ABSTRACT
Introduction: Thyroglossal duct cysts are a common congenital anomaly in the neck which usually present in adulthood as a midline neck swelling the location of which can vary from lingual, suprahyoid, infrahyoid and suprasternal. Case Report: Here we have described the case of a thirty-year-old male who presented with a history of recent onset dysphonia and an unnoticed neck swelling. Clinical examination revealed a midline 2 x 2 cm cystic lesion in the neck. On further evaluation using laryngoscopy and computed tomography the patient was found to have a smooth mucosa-covered cyst in the subglottic location. Surgical excision of the cyst was done via laryngofissure and the postoperative course was uneventful. The postoperative biopsy revealed a subglottic thyroglossal cyst. Conclusions: Though there have been reports of intralaryngeal extension of thyroglossal duct cysts, the subglottic location is extremely rare. Through this case report, we would like to highlight the atypical presentation of thyroglossal duct cysts and how an innocuous pathology can turn potentially life-threatening. We would also recommend avoiding a fine needle aspiration cytology in such cases due to the critical location.
ABSTRACT
Purpose: Telemedicine-enabled, portable digital slit lamps can help to decentralize screening to close-to-patient contexts. We report a novel design for a portable, digital slit lamp using a smartphone. It works on an advanced optical design and has the capability of instantaneous, objective photodocumentation to capture anterior segment images and is telemedicine-enabled. Methods: The device is constructed keeping its usability and the importance of design ergonomics for nonspecialized field personnel in mind. The optical design is described, and the resolution and magnification are compared with traditional desktop-based slit lamps. A Health Insurance Portability and Accountability Act (HIPAA)-compliant, patient management software is integrated to synchronize the captured images with a secure cloud server along with a sharpness algorithm to extract the best focused frames of the cornea, iris, and lens, from videos. We demonstrate its photodocumentation ability and teleophthalmology feasibility by capturing images in a pilot study from nine subjects. Results: Images were obtained in various illumination, magnification, and filter settings. Synchronous and asynchronous teleophthalmology consults were conducted. The performance of the device was shown to be limited by the smartphone sensor resolution and not the optical design, because the Air Force target resolution was found to be the same on smartphone-mounted traditional slit lamps despite a lower magnification. Conclusions: The novel, portable, digital slit lamp with advanced optical design using smartphones has the ability to screen for anterior segment pathologies using telemedicine. Translational Relevance: A portable, telemedicine-friendly, ergonomically designed, slit lamp used by nonspecialist personnel allows for both synchronous and asynchronous modes of consultation at remote locations, facilitating mass screening programs.
Subject(s)
Ophthalmology , Telemedicine , Humans , Mass Screening , Photography , Pilot Projects , Slit Lamp , Smartphone , United StatesABSTRACT
The aim of this study is to assess the incidence of post traumatic BPPV and evaluate its treatment outcomes in mild and moderate traumatic head injury patients. The study population consisted of 128 patients (89 male:39 female) who were admitted with head and neck injury (Motor Vehicle Accident, Blow to the head, Fall from Height, Whiplash injury) as inpatients in Department of Neurosurgery in Tertiary care hospital in Kerala during a 2 month period from 1st April 2014 to 31st May 2014. The age range was 10-70 years and mean 39.8 with standard deviation 15.5. All cases were evaluated and serially followed up to a period of 6 months in Department of Otorhinolaryngology. In our study, the number of patients with mild injuries (Glasgow coma scale 13-15) were 108 and moderate injury (Glasgow coma scale 9-12) were 20. We found out that post traumatic BPPV was found to be 17% of the traumatic brain injury patients. All patients were treated with particle re-positioning maneuvers and were followed up for a period of 6 months. Recurrence were reported in 9 (40.9%) patients. In these patients re positioning maneuvers were repeated.
