L. Somu

Fungal Laryngitis in Immunocompetent Patients

The diagnosis of fungal laryngitis is often overlooked in immunocompetent patients because it is commonly considered a disease of the immunocompromised. Further confusion is caused by clinical and histological similarity to more common conditions like Leukoplakia. Demonstration of hyperkeratosis particularly if associated with intraepithelial neutrophils on biopsy should trigger a search for fungus using specialized stains. These patients usually present with hoarseness of voice. Pain is present inconsistently along with dysphagia and odynophagia. We present three cases of fungal laryngitis in immunocompetent patients out of which one underwent microlaryngeal surgery with excision biopsy. All these patients responded well with oral antifungal therapy.

Tracheostomal Myiasis: A Case Report and Review of the Literature

“Myiasis” is considered in Hindu mythology as “Gods punishment for sinners.” It is known to infest live human or animal tissue. Literature abounds with reports of myiasis affecting the nasal cavity, ear, nonhealing ulcers, exophytic malignant growth, and cutaneous tissue. But report of myiasis of the tracheal stoma is rare. Only a few cases of tracheal myiasis have been reported in literature. We report a case of tracheostomal myiasis in an elderly male. The species which had infested the stoma was identified as Chrysomya bezziana, an obligate parasite. This is to our knowledge the first case report of an obligate parasite (Chrysomya bezziana) infestation of the tracheostoma from India.

Missing fish bone: case report and literature review

Missing fish bone: case report and literature review Sandeep Kumar Jha, MS⁎, S. Prasanna Kumar, DNB, L. Somu, MS, Arunachalam Ravikumar, MS Department of Otorhinolaryngology and Head & Neck Surgery, Chettinad Health Research Institute, Kelambakkam, Chennai 600015, Tamil Nadu, India Department of Otorhinolaryngology and Head & Neck Surgery, Sri Ramchandra Medical College and Research Institute, Chennai, Tamil Nadu, India Received 3 January 2012

Functional study of nasal mucosa in endoscopic sinus surgery and its correlation to electron microscopy of cilia

The effect of functional endoscopic sinus surgery (FESS) was evaluated in 20 patients with chronic sinusitis. The physiological function of sinus mucosa and its mucociliary transport mechanism was assessed pre and post operatively in patients undergoing FESS by performing Saccharin clearance test. The effect of functional sinus surgery on nasal mucosa was evaluated using scanning electron microscopy and study of the ultrastructure of cilia in pre and post operative patients and correlation with histopathological examination. The mucociliary transport mechanism of the sinus mucosa improved 6 weeks following surgery. Histopathologically there was evidence of improvement in the ciliary population and decrease in inflammation, ulceration, fibrosis, vascular congestion, edema, squamous cell metaplasia, basement membrane thickening and polyp formation in comparison to the diseased mucosa sampled preoperatively. Scanning electron microscopic examination revealed considerable increase in the ciliary area as well as the orientation of cilia. Subjective improvement 6 weeks following surgery was confirmed by decrease in saccharin test time. This study revealed that FESS is an effective surgical procedure in chronic sinusitis and improves the overall function of the sinuses

Inflammatory pseudotumours of the paranasal sinuses

Inflammatory pseudotumors are clinocopathologically distinctive but biologically controversial entities. They have been described in the lungs, abdomen, retroperitoneum and extremities, but rarely affect the head and neck region. This report is of 2 cases of pseudo tumor of the paranasal sinuses with varied clinical presentation and successful outcome following treatment.

Sino Nasal Teratocarcinosarcoma-An Interesting Clinical Entity

Sinonasal teratocarcinoma is a rare tumour of the paranasal sinuses. It was earlier termed as teratoid carcinosarcoma or teratocarcinoma. It is a highly aggressive tumour with a 5 year survival rate of 45 %. Here we report a case of sinonasal teratocarcinoma who was managed excision of tumour by lateral rhinotomy approach followed by radiotheraphy.

Giant tumour of the pterygopalatine fossa

Neurilemmomas are benign and slow growing tumours. Neurilemmomas of the pterygopalatine fossa are rare. In this paper we present a case of schwannoma arising in the pterygopalatine fossa with extension into infratemporal fossa and floor of the orbit. A transantral approach was used for excision of the tumor following which the defect in the floor of the orbit was reconstructed with the help of a temporoparietal flap.