A Comparative Study of the Treatment of Oral Premalignant Lesions with Surgical Excision and Medical Therapy.

Introduction: Potentially malignant oral epithelial lesions are a group of oral conditions with an altered morphological state of the normal mucosal lining and include different lesions such as leukoplakia, erythroplakia, submucosal fibrosis, and lichen planus. Aim: To compare the outcome of premalignant oral lesions after medical therapy consisting of submucosal intralesional injection of triamcinolone with hyaluronidase and surgical excision. Materials and Methods: This was a comparative prospective interventional study and the study was conducted among 50 patients presented to the Department of Otorhinolaryngology with premalignant oral lesions from the year 2020 to 2022. Patients were divided into two groups by random allocation, group A was treated with medical therapy, and Group B was treated with surgical excision and followed for a minimum of 6 months and the outcome has been categorized. Results: All patients were divided into two groups-group A and group B, group A consisted of 22 (44%) patients who were given medical therapy, and group B consisted of 28 (56%) patients who underwent surgical excision. In group A, the clinical response was seen in 8 (36.36%) and in group B, the clinical response was seen in 18 (64.29%) patients. Conclusion: Surgical excision was found to be better with more cases of clinical response (64.29%) when compared to medical treatment (36.36%) with a p value of 0.0497 which is significant whereas malignant transformation was almost equal in medical therapy and surgical treatment which was 13.64% and 14.28%, respectively.

A Prospective Clinical Study of Bacteriological Profile and their Antibiotic Susceptibilty Profile in Patients with Chronic Rhinosinusitis: The Recent Scenario in Northern India.

Objectives: 1. To determine the prevailing scenario of the bacteriological profile of patients with CRS, 2. To identify their antibiotic susceptibility profile. Material and methods: The study was conducted on 100 patients in the Department of ENT and Microbiology from December 2020-2022. Patients above the age of 12 years were evaluated. Those who received antibiotics in the last 12 months. and age < 12 years were excluded. Patients were subjected to a detailed history, clinical and radiological examination. After the informed consent of patients and ethical cleareance, samples were taken from the middle meatus area and studied for antibiotics sensitivity: levofloxacin, vancomycin, amikacin, amoxicillin-clavulanic acid and azithromycin. Results: The study was male predominance (71%), with the maximum of patients in the age group 21-30 years (38%). The most common clinical features were nasal obstruction ( 96%) and mucopurulent discharge (100%). The most common isolate was Staphylococcus aureus (45.16%). In Gram-positive, the maximum resistance was shown to azithromycin and amoxicillin-clavulanic acid and the maximum sensitivity to vancomycin, levofloxacin and amikacin. Conclusions: Antibiotic resistance seems to be emerging for azithromycin and amoxicillin-clavulanic acid at a higher rate. MRSA ( 19.35%) maintains a significant presence with associated increased levels of antibiotic resistance.

An Unusual Presentation of Angiolymphoid Hyperplasia with Eosinophilia as Postauricular Mass: A case Report.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign, reactive vaso-proliferative condition in the dermal and subcutaneous tissues of the head and neck. A 28-year-old female presented with slow-growing painless swelling behind her left ear. FNAC revealed benign soft tissue neoplasm and histopathological examination after surgical excision revealed angiolymphoid hyperplasia with eosinophilia. ALHE origin has been variously attributed to prior trauma, hyperestrogenemia, infectious agents, atopy, reactive hyperplasia, and benign neoplasia. Retroauricular ALHE has been rarely reported. However, on the basis of our case report, it should be a viable differential diagnosis when large subcutaneous tumors of the head and neck are encountered. When big subcutaneous tumors of the head and neck are present, especially in females, a valid differential diagnosis for angiolymphoid hyperplasia with eosinophilia, a rare condition marked by dermal or subcutaneous endothelial cell proliferation, should also be considered.

Mucoepidermoid Carcinoma of the Parotid Gland Mimicking Pleomorphic Adenoma on Cytology: A Case Report.

Salivary gland tumors most commonly involve the parotid gland. Among all the tumors, 80% are benign and of all the benign tumors 80% originate from the parotid gland. The pleomorphic adenoma is the most common benign tumor whereas the mucoepidermoid carcinoma is the most prevalent malignant tumor. Mucoepidermoid carcinoma is a diagnostic challenge on FNAC with a high false negative rate. A 17-year-old female presented with slow-growing painless swelling below the right ear for two years. The history and clinical examination appeared to be benign parotid swelling. The further investigation proceeded and fine needle aspiration cytology was performed. A case of the parotid lump which has shown the pleomorphic adenoma of the parotid gland on cytology. Surgical resection was done and a post-operative specimen of the parotid gland showed mucoepidermoid carcinoma on histopathology. FNAC is not always reliable in the case of mucoepidermoid carcinoma of the parotid gland, especially in the low-grade type. The confirmatory diagnosis can be made only after the histopathological examination.