Satish Mehta

Cryosurgery in vasomotor rhinitis—an analysis of 156 patients

156 patients of vasomotor rhinitis were treated with cryodestruction of nasal branches of vidian nerve. These patients were divided into two groups A and B. In Group ‘A’ intermittent partial nasal obstruction-was the main symptom (82 patients) and in Group ‘B’ watery nasal discharge was the predominant symptom (74 patients).

Presentation of carcinoma larynx and laryngopharynx— An analysis of 840 cases

Clinical records of 840 cases of carcinoma larynx and laryngopharynx were studied. These patients were admitted in Nehru Hospital, Postgraduate Institute of Medical Education & Research, Chandigarh during the period 1971–1986. Maximum number of patients (308) presented in the 5th decade of life. About 1,3rd of patients (302) belonged to Uttar Pradesh State of India. History of smoking was present in 668 patients (79.59%). The commonest site of involvement was supraglottis (264 patients). 508 patients (60.48%) presented in stage IV. Metastasis to the neck nodes was present in 571 patients (67.85%). 349 patients (41.54%) had healed pulmonary tuberculosis lesions while another 76 patients (9.09%) had active tubercular lung lesion. 96 patients (11.42%) had associated tuberculosis of cervical lymph nodes. Squamous cell carcinoma was the commonest histopathological variety in 97.73% patients. 203 patients were treated with combination of surgery and radiotherapy, curative radio therapy (5500 rads) was given in 196 patients and 441 patients had advanced disease, hence only palliative radiotherapy was given.

PRIMARY POSTERIOR ORO PHARYNGEAL WALL TUBERCULOSIS

Tuberculosis involvement of pharynx is a rare entity. Whenever encountered, it is usually associated either with pulmonary tuberculosis or cervical lymphadenopathy. Isolated involvement of posterior oropharyngeal wall tuberculosis is presented in this paper.

Retropharyngeal cystic hygroma

A case of cystic hygroma of retropharyngeal space is being reported in a 5 years male child. The patient presented with a painless swelling on right side of the neck, dysphagia, change in voice and respiratory stridor. Surgical excision was done under general anaesthesia and the histopathology of which was consistent with cystic hygroma.

Laryngeal papillomatosis—Analysis of 20 cases

A study of 20 patients of laryngeal papillomatosis is presented with an analysis of epidemiological factors, results of surgery and systemic use of levamisole. The youngest patient was 6 months old. 9 out of 20 patients presented with stridor. Involvement of bronchus and lung parenchyma was not seen in any of the cases. Repeated surgical excision (14 on average) were needed in majority of patients to achieve cure. Role of levamisole needs further evaluation.

Salivary gland tumours—Analysis of 162 cases

The clinical records of 162 cases of salivary gland tumours were studied. Parotid gland was the commonest site for origin of tumour (110 cases.) Commonest benign tumour was pleomorphic adenoma (42 cases) and the commonest malignant tumour was mucoepidermoid carcinoma (26 out of 162 cases). The next common tumours were adenoidcystic and undifferentiated carcinoma which constituted 23 and 20 cases respectively. Surgery or surgery with radiotherapy were the main modalities of treatment for the primary tumours. Twenty patients had recurrence within three years after the treatment. These patients were treated with either revision surgery or external radiations. Chemotherapy was given to one patient of soft tissue sarcoma. Twenty nine patients had post-operative complications like facial paralysis, parotid fistula, skin necrosis and Frey’s syndrome.

Laryngo-tracheal trauma (a retrospective study)

Thirty five cases of laryngotracheal trauma in the age group of 1–72 years are being reported in this study. Unilateral vocal cord palsy was noted in 20 cases and left side was involved more commonly than the right. The extent of the injuries varied from simple haematoma in the ventricle to a completely shattered larynx and avulsion of the trachea. All neck wounds were explored and debrided under general anaesthesia. Surgical exploration of laryngotracheal injuries was directed towards an open reduction and stabilization in position of function. Complications like laryngeal stenosis and permanent tracheostomy can be best avoided, if managed at the earliest.