Otolaryngology Commons^™

Malignant Peripheral Nerve Sheath Tumour Of Maxilla, Naeem Sultan Ali, Montasir Junaid, Kanwal Aftab

Section of Otolaryngology, Head & Neck Surgery

Malignant peripheral nerve sheath tumour (MPNST) is a very rare entity in head and neck with high rate of recurrences and local invasiveness. This tumour is usually found in lower extremities and only 10-12% occur in head and neck region. The diagnosis is considered as the most elusive and difficult among soft tissue sarcomas because of its non specific presentation, both clinically as well as pathologically. This difficulty has now been overcome by immunohistochemistry. We report here a case of MPNST in a 50 years old male with a localized right maxillary growth.

Successful Management Of Aggressive Fibromatosis Of The Neck Using Wide Surgical Excision: A Case Report., Zain A. Sobani, Montasir Junaid, Mumtaz J Khan

Section of Otolaryngology, Head & Neck Surgery

Introduction:Aggressive fibromatosis is a benign tumor, thought to arise from deep musculoaponeurotic structures, rarely found in the head or neck. However, when it does occur in the head and neck region, it tends to be more aggressive and associated with significant morbidity, which may be attributed to the vital vascular, neurological or anatomical structures in close proximity. Case Presentation: We report the case of a 39-year-old Pakistani man who presented with a two-month history of a lump on the right side of his neck. The mass was excised and histopathological analysis revealed a case of aggressive fibromatosis.

Conclusions:

Due …

Preliminary Report--Near Total Laryngectomy For Scc Larynx, Asif Arain, Shehzad Ghaffar

Section of Otolaryngology, Head & Neck Surgery

A retrospective analysis was performed on patients subjected to near-total laryngectomy at Aga Khan University Hospital Karachi from September 2006 and May 2010, to evaluate the functional outcome of Near Total Laryngectomy and its effect on disease control. In all of these advanced stage laryngeal-hypopharyngeal squamous cancer patients, the disease was limited to one side of the larynx-hypopharynx. Four patients were staged as T3 and rest were T4; near total laryngectomy was done in all 07 patients. Post operative adjuvant radiotherapy was given to 06 patients. All of these patients are on regular oral diet and maintaining their body weight. …

Diagnostic Accuracy Of Fine Needle Aspiration Cytology In Parotid Lesions, Naeem Sultan Ali, Shabbir Akhtar, Montasir Junaid, Sohail Awan, Kanwal Aftab

Section of Otolaryngology, Head & Neck Surgery

Objective:Histopathology of parotid gland tumors is extremely varied and complex due to heterogeneous cellular composition. Preoperative diagnostic tools include fine needle aspiration cytology, the role of which remains controversial. The aim of this paper is to evaluate the usefulness and accuracy of fine needle aspiration cytology (FNAC) in the diagnosis of parotid gland tumors.

Methods:

We retrospectively reviewed charts of 129 Patients who underwent parotidectomy for parotid lesions at Aga Khan University Hospital from 2002 to 2010. We compared the results of preoperative FNAC with final histopathological diagnosis.

Results:

Concordance with histological results was observed in 86%, specificity was …

Extracranial Meningioma: An Unusual Presentation Of A Mass Over Inner Canthus Of Left Eye, Nasir Ali, Mubasher Ikram, Tahir Shafi Khan, Syed Athar Enam, Abdul Qadir Jangda, Farrok Karsan

Section of Otolaryngology, Head & Neck Surgery

ABSTRACT Meningiomas are commonly encountered as intracranial brain tumours, but extracranial meningiomas do occur although seen rarely. Here we present a case of extracranial meningioma presenting as a mass over the medial canthus of left eye and the glabella with extension into the left ethmoid sinuses, without any neurological symptoms or signs. The patient underwent surgical excision, plastic surgical reconstruction and adjuvant radiotherapy after 3-dimensional conformal treatment planning.

Rhinocerebral Zygomycosis In Pakistan: Clinical Spectrum, Management, And Outcome, Mubasher Ikram, Moghira Iqbal, Muhammad Aslam Khan, Erum Khan, Mahnaz Shah, Raymond A., Jr Smego

Section of Otolaryngology, Head & Neck Surgery

OBJECTIVE: To study the disease spectrum and salient management features of 36 patients with histopathologically-confirmed rhinocerebral zygomycosis seen at our academic center over a 16-year period.

METHODS: Retrospective review of patients admitted to the Aga Khan University Hospital in Karachi, Pakistan from January 1991 to December 2006 with histopathologically-confirmed zygomycosis of the head and neck.

