Pleomorphic adenoma (PA) is the most common neoplasm of the salivary gland. Fat-containing tumors... more Pleomorphic adenoma (PA) is the most common neoplasm of the salivary gland. Fat-containing tumors encountered in salivary glands are very rare. We had a case of PA of parapharyngeal space and surprisingly the final histopathology showed an unusual finding of lipometapasia. We believe that this is the first case from parapharyngeal space to be reported in the literature. The aim of this report is to discuss the behavior of lipometaplasia in PA with review of literature. Pathological characterization of this rare tumor might help in proper classification and enhance their recognition.
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium... more Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tuberculosis affects all tissues of the body, although some more commonly than the others. Pulmonary tuberculosis is the most common type of tuberculosis accounting for approximately 80 % of the tuberculosis cases. Tuberculosis of the otorhinolaryngeal region is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge. Over three years, only five out of 121 patients suspected to have tuberculosis of the otorhinolaryngeal region (cervical adenitis excluded) had Mycobacterium tuberculosis culture-proven disease. Additional 7 had histology-proven tuberculosis. Only one patient had concomitant sputum-positive pulmonary tuberculosis. We look at the various clinical and laboratory aspects of tuberculosis of the otorhinolaryngeal region that would help to diagnose this uncommon but impor...
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2003
Auditory neuropathy (AN), a recently described clinical entity, is a sensorineural disorder where... more Auditory neuropathy (AN), a recently described clinical entity, is a sensorineural disorder where the patient has hearing loss with impaired word discrimination out of proportion to pure tone loss in the pressence of abnormal / absent auditory brain stem responses, and normal outer hair cell as measured by otoacoustic emissions and / cochlear microphonics. It is essential that the practicing, ENT surgeon have a high degree of suspicion of AN in patients complaining of difficulty in understanding speech with hearing loss and audiological evidence of dissociation between pure-tone and speech audiometry. Appropriate newer diagnostic tests of ABR and OAE and /or CM for confirmation of AN is essential. We present a series of four patients with auditory neuropathy from a tertiary care teaching hospital. This is the first Series of 4 cases of this clinical entity from the Indian subcontinent.
Background: Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary... more Background: Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary gland cancer with high morbidity and mortality and poor response to treatment. The current options of treatment include radical surgery followed by radiotherapy (RT) with or without chemotherapy. The aim of this study was to analyse the patterns of recurrences, possible predictors of outcome and role of RT in a cohort of patients with non-metastatic SDC. Methods: A retrospective review of patients treated between 2010 and 2019 with histologically proven non-metastatic SDC was conducted. Results: Sixteen patients were included in the series. Median follow-up was 25 months. Progression-free survival (PFS) and overall survival (OS) at 12 months were 61% and 80%, respectively. Seven out of the 16 patients had disease progression, distant metastases being most frequent. Four patients died due to disease progression. PFS was significantly worse for patients with pathological neck node positiv...
International Journal of Otorhinolaryngology and Head and Neck Surgery, Jun 23, 2018
Laryngeal malignancy is the second common malignancy of the upper aero digestive tract, the first... more Laryngeal malignancy is the second common malignancy of the upper aero digestive tract, the first being malignancies arising from the oral cavity. 90% of these malignancies arise from the epithelial lining of the larynx and hence are histologically squamous cell tumors. 1 These carcinomas commonly affect the glottis. They can also develop from various premalignant lesions of the larynx. Early detection and treatment of laryngeal cancer is of paramount importance. The standard of care for patients diagnosed with advanced laryngeal cancers was changed after the publication of Veterans administration laryngeal trial in 1991. Radiation trial oncology group 91-11(RTOG 91-11) was another important trial 2 which demonstrated that concurrent chemo radiation had higher laryngeal preservation rates when compared to induction chemotherapy alone. One of the limitations of this trial was that it excluded patients with large volume T4 disease. 2
This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling dia... more Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling diagnosed to be thyroglossal cyst clinically which turns out to be a papillary carcinoma arising in thyroglossal cyst. She underwent sistrunk procedure with total thyroidectomy and diseasefree on follow up evaluation. Even though preoperative ultrasonography had shown thyroid nodule, the final histology did not show malignancy. There is a paucity of clear-cut guidelines in the management of the thyroid gland in a thyroglossal cyst carcinoma. In thyroglossal cyst carcinoma cases, we recommend thyroidectomy only when there is a thyroid nodule with high-risk features.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The aim of this study is to assess the thyroid gland involvement in the preoperative ... more Background: The aim of this study is to assess the thyroid gland involvement in the preoperative contrast enhanced computed tomography (CECT) of neck with histopathology (HPE) in determining the indications for ipsilateral thyroidectomy in patients undergoing total laryngectomy in laryngeal and hypopharyngeal cancers.Methods: Forty patients diagnosed clinically with stage 3 laryngeal and hypopharyngeal cancer were subjected to CECT of neck. Patients with cartilage erosion and extra laryngeal spread on CECT (T3, T4a) were routinely taken for total laryngectomy, partial pharyngectomy and hemi thyroidectomy. Specimens were sent for histopathological analysis and which was compared with preoperative CECT scan. Results: Of the forty cases, only four patients had thyroid gland involvement in CECT scan and 2 of the 40 had thyroid gland involvement in histopathology. Of the four patients where the CT scan which showed infiltration of the thyroid gland, none had thyroid gland involvement in...
