Papers by Rajagopalan Raman
American Journal of Rhinology and Allergy, 2012
Surgical navigation systems have been used increasingly in guiding complex ear, nose, and throat ... more Surgical navigation systems have been used increasingly in guiding complex ear, nose, and throat surgery. Although these are helpful, they are only beneficial intraoperatively; thus, the novice surgeon will not have the preoperative training or exposure that can be vital in complex procedures. In addition, there is a lack of reliable models to give surgeons hands-on training in performing such procedures. A technique using an industrial rapid prototyping process by three-dimensional (3D) printing was developed, from which accurate spatial models of the nasal cavity, paranasal sinuses (sphenoid sinus in particular), and intrasellar/pituitary pathology were produced, according to the parameters of an individual patient. Image-guided surgical (IGS) techniques on two different platforms were used during endoscopic transsphenoidal surgery to test and validate the anatomical accuracy of the sinus models by comparing the models with radiological images of the patient on IGS. It was possible to register, validate, and navigate accurately on these models using commonly available navigation stations, matching accurately the anatomy of the model to the IGS images. These 3D models can be reliably used for teaching/training and preoperative planning purposes.
Journal of Clinical Neuroscience, 2012
In neurosurgery and ear, nose and throat surgery the application of computerised navigation syste... more In neurosurgery and ear, nose and throat surgery the application of computerised navigation systems for guiding operations has been expanding rapidly. However, suitable models to train surgeons in using navigation systems are not yet available. We have developed a technique using an industrial, rapid prototyping process from which accurate spatial models of the cranium, its contents and pathology can be reproduced for teaching. We were able to register, validate and navigate using these models with common available navigation systems such as the Medtronic StealthStation S7 Ò .
Journal of Neurosurgery, 2008
Xanthoma formation is frequently seen over the subcutaneous tissue of extensor surfaces and tendo... more Xanthoma formation is frequently seen over the subcutaneous tissue of extensor surfaces and tendons that have received minor trauma or friction in patients with hypercholesterolemia. However, temporal bone xanthomas with intracranial extension are uncommon. To the best of the authors' knowledge, this is the second report in the literature in which bilateral extension of a xanthoma is described. Xanthomas of the temporal bone are benign lesions, and complete or even partial removal is effective. The predisposing cause of the lesion should also be treated.
Auris Nasus Larynx, Aug 2011
The higher field strength magnetic resonance imaging (MRI) such as 3 Tesla (T) and above generate... more The higher field strength magnetic resonance imaging (MRI) such as 3 Tesla (T) and above generates noise that has potential detrimental effects on the hearing. Temporary threshold shifts following MRI examination have been reported for MRI with lower field strength. Such effect, however, have not been reported so far for a 3 T MRI. We report a case that exemplifies the possible detrimental effects of a 3 T MRI generated noise on the auditory system. Our patient underwent investigation of his chronic backache in a 3 T MRI unit and developed hearing loss and tinnitus post-MRI examination. Hearing assessment was done using pure tone audiogram, distortion product otoacoustic emission (DPOAE) and brainstem electrical response audiometry (BERA) which revealed a unilateral sensorineural hearing loss which recovered within 3 days. However the tinnitus persisted. This is possibly a case of temporary threshold shift following noise exposure. However a sudden sensorineural hearing loss remains the other possibility. (C). 2010 Elsevier Ireland Ltd. All rights reserved.
American Journal of Otolaryngology, 2000
... Yung-An Tsou, Chia-Der Lin, Yuan-Kai Cheng, Ming-Hsui Tsai ... However Pyle [3] believes that... more ... Yung-An Tsou, Chia-Der Lin, Yuan-Kai Cheng, Ming-Hsui Tsai ... However Pyle [3] believes that hypoplasia of the vestibular aqueduct from the neonatal period to the age of 4 years is a contributing factor of SNHL around the perilingual period. ...
The Journal of Laryngology & Otology, 2008
To develop an easy method of performing myringotomy and grommet insertion, using minimal instrume... more To develop an easy method of performing myringotomy and grommet insertion, using minimal instruments. An ear speculum and a branula were used. This method was found to be useful. An easy method of performing myringotomy and grommet insertion is proposed.
The Journal of Laryngology & Otology, 2008
We report a method of inserting a T-tube. A 14-G branula and a T-tube are used. This method was f... more We report a method of inserting a T-tube. A 14-G branula and a T-tube are used. This method was found to be simple and required few instruments. To the best of our knowledge, this method has not previously been reported.
Tropical Doctor, 2010
An idea to fix broken nose pads of spectacles has been suggested.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2009
Objective To determine the correlation between hypertensive retinopathy (which is the end-organ d... more Objective To determine the correlation between hypertensive retinopathy (which is the end-organ damage of the vessels due to chronic hypertension) with sensorineural hearing loss.
An instrument has been designed to combine a suction and an elevator for use in ear surgery.
Ear, nose, & throat journal, 2006
The Medical journal of Malaysia, 2005
The use of airway stents for the treatment of benign airway stenosis is increasingly advocated. H... more The use of airway stents for the treatment of benign airway stenosis is increasingly advocated. However, the long-term safety and efficiency of these devices has not been established. We present a case of tracheal stenosis. which persisted despite open surgical and laser correction. The patient required tracheal stent insertion and is currently well with no respiratory difficulty. The use of metallic or silicon intraluminal stent remains appropriate in cases in which there is defined and relative short-term end point of treatment.
