Biomedical subjects
Publications and source records attributed to R C Deka.
Tuberculosis of the maxillary sinus is rare. Likewise, an acute onset that necessitates incision and drainage is also very uncommon. We report the case of a 15-year-old girl who came to us with an abscess on the left side of her face. She was found to have tuberculosis of the left maxillary antrum.
This paper attempts to define and categorize the vertigo associated with migraine. A retrospective chart review of 344 cases of vertigo identified 19 cases with headaches characteristic of migraine as per strictly defined criteria (International Headache Society, 1988). Four distinct types of vertiginous syndromes were noted. The commonest syndrome (Group I) manifested transient episodes of imbalance with additional momentary subjective rotary vertigo worsened by movement. The attacks lasted a few hours and evaluation in the inter-episode interval demonstrated no vestibular deficit. Group II manifested transient objective rotatory vertigo of from 10 minutes to a few hours but no demonstrable permanent vestibular deficit. Group III displayed symptoms and signs characteristic of benign paroxysmal positional vertigo (BPPV) and Group IV manifested a permanent unilateral labyrinthine weakness. Causation of vertigo by migraine was implied in 10 of 19 cases where the headache and vertigo occurred simultaneously and in two other cases where the vertigo improved with anti-migraine prophylactic treatment. Four distinct and characteristic vertigo syndromes have been noted with migraine. Their spectrum ranges from a transient reversible dysfunction to a more permanent destruction, and includes involvement of both the peripheral and the central vestibular systems.
A case of entomophthoromycosis of the nose and paranasal sinus is presented. To our knowledge, this is the youngest patient reported with this infection. Though the clinical picture mimicked a malignancy, histopathology clinched the diagnosis of entomophthoromycosis. The lesions resolved completely with oral potassium iodide.
Congenital laryngeal cysts are very rare and if mismanaged, lead to a high incidence of morbidity and mortality. The case may present as severe stridor and emergent management can obviate a tracheostomy, achieving cure in the process. We report here a case of supraglottic cyst, which was completely occluding the airway and was managed in the emergency setting.
We describe the usefulness of molecular graphics and structural fitting techniques as powerful and reliable tools for quick screening of zeolite catalysts for shape selectivity. The syntheses of 4,4'-diisopropylbiphenyl and p-isobutylethylbenzene are considered as case studies. Molecular graphics analysis of the isomers of diisopropylbiphenyl and isobutylethylbenzene in various zeolites indicates that large-pore zeolites are needed for the synthesis of these alkylaromatics. The importance of size and shape of the channels of large-pore zeolites is clearly brought out by the structural fitting technique. From the analysis of the results of molecular graphics studies and the structural fitting studies, it is inferred that ZSM-12 and mordenite are suitable zeolites for shape-selective production of diisopropylbiphenyl, and that offretite and mordenite are suitable zeolites for shape-selective production of p-isobutylethylbenzene.
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This paper is a retrospective study of 15 patients with parapharyngeal neurofibromas operated over a six year period. No patient presented with a neurological deficit. CT scans revealed a well encapsulated moderately enhancing mass in ten cases. The tumour was removed by a transcervical approach in ten cases while in five a cervical-transpharyngeal route with mandibulotomy was used; in three of the latter group the tumour was retropharyngeal. In two cases a recurrence was successfully excised. It was realized that a mandibulotomy was required when the internal carotid was displaced medially, or if the tumour extended to the base of skull or when its vertical diameter exceeded 8 cm.
Sixty head injury patients were evaluated for hearing loss; ten underwent ABER testing. Forty percent of the cases had hearing loss of different degrees. The audiometric pattern was variable in the different types of injuries, although the incidence of conductive deafness was quite low (5%). In most of the cases of sensorineural hearing loss, the end organ was implicated. Recruitment was demonstrated in the ABERs, as well as in the retrocochlear lesions, by studying the IPLs present.
Chronic renal failure can produce malfunction of multiple organs, including auditory and vestibular apparatus. Twelve patients of chronic renal failure of varying etiologies treated conservatively were subjected to vestibular function tests. Only 33% of the patients had normal ENG data. Fifty-eight per cent of the patients had canal paresis and 8% showed hyperactive response. Ototoxic drugs like furosemide may be most important factor in aetiology of vestibular dysfunction in chronic renal failure.
A case of acquired tracheo-oesophageal fistula in a 16-year-old boy, caused by a bullet wound, is presented. The fistula was located just below the cricoid cartilage and was successfully treated by excision of the fistula followed by interposition of the sternomastoid muscle.
A case of giant cell tumour of the temporo-sphenoidal region and superior part of infratemporal fossa is presented along with a brief review of the literature. The tumour mass was removed by curettage using a Weber-Fergusson incision with transection of the zygoma. There was no recurrence at three-year follow up.
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Large acoustic or nonacoustic cerebellopontile angle tumors cause severe to total hearing loss on the same side. Such a tumor can also cause hearing loss on the opposite side by pressure effect on the brain stem. This was observed in 23 patients with large tumors that were surgically treated. Their computed tomographic scans and surgical findings supported the auditory brain-stem evoked potential changes noted in this study. Early removal of such a tumor is essential to prevent any possible hearing loss on the opposite side that may be produced by the tumor.
Nasal septal deviation (DNS) occurs more frequently during childhood although it occurs at any age due to trauma. Recently, it has been increasingly recognized that nasal septal deviation is seen also at birth and a number of explanations for this occurrence is forwarded. Awareness of such occurrence and its recognition at birth both by pediatricians and obstetricians is essential for early interventional management of this condition in close collaboration with the otorhinolaryngologists. Closed surgical intervention of this defect carried out early after it was detected at birth benefitted the afflicted in terms of nasal airway improvement and its maintenance resulting in normalization of its anatomy and physiology in long term follow-up. Septal deviation detected at birth if left alone without interventional procedure continues to persist. It is furthermore accompanied by statistically valied symptoms like upper respiratory infections, cough, earache, ear discharge, fever, mouth breathing and at times feeding difficulty during infancy and childhood. Long term follow-up of children who underwent closed surgical correction of DNS at birth, revealed no untoward effects such as nasofacial disproportion or retardation of facial growth. Early interventional management of DNS detected at birth therefore appears to be a safe procedure. It can even be performed by neonatologists or an obstetrician. Such an intervention procedure early in life can prevent septoplasty surgery at a latter date besides preventing a number of nasal airway-related conditions.
Two cases of congenital mid-line sinus of the nose are presented. The etiology of the condition with emphasis on its embryology and treatment are discussed. A reversed 'u' incision in each nostril gives a wider exposure and is more acceptable cosmetically.
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