SAUMIK DAS

Introduction Apart from the malignant ulcers a wide variety of dermatological and other systemic conditions can affect oral cavity and often be a diagnostic challenge due to their similar presenting features and appearance. Despite being benign, some of them may be fatal if not diagnosed and treated timely. This study aims to assess the incidence of different non malignant ulcers in oral cavity and to estimate the need for histopathological examination for confirmation of the condition for proper management. Materials and Methods  An institution based observational study was conducted over a time period of 16 months at a tertiary care institute. Total 172 cases were included in the present study irrespective of age, sex and duration. Malignant lesions were excluded from the study. Results The present study shows a slight male preponderance (M:F = 1.48:1) with majority of cases were in age group 20-40 years of age (43.02%). Most commonly encountered were recurrent aphthous stomatitis...

Introduction Recurrent Laryngeal Nerve Palsy (RLNP) is the most common complication of thyroid surgery. Patients complain of hoarseness of voice and sometimes variable amount of respiratory distress due to palsy of recurrent laryngeal nerve (RLN), extra laryngeal branches of which are often ligated along with Inferior Thyroid Artery (ITA) during thyroidectomy. So prevalence and variable pattern of extra laryngeal nerve branches (ELNB) of RLN should be known to the thyroid surgeon to avoid post operative complications. Materials and Methods   Dissection was carried on the neck of properly embalmed 25 adult cadavers including both sexes in the dissection hall to study extra laryngeal nerve branches (ELNB) of 50 RLN specimens. Results Out of 50 RLN, 13 nerves (26%) have ELNBs. Only in 4 cadavers (16%) they are bilateral. In 9 cases RLN branches were surrounding either single trunk of ITA or branches of the artery. In rest of the 4 cases ELNBs were passing entirely either in front or be...

Retinoblastoma is the most common intraocular tumor during childhood. These tumors though respond to treatment are prone to develop second malignancy, recurrence and metastasis which may present as sinonasal mass. We are presenting a rare case of metastatic retinoblastoma of sinonasal region in a 3-year-old male child. The mode of presentation and management of the case is presented along with a review of the literature. How to cite this article Jana T, Sengupta M, Das S, Saha AK, Saha S. An Unusual ENT Presentation of Retinoblastoma: A Diagnostic Dilemma. Clin Rhinol An Int J 2016;9(2):90-93.

Nasopharyngeal angiofibromas are benign tumors of the nasopharynx that occur in adolescent boys. The extensive extensions and various clinical presentations of the tumor have been well documented in the literature. Very rarely, these tumors may extend outside the nasal cavity as a large polypoid mass. Two interesting cases of angiofibroma with atypical presentations, showing extensive spread in multiple directions, are reported here. In one case, the angiofibroma exited the right nostril as a large polypoidal mass and also presented as an intraoral tumor in the right upper gingivo-alveolar region. In the other case, in addition to polypoidal presentation through the anterior nares, the tumor produced severe respiratory obstruction resulting from extensive bulging of the soft palate.

Sporotrichosis is commonly a chronic infection caused by Sporothrix schenckii, a saprophytic fungus and is usually limited to cutaneous and subcutaneous tissues. Disseminated systemic, osteoarticular or pulmonary sporotrichosis have been reported but nasal sinusitis by this fungus is extremely infrequent. Earlier report from southern India documented a case of maxillary sinusitis by Sporothrix schenckii. Here we report a similar case of bilateral maxillary sinusitis in a middle aged female from a village of Bihar, a state in eastern India. She underwent endoscopic maxillary sinus surgery for nasal symptoms and diagnosed to have sporotrichotic infection of maxillary sinuses. The diagnosis was done by mycological and histopathological examination and patient improved under antifungal chemotherapy.

Hibernomas are benign tumors made up of brown fat. They are rarely encountered in otolaryngologic clinical practice, as they are usually located in the interscapular area, axilla, thigh, mediastinum, and retroperitoneum. We report an extremely rare case of a very large hibernoma in a 45-year-old man who presented with a 4-year history of neck swelling. Radioimaging was suggestive of a mass in both parapharyngeal spaces; the lesion was more prominent on the left side. The mass extended from C2 into the retropharyngeal space and superior mediastinum. Fine-needle aspiration cytology failed to yield a diagnosis. On surgical exploration, a tumor measuring 17 × 16 × 5 cm was removed and sent for histopathologic examination. Light microscopy was suggestive of a hibernoma. Staining with oil red O confirmed the diagnosis. To the best of our knowledge, a large hibernoma with such massive extension has not been previously reported in the literature.

Nasopharyngeal angiofibromas are benign tumors of the nasopharynx that occur in adolescent boys. The extensive extensions and various clinical presentations of the tumor have been well documented in the literature. Very rarely, these tumors may extend outside the nasal cavity as a large polypoid mass. Two interesting cases of angiofibroma with atypical presentations, showing extensive spread in multiple directions, are reported here. In one case, the angiofibroma exited the right nostril as a large polypoidal mass and also presented as an intraoral tumor in the right upper gingivo-alveolar region. In the other case, in addition to polypoidal presentation through the anterior nares, the tumor produced severe respiratory obstruction resulting from extensive bulging of the soft palate.

