Since Toti described the initial dacryocystorhinostomy (DCR) operation in 1904 many technical modifications have evolved (Becker in Ophthalmic Surg 19:419-427, 1988). Overall, three groups of procedures are currently practised; external DCR, endoscopic DCR with contact laser, and surgical endoscopic DCR without laser (Woog et al. in Am J Ophthalmol 116:1-10, 1993; Jokinen and Karja in Arch Otolaryngol 100:41-44, 1974. Many factors influence the outcome of these different approaches. The purpose of this study was to improve the long term surgical outcome in endonasal DCR. A retrospective analysis of more than 1,500 patients, who underwent primary endoscopic DCR, was done and specific small modifications were identified and applied in the next 108 cases showing an improvement in the results.
An endoscope was used in transsphenoidal surgery and eventually replaced the operating microscope as a tool for visualization. Initially patients underwent operation via a sublabial transseptal approach using a rigid endoscope in conjunction with an operating microscope. The subsequent operations were performed through a nostril using only rigid endoscopes, initially through single nostril by one surgeon (two hands) and later through both nostrils by two surgeons (four surgeons). This is a retrospective study of 96 patients who had pituitary adenomas in last ten years. Postoperatively all patients who had undergone endonasal endoscopic surgery had unobstructed nasal airways with minimal discomfort. More than half of the patients required only an overnight hospitalization.
Papillary thyroid carcinoma is well known for its low malignant potential and good prognosis. The outcome can be fatal in patients with low compliance and delayed treatment. Recent advances in ultrasonographic screening and US guided fine needle aspiration biopsy has facilitated early diagnosis of papillary thyroid carcinomas. This epithelial thyroid tumour accounts for more than 80 % of all thyroid tumours. An occult primary carcinoma of thyroid presenting as lymphangioma has been reported rarely. We present a case of a 40-year-old female patient with huge cystic midline swelling on the right side of the neck mimicking lymphangioma on USG. MRI neck showed a cystic mass causing displacement of the trachea and arising from Rt lobe of thyroid gland. Hemithyroidectomy was carried out and histopathology revealed papillary carcinoma. In patients with neck swellings presenting as huge cystic mass the differential diagnosis of Intra cystic variant of papillary carcinoma thyroid and metastatic thyroid papillary carcinoma must always be considered prior to planning surgery.
Mucoceles are benign, encapsulated, expansible, locally invasive masses within a paranasal sinus filled with mucus and lined by epithelium. Sphenoid sinus mucoceles are relatively rare, accounting for only 1% of all paranasal sinus mucoceles. Usually presenting with headache but can rarely result in visual defect, diplopia and at times, ptosis. We present two cases of sphenoid sinus mucocele where patient presented with ophthalmoplegia, ptosis and/or sudden onset vision loss. With the help of imaging studies like CT scan and MRI of paranasal sinus diagnosis was made and immediate surgical intervention was planned which resulted in acceptable improvement of symptoms and vision.
Background: Hearing is important for learning to talk. Without speech and hearing it is difficult for interpersonal relationships to develop and thrive The aim of this study was to screen high risk newborn for hearing loss by TEOAE and ABER technique and to find out the risk factor associated with hearing loss in newborn infants. Methods: A total of 103 high risk neonates were randomly selected from NICU of this hospital after clinical stabilization. Transiently evoked otoacoustic emissions were performed in all the neonates. Neonates who passed transiently evoked otoacoustic emissions test were subjected to Auditory Brainstem Evoked Response (ABER) test for confirming hearing loss. Results: Hearing assessment done in all 103 patients and a total of 8 neonates were found to have hearing abnormalities, out of these 8 new-borns 5 had conductive hearing loss and 3 had sensorineural hearing loss. Low Birth weight and ventilator support were observed significantly associated with occurrence of hearing loss. No significant association of hearing loss was observed with gestational age, sex, infection, and associated diseases. Conclusions: Low Birth weight and mechanical ventilator were significantly associated with hearing loss.
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