Facial Nerve in Parotid Surgery- do Landmarks Differ With Varying Statures?

Aim: To measure the distance of facial nerve from tragal pointer, tympanic plate and digastric muscle, also length of the facial nerve trunk and to establish any variation according to different patient stature. Methodology: Intraoperative measurements were taken using Castroviejo Callipers (20 mm). Height and weight of each was taken and tabulated. Results: The average height was 162 ± 9 cm while the average weight was 58 ± 9 kg. The average length of the extratemporal part of the facial nerve trunk, distance of the facial nerve from the tragal pointer, distance from the outer edge of tympanic plate, distance from the posterior end of the superior border of posterior belly of digastric muscle was 1 ± 0.2 cm, 1 ± 0.1 cm, 0.3 ± 0.2 cm and 0.2 ± 0.1 cm, respectively. Summary: No major difference was found in the landmarks despite varying stature.

Disseminated Histoplasmosis presenting as oropharyngeal mass lesion.

A 62 year old man from Silchar in North East India presented with complaints of painful swallowing, hoarseness, fever, anorexia and weight loss. Oropharyngeal examination revealed reddish ulcero-nodular lesion involving left tonsillar area and base of tongue which was clinically suspicious of malignancy. Radiological examination revealed involvement of bilateral adrenals by a mass. The biopsy of the oropharyngeal lesion showed many fungal spores morphologically favoring Histoplasmosis. Treatment with Amphotericin B followed by Itraconazole resulted recovery of lesions.

Adenoid cystic carcinoma of the upper trachea: a rare neoplasm.

Primary malignant tracheal tumors are not common and adenoid cystic carcinoma (ACC) of trachea is rare. We report an extremely rare case of ACC of proximal trachea, which was diagnosed in a 42-year-old male who presents with 6-month history of dyspnea. Lateral skiagram of neck, computed tomography, and magnetic resonance imaging revealed a broad-based polypoidal soft tissue mass arising from posterior wall of the proximal trachea. Biopsy confirmed the diagnosis of ACC. The patient was treated by surgical resection followed by radiotherapy and is on regular follow-up. Follow-up at 18 months post-treatment showed no local recurrence or distant metastases. The literature on tracheal ACC is reviewed. Image findings are briefly discussed.