Ear, nose, & throat journal, 2005
Ear, nose, & throat journal, 2010
Acta medica Iranica, 2012
We report a rare case of base of tongue tuberculosis following pulmonary tuberculosis. Patient pr... more We report a rare case of base of tongue tuberculosis following pulmonary tuberculosis. Patient presented to us with chief complaints of sore throat and pain on swallowing for period of 3 months. On examination with 70 degree telescope, we observed an ulcer on right side of base of tongue. The edges of the ulcer appeared to be undermined with whitish slough at the centre of the ulcer. Examination of neck showed a multiple small palpable middle deep cervical lymph nodes on right side of neck. Biopsy of the ulcer was taken, which showed granulomatous inflammation, suggestive of tuberculosis. Laboratory investigations revealed a raise in erythrocyte sedimentation rate, sputum for acid fast bacilli was strongly positive. Chest X ray was performed for patient showed multiple areas of consolidation. Patient was referred to chest clinic for further management of tuberculosis and was started on anti-tuberculous drugs. In conclusion tuberculosis of oral cavity is rare, but should be considere...
Critical Care Medicine, 1992
To determine whether or not the presence of a nasogastric tube causes a change in the bacterial f... more To determine whether or not the presence of a nasogastric tube causes a change in the bacterial flora in the oropharynx. Cohort (prospective) design with concurrent control. General Surgical and Ear, Nose, and Throat Units of a tertiary care hospital. Sixteen patients with and 14 patients without a nasogastric tube. Patients scheduled to undergo surgery under general anesthesia with endotracheal intubation were eligible for inclusion in the study. From these patients, a study cohort of 16 consecutive patients who were to have nasogastric tube intubation and 14 patients who were not to have nasogastric intubation were enrolled. All patients had a high oropharyngeal swab taken for bacteriologic culture just before surgery. The swab of the oropharynx for culture was repeated after 48 to 72 hrs. The type of organism grown was identified and compared between and within the two groups. There was a significant increase in the frequency of colonization of the oropharynx by pathogenic Gram-negative bacteria after 48 to 72 hrs of nasogastric intubation in comparison with the preintubation level (p < .01) as well as in comparison with the group that did not have nasogastric intubation (p < .001). The pathogens included Pseudomonas, Klebsiella, Proteus and Escherichia coli. There was also a tendency for suppression of normal flora. There was no significant change in the flora of the control group of patients who did not have nasogastric intubation. The two groups were comparable with respect to age, gender, severity of underlying illness, and use of prophylactic perioperative antibiotics. The presence of nasogastric tubes in patients predisposes to colonization by Gram-negative pathogenic bacteria within 48 to 72 hrs.
The Journal of Laryngology & Otology, 1991
An analysis of 420 consecutive cases of obliterative otosclerosis seen in the Christian Medical C... more An analysis of 420 consecutive cases of obliterative otosclerosis seen in the Christian Medical College Hospital, Vellore is presented. The proportion of truly obliterative otosclerosis is 33.09 per cent (139 ears). Our male to female ratio in truly obliterative otosclerosis is 1.48:1, while in the non-obliterative group it is 1.34:1. The mean age at onset in the obliterative group was 19.14 while in the non-obliterative group it was 25.60. This is statistically significant (P less than 0.001). The age at presentation was 25.90 in the obliterative group while in non-obliterative group it was 30.86; this is also statistically significant (P less than 0.001). However the time interval between the age at onset and the age at presentation is not statistically significant.
The Medical Journal of Malaysia, Apr 1, 2005
Two cases of glomus tympanium tumor of the middle ear stage 'type A' according to... more Two cases of glomus tympanium tumor of the middle ear stage 'type A' according to Fisch classification, are presented due to their rarity in this part of the world. These tumors were excised by end aural tympanotomy approach and there has been no recurrence in both patients to date.
Ear Nose Throat Journal, Jun 1, 2007
We conducted a prospective study of 60 patients in a tertiary care referral center to ascertain t... more We conducted a prospective study of 60 patients in a tertiary care referral center to ascertain the status of cell-mediated immunity as determined by delayed hypersensitivity reactions in patients with nasopharyngeal carcinoma (NPC) or allergic rhinitis. Delayed hypersensitivity as detected by Mantoux testing is generally accepted as a reflection of the level of cell-mediated immunoactivity-the less hypersensitivity reaction that occurs, the lower the level of immunoactivity is, and vice versa. Our study population was made up of three groups: 20 newly diagnosed patients with NPC (pretreatment), 20 age- and sex-matched patients with allergic rhinitis, and 20 matched controls without either disease. A negative Mantoux test (0- to 5-mm induration) was seen in 13 patients with NPC (65.0%), in 17 patients with allergic rhinitis (85.0%), and in 16 controls (80.0%); none of these differences was statistically significant. However, it is interesting that while the NPC group had the lowest percentage of negative Mantoux results overall, it had the highest percentage of patients who had no reaction at all (i.e., 0-mm induration); a complete absence of any reaction was seen in 7 of the 13 Mantoux-negative NPC patients (53.8%), compared with 2 of the 17 Mantoux-negative allergic rhinitis patients (11.8%) and 3 of the 16 Mantoux-negative controls (18.8%). An absence of a reaction generally indicates a very limited degree of cell-mediated immunoactivity. Therefore, we conclude that patients with NPC appear to have significantly less cell-mediated immunity than do patients with allergic rhinitis and normal controls; no statistically significant difference was noted between the latter two groups.
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Papers by Rajagopalan Raman