Management of parapharyngeal space tumours

To determine the role of clinical features, fine needle aspiration cytology [FNAC] and computed tomography [CT] scan in diagnosing parapharyngeal space [PPS] tumors and treatment options. A descriptive study. From July 2000 to July 2002 at Pakistan Institute of Medical Sciences, Islamabad. Patients diagnosed as having PPS tumors were studied. The medical record of patients was reviewed for their age, gender, clinical features, investigations [FNAC and CT scan] and treatment. The mean age, percentage of different clinical features and the sensitivity and specificity of FNAC was determined. The mean age of patients presenting with PPS tumours was 33.6 years. The most common clinical features were neck mass [93%] and bulge in lateral pharyngeal wall [80%]. The CT scan showed exact location and extent of tumour in 11 out of 15 cases. The sensitivity and specificity of FNAC was 70% and 85% respectively. The most common tumours were neurogenic tumours [6] and salivary gland tumours [4]. Surgery was performed in all except 2 patients with lymphoma in whom radiation and chemotherapy was recommended. This study indicates that PPS tumours are usually benign neurogenous and salivary gland tumours presenting with neck mass and bulge in oropharynx. FNAC and CT scan are important in diagnostic work up and treatment planning. Surgery has the best results in most cases

Association of smoking with lymph node metastasis in early stages of squamous cell carcinoma of tongue

To determine the relationship of lymph node metastasis with smoking in T1 and T2 staged squamous cell carcinoma [SCC] of tongue. An analytical study. ENT Department of Pakistan Institute of Medical Sciences, Islamabad, from 1st January 2001 to 31st December 2002. A total of 60 patients of T1 and T2 of SCC of oral tongue were selected. These patients were divided into two groups on the basis of history of smoking. Also these patients were clinically examined for lymph node metastasis and FNAC done for the confirmation of diagnosis. Odds ratio [OR] and p-value were statistically determined to asses the association between lymph node metastasis and smoking. The odds ratio for patients with history of smoking to develop lymph node metastasis was 1.896 but association was statistically insignificant [p = 0.24]. This study indicates that although smoking increases the risk for lymph node metastasis but the association is insignificant in T1 and T2 staged SCC of tongue