Delayed postmastoidectomy bleed from anterior tympanic artery and its management using endovascular microcoils.

Bleeding during mastoidectomy usually occurs because of injury to the dura mater and/or sigmoid sinus, which, in most cases, can be controlled easily. The other important cause is damage to the internal carotid artery during its course in the middle ear. Bleeding from the external carotid artery or a branch of it is very rare and unknown. We hereby report an extremely rare and first case of delayed torrential bleeding after modified radical mastoidectomy, which was because of infective necrosis and subsequent blowout of the anterior tympanic branch of superficial temporal artery and its management using microcoils via an endovascular approach.

The lifeline express--a mobile ear clinic for rural India.

The objectives of this study were to review the application and feasibility of providing screening, diagnosis, medical and surgical treatment for patients with ear discharge by setting a mobile hospital in rural India. The study was retrospective. The study involved collection of data from 1992 to 2005 from patients with ear diseases. The number of patients operated on for ear conditions and the distribution of free hearing aids were also recorded. Data regarding length of postoperative stay, complications and graft failure rates was collected from local medical centers and analyzed. Out of 304,321 patients, 4,426 were operated on for ear diseases, mostly ear perforations, grommet insertions and cholesteatoma surgeries. A total of 11,913 audiometric evaluations were done and 9,045 hearing aids were distributed. An overall success rate of 78.8% was achieved for achieving a dry ear and approximately 60% reported significant improvement in audiometric thresholds.

Bilateral first and second arch anomalies: a rare presentation.

Branchial sinuses are one of the most common congenital anomalies present. They are usually unilateral; bilateral cases are present but are rare. The presentation of bilateral branchial sinus anomalies along with bilateral first arch anomalies is very rare. Here, we present a case of bilateral first arch anomalies co-existing with bilateral second arch anomalies in a patient with no related family history and no associated syndrome.

Primary tuberculosis of oral cavity: a rare entity revisited.

Oral lesions of tuberculosis though uncommon, are seen both in the primary as well as the secondary stages of the disease. In secondary tuberculosis, the oral manifestations are accompanied by lesions in the lung, lymph nodes, or any other organ system of the body. This can be detected by the usual clinical history and systemic examination. Primary oral tuberculosis may thus present as a diagnostic challenge to the clinician. Amongst the oral lesions also, tongue is the usual site for tubercular infection, with the upper lip and soft palate being the least affected. The authors report two rare cases of children with isolated primary tuberculosis of the lip and uvula. Interestingly, the first case presenting just as a diffuse swelling of the upper lip, and the second as pain in throat with congestion and granulations on the uvula. We suggest a distinct Indian social habit which predisposes to primary lip and uvular tuberculosis, sites not common in the rest of the world. The habit of doing "datoon" i.e. brushing of the teeth with neem twigs in rural India, which at times causes trauma on the palate and thus predisposing to seedling of the wound with mycobacterium tuberculosis.