Gul Motwani

Intramuscular haemangioma of head and neck region.

Intramuscular haemangiomas are rare benign haemangiomas occurring within the skeletal muscle. These are uncommon tumours in the head and neck region and occur most frequently on the trunk and extremities. Fewer than 80 cases of intra-muscular haemangioma in the head and neck region have been reported in the literature. A case of intramuscular haemangioma of the sternocleidomastoid muscle is presented. The review of occurrence and natural history of such tumours is described and clinical and radiological presentation, histological classifications and treatment modalities are discussed.

Fistula of the Fourth Branchial Pouch

Most of the congenital anomalies of the branchial apparatus are from the second arch, pouch, and cleft; some are from the first and third arches. Fourth branchial pouch remnants are very rare. We present a rare case of fourth branchial fistula, with characteristic clinical features of recurrent left-sided neck abscess that burst spontaneously, forming a fistula. Diagnosis of fourth branchial pouch fistula was confirmed by contrast radiography (ie, fistulogram and barium swallow) revealing the internal opening in the apex of the left pyriform fossa.

Comparative study of endoscopic aided septoplasty and traditional septoplasty in posterior nasal septal deviations

Patients with deviated nasal septum are advised surgery, which has seen several modifications since its inception. This recent technique of using nasal endoscopes gives better illumination and access to posterior septal deviations. The aim of the study was to identify the nasal septal pathology in relation to lateral nasal wall in a precise way and to correct this with minimal exposure, limited manipulation and least resection. Twenty five patients underwent endoscope aided and 25 conventional septoplasty. Results were graded on subjective and objective improvement. Endoscopic aided septoplasty (Otolaryngol Head Neck Surg, 1999; 120, 678; Laryngoscope 1994, 104, 1507; J Laryngol Otol 1998, 112, 934; Ear Nose Throat J 1997, 76, 622) was found to be safe, effective and conservative approach with better patient compliance, shorter recovery time and greater stability of remaining septum.

Role of mitomycin C in reducing adhesion formation following endoscopic sinus surgery

OBJECTIVE To study the role of mitomycin C in reducing adhesion formation following endoscopic sinus surgery. STUDY DESIGN Prospective, randomized, controlled trial. SETTING Tertiary care referral centre. PATIENTS Thirty patients were selected suffering long-term problems with bilateral chronic rhinosinusitis, with no relief obtained from medical therapy. Patients requiring revision sinus surgery or having acute upper respiratory tract infection were excluded. INTERVENTIONS Diagnostic nasal endoscopies and non-contrast computerized tomography of nose and paranasal sinuses were undertaken and, following confirmation of the diagnosis, functional endoscopic sinus surgery (FESS) was carried out bilaterally using the Messerklinger technique. On completion of the surgery, a cotton wick soaked in mitomycin C was placed in one or other side of the nose in the middle meatus. Follow up was for three months and patients were assessed for subjective and objective improvement in their symptoms. RESULTS Post-operatively, of the 11 (36.6 per cent) patients complaining of persistent nasal obstruction, nine had complaints limited to the control side only (p=0.005). Out of the nine (30 per cent) patients complaining of recurrent nasal discharge, eight had complaints on the control side and only one reported discharge from both sides (p=0.006). CONCLUSION Mitomycin C may be topically applied in post-operative FESS cases to reduce adhesion formation and hence the need for revision surgery.

Functional voice disorders and their occurrence in 100 patients of hoarseness as seen on fibreoptic laryngoscopy

During a six month period, one hundred patients presenting with the primary complaint of hoarseness, in the out- patients department of otolaryngology at Safdarjung Hospital New Delhi were taken up fot the study Fach patient after being subjected to a detailed history- taking and examination, including a Fibreoptic Laryngoscopy was then put into one of ten categories on the basis of the ultimate diagnosis Functional voice disorders, forming the largest category with 51%, included lesions such as vocal nodules and polyps, which are secondary to vocal abuse A detailed study of the various types of functional voice disorders along with factors such as male female ratio and associated contributory factors was done the efficacy of the Fibreoptic laryngoscope as a diagnostic tool was also assessed

Tuberculosis of tongue

Oral lesions of tuberculosis are rare and when present they are usually secondary to pulmonary tuberculosis. Persistent painful oral ulcer may be the only symptom for which the patient seeks advice. In the absence of clinical features of any systemic disease, these lesions may be misdiagnosed. Histopathological examination in such cases must be performed so as not to miss some rare conditions.

A rare case of Rosai-Dorfman disease of the paranasal sinuses

An unusual case of a 6-year-old male child presenting with a history of bilateral nasal obstruction of 3 years duration is reported. Endoscopic surgery was performed and the specimen sent for histopathological examination. The report revealed the surprise diagnosis of Rosai-Dorfman disease. This case of isolated extranodal involvement (paranasal sinuses) by this disease is presented and the literature available reviewed.

Functional endoscopic sinus surgery results in 69 patients.

Sixty nine patients with sinonasal symptoms were subjected to diagnostic endoscopy. Functional endoscopic sinus surgery was done subsequently for chronic sinusitis in 42 patients, for ethmoidal polypi in 18 patients and for antrochoanal polypi in 9 patients. A follow up of 18 to 36 months ( mean 27 months) reveals a success rate of 84% in the overall study, 81.5% in patients with chronic sinusitis alone, 87.5% in ethmoidal polypi and 100% in patients with antrochoanal polyps.

Extranasopharyngeal angiofibroma arising from the infratemporal region

Angiofibroma is a histologically benign but locally invasive tumour of the blood vessels characterized by architecturally irregular vessels set in a fibrous stroma. The commonest site for occurrence of these tumours in the body is the nasopharynx. It is rare to find extranasopharyngeal origin of angiofibromas. The infratemporal fossa is a very rare site of extra nasopharyngeal angiofibroma with only 4 cases reported in the literature. We report here a case of a vascular mass arising from the infratemporal fossa of a 13-year-old boy that was confirmed to be a case of angiofibroma histopathologically. A review is also made of the other reported cases of angiofibroma arising from the infratemporal fossa. The likely theory of origin of the tumour and its management is also discussed.

Ameloblastoma mandible: Repair by iliac crest graft following hemimandibulectomy

The ameloblastoma is a slow growing, benign but locally invasive neoplasm. Falkson gave the first detailed description of this tumor in 1879 and Churchill introduced the term ameloblastoma. The exact origin of the neoplastic epithelium is unclear although the strong resemblance to ameloblasts supports an odontogenic origin. The predominant opinion is that it is derived from the remnants of the dental lamina.