Prevalence of p-16 Positive Laryngeal and Pharyngeal Tumors in Nepalese Population: A Hospital based Cross-sectional Study.

INTRODUCTION: P16 overexpression is considered as a good prognostic marker for oropharyngeal squamous cell carcinoma. However, there are very few literatures on the prevalence and outcomes of p16 overexpression in non-oropharyngeal squamous cell carcinoma and benign head and neck tumors. The aim of our study was to estimate the hospital based prevalence of p16 positive laryngeal and pharyngeal tumors and to compare it with the prevalence of p16 expression in the non tumor tissue (tonsils). METHODS: This was a descriptive cross-sectional study. Cases of all genders >15 years presenting with malignant or benign tumors of larynx and all the subsites of pharynx were included in the study for evaluation of p16 expression by immunohistochemistry. Tonsillar tissue of cases undergoing tonsillectomy for recurrent acute tonsillitis were taken as non-tumorous tissue to evaluate for p16 expression. RESULTS: A total of 48 cases were included in our study with 24 cases having different tumors of head and neck region and 24 cases having recurrent acute tonsillitis who were kept under non-tumor group. Eight cases (33.3%) in the tumor group showed positive stain for p16 in IHC. In non tumor group, 7 cases (29.1%) showed positive IHC staining for p16. CONCLUSIONS: P16 expression can be present in both benign and malignant tumors of various subsites of head and neck region and also in tonsillar tissue affected by inflammation.

Foreign body pyriform sinus: an unusual presentation.

This is a case report of a foreign body (chicken bone) on the left pyriform sinus impacted in its lateral wall. Although it could be seen on x-ray soft tissue neck lateral view and on CT scan of the neck, the foreign body could not be found by rigid oesophagoscopy which was done twice. It was detected and removed by lateral pharyngotomy under GA. A brief review of literature is also included.

Oncocytoma of maxillary sinus--a rare presentation.

A case of Oncocytoma of maxillary sinus in a 73 years old female is reported along with a brief review of literature. To the best of our knowledge this extremely rare tumor is the first of its kind reported in Nepal. Literature review has revealed only four such cases originating from maxillary sinus.

Frequency and effective treatment of ulcers and sinuses in cases of tuberculous cervical lymphadenitis.

OBJECTIVE: To investigate the frequency and effective treatment of ulcers and sinuses in cases of tuberculous cervical lymphadenitis (TCL). DESIGN: Observational cross-sectional study. PLACE AND DURATION OF STUDY: Department of ENT, Head and Neck Surgery of Tribhuvan University Teaching Hospital (TUTH), Kathmandu, Nepal, during the period of two years from March, 2000 to February, 2002. PATIENTS AND METHODS: A hundred cases of histopathologically confirmed cases of tuberculous cervical lymphadenitis of more than six weeks of duration were included in the study. Overall frequency of the complication as well as the efficacy of treatment regime was considered. RESULTS: Out of 100 patients, 8 (8%) were found to develop ulcers and/or sinuses during the process of development of TCL which were effectively treated (100% cure rate). Mode of treatment was surgical excision of ulcers/sinuses along with affected underlying lymph nodes, followed by short course of anti-tubercular chemotherapy. Not a single case recurred during their follow-up period. CONCLUSION: In this series there was a low frequency of formation of ulcers/sinuses during the process of development of TCL. Surgical excision of ulcers/sinuses along with affected underlying lymph nodes, followed by short course of anti-tubercular chemotherapy is the effective methods of their treatment.

Outcome of surgical management of laryngeal carcinoma: a 5-year experience.

OBJECTIVE: To investigate the outcome of surgically managed laryngeal carcinoma patients attending an outpatient clinic over a 5-year period. MATERIAL AND METHODS: This was an analytical, retrospective, cross-sectional study. A total of 36 laryngeal carcinoma patients who were managed surgically with or without radiotherapy were analyzed. RESULTS: A total of 32 patients (89%) were found to be disease-free during follow-up for up to 5 years. Two patients (5.5%) died because of intercurrent infection and recurrence of the disease and two (5.5%) were lost to follow-up 5 and 7 months after surgery, respectively. CONCLUSIONS: The results indicate that the best disease-free rates can be achieved by managing laryngeal carcinoma surgically with or without radiotherapy depending on the advancement and aggressiveness of the disease.

Penetrating injury of parotid gland and external auditory canal: a unique combination.

A unique case is presented of a penetrating injury of the parotid gland and complete transection of the cartilaginous portion of the external auditory canal by a tree branch. A subsequent superficial parotidectomy along with end-to-end anastomosis of the external auditory canal and appropriate antimicrobial therapy was successful. A review of the literature did not reveal any previous similar cases.