Neena Chaudhary

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.

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.

Comparison of the efficacy of clinical examination, ultrasound neck and computed tomography in detection and staging of cervical lymph node metastasis in head and neck cancers.

There are many modalities, which are being used for detection of cervical lymph nodes in head and neck cancers clinical examination, computed tomography, ultrasound, magnetic resonance imaging and radionuclide scintigraphy. Various studies in past have highlighted their benefits and drawbacks used singly or in comparison with others. Here we present the study of 100 patients comparing the result of clinical examination, computed tomography and ultrasound.

Tuberculosis of paranasal sinuses

Nasal tuberculosis is very rare but much rarer is tuberculosis of paranasal sinuses. It involves especially the maxillary sinus and is usually unilateral. We report an unusual case of tuberculosis of frontal and maxillary sinus in a 68 years old male, who presented with a swelling above left medial canthus, with no other eye or nasal complaints. Clinical and radiological findings on our initial evaluation suggested that the patient had left frontal mucocoele with bilateral maxillary haziness. Diagnosis was established on FNAC report and subsequent Ziehl — Neelsen staining of nasal swabs and tuberculin skin test. Later chest x-ray examination was suggestive of pulmonary tuberculosis, which was the primary cause. Patient responded well to antituberculosis drug therapy.

Nasal endoscopy-evaluation in epistaxis

Epistaxis is generally of two types : one where a cause is recognised ( Local or Systemic ) and the other where the cause is not known. All cases of nose bleeds with no evident cause is customarily categorised into an Idiopathic type. Anterior rhinoscopy ordinarily gives a very limited view of the nose and the probable cause of epistaxis, and this, we feel could he one of the reasons why a proper diagnosis is not always likely. Another problem is the poor localisation of the site of bleeding point. Such cases pose a problem in implementing treatment, as the cause or the site is not easily located. This study tries to venture the exquisite and wide vision provided by the Nasal endoscope. This study also tries to investigate the possibility of reaching the inaccessible bleeding points, to treat them directly. The study was conducted on 60 patients who attended the Out Patient Department and the Indoor ward with complaints of Epistaxis.

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.

Teratoma tongue: Case report and review of literature

Teratomas are true neoplasms composed of tissues from all three germinal layers and may exhibit variable levels of maturity. They have an unknown origin and eccentric microscopic appearance. Teratomas arising from the oral cavity are rare in the newborn; only 22 cases have been reported in the literature. We describe a female neonate with an oral teratoma originating from the tongue that was successfully treated with surgery.

Primary Thyroid Tuberculosis

In India, it is estimated that more than 40% of the adults are infected with tuberculosis bacilli and every year 2 million people develop tuberculosis and nearly 500,000 die from it1. But, tuberculosis of the thyroid gland occurs only rarely. Since extra-pulmonary tuberculosis is now seen relatively more frequently, the existence of this condition should be recognized when goitres are being treated. We present a case of right thyroid nodule associated with low grade fever and weight loss. No signs and symptoms of hypothyroidism or hyperthyroidism were present. Patient did not have any other tuberculosis focus. Routine investigation and chest X-ray were normal. Sputum for Acid Fast Bacilli was negative. Fine Needle Aspiration Cytology and Contrast Enhanced Computed Tomography led to a diagnosis of Primary Thyroid Tuberculosis in a euthyroid patient. Patient responded well to Anti tubercular Drug Therapy along with repeated aspiration.

Role of autografts in the reconstruction of ossicular chain in intact canal wall procedures.

Improvement of hearing in ossiculoplasty depends on the efficiency of the methods to reestablish the ossicular continuity and the connection with the tympanic membrane. While various prostheses have been used to bridge the ossieular defect, we have used autogenous bone (incus remnant & cortical bone ) and autogenous cartilage (frugal & conchal) for reconstruction of ossicular continuity.Hearing results at I8 months follow up have been fairly good i.e., 84% patients had closure of air bone gap within 20 dB and 37% had closure of air bone gap within 10 dB.