Sinonasal neoplasms are rare and exceptional site for metastatic tumours and comprising <3 % of all malignant aerodigestive tumours and <1 % of all malignancies. Renal cell carcinoma is known to metastasise to the most unusual sites, the sinonasal region being one of them. We here by present a case of 60 year old male patient who presented with epistaxis and nasal obstruction. Clinical examination and CT scan revealed a tumour in the right nasal cavity and maxillary sinus. The presence of primary renal cell carcinoma was recognized only after surgical removal of metastatic tumour. Very few reports have been presented in literature of metastatic renal cell carcinoma in the sinonasal region. We present this case to document its occurrence; highlight the rarity, presentation and difficulties in diagnosis and treatment along with review of literature.
BACKGROUND AND OBJECTIVESTo study the clinical aspects of benign lesions of pinna and to evaluate aetiopathological factors, prevalence and management options.
<p class="abstract"><strong>Background:</strong> Inhalation/aspiration of foreign bodies (FB) into upper aerodigestive tract are very commonly encountered by otorhinolaryngologists. Most foreign bodies in adults are manageable, but sometimes can lead to fatal consequences in children. However, despite significant advances in instrumentation, they remain a therapeutic and diagnostic challenge. The aim was to study the clinical presentation, site of impaction, complications and management of foreign bodies in upper aerodigestive tract.</p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted in department of ENT-Head and Neck Surgery, Rajarajeswari Medical College and Hospital, Bangalore. A total of 50 eligible patients were reviewed who got operated for foreign body in upper aerodigestive tract under general anaesthesia. </p><p class="abstract"><strong>Results:</strong> History of foreign body was present in 86% of cases and 25% of the patients had complaints of difficulty in breathing. Nose being most common site in 74%, 70% of the patient belongs to 0-10 age group and male: female ratio was 1.7:1. Complications were seen in 12% of patients. Foreign body removal rate was 100%.</p><p class="abstract"><strong>Conclusions:</strong> Early diagnosis is the key to successful and uncomplicated management of FB in upper aerodigestive tract. An orderly and systematic approach along with proper history and clinical examination is keystone in diagnosis and early management.</p>
<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed. </p><p class="abstract"><strong>Results:</strong> The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.</p><p class="abstract"><strong>Conclusions:</strong> Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.</p>
<p class="abstract"><strong>Background:</strong> Malignancies of oral cavity are quite common in India and other developing countries. Oral cancer is one of the ten most common cancers and oral cavity is the second most common site of primary tumors involving head and neck. In this study, we studied etiopathological factors affecting oral malignancy with a view to determine a correlation between the host and environment and additional stress put on oral tissue by social and nutritional factors of population.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted and data for the study was collected from patients presenting with oral malignancy/dysplasia. An informed written consent was taken from patient, and cases meeting the selection criteria were included in the study. A detailed history and a thorough clinical examination were done in about 50 patients. </p><p class="abstract"><strong>Results:</strong> A total of 50 cases were studied over a period of 18 months. Among study subjects 64% were in the age group ≥50 years. Commonest site involved was buccal mucosa with a preponderance over right side. Chewing was a commonest addictive habits among study subjects. Histopathologically 98% of cases turned out to be “squamous cell carcinoma” of varying differentiation.</p><p class="abstract"><strong>Conclusions:</strong> Because of different life styles, habits and customs, poor oral hygiene among illiterates compared to literate’s oral malignancies are still a major health problem in developing countries like India. Timely surveys and registry programmes will give changing trends in such a grievous health issue.</p>
<p class="abstract"><strong>Background:</strong> Endoscopic endonasal dacryocystorhinostomy (EN DCR) has now become a procedure of choice for nasolacrimal duct obstruction or in chronic dacryocystitis. Lots of debate is still going on regarding stent placement following surgery. The purpose of this study is to analyse the subjective and objective success following EN DCR with stents.</p><p class="abstract"><strong>Methods:</strong> In this single centre study, 30 patients underwent EN DCR surgery from May 2011 to March 2013, out of those 20 eligible patients with 26 nasolacrimal duct obstructions underwent EN DCR with stents, and they were included in the study. Success rates were determined with subjective assessment of the patient symptoms and objective evaluation by lacrimal syringing. </p><p class="abstract"><strong>Results:</strong> 80.7% patients underwent primary surgery and 19.2% patient’s revision surgery, overall success rates was 88.4% out of which 95.2% success rate for primary surgery and 60% success rates of revision surgery. 11.5% of patients complained of persistent symptoms and success rate of ENDCR with stents was observed in 95.2% of patients after primary surgery and in 60% of patient’s after revision surgery. Stent removal was done on 4-6 weeks (mean duration- 5 weeks) and patients follow up time was 6 months.</p><p class="abstract"><strong>Conclusions:</strong> Whether to stent or to not still remain a topic of debate in EN DCR surgery, however ENDCR with stents represents the procedure of choice for treating nasolacrimal duct obstructions.</p>
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