Oral and oropharyngeal squamous cell carcinoma in our population: the clinic-pathological and morphological description of 153 cases / Carcinoma de células escamosas oral y orofaríngeo en nuestra población: descripción clínico-patológica y morfológica de 153 casos

Oral cavity and oropharynx are one of the commonest sites for cancers in our population due to a high prevalence of tobacco use, especially chewing, in our country. The objective of this study was to prospectively assess the clinico-pathological and morphological aspects of the patients presenting to us with these malignancies. We studied 153 patients with oral and oropharyngeal squamous cell carcinoma who were managed in the department of otolaryngology and head and neck surgery between January 2006 and December 2007 at Maulana Azad Medical College and associated hospitals in New Delhi. There were 127 male patients (83 percent) and 26 females (17 percent) with ages ranging from 22 years to 70 years. One hundred and eleven patients (73 percent) presented with oral cavity and 42 patients (27 percent) with oropharyngeal carcinomas. Most common site of presentation in the oral cavity was the buccal mucosa, whereas, base of tongue was the commonest site in the oropharynx. Amongst the oral cavity cancers, 51 each (46 percent each) were well differentiated and moderately differentiated, whereas, 9 (8 percent) were poorly differentiated cancers. However, amongst the oropharyngeal cancers, 27 (64 percent) were moderately differentiated and 15 (36 percent) were poorly differentiated. Overall, 73 patients presented with lymphadenopathy on presentation, out of which, 44 patients were those with oral cavity and 29 with oropharyngeal cancers. There was a significant correlation between the site (i.e. oral cavity or orophaynx) and lymphadenopathy on presentation. Fifty nine patients (39 percent) presented to us with early stage disease (i.e. stage I and II), whereas, 94 patients (61 percent) presented with late stage disease (i.e. stage III and IV). There was a significant correlation between the site (i.e. oral cavity or oropharynx) and stage at presentation.

En nuestro país, la cavidad oral y orofaringe son los sitios más comunmente afectados por cáncer, debido a la alta prevalencia del consumo de tabaco, especialmente, el tabaco de mascar. El objetivo de este estudio fue evaluar prospectivamente los aspectos clínico-patológicos y morfológicos de los pacientes que acuden con estas malignidades. Se estudiaron 153 pacientes con carcinoma de células escamosas de la cavidad oral y orofaringe que fueron tratados en el Servicio de Otorrinolaringología y Cirugía de Cabeza y Cuello entre enero del 2006 y diciembre del 2007 en Maulana Azad Medical College y hospitales asociados en Nueva Delhi. Se evaluaron pacientes de ambos sexos, 127 hombres (83 por ciento) y 26 mujeres (17 por ciento) con edades entre 22 a 70 años. Ciento once pacientes (73 por ciento) presentaron carcinoma de la cavidad oral y 42 (27 por ciento) carcinomas de la orofaringe. El sitio más común de presentación en la cavidad oral fue la mucosa bucal, mientras que la base de la lengua fue el sitio más común de la orofaringe. Entre los cánceres de la cavidad oral, 51 (46 por ciento cada uno) estaban bien diferenciados y moderadamente diferenciados, mientras que 9 (8 por ciento) fueron escazamente diferenciado. Sin embargo, entre los cánceres de la orofaringe, 27 (64 por ciento) fueron moderadamente diferenciados y 15 (36 por ciento) fueron pobremente diferenciados. En total, 73 pacientes se presentaron con adenopatías, de los cuales, 44 pacientes fueron en la cavidad oral y 29 en la orofaringe. Se observó una correlación significativa entre el sitio (es decir, la cavidad oral u orofaringe) y la presentación de adenopatías. Cincuenta y nueve pacientes (39 por ciento) se presentaron con enfermedad en estadio temprano (estadios I y II), mientras que 94 pacientes (61 por ciento) se presentaron con enfermedad en estadio tardío (etapas III y IV). Se observó una correlación significativa entre el sitio (cavidad oral u orofaringe) y la etapa en la presentación.

Clear cell myoepithelioma of the hard palate

Salivary gland myoepitheliomas are rare tumours. We report the case of a 40-year-old female who presented to us with a hard palatal mass. The tumour was excised with a healthy rim of surrounding tissue. Histological and immunohistochemical analyses revealed the tumour to be a myoepithelioma of the clear cell variety.

Pneumatization of Mastoid Air Cells: Role of Acquired Factors / Neumatización de las Células Mastoideas: Rol de Factores Adquiridos

The exact mechanism of the pneumatization of the mastoid air cell system and the factors influencing the pneumatization are poorly understood. Both genetic as well as acquired factors have been implicated to influence this pneumatization process. Since pneumatization of the mastoid air cell system is considered an important prognostic factor in the outcome of reconstructive ear surgeries, a cohort study was carried out to assess the role of two important acquired factors i.e. duration of chronic otitis media and auditory tube functional status on the pneumatization of mastoid air cells. 50 individuals with unilateral chronic otitis media underwent assessment of their mastoid air cell system using planimetry and auditory tube functions using flourescein dye nasopharyngoscopy. The results were in accordance with the previous studies indicating a definite influence of chronic middle ear disease on the pneumatization process, although the duration of disease was not significant. In contrast to some of the previous studies, no influence of auditory tube functional status was found on the mastoid pneumatization.

