Tuberculosis has global presence and no part of human body is immune to it, most frequent site beings lungs. Nasopharyngeal tuberculosis is a rare type of extrapulmonary tuberculosis comprising only less than 1% of tuberculosis found in the upper respiratory tract. The authors are presenting here a case of primary tuberculousis affecting the nasopharynx (adenoids) which is one of the rare differential diagnosis of nasopharyngeal mass. Isolated nasopharyngeal tuberculosis is a rare condition even in the endemic areas. In literature there are varied clinical presentations of nasopharyngeal tuberculosis. Tuberculosis should be one of the differential diagnosis of nasopharyngeal lesion. Biopsy and histologic study should be performed in every patient to avoid misdiagnosis. When treated properly, nasopharyngeal tuberculosis carries a excellent prognosis, and complete resolution of disease is the rule.
A prospective study of 100 consecutive patients of deviated nasal septum to analyze association of septal deviation with external nasal deformity was undertaken at Acharya Vinoba Bhave rural Hospital of Jawaharlal Nehru Medical College, Sawangi (Meghe) Wardha from January 2009 to September 2010. Nasal septal deviations were evaluated by clinical examination and diagnostic nasal endoscopy while external nasal deformities, after evaluating, were documented using high resolution photography Nasal septal deviations were classified in seven types from I to VII by using Mladina's classification modified by Janardhan et al. Jang classification was employed to classify external nasal deformities. 66% of the patients with deviated nasal septum were symptomatic while 34 lacked symptoms. Nasal obstruction was the most frequent symptom in 64% followed by nasal discharge in 33% Type VII was the most common type of deviation in 29%. Study revealed that 67% of the patients with deviated nasal septum had external nasal deformity and of the 67 patients with external deformity, Type I deformity was most frequent (26%). Remarkable feature of our study was Type I, III, V septal deviations were not associated with external deviation Type II septal deviations were commonly associated with Type III external deformity (7%) and Type IV septal deviation were closely associated with Type I external deformity (12%).
Introduction Posterior tympanotomy through facial recess (FR) is the conventional and most preferred approach to facilitate cochlear implantation, especially when the electrode is inserted through the round window. The complications of the FR approach can be minimized by proper understanding of the anatomy of the FR.
Objective The present study was undertaken to assess the various parameters of FR and round window visibility, which may be of relevance for cochlear implant surgery.
Methods Thirty-five normal wet human cadaveric temporal bones were studied by dissection for anatomy of FR and posterior tympanum. Photographs were taken with an 18 megapixels digital camera, which were then imported to a computer to determine various parameters.
Results The mean distance from the take-off point/crotch of the chorda tympani nerve (CTN) to the stylomastoid foramen was 4.08 ± 0.8 mm (range of 2.06 - 5.5 mm). The variations in the course of the CTN included origin at the level of the lateral semicircular canal. The mean chorda-facial angle in our study was 26.91° ± 1.19°, with a range of 25° to 28.69°. The mean FR length ranged between 9.4 mm and 18.56 mm (mean of 12.41 ± 2.91mm) and varied with the origin of the CTN and pneumatization of temporal bone. The average maximum width of the FR was 2.93 ± 0.4 mm (range 2.24–3.45 mm) and the mean width of the FR at the level of the round window was 2.65 ± 0.41 mm.
Conclusion The FR approach provides good access to the round window membrane in all cases. In some cases, table adjustment is required.
To study the pneumatization pattern of mastoid bone in cases of squamousal type of chronic otits media and analyze pneumatization pattern of opposite normal ear in cases of unilateral chronic otitis media (COM). A total of 94 patients (104 ears) between the age group of 7-84 years attending the E.N.T outpatients, inpatients and casualty of Acharya Vinoba Bhave Rural Hospital, Sawangi (Maghe), Wardha, after applying inclusion and exclusion criteria were found suitable and hence selected for the present study and were subjected to bilateral X-ray mastoid (Schuller's view). HRCT temporal bone done in selected 55 patients. On analyzing patients radiologically (X-ray mastoid), it was found that out 104 ears, mastoid was pneumatized in 2 (1.92 %) diploic in 20 (19.23 %) and sclerotic in 82 (78.85 %) ears. Contralateral mastoid of 70 normal ears, mastoid was pneumatized in 30 (42.86 %) diploic in 22 (31.43 %) and sclerotic in 18 (25.71 %) ears. Most of the diseased ear demonstrated non pneumatized mastoid (98.08 %) whereas contra lateral mastoid of 70 normal ear, showed significantly more pneumatization This difference is statistically significant (P value < 0.0001). Significantly more sclerosis and non pneumatization in the ear with COM of squamousal type than the healthy contralateral ear supports the environmental theory.
Impacted laryngeal foreign body could lead to catastrophic consequences if appropriate diagnostic and therapeutic procedures are not promptly instituted. A case of 4-year-old child who presented with a 4-day history of probable ingestion or aspiration of a pen part and history of occasional noisy breathing on exertion and swallowing is reported. On examination, the child appeared asymptomatic on general examination. CT scan of larynx and chest revealed foreign body in the larynx. A conical plastic foreign body in the laryngotracheal junction was retrieved by rigid bronchoscopy. The asymptomatic nature of the foreign body was related to the presence of a lumen within the foreign body permitting ventilation and the inert nature of the material. The case demonstrates the importance of the history, CT scan in case of suspicion, and the need for urgent bronchoscopy with appropriate anesthetic technique.
Nasopharyngeal cysts are rare, small in size and asymptomatic, usually diagnosed as in incidental finding on MRI. Large cyst commonly presents with obstructive symptoms. Tornwaldt cysts occur in the midline bursa of the nasopharynx above the upper border of the superior constrictor muscle. They represent as a communication between notochord remnants and the pharyngeal endoderm. We report this case because of its presentation and size (2.5 × 2 cm). It was presented as intermittent cervical pain, stiffness and vertigo because of prevertebral cervical muscle spasm due to cyst and nasal symptoms were not predominant. Although rare, it should be kept as a differential diagnosis for cervical myelgia and stiffness.
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