A customised laryngeal stent for glottic airway reconstruction.

OBJECTIVE: Laryngotracheal reconstructive surgery very often requires placement of laryngeal stents, but most of the available stents either do not conform to the shape of the glottis or are open at the upper end, causing significant tissue reaction and aspiration. LT-Mold is an ideal stent in this respect, but it is not readily available. CASE REPORT: The authors of this study fashioned a laryngeal stent out of a readily available Montgomery T-tube in such a way that it had a closed upper end and was well-conformed to the architecture of the larynx. This stent was used in a case of posterior expansion laryngoplasty, and post-operatively the patient had a patent airway with good voice and no aspiration. CONCLUSION: A customised laryngeal stent is well tolerated and helps to solve complicated cases of posterior glottic stenosis.

The effect of bismuth subgallate as haemostatic agent in tonsillectomy.

Tonsillectomy is one of the frequent operations performed by Otolaryngologists world over: Otolaryngologists are in search of a technique of tonsillectomy where the operation time and operative blood loss is less. This study was carried out to evaluate the effect of bismuth subgallate (BSG) and adrenaline on tonsillectomy time blood loss during the surgery as well as on the number of ties used. A prospective randomized trial of 60 patients was carried out, in which 30 had a tonsillectomy performed using BSG as haemostatic agent and in the remaining no heamostatic agent was used. Application of BSG in the tonsillar fossae reduces the operation time by 31.49%, the operative blood loss by 33.28% and also reduces the number of ties used by 53.33%. All these results are statistically significant.

Ectopic multinodular Goitre-An unusual case.

Ectopic thyroid tissue is usually found in the midline along the path of descent of the thyroid gland, such as in the tongue, larynx, trachea, oesophagus, etc. Initially, laterally placed thyroid tissues were found to contain malignant tissue and hence the term lateral aberrant thyroid tumours. Some attributed these to metastatic deposits of primary thyroid carcinoma while others felt that these were primary tumours of aberrant thyroid tissue. In later years, benign ectopic thyroid tissues were described in the lateral neck. It was felt that ectopic thyroid tissues are derived from thyroid cell rests that have failed to fuse with the main thyroid tissue during development. They are subjected to the same goitrogenic stimulation as the normally placed thyroid tissue. Our case supports the view that not all laterally placed thyroid tissues are malignant and also presents an unusual subplatysmal location of ectopic thyroid tissue.

Giant cell reparative granuloma of maxilla.

Giant Cell Reparative Granuloma is a reparative process in mandible. A case of Giant Cell Reparative Granuloma of Maxilla in a 15 years old female is reported. Tumour is very rare in maxilla and more often is diagnosed as a giant cell tumour. The case is reported on account of its rarity in maxilla and dilemma in differentiating it from other giant cell lesions. Differentiation is only based on the clinical test histopathological examination.

A microbiological study of anterior nasal packs in epistaxis.

Bleeding per nose is one of the comnonest ailment encountered by each and every otolaryngologvst Since hemostasis is immediate concern, anterior nasal pressure pack is put and is usually allowed to remain for 24-72 hours. Blood soaked pack and raw mucosal surface are good media for bacterial multiplication resulting in infection including sinusitis and sometimes toxic shock syndromes.Present study is conducted to work out bacterial flora of anterior nasal pack and effect of svstemic antibiotics in controlling it. Thirty cases of epistaxis of different etiology were included. Out of these 26 cases were positive on culture. These included Staphylococcus aureus 70%,. Pseudomonas aeruginosa twenty three percent. Klabsiella pneumonia and proteus mirabilis 3.3%, Streptococcus and Hemolyticus 3.3%. Details of type and duration of packing and its relation with organism cultured are discussed. It is concluded that the packing material should be soaked with antibiotics prior to use and should not be keep for more than 48 hours. And systemic antibiotics does not have any significant on this local infection due to packing.

An unusual case of solitary scleroma of cheek.

Scleroma is a disease of unwashed and occurs in people living in poor unhygienic conditions. Commonly it involves respiratory tract. We encountered a case of scleroma over cheek presenting as a solitary nodule without any sign of nasal scleroma.