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Biomedical subjects

Kishore Chandra Prasad

Publications and source records attributed to Kishore Chandra Prasad.

9 recordsLinked to original sources

Early oral feeds in laryngectomized patients.

OBJECTIVES: It is a common practice to start oral feeding after 7 to 10 days in patients who have undergone laryngeal surgeries. It was our observation that when oral feeds were initiated earlier than this period, there was no increase in the incidence of pharyngocutaneous fistulas. This prospective study is about our experience in initiating early oral feeds in the postoperative period (on the 2nd day) in laryngectomized patients. METHODS: Seventy-eight patients underwent laryngectomy with or without partial pharyngectomy over a period of 38 months between October 2001 and December 2004. The oral feeds were initiated on the 2nd postoperative day in 40 patients. Thirty-eight patients served as controls in whom feeds were initiated after the 10th postoperative day. RESULTS: Only 1 patient in the study group and 2 patients in the control group developed pharyngocutaneous fistulas. Most patients in the control group wished to avoid nasogastric intubation in the recovery period because of discomfort, gastric symptoms, and the need to taste food. CONCLUSIONS: With this study we can assume that in a select group of patients, it is possible to initiate oral feeding much earlier in the postoperative period than was formerly thought.

Aged↗

Congenital laryngeal saccular cyst: report of a case in an infant.

Respiratory obstruction and stridor in infants and children are not uncommon. A rare cause of these life-threatening symptoms is congenital saccular cyst. An accurate diagnosis of saccular cyst can be made by eliciting a good history, by endoscopic visualization of the lesion, and by computed tomography. Endoscopic excision is the preferred treatment for infants, whereas an external approach is reserved for older children. It can be difficult for anesthetists to intubate infants when the anatomy of the larynx is distorted, but the choice of tracheotomy for an infant has many drawbacks as well. We discuss the clinical presentation and management of a 3-month-old boy who was brought to us with a congenital laryngeal saccular cyst.

Cysts↗

Thyroglossal duct cyst: an unusual presentation.

Most thyroglossal duct cysts are located at or very close to the midline. They generally manifest as painless neck swellings, and they move on protrusion of the tongue and during deglutition. We describe a case of thyroglossal duct cyst that was unusual in that the cyst was located far from the midline, it did not move on protrusion of the tongue, and it was associated with symptoms of dysphagia and extensive neck swelling that mimicked a colloid goiter

Adult↗

Pedunculated cribriform adenocarcinoma of the base of the tongue.

A handful of cases of cribriform adenocarcinoma of the tongue have been reported in the literature, but in none of these cases was the tumor pedunculated. By the time these patients sought treatment, most of the tumors had metastasized to the cervical lymph nodes. We report the case of a 65-year-old woman who had a large, pedunculated, cribriform adenocarcinoma that had arisen from the base of the tongue. This case was also unusual because the tumor had not metastasized. The patient was treated with surgery and radiotherapy. To the best of our knowledge, cribriform pedunculated adenocarcinoma of the base of the tongue has not been previously reported.

Adenocarcinoma, Papillary↗

Leiomyosarcoma of the maxillary sinuses: report of two cases.

Leiomyosarcoma is a malignant smooth-muscle tumor that has a predilection for the gastrointestinal tract and the female genital tract. It is locally fast-spreading and highly aggressive, and the prognosis is poor. We report two cases of leiomyosarcoma of the maxilla in patients who sought treatment for maxillary swelling, nasal obstruction, and epistaxis; one patient also had orbital involvement and cervical lymph node metastasis. Both patients underwent radical surgery followed by chemo- and/or radiotherapy. The patient with orbital involvement died shortly thereafter, but the other was disease-free at 18 months.

Adult↗

Teratocarcinosarcoma of the nose, paranasal sinuses and nasopharynx.

Teratomas affecting the head and neck are rare tumours of ambiguous origin. The benign form is seen in children and mostly affects the nasopharynx. Malignant tumours in the upper jaw have been reported rarely. They are almost exclusively seen in the adult male. They are highly aggressive tumours that are difficult to diagnose pre-operatively due to the varied histological patterns. Treatment options available are surgery, radiotherapy or a combination of both. Despite intensive treatment, the prognosis is still poor. A rare case of teratocarcinosarcoma of the nose, paranasal sinuses and nasopharynx in a 25-year-old male is presented. The tumour had a non-germ cell tumour origin. The clinical features, pathologic characteristics and treatment are detailed. It was managed by surgery, radiotherapy and chemotherapy.

Adult↗

Elongated styloid process (Eagle's syndrome): a clinical study.

PURPOSE: Elongated styloid process can be a source of craniofacial and cervical pain and remains a diagnostic challenge to many. The aim of the study was to determine the symptomatology and various criteria for the diagnosis of an elongated styloid process and its management. PATIENTS AND METHODS: Our clinical study consisted of 58 patients with elongated styloid process who had symptoms of vague cervicofacial pain and presented to our department during a period of 10 years. Special emphasis is given to palpation of the tonsillar fossa, lidocaine infiltration test, and orthopantomography. RESULTS: Minimal complications and zero incidence of deep neck infection were noted. CONCLUSIONS: All of the patients were managed surgically through the intraoral approach, which was found to be a safe procedure.

Adolescent↗

Basaloid squamous cell carcinoma of the larynx: report of a case.

Basaloid squamous cell carcinoma is a variant of squamous cell carcinoma. This malignancy has a predilection for the upper aerodigestive tract, although it has been found in multiple other sites. The tumor is highly aggressive biologically, and the overall prognosis is poor despite intensive treatment. We describe a case of basaloid squamous cell carcinoma of the larynx that metastasized to the spine.

Carcinoma, Squamous Cell↗

A comprehensive study on lesions of the pinna.

PURPOSE: Pinna contributes enormously to the facial aesthesis. Lesions affecting the pinna can lead to overt disfigurement and change the entire appeal of the face. Gross deformity can occur because of a delay in diagnosis and mismanagement. The aim of our study was to determine the clinical presentation, relevant investigations, appropriate treatment, timing of surgical intervention, and complications encountered. Factors that predispose and aggravate the condition and their appropriate management are also discussed. The point to be emphasized is that a good clinical history and examination alone is sufficient to diagnose the conditions without the aid of any special investigation. MATERIALS AND METHODS: Our clinical study comprised of 307 cases of men and women patients presenting with swelling of the pinna, who attended the Ear, Nose, and Throat Department, Kasturba Medical College, Mangalore, India, during the period of February 1992 to June 2002. Wide bore needle aspiration was done for the majority of cases of seroma and hematoma. Patients who had recurrence were managed by window procedure. Incision and drainage with or without curettage of diseased cartilage was performed for perichondritis. Other lesions like keloid, hemangioma, dermoid cyst, sebaceous cyst, and malignancy were managed by complete excision. A firm pressure dressing was applied in all cases after surgery. Majority of the cases were done under local anesthesia. RESULTS: Prompt surgical intervention under good antibiotic cover gave excellent results with minimal complications. CONCLUSIONS: Surgical intervention at the earliest followed by a firm pressure dressing under antibiotic cover decreases the morbidity. Diabetes mellitus plays a significant role in few of the conditions and has to be simultaneously controlled.

Adolescent↗