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Biomedical subjects

S B Mann

Publications and source records attributed to S B Mann.

At least 19 recordsLinked to original sources

Measurement of laryngeal dimensions in neonates.

Intimate knowledge of laryngeal anatomy and various laryngeal dimensions is crucial for successful airway management. Selection of a proper endotracheal tube is also a critical factor. Subglottic dimension is the most important measurement of larynx because of it being the narrowest part of the infant larynx. Data about various infantile laryngeal dimensions in Indian population is sparse. In this article, we present various laryngeal dimensions using 30 infantile laryngeal autopsy specimens and review of literature.

Female↗

Incidence of pharyngeal hypophysis in neonates a histologic study.

The presence of adenohypophysial tissue in the nasopharynx is no longer disputed. This study was performed in 50 neonatal cadavers subjected to medical autopsy within 6 hours of death. The aim was to study the incidence of extrasellar pituitary tissue in the nasopharynx and its various histologic cell types. The transpalatal approach was used to obtain the specimens. The specimens were stained with hematoxylin and eosin and periodic acid-Schiff-orange G for selective demonstration of adenohypophysial cells. Histopathologic evaluation led to the detection of pituitary tissue in 16% of the examined specimens. Selective staining demonstrated a 6% positive incidence of adenohypophysial cells. The pharyngeal hypophysis exists in 2 forms: a typical adenohypophysial collection of cells and an atypical subepithelial cluster. The incidence of hypophysial tissue was higher in the older neonates, perhaps because of hormonal stimulation of the caudal remnant of Rathke's pouch.

Adenoids↗

Psychological findings in benign paroxysmal positional vertigo and psychogenic vertigo.

OBJECTIVE: A prospective study conducted at the Post Graduate Institute of Medical Education and Research, Chandigarh, India, to study the psychological factors in cases of benign paroxysmal positional vertigo (BPPV) and to compare them with patients with psychogenic vertigo. METHODS: In the present study, 75 subjects each (25-45 years) with BPPV and psychogenic vertigo were compared with an equal number of age- and sex-matched normal controls using the psychological and audiovestibular test batteries. RESULTS: The psychological variables tested, namely, loneliness, depression, anxiety components, introversion, and social desirability, were found to be statistically significant (p < .01) for the three groups (i.e., BPPV, psychogenic, and control). There was no significant difference among the three groups on the audiovestibular measures. CONCLUSION: Psychological factors play an important role in patients with BPPV. The provoking activities result in precipitation of an acute attack and the patients experience heightened emotionality because of the incapacitating feeling of severe vertigo.

Acute Disease↗

The role of ultrasonography in the management of tumors of the neck.

By themselves, clinical examination and palpation do not provide an accurate assessment of metastatic neck nodes. They do not yield sufficient information to ascertain the benign or malignant nature of nodes or to determine the presence of extracapsular spread and vascular invasion. The use of real-time ultrasonography with high-frequency transducers can significantly improve the evaluation of patients with neck masses. We studied the use of ultrasound in evaluating metastatic neck disease in 25 patients. We found that it is useful not only in detecting neck nodes, but in assessing their characteristics and the degree of vascular invasion. We recommend that ultrasonography be routinely performed as part of the evaluation of all patients with head and neck masses. It is also valuable in the postoperative or postirradiation followup of patients whose necks are otherwise difficult to evaluate.

Biopsy, Needle↗

Non-randomized comparison of surgical modalities for paranasal sinus mycoses with intracranial extension.

Mycotic infections of paranasal sinuses are frequently reported in southern Asia. Aspergillus and Mucor species are the predominant ones. Intracranial extension of paranasal sinus mycoses is a difficult problem to manage. We report 18 cases of paranasal sinus mycoses with intracranial extensions. The commonest manifestations were nasal discharge (67%), nasal obstruction (50%), ocular symptoms such as proptosis (44%), telecanthus (39%) and ophthalmoplegia. Computerized tomography scans were found to be quite informative regarding the nature and extent of the disease (100% sensitivity and 78% specificity). A combined intracranial-extracranial approach (six cases) gave a distinct advantage over only adopting an extracranial approach (12 cases). A 17% incidence of CSF leak was noted by adopting only an extracranial approach as well as a recurrence in four cases out of the 12 that were treated using this method (P < 0.05). A slight increase in morbidity was associated with the combined intracranial-extracranial treatment, but no recurrence or significant complications were noted in this approach.

