RESUMO
Granulomatosis with polyangiitis is a rare disease with involvement of multiple organ system. It classically affects the upper respiratory tract, lower respiratory tract and kidneys. 90% of patients present with upper respiratory diseases like rhinosinusitis, nasal polyposis, nasal septal perforation, serous otitis media, impaired hearing and stridor due to subglottic stenosis. Disease manifests in two forms as limited disease i.e. without renal involvement and generalized disease i.e. with renal involvement. It needs to be differentiated from chronic granulomatous diseases like tuberculosis and delay in the treatment should be prevented. Here we present a case with disease limited to Nose and Paranasal sinuses.
RESUMO
To study the usefulness of clinical features, histopathological and radiological features in diagnosis and management of salivary gland lesions. Prospective study conducted at the department of ENT of a tertiary care centre in central India. A total of 162 patients who were treated over a period of 2 years for salivary gland lesions were studied with regards to correlation between clinical diagnosis, cytological examination and radiological features with histopathological diagnosis. Mean age group was 23.94 (± 15.43) years. There was slight male preponderance. Commonest presenting complaint was swelling. The most common gland involved was minor salivary glands followed by parotid gland. Sensitivity of clinical diagnosis, USG and FNAC for neoplastic lesions was found to be 80%, 95.65% and 79.61% respectively. Specificity of clinical diagnosis, USG and FNAC for neoplastic lesions was found to be 100%, 100% and 97.23% respectively. At the end of the study we concluded that combination of thorough clinical examination, radiological and cytological examination help in proper diagnosis, but it should always be confirmed on histopathology because some surprises are expected with regards to the nature of salivary gland lesions.
RESUMO
To study the technique of intra-operative imprint cytology for intraoprative diagnosis and management in cases of Head and Neck malignant lesions and to compare its result with postoperative histopathology. Prospective study conducted over 2 yrs period at the Department of ENT of a tertiary care centre in central India. A total of 60 patients who were operated for Head and Neck malignant lesions were studies with regards to intraoperative diagnosis, marginal status and lymphnodal status and compared with postoperative histopathology. Mean age-group was 47.70 (± 13.7) years. There was male preponderance. Bucco-aveolar complex lesions constituted the majority followed by Tongue and thyroid lesions. Intraoperative cytology technique showed a sensitivity of 92.98%, 80.60% and 92.30% as regards the intraoperative diagnosis, marginal clearance and nodal metastases respectively; while the specificity was 100%, 90.09% and 83.33% respectively. At the end of the study we conclude that intra-operative cytology is a good technique for intra-operative evaluation in Head and Neck lesions, where facilities for frozen section are not available. It can be used as a simple, non-expensive and rapid alternative to frozen section. A larger and longer study can validate its routine use in surgical setups where high-end pathology setup is not available.
RESUMO
(1) To study the presenting complaints or complaints suggestive of foreign bodies in the tracheobronchial tract. (2) To study the clinical findings. (3) To study the correlation between clinical and radiological findings. (4) To study different types of foreign bodies. (5) To study the complications caused by foreign bodies. A total of 115 patients presenting with foreign body aspiration in the tracheobronchial tract were included in the study. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted. Foreign bodies in trachea and bronchus were removed by rigid bronchoscopy under general anaesthesia. Jackson rigid bronchoscope with a fibre optic light source and venturi technique anaesthesia was used. In the present study, foreign body aspiration was found to be maximum in the 1-3 year old age group. The average time lapse between aspiration of symptoms and presentation was found to be 1-3 days. Positive history was given in only 68% cases. Cough and breathlessness were the most common presenting symptoms. The commonest clinical signs were decreased chest movement and air entry on the affected side. Collapse of the affected side was the most common radiological finding. The commonest site of impaction was the right main bronchus. Majority of the foreign bodies were vegetative, peanut being the most common. The commonest complication following foreign body aspiration was atelectasis of the affected lung. Successful removal of foreign bodies was possible in all the patients. In paediatric respiratory compromise, the presence of unilateral diminished breath sounds, a pathological chest X-ray and a clinical triad of cough, choking and wheezing, is a powerful indicator of tracheobronchial foreign body aspiration. Since no single or combined variables can predict foreign body aspiration with full certainty, bronchoscopic exploration must be performed if tracheobronchial foreign body aspiration is suspected.