Thyroglossal duct cysts are common midline neck swellings that can present at any site along thei... more Thyroglossal duct cysts are common midline neck swellings that can present at any site along their migratory pathway. They are frequently situated just below the hyoid bone. Extension to the subglottic area is very rare; such an unusual presentation can complicate the diagnosis of a thyroglossal duct cyst. We report the case of a 30-year-old man who presented with a subglottic thyroglossal duct cyst and associated laryngeal symptoms. To the best of our knowledge, only 2 similar cases have been previously reported in the literature, both of which occurred in 2-year-old boys. We believe, therefore, that ours is the first reported case of a subglottic thyroglossal duct cyst in an adult. We discuss the clinical presentation, diagnosis, and treatment of our patient, and we summarize the literature on intralaryngeal thyroglossal duct cysts.
Introduction: Excessive bleeding during ear surgery is a troublesome problem which could be relat... more Introduction: Excessive bleeding during ear surgery is a troublesome problem which could be related to inadequate infiltration, active infection, trauma to the dura or jugular bulb or sudden hypertension. When the problem recurs in the postoperative period, despite intraoperative control of the field, a bleeding diathesis should be suspected. Case report: We present two adult patients in whom excessive intraoperative and postoperative bleeding associated with ear surgery led to the diagnosis of congenital mild haemophilia A. Conclusion: This case report highlights the fact that excessive perioperative bleeding for which no other cause can be found in an adult patient should suggest the presence of a bleeding diathesis like haemophilia A or B for which detailed coagulation workup is required. Any subsequent surgery would need to be performed with administration of specific perioperative medication to reduce the possibility of excessive bleeding.
Langerhans cell histiocytosis (LCH), previously known as histiocytosis X, is a rare disorder char... more Langerhans cell histiocytosis (LCH), previously known as histiocytosis X, is a rare disorder characterized by clonal proliferation and excess accumulation of pathologic Langerhans cells causing local or systemic effects. Bone is the most common organ involved and a single skull lesion is the most frequent presentation of childhood LCH. However, sphenoid sinus is an uncommon condition of involvement in LCH. Here we report a case of LCH in the sphenoid sinus, which occurred in a seven-year-old girl who presented initially with headache. The girl had suffered from headache for one month before she went to an otorhinolaryngologist one week before. Magnetic resonance imaging (MRI) showed a lesion of inflammatory granuloma. Surgery was performed and the disease was diagnosed pathologically as single-site LCH via hematoxylin-eosin (H&E) and immunohistochemical staining.
Thyroglossal duct cysts are common midline neck swellings that can present at any site along thei... more Thyroglossal duct cysts are common midline neck swellings that can present at any site along their migratory pathway. They are frequently situated just below the hyoid bone. Extension to the subglottic area is very rare; such an unusual presentation can complicate the diagnosis of a thyroglossal duct cyst. We report the case of a 30-year-old man who presented with a subglottic thyroglossal duct cyst and associated laryngeal symptoms. To the best of our knowledge, only 2 similar cases have been previously reported in the literature, both of which occurred in 2-year-old boys. We believe, therefore, that ours is the first reported case of a subglottic thyroglossal duct cyst in an adult. We discuss the clinical presentation, diagnosis, and treatment of our patient, and we summarize the literature on intralaryngeal thyroglossal duct cysts.