RESULTS: Mean patient age was 40 +/- 5.0 years (range, 34-63 years), and 23 (64%) patients were male. Thirty-two (89%) patients were referred from clinical services other than otolaryngology. Underlying predisposing conditions included diabetes mellitus (21 patients), haematologic diseases (9), and renal failure (6). Twenty …

Harmonic Scalpel Versus Electrocautery Tonsillectomy: A Comparative Study In Adult Patients, Naeem Sultan Ali, Mubasher Ikram, Shabbir Akhtar, Iqbal Moghira, Ahmad Nawaz, Asif Arain

Section of Otolaryngology, Head & Neck Surgery

OBJECTIVE: To compare harmonic scalpel (HS) tonsillectomy with electrocautery (EC) tonsillectomy in terms of operating time, intra-operative blood loss, post-operative pain and secondary haemorrhage.METHODS: Sixty adult patients subjected to tonsillectomy only, were evaluated in this prospective study. The patients were stratified into 2 groups (30 each) based on the dissecting instrument used (HS vs. EC) at Aga Khan University Hospital Karachi Pakistan from June, 2006 to August, 2008.RESULTS: The mean operative time was less in electrocautery group (EC 3.57 +/- 0.85 minutes Vs HS 4.20 +/- 1.37 minutes; p

Intelligibility Of Electrolarynx Speech Using A Novel Hands-Free Actuator, Brian Madden, Mark Nolan, Ted Burke, James Condron, Eugene Coyle

Conference Papers

During voiced speech, the larynx provides quasi-periodic acoustic excitation of the vocal tract. In most electrolarynxes, mechanical vibrations are produced by a linear electromechanical actuator, the armature of which percusses against a metal or plastic plate at a frequency within the range of glottal excitation. In this paper, the intelligibility of speech produced using a novel hands-free actuator is compared to speech produced using a conventional electrolarynx. Two able-bodied speakers (one male, one female) performed a closed response test containing 28 monosyllabic words, once using a conventional electrolarynx and a second time using the novel design. The resulting audio recordings …

Heat Shock Protein Induced Protection Against Cisplatin-Induced Hair Cell Death, Tiffany Gray Baker

MUSC Theses and Dissertations

Cisplatin is a highly successful and widely used chemotherapy for the treatment of various solid malignancies in both adult and pediatric patients. Side effects of cisplatin include nephrotoxicity and ototoxicity. Cisplatin's ototoxic effect results in part from damage to and death of cochlear hair cells. Mechanisms underlying cisplatin-induced hair cell death are poorly understood and have been attributed to DNA damage, oxidative stress, and inflammation. This study was designed to determine the role of p53 in cisplatin-induced hair cell death and to investigate heat shock proteins (HSPs) as potential protectants against cisplatin-induced hair cell death using adult mouse utricle as …

Aggressive Embryonal Rhabdomyosarcoma Presenting As Schwanoma : A Case Report, Mohammad Sohail Awan, Montasir Junaid, Zain A. Sobani

Department of Radiology

Rhabdomyosarcomas (RMS) are thought to arise from pluripotent muscle cell precursors intended to form the bodyís future striated muscle. Due to the wide distribution of striated muscle across the body these tumors may appear anywhere and cause symptoms accordingly. Presenting symptoms are highly variable and based on the tumor size and location making clinical diagnosis difficult. The diagnosis of RMS is based on histological examination; however they express varying cytologic pictures representing the different stages of rhabdomyoblasts and their development into skeletal muscle presenting pictures from highly to poorly differentiated neoplasms. Therefore their histological diagnosis also requires the use of …

Supernumerary, Ectopic Tooth In The Maxillary Antrum Presenting With Recurrent Haemoptysis., Taimur Saleem, Umair Khalid, Anam Hameed, Shehzad Ghaffar

Section of Otolaryngology, Head & Neck Surgery

Ectopic eruption of teeth in non-dental sites is a rare phenomenon and can present in a variety of ways such as chronic or recurrent sinusitis, sepsis, nasolacrimal duct obstruction, headaches, ostiomeatal complex disease and facial numbness. However, presentation of such Patients with recurrent haemoptysis has not been described in the literature so far. We have described a case of an ectopic, supernumerary molar tooth in the maxillary antrum in a Patient who initially presented with haemoptysis. A 45-year-old male presented with a 2-month history of episodic haemoptysis. A pedunculated growth from the inferior nasal turbinate was seen with fibre-optic visualization. …

Congenital Bilateral Choanal Atresia, Ali Faisal Saleem, Shabina Arif, Nadeem Aslam, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Abstract: Congenital choanal atresia (CCA) is the developmental failure of the nasal cavity to communicate with nasopharynx. Surgical repair is recommended in the first weeks of life in bilateral cases because this is a life-threatening situation in newborns. This is a case report of a full term, healthy newborn baby presenting with intermittent attacks of cyanosis and respiratory distress soon after birth. On examination, alternating cyanosis and normal colour was observed in the infant. The insertion of nasal catheters in both the nares revealed the diagnosis of bilateral CCA. For this rare condition, conservative management was followed with elective transnasal …

The Challenge Of Head & Neck Squamous Cell Carcinoma Control In Pakistan, Syed Mohammad Asad Zaidi, Nauman Fazal Manzoor, Shabbir Akhtar

Section of Otolaryngology, Head & Neck Surgery

No abstract provided.

