Stankiewicz, J. A. The endoscopic approach to the sphenoid sinus. Laryngoscope, 99:218-22, 1989.

The objective is to assess the role of socioeconomic factors and health-seeking behavior in treatment delay in oral and oropharyngeal cancer in our population. This article adapts-design: prospective study and setting: tertiary care centre. We studied 153 patients with oral and oropharyngeal squamous cell carcinoma who were managed in the department of otolaryngology and head and neck surgery between January 2006 and December 2007. There were 127 male patients (83%) and 26 females (17%) with ages ranging from 22 years to 70 years. Fifty-nine patients (39%) presented to us with early stage disease (i.e. stage I and II), whereas, 94 patients (61%) presented with late stage disease (i.e. stage III and IV). Of the 59 patients presenting with early stage disease, 20 were illiterate and 39 literate with 28 patients (47%) belonging to low socio-economic status and 32 patients (54%) having an access to primary health centre (PHC). Of the 94 patients presenting with late stage disease, 53 were illiterate and 41 literate with 58 patients (62%) belonging to low socio-economic status and 38 patients (40%) having an access to primary health centre. Literacy, socio-economic status, access to primary health centre and health-seeking behavior of our population has a significant association with the stage of presentation of patients with oral and oropharyngeal cancer.

Parotid gland tuberculosis is rare and may present in different clinical forms. We present three cases of tuberculosis of the parotid gland that presented to us with different clinico-pathological appearances. The cases were diagnosed on the basis of histopathological evaluation and fine needle aspiration cytology. All the patients responded to four-drug antitubercular chemotherapy.

SUMMARY:The exact mechanism of the pneumatization of the mastoid air cell system and the factors influencing the pneumatization are poorly understood. Both genetic as well as acquired factors have been implicated to influence this pneumatization process. Since pneumatization of the mastoid air cell system is considered an important prognostic factor in the outcome of reconstructive ear surgeries, a cohort study was carried out to assess the role of two important acquired factors i.e. duration of chronic otitis media and auditory tube functional status on the pneumatization of mastoid air cells. 50 individuals with unilateral chronic otitis media underwent assessment of their mastoid air cell system using planimetry and auditory tube functions using flourescein dye nasopharyngoscopy. The results were in accordance with the previous studies indicating a definite influence of chronic middle ear disease on the pneumatization process, although the duration of disease was not significant. In contrast to some of the previous studies, no influence of auditory tube functional status was found on the mastoid pneumatization.

Purpose To evaluate retinopathy of prematurity (ROP) screening practice in reverse Kangaroo Mother Care (R-KMC) with respect to stress and pain to the infant. Methods In a pilot study we evaluated ROP screening practice in R-KMC in 20 babies at risk of ROP. The R-KMC differed from the conventional KMC with respect to the baby position where the baby lay supine on mother's chest. With the mother lying supine and the baby in R-KMC position, screening examinations were done with indirect ophthalmoscope. The outcome measures included stress (quantified by pulse, respiration, and oxygen saturation) and pain to the baby by observing facial expression (eye squeezing, crying, and brow bulge). The heart rate, respiratory rate, and SpO2 (%) were compared before and immediately after the procedure using paired t-test. Result Mean (±SD) gestational age and birth weight were 30.8±2.3 weeks and 1362.5±253.9 g, respectively. During examination in R-KMC position 8 babies (40%) were completely relaxed (no eye squeezing and crying), 10 (50%) were partially relaxed (no brow bulge) and 2 babies (10%) were not relaxed. A change in heart and respiration rate both by 10 per minute was recorded in 12 (60%) and 10 (50%) babies, respectively. Five babies (25%) had reduction in blood oxygen concentration below 92%. The majority of the mothers (19 of 20) were relaxed. Conclusion ROP screening in R-KMC can be a baby friendly screening practice with respect to stress and pain to the infant and needs further evaluation in a larger cohort.

Tuberculous osteomyelitis of the temporal bone is a rare and dangerous entity that should be included in the differential diagnosis of infectious processes of the base of the skull. We present the case of an 11-year-old child who presented with diplopia, ear discharge and hearing loss. The radiological and histopathological findings revealed tuberculous otitis with osteomyelitis and an abscess in the petrous apex. The child responded to anti-tuberculous chemotherapy. The diagnosis and management of tuberculous osteomyelitis are discussed and a brief review of the literature is presented.

SUMMARY:Oral cavity and oropharynx are one of the commonest sites for cancers in our population due to a high prevalence of tobacco use, especially chewing, in our country. The objective of this study was to prospectively assess the clinico-pathological and morphological aspects of the patients presenting to us with these malignancies. We studied 153 patients with oral and oropharyngeal squamous cell carcinoma who were managed in the department of otolaryngology and head and neck surgery between January 2006 and December 2007 at Maulana Azad Medical College and associated hospitals in New Delhi. There were 127 male patients (83%) and 26 females (17%) with ages ranging from 22 years to 70 years. One hundred and eleven patients (73%) presented with oral cavity and 42 patients (27%) with oropharyngeal carcinomas. Most common site of presentation in the oral cavity was the buccal mucosa, whereas, base of tongue was the commonest site in the oropharynx. Amongst the oral cavity cancers, 51 each (46% each) were well differentiated and moderately differentiated, whereas, 9 (8%) were poorly differentiated cancers. However, amongst the oropharyngeal cancers, 27 (64%) were moderately differentiated and 15 (36%) were poorly differentiated. Overall, 73 patients presented with lymphadenopathy on presentation, out of which, 44 patients were those with oral cavity and 29 with oropharyngeal cancers. There was a significant correlation between the site (i.e. oral cavity or orophaynx) and lymphadenopathy on presentation. Fifty nine patients (39%) presented to us with early stage disease (i.e. stage I and II), whereas, 94 patients (61%) presented with late stage disease (i.e. stage III and IV). There was a significant correlation between the site (i.e. oral cavity or oropharynx) and stage at presentation.

We report the case of a 26-year-old man who presented to us with dysphagia secondary to blunt trauma to the neck. The patient was found to have a hyoid bone fracture with pharyngeal perforation and resultant neck abscess. The patient responded to prompt surgical and medical management. We believe this to be the first report of such a case.