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Tuberculosis affects all tissues of the body, although some more commonly than the others. Pulmonary tuberculosis is the most common type of tuberculosis accounting for approximately 80% of the tuberculosis cases. Tuberculosis of the otorhinolaryngeal region is one of the rarer forms of extrapulmonary tuberculosis but still poses a significant clinical and diagnostic challenge. Over three years, only five out of 121 patients suspected to have tuberculosis of the otorhinolaryngeal region (cervical adenitis excluded) had Mycobacterium tuberculosis culture-proven disease. Additional 7 had histology-proven tuberculosis. Only one patient had concomitant sputum-positive pulmonary tuberculosis. We look at the various clinical and laboratory aspects of tuberculosis of the otorhinolaryngeal region that would help to diagnose this uncommon but important form of extrapulmonary tuberculosis.

Angioleiomyoma is a rare benign tumor in the nasal cavity. There are very few reports in literature. A 34 year old male presented with left sided nasal obstruction and epistaxis. Clinical evaluation revealed a lesion replacing the anterior two-third of the Left inferior turbinate. An endoscopic excision under hypotensive anesthesia was performed. Histopathology confirmed a diagnosis of Angioleiomyoma. The cause and site of origin of angioleiomyomas when they arise from the inferior turbinate remains unclear. We review the literature available on nasal angioleiomyoma. When limited to the nasal cavity endoscopic excision is the treatment of choice.

Tumors of the accessory parotid gland are very rare. Surgical removal of an accessory parotid tumor is usually accomplished by superficial parotidectomy through an external neck incision. However, this procedure inevitably results in a neck scar. In this case, we performed complete excision of a parotid tumor via an endoscopic-assisted transoral approach. Resection of such benign tumors can be achieved with less morbidity by endoscope-assisted surgery with a nerve monitoring system. The field of transoral surgery will continue to expand with technological advancements.

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Thyroglossal duct carcinoma (TGDC) is a rare disease with few reported series. No clear consensus exists regarding further management after adequate excision of the cyst, especially the role of total thyroidectomy and postoperative radioiodine therapy. We review our experience of nine cases and the literature to clarify the management of this rare condition. A retrospective study over a period of 10 years was performed using the clinical records from Christian Medical College, Vellore to identify patients with TGDC and to assess the frequency of cases with concomitant papillary carcinoma of the thyroid. The clinical presentation, fine needle aspiration cytology (FNAC), imaging, treatment and follow-up were analyzed. There were a total of nine cases of TGDC with five males. Imaging available in six patients detected a suspicious lesion in four cysts and three thyroid glands. Preoperative FNAC detected atypical cells in two of five cases. Thyroid carcinoma was seen in four (44.4%) after histopathological evaluation. Ultrasound of the neck and image-guided FNAC of the cyst may be adequate initial investigation for thyroglossal cysts. FNAC by itself is not a good investigation to diagnose TGDC as rate of false-negatives and inadequate specimens were high. Solid components and calcification on imaging were predictive of carcinoma within a thyroglossal cyst in 100% cases. All patients with TGDC may be offered total thyroidectomy as a simultaneous or staged procedure to address the high incidence of concomitant thyroid foci of cancer. The role of adjuvant therapy is still debatable.

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