Management of Rhinosporidiosis: by Coblation.

Rhinosporidiosis is a granulomatous disease commonly affecting the mucous membrane. It is caused by Rhinosporidium seeberi, an aquatic parasite & seen affecting the nose, paranasal sinuses most commonly. A retrospective study was conducted at a tertiary care hospital situated in Indian peninsula and five patients who were diagnosed and treated for rhinosporidiosis were analysed. Surgical excision by coblator along with medical management using Dapsone 100 mg once daily for 6 months given promising results in view of reducing recurrence. Combined approach of management including surgical excision using coblator and medical therapy with dapsone is effective in managing the rhinosporidiosis with no recurrence.

Endoscopic Assisted Cold Steel adenoidectomy - A Cost Effective Modification for Better Outcome.

Introduction: Adenoidectomy is most commonly performed in children to alleviate the symptoms pertaining to adenoid hypertrophy. The conventional cold steel method utilizing adenoid curette is the most commonly performed method in the world even after the invention of endoscopes & powered instruments like coblator & microdebrider due to the cost & time factors. The conventional method being a blind procedure, carries higher rate of recurrence due to remnant tissues. The visualization of the adenoid tissue in nasopharynx through the nasal endoscope helps in better engagement of adenoids into the curette & adequate tissue clearance with reduced recurrence of symptoms. Aim: To study the effect of visualization of adenoid tissue for better tissue clearance in conventional adenoidectomy. Objectives: To compare the duration of surgery, blood loss & recurrence rate following conventional cold steel adenoidectomy (CSA) & endoscope assisted cold steel adenoidectomy (EACSA). Method: 50 patients who underwent adenoidectomy with various indications were grouped into two groups with 25 patients each. Group A underwent (CSA)with or without tonsillectomy & Group B underwent (EACSA) with or without tonsillectomy were followed up for the duration of 3 months. The patients were evaluated for duration of surgery & post operatively for the recurrence at 3rd month of follow up. Results: In our study, it was found that the tissue clearance in Group A was significantly low. The recurrence rate of 48% was observed in CSA group compared to 0% in group B with EACSA. The duration of surgery in both the procedures were comparable. Conclusion: EACSA is an effective modification to CSA. It adds the benefits of endoscopic visualization of adenoid for the conventional curettage. The high recurrence rates of CA can be effectively reduced with no significant variation in duration of surgery.

Primary Secretory Paraganglioma of Facial Nerve Canal: A Case Report.

Paragangliomas (PGLs) of Head and Neck region account for 0.6% of Head and Neck Tumours. These may originate in paraganglionic tissues in the area of carotid bifurcation, vagus nerve, tympanic plexus and very rarely along vertical Facial nerve canal (FNC). We intend to describe a rare case of primary paraganglioma of FNC associated with hypoxia of submarine environment, its characterization and multidisciplinary approach towards its management.

Pterygium excision and conjunctival autograft: A comparative study of techniques.

BACKGROUND: Use of conjunctival autograft following excision has reduced the recurrence rate of primary pterygium. This study compares the use of fibrin glue, autologous blood, and sutures in placing the conjunctival autograft in reference to surgical time taken, postoperative discomfort, and recurrence during follow-up. MATERIALS AND METHODS: Sixty patients with primary pterygium were included in the study and divided into three groups. In Group I, autograft was attached in place with help of 10-0 polyamide monofilament suture; in Group II, with autologous blood; and in Group III, with fibrin glue. All three groups were compared in terms of surgical time, postoperative discomfort, and recurrence. RESULTS: The average surgical time taken was least with fibrin glue group (Group III), i.e., 36.2 min, followed by 44.8 min with autologous blood group (Group II) and maximum of 53.3 min with suture group (Group I). Postoperative discomfort was seen maximum in th suture group (Group I) and was minimal in the fibrin glue group (Group III). At the end of final follow-up at 6 months, one case of recurrence was seen in both Group I and Group II. No recurrence was seen in Group III. CONCLUSION: The study concluded that fibrin glue remains the most effective method for attaching conjunctival autograft in pterygium surgery with least surgical time and postoperative discomfort. Autologous blood is an effective alternative which is easily available, economical, vis a vis fibrin glue with less surgical time and postoperative discomfort. Use of sutures is an older technique with maximum surgical time and postoperative discomfort. Recurrence is least with fibrin glue.

Minor trauma triggering cervicofacial necrotizing fasciitis from odontogenic abscess.

Necrotizing fasciitis (NF) of the face and neck is a very rare complication of dental infection. Otolaryngologists and dentists should be familiar with this condition because of its similarity to odontogenic deep neck space infection in the initial stages, its rapid spread, and its life-threatening potential. Trauma has been reported to be an important predisposing factor for NF of the face. In this paper, we describe the presentation and treatment of a 62-year-old man who developed NF of the face and neck following bilateral odontogenic deep neck space abscesses. The disease progressed rapidly, with necrosis of the skin, after the patient inflicted minor trauma in the form of application of heated medicinal leaves. The organism isolated in culture from pus was Acinetobacter sp. The comorbid conditions in our patient were anemia and chronic alcoholism. The patient was managed by immediate and repeated extensive debridements and split-skin grafting.