Rajat Bhatia

Primary extraskeletal Ewing's sarcoma of the maxilla with intraorbital extension.

Extraskeletal Ewing’s sarcoma is often described as a tumour involving the soft tissues of the lower extremities and the paravertebral region. Primary Ewing’s sarcoma of the cranium is extremely rare, with only 17 cases reported so far [24]. Involvement of the paranasal sinus is a very rare entity. Involvement of facial bones is characterized by clinical and radiological features distinct from those commonly observed in other sites. Because of the above peculiarities a delay in diagnosis and thus in starting treatment is very probable in such cases. Primary Ewings sarcoma rarely arises in the facial skeleton and only occasionally in the maxilla. To date, there have been 22 cases of maxillary Ewing’s sarcoma reported in the English-language literature [25]. We report here a new case of Ewing’s sarcoma localized to the maxillary sinus, nose and the orbit, successfully treated by surgery, local high dosage radiotherapy and systemic chemotherapy.

A study of temporal bone fractures

Many young adults are now killed and injured in accidents than from another causes. More than 75% of these injuries are to the head, and the ear being the most frequently injured sensory organ of the body. Temporal bone or basilar skull fractures are extremely common in any head injury. Injuries to the temporal bone may be considered in three groups: Those affecting the external auditory meatus (extralabyranthine fractures), those largely affecting middle ear cleft (tympanolabyranthine) and those affecting the internal ear (labyrinthine fractures). Many injuries, however, involve all these structures.The sudden onset of facial paralysis, vertigo and hearing impairment after a head injury is a matter of great concern for the patients and clinicians. Presence of cerebrospinal fluid leak (CSF Otorrhoea) can be a challenge for both the neurosurgeons and otologists. We hereby present 86 patients of temporal bone fractures who presented in the departments of emergency, Neurosurgery or ENT of Himalayan Institute of Medical Sciences, Dehradun during last 10 years (1996–2006).

Isolated palate ulcer due to mucormycosis

Mucormycosis is a rare but serious fungal infection that rapidly attacks and kills its untreated victims, who are often immunocompromised. It is one of the most fulminant and often fatal mycotic infections known to human beings. Rhinocerebral mucormycosis is the commonest presentation and its extension to the orbit and brain is quite usual but the palatal involvement is a rare and late occurrence. Isolated location of mucormycosis on the palate in an immunocompetent host is an unusual clinical entity. Here we report a case of deep hard palate ulcer due to mucormycosis in a 56-year-old man without any predisposing factor. He was successfully treated with a combination of surgical debridement and systemic liposomal amphotericin B administration for six weeks. By presenting this case report we would like to emphasis that mucormycosis should be included in the differential diagnosis of the hard palate ulcers even in immunocompetent patient.

Lacrimal sac diverticulum due to Rhinosporidiosis

Rhinosporidiosis is a disease affecting primarily the mucosa of nose, conjunctiva and urethra. Larynx, trachea, skin and lungs are less frequently involved. It is endemic in some Asiatic regions, affecting people of any age and sex. Its manifestation is a polypoid mass growing inside the affected nasal cavity and the treatment is surgical excision, with adjuvant radiotherapy and chemotherapy. Rhinosporidium seeberi is the aetiological agent. The lesion may recur and sometimes cause osteolytic bone lesions. A case of Rhinosporidiosis with an unusual feature of spread to the nasopharyngeal area and chronicity of 2 years is presented.

Betropharyngeal abscesses: Revisited

Retropharyngeal abscesses were fairly common in preantibiotic era but the advent of antibiotics has reduced the overall incidence of these abscesses. They still continue to occur specially in developing world and carry significant morbidity and even mortality if not managed properly. The prevalence of this abscess in the young children pose a bigger challenge, as the examination of oral cavity is difficult. Emphasis is placed on the age, sex, type, and duration of symptoms, bacteriology, methodology of diagnosis, therapy and complications. With proper antibiotic cover and surgical management, majority of patients today survive without major residual squeal. Hereby we present a series of 15 cases of retropharyngeal abscess.

Zenker’s diverticulum - a case report

A Zenker’s diverticulum is a blind pouch that branches off the cervical esophagus. Affected individuals may suffer from long-standing swallowing difficulties, regurgitation, bad breath, weight loss, and even aspiration.. Here we report a 80-years-old male presenting with dysphagia and regurgitation. Barium swallow reported the presence of a Zenker’s diveticulum. In view of the patient’s age, endoscopic diathermy was considered as a therapeutic option for the management.

Tubercular laryngitis: case series.

IntroductionTubercular laryngitis is a known entity since a long time but it’s presentation, diagnosis and management has undergone a drastic makeover after the advent of chemotherapy in the form of ATT (Anti tubercular treatment), modernized diagnostic aids and early detection of lesions.Materials and methodsThis prospective study was conducted on 180 patients. Each patient were subjected to detailed history and thorough ENT and head neck examination including laryngeal examination by visualization of the vocal cords, possibly using indirect laryngoscopy,. exible naso-laryngoscopy or rigid laryngoscopy Results Tubercular laryngitis was clinically diagnosed by laryngeal endoscopy and diagnosis con. rmed by laryngeal biopsy.ConclusionAll patients showed remarkable improvement with anti-tubercular treatment.

Thyroglossal duct cyst in hyoid bone: Unusual location

A 10-year-old female presenting with a discharging sinus in the midline of the neck of one month duration was diagnosed to have a thyroglossal sinus. She underwent sistrunk’s operation, intra-operatively a thyroglossal duct cyst was atypically sited in the intrahyoid region. The cyst may be located in the intralingual, suprahyoid, thyrohyoid or suprasternal region. A literature search revealed that this intrahyoid location of a thyroglossal duct cyst is extremely rare and so far only three cases have been reported. A case and review of literature regarding this unusual entity are presented.