Rhabdomyosarcoma of head and neck--an analysis of 24 cases.

Clinical records of 24 cases or rhabdomyosarcoma involving head and neck region were studied. Majority of the patients (83.3%) were under five years of age. The common sites of involvement were the middle ear (50%) and the nasopharynx (17%). Embryonal variety was noted in majority of patients (83.3%). Pain and swelling in the post aural or pre-auricular region was the commonest mode of presentation. Last four cranial nerves were involved in eight patients and four patients had extension of the tumor in the posterior cranial fossa. Twenty patients having embryonal rhabdomyosarcoma received combination of chemotherapy and radiotherapy. Half of these remained tumor free upto six months. Surgical extirpation was done only in two patients, where the disease was localised. The tumor in these two patients was of pleomorphic variety and did not recur till two years after surgery.

Electrical response audiometry (ERA) in infants.

The electric response audiometry is a useful diagnostic technique for identifying hearing loss in infants. Among the various electrical responses, the BSER enables us to arrive at an accurate early clinical diagnosis of hearing loss in infants so that effective auditory input, which is the prime requisite for the conceptual foundation for the growth of communication, can be provided through appropriate intervention programmes. The electric response audiometry provides information regarding the physiologic state of the peripheral organs and auditory pathways but however, cannot ascertain whether the infant can hear, in terms of perceiving auditory information. Inspite of this major limitation, the growing acceptance of brainstem electrical potentials in clinics and laboratories throughout the world attests to their increasing importance especially in the assessment of hearing sensitivity of infants.

Effect of instant preparation of betel nut (pan masala) on the oral mucosa of albino rats.

Paste made out of an instant betel nut preparation was painted into the oral cavity of 21 albino rats on alternate days for a period of six months. Biopsies were taken from the oral mucosa at the beginning of the study and every two months there after and compared histopathologically with those obtained from a control group of 14 albino rats. Mild to moderate loss of nuclear polarity and increase in keratoses, parakeratoses, inflammatory cell infiltration and vascularity were noted when compared to the control group. The increase in mitotic figures was statistically insignificant and no definite changes in pigmentation or atypical cells were seen. These findings suggest the possibility of mild leukoplakia. Submucosal collagen increased steeply and steadily throughout the study period and at the end of six months, 88.23 per cent of biopsies showed thickened and condensed sub-mucosal collagen, indicating submucous fibrosis.

Post laryngectomy complications and their mode of management--an analysis of 203 cases.

Two hundred and three laryngectomized patients have been evaluated for the possible causes of post operative complications. 58 out of 203 patients (28.5%) developed pharyngocutaneous fistula. Wound infection was present in 57 cases (28%). Two patients had flap necrosis and 12 patients developed dysphagia after surgery due to pharyngeal stenosis. The possible causes attributed to high occurrence of pharyngocutaneous fistula are, advanced nature of disease, preoperative radio therapy and wound sepsis. Prior to 1980, the incidence of pharyngocutaneous fistula in our series (Arora et al. 1983) was 41.6 percent. But it decreased to 13.7 percent between January 1981 to June 1987. The important factors which led to the decreased incidence of pharyngocutaneous fistula were thought to be the change of suture material for pharyngeal repair from chromic catgut to Vicryl, use of vacuum suction as a replacement of corrugated rubber drain and aseptic syringe drainage and postoperative coverage with broad spectrum antibiotics.

Brain stem evoked response audiometry in neonates.

Brain stem evoked response audiometry (BERA) was performed in 50 normal full term newborn infants (25 male, 25 female) to generate normative data base for this age group. The stimuli of 30 dB, 40 dB and 80 dB nHL (normal hearing level) intensities were delivered to each subjects. 30 dB stimulus failed to produce clear wave patterns, whereas upto six vertex positive waves were recognised among which waves I, III and V were commonly present. The absolute latencies of waves I and V at 40 dB nJL were 2.54 +/- 0.21 msec and 7.56 +/- 0.26 msec and at 80 dB nHL these were 2.06 +/- 0.15 msec and 7.09 +/- 0.17 msec respectively. I-V interpeak latencies (IPL) were 5.02 +/- 0.13 msec at 40 dB and 5.03 +/- 0.13 at 80 dB nHL. The latencies of waves I and V were decreased with the increase of intensity of stimuli with the rate of 0.012 msec/dB, bit I-V IPL, i.e., central conduction time remained almost constant. There were no statistically significant differences in the brain stem auditory evoked responses between male and female subjects. Brain stem evoked response audiometry is objective and reliable for hearing screening in neonates.

Eighth nerve evaluation in leprosy.

25 cases of bacillary positive leprosy patients and 25 age and sex matched controls were investigated for assessment of cochleo-vestibular status. Impaired hearing was complained of by 4 patients. None had tinnitus, dizziness or vertigo. On testing 44% patients were found to have unilateral or bilateral perceptive deafness. Specialised tests of hearing indicated that the deafness was of cochlear type. The vestibular functions were not affected. Leprosy seems to selectively involve the cochlea.