Bleomycin sclerotherapy in congenital lymphatic and vascular malformations of head and neck.

Bleomycin is an established antineoplastic drug, but recently some attempts were made to inject it locally as a sclerosing agent in cases of congenital lymphatic malformations. We present the outcome of this treatment modality tried on 10 paediatric cases of whom 9 had such malformation in the cervical region and one in the parotid region. Seven of these cases had congenital lymphatic malformation while three had haemodynamically less active congenital vascular malformation. All these children were subjected to percutaneous intralesional administration of bleomycin. The size of swelling reduced by 50% or more in seven patients out of which three showed complete or near complete response. There were no major deleterious side effects.

Periosteo-Temporofascial flap for cavity obliteration - first Indian study.

Healing of the mastoid cavtiycompletely is the desired result after a mastoid surgery. Even after the Sade's principles' of the complete disease clearance, adequate lowering of the facial ridge, good meatoplasty and closure of the perforation of the tympanic membrane are fallowed, the complete healing of tike mastoid cavity is sometimes net the end result. According to various surgeons, the incidence of discharging mastoid cavity after a open cavity mastoid surgery is between /0-60%-H The usual techniques of obliteration of the mastoid cavity to decrease the size of the mastoid cavity, unusually has good healing results due to good vascularity. The failure ta the early detectmn 0/disease recurrence and risk of sudden appearance of intra-cranial complications are the most important disadvantages of the technique. We undertook a study in SO randomly chosen patients of Unsafe CSOM. Twenty five underwent obliteration of the mastoid cavity with Periosteo-Temporofascial flap, which is based on branches of posterior auricular artery and rest twenty five underwent non-obliteration of the mastoid cavity. Tfie results between the two groups were compared in terms of healing of the mastoid cavity and hearing gain after operation. Very good results in terms of healing of the cavity were seen after obliteration surgery. The rate of healing of the cavity was much faster after obliteration. The additional advantage with the flap is the see-through character of the cavity lining, which would lead to early detection of the disease recurrence. No significant increase in the hearing was seen in the obliterated patients as compared to non-obliterated cases.

Butterfly inlay tympanoplasty: A study in Indian scenario.

Popularly myringoplasty is done by an underlay or an onlay technique using mostly temporalis fascia graft. A new technique of inlay tympanoplasty using composite cartilage perichondrium graft is applied in the present study of 20 patients, for closure of small to medium sized perforations. The results have been analysed in terms of graft take up rate and hearing improvement.