Pleomorphic adenoma (PA) is the most common neoplasm of the salivary gland. Fat-containing tumors... more Pleomorphic adenoma (PA) is the most common neoplasm of the salivary gland. Fat-containing tumors encountered in salivary glands are very rare. We had a case of PA of parapharyngeal space and surprisingly the final histopathology showed an unusual finding of lipometapasia. We believe that this is the first case from parapharyngeal space to be reported in the literature. The aim of this report is to discuss the behavior of lipometaplasia in PA with review of literature. Pathological characterization of this rare tumor might help in proper classification and enhance their recognition.
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium... more Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Tuberculosis affects all tissues of the body, although some more commonly than the others. Pulmonary tuberculosis is the most common type of tuberculosis accounting for approximately 80 % of the tuberculosis cases. Tuberculosis of the otorhinolaryngeal region is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge. Over three years, only five out of 121 patients suspected to have tuberculosis of the otorhinolaryngeal region (cervical adenitis excluded) had Mycobacterium tuberculosis culture-proven disease. Additional 7 had histology-proven tuberculosis. Only one patient had concomitant sputum-positive pulmonary tuberculosis. We look at the various clinical and laboratory aspects of tuberculosis of the otorhinolaryngeal region that would help to diagnose this uncommon but impor...
Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2003
Auditory neuropathy (AN), a recently described clinical entity, is a sensorineural disorder where... more Auditory neuropathy (AN), a recently described clinical entity, is a sensorineural disorder where the patient has hearing loss with impaired word discrimination out of proportion to pure tone loss in the pressence of abnormal / absent auditory brain stem responses, and normal outer hair cell as measured by otoacoustic emissions and / cochlear microphonics. It is essential that the practicing, ENT surgeon have a high degree of suspicion of AN in patients complaining of difficulty in understanding speech with hearing loss and audiological evidence of dissociation between pure-tone and speech audiometry. Appropriate newer diagnostic tests of ABR and OAE and /or CM for confirmation of AN is essential. We present a series of four patients with auditory neuropathy from a tertiary care teaching hospital. This is the first Series of 4 cases of this clinical entity from the Indian subcontinent.
Background: Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary... more Background: Salivary duct carcinoma (SDC) is an extremely rare and aggressive subtype of salivary gland cancer with high morbidity and mortality and poor response to treatment. The current options of treatment include radical surgery followed by radiotherapy (RT) with or without chemotherapy. The aim of this study was to analyse the patterns of recurrences, possible predictors of outcome and role of RT in a cohort of patients with non-metastatic SDC. Methods: A retrospective review of patients treated between 2010 and 2019 with histologically proven non-metastatic SDC was conducted. Results: Sixteen patients were included in the series. Median follow-up was 25 months. Progression-free survival (PFS) and overall survival (OS) at 12 months were 61% and 80%, respectively. Seven out of the 16 patients had disease progression, distant metastases being most frequent. Four patients died due to disease progression. PFS was significantly worse for patients with pathological neck node positiv...
International Journal of Otorhinolaryngology and Head and Neck Surgery, Jun 23, 2018
Laryngeal malignancy is the second common malignancy of the upper aero digestive tract, the first... more Laryngeal malignancy is the second common malignancy of the upper aero digestive tract, the first being malignancies arising from the oral cavity. 90% of these malignancies arise from the epithelial lining of the larynx and hence are histologically squamous cell tumors. 1 These carcinomas commonly affect the glottis. They can also develop from various premalignant lesions of the larynx. Early detection and treatment of laryngeal cancer is of paramount importance. The standard of care for patients diagnosed with advanced laryngeal cancers was changed after the publication of Veterans administration laryngeal trial in 1991. Radiation trial oncology group 91-11(RTOG 91-11) was another important trial 2 which demonstrated that concurrent chemo radiation had higher laryngeal preservation rates when compared to induction chemotherapy alone. One of the limitations of this trial was that it excluded patients with large volume T4 disease. 2
This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling dia... more Carcinoma arising in a thyroglossal cyst is rare. We present a case of anterior neck swelling diagnosed to be thyroglossal cyst clinically which turns out to be a papillary carcinoma arising in thyroglossal cyst. She underwent sistrunk procedure with total thyroidectomy and diseasefree on follow up evaluation. Even though preoperative ultrasonography had shown thyroid nodule, the final histology did not show malignancy. There is a paucity of clear-cut guidelines in the management of the thyroid gland in a thyroglossal cyst carcinoma. In thyroglossal cyst carcinoma cases, we recommend thyroidectomy only when there is a thyroid nodule with high-risk features.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: The aim of this study is to assess the thyroid gland involvement in the preoperative ... more Background: The aim of this study is to assess the thyroid gland involvement in the preoperative contrast enhanced computed tomography (CECT) of neck with histopathology (HPE) in determining the indications for ipsilateral thyroidectomy in patients undergoing total laryngectomy in laryngeal and hypopharyngeal cancers.Methods: Forty patients diagnosed clinically with stage 3 laryngeal and hypopharyngeal cancer were subjected to CECT of neck. Patients with cartilage erosion and extra laryngeal spread on CECT (T3, T4a) were routinely taken for total laryngectomy, partial pharyngectomy and hemi thyroidectomy. Specimens were sent for histopathological analysis and which was compared with preoperative CECT scan. Results: Of the forty cases, only four patients had thyroid gland involvement in CECT scan and 2 of the 40 had thyroid gland involvement in histopathology. Of the four patients where the CT scan which showed infiltration of the thyroid gland, none had thyroid gland involvement in...
