Blood glutathione levels in head and neck malignancies.

Blood glutathione was estimated in fifty patients of head and neck cancer in the age group of 18-76 years and the results were compared with a group of normal healthy controls. Mean blood glutathione level was found to be significantly lowered in patients than the controls. Irrespective of the site, TNM classification, histopathology, and character of lesion, fall in blood glutathione was nearly same in all the patients. The mean level was significantly increased after radiotherapy when compared with the levels before radiotherapy. The decreased levels of GSH in-patients with head and neck cancer, observed in the present study, may be due to its increased utilization by the cells. The results suggest that patients with head and neck cancer have increased oxidative stress.

Role of rhinomanometry to assess nasal airflow and resistance in patients undergoing septoplasty.

Nasal obstruction is a common symptom. Rhinomanometry is a tool to objectively assess the nasal airway. A prospective study was undertaken to assess the nasal airflow and nasal resistance in 25 patients of deviated nasal septum undergoing septoplasty using rhinomanometry preoperatively and postoperatively. Rhinomanometric improvement in nasal airflow and decreased nasal resistance were found in 88% patients after surgery.

Bacteriological study of paediatric and adult chronic suppurative otitis media.

Chronic suppurative otitis media (CSOM) is one of the commonest illnesses in ENT practice which requires medical attention all the more in children of poor socio-economic status having in past inadequate treatment and negligent medical care. The present study was conducted to find out the various aerobic and anaerobic microorganisms associated with CSOM in paediatric and adult cases and their current antimicrobial susceptibility pattern as a guide to therapy. Samples were collected from 109 clinically diagnosed cases of CSOM and processed according to standard protocols. Out of 74 paediatric CSOM cases, 72 (97.2%) were bacterial culture positive while out of 35 adult CSOM cases, 28 (80%) were culture positive. Bilateral CSOM was slightly more common in adults (25%) than paediatric (21.4%) age group. Polymicrobial nature of CSOM was noted in both paediatric (70.8%) and adult (71.4%) cases while number of organisms isolated per lesion was slightly higher in adults (2.5) as compared to paediatric (1.95) cases. In paediatric CSOM, Staphylococcus aureus was the commonest aerobic isolate while in adult CSOM, Pseudomonas aeruginosa was the commonest one. Among anaerobes Peptostreptococcus spp. was commonest in CSOM where as Prevotella melaninogenica in adult CSOM. Sensitivity of S. aureus to cefuroxime was 72.2% while that of gram negative bacilli was higher to cefotaxime (90 to 100%). Among anaerobes higher sensitivity was seen to metronidazole (98.6%), clindamycin (95.7%) and chloramphenicol (98.6%). In view of the polymicrobial etiology of CSOM, prompt appropriate antimicrobial therapy can effectively reverse the disease process thereby preventing longterm sequelae.

Intra-oral minor salivary duct carcinoma.

Salivary duct carcinoma (SDC) is a recently described highly malignant tumor, seen most commonly in the parotid gland & occurs in the 6th and 7th decade of life. Rarely, it occurs in the minor salivary glands. The case is presented because of its rare occurrence and unusually presenting as a swelling predominantly involving the maxillary bone. The tumor bears histological homology with breast carcinoma, prostatic carcinoma and sweat duct carcinoma.

Wegener's granulomatosis: a case with laryngeal involvement.

A patient of Wegener's granulomatosis (WG) with laryngeal involvement and respiratory difficulty has been described. Direct laryngoscopic biopsy led to the diagnosis of Wegener's granulomatosis. The patient underwent a tracheostomy and was subsequently treated with cyclophosphamide and corticosteroids to which he responded.

Effect of adeno-tonsillectomy on hearing threshold and middle ear pressure.

Out of 50 children (100 ears) undergoing adeno-tonsillectomy, 34 ears had hearing threshold 20-50 dB (20 dB is normal) and 32 ears showed negative middle ear pressure of 100 to 400 mmH2O (100 mmH2O is normal). Post-operatively only 7 ears had hearing threshold of 20-30 dB and negative middle ear pressure of 100 to 200 mmH2O. Thus adenoidectomy improves eustachian tube functions.

Crystallization test for the detection of head and neck cancer.

Twenty-five patients suffering from head and neck cancer and 25 healthy individuals were subjected to a blood crystallization test with 20% cupric chloride solution and the patterns were compared. In the healthy control group, the typical pattern was an eccentrically placed center of gravity with needles arranged in a radiating fashion, while in the malignant group, there was a transverse bar or transverse formation. The sensitivity of this test procedure was 88%. We therefore conclude that this study is an interesting reliable, economical and above all useful adjunctive for a mass screening programme in the diagnosis of malignant diseases of the head and neck region. The test is based purely on physical phenomena and hence should be performed under controlled physical conditions.

Nasal mucociliary clearance & mucus pH in patients with diabetes mellitus.

Nasal mucociliary clearance (NMC) time and nasal mucus pH were studied in 50 patients suffering from diabetes mellitus and in a group of 50 healthy non-smokers and non-alcoholic controls. NMC time and pH values were found to be significantly increased in diabetics (NMC = 18.02 +/- 5.08 and pH = 7.96 +/- 0.75) as compared to controls (NMC = 7.49 +/- 1.06 and pH 6.43 +/- 0.67). The increase in NMC and pH was much more in patients having insulin dependent diabetes mellitus (IDDM) (NMC - 20.87 +/- 4.71 and pH -8.38 +/- 0.56) than in non-insulin dependent diabetes mellitus (NIDDM) (NMC - 15.16 +/- 3.67 and pH -7.53 +/- 0.687) and also when the duration of disease was more than 10 yr (NMC - 22.36 +/- 4.36 and pH -8.47 +/- 0.607). This impairment was attributed to osmotic diuresis with loss of water and electrolytes from all parts of the body and also small vessel abnormalities encountered in diabetes.

Tuberculosis of middle ear cleft.

Three cases of tuberculosis of middle ear cleft who presented with ear discharge, postaurale swelling post-aural fistula and facial nerve palsy in one case are reported. Audiometry showed conductive deafness in two cases and sensorineural deafness in one case. Roentgenograms revealed bony erosion of the mastoid bone in two cases and coalescence of mastoid air cells in one case. Modified radical mastoidectomy was done in all the three cases and histopathology of tissue removed on operation revealed tuberculosis. All the symptoms except facial nerve palsy improved and post-aural wound healed completely with anti-tubercular therapy. Early recognition and specific therapy may avoid these complications like fistula formation, facial nerve palsy and deafness and may well reduce the need for surgical procedure.

Serum immunoglobulins in patients with chronic tonsillitis.

Serum immunoglobulin (IgG, IgA and IgM) levels were determined in patients with chronic tonsillitis before and one month after tonsillectomy. The preoperative levels of serum IgG, IgA and IgM were significantly higher when compared with the controls. The increase may be due to repeated antigenic stimulation. The post-operative levels for the three immunoglobulins were decreased; however, a significant reduction was observed for IgG only where the mean value was comparable with the control group. The data confirm that tonsillectomy does not disturb the humoral immune system of the body.