To Identify the Dangerous Length of External Laryngeal Nerve In Relation to Thyroid Pole In Cadaveric Thyroid Glands

Introduction: The external laryngeal nerve passes through the “space of Reeve” cricothyroid space. It has also been described as lying in the Joll’s triangle. It is often inadvertently neglected during thyroid surgeries. It has been named after a singer who lost her voice after a thyroid surgery, as the “nerve of Galli Curci” Aim: To identify the dangerous length of the external laryngeal nerve in relation to the thyroid pole. Material and Methods: Fifty laryngeal nerves were dissected using conventional method of dissection, in twentyfive embalmed cadavers used for teaching purpose at Karpaga Vinayaga Institute of Medical Sciences and Research, Madurantakam. The observations were noted and photographs taken. The course and relations were carefully noted. Results: 38 specimens (76%) had the superior laryngeal nerve measuring 4cm. in 8 specimens (16%) it was 3.5 cm and in 04 specimens (8%) it measured 3.8 cm. It was observed that the external laryngeal nerve crossed the superior thyroid pole at less than 1cm only in three (6%) of the fifty nerves. Conclusions: The critical length of the nerve would be dangerous if the nerve crosses the superior thyroid pedicle close to thyroid pole at less than 1 cm. The consequences of neglecting the critical length would injure the nerve and cause dysphonia or raspy voice.

Extradural with intramural-extramedullary and intramedullary tuberculoma of the spine without bony involvement

Extradural with intradural-extramedullay and intramedullary spinal tuberculomas causeing spinal cord compression is an uncommon entity. We report a case of a 20-year-old female patient who was undergoing treatment for intracranial tuberculous infection with triple chemotherapy antituberculous regimen. One month later she presented to us with progressive paraparesis and MRI scan showed a dorsal intradural-extramedullary lesion. She underwent laminectomy and excision of the lesion. She was readmitted 2 weeks later with flaccid paraplegia, and MRI scan showed an intramedullary lesion extending from D3 -D7 level. This case is unusual in regard to the concurrent extradural with intradural-extramedullay and intramedullary with intracranial tuberculomas. Also interesting is the absence of bony involvement

Surgery for ossification of the posterior longitudinal ligament of the cervical spine.

The authors present their surgical experience with fifty seven cases of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine, operated between January 1992 and January 1999. Continuous OPLL was seen in the majority of patients (40/57). Posterior decompressive surgery was performed in 18 patients, a median corpectomy and excision of the OPLL in 28 and anterior segmental decompression in 11 patients. One patient had a transient weakness of muscles supplied by the C5 myotome following a C4-C5 corpectomy. 84.2% of the patients showed improvement by at least one grade at the time of discharge. 92.8% of patients who underwent a corpectomy improved in the immediate post-operative period as compared to 90.9% of those who underwent an anterior segmental decompression and 83.3% of those who underwent a posterior decompressive procedure. 97.7% of the 44 patients followed-up between one and five years showed neurological improvement. Thirty-two patients (72.7 %) had regained normal or near normal neurological function and returned to their jobs. Good results were obtained when the surgical approach and the procedure adopted were individualised.

Stereotactic surgery in India: the past, present and the future.

The achievements of Indian neurosurgeons in different fields of stereotactic surgery over the past decades have been discussed. This covers diverse areas like Parkinson's disease, abnormal movements, cerebral palsy, spasticity, pain relief, and sedative and functional neurosurgery. Recently, technological advances have made stereotactic surgery useful in many fields like deep biopsies, minimally invasive surgery and radiosurgery. Apart from these areas, there is still a big scope for revival of surgery on deep structures of the brain, as was practised earlier. This will lead to newer knowledge about brain function and also give relief to many patients. The future is bright, provided Indian neurosurgeons show a paradigm shift in their thinking and bring out new ideas. Interaction with other scientific disciplines is necessary in the future if new knowledge has to be added or new techniques have to be devised.

Isolation of 75Se binding protein from hepatic tissues of chick embryos.

Distribution study using 75Se shows that maximum accumulation was in liver tissues after 24h of 75Se administration. Induction of selenium binding protein (Se-P) in hepatic tissues of chick embryo was observed. Chick embryo hepatic Se-P was isolated after 24h of 75Se treatment using Sephadex G-75 column chromatography. Fractions of induced protein shows the presence of maximum concentration of 75Se. This induced protein was found to have an approximate molecular weight of 56 KD on molecular sieve. It also showed an absorbance maxima at 254 nm, which indicates the presence of high concentrations of sulphydryl groups.