Surinder K Singhal

Genetic correlation in otosclerosis.

PURPOSE The aim of this study was to determine the relationship of HLA typing in patients with otosclerosis. MATERIALS AND METHODS We used a prospective study in which HLA typing of 100 surgically confirmed otosclerosis patients were compared with age and sex matched normal individuals. RESULTS HLA-A3, HLA-A9, HLA-A11, and HLA-B13 were found to be significantly higher (P < .05, .01, and .01, respectively). HLA-A9 and HLA-A11 were found to be higher (P < .01) in patients with a positive family history, indicating genetic heterogenicity. CONCLUSIONS Higher values of HLA-A9, HLA-11, and HLA-B13 in patients with otosclerosis compared with normal individuals strongly suggests a genetic, HLA-related component.

Salivary gland tumors - our experience

Salivary gland neoplasms represent the most complex and diverse group of tumors encountered by the head and neck oncologist. Their diagnosis and management is complicated by their relative infrequency (1% of head and neck tumors)1, the limited amount of pre-treatment information available and the wide range of biologic behavior seen with the different pathologic lesion. Approximately 80% of salivary gland tumors are found in the parotid gland, 10 to 15% in the submandibular gland and 5 to 10% in the minor salivary glands. This retrospective study was conducted at government Medical college & Hospital, Chandigarh including 36 patients treated between January 1997 to June 2001 with the aim to contribute to the discussion about the best way to treat salivary gland neoplasms by analyzing data of patients treated in our hospital.

Osteomyelitis of the skull base due to mucormycosis

INTRODUCTION O steomyelitis of the skull base (SBO) is a well described but uncommon entity with a high mortality rate (Chandler et, al. 1986, Beneke J.E 1989). This condition is usually secondary to infection in the external auditory meatus or middle ear by gram negative organisms in the absence of adequate host response. We report a case of osteomyelitis of the skull base due to mucormycosis in an immunocompetent patient who presented with multiple cranial nerve palsies.

Mucormycosis: Battle with the Deadly Enemy over a Five-Year Period in India

Mucormycosis is an emerging opportunistic fungal infection. Increasing immunocompromization, widespread use of antibacterial and antifungal agents (such as voriconazole prophylaxis), carcinomas, transplantation and lifestyle diseases such as diabetes are the main contributors to this situation. The predominant clinical manifestations of mucormycosis vary from host to host, with rhino-orbital-cerebral, pulmonary, cutaneous, and gastrointestinal infections being the most common. In India, the prevalence of mucormycosis is approximately 0.14 cases/1000 population, which is about 70 times the worldwide-estimated rate for mucormycosis. The present study was undertaken over a period of five years (January 2009–December 2014) to determine the prevalence of mucormycosis. The samples suspected of mucormycosis were examined by direct KOH wet mount and cultured on Sabouraud’s dextrose agar without actidione and on blood agar as per standard mycological techniques. Histopathological correlation was done for most of the cases. Antifungal susceptibility testing was performed by the EUCAST reference method. We identified a total of 82 cases of mucormycosis out of a total of 6365 samples received for mycological culture and examination during the said time period. Out of these, 56 were male patients and 27 were females. Most common presentation was rhino-orbito-cerebral (37), followed by cutaneous (25), pulmonary (14), oral cavity involvement (4) and gastrointestinal (2). The most common risk factors were diabetes and intramuscular injections. The fungi isolated were Rhizopus arrhizus (17), Apophysomyces variabilis (12), R. microsporus (9), Lichtheimia ramosa (8), Saksenaea erythrospora (5), Syncephalastrum racemosus (4), R. homothallicus (2), Rhizomucor pusillus (1), Mucor irregularis (1) and A. elegans (1). The mainstay of the treatment was amphotericin B, along with extensive surgical debridement whenever feasible. Most of the patients (50) recovered, but 25 died. The rest of the patients left against medical advice. “Nip in the Bud” should be the mantra for clinicians/surgeons for a favorable prognosis. Early diagnosis, prompt institution of appropriate antifungal therapy, surgical debridement whenever necessary, knowledge of risk factors and their timely reversal is the key for management.

Quality of life in patients with fungal infection of nose and paranasal sinuses: A study from North India

Background: Fungal infections of nose and paranasal sinuses have a protracted course with frequent relapses and recurrences. Quality of life (QOL) of such patients is severely affected. Materials and Methods: The aim of this study was to assess QOL of patients with fungal infection of nose and paranasal sinuses. The objective was to assess disease specific QOL, health-related QOL, and global QOL. Cross sectional assessment was carried out on thirty patients with the diagnosis of fungal infection of nose and paranasal sinuses. Results: The total Sino Nasal Outcome Test score was indicative of “moderate degree of problem.” Regarding generic QOL, as assessed using WHOQOL-Bref, the sample had overall moderate QOL in all domains. On the contrary, on the Short Form-36, highest scores were obtained on the individual domains of “physical functioning” and “pain” with lowest scores on the domains of “general health” and “role limitation due to physical health.” Conclusion: It can be concluded that Indian patients with fungal infection of paranasal sinuses report moderate degree of QOL on both disease specific (SNOT-20) and global (WHOQOL-Bref) scales with mild to moderate limitation on health-related QOL scale (SF-36).

Inverted papilloma - an analysis of 30 cases.

Clinical, radiological and surgical details of 30 patients of inverted papilloma treated between the years 1990-1995 were analysed. Inverted papilloma is a benign but locally aggressive tumour. Unilateral nasal obstruction with or without bleeding was the commonest presenting feature. More than half of the patients gave history of previous surgery. CT scan is a good modality to know the exact extent of the lesion and plan surgery. Radical surgery was done in all patients. We had recurrence in 1 patient (3.3%) and two patients had carcinomatous change (6.6%). The results are presented with brief review of literature.

Basaloid squamous cell carcinoma - larynx.

Basaloid squamous cell carcinoma is a rare variant of squamous cell carcinoma, Larynx has been an uncommon site of this tumour which is said to have aggressive biological behaviour with high incidence of cervical and distant metastasis along with second primary. Two cases of laryngeal basaloid squamous cell carcinoma are reported with relevant review of literature. The submucosal spread of tumour is highlighted alongwith role of preoperative radio therapy.