Girish Mishra

Endolymphatic Duct Papillary Tumour: Captured Undercover of Complicated Chronic Otitis Media

Endolymphatic sac tumor is a rare invasive benign neoplasm occurring sporadically or in Von Hippel–Lindau disease. This case mimics clinically to a complicated chronic otitis media with left ear discharge and facial weakness with sudden onset headache, vomiting, vertigo.

Use of dynamic compression plates in rigid internal fixation for Mandibular fractures

Vehicular accidents and Urban violence continues to be a major source of faciomaxillary injuries, Mandible being more commonly injured than other facial bones. A series of seventy five patients surgically treated for facial fractures between Jan ’92 and Dec. ’94 was reviewed. Of these, 51 had mandibular fractures at different sites like Angle and Body, Body and/or Symphysis and Ascen-ding Ramus. All these patients were treated with rigid internal fixation using Dynamic Compression Plate on A. O principle. It provided complete anatomical reduction and stimulated bone healing and full range of movement. It decreases morbidity and Hows better control of patient’s nutrional status. Patients can return to normal routine work after 8 to 10 days.

Non-compliance With Neonatal Hearing Screening Follow-up in Rural Western India

ObjectiveThe reasons of failure to follow-up for the Universal Neonatal Hearing Screening (UNHS) program were delineated.MethodsReview of case records for data related to follow-up of neonates who underwent the UNHS between February 2012 - January 2015.Results2534 neonates underwent primary screening with Distortion Product Oto-acoustic Emission (DPOAE). 14 (26.9%) were lost to follow-up between the first and second DPOAE screenings. 275 neonates (including high-risk cases) were to undergo confirmatory Brain Evoked Response Audiometry testing out of which 201 (73.4%) came for follow-up. Out of 74 who failed to follow-up (including those lost between first and second DOPAE screenings), unwillingness and non-compliance was the commonest reason.ConclusionIncreasing awareness and counseling of the caretaker are important interventions for ensuring good follow-up in hearing screening programs.

Novel Program of Using Village Health Workers in Early Detection and Awareness of Head and Neck Cancers: Audit of a Community Screening Program

Head and neck cancers together (oral cavity, pharynx and larynx) are sixth commonest worldwide and are the commonest cancers in developing countries. The Cancer Project was started in Kheda/Anand, Gujarat, a harvest land of tobacco. The objective of this programme was to indoctrinate the most vulnerable and the least tended upon; the basics of head and neck cancers via the medium of their own kins. Voluntary village health workers were educated and trained to pick up the early signs of head and neck cancers. Oral self examination was taught to them and they went to peripheral villages to screen the population. They would refer suspicious cases to tertiary healthcare centre. The population was enlightened upon the basics of preventable measures, treatment options and rehabilitation facilities for head and neck cancer patients. Knowledge, attitude and practice analysis was done in the population which showed widespread disbelief and false practices. A population of 26,10,432 was surveyed in 1862 villages of which 10,522 (1.1%) individuals successfully quit the habit. The minimally educated workers referred 3309 suspicious individuals to higher centre of which 1890 (57.11%) tested positive for cancer. A lot of resource is put in research and development of rapid diagnosis and complete cure; however such a minimally costing program may help the most in primordial, primary and secondary level of prevention. Such programs should be advocated on the global platform on lines of Breast Self Examination.

Resolving Perplexity: Comparison of Endoscopic Dacryocystorhinostomy With and Without Stent

Abstract Endoscopic dacryocystorhinostomy (DCR) is an effective surgical procedure to treat nasolacrimal duct obstruction. This study was conducted with an aim of comparing the success rate between use of stent and without use of stent in endoscopic DCR. A prospective randomized study was conducted. Total 50 cases with signs of nasolacrimal duct blockage were included. The cases were randomly divided in two groups with 25 cases in each group. Group A cases underwent endoscopic DCR with stent and group B without stent. The follow up was till 12th week. Both subjective and objective outcomes were noted. By 12th week, only 8% cases had no relief of symptoms in group A while 92% cases of group A and all cases of group B had complete relief of symptoms. In objective outcome, by the 12th week, in group A 92% cases had full patency while in group B 100% cases had full patency. Overall complications in postoperative period were seen in 28% patients in group A and 12% patients in group B. In this study the surgical results of endoscopic DCR with or without stent came almost equal with no statistical difference in the success rate between stent group and non-stent group. Now that Endoscopic DCR without stent is equally effective and reduces cost, we recommend that the endoscopic DCR without stent should be preferred.

Eye Inside Out: Endonasal Endoscopic Reposition of Eye from Nose with Complete Vision Regainment

Faciomaxillary and ocular trauma is a common entity in most emergency and trauma units. We came across a 68-year-old female patient with a history of bull horn injury over the right eye. Examination revealed an empty orbital socket with unreliable perception of light present. Imaging showed that the eye had displaced posteroinferomedially to be lying in the ethmoid air cells in the nasal cavity. Under nasal endoscopic guidance, the eye was reposited back into the orbital socket and conjunctival sutures were taken to stabilize the position. The patient had vision of counting fingers at 1.5 m on the first postoperative day which improved to 6/24 on last follow-up. Such is the rarity that never before has such a case been described in literature where traumatic displacement of eyeball into the nose has been successfully repositioned by an endonasal endoscope with appreciable regaining of vision. It also further promotes endonasal endoscopic approach in the management of orbital blow out injuries.

Dermatofibrosarcoma protuberans: Rare cause of head and neck swelling

Dermatofibrosarcoma protuberance of head and neck is a rare neoplasm and accounts for less than one percent of Head and Neck Neoplasm. The objective of this report is to understand etiology, presentation, histopathologic identification and treatment option for this tumour. The goal of current report is to acquaint the clinician with presentation and treatment option for this disease.

Widening the horizons of otolaryngologist an interdisciplinary approach for surgical problems of cervical spine.

Till recent past the realm of ENT surgeons was limited to tonsils and mastoids. But with the passage of time and strides made by the Biomedical Engineering, the horizon has widened and the Otolaryngology has kept pace with other medical specialities. Lesions of Clivus, cervicomedullary junction and cervical vertebra often present difficulty to the Neuro Surgeon and Orthopaedic Surgeon. The role of ENT surgeon in these cases of cervical spine surgery can be significant. A successful attempt has been made to approach various levels of cervical spine anteriorly either transorally, transpharyngeally or transcervically.Although these techniques are well suited to the training and experience of the Head & Neck ± surgeon, it is our perception that the procedure is underused by the members of our speciality. Although these approaches are safe and reliable, it is not part of the Otolaryngologist’s usual surgical armamentarium.In the present study a series of thirteen patients presented between February ’91 and July ’94, with various pathologies of Cervical Spine with or without neurological deficits is reviewed. The surgical technique is discussed and methods to prevent potential complications and adverse sequelae are also addressed.