RESUMEN
Objective This study aims to evaluate the effect of inferior turbinate reduction on middle ear compliance and pressure. Methods A prospective observational study was conducted on 100 patients between 20 and 60 years of age with bilateral nasal obstruction due to inferior turbinate hypertrophy and a normal-looking external and middle ear. The Wilcoxon signed-rank test with a 95% confidence interval was used to compare the middle ear peak compliance and pressure on tympanometry before and one month after the inferior turbinate reduction surgery. Results The mean age was 28.44 ± 8.23 years, with a male/female ratio of 7:3. After surgery, patients with normal compliance increased by 8%, high compliance decreased by 12%, and low compliance increased by 4% in the right ear. High compliance decreased by 2%, normal compliance decreased by 10%, and low compliance increased by 12% in the left ear. Positive tympanometric peak pressure (TPP) increased by 37% and 43% in the right and left ears, respectively. Conclusion After turbinate reduction surgery, the overall tympanometric peak pressure and compliance improved. However, we did not see an obvious improvement in low middle ear compliance. Thus, turbinate reduction surgery might benefit patients with inferior turbinate hypertrophy and associated poor middle ear ventilation.
RESUMEN
Carcinosarcoma or sarcomatoid carcinoma is a highly malignant variant of squamous cell carcinoma, which comprises 2 to 3 % of all laryngeal cancer. It is considered to be a biphasic tumour, composed of a squamous cell carcinoma (in situ or invasive) and spindle cell carcinoma with sarcomatous appearance. We present a case of huge carcinosarcoma of larynx in a 34 year-old male who developed severe stridor and dysphagia. The diagnosis was confirmed histopathologically, hence the disease was treated through total laryngectomy followed by adjuvant chemotherapy and radiotherapy. The patient is well and hearty for the past one and a half years.
RESUMEN
Extranodal NK/T-cell lymphoma, nasal type (ENKL) is a rare lymphoid neoplasm that in the past has been grouped with a variety of granulomatous diseases. ENKL occurs in all age groups. However, it seems to occur more often in people in their 50s and affects more men than women. It is strongly linked to the Epstein-Barr virus (EBV), especially in people of Asian countries. Because this type of lymphoma occurs in organs or tissues other than lymph nodes, it is called ENKL. This is a case report of a 25-year-old female patient who presented with a nonhealing ulcer at the right nasal ala involving the upper lip and cheek for the last 2 months, which had been treated with antitubercular treatment without success. After biopsy and immunohistochemical (IHC) analysis, the patient had been diagnosed a case of extranodal T-cell lymphoma.
RESUMEN
A malignant melanoma is a highly lethal melanocytic neoplasm. A neoplasm usually affects the skin. Malignant melanomas in the head and neck region are rare, accounting for less than 1% of all melanomas. Malignant melanoma of the nose and paranasal sinuses is an aggressive disease typically presenting at an advanced stage, with a 5-year survival rate ranging 20-30%. Melanomas are tumors arising from melanocytes, which are neuroectodermally derived cells located in the basal layers of the skin. This is a case report of a 35-year-old male, who presented with very aggressive disease and developed liver metastasis.
RESUMEN
Foreign body aspiration is one of the leading causes of accidental death in children. In older infants, tendency to explore their environment by putting objects in mouth leads to aspiration, but in younger infants below 6 months of age, as they are non ambulatory, it is the elder sibling who puts the foreign body into younger child's mouth. Diagnosis is often difficult because of no definite history in most cases. The purpose of this study is to diagnose and manage airway foreign bodies in younger infants with unusual presentation and no definite history. All patients referred to our Otorhinolaryngology Department with respiratory symptoms unresponsive to medical treatment and no definite history of foreign body aspiration were prospectively evaluated using virtual bronchoscopy. All patients underwent rigid bronchoscopy and foreign body removal with use of a maneuver in some cases.
RESUMEN
The nasal septum is an important physiological and support structure of the nose. The nasal septal deviation causes alteration in air flow, mucociliary clearance and effects structures of the lateral nasal wall causing various nasal symptoms and other sinonasal disease. A systematic analysis was performed to measure the angle of septal deviation on CT scan PNS coronal section and to evaluate the influence of increasing septal angle deviation on the severity of lateral nasal wall abnormalities. A total of 61 patients with clinical evidence of chronic rhinosinusitis refractory to medical therapy for minimum three months were included in this study. After preliminary anterior & posterior rhinoscopic examination, all patients were evaluated with nasal endoscopy & CT scan PNS coronal view. There was statistically significant increase in hypertrophy of the middle turbinates and prominence of bulla ethmoidalis with OMC impingement on the side opposite to the direction of septal deviation. No apparent statistically significant difference between ipsilateral and contra lateral side OMC disease and anterior sinus mucosal disease in relation to direction of septal deviation in various groups was seen. We concluded that there is a strong association of increasing angles of septal deviation with corresponding patterns of disease in ostiomeatal complex. The result of the present study reemphasized the fact that, obstruction at ostiomeatal complex and anterior ethmoids secondary to septal deviation is the key factor for causation of chronic sinusitis.
RESUMEN
The aim of this study is to evaluate the results of closure of subtotal perforation by tympanoplasty using underlay technique with the perichondrium/temporalis fascia graft supported by single cartilage slice anteriorly. Our hypothesis was that the cartilage support, single slice, offers an extremely reliable method for reconstruction of the tympanic membrane in cases of advanced middle ear pathology and Eustachian tube dysfunction. Retrospective and prospective study of patient undergoing tympanoplasty in subtotal perforation with graft supported by a slice of cartilage between March 2000 and October 2005. Intact perichondrium/temporalis fascia was placed as graft in subtotal perforation, supported by a slice of cartilage. Slice was placed anteriorly from hypotympanum to anterior part of attic. It does not obstruct Eustachian tube opening, as it is curved with concavity facing towards medial wall and lined by perichondrium without any raw area, which prevents adhesion formation. Hearing results were reported using four frequency (500, 1,000, 2,000 and 3,000) pure tone average air-bone gap. During the study period, perichondrium/temporalis fascia graft with support of cartilage slice was used for tympanic membrane reconstruction in 94 patients. Overall graft take rate was 98.94 %. In 95.74 % of patients of different types of tympanoplasty achieved hearing level of 30 dB or less. Complications included residual perforation in (1.06 %), infection or gaping of wound in 2 (2.13 %). Cartilage slice support offers an extremely reliable method for reconstruction of tympanic membrane in cases of high-risk perforation (subtotal perforation, retraction pocket, cholesteatoma, anterior perforation of tympanic membrane).