KTP Laser assisted microendoscopic cricopharyngeal myotomy and web excision for dysphagia management.

Cricopharyngeal dysfunction is defined as the delayed or incomplete relaxation of the cricopharyngeal muscle during swallowing. This may cause dysphagia and aspiration, affecting the quality of life. For this condition, injection of botulinum toxin into the cricopharyngeus, dilatation of cricopharynx with bougies and external cricopharyngeal myotomy have been the treatment of choice with varying results. We present in this paper the treatment of this clinical condition by KTP 532 laser a recent advance in the field of Otolaryngology and Head and Neck Surgery. Very few series have been reported in literature so far regarding the use of laser for cricopharyngeal myotomy. This is perhaps the first series of eight cases of KTP laser assisted microendoscopic cricopharyngeal myotomy and web excision reporting the benefit of this treatment by an Indian author in an Indian Journal. KTP laser assisted cricopharyngeal myotomy avoids an external scar; aids precise incision at the cricopharynx by direct visualization, brings optimum results in deglutition and reduces postoperative morbidity and complications. The short hospital stay reduces the overall cost. The use of KTP 532 laser in the treatment of selected cases with cricopharyngeal dysfunction is therefore safe and effective.

The dilemma of a lateral pharyngeal mass causing stridor in a neonate.

Neonatal stridor resulting from intrinsic or extrinsic aberration in the upper respiratory tract often poses not only a diagnostic problem, but also a difficult airway and a dilemma as to the necessity / timing of surgical intervention. A 45 day old female child with increasing stridor since birth was managed by emergency intubation and CT scan followed by excision biopsy of the cystic left sided parapharyngeal mass via a transcervical approach. On histopathology, the excised specimen was reported as cystic salivary choristoma.

Surgical access to parapharyngeal space tumours--the Manipal experience.

A few series of parapharyngeal space tumours have been reported earlier but recently not many series have been published in English literature. It is rare for any medical center, let alone an individual surgeon, to develop sufficient experience in evaluating these tumours. We present our experience in the treatment of 41 cases of parapharyngeal tumours from January 1992 to December 2001. FNAC, ultrasound and CT scan of the presenting mass was done in most of the patients as the main pre-operative work-up. The strategic location and extension of the tumour may occasionally alter the surgical approach for tumour excision.