Adolescent↗

CT findings in involvement of the paranasal sinuses by lepromatous leprosy.

The role of nasal infection in the transmission of leprosy has been extensively studied. Leprosy can affect the paranasal sinuses due to mucosal continuity and bacillaemia. This prospective study was performed on 25 untreated patients with lepromatous leprosy. 5 mm contiguous axial and coronal CT sections of paranasal sinuses, on soft tissue and bone windows, were obtained in all patients. Each sinus was examined for mucosal thickening, soft tissue densities and bony outlines. Representative biopsies were taken from ethmoid sinus to confirm the radiological diagnosis in 12 patients with multiple paranasal sinus involvement. Ethmoid aircells were involved in 20 patients (80%). Maxillary, frontal and sphenoid sinuses showed abnormalities in 12, four and three patients, respectively. The ethmoid biopsy showed involvement by lepromatous leprosy in seven of 12 patients (58.3%). Involvement of paranasal sinuses is common in lepromatous leprosy and is of considerable epidemiological significance.

Adolescent↗

Aural cholesteatoma: role of tumor necrosis factor-alpha in bone destruction.

HYPOTHESIS: The bone destruction in cholesteatoma is multifactorial. This study was undertaken to define the role of tumor necrosis factor-alpha (TNF-alpha) in bone destruction associated with cholesteatoma. BACKGROUND: Tumor necrosis factor-alpha is an important inflammatory cytokine secreted by activated macrophages. It stimulates keratinocytes as an autocrine growth regulator. Few authors have localized TNF-alpha in aural cholesteatoma. An attempt was made in this study to show a correlation between TNF-alpha and cholesteatoma associated bone destruction by localizing TNF-alpha in cholesteatoma and measuring its serum level. METHODS: Serum TNF-alpha levels were measured in 20 patients with cholesteatoma of temporal bone and histochemical staining was used to localize TNF-alpha in pathologic tissue excised at surgery. RESULTS: Serum TNF-alpha levels in patients with cholesteatoma were significantly higher than in controls. In addition, TNF-alpha levels in patients with bone destruction were higher than in those without bone destruction. However, there was no correlation between age of the patient and serum TNF-alpha levels. The TNF-alpha was localized in various layers of cholesteatoma epithelium using indirect immunoperoxidase staining. CONCLUSION: TNF-alpha is one of the cytokines produced by cholesteatoma that may be an important mediator of bone destruction associated with cholesteatoma. TNF-alpha has been localized in various layers of cholesteatoma and exerts a locally destructive effect on bone. Serum TNF-alpha levels are related to the extent of bone destruction.

Adolescent↗

Comparative efficacy and safety of terfenadine with pseudoephedrine and terfenadine alone in allergic rhinitis.

A randomized, double-blind clinical trial was conducted on 41 adult patients to compare the efficacy and safety of the combination of terfenadine and pseudoephedrine with that of terfenadine alone. Efficacy of treatment evaluated by the physician and patients showed an excellent rating in 45.45% patients in the combination treatment group compared with an excellent rating in 10.53% in the single treatment group. The difference between both treatments was statistically significant, with a z value of 1.660 (p < 0.05). The combination of terfenadine and pseudoephedrine was found to result in faster relief in a greater number of patients than terfenadine alone. However, both drugs were well tolerated.

Adolescent↗

Comparative ABR profile in high risk infants.

Auditory brainstem responses (ABR) were studied in 52 children upto the age of 3 months, suffering from neonatal jaundice, prematurity, pyogenic meningitis and septicemia. Absolute latency of wave I and interpeak latency I-V were found to be significantly delayed in cases of jaundice and absolute latency of wave V and interpeak latency I-V were prolonged in cases with prematurity. In cases following pyogenic meningitis absolute latency of wave V and interpeak latency of I-III, I-V were significantly delayed compared to septicemia where absolute latency I, V and interpeak latency I-V were significantly delayed (P < 0.05). Maximum auditory insult was seen in cases with neonatal jaundice where 30.77% each had severe SN deafness and 30.77% had moderate degree of deafness compared to prematurity, meningitis and septicemia where 14.28, 7.69 and 25% were found to have severe SN deafness and 7.14, 38.46 and 25% had moderate deafness. Overall incidence of deafness of any kind in these factors was 44.23%.

Brain Stem↗

Study of ethmoid sinus involvement in multibacillary leprosy.

