Unusual Locations of Inverted Papilloma.

Inverted papilloma is a tumor found involving the nasal cavity and paranasal sinuses. They are not cancerous but can be locally aggressive. They are most commonly seen involving the lateral wall of nose and maxillary sinus. When the tumor involves the frontal sinus and sphenoid sinus or the post ethmoid cells it presents a surgical challenge. Inverted papilloma almost always occur unilateraly and affect mainly the maxillary sinus. Inverted papilloma arising from the sphenoid and frontal sinuses are rare. Here we present two cases; one involving a 60 year man, with inverted papilloma originating from the frontal sinus and another case where it originated from the sphenoid sinus anterior wall and posterior ethmoidalcell (Onodi cell) and was resected endoscopically.

Rare Case of Nasal Tip Schwannoma - A Case Report.

Schwannoma is a benign neurogenic neoplasm which is arising from schwann cells of peripheral nerve sheath. It can occur in anywhere in the body. Schwannoma of sinonasal tract is extremely rare. Here we report a rare case of schwannoma of nasal tip. A 45 year old male presented with a swelling of tip of the nose, causing cosmetic deformity with no other associated symptoms. Surgical excision of the mass done by using external rhinoplasty approach. Histolopathology report of specimen showed a well circumscribed schwannoma with Antoni A and Antoni B areas.

A Googly in the Neck-Castleman Disease.

Lymphoproliferative disorders comprise of a group of heterogenous diseases characterised by uncontrolled production of lymphocytes.Castleman disease (CD) is one such disease and comprises of a group of rare disorders that involve enlarged lymph nodes and a broad range of inflammatory symptoms and laboratory abnormalities [1]. We came across young girl who presented to us in the out patient department with this disease After ruling out other pathologies and confirming the diagnosis by doing a tissue biopsy the girl was treated surgically and is disease free till date.

Observational Study on Clinical Features and Management of Skull Base Osteomyelitis in Hospitalised Patients at a Tertiary Care Hospital.

1. To study the various clinical presentations, microbiological and radiological profiles in patients of skull base osteomyelitis, to know about the underlying comorbidities or immunocompromised status and its relation to the disease and its management. 2. To study the effect of long term intravenous antimicrobial therapy with respect to clinical outcomes and radiological improvement and to study the long term outcomes of the treatment. This is an observational prospective and retrospective study. Thirty adult patients who were diagnosed with skull base osteomyelitis by clinical/microbiological and or radiological features were treated with long term intravenous antibiotics according to pus culture and s for 6-8 weeks and they were followed up for 6 months. Clinical improvement in symptoms and signs, radiological imaging features and pain score were assessed after 3 and 6 months. We noticed in our study that skull base osteomyelitis are more common in older patients with male predominance. Presenting symptoms include ear discharge, otalgia, hearing, cranial nerve palsy. Immunocompromised state, mainly Diabetes mellitus is closely associated with skull base osteomyelitis. Majority of patients showed Pseudomonas related species on pus culture and sensitivity. All the patients showed temporal bone involvement in CT and MRI. Other bones involved were shenoid, clivus and occipital bone. Majority showed good clinical response to intravenous ceftazidime, combination of piperacillin and tazobactum, followed by combination of piptaz and Ciprofloxacin. Treatment duration was 6-8 weeks. All patients showed clinical improvement in symptoms and relief in pain after 3 and 6 months. Skull base osteomyelitis is a rare condition, most commonly seen in elderly patients with diabetes mellitus and or other immunocompromised condition. Pseudomonas related species are the major causes of skull base osteomyelitis. Long term pus culture and sensitivity bases intravenous antibiotic therapy is the main stay of treatment.