P. K. Kakar

Oral Submucous Fibrosis ― treatment with hyalase

Oral Submucous Fibrosis (OSMF) is a disease of unknown etiology. A total of 96 patients with Oral Submucous Fibrosis have received four regimens of treatment--local dexamethasone, local hyaluronidase, local combination of dexamethasone and hyaluronidase, and local placental extract. The patients were followed up for a period varying from 3 months to 2 years. The group of patients receiving hyaluronidase alone showed quicker improvement in symptoms although its combination with dexamethasone gave somewhat better longer-term results. A new regimen for the treatment of submucous fibrosis is recommended.

Leiomyosarcoma of paranasal sinuses

A leiomyosarcoma of the upper respiratory and food passages is a rarity. Two rare cases of leiomyosarcoma of the paranasal sinuses, of which one developed recurrence are reported.

Middle-ear cholesteatoma in children—an Indian perspective

A study of the clinical presentation of acquired aural cholesteatoma in 51 Indian children is presented. An attempt has been made to assess the impact of this chronic ear disease in terms of the morbidity it incurs upon the paediatric population. The preponderance of bilateral presentation in cholesteatomatous otitis media (24.5 per cent) and the associated sensorineural or mixed hearing loss (in 25.4 per cent of the ears) is emphasized, to reflect the alarming audiological disability in the afflicted child. An attempt has been made to correlate the otoscopic profile with the extent of disease, osteitic damage and co-existing complications. It was noted that, in Indian children, mesotympanic choleasteatoma was more often associated with large defects of the pars tensa (viz. marginal, subtotal and total perforations--54.4 per cent) than with postero-superior retraction pockets (37.2 per cent) or purely attic defects (7.8 per cent). Further analysis revealed this common otoscopic presentation to be a more active process, occurring in predominantly cellular mastoids and associated with extensive disease. Based on this study, a more aggressive canal down tympanomastoid approach is advocated for children presenting with this otoscopic profile.

The problems of scleroma in India

1. Scleroma is not uncommon in Delhi and its surroundings. 2. Nasal discharge and epistaxis are earliest signs of nasal involvement. 3. Rhinoscleroma exists in 4 stages and an effort should be made to diagnose the case in earlier catarrhal or atrophic stages. 4. Relief provided by medical treatment is best in 1st and 2nd stage and only transitory symptomatic relief occur in granulomatous and cicatricial stage. Results of reconstructive surgery are poor as a whole.

Role of N-Nitrosodimethylamine (NDMA) as a carcinogenic agent for tumours of nasal cavities in workers of leather industry

The chemical used during leather tanning Dimethylene Sulphate (DMS) is nitrosated, perhaps, by Oxides of Nitrogen in air, to produce N-Dimethyl-nitosamine (NDMA) which has been proved to be carcinogenic to various body organs including nasal cavity. This study was aimed at finding the incidence of nasal tumuors in leather tanning workers and to campare with that of general population to ascertain if nitrosamines are significant occupational hazardous agents.

Auditory pattern in deafness following meningococcal meningitis

Thirty cases complaining of hearing loss following the attack of meningococcal meningitis during its epidemic in Delhi, between March ’85 and July ’85, were taken up for audiological study. Different audiological tests including pure tone audiometry and auditory brainstem response (ABR) were done at regular intervals for 2 J years in such sixty ears of thirty cases. The influence of different factors on the auditory outcome like, the age of patient, the duration of disease prior to hearing loss and the severity of initial hearing loss, have been discussed.

Leiomyosarcoma of the nose and paranasal sinuses

Leiomyosarcoma of Nose and Paranasal sinuses is a rare tumour. 20 cases have been reported in world literature of Leiomyosarcoma of nose and P.N.S. An additional case of leiomyosarcoma of nose and P.N.S. is reported.

A clinical trial of cotrimazine (Aubril) in Ear, Nose & Throat infections

An open clinical trial of cotrimazine (Aubril) was conducted in 44 patients suffering from Ear, Nose and Throat (EIMT) infections. The daily dosage employed was 1 g. for 7 to 10 days with a loading dose of 2 g. on the first day. A total of 52 infections were present in the 38 patients finally assemble for efficacy and tolerability. Thiry-five infections were considered cured, 16 improved, while only 1 failed to respond, Side effects were recorded in 3 patients (7.9%) and consisted of nausea in two patients and pain in abdomen in the third. We conclude that cotrimazine (Aubril) is an efficacious and well tolerated antimicrobial agent for the treatment of common EIMT infections.

Atrophic rhinitis-role of placental grafts

20 Cases of Primary Atrophic Rhinitis were subjected to placental graft implantation by a sublabial approach. Technique of surgery and results obtained are discussed which indicates that placental grafts are a valuable assets in the management of Primary Atrophic Rhinitis.

Experiences with Cryosurgery in Otolaryngological Practice

70 patients with a benign, premalignant or malignant lesion of the head and neck were treated by cryosurgery. Good results have been obtained in the treatment of various benign lesions like haemangioma, papilloma etc. Cryotherapy was found to be satisfactory in the treatment of leukoplakia, where the lesions could be eliminated completely without severe scar formation or functional disability. Palliative cryosurgery was employed in 3 uncurable tumours and the results, apart from pain relief have been disappointing. 29 localised malignant lesions were treated by cryosurgery with an intent to cure. Local Tumour control was seen in 85.3% of cases.