Laterality of pleomorphic adenoma of parotid gland

Although pleomorphic adenoma is the commonest benign tumor of both major and minor salivary glands, yet it bears certain peculiar characters like invariable growth rate, short spells of spurts of growth, long quiescent periods, invasion of surrounding tissues by its capsular projections, recurrence, notorious for implantation and classic origin from the tail of parotid gland. Since the nerve of facial expression [facial nerve] falls within the domain of otolaryngologists but its course along with its variable branches through the parotid gland has always remained an area of common interest between general and ENT surgeons. With the more and more involvement of E.N.T. surgeons in head and neck oncology, the cancer of salivary glands looks to be being taken over by them in recent decades. FNAC inspite of its accuracy is loosing its superiority over modern ultrasonography. This is an observational study. This study was carried out in Combined Military Hospital Lahore from Feb 2005 to Feb 2008. A total of 28 patients with unilateral mass of parotid gland, all with FNAC [Fine needle aspiration cytology] positive for pleomorphic adenoma were included in the study without any discrimination of age, sex or size of tumor. Each patient underwent CT scan and surgical modality of treatment was selected for every patient with post-operative histopathology study to confirm or otherwise of FNAC diagnosis. Female male ratio was 3:4, mean age in males was 44, in females was 37. Histopathology-disproved FNAC in 7.14%. Ratio between involvement of superficial lobe and both lobes was 13:1. Post-operative transient facial nerve paresis was seen in 12 out of 28 patients and there was surprising laterality of right parotid involvement, ratio between right and left parotid being 11:3. Smallest tumor at presentation was 3x3 centimeter and largest was 14x10 centimeter in size. Markedly more incidence of pleomorphic adenoma on right side of face is observed. It has not been reported previously. Zero percent facial nerve severance in 28 parotidectomies reflects vigilance and surgical skill of today's otorhinolaryngologists

Frequency of chronic suppurative otitis media in the junior ranks of Pakistan Army

The purpose of this study were to find out the frequency of chronic suppurative otitis media [CSOM] in the junior ranks of army, and to find out the number of such patients serving in low medical category due to CSOM. It was a simple multi-centre descriptive study. This study was conducted in ENT department of Combined Military Hospital Lahore from March 2003 to August 2003. Feedback was also taken from CMH Abbottabad and HIT Hospital Wah during this period. A total of 5000 junior ranks were examined for CSOM. Out of these 56 [1.12%] were suffering from inactive mucosal disease. Seventy nine [1.58%] had active mucosal disease. Attico antral disease was present in 33 [0.66%] subjects and out of these 8 [0.16%] subjects had undergone mastoid exploration in the past. Ninety [1.8%] cases were serving in low medical category due to CSOM. The frequency of CSOM is significantly high in the army [03.36%], considering that all inductions are made after initial medical examination. By observing few precautions the frequency may be reduced, thus decreasing the financial drain on national exchequer