Infolding of Nasolabial Flap: An Excellent Surgical Technique for Full-Thickness Defect of the Lip.

To find out the usefulness of the infolding technique of nasolabial flap to reconstruct full-thickness defects of the lower lip. It is a retrospective analysis of 5 surgically operated cases. The infolding nasolabial flaps were utilized for the full thickness defect over the lower lip in carcinoma of the oral cavity from January 2018 to July 2019. The patients were followed up for a minimum period of 12 months, and the outcomes were evaluated. The mean age of the patients was 39.72 ± 7.58 years (range 30-52 years). The infolding nasolabial flap has used each case for the reconstruction of the lower lip. The average length and breadth of the flaps were 65 mm (range 60-75 mm) and 35 mm (range 30-40 mm), respectively. One patient presented with partial necrosis of the flap its tip. The functional and cosmetic outcomes were found satisfactory till 12 months of follow-up, and none of the patients had a recurrence of the disease. Infolding of the nasolabial flap can be a good surgical technique for the reconstruction of the full-thickness defect of the lower lip, ensuring satisfactory functional and cosmetic outcomes without causing major intraoperative/postoperative complications in patients with carcinoma of the lower lip.

Management of Symptomatic Grade I and II Laryngeal Cleft: Experience of a Tertiary Care Center and Review of Literature.

Laryngeal cleft is a rare pathology and needs a high index of suspicion for diagnosis. Various classifications are used but the Inglis classification which describes 4 grades of cleft is most widely accepted. Grade 3 and 4 clefts are very rare and are usually associated with other congenital abnormalities. Grade 1 and 2 clefts are more common and can be easily corrected with good outcomes. We are presenting our experience with 9 cases of low grade (Grade 1 and 2) laryngeal cleft which were managed successfully in our department. Out of the 9 cases 4 failed conservative management and required a trans-oral repair. All patients improved with management, except one who intermittently developed another episode of pneumonia 2 months' post-surgery. However satisfactory cleft obliteration was confirmed on endoscopy and the patient has been under close follow up ever since. Majority of low grade laryngeal clefts can be managed with dietary modifications and feeding rehabilitation. Those who do not respond usually require surgical repair with near complete resolution of symptoms.

Primary Endoscopic Stapes Surgery: A Comparison of Adipose Tissue and Gelfoam Seal.

To compare the efficacy between the commonly used sealing materials, i.e., adipose tissue and the gelfoam in primary endoscopic stapedotomy. Lobular fat and gelfoam have been used in patients who underwent endoscopic stapedotomy between two groups, each containing 29 patients. The hearing outcomes and postoperative complications were compared at the end of 12 weeks between two groups. The ABG of ≤ 10 dB was achieved in 69% of cases in group A and 76% of cases in group B. There was a significant short-term (1 week) improvement in the Dizziness Handicap Inventory score (p = 00) with patients of adipose tissue seal compared to the gelfoam. Although the audiological outcomes were comparable between the two groups, the use of the adipose tissue can be a better alternative than gelfoam to control vertigo in the early postoperative period without causing any significant morbidity to the patient.

Intraconal orbital dermoid cyst: a rare location.

Intraconal dermoid cysts are very unusual in routine clinical practice. Clinical symptoms depend upon the site and extension of the lesion. Though rare, proptosis, diplopia, and orbital pain are the presenting symptoms encountered in patients with an intraorbital dermoid cyst. Although radiology can be diagnostic, a complete correlation with the final histopathology is always mandatory for its confirmation. Endoscopic excision of the cyst ensures a complete cure for the disease without any intraoperative/postoperative complications.

Exclusive endoscopic transcanal approach to lateral skull base lesions: Institutional experience of 3 cases.

INTRODUCTION: Majority of petrous bone and lateral skull base pathologies are benign in nature. The complex anatomy usually warrants an extensive approach with associated morbidity. CASE SUMMARY: Two cases of petrous bone cholesteatoma (1 congenital cholesteatoma with facial palsy and 1 acquired cholesteatoma) and a case of glomus tympanicum were treated with exclusive endoscopic transcanal approach. The cases of petrous cholesteatoma were addressed with trans-promontorial and infra-cochlear approaches. The mean operative time was approximately 140 min. No CSF otorrhoea was noticed in the post-operative period. The average period of hospital stay was 3.7 days. CONCLUSION: In the subset of cases with limited benign disease an endoscopic trans-canal approach is a better alternative to an external approach. It decreases operative time, blood loss, chance of meningitis, morbidity and hospital stay. The lack of depth perception is a major hurdle which can be come over by experience in endoscopic middle ear surgery. This approach can create direct access to cochlea/petrous apex/internal auditory canal (IAC)/Supra-geniculate ganglion region.