Multiple foreign bodies lodged in the oesophagus are extremely rare. Here an unusual case of two coins accidentally lodged at the oesophageal inlet of a six-year-old girl is reported. The coins were successfully removed by oesophagoscopy. It is to be noted that apart from the straight x-ray (PA view) of the neck and chest, a lateral view is essential for proper characterisation and identification of the type and number of foreign bodies prior to surgical removal.

Supernumerary nostril is a very rare congenital anomaly. It can be unilateral or bilateral, and it sometimes occurs in the presence of other congenital deformities. Behind the external opening of a supernumerary nostril is a small accessory nasal cavity, which may or may not communicate with the normal nasal cavity on the same side. We describe a new case in which the supernumerary nostril with a small accessory nasal cavity, which did not communicate with the normal nasal cavity on the same side, appeared in a young girl who also had microcornea and congenital cataract. The accessory nasal cavity was successfully removed surgically. We believe that this case may represent the first reported case of a supernumerary nostril with a congenital cataract on the same side. We also discuss the hypotheses that have been proposed to explain supernumerary nostrils.

Forestier disease or diffuse idiopathic skeletal hyperostosis (DISH) is an uncommon cause of dysphagia. Due to rarity of this condition there is neither any demographic data nor any consensus about the investigation and treatment modalities. Here an effort is made in the present article to compile the information regarding the demographic and clinical features, investigation modalities and different methods of treatment from all the available case reports of dysphagia due to Forestier disease in the English literature till date. Three cases of the same condition are also reported in the present paper. Three cases of dysphagia due to Forestier disease treated in the ENT department of R.G. Kar Medical College and Hospital are reported herewith. A systematic review of literature is also done. All the case reports of dysphagia due to Forestier disease are obtained by World Wide Web search (WWWS) using 'Forestier Disease', 'DISH' and 'dysphagia' as the key words. Data regarding age, sex, duration of the symptom, associated symptoms, investigations done, level of vertebrae involved and different modalities of treatment with result are collected and analyzed systematically. We found total 73 cases of dysphagia due to Forestier disease. The condition commonly affects males (M:F 5.64:1) in older age group (94.52% cases are 60 years or above), often presented to the treatment facility after a long time of initiation of the symptom. Barium swallow X-rays and lateral neck X-ray were the most common investigations done to arrive at a diagnosis as per result of systematic review. Surgical removal of the causative osteophytes were the definitive treatment, but if surgery is contraindicated, conservative measures like switchover to liquid and semisolid food and proper swallow training also improve the condition to some extent. Dysphagia due to Forestier disease mostly affects older male, often has a chronic course. It can be diagnosed with simple investigations like neck X-ray or barium swallow X-rays. The definitive treatment is surgical, but if contraindicated the problem can be palliated with simple measures like swallow training and change of food.

Congenital choanal atresia has been recognized for over 200 years, first described by Roederer in 1775. Choanal atresia is an uncommon congenital anomaly. Choanal atresia is strongly suspected on the clinical sign and symptoms and confirmed with radiographs. CA repair in teenagers is not as common as it is in babies, but it still takes place and with good result. Transnasal endoscopic repair of CA is a safe and successful technique.

To compare the effectiveness and safety of cefpodoxime and ciprofloxacin for the treatment of mild to moderate cases of acute exacerbation of chronic suppurative otitis media (AECSOM). Adult patients diagnosed with AECSOM were screened and patients fulfilling the inclusion criteria were randomized to receive either cefpodoxime 200 mg twice daily or ciprofloxacin 500 mg twice daily orally for 7 days. The primary outcome of this randomized, open-labeled, phase IV clinical trial (Registration Number - CTRI/2011/10/002079) was clinical success rate at day 14 visit and the secondary outcome was incidence of adverse events (AEs). Forty-six patients were enrolled: 23 in the cefpodoxime group and 23 in the ciprofloxacin group. The clinical success rates were 95.6% in the cefpodoxime group versus 90.9% in the ciprofloxacin group. These rates are comparable, but no statistically significant difference was observed between the groups. Few mild and self-limiting AEs were observed and the tolerability of both the drugs was also good. The results of this randomized, open-labeled phase IV clinical trial showed that a 7-day course of cefpodoxime is therapeutically comparable to ciprofloxacin in terms of both clinical effectiveness and safety for the treatment of patients with AECSOM.

A prospective series of 44 consecutive endonasal DCRs performed from January 1999 to December 2000 was entered into the study. The new technique involved creation of a large bony ostium and mucosal flaps to create an anastamosis between the lacrimal sac mucosa and nasal ...

A prospective series of 44 consecutive endonasal DCRs performed from January 1999 to December 2000 was entered into the study. The new technique involved creation of a large bony ostium and mucosal flaps to create an anastamosis between the lacrimal sac mucosa and nasal ...