Thyroglossal duct cysts are common midline neck swellings that can present at any site along thei... more Thyroglossal duct cysts are common midline neck swellings that can present at any site along their migratory pathway. They are frequently situated just below the hyoid bone. Extension to the subglottic area is very rare; such an unusual presentation can complicate the diagnosis of a thyroglossal duct cyst. We report the case of a 30-year-old man who presented with a subglottic thyroglossal duct cyst and associated laryngeal symptoms. To the best of our knowledge, only 2 similar cases have been previously reported in the literature, both of which occurred in 2-year-old boys. We believe, therefore, that ours is the first reported case of a subglottic thyroglossal duct cyst in an adult. We discuss the clinical presentation, diagnosis, and treatment of our patient, and we summarize the literature on intralaryngeal thyroglossal duct cysts.
Introduction: Excessive bleeding during ear surgery is a troublesome problem which could be relat... more Introduction: Excessive bleeding during ear surgery is a troublesome problem which could be related to inadequate infiltration, active infection, trauma to the dura or jugular bulb or sudden hypertension. When the problem recurs in the postoperative period, despite intraoperative control of the field, a bleeding diathesis should be suspected. Case report: We present two adult patients in whom excessive intraoperative and postoperative bleeding associated with ear surgery led to the diagnosis of congenital mild haemophilia A. Conclusion: This case report highlights the fact that excessive perioperative bleeding for which no other cause can be found in an adult patient should suggest the presence of a bleeding diathesis like haemophilia A or B for which detailed coagulation workup is required. Any subsequent surgery would need to be performed with administration of specific perioperative medication to reduce the possibility of excessive bleeding.
Langerhans cell histiocytosis (LCH), previously known as histiocytosis X, is a rare disorder char... more Langerhans cell histiocytosis (LCH), previously known as histiocytosis X, is a rare disorder characterized by clonal proliferation and excess accumulation of pathologic Langerhans cells causing local or systemic effects. Bone is the most common organ involved and a single skull lesion is the most frequent presentation of childhood LCH. However, sphenoid sinus is an uncommon condition of involvement in LCH. Here we report a case of LCH in the sphenoid sinus, which occurred in a seven-year-old girl who presented initially with headache. The girl had suffered from headache for one month before she went to an otorhinolaryngologist one week before. Magnetic resonance imaging (MRI) showed a lesion of inflammatory granuloma. Surgery was performed and the disease was diagnosed pathologically as single-site LCH via hematoxylin-eosin (H&E) and immunohistochemical staining.
Thyroglossal duct cysts are common midline neck swellings that can present at any site along thei... more Thyroglossal duct cysts are common midline neck swellings that can present at any site along their migratory pathway. They are frequently situated just below the hyoid bone. Extension to the subglottic area is very rare; such an unusual presentation can complicate the diagnosis of a thyroglossal duct cyst. We report the case of a 30-year-old man who presented with a subglottic thyroglossal duct cyst and associated laryngeal symptoms. To the best of our knowledge, only 2 similar cases have been previously reported in the literature, both of which occurred in 2-year-old boys. We believe, therefore, that ours is the first reported case of a subglottic thyroglossal duct cyst in an adult. We discuss the clinical presentation, diagnosis, and treatment of our patient, and we summarize the literature on intralaryngeal thyroglossal duct cysts.
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