Intraconal orbital dermoid cyst: a rare location

Intraconal dermoid cysts are very unusual in routine clinical practice. Clinical symptoms depend upon the site and extension of the lesion. Though rare, proptosis, diplopia, and orbital pain are the presenting symptoms encountered in patients with an intraorbital dermoid cyst. Although radiology can be diagnostic, a complete correlation with the final histopathology is always mandatory for its confirmation. Endoscopic excision of the cyst ensures a complete cure for the disease without any intraoperative/postoperative complications.

A rare case of chondrosarcoma arising in parotid with extension to lateral skull base.

Chondrosarcomas of head and neck region are rare. Very few cases of chondrosarcomas arising in parotid gland have been reported and none with intracranial extension. We report a case of a female presenting with a parotid swelling and a mass in external auditory canal with extradural extension to posterior cranial fossa. With a preoperative fine needle aspiration diagnosis of pleomorphic adenoma, it was excised and the histopathology came out to be low-grade myxoid chondrosarcoma. She has not received any adjuvant chemoradiotherapy and there is no evidence of recurrence at months.

Penetrating Neck Injuries: from ER to OR.

Neck contains several vital structures, in a small close space, in complex relationship to each other, and unprotected by any bony framework. Any injury to this crucial region, hence mostly becomes an acute emergency. Appropriately managing the same has always been a point of constant discussion amongst head and neck surgeons. The basic aim of the study was to discuss the management, comorbidities, prognosis and associated complications encountered in a series of patients with penetrating neck trauma (piercing platysma), presenting to the emergency over a period of 1 year. Combat injuries and patients declared as brought dead at the time of first examination were excluded. This was a retrospective study of patients with cut throat injury, managed at a tertiary center of northern India from June 2014 to September 2015. Following management in the ER as per ATLS guidelines, all patients were then operated for specific injuries. Graph pad software was used for statistical analysis. Of the 15 patients studied in total, 11 (73.3%) were males. The mean patient age was 33.67 years. Mean duration of presentation was 20.85 h. 60% patients had homicidal injuries. Tracheostomy and Ryle's tube insertion was done in 8 (53.3%) patients. Exploration and surgical repair was done in all patients without any mortality. 4 patients developed post-operative complications. Mean duration of hospital stay was 9.2 days. Immediate resuscitation followed by exploration and primary repair is a must in all patients of penetrating neck injury.

Vallecular Neurofibroma Successfully Managed with Endoscopic Assisted Coblation: A Novel Technique.

Although solitary neurofibroma can affect the various subsites of the head and neck region, oropharyngeal neurofibroma is very rare and total five cases (four in the soft palate and one in the palatine tonsil) have been reported. Here we present a 42-year old female patient presented to the out patient department with respiratory obstruction and voice change for 3 months. Complete excision of the mass was achieved by endoscopic coablation and which was confirmed to be a neurofibroma.

Bardet Biedl Syndrome - A Report of Two Cases with Otolaryngologic Symptoms.

Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive disorder characterized primarily by rod-cone dystrophy, postaxial polydactyly, central obesity, mental retardation, hypogonadism, and renal dysfunction. We present two cases of this syndrome, both female, who presented with complaints of nyctalopia and mental retardation, and additionally one of them had sensorineural hearing loss while the other had serous otitis media. Hearing loss being a rare presentation is worth reporting. Both the patients were given a course of vitamin A and the parents were counseled regarding the prognosis and additional complications associated with the syndrome.

Solitary Head and Neck Cysticercosis: A Series of Rare Cases.

INTRODUCTION: Cysticercosis is a disease which is caused by the infestation of the larvae Taenia solium, with humans acting as an intermediate host instead of a definitive host. Head and neck involvement including maxillofacial and oral involvement of cysticercosis is quite rare. CASE REPORT: We report a series of rare cases of cysticercosis of the head and neck region encountered in a tertiary hospital in Northern India with a brief review of literature and its diagnosis and management. The patients had undergone ultrasonography, FNAC and CT scan. All the cases were treated by Oral Albendazole tablets. The period of study was from August 2014 to August 2015. FNAC proved to be a highly effective way of diagnosis corroborated by imaging evidence. Treatment with albendazole was curative in all the cases. CONCLUSIONS: Cytopathology has emerged as an excellent diagnostic modality for cysticercosis. Medical treatment with antihelminthics produces excellent results, as illustrated in our case, and can eliminate the need of surgery.