Shruti Dhingra

Oral and Oropharyngeal Squamous Cell Carcinoma in Our Population: The Clinic-Pathological and Morphological Description of 153 Cases

En nuestro pais, la cavidad oral y orofaringe son los sitios mas comunmente afectados por cancer, debido a la alta prevalencia del consumo de tabaco, especialmente, el tabaco de mascar. El objetivo de este estudio fue evaluar prospectivamente los aspectos clinico-patologicos y morfologicos de los pacientes que acuden con estas malignidades. Se estudiaron 153 pacientes con carcinoma de celulas escamosas de la cavidad oral y orofaringe que fueron tratados en el Servicio de Otorrinolaringologia y Cirugia de Cabeza y Cuello entre enero del 2006 y diciembre del 2007 en Maulana Azad Medical College y hospitales asociados en Nueva Delhi. Se evaluaron pacientes de ambos sexos, 127 hombres (83%) y 26 mujeres (17%) con edades entre 22 a 70 anos. Ciento once pacientes (73%) presentaron carcinoma de la cavidad oral y 42 (27%) carcinomas de la orofaringe. El sitio mas comun de presentacion en la cavidad oral fue la mucosa bucal, mientras que la base de la lengua fue el sitio mas comun de la orofaringe. Entre los canceres de la cavidad oral, 51 (46% cada uno) estaban bien diferenciados y moderadamente diferenciados, mientras que 9 (8%) fueron escazamente diferenciado. Sin embargo, entre los canceres de la orofaringe, 27 (64%) fueron moderadamente diferenciados y 15 (36%) fueron pobremente diferenciados. En total, 73 pacientes se presentaron con adenopatias, de los cuales, 44 pacientes fueron en la cavidad oral y 29 en la orofaringe. Se observo una correlacion significativa entre el sitio (es decir, la cavidad oral u orofaringe) y la presentacion de adenopatias. Cincuenta y nueve pacientes (39%) se presentaron con enfermedad en estadio temprano (estadios I y II), mientras que 94 pacientes (61%) se presentaron con enfermedad en estadio tardio (etapas III y IV). Se observo una correlacion significativa entre el sitio (cavidad oral u orofaringe) y la etapa en la presentacion.

Metallic Stents for Proximal Tracheal Stenosis: Is It Worth the Risk?

Objective. To demonstrate the risk associated with blocked proximal tracheal stents when a patient presents with acute respiratory distress, with blockage of stent and what is the best management we can offer without damage to the stent and its associated complications. Case Report. A 22-yr-old, male patient, presented in severe respiratory distress. He had history of corrosive poisoning for which he was tracheotomised. A stainless steel wire mesh stent was placed in the trachea, from the subglottis, to just above the carina. One month later, he presented with a critically compromised airway with severe respiratory distress. Emergency tracheostomy was done and the metallic stent had to be cut open, in order to provide an airway. Conclusion. Management of blocked proximal stents with patient in respiratory distress remains a challenge. Formation of granulation tissue is common and fibreoptic bronchoscopic assisted intubation may not always be possible. A regular follow up of all patients with stents is essential. Placement of stents within a few centimetres of cricotracheal junction should not be encouraged for long term indications.

Teeth in Rare Locations with Rare Complications: An Overview

Ectopic presence of teeth within the dentate region is common in clinical practice. However, the presence of teeth in non-dentate areas such as the nasal cavity or the maxillary sinus is rare. These may remain asymptomatic for years, may be misdiagnosed as foreign bodies, or may present with some serious complications involving the nose and paranasal sinuses. Complications such as nasal obstruction, epistaxis, headaches, rhinolith formation, epiphora, sinusitis and oro-antral fistula have been well described in literature, however, very few cases of antro-cutaneous fistulas have been reported. We discuss three cases of ectopic eruptions of teeth, all occurring in children. The clinical and radiographic findings of the cases, possible etiology, complication, diagnosis and treatment are discussed.

Unusual presentations of intracranial meningiomas: Report of two cases and review of the literature.

Meningiomas at extracranial sites are uncommon clinical presentations. They may present in the form of benign, slow.growing masses or may exhibit aggressive malignant behavior. We report two cases of intracranial meningiomas presenting at extracranial sites that are, at the sinonasal tract/external auditory canal and as a neck mass. The clinical presentations, histopathological features and appropriate management are discussed.