Biomedical subjects
Publications and source records attributed to D J Premachandra.
Submucosal diathermy (SMD) is a common surgical procedure carried out to improve the nasal airway. A case is presented in which it was followed by profuse epistaxis which required transfusion of 28 units of blood, eight units of fresh frozen plasma (FFP) and four units of platelets within 14 days.
Button batteries spontaneously leak corrosive electrolyte solution on exposure to moisture. Tissue in contact with such solution will undergo liquefaction necrosis. Three cases of skin, bone and tympanic membrane necrosis caused by a leaking button battery lodged in the external auditory meatus are described.
Premature biopsy of a potentially malignant neck node compromises patient survival. Despite documented evidence that biopsy of a malignant neck mass prior to a search for a primary source will increase the incidence of regional recurrence and distance metastasis, patients are often referred for head and neck assessment having already had a positive neck node biopsy. We maintain that biopsy of an asymmetrically enlarged cervical lymph node in an adult should be preceded by full upper aerodigestive tract evaluation to include indirect laryngoscopy, a high resolution computed tomography scan and panendoscopy with free field biopsy.
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Facial nerve palsy is a known complication of acute suppurative otitis media. Cases of facial nerve palsy following secretory otitis media have not been reported in the world literature. We report a case of bilateral facial nerve palsy following secretory otitis media.
Button batteries spontaneously leak alkaline electrolyte solution on exposure to moisture, causing liquefaction necrosis of adjacent tissue. We describe two cases in which a button battery in the external auditory meatus caused skin, bone and tympanic membrane necrosis. Review of the world literature on button batteries acting as foreign bodies reveals lower motor neurone facial nerve palsy, nasal septal perforation and fatal esophago-aortic fistula as among the ENT complications. Batteries lodged in these sites must be removed as a matter of the utmost urgency.
The non-recurrent course of the inferior laryngeal nerve is a rare anomaly. The incidence varies from 0.3 to 4% on the right side. It is extremely rare on the left side. The awareness of such an anomaly is essential as the risk of damage to the nerve is higher during thyroid surgery. Two cases of non-recurrent laryngeal nerve are reported, and the embryology and method of identification are discussed.