Critical Evaluation Of Complications Of Neck Dissection

BACKGROUND: Radical neck dissection is a reliable method of treating patients with head and neck cancer; it carries substantial morbidity and complications. This surgery has become a routine in many oncological centres but knowledge of possible complications and their management is a must for treating surgeons METHODS: In this study 60 patients undergoing neck dissection as elective or therapeutic, comprehensive or selective, as a sole procedure or combined with other surgery, with or without other modalities of treatment were selected and managed and all the complications were critically analysed. RESULTS: A total of 26 complications (43.3%) occurred in this study. There were 7 cases of thoracic duct injury (11.6%), 5 cases of post operative chyle leak (8.3%) and 2 cases of RLN injury (3.3%) and 1 case of injury to main trunk of facial nerve (1.6%), 2 patients had temporary paresis of marginal mandibular nerve (3.3%). Post operatively marginal necrosis of skin flap was present in 8 patients (13.3%) and 1 patient had facial and glottic oedema (1.6%). CONCLUSION: Despite the best planning, complications can still occur but their impact can be minimised by a vigilant and proactive emphasis in the entire peri-operative period.

Disseminated blastomycosis in a child with a brief review of the Indian literature.

Disseminated blastomycosis is rare in India, particularly in the pediatric population. We discuss the clinical picture, progress and outcome of disseminated blastomycosis in a 4-year-old child. We also present a brief review of the literature focussing on the scenario of blastomycosis in India.

Large congenital melanocytic nevus with metastatic melanoma with a probable primary in the lung.

Large congenital melanocytic nevi (>20 cm in greatest diameter) are very rare and are seen in approximately 1 in 20,000 newborns. The major risk these patients face is the development of neurocutaneous melanosis or malignant melanoma. We report a rare case of large congenital melanocytic nevus with metastatic melanoma in a 40-year-old woman. In this case, though the primary was not established with certainty, on the basis of clinical course and radiological evaluation of various organs, we presume that the primary could be in the lung.

Sturge - Weber syndrome.

Sturge - Weber syndrome (SWS) is a rare disorder that occur with a frequency of approximately 1 per 50,0001. It isa neurocutaneous syndrome, characterized by a facial vascular birthmark and neurological abnormalities. The hallmark is intracranial vascular angioma, most often involving the occipital and posterior parietal lobes, but it can also affect the other cortical regions. An ipsilateral facial cutaneous vascular malformation (port wine nevus)usually affects the upper face. Other clinical findings associated with SWS are seizures, glaucoma, hemiparesis,mental retardation and delayed developmental milestones. This article reports a case of 8 years old boy who presented with weakness of right half of body since birth, mental retardation and delayed developmental milestones.Clinical examination revealed deep purple nevus on left lower face, and less power of left upper & lower limbs.X-ray skull showed calcification. C.T. Scan of brain revealed curvilinear calcification with focal atrophy.

Smoking women and their lung function tests.

Smoking amongst women has become significant as the number of smoking women is increasing gradually in this developing society. It affects the lungs to produce Chronic Obstructive Pulmonary Disease (COPD). Present study was conducted over 100 smoker's women and 100 non-smoker women in the age group of 30-40 Years. Three Lung Function Tests--FEVI, FVC and PEFR were employed to all smoking and non-smoking women. It was observed that all the above mentioned three parameters of lung function tests were reduced significantly among smoker women as compared to non-smoker women. These reduced parameters of lung function test among heavy smokers are suggestive of chronic obstructive lung diseases.

Post-mortem ocular changes: a study on autopsy cases in Bharatpur Hospital.

Post mortem eye changes are important evidences to assess post mortem interval. Present study was conducted at Bharatpur Hospital, Bharatpur over 150 autopsy cases during year 1999-2000. In 140 autopsy cases usual post mortem eye findings were observed, e.g. dull cornea, dilated and fixed pupil and soft eye. Fundus findings like cattle-truck appearance could be observed in 10 cases.

A study of correlation between vitreous potassium level and post mortem interval.

Present study was undertaken to study the correlation of potassium level of vitreous humor with time since death. Vitreous was collected from 150 medicolegal autopsy cases between August 2000 to March 2001 in Bharatpur Hospital, Bharatpur, Chitwan, Nepal. There was a linear increase in vitreous potassium level with rise of postmortem interval. This indicates that rise in potassium levels after death has a strong correlation with the PMI.

Road traffic accident (RTA) as major killer: a report on medico-legal autopsies in Bharatpur hospital.

Road traffic accidents are the major cause of medico-legal deaths. In present study out of 229 autopsy cases in one year, 110 deaths were due to road traffic accident (R.T.A.) which shows the magnitude of the problem in Chitwan and adjacent districts in Nepal.