El mecanismo exacto de la neumatización del sistema de células mastoideas y los factores que influencian este proceso es pobremente comprendido. Factores genéticos, como también adquiridos, han sido implicados en el proceso de neumatización del sistema de células mastoideas. Esta neumatización es considerada un factor de importante pronóstico en la conducción de las cirugías reconstructivas de oído. Hemos llevado a cabo un estudio para explicar el rol de dos importantes factores adquiridos en la duración de las otitis media crónica y el status funcional de la tuba auditiva en la neumatización de las células mastoideas. En 50 individuos, con otitis media crónica unilateral, se estudió su sistema de células aeríferas mastoideas usando la planimetría y las funciones de la tuba auditiva usando fluorescina, vía nasofaringoscopía. Los resultados concuerdan con estudios previos, indicando una influencia definida de enfermedades crónicas del oído medio en el proceso de neumatización, aunque la duración de la enfermedad no fue significativa. En contraste con los estudios previos, no se encontró influencia del status funcional de la tuba auditiva en la neumatización mastoidea.

An unusual cause of recurrent cheek abscess: a clinical case

We report the case of a 16-year-old female who presented to us with a recurrent cheek abscess following a blow to the cheek. On drainage of the abscess, a piece of betel nut was retrieved from the cheek. The patient recalled having a betel nut in her mouth at the time of the blow.

Extensive gas-forming infection of the deep neck and laryngeal spaces

We report the case of a 46-year-old diabetic male who presented to us with swelling in the neck associated with dysphagia and respiratory discomfort following dental infection. The CT-scan and soft tissue neck radiograms of the patient revealed an extensive head and neck abscess with gas pockets. Prompt surgical intervention with ntibiotic coverage and control of diabetes led to recovery of the patient. The absence in the literature of any previous report of a laryngeal gasforming abscess resulting from a primary dental infection prompted us to report this case

Extensive gas-forming infection of the deep neck and laryngeal spaces%Infecção formada por gás extenso na profundidade do pescoço e espaços laríngeos

We report the case of a 46-year-old diabetic male who presented to us with swelling in the neck associated with dysphagia and respiratory discomfort following dental infection. The CT-scan and soft tissue neck radiograms of the patient revealed an extensive head and neck abscess with gas pockets. Prompt surgical intervention with ntibiotic coverage and control of diabetes led to recovery of the patient. The absence in the literature of any previous report of a laryngeal gasforming abscess resulting from a primary dental infection prompted us to report this case

Tubercular pansinusitis presenting as a nasal polyp.

Tuberculosis of the paranasal sinuses is an uncommon presentation. We present a case of a 16 year old female who presented with a polypoidal nasal mass and symptoms consistent with chronic sinusitis. The computerized tomography scan of the paranasal sinuses was consistent with pansinusitis and sinonasal polyp. The polyp was excised and the histopathological evaluation of the surgically removed tissue revealed it to be tuberculous. The patient responded to four drug anti-tuberculous treatment.

Solitary tuberculous ulceration of Pinna: A rare presentation.

Tuberculosis of pinna is a rare presentation. We present a case of a 25 year-old woman who presented with a chronic, non-healing ulceration of pinna. On histopathological evaluation of the incisional biopsy from the lesion, she was found to have tuberculosis of pinna. She responded to 4-drug anti-tubercular treatment. To our knowledge, there has been no previous report of any similar case in the past.

Study of Sphenoid Sinus Anatomy in Relation to Endoscopic Surgery / Estudio Anatómico del Seno Esfenoidal en Relación con la Cirugía Endoscópica

For radical surgery of the past, the precise definition of the clefts of the paranasal sinuses was of limited significance. In the recent years, the transsphenoidal approach to the pituitary gland has come into practice and the study of the surgical anatomy and relationships of the sphenoid sinus has gained increased significance. To better define this anatomy, 20 sphenoid sinuses in cadavers were dissected to reveal important anatomical relationships, dimensions, volume and pneumatization of the sphenoid sinus. The results of the study are discussed with particular reference to the important surgical anatomical features of the sphenoid sinus. The results also point towards the possibility of racial variations in terms of relationships of the sphenoid sinus to internal carotid artery and optic nerve in the Indian population.

En las cirugías radicales del pasado, la definición precisa de las hendiduras de los senos paranasales fueron de importancia limitada. En los últimos años, el abordaje transesfenoidal de la hipófisis y las relaciones del seno esfenoidal han tenido en la práctica y en el estudio de la anatomía quirúrgica, un significativo incremento. Para definir mejor esta anatomía, 20 senos esfenoidales fueron disecados en cadáveres para revelar importantes relaciones anatómicas, dimensiones, volumen y neumatización del seno esfenoidal. Los resultados de este estudio son discutidos con referencia particular para la anatomía quirúrgica del seno esfenoidal. Los resultados también apuntan hacia la posibilidad de variaciones raciales, en términos de relaciones del seno esfenoidal con la arteria carótida interna y el nervio óptico, en la población de la India.