Prevalence of Otorhinolaryngeal Malignancies in Thanjavur Delta Region—A Prospective Study

Malignancy of otorhinolaryngeal region is the 6th common malignancy worldwide and nowadays the incidence is increasing in developing countries like India. This malignancy contributes to 23% of male and 6% of female population of India [1]. Malignancies included in this study are those of oralcavity, oropharynx, nasopharynx, hypopharynx, larynx, thyroid, nose, paranasal sinuses and salivary gland tumors. This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Thanjavur Medical College, Thanjavur, Tamilnadu India, over a period of 2 years from August 2013 to February 2015. Histopathologically confirmed cases alone were taken for this study. In our study the laryngeal and hypopharyngeal malignancies outnumber the other regions. Males are more commonly affected and the age group of around 40 - 50 years is more commonly involved. Smoking and alcohol intake plays a major etiological factor. Cancer awareness programmes and health education regarding risk factors can help to reduce the incidence of malignancies in our Thanjavur delta region.

Assessment of Hearing Status by Pure Tone Audiogram—An Institutional Study

Aim: To assess the hearing status of the study subjects in terms of degree and type of hearing loss, and establish the burden of this disability in the society. Materials and methods: This is a prospective study conducted in patients who attend our OPD. After an otorhinolaryngeal examination, all the patients were subjected to pure tone audiometry using MAICA-MA52 audiometer. Results: Our study comprises 1012 males (64%) and 563 females (36%). Out of this, about 15% have conductive deafness and 42% have sensorineural hearing loss. About 29% suffer from mild hearing loss, 26% moderate and 11% severe hearing loss. The alarming information is that about 5% have total hearing loss of Sudden Sensorineural type (SSNHL). Conclusion: Pure tone audiometry is cost effective and easy to perform. Early diagnosis and timely intervention will reduce the morbidity of deafness in our country. Hence it is necessary to identify and treat sudden sensorineural hearing loss and noise induced hearing loss at an early stage.

Surgical Audit of Sino-Nasal Diseases in a Tertiary Care Centre—A Prospective Study

Aims of the study: 1) To study the distribution of various Sino-nasal diseases in our region;2) To emphasize the significance of Functional Endoscopic Sinus Surgery. Material and methods: This surgical study was carried out in the Department of Otorhinolaryngology and Head and Neck Surgery, Thanjavur Medical College, Thanjavur. The study period was from 21st March 2014 to 20th March 2015 (267 cases). After a preliminary examination, all patients were subjected to Diagnostic Nasal Endoscopy followed by radiological examination. Based on the symptoms and the findings, patients were treated by surgery (mainly FESS), pharmacotherapy, and chemo-radiotherapy. Results: In our study, the majority of cases were deviated nasal septum with sinusitis about 62% (165 cases). The other cases were antrochoanal polyp 8% (21 cases), ethmoidal polyposis 9% (23 cases) and others 21% (51 cases). The age group vulnerable for these diseases is 20 - 40 years. Males are affected more commonly than females. Conclusion: Majority of the cases were treated by Functional Endoscopic Sinus Surgery. So we have to improve the surgical skills in this field to achieve a good outcome.

An Unusual Foreign Body in the Nasal Cavity

The nasal foreign bodies are commonly seen up to the age of 12. This is a rare case of a 10-year-old boy who had playfully introduced an almost straight sharp rigid iron wire of length 13 cm into his nose. The patient presented with the foreign body protruding outside his nose. Radiological investigations revealed that the foreign body had hooked around the posterior end of the bony septum which was removed under endoscopic guidance.

New Approach in the Management of Adult Epiglottic Abscess—A Case Report

Background: Epiglottic abscess in an otherwise healthy adult is seen as a rare sequelae of acute epiglottitis. It is a life threatening condition which requires emergency management, which if not done early, may result in fatality. Respiratory infections, exposure to environmental chemical or trauma which may lead to inflammation and infection of the structures around the throat which may lead on to epiglottitis, and an epiglottis abscess very rarely. In our case, patient was immediately managed by doing an emergency tracheostomy followed by incision and drainage in the OPD (outpatient department). This emphasizes on need for emergency airway management by doing a tracheostomy there by facilitating incision and drainage in a case of epiglottic abscess as a daycare procedure. Aim: The primary aim of this clinical record is to emphasize the need for immediate airway management in epiglottic abscess there by facilitating incision and drainage as an OPD (out-patient department) Procedure. Case Presentation: A 45-year-old man presented to the OPD (outpatient department) with complaints of dysphagia, odynophagia, muffled voice, noisy breathing for the previous 7 hours. On clinical examination pt was in stridor & respiratory distress. Since the pt was in stridor, it was immediately shifted to the OT (operation theatre), and an emergency tracheostomy was done and the airway was secured, following which a video laryngoscopic examination was done in the OPD, which revealed oedematous enlarged epiglottis with pus pointing obscuring the laryngeal inlet. Abscess was incised and drained, and pus was sent for culture & sensitivity. Pt was treated with I. V (intravenous) antibiotics as per culture reports and subsequent video laryngoscopic examination revealed near normal epiglottis with an adequate laryngeal inlet. Conclusion: Patients with epiglottic abscess are at increased risk of airway compromise, hence in such patients airway should be immediately secured by doing an emergency tracheostomy. This case shows the benefits of an emergency tracheostomy for doing incision and drainage for epiglottic abscess as an OPD procedure.

A Loculated Pyocele of Maxillary Sinus—A Rare Case Report

Pyocele of maxillary sinus occurs unusually, when its mucocele content gets secondarily infected. Most of the pyocele occupies the frontal and anterior ethmoid sinus involving the frontal-ethmoidal complex expanding into the orbit leading to ocular disorders. Maxillary sinus presentation is rare, and our patient had a well defined loculated pyocele in her right maxillary sinus that we suspected with radiological images and was confirmed by needle aspiration under endoscopic guidance to the pyocele sac. Here we would like to describe more in detail about the nature of the mucopyocele in paranasal sinuses, its presentation and various surgical modalities of treating the pyocele.