Introduction Patients with lesions of the skull base form a minor but very important subgroup of patients presenting to the ENT surgeon or are referred from other departments with complaints such as headache, nasal discharge and nasal obstruction. This study was done to study the clinical presentation of the patients with lesions of the skull base, assess intra operative findings and complications, and to document post operative clinical course and histopathological reports. Materials and Methods A prospective study was conducted on 10 patients with skull base lesions, who were operated on at our institution between August 2014 and August 2015. Patients with clinically and radiologically documented skull base lesions operated by endoscopic methods were included, while those operated on with open methods or those having involvement of the cavernous sinuses and the internal carotid arteries were excluded. Results All patients in the group were successfully operated on with no major intra operative or post operative complications encountered. Adequate tissue was obtained for biopsy with adequate sellar decompression and plugging of CSF leaks was done as required. Conclusion Endoscopic interventions for the skull base lesions can be safely performed in tertiary care set ups with minimal intra operative and post operative morbidity and have a better prognosis than other open procedures.
Pharyngo-cutaneous fistula is a common complication after laryngectomy, which increases both the morbidity and the hospital stay. The incidence rate varies from 8.7% to 24.8% in different institutions. The continuous salivary leak is very much troublesome for the patients. There are various predisposing factors out of which preoperative radiotherapy, diabetes, malnutrition is very important. Spontaneous closure occurs in most of the cases on conservative management and only a few need surgical closures. Surgical methods used are direct surgical repair in two layers inner mucosa and outer skin, single distant flap like DP or PMMC, double distant flap like DP and PMMC one for inner mucosa and another for outer skin. Post operative swallowing was satisfactory in all the cases and there was no recurrence of fistula in one and half year follow up.Keywords Laryngectomy PCF-pharyngo cutaneous fistula Direct suture DP-deltopectoral flap PMMCpectoralis major myocutaneous flap.
Primary solitary extramedullary plasmacytoma of the larynx involving the true vocal cords is an extremely rare entity. Extramedullary plasmacytoma has the potential to transform into multiple myeloma and mandates strict vigilance and routine follow-up. We describe such a case in a 29-year-old pregnant woman who presented with progressive hoarseness, dysphagia and intermittent respiratory difficulty. Fiberoptic laryngoscopy revealed a fleshy mass involving the posterior third of the true vocal cords, encroaching on the ventricle and false cords. Histopathology and immunohistochemistry revealed extramedullary plasmacytoma of a monoclonal nature. In spite of Bence Jones proteinuria and a rising serum β2-microglobulin level, a thorough search for metastasis and subsequent treatment with radiotherapy were delayed due to the patient's pregnancy. She is the youngest adult ever reported with primary solitary extramedullary plasmacytoma involving the true cords. Described for the first time in pregnancy, the relevant issues in management are highlighted.
Background: Vocal cord nodules are bilateral, benign, and callous like growths of the mid portion of the membranous vocal folds. They are of variable size and characterised histologically by thickening of epithelium with a variable degree of inflammation in the underlying superficial lamina propria1. They characteristically produced hoarseness, discomfort and an unstable voice when speaking or singing. AIMS: Comparison between post treatment (surgical and conservative treatment groups) voice quality of the two groups and post treatment status of nodules in both the groups. MATERIAL AND METHODS: Outpatient department and Indoor wards of Department of ENT and Head Neck surgery, R. G Kar Medical College. Patients attending ENT OPD of R G Kar Medical College during the Study period were the study population. Sample size was atleast 50 Patients. RESULT: In group-A, 4(23.5%) patients were regressing and 13(76.5%) patients had resolve. In group-B, 4(12.1%) patients were persisting and 29(87.9%) patients were regressing. Association of post Rx VCN vs. group was statistically significant (p<0.001). CONCLUSION: Vocal fold nodule is one of the most frequent benign laryngeal lesions, influencing the quality of life of those affected by them, primarily the vocal production. Despite being a well-established therapy in conjunction with surgery, speech therapy alone may also be effective in treating these lesions.
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