Mucormycosis, caused by saprophytic fungi of the order Mucorales of the class Zygomycetes, is a rare opportunistic fungal infection, which has a rapidly progressive and fulminant course with fatal outcome. These fungi are ubiquitous, found in soil, bread molds, decaying fruits and vegetables. The most common form of mucormycosis is rhinocerebral and is usually seen in uncontrolled diabetes mellitus or in immunocompromised patients. This fungus invades the arteries, leading to thrombosis that subsequently causes necrosis of hard and soft tissues. We report a case of palatal perforation by rhino-maxillary mucormycosis in an immunocompromised patient. The aim of this article is to draw attention to the clinical presentation and pathogenesis of mucormycosis and to emphasize the need for high degree of suspicion in its diagnosis and management.
The close proximity of the styloid process to many of the vital neurovascular structures in the neck makes it clinically significant. The styloid process is said to be elongated if it is longer than 3.0 cm in length. Anatomical variations are very common and clinical symptoms arising from such variations have to be recognized. Elongated styloid processes may cause chronic throat pain along with foreign body sensation, dysphagia, vague facial pain, and otalgia. Surgical excision of an elongated styloid is considered as a satisfactory treatment for such cases. Here, we present a unique case of bilaterally elongated styloids that could be visualized just by depressing the tongue, when they appeared like the tusks of an elephant in the oropharyngeal region.
<p class="abstract"><strong>Background:</strong> The aim of the study was to study the role of computer aided endoscopic sinus surgery for treatment of extensive sinonasal polyposis by comparing cases with and without navigation.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 75 patients with extensive nasal polyposis attending outpatient section of department of ENT, BLDE University’s Sri BM Patil Medical College, Hospital, Vijaypur was done from January 2015 to December 2017. 37 cases were randomly subjected to surgery with navigation. Other group included 38 cases which underwent surgery without navigation. </p><p class="abstract"><strong>Results:</strong> A total of 75 cases of which 39 were males and 36 females with an age range of 9-76 years. Patients were studied for preoperative and postoperative SNOT-22 symptom scores. These values showed significant improvement with p<0.001. The comfort level of the surgeon intraoperatively was good in 89.18%, medium in 10.8% and bad in 0% cases in navigation guided surgeries. Whereas in surgeries without navigation, it was good in 78.9%, medium 10.52% and bad in 10.52% cases. Intraoperatively disease clearance adequacy was partial in 1 case (2.7%) and total in 36 cases (97.3%). In cases without navigation, the scores were 4 (10.5%) partially cleared, 34 (89.5%) totally cleared. No major (0%) and one minor complication, 1(3%) in surgery with navigation occurred. In group without navigation guided surgery, Major complication was 13% and minor was 11%. These values are indicative of P value 0.021.</p><p class="abstract"><strong>Conclusions:</strong> The computer aided navigation guided surgery is a necessary tool in cases of extensive lesions like sinonasal polyposis.</p>
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