Mondini dysplasia and pyogenic meningitis.

Mondini dysplasia with cerebrospinal fluid leak is a rare cause of recurrent pyogenic meningitis in children. We describe an eleven-year-old female child who presented with the fifth recurrent episode of pyogenic meningitis and unilateral sensorineural deafness. Mondini dysplasia of the inner ear with CSF-perilymph fistula was proven on an HRCT of the temporal bone and MRI. Successful operative intervention was undertaken to close the defect. Though rare, Mondini dysplasia should be considered as a cause of recurrent meningitis in children, especially if they have sensorineural deafness.

Pre and post betahistine therapy 99m Tc - HMPAO brain spect studies in patients with vertigo.

Vertebro basilar insufficiency (VBI) is a well known cause of vertigo. Brain Single Photon Emission Computed Tomography (SPECT) is an important diagnostic tool to detect and to quantitate the perfusion abnormalities in different areas of the brain. Effect of an antivertigo drug Betahistine on improving the hypoperfusion in different areas of the brain in vertigo patients was studied using brain SPECT. Betahistine at a dose of 16 mg three times daily was shown to improve perfusion in the hypoperfused areas of the brain resulting in relief from symptoms of vertigo. The cerebellar region, which is the most important area involved in vertigo patients with vascular pathology, showed almost complete normalisation of perfusion following Betahistine therapy.

Persistent frontal fistula.

The frontal sinus is prone to various complications--usually secondary to blockage of the fronto-nasal duct and stagnation of frontal sinus secretions. These pent-up secretions may result in pressure necrosis of the inferior or posterior sinus wall. Involvement of anterior wall is uncommon. We present a case of an anterior wall frontal sinus fistula and discuss its management.

Nasolacrimal duct foreign body--endoscopic removal.

Foreign body in the nasolacrimal duct is extremely rare. We present a case of foreign body of nasolacrimal duct responsible for recurrent dacryocystitis which was removed with the help of an endoscope.

Clival chordoma in an infant.

An unusual case of clival chordoma seen in a 7 month 16 day old infant is presented. The literature on this subject, clinical course of such tumours and the management strategy in paediatric age group is reviewed.

Sebaceous adenoma in the region of the medial canthus causing proptosis.

A case of sebaceous adenoma in the region of the medial canthus causing proptosis is presented along with a review of the medical literature. The clinicopathological aspects of the tumour are discussed. The mode of treatment was surgical excision. A six month follow-up showed a reduction in the proptosis with no recurrence.

Allergic fungal sinusitis: incidence and clinical and pathological features of seven cases.

Allergic fungal sinusitis, like allergic bronchopulmonary fungal disease, is a noninvasive inflammatory process. It manifests as recurrent nasal polyposis. Histologically the characteristic feature is the presence of thick mucin with dense collections of degenerating eosinophils and Charcot-Leyden crystals (allergic mucin). Demonstration of fungal hyphae in allergic mucin is diagnostic of the disease. We reviewed 85 cases of nasal polyposis operated upon during a period of four years. Allergic fungal sinusitis was diagnosed in seven (8.2%) cases on the basis of presence of allergic mucin and fungal hyphae. History of previous nasal polypectomy was present in four of the seven cases, and in six of the remaining 78. There were no clinical or radiological features that could distinguish the cases of allergic fungal sinusitis from the rest. Aspergillus fumigatus, Mucor and Cladosporium were cultured from one case each.

Orbital cysticercosis.

Orbital cysticercosis is a rare condition. We report here 3 cases with orbital cysticercosis who presented with proptosis and ptosis (Case no. 1 and 2) and focal seizures (Case no. 3). All of them had a vision of 6/6. Diagnosis of cysticercosis was made on CT Scan. The lesions isolated in Cases 1 and 2 and were excised. Drug therapy was given to treat any persisting infestation. Case no 3 had multiple brain cysticerci in addition to the orbital one. However, the patient was lost to follow-up.

Functional endoscopic sinus surgery--II (A preliminary study).

Seventy-eight patients of chronic sinusitis were subjected to functional endoscopic sinus surgery by the technique described in the previous paper. The clinical features, findings at surgery and the results of this technique are described here.

Functional endoscopic sinus surgery--I (Anatomy, diagnosis, evaluation and technique).

It has been proved beyond doubt that the causation and perpetuation of disease in the dependent sinuses (maxillary and frontal sinuses) is secondary to disease of the ostiomeatal complex, the primary focus of which is the anterior ethmoid. Based on this concept, functional endoscopic sinus surgery (FESS) aims at correcting the underlying pathology in the ethmoids and helps to re-establish normal ventilation and mucociliary clearance of the dependent sinuses.

Surgical management of CSF otorrhoea (a case report).

Four cases of CSF otorrhoea following surgery are presented. The etiopathology and its surgical management are discussed.