Anish Gupta

Endoscopic Endonasal Management of Pseudotumor Cerebri: Is it Effective?

Purpose: To study the efficacy and safety of endoscopic endonasal optic nerve fenestration for the management of idiopathic intracranial hypertension (IIH).

Postgraduate institute management protocol for invasive Aspergillus flavus sinusitis: is it effective?

OBJECTIVE To analyze the results of a postgraduate institute management protocol for invasive Aspergillus flavus sinusitis. METHODS This was a prospective study wherein all patients with a final histopathological diagnosis of invasive sino-orbital aspergillosis were included for the period between January 1998 and December 2005. All the patients were negative for HIV, diabetes, and chronic granulomatous disease. All patients were evaluated clinically, biochemically, and radiologically for the condition, and were classified into four groups on the basis of clinical and radiological findings. All patients were subjected to endonasal endoscopic biopsy and were subjected as per the management protocol. These patients were then followed up clinically, endoscopically, and radiologically for a period ranging from 9 months to 7 years. RESULTS A total of 74 patients were enrolled in the study, 52 males and 22 females, ranging in age from 26 to 53 years. The most common sign was proptosis. The patients in each group were subjected to the treatment protocol decided for the group. Overall, residual disease was seen in 14 patients (18.9%) and recurrence was seen in six patients (8.1%). Twenty-four (32.4%) patients died of the disease in our series. Residual disease and recurrent disease were seen more often in the advanced cases. CONCLUSION Invasive sino-orbital aspergillosis is associated with significant mortality. By following our management protocol we were able to reduce the mortality to 32.4% in our series.

Neurofibroma of tongue

The benign tumours of the tongue are far less common than the malignant ones. Among bening tumours, Papilloma, fibroma, adenoma, mucous cyst, lymphangioma are the tumours most frequently encountered. Neurofibroma of the tongue is rare. A review of the available literature records only 37 cases of tumours of Nerve sheath origin of tongue1,2,3. The rarity of lingual benign tumours and their distinctive histopathological features have prompted us to report this case.

A Giant Lateral Cervical Cyst

The Branchial apparatus was first described by Von Baer in 1827. (cited by King. 1949) After five years the cervical fistula was recognised as an anomalie of Branchial apparatus. By 1864 the term “branchial fistulae” had been applied, and soon thereafter cysts of the lateral neck were to be ascribed to branchial origin. Everything appeared to fit nicely into this neat categorization until 1912 when Wenglowski published the results of his dissections of Cadavers and human embryos, which led him to doubt the branchiogenic origin of many lateral cervical cysts. In the ensuing years various theories as to the exact pathogenesis of these anomalies have been proposed with more controversies on the matter of cysts than on fistulas or sinuses.There are four theories of origin of branchial cysts but because of the complicated development of the neck none has been proven by empryological investigation. Most of the theories attempted to correlate clinical findings with known embryological facts and none can stand close scrutiny4. Here a case is reported who presented to us with large lateral cervical cyst extending from angle of jaw to sternoclavicular joint, strengthening the cervical sinus theory. It postulates that branchial cysts represent remains of the cervical sinus of His which is formed by the second arch growing down to meet the fifth.