Schwannoma of the nose and paranasal sinuses

Sckhwannoma is a benign tumor arising from the Schwann cells of nerve sheath.Through they arise more commonly in the head and neck than other regions, a through search in the liturature including medline revealed only about 47 reported cases of schwannoma in the paranasal sinuses of which the maxillary sinus involvement is more common. We report three cases of schwannoma arising from unusual sites in the paranasal sinuses with different modes of presttation each requiring a specific approach for surgical excision Transnasal endoscopic approach in combination with vonventional approaches is of immense value in the surgical management of these benign lessions of the paranasal sinuses.     

Pilot study of salivary butyrylcholinesterase,phosphodiesterase, thiols and cerulopalsmin in auditory neuropathy

ObjectiveTo estimate butyrylcholinesterase (BChE), phosphodiesterase (PDE), thiols and cerulopalsmin by non – invasive means in saliva a of subjects (both cases and controls) and correlated to their hearing sensitivity.MethodsTotal of 13 subjects participated in this study. Among them 7 were having auditory neuropathy and 6 were healthy controls. Unstimulated saliva (10 ml) was collected from each participant. Ceruloplasmin, thiols, phosphodiesterase and pseudocholinesterase were estimated by colorimetric method in the salivary samples.ResultsSalivary BChE and PDE levels were marginally elevated and protein thiols were marginally decreased in cases as compared to that of controls. Salivary ceruloplasmin was significantly decreased (p = 0.022) in cases as compared to that of controls.ConclusionsSaliva can be used as a potential noninvasive tool for evaluation of disorders.     

Surgical access to parapharyngeal space tumours--the Manipal experience

A few series of parapharyngeal space tumours have been reported earlier but recently not many series have been published in English literature. It is rare for any medical center, let alone an individual surgeon, to develop sufficient experience in evaluating these tumours. We present our experience in the treatment of 41 cases of parapharyngeal tumours from January 1992 to December 2001. FNAC, ultrasound and CT scan of the presenting mass was done in most of the patients as the main pre-operative work-up. The strategic location and extension of the tumour may occasionally alter the surgical approach for tumour excision.     

Osteolipoma of the skull base

Although lipomas are the most common benign tumours of the head and neck, the involvement of the skull base is rare and it is also very rare for a lipoma to undergo osseous metaplasia to become an ossifying lipoma or osteolipoma. We present a case of a solitary osteolipoma involving the skull base in a 17-year-old girl. A few cases of osteolipoma involving the head and neck have been reported, but this may be the first reported case of a solitary osteolipoma involving the skull base with extension to the infratemporal fossa and parapharyngeal space. The computed tomography (CT) scan helped to clinch the diagnosis and the histopathology confirmed it. The clinical presentation, role of CT scan, surgical approach used, histological features and the review of literature are discussed.     

KTP Laser assisted microendoscopic cricopharyngeal myotomy and web excision for dysphagia management

Cricopharyngeal dysfunction is defined as the delayed or incomplete relaxation of the cricopharyngeal muscle during swallowing. This may cause dysphagia and aspiration, affecting the quality of life. For this condition, injection of botulinum toxin into the cricopharyngeus, dilatation of cricopharynx with bougies and external cricopharyngeal myotomy have been the treatment of choice with varying results. We present in this paper the treatment of this clinical condition by KTP 532 laser a recent advance in the field of Otolaryngology and Head and Neck Surgery. Very few series have been reported in literature so far regarding the use of laser for cricopharyngeal myotomy. This is perhaps the first series of eight cases of KTP laser assisted microendoscopic cricopharyngeal myotomy and web excision reporting the benefit of this treatment by an Indian author in an Indian Journal. KTP laser assisted cricopharyngeal myotomy avoids an external scar; aids precise incision at the cricopharynx by direct visualization, brings optimum results in deglutition and reduces postoperative morbidity and complications. The short hospital stay reduces the overall cost. The use of KTP 532 laser in the treatment of selected cases with cricopharyngeal dysfunction is therefore safe and effective.     

Solitary adult myofibroma of the pinna.

Solitary myofibroma is a recently described benign neoplasm of the skin or superficial soft tissue and it represents the adult counterpart of infantile myofibromatosis. This new clinicopathological entity is being recognized increasingly. A case of solitary myofibroma occurring in the pinna of a 50-year-old woman is presented. Such a lesion occurring in the pinna of an adult has not been reported in the literature.     

Hyalinizing clear cell carcinoma of the base of tongue

Hyalinizing clear cell carcinoma is a rare, low-grade neoplasm of the minor salivary glands. It is composed exclusively of epithelial cells with optically clear cytoplasm. There are only a few isolated cases reported in the literature involving the base of tongue. The treatment of choice is wide excision and selective neck dissection, with or without radiotherapy. The prognosis of these tumours is good. A 57-year-old male patient presented with a lesion in the base of tongue, which was well enhanced on contrast computerized tomography scan. Once confirmed by biopsy, the hyalinizing clear cell carcinoma was resected via a transcervical approach. The patient underwent postoperative radiotherapy. There was no evidence of locoregional recurrence or distant metastasis at 18 months of follow up.     

Fourth branchial pouch sinus: A case report

The fourth branchial pouch sinus is a very rare developmental anomaly; it usually presents as a recurring abscess in the left side of the neck. A high index of suspicion, combined with Barium swallow and computed tomography scan, aids in diagnosis. A case of branchial pouch anomaly is reported here for its rarity and late presentation. Complete excision of the entire epithelial tract combined with ipsilateral thyroid lobectomy remains the mainstay of management.     

KTP-532 laser cordotomy for bilateral abductor paralysis

Various lateralization procedures have been described in the past to treat bilateral vocal cord paralysis. Though endoscopie lateralization gives good results in terms ofdecannulation rates, the postoperative voice quality is often poor. KTP-532 laser assisted posterior cordotomy was done in 3 cases. This preliminary study showd 100% decannulation rate and good post-operative voice quality. The latter was assessed both subjectively and objectively on VAGMI scales.     

Endoscopic dacryocystorhinostomy and retrograde nasolacrimal duct dilatation with cannulation: our experience

Endoscopic endonasal dacryocystorhinostomy [EDCR] is considered to be a superior alternative technique to the conventional external dacryocystorhinostomy [DCR], both in primary and secondary cases. It is of particular value in children and young adults as it avoids an external scar. Sixteen cases of chronic dacryo-cystitis were treated by the endoscopic technique, including 8 revision cases of failed external approach. In all cases except one, a patent nasolacrimal fistula was noted, with a success rate of 93.7%. The authors share their experience in EDCR and review the relevant literature.