplastic left heart syndrome were the most common of the cardiovascular anomalies included. The majority (92%) had unilateral left immobility. Recovery of motion was observed in 29% ranging from 1-month to 3-years. Hypoplastic left heart syndrome had a significant negative correlation with recovery. Forty-six percent required gastrostomy tube placement either to supplement their oral intake or to completely meet their nutritional needs. Forty-eight percent required subsequent aerodigestive surgery including direct laryngoscopy/bronchoscopy (22%), tracheostomy (8%) and vocal fold injection (5%).
Conclusion
Counseling of families and primary care providers regarding the impact of pediatric vocal fold immobility after cardiac surgery should include the high potential requirement for supplemental alimentation as well as the need for feeding and speech therapy. Longitudinal otolaryngology and speech pathology care is imperative with vocal fold immobility since the majority of these patients do not experience functional recovery and may require further interventions over time.
Keywords
Vocal cord paralysis; Pediatric cardiovascular surgery; Pediatric aerodigestive disorders; Voice; Swallow; Gastrostomy.

The coexistence of a head and neck cancer and a lymph node tuberculosis is rarely described. The problem is essentially diagnostic. We report the case of a patient with cervical lymphadenopathy and non suspect swelliing of nasopharynx. Histopathological study of lymph node reveled an association of a tubercular adenitis and a metastasis of a squamous cell carcinoma.

Objective
To evaluate the effectiveness of medial flap inferior turbinoplasty for the treatment of nasal obstruction in children.

Patients and Methods
This study was conducted at the ear nose throat (ENT) Department at Minia University Hospital, Minia, Egypt which include 40 children with bilateral nasal obstruction due to bilateral hypertrophied inferior turbinates that did not respond to medical treatment for 3 successive months in the form of (systemic antihistamines, systemic and local decongestant drugs and local corticosteroid spray) who attended the ENT outpatient clinic. All patients were subjected to turbinate reduction through medial flap inferior turbinoplasty.

Results
Forty patients with bilateral hypertrophied inferior turbinates were assessed. Ninety days after surgery, 90% of patients transformed from severe or moderate degrees of nasal obstruction “pre-operatively” to mild degree or completely with no nasal obstruction; 80% of patients had grade I improvement in nasal obstruction and 14 patients had only grade II improvement; only
10% of patients had crustation.

Conclusion
Medial flap inferior turbinoplasty is safe and effective in the treatment of nasal obstruction in children with almost no complications was recorded.

Keywords
Inferior turbinate hypertrophy; Inferior turbinoplasty; Nasal obstruction; Children.