ABSTRACT
Introduction: Rhinosporidiosis is an enigmatic disease with many unsolved queries right from taxonomy to treatment. This study has been done to understand the disease characteristics with a peek into the lesser known immunological aspects of it by studying the changes in levels of certain primarily cell-mediated immunity (CMI)-specific cytokines in rhinosporidiosis patients. Materials and Methods: A prospective observational study was performed. Detailed epidemiological and clinicoradiological assessment was done along with selected inflammatory and immunological markers. The tests for immunological parameters were done by ELISA and CLIA and data were compiled and analyzed using appropriate statistics. Results: Disease showed male predominance and all patients gave a universal pond bathing history. Majority patients had O+ve blood group. Right side was affected most with nasal obstruction being commonest symptom. Nasal cavity was involved in majority of cases with inferior turbinate and meatus being sites of maximum occurrence and attachment. Nasopharynx, oropharynx were other involved sites. Extra-nasal sites included skin and parotid gland. Endoscopic and CECT findings were similar and confirmed intraoperatively. Tests for inflammatory markers showed no significant change in patients. Immunological markers -IL-6, TNF-beta- levels showed significant increase though no such increase was found with IFN-gamma levels. Conclusion: Rhinosporidiosis has a definite epidemiological and clinical-radiological profile. A clear association with exposure to contaminated water is present which could not be further associated with disease duration or recurrence. The immunological profile needs to be further investigated upon since it remains quite elusive.
ABSTRACT
Background: The purpose of this retrospective study is to evaluate the outcome of Montgomery T-tube insertion in our institution (AIIMS, Raipur). This study also throws light on its indications and complications. Methods: This is a retrospective study of 10 patients who presented with laryngotracheal stenosis and managed by Laryngofissure with Montgomery Tube insertion in the Department of Otorhinolaryngology, Head and Neck Surgery atAll India Institute of Medical Sciences (AIIMS) Raipur, India, during the period of January 2018- JUNE 2020. Results: The most common cause of laryngotracheal stenosis was prolonged intubation as seen in 80% patients.Majority of patients (40%) in this study were in the 3rd decade. In this study all the patients underwent tracheostomy prior to treatment for stenosis. The most common complication seen was surgical emphysema in post-operative period seen in 6 patients (60%) followed by crusting in 4 patients (40%), secondary granulation tissue formation in 4 patients (40%). Montgomery tube reinsertion had to be done in 2 patients (20%). Conclusions: Laryngotracheal stenosis (LTS) has always been and will remain a challenge to the otolaryngologistsand a multidisciplinary approach is required to tackle it.A multitude of surgeries have been described for the management of Laryngotracheal stenosis ranging from Endoscopic dilatation and cricotracheal resection with anterior and posterior grafting and anastomosis but many of them require specialized training and expertise,prolonged ICU care and have morbidity and mortality. 'Laryngofissure and Montgomery Tube stenting provides a safe and easy treatment option which can be done at most centres provided appropriate case selection has been done.
