Schwannoma of Nasal Inferior Turbinate in Young Male: A Rare Occurrence.

A12-year old boy presented to the ENT Department of Abbasi Shaheed Hospital, Karachi, with a one year history of progressively increasing unilateral right sided nasal obstruction. He denied any other symptoms like that of rhinorrhea, epistaxis, facial pain, headache and any history of nasal trauma. After routine clinical examination, CT scan nose/PNS with contrast was advised and subsequently biopsy was done that revealed the mass to be as schwannoma. This was then removed via a lateral rhinotomy approach and the postoperative specimen again revealed the same. The boy was followed for 1-year and no recurrence is seen. He is still in the follow-up phase.

Fibrous dysplasia of mandible.

An elderly male presented to the ENT, Outpatient Department at Abbasi Shaheed Hospital (ASH) with a mass on the left side of the face and lower jaw for 8 - 9 years. It was of a tennis ball size. No treatment was sought by him during those years. A diagnosis of benign fibro-osseous lesion of the mandible was made. Later the histopathology proved the same. he first occurrence in a male gender and involvement of the mandible is uncommon.

Postembolization infarction in juvenile nasopharyngeal angiofibroma.

We report the occurrence of cerebro-vascular accident, following selective embolization of internal maxillary artery (IMA) in a young male patient aged 18 years admitted at ENT Department, Abbasi Shaheed Hospital (ASH) with diagnosis of recurrent juvenile nasophayrngeal angiofibroma (JNA). Angiography and selective trans-femoral embolization was done as an adjunctive measure before the definite surgical removal of this benign tumourous condition. The child developed weakness of the right half of body with slurred speech and drowsiness. CT scan of brain revealed the diagnosis of postembolization infarction. The patient recovered with no obvious signs of clinical residual weakness. Surgical excision after ligation of feeding vessel has been planned.

Fine needle aspiration cytology: sensitivity and specificity in thyroid lesions.

BACKGROUND: Thyroid enlargement is one of the common problems in patients presenting at outpatients department of ENT particularly in females. Thyroid nodules are common, thyroid cancer is uncommon and the most common way for it to present is as a solitary thyroid nodule. This study was conducted to evaluate the sensitivity and specificity of Fine Needle Aspiration Cytology (FNAC) in thyroid diseases. METHOD: This prospective analytic study was conducted at ENT Department of Karachi Medical and Dental College/Abbasi Shaheed Hospital during year 2004-8. One hundred and five cases were enrolled who underwent thyroid surgery after complete evaluation by history, clinical examination, Thyroid profile, Thyroid Scintigraphy, Ultrasound neck and FNAC. In cases which were revealed malignant by FNAC, CT scan were done to see the extent of disease and neck node status. Surgery was done in all cases and specimens sent for histopathology. RESULTS: Male to female ratio of the patients was 1:8.5. Most common lesion was benign nodule (96). Malignant lesions were 9 in FNAC. In histopathology, the benign nodules were 92, and malignant cases were 13. Sensitivity of FNAC was 61.53% and specificity was 98.9%. CONCLUSION: FNAC in Thyroid has high sensitivity and specificity.

An unusual foreign body in trachea.

We report a very unusual case of foreign body (FB) in the tracheo-bronchial tract of a male child, who presented to us in the Emergency Department at our tertiary care centre with the complaint of FB in throat, cough bouts and choking sensation with pain and difficulty in breathing for whom an emergency rigid endoscopy was carried out after appropriate investigations.

The effect of traffic noise on the hearing level of people on Karachi streets.

OBJECTIVE: To study the effects of traffic noise on hearing ability of subjects prone to traffic noise exposure. METHOD: A hospital based prospective study was performed comprising of 200 selected subjects significantly exposed to traffic noise. These included rickshaw drivers, traffic constables and shopkeepers in central business area. All subjects were questioned according to a Performa after which ENT examination was carried out followed by Pure Tone Audiometery. RESULTS: Hearing impairment showed correlation with the duration of job when analyzed by linear regression analysis with correlation coefficient r = 0.36 (p < 0.001), Hearing impairment was 33.81 + 0.42 dB according to the duration of job (in years). CONCLUSION: Subjects are perceptually exposed to potentially damaging sound pressure level in the metropolis of Karachi. It was observed that audiologically consistent noise induced hearing loss was found to be 0.42 dB per octave from 500Hz to 2000Hz per year of duration of job.

Carcinoma cheek: regional pattern and management.

BACKGROUND: Oral cancer varies globally and regionally, and is closely linked with geographical, social, economical, biological, ethnic, dietary and environmental factors. In western countries it accounts for about 2-5% while in the south-east Asia for about 40% of all cancers. In Pakistan it is second commonest tumour after bronchogenic carcinoma in males and breast carcinoma in females. The objectives of this study were to find out the pattern of carcinoma cheek in our region, its etiological associations, management and prognosis. This study was conducted in the Otolaryngology and Head and Neck Surgery Department of Civil Hospital, Karachi from April 1995 to December 1998. It was prospective study. METHODS: Forty-five cases of primary carcinoma cheek were diagnosed and investigations including OPG and CT scan were carried out along with other required investigations to evaluate the extension of tumour, bony erosion and metastasis. TNM staging was done. All patients were treated surgically, sent for post-operative radiotherapy or chemoradiation and followed up for 3 years. RESULT: Among 45 cases of oral cancer, 28 were females and 17 were males. Common presenting symptom was growth or ulcer. It was more common in 41-50 years of age. Squamous cell carcinoma (SCC) was found in 95.5% of the cases. Most of the patients 31 (68%) were in T4 stage. Surgical excision was done in all cases with reconstructuion in 23 cases and neck dissection in 39 cases. In the follow up for 3 years, 30 patient remained disease free. CONCLUSION: Carcinoma cheek is a common entity in our region and now it is seen in relatively younger patients. Oral cancer is a self preventable disease. What is required is to develop awareness of oral hygiene and discourage the habit of social carcinogens use. Early diagnosis and treatment offers better chance of cure whereas advance disease has a poor prognosis.

Association of herpes simplex virus infection and Bell's palsy.

OBJECTIVE: To determine the association of the Herpes Simplex virus Type-1 infection and Bell's palsy in patients treated at the outpatient department of a tertiary care center. METHODS: A prospective, observational study was carried out at the outpatient department of Medical and ENT units of Abbasi Shaheed Hospital, Karachi. Fifty patients were enrolled in the study with their informed and written consent, between 2006-2007. All were >12 years of age. They were diagnosed as having Bell's palsy and were investigated for serologic evidence of Herpes simplex virus (HSV). The IgG and IgM antibodies for HSV were identified in the blood samples at the Aga Khan University hospitals laboratory. RESULT: Of the 50 patients enrolled, 35 (70%) patients were IgG/IgM positive for the HSV stressing the etiological association of HSV with Bell's palsy. CONCLUSION: The study suggests that a relationship exists between HSV infection and Bell's palsy. The information might prove helpful in hastening the recovery by modifying management guidelines in view of the results of this study.