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Hypophysitis is a rare pituitary condition that commonly presents with nonspecific clinical and radiological patterns and is commonly misdiagnosed as pituitary adenoma. Definitive diagnosis can be made only by histopathology. No clearcut guidelines have been established for its management. This is a case report of one of such rare case.
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Orbital complications of rhino-sinusitis was one of the most common extracranial complications in the pre-antibiotic era. However, the incidence of intra-orbital complications secondary to rhinosinusitis has significantly decreased in recent times with the advertent usage of broad-spectrum antibiotics. The subperiosteal abscess is one of the most common intraorbital complications of acute rhinosinusitis. This is a case report of a 14-year-old girl who presented with diminished vision and ophthalmoplegia which on evaluation was diagnosed to be a case of a subperiosteal abscess. The patient was treated by endoscopic sinus surgery and with complete post-operative recovery to normal vision and ocular movements. This report aims at describing the presentation and management of the condition.
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Effective management of Tumors of Nose and Paranasal Sinuses (PNS) require adequate vascular control of the vessels supplying the tumor to facilitate complete removal and to reduce the complications. To emphasize the role of prior control of feeding vessels in reducing intraoperative blood loss, achieving bloodless fields for endoscopic excision and in facilitating complete excision of tumors of Nose and PNS. A prospective study of 23 patients who were operated for various tumors of Nose and PNS by either Endoscopic or Open approaches for which intraoperative control of the feeding vessels was done based on the Radiological findings. The mean average blood loss was 280 ml and mean Operating time for Endoscopic approach was less than 2 h. All the patients were stable postoperatively and none of the patients had worrisome intraoperative hemorrhage or required multiple blood transfusions. All the patients had complete removal of the tumor. Prior identification of all the vessels that supply the tumor and planning to control them before manipulating the tumor always gives us good results. Tumors supplied by single vessel can be controlled by Embolization or intraoperative clamping, when the tumor is supplied by multiple vessels or when it is not possible to access the vessel by the size of the tumor, Temporary Clamping of the main vessel is a definitive alternative.
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Mass lesions of the larynx are one of the most common clinical entity which we come across in routine otorhinolaryngology and head neck practice with varied symptomatology. Among all the mass lesions of the larynx, Epithelial neoplasms constitute up to 97%. Mesenchymal tumours of the larynx constitute only 0.3-1.0% of all the laryngeal tumors. Abundance of cartilage structures in the larynx made it a spot for mesenchymal tumors [chondromas and chandrosacrcomas]. The spectrum of mesenchymal neoplasms can vary from chondromas, chondroblastoma to chondrosarcoma. Here we want to share our experience of a mesenchymal tumour of the larynx. This case is reported for the rarity and ambiguity in diagnosis. Though these are slow-growing tumours with an early presentation, in our case, the patient had a supportive tracheostomy without definitive treatment for more than 2 years. We managed this patient by excising the mass by lateral pharyngotomy with the preservation of larynx followed by successful Decannulation in 20 days.
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Rapidly evolving global economic status has changed professional behavior. Of late, there is a drastic increase in professional voice users and thereby increase in the patients with voice disorders. Clinically, the changes in the voice can only be perceived but cannot be quantified and documented. It is therefore necessary to have a gadget/tool which is simple and with which we can document and quantify the voice change objectively. This is a prospective case control study with 50 normal control subjects (25 male and 25 female subjects) who had no voice complaints and 50 patients(cases) who presented with complaints of change in voice due to various voice pathologies, the voices were recorded from the control group and also from the cases group both pre and posttreatment and were analyzed. The disease specific frequency in various pathologies of voice pre and post treatment were documented. The degree of change in voice frequency pre and post treatment were compared with each other and with the average frequency obtained from the voices in the control group. Office based acoustic analysis can definitely be used as a simple tool for documenting voice changes on outpatient basis and it provides a dependable documented evidence with which we can even compare the results following treatment.
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Foreign body of aerodigestive tract is one of the most common emergency which all the otolaryngologists do come across in the pediatric patients. Among the airway and digestive tract foreign bodies, airway foreign bodies always possess major risk. Only 47% cases will give a probable positive history. Most of the time the airway foreign bodies are radiolucent. Apart from the indirect signs like hyperinflation, collapse or pneumothorax there are no direct evidences regarding the type and number of foreign bodies on radiographs. The chances of having multiple foreign bodies in the same bronchus or in both the bronchi are not remote. Babies presenting with foreign bodies in bilateral bronchus have graver prognosis than the babies with unilateral foreign bodies. Here we want to share our experience in managing 7 cases of bilateral foreign body bronchus.
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A wide variety of lesions occur in maxilla. Non specificity of clinical and radiological features makes diagnosis of these lesions a difficult task. We report six interesting cases of maxillary swelling among a total number of 37 such lesions of maxilla. These six cases are as follows two cases of central giant cell granuloma, two cases of fibrous dysplasia, one case of pigmented melanotic neuroectodermal tumor and one case of solitary myofibroma.
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The purpose of stenting for tracheal lesions varies from palliation, to cure, to stabilization while a reconstructive effort heals. This article describes a technique of fabricating customised acrylic tracheal stent for a patient with tracheal stenosis. Custom made acrylic tracheal stent described in this article facilitates easy manipulation during surgery and is cost effective when compared to pre fabricated silicone or other metallic stents.
RESUMEN
PURPOSE: The inhalation of nasal snuff (powdered tobacco) is a common addiction in the Indian subcontinent. In the western world, there is a resurgence of interest in nasal snuff because it does have the morbidity associated with smoked tobacco. Very few studies have reported the long-term effects of snuff on nasal mucosa. The objective of the present study was to investigate the effect of long-term use of snuff on the nasal mucosa. MATERIALS AND METHODS: We conducted a retrospective study on 29 snuff users. We investigated the reasons for initiation of this particular form of addiction along with the clinical signs and symptoms of long-term snuff usage. At the time of the study, all patients complained of one or more nasal symptoms. Nasal obstruction and nasal discharge taken together were reported by 62.5% of patients. Gross mucosal edema of the septum and turbinates was the main finding on nasal examination. The absolute eosinophil count and total serum immunoglobulin E were elevated in 62.5% and 66.7% of patients, respectively. On skin prick test, 41% of patients reacted positively to snuff and 25% to tobacco. Histopathologic examination of the turbinates (16 patients) showed squamous metaplasia, capillary proliferation, capillary and venous dilatation, inflammatory cell reaction, subepithelial edema, and fibrosis. CONCLUSIONS: Much has been written about the advantages of nasal snuff over products that deliver tobacco smoke. Our study shows that snuff users, after long-term abuse, develop a form of chronic rhinitis, as a consequence of which they develop blocked and stuffy noses. We conclude that nasal snuff is not a suitable substitute for smoked tobacco because it does not avoid ill health.