<p class="abstract"><strong>Background:</strong> Thyroglossal duct cysts are the most common midline neck swellings. They are routinely treated by surgeons with simple excision.</p><p class="abstract"><strong>Methods:</strong> We present a retrospective study of a series of 30 cases operated in our hospital over a period of five years and the challenges faced during investigations, surgery and postoperative period. All patients were clinically diagnosed as thyroglossal duct cysts. The diagnosis confirmed with USG Neck and FNAC of the swelling. CECT NECK was used to delineate the normal thyroid and patients were subjected to Sistrunk procedure under general anesthesia.</p><p class="abstract"><strong>Results:</strong> The outcome of all cases was good with one case being a revision surgery and another case going in for delayed healing due to infection. All patients were healthy with no complaints postoperatively.</p><p class="abstract"><strong>Conclusions:</strong> This study validates the Sistrunk surgery as the best method of excision to avoid recurrences. This article highlights the variant presentations of this cyst in our institution and the challenges we faced in diagnosis, during surgery and later as well.</p>
Background: Managing individuals with bilateral vocal fold abductor paralysis is difficult and frequently requires surgery. It necessitates a delicate balance between airway and phonation. In this article, we discuss our experience with coblation in posterior cordotomy to treat patients with bilateral abductor paralysis (Coblation assisted Kashima Surgery). Patients and Methods: A prospective study was done among 27 patients with bilateral vocal fold paralysis who underwent coblation assisted Kashima surgery at our tertiary care hospital. The handicap index and dyspnoeic scores were assessed before and after surgery. All patients were tracheostomised and after successful Kashima surgery, the tracheostoma was closed. Patients were followed up for a period of 3 months for worsening of voice/ dyspnoea/ aspiration. Results: Of the 27 patients, 19 were males and 8 were females, most common aetiology of the vocal cord palsy was subsequent to thyroid surgery (Total thyroidectomy). The study showed that there was a significant mean difference between pre and post-tests among patients with dyspnoea index with P-value < 0.05 i.e., 0.02. It also showed that there was significant mean difference between pre and post-tests among patients with VHI Index with P-value < 0.05 i.e., 0.04. Conclusion: Kashima operation gives good results with respect to airway improvement. Voice outcomes vary from patient to patient, however overall patient satisfaction with respect to voice was good.
<p class="abstract"><strong>Background:</strong> Obstructive sleep apnea is the most common form of sleep-disordered breathing. However, obstructive sleep apnea has been associated with much more insidious conditions, including hypertension, diabetes, heart disease, stroke, and daytime somnolence can lead to a dramatically increased risk of motor vehicle accidents.</p><p class="abstract"><strong>Methods:</strong> This study was conducted in our institution in 34 OSA patients. After thorough evaluation with PSG, dynamic MRI, DISE patients were treated with various surgeries depending on the level of obstruction. Commonly UPPP, ESP, zetaplasty, tonsillectomy, tongue base reduction were done either alone or in combination. </p><p class="abstract"><strong>Results:</strong> Pre and postoperative polysomnograhpy for obstructive sleep apnea was evaluated and statistically analyzed. Significant proportion of patients improved both subjectively and objectively as determined by reduction in AHI from 41.73±13.94 to 15.77±9.13, reduction in ESS from 16.41+3.09 to 5.14±3.41 and reduction in snoring.</p><p><strong>Conclusions:</strong> OSA can be easily treated with proper preoperative investigations, appropriate surgery, prevention of complications and continued lifestyle modifications. </p>
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