Therapeutic Modalities in Head-Neck Neoplasia and Prognostication: A Review.

Neoplasia of the head and the neck necessitates intervention, surgical or otherwise, as the site and stage of the pathology may dictate. The various therapeutic modalities employed and prognosis has been reviewed.

Invasive rhino-orbital fungal sinusitis following dental manipulation.

Rhinocerebral mucormycosis is a fulminant fungal infection of the nose and paranasal sinuses in immunocompromised patients. But mucormycosis following dental manipulation in immunocompetent patients leading to orbital involvement is rare. The objective of this study was to highlight the variable presentations of mucormycosis. We had two immunocompetent patients, who had undergone some dental treatment by quacks, later developed fulminant mucormycosis of the paranasal sinuses and blindness. The endoscopic sinus surgery and Amphotericin B chemotherapy resulted in a good outcome. This disease requires an aggressive approach of combined endoscopic sinus surgery and Amphotericin B to increase the chances of survival in these patients.

Nasal polyps: a clinical, histopathological and radiological profile.

OBJECTIVE: Comparison of clinical, radiological & histopathological profile in nasal polyps. MATERIAL #ENTITYSTARTX00026; METHOD: A prospective randomized study conducted on 50 patients of nasal polyps (diagnosed clinically or radiologically) from July 2003 to December 2005 selected from the inpatient department of Otorhinolaryngology, Dayanand Medical College & Hospital, Ludhiana. RESULTS: The results show that 70% of the clinical findings were consistent with radiological findings. However in rest 30% of cases, a difference of opinion was seen in non neoplastic and neoplastic lesions. The diagnosis of allergic fungal or allergic non fungal can only be established on histopathology. CONCLUSION: It is concluded that for proper evaluation of nasal polyps clinical, radiological and histopathological evaluation should be done in all the patients, where radiology provides a road map to the endoscopic surgeons and warns of any existing or impending complications. Histopathology always gives a confirmatory diagnosis.

Invasive fungal sinusitis of isolated sphenoid sinus in immunocompetent subjects.

Invasive fungal sinusitis of the paranasal sinuses in a healthy immunocompetent person is uncommon. Isolated involvement of any paranasal sinus, particularly sphenoid sinus is rare. In this study, five immunocompetent patients who had no nasal complaints but obscure symptoms of headache and orbital symptoms such as diplopia, retro-orbital pain and loss of vision were diagnosed to be having fulminant fungal sinusitis of the sphenoid sinus. Three patients had aspergillosis and two patients had mucormycosis. These patients initially presented to neurologists and ophthalmologists because they had no ENT complaints. The diagnosis was made on endoscopy, radiology and histopathology. They were treated aggressively according to the standard protocols. The purpose of this paper is to bring to light the changing clinical spectrum of invasive fungal sinusitis. It can occur in immunocompetent patients and in the form of isolated sphenoid sinus involvement.

Role of F.E.S.S. in chronic sinusitis.

Functional endoscopic sinus surgery (FESS) is a new and exciting treatment for chronic sinus disease. A prospective study of 50 patients undergoing FESS was undertaken at the department of Otolaryngology, Dayanand Medical College & Hospital, Ludhiana. Parameters studied included patient symptoms, medical history, medical therapy, radiologic findings, complications and postoperative symptoms. 62% of our patients had sinonasal polypi (ethmoidal polypi 56%, antrochoanal polypi 6%) while 38% had chronic sinusitis. Osteomeatal complex involvement (88%) was the most common preoperative CT scan findings. All the cases were subsequently suhjected to functional endoscopic sinus surgery, studied for post-operative complications and 82% of the patients achieved improvement in preoperative symptoms. It was concluded that FESS is a highly successful treatment for chronic sinus disease.