The Internet Journal of Thoracic and Cardiovascular Surgery, 2008
Tuberculosis is often included in the differential diagnosis for almost every set of symptoms tha... more Tuberculosis is often included in the differential diagnosis for almost every set of symptoms that a patient may present to the hospital with. We report a case of extrapulmonary tuberculosis presenting as a life threatening emergency. A 51 year old male presented with a swelling on the right side of the neck and a sinus that was discharging serosanguinous fluid. A Doppler study revealed a false aneurysm of the internal carotid artery which ruptured before any elective management could be instituted. He was resuscitated and subjected to an emergency CT angiogram which confirmed the diagnosis. This was followed by right internal carotid artery ligation and an excision biopsy of lymph nodes in the field which revealed on histopathology to be of tuberculous origin. He was a known case of pulmonary tuberculosis who had defaulted on treatment. This case is highlighted to stress upon an uncommon manifestation of a very common and non malignant disease.
Juvenile nasopharyngeal angiofibroma (JNA) is a benign, locally aggressive, highly vascular tumou... more Juvenile nasopharyngeal angiofibroma (JNA) is a benign, locally aggressive, highly vascular tumour often occurring at the superior margin of the sphenopalatine foramen occurring exclusively in adolescent males. JNA is uncommon and accounts for approximately 0.5% of all head and neck neoplasms. The median age at diagnosis is 15 years. Presenting symptoms commonly include nasal obstruction and epistaxis. Approximately 20% of patients have evidence of skull base invasion at the time of diagnosis. JNAs may be hormonally dependant. Hagen et al studied androgen receptor binding in cultured tumour fibroblasts from 3 patients with JNA and demonstrated that cell proliferation increased with testosterone and decreased with antiandrogens. Spontaneous regression is unlikely but has been observed with increasing age. The main stay of treatment of JNA is surgical excision. Preoperative role of devascularizaion is discussed. In this study , 32 cases were analysed. Nasal obstruction and epistaxis w...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Background: The main aim of this study was to find out the ear, nose, and throat (ENT) manifestat... more Background: The main aim of this study was to find out the ear, nose, and throat (ENT) manifestations in a selected regional population of 100 HIV infected patients, to identify the commoner ENT manifestations among them and to make these manifestations, a guide for regional ENT surgeons, to diagnose HIV/AIDS patients early and to treat them accordingly.Methods: The study was a prospective study which was conducted for a period of five years which included 100 HIV seropositive patients, among the patients attending the Outpatient Department of the Otorhinolaryngology and anti-retroviral therapy centre across Government Hospitals in Tamil Nadu according to our inclusion or exclusion criteria. Detailed ENT clinical examination as well as laboratory investigations were carried out to evaluate the nature of ENT presentations of HIV infection. Results: Out of the 100 HIV positive patients, who had some form of ENT symptoms, the most common ENT manifestation in HIV/AIDS was oral candidia...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Background: Rhinosporidiosis is a disease caused by Rhinosporidium seeberi that affects the mucou... more Background: Rhinosporidiosis is a disease caused by Rhinosporidium seeberi that affects the mucous membranes primarily. Nose is the commonest organ to be involved. The authors of this paper with more than ten years of experience across various institutions in Tamil Nadu have analysed their cases and have found out that posterior lip of valve of hasner in the inferior meatus to be the site of attachment in primary nasal rhinosporidiosis irrespective of the endemicity of the region.Methods: This is a prospective study of seventy eight cases of primary rhinosporidiosis over a period of ten years (February 2009 to December 2019). Recurrent cases, those who did not come for follow up and who were operated under local anesthesia were not included in this study. All the patients (45) were subjected to endoscopic surgery for excision of the rhinosporidiosis under general anesthesia after informed written consent and sent for histopathological examination. Results: Most common age group bei...
The Internet Journal of Thoracic and Cardiovascular Surgery, 2008
Tuberculosis is often included in the differential diagnosis for almost every set of symptoms tha... more Tuberculosis is often included in the differential diagnosis for almost every set of symptoms that a patient may present to the hospital with. We report a case of extrapulmonary tuberculosis presenting as a life threatening emergency. A 51 year old male presented with a swelling on the right side of the neck and a sinus that was discharging serosanguinous fluid. A Doppler study revealed a false aneurysm of the internal carotid artery which ruptured before any elective management could be instituted. He was resuscitated and subjected to an emergency CT angiogram which confirmed the diagnosis. This was followed by right internal carotid artery ligation and an excision biopsy of lymph nodes in the field which revealed on histopathology to be of tuberculous origin. He was a known case of pulmonary tuberculosis who had defaulted on treatment. This case is highlighted to stress upon an uncommon manifestation of a very common and non malignant disease.
Juvenile nasopharyngeal angiofibroma (JNA) is a benign, locally aggressive, highly vascular tumou... more Juvenile nasopharyngeal angiofibroma (JNA) is a benign, locally aggressive, highly vascular tumour often occurring at the superior margin of the sphenopalatine foramen occurring exclusively in adolescent males. JNA is uncommon and accounts for approximately 0.5% of all head and neck neoplasms. The median age at diagnosis is 15 years. Presenting symptoms commonly include nasal obstruction and epistaxis. Approximately 20% of patients have evidence of skull base invasion at the time of diagnosis. JNAs may be hormonally dependant. Hagen et al studied androgen receptor binding in cultured tumour fibroblasts from 3 patients with JNA and demonstrated that cell proliferation increased with testosterone and decreased with antiandrogens. Spontaneous regression is unlikely but has been observed with increasing age. The main stay of treatment of JNA is surgical excision. Preoperative role of devascularizaion is discussed. In this study , 32 cases were analysed. Nasal obstruction and epistaxis w...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Background: The main aim of this study was to find out the ear, nose, and throat (ENT) manifestat... more Background: The main aim of this study was to find out the ear, nose, and throat (ENT) manifestations in a selected regional population of 100 HIV infected patients, to identify the commoner ENT manifestations among them and to make these manifestations, a guide for regional ENT surgeons, to diagnose HIV/AIDS patients early and to treat them accordingly.Methods: The study was a prospective study which was conducted for a period of five years which included 100 HIV seropositive patients, among the patients attending the Outpatient Department of the Otorhinolaryngology and anti-retroviral therapy centre across Government Hospitals in Tamil Nadu according to our inclusion or exclusion criteria. Detailed ENT clinical examination as well as laboratory investigations were carried out to evaluate the nature of ENT presentations of HIV infection. Results: Out of the 100 HIV positive patients, who had some form of ENT symptoms, the most common ENT manifestation in HIV/AIDS was oral candidia...
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2020
Background: Rhinosporidiosis is a disease caused by Rhinosporidium seeberi that affects the mucou... more Background: Rhinosporidiosis is a disease caused by Rhinosporidium seeberi that affects the mucous membranes primarily. Nose is the commonest organ to be involved. The authors of this paper with more than ten years of experience across various institutions in Tamil Nadu have analysed their cases and have found out that posterior lip of valve of hasner in the inferior meatus to be the site of attachment in primary nasal rhinosporidiosis irrespective of the endemicity of the region.Methods: This is a prospective study of seventy eight cases of primary rhinosporidiosis over a period of ten years (February 2009 to December 2019). Recurrent cases, those who did not come for follow up and who were operated under local anesthesia were not included in this study. All the patients (45) were subjected to endoscopic surgery for excision of the rhinosporidiosis under general anesthesia after informed written consent and sent for histopathological examination. Results: Most common age group bei...
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Papers by Shanmuga Ashok