Postoperative Complications Of Powered Intracapsular Tonsillectomy And Monopolar Electrocautery Tonsillectomy In Teens Versus Adults., Douglas R Johnston, Michael Gaslin, Maurits Boon, Edmund Pribitkin, David Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES: This study was performed to determine whether teens have different rates of posttonsillectomy hemorrhage, admission for dehydration, or recurrent tonsillitis compared to adults. Specifically, these parameters were compared within two groups: patients who underwent powered intracapsular tonsillectomy (PIT) and those who underwent monopolar electrocautery tonsillectomy (MET).

METHODS: In a retrospective review of 579 patients at least 12 years of age from January 2000 to July 2006 in a tertiary referral center, outcome measures of reoperation for hemorrhage, readmission or emergency room visit for dehydration, and postoperative tonsillitis were compared for 200 patients 12 to 19 years of age and …

Intelligibility Of Electrolarynx Speech Using A Novel Actuator, Brian Madden, Mark Nolan, Ted Burke, James Condron, Eugene Coyle

Conference Papers

During voiced speech, the larynx provides quasi-periodic acoustic excitation of the vocal tract. Following a laryngectomy, some people speak using an electrolarynx which replaces the excitatory function of the absent larynx. Drawbacks of conventional electrolarynx designs include the buzzing monotonic sound emitted, the need for a free hand to operate the device, and difficulty experienced by many laryngectomees in adapting to its use. Despite these shortcomings, it remains the preferred method of speech rehabilitation for a substantial minority of laryngectomees. In most electrolarynxes, mechanical vibrations are produced by a linear electromechanical actuator, the armature of which percusses against a metal …

Endoscopic Repair Of High-Flow Cranial Base Defects Using A Bilayer Button., Adam J. Luginbuhl, Peter G. Campbell, James Evans, Marc Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVES/HYPOTHESIS: Repair of the skull base still begins with a direct repair of the dural defect. We present a new button closure for primary repair of the dura for high flow defects.

STUDY DESIGN: Retrospective review.

METHODS: We reviewed our 20 cases of primary button grafts and compared the results to the previous 20 high-flow open-cistern cerebrospinal fluid (CSF) cases. Subjects were excluded if they had no violation of the arachnoid space or potential for low-flow CSF leak. The button is constructed so that the inlay portion is at least 25% larger than the dural defect, and the onlay portion …

Parotidectomy: A Review Of 112 Patients Treated At A Teaching Hospital In Pakistan, Naeem Sultan Ali, Ahmad Nawaz, Shaheryar Rajput, Mubasher Ikram

Section of Otolaryngology, Head & Neck Surgery

Objective:The Purpose of this study was to analyze the clinical presentation, histopathology and complications following parotid surgery.

Methods:

We retrospectively reviewed the charts of 112 Patients who underwent parotidectomy from January 2000 to February 2010. Data including age, sex, clinical signs and symptoms, histology and complication were collected from medical records.

Results:

Of the total, 82 (74%) had benign lesions, 30 (36%) had malignant tumors. The most common benign tumor was pleomorphic adenoma (57%), and the most common malignant tumor was mucoepidermoid carcinoma (16%). Analysis of the correlation between fine-needle aspiration cytology and final histology revealed that fine-needle aspiration …

Comparison Of Different Treatment Modalities In Advanced Laryngeal Hypopharyngeal Squamous Cell Carcinoma, Shehzad Ghaffar, Mubasher Ikram, Sardar Zakariya Imam, Yasir Jamal Sepah

Section of Otolaryngology, Head & Neck Surgery

OBJECTIVE: To compare outcome of patients with advanced laryngeal hypopharyngeal squamous cell carcinoma treated surgically or with chemotherapy and/or radiotherapy.

STUDY DESIGN: Observational study.

PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, from January 2000 to December 2005.

METHODOLOGY: Medical records of already treated stage-III and IV squamous cell carcinoma of larynx/hypopharynx patients were reviewed. Group-A comprised of patients treated with surgery +/- adjuvant therapy whereas non-surgically managed patients were labeled as group-B. One hundred and nineteen out of 275 met the inclusion criteria. Kaplan Meier technique was used to estimate mean recurrence time with standard errors. …

Factors Associated With Recurrent Nasal Polyps: A Tertiary Care Experience, Shabbir Akhtar, Mubasher Ikram, Iqbal Azam, Tariq Dahri

Section of Otolaryngology, Head & Neck Surgery

OBJECTIVE: To assess the factors associated with recurrence of nasal polyps in operated patients by endoscopic surgery.

METHODS: A retrospective study was conducted on 192 patients operated for nasal polyps in a hospital set-up between 2001 and 2007. The median follow-up period was 24 months (range 12 months to 60 months). Ten variables were analyzed to study their association with polyp recurrence namely; age, gender, history of purulent nasal discharge, facial pain, anosmia, post nasal dripping (PND), headache, nasal allergy, asthma and computed tomography (C.T) staging. Analysis of recurrences was accomplished using independent sample t-test, chi-square and Fishers exact test. …