The nasal mucosal involvement in lepromatous leprosy is well recognized. Currently interest has centred around the involvement of paranasal sinuses in leprosy. They act as a reservoir and constant source of reinfection to the nasal mucosa. In the present prospective study 25 untreated patients with multi-bacillary leprosy were included. Clinical examination, computed tomography (CT) scan of paranasal sinuses, ethmoid sinus endoscopy and biopsy were carried out in all patients, to investigate the involvement of the paranasal sinuses in leprosy. Ethmoid sinus involvement was noted in 20 patients on CT scan. Bilateral involvement was more common (65 per cent). Anterior ethmoids were more commonly affected (65 per cent). On ethmoid sinus endoscopy abnormal mucosa was noted in 17 patients (68 per cent). Ethmoid sinus biopsy was confirmative in 16 patients (64 per cent). Statistically significant correlation was found between CT findings, sinus endoscopy and sinus biopsy findings.

Adolescent↗

Pseudoaneurysm of subclavian artery--atypical presentation.

We present a rare case of pseudoaneurysm of right subclavian artery who presented with supraclavicular mass. Injury of the subclavian artery causing pseudoaneurysm is a serious surgical emergency and a surgical intervention is indicated.

Anastomosis, Surgical↗

Computed tomographic study of paranasal sinuses in lepromatous leprosy.

Twenty patients (18 males, 2 females) with lepromatous leprosy and 10 age- and sex-matched controls were subjected to computed tomographic (CT) scans of the paranasal sinuses (PNS). The mean bacterial (BI) and morphological indexes were 3.4+ and 1%, respectively. Nasal symptoms were present in nine (45%) patients; 15 (75%) out of 20 patients showed significant abnormalities on CT scans of the PNS compared to none of the 10 controls. The maxillary and ethmoid sinuses were affected in 11 (55%) patients each, followed by the sphenoid sinus in four (20%) patients. Frontal sinus involvement was least frequent, only one (5%) patient showed CT changes. Mucosal thickening was the most common finding followed by soft-tissue densities and, rarely, a fluid level was seen in the PNS. Involvement of the PNS correlated with a high BI of 4+ or more (75% vs 37.5%). Paranasal sinus involvement is an integral part of lepromatous leprosy since histological involvement was present even when the CT scan was apparently normal.

Female↗

Surgical management of bilateral immobile vocal folds and long-term follow-up.

Sixty-one cases of bilateral immobile vocal folds were classified as traumatic (52.46 per cent), idiopathic (39.34 per cent) or iatrogenic (8.20 per cent). During follow-up the idiopathic group of patients had a better prognosis (p < 0.05) compared to the traumatic or iatrogenic group. A spontaneous recovery was seen in 58.33 per cent of cases in the idiopathic group, 56.25 per cent in the traumatic group and 40.0 per cent in the iatrogenic group within a period of one year. Patients who failed to show spontaneous recovery were either subjected to arytenoidectomy with fold lateralization, endoscopic fold lateralization or laser cordectomy, showing 70.0 per cent, 66.67 per cent and 80.0 per cent recovery respectively. These cases have been discussed.

Adolescent↗

Laryngeal malakoplakia.

We report a case of malakoplakia of the epiglottis in a 45-year-old female patient. Only three cases of laryngeal malakoplakia have been reported in the world literature, one of which was associated with tracheal malakoplakia. To our knowledge this is the first reported case of isolated malakoplakia of the epiglottis. Malakoplakia, a rare granulomatous lesion, has been seen more frequently in the urinary tract. Other organs like the genito-urinary tract, testis, epididymis, lymph nodes, middle ear, nasopharynx, tonsil and retroperitoneal tissue have been also involved though less frequently.

Epiglottis↗

Modified laryngotracheoplasty for surgical management of chronic laryngotracheal stenosis in adults.

A new surgical technique of laryngotracheoplasty with posterior cricoid splitting and grafting with thyroid cartilage and long-term stenting was exclusively used in 10 patients presenting with laryngotracheal stenosis. The initial results have been found to be extremely satisfactory. The surgical method consists of meticulous handling of granulation tissue, minimum excision of scar tissue and reconstruction of laryngotracheal mucosa and posterior cricoid split with thyroid cartilage grafting followed by insertion of a silicone stent in a swiss roll fashion. The operative wound at the end is closed in such a fashion that no tissue layers are approximated between stent and skin. The clinical picture and etiologic aspects of laryngotracheal stenosis are being reviewed.